Sample records for finally case studies

  1. Nanomaterial Case Study: Nanoscale Silver in Disinfectant Spray (Final Report)

    EPA Science Inventory

    EPA announced the release of the final report, Nanomaterial Case Study: Nanoscale Silver in Disinfectant Spray. This report represents a case study of engineered nanoscale silver (nano-Ag), focusing on the specific example of nano-Ag as possibly used in disinfectant spr...

  2. An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate Case Study (Final Report, 2010)

    EPA Science Inventory

    EPA announced the availability of the final report, An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate Case Study. This report outlines an approach to evaluate genomic data for use in risk assessment and a case study to ...

  3. Interactions of Science and Technology in the Innovative Process: Some Case Studies. Final Report.

    ERIC Educational Resources Information Center

    Battelle Memorial Inst., Columbus, OH. Columbus Labs.

    This is the final report of the latest effort in a series sponsored by the National Science Foundation on the innovation process. It adds to the store of retrospective case studies by documenting historically the significant events in several technological innovations of high social impact. These cases, drawn together by the Battelle Columbus…

  4. Impacts of Outer Continental Shelf (OCS) development on recreation and tourism. Volume 2. Final report and case studies

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

    Not Available

    The final report for the project is comprised of five volumes. The volume presents the study conclusions, summarizes the methodology used (more detail is found in Volume 3), discusses four case study applications of the model, and contains profiles of coastal communities in an Appendix.

  5. Climate Change Vulnerability Assessments: Four Case Studies of Water Utility Practices (2011 Final)

    EPA Science Inventory

    EPA has released the final report titled, Climate Change Vulnerability Assessments: Four Case Studies of Water Utility Practices. This report was prepared by the National Center for Environmental Assessment's Global Climate Research Staff in the Office of Research and D...

  6. BASINs and WEPP Climate Assessment Tools (CAT): Case Study Guide to Potential Applications (Final Report)

    EPA Science Inventory

    EPA announced the release of the final report, BASINs and WEPP Climate Assessment Tools (CAT): Case Study Guide to Potential Applications. This report supports application of two recently developed water modeling tools, the Better Assessment Science Integrating point & ...

  7. Uncertainty and Variability in Physiologically-Based Pharmacokinetic (PBPK) Models: Key Issues and Case Studies (Final Report)

    EPA Science Inventory

    EPA announced the availability of the final report, Uncertainty and Variability in Physiologically-Based Pharmacokinetic (PBPK) Models: Key Issues and Case Studies. This report summarizes some of the recent progress in characterizing uncertainty and variability in physi...

  8. Nanomaterial Case Studies: Nanoscale Titanium Dioxide in Water Treatment and in Topical Sunscreen (Final)

    EPA Science Inventory

    EPA announced the availability of the final report, Nanomaterial Case Studies: Nanoscale Titanium Dioxide in Water Treatment and in Topical Sunscreen. This report is a starting point to determine what is known and what needs to be known about selected nanomaterials as par...

  9. [DIAGNOSTIC AND TREATMENT STRATEGY IN FOLLICULAR TUMOR OF THYROID GLAND].

    PubMed

    Mikhaĭlova, M V; Zubarovskiĭ, I N; Osipenko, S K

    2015-01-01

    The article is based on the treatment results of 44 patients with follicular tunor of thyroid gland. A staged morphological assessment of thyroid nodes was performed for all patients: in case of preoperative fine-needle biopsy, urgent intraoperative study and according to results of final histological research. The urgent histological study of surgical material was conducted for 44 patients with diagnosis "follicular tumor" according to fine-needle biopsy. The data of final histological study were matched with findings of intraoperative research. A micro-follicular adenoma was detected in 22 patients (50%) and 6 (13,6%) patients had this diagnosis combined with autoimmune thyroiditis. The general part of patients didn't changed in final study, but the rate of diagnosis "micro-follicular adenoma against the background of autoimmune thyroiditis" increased. Papillary carcinoma was revealed in 5 (11,4%) patients and follicular cancer had 4 (9,1%) patients detected in intraoperative study and 3 (6,8%) more patients according to data of final research. The histopathologic feature of colloid goiter was observed in 7 (15,9%) cases and a part of such patients reduced to 6,8% during final study. One of the patients (2,3%) had final diagnosis "oncocytoma". In case of thyroid nodules detection the needle biopsy should be carried out regardless to the size of nodule. The authors recommended performing the surgery with the urgent histological study in case of undetermined histological report. The following surgical strategy was specified by the results of the urgent histological report.

  10. Preparing Teachers for Diversity: The Role of Initial Teacher Education. Annex 2 To the Final Report to DG Education, Youth, Sport and Culture of the European Commission. Case Study Summaries

    ERIC Educational Resources Information Center

    European Commission, 2017

    2017-01-01

    "Preparing Teachers for Diversity: The Role of Initial Teacher Education. Annex 2 To the Final Report to DG Education, Youth, Sport and Culture of the European Commission. Case Study Summaries" is designed as a companion document to the final report "Preparing Teachers for Diversity: The Role of Initial Teacher Education. Final…

  11. Spelling in African American Children: The Case of Final Consonant Devoicing

    ERIC Educational Resources Information Center

    Treiman, Rebecca; Bowman, Margo

    2015-01-01

    This study examined the effect of dialect variation on children's spelling by using devoicing of final /d/ in African American Vernacular English (AAVE) as a test case. In line with the linguistic interference hypothesis, African American 6-year-olds were significantly poorer at spelling the final "d" of words such as "salad"…

  12. LYNX community advocacy & service engagement (CASE) project final report.

    DOT National Transportation Integrated Search

    2009-05-14

    This report is a final assessment of the Community Advocacy & Service Engagement (CASE) project, a LYNX-FTA research project designed : to study transit education and public engagement methods in Central Florida. In the Orlando area, as in other part...

  13. Final Part-Word Repetitions in School-Age Children: Two Case Studies

    ERIC Educational Resources Information Center

    McAllister, Jan; Kingston, Mary

    2005-01-01

    In contrast to the many published accounts of the disfluent repetition of sounds at the beginnings of words, cases where it is predominantly the final parts of words that are repeated have been reported relatively rarely. With few exceptions, those studies that have been published have described either pre-school children or neurologically…

  14. The Impact of CETA on Institutional Vocational Education. Case Studies and Final Report, 1977.

    ERIC Educational Resources Information Center

    Anderson, Robert; Rozansky, Rosa D.

    This final report summarizes the findings of the National League of Cities and U.S. Conference of Mayors concerning CETA funded programs. It also examines three case studies in Chicago; Erie, Pennsylvania; and the Virginia Peninsula. The report discusses the need for cooperation between CETA and the vocational education system. Characteristics of…

  15. Comprehensive Environmental Assessment Applied to Multiwalled Carbon Nanotube Flame-Retardant Coatings in Upholstery Textiles: A Case Study Presenting Priority Research Gaps for Future Risk Assessments (Final Report)

    EPA Science Inventory

    In September 2013, EPA announced the availability of the final report, Comprehensive Environmental Assessment Applied to Multiwalled Carbon Nanotube Flame-Retardant Coatings in Upholstery Textiles: A Case Study Presenting Priority Research Gaps for Future Risk Assessments...

  16. Assessing Complex Emergency Management with Clinical Case-Vignettes: A Validation Study

    PubMed Central

    2015-01-01

    Objective To evaluate whether responses to dynamic case-vignettes accurately reflect actual practices in complex emergency situations. We hypothesized that when obstetricians were faced with vignette of emergency situation identical to one they previously managed, they would report the management strategy they actually used. On the other hand, there is no reason to suppose that their response to a vignette based on a source case managed by another obstetrician would be the same as the actual management. Methods A multicenter vignette-based study was used in 7 French maternity units. We chose the example of severe postpartum hemorrhage (PPH) to study the use of case-vignettes for assessing the management of complex situations. We developed dynamic case-vignettes describing incidents of PPH in several steps, using documentation in patient files. Vignettes described the postpartum course and included multiple-choice questions detailing proposed clinical care. Each participating obstetrician was asked to evaluate 4 case-vignettes: 2 directly derived from cases they previously managed and 2 derived from other obstetricians’ cases. We compared the final treatment decision in vignette responses to those documented in the source-case by the overall agreement and the Kappa coefficient, both for the cases the obstetricians previously managed and the cases of others. Results Thirty obstetricians participated. Overall agreement between final treatment decisions in case-vignettes and documented care for cases obstetricians previously managed was 82% (Kappa coefficient: 0.75, 95% CI [0.62–0.88]). Overall agreement between final treatment decisions in case-vignettes and documented care in vignettes derived from other obstetricians’ cases was only 48% (Kappa coefficient: 0.30, 95% CI [0.12–0.48]). Final agreement with documented care was significantly better for cases based on their own previous cases than for others (p<0.001). Conclusions Dynamic case-vignettes accurately reflect actual practices in complex emergency situations. Therefore, they can be used to assess the quality of management in these situations. PMID:26383261

  17. The Impact of the Pre-Instructional Cognitive Profile on Learning Gain and Final Exam of Physics Courses: A Case Study

    ERIC Educational Resources Information Center

    Capizzo, Maria Concetta; Nuzzo, Silvana; Zarcone, Michelangelo

    2006-01-01

    The case study described in this paper investigates the relationship among some pre-instructional knowledge, the learning gain and the final physics performance of computing engineering students in the introductory physics course. The results of the entrance engineering test (EET) have been used as a measurement of reading comprehension, logic and…

  18. Clinico-pathological study to evaluate oral lichen planus for the establishment of clinical and histopathological diagnostic criteria.

    PubMed

    Hiremath, Santhosh; Kale, Alka D; Hallikerimath, Seema

    2015-01-01

    Lichen planus and lichenoid lesions affecting the oral cavity show similar clinico-pathological features creating a diagnostic dilemma. Hence, the aim of the present study was to establish a clinical and histopathological correlation in the diagnosis of oral lichen planus, based on the modified WHO diagnostic criteria of oral lichen planus and oral lichenoid lesions proposed by Van der Meij and Van der Waal in 2003. In the present study, 100 cases of oral lichen planus were clinically and histopathologically analyzed. Out of the 100 cases, 50 were prospective and 50 were retrospective cases. Prospective cases were collected based on the clinical diagnosis of oral lichen planus and oral lichenoid lesion. Retrospective cases were collected based on the histopathological diagnosis of oral lichen planus. Both the clinical and histopathological analyses were performed based on a proposal for a set of modified diagnostic criteria of oral lichen planus and oral lichenoid lesion. A final diagnosis of oral lichen planus was made only after the correlation of the clinical diagnosis with the histopathological diagnosis. The interobserver agreement among three observers for both prospective and retrospective cases in the final diagnosis of oral lichen planus was found to be "good" to "very good" indicating high reproducibility. However, the final diagnoses of true oral lichen planus after clinico-pathological correlation in prospective and retrospective study groups appeared to be 38.0% and 54.0% respectively. The results of the present study revealed mild to moderate clinico-pathological correlation in the final diagnosis of oral lichen planus for the prospective and retrospective study groups respectively.

  19. The Multi-Disciplinary Graduate Program in Educational Research. Final Report, Part IV; The Utilization of Sociological Ideas in Organizational Planning: A Case Study.

    ERIC Educational Resources Information Center

    Lazarsfeld, Paul F., Ed.

    This document, the fourth in the final report on the Multi-Disciplinary Graduate Program in Educational Research, is a qualitative case study designed to show the form of sociological contributions to and the role of sociologists in policy formulation at an American Educational Research Association (AERA) colloquium. Discussions at the conference…

  20. OD in Schools: The State of the Art. Vol. IV: Case Studies. Final Report.

    ERIC Educational Resources Information Center

    Fullan, Michael; And Others

    This volume, the fourth of a five-volume series, contains three onsite case studies of organization development (OD) selected from a sample of 76 school districts. The purpose of the case studies was to analyze in detail different types of OD programs and their use. Each case study represents a different OD focus: case study A involves a survey…

  1. IVHS Institutional Issues and Case Studies, Analysis and Lessons Learned, Final Report

    DOT National Transportation Integrated Search

    1994-04-01

    This 'Analysis and Lessons Learned' report contains observations, conclusions, and recommendations based on the performance of six case studies of Intelligent Vehicle-Highway Systems (IVHS) projects. Information to support the development of the case...

  2. Final Draft Feedback in First-Year Composition: A Case Study of Non-Native English Speaking Students in North America

    ERIC Educational Resources Information Center

    Nash, J. Gail

    2012-01-01

    Scope and Methods: This dissertation examines final draft feedback in a semester long first-year composition class consisting of both native and non-native speakers of English (NES & NNES) attending university. In addition to examining the teacher's commentary on final drafts and the students' responses to it, this study investigated effects…

  3. Teaching case studies on emergency evacuation : final report

    DOT National Transportation Integrated Search

    2011-02-15

    Through the development of four Harvard Kennedy School case studies, this project explored the policy and institutional dimensions of emergency evacuation planning and implementation in two major metropolitan areas Houston and New Orleans. By pro...

  4. Case Studies in a Physiology Course on the Autonomic Nervous System: Design, Implementation, and Evaluation

    ERIC Educational Resources Information Center

    Zimmermann, Martina

    2010-01-01

    The introduction of case studies on the autonomic nervous system in a fourth-semester physiology course unit for Pharmacy students is described in this article. This article considers how these case studies were developed and presents their content. Moreover, it reflects on their implementation and, finally, the reception of such a transformation…

  5. An Investigation of Strategic Decision Making in Service Marketing through Case Study Development and Analysis

    ERIC Educational Resources Information Center

    Rosetti, Joseph L.; Maceiko, Meghan

    2009-01-01

    Through the collaborative efforts of an undergraduate student and a professor of marketing, this paper focuses on a case study and corresponding teaching notes developed as a final component of an independent study in service marketing. The case utilizes the hospitality industry as the template for analysis of the appropriateness of marketing…

  6. A Case Study: Problem-Based Learning for Civil Engineering Students in Transportation Courses

    ERIC Educational Resources Information Center

    Ahern, A. A.

    2010-01-01

    This paper describes two case studies where problem-based learning (PBL) has been introduced to undergraduate civil engineering students in University College Dublin. PBL has recently been put in place in the penultimate and final year transport engineering classes in the civil engineering degree in University College Dublin. In this case study,…

  7. Student Ownership of Projects in an Upper-Division Optics Laboratory Course: A Multiple Case Study of Successful Experiences

    ERIC Educational Resources Information Center

    Dounas-Frazer, Dimitri R.; Stanley, Jacob T.; Lewandowski, H. J.

    2017-01-01

    We investigate students' sense of ownership of multiweek final projects in an upper-division optics lab course. Using a multiple case study approach, we describe three student projects in detail. Within-case analyses focused on identifying key issues in each project, and constructing chronological descriptions of those events. Cross-case analysis…

  8. Test-Case Generation using an Explicit State Model Checker Final Report

    NASA Technical Reports Server (NTRS)

    Heimdahl, Mats P. E.; Gao, Jimin

    2003-01-01

    In the project 'Test-Case Generation using an Explicit State Model Checker' we have extended an existing tools infrastructure for formal modeling to export Java code so that we can use the NASA Ames tool Java Pathfinder (JPF) for test case generation. We have completed a translator from our source language RSML(exp -e) to Java and conducted initial studies of how JPF can be used as a testing tool. In this final report, we provide a detailed description of the translation approach as implemented in our tools.

  9. Designing and Maintaining a Communication Consulting Relationship: A Fire Officer Case Study

    ERIC Educational Resources Information Center

    Cragan, John F.

    2008-01-01

    This case study describes a 35-year communication consulting relationship with the Illinois Fire Chiefs' Association. This case explains the fire chiefs' educational problems, the five-step method for creating an educational curriculum for fire officers, and the five-step procedure for continuous evaluation of the curriculum. Finally, an…

  10. Benzene Case Study Final Report - Second Prospective Report Study Science Advisory Board Review, July 2009

    EPA Pesticide Factsheets

    EPA developed a methodology for estimating the health benefits of benzene reductions and has applied it in a metropolitan-scale case study of the benefits of CAA controls on benzene emissions to accompany the main 812 analysis.

  11. Long-term study of patients with congenital pit of the optic nerve and persistent macular detachment.

    PubMed

    Theodossiadis, G P; Panopoulos, M; Kollia, A K; Georgopoulos, G

    1992-08-01

    During the period 1970-87 we evaluated the changes of the optic disc, peripapillary area, detached macula and visual acuity in 16 cases with congenital pit of the optic nerve and macular detachment. The study revealed in 9 of the 16 cases (56%) an increase of the dimension of the pit or changes in its color, findings which were directly related to the duration of the macular detachment. Chorioretinal scarring, pigment migration, or both, were also noted mainly at the temporal margin of optic disc. In 5/16 cases we found during the follow-up an extension of macular elevation. In altogether 10 out of 16 cases the retinal elevation covered the larger portion of the mid-periphery temporally. In 7/16 cases the final visual acuity remained unchanged, in 9/16 cases deteriorated. The difference, however, in the latter 9 cases between initial and final visual acuity was negligible. During the follow-up period deterioration of the visual fields was also noted.

  12. Development of Curriculum in American Civilization for the General Student: Case Study Approach. Final Report.

    ERIC Educational Resources Information Center

    Gibson, John S.; Kenosian, Elisabeth M.

    Case studies in each of the parts deal with specific problems in the mainstream of United States history and are designed to help the general level student relate the case study and the theme of the past to similar problems today. Each theme deals with the resolution of conflict in historical ideologies. 1) Studies on intolerance in American life…

  13. Do substantial BMI reduction episodes among Swedish schoolchildren have any impact on their final height?

    PubMed

    Nilsen, Bente B; Yngve, Agneta; Werner, Bo

    2018-07-01

    This study investigated whether substantial body mass index (BMI) reductions in Swedish schoolchildren aged seven years to 19 years, caused by disease, healthy or unhealthy behaviour, had any impact on their final height. We used height and weight data on 6572 subjects from two nationally representative longitudinal samples of Swedish children born in 1973 and 1981. These provided information on their final height and any BMI reduction episodes. Of the 6572 subjects (50.9% boys), among individuals with information on final height, 1118 had a BMI reduction of 5% and <10%, and 346 had at least one substantial BMI reduction of 10% or more. On a group level, there was no statistically significant difference in the final height of individuals with BMI reductions of 10% or more and those without. The findings were independent of age and the subject's BMI at the start of the reduction episode. However, there were a number of cases where a substantial BMI reduction probably had an impact on the subject's final height. Our study found no evidence that a substantial BMI reduction had any impact on final height on a group level, but further analyses of specific case studies are necessary to determine whether substantial BMI reduction might have an impact on final height. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. Rural automated highway systems case study : greater Yellowstone rural ITS corridor : final report

    DOT National Transportation Integrated Search

    1998-01-01

    In cooperation with the National Automated Highway System Consortium (NAHSC), case studies are being conducted on existing transportation corridors to determine the feasibility of AHS. Initial activities by the NAHSC have focused on urbanized areas. ...

  15. Pedestrian safety impacts of curb extensions : a case study : final report.

    DOT National Transportation Integrated Search

    2005-07-01

    This report documents a case study evaluating motorist yielding behavior at a crosswalk in Albany, Oregon. In 2003 the City of Albany installed curb extensions, continental markings and advance stop bars at several uncontrolled intersections along th...

  16. Comprehensive Environmental Assessment Applied to ...

    EPA Pesticide Factsheets

    In September 2013, EPA announced the availability of the final report, Comprehensive Environmental Assessment Applied to Multiwalled Carbon Nanotube Flame-Retardant Coatings in Upholstery Textiles: A Case Study Presenting Priority Research Gaps for Future Risk Assessments. This final report presents a case study of multiwalled carbon nanotubes (MWCNTs); it focuses on the specific example of MWCNTs as used in flame-retardant coatings applied to upholstery textiles. This case study is organized around the comprehensive environmental assessment (CEA) framework, which structures available information pertaining to the product life cycle, environmental transport and fate, exposure-dose in receptors (i.e., humans, ecological populations, and the environment), and potential impacts in these receptors. A group of experts representing multiple disciplines and multiple sector perspectives used an earlier draft of the case study in conjunction with a structured workshop process to identify and prioritize research gaps that, if pursued, could inform future MWCNT assessment efforts. The final report is not a health, risk, or exposure assessment and as such does not draw conclusions about potential risks, or present an exhaustive review of the literature. Rather, it presents the MWCNT research priorities that experts identified in this application of CEA in order to aid research planning throughout the scientific community. The outcomes of these research efforts may subsequ

  17. Placement-Based Learning and Learner Engagement: Findings from a New University in the UK

    ERIC Educational Resources Information Center

    Murphy, Timothy R. N.; Folgueiras Bertomeu, Pilar; Mannix McNamara, Patricia

    2016-01-01

    This paper addresses the potential for engaged learning among final-year undergraduate Education Studies students at a new, post-1992. It discusses a case study analysis of a "Directed Experiential Learning" (DEL) intervention in the final year of an education studies degree designed to engage and motivate students and emphasise the…

  18. Using Insider Research in MEd Final Projects to Bridge the Theory/Practice Gap

    ERIC Educational Resources Information Center

    Arar, Khalid

    2018-01-01

    This paper aims to identify key issues involved in MEd final project supervision and to highlight the potential of supervision from an academic institution to change educational reality through the postgraduate student-teachers' work-based final project as insider researchers in Israeli schools. It draws on analysis of case-study data from two…

  19. Career Ladders and Teacher Incentives: The Utah Experiment. Part II: Case Studies. Final Report: Secretary's Discretionary Program Implementation Grant to Develop Teacher Incentive Structures.

    ERIC Educational Resources Information Center

    Peterson, Ken; Kauchak, Don

    This volume, the second of two reports on development of teacher incentive structures, presents case studies of a career ladder design and teacher evaluation experiment in four Utah school districts. Case studies examined relationships among career ladder features, process variables, and career ladder effectiveness, which is defined in terms of…

  20. Developing Army Leaders through Increased Rigor in Professional Military Training and Education

    DTIC Science & Technology

    2017-06-09

    leadership. Research Methodology An applied, exploratory, qualitative research methodology via a structured and focused case study comparison was...research methodology via a structured and focused case study comparison. Finally, it will discuss how the methodology will be conducted to make...development models; it serves as the base data for case study comparison. 48 Research Methodology and Data Analysis A qualitative research

  1. It is Time the United States Air Force Changes the way it Feeds its Airmen

    DTIC Science & Technology

    2008-03-01

    narrative , phenomenology , ethnography , case study , and grounded theory . In purpose, these strategies are...methodology) the research will be analyzed. Methodology A qualitative research methodology and specifically a case study strategy for the...well as theory building in chapter five . Finally, in regards to reliability, Yin’s (2003) case study protocol guidance was used as a means to

  2. Integrated system of phytodepuration and water reclamation: A comparative evaluation of four municipal wastewater treatment plants.

    PubMed

    Petroselli, Andrea; Giannotti, Maurizio; Marras, Tatiana; Allegrini, Elena

    2017-06-03

    In dry regions, water resources have become increasingly limited, and the use of alternative sources is considered one of the main strategies in sustainable water management. A highly viable alternative to commonly used water resources is treated municipal wastewater, which could strongly benefit from advanced and low-cost techniques for depuration, such as the integrated system of phytodepuration (ISP). The current manuscript investigates four Italian case studies with different sizes and characteristics. The raw wastewaters and final effluents were sampled on a monthly basis over a period of up to five years, allowing the quantification of the ISP performances. The results obtained show that the investigated plants are characterized by an average efficiency value of approximately 83% for chemical oxygen demand removal, 84% for biochemical oxygen demand, 89% for total nitrogen, 91% for total phosphorus, and 85% for total suspended solids. Moreover, for three of the case studies, the ISP final effluent is suitable for irrigation, and in the fourth case study, the final effluent can be released in surface water.

  3. Tuberculous otitis media: two case reports and literature review.

    PubMed

    Awan, Mohammad Sohail; Salahuddin, Iftikhar

    2002-11-01

    Tuberculous otitis media can be difficult to diagnose because it can easily be confused with other acute or chronic middle ear conditions. Compounding this problem is the fact that physicians are generally unfamiliar with the typical features of tuberculous otitis media. Finally, the final diagnosis can be difficult because it requires special culture and pathologic studies. To increase awareness of this condition, we describe two cases of tuberculous otitis media and we review the literature.

  4. First do no harm: is it any longer safe to write case reports?

    PubMed

    Brown, Laura S

    2014-12-01

    This article explores the risks to authors and their clients of creating psychological literature based on case studies. The author considers how the events that occurred in Nicole Taus's case might have affected those clients with whom she wrote case studies. Finally, the author analyzes the potential losses to the field should other participants in case studies be at risk of the kind of intrusive invasion of privacy experienced by Taus and calls for the development of ethical principles for psychological science. © The Author(s) 2014.

  5. Accuracy of frozen section in the diagnosis of ovarian tumours.

    PubMed

    Toneva, F; Wright, H; Razvi, K

    2012-07-01

    The purpose of our retrospective study was to assess the accuracy of intraoperative frozen section diagnosis compared to final paraffin diagnosis in ovarian tumours at a gynaecological oncology centre in the UK. We analysed 66 cases and observed that frozen section consultation agreed with final paraffin diagnosis in 59 cases, which provided an accuracy of 89.4%. The overall sensitivity and specificity for all tumours were 85.4% and 100%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 100% and 89.4%, respectively. Of the seven cases with discordant results, the majority were large, mucinous tumours, which is in line with previous studies. Our study demonstrated that despite its limitations, intraoperative frozen section has a high accuracy and sensitivity for assessing ovarian tumours; however, care needs to be taken with large, mucinous tumours.

  6. Nanomaterial Case Study: Nanoscale Silver in Disinfectant ...

    EPA Pesticide Factsheets

    EPA announced the release of the final report, Nanomaterial Case Study: Nanoscale Silver in Disinfectant Spray. This report represents a case study of engineered nanoscale silver (nano-Ag), focusing on the specific example of nano-Ag as possibly used in disinfectant sprays. This case study is organized around the comprehensive environmental assessment (CEA) framework, which structures available information pertaining to the product life cycle, environmental transport and fate, exposure-dose in receptors (i.e., humans, ecological populations, and the environment), and potential impacts in these receptors. The document does not draw conclusions about potential risks. Instead, it is intended to be used as part of a process to identify what is known and unknown about nano-Ag in a selected application. In turn, the external review draft of the document provided a starting point to identify and prioritize possible research directions to support future assessments of nanomaterials. The information presented in the case study and the questions raised in this document are a foundation for a process to determine priorities among various research topics and directions. After that process has been completed, a final chapter will be added to this document to summarize highlights from preceding chapters and the major research issues that have emerged.

  7. Knowledge of tuberculosis management using directly observed treatment short course therapy among final year medical students in South Western Nigeria.

    PubMed

    Olakunle, Olarewaju Sunday; Oladimeji, Olanrewaju; Olalekan, Adebimpe Wasiu; Olugbenga-Bello, Adenike; Akinleye, Callistus; Oluwatoyin, Olarewaju Abiodun

    2014-01-01

    Equipping medical graduates with the competence to manage tuberculosis is not just imperative but also urgent as the diseases have been consistently listed as one of the major causes of morbidity and mortality in Nigeria. However, there were no baseline studies done on knowledge of final year medical students on various aspects of TB diagnosis and management under directly observed treatment short course therapy (DOTS) which forms the basis of this study. A total of 241 final year medical students from three medical colleges in Nigeria were interviewed. The questions assessed their knowledge about various modes of transmission, symptoms and management of tuberculosis under DOTS. More than half of the respondents (i.e. 69%) had poor knowledge on TB disease. Only 33.6% mentioned sputum smear as the best tool of diagnosing TB according to guideline. Poor knowledge was also exhibited when asked of various categories under DOTS treatment regimen, as 46.1% correctly mentioned cat 1 and 2. Minority 18.7% and 6.7% had complete knowledge of 6 months duration for new TB cases and 8 months for re-treatment cases respectively. Less than one tenth, i.e. 4.6% and 2.9% could correctly defined what is called a new TB case and re-treatment cases according to standard guideline. The study reveals gross inadequacies in TB knowledge and management practices among Nigerian final year medical students. There is urgent need for incorporation of National TB guideline into existing undergraduate medical education curriculum as well as students rotation through activities in DOTS clinic.

  8. Evidence of virtual patients as a facilitative learning tool on an anesthesia course.

    PubMed

    Leung, Joseph Y C; Critchley, Lester A H; Yung, Alex L K; Kumta, Shekhar M

    2015-10-01

    Virtual patients are computerised representations of realistic clinical cases. They were developed to teach clinical reasoning skills through delivery of multiple standardized patient cases. The anesthesia course at The Chinese University of Hong Kong developed two novel types of virtual patients, formative assessment cases studies and storyline, to teach its final year medical students on a 2 week rotational course. Acute pain management cases were used to test if these two types of virtual patient could enhance student learning. A 2 × 2 cross over study was performed in academic year 2010-2011 on 130 students divided into four groups of 32-34. Performance was evaluated by acute pain management items set within three examinations; an end of module 60-item multiple choice paper, a short answer modified essay paper and the end of year final surgery modified essay paper. The pain management case studies were found to enhanced student performance in all three examinations, whilst the storyline virtual patient had no demonstrable effect. Student-teaching evaluation questionnaires showed that the case studies were favored more than the storyline virtual patient. Login times showed that students on average logged onto the case studies for 6 h, whereas only half the students logged on and used the storyline virtual patient. Formative assessment case studies were well liked by the students and reinforced learning of clinical algorithms through repetition and feedback, whereas the educational role of the more narrative and less interactive storyline virtual patient was less clear .

  9. Soft tissue balancing in total knee arthroplasty using sensor-guided assessment: is there a learning curve?

    PubMed

    Gharaibeh, Monther A; Chen, Darren B; MacDessi, Samuel J

    2018-05-01

    Sensor-guided assessment for soft tissue balance in total knee arthroplasty (TKA) has been reported to improve patient satisfaction and self-reported outcome scores. As more surgeons adopt this technology in TKA, we performed this study to identify if there is a learning curve with its use. Analysis of a total of 90 consecutive cases was performed in this study. Initial and final intercompartmental pressure differences were recorded before and after knee ligament balancing. The first 45 patients (group 1) were compared to the last 45 patients (group 2) in terms of operative time and the final state of knee balance. A balanced knee was defined as pressure difference between medial and lateral compartments of ≤15 pounds. Group 1 had 10 unbalanced knees in the final pressure difference assessment, while all cases in group 2 were balanced (P < 0.001). There was no statistically significant difference in mean operative time between the two groups. A scatter plot of intercompartmental pressure difference identified that after 30 cases, the capacity to achieve knee ligament balance improved. This study suggests that there is a learning curve with the use of sensor-guided assessment in TKA in achieving knee balance; however, the differences noted between initial and final groups were small and may not be of clinical significance. © 2018 Royal Australasian College of Surgeons.

  10. Admiral Furman Academy: A Case Study in Selected Not-for-Profit Auditing Issues

    ERIC Educational Resources Information Center

    Grippo, Frank J.; Nassiripour, Sia

    2009-01-01

    The purpose of this case is to help students explore accounting and auditing issues often confronted by auditors of not-for-profit organizations. Given final financial statements, the goal of the case is to require students to prepare the footnotes that would be considered an integral part of the financial statements. The case is intended for…

  11. Central nervous system lesions: correlation of intraoperative and final diagnoses, six year experience at a referral centre in a developing country, Pakistan.

    PubMed

    Ud Din, Nasir; Memon, Aisha; Idress, Romana; Ahmad, Zubair; Hasan, Sheema

    2011-01-01

    Intraoperative consultation of CNS lesions provides accurate diagnosis to neurosurgeons. Some lesions, however, may cause diagnostic difficulty. In this study accuracy of intraoperative consultations of CNS lesions and discrepancies in diagnosis and deferrals were analysed. All CNS cases from May 1, 2004 to September 20, 2010 in which intraoperative frozen section had been performed, and which were reported in the Section of Histopathology, Aga Khan University Hospital, Karachi Pakistan were retrieved. The diagnoses given on FS were compared with the final diagnosis given on permanent sections (and additional material if received), as indicated in the frozen section and final pathology report. During the study period, 171 CNS cases were received for intraoperative consultation. In all cases, cryostat sections (FS) plus cytology smears were prepared. The ages of the patients ranged from 03 to 77 years. 106 were males and 65 were females. Out of these 171 cases, 160 cases (94.1 %) were concordant, 10 cases (5.8 %) were discrepant, and one case was deferred until permanent sections. The diagnostic accuracy of frozen section was 88.9%. The sensitivity and specificity were 94.8% and 87.5% respectively. The positive predictive value was 98.6% and negative predictive value was 63.6%. All our cases in which intraoperative consultation was requested were sent for primary diagnosis. Adequacy per se was not a criterion for sending cases for intraoperative consultation. Our results show a reasonably high percentage of accuracy in the intraoperative diagnosis of CNS lesions. However, there are limitations and some lesions pose a diagnostic challenge. There is a need to improve our own diagnostic skills and establish better communication with neurosurgeons.

  12. Effect of skill laboratory training on academic performance of medical students.

    PubMed

    Khan, Muhammad Alamgir; Shabbir, Faizania; Qamar, Khadija; Rajput, Tausif Ahmed

    2017-05-01

    To observe the effect of skill lab training on academic performance of final year medical students in terms of marks obtained in long case, short case, objective structured clinical examination and viva. The cross-sectional comparative study was conducted at Army Medical College, Rawalpindi from February to April 2015. Two batches of final year MBBS were recruited for the study. Batch 1 received conventional training, and Batch 2 received skill lab training. The performance of students was assessed by comparing the marks obtained in long case, short case, objective structured clinical examination and viva. Data was analysed using SPSS 23. Of the 335 subjects, 168(50.1%) were male and 167(49.9%) were female students with a mean age of 21.79±1.02 years. Batch 1 had 151(45%) students and Batch 2 had 184(55%). Batch 2 got significantly higher marks in long case, short case and objective structured clinical examination (p<0.05 each). Viva result was not found to be related to training (p>0.05). Acquisition of clinical skills significantly improved when medial students were trained in skill laboratories.

  13. A new approach on seismic mortality estimations based on average population density

    NASA Astrophysics Data System (ADS)

    Zhu, Xiaoxin; Sun, Baiqing; Jin, Zhanyong

    2016-12-01

    This study examines a new methodology to predict the final seismic mortality from earthquakes in China. Most studies established the association between mortality estimation and seismic intensity without considering the population density. In China, however, the data are not always available, especially when it comes to the very urgent relief situation in the disaster. And the population density varies greatly from region to region. This motivates the development of empirical models that use historical death data to provide the path to analyze the death tolls for earthquakes. The present paper employs the average population density to predict the final death tolls in earthquakes using a case-based reasoning model from realistic perspective. To validate the forecasting results, historical data from 18 large-scale earthquakes occurred in China are used to estimate the seismic morality of each case. And a typical earthquake case occurred in the northwest of Sichuan Province is employed to demonstrate the estimation of final death toll. The strength of this paper is that it provides scientific methods with overall forecast errors lower than 20 %, and opens the door for conducting final death forecasts with a qualitative and quantitative approach. Limitations and future research are also analyzed and discussed in the conclusion.

  14. 76 FR 14906 - Laminated Woven Sacks From the People's Republic of China: Final Results of First Antidumping...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... has added several case numbers to the Case Reference file within the Automated Commercial Environment... Vietnam: Preliminary Results, Preliminary Partial Rescission and Final Partial Rescission of the Second... the Socialist Republic of Vietnam: Final Results and Final Partial Rescission of Antidumping Duty...

  15. Evaluating the Difference between Virtual and Paper-Based Clinical Cases in Family Medicine Undergraduate Education

    PubMed Central

    Cagran, Branka

    2018-01-01

    Introduction A “virtual patient” is defined as a computer program which simulates real patients' cases. The aim of this study was to determine whether the inclusion of virtual patients affects the level of factual knowledge of family medicine students at the undergraduate level. Methods This was a case-controlled prospective study. The students were randomly divided into experimental (EG: N = 51) and control (CG: N = 48) groups. The students in the EG were asked to practice diagnosis using virtual patients instead of the paper-based clinical cases which were solved by the students in the CG. The main observed variable in the study was knowledge of family medicine, determined by 50 multiple choice questions (MCQs) about knowledge of family medicine. Results There were no statistically significant differences in the groups' initial knowledge. At the final assessment of knowledge, there were no statistically significant differences between the groups, but there was a statistically significant difference between their initial and final knowledge. Conclusions The study showed that adding virtual patient cases to the curriculum, instead of paper clinical cases, did not affect the level of factual knowledge about family medicine. Virtual patients can be used, but a significant educational outcome is not expected. PMID:29568779

  16. Analyzing the impacts of final demand changes on total output using input-output approach: The case of Japanese ICT sectors

    NASA Astrophysics Data System (ADS)

    Zuhdi, Ubaidillah

    2014-03-01

    The purpose of this study is to analyze the impacts of final demand changes on total output of Japanese Information and Communication Technologies (ICT) sectors in future time. This study employs one of analysis tool in Input-Output (IO) analysis, demand-pull IO quantity model, in achieving the purpose. There are three final demand changes used in this study, namely (1) export, (2) import, and (3) outside households consumption changes. This study focuses on "pure change" condition, the condition that final demand changes only appear in analyzed sectors. The results show that export and outside households consumption modifications give positive impact while opposite impact could be seen in import change.

  17. Narrowing the Skills Gap: Workplace Literacy Programs in Canada. Final Report.

    ERIC Educational Resources Information Center

    Ottawa Univ. (Ontario).

    This report documents, in case study format, eight workplace literacy programs in Canada. Introductory materials highlight conclusions and discuss reasons for undertaking the project to document the Canadian experience in basic skills training from the perspective of the employer and employee and program design. Each case study or program profile…

  18. Case study and lessons learned for the Great Lakes ITS Program, Airport ITS Integration and the Road Infrastructure Management System projects, final report, Wayne County, Michigan

    DOT National Transportation Integrated Search

    2007-03-02

    This report presents the case study and lessons learned for the national evaluation of the Great Lakes Intelligent Transportation Systems (GLITS) Airport ITS Integration and Road Infrastructure Management System (RIMS) projects. The Airport ITS Integ...

  19. Primary Datasets for Case Studies of River-Water Quality

    ERIC Educational Resources Information Center

    Goulder, Raymond

    2008-01-01

    Level 6 (final-year BSc) students undertook case studies on between-site and temporal variation in river-water quality. They used professionally-collected datasets supplied by the Environment Agency. The exercise gave students the experience of working with large, real-world datasets and led to their understanding how the quality of river water is…

  20. Communicating and Teaching Languages: A Module for Life

    ERIC Educational Resources Information Center

    Koglbauer, René; Andersen, Elizabeth; Stewart, Sophie

    2016-01-01

    This case study introduces a final year undergraduate module in the School of Modern Languages at Newcastle University. The module offers a model for embedding careers in modern languages teaching into the curriculum, and thereby enhancing student employability. The case study gives an insight into the various strands of activity undertaken by the…

  1. Schools Located Near Highways: Problems and Prospects. Final Report [and] Case Studies.

    ERIC Educational Resources Information Center

    Wells, Leslie J.; Shapiro, Richard; Felsburg, Robert W.

    In this 1977 publication, findings and recommendations are presented from 22 case studies involving the impact on schools adjacent to highway systems in the states of California, New Mexico, Colorado, Texas, Missouri, Maryland, and Virginia. The impacts described include: noise; vehicular and pedestrian safety; air pollution; access; circulation…

  2. Mature vs. Active Deep-Seated Landslides: A Comparison Through Two Case Histories in the Alps

    NASA Astrophysics Data System (ADS)

    Delle Piane, Luca; Perello, Paolo; Baietto, Alessandro; Giorza, Alessandra; Musso, Alessia; Gabriele, Piercarlo; Baster, Ira

    2016-06-01

    Two case histories are presented, concerning the still poorly known alpine deep-seated gravitational slope deformations (DSD) located nearby Lanzada (central Italian Alps), and Sarre (north-western Italian Alps). The Lanzada DSD is a constantly monitored, juvenile, and active phenomenon, partly affecting an existing hydropower plant. Its well-developed landforms allow a precise field characterization of the instability-affected area. The Sarre DSD is a mature, strongly remodeled phenomenon, where the only hazard factor is represented by secondary instability processes at the base of the slope. In this case, the remodeling imposed the adoption of complementary analytical techniques to support the field work. The two presented studies had to be adapted to external factors, namely (a) available information, (b) geological and geomorphological setting, and (c) final scope of the work. The Lanzada case essentially relied upon accurate field work; the Sarre case was mostly based on digital image and DTM processing. In both cases a sound field structural analysis formed the necessary background to understand the mechanisms leading to instability. A back-analysis of the differences between the study methods adopted in the two cases is finally presented, leading to suggestions for further investigations and design.

  3. Ethnic Identity Construction in the Schooling Context: A Case Study of a Tibetan Neidi Boarding School in China

    ERIC Educational Resources Information Center

    Zhiyong, Zhu

    2007-01-01

    This article reviews the studies concerning ethnic identity construction in the schooling context. Next, it outlines a conceptual framework about theories of ethnic identity. Finally, it demonstrates a case study of ethnic identity construction of Neidi Tibet School with data collection and analysis. (Contains 1 note, 2 tables, and 2 figures.)

  4. Introduction of vertical integration and case-based learning in anatomy for undergraduate physical therapy and occupational therapy students.

    PubMed

    Parmar, Suresh K; Rathinam, Bertha A D

    2011-01-01

    The purpose of the present pilot study was to evaluate the benefits of innovative teaching methodologies introduced to final year occupational and physical therapy students in Christian Medical College in India. Students' satisfactions along the long-term retention of knowledge and clinical application of the respiratory anatomy have been assessed. The final year undergraduate physical therapy and occupational therapy students had respiratory anatomy teaching over two sessions. The teaching involved case-based learning and integrated anatomy lectures (vertical integration) with the Anatomy department. Pretest and immediate and follow-up post-tests were conducted to assess the effectiveness of the innovative methods. A feedback questionnaire was marked to grade case-based learning. The method of integrated and case-based teaching was appreciated and found to be useful in imparting knowledge to the students. Students retained the gained knowledge adequately and the same was inferred by statistically significant improvement in both post-test scores. Vertical integration of anatomy in the final year reinforces their existing knowledge of anatomy. Case-based learning may facilitate the development of effective and clinically sound therapists. Copyright © 2011 American Association of Anatomists.

  5. How the Contents of a Bachelor's Degree Final Project of Engineering Evolve towards Innovative Scientific Knowledge: Keys to Success

    ERIC Educational Resources Information Center

    Núñez, Cristina; Guinea, Ana; Callau, Sara; Bengoa, Christophe; Basco, Josep; Gavaldà, Jordi

    2017-01-01

    The Bachelor's Degree Final Project (BDFP) of our school aims to develop a real constructive project, enhance cooperative teamwork and increase productivity of students. We present a real case study, related with engineering and scientific innovation results obtained by BDFP, which has led to an innovative scientific study presented at the 7th…

  6. Characteristics of Endophthalmitis after Cataract Surgery in the United States Medicare Population.

    PubMed

    Gower, Emily W; Keay, Lisa J; Stare, Dianne E; Arora, Pallavi; Cassard, Sandra D; Behrens, Ashley; Tielsch, James M; Schein, Oliver D

    2015-08-01

    Endophthalmitis is a rare but sight-threatening infection after cataract surgery. Roughly one third of eyes remain blind after treatment. We report United States population-based data on microbiological investigations and treatment patterns plus risk factors for poor outcomes. Retrospective cohort study. Medicare beneficiaries from 5 states in whom endophthalmitis developed within 6 weeks after cataract surgery in 2003 and 2004. We identified endophthalmitis cases occurring after cataract surgery using Medicare billing claims. We contacted treating physicians and requested they complete a questionnaire on clinical and microbiological data and submit relevant medical records. Two independent observers reviewed materials to confirm that cases met a standardized definition. Positive culture results, vitrectomy status, microbiology spectrum, and final visual acuity. In total, 615 cases met our case definition. Initial visual acuity was counting fingers or worse for 72%. Among 502 cases with known culture results, 291 (58%) had culture positive results. Twelve percent had positive results for streptococci. More than 99% of cases were treated with intravitreal vancomycin. Vitrectomy was performed in 279 cases (45%), including 201 cases with initial acuity better than light perception. Rates of vitrectomy varied across states, with California having the highest rate and Michigan having the lowest (56% and 19% of cases, respectively). Overall, 43% of individuals achieved visual acuity of 20/40 or better. Poor initial acuity (adjusted odds ratio [OR], 1.08; 95% confidence interval [CI], 1.04-1.12 per 0.10 logarithm of the minimum angle of resolution units), older age at diagnosis (OR, 1.22; 95% CI, 1.03-1.45 per 5-year increase), and more virulent organisms were important predictors of poor final visual acuity. Cases with streptococci infection were 10 times more likely to have poor final acuity than coagulase-negative staphylococci cases (adjusted OR, 11.28; 95% CI, 3.63-35.03). Vitrectomy was not predictive of final visual acuity (adjusted OR, 1.26; 95% CI, 0.78-2.04). Population-based data on the microbiology of acute postoperative endophthalmitis in the United States after cataract surgery are consistent with prior reports. Vitrectomy usage is higher than that recommended from the Endophthalmitis Vitrectomy Study, with no evidence of increased benefit. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  7. Conceptual Tutoring Software for Promoting Deep Learning: A Case Study

    ERIC Educational Resources Information Center

    Stott, Angela; Hattingh, Annemarie

    2015-01-01

    The paper presents a case study of the use of conceptual tutoring software to promote deep learning of the scientific concept of density among 50 final year pre-service student teachers in a natural sciences course in a South African university. Individually-paced electronic tutoring is potentially an effective way of meeting the students' varied…

  8. Evaluation of Final Examination Papers in Engineering: A Case Study Using Bloom's Taxonomy

    ERIC Educational Resources Information Center

    Swart, A. J.

    2010-01-01

    Questions are used to obtain information, stimulate thinking, and redirect reasoning. Academics in higher education use questions on a daily basis to stimulate thinking and reasoning in students. Final examination papers are used by academics to assess the retention and application skills of students. The assumption, however, exists that questions…

  9. Educational Information System for Ontario. Final Report, March 1977-April 1978.

    ERIC Educational Resources Information Center

    Auster, Ethel; Lawton, Stephen B.

    This final report describing the operation and research of the EISO project, which provides online bibliographic search services to educators of Ontario, briefly summarizes the first and second interim reports. In addition, it discusses users and the uses of EISO information by providing mini-case studies to illustrate quantitative data and…

  10. Applied and Transformed Understanding in Introductory Psychology: Analysis of a Final Essay Assignment

    ERIC Educational Resources Information Center

    Clark, Kevin M.

    2010-01-01

    This paper describes a case study of the impact of the introductory psychology course on students' understanding of their life experiences and course-related ideas. Student responses to a final essay assignment were analyzed to construct composites for areas of applied and transformed understanding. Results are important for psychology teachers…

  11. A Study of the Nontraditional and Social Impact of Vocational Education on Individuals in Illinois.

    ERIC Educational Resources Information Center

    Carvell Education Managment Planning, Inc., Los Angeles, CA.

    This final report concludes a three-year project to identify the program impact on 125 youths and adults who took vocational education in eight locations in Illinois. The longitudinal case study began in 1978-79 when the subjects were still enrolled in their vocational programs. Many of the students who became case subjects for the study were…

  12. Educational Triage and Ability-Grouping in Primary Mathematics: A Case-Study of the Impacts on Low-Attaining Pupils

    ERIC Educational Resources Information Center

    Marks, Rachel

    2014-01-01

    This case-study, drawing on an unanticipated theme arising from a wider study of ability-grouping in primary mathematics, documents some of the consequences of educational triage in the final year of one primary school. The paper discusses how a process of educational triage, as a response to accountability pressures, is justified by teachers on…

  13. An analysis of OWI arrests and convictions in Iowa.

    DOT National Transportation Integrated Search

    2011-07-01

    The primary goal of the project was to document the demographic profile of OWI offenders in Iowa. The study is based on both aggregate and case-level data. The case level data produced a final sample of 118,675 OWI convictions. That occurred from 200...

  14. Impact of OSHA final rule--recording hearing loss: an analysis of an industrial audiometric dataset.

    PubMed

    Rabinowitz, Peter M; Slade, Martin; Dixon-Ernst, Christine; Sircar, Kanta; Cullen, Mark

    2003-12-01

    The 2003 Occupational Safety and Health Administration (OSHA) Occupational Injury and Illness Recording and Reporting Final Rule changed the definition of recordable work-related hearing loss. We performed a study of the Alcoa Inc. audiometric database to evaluate the impact of this new rule. The 2003 rule increased the rate of potentially recordable hearing loss events from 0.2% to 1.6% per year. A total of 68.6% of potentially recordable cases had American Academy of Audiology/American Medical Association (AAO/AMA) hearing impairment at the time of recordability. On average, recordable loss occurred after onset of impairment, whereas the non-age-corrected 10-dB standard threshold shift (STS) usually preceded impairment. The OSHA Final Rule will significantly increase recordable cases of occupational hearing loss. The new case definition is usually accompanied by AAO/AMA hearing impairment. Other, more sensitive metrics should therefore be used for early detection and prevention of hearing loss.

  15. Impact of OSHA Final Rule—Recording Hearing Loss: An Analysis of an Industrial Audiometric Dataset

    PubMed Central

    Rabinowitz, Peter M.; Slade, Martin; Dixon-Ernst, Christine; Sircar, Kanta; Cullen, Mark

    2013-01-01

    The 2003 Occupational Safety and Health Administration (OSHA) Occupational Injury and Illness Recording and Reporting Final Rule changed the definition of recordable work-related hearing loss. We performed a study of the Alcoa Inc. audiometric database to evaluate the impact of this new rule. The 2003 rule increased the rate of potentially recordable hearing loss events from 0.2% to 1.6% per year. A total of 68.6% of potentially recordable cases had American Academy of Audiology/American Medical Association (AAO/AMA) hearing impairment at the time of recordability. On average, recordable loss occurred after onset of impairment, whereas the non-age-corrected 10-dB standard threshold shift (STS) usually preceded impairment. The OSHA Final Rule will significantly increase recordable cases of occupational hearing loss. The new case definition is usually accompanied by AAO/AMA hearing impairment. Other, more sensitive metrics should therefore be used for early detection and prevention of hearing loss. PMID:14665813

  16. THe Case Method of Instruction (CMI) Project. Final Report.

    ERIC Educational Resources Information Center

    McWilliam, P. J.; And Others

    This final report describes the Case Method of Instruction (CMI) Project, a project to develop, field test, and disseminate training materials to facilitate the use of the Case Method of Instruction by inservice and preservice instructors in developmental disabilities. CMI project activities focused on developing a collection of case stories and…

  17. Implications of Information Technology for Employment, Skills, and Wages: Findings from Sectoral and Case Study Research. Final Report

    ERIC Educational Resources Information Center

    Handel, Michael J.

    2004-01-01

    This paper reviews evidence from industry-specific and case studies that shed light on the extent to which computers and automation eliminate jobs, raise job skill requirements, and, consequently, contribute to increased wage inequality between less- and more skilled workers. This paper complements a previous review of large-scale econometric…

  18. Case Studies in Systems Chemistry. Final Report. [Includes Complete Case Study, Carboxylic Acid Equilibria

    ERIC Educational Resources Information Center

    Fleck, George

    This publication was produced as a teaching tool for college chemistry. The book is a text for a computer-based unit on the chemistry of acid-base titrations, and is designed for use with FORTRAN or BASIC computer systems, and with a programmable electronic calculator, in a variety of educational settings. The text attempts to present computer…

  19. Designing for Diverse Learning: Case Study of Place-Based Learning in Design and Technologies Pre-Service Teacher Education

    ERIC Educational Resources Information Center

    Best, Marnie; MacGregor, Denise; Price, Deborah

    2017-01-01

    Place-based learning experiences in Design and Technologies education connect people and place with design processes and products. Drawing on place-based learning, this case study shares the experiences of eight final year pre-service Design and Technologies education students from the University of South Australia as they collaborated with…

  20. A Case Study of Technical Assistance to Demonstration Programs for Young Handicapped Children. Part III.

    ERIC Educational Resources Information Center

    Behr, Shirley K.; And Others

    The report describes the third and final year of a 3-year case study of the technical assistance process as implemented by the Technical Assistance Development System (TADS) for the staffs of two demonstration programs for preschool handicapped children and their families. Following a review of TADS and the two demonstration programs, the…

  1. Two Different Approaches to Teaching Final-Year Projects for Mechanical Engineers and Biotechnologists at Ngee Ann Polytechnic--Case Studies Approach.

    ERIC Educational Resources Information Center

    Walsh, Kath; Rebaczonok-Padulo, Michael

    1993-01-01

    Ngee Ann Polytechnic, a leading postsecondary technical institution in Singapore, offers English for academic and occupational purposes to prepare students for writing their final year projects. This article discusses the approaches used in Mechanical Engineering and Biotechnology projects. A sample exercise is appended. (Contains two references.)…

  2. 77 FR 54917 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-06

    ... values for inter-observer reliabilities when coding was done by only one observer, in both cases leading... Research Integrity (ORI) has taken final action in the following case: Marc Hauser, Ph.D., Harvard... collaborators that he miscoded some of the trials and that the study failed to provide support for the initial...

  3. Northwood High School: A Good Place To Work? Final Deliverable.

    ERIC Educational Resources Information Center

    Louis, Karen Seashore

    Prepared to assist teachers who are using the case in class discussion, this case study describes a suburban, college-preparatory high school located in the pseudonymously named "Northwood," a midwestern "rust belt" city characterized by rapidly shifting demographics and a growing commercial tax base. Although the city is now…

  4. Hong Kong's Cross-System University Partnerships

    ERIC Educational Resources Information Center

    Postiglione, Gerard A.; Yunyun, Qin; Te, Alice Y. C.

    2016-01-01

    The authors examine the special case of Hong Kong higher education's institutional partnerships in the Chinese mainland. After noting the rise of cross-system university partnership in Asia, it provides a neoinstitutional perspective on the differences between the two China higher education systems. Finally, a case study of the experience of the…

  5. Mid-term Results of Total Knee Arthroplasty Using PFC Sigma RP-F.

    PubMed

    Kim, Jun-Young; Cheon, Sang-Ho; Kyung, Hee-Soo

    2012-12-01

    We compared the mid-term results after total knee arthroplasty (TKA) using PFC Sigma RP-F mobile model with PFC Sigma PS fixed model. We analyzed 45 knees that underwent TKA with PFC Sigma RP-Fn (study group) and 45 knees with PFC Sigma PS (control group). The mean follow-up period was 65 months (range, 60-69 months). The evaluation system of the American knee society was used for clinical and radiological assessment. Also, the maximal knee flexion angle was assessed. The mean maximum flexion angle in the study group (135°) was greater than that in the control group (125°) at the early post-operation & final follow-up period (p=0.033). The range of motion (ROM) in the study group was recovered earlier at the postoperative 6 months, and ROM gain was improved to a greater extent at the final follow-up period (p=0.039). The knee score and function score and radiographic evaluation were no difference between the two groups (p>0.05) at the final follow-up. The two cases of radiolucency in posterior condyle and medial tibial plateau and one case of patellar elongation were seen in the study group. The PFC Sigma RP-F mobile system appears to facilitate greater maximum flexion angle and ROM gain with two cases of radiolucent line.

  6. Project on Social Architecture in Education. Final Report. Part III: Case Studies. Chapter 9: Arts Co-op: An Experimental High School Program.

    ERIC Educational Resources Information Center

    Sullivan, Ellen Wahl

    This document contains chapter 9 of the final report of the Project on Social Architecture in Education. Chapter 9 is about a regional experimental high school program for the arts. Several features distinguished Arts Co-op from the other schools in the study. For one, it was a special purpose school, focused on the arts, and not offering a…

  7. Surface and guided waves on structured surfaces and inhomogeneous media

    NASA Astrophysics Data System (ADS)

    Polanco, Javier

    Surface and guided waves on structured surfaces and inhomogeneous media studies the propagation of waves in systems with spatially varying parameters. In the rainbow case (chapter 1), the dielectric constant changes with coordinates. In the cylinder case: boundary and the metal (chapter 2), it is a curved surface. Finally, in the last case (chapter 3), the dielectric constant changes in z-direction.

  8. Modelling the effect of the physical and chemical characteristics of the materials used as casing layers on the production parameters of Agaricus bisporus.

    PubMed

    Pardo, Arturo; Emilio Pardo, J; de Juan, J Arturo; Zied, Diego Cunha

    2010-12-01

    The aim of this research was to show the mathematical data obtained through the correlations found between the physical and chemical characteristics of casing layers and the final mushrooms' properties. For this purpose, 8 casing layers were used: soil, soil + peat moss, soil + black peat, soil + composted pine bark, soil + coconut fibre pith, soil + wood fibre, soil + composted vine shoots and, finally, the casing of La Rioja subjected to the ruffling practice. The conclusion that interplays in the fructification process with only the physical and chemical characteristics of casing are complicated was drawn. The mathematical data obtained in earliness could be explained in non-ruffled cultivation. The variability observed for the mushroom weight and the mushroom diameter variables could be explained in both ruffled and non-ruffled cultivations. Finally, the properties of the final quality of mushrooms were established by regression analysis.

  9. Case file audit of Lidcombe program outcomes in a student-led stuttering clinic.

    PubMed

    McCulloch, Julia; Swift, Michelle C; Wagnitz, Bianca

    2017-04-01

    The current study aimed to benchmark clinical outcomes for preschool-aged clients (2;0-5;11 years old) that attended a student-led clinic and undertook the Lidcombe Program. A case file audit was undertaken for all preschool clients who attended the clinic between February 2008 and February 2013 and commenced the Lidcombe Program. Clients were grouped according to Stage 1 completion. A mixed ANOVA was used to test for differences between the groups in initial and final percentage syllables stuttered (%SS). Associations between case variable factors and treatment duration were investigated using Pearson correlations. Clients who completed Stage 1 had final %SS and severity rating (SR) scores comparable to the literature; however, the median Stage 1 duration was greater. Over half of the clients (57%) withdrew prior to completing Stage 1. These clients had a significantly higher %SS at final treatment session than their completing peers. Initial %SS and SR scores were the only case variables associated with treatment duration. Students can achieve the same short-term treatment outcomes for children who stutter using the Lidcombe Program as the current published literature; however, treatment duration is greater and may impact completion. Implications of this for clinical education are discussed.

  10. BASINs and WEPP Climate Assessment Tools (CAT): Case ...

    EPA Pesticide Factsheets

    EPA announced the release of the final report, BASINs and WEPP Climate Assessment Tools (CAT): Case Study Guide to Potential Applications. This report supports application of two recently developed water modeling tools, the Better Assessment Science Integrating point & Non-point Sources (BASINS) and the Water Erosion Prediction Project Climate Assessment Tool (WEPPCAT). The report presents a series of short case studies designed to illustrate the capabilities of these tools for conducting scenario based assessments of the potential effects of climate change on streamflow and water quality. This report presents a series of short, illustrative case studies using the BASINS and WEPP climate assessment tools.

  11. [Prevalence of altered mismatch repair protein nuclear expression detected by immunohistochemistry on adenomas with high-grade dysplasia and features associated with this risk in a population-based study].

    PubMed

    Basterra, Marta; Gomez, Marta; Mercado, María Del Rosario; Irisarri, Rebeca; Amorena, Edurne; Arrospide, Arantzazu; Montes, Marta; Aisa, Gregorio; Cambra, Koldo Iñaki; Urman, Jesús

    2016-10-01

    Alteration of mismatch repair system protein expression detected by immunohistochemistry (IHQ) in tumoural tissue is a useful technique for Lynch Syndrome (LS) screening. A recent review proposes LS screening through immunohistochemical study not only in all diagnosed cases of colorectal cancer (CRC) but also in advanced adenomas, especially in young patients. To assess the prevalence of altered IHQ carried out in all adenomas with high-grade dysplasia (HGD) diagnosed in our community in 2011, as well as the variables associated with this alteration. We included all the cases of adenomatous polyps with HGD diagnosed in the three public pathology laboratories of Navarre during 2011 and performed a statistical study to assess the association between different patient and lesion characteristics and altered IHQ results. A total of 213 colonic adenomas with HGD were diagnosed, and 26 (12.2%) cases were excluded from the final analysis (2 known LS, 22 without IHQ study and 2 with inconclusive IHQ studies). The final number of adenomas included was 187. Pathologic results were found in 10 cases (5.35%)-6 cases in MLH1 and PMS2, 2 cases in PMS2, 1 case in MSH6 and 1 case in MSH2 and MSH6. The factors showing a statistically significant association with the presence of abnormal proteins were the synchronous presence of CRC, the presence of only one advanced adenoma, proximal location of HGD and age <50 years. The percentage of pathologic nuclear expression found in IHQ is high. Consequently, screening of all diagnosed HGD could be indicated, especially in young patients, with a single AA and proximal HGD. Copyright © 2015 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  12. Evaluation of the Impact of ESEA Title I Programs for Migrant Children of Migrant Agricultural Workers. Volume IV--Appendices. Final Report.

    ERIC Educational Resources Information Center

    Exotech Systems, Inc., Falls Church, VA.

    Volume IV of the evaluation report consists of case studies from 10 migrant education projects in 8 of the sample States. These projects were visited in July through September 1973. The case studies give noteworthy or innovative aspects of the projects, detailed descriptions, and the functions. The projects are: (1) Harnett County Summer Migrant…

  13. Weight enforcement and evasion : Oregon case study: final report.

    DOT National Transportation Integrated Search

    2002-03-01

    This study examines the incidence of overweight trucks and its relation to regulatory enforcement activity. Addressed are questions of scale operations in relation to weight violations and the effectiveness of enforcement levels, automated preclearan...

  14. 46 CFR Appendix II to Part 390 - Sample Capital Construction Fund Agreement

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) In the case of a vessel constructed or acquired within one year of final delivery from the shipyard... date of such vessel's final delivery; (2) In the case of a vessel reconstructed or acquired more than one year after final delivery from the shipyard after construction with the aid of qualified...

  15. 46 CFR Appendix II to Part 390 - Sample Capital Construction Fund Agreement

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) In the case of a vessel constructed or acquired within one year of final delivery from the shipyard... date of such vessel's final delivery; (2) In the case of a vessel reconstructed or acquired more than one year after final delivery from the shipyard after construction with the aid of qualified...

  16. Comparison of ultra-congruent mobile- and fixed-bearing navigation-assisted total knee arthroplasty with minimum 5-year follow-up.

    PubMed

    Kim, Seong Hwan; Lim, Jung-Won; Ko, Young-Bong; Song, Min-Gu; Lee, Han-Jun

    2016-11-01

    The purpose of this study was to compare the midterm outcomes between fixed and mobile ultra-congruent (UC) bearings in total knee arthroplasty (TKA). This is a retrospective matched-pairs case-control study of patients who underwent primary navigation-assisted TKA with a minimum 5-year follow-up. A total of 182 cases involved the fixed UC bearing system as Group 1 and 101 cases involved mobile UC bearing system group as Group 2. After 1:1 matching, 73 knees in each group were enrolled. Clinical and radiographic outcomes were evaluated. The overall survival was 143 of 146 cases (97.9 %) at final follow-up, and 72 of 73 cases (96.3 %) in Group 1 and 71 of 73 cases (95.8 %) in Group 2 at final follow-up based on an endpoint of revision surgery. The reasons of revision TKA were periprosthetic fracture in Group 1, infection and bearing dislocation in Group 2. There was no statistical difference in Hospital for Special Surgery (HSS) scores, Knee Society Scores (KSS), WOMAC index score evaluations between groups. This study demonstrated that the fixed-bearing UC prosthesis could provide satisfactory performance compared with that of the mobile-bearing UC prosthesis with minimum 5-year follow-up. The fixed-bearing UC prosthesis could be considered in navigation-assisted TKA with theoretical advantages of UC design. IV.

  17. Asymmetries in Phonological Development: The Case of Word-Final Cluster Acquisition in Welsh-English Bilingual Children

    ERIC Educational Resources Information Center

    Mayr, Robert; Howells, Gwennan; Lewis, Rhonwen

    2015-01-01

    This study provides the first systematic account of word-final cluster acquisition in bilingual children. To this end, forty Welsh-English bilingual children differing in language dominance and age (2;6 to 5;0) participated in a picture-naming task in English and Welsh. The results revealed significant age and dominance effects on cluster…

  18. Disabled Children and Their Families: The Impact of Public Law 94-142. Revised Final Report--Year I.

    ERIC Educational Resources Information Center

    Sullivan, Mary Beth; And Others

    The report details the case studies of six families with disabled children, ranging in age from 6 to 18 years, as part of a study to investigate the impact of P.L. 94-142 (the Education for All Handicapped Children Act). An introduction points out that a naturalistic case study approach was used to address the parents experiences with P.L. 94-142,…

  19. Dynamic nonrobotic telemicroscopy via skype: A cost effective solution to teleconsultation.

    PubMed

    Sirintrapun, Sahussapont J; Cimic, Adela

    2012-01-01

    Skype is a peer to peer software application that has been historically used for voice and video calls, instant messaging, and file transfer over the Internet. Few studies are available using Skype specifically for telepathology. Our aim is to show that dynamic nonrobotic teleconsultation is possible and even effective via means of a standard microscope camera capable of live acquisition, Skype, an established broad band internet connection, and experienced pathologists. Both the consulting "sending" pathologist and consultant "receiving" pathologist are reasonably experienced general surgical pathologists at junior attending level with several years of experience in sign out. Forty-five cases were chosen encompassing a broad range of surgical pathology specimens. The cases were prospectively evaluated with the consultant diagnosis used as a preliminary pathologic impression with the final diagnosis being confirmation. Versions of Skype 5.0 and above were used along with established broadband internet connections, usually between academic medical institutions. Forty of forty-five cases (89%) were essentially concordant. In four of forty-five cases (9%), the consulting impression gave a differential, but favored an entity which did not match the final diagnosis. Only one case (2%) did the consulting impression not match the final diagnosis; a discordant opinion. The image quality via Skype screen sharing option is excellent. Essentially no lag time was seen. We have shown in our small pilot study that Skype is an effective cost-efficient means for teleconsultation, particularly in the setting of entity-related differential diagnoses in surgical pathology and when both the consulting and consultant pathologists are reasonably experienced.

  20. Perioperative Care and the Importance of Continuous Quality Improvement—A Controlled Intervention Study in Three Tanzanian Hospitals

    PubMed Central

    Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus–Dieter; Spies, Claudia

    2015-01-01

    Introduction Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. Methods All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Results Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, p<0.001). Postoperative Inpatient Care initially improved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p <0.001), while postoperative care did not significantly change. Anaesthetic Complication Rate in the intervention hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (p<0.0010). Surgical Case Fatality Rate in the control group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Discussion Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Conclusion Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach. PMID:26327392

  1. Perioperative Care and the Importance of Continuous Quality Improvement--A Controlled Intervention Study in Three Tanzanian Hospitals.

    PubMed

    Bosse, Goetz; Abels, Wiltrud; Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus-Dieter; Spies, Claudia

    2015-01-01

    Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, p<0.001). Postoperative Inpatient Care initially improved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p <0.001), while postoperative care did not significantly change. Anaesthetic Complication Rate in the intervention hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (p<0.0010). Surgical Case Fatality Rate in the control group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach.

  2. 1997 federal highway cost allocation study : final report

    DOT National Transportation Integrated Search

    2009-10-01

    The purpose of this case study report is to examine the ways in which metropolitan planning organizations (MPOs) and State Departments of Transportation (DOTs) have responded to Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Lega...

  3. A 3-year prospective study on ocular injuries with tennis or cricket ball while playing cricket: A case series.

    PubMed

    Mahapatra, Santosh Kumar; Malhotra, Kundan; Mendke, Rohit Ganapatrao

    2018-02-01

    The purpose of this study is to study the clinical features, visual outcome, management, and ocular complications of ocular injury, following trauma with tennis or cricket ball. A prospective, noncomparative case study of patients having injury with tennis/cricket ball while playing cricket was conducted between January 2013 and April 2016. Seventy-six eyes of 76 patients were studied. Presenting vision, age, gender, time since injury, general and ocular examination, intraocular pressure, indirect ophthalmoscopy, B scan, and X-ray/computed tomography scan findings were noted. Patients were managed medically or surgically as per the need and followed up at least for 6 months. Seventy-six eyes of 76 patients were studied. All cases were male, except two. Majority (80.2%) were <25 years. Median presenting visual acuity (VA) was 6/36 and median final VA was 6/18. Significant findings in the decreasing order of frequency were sphincter tear (26.3%), retinal detachment (23.6%), angle recession (18.4%), choroidal rupture (17.1%), and Berlin's edema (15.7%). Most of the cases (69.7%) were managed medically. Only 30.2% cases needed surgical intervention. Final visual outcome in our study was depended on initial VA (P = 0.000). It was also correlating with presenting clinical feature (P = 0.010) and type of intervention (medical/surgical) (P = 0.001). Cricket-related ocular injury generally has a poor prognosis with most cases being closed globe injury; retinal detachment is the most common vision-threatening presentation. In spite of being a common event, cricket-related injury is sparingly documented and hence needs further studies for proper documentation, prognostication, and formulation of definitive management plan.

  4. Evaluation of the level of difficulty of patient cases for veterinary problem-solving examination: a preliminary comparison of three taxonomies of learning.

    PubMed

    Koskinen, Heli

    2007-01-01

    An important issue that has received insufficient attention in the use of problem-based learning in the medical curriculum is the mode of assessing the level of difficulty of patient cases. In the present study, the level of difficulty of case-based questions in a veterinary degree final examination in reproduction was evaluated. First, cognitive taxonomies were evaluated to clarify whether qualitative methods such as Bloom's taxonomy, the Structure of the Observed Learning Outcome (SOLO) taxonomy, and the Amsterdam Clinical Challenge Scale (ACCS) differed from each other as evaluation tools for problem-based cases. Using these taxonomies, 30 case-based questions from the final examination in reproduction in the Helsinki veterinary program were initially evaluated to determine which one was best suited to the evaluation of the difficulty of cases. In follow-up, the same cases were also evaluated by an experienced veterinary instructor in reproduction, with the aim of gaining insight into using these approaches to evaluating difficulty. It would appear, from this preliminary assessment, that the SOLO taxonomy may be the most suitable for evaluating the difficulty of patient cases, since the instructor's quality rating resembled more closely the SOLO than the Bloom taxonomy or the ACCS. It is to be emphasized that the purpose of this study was to provide a preliminary evaluation of possible approaches that might be used to assess patient-case difficulty. Resolving all issues will require a greater number of evaluations of all components.

  5. An empirical study using permutation-based resampling in meta-regression

    PubMed Central

    2012-01-01

    Background In meta-regression, as the number of trials in the analyses decreases, the risk of false positives or false negatives increases. This is partly due to the assumption of normality that may not hold in small samples. Creation of a distribution from the observed trials using permutation methods to calculate P values may allow for less spurious findings. Permutation has not been empirically tested in meta-regression. The objective of this study was to perform an empirical investigation to explore the differences in results for meta-analyses on a small number of trials using standard large sample approaches verses permutation-based methods for meta-regression. Methods We isolated a sample of randomized controlled clinical trials (RCTs) for interventions that have a small number of trials (herbal medicine trials). Trials were then grouped by herbal species and condition and assessed for methodological quality using the Jadad scale, and data were extracted for each outcome. Finally, we performed meta-analyses on the primary outcome of each group of trials and meta-regression for methodological quality subgroups within each meta-analysis. We used large sample methods and permutation methods in our meta-regression modeling. We then compared final models and final P values between methods. Results We collected 110 trials across 5 intervention/outcome pairings and 5 to 10 trials per covariate. When applying large sample methods and permutation-based methods in our backwards stepwise regression the covariates in the final models were identical in all cases. The P values for the covariates in the final model were larger in 78% (7/9) of the cases for permutation and identical for 22% (2/9) of the cases. Conclusions We present empirical evidence that permutation-based resampling may not change final models when using backwards stepwise regression, but may increase P values in meta-regression of multiple covariates for relatively small amount of trials. PMID:22587815

  6. A review of published research on adult dissociative identity disorder: 2000-2010.

    PubMed

    Boysen, Guy A; VanBergen, Alexandra

    2013-01-01

    The purpose of this study was to assess the scientific and etiological status of dissociative identity disorder (DID) by examining cases published from 2000 to 2010. In terms of scientific status, DID is a small but ongoing field of study. The review yielded 21 case studies and 80 empirical studies, presenting data on 1171 new cases of DID. A mean of 9 articles, each containing a mean of 17 new cases of DID, emerged each year. In terms of etiological status, many of the central criticisms of the disorder's validity remain unaddressed. Most cases of DID emerged from a small number of countries and clinicians. In addition, documented cases occurring outside treatment were almost nonexistent. Finally, people simulating DID in the laboratory were mostly indistinguishable from individuals with DID. Overall, DID is still a topic of study, but the research lacks the productivity and focus needed to resolve ongoing controversies surrounding the disorder.

  7. Clinical Case Studies in Psychoanalytic and Psychodynamic Treatment

    PubMed Central

    Willemsen, Jochem; Della Rosa, Elena; Kegerreis, Sue

    2017-01-01

    This manuscript provides a review of the clinical case study within the field of psychoanalytic and psychodynamic treatment. The method has been contested for methodological reasons and because it would contribute to theoretical pluralism in the field. We summarize how the case study method is being applied in different schools of psychoanalysis, and we clarify the unique strengths of this method and areas for improvement. Finally, based on the literature and on our own experience with case study research, we come to formulate nine guidelines for future case study authors: (1) basic information to include, (2) clarification of the motivation to select a particular patient, (3) information about informed consent and disguise, (4) patient background and context of referral or self-referral, (5) patient's narrative, therapist's observations and interpretations, (6) interpretative heuristics, (7) reflexivity and counter-transference, (8) leaving room for interpretation, and (9) answering the research question, and comparison with other cases. PMID:28210235

  8. On the pedagogy of pharmacological communication: a study of final semester health science students.

    PubMed

    Zetterqvist, Ann; Aronsson, Patrik; Hägg, Staffan; Kjellgren, Karin; Reis, Margareta; Tobin, Gunnar; Booth, Shirley

    2015-10-26

    There is a need to improve design in educational programmes for the health sciences in general and in pharmacology specifically. The objective of this study was to investigate and problematize pharmacological communication in educational programmes for the health sciences. An interview study was carried out where final semester students from programmes for the medical, nursing and specialist nursing in primary health care professions were asked to discuss the pharmacological aspects of two written case descriptions of the kind they would meet in their everyday work. The study focused on the communication they envisaged taking place on the concerns the patients were voicing, in terms of two features: how communication would take place and what would be the content of the communication. A phenomenographic research approach was used. The results are presented as outcome spaces, sets of categories that describe the variation of ways in which the students voiced their understanding of communication in the two case descriptions and showed the qualitatively distinct ways in which the features of communication were experienced. The results offer a base of understanding the students' perspectives on communication that they will take with them into their professional lives. We indicate that there is room for strengthening communication skills in the field of pharmacology, integrating them into programmes of education, by more widely implementing a problem-based, a case-oriented or role-playing pedagogy where final year students work across specialisations and there is a deliberate effort to evoke and assess advanced conceptions and skills.

  9. Improving ethical knowledge and sensemaking from cases through elaborative interrogation and outcome valence.

    PubMed

    Johnson, James F; Bagdasarov, Zhanna; MacDougall, Alexandra E; Steele, Logan; Connelly, Shane; Devenport, Lynn D; Mumford, Michael D

    2014-01-01

    The case-based approach to learning is popular among many applied fields. However, results of case-based education vary widely on case content and case presentation. This study examined two aspects of case-based education-outcome valence and case elaboration methods-in a two-day case-based Responsible Conduct of Research (RCR) ethics education program. Results suggest that outcome information is an integral part of a quality case. Furthermore, valence consistent outcomes may have certain advantages over mixed valence outcome information. Finally, students enjoy and excel working with case material, and the use of elaborative interrogation techniques can significantly improve internally-focused ethical sensemaking strategies associated with personal biases, constraints, and emotions.

  10. Exploring the Impacts of Accelerated Delivery on Student Learning, Achievement and Satisfaction

    ERIC Educational Resources Information Center

    Wilkins, Stephen; Martin, Susan; Walker, Ian

    2010-01-01

    This case study examines the impacts on student learning, achievement and satisfaction when year 13 (final year) students at a large UK sixth-form college take a GCE A level in one year instead of the usual two years. Data relating to the entry qualifications and final A level grades achieved by 879 students on both accelerated and non-accelerated…

  11. The e-Learning Tool Voxopop and Its Benefits on Oral Skills: Activities for Final Year Students of German

    ERIC Educational Resources Information Center

    Stollhans, Sascha

    2015-01-01

    This case study demonstrates how Voxopop, a voice based e-learning tool, can be used to practise oal skills in the target language by presenting activities which have been developed for students of German at the University of Nottingham. The focus lies on an ongoing innovative project designed to improve final year students' oral skills by having…

  12. Stable reconstruction using halo vest for unstable upper cervical spine and occipitocervical instability.

    PubMed

    Ogihara, Nobuhide; Takahashi, Jun; Hirabayashi, Hiroki; Hashidate, Hiroyuki; Mukaiyama, Keijiro; Kato, Hiroyuki

    2012-02-01

    Upper cervical or occipitocervical disorders such as rheumatoid arthritis present as atlantoaxial subluxation, vertical subluxation of the axis, and subaxial subluxation, which produce myelopathy and severe pain. In such cases, occipitocervical reconstruction surgery may be indicated, and several reports have described reduction of subluxation by fixing the halo vest before this surgery. The purpose of this study was to evaluate the efficacy of using the halo vest before the surgery for unstable upper cervical spine and for occipitocervical instability. Twenty-eight patients (9 men and 19 women; mean age, 61.8 years at surgery) who presented with atlantoaxial or occipitocervical fusion were studied. In all cases, the halo vest was fixed in the conscious condition, and subluxation was reduced before the surgery. The mean follow-up period was 45 months. Roentgenologic measurement and clinical evaluation were performed before the surgery and at the final follow-up. Using the halo vest resulted in significant reductions in the atlantodental interval, the space available for the spinal cord, and the Ranawat value (p < 0.05), and these were maintained until the final follow-up. The mean Japanese Orthopedic Association score significantly improved from 9.5 before surgery to 12.2 at the final follow-up (p = 0.01). Nineteen cases (68%) improved by more than 1 grade by Ranawat's classification after surgery and 16 cases (57%) maintained the same at the follow-up visit. Conscious preoperative reduction using the halo vest for occipitocervical disorders is a useful and safe technique.

  13. Active traffic management case study: phase 1 : final report.

    DOT National Transportation Integrated Search

    2016-03-01

    This study developed a systematic approach for using data from multiple sources to provide active traffic management : solutions. The feasibility of two active traffic management solutions is analyzed in this report: ramp-metering and real-time : cra...

  14. Endophthalmitis after intravitreal injections. Incidence, management and prognosis.

    PubMed

    Tarragó, R; Olea, J L; Ramírez, C; Escudero, L

    2017-03-01

    To assess the rate of endophthalmitis after intravitreal injection (IVI) in a «clean room» of a single health centre, following the guidelines of the Spanish Vitreo-Retinal Society (SERV). An analysis was performed on the culture specimens, response to treatment, and final outcomes (guidelines). A retrospective, observational study was conducted on a consecutive case series of patients diagnosed with infectious endophthalmitis after IVI in a single health centre between 2010 and 2015. Intravitreal and systemic treatment was given following the SERV guidelines. The patients were followed up the case was resolved. There were 5 cases of endophthalmitis out of 9467 IVI (incidence 0.053%). Positive cultures were obtained in aqueous and/or vitreous fluid in all cases, with Staphylococcus epidermidis being involved in 4 out of 5 cases. In 2 cases, final visual acuity was non-light perception due to intractable retinal detachments after resolution of the infectious process. IVI performed in a «clean room» have a low incidence of endophthalmitis. The most common infectious agent was Staphylococcus species. In 2 cases the functional prognosis was poor. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Comparison of victims' reports and court records of intimate partner violence perpetrators' criminal case outcomes.

    PubMed

    Bell, Margret E; Larsen, Sadie E; Goodman, Lisa A; Dutton, Mary Ann

    2013-09-01

    Intimate partner violence (IPV) victims often report feeling confused and uninformed about court proceedings, including even about the final disposition of the case against their partner. This is problematic because victims' decisions in responding to subsequent abuse may be significantly influenced by their beliefs about the outcomes of prior court experiences. Also, researchers often rely on victim report of court case outcomes; discrepancies between women's reports and official records may account for some of the conflicting findings in the empirical literature. In the current study, we compared the reports of case outcome given by 81 women recruited immediately after the final hearing of an IPV-related criminal case against their perpetrator with court records of case outcome. Findings revealed a fair level of agreement between women's reports and court files that was significantly different from the level of agreement expected by chance, but far from perfect. Level of agreement increased substantially when cases involving suspended sentences were removed. In reviewing these findings, we discuss the extent to which results can or cannot be interpreted as reflecting the accuracy of women's knowledge and review their implications for IPV researchers and court systems.

  16. The Impact of an Online Crowdsourcing Diagnostic Tool on Health Care Utilization: A Case Study Using a Novel Approach to Retrospective Claims Analysis.

    PubMed

    Juusola, Jessie L; Quisel, Thomas R; Foschini, Luca; Ladapo, Joseph A

    2016-06-01

    Patients with difficult medical cases often remain undiagnosed despite visiting multiple physicians. A new online platform, CrowdMed, uses crowdsourcing to quickly and efficiently reach an accurate diagnosis for these patients. This study sought to evaluate whether CrowdMed decreased health care utilization for patients who have used the service. Novel, electronic methods of patient recruitment and data collection were utilized. Patients who completed cases on CrowdMed's platform between July 2014 and April 2015 were recruited for the study via email and screened via an online survey. After providing eConsent, participants provided identifying information used to access their medical claims data, which was retrieved through a third-party web application program interface (API). Utilization metrics including frequency of provider visits and medical charges were compared pre- and post-case resolution to assess the impact of resolving a case on CrowdMed. Of 45 CrowdMed users who completed the study survey, comprehensive claims data was available via API for 13 participants, who made up the final enrolled sample. There were a total of 221 health care provider visits collected for the study participants, with service dates ranging from September 2013 to July 2015. Frequency of provider visits was significantly lower after resolution of a case on CrowdMed (mean of 1.07 visits per month pre-resolution vs. 0.65 visits per month post-resolution, P=.01). Medical charges were also significantly lower after case resolution (mean of US $719.70 per month pre-resolution vs. US $516.79 per month post-resolution, P=.03). There was no significant relationship between study results and disease onset date, and there was no evidence of regression to the mean influencing results. This study employed technology-enabled methods to demonstrate that patients who used CrowdMed had lower health care utilization after case resolution. However, since the final sample size was limited, results should be interpreted as a case study. Despite this limitation, the statistically significant results suggest that online crowdsourcing shows promise as an efficient method of solving difficult medical cases.

  17. An Approach to Using Toxicogenomic Data in US EPA Human ...

    EPA Pesticide Factsheets

    EPA announced the availability of the final report, An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate Case Study. This report outlines an approach to evaluate genomic data for use in risk assessment and a case study to illustrate the approach. The dibutyl phthalate (DBP) case study example focuses on male reproductive developmental effects and the qualitative application of genomic data because of the available data on DBP. The case study presented in this report is a separate activity from any of the ongoing IRIS human health assessments for the phthalates. The National Center for Environmental Assessment (NCEA) prepared this document for the purpose of describing and illustrating an approach for using toxicogenomic data in risk assessment.

  18. Usefullness of IGH/TCR PCR studies in lymphoproliferative disorders with inconclusive clonality by flow cytometry.

    PubMed

    Ribera, Jordi; Zamora, Lurdes; Juncà, Jordi; Rodríguez, Inés; Marcé, Silvia; Cabezón, Marta; Millá, Fuensanta

    2013-07-25

    In up to 5-15% of studies of lymphoproliferative disorders (LPD) flow cytometry (FCM) or immunomorphologic methods cannot discriminate malignant from reactive processes. The aim of this work was to determine the usefulness of PCR for solving these diagnostic uncertainties. We analyzed IGH and TCRγ genes by PCR in 106 samples with inconclusive FCM results. A clonal result was registered in 36/106 studies, with a LPD being confirmed in 27 (75%) of these cases. Specifically, 9/9 IGH clonal and 16/25 TCRγ clonal results were finally diagnosed with LPD. Additionally, 2 clonal TCRγ samples with suspicion of undefined LPD were finally diagnosed with T LPD. Although polyclonal results were obtained in 47 of the cases studied (38 IGH and 9 TCRγ), hematologic neoplasms were diagnosed in 4/38 IGH polyclonal and in 1/9 TCRγ polyclonal studies. There were also 14 PCR polyclonal results (4 IGH, 10 TCRγ), albeit non-conclusive. Of these, 2/4 were eventually diagnosed with B-cell lymphoma and 3/10 with T-cell LPD. In 8 IGH samples the results of PCR techniques were non-informative but in 3/8 cases a B lymphoma was finally confirmed. We concluded that PCR is a useful technique to identify LPD when FCM is inconclusive. A PCR clonal B result is indicative of malignancy but IGH polyclonal and non-conclusive results do not exclude lymphoid neoplasms. Interpretation of T-cell clonality should be based on all the available clinical and analytical data. © 2013 Clinical Cytometry Society. Copyright © 2013 Clinical Cytometry Society.

  19. Roadway usage patterns : urban case studies - final report

    DOT National Transportation Integrated Search

    1996-01-01

    The Orlando Test Network Study was one of a series of investigations conducted as part of the TravTek operational test of an advanced traveler information and traffic management system (ATIS/ATMS). The TravTek system consisted of the Orlando Traffic ...

  20. Planning for Post-Regime Change Environments: The Introduction of a Post-Regime Environment Planning Partnership (PREPP)

    DTIC Science & Technology

    2016-05-26

    makers. The third case study, on Nigeria , will provide an analysis of a peaceful transition of power. Finally, the structure for a proposed Post...15. SUBJECT TERMS Regime Change, National Security Council, Kosovo, Libya, Nigeria , transition of power, post-regime change planning. 16. SECURITY...conflation that exists between the planning element and politically appointed decision makers. The third case study, on Nigeria , will provide an analysis of

  1. Constitutional growth delay pattern of growth in velo-cardio-facial syndrome: longitudinal follow up and final height of two cases.

    PubMed

    Turan, Serap; Ozdemir, Nihal; Güran, Tülay; Akalın, Figen; Akçay, Teoman; Ayabakan, Canan; Yılmaz, Yüksel; Bereket, Abdullah

    2008-01-01

    We report two patients with velo-cardio-facial syndrome (VCFS) who were admitted to our pediatric endocrinology clinic because of short stature and followed longitudinally until attainment of final height. Both patients followed a growth pattern consistent with constitutional delay of puberty with normal and near normal final height. Case 2 also had partial growth hormone (GH) deficiency and severe short stature (height SDS -3.4 SDS), but showed spontaneous catch-up and ended up with a final height of -2 SDS. These cases suggest that short stature in children with VCFS is due to a pattern of growth similar to that observed in constitutional delay of growth and puberty.

  2. Dynamic nonrobotic telemicroscopy via skype: A cost effective solution to teleconsultation

    PubMed Central

    Sirintrapun, Sahussapont J.; Cimic, Adela

    2012-01-01

    Context: Skype is a peer to peer software application that has been historically used for voice and video calls, instant messaging, and file transfer over the Internet. Few studies are available using Skype specifically for telepathology. Aims: Our aim is to show that dynamic nonrobotic teleconsultation is possible and even effective via means of a standard microscope camera capable of live acquisition, Skype, an established broad band internet connection, and experienced pathologists. Settings and Design: Both the consulting “sending” pathologist and consultant “receiving” pathologist are reasonably experienced general surgical pathologists at junior attending level with several years of experience in sign out. Forty-five cases were chosen encompassing a broad range of surgical pathology specimens. The cases were prospectively evaluated with the consultant diagnosis used as a preliminary pathologic impression with the final diagnosis being confirmation. Materials and Methods: Versions of Skype 5.0 and above were used along with established broadband internet connections, usually between academic medical institutions. Results: Forty of forty-five cases (89%) were essentially concordant. In four of forty-five cases (9%), the consulting impression gave a differential, but favored an entity which did not match the final diagnosis. Only one case (2%) did the consulting impression not match the final diagnosis; a discordant opinion. Conclusions: The image quality via Skype screen sharing option is excellent. Essentially no lag time was seen. We have shown in our small pilot study that Skype is an effective cost-efficient means for teleconsultation, particularly in the setting of entity-related differential diagnoses in surgical pathology and when both the consulting and consultant pathologists are reasonably experienced. PMID:23024887

  3. The Process of Technology Transfer: A Case Study of the National Aero-Space Plane Program.

    DTIC Science & Technology

    1995-09-01

    often characterize qualitative research ( Bryman , 1989:173,178). A final advantage of the case study method is that it is used to develop hypotheses for...November 1992). Bryman , Alan. Research Methods and Organizational Studies. Winchester MA: Unwin Hyman Inc., 1989. Chapman, Richard L. "The Federal...and C. William Emory. Business Research Methods . Chicago: Richard D. Irwin Inc., 1995. Creighton, J.W., J.A. Jolly, and T.A. Buckles. "The Manager’s

  4. 76 FR 23502 - Fee-Generating Cases

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-27

    ... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Legal Services Corporation's regulation... Assistant General Counsel, Office of Legal Affairs, Legal Services Corporation, 3333 K Street, NW...

  5. Developing integrated clinical reasoning competencies in dental students using scaffolded case-based learning - empirical evidence.

    PubMed

    Postma, T C; White, J G

    2016-08-01

    This study provides empirical evidence of the development of integrated clinical reasoning in the discipline-based School of Dentistry, University of Pretoria, South Africa. Students were exposed to case-based learning in comprehensive patient care (CPC) in the preclinical year of study, scaffolded by means of the four-component instructional design model for complex learning. Progress test scores of third- to fifth-year dental students, who received case-based teaching and learning in the third year (2009-2011), were compared to the scores of preceding fourth- and fifth-year cohorts. These fourth- and fifth-year cohorts received content-based teaching concurrently with their clinical training in CPC. The progress test consisted of a complex case study and 32 MCQs on tracer conditions. Students had to gather the necessary information and had to make diagnostic and treatment-planning decisions. Preclinical students who participated in the case-based teaching and learning achieved similar scores compared to final-year students who received lecture-based teaching and learning. Final-year students who participated in the case-based learning made three more correct clinical decisions per student, compared to those who received content-based teaching. Students struggled more with treatment-planning than with diagnostic decisions. The scaffolded case-based learning appears to contribute to accurate clinical decisions when compared to lecture-based teaching. It is suggested that the development of integrated reasoning competencies starts as early as possible in a dental curriculum, perhaps even in the preclinical year of study. Treatment-planning should receive particular attention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Virtual Planning, Control, and Machining for a Modular-Based Automated Factory Operation in an Augmented Reality Environment

    PubMed Central

    Pai, Yun Suen; Yap, Hwa Jen; Md Dawal, Siti Zawiah; Ramesh, S.; Phoon, Sin Ye

    2016-01-01

    This study presents a modular-based implementation of augmented reality to provide an immersive experience in learning or teaching the planning phase, control system, and machining parameters of a fully automated work cell. The architecture of the system consists of three code modules that can operate independently or combined to create a complete system that is able to guide engineers from the layout planning phase to the prototyping of the final product. The layout planning module determines the best possible arrangement in a layout for the placement of various machines, in this case a conveyor belt for transportation, a robot arm for pick-and-place operations, and a computer numerical control milling machine to generate the final prototype. The robotic arm module simulates the pick-and-place operation offline from the conveyor belt to a computer numerical control (CNC) machine utilising collision detection and inverse kinematics. Finally, the CNC module performs virtual machining based on the Uniform Space Decomposition method and axis aligned bounding box collision detection. The conducted case study revealed that given the situation, a semi-circle shaped arrangement is desirable, whereas the pick-and-place system and the final generated G-code produced the highest deviation of 3.83 mm and 5.8 mm respectively. PMID:27271840

  7. Virtual Planning, Control, and Machining for a Modular-Based Automated Factory Operation in an Augmented Reality Environment.

    PubMed

    Pai, Yun Suen; Yap, Hwa Jen; Md Dawal, Siti Zawiah; Ramesh, S; Phoon, Sin Ye

    2016-06-07

    This study presents a modular-based implementation of augmented reality to provide an immersive experience in learning or teaching the planning phase, control system, and machining parameters of a fully automated work cell. The architecture of the system consists of three code modules that can operate independently or combined to create a complete system that is able to guide engineers from the layout planning phase to the prototyping of the final product. The layout planning module determines the best possible arrangement in a layout for the placement of various machines, in this case a conveyor belt for transportation, a robot arm for pick-and-place operations, and a computer numerical control milling machine to generate the final prototype. The robotic arm module simulates the pick-and-place operation offline from the conveyor belt to a computer numerical control (CNC) machine utilising collision detection and inverse kinematics. Finally, the CNC module performs virtual machining based on the Uniform Space Decomposition method and axis aligned bounding box collision detection. The conducted case study revealed that given the situation, a semi-circle shaped arrangement is desirable, whereas the pick-and-place system and the final generated G-code produced the highest deviation of 3.83 mm and 5.8 mm respectively.

  8. Virtual Planning, Control, and Machining for a Modular-Based Automated Factory Operation in an Augmented Reality Environment

    NASA Astrophysics Data System (ADS)

    Pai, Yun Suen; Yap, Hwa Jen; Md Dawal, Siti Zawiah; Ramesh, S.; Phoon, Sin Ye

    2016-06-01

    This study presents a modular-based implementation of augmented reality to provide an immersive experience in learning or teaching the planning phase, control system, and machining parameters of a fully automated work cell. The architecture of the system consists of three code modules that can operate independently or combined to create a complete system that is able to guide engineers from the layout planning phase to the prototyping of the final product. The layout planning module determines the best possible arrangement in a layout for the placement of various machines, in this case a conveyor belt for transportation, a robot arm for pick-and-place operations, and a computer numerical control milling machine to generate the final prototype. The robotic arm module simulates the pick-and-place operation offline from the conveyor belt to a computer numerical control (CNC) machine utilising collision detection and inverse kinematics. Finally, the CNC module performs virtual machining based on the Uniform Space Decomposition method and axis aligned bounding box collision detection. The conducted case study revealed that given the situation, a semi-circle shaped arrangement is desirable, whereas the pick-and-place system and the final generated G-code produced the highest deviation of 3.83 mm and 5.8 mm respectively.

  9. 32 CFR 206.5 - Final proposal process.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... be evaluated in two basic categories: (1) Proposals that address study abroad infrastructure and (2... foreign cultural competency? In the case of study abroad programs, how will the success and impact of study abroad experiences be assessed. Proposals should not defer the consideration of these issues to a...

  10. 32 CFR 206.5 - Final proposal process.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... be evaluated in two basic categories: (1) Proposals that address study abroad infrastructure and (2... foreign cultural competency? In the case of study abroad programs, how will the success and impact of study abroad experiences be assessed. Proposals should not defer the consideration of these issues to a...

  11. 32 CFR 206.5 - Final proposal process.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... be evaluated in two basic categories: (1) Proposals that address study abroad infrastructure and (2... foreign cultural competency? In the case of study abroad programs, how will the success and impact of study abroad experiences be assessed. Proposals should not defer the consideration of these issues to a...

  12. 32 CFR 206.5 - Final proposal process.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... be evaluated in two basic categories: (1) Proposals that address study abroad infrastructure and (2... foreign cultural competency? In the case of study abroad programs, how will the success and impact of study abroad experiences be assessed. Proposals should not defer the consideration of these issues to a...

  13. 32 CFR 206.5 - Final proposal process.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... be evaluated in two basic categories: (1) Proposals that address study abroad infrastructure and (2... foreign cultural competency? In the case of study abroad programs, how will the success and impact of study abroad experiences be assessed. Proposals should not defer the consideration of these issues to a...

  14. 28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial... BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR...

  15. 28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial... BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR...

  16. 28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial... BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR...

  17. 28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial... BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR...

  18. Brief Report: Independent Validation of Autism Spectrum Disorder Case Status in the Utah Autism and Developmental Disabilities Monitoring (ADDM) Network Site

    ERIC Educational Resources Information Center

    Bakian, Amanda V.; Bilder, Deborah A.; Carbone, Paul S.; Hunt, Tyler D.; Petersen, Brent; Rice, Catherine E.

    2015-01-01

    An independent validation was conducted of the Utah Autism and Developmental Disabilities Monitoring Network's (UT-ADDM) classification of children with autism spectrum disorder (ASD). UT-ADDM final case status (n = 90) was compared with final case status as determined by independent external expert reviewers (EERs). Inter-rater reliability…

  19. Using Remote Access to Scientific Instrumentation to Create Authentic Learning Activities in Pharmaceutical Analysis

    PubMed Central

    Albon, Simon P.; Cancilla, Devon A.; Hubball, Harry

    2006-01-01

    Objectives To pilot test and evaluate a gas chromatography-mass spectrometry (GCMS) case study as a teaching and learning tool. Design A case study incorporating remote access to a GCMS instrument through the Integrated Laboratory Network (ILN) at Western Washington University was developed and implemented. Student surveys, faculty interviews, and examination score data were used to evaluate learning. Assessment While the case study did not impact final examination scores, approximately 70% of students and all faculty members felt the ILN-supported case study improved student learning about GCMS. Faculty members felt the “live” instrument access facilitated more authentic teaching. Students and faculty members felt the ILN should continue to be developed as a teaching tool. Conclusion Remote access to scientific instrumentation can be used to modify case studies to enhance student learning and teaching practice in pharmaceutical analysis. PMID:17149450

  20. Case Studies in Modelling, Control in Food Processes.

    PubMed

    Glassey, J; Barone, A; Montague, G A; Sabou, V

    This chapter discusses the importance of modelling and control in increasing food process efficiency and ensuring product quality. Various approaches to both modelling and control in food processing are set in the context of the specific challenges in this industrial sector and latest developments in each area are discussed. Three industrial case studies are used to demonstrate the benefits of advanced measurement, modelling and control in food processes. The first case study illustrates the use of knowledge elicitation from expert operators in the process for the manufacture of potato chips (French fries) and the consequent improvements in process control to increase the consistency of the resulting product. The second case study highlights the economic benefits of tighter control of an important process parameter, moisture content, in potato crisp (chips) manufacture. The final case study describes the use of NIR spectroscopy in ensuring effective mixing of dry multicomponent mixtures and pastes. Practical implementation tips and infrastructure requirements are also discussed.

  1. Electrification of buildings and industry in the United States: Drivers, barriers, prospects, and policy approaches

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

    Deason, Jeff; Wei, Max; Leventis, Greg

    The report offers several use cases and case studies of electrification in buildings and industry: air source heat pumps for space heating, zero net energy buildings, electric water heaters and demand response, electric arc furnaces, and electric boilers. Finally, the report suggests several areas for further research to better understand and advance beneficial electrification.

  2. Case-based Influence in Conflict Management

    DTIC Science & Technology

    2014-10-31

    AFRL-OSR-VA-TR-2014-0337 CASE-BASED INFLUENCE IN CONFLICT MANAGEMENT Robert Axelrod ARTIS RESEARCH & RISK MODELING Final Report 10/31/2014...FA9550-10-1-0373 Dr. Robert Axelrod - PI Dr. Richard Davis- PD ARTIS Research & Risk Modeling ARTIS 5741 Canyon Ridge North Cave Creek, AZ 85331-9318...analysis of the timing of cyber conflict that quickly received attention from over 30 countries. 3 1 Axelrod , Final Report and Publications Final

  3. Development of PCK for Novice and Experienced University Physics Instructors: A Case Study

    ERIC Educational Resources Information Center

    Jang, Syh-Jong; Tsai, Meng-Fang; Chen, Ho-Yuan

    2013-01-01

    The current study assessed and compared university students' perceptions' of a novice and an experienced physics instructor's Pedagogical Content Knowledge (PCK). Two college physics instructors and 116 students voluntarily participated in this study. The research model comprised three workshops, mid-term and final evaluations and instructor…

  4. Characterizing mammographic images by using generic texture features

    PubMed Central

    2012-01-01

    Introduction Although mammographic density is an established risk factor for breast cancer, its use is limited in clinical practice because of a lack of automated and standardized measurement methods. The aims of this study were to evaluate a variety of automated texture features in mammograms as risk factors for breast cancer and to compare them with the percentage mammographic density (PMD) by using a case-control study design. Methods A case-control study including 864 cases and 418 controls was analyzed automatically. Four hundred seventy features were explored as possible risk factors for breast cancer. These included statistical features, moment-based features, spectral-energy features, and form-based features. An elaborate variable selection process using logistic regression analyses was performed to identify those features that were associated with case-control status. In addition, PMD was assessed and included in the regression model. Results Of the 470 image-analysis features explored, 46 remained in the final logistic regression model. An area under the curve of 0.79, with an odds ratio per standard deviation change of 2.88 (95% CI, 2.28 to 3.65), was obtained with validation data. Adding the PMD did not improve the final model. Conclusions Using texture features to predict the risk of breast cancer appears feasible. PMD did not show any additional value in this study. With regard to the features assessed, most of the analysis tools appeared to reflect mammographic density, although some features did not correlate with PMD. It remains to be investigated in larger case-control studies whether these features can contribute to increased prediction accuracy. PMID:22490545

  5. Windrow co-composting of natural casings waste with sheep manure and dead leaves

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

    Makan, Abdelhadi, E-mail: abdelhadi.makan@gmail.com

    Highlights: • Waste management opportunities in small and medium companies were highlighted. • Pilot scale program for windrow co-composting of natural casings was investigated. • Compost preparation, characterization and application phases were discussed. • Natural casings co-composting has proved more viable and cost effective solution. - Abstract: After studying the waste management opportunities in small and medium companies of natural casings, composting has proved more viable and cost effective solution for the valorization of these types of waste, but its feasibility depends on the final product value. This paper investigated a pilot scale program for the windrow co-composting of naturalmore » casings waste with sheep manure and dead leaves incorporation. Processing, characterization and application of the final compost were described and the final compost was analyzed for pathogens, metals, nutrients, maturity, and agronomic parameters. The results showed that all test result levels were below the limits specified in the EPA regulations published in Title 40, Section 503, of the Code of Federal Regulations (40 CFR 503). Moreover, the agronomic value tests which include nutrients, organic matter, pH, electrical conductivity, etc. showed that the compost had high organic-matter content and low salt content, all of which indicate good compost characteristics. The ratio of nitrogen (N), phosphorus (P), and potassium (K), or NPK ratio, was measured at 1.6–0.9–0.7. Reported units are consistent with those found on fertilizer formulations.« less

  6. Constitutional Growth Delay Pattern of Growth in Velo−Cardio−Facial Syndrome: Longitudinal follow up and final height of two cases

    PubMed Central

    Özdemir, Nihal; Güran, Tülay; Akalın, Figen; Akçay, Teoman; Ayabakan, Canan; Yılmaz, Yüksel; Bereket, Abdullah

    2008-01-01

    We report two patients with velo−cardio−facial syndrome (VCFS) who were admitted to our pediatric endocrinology clinic because of short stature and followed longitudinally until attainment of final height. Both patients followed a growth pattern consistent with constitutional delay of puberty with normal and near normal final height. Case 2 also had partial growth hormone (GH) deficiency and severe short stature (height SDS −3.4 SDS), but showed spontaneous catch−up and ended up with a final height of −2 SDS. These cases suggest that short stature in children with VCFS is due to a pattern of growth similar to that observed in constitutional delay of growth and puberty. Conflict of interest:None declared. PMID:21318064

  7. The benefits and pitfalls of post-mortem computed tomography in forensic external examination: A retrospective study of 145 cases.

    PubMed

    Willaume, Thibault; Farrugia, Audrey; Kieffer, Estelle-Marie; Charton, Jeanne; Geraut, Annie; Berthelon, Laurent; Bierry, Guillaume; Raul, Jean-Sébastien

    2018-05-01

    Nowadays, post-mortem computed tomography (PMCT) has become an integral part of Forensic practice. The purpose of the study was to determine PMCT impact on diagnosis of the cause of death within the context of the external examination of the body, when autopsy has, at first, not been requested. We reviewed the records of 145 cases for which unenhanced PMCT was performed in addition to the external examination of the body from January 2014 to July 2015 at the Institute of Forensic medicine in Strasbourg (France). We confronted final reports from forensic pathologist to the corresponding PMCT reports. Data were collected in a contingency table and the impact of PMCT on the final conclusions of the forensic pathologist was evaluated via a Chi 2 test. PMCT results significantly impact the final conclusions of forensic pathologist (p<0,001). In some cases, PMCT permits etiological diagnosis by revealing a cause of death hidden from external examination (mainly natural death) or by supporting the clinical findings of the forensic pathologist. In other cases (traumatic death), PMCT enables fast and exhaustive lesion assessment. Lastly, there are situations where PMCT may be ineffective (intoxication, hanging or some natural deaths). Performing PMCT within the context of the external examination of the body when autopsy has, at first, not been requested could bring significant benefits in diagnosing the cause of death. The impact of PMCT varies depending on the circumstances of death. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Ocular infections caused by Scedosporium apiospermum: A case series.

    PubMed

    Ramakrishnan, Seema; Mandlik, Kunal; Sathe, Tejashree Sanket; Gubert, Joseph; Krishnan, Thiruvengada; Baskaran, Prabu

    2018-01-01

    The aim of our retrospective study is to report a case series of ocular infections caused by a rare fungus, Scedosporium apiospermum, in a South Indian population. Thirteen cases of culture-positive S. apiospermum infections diagnosed between January 2011 and March 2016 were included in this study. The parameters evaluated were predisposing factors, treatment and final clinical outcome. The most common mode of presentation was keratitis (84.6%) followed by sclerokeratitis (15.3%). The predisposing factors involved were unspecified foreign body injury (30.7%), organic matter injury (15.3%), uncontrolled diabetes (7.6%), and recent manual small-incision cataract surgery (7.6%). Five cases (38.46%) had no predisposing factor. Of the 11 keratitis cases, nine (69.2%) responded well to combination medical therapy while one case (7.6%) required therapeutic keratoplasty. One case was lost to follow-up. Both cases which presented with sclerokeratitis showed no response to medico-surgical treatment progressing to panophthalmitis and evisceration.

  9. The course of the buccal nerve: relationships with the temporalis muscle during the prenatal period

    PubMed Central

    MÉRIDA-VELASCO, J. R.; RODRÍGUEZ-VÁZQUEZ, J. F.; CUADRA, C.; MÉRIDA-VELASCO, J. A.; JIMÉNEZ-COLLADO, J.

    2001-01-01

    The aim of this study was to describe the course of the buccal nerve and its relationships with the temporalis muscle during the prenatal period. Serial sections of 90 human fetal specimens ranging from 9 to 17 wk development were studied by light microscopy. Each fetal specimen was studied on both right and left sides, making a total of 180 cases for study. A 3-D reconstruction of the region analysed in one of the specimens was made. In 89 cases the buccal nerve was located medial to the temporalis muscle; in 73 cases it penetrated the muscle; in 15 cases it lay in a canal formed by the muscle fibres and was covered by fascia, and finally, in 3 cases it was a branch of the inferior alveolar nerve. The study has revealed that in a large number of cases the buccal nerve maintains an intimate association with the temporalis muscle. PMID:11327204

  10. Windrow co-composting of natural casings waste with sheep manure and dead leaves.

    PubMed

    Makan, Abdelhadi

    2015-08-01

    After studying the waste management opportunities in small and medium companies of natural casings, composting has proved more viable and cost effective solution for the valorization of these types of waste, but its feasibility depends on the final product value. This paper investigated a pilot scale program for the windrow co-composting of natural casings waste with sheep manure and dead leaves incorporation. Processing, characterization and application of the final compost were described and the final compost was analyzed for pathogens, metals, nutrients, maturity, and agronomic parameters. The results showed that all test result levels were below the limits specified in the EPA regulations published in Title 40, Section 503, of the Code of Federal Regulations (40 CFR 503). Moreover, the agronomic value tests which include nutrients, organic matter, pH, electrical conductivity, etc. showed that the compost had high organic-matter content and low salt content, all of which indicate good compost characteristics. The ratio of nitrogen (N), phosphorus (P), and potassium (K), or NPK ratio, was measured at 1.6-0.9-0.7. Reported units are consistent with those found on fertilizer formulations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Variation between Hospitals with Regard to Diagnostic Practice, Coding Accuracy, and Case-Mix. A Retrospective Validation Study of Administrative Data versus Medical Records for Estimating 30-Day Mortality after Hip Fracture.

    PubMed

    Helgeland, Jon; Kristoffersen, Doris Tove; Skyrud, Katrine Damgaard; Lindman, Anja Schou

    2016-01-01

    The purpose of this study was to assess the validity of patient administrative data (PAS) for calculating 30-day mortality after hip fracture as a quality indicator, by a retrospective study of medical records. We used PAS data from all Norwegian hospitals (2005-2009), merged with vital status from the National Registry, to calculate 30-day case-mix adjusted mortality for each hospital (n = 51). We used stratified sampling to establish a representative sample of both hospitals and cases. The hospitals were stratified according to high, low and medium mortality of which 4, 3, and 5 hospitals were sampled, respectively. Within hospitals, cases were sampled stratified according to year of admission, age, length of stay, and vital 30-day status (alive/dead). The final study sample included 1043 cases from 11 hospitals. Clinical information was abstracted from the medical records. Diagnostic and clinical information from the medical records and PAS were used to define definite and probable hip fracture. We used logistic regression analysis in order to estimate systematic between-hospital variation in unmeasured confounding. Finally, to study the consequences of unmeasured confounding for identifying mortality outlier hospitals, a sensitivity analysis was performed. The estimated overall positive predictive value was 95.9% for definite and 99.7% for definite or probable hip fracture, with no statistically significant differences between hospitals. The standard deviation of the additional, systematic hospital bias in mortality estimates was 0.044 on the logistic scale. The effect of unmeasured confounding on outlier detection was small to moderate, noticeable only for large hospital volumes. This study showed that PAS data are adequate for identifying cases of hip fracture, and the effect of unmeasured case mix variation was small. In conclusion, PAS data are adequate for calculating 30-day mortality after hip-fracture as a quality indicator in Norway.

  12. Molecular investigations of β-thalassemic children in Erbil governorate

    NASA Astrophysics Data System (ADS)

    Hasan, Ahmad N.; Al-Attar, Mustafa S.

    2017-09-01

    The present work studies the molecular investigation of 40 thalassemic carriers using polymerase chain reaction. Forty thalassemic carriers who were registered and treated at Erbil thalassemic center and twenty apparently healthy children have been included in the present study. Ages of both groups ranged between 1-18 years. Four primers used to detect four different beta thalassemia mutations they were codon 8/9, codon 8, codon 41/42 and IVS-1-5. The two most common mutations detected among thalassemia group were Cd8/9 with 8 cases (20%) and Cd-8 with 6 cases (15%) followed by codon 41/42 with 4 cases (10%) which investigated and detected for the first time in Erbil governorate through the present study and finally IVS-1-5 with 3 cases (7.5%), while no any cases detected among control group.

  13. [Application of Ocular Trauma Score in Mechanical Ocular Injury in Forensic Medicine].

    PubMed

    Xiang, Jian; Guo, Zhao-ming; Wang, Xu; Yu, Li-li; Liu, Hui

    2015-10-01

    To evaluate the application value for the prognosis of mechanical ocular injury cases using ocular trauma score (OTS). Four hundred and eleven cases of mechanical ocular trauma were retrospectively reviewed. Of the 449 eyes, there were 317 closed globe injury and 132 open globe injury. OTS variables included numerical values as initial visual acuity, rupture, endophthalmitis, perforat- ing or penetrating injury, retinal detachment and relative afferent pupillary block. The differences be- tween the distribution of the final visual acuity and the probability of standard final visual acuity were compared to analyze the correlation between OTS category and final visual acuity. The different types of ocular trauma were compared. Compared with the distribution of final visual acuity in standard OTS score, the ratio in OTS-3 category was statistically different in present study, and no differences were found in other categories. Final visual acuity showed a great linear correlation with OTS category (r = 0.71) and total score (r = 0.73). Compared with closed globe injury, open globe injury was generally associated with lower total score and poorer prognosis. Rupture injury had poorer prognosis compared with penetrating injury. The use of OTS for the patients with ocular trauma can provide re- liable information for the evaluation of prognosis in forensic medicine.

  14. Evaluation of the role of incentive structure on student participation and performance in active learning strategies: A comparison of case-based and team-based learning.

    PubMed

    Carrasco, Gonzalo A; Behling, Kathryn C; Lopez, Osvaldo J

    2018-04-01

    Student participation is important for the success of active learning strategies, but participation is often linked to the level of preparation. At our institution, we use two types of active learning activities, a modified case-based learning exercise called active learning groups (ALG) and team-based learning (TBL). These strategies have different assessment and incentive structures for participation. Non-cognitive skills are assessed in ALG using a subjective five-point Likert scale. In TBL, assessment of individual student preparation is based on a multiple choice quiz conducted at the beginning of each session. We studied first-year medical student participation and performance in ALG and TBL as well as performance on course final examinations. Student performance in TBL, but not in ALG, was strongly correlated with final examination scores. Additionally, in students who performed in the upper 33rd percentile on the final examination, there was a positive correlation between final examination performance and participation in TBL and ALG. This correlation was not seen in students who performed in the lower 33rd percentile on the final examinations. Our results suggest that assessments of medical knowledge during active learning exercises could supplement non-cognitive assessments and could be good predictors of performance on summative examinations.

  15. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2010; minimum data set, version 3.0 for skilled nursing facilities and Medicaid nursing facilities. Final rule.

    PubMed

    2009-08-11

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2010. In addition, it recalibrates the case-mix indexes so that they more accurately reflect parity in expenditures related to the implementation of case-mix refinements in January 2006. It also discusses the results of our ongoing analysis of nursing home staff time measurement data collected in the Staff Time and Resource Intensity Verification project, as well as a new Resource Utilization Groups, version 4 case-mix classification model for FY 2011 that will use the updated Minimum Data Set 3.0 resident assessment for case-mix classification. In addition, this final rule discusses the public comments that we have received on these and other issues, including a possible requirement for the quarterly reporting of nursing home staffing data, as well as on applying the quality monitoring mechanism in place for all other SNF PPS facilities to rural swing-bed hospitals. Finally, this final rule revises the regulations to incorporate certain technical corrections.

  16. La Grande/Island City case study indirect land use and growth impacts of highway improvements : final report.

    DOT National Transportation Integrated Search

    2000-04-01

    To improve environmental analysis of indirect land use impacts of highway capacity improvements, this study analyzed the land use and growth patterns of 20 Oregon communities over 20 years. Using a Geographic Information System and aerial photos, gro...

  17. Effects of laparoscopic myotomy on the esophageal motility pattern of esophageal achalasia as measured by high-resolution manometry.

    PubMed

    Salvador, Renato; Savarino, Edoardo; Pesenti, Elisa; Spadotto, Lorenzo; Voltarel, Guerrino; Capovilla, Giovanni; Cavallin, Francesco; Nicoletti, Loredana; Valmasoni, Michele; Ruol, Alberto; Merigliano, Stefano; Costantini, Mario

    2017-09-01

    Esophageal achalasia can be classified on the grounds of three distinct manometric patterns that correlate well with final outcome after laparoscopic Heller-Dor myotomy (LHM). No analytical data are available, however, on the postoperative picture and its possible correlation with final outcome. The aims of this study were: (a) to investigate whether manometric patterns change after LHM for achalasia; (b) to ascertain whether postoperative patterns and/or changes can predict final outcome; and (c) to test the hypothesis that the three known patterns represent different stages in the evolution of the disease. During the study period, we prospectively enlisted 206 consecutive achalasia patients who were assessed using high-resolution manometry (HRM) before undergoing LHM. Symptoms were scored using a detailed questionnaire. Barium swallow, endoscopy and HRM were performed, before and again 6 months after surgery. Preoperative HRM revealed the three known patterns with statistically different esophageal diameters (pattern I having the largest), and patients with pattern I had the highest symptom scores. The surgical treatment failed in 10 cases (4.9%). The only predictor of final outcome was the preoperative manometric pattern (p = 0.01). All patients with pattern I preoperatively had the same pattern afterward, whereas nearly 50% of patients with pattern III before LHM had patterns I or II after surgery. There were no cases showing the opposite trend. Neither a change of manometric pattern after surgery nor a patient's postoperative pattern was a predictor of final outcome, whereas preoperative pattern confirmed its prognostic significance. The three manometric patterns distinguishable in achalasia may represent different stages in the disease's evolution, pattern III and pattern I coinciding with the early and final stages of the disease, respectively.

  18. Snoring intensity after a first session of soft palate radiofrequency: predictive value of the final result.

    PubMed

    Blumen, Marc Bernard; Vezina, Jean Philippe; Bequignon, Emilie; Chabolle, Frederic

    2013-06-01

    To determine whether snoring sound intensity measured after a first soft palate radiofrequency (RF) session for simple snoring helps predict the final result of the treatment. Observational retrospective study. We conducted a retrospective review of 105 subjects presenting with simple snoring or mild sleep apnea. All patients underwent two to three sessions of RF-assisted stiffening of the soft palate. In addition, uvulectomy was performed in case of a long uvula, and two paramedian trenches were created in the presence of palatal webbing. Snoring sound intensity was evaluated by the bed partner after each session. Eighty-six men and 19 women were included in the study. Mean age was 51.7 ± 9.8 years, and mean body mass index was 24.7 ± 4.4 kg/m(2) . The mean apnea/hypopnea index was 6.6 ± 4.2/h. The mean snoring sound intensity, as evaluated on a 10-cm visual analog scale (VAS), decreased from 8.2 ± 1.5 to 3.5 ± 2.2 after all sessions (P < .0001). A score of 3 was determined as being a score that satisfied the bed partner. Two groups were formed according to the final snoring sound intensity, using 3 as a threshold. Both groups had similar preoperative characteristics, but the snoring sound intensity was significantly lower after the first session in the group with final score <3 (P = .01). Similarly, a VAS score >7 after the first session was associated with a final score <3 in 30% of the cases. Snoring sound intensity after the first RF session helps predict the final outcome of RF-assisted stiffening of the soft palate for simple snoring. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

  19. The Power of a Question: A Case Study of Two Organizational Knowledge Capture Systems

    NASA Technical Reports Server (NTRS)

    Cooper, Lynn P.

    2003-01-01

    This document represents a presentation regarding organizational knowledge capture systems which was delivered at the HICSS-36 conference held from January 6-9, 2003. An exploratory case study of two knowledge resources is offered. Then, two organizational knowledge capture systems are briefly described: knowledge transfer from practitioner and the use of questions to represent knowledge. Finally, the creation of a database of peer review questions is suggested as a method of promoting organizational discussions and knowledge representation and exchange.

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

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

  1. Study of conformally flat polytropes with tilted congruence

    NASA Astrophysics Data System (ADS)

    Sharif, M.; Sadiq, Sobia

    This paper is aimed to study the modeling of spherically symmetric spacetime in the presence of anisotropic dissipative fluid configuration. This is accomplished for an observer moving relative to matter content using two cases of polytropic equation-of-state under conformally flat condition. We formulate the corresponding generalized Tolman-Oppenheimer-Volkoff equation, mass equation, as well as energy conditions for both cases. The conformally flat condition is imposed to find an expression for anisotropy which helps to study spherically symmetric polytropes. Finally, Tolman mass is used to analyze stability of the resulting models.

  2. Predicting performance with traffic analysis tools : final report.

    DOT National Transportation Integrated Search

    2008-03-01

    This document provides insights into the common pitfalls and challenges associated with use of traffic analysis tools for predicting future performance of a transportation facility. It provides five in-depth case studies that demonstrate common ways ...

  3. Transportation Management For Corridors And Activity Centers: Opportunities And Experiences, Final Report

    DOT National Transportation Integrated Search

    1986-05-01

    THIS REPORT CONSISTS OF TWO SECTIONS, TRANSPORTATION MANAGEMENT FOR CORRIDORS AND TRANSPORTATION MANAGEMENT FOR ACTIVITY CENTERS, THAT DESCRIBE TRANSPORTATION MANAGEMENT EXPERIENCES IN THE UNITED STATES. : CASE STUDIES ARE THE FOCUS OF EACH SECTIO...

  4. Case study: Lockheed-Georgia Company integrated design process

    NASA Technical Reports Server (NTRS)

    Waldrop, C. T.

    1980-01-01

    A case study of the development of an Integrated Design Process is presented. The approach taken in preparing for the development of an integrated design process includes some of the IPAD approaches such as developing a Design Process Model, cataloging Technical Program Elements (TPE's), and examining data characteristics and interfaces between contiguous TPE's. The implementation plan is based on an incremental development of capabilities over a period of time with each step directed toward, and consistent with, the final architecture of a total integrated system. Because of time schedules and different computer hardware, this system will not be the same as the final IPAD release; however, many IPAD concepts will no doubt prove applicable as the best approach. Full advantage will be taken of the IPAD development experience. A scenario that could be typical for many companies, even outside the aerospace industry, in developing an integrated design process for an IPAD-type environment is represented.

  5. [The changing spectrum of fever of unknown origin: trends and comparison with previous series at the Salvador Zubirán National Institute of Nutrition].

    PubMed

    Molina-Gamboa, J; Rivera-Morales, I; Camacho-Mezquita, E; Ponce-de-León, S

    1994-01-01

    We reviewed 400 medical records of patients admitted because of fever at the National Institute of Nutrition Salvador Zubirán between January 1, 1988 to December 31, 1992. Patient characteristics, diagnostic methods, final diagnosis and patient progress were analyzed, comparing these data with the previous series of the institute. We found 77 cases of fever of unknown origin (FUO), 47 males and 30 females, between 14 to 87 years of age. The final diagnosis encountered were: infections (40%), neoplasias (23%), collagen diseases (13%), and other diagnosis (8%). Sixteen percent of the cases remained without a final diagnosis. The most frequent infections were HIV infection (19%), tuberculosis (19%) and endocarditis (13%). The most common neoplasia was lymphoma (55.6%), with 90% of Hodgkin's disease. SLE was the most common autoimmune disease found. The methods to establish a final diagnosis were: biopsies (52%), serology (17%), cultures (12%), image (11%), and clinical (8%). Final diagnosis by serology tests increased from 2 to 17% in comparison with previous reports. Eight laparotomies were done, which is a less frequent practice than previously (10 vs 35%). We saw only one case of amebic hepatic abscess and had no cases of malaria and salmonellosis as final diagnosis of FUO; HIV infection was found to be a new major cause of FUO.

  6. Distance, Online and Campus Higher Education: Reflections on Learning Outcomes

    ERIC Educational Resources Information Center

    McPhee, Iain; Soderstrom, Tor

    2012-01-01

    Purpose: The purpose of this paper is to discuss performance in postgraduate education in Sweden and Scotland. Drawing on two cases, the paper considers three themes: differences in students' performance by study mode, differences in students' performance by length of study, and finally comparing performance by study mode between modules in…

  7. 77 FR 38282 - Final Test Guidelines; OCSPP 850 Series; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... conditions. EPA is changing the title of OPPTS 850.4450 ``Aquatic Plants Field Study, Tier III'' test....4300 ``Terrestrial Plants Field Study, Tier III'' test guideline. Public Draft OPPTS 850.4025 ``Target..., OCSPP 850.4300 ``Terrestrial Plants Field Study.'' The target area test guideline covers a special case...

  8. E-Mentoring for Professional Development of Pre-Service Teachers: A Case Study

    ERIC Educational Resources Information Center

    Kahraman, Mehmet; Kuzu, Abdullah

    2016-01-01

    This study focused on supporting the professional development of information technologies pre-service teachers with e-mentoring approach. The e-mentoring program was conducted in four basic phases; preparation, matching, interaction and finalizing. In the study, the data were collected via researcher journals, semi-structured interviews held with…

  9. Endoscopy and histopathology in the examination of the nasal cavity in dogs.

    PubMed

    Sapierzyński, R; Zmudzka, M

    2009-01-01

    Nasal diseases of chronic nature are a common clinical complaint in canine practice. However, precise diagnosis in these cases is often difficult and require the use of various, additional diagnostic methods. The aim of this study was to estimate the occurrence of diseases of the upper respiratory tracts in dogs, and to evaluate the usefulness of endoscopy in the diagnostic process as a method of obtaining a final diagnosis. In the group of dogs in which rhinoscopy was performed, the most common final diagnoses were nonspecific chronic rhinitis, followed by neoplasms and infectious rhinitis. It can be concluded that rhinoscopy should be considered mainly as a preliminary method of inspection of the nasal cavity, helpful in obtaining the most representative tissue specimen/specimens for histopathology. In some cases, especially foreign objects and congenital abnormalities rhinoscopy can give the possibility of obtaining a final diagnosis. However, even in these situations and also when any macroscopic lesion is found during endoscopy, microscopic examination of the mucosa specimen should be performed.

  10. Shuttle Case Study Collection Website Development

    NASA Technical Reports Server (NTRS)

    Ransom, Khadijah S.; Johnson, Grace K.

    2012-01-01

    As a continuation from summer 2012, the Shuttle Case Study Collection has been developed using lessons learned documented by NASA engineers, analysts, and contractors. Decades of information related to processing and launching the Space Shuttle is gathered into a single database to provide educators with an alternative means to teach real-world engineering processes. The goal is to provide additional engineering materials that enhance critical thinking, decision making, and problem solving skills. During this second phase of the project, the Shuttle Case Study Collection website was developed. Extensive HTML coding to link downloadable documents, videos, and images was required, as was training to learn NASA's Content Management System (CMS) for website design. As the final stage of the collection development, the website is designed to allow for distribution of information to the public as well as for case study report submissions from other educators online.

  11. Radiotherapy quality assurance report from children's oncology group AHOD0031

    PubMed Central

    Dharmarajan, Kavita V.; Friedman, Debra L.; FitzGerald, T.J.; McCarten, Kathleen M.; Constine, Louis S.; Chen, Lu; Kessel, Sandy K.; Iandoli, Matt; Laurie, Fran; Schwartz, Cindy L.; Wolden, Suzanne L.

    2016-01-01

    Purpose A phase III trial assessing response-based therapy in intermediate-risk Hodgkin lymphoma, mandated real-time central review of involved field radiotherapy and imaging records by a centralized review center to maximize protocol compliance. We report the impact of centralized radiotherapy review upon protocol compliance. Methods Review of simulation films, port films, and dosimetry records was required pre-treatment and after treatment completion. Records were reviewed by study-affiliated or review center-affiliated radiation oncologists. A 6–10% deviation from protocol-specified dose was scored as “minor”; >10% was “major”. A volume deviation was scored as “minor” if margins were less than specified, or “major” if fields transected disease-bearing areas. Interventional review and final compliance review scores were assigned to each radiotherapy case and compared. Results Of 1712 patients enrolled, 1173 underwent IFRT at 256 institutions in 7 countries. An interventional review was performed in 88% and a final review in 98%. Overall, minor and major deviations were found in 12% and 6%, respectively. Among the cases for which ≥ 1 pre-IFRT modification was requested by QARC and subsequently made by the treating institution, 100% were made compliant on final review. In contrast, among the cases for which ≥ 1 modification was requested but not made by the treating institution, 10% were deemed compliant on final review. Conclusion In a large trial with complex treatment pathways and heterogeneous radiotherapy fields, central review was performed in a large percentage of cases pre-IFRT and identified frequent potential deviations in a timely manner. When suggested modifications were performed by the institutions, deviations were almost eliminated. PMID:25670539

  12. 75 FR 38687 - Federal Acquisition Regulation; FAR Case 2008-023, Clarification of Criteria for Sole Source...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... a sole source SDVOSB concern acquisition. The final rule contains language that more closely mirrors...-AL29 Federal Acquisition Regulation; FAR Case 2008-023, Clarification of Criteria for Sole Source...: Final rule. SUMMARY: The Civilian Agency Acquisition Council and the Defense Acquisition Regulations...

  13. Case Closure Procedures for Foreign Military Sales

    DTIC Science & Technology

    1990-04-05

    This is our final report on the Audit of Case Closure Procedures for Foreign Military Sales for your information and use. Comments on a draft of this...report were considered in preparing the final report. We made the audit from January through August 1989. The objectives of the audit were to

  14. A Case Study of Self-Affirmations in Teacher Education

    ERIC Educational Resources Information Center

    Robinson, Scott

    2014-01-01

    This qualitative study reports on what was learned from two former teacher candidates, who engaged in self-affirmation writing exercises in an education seminar during their final semester in a teacher education program. Self-affirmations, as presented here, are brief psychological interventions designed to enhance the self-integrity of teacher…

  15. A Case Study of Classroom Podcast in Ohlone Community College

    ERIC Educational Resources Information Center

    Pham, Jim

    2010-01-01

    This study examined students' use of podcasting and related personal entertainment technologies for learning (the frequency of classroom podcast usage) The effectiveness of podcasting was measured by students' achievement on the course midterm and final examinations. A quasi-experimental design was used. Two intact groups (classroom instruction…

  16. Multimodal Representations in Senior Biology Assessments: A Case Study of NSW Australia

    ERIC Educational Resources Information Center

    Van Rooy, Wilhelmina Sabina; Chan, Eveline

    2017-01-01

    This paper investigates the use of multimodal representations to assess biological understanding in the final senior secondary school public examination in New South Wales, Australia. The investigation emanates from a larger Australian study concerned with the impact of disciplinary and technological innovations on science pedagogy, particularly…

  17. How small is small enough? Role of robotics in paediatric urology

    PubMed Central

    Ganpule, Arvind P.; Sripathi, Venkat

    2015-01-01

    The well-known advantages of robotic surgery include improved dexterity, three-dimensional operating view and an improved degree of freedom. Robotic surgery is performed for a wide range of surgeries in urology, which include radical prostatectomy, radical cystectomy, and ureteric reimplantation. Robotic paediatric urology is evolving. The major hindrance in the development of paediatric robotics is, first, the differences in practice patterns in paediatric urology compared with adult urology thereby making development of expertise difficult and secondly it is challenging to conduct proper studies in the paediatric population because of the paucity of cases. The difficulties in conducting these studies include difficulty in designing a proper randomised study, difficulties with blinding, and finally, the ethical issues involved, finally the instruments although in the phase of evolution require a lot of improvement. In this article, we review the relevant articles for paediatric robotic surgery. We emphasise on the technical aspects and results in contemporary paediatric robotic case series. PMID:25598599

  18. How small is small enough? Role of robotics in paediatric urology.

    PubMed

    Ganpule, Arvind P; Sripathi, Venkat

    2015-01-01

    The well-known advantages of robotic surgery include improved dexterity, three-dimensional operating view and an improved degree of freedom. Robotic surgery is performed for a wide range of surgeries in urology, which include radical prostatectomy, radical cystectomy, and ureteric reimplantation. Robotic paediatric urology is evolving. The major hindrance in the development of paediatric robotics is, first, the differences in practice patterns in paediatric urology compared with adult urology thereby making development of expertise difficult and secondly it is challenging to conduct proper studies in the paediatric population because of the paucity of cases. The difficulties in conducting these studies include difficulty in designing a proper randomised study, difficulties with blinding, and finally, the ethical issues involved, finally the instruments although in the phase of evolution require a lot of improvement. In this article, we review the relevant articles for paediatric robotic surgery. We emphasise on the technical aspects and results in contemporary paediatric robotic case series.

  19. Hydrodynamic cavitation for sonochemical effects.

    PubMed

    Moholkar, V S; Kumar, P S; Pandit, A B

    1999-03-01

    A comparative study of hydrodynamic and acoustic cavitation has been made on the basis of numerical solutions of the Rayleigh-Plesset equation. The bubble/cavity behaviour has been studied under both acoustic and hydrodynamic cavitation conditions. The effect of varying pressure fields on the collapse of the cavity (sinusoidal for acoustic and linear for hydrodynamic) and also on the latter's dynamic behaviour has been studied. The variations of parameters such as initial cavity size, intensity of the acoustic field and irradiation frequency in the case of acoustic cavitation, and initial cavity size, final recovery pressure and time for pressure recovery in the case of hydrodynamic cavitation, have been found to have significant effects on cavity/bubble dynamics. The simulations reveal that the bubble/cavity collapsing behaviour in the case of hydrodynamic cavitation is accompanied by a large number of pressure pulses of relatively smaller magnitude, compared with just one or two pulses under acoustic cavitation. It has been shown that hydrodynamic cavitation offers greater control over operating parameters and the resultant cavitation intensity. Finally, a brief summary of the experimental results on the oxidation of aqueous KI solution with a hydrodynamic cavitation set-up is given which supports the conclusion of this numerical study. The methodology presented allows one to manipulate and optimise of specific process, either physical or chemical.

  20. Psychological stress and burnout in medical students: a five-year prospective longitudinal study.

    PubMed

    Guthrie, E; Black, D; Bagalkote, H; Shaw, C; Campbell, M; Creed, F

    1998-05-01

    The aim of this study was to assess psychological morbidity and symptoms of burnout in medical students during their undergraduate training, and to identify baseline factors that predict psychological morbidity in students in the final year of the course. It was a 5-year prospective longitudinal cohort study. Students were assessed in years 1, 4 and 5 of their medical undergraduate training by means of the GHQ-12 and the Maslach Burnout Inventory. 172 (84.3%), 157 (77.0%) and 155 (75.9%) students out of an original group of 204 completed assessments in years 1, 4 and 5, respectively. 18 students were above threshold on the GHQ-12 on all three occasions, 25 on two occasions and 43 on one occasion; 69 students were never a 'case'. Students who were cases on two or more occasions were more likely to find the medical course stressful during the first year, but not subsequent years. There was no significant difference between the percentages of men and women who scored as cases on the GHQ-12 in any of the years. The best predictor of psychological morbidity in the final year of the course was the GHQ-12 score in year 1. This study suggests that a small group of students repeatedly experience psychological distress during their medical training.

  1. Risk factors for death from canine parvoviral-related disease in Australia.

    PubMed

    Ling, Monika; Norris, Jacqueline M; Kelman, Mark; Ward, Michael P

    2012-08-17

    Canine parvovirus (CPV) is a highly contagious cause of serious and often fatal disease in dogs worldwide despite the availability of safe and efficacious vaccines. Although a number of studies have focussed on identifying risk factors in disease development, risk factors associated with death from CPV are largely unknown. In this study we analysed a total of 1451 CPV cases reported from an Australian surveillance system - using univariate and multivariate techniques - to determine significant risk factors associated with death and euthanasia. A crude case fatality rate of 42.3% was estimated - higher than has been reported previously. We found that 3.3% of CPV cases had a history of vaccination in the previous 12 months, despite having completed the primary puppy vaccination course. The majority (89.5%) of these cases occurred in dogs <12 months of age, indicating failure of the primary vaccination course to provide protective immunity (most likely due to interference of the vaccine antigen with maternal antibodies but other reasons are discussed). Extending the age at which the final puppy vaccination is administered might be one of several strategies to consider. The final multivariate model showed that in non-litter CPV cases, risk of death was significantly associated with season of diagnosis (summer) and pedigree type (hounds and non-sporting dogs). Euthanasia in non-litter CPV cases was significantly associated with season of diagnosis (summer), state of residence (Northern Territory/South Australia/Tasmania combined), age (

  2. Investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with Clostridium difficile infection.

    PubMed

    Chung, Philip; Currie, Brian; Guo, Yi; Talansky, Moshe; Brown, Shakara; Ostrowsky, Belinda

    2014-10-01

    Antimicrobial exposure remains an important risk factor for developing Clostridium difficile infection (CDI). Efficient method to identify antibiotics associated with CDI is important for formulating strategies to curtail their use. As a prelude to a more extensive Agency for Healthcare Research and Quality-funded project (Evaluation & Research on Antimicrobial Stewardship's Effect on Clostridium difficile), we undertook an exploratory evaluation to determine a resource-efficient method for identifying antibiotic targets for antimicrobial stewardship interventions. The study compared a series of 6 focused case-control studies. Cases consisted of patients with laboratory-confirmed CDI admitted from July-October 2009. Controls were selected from patients without CDI hospitalized during the same period. Five groups of controls were matched to cases (2:1 ratio) using group-specific matching criteria, including admission date, age, type of admission, length of stay (LOS) to discharge, and/or LOS to CDI diagnosis. The final control group was selected from patients who received antibiotics during hospitalization. Data, including demographics and antibiotic usage, were compared between case and control groups. A total of 126 cases were matched to 6 groups of 252 controls. For control groups 1-5, the use of piperacillin and tazobactam, ceftriaxone or cefepime, ciprofloxacin or moxifloxacin, intravenous vancomycin, azithromycin, and antibiotics of last resort were significantly more frequent in case than control patients. For the final control group, the associations between ceftriaxone or cefepime, and ciprofloxacin or moxifloxacin use and CDI no longer persisted. This could in part be explained by differences in comorbidities between case and control patients even with stringent matching criteria. Use of a simple matching strategy to conduct case-control studies is an efficient and feasible compromise strategy, especially in resource-limited settings, to identify high-risk antibiotics associated with CDI. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Nagy-Soper subtraction scheme for multiparton final states

    NASA Astrophysics Data System (ADS)

    Chung, Cheng-Han; Robens, Tania

    2013-04-01

    In this work, we present the extension of an alternative subtraction scheme for next-to-leading order QCD calculations to the case of an arbitrary number of massless final state partons. The scheme is based on the splitting kernels of an improved parton shower and comes with a reduced number of final state momentum mappings. While a previous publication including the setup of the scheme has been restricted to cases with maximally two massless partons in the final state, we here provide the final state real emission and integrated subtraction terms for processes with any number of massless partons. We apply our scheme to three jet production at lepton colliders at next-to-leading order and present results for the differential C parameter distribution.

  4. Indirect supportive evidence for diagnosis of tuberculosis-related uveitis: from the tuberculin skin test to the new interferon gamma release assays.

    PubMed

    Llorenç, Víctor; González-Martin, Julian; Keller, Johannes; Rey, Amanda; Pelegrín, Laura; Mesquida, Marina; Adán, Alfredo

    2013-03-01

    To evaluate clinical and paraclinical parameters for the indirect diagnosis of tuberculosis-related uveitis (TRU). Prospective 2-year study in a tertiary referral centre. Patients with clinically suspected TRU were recruited. Demographical and clinical data were recorded. QuantiFERON(®) -TB Gold (QFT), tuberculosis skin test (TST) and pulmonary X-ray were performed, and other possible uveitis aetiologies were ruled out. Further investigations were also performed case by case after consultation. After final assessment, standard antituberculosis therapy was started if TRU was considered highly probable. Finally, diagnosis of TRU was established according to current criteria and set as gold standard. Strength of association for TRU was determined by odds ratio and compared by appropriate tests. Concordance and binary classification tests were also assessed.   The study included 103 patients, 54 men and 49 women. Mean age 45.6 years. Sixty-eight patients were Spanish-born and 35 were foreign-born. Final diagnosis included 33 (32%) cases of TRU and 70 (67%) cases with other diagnoses. Asian origin (OR = 3.50, p = 0.046), previous tuberculosis (TB) contact (OR = 2.61, p = 0.026), TB in the past (OR = 6.18, p = 0.004) and associated retinal vasculitis (OR = 7.85, p < 0.001) were significantly related to TRU. Sensitivity (S) and specificity (Sp) of the TST and QFT did not differ significantly (S 87% versus 90% and Sp 85% versus 82%, respectively) with fair agreement (k = 0.607). In a Western urban multi-ethnic population, patients from Asia, TB history or contact in the past and vasculitis are at higher risk of TRU. TST and QF are complementary providing enough S and Sp to support the diagnosis. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  5. Abdominal pain in adult sickle cell disease patients: a nigerian experience.

    PubMed

    Akingbola, T S; Kolude, B; Aneni, E C; Raji, A A; Iwara, K U; Aken'Ova, Y A; Soyannwo, O A

    2011-12-01

    Abdominal pain is a relatively frequent occurrence in sickle cell disease. The aetiology of abdominal pain in sickle cell disease is often difficult to diagnose clinically. Despite the frequent occurrence, diagnostic dilemma, and the need for an accurate, early diagnosis, abdominal pain in sickle cell disease has not been rigorously studied. We therefore sought to describe the different presentations and patterns of abdominal pain in persons with sickle cell disease. A prospective case series of 20 patients was done in which data was collected on demographic characteristics, hemoglobin electrophoresis patterns, a description of the abdominal pain including sites, severity, and type of pain, packed cell volume and the provisional and final diagnosis. Haemoglobin S patients were 17 in number constituting eightyfive percent (85%) of our study population whilst the rest 3 were Hb S+C. Most patients (70%) had one site of abdominal pain. The pain was mainly colicky or tightening, moderate to severe in nature and, in some cases, associated with vomiting. We did not find any significant difference between the steady state PCV and the PCV during the acute abdominal pain episodes. The final diagnosis showed that only 38.8% of the patients had vasoocclusive crises and the reliability index between the provisional diagnosis and the final diagnosis was 67%. Abdominal pain in sickle cell disease may present in different ways and it is important to recognize that the possible diagnoses are numerous. Not all cases are due to vasoocclusive crises. Early diagnosis and prompt treatment can be life saving.

  6. Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    PubMed

    2017-11-07

    This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

  7. Phrase-Final Words in Greek Storytelling Speech: A Study on the Effect of a Culturally-Specific Prosodic Feature on Short-Term Memory.

    PubMed

    Loutrari, Ariadne; Tselekidou, Freideriki; Proios, Hariklia

    2018-02-27

    Prosodic patterns of speech appear to make a critical contribution to memory-related processing. We considered the case of a previously unexplored prosodic feature of Greek storytelling and its effect on free recall in thirty typically developing children between the ages of 10 and 12 years, using short ecologically valid auditory stimuli. The combination of a falling pitch contour and, more notably, extensive final-syllable vowel lengthening, which gives rise to the prosodic feature in question, led to statistically significantly higher performance in comparison to neutral phrase-final prosody. Number of syllables in target words did not reveal substantial difference in performance. The current study presents a previously undocumented culturally-specific prosodic pattern and its effect on short-term memory.

  8. Reversible grasp reflexes in normal pressure hydrocephalus.

    PubMed

    Thomas, Rhys H; Bennetto, Luke; Silva, Mark T

    2009-05-01

    We present two cases of normal pressure hydrocephalus in combination with grasp reflexes. In both cases the grasp reflexes disappeared following high volume cerebrospinal fluid removal. In one of the cases the grasp reflexes returned over a period of weeks but again resolved following definitive cerebrospinal fluid shunting surgery, and remained absent until final follow up at 9 months. We hypothesise that resolving grasp reflexes following high volume CSF removal has both diagnostic and prognostic value in normal pressure hydrocephalus, encouraging larger studies on the relevance of primitive reflexes in NPH.

  9. Disk MHD generator study

    NASA Technical Reports Server (NTRS)

    Retallick, F. D.

    1980-01-01

    Directly-fired, separately-fired, and oxygen-augmented MHD power plants incorporating a disk geometry for the MHD generator were studied. The base parameters defined for four near-optimum-performance MHD steam power systems of various types are presented. The finally selected systems consisted of (1) two directly fired cases, one at 1920 K (2996F) preheat and the other at 1650 K (2500 F) preheat, (2) a separately-fired case where the air is preheated to the same level as the higher temperature directly-fired cases, and (3) an oxygen augmented case with the same generator inlet temperature of 2839 (4650F) as the high temperature directly-fired and separately-fired cases. Supersonic Mach numbers at the generator inlet, gas inlet swirl, and constant Hall field operation were specified based on disk generator optimization. System pressures were based on optimization of MHD net power. Supercritical reheat stream plants were used in all cases. Open and closed cycle component costs are summarized and compared.

  10. Today's Urban University Students: Part 2. A Case Study of Hunter College. Final Report on the Urban University Study.

    ERIC Educational Resources Information Center

    Davila, Evelyn M.

    Characteristics and needs of Hunter College students were studied during 1981-1983. The college's use of institutional research to accommodate an increasingly nontraditional student body was also assessed. Attention was directed to: the student population's ethnicity, income, and employment; students' academic experiences; times of day most…

  11. Service Quality of State Universities in Turkey: The Case of Ankara

    ERIC Educational Resources Information Center

    Eres, Figen

    2011-01-01

    The aim of this study is determine the service quality perceptions of students being educated at state universities in Ankara. The sample of the study is composed of final grade students of faculties of Economics and Administrative Sciences. The sample of the study is composed of a total of randomly selected students. There were 416 returned…

  12. Desegregation Case Studies. Volume I: Final Report.

    ERIC Educational Resources Information Center

    Russell, Susan Higley; And Others

    This study focused on the role played in school desegregation by the Emergency School Aid Act (ESAA), Title IV of the Civil Rights Act, and Office of Civil Rights (OCR) enforcement of Title IV. The study examined the ways in which five urban school districts made use of assistance programs and have been affected by Title IV. School district…

  13. Active case-finding for tuberculosis by mobile teams in Myanmar: yield and treatment outcomes.

    PubMed

    Myint, Ohnmar; Saw, Saw; Isaakidis, Petros; Khogali, Mohammed; Reid, Anthony; Hoa, Nguyen Binh; Kyaw, Thi Thi; Zaw, Ko Ko; Khaing, Tin Mi Mi; Aung, Si Thu

    2017-06-02

    Since 2005, the Myanmar National Tuberculosis Programme (NTP) has been implementing active case finding (ACF) activities involving mobile teams in hard-to-reach areas. This study revealed the contribution of mobile team activities to total tuberculosis (TB) case detection, characteristics of TB patients detected by mobile teams and their treatment outcomes. This was a descriptive study using routine programme data between October 2014 and December 2014. Mobile team activities were a one-stop service and included portable digital chest radiography (CXR) and microscopy of two sputum samples. The algorithm of the case detection included screening patients by symptoms, then by CXR followed by sputum microscopy for confirmation. Diagnosed patients were started on treatment and followed until a final outcome was ascertained. A total of 9 349 people with symptoms suggestive of TB were screened by CXR, with an uptake of 96.6%. Of those who were meant to undergo sputum smear microscopy, 51.4% had sputum examinations. Finally, 504 TB patients were identified by the mobile teams and the overall contribution to total TB case detection in the respective townships was 25.3%. Among total cases examined by microscopy, 6.4% were sputum smear positive TB. Treatment success rate was high as 91.8% in study townships compared to national rate 85% (2014 cohort). This study confirmed the feasibility and acceptability of ACF by mobile teams in hard-to-reach contexts, especially when equipped with portable, digital CXR machines that provided immediate results. However, the follow-up process of sputum examination created a significant barrier to confirmation of the diagnosis. In order to optimize the ACF through mobile team activity, future ACF activities were needed to be strengthened one stop service including molecular diagnostics or provision of sputum cups to all presumptive TB cases prior to CXR and testing if CXR suggestive of TB.

  14. Needs, barriers, and analysis methods for integrated urban freight transportation : final report.

    DOT National Transportation Integrated Search

    2015-08-01

    In this joint project University of Maryland, West Virginia University, and Morgan State University worked together to : solve critical problems associated with urban freight systems. A review of literature and case studies on freight : villages and ...

  15. Treatment effect, postoperative complications, and their reasons in juvenile thoracic and lumbar spinal tuberculosis surgery.

    PubMed

    He, Qing-Yi; Xu, Jian-Zhong; Zhou, Qiang; Luo, Fei; Hou, Tianyong; Zhang, Zehua

    2015-10-01

    Fifty-four juvenile cases under 18 years of age with thoracic and lumbar spinal tuberculosis underwent focus debridement, deformity correction, bone graft fusion, and internal fixation. The treatment effects, complications, and reasons were analyzed retrospectively. There were 54 juvenile cases under 18 years of age with thoracolumbar spinal tuberculosis. The average age was 9.2 years old, and the sample comprised 38 males and 16 females. The disease types included 28 thoracic cases, 17 thoracolumbar cases, and 9 lumbar cases. Nerve function was evaluated with the Frankel classification. Thirty-six cases were performed with focus debridement and deformity correction and were supported with allograft or autograft in mesh and fixed with pedicle screws from a posterior approach. Eight cases underwent a combined anterior and posterior surgical approach. Nine cases underwent osteotomy and deformity correction, and one case received focus debridement. The treatment effects, complications, and bone fusions were tracked for an average of 52 months. According to the Frankel classification, paralysis was improved from 3 cases of B, 8 cases of C, 18 cases of D, and 25 cases of E preoperatively. This improvement was found in 3 cases of C, 6 cases of D, and 45 cases of E at a final follow-up postoperatively. No nerve dysfunction was aggravated. VAS was improved from 7.8 ± 1.7 preoperatively to 3.2 ± 2.1 at final follow-up postoperatively. ODI was improved from 77.5 ± 17.3 preoperatively to 28.4 ± 15.9 at final follow-up postoperatively. Kyphosis Cobb angle improved from 62.2° ± 3.7° preoperatively to 37° ± 2.4° at final follow-up postoperatively. Both of these are significant improvements, and all bone grafts were fused. Complications related to the operation occurred in 31.5% (17/54) of cases. Six cases suffered postoperative aggravated kyphosis deformity, eight cases suffered proximal kyphosis deformity, one case suffered pedicle penetration, one case suffered failure of internal devices, and one case suffered recurrence of tuberculosis. As long as the treatment plan is fully prepared, the surgical option can achieve a satisfactory curative effect in treating juvenile spinal tuberculosis despite some complications.

  16. Case management lessons from a public/private partnership to finance long-term care.

    PubMed

    Mahoney, K

    1992-01-01

    In June of 1987, Connecticut's State Task Force on Private and Public Responsibilities for Financing Long-Term Care for the Elderly released its final report. This Governor's Commission, concluding that neither the private nor the public sector had much short-term hope of solving this difficult problem alone, recommended the creation of a public/private partnership. As this partnership was forged, some unique insights were gained into the functions of case management. This case study shows how case management can help coordinate the private and public roles, but it also raises some research questions which must be tackled before case management can fulfill its promise to help stretch and conserve scarce resources.

  17. Ocular infections caused by Scedosporium apiospermum: A case series

    PubMed Central

    Ramakrishnan, Seema; Mandlik, Kunal; Sathe, Tejashree Sanket; Gubert, Joseph; Krishnan, Thiruvengada; Baskaran, Prabu

    2018-01-01

    The aim of our retrospective study is to report a case series of ocular infections caused by a rare fungus, Scedosporium apiospermum, in a South Indian population. Thirteen cases of culture-positive S. apiospermum infections diagnosed between January 2011 and March 2016 were included in this study. The parameters evaluated were predisposing factors, treatment and final clinical outcome. The most common mode of presentation was keratitis (84.6%) followed by sclerokeratitis (15.3%). The predisposing factors involved were unspecified foreign body injury (30.7%), organic matter injury (15.3%), uncontrolled diabetes (7.6%), and recent manual small-incision cataract surgery (7.6%). Five cases (38.46%) had no predisposing factor. Of the 11 keratitis cases, nine (69.2%) responded well to combination medical therapy while one case (7.6%) required therapeutic keratoplasty. One case was lost to follow-up. Both cases which presented with sclerokeratitis showed no response to medico-surgical treatment progressing to panophthalmitis and evisceration. PMID:29283143

  18. 19 CFR 12.9 - Release for final delivery to consignee.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...; DEPARTMENT OF THE TREASURY SPECIAL CLASSES OF MERCHANDISE Meat and Meat-Food Products § 12.9 Release for final delivery to consignee. No meat, meat-food products, or animal casings shall be released for final...

  19. 19 CFR 12.9 - Release for final delivery to consignee.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...; DEPARTMENT OF THE TREASURY SPECIAL CLASSES OF MERCHANDISE Meat and Meat-Food Products § 12.9 Release for final delivery to consignee. No meat, meat-food products, or animal casings shall be released for final...

  20. Awakening Sleepy Knowledge: Transformative Learning in Action. Final Report of the Transformative Learning through Environmental Action Project.

    ERIC Educational Resources Information Center

    York Univ., Toronto (Ontario).

    This document summarizes and presents materials produced during a qualitative international study of the role of transformative learning in achieving sustainable societies and global responsibility that included the following activities: case studies of experiences with transformative learning in seven countries; international survey and workshop;…

  1. Studies in Public Library Government, Organization, and Support. Final Report.

    ERIC Educational Resources Information Center

    Garrison, Guy

    This report consists of six individual reports that were done by staff members at the Library Research Center as part of the overall project. In Part I, "Financing Public Library Expansion: Case Studies of Three Defeated Bond Issue Referendums," Ruth G. Lindahl and William S. Berner analyze defeated library bond issue referendums in…

  2. A Research on Future Mathematics Teachers' Instructional Explanations: The case of Algebra

    ERIC Educational Resources Information Center

    Guler, Mustafa; Celik, Derya

    2016-01-01

    In this study, explanations of future mathematics teachers about algebra were analysed according to the levels of understanding used by Kinach (2002). The participants for the study were 101 teacher candidates attending the final semester of a teacher training program. For data collection, a form containing four scenario-type items were…

  3. Optimal Control for Quantum Driving of Two-Level Systems

    NASA Astrophysics Data System (ADS)

    Qi, Xiao-Qiu

    2018-01-01

    In this paper, the optimal quantum control of two-level systems is studied by the decompositions of SU(2). Using the Pontryagin maximum principle, the minimum time of quantum control is analyzed in detail. The solution scheme of the optimal control function is given in the general case. Finally, two specific cases, which can be applied in many quantum systems, are used to illustrate the scheme, while the corresponding optimal control functions are obtained.

  4. Enhancing work outcome for three persons with traumatic brain injury.

    PubMed

    Target, P; Wehman, P; Petersen, R; Gorton, S

    1998-03-01

    A case study approach is used to illustrate how three survivors of severe traumatic brain injury were able to gain and maintain employment with the assistance of a supported employment programme. Emphasis on the different types of accommodations, including the design and implementation of compensatory strategies, is provided for each case. Finally, on overview of steps that can be taken to enhance the use of such strategies on the job is presented.

  5. Neonatal seizures in a rural Iranian district hospital: etiologies, incidence and predicting factors.

    PubMed

    Sadeghian, Afsaneh; Damghanian, Maryam; Shariati, Mohammad

    2012-01-01

    Current study determined the overall incidence, common causes as well as main predictors of this final diagnosis among neonates admitted to a rural district hospital in Iran. This study was conducted on 699 neonates who were candidate for admission to the NICU. Study population was categorized in the case group, including patients exposed to final diagnosis of neonatal seizures and the control group without this diagnosis. Neonatal seizure was reported as final diagnosis in 25 (3.6%) of neonates. The most frequent discharge diagnosis in the seizure group was neonatal sepsis and in the non-seizure group was respiratory problems. No significant difference was found in early fatality rate between neonates with and without seizures (8.0% vs. 10.1%). Only gestational age <38 week had a relationship with the appearance of neonatal seizure. Low gestational age has a crucial role for predicting appearance of seizure in Iranian neonates.

  6. Life cycle assessment of European pilchard (Sardina pilchardus) consumption. A case study for Galicia (NW Spain).

    PubMed

    Vázquez-Rowe, Ian; Villanueva-Rey, Pedro; Hospido, Almudena; Moreira, María Teresa; Feijoo, Gumersindo

    2014-03-15

    European pilchard or sardines (Sardina pilchardus) are an attractive raw material to extract from Iberian waters, since they constitute a cheap source of protein and they are a popular product among consumers. This has led to a wide range of final products available for consumers to purchase based on this single raw material. Therefore, this study presents a cross-product environmental assessment using life cycle assessment of three different final products based on sardine landings: canned sardines, fresh sardines and European hake caught by using sardine as bait. In addition, the products were followed throughout their entire life cycle, considering different cooking methods for each final product. Results showed high variability in environmental impacts, not only between the three final products, but also when one single product was cooked in different ways, highlighting the importance that the consumption phase and other post-landing stages may have on the final environmental profile of seafood. Results are then analysed regarding relevant limitations and uncertainties, as well as in terms of the consumer and policy implications. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. 77 FR 50855 - Oil and Gas and Sulphur Operations on the Outer Continental Shelf-Increased Safety Measures for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-22

    ... according to the design. The third- subsea function and pressure tests party verification must include...; Requires new casing and cementing integrity tests; Establishes new requirements for subsea secondary BOP... that, for the final casing string (or liner if it is the final string), an operator must install one...

  8. 76 FR 57017 - Certain Cased Pencils From the People's Republic of China: Notice of Court Decision Not in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-15

    ... the People's Republic of China: Notice of Court Decision Not in Harmony With Final Results of... Republic of China covering the period of review (``POR'') of December 1, 2006, through November 30, 2007 with respect to Rongxin. See Certain Cased Pencils from the People's Republic of China: Final Results...

  9. Search engine as a diagnostic tool in difficult immunological and allergologic cases: is Google useful?

    PubMed

    Lombardi, C; Griffiths, E; McLeod, B; Caviglia, A; Penagos, M

    2009-07-01

    Web search engines are an important tool in communication and diffusion of knowledge. Among these, Google appears to be the most popular one: in August 2008, it accounted for 87% of all web searches in the UK, compared with Yahoo's 3.3%. Google's value as a diagnostic guide in general medicine was recently reported. The aim of this comparative cross-sectional study was to evaluate whether searching Google with disease-related terms was effective in the identification and diagnosis of complex immunological and allergic cases. Forty-five case reports were randomly selected by an independent observer from peer-reviewed medical journals. Clinical data were presented separately to three investigators, blinded to the final diagnoses. Investigator A was a Consultant with an expert knowledge in Internal Medicine and Allergy (IM&A) and basic computing skills. Investigator B was a Registrar in IM&A. Investigator C was a Research Nurse. Both Investigators B and C were familiar with computers and search engines. For every clinical case presented, each investigator independently carried out an Internet search using Google to provide a final diagnosis. Their results were then compared with the published diagnoses. Correct diagnoses were provided in 30/45 (66%) cases, 39/45 (86%) cases, and in 29/45 (64%) cases by investigator A, B, and C, respectively. All of the three investigators achieved the correct diagnosis in 19 cases (42%), and all of them failed in two cases. This Google-based search was useful to identify an appropriate diagnosis in complex immunological and allergic cases. Computing skills may help to get better results.

  10. Application of IHSDM: KY 30 case study : final report.

    DOT National Transportation Integrated Search

    2017-09-01

    A section of KY 30 in Jackson and Owsley Counties is targeted for redesign to provide a safer and more efficient corridor that will support economic activity in eastern Kentucky. Data for the existing KY 30 alignment and eight alternative alignments ...

  11. Care of a Homebound Super Obese Patient: A Case Study.

    PubMed

    Pagels, Jamie Lynn

    2016-03-01

    Obesity is becoming more prevalent in the United States with almost 40% of the population being overweight or obese. A new category, defining super obesity as a body mass index of 50 or higher, has been added. The purpose of this article is to use a case study to develop a more thorough understanding of the complex care needs of the super obese patient and how home healthcare clinicians can use technology to advocate for super obese patients who are home and bedbound. A review of the literature and discussion will be provided. Potential technologies involved in provision of care will also be explored. Finally, a summary of the case along with proposed solutions will be offered.

  12. Understanding Grammars through Diachronic Change

    PubMed Central

    Madariaga, Nerea

    2017-01-01

    In this paper, I will vindicate the importance of syntactic change for the study of synchronic stages of natural languages, according to the following outline. First, I will analyze the relationship between the diachrony and synchrony of grammars, introducing some basic concepts: the notions of I-language/E-language, the role of Chomsky's (2005) three factors in language change, and some assumptions about language acquisition. I will briefly describe the different approaches to syntactic change adopted in generative accounts, as well as their assumptions and implications (Lightfoot, 1999, 2006; van Gelderen, 2004; Biberauer et al., 2010; Roberts, 2012). Finally, I will illustrate the convenience of introducing the diachronic dimension into the study of at least certain synchronic phenomena with the help of a practical example: variation in object case marking of several verbs in Modern Russian, namely, the verbs denoting avoidance and the verbs slušat'sja “obey” and dožidat'sja “expect,” which show two object case-marking patterns, genitive case in standard varieties and accusative case in colloquial varieties. To do so, I will review previous descriptive and/or functionalist accounts on this or equivalent phenomena (Jakobson, 1984 [1936]; Clancy, 2006; Nesset and Kuznetsova, 2015a,b). Then, I will present a formal—but just synchronic—account, applying Sigurðsson (2011) hypothesis on the expression of morphological case to this phenomenon. Finally, I will show that a formal account including the diachronic dimension is superior (i.e., more explanative) than purely synchronic accounts. PMID:28824474

  13. Anatomy and histology of the scrotal ligament in adults: inconsistency and variability of the gubernaculum testis.

    PubMed

    Cavalie, G; Bellier, Alexandre; Marnas, G; Boisson, B; Robert, Y; Rabattu, P Y; Chaffanjon, P

    2018-04-01

    The anatomy of gubernaculum testis (GT) is often discussed; however, the postnatal anatomy of the GT or scrotal ligament (SL) is rarely described. Hence, we performed an anatomical and histological study to analyze histologically the structures between testis and scrotum. We performed anatomical dissections on 25 human fresh cadavers' testes. Each testis was removed with its envelopes and macroscopically analyzed. Then samples were included for histological study. Finally, they were analyzed under microscope, looking for attachments between testis, epididymis and scrotal envelopes. The absence of proximal and distal attachment was found in 56.0% of cases. Looking at the proximal attachment of the SL, the main one found is the epididymal attachment (28.0%), whereas no cases of testis attachment was found. Distally, there are more variations with scrotal attachment (12%) and cremaster attachment (12.0%). We found a significant prevalence of multiple adherences in 16.0% of cases too. Finally, in 15 cases (57.7%) an attachment is present between testis and epididymis, as it is commonly described. In the majority of cases there is no attachment of the lower pole of the testis and epididymis and these structures remain free. So it seems that the SL disappears with aging. Moreover, there is not only one kind of ligamentous attachment, but a high variability of attachments at the lower pole of the testiculo-epididymal structure. When it exists, this structure is never a real ligament and it seems more appropriate to use the term "attachments".

  14. Can an intervention based on a serious videogame prior to cognitive behavioral therapy be helpful in bulimia nervosa? A clinical case study.

    PubMed

    Giner-Bartolomé, Cristina; Fagundo, Ana B; Sánchez, Isabel; Jiménez-Murcia, Susana; Santamaría, Juan J; Ladouceur, Robert; Menchón, José M; Fernández-Aranda, Fernando

    2015-01-01

    Several studies have highlighted the implications of impulsivity and novelty seeking for both the maintenance and the process of recovery from bulimia nervosa (BN). Cognitive behavioral therapy (CBT) is the treatment of choice for BN, but for some cases, this treatment alone might not be sufficient for reducing the high levels of impulsivity. The paper presents a case report of a patient with BN, examining the effectiveness of using a videogame (VG; Playmancer) as an additional intervention designed to address impulsivity. Psychometric and neuropsychological measures were collected at baseline. After this assessment, Playmancer was applied prior to CBT, following an "A-B-A-C-A" single case experimental design. Impulsivity levels were assessed with the Conner's Continuous Performance Test II (CPT-II). After the Playmancer treatment, the patient started CBT, and the levels of impulsivity were recorded again. Finally, psychometric and neuropsychological measures were collected after treatment. Weekly frequency of binges and vomiting were also recorded during the entire procedure. After the VG intervention, psychometric measures such as anxiety levels, impulsivity and novelty seeking decreased. Regarding the neuropsychological measures, impulsivity levels (measured with the CPT-II) progressively decreased throughout the intervention, and an improvement in decision making capacities was observed. Furthermore, the frequency of binges also decreased during and after the VG intervention. This case report suggests that using the Playmancer VG to reduce impulsivity prior to CBT may enhance the final results of the treatment for BN.

  15. Assessment of Surgical Learning Curves in Transoral Robotic Surgery for Squamous Cell Carcinoma of the Oropharynx

    PubMed Central

    Albergotti, William G.; Gooding, William E.; Kubik, Mark W.; Geltzeiler, Mathew; Kim, Seungwon; Duvvuri, Umamaheswar; Ferris, Robert L.

    2017-01-01

    IMPORTANCE Transoral robotic surgery (TORS) is increasingly employed as a treatment option for squamous cell carcinoma of the oropharynx (OPSCC). Measures of surgical learning curves are needed particularly as clinical trials using this technology continue to evolve. OBJECTIVE To assess learning curves for the oncologic TORS surgeon and to identify the number of cases needed to identify the learning phase. DESIGN, SETTING, AND PARTICIPANTS A retrospective review of all patients who underwent TORS for OPSCC at the University of Pittsburgh Medical Center between March 2010 and March 2016. Cases were excluded for involvement of a subsite outside of the oropharynx, for nonmalignant abnormality or nonsquamous histology, unknown primary, no tumor in the main specimen, free flap reconstruction, and for an inability to define margin status. EXPOSURES Transoral robotic surgery for OPSCC. MAIN OUTCOMES AND MEASURES Primary learning measures defined by the authors include the initial and final margin status and time to resection of main surgical specimen. A cumulative sum learning curve was developed for each surgeon for each of the study variables. The inflection point of each surgeon’s curve was considered to be the point signaling the completion of the learning phase. RESULTS There were 382 transoral robotic procedures identified. Of 382 cases, 160 met our inclusion criteria: 68 for surgeon A, 37 for surgeon B, and 55 for surgeon C. Of the 160 included patients, 125 were men and 35 were women. The mean (SD) age of participants was 59.4 (9.5) years. Mean (SD) time to resection including robot set-up was 79 (36) minutes. The inflection points for the final margin status learning curves were 27 cases (surgeon A) and 25 cases (surgeon C). There was no inflection point for surgeon B for final margin status. Inflection points for mean time to resection were: 39 cases (surgeon A), 30 cases (surgeon B), and 27 cases (surgeon C). CONCLUSIONS AND RELEVANCE Using metrics of positive margin rate and time to resection of the main surgical specimen, the learning curve for TORS for OPSCC is surgeon-specific. Inflection points for most learning curves peak between 20 and 30 cases. PMID:28196200

  16. Clinical and genetic characterization of pituitary gigantism: an international collaborative study in 208 patients.

    PubMed

    Rostomyan, Liliya; Daly, Adrian F; Petrossians, Patrick; Nachev, Emil; Lila, Anurag R; Lecoq, Anne-Lise; Lecumberri, Beatriz; Trivellin, Giampaolo; Salvatori, Roberto; Moraitis, Andreas G; Holdaway, Ian; Kranenburg-van Klaveren, Dianne J; Chiara Zatelli, Maria; Palacios, Nuria; Nozieres, Cecile; Zacharin, Margaret; Ebeling, Tapani; Ojaniemi, Marja; Rozhinskaya, Liudmila; Verrua, Elisa; Jaffrain-Rea, Marie-Lise; Filipponi, Silvia; Gusakova, Daria; Pronin, Vyacheslav; Bertherat, Jerome; Belaya, Zhanna; Ilovayskaya, Irena; Sahnoun-Fathallah, Mona; Sievers, Caroline; Stalla, Gunter K; Castermans, Emilie; Caberg, Jean-Hubert; Sorkina, Ekaterina; Auriemma, Renata Simona; Mittal, Sachin; Kareva, Maria; Lysy, Philippe A; Emy, Philippe; De Menis, Ernesto; Choong, Catherine S; Mantovani, Giovanna; Bours, Vincent; De Herder, Wouter; Brue, Thierry; Barlier, Anne; Neggers, Sebastian J C M M; Zacharieva, Sabina; Chanson, Philippe; Shah, Nalini Samir; Stratakis, Constantine A; Naves, Luciana A; Beckers, Albert

    2015-10-01

    Despite being a classical growth disorder, pituitary gigantism has not been studied previously in a standardized way. We performed a retrospective, multicenter, international study to characterize a large series of pituitary gigantism patients. We included 208 patients (163 males; 78.4%) with growth hormone excess and a current/previous abnormal growth velocity for age or final height >2 s.d. above country normal means. The median onset of rapid growth was 13 years and occurred significantly earlier in females than in males; pituitary adenomas were diagnosed earlier in females than males (15.8 vs 21.5 years respectively). Adenomas were ≥10 mm (i.e., macroadenomas) in 84%, of which extrasellar extension occurred in 77% and invasion in 54%. GH/IGF1 control was achieved in 39% during long-term follow-up. Final height was greater in younger onset patients, with larger tumors and higher GH levels. Later disease control was associated with a greater difference from mid-parental height (r=0.23, P=0.02). AIP mutations occurred in 29%; microduplication at Xq26.3 - X-linked acrogigantism (X-LAG) - occurred in two familial isolated pituitary adenoma kindreds and in ten sporadic patients. Tumor size was not different in X-LAG, AIP mutated and genetically negative patient groups. AIP-mutated and X-LAG patients were significantly younger at onset and diagnosis, but disease control was worse in genetically negative cases. Pituitary gigantism patients are characterized by male predominance and large tumors that are difficult to control. Treatment delay increases final height and symptom burden. AIP mutations and X-LAG explain many cases, but no genetic etiology is seen in >50% of cases. © 2015 Society for Endocrinology.

  17. Computer-assisted expert case definition in electronic health records.

    PubMed

    Walker, Alexander M; Zhou, Xiaofeng; Ananthakrishnan, Ashwin N; Weiss, Lisa S; Shen, Rongjun; Sobel, Rachel E; Bate, Andrew; Reynolds, Robert F

    2016-02-01

    To describe how computer-assisted presentation of case data can lead experts to infer machine-implementable rules for case definition in electronic health records. As an illustration the technique has been applied to obtain a definition of acute liver dysfunction (ALD) in persons with inflammatory bowel disease (IBD). The technique consists of repeatedly sampling new batches of case candidates from an enriched pool of persons meeting presumed minimal inclusion criteria, classifying the candidates by a machine-implementable candidate rule and by a human expert, and then updating the rule so that it captures new distinctions introduced by the expert. Iteration continues until an update results in an acceptably small number of changes to form a final case definition. The technique was applied to structured data and terms derived by natural language processing from text records in 29,336 adults with IBD. Over three rounds the technique led to rules with increasing predictive value, as the experts identified exceptions, and increasing sensitivity, as the experts identified missing inclusion criteria. In the final rule inclusion and exclusion terms were often keyed to an ALD onset date. When compared against clinical review in an independent test round, the derived final case definition had a sensitivity of 92% and a positive predictive value of 79%. An iterative technique of machine-supported expert review can yield a case definition that accommodates available data, incorporates pre-existing medical knowledge, is transparent and is open to continuous improvement. The expert updates to rules may be informative in themselves. In this limited setting, the final case definition for ALD performed better than previous, published attempts using expert definitions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    PubMed

    2016-11-03

    This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

  19. Views of Pre-Service Teachers Following Teaching Experience on Use of Dynamic Geometry Software

    ERIC Educational Resources Information Center

    Günes, Kardelen; Tapan-Broutin, Menekse Seden

    2017-01-01

    The study aims to determine the views of final-year pre-service mathematics teachers towards their experience of the use of dynamic geometry software in teaching, following the implementation processes that they carried out when using this software in a real classroom environment. The study was designed as a case study, which is one of the…

  20. Psorinum Therapy in Treating Stomach, Gall Bladder, Pancreatic, and Liver Cancers: A Prospective Clinical Study

    PubMed Central

    Chatterjee, Aradeep; Biswas, Jaydip; Chatterjee, Ashim; Bhattacharya, Sudin; Mukhopadhyay, Bishnu; Mandal, Syamsundar

    2011-01-01

    We prospectively studied the clinical efficacy of an alternative cancer treatment “Psorinum Therapy” in treating stomach, gall bladder, pancreatic and liver cancers. Our study was observational, open level and single arm. The participants' eligibility criteria included histopathology/cytopathology confirmation of malignancy, inoperable tumor, and no prior chemotherapy or radiation therapy. The primary outcome measures of the study were (i) to assess the radiological tumor response (ii) to find out how many participants survived at least 1 year, 2 years, 3 years, 4 years and finally 5 years after the beginning of the study considering each type of cancer. Psorinum-6x was administered orally to all the participants up to 0.02 ml/Kg body weight as a single dose in empty stomach per day for 2 years along with allopathic and homeopathic supportive cares. 158 participants (42 of stomach, 40 of gall bladder, 44 of pancreatic, 32 of liver) were included in the final analysis of the study. Complete tumor response occurred in 28 (17.72%) cases and partial tumor response occurred in 56 (35.44%) cases. Double-blind randomized controlled clinical trial should be conducted for further scientific exploration of this alternative cancer treatment. PMID:21197093

  1. Primary angioplasty and routine utilization of thrombus aspiration devices: feasibility and results in a consecutive series of 486 patients.

    PubMed

    Varbella, Ferdinando; Gagnor, Andrea; Luceri, Stefania; Bongioanni, Sergio; Nannini, Cristiana; Masi, Andrea Sibona; Tripodi, Rosario; Pron, Paolo Giay; Mainardi, Loredana; Badalì, Antonino; Conte, Maria R

    2007-04-01

    Primary percutaneous transluminal coronary angioplasty (PTCA) is the treatment of choice for acute ST-segment elevation myocardial infarction (STEMI) in high-volume centres with experienced operators, but is often limited by a suboptimal microvascular perfusion due to distal embolization and impaired myocardial perfusion. The present study investigates whether routine use of thrombus aspiration (TA) devices is feasible in daily practice, along with its safety and effectiveness. This study is based on a series of 486 consecutive STEMI patients treated at our single institution by the same three operators (from 2001 to 2005). They underwent primary PTCA with or without TA according to these angiographic features: infarct related artery (IRA) diameter>or=3 mm; thrombotic occlusion or angiographic evidence of thrombus; absence of severe proximal tortuosity or calcification. We evaluate the efficacy of TA in terms of procedural success, coronary thrombolysis in myocardial infarction (TIMI) flow, myocardial blush grade (MBG), resolution>or=50% of ST segment elevation, and clinical events during hospital stay and at 6-month follow-up. A total of 486 primary PTCAs were performed, 217 (44.6%) with TA as a first device using RESCUE (n=65), EXPORT (n=140) and DIVER-CE (n=12) catheters. In 141 (65%) cases, macroscopic material was aspirated. The patients submitted to TA were more often males (84.7% versus 71.7%, P<0.05) and younger (age: 61.02+/-11.91 versus 64.47+/-10.59 years, P<0.01) than patients treated with traditional PTCA and the IRA was more frequently occluded at angiography (basal TIMI 0: 70.5% versus 47.9%). Application of the TA did not increase the complexity of the procedure (door-to-balloon times, minutes of fluoroscopy and amount of dye). TA alone was effective to restore TIMI 3 flow in 187 cases (86.2%) as a first device and in three other cases (1.4%) after predilatation with balloon. Direct stenting without predilatation was possible in 144 cases (66.4%) after TA. TA was not effective in 27 cases (12.4%) and this subgroup had both angiographic and clinical unfavourable results in comparison with the effective TA group (final TIMI 1 in 11.1% versus 0.5%, P<0.015; final MBG 1 in 55.5% versus 9.5%, P<0.001; lack of ST segment resolution>or=50% in 44.4% versus 7.9%, P<0.001; in-hospital mortality 14.8% versus 2.6%, P<0.05 and mortality at 6 months 18.5% versus 3.1%, P<0.05). In the whole TA population, final TIMI 3 flow was achieved in 203 cases (93.5%), final MBG 3 in 145 cases (66.8%) and ST segment resolution>or=50% in 185 cases (85.2%), in-hospital mortality was 4.1% and cumulative mortality at 6-month follow-up was 5.5%. In our case series, 486 consecutive unselected patients with STEMI were treated in a primary PTCA high-volume centre using TA devices. Our study demonstrates that, in STEMI patients treated with primary PTCA, a routine strategy with TA before angioplasty guided by angiographic selection criteria is feasible in almost 50% of cases, is safe and effective, does not increase procedural time and offers good results in terms of tissue perfusion, both epicardial (TIMI flow) and myocardial (MBG, ST regression). When successfully performed, TA identifies a population with favourable in-hospital and 6-month outcome.

  2. 40 CFR 155.58 - Procedures for issuing a decision on a registration review case.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) State whether it believes that additional data are needed and, if so, describe what is needed. A FIFRA 3(c)(2)(B) notice requiring such data may be issued in conjunction with a proposed or final decision... remain open until all actions required in the final decision on the registration review case have been...

  3. 28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE HEARINGS...

  4. Managing with A/E Ease

    DTIC Science & Technology

    1988-07-01

    16. Construction Fixes ($K). ([ a16(s) [ bl6 (s)] [ d16(s) 17. Final Actions on Pursuit Cases. ([ a17(s) ]) [bl7(s)] [ d17(s) 18. Carry Over to Next...Construction Fixes ($K). ( [al6 ]) [ b16 ] [d16 17. Final Actions on Pursuit Cases. ( [a17 ]) [b17 ] [d17 18. Carry Over to Next Quarter. [b18 ] [d18 .else

  5. 40 CFR 155.58 - Procedures for issuing a decision on a registration review case.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) State whether it believes that additional data are needed and, if so, describe what is needed. A FIFRA 3(c)(2)(B) notice requiring such data may be issued in conjunction with a proposed or final decision... remain open until all actions required in the final decision on the registration review case have been...

  6. 78 FR 59859 - Defense Federal Acquisition Regulation Supplement: Allowability of Legal Costs for Whistleblower...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    ... considered in the formation of a final rule. ADDRESSES: Submit comments identified by DFARS Case 2013-D022... (for DoD only) and two FAR cases (for title 41 agencies), which are independent, but parallel... response to this interim rule in the formation of the final rule. List of Subjects in 48 CFR Parts 216 and...

  7. 78 FR 14266 - Polyethylene Terephthalate Film, Sheet, and Strip From Taiwan: Notice of Correction to the Final...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... Film, Sheet, and Strip From Taiwan: Notice of Correction to the Final Results of the 2010-2011... film, sheet, and strip (PET Film) from Taiwan.\\1\\ The period of review covered July 1, 2010, through... an incorrect case number associated with PET Film from Taiwan (i.e., incorrect case number A-533-824...

  8. 76 FR 12323 - Certain Cased Pencils From the People's Republic of China: Final Results of the Expedited Third...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-07

    ... duty order would be likely to lead to continuation or recurrence of dumping at the margins identified... of Amended Final Determination of Sales at Less Than Fair Value and Amended Antidumping Duty Order in...''). Specifically excluded from the scope of the order are mechanical pencils, cosmetic pencils, pens, non-cased...

  9. Bowman's layer encystment in cases of persistent Acanthamoeba keratitis.

    PubMed

    Yokogawa, Hideaki; Kobayashi, Akira; Yamazaki, Natsuko; Ishibashi, Yasuhisa; Oikawa, Yosaburo; Tokoro, Masaharu; Sugiyama, Kazuhisa

    2012-01-01

    The purpose of this study was to report Acanthamoeba encystment in Bowman's layer in Japanese cases of persistent Acanthamoeba keratitis (AK). Laser confocal microscopic images of the cornea were obtained in vivo from 18 consecutive eyes from 17 confirmed AK patients. Retrospectively, 14 cases treated over 4 months were categorized as a nonpersistent group and three cases that required prolonged therapy for more than 6 months were categorized as a persistent group. Clinical outcomes based on final best-corrected visual acuity were retrospectively analyzed, and selected confocal images were evaluated qualitatively for abnormal findings. The final best-corrected visual acuity was significantly lower (P < 0.01) for patients in the persistent group compared with that in the nonpersistent group. At the initial visit, in vivo confocal microscopy demonstrated Acanthamoeba cysts exclusively in the epithelial layer in both the nonpersistent group (80%) and the persistent group (100%). At a subsequent follow-up visit, numerous Acanthamoeba cysts were observed in the epithelial cell layer and in Bowman's layer in all patients with persistent AK, but Acanthamoeba cysts were undetectable in all cases with nonpersistent AK tested. Invasion of cysts into Bowman's layer was characteristically observed in patients with persistence of AK. This finding suggests that invasion of Acanthamoeba cysts into Bowman's layer may be a useful predictor for a persistent clinical course.

  10. Intra-Operative Frozen Sections for Ovarian Tumors – A Tertiary Center Experience

    PubMed Central

    Arshad, Nur Zaiti Md; Ng, Beng Kwang; Paiman, Noor Asmaliza Md; Mahdy, Zaleha Abdullah; Noor, Rushdan Mohd

    2018-01-01

    Background: Accuracy of diagnosis with intra-operative frozen sections is extremely important in the evaluation of ovarian tumors so that appropriate surgical procedures can be selected. Study design: All patients who with intra-operative frozen sections for ovarian masses in a tertiary center over nine years from June 2008 until April 2017 were reviewed. Frozen section diagnosis and final histopathological reports were compared. Main outcome measures: Sensitivity, specificity, positive and negative predictive values of intra-operative frozen section as compared to final histopathological results for ovarian tumors. Results: A total of 92 cases were recruited for final evaluation. The frozen section diagnoses were comparable with the final histopathological reports in 83.7% of cases. The sensitivity, specificity, positive predictive value and negative predictive value for benign and malignant ovarian tumors were 95.6%, 85.1%, 86.0% and 95.2% and 69.2%, 100%, 100% and 89.2% respectively. For borderline ovarian tumors, the sensitivity and specificity were 76.2% and 88.7%, respectively; the positive predictive value was 66.7% and the negative predictive value was 92.7%. Conclusion: The accuracy of intra-operative frozen section diagnoses for ovarian tumors is high and this approach remains a reliable option in assessing ovarian masses intra-operatively. PMID:29373916

  11. Psychological stress and burnout in medical students: a five-year prospective longitudinal study.

    PubMed Central

    Guthrie, E; Black, D; Bagalkote, H; Shaw, C; Campbell, M; Creed, F

    1998-01-01

    The aim of this study was to assess psychological morbidity and symptoms of burnout in medical students during their undergraduate training, and to identify baseline factors that predict psychological morbidity in students in the final year of the course. It was a 5-year prospective longitudinal cohort study. Students were assessed in years 1, 4 and 5 of their medical undergraduate training by means of the GHQ-12 and the Maslach Burnout Inventory. 172 (84.3%), 157 (77.0%) and 155 (75.9%) students out of an original group of 204 completed assessments in years 1, 4 and 5, respectively. 18 students were above threshold on the GHQ-12 on all three occasions, 25 on two occasions and 43 on one occasion; 69 students were never a 'case'. Students who were cases on two or more occasions were more likely to find the medical course stressful during the first year, but not subsequent years. There was no significant difference between the percentages of men and women who scored as cases on the GHQ-12 in any of the years. The best predictor of psychological morbidity in the final year of the course was the GHQ-12 score in year 1. This study suggests that a small group of students repeatedly experience psychological distress during their medical training. PMID:9764076

  12. Ovarian Fibroma: A Clinico-pathological Study of 23 Cases with Review of Literature.

    PubMed

    Parwate, Nikhil Sadanand; Patel, Shilpa M; Arora, Ruchi; Gupta, Monisha

    2016-12-01

    The purpose of this study was to correlate the clinical findings, RMI-4 index and frozen section, in cases of ovarian fibroma with the final histopathology. This is a retrospective study of clinical and pathological features of 23 patients of ovarian fibroma. The patient's age ranged from 34 to 66 years (mean-49 years). The most common presenting symptom was abdominal pain. On clinical examination, the mean size of ovarian tumor was 9.5 cm, CA-125 levels were found to be raised in 14 patients, and it was associated with ascites in 10 patients. USG showed a well-circumscribed mass (with a mean size of 14 cm), on the left side in 14 cases and on the right side in 9 patients. RMI-4 was calculated in all the patients, and it revealed the possibility of a benign histology in 17 patients. All patients underwent exploratory laparotomy with the removal of ovarian tumor followed by frozen section examination. All but one (22/23) patient had positive correlation among frozen section and final histopathological findings. Ovarian fibroma generally tends to occur in post-menopausal women. All the patients in our study of ovarian fibroma were symptomatic, with the presence of palpable mass in majority of patients. RMI-4 Index correlated very well with benign nature of disease. Frozen section has an invaluable role at surgery; fertility-conserving surgery is the choice in young women. Clinical findings, RMI-4 Index and frozen section, play vital roles before and during surgery in cases of benign ovarian tumors.

  13. Teaching Data Use and School Leadership

    ERIC Educational Resources Information Center

    Vanover, Charles; Hodges, Olivia

    2015-01-01

    This case study uses evidence collected for accreditation and programme improvement at a small university Master's and certification programme in Educational Leadership Development to describe efforts to help leadership candidates use data during the programme's final internship experience. Programme features supporting the growth of candidates'…

  14. Drinking driver and traffic safety project. Volume 2, Probabilities for drinking drivers

    DOT National Transportation Integrated Search

    1973-10-01

    This is the second volume of a final report of a four-year study of drinking drivers. It includes a brief description of a prediction model developed from over 4000 cases, including drinking drivers, recidivist drinking drivers and drivers license ap...

  15. A data storage and retrieval model for Louisiana traffic operations data : final report.

    DOT National Transportation Integrated Search

    1995-09-01

    The type and amount of data managed by the Louisiana Department of Transportation and Development (DOTD) are huge. In many cases, these data are used to perform traffic engineering studies and highway safety analyses, among others. At the present tim...

  16. Drinking driver and traffic safety project. Volume 1

    DOT National Transportation Integrated Search

    1972-05-01

    This is the final report of a four-year study of drinking drivers. On the basis of analyses of over 4,000 cases (approximately 1400 of whom were driver's license applicants who had no convictions for drunk-driving, and the remainder had been convicte...

  17. Demonstration of TRAF-NETSIM for traffic operations management : final report.

    DOT National Transportation Integrated Search

    1991-08-01

    The utility of the simulation package TRAF-NETSIM to the traffic engineer is assessed and demonstrated by means of a case study. The methodology employed in performing the analysis is presented in a way that will aid future users of TRAF-NETSIM. The ...

  18. Sarcomas in north west England: I. Histopathological peer review.

    PubMed

    Harris, M; Hartley, A L; Blair, V; Birch, J M; Banerjee, S S; Freemont, A J; McClure, J; McWilliam, L J

    1991-08-01

    A total of 468 cases of bone, soft tissue and visceral sarcomas (and certain other tumours) diagnosed during the years 1982-84 in North West England were entered in a study of histopathological peer review, incidence and survival. This paper describes the effects of peer review. Material was reviewed by a panel of five pathologists for 413 of the 450 cases originally registered as sarcomas with the Regional Cancer Registry. The diagnosis of sarcomas was confirmed in 76% cases and and there was agreement on sub-type for 53% cases. Measures of agreement were lowest for the two sub-types most commonly diagnosed i.e. malignant fibrous histiocytoma and leiomyosarcoma. Degree of agreement between individual pathologists and final panel diagnosis was also very variable but never less than 65%. It is concluded that second opinion is essential in cases of presumed sarcomas for studies of incidence and aetiology and to ensure that appropriate treatment is selected.

  19. Circumstellar Matter Studied by Spectrally-Resolved Interferometry

    NASA Astrophysics Data System (ADS)

    Millour, F.

    2012-12-01

    This paper describes some generalities about spectro-interferometry and the role it has played in the last decade for the better understanding of circumstellar matter. I provide a small history of the technique and its origins, and recall the basics of differential phase and its central role for the recent discoveries. I finally provide a small set of simple interpretations of differential phases for specific astrophysical cases, and intend to provide a "cookbook" for the other cases.

  20. Prolonged fever in peritoneal tuberculosis: A case report

    NASA Astrophysics Data System (ADS)

    Zein, U.; Irwandi, S.; Habib, H.; Lim, H.; Pasha, M.; Janis, I.; Saragih, R. H.; Ginting, Y.; Effendy-Y S, R.

    2018-03-01

    Peritoneal tuberculosis may lead to delayed diagnosis because of the nonspecific features such as fever, abdominal distension, abdominal tenderness, ascites, and weight loss. Here, wereported a case of prolonged fever and abdominal pain which was due to peritoneal tuberculosis. Initial examinations including acomplete blood test and serologic tests did not lead to the diagnosis. A final diagnosis was made by abdominal CT-scan and laparoscopy combined with histopathological studies. Antituberculous medications provided a good clinical response in this patient.

  1. [The relationship between MMR vaccination level and the number of new cases of autism in children].

    PubMed

    Mrozek-Budzyn, Dorota; Kiełtyka, Agnieszka

    2008-01-01

    The MMR vaccination coverage in Malopolskie voivodeship improved rapidly and finally reached a high level during last years. The number of new cases of autism spectrum disorders in children during that time revealed a slightly rising but not significant trend, while the number of childhood autism were stable. Ecological study showed no correlation between MMR vaccination and an increased risk of childhood autism and autism spectrum disorders in children.

  2. Vitamin C Intake and Pancreatic Cancer Risk: A Meta-Analysis of Published Case-Control and Cohort Studies.

    PubMed

    Hua, Yong-Fei; Wang, Gao-Qing; Jiang, Wei; Huang, Jing; Chen, Guo-Chong; Lu, Cai-De

    2016-01-01

    Observational studies inconsistently reported the relationship between vitamin C intake and risk of pancreatic cancer. We conducted a meta-analysis of published case-control and cohort studies to quantify the association. Potentially eligible studies were found on PubMed and EMBASE databases through May 31, 2015. A random-effects model was assigned to compute summary point estimates with corresponding 95% confidence intervals (CIs). Subgroup and meta-regression analyses were also performed to explore sources of heterogeneity. Our final analyses included 20 observational studies comprising nearly 5 thousand cases of pancreatic cancer. When comparing the highest with the lowest categories of vitamin C intake, the summary odds ratio/relative risk for case-control studies (14 studies), cohort studies (6 studies) and all studies combined was 0.58 (95% CI: 0.52-0.66), 0.93 (95% CI: 0.78-1.11) and 0.66 (95% CI: 0.58-0.75), respectively. The difference in the findings between case-control and cohort studies was statistically significant (P < .001). Possible publication bias was shown in the meta-analysis of case-control studies. There is insufficient evidence to conclude any relationship between vitamin C intake and risk of pancreatic cancer. The strong inverse association observed in case-control studies may be affected by biases (eg, recall and selection biases) that particularly affect case-control studies and/or potential publication bias. Future prospective studies of vitamin C intake and pancreatic cancer are needed.

  3. 28 CFR 94.52 - Final agency decision.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Final agency decision. 94.52 Section 94.52 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Appeal Procedures § 94.52 Final agency decision. In cases...

  4. 28 CFR 94.52 - Final agency decision.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Final agency decision. 94.52 Section 94.52 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Appeal Procedures § 94.52 Final agency decision. In cases...

  5. 28 CFR 94.52 - Final agency decision.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Final agency decision. 94.52 Section 94.52 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Appeal Procedures § 94.52 Final agency decision. In cases...

  6. 28 CFR 94.52 - Final agency decision.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Final agency decision. 94.52 Section 94.52 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Appeal Procedures § 94.52 Final agency decision. In cases...

  7. 28 CFR 94.52 - Final agency decision.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Final agency decision. 94.52 Section 94.52 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Appeal Procedures § 94.52 Final agency decision. In cases...

  8. The Introduction and Refinement of the Assessment of Digitally Recorded Audio Presentations

    ERIC Educational Resources Information Center

    Sinclair, Stefanie

    2016-01-01

    This case study critically evaluates benefits and challenges of a form of assessment included in a final year undergraduate Religious Studies Open University module, which combines a written essay task with a digital audio recording of a short oral presentation. Based on the analysis of student and tutor feedback and sample assignments, this study…

  9. Inquiring into Pre-Service Content Area Teachers' Development of Literacy Practices and Pedagogical Content Knowledge

    ERIC Educational Resources Information Center

    Mitton Kukner, Jennifer; Murray Orr, Anne

    2015-01-01

    The focus of this qualitative multi-year case study is on preservice teachers' experiences related to the development of their literacy practices in teaching high school science, math, social studies and other content area courses during their final field placement in a teacher education program. Results indicate tangible indicators of overall…

  10. Workplace Education Efforts in Small Business: Learning from the Field. Final Report.

    ERIC Educational Resources Information Center

    Vencill, Mary P.; And Others

    A study identified and conducted onsite case studies of 18 different education programs conducted by small companies. Two-thirds of them were conducted by manufacturing companies; the remainder were in health services, construction, or transportation companies. Most of the programs served fewer than 25 workers and had been in operation for less…

  11. Effect of Continuous Assessment on Learning Outcomes on Two Chemical Engineering Courses: Case Study

    ERIC Educational Resources Information Center

    Tuunila, R.; Pulkkinen, M.

    2015-01-01

    In this paper, the effect of continuous assessment on the learning outcomes of two chemical engineering courses is studied over a several-year period. Average grades and passing percentages of courses after the final examination are reported and also student feedback on the courses is collected. The results indicate significantly better learning…

  12. The Total Impact of Manpower Programs: A Four-City Case Study. Volume II--Final Report.

    ERIC Educational Resources Information Center

    Olympus Research Corp., Washington, DC.

    Based on followup interviews with 1700 participants, this study is an evaluation of Federal manpower programs in Boston, Denver, and San Francisco-Oakland. Included are Manpower Development and Training Act Programs, Work Incentive Programs, and Concentrated Employment Program from late 1969 to early 1970. Program impact on enrollees, employers,…

  13. Development of a Residential Education Program for Emotionally Deprived Pseudo-Retarded Blind Children, Volumes II and III. Final Report.

    ERIC Educational Resources Information Center

    Rigby, Mary E.; Woodcock, Charles C.

    A continuation of a report (EC 004 818) presents appended case studies of 15 children involved in a residential school program for the multiply handicapped blind. Each study provides information and developmental history, medical data, personal hygiene, eating habits, physical development, psychological adjustment, object recognition, classroom…

  14. Lesbians still face job discrimination.

    PubMed

    Ryniker, Margaret R

    2008-01-01

    This article examines continued discrimination against lesbians in the workplace. A number of cases from various jurisdictions in the United States are highlighted. The paper studies two common forms of discrimination: denial of employment benefits to same sex partners, and sexual harassment. On the first front, the case law suggests that health insurance coverage for one's partner is becoming the norm. On the question of sexual harassment in the workplace, the case law did not provide protection for lesbians. Finally, U.S. employment policies related to sexual orientation are contrasted with those in Israel, which provides much greater protection from discrimination.

  15. ABDOMINAL PAIN IN ADULT SICKLE CELL DISEASE PATIENTS: A NIGERIAN EXPERIENCE

    PubMed Central

    Akingbola, T.S.; Kolude, B.; Aneni, E.C.; Raji, A.A.; Iwara, K.U.; Aken’Ova, Y.A.; Soyannwo, O.A.

    2011-01-01

    Background: Abdominal pain is a relatively frequent occurrence in sickle cell disease. The aetiology of abdominal pain in sickle cell disease is often difficult to diagnose clinically. Despite the frequent occurrence, diagnostic dilemma, and the need for an accurate, early diagnosis, abdominal pain in sickle cell disease has not been rigorously studied. Objective: We therefore sought to describe the different presentations and patterns of abdominal pain in persons with sickle cell disease. Methods: A prospective case series of 20 patients was done in which data was collected on demographic characteristics, hemoglobin electrophoresis patterns, a description of the abdominal pain including sites, severity, and type of pain, packed cell volume and the provisional and final diagnosis. Results: Haemoglobin S patients were 17 in number constituting eightyfive percent (85%) of our study population whilst the rest 3 were Hb S+C. Most patients (70%) had one site of abdominal pain. The pain was mainly colicky or tightening, moderate to severe in nature and, in some cases, associated with vomiting. We did not find any significant difference between the steady state PCV and the PCV during the acute abdominal pain episodes. The final diagnosis showed that only 38.8% of the patients had vasoocclusive crises and the reliability index between the provisional diagnosis and the final diagnosis was 67%. Conclusion: Abdominal pain in sickle cell disease may present in different ways and it is important to recognize that the possible diagnoses are numerous. Not all cases are due to vasoocclusive crises. Early diagnosis and prompt treatment can be life saving. PMID:25161492

  16. A Qualitative Study on Change Management in Primary Schools Award Winning and Non-Award Winning Schools Case in Study of TQM

    ERIC Educational Resources Information Center

    Altunay, Esen; Arli, Didem; Yalcinkaya, Munevver

    2012-01-01

    The aim of this study was to determine the need of change in primary schools and to reveal out the principals' experiences during the change process by taking the total quality management practices into consideration and finally give suggestions according to the results of the study. In this study by employing qualitative research method, semi…

  17. Interstitial insertion of RARα gene into PML gene in a patient with acute promyelocytic leukemia (APL) lacking the classic t(15;17).

    PubMed

    Goldschmidt, Neta; Yehuda-Gafni, Orly; Abeliovich, Deborah; Slyusarevsky, Elena; Rund, Deborah

    2010-10-01

    The diagnosis of APL is based on clinical and morphological tests though the final diagnosis is at the molecular level. An accurate diagnosis is important as it mandates targeted therapy to improve survival. We report a case of APL without t(15;17) in conventional cytogenetic study and with initially negative fluorescence in situ hybridization (FISH) study on cells in interphase. Reverse transcription polymerase chain reaction (RT-PCR) for the promyelocytic/retinoic acid receptor alpha gene (PML/RARα) fusion oncogene proved the clinical diagnosis as well as FISH study on cells in metaphase. The cause was a cryptic translocation of the RARα gene into PML. We reviewed 36 additional cases of APL diagnosed in our hospital since 1992. This was the only case that failed to show t(15;17) in cytogenetics. However, three cases with t(15;17) in cytogenetics had negative RT-PCR for PML/RARα. Our case emphasizes that cytogenetics, FISH and RT-PCR studies are complementary studies for the molecular diagnosis of APL.

  18. Simple F Test Reveals Gene-Gene Interactions in Case-Control Studies

    PubMed Central

    Chen, Guanjie; Yuan, Ao; Zhou, Jie; Bentley, Amy R.; Adeyemo, Adebowale; Rotimi, Charles N.

    2012-01-01

    Missing heritability is still a challenge for Genome Wide Association Studies (GWAS). Gene-gene interactions may partially explain this residual genetic influence and contribute broadly to complex disease. To analyze the gene-gene interactions in case-control studies of complex disease, we propose a simple, non-parametric method that utilizes the F-statistic. This approach consists of three steps. First, we examine the joint distribution of a pair of SNPs in cases and controls separately. Second, an F-test is used to evaluate the ratio of dependence in cases to that of controls. Finally, results are adjusted for multiple tests. This method was used to evaluate gene-gene interactions that are associated with risk of Type 2 Diabetes among African Americans in the Howard University Family Study. We identified 18 gene-gene interactions (P < 0.0001). Compared with the commonly-used logistical regression method, we demonstrate that the F-ratio test is an efficient approach to measuring gene-gene interactions, especially for studies with limited sample size. PMID:22837643

  19. Rigour in qualitative case-study research.

    PubMed

    Houghton, Catherine; Casey, Dympna; Shaw, David; Murphy, Kathy

    2013-03-01

    To provide examples of a qualitative multiple case study to illustrate the specific strategies that can be used to ensure the credibility, dependability, confirmability and transferability of a study. There is increasing recognition of the valuable contribution qualitative research can make to nursing knowledge. However, it is important that the research is conducted in a rigorous manner and that this is demonstrated in the final research report. A multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Multiple sources of evidence were collected: semi-structured interviews (n=58), non-participant observations at five sites and documentary sources. Strategies to ensure the rigour of this research were prolonged engagement and persistent observation, triangulation, peer debriefing, member checking, audit trail, reflexivity, and thick descriptions. Practical examples of how these strategies can be implemented are provided to guide researchers interested in conducting rigorous case study research. While the flexible nature of qualitative research should be embraced, strategies to ensure rigour must be in place.

  20. Mejoramiento de la Produccion de Materiales de Educacion en Poblacion para la Ensenanza Primaria y la Post-Alfabetizacion. Taller Regional (Santiago, Chile, 27 mayo-5 junio, 1987). Informe Final (Upgrading the Production of Population Education Materials for Primary Education and Post-Literacy. Regional Workshop (Santiago, Chile, May 27-June 5, 1987). Final Report.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Santiago (Chile). Regional Office for Education in Latin America and the Caribbean.

    This report contains the results of an operational training workshop covering 11 case studies on the production of teaching materials for population education and used for elementary education, literacy, and post-literacy programs. The workshop covered the planning and design for the production of teaching materials including an eight step…

  1. Demonstration of a Model-Based Technology for Monitoring Water Quality and Corrosion in Water-Distribution systems

    DTIC Science & Technology

    2016-12-01

    Kamojjala, 2014, “Real-Time M0deling of Water Distribution Systems: A Case Study ,” Journal AWWA, Vol. 106, No. 9 (September 2014.) Feinauer, Lynn R...Quality and Corrosion in Water-Distribution Systems Final Report on Project F07-AR05 Co ns tr uc tio n En gi ne er in g R es ea rc h La bo ra to...Final Report on Project F07-AR05 Vicki L. Van Blaricum Construction Engineering Research Laboratory U.S. Army Engineer Research and Development Center

  2. Sex-biased prevalence in infections with heterosexual, direct, and vector-mediated transmission: A theoretical analysis.

    PubMed

    Pugliese, Andrea; Gumel, Abba B; Milner, Fabio A; Velasco-Hernandez, Jorge X

    2018-02-01

    Three deterministic Kermack-McKendrick-type models for studying the transmission dynamics of an infection in a two-sex closed population are analyzed here. In each model it is assumed that infection can be transmitted through heterosexual contacts, and that there is a higher probability of transmission from one sex to the other than vice versa. The study is focused on understanding whether and how this bias in transmission reflects in sex differences in final attack ratios (i.e. the fraction of individuals of each sex that eventually gets infected). In the first model, where the other two transmission modes are not considered, the attack ratios (fractions of the population of each sex that will eventually be infected) can be obtained as solutions of a system of two nonlinear equations, that has a unique solution if the net reproduction number exceeds unity. It is also shown that the ratio of attack ratios depends solely on the ratio of gender-specific susceptibilities and on the basic reproductive number of the epidemic Ro, and that the gender-specific final attack-ratio is biased in the same direction as the gender-specific susceptibilities. The second model allows also for infection transmission through direct, non-sexual, contacts. In this case too, an analytical expression is derived from which the attack ratios can be obtained. The qualitative results are similar to those obtained for the previous model, but another important parameter for determining the value of the ratio between the attack ratios in the two sexes is obtained, the relative weight of direct vs. heterosexual transmission (namely, ρ). Quantitatively, the ratio of final attack ratios generally will not exceed 1.5, if non-sexual transmission accounts for most transmission events (ρ≥0.6) and the ratio of gender-specific susceptibilities is not too large (say, 5 at most). The third model considers vector-borne, instead of direct transmission. In this case, we were not able to find an analytical expression for the final attack ratios, but used instead numerical simulations. The results on final attack ratios are actually quite similar to those obtained with the second model. It is interesting to note that transient patterns can differ from final attack ratios, as new cases will tend to occur more often in the more susceptible sex, while later depletion of susceptibles may bias the ratio in the opposite direction. The analysis of these simple models, despite their lack of realism, can help in providing insight into, and assessment of, the potential role of gender-specific transmission in infections with multiple modes of transmission, such as Zika virus (ZIKV), by gauging what can be expected to be seen from epidemiological reports of new cases, disease incidence and seroprevalence surveys.

  3. Study on the effects of flow in the volute casing on the performance of a sirocco fan

    NASA Astrophysics Data System (ADS)

    Adachi, Tsutomu; Sugita, Naohiro; Ohomori, Satoshi

    2004-08-01

    The flow at the exit from the runner blade of a centrifugal fan with forward curved blades (a sirocco fan) sometimes separates and becomes unstable. We have conducted many researches on the impeller shape of a sirocco fan, proper inlet and exit blade angles were considered to obtain optimum performance. In this paper, the casing shape were decided by changing the circumferential angle, magnifying angle and the width, 21 sorts of casings were used. Performance tests, inner flow velocity and pressure distributions were measured as well. Computational fluid dynamic calculations were also made and compared with the experimental results. Finally, the most suitable casing shape for best performance is considered.

  4. PERSISTENCE OF TETRACHLORODIBENZO-P-DIOXIN IN SOIL: TIMES BEACH CASE STUDY. (R825549C032)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  5. User-Centric Approach for Benchmark RDF Data Generator in Big Data Performance Analysis

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

    Purohit, Sumit; Paulson, Patrick R.; Rodriguez, Luke R.

    This research focuses on user-centric approach of building such tools and proposes a flexible, extensible, and easy to use framework to support performance analysis of Big Data systems. Finally, case studies from two different domains are presented to validate the framework.

  6. In situ microscopy across scales for the characterization of crystal growth mechanisms: the case of europium oxalate

    DOE PAGES

    Soltis, Jennifer A.; Isley, William C.; Conroy, Michele; ...

    2018-01-01

    The development of targeted syntheses requires a better understanding of how production pathways affect the final product, but many ex situ techniques used for studying nanoparticle growth are unsuitable as standalone methods for identifying and characterizing growth mechanisms.

  7. In situ microscopy across scales for the characterization of crystal growth mechanisms: the case of europium oxalate

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

    Soltis, Jennifer A.; Isley, William C.; Conroy, Michele

    The development of targeted syntheses requires a better understanding of how production pathways affect the final product, but many ex situ techniques used for studying nanoparticle growth are unsuitable as standalone methods for identifying and characterizing growth mechanisms.

  8. HOW SMART IS THE SMART GROWTH INITIATIVE? A CASE STUDY IN AUSTIN, TEXAS. (R827582)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  9. Assessing the Effectiveness of Case-Based Collaborative Learning via Randomized Controlled Trial.

    PubMed

    Krupat, Edward; Richards, Jeremy B; Sullivan, Amy M; Fleenor, Thomas J; Schwartzstein, Richard M

    2016-05-01

    Case-based collaborative learning (CBCL) is a novel small-group approach that borrows from team-based learning principles and incorporates elements of problem-based learning (PBL) and case-based learning. CBCL includes a preclass readiness assurance process and case-based in-class activities in which students respond to focused, open-ended questions individually, discuss their answers in groups of 4, and then reach consensus in larger groups of 16. This study introduces CBCL and assesses its effectiveness in one course at Harvard Medical School. In a 2013 randomized controlled trial, 64 medical and dental student volunteers were assigned randomly to one of four 8-person PBL tutorial groups (control; n = 32) or one of two 16-person CBCL tutorial groups (experimental condition; n = 32) as part of a required first-year physiology course. Outcomes for the PBL and CBCL groups were compared using final exam scores, student responses to a postcourse survey, and behavioral coding of portions of video-recorded class sessions. Overall, the course final exam scores for CBCL and PBL students were not significantly different. However, CBCL students whose mean exam performance in prior courses was below the participant median scored significantly higher than their PBL counterparts on the physiology course final exam. The most common adjectives students used to describe CBCL were "engaging," "fun," and "thought-provoking." Coding of observed behaviors indicated that individual affect was significantly higher in the CBCL groups than in the PBL groups. CBCL is a viable, engaging, active learning method. It may particularly benefit students with lower academic performance.

  10. Comparison of Estimates between Cohort and Case-Control Studies in Meta-Analyses of Therapeutic Interventions: A Meta-Epidemiological Study.

    PubMed

    Lanza, Amy; Ravaud, Philippe; Riveros, Carolina; Dechartres, Agnes

    2016-01-01

    Observational studies are increasingly being used for assessing therapeutic interventions. Case-control studies are generally considered to have greater risk of bias than cohort studies, but we lack evidence of differences in effect estimates between the 2 study types. We aimed to compare estimates between cohort and case-control studies in meta-analyses of observational studies of therapeutic interventions by using a meta-epidemiological study. We used a random sample of meta-analyses of therapeutic interventions published in 2013 that included both cohort and case-control studies assessing a binary outcome. For each meta-analysis, the ratio of estimates (RE) was calculated by comparing the estimate in case-control studies to that in cohort studies. Then, we used random-effects meta-analysis to estimate a combined RE across meta-analyses. An RE < 1 indicated that case-control studies yielded larger estimates than cohort studies. The final analysis included 23 meta-analyses: 138 cohort and 133 case-control studies. Treatment effect estimates did not significantly differ between case-control and cohort studies (combined RE 0.97 [95% CI 0.86-1.09]). Heterogeneity was low, with between-meta-analysis variance τ2 = 0.0049. Estimates did not differ between case-control and prospective or retrospective cohort studies (RE = 1.05 [95% CI 0.96-1.15] and RE = 0.99 [95% CI, 0.83-1.19], respectively). Sensitivity analysis of studies reporting adjusted estimates also revealed no significant difference (RE = 1.03 [95% CI 0.91-1.16]). Heterogeneity was also low for these analyses. We found no significant difference in treatment effect estimates between case-control and cohort studies assessing therapeutic interventions.

  11. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2012. Final rule.

    PubMed

    2011-08-08

    This final rule updates the payment rates used under the prospective payment system for skilled nursing facilities (SNFs) for fiscal year 2012. In addition, it recalibrates the case-mix indexes so that they more accurately reflect parity in expenditures between RUG-IV and the previous case-mix classification system. It also includes a discussion of a Non-Therapy Ancillary component currently under development within CMS. In addition, this final rule discusses the impact of certain provisions of the Affordable Care Act, and reduces the SNF market basket percentage by the multi-factor productivity adjustment. This rule also implements certain changes relating to the payment of group therapy services and implements new resident assessment policies. Finally, this rule announces that the proposed provisions regarding the ownership disclosure requirements set forth in section 6101 of the Affordable Care Act will be finalized at a later date.

  12. What Subject Matter Knowledge Do Second-Level Teachers Need to Know to Teach Trigonometry? An Exploration and Case Study

    ERIC Educational Resources Information Center

    Walsh, Richard; Fitzmaurice, Olivia; O'Donoghue, John

    2017-01-01

    This study reports on the level of trigonometry Subject Matter Knowledge (SMK) of third and final-year pre-service second-level mathematics teachers () at an Irish third-level institution. The aim of the study was to determine if this sample of prospective teachers has an appropriate level of SMK to teach second-level trigonometric concepts. The…

  13. A Framework for Implementing Virtual Collaborative Networks - Case Study on Automobile Components Production Industry

    NASA Astrophysics Data System (ADS)

    Parvinnia, Elham; Khayami, Raouf; Ziarati, Koorush

    Virtual collaborative networks are composed of small companies which take most advantage from the market opportunity and are able to compete with large companies. So some frameworks have been introduced for implementing this type of collaboration; although none of them has been standardized completely. In this paper we specify some instances that need to be standardized for implementing virtual enterprises. Then, a framework is suggested for implementing virtual collaborative networks. Finally, based on that suggestion, as a case study, we design a virtual collaborative network in automobile components production industry.

  14. Semantic e-Science in Space Physics - A Case Study

    NASA Astrophysics Data System (ADS)

    Narock, T.; Yoon, V.; Merka, J.; Szabo, A.

    2009-05-01

    Several search and retrieval systems for space physics data are currently under development in NASA's heliophysics data environment. We present a case study of two such systems, and describe our efforts in implementing an ontology to aid in data discovery. In doing so we highlight the various aspects of knowledge representation and show how they led to our ontology design, creation, and implementation. We discuss advantages that scientific reasoning allows, as well as difficulties encountered in current tools and standards. Finally, we present a space physics research project conducted with and without e-Science and contrast the two approaches.

  15. KEY ITEMS OF INNOVATION MANAGEMENT IN THE PRIMARY HEALTHCARE CENTRES CASE STUDY: FINLAND.

    PubMed

    Aslani, Alireza; Zolfagharzadeh, Mohammad Mahdi; Naaranoja, Marja

    2015-09-01

    Trends such as aging populations, excess costs, rising public expectations, and progress in medical science and technologies point out the necessity of adaptation and development of innovation in the healthcare systems particularly in developed countries. The main objective of this article is to review diffusion of innovation in the healthcare sector. Different types of innovation, diffusion characteristics, and adoption mechanisms are the subjects that are discussed in the selected case study, Finland. Finally, the key items of innovation management in the Finnish health system are introduced. The results can be implemented in other countries as well.

  16. Influence of health promotion bureaucracy on community participation: a Canadian case study.

    PubMed

    Boyce, William F

    2002-03-01

    The purpose of this paper is to illustrate, through a Canadian case study, the bureaucratic support and obstacles for community participation in health promotion. The paper begins with a brief history of the development of a participatory health promotion programme in Canada. The role of bureaucracies on participation of communities is highlighted. Secondly, the paper describes how a variety of bureaucratic factors affected grassroots community participation efforts of local projects in one province. Finally, discussion focuses on how community participation is constrained in a bureau-cratically mediated activity such as health promotion.

  17. Performance of small water treatment plants: The case study of Mutshedzi Water Treatment Plant

    NASA Astrophysics Data System (ADS)

    Makungo, R.; Odiyo, J. O.; Tshidzumba, N.

    The performance of small water treatment plants (SWTPs) was evaluated using Mutshedzi WTP as a case study. The majority of SWTPs in South Africa (SA) that supply water to rural villages face problems of cost recovery, water wastages, limited size and semi-skilled labour. The raw and final water quality analyses and their compliance were used to assess the performance of the Mutshedzi WTP. Electrical conductivity (EC), pН and turbidity were measured in the field using a portable multimeter and a turbidity meter respectively. Atomic Absorption Spectrometry and Ion Chromatography were used to analyse metals and non-metals respectively. The results were compared with the Department of Water Affairs (DWA) guidelines for domestic use. The turbidity levels partially exceeded the recommended guidelines for domestic water use of 1 NTU. The concentrations of chemical parameters in final water were within the DWA guidelines for domestic water use except for fluoride, which exceeded the maximum allowable guideline of 1.5 mg/L in August 2009. Mutshedzi WTP had computed compliance for raw and final water analyses ranging from 79% to 93% and 86% to 93% throughout the sampling period, respectively. The results from earlier studies showed that the microbiological quality of final water in Mutshedzi WTP complied with the recommended guidelines, eliminating the slight chance of adverse aesthetic effects and infectious disease transmission associated with the turbidity values between 1 and 5 NTU. The study concluded that Mutshedzi WTP, though moving towards compliance, is still not producing adequate quality of water. Other studies also indicated that the quantity of water produced from Mutshedzi WTP was inadequate. The findings of the study indicate that lack of monitoring of quantity of water supplied to each village, dosage of treatment chemicals, the treatment capacity of the WTP and monitoring the quality of water treated are some of the factors that limit the performance of Mutshedzi WTP. These have been confirmed in literature to be widespread in similar WTPs in SA. It is recommended that water meters be provided and the community be advised to subsidise the cost of water supply. The study recommended that the treatments of turbidity and fluoride should form critical functions of the plant to ensure that final water for domestic use is always safe from any harmful substances or disease causing pathogens. The study concluded that the WTP only needs minor improvement to boost its efficiency with regard to the treatment of raw water. This will also ensure that the plant achieves 100% compliance for final water.

  18. The efficiency of utilization of potential donors for organ transplantation in Saudi Arabia: a pilot study.

    PubMed

    Al Sebayel, M I M; Khalaf, H A

    2004-09-01

    Organ shortage has been the main obstacle in the progress of organ transplantation in Saudi Arabia. The aim of this pilot study was to determine the percentage of potential donors among all deaths in Riyadh hospital intensive care units (ICUs). Mortality data were collected by a medical professional in each ICU and analyzed on weekly basis for 1 year (June 2001 through May 2002): The final analysis at the end of the year showed the number of brain death cases in all hospitals to be 114 out of 542 deaths. Fifty-four percent occurred in one hospital. Thirty-eight cases were reported to the Saudi Center for Organ Transplantation (33%). Documentation was completed in only 23 cases (60%). Only four cases became actual donors. In conclusion, there is underreporting of brain death cases. Dealing with the reported cases is inefficient since only four cases became actual donors out of 38. Improving the efficiency of ICUs in dealing with brain death cases (reporting, documentation, maintenance and consent) will require solving several problems at the medical, administrative, religious, and mass media levels.

  19. [Radicalism and feminism: The case of Poulain de la Barre].

    PubMed

    Pellegrin, Marie-Frédérique

    2015-12-01

    Early modern radicalism and its criteria are described and defined by Jonathan Israel in various works. Poulain de la Barre, one of the first modern feminist thinkers, first is used by Israel as an example of the so-called radical Enlightenment and finally is rejected as such. This case study exhibed the necessity of questionning the coherence of the required criteria for defining a « radical » thinker, especially when examinating carefully the last paragraph of Spinoza's Political Treatise.

  20. On estimation of time-dependent attributable fraction from population-based case-control studies.

    PubMed

    Zhao, Wei; Chen, Ying Qing; Hsu, Li

    2017-09-01

    Population attributable fraction (PAF) is widely used to quantify the disease burden associated with a modifiable exposure in a population. It has been extended to a time-varying measure that provides additional information on when and how the exposure's impact varies over time for cohort studies. However, there is no estimation procedure for PAF using data that are collected from population-based case-control studies, which, because of time and cost efficiency, are commonly used for studying genetic and environmental risk factors of disease incidences. In this article, we show that time-varying PAF is identifiable from a case-control study and develop a novel estimator of PAF. Our estimator combines odds ratio estimates from logistic regression models and density estimates of the risk factor distribution conditional on failure times in cases from a kernel smoother. The proposed estimator is shown to be consistent and asymptotically normal with asymptotic variance that can be estimated empirically from the data. Simulation studies demonstrate that the proposed estimator performs well in finite sample sizes. Finally, the method is illustrated by a population-based case-control study of colorectal cancer. © 2017, The International Biometric Society.

  1. Nanomaterial Case Study: Nanoscale Silver in Disinfectant ...

    EPA Pesticide Factsheets

    This draft document presents a case study of engineered nanoscale silver (nano-Ag), focusing on the specific example of nano-Ag as possibly used in disinfectant sprays. This case study is organized around a comprehensive environmental assessment (CEA) framework, which combines a product life-cycle perspective with the risk assessment paradigm. The document does not draw conclusions about potential risks. Instead, it is intended to be used as part of a process to identify what is known and unknown about nano-Ag in a selected application and can be used as a starting point to identify and prioritize possible research directions to support future assessments of nanomaterials. The information presented in the case study and the questions raised in this document are a foundation for a process to determine priorities among various research topics and directions. After that process has been completed, a final chapter will be added to this document to summarize highlights from preceding chapters and the major research issues that have emerged.

  2. Accuracy of pre-operative hysteroscopic guided biopsy for predicting final pathology in uterine malignancies.

    PubMed

    Martinelli, Fabio; Ditto, Antonino; Bogani, Giorgio; Signorelli, Mauro; Chiappa, Valentina; Lorusso, Domenica; Haeusler, Edward; Raspagliesi, Francesco

    2017-07-01

    To evaluate concordance (C) between pre-operative hysteroscopic-directed sampling and final pathology in uterine cancers. A retrospective cross-sectional evaluation of prospectively collected data of women who underwent hysterectomy for uterine malignancies and a previous hysteroscopic-guided biopsy was performed. Diagnostic concordance between pre-operative (hysteroscopic biopsy) and postoperative (uterine specimen) histology was evaluated. In endometrioid-endometrial cancers cases Kappa (k) statistics was applied to evaluate agreement for grading (G) between the preoperative and final pathology. A total 101 hysterectomies for uterine malignancies were evaluated. There were 23 non-endometrioid cancers: 7 serous (C:5/7, 71.4%); 10 carcinosarcomas (C:7/10, 70%, remaining 3 cases only epithelial component diagnosed); 3 clear cell (C:3/3, 100%); 3 sarcomas (C:3/3, 100%). In 78 cases an endometrioid endometrial cancer was found. In 63 cases there was a histological C (63/78, 80.8%) between hysteroscopic-guided biopsy and final pathology, while in 15 cases (19.2%) only hyperplasia (with/without atypia) was found preoperatively. Overall accuracy to detect endometrial cancer was 80.2%. In 50 out of 63 endometrial cancers (79.4%) grading was concordant. The overall level of agreement between preoperative and postoperative grading was "substantial" according to Kappa (k) statistics (k 0.64; 95% CI: 0.449-0.83; p < 0.001), as well as for G1 (0.679; 95% CI: 0.432-0.926; p < 0.001) and G3 (0.774; 94% CI: 0.534-1; p < 0.001), while for G2 (0.531; 95% CI: 0.286-0.777; p < 0.001) it was moderate. In our series we found an 80% C between pre-operative hysteroscopic-guided biopsy and final pathology, in uterine malignancies. Moreover, hysteroscopic biopsy accurately predicted endometrial cancer in 80% of cases and "substantially" predicted histological grading. Hysteroscopic-guided uterine sampling could be a useful tool to tailor treatment in patients with uterine malignancies.

  3. Can an intervention based on a serious videogame prior to cognitive behavioral therapy be helpful in bulimia nervosa? A clinical case study

    PubMed Central

    Giner-Bartolomé, Cristina; Fagundo, Ana B.; Sánchez, Isabel; Jiménez-Murcia, Susana; Santamaría, Juan J.; Ladouceur, Robert; Menchón, José M.; Fernández-Aranda, Fernando

    2015-01-01

    Background: Several studies have highlighted the implications of impulsivity and novelty seeking for both the maintenance and the process of recovery from bulimia nervosa (BN). Cognitive behavioral therapy (CBT) is the treatment of choice for BN, but for some cases, this treatment alone might not be sufficient for reducing the high levels of impulsivity. The paper presents a case report of a patient with BN, examining the effectiveness of using a videogame (VG; Playmancer) as an additional intervention designed to address impulsivity. Design: Psychometric and neuropsychological measures were collected at baseline. After this assessment, Playmancer was applied prior to CBT, following an “A-B-A-C-A” single case experimental design. Impulsivity levels were assessed with the Conner’s Continuous Performance Test II (CPT-II). After the Playmancer treatment, the patient started CBT, and the levels of impulsivity were recorded again. Finally, psychometric and neuropsychological measures were collected after treatment. Weekly frequency of binges and vomiting were also recorded during the entire procedure. Results: After the VG intervention, psychometric measures such as anxiety levels, impulsivity and novelty seeking decreased. Regarding the neuropsychological measures, impulsivity levels (measured with the CPT-II) progressively decreased throughout the intervention, and an improvement in decision making capacities was observed. Furthermore, the frequency of binges also decreased during and after the VG intervention. Discussion: This case report suggests that using the Playmancer VG to reduce impulsivity prior to CBT may enhance the final results of the treatment for BN. PMID:26236261

  4. “End-Stage” Neurofibrillary Tangle Pathology in Preclinical Alzheimer's Disease: Fact or Fiction?

    PubMed Central

    Abner, Erin L.; Kryscio, Richard J.; Schmitt, Frederick A.; SantaCruz, Karen S.; Jicha, Gregory A.; Lin, Yushun; Neltner, Janna M.; Smith, Charles D.; Van Eldik, Linda J.; Nelson, Peter T.

    2011-01-01

    Among individuals who were cognitively intact before death, autopsies may reveal some Alzheimer's disease-type pathology. The presence of end-stage pathology in cognitively intact persons would support the hypothesis that pathological markers are epiphenomena. We assessed advanced neurofibrillary (Braak stages V and VI) pathology focusing on nondemented individuals. Data from the National Alzheimer's Coordinating Center database (n = 4,690 included initially) and from the Nun Study (n = 526 included initially) were analyzed, with antemortem information about global cognition and careful postmortem studies available from each case. Global cognition (final Mini-Mental State Examination scores [MMSE] and clinical ‘dementia’ status) was correlated with neuropathology, including the severity of neurofibrillary pathology (Braak stages and neurofibrillary tangle counts in cerebral neocortex). Analyses support three major findings: 1. Braak stage V cases and Braak VI cases are significantly different from each other in terms of associated antemortem cognition; 2. There is an appreciable range of pathology within the category of Braak stage VI based on tangle counts such that brains with the most neurofibrillary tangles in neocortex always had profound antemortem cognitive impairment; and 3. There was no nondemented case with final MMSE score of 30 within a year of life and Braak stage VI pathology. It may be inappropriate to combine Braak stages V and VI cases, particularly in patients with early cognitive dysfunction, since the two pathological stages appear to differ dramatically in terms of both pathological severity and antemortem cognitive status. There is no documented example of truly end-stage neurofibrillary pathology coexisting with intact cognition. PMID:21471646

  5. Case-control studies in diabetes. Do they really use a case-control design?

    PubMed

    Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

    2017-07-01

    Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

  6. Issue Management by School Superintendents: Final Report. Part II.

    ERIC Educational Resources Information Center

    Huff, Anne S.; Pondy, Louis R.

    Four papers generated by a broader study of issues management in three suburban Chicago school districts are collected here. "Achieving Routine" focuses on the effective routinization of organizational change, in this case a curriculum decision, through the use of administrative mechanisms and the conceptual linkage of the new to…

  7. The Impact of Automation on Libraries. Final Report.

    ERIC Educational Resources Information Center

    Cline, Hugh F.; Sinnott, Loraine T.

    This project examined a series of alternative policies for the management and funding of university libraries as they adopt and adapt to various information science technologies to accomplish the functions of acquisitions, cataloging, circulation, and reference services. Comparative case studies were completed at the University of Chicago,…

  8. CHARACTERISTICS OF HUMAN SPERM CHROMATIN STRUCTURE FOLLOWING AN EPISODE OF INFLUENZA AND HIGH FEVER: A CASE STUDY. (R827019)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  9. Quantifying spatial and temporal variability of methane emissions from a complex area source: case study of a central Indiana landfill

    EPA Science Inventory

    strengths, limitations, and uncertainties of these two approaches. Because US landfills are highly-engineered and composed of daily, intermediate, and final cover areas with differing thicknesses, composition, and implementation of gas recovery, we also expected different emissi...

  10. THREE-DIMENSIONAL HYDRODYNAMIC MODEL, STUDY CASES FOR QUARTER ANNULAR AND IDEALIZED SHIP CHANNEL PROBLEMS. (R828773C002)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  11. A GRADIENT ANALYSIS OF URBAN LANDSCAPE PATTERN: A CASE STUDY FROM THE PHOENIX METROPOLITAN REGION, ARIZONA, USA. (R827676)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  12. AIR POLLUTION AND CASE FATALITY OF SARS IN THE PEOPLE'S REPUBLIC OF CHINA: AN ECOLOGIC STUDY. (R827352)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  13. Do Prospective Mathematics Teachers Teach Who They Say They Are?

    ERIC Educational Resources Information Center

    van Putten, Sonja; Stols, Gerrit; Howie, Sarah

    2014-01-01

    In this case study, the professional mathematics teacher identity (PMTI) of final year mathematics education students is investigated in terms of their self-perceived and actualised identity. These prospective teachers were required to discuss and describe their own PMTI in terms of three aspects: mathematics specialisation, teaching-and-learning…

  14. Geothermal Heat Pumps Score High Marks in Schools.

    ERIC Educational Resources Information Center

    National Renewable Energy Lab (DOE).

    Geothermal heat pumps (GHPs) are showing their value in providing lower operating and maintenance costs, energy efficiency, and superior classroom comfort. This document describes what GHPs are and the benefits a school can garner after installing a GHP system. Three case studies are provided that illustrate these benefits. Finally, the Department…

  15. Peer Review Methods for ESL Writing Improvement

    ERIC Educational Resources Information Center

    Soares, Colleen J.

    2004-01-01

    This teacher research shows how peer reviews change draft papers. In the majority of cases, final papers improved in content. The study analyzes data collected from 40 intermediate/advanced nonnative speakers of English enrolled in freshman composition for international students at a large private university. It also examines student reflections…

  16. CAUSAL ANALYSIS OF BIOLOGICAL IMPAIRMENT IN LONG CREEK, A SANDY-BOTTOMED STREAM IN COASTAL SOUTHERN MAINE (Final Report)

    EPA Science Inventory

    This assessment presents results from a complex causal assessment of a biologically impaired, urbanized coastal watershed located primarily in South Portland, Maine, USA—the Long Creek watershed. This case study serves as an example implementation of U.S. Environmental Protectio...

  17. Truck Size and Weight Modelling Workshop : activity 2 : Task C refine freight diversion models for all modes

    DOT National Transportation Integrated Search

    1995-09-01

    One final overall observation from the workshop was that FHWA should consider case studies o f : industry practices. This approach differs from TS&W modeling, but could be used to build a microapproach for national TS&W analysis. For example, differe...

  18. A new symmetrical quasi-classical model for electronically non-adiabatic processes: Application to the case of weak non-adiabatic coupling

    DOE PAGES

    Cotton, Stephen J.; Miller, William H.

    2016-10-14

    Previous work has shown how a symmetrical quasi-classical (SQC) windowing procedure can be used to quantize the initial and final electronic degrees of freedom in the Meyer-Miller (MM) classical vibronic (i.e, nuclear + electronic) Hamiltonian, and that the approach provides a very good description of electronically non-adiabatic processes within a standard classical molecular dynamics framework for a number of benchmark problems. This study explores application of the SQC/MM approach to the case of very weak non-adiabatic coupling between the electronic states, showing (as anticipated) how the standard SQC/MM approach used to date fails in this limit, and then devises amore » new SQC windowing scheme to deal with it. Finally, application of this new SQC model to a variety of realistic benchmark systems shows that the new model not only treats the weak coupling case extremely well, but it is also seen to describe the “normal” regime (of electronic transition probabilities ≳ 0.1) even more accurately than the previous “standard” model.« less

  19. A new symmetrical quasi-classical model for electronically non-adiabatic processes: Application to the case of weak non-adiabatic coupling

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

    Cotton, Stephen J.; Miller, William H.

    Previous work has shown how a symmetrical quasi-classical (SQC) windowing procedure can be used to quantize the initial and final electronic degrees of freedom in the Meyer-Miller (MM) classical vibronic (i.e, nuclear + electronic) Hamiltonian, and that the approach provides a very good description of electronically non-adiabatic processes within a standard classical molecular dynamics framework for a number of benchmark problems. This study explores application of the SQC/MM approach to the case of very weak non-adiabatic coupling between the electronic states, showing (as anticipated) how the standard SQC/MM approach used to date fails in this limit, and then devises amore » new SQC windowing scheme to deal with it. Finally, application of this new SQC model to a variety of realistic benchmark systems shows that the new model not only treats the weak coupling case extremely well, but it is also seen to describe the “normal” regime (of electronic transition probabilities ≳ 0.1) even more accurately than the previous “standard” model.« less

  20. An Investigation into the Length of Hospital Stay for Deaf Mental Health Service Users

    ERIC Educational Resources Information Center

    Baines, Di; Patterson, Neil; Austen, Sally

    2010-01-01

    This study looked at the average length of hospital stay for inpatients in a specialist deaf mental health service over a 10-year period, in comparison to that of a general psychiatric hearing cohort. In addition, two case studies of deaf inpatients were carried out looking specifically at the prerequisite factors governing discharge. Finally, a…

  1. What Are Extraordinary Gifted Children like (Equal to or above 189 IQ)? A Study of 10 Cases

    ERIC Educational Resources Information Center

    Mate, Yolanda Benito

    2009-01-01

    After a short introduction about previous studies on extraordinarily gifted children with an IQ of over 170, this article refers to the descriptive characteristics of ten children with IQ of over 189. After this, the developmental and learning characteristics of these children are described and finally empirical research about aspects that…

  2. Reverse Engineering and Software Products Reuse to Teach Collaborative Web Portals: A Case Study with Final-Year Computer Science Students

    ERIC Educational Resources Information Center

    Medina-Dominguez, Fuensanta; Sanchez-Segura, Maria-Isabel; Mora-Soto, Arturo; Amescua, Antonio

    2010-01-01

    The development of collaborative Web applications does not follow a software engineering methodology. This is because when university students study Web applications in general, and collaborative Web portals in particular, they are not being trained in the use of software engineering techniques to develop collaborative Web portals. This paper…

  3. From Students of Teaching to Teachers of Students: Teacher Induction around the Pacific Rim.

    ERIC Educational Resources Information Center

    Moskowitz, Jay, Ed.; Stephens, Maria, Ed.

    This is the final report of Phase 2 of a study on teacher training and professional development in the nation members of Asia Pacific Economic Cooperation (APEC). Phase 2 examined policy and practices of teacher induction in 11 participating APEC members. This report provides responses to a survey and three case studies. The survey asked Education…

  4. Energy Implementation Centers: A Method of Speeding the Use of Solar Energy and Other Energy Conserving Technologies. Final Report.

    ERIC Educational Resources Information Center

    Hirshberg, A. S.; And Others

    This report examines the role of implementation centers as a vehicle for speeding the use of solar energy and energy conservation. It covers a study of previous building industry innovations; a brief review of the diffusion of innovation literature, including several case studies; identification of the solar thermal application process and…

  5. A Regional Approach to Rail Transit Training for the New York Metropolitan Area. Final Report.

    ERIC Educational Resources Information Center

    McKnight, Claire E.; Rotter, Naomi

    A study examined the feasibility of a regional approach to rail transit training in the New York metropolitan area. First, case studies were collected to document existing training practices at the five agencies currently responsible for training rail transit workers in the New York metropolitan area and to identify mutual training needs that…

  6. Case Studies of Schools Receiving School Improvement Grants. Final Report. NCEE 2016-4002

    ERIC Educational Resources Information Center

    Le Floch, Kerstin Carlson; O'Day, Jennifer; Birman, Beatrice; Hurlburt, Steven; Nayfack, Michelle; Halloran, Clare; Boyle, Andrea; Brown, Seth; Mercado-Garcia, Diana; Goff, Rose; Rosenberg, Linda; Hulsey, Lara

    2016-01-01

    The Study of School Turnaround (SST) examines the change process in a diverse, purposive sample of schools receiving federal School Improvement Grants (SIG) from 2010-11 to 2012-13. With the passage of the American Recovery and Reinvestment Act of 2009 (ARRA), the SIG program underwent three major shifts. First, ARRA boosted total SIG funding in…

  7. 37 CFR 2.64 - Final action.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Final action. 2.64 Section 2... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES Examination of Application and Action by Applicants § 2.64 Final action. (a) On the first or any subsequent reexamination or reconsideration the refusal of the...

  8. 37 CFR 2.64 - Final action.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Final action. 2.64 Section 2... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES Examination of Application and Action by Applicants § 2.64 Final action. (a) On the first or any subsequent reexamination or reconsideration the refusal of the...

  9. Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.

    PubMed

    Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

    2016-01-01

    The contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions. Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. In the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. The design of the study made it difficult to draw definite cause-and-effect conclusions. The Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients' attributes and the medical decisions made at these meetings show that these attributes should be taken into account in order to understand how medical decisions are reached in difficult situations of this kind.

  10. Communication of scientific uncertainty: international case studies on the development of folate and vitamin D Dietary Reference Values.

    PubMed

    Brown, Kerry A; de Wit, Liesbeth; Timotijevic, Lada; Sonne, Anne-Mette; Lähteenmäki, Liisa; Brito Garcia, Noé; Jeruszka-Bielak, Marta; Sicińska, Ewa; Moore, Alana N; Lawrence, Mark; Raats, Monique M

    2015-06-01

    Transparent evidence-based decision making has been promoted worldwide to engender trust in science and policy making. Yet, little attention has been given to transparency implementation. The degree of transparency (focused on how uncertain evidence was handled) during the development of folate and vitamin D Dietary Reference Values was explored in three a priori defined areas: (i) value request; (ii) evidence evaluation; and (iii) final values. Qualitative case studies (semi-structured interviews and desk research). A common protocol was used for data collection, interview thematic analysis and reporting. Results were coordinated via cross-case synthesis. Australia and New Zealand, Netherlands, Nordic countries, Poland, Spain and UK. Twenty-one interviews were conducted in six case studies. Transparency of process was not universally observed across countries or areas of the recommendation setting process. Transparency practices were most commonly seen surrounding the request to develop reference values (e.g. access to risk manager/assessor problem formulation discussions) and evidence evaluation (e.g. disclosure of risk assessor data sourcing/evaluation protocols). Fewer transparency practices were observed to assist with handling uncertainty in the evidence base during the development of quantitative reference values. Implementation of transparency policies may be limited by a lack of dedicated resources and best practice procedures, particularly to assist with the latter stages of reference value development. Challenges remain regarding the best practice for transparently communicating the influence of uncertain evidence on the final reference values. Resolving this issue may assist the evolution of nutrition risk assessment and better inform the recommendation setting process.

  11. Abstracting ICU Nursing Care Quality Data From the Electronic Health Record.

    PubMed

    Seaman, Jennifer B; Evans, Anna C; Sciulli, Andrea M; Barnato, Amber E; Sereika, Susan M; Happ, Mary Beth

    2017-09-01

    The electronic health record is a potentially rich source of data for clinical research in the intensive care unit setting. We describe the iterative, multi-step process used to develop and test a data abstraction tool, used for collection of nursing care quality indicators from the electronic health record, for a pragmatic trial. We computed Cohen's kappa coefficient (κ) to assess interrater agreement or reliability of data abstracted using preliminary and finalized tools. In assessing the reliability of study data ( n = 1,440 cases) using the finalized tool, 108 randomly selected cases (10% of first half sample; 5% of last half sample) were independently abstracted by a second rater. We demonstrated mean κ values ranging from 0.61 to 0.99 for all indicators. Nursing care quality data can be accurately and reliably abstracted from the electronic health records of intensive care unit patients using a well-developed data collection tool and detailed training.

  12. Black hole formation due to collapsing dark matter in a presence of dark energy in the brane-world scenario

    NASA Astrophysics Data System (ADS)

    Shah, Hasrat Hussain

    In the last three to four decades, various programs have been studied in order to investigate the final fate of gravitational collapse of massive astronomical objects. In the theoretical context, Black Holes (BHs) are the consequence of final stage of the gravitational collapse. In this work, we investigated the gravitational collapse process of a spherically symmetric star constituted of dark matter (DM), ρM, and Dark Energy (DE), ρ in the context of the brane-world scenario. In our model, we discussed the anisotropy of the pressure in a fluid with Equation of State (EoS) pt = kρ and pr = lρ, (l + 2k < ‑1). We briefly discussed various cases of gravitational collapse and it is found that BH can be formed by the gravitational collapse in brane-world regime while in some cases there is only a naked singularity at their end state.

  13. Towards a Neurodevelopmental Model of Clinical Case Formulation

    PubMed Central

    Solomon, Marjorie; Hessl, David; Chiu, Sufen; Olsen, Emily; Hendren, Robert

    2009-01-01

    Rapid advances in molecular genetics and neuroimaging over the last 10-20 years have been a catalyst for research in neurobiology, developmental psychopathology, and translational neuroscience. Methods of study in psychiatry, previously described as “slow maturing,” now are becoming sufficiently sophisticated to more effectively investigate the biology of higher mental processes. Despite these technological advances, the recognition that psychiatric disorders are disorders of neurodevelopment, and the importance of case formulation to clinical practice, a neurodevelopmental model of case formulation has not yet been articulated. The goals of this manuscript, which is organized as a clinical case conference, are to begin to articulate a neurodevelopmental model of case formulation, to illustrate its value, and finally to explore how clinical psychiatric practice might evolve in the future if this model were employed. PMID:19248925

  14. Portable gamma camera guidance in sentinel lymph node biopsy: prospective observational study of consecutive cases.

    PubMed

    Peral Rubio, F; de La Riva, P; Moreno-Ramírez, D; Ferrándiz-Pulido, L

    2015-06-01

    Sentinel lymph node biopsy is the most important tool available for node staging in patients with melanoma. To analyze sentinel lymph node detection and dissection with radio guidance from a portable gamma camera. To assess the number of complications attributable to this biopsy technique. Prospective observational study of a consecutive series of patients undergoing radioguided sentinel lymph node biopsy. We analyzed agreement between nodes detected by presurgical lymphography, those detected by the gamma camera, and those finally dissected. A total of 29 patients (17 women [62.5%] and 12 men [37.5%]) were enrolled. The mean age was 52.6 years (range, 26-82 years). The sentinel node was dissected from all patients; secondary nodes were dissected from some. In 16 cases (55.2%), there was agreement between the number of nodes detected by lymphography, those detected by the gamma camera, and those finally dissected. The only complications observed were seromas (3.64%). No cases of wound dehiscence, infection, hematoma, or hemorrhage were observed. Portable gamma-camera radio guidance may be of use in improving the detection and dissection of sentinel lymph nodes and may also reduce complications. These goals are essential in a procedure whose purpose is melanoma staging. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  15. Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study.

    PubMed

    Eastwood, K; Paterson, B J; Levi, C; Givney, R; Loewenthal, M; DE Malmanche, T; Lai, K; Granerod, J; Durrheim, D N

    2015-11-01

    Few countries routinely collect comprehensive encephalitis data, yet understanding the epidemiology of this condition has value for clinical management, detecting novel and emerging pathogens, and guiding timely public health interventions. When this study was conducted there was no standardized diagnostic algorithm to aid identification of encephalitis or systematic surveillance for adult encephalitis. In July 2012 we tested three pragmatic surveillance options aimed at identifying possible adult encephalitis cases admitted to a major Australian hospital: hospital admissions searches, clinician notifications and laboratory test alerts (CSF herpes simplex virus requests). Eligible cases underwent structured laboratory investigation and a specialist panel arbitrated on the final diagnosis. One hundred and thirteen patients were initially recruited into the 10-month study; 20/113 (18%) met the study case definition, seven were diagnosed with infectious or immune-mediated encephalitis and the remainder were assigned alternative diagnoses. The laboratory alert identified 90% (102/113) of recruited cases including six of the seven cases of confirmed encephalitis suggesting that this may be a practical data source for case ascertainment. The application of a standardized diagnostic algorithm and specialist review by an expert clinical panel aided diagnosis of patients with encephalitis.

  16. Evaluation of an online, case-based interactive approach to teaching pathophysiology.

    PubMed

    Van Dijken, Pieter Canham; Thévoz, Sara; Jucker-Kupper, Patrick; Feihl, François; Bonvin, Raphaël; Waeber, Bernard

    2008-06-01

    The aim of this study was to evaluate a new pedagogical approach in teaching fluid, electrolyte and acid-base pathophysiology in undergraduate students. This approach comprises traditional lectures, the study of clinical cases on the web and a final interactive discussion of these cases in the classroom. When on the web, the students are asked to select laboratory tests that seem most appropriate to understand the pathophysiological condition underlying the clinical case. The percentage of students having chosen a given test is made available to the teacher who uses it in an interactive session to stimulate discussion with the whole class of students. The same teacher used the same case studies during 2 consecutive years during the third year of the curriculum. The majority of students answered the questions on the web as requested and evaluated positively their experience with this form of teaching and learning. Complementing traditional lectures with online case-based studies and interactive group discussions represents, therefore, a simple means to promote the learning and the understanding of complex pathophysiological mechanisms. This simple problem-based approach to teaching and learning may be implemented to cover all fields of medicine.

  17. Final inpatient rehabilitation PPS rule improves on proposed rule.

    PubMed

    Reynolds, M

    2001-10-01

    On August 7, 2001, the Centers for Medicare and Medicaid Services (CMS--formerly HCFA) released the final rule for a new prospective payment system (PPS) for inpatient rehabilitation services describing the process that must be used to receive payment for such services provided to Medicare beneficiaries. The process consists of five steps: First, a clinician performs assessments of the patient upon admission and at discharge. Second, the patient is classified into a case-mix group (CMG) with an assigned relative-value weight within that CMG. Third, the Federal prospective payment rate is determined by multiplying the relative-value weight by an annually updated, budget-neutral conversion factor. Fourth, the Federal prospective payment rate is adjusted to account for facility-specific factors. Finally, the facility-adjusted payment rate may be adjusted for case-specific factors. The final rule eliminates three deficiencies in the proposed rule by providing increased payment for treating any comorbidities documented prior to the second day before discharge, providing more appropriate payment for transfer cases, and minimizing the paperwork associated with patient assessment.

  18. Office of Exploration: Exploration studies technical report. Volume 2: Studies approach and results

    NASA Technical Reports Server (NTRS)

    Roberts, Barney B.; Bland, Dan

    1988-01-01

    The NASA Office of Exploration has been tasked with defining and recommending alternatives for an early 1990's national decision on a focused program of human exploration of the solar system. The Mission Analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report describes the process that has been developed in a case study approach. The four case studies that were developed in FY88 include: (1) human expedition to Phobos; (2) human expeditions to Mars; (3) lunar observatory; and (4) lunar outpost to early Mars evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work. Volume 2 describes the case study process, the technical results of each of the case studies, and opportunities for additional study. Included in the discussion of each case study is a description of the mission key features and profile. Mission definition and manifesting are detailed, followed by a description of the mission architecture and infrastructure. Systems concepts for the required orbital nodes, transportation systems, and planetary surface systems are discussed. Prerequisite implementation plans resulting from the synthesized case studies are described and in-depth assessments are presented.

  19. A contribution to the discussion concerning the variability of the third peroneal muscle: an anatomical analysis on the basis of foetal material.

    PubMed

    Domagała, Z; Gworys, B; Kreczyńska, B; Mogbel, S

    2006-11-01

    The aim of the work was to make a systemic study of the variability of the human musculus peroneus tertius during the foetal period. Examination was made of 193 foetuses of ages ranging from 84 to 256 days after conception. The results obtained indicated that the musculus peroneus tertius was present in 83.16% of the human foetuses studied and that its intrauterine development was progressive and almost proportional. Previous studies have not revealed dimorphic or bilateral differences with respect to any of the features examined. On the basis of the examinations and bibliographical data a uniform typology of the musculus peroneus tertius variants was created and three final types were distinguished: the pithecogenic (44% cases), eugenic (34% cases) and progenic (22% cases).

  20. Tomosynthesis in the Diagnostic Setting: Changing Rates of BI-RADS Final Assessment over Time.

    PubMed

    Raghu, Madhavi; Durand, Melissa A; Andrejeva, Liva; Goehler, Alexander; Michalski, Mark H; Geisel, Jaime L; Hooley, Regina J; Horvath, Laura J; Butler, Reni; Forman, Howard P; Philpotts, Liane E

    2016-10-01

    Purpose To evaluate the effect of tomosynthesis in diagnostic mammography on the Breast Imaging Reporting and Data System (BI-RADS) final assessment categories over time. Materials and Methods This retrospective study was approved by the institutional review board. The authors reviewed all diagnostic mammograms obtained during a 12-month interval before (two-dimensional [2D] mammography [June 2, 2010, to June 1, 2011]) and for 3 consecutive years after (tomosynthesis year 1 [2012], tomosynthesis year 2 [2013], and tomosynthesis year 3 [2014]) the implementation of tomosynthesis. The requirement to obtain informed consent was waived. The rates of BI-RADS final assessment categories 1-5 were compared between the 2D and tomosynthesis groups. The positive predictive values after biopsy (PPV3) for BI-RADS category 4 and 5 cases were compared. The mammographic features (masses, architectural distortions, calcifications, focal asymmetries) of lesions categorized as probably benign (BI-RADS category 3) and those for which biopsy was recommended (BI-RADS category 4 or 5) were reviewed. The χ(2) test was used to compare the rates of BI-RADS final assessment categories 1-5 between the two groups, and multivariate logistic regression analysis was performed to compare all diagnostic studies categorized as BI-RADS 3-5. Results There was an increase in the percentage of cases reported as negative or benign (BI-RADS category 1 or 2) with tomosynthesis (58.7% with 2D mammography vs 75.8% with tomosynthesis at year 3, P < .0001). A reduction in the percentage of probably benign (BI-RADS category 3) final assessments also occurred (33.3% with 2D mammography vs 16.4% with tomosynthesis at year 3, P < .0001). Although the rates of BI-RADS 4 or 5 assessments did not change significantly with tomosynthesis (8.0% with 2D mammography vs 7.8% with tomosynthesis at year 3, P = .2), there was a significant increase in the PPV3 (29.6% vs 50%, respectively; P < .0001). These trends increased during the 3 years of tomosynthesis use. Conclusion Tomosynthesis in the diagnostic setting resulted in progressive shifts in the BI-RADS final assessment categories over time, with a significant increase in the proportion of studies classified as normal, a continued decrease in the rate of studies categorized as probably benign, and improved diagnostic confidence in biopsy recommendations. (©) RSNA, 2016.

  1. Bowman’s layer encystment in cases of persistent Acanthamoeba keratitis

    PubMed Central

    Yokogawa, Hideaki; Kobayashi, Akira; Yamazaki, Natsuko; Ishibashi, Yasuhisa; Oikawa, Yosaburo; Tokoro, Masaharu; Sugiyama, Kazuhisa

    2012-01-01

    Background The purpose of this study was to report Acanthamoeba encystment in Bowman’s layer in Japanese cases of persistent Acanthamoeba keratitis (AK). Methods Laser confocal microscopic images of the cornea were obtained in vivo from 18 consecutive eyes from 17 confirmed AK patients. Retrospectively, 14 cases treated over 4 months were categorized as a nonpersistent group and three cases that required prolonged therapy for more than 6 months were categorized as a persistent group. Clinical outcomes based on final best-corrected visual acuity were retrospectively analyzed, and selected confocal images were evaluated qualitatively for abnormal findings. Results The final best-corrected visual acuity was significantly lower (P < 0.01) for patients in the persistent group compared with that in the nonpersistent group. At the initial visit, in vivo confocal microscopy demonstrated Acanthamoeba cysts exclusively in the epithelial layer in both the nonpersistent group (80%) and the persistent group (100%). At a subsequent follow-up visit, numerous Acanthamoeba cysts were observed in the epithelial cell layer and in Bowman’s layer in all patients with persistent AK, but Acanthamoeba cysts were undetectable in all cases with nonpersistent AK tested. Conclusion Invasion of cysts into Bowman’s layer was characteristically observed in patients with persistence of AK. This finding suggests that invasion of Acanthamoeba cysts into Bowman’s layer may be a useful predictor for a persistent clinical course. PMID:22927735

  2. Review of Research on Teachers’ Pedagogical Judgments, Plans, and Decisions,

    DTIC Science & Technology

    1982-11-01

    simulation studies; and (3) training studies. Four laboratory and classroom studies have examined the degree to which reading clinicians and classroom teachers...clinicians who diagnosed the same cases. Finally, training teachers to conduct a systematic diagnosis of a reading problem increased the accuracy of their...evidence that training can overcome these inaccuracies to some degree, additional research on teachers’ judgmental processes is needed. Such research

  3. Validation of Student and Parent Reported Data on the Basic Grant Application Form: Institution/OE Referral Study, Pre-Established and ACT Criteria Study, Overpayment Recovery. Final Report, Volume 2.

    ERIC Educational Resources Information Center

    Walters, Pamela Barnhouse; And Others

    The validity of information provided in applications to the Basic Educational Opportunity Grant (BEOG) program was studied, along with procedures used in recovering overpayments. The objective was to investigate misreporting and misuse of the BEOG program. A 1977-1978 study reviewed cases referred to the U.S. Office of Education by educational…

  4. Validation of Student and Parent Report Data on the Basic Grant Application Form: Institution Referral Study, Pre-established Criteria Study, Overpayment Recovery. Final Report, Volume 2.

    ERIC Educational Resources Information Center

    Vogel, Ronald J.; And Others

    The types and ranges of errors made on applications to the Basic Educational Opportunity Grant (BEOG) program were studied, along with procedures used in recovering overpayments. The objective was to assess the scope and nature of misreporting and misuse of the BEOG program. A 1975-1976 study reviewed cases referred to the U.S. Office of Education…

  5. Essential competencies in prescribing: A first european cross-sectional study among 895 final-year medical students.

    PubMed

    Brinkman, D J; Tichelaar, J; Schutte, T; Benemei, S; Böttiger, Y; Chamontin, B; Christiaens, T; Likic, R; Maˇiulaitis, R; Marandi, T; Monteiro, E C; Papaioannidou, P; Pers, Y M; Pontes, C; Raskovic, A; Regenthal, R; Sanz, E J; Tamba, B I; Wilson, K; Vries, Tp de; Richir, M C; Agtmael, Ma van

    2017-02-01

    European medical students should have acquired adequate prescribing competencies before graduation, but it is not known whether this is the case. In this international multicenter study, we evaluated the essential knowledge, skills, and attitudes in clinical pharmacology and therapeutics (CPT) of final-year medical students across Europe. In a cross-sectional design, 26 medical schools from 17 European countries were asked to administer a standardized assessment and questionnaire to 50 final-year students. Although there were differences between schools, our results show an overall lack of essential prescribing competencies among final-year students in Europe. Students had a poor knowledge of drug interactions and contraindications, and chose inappropriate therapies for common diseases or made prescribing errors. Our results suggest that undergraduate teaching in CPT is inadequate in many European schools, leading to incompetent prescribers and potentially unsafe patient care. A European core curriculum with clear learning outcomes and assessments should be urgently developed. © 2016 The Authors. Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of The American Society for Clinical Pharmacology and Therapeutics.

  6. [Shigellosis outbreak with 146 cases related to a fair].

    PubMed

    Castell Monsalve, Juan; Gutiérrez Avila, Gonzalo; Rodolfo Saavedra, Remedios; Santos Azorín, Antonia

    2008-01-01

    On September 3, 2005, the Ciudad Real Public Health Service (Spain) received a report of 20 cases of gastroenteritis in the municipality of Daimiel. We conducted an investigation to determine the cause or causes of the outbreak and to implement control measures. Most of the cases involved young people who visited the municipality's fair. We carried out a descriptive study and an analytic case-control study. In the descriptive study, all variables of interest available in the medical records were included. In the case-control study, each case was matched with a control by age (plus or minus 5 years), gender, and attendance at the fair. Sixty-five cases and 65 controls were finally included in the study. Samples of foods and stools from food handlers were taken. We found 196 cases, 146 of which were confirmed. The epidemic curve suggested a common source of infection with a short period of activity. The case-control study showed an association between infection and eating potatoes with a sauce at any of the fair's five food stalls (OR = 20.56; 95%CI, 6.15-75.93; p < 0.0001). Logistic regression analysis showed an association with eating potatoes in food stall number 2 (OR = 6.38; 95%CI, 1.70-23.90; p < 0.0059). Neither samples of foods nor stools from food handlers yielded any positive results. However, Shigella sonnei was isolated from stool samples from 20 cases. The epidemiological study suggested that the most probable cause of the outbreak was a sauce, handmade with garlic, milk, and oil and served with the potatoes.

  7. Attempted suicide by cop: a case study of traumatic brain injury and the insanity defense.

    PubMed

    Bresler, Scott; Scalora, Mario J; Elbogen, Eric B; Moore, Y Scott

    2003-01-01

    Over the years, there have been a number of well-publicized incidents involving persons who seemingly maneuver police officers into shooting them. Such cases, while relatively rare compared with most forms of violence, nevertheless pose difficult challenges to law enforcement agencies. Relatively little is known about persons who engage in suicide by cop incidents. To our knowledge, there has been no published indepth research on instigators of suicide by cop who survived. In this paper, we present a case study of an individual who engaged in and lived through three separate "attempted suicide by cop" incidents. After describing relevant history as well as events of the most recent incident, we compare the case with the extant literature on suicide by cop and analyze commonalities and differences. Finally, we examine the legal considerations involved, with particular attention devoted to the role the individual's traumatic brain injury played in applying the insanity defense.

  8. Environmental Factors Contributing to Wrongdoing in Medicine: A Criterion-Based Review of Studies and Cases

    PubMed Central

    DuBois, James M.; Carroll, Kelly; Gibb, Tyler; Kraus, Elena; Rubbelke, Timothy; Vasher, Meghan; Anderson, Emily E.

    2012-01-01

    In this paper we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research. PMID:23226933

  9. [Based on the incidence of Creutzfeldt-Jakob disease in the Lanzarote healthcare area. Description of two definitive cases].

    PubMed

    Hernández-Ramos, F J; Martínez Martín, M; Esteban Robayna, M; Jensen Toll, F; Palacios Llopis, S

    2005-01-01

    We present two cases who have been diagnosed of definitive Creutzfeldt-Jakob disease in the health area of Lanzarote in the period January 2002 to January 2004. The two cases are presented with clinical description, complementary tests -- including electroencephalogram, 14-3-3 protein determination -- study of the prionic protein gene, and histopathologic findings. In this article, we try to show the importance of trying to reach a definitive diagnosis with the histopathologic study once there is clinical suspicion (a diagnosis that is probable or possible). In addition our cases show that communication between the clinical and the epidemiological coordinator of the regional community and the National Center of Epidemiology is very important. We refer to the clear growth in the incidence of the disease in the population of Lanzarote in the period above mentioned. Finally, we discuss whether this growth is or is not an isolated event.

  10. Lightening the Load of a USMC Rifle Platoon Through Robotics Integration

    DTIC Science & Technology

    2014-06-01

    40 Figure 13. Resource Consumption for Resources X,Y, and Z for All Cases ....................44 Figure 14...Percentage of Resources Used for All Cases ...................................................45 Figure 15. Operational Reach of Resource X... All Cases ...............................51 Figure 20. Distance from Final Objective for All Cases

  11. 24 CFR 200.204 - What actions may HUD take against unsatisfactory appraisers on the Appraiser Roster?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... appraiser; (vi) Being issued a final debarment, suspension, or limited denial of participation; (vii... you have been issued a final debarment, suspension, or limited denial of participation, in which case...) Automatic removal for issuance of final debarment, suspension, or limited denial of participation. If you...

  12. Formal Assurance Certifiable Tooling Formal Assurance Certifiable Tooling Strategy Final Report

    NASA Technical Reports Server (NTRS)

    Bush, Eric; Oglesby, David; Bhatt, Devesh; Murugesan, Anitha; Engstrom, Eric; Mueller, Joe; Pelican, Michael

    2017-01-01

    This is the Final Report of a research project to investigate issues and provide guidance for the qualification of formal methods tools under the DO-330 qualification process. It consisted of three major subtasks spread over two years: 1) an assessment of theoretical soundness issues that may affect qualification for three categories of formal methods tools, 2) a case study simulating the DO-330 qualification of two actual tool sets, and 3) an investigation of risk mitigation strategies that might be applied to chains of such formal methods tools in order to increase confidence in their certification of airborne software.

  13. Malaria is associated with poor school performance in an endemic area of the Brazilian Amazon

    PubMed Central

    Vitor-Silva, Sheila; Reyes-Lecca, Roberto C; Pinheiro, Tamam RA; Lacerda, Marcus VG

    2009-01-01

    Background Approximately 40% of the world's population is at risk for malaria. In highly endemic tropical areas, malaria is a major cause of morbidity and mortality during infancy. There is a complex interrelationship between malaria, malnutrition and intestinal helminths, and this may impair cognitive development in children. The aim of this study was to determine the relationship between malaria and school performance in children living in an endemic area where Plasmodium vivax is the species responsible for most of the cases. Methods The study was conducted in the Municipality of Careiro, Amazonas, Brazil, with five to14 year-old children, studying the first eight grades of public school, during the year 2008. After an initial active case detection, during nine months of follow-up, passive malaria cases detection was instituted, through a thick blood smear performed in every child with fever. School performance was evaluated by the final notes in Mathematics and Portuguese Language. Performance was considered poor when either of the final notes in these disciplines was below the 50th percentile for the respective class and grade. Results The total number of students followed-up in the cohort was 198. Malarial attacks were reported in 70 (35.4%) of these students, with no cases of severe disease. Plasmodium vivax was detected in 69.2% of the attacks, Plasmodium falciparum in 25.5% and both species in 5.3%. In the multivariate analysis, adjusting for age, mother's education, time living in the study area and school absenteeism, presenting with at least one episode of malaria independently predicted a poor performance at school [OR = 1.91 (1.04-3.54); p = 0.039]. Conclusion Non-severe malaria compromises the school performance of children even during a nine-month follow-up, potentially contributing to the maintenance of underdevelopment in countries endemic for malaria. This is the first evidence of such impact in Latin America, where P. vivax is responsible for the majority of the cases. PMID:19835584

  14. Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    PubMed

    2015-11-05

    This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.

  15. Puncture initial data for black-hole binaries with high spins and high boosts

    NASA Astrophysics Data System (ADS)

    Ruchlin, Ian; Healy, James; Lousto, Carlos O.; Zlochower, Yosef

    2017-01-01

    We solve the Hamiltonian and momentum constraints of general relativity for two black holes with nearly extremal spins and relativistic boosts in the puncture formalism. We use a non-conformally-flat ansatz with an attenuated superposition of two Lorentz-boosted, conformally Kerr or conformally Schwarzschild 3-metrics and their corresponding extrinsic curvatures. We compare evolutions of these data with the standard Bowen-York conformally flat ansatz (technically limited to intrinsic spins χ =S /MADM2=0.928 and boosts P /MADM=0.897 ), finding, typically, an order of magnitude smaller burst of spurious radiation and agreement with inspiral and merger. As a first case study, we evolve two equal-mass black holes from rest with an initial separation of d =12 M and spins χi=Si/mi2=0.99 , compute the waveforms produced by the collision, the energy and angular momentum radiated, and the recoil of the final remnant black hole. We find that the black-hole trajectories curve at close separations, leading to the radiation of angular momentum. We also study orbiting nonspinning and moderate-spin black-hole binaries and compare these with standard Bowen-York data. We find a substantial reduction in the nonphysical initial burst of radiation which leads to cleaner waveforms. Finally, we study the case of orbiting binary black-hole systems with spin magnitude χi=0.95 in an aligned configuration and compare waveform and final remnant results with those of the SXS Collaboration [54 A. H. Mroue et al., Phys. Rev. Lett. 111, 241104 (2013)., 10.1103/PhysRevLett.111.241104], finding excellent agreement. This represents the first moving puncture evolution of orbiting and spinning black holes exceeding the Bowen-York limit. Finally, we study different choices of the initial lapse and lapse evolution equation in the moving puncture approach to improve the accuracy and efficiency of the simulations.

  16. From Read Ahead to Literacy Coalition: The Leadership Role of the Central New York Community Foundation in the Creation of a Local Institution

    ERIC Educational Resources Information Center

    Ridzi, Frank; Carmody, Virginia; Byrnes, Kathy

    2011-01-01

    This paper applies the lens of recent literature on neoinstitutionalism and institutional entrepreneurship to understand the stages of growth in a new community Literacy Coalition. It explores the interactional, technical and cultural phases of institution building identified in other case studies as they emerge in this community study. Finally,…

  17. Research into the Deployment and Impact of Support Staff Who Have Achieved HLTA Status. Final Report

    ERIC Educational Resources Information Center

    Wilson, Rebekah; Sharp, Caroline; Shuayb, Maha; Kendall, Lesley; Wade, Pauline; Easton, Claire

    2007-01-01

    This report details the findings of two surveys designed to investigate the deployment and impact of support staff who have achieved higher level teaching assistant (HLTA) status in England and to assess the impact or effect they are having in schools, along with interview data collected from nine case-study schools. The study sought to: (1)…

  18. Creation of Audiovisual Presentations as a Tool to Develop Key Competences in Secondary-School Students. A Case Study in Science Class

    ERIC Educational Resources Information Center

    Ezquerra, Ángel; Manso, Javier; Burgos, Mª Esther; Hallabrin, Carla

    2014-01-01

    New curricular plans based on key competences create the need for new educational proposals that allow their development. This article describes a proposal to develop key competences through project-based learning. The project's objective is the creation of a digital video. The following study was carried out with students in their final two years…

  19. Elementary Preservice Teachers' Mathematical Knowledge for Teaching: Using Situated Case Studies and Educative Experiences to Examine and Improve the Development of MKT in Teacher Education

    ERIC Educational Resources Information Center

    Johnson, Tracy L.

    2011-01-01

    This study examined pre-service teachers' development of mathematical knowledge for teaching (MKT) over their final year in a university based teacher education program. This was done through analyzing written reflections, focus group interviews, individual interviews, teaching observations, and post-observation interviews as well as through the…

  20. Impact of the Mexican Alien Commuter on the Apparel Industry of El Paso, Texas--A Case Study. Final Report.

    ERIC Educational Resources Information Center

    Rungeling, Brian Scott

    This study analyzed what effect commuters had on wage levels, employment, and industrial locations, and the relative importance of the commuter as part of the work force. A questionnaire was administered to 190 workers and to their 20 employers in the apparel industry of El Paso, Texas. The questionnaires revealed that the commuters were paid the…

  1. CONTROL FOR SEASONAL VARIATION AND TIME TREND IN CASE-CROSSOVER STUDIES OF ACUTE EFFECTS OF ENVIRONMENTAL EXPOSURES. (R827353C004)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  2. Changing the Teaching/Learning Procedures in Physics for Agricultural Engineering. A Case Study

    ERIC Educational Resources Information Center

    Mulero, Angel; Parra, M. Isabel; Cachadina, Isidro

    2012-01-01

    The subject "Physical Fundamentals of Engineering" for agricultural engineers in the University of Extremadura has long had high rates of students not attending classes, not presenting for examinations and, finally, failing the subject. During the 2007 and 2008 courses, the teaching/learning procedures were strongly modified. Analysis of the…

  3. Did the CP audits promote the enterprises' CP? A case study in Beijing.

    PubMed

    Yu, Gang; Huang, Jun; Chen, Qing

    2002-03-09

    Seven enterprises that have had recent Cleaner Production (CP) audits in Beijing were interviewed to identify whether these enterprises implemented the audit recommendations. If enterprises did implement the recommendations, their reasons and the results were analyzed. Finally, some suggestions on how to promote enterprise-wide CP were given.

  4. Primary Mathematics Teacher Education Encountering Difficult Terrain: A Personal Perspective

    ERIC Educational Resources Information Center

    Norton, Stephen

    2016-01-01

    This paper is a case study in preparing prospective primary teachers to teach mathematics at one Australian university. The paper describes the content knowledge of prospective teachers, pre and post a final mathematics curriculum subject. The teaching approach which attempts to account for both content and pedagogical content knowledge is…

  5. Genuinely Multipartite Concurrence of N-qubit X Matrices (Author’s Final Manuscript)

    DTIC Science & Technology

    2012-12-05

    Horne- Zeilinger (GHZ) states. We study the case when each qubit interacts with a local amplitude damping channel. It is shown that only one type of GHZ...multipartite entanglement that is simple to calculate. Only for Greenberger-Horne- Zeilinger (GHZ) states that undergo pure dephasing, has there been a

  6. A Case Study on the Failure of Management Controls around Expected Benefit Development

    ERIC Educational Resources Information Center

    Parsons, Earl H.

    2013-01-01

    Organization leaders manage change through projects to realize specific expected benefits. Under Expectation-Confirmation theory, expected benefits can be used to judge the ongoing viability and final success of the project. Organization leaders often develop management controls to ensure that the expected benefits are defined to allow their use…

  7. Service Delivery Experiences and Intervention Needs of Military Families with Children with ASD

    ERIC Educational Resources Information Center

    Davis, Jennifer M.; Finke, Erinn; Hickerson, Benjamin

    2016-01-01

    The purpose of this study was to describe the experiences of military families with children with autism spectrum disorder (ASD) specifically as it relates to relocation. Online survey methodology was used to gather information from military spouses with children with ASD. The finalized dataset included 189 cases. Descriptive statistics and…

  8. Library Power in Philadelphia: Final Report from Seven Case Studies.

    ERIC Educational Resources Information Center

    Useem, Elizabeth; Coe, Cati

    Library Power seeks to activate an underutilized resource--a school's library program--in ways that promote schoolwide changes in the curriculum and instruction. This three-year initiative of the DeWitt Wallace-Readers' Digest Fund, located in 19 sites across the country, connects elementary and middle school libraries more directly to classroom…

  9. The Use of Final-Letter Braille Contractions: A Case Study

    ERIC Educational Resources Information Center

    Tallon, Emily M.; Herzberg, Tina S.

    2013-01-01

    Louis Braille developed a six-dot braille code in the early 1800s, thus creating an effective way for persons who are visually impaired to communicate through reading and writing (Holbrook, D'Andrea, & Sanford, 2011). Students with visual impairments require braille instruction from teachers of students with visual impairments, who are responsible…

  10. Supporting Quality Timely PhD Completions: Delivering Research Outcomes

    ERIC Educational Resources Information Center

    Gasson, Susan

    2015-01-01

    The case study used a three-phase organising process to explain how design and implementation of an accessible and interactive electronic thesis submission form streamlined quality assurance of theses and their timely dissemination via an online thesis repository. The quality of the theses submitted is assured by key academics in their final sign…

  11. Rural health networks in Florida.

    PubMed

    Duncan, R P; Klepper, B R; Krumerman, C J; Kuhn, S L

    1995-01-01

    This article describes the development of rural health networks in Florida, which has adopted formal policies to support these networks. First, the history and content of the relevant legislation are described. The current networks are identified and their development to date summarized. Finally, a detailed case study is employed to outline the steps taken to establish one network.

  12. Intelligent Engine Systems: HPT Clearance Control

    NASA Technical Reports Server (NTRS)

    2008-01-01

    The Advanced Thermally Actuated Clearance Control System underwent several studies. Improved flow path isolation quantified what can be gained by making the HPT case nearly adiabatic. The best method of heat transfer was established, and finally two different borrowed air cooling circuits were evaluated to be used for the HPT Active Clearance Control System.

  13. Youth Intervention for Peace Project: Burundi Case Study

    ERIC Educational Resources Information Center

    Bigirindavyi, Jean-Paul

    2004-01-01

    The experience of Rwanda's genocide in 1994 shocked the world into disbelief as Western media finally focused their attention on the region's ongoing conflict. Yet little is being done today to prevent the reproduction of a parallel disaster in its twin country, Burundi, where similar conflict patterns may spark another intensely violent civil…

  14. Evaluating Best Practices for Video Tutorials: A Case Study

    ERIC Educational Resources Information Center

    Weeks, Thomas; Putnam Davis, Jennifer

    2017-01-01

    This article will explore one library's experience creating best practices for the creation of video tutorials. First, a literature review establishes the best practices other creators have used. Then, the authors apply these best practices to the creation of their first video tutorial. Finally, they evaluate the usefulness of each practice in…

  15. Enhancing Teachers' Curriculum Ownership via Teacher Engagement in State-Based Curriculum-Making: The Estonian Case

    ERIC Educational Resources Information Center

    Mikser, Rain; Kärner, Anita; Krull, Edgar

    2016-01-01

    Teachers' curriculum ownership is increasingly gaining attention in many countries. It is particularly important that under the conditions of centralized curriculum-making, teachers as final implementers of curricular ideas identify themselves with these ideas. This study investigates Estonian upper secondary school teachers' views on the impact…

  16. Reading Comprehension: Techniques for Assessment and Optimization.

    ERIC Educational Resources Information Center

    Tyler, Sherman W.; And Others

    Three studies examined the nature of individual differences and the role of advance information in reading comprehension. The subjects, 116 college students, read short passages--in some cases preceded by a given type of advance organizer--recalled the information therein, and finally sorted ideas from the passage into groups of similar ideas.…

  17. Thinking about Evolution: Combinatorial Play as a Strategy for Exercising Scientific Creativity

    ERIC Educational Resources Information Center

    Wingate, Richard J. T.

    2011-01-01

    An enduring focus in education on how scientists formulate experiments and "do science" in the laboratory has excluded a vital element of scientific practice: the creative and imaginative thinking that generates models and testable hypotheses. In this case study, final-year biomedical sciences university students were invited to create and justify…

  18. Alternative approaches to analytical designs in occupational injury epidemiology.

    PubMed

    Mittleman, M A; Maldonado, G; Gerberich, S G; Smith, G S; Sorock, G S

    1997-08-01

    In this paper, we discuss the theoretical framework upon which observational studies of occupational injuries are based. Following a general description of how causal effects are estimated, the challenges faced by researchers working in this area are outlined, with an emphasis on case-control studies. These challenges include defining the at-risk period for workers whose tasks change over time and whose hazard period may be very brief, evaluating the underreporting of both exposures and injuries, and considering the effects of multiple injuries per individual on study design and data analysis. We review both the theoretical and practical considerations in the design and conduct of traditional case-control studies, based on the collection of individual level data, as well as other approaches, such as using information culled from administrative and descriptive databases, and case-control studies in which the plant or work site is the unit of analysis. The case-crossover design is also reviewed and its utility for reducing confounding due to differences between individuals by self-matching is highlighted. While this design has not yet been applied to the work setting, its potential for increasing our understanding of the causes of acute-onset occupational injuries seems promising. Finally, a variety of hybrid designs are discussed, including combinations of case-control, case-crossover, and cohort designs.

  19. Schur polynomials and biorthogonal random matrix ensembles

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

    Tierz, Miguel

    The study of the average of Schur polynomials over a Stieltjes-Wigert ensemble has been carried out by Dolivet and Tierz [J. Math. Phys. 48, 023507 (2007); e-print arXiv:hep-th/0609167], where it was shown that it is equal to quantum dimensions. Using the same approach, we extend the result to the biorthogonal case. We also study, using the Littlewood-Richardson rule, some particular cases of the quantum dimension result. Finally, we show that the notion of Giambelli compatibility of Schur averages, introduced by Borodin et al. [Adv. Appl. Math. 37, 209 (2006); e-print arXiv:math-ph/0505021], also holds in the biorthogonal setting.

  20. Mechatronic system design course for undergraduate programmes

    NASA Astrophysics Data System (ADS)

    Saleem, A.; Tutunji, T.; Al-Sharif, L.

    2011-08-01

    Technology advancement and human needs have led to integration among many engineering disciplines. Mechatronics engineering is an integrated discipline that focuses on the design and analysis of complete engineering systems. These systems include mechanical, electrical, computer and control subsystems. In this paper, the importance of teaching mechatronic system design to undergraduate engineering students is emphasised. The paper offers the collaborative experience in preparing and delivering the course material for two universities in Jordan. A detailed description of such a course is provided and a case study is presented. The case study used is a final year project, where students applied a six-stage design procedure that is described in the paper.

  1. Intercalary defects reconstruction of the femur and tibia after primary malignant bone tumour resection. A series of 13 cases.

    PubMed

    Brunet, O; Anract, P; Bouabid, S; Babinet, A; Dumaine, V; Toméno, B; Biau, D

    2011-09-01

    Performing intercalary segment reconstruction after malignant bone tumour resection results in both mechanical and biological challenges. Fixation must be solid enough to avoid short-term or mid-term mechanical failure. The use of an allograft or autograft must ensure long-term survival of the reconstruction. The goal of this study was to analyse the clinical and radiological outcomes of these reconstructions. Thirteen patients were operated on eight femurs and five tibias. The median age was 20 years old (range 14-50). The most common diagnosis was osteosarcoma. The median resection length was 15cm (Q1-Q3: 6-26). A plate was used for fixation in nine cases and an intramedullary locked nail in four cases. An isolated bone autograft was used in two cases, an isolated bone allograft in one case, a dual autograft-allograft composite in six cases, and vascularised fibula and allograft combination in four cases. The cumulative probability of union was 46% (95% CI: 0-99%) at 1 year; at the final follow-up, union was achieved in 12 patients (92%). Because of non-unions, 13 iterative procedures were needed to obtain these results. A non-displaced fracture of a cuboid-shaped tibial graft occurred in one patient, which was treated conservatively. Three infections occurred. The results of intercalary segmental defects reconstruction after bone tumour resection were good, both from an oncologic and radiological point-of-view. One or more iterative procedures are sometimes needed to finally obtain bone union. We prefer to use a free rectangular cuboidal tibial graft since reconstruction with a vascularised autograft is technically more difficult. The choice of fixation methods is still controversial and no approach was found to be superior. Level IV. Retrospective study. Copyright © 2011. Published by Elsevier Masson SAS.

  2. Next Steps.

    DOT National Transportation Integrated Search

    2016-01-01

    Next Steps : Use case development : Developing representative use cases for receivers : Defining parameters for transmit application for uplink and down link : Defining and finalize propagation models to be used : Antenna Characte...

  3. Rotational Flap to Enhance Buccal Gingival Thickness and Implant Emergence Profile in the Esthetic Zone: Two Cases Reports

    PubMed Central

    AL-Juboori, Mohammed Jasim

    2017-01-01

    Objective: Many techniques have been developed to enhance the gingival thickness, gingival level and emergence profile around the implant in the esthetic zone. Introduction: In this study, a buccal rotational flap was used to improve the implant site in the esthetic zone and increase gingival tissue thickness. Methods: Two cases involved the use of a rotational flap during second-stage implant surgery, one case involved the use of a temporary crown with a healing abutment, and another case involved the use of a healing abutment. Result: The cases were followed up until the final crown was placed. The implant site was improved in 2 cases; the gingival thickness increased, the gingival level was enhanced and the emergence profile was developed. Conclusion: Many factors affect the results of a rotational flap; some factors are surgical, while others are prosthetic, biological and anatomical. PMID:28839477

  4. [Analysis of final judgements in cases of medical negligence occurred in Ukraine].

    PubMed

    Franchuk, Valentyn V; Trach Rosolovska, Svitlana V; Selskyy, Petro R; Mykolenko, Anna Z; Bodnar, Petro Ya

    2018-01-01

    Introduction: The peculiarities of the disadvantages of providing medical care in Ukraine are not well-known abroad. The aim: To study the peculiarities of court decisions in cases of unfavorable consequences of medical activity. Materials and methods: The article analyzes the official data of the General Prosecutor's Office of Ukraine and the website of court decisions regarding criminal cases against medical practitioners. Review: Approximately 600 cases of alleged medical malpractice cases are registered annually in Ukraine. Only less than one percent of them are brought to the court. The guilt of medical practitioners was proven in majority (80,8%) of court decisions. Acquittals of defendants were pronounced in 5,9% of court verdicts. Obstetrics and gynecology, surgery, internal medicine and anesthesiology are in the top of high-risk medical specialties. Conclusions: Majority of medical malpractice litigations are sued in Ukraine baselessly. In cases of medical negligence majority of defendants are acquitted as usual.

  5. Hemangiopericytoma in a male breast. Report of a case with cytologic, histologic and immunochemical studies.

    PubMed

    Jiménez-Ayala, M; Díez-Nau, M D; Larrad, A; Ferrer-Vergara, L; Rodriguez-Costa, J; Lacruz, C; Escalona-Zapata, J

    1991-01-01

    A hemangiopericytoma in a male breast was studied by fine needle aspiration (FNA) biopsy. The FNA smears contained tissue clumps showing knob-like formations of atypical cells, spindle-shaped cells and fragments of capillaries lined by normal endothelial cells. Immunocytochemical study showed a positive reaction for vimentin, but a negative reaction for desmin and keratin. Staining for Factor VIII was positive only in the capillaries and endothelial cells. The cytodiagnosis was "mesenchymal tumor." Histopathologic study of the mastectomy specimen made the final diagnosis of hemangiopericytoma. While FNA cytology and immunocytochemistry cannot make a definitive diagnosis of this rare vascular tumor, they can be decisive in planning the surgical treatment, as in the present case.

  6. Modeling of policies for reduction of GHG emissions in energy sector using ANN: case study-Croatia (EU).

    PubMed

    Bolanča, Tomislav; Strahovnik, Tomislav; Ukić, Šime; Stankov, Mirjana Novak; Rogošić, Marko

    2017-07-01

    This study describes the development of tool for testing different policies for reduction of greenhouse gas (GHG) emissions in energy sector using artificial neural networks (ANNs). The case study of Croatia was elaborated. Two different energy consumption scenarios were used as a base for calculations and predictions of GHG emissions: the business as usual (BAU) scenario and sustainable scenario. Both of them are based on predicted energy consumption using different growth rates; the growth rates within the second scenario resulted from the implementation of corresponding energy efficiency measures in final energy consumption and increasing share of renewable energy sources. Both ANN architecture and training methodology were optimized to produce network that was able to successfully describe the existing data and to achieve reliable prediction of emissions in a forward time sense. The BAU scenario was found to produce continuously increasing emissions of all GHGs. The sustainable scenario was found to decrease the GHG emission levels of all gases with respect to BAU. The observed decrease was attributed to the group of measures termed the reduction of final energy consumption through energy efficiency measures.

  7. Aerodynamic instability: A case history

    NASA Technical Reports Server (NTRS)

    Eisenmann, R. C.

    1985-01-01

    The identification, diagnosis, and final correction of complex machinery malfunctions typically require the correlation of many parameters such as mechanical construction, process influence, maintenance history, and vibration response characteristics. The progression is reviewed of field testing, diagnosis, and final correction of a specific machinery instability problem. The case history presented addresses a unique low frequency instability problem on a high pressure barrel compressor. The malfunction was eventually diagnosed as a fluidic mechanism that manifested as an aerodynamic disturbance to the rotor assembly.

  8. On the adiabatic limit of Hadamard states

    NASA Astrophysics Data System (ADS)

    Drago, Nicolò; Gérard, Christian

    2017-08-01

    We consider the adiabatic limit of Hadamard states for free quantum Klein-Gordon fields, when the background metric and the field mass are slowly varied from their initial to final values. If the Klein-Gordon field stays massive, we prove that the adiabatic limit of the initial vacuum state is the (final) vacuum state, by extending to the symplectic framework the adiabatic theorem of Avron-Seiler-Yaffe. In cases when only the field mass is varied, using an abstract version of the mode decomposition method we can also consider the case when the initial or final mass vanishes, and the initial state is either a thermal state or a more general Hadamard state.

  9. 76 FR 42129 - Agency Information Collection Activities: Case Submission Form, Case Assistance Form

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-18

    ... is in the final phase of development with successful testing of a pilot version conducted in the 4th... will refer case specific issues to the Customer Assistance Office for USCIS for further research, and...

  10. Validation of Student and Parent Report Data on the Basic Grant Application Form. Final Report. Volume II, Estimated Income: CRT Look-Up Study, Individual Case Follow-Up Study, IRS Sample Study.

    ERIC Educational Resources Information Center

    Novalis, Carol

    The use of estimated income to analyze financial need of applicants to the Basic Educational Opportunity Grant (BEOG) program was investigated. Attention was focused on: how well applicants estimate their income; reasons for errors in estimation, and whether applicants supplying income tax returns supply true versions. For 1,547 eligible BEOG…

  11. Genetic Association Study of Ancestry-Matched African American Prostate Cancer Cases and Control

    DTIC Science & Technology

    2009-04-01

    TO THE ABOVE ADDRESS. 1. REPORT DATE 1 April 2009 2 . REPORT TYPE Final 3. DATES COVERED 1 April 2008 – 31 March 2009 4. TITLE AND SUBTITLE...matching, we have identified and confirmed several prostate cancer susceptibility loci in this study population, on chromosomes 2 , 8 and 17. These and...prostate cancer susceptibility loci in these studies, on chromosomes 2 , 8, and 17. These and other ongoing studies will provide unprecedented insight

  12. Magnetic resonance imaging-ultrasound fusion biopsy for prediction of final prostate pathology.

    PubMed

    Le, Jesse D; Stephenson, Samuel; Brugger, Michelle; Lu, David Y; Lieu, Patricia; Sonn, Geoffrey A; Natarajan, Shyam; Dorey, Frederick J; Huang, Jiaoti; Margolis, Daniel J A; Reiter, Robert E; Marks, Leonard S

    2014-11-01

    We explored the impact of magnetic resonance imaging-ultrasound fusion prostate biopsy on the prediction of final surgical pathology. A total of 54 consecutive men undergoing radical prostatectomy at UCLA after fusion biopsy were included in this prospective, institutional review board approved pilot study. Using magnetic resonance imaging-ultrasound fusion, tissue was obtained from a 12-point systematic grid (mapping biopsy) and from regions of interest detected by multiparametric magnetic resonance imaging (targeted biopsy). A single radiologist read all magnetic resonance imaging, and a single pathologist independently rereviewed all biopsy and whole mount pathology, blinded to prior interpretation and matched specimen. Gleason score concordance between biopsy and prostatectomy was the primary end point. Mean patient age was 62 years and median prostate specific antigen was 6.2 ng/ml. Final Gleason score at prostatectomy was 6 (13%), 7 (70%) and 8-9 (17%). A tertiary pattern was detected in 17 (31%) men. Of 45 high suspicion (image grade 4-5) magnetic resonance imaging targets 32 (71%) contained prostate cancer. The per core cancer detection rate was 20% by systematic mapping biopsy and 42% by targeted biopsy. The highest Gleason pattern at prostatectomy was detected by systematic mapping biopsy in 54%, targeted biopsy in 54% and a combination in 81% of cases. Overall 17% of cases were upgraded from fusion biopsy to final pathology and 1 (2%) was downgraded. The combination of targeted biopsy and systematic mapping biopsy was needed to obtain the best predictive accuracy. In this pilot study magnetic resonance imaging-ultrasound fusion biopsy allowed for the prediction of final prostate pathology with greater accuracy than that reported previously using conventional methods (81% vs 40% to 65%). If confirmed, these results will have important clinical implications. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  13. NEUROBILOGY OF ASPERGER'S SYNDROME : A CASE STUDY AND OVERVIEW

    PubMed Central

    Duggal, Harpreet S.; Dutta, Siddhartha; Sinha, Vinod K.; Basu, Soumya; Pandey, Smita; Nizamie, Haque S.; Nizamie, Alka

    2001-01-01

    Asperger's syndrome is an autistic spectrum disorder, which has engendered lesser attention in comparison to autism. Recent literature has focused on the involvement of cortical areas of the brain in this syndrome. We report a case of Asperger′s syndrome in which an extensive work-up, including neuropsychological, neurophysiological and neuroimaging procedures, were undertaken. The findings of the various investigative procedures are discussed and literature supporting the neurobiological basis of Asperger's syndrome is highlighted. Finally, we briefly touch upon the ‘Theory of Mind’ construct in autistic spectrum disorders. PMID:21407867

  14. [Limitation of medical treatment and ethics in chronic recurrent Clivus chordoma].

    PubMed

    Egger, Alexandra; Müller-Busch, H Christof

    2008-01-01

    In this paper ethical questions concerning the limitation and termination of medical treatment of comatose patients will be discussed on the basis of a case study. The team is confronted with extremely high communicative and ethical demands, since every person engaged in the treatment and care of the patient should take part in this decision making process. The final responsibility regarding the medical decisions, however, lies with the doctor in charge. In such cases advance directives or living wills are important and should be taken into consideration.

  15. Mixtures of beta distributions in models of the duration of a project affected by risk

    NASA Astrophysics Data System (ADS)

    Gładysz, Barbara; Kuchta, Dorota

    2017-07-01

    This article presents a method for timetabling a project affected by risk. The times required to carry out tasks are modelled using mixtures of beta distributions. The parameters of these beta distributions are given by experts: one corresponding to the duration of a task in stable conditions, with no risks materializing, and the other corresponding to the duration of a task in the case when risks do occur. Finally, a case study will be presented and analysed: the project of constructing a shopping mall in Poland.

  16. A case-study of landfill minimization and material recovery via waste co-gasification in a new waste management scheme.

    PubMed

    Tanigaki, Nobuhiro; Ishida, Yoshihiro; Osada, Morihiro

    2015-03-01

    This study evaluates municipal solid waste co-gasification technology and a new solid waste management scheme, which can minimize final landfill amounts and maximize material recycled from waste. This new scheme is considered for a region where bottom ash and incombustibles are landfilled or not allowed to be recycled due to their toxic heavy metal concentration. Waste is processed with incombustible residues and an incineration bottom ash discharged from existent conventional incinerators, using a gasification and melting technology (the Direct Melting System). The inert materials, contained in municipal solid waste, incombustibles and bottom ash, are recycled as slag and metal in this process as well as energy recovery. Based on this new waste management scheme with a co-gasification system, a case study of municipal solid waste co-gasification was evaluated and compared with other technical solutions, such as conventional incineration, incineration with an ash melting facility under certain boundary conditions. From a technical point of view, co-gasification produced high quality slag with few harmful heavy metals, which was recycled completely without requiring any further post-treatment such as aging. As a consequence, the co-gasification system had an economical advantage over other systems because of its material recovery and minimization of the final landfill amount. Sensitivity analyses of landfill cost, power price and inert materials in waste were also conducted. The higher the landfill costs, the greater the advantage of the co-gasification system has. The co-gasification was beneficial for landfill cost in the range of 80 Euro per ton or more. Higher power prices led to lower operation cost in each case. The inert contents in processed waste had a significant influence on the operating cost. These results indicate that co-gasification of bottom ash and incombustibles with municipal solid waste contributes to minimizing the final landfill amount and has great possibilities maximizing material recovery and energy recovery from waste. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Periapical lesions are not always a sequelae of pulpal necrosis: a retrospective study of 1521 biopsies.

    PubMed

    Kontogiannis, T G; Tosios, K I; Kerezoudis, N P; Krithinakis, S; Christopoulos, P; Sklavounou, A

    2015-01-01

    To record the incidence of lesions that were not the sequelae of pulpal necrosis (non-SPN) amongst 1521 biopsies of periapical lesions submitted with a clinical diagnosis of a sequelae of pulpal necrosis (SPN). A retrospective study of 1521 biopsy request forms of specimens submitted for histopathological examination with a clinical diagnosis 'periapical inflammation', 'periapical abscess', 'periapical granuloma' or 'periapical cyst' during an arbitrarily selected 14-year period was undertaken. Gender and age of the patient, site and maximum diameter of the lesion, symptoms, inclusion of the final diagnosis in the differential diagnosis and specialty of the clinician submitting the biopsy material were recorded in each case. The final diagnosis for each case was extracted from the pathology report, and two groups were formed, SPN and non-SPN lesions. Differences between the respective features of SPN and non-SPN cases were analysed with Yate's chi-square test and t-test (significance level P < 0.05) RESULTS: In 52 of the 1521 cases examined (3.42%), the histological diagnosis was not consistent with a SPN. In most non-SPN cases, the histopathological diagnosis was not included in the differential diagnosis. The keratocystic odontogenic tumour [odontogenic keratocyst (OKC)] was the most frequent non-SPN lesion (34.62%). Other, yet less frequent, non-SPN lesions included glandular odontogenic cysts, lateral periodontal cysts, central ossifying fibromas as well as malignancies (metastatic carcinomas and Langerhans cell histiocytosis). Non-SPN lesions appeared in the periapical region mimicking a SPN, although rarely. Most of them were developmental cysts, in particular OKCs, but odontogenic tumours, such as ameloblastoma, or malignant lesions were also diagnosed. Histological examination of tissue harvested from periapical lesions should be performed, in particular when those lesions are large. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  18. 22 CFR 72.5 - Final report of death.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

  19. 75 FR 19168 - Federal Acquisition Regulation; FAR Case 2009-005, Use of Project Labor Agreements for Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... located on Indian reservations. Response: GSA, DoD, and NASA have clarified in the final rule that project... Administration (GSA), and National Aeronautics and Space Administration (NASA). ACTION: Final rule. SUMMARY: GSA, DOD, and NASA are issuing a final rule amending the Federal Acquisition Regulation (FAR) to implement...

  20. 22 CFR 72.5 - Final report of death.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

  1. 22 CFR 72.5 - Final report of death.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

  2. 22 CFR 72.5 - Final report of death.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

  3. 22 CFR 72.5 - Final report of death.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

  4. Triple Test in Carcinoma Breast

    PubMed Central

    Sameer; Mukherjee, Arindam

    2014-01-01

    Introduction: The commonest clinical presentation in majority of breast pathology is a lump. A definite diagnosis of breast lump is very important for the surgeon to decide on the final course of treatment and also saves the patient from unnecessary physical, emotional and psychological trauma if there is a definite preoperative diagnosis of benign lesion. The present study was done to evaluate the effectiveness and relevance of “TRIPLE TEST”in diagnosis of carcinoma breast in rural labour class population. Materials and Methods: The present study was a prospective study conducted on patients over 35 years of age having palpable breast lumps presenting in the out patient department of general surgery, ESI Hospital Basaidarapur New Delhi, India. The duration of study was from May 2007 to June 2009 and a total of 100 cases were studied. Each patient was subjected to a detailed history, clinical breast examination ,diagnostic mammography and FNAC. In this study, the results of each modality was divided in three groups: benign, suspicious and malignant. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of each test was calculated individually and as combined. Result: Out of 100 patients enrolled in this study, 60 cases were benign and 40 cases were of malignant breast disease. The age of patients with carcinoma breast in the series varied from 35 years to 70 years. The highest incidence of malignancy noted was 30% in 41-50 years age group (4th decade) followed by 27.5% in 51-60 years age group (5th decade). The sensitivity of clinical examination was found to be 75%, specificity was 83.3%, positive predictive value (PPV) of 75% and diagnostic accuracy of 80%. The sensitivity, specificity, positive predictive value and diagnostic accuracy of mammography was calculated and was found to be 94.9% , 90% , 86% and 92% respectively. The sensitivity, specificity, positive predictive value and diagnostic accuracy of FNAC was 94.7%, 98.3%, 97.3% and 96.6% respectively. Out of 100 cases triple test was concordant (all three test either benign or malignant) in 80 cases, all the benign cases detected by triple test were benign on final biopsy i.e. 100% specificity and 100% negative predictive value. Conclusion: TTS is an accurate and least invasive diagnostic test based on which definitive treatment can be initiated. PMID:25478391

  5. Good Housekeeping Implementation for Improving Efficiency in Cassava Starch Industry (Case Study : Margoyoso District, Pati Regency)

    NASA Astrophysics Data System (ADS)

    Aji, Wijayanto Setyo; Purwanto; Suherman, S.

    2018-02-01

    Cassava starch industry is one of the leading small-medium enterprises (SMEs) in Pati Regency. Cassava starch industry released waste that reduces the quantity of final product and potentially contamined the environment. This study was conducted to observe the feasibility of good housekeeping implementation to reduce waste and at the same time improve efficiency of production process. Good housekeeping opportunities are consideration by three aspect, technical, economy and environmental. Good housekeeping opportunities involved water conservation and waste reduction. These included reuse of water in washing process, improving workers awareness in drying section and packaging section. Implementation of these opportunities can reduce water consumption, reduce wastewater and solid waste generation also increased quantity of final product.

  6. Morphology and spelling in French students with dyslexia: the case of silent final letters.

    PubMed

    Quémart, Pauline; Casalis, Séverine

    2017-04-01

    Spelling is a challenge for individuals with dyslexia. Phoneme-to-grapheme correspondence rules are highly inconsistent in French, which make them very difficult to master, in particular for dyslexics. One recurrent manifestation of this inconsistency is the presence of silent letters at the end of words. Many of these silent letters perform a morphological function. The current study examined whether students with dyslexia (aged between 10 and 15 years) benefit from the morphological status of silent final letters when spelling. We compared, their ability to spell words with silent final letters that are either morphologically justified (e.g., tricot, "knit," where the final "t" is pronounced in morphologically related words such as tricoter, "to knit" and tricoteur "knitter") or not morphologically justified (e.g., effort, "effort") to that of a group of younger children matched for reading and spelling level. Results indicated that the dyslexic students' spelling of silent final letters was impaired in comparison to the control group. Interestingly, morphological status helped the dyslexics improve the accuracy of their choice of final letters, contrary to the control group. This finding provides new evidence of morphological processing in dyslexia during spelling.

  7. Associated characteristics and impact on recurrence and survival of free-floating tumor fragments in the lumen of fallopian tubes in Type I and Type II endometrial cancer.

    PubMed

    Albright, Benjamin B; Black, Jonathan D; Passarelli, Rachel; Gysler, Stefan; Whicker, Margaret; Altwerger, Gary; Menderes, Gulden; Buza, Natalia; Hui, Pei; Santin, Alessandro D; Azodi, Masoud; Silasi, Dan-Arin; Ratner, Elena S; Litkouhi, Babak; Schwartz, Peter E

    2018-02-01

    This study sought to evaluate characteristics of cases of free-floating tumor fragments within the lumen of fallopian tubes ('floaters') on final pathology for Type I and Type II endometrial adenocarcinoma, including relationships with disease recurrence and mortality. A single institution experience of 1022 consecutive cases of uterine cancer presenting between 2005 and 2010 was retrospectively reviewed, with data extraction from electronic medical records. Associations of floaters with baseline characteristics were studied with logistic regression, and relationships with disease recurrence and survival were assessed with Cox proportional hazards models. Among 816 included cases of Type I or Type II endometrial adenocarcinoma, floaters were identified on final pathology for 20 patients (2.5%). Patient characteristics of cases with floaters mirrored the overall sample. With adjustment, presence of floaters trended towards association with laparoscopic/robotic approach (OR = 3.84; 95%CI 0.98-15.1), and was significantly associated with lymphovascular invasion (OR = 9.65; 95%CI 2.35-39.6) and higher stage disease. Although floaters were associated with increased risk of recurrence in unadjusted analysis (HR = 3.22; 95%CI 1.41-7.37), after adjustment for disease type, stage, and patient comorbidities, no evidence for impact on disease recurrence or overall survival was found. The presence of floaters is rare. Floaters were generally associated with more extensive disease, but no evidence was found to show any independent prognostic impact on risk of recurrence or death. In agreement with prior research, this study found a trend towards association of floaters with laparoscopic/robotic approach, indicating the possibility of floaters sometimes being the result of trauma from uterine manipulator insertion.

  8. Virtual patients: the influence of case design and teamwork on students' perception and knowledge - a pilot study.

    PubMed

    Jäger, Frederik; Riemer, Martin; Abendroth, Martin; Sehner, Susanne; Harendza, Sigrid

    2014-07-08

    Virtual patient (VP) cases are an effective teaching method, although little is known about how to design and implement them for maximum effectiveness. The aim of this study was to explore the effect of case design and teamwork on students' learning outcome. One hundred forty-six undergraduate medical students participated in a mandatory medical computer science course consisting of five seminars. At the end of each seminar, they worked on one VP case, either in teams of two or individually. Each student filled out an introductory and a final survey and a feedback sheet after completing each case. Additionally, there was a surprise multiple choice (MC) test after the last seminar with three questions regarding each case. Students with more clinical experience and students who had worked in a team performed significantly better on MC questions. Students with less clinical experience more frequently used information which had been positioned less prominently on the case material. Certain aspects of case design were rated more positively by students who had an interest in e-learning. In general, students preferred to work on cases for less than 15 minutes. Clinically more advanced students and students working with a partner seem to benefit most from short VP cases with prominently presented information.

  9. 78 FR 47699 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Findings of Research Misconduct... Research Integrity (ORI) has taken final action in the following case: Pratima Karnik, Ph.D., Case Western... Professor, Department of Dermatology, Case Western Reserve University (CWRU), engaged in research misconduct...

  10. The role of assessment packages for diagnostic consultations: A conversation analytic perspective.

    PubMed

    Rossen, Camilla B; Buus, Niels; Stenager, Egon; Stenager, Elsebeth

    2015-05-01

    This article reports a conversation analysis of assessment package consultations. Healthcare delivery packages belong to a highly structured mode of healthcare delivery, in which specific courses of healthcare interventions related to assessment and treatment are predefined, both as to timing and content. Assessment packages are widely used in an increasing number of medical specialities; however, there is a lack of knowledge about how packaged assessment influences the interaction between doctor and patient. In this study, we investigate the final consultation in assessment packages, which is when the final clarification of the patient's symptoms takes place. The primary data of the study were eight audio recordings of consultations, and the secondary data were ethnographic field descriptions. In most consultations, packaged assessment was a resource as it provided fast and efficient clarification. In most cases, clarification was treated as good news since it either confirmed the absence of a serious disease or resulted in a diagnosis leading to relevant treatment offers. However, in some cases, clarification was not perceived as good news. This was the case in consultations with patients whose goal was to leave the consultation with clarification in the form of a definite diagnosis, but who were not offered such clarification. These patients negotiated the outcome of the consultation by applying implicit and explicit pressure, which induced the doctors to disregard the boundaries of the package and offer the patient more tests. The study highlights some of the problems related to introducing narrow, specialized package assessment. © The Author(s) 2014.

  11. Introducing integrated product and process development into the education of science and engineering undergraduates: a lecture course with an accompanying case-study programme at the ETH chemistry department.

    PubMed

    Fenner, K; Jödicke, G; Alean-Kirkpatrick, P; Hungerbühler, K

    2001-04-01

    Increased quality requirements in the development of chemical products and a growing awareness within society of the activities of chemical companies present a new challenge to the education of young scientists. Nowadays, the teaching of chemists, chemical engineers and environmental scientists at universities has to go beyond the traditional, discipline-orientated knowledge acquisition. The students also have to learn to work and communicate in interdisciplinary teams, to solve application-oriented tasks and to integrate scientific, economical, ecological and social aspects into their work. For this reason, a case-study programme was launched at the chemistry department of the Swiss Federal Institute of Technology. In this paper, we describe the organisational aspects of the programme, its inclusion into academic and industrial environments and summarise some of the scientific methodologies applied. One of the seven case-studies, an assessment of a modern insecticide, is presented in more detail. Finally, we discuss how far the case-study programme is suitable for introducing a new mode of knowledge production to universities.

  12. Traumatic injury pattern analysis in a light rail transit death: a retrospective case study.

    PubMed

    Kendell, Ashley E; Fleischman, Julie M; Fulginiti, Laura C

    2015-05-01

    Within the context of medical examiner's offices, forensic anthropologists are increasingly being asked to assist with the interpretation of traumatic skeletal injury. This case study presents an example of trauma analysis performed by forensic anthropologists at the Maricopa County Forensic Science Center in Phoenix, Arizona. The primary goal of this study is to document an uncommon pattern of traumatic injury-severe grinding abrasions of the lower appendage that macroscopically resemble sharp force trauma, especially as observed in dismemberment cases-resulting from an individual being dragged beneath a Light Rail train for c. 1.7 miles. The abraded skeletal elements include a femoral shaft fragment, a femoral head portion, and the right foot. Second, this study aims to illustrate the efficacy of forensic anthropological analysis of patterned skeletal trauma. Finally, this study demonstrates the critical importance of analyzing scene information before drawing conclusions as to the etiology of a traumatic injury pattern. © 2015 American Academy of Forensic Sciences.

  13. Spatio-temporal Bayesian model selection for disease mapping

    PubMed Central

    Carroll, R; Lawson, AB; Faes, C; Kirby, RS; Aregay, M; Watjou, K

    2016-01-01

    Spatio-temporal analysis of small area health data often involves choosing a fixed set of predictors prior to the final model fit. In this paper, we propose a spatio-temporal approach of Bayesian model selection to implement model selection for certain areas of the study region as well as certain years in the study time line. Here, we examine the usefulness of this approach by way of a large-scale simulation study accompanied by a case study. Our results suggest that a special case of the model selection methods, a mixture model allowing a weight parameter to indicate if the appropriate linear predictor is spatial, spatio-temporal, or a mixture of the two, offers the best option to fitting these spatio-temporal models. In addition, the case study illustrates the effectiveness of this mixture model within the model selection setting by easily accommodating lifestyle, socio-economic, and physical environmental variables to select a predominantly spatio-temporal linear predictor. PMID:28070156

  14. An Analysis of Online Students' Behaviors on Course Sites and the Effect on Learning Performance: A Case Study of Four LIS Online Classes

    ERIC Educational Resources Information Center

    Zhang, Xiangmin

    2016-01-01

    This research investigated the relationship between online students' behaviors in a learning management system and their learning performance, as measured by their final grades. Four online information technology classes in a major U.S. library and information science program were studied. The course sites' log data, as well as the students' final…

  15. Correction of antebrachial angulation-rotation deformities in dogs with oblique plane inclined osteotomies.

    PubMed

    Franklin, Samuel P; Dover, Ryan K; Andrade, Natalia; Rosselli, Desiree; M Clarke, Kevin

    2017-11-01

    To describe oblique plane inclined osteotomies and report preliminary data on outcomes in dogs treated for antebrachial angulation-rotation deformities. Retrospective clinical study. Six antebrachii from 5 dogs. Records of dogs with antebrachial angulation-rotation deformities treated with oblique plane inclined osteotomies were reviewed. Postoperative frontal, sagittal, and transverse plane alignments were assessed subjectively, and alignment in the frontal and sagittal planes was quantified on radiographs. Outcomes were classified based on owner's and veterinarian's evaluation as full, acceptable, and unacceptable function. Complications were classified as minor, major, or catastrophic. Limb alignment was subjectively considered excellent in 1 case, good in 3 cases, and fair in 2 cases. Osseous union was achieved in all cases (mean 10.5 weeks; range, 6-13 weeks). Outcomes were assessed by the veterinarian as return to full function in 5 cases and acceptable function in 1 case at the final in-hospital follow-up (mean 44 weeks; range, 6-124 weeks). All owners classified their dogs as returning to full function at the final phone/email interview (mean 107 weeks; range, 72-153 weeks). Implants were removed due to infection or irritation in 3/6 limbs, while the other 3 limbs had minor dermatitis secondary to postoperative external coaptation. No catastrophic complications occurred. Oblique plane inclined osteotomies led to a successful outcome in all 6 limbs, but the technique can be challenging and does not always lead to optimal alignment. Future refinement of this technique could focus on the development of patient-specific osteotomy guides to improve accuracy and precision. © 2017 The American College of Veterinary Surgeons.

  16. Coxa vara in postseptic arthritis of the hip in children.

    PubMed

    Johari, Ashok N; Hampannavar, Aravind; Johari, Ratna A; Dhawale, Arjun A

    2017-07-01

    The behavior and treatment of coxa vara and pseudarthrosis of the proximal femur secondary to sepsis is not well described. The aim of this study is to describe the pathoanatomy for coxa vara and pseudarthrosis in postseptic hips, evaluate progression of neck shaft angle (NSA), and discuss treatment. This is a retrospective case series of 20 patients (21 hips). There were 11 hips with predominant avascular necrosis of the capital femoral epiphysis without pseudarthrosis (type 1) and 10 with pseudarthrosis (type 2). The interobserver κ value was 0.79. There was a decrease in NSA from 110.3° to 99.3° during an average follow-up duration of 5.2 years (range: 2-14 years). The average change in NSA between the initial presentation and the final follow-up was 5.5° in type 1 and 17.1° in type 2. Nine patients underwent a surgical intervention. In cases where subtrochanteric valgus osteotomy was performed, the mean preoperative NSA was 94° and the mean NSA at the final follow-up was 128°; all operated pseudarthroses healed without bone grafting. Acetabuloplasty is not necessary in most cases.

  17. Cosmetic wastewater treatment by coagulation and advanced oxidation processes.

    PubMed

    Naumczyk, Jeremi; Bogacki, Jan; Marcinowski, Piotr; Kowalik, Paweł

    2014-01-01

    In this study, the treatment process of three cosmetic wastewater types has been investigated. Coagulation allowed to achieve chemical oxygen demand (COD) removal of 74.6%, 37.7% and 74.0% for samples A (Al2(SO4)3), B (Brentafloc F3) and C (PAX 16), respectively. The Fenton process proved to be effective as well - COD removal was equal to 75.1%, 44.7% and 68.1%, respectively. Coagulation with FeCl3 and the subsequent photo-Fenton process resulted in the best values of final COD removal equal to 92.4%, 62.8% and 90.2%. In case of the Fenton process, after coagulation these values were equal to 74.9%, 50.1% and 84.8%, while in case of the H2O2/UV process, the obtained COD removal was 83.8%, 36.2% and 80.9%. High value of COD removal in the Fenton process carried out for A and C wastewater samples was caused by a significant contribution of the final neutralization/coagulation. Very small effect of the oxidation reaction in the Fenton process in case of sample A resulting from the presence of antioxidants, 'OH radical scavengers' in the wastewater.

  18. Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model.

    PubMed

    Li, Dongdong; Chu, Chi Meng; Ng, Wei Chern; Leong, Wai

    2014-11-01

    This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. [Organic and functional limitations due to milking phenomenon: a clinical case report].

    PubMed

    Gómez-Henry, Juan Carlos; Rodríguez-Pérez, Francisco Antonio

    2014-01-01

    The incidence of milking phenomenon is between 0.6 and 4 % in angiographic series; however, autopsy studies raise the incidence of myocardial bridges up to 85 %. This malformation goes unnoticed in most cases but can have a big impact on personal and professional level. The objective was to present an example of milking phenomenon with disability and professional consequences. Male, 44 years old, bricklayer and farmhand laborer. He referred tonsillectomy and osteoarthritis and being a smoker of 10 cigarettes per day, drinking 2-3 cups of coffee daily and 2-3 glasses of wine at the weekends. The primary care physician referred him to cardiologist with suspicion of arrhythmia. The cardiology service report mentioned electrocardiogram at sinusal rhythm, 90 beats per minute and incomplete right bundle-branch block. At ergonomics test, in the first stage of Bruce protocol, the patient's development of hypertensive crisis suggested a milking phenomenon. Finally, the diagnosis was established by angiographic studies with left common branch, circumflex coronary artery, right coronary artery and anterior descendent artery, without evidence of pathology but it was seen systolic compression on the medial segment. The case was concluded by the disability assessment team, recognizing a total permanent disability with limitations for activities requiring moderate physical efforts. The milking phenomenon diagnosis that could be related with ischemic heart disease is by angiography. Finally, the patient ended with total permanent disability.

  20. Theory of Auger core-valence-valence processes in simple metals. II. Dynamical and surface effects on Auger line shapes

    NASA Astrophysics Data System (ADS)

    Almbladh, C.-O.; Morales, A. L.

    1989-02-01

    Auger CVV spectra of simple metals are generally believed to be well described by one-electron-like theories in the bulk which account for matrix elements and, in some cases, also static core-hole screening effects. We present here detailed calculations on Li, Be, Na, Mg, and Al using self-consistent bulk wave functions and proper matrix elements. The resulting spectra differ markedly from experiment and peak at too low energies. To explain this discrepancy we investigate effects of the surface and dynamical effects of the sudden disappearance of the core hole in the final state. To study core-hole effects we solve Mahan-Nozières-De Dominicis (MND) model numerically over the entire band. The core-hole potential and other parameters in the MND model are determined by self-consistent calculations of the core-hole impurity. The results are compared with simpler approximations based on the final-state rule due to von Barth and Grossmann. To study surface and mean-free-path effects we perform slab calculations for Al but use a simpler infinite-barrier model in the remaining cases. The model reproduces the slab spectra for Al with very good accuracy. In all cases investigated either the effects of the surface or the effects of the core hole give important modifications and a much improved agreement with experiment.

  1. Mass measurement using energy spectra in three-body decays

    DOE PAGES

    Agashe, Kaustubh; Franceschini, Roberto; Kim, Doojin; ...

    2016-05-24

    In previous works we have demonstrated how the energy distribution of massless decay products in two body decays can be used to measure the mass of decaying particles. In this study, we show how such results can be generalized to the case of multi-body decays. The key ideas that allow us to deal with multi-body final states are an extension of our previous results to the case of massive decay products and the factorization of the multi-body phase space. The mass measurement strategy that we propose is distinct from alternative methods because it does not require an accurate reconstruction ofmore » the entire event, as it does not involve, for instance, the missing transverse momentum, but rather requires measuring only the visible decay products of the decay of interest. To demonstrate the general strategy, we study a supersymmetric model wherein pair-produced gluinos each decay to a stable neutralino and a bottom quark-antiquark pair via an off -shell bottom squark. The combinatorial background stemming from the indistinguishable visible final states on both decay sides can be treated by an “event mixing” technique, the performance of which is discussed in detail. In conclusion, taking into account dominant backgrounds, we are able to show that the mass of the gluino and, in favorable cases, that of the neutralino can be determined by this mass measurement strategy.« less

  2. Preserving privacy whilst maintaining robust epidemiological predictions.

    PubMed

    Werkman, Marleen; Tildesley, Michael J; Brooks-Pollock, Ellen; Keeling, Matt J

    2016-12-01

    Mathematical models are invaluable tools for quantifying potential epidemics and devising optimal control strategies in case of an outbreak. State-of-the-art models increasingly require detailed individual farm-based and sensitive data, which may not be available due to either lack of capacity for data collection or privacy concerns. However, in many situations, aggregated data are available for use. In this study, we systematically investigate the accuracy of predictions made by mathematical models initialised with varying data aggregations, using the UK 2001 Foot-and-Mouth Disease Epidemic as a case study. We consider the scenario when the only data available are aggregated into spatial grid cells, and develop a metapopulation model where individual farms in a single subpopulation are assumed to behave uniformly and transmit randomly. We also adapt this standard metapopulation model to capture heterogeneity in farm size and composition, using farm census data. Our results show that homogeneous models based on aggregated data overestimate final epidemic size but can perform well for predicting spatial spread. Recognising heterogeneity in farm sizes improves predictions of the final epidemic size, identifying risk areas, determining the likelihood of epidemic take-off and identifying the optimal control strategy. In conclusion, in cases where individual farm-based data are not available, models can still generate meaningful predictions, although care must be taken in their interpretation and use. Copyright © 2016. Published by Elsevier B.V.

  3. Computer-based simulation training in emergency medicine designed in the light of malpractice cases.

    PubMed

    Karakuş, Akan; Duran, Latif; Yavuz, Yücel; Altintop, Levent; Calişkan, Fatih

    2014-07-27

    Using computer-based simulation systems in medical education is becoming more and more common. Although the benefits of practicing with these systems in medical education have been demonstrated, advantages of using computer-based simulation in emergency medicine education are less validated. The aim of the present study was to assess the success rates of final year medical students in doing emergency medical treatment and evaluating the effectiveness of computer-based simulation training in improving final year medical students' knowledge. Twenty four Students trained with computer-based simulation and completed at least 4 hours of simulation-based education between the dates Feb 1, 2010 - May 1, 2010. Also a control group (traditionally trained, n =24) was chosen. After the end of training, students completed an examination about 5 randomized medical simulation cases. In 5 cases, an average of 3.9 correct medical approaches carried out by computer-based simulation trained students, an average of 2.8 correct medical approaches carried out by traditionally trained group (t = 3.90, p < 0.005). We found that the success of students trained with simulation training in cases which required complicated medical approach, was statistically higher than the ones who didn't take simulation training (p ≤ 0.05). Computer-based simulation training would be significantly effective in learning of medical treatment algorithms. We thought that these programs can improve the success rate of students especially in doing adequate medical approach to complex emergency cases.

  4. Assessment of the post-implant final left ventricular lead position: a comparative study between radiographic and angiographic modalities.

    PubMed

    Kumar, Prabhat; Blendea, Dan; Nandigam, Veena; Moore, Stephanie A; Heist, E Kevin; Singh, Jagmeet P

    2010-10-01

    Post-implant lateral and postero-anterior chest X-rays (CXR) are often utilized to determine the final LV lead tip position after cardiac resynchronization therapy (CRT). This study sought to compare post-implant standard CXRs with intra-procedural rotational coronary venous angiography (RCVA) to localize the final LV lead position. Sixty-four patients undergoing CRT (69.2 ± 11.4 years; males 68.7%; ischemic cardiomyopathy 59.4%; NYHA class 2.9 ± 0.5 and LV ejection fraction 24% ± 9%) were included in the study. RCVA was done by recording a rapid 4-second isocentric cine-loop from RAO 55° to LAO 55° (120 frames). Conventional CXR method (CC) and a composite CXR strategy (CM) based on two-view CXR were separately compared with RCVA. The most common pacing site was lateral (64.1%), followed by postero-lateral (23.4%) and antero-lateral (10.9%). In 73.4% (47) cases, the LV lead position was misclassified by CC as compared to RCVA. Among the 47 (73.4%) cases misclassified by CC approach, 35 had lateral LV lead position misclassified by CC as postero-lateral (77%), posterior (20%) and antero-lateral (3%). On the other hand, CM strategy classified the LV lead position correctly in 46 (71.9%) of the patients (p < 0.0001). The composite CXR strategy is a useful method for post-procedure LV lead localization. Due to its simplicity, it can be widely applied in post-implant evaluation of LV lead position in CRT patients.

  5. Visual Literacy in Primary Science: Exploring Anatomy Cross-Section Production Skills

    ERIC Educational Resources Information Center

    García Fernández, Beatriz; Ruiz-Gallardo, José Reyes

    2017-01-01

    Are children competent producing anatomy cross-sections? To answer this question, we carried out a case study research aimed at testing graphic production skills in anatomy of nutrition. The graphics produced by 118 children in the final year of primary education were analysed. The children had to draw a diagram of a human cross section,…

  6. Safety performance enhancement analysis of rumble stripes with elements : a case study on rural highway US 285 in New Mexico : final report.

    DOT National Transportation Integrated Search

    2016-08-31

    U.S. 285 is a major highway that runs through Colorado, New Mexico, and Texas with a large portion acting as a crucial corridor for the eastern portion of New Mexico, and also carries a significant portion of overturn crashes. Shoulder rumble strips ...

  7. "This I Believe" about the Teaching of Writing: Secondary Teachers' Digital Essays about Their Pedagogical Understandings

    ERIC Educational Resources Information Center

    Morgan, Denise M.; Levinson, Natasha

    2017-01-01

    This case study (Merriam & Tisdell, 2016) examines the final projects of two secondary teachers in a graduate course about writing pedagogy. Teachers created digital essays along the lines of the National Public Radio's "This I Believe" essays, which articulated their beliefs about the teaching of writing. We posed two research…

  8. Thermal conduction and gravitational collapse

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

    Herrera, L.; Jimenez, J.; Esculpi, M.

    1987-11-15

    A method used to study the evolution of radiating spheres, reported some years ago by Herrera, Jimenez, and Ruggeri, is extended to the case in which thermal conduction within the sphere is taken into account. By means of an explicit example it is shown that heat flow, if present, may play an important role, affecting the final outcome of collapse.

  9. PROPAGATION OF UNCERTAINTY IN HOURLY UTILITY NOX EMISSIONS THROUGH A PHOTOCHEMICAL GRID AIR QUALITY MODEL: A CASE STUDY FOR THE CHARLOTTE, NC, MODELING DOMAIN (R826766)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  10. The solution of transcendental equations

    NASA Technical Reports Server (NTRS)

    Agrawal, K. M.; Outlaw, R.

    1973-01-01

    Some of the existing methods to globally approximate the roots of transcendental equations namely, Graeffe's method, are studied. Summation of the reciprocated roots, Whittaker-Bernoulli method, and the extension of Bernoulli's method via Koenig's theorem are presented. The Aitken's delta squared process is used to accelerate the convergence. Finally, the suitability of these methods is discussed in various cases.

  11. The Silent North: A Case Study on Deafness in a Dene Community.

    ERIC Educational Resources Information Center

    Castleden, Heather

    2002-01-01

    In an isolated, northern Canadian, Indigenous community, interviews were conducted with family and community members connected to a young deaf boy, who finally was sent away to a residential school. Findings highlight the lack of culturally relevant services in northern communities, prevalence of otitis media and hearing loss in Native children,…

  12. 76 FR 40798 - Antidrug and Alcohol Misuse Prevention Programs for Personnel Engaged in Specified Aviation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-12

    ... includes contractors and subcontractors. Contracting companies have two testing options: Option one is for... case today and as such, there are no alternatives to the final rule that could have been considered and... stations would be classified as small business under NAICS 488180, the FAA reviewed a recent study...

  13. Sustainable tourism development: the case study of Antalya, Turkey

    Treesearch

    Latif Gurkan Kaya; Richard Smardon

    2001-01-01

    This paper discuss ideas about how tourism can be made base for sustainable tourism development in Antalya, Turkey. The introduction is a general overview of sustainable tourism development in coastal areas. The paper also addresses the role of NGOs in the course of development. Information is given about coastal tourism facilities in Turkey. Finally, sustainable...

  14. Factors Affecting Student Choice of the Undergraduate Research Project: Staff and Student Perceptions

    ERIC Educational Resources Information Center

    Harland, Janice; Pitt, Sarah; Saunders, Venetia

    2005-01-01

    As pressures on resources are growing and some question the value and types of final year research work for students in the biosciences and other disciplines, it is important to be well informed about student expectations of their project. In this case study within Biomolecular Sciences, questionnaires were used to compare staff and student…

  15. How Teachers Teach the Writing Process. Final Report.

    ERIC Educational Resources Information Center

    Perl, Sondra; And Others

    Presented in this report are the results of a three-year case study designed (1) to document what happened in the classrooms of 10 teachers who were trained in a process approach to the teaching of writing, and (2) to provide those teachers with occasions to deepen their understanding of the process approach, by collaborating with them in the…

  16. Embedding Research in a Field-Based Module through Peer Review and Assessment for Learning

    ERIC Educational Resources Information Center

    Nicholson, Dawn T.

    2011-01-01

    A case study is presented of embedding research in a final year undergraduate, field-based, physical geography module. The approach is holistic, whereby research-based learning activities simulate the full life cycle of research from inception through to peer review and publication. The learning, teaching and assessment strategy emphasizes the…

  17. Exploring Students' Perceptions about English Learning in a Public University

    ERIC Educational Resources Information Center

    Jiménez, Patricia Kim

    2018-01-01

    This manuscript reports the final findings of an exploratory, descriptive case study that aimed at exploring the perceptions of a group of English as a foreign language students in a public university regarding their English learning and the commitment level through the process. A questionnaire, a survey, and the teacher's diary were the…

  18. Introduction of Vertical Integration and Case-Based Learning in Anatomy for Undergraduate Physical Therapy and Occupational Therapy Students

    ERIC Educational Resources Information Center

    Parmar, Suresh K.; Rathinam, Bertha A. D.

    2011-01-01

    The purpose of the present pilot study was to evaluate the benefits of innovative teaching methodologies introduced to final year occupational and physical therapy students in Christian Medical College in India. Students' satisfactions along the long-term retention of knowledge and clinical application of the respiratory anatomy have been…

  19. Influences on Personal Understanding: Intentions, Approaches to Learning, Perceptions of Assessment, and a "Meeting of Minds"

    ERIC Educational Resources Information Center

    Karagiannopoulou, Evangelia; Entwistle, Noel

    2013-01-01

    Using a case-study approach, interviews with four final-year psychology students showed different approaches to learning and varying experiences of teaching in courses assessed through open-book exams. Analysis of their experiences, supported by previous research findings, provided insights into the reasons for the contrasting approaches being…

  20. Student Voice Use and Vocal Health during an All-State Chorus Event

    ERIC Educational Resources Information Center

    Daugherty, James F.; Manternach, Jeremy N.; Price, Kathy K.

    2011-01-01

    This field-based case study documented students' (N = 256) voice use and voice health perceptions during a 3-day all-state high school chorus event through daily surveys, phonation duration data, analysis of rehearsal voice use behaviors, and field notes. Among the primary results are the following: (a) First and final day survey comparisons…

  1. A CASE-CROSSOVER STUDY OF THE RELATIONSHIP OF FINE PM LEVELS TO SUDDEN CARDIAC ARREST IN INDIVIDUALS WITH AND WITHOUT CARDIAC DISEASE. (R827355C001)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  2. Case Study of a College that Closed: Saint Mary's College

    ERIC Educational Resources Information Center

    Brown, Alice W.

    2011-01-01

    Few colleges choose to close. One that did was Saint Mary's College in Raleigh, North Carolina. Although trustees resisted for a decade, they ultimately made the decision before an anticipated denial of accreditation, allowing the college to control its final days in ways not possible for those who wait until an outside agency forces closure. This…

  3. An Analysis of Adjuncts: A Syntacto-Discoursal Approach (A Case Study in Contemporary Persian)

    ERIC Educational Resources Information Center

    Jafari, Azita; Sedigh Ziabari, Roya

    2008-01-01

    In broad terms, this paper is concerned with adjunct construction in Persian, which is an Indo-Iranian Language. During the recent century, specially in its final decades, different researches have been done about adjuncts and adjunction among different languages, but despite the fact that they are very important in Persian language, no attempts…

  4. TECHNOLOGY TRANSFER OF AN INNOVATIVE REMEDIATION TECHNOLOGY FROM THE LABORATORY TO THE FIELD: A CASE STUDY OF IN SITU AEROBIC COMETABOLIC BIOREMEDIATION. (R825689C067)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  5. Under-Representation of Males in the Early Years: The Challenges Leaders Face

    ERIC Educational Resources Information Center

    Mistry, Malini; Sood, Krishan

    2013-01-01

    This article investigates why there appears to be an under-representation of males in comparison to their female colleagues in the Early Years (EY) sector, and the perception of male teachers progressing more quickly to leadership positions when they do enter this context. Using case studies of final year male students on an Initial Teacher…

  6. 24 CFR 266.420 - Closing and endorsement by the Commissioner.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... (a) Closing. Before disbursement of loan advances in periodic advances cases, and in all cases after... market occupancy percentages, value/replacement cost, interest rate, and similar statistical information... certification for periodic advances cases, if submitted for final endorsement, that advances were made...

  7. 37 CFR 1.111 - Reply by applicant or patent owner to a non-final Office action.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... owner to a non-final Office action. 1.111 Section 1.111 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES... patent owner to a non-final Office action. (a)(1) If the Office action after the first examination (§ 1...

  8. 28 CFR 68.56 - Judicial review of a final agency order in cases arising under section 274A or 274C.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... review by the Chief Administrative Hearing Officer of a final order by an Administrative Law Judge shall... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Judicial review of a final agency order... OF JUSTICE (CONTINUED) RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE HEARINGS BEFORE...

  9. 77 FR 21529 - Freshwater Crawfish Tail Meat From the People's Republic of China: Final Results of Antidumping...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-10

    ... question, including when that rate is zero or de minimis.\\5\\ In this case, there is only one non-selected... calculations for one company. Therefore, the final results differ from the preliminary results. The final... not to calculate an all-others rate using any zero or de minimis margins or any margins based entirely...

  10. 78 FR 52500 - Polyethylene Terephthalate Film, Sheet, and Strip From the People's Republic of China: Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-23

    ... Film, Sheet, and Strip From the People's Republic of China: Notice of Court Decision Not in Harmony..., available at: http://ia.ita.doc.gov/remands (``PET Film Final Remand''). Consistent with the decision of the... that the final judgment in this case is not in harmony with the Department's PET Film Final Results \\2...

  11. 37 CFR 1.111 - Reply by applicant or patent owner to a non-final Office action.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... owner to a non-final Office action. 1.111 Section 1.111 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES... patent owner to a non-final Office action. (a)(1) If the Office action after the first examination (§ 1...

  12. 37 CFR 1.111 - Reply by applicant or patent owner to a non-final Office action.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... owner to a non-final Office action. 1.111 Section 1.111 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES... patent owner to a non-final Office action. (a)(1) If the Office action after the first examination (§ 1...

  13. 37 CFR 1.111 - Reply by applicant or patent owner to a non-final Office action.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... owner to a non-final Office action. 1.111 Section 1.111 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES... patent owner to a non-final Office action. (a)(1) If the Office action after the first examination (§ 1...

  14. 37 CFR 1.111 - Reply by applicant or patent owner to a non-final Office action.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... owner to a non-final Office action. 1.111 Section 1.111 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES... patent owner to a non-final Office action. (a)(1) If the Office action after the first examination (§ 1...

  15. A spatial analysis of the spread of mumps: the importance of college students and their spring-break-associated travel.

    PubMed

    Polgreen, P M; Bohnett, L C; Yang, M; Pentella, M A; Cavanaugh, J E

    2010-03-01

    To characterize the association between county-level risk factors and the incidence of mumps in the 2006 Iowa outbreak, we used generalized linear mixed models with the number of mumps cases per county as the dependent variable. To assess the impact of spring-break travel, we tested for differences in the proportions of mumps cases in three different age groups. In the final multivariable model, the proportion of Iowa's college students per county was positively associated (P<0.0001) with mumps cases, but the number of colleges was negatively associated with cases (P=0.0002). Thus, if the college students in a county were spread among more campuses, this was associated with fewer mumps cases. Finally, we found the proportion of mumps cases in both older and younger persons increased after 1 April (P=0.0029), suggesting that spring-break college travel was associated with the spread of mumps to other age groups.

  16. Experimental analysis of the boundary layer transition with zero and positive pressure gradient

    NASA Technical Reports Server (NTRS)

    Arnal, D.; Jullen, J. C.; Michel, R.

    1980-01-01

    The influence of a positive pressure gradient on the boundary layer transition is studied. The mean velocity and turbulence profiles of four cases are examined. As the intensity of the pressure gradient is increased, the Reynolds number of the transition onset and the length of the transition region are reduced. The Tollmein-Schlichting waves disturb the laminar regime; the amplification of these waves is in good agreement with the stability theory. The three dimensional deformation of the waves leads finally to the appearance of turbulence. In the case of zero pressure gradient, the properties of the turbulent spots are studied by conditional sampling of the hot-wire signal; in the case of positive pressure gradient, the turbulence appears in a progressive manner and the turbulent spots are much more difficult to characterize.

  17. Documentation Supplement for Base Case v4.10_FTransport - Updates for Final Transport Rule

    EPA Pesticide Factsheets

    View the document that describes the changes implemented as a result for the Final Cross-State Air Pollution Rule (Transport Rule) analysis in EPA’s application of the Integrated Planning Model (IPM).

  18. Rules for success in environmental negotiation

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

    Taylor, J.G.; Burkardt, N.; Lamb, B.L.

    Scientists at the Mid-Continent Ecological Science Center of the National Biological Service conducted a series of case studies of FERC license consultations. The goal of these studies was to test hypotheses about factors that contribute to success in interagency negotiations. Based on their analysis of six case studies, the researchers constructed a list of ten rules for success. Examples include: (1) analyze the incentives of each party to negotiate, (2) paying special attention to parties who gain by not negotiating, (3) clarifying the technical issues so that all parties and that they coincide with resource management objectives, and (4) makingmore » sure that the final agreement is feasible from both a physical and a policy perspective so that it can actually be implemented.« less

  19. Probing community nurses' professional basis: a situational case study in diabetic foot ulcer treatment.

    PubMed

    Schaarup, Clara; Pape-Haugaard, Louise; Jensen, Merete Hartun; Laursen, Anders Christian; Bermark, Susan; Hejlesen, Ole Kristian

    2017-03-01

    Complicated and long-lasting wound care of diabetic foot ulcers are moving from specialists in wound care at hospitals towards community nurses without specialist diabetic foot ulcer wound care knowledge. The aim of the study is to elucidate community nurses' professional basis for treating diabetic foot ulcers. A situational case study design was adopted in an archetypical Danish community nursing setting. Experience is a crucial component in the community nurses' professional basis for treating diabetic foot ulcers. Peer-to-peer training is the prevailing way to learn about diabetic foot ulcer, however, this contributes to the risk of low evidence-based practice. Finally, a frequent behaviour among the community nurses is to consult colleagues before treating the diabetic foot ulcers.

  20. Bringing explicit insight into cognitive psychology features during clinical reasoning seminars: a prospective, controlled study.

    PubMed

    Nendaz, Mathieu R; Gut, Anne M; Louis-Simonet, Martine; Perrier, Arnaud; Vu, Nu V

    2011-04-01

    Facets of reasoning competence influenced by an explicit insight into cognitive psychology features during clinical reasoning seminars have not been specifically explored. This prospective, controlled study, conducted at the University of Geneva Faculty of Medicine, Switzerland, assessed the impact on sixth-year medical students' patient work-up of case-based reasoning seminars, bringing them explicit insight into cognitive aspects of their reasoning. Volunteer students registered for our three-month Internal Medicine elective were assigned to one of two training conditions: standard (control) or modified (intervention) case-based reasoning seminars. These seminars start with the patient's presenting complaint and the students must ask the tutor for additional clinical information to progress through case resolution. For this intervention, the tutors made each step explicit to students and encouraged self-reflection on their reasoning processes. At the end of their elective, students' performances were assessed through encounters with two standardized patients and chart write-ups. Twenty-nine students participated, providing a total of 58 encounters. The overall differences in accuracy of the final diagnosis given to the patient at the end of the encounter (control 63% vs intervention 74%, p = 0.53) and of the final diagnosis mentioned in the patient chart (61% vs 70%, p = 0.58) were not statistically significant. The students in the intervention group significantly more often listed the correct diagnosis among the differential diagnoses in their charts (75% vs 97%, p = 0.02). This case-based clinical reasoning seminar intervention, designed to bring students insight into cognitive features of their reasoning, improved aspects of diagnostic competence.

  1. Deriving a no expected sensitization induction level for fragrance ingredients without animal testing: An integrated approach applied to specific case studies.

    PubMed

    Natsch, Andreas; Emter, Roger; Haupt, Tina; Ellis, Graham

    2018-06-01

    Cosmetic regulations prohibit animal testing for the purpose of safety assessment and recent REACH guidance states that the local lymph node assay (LLNA) in mice shall only be conducted if in vitro data cannot give sufficient information for classification and labelling. However, Quantitative Risk Assessment (QRA) for fragrance ingredients requires a NESIL, a dose not expected to cause induction of skin sensitization in humans. In absence of human data, this is derived from the LLNA and it remains a key challenge for risk assessors to derive this value from non-animal data. Here we present a workflow using structural information, reactivity data and KeratinoSens results to predict a LLNA result as a point of departure. Specific additional tests (metabolic activation, complementary reactivity tests) are applied in selected cases depending on the chemical domain of a molecule. Finally, in vitro and in vivo data on close analogues are used to estimate uncertainty of the prediction in the specific chemical domain. This approach was applied to three molecules which were subsequently tested in the LLNA and 22 molecules with available and sometimes discordant human and LLNA data. Four additional case studies illustrate how this approach is being applied to recently developed molecules in the absence of animal data. Estimation of uncertainty and how this can be applied to determine a final NESIL for risk assessment is discussed. We conclude that, in the data-rich domain of fragrance ingredients, sensitization risk assessment without animal testing is possible in most cases by this integrated approach.

  2. Adoption of the HPV vaccine: a case study of three emerging countries.

    PubMed

    Caro Martínez, Araceli; Espín Balbino, Jaime; Lemgruber, Alexandre; Martín Ruiz, Eva; Olry de Labry Lima, Antonio; García-Mochón, Leticia; Lessa, Fernanda

    2017-05-01

    The human papillomavirus (HPV) vaccine has recently attracted considerable attention in emerging countries, due to its potential to reduce the impact of HPV-related diseases. This case study sheds new light about the variety of HTA arrangements, methods and processes involved in the adoption and use of HPV vaccines in a selected sample of central, eastern and southern Europe and Latin America and the Caribbean, all of them emerging in the use of HTA. A multi-country case study was designed. Mixed methods, document review, semi-structured surveys and personal communication with experts, were used for data collection and triangulation. This study shows that common elements of good practice exist in the processes and methods used, with all countries arriving at the same appraisal recommendations. However, the influence of socio-politico-economic factors appears to be determinant on the final decisions and restrictions to access made. This case study intends to draw useful lessons for policymakers in emerging settings interested in the adoption of the HPV vaccine supported by evidence-informed processes, such as those offered by institutionalized HTA. Future studies are also recommended to elucidate the specific roles that social values and uncertainties play in vaccine decision-making across different societies.

  3. Detailed analysis of grid-based molecular docking: A case study of CDOCKER-A CHARMm-based MD docking algorithm.

    PubMed

    Wu, Guosheng; Robertson, Daniel H; Brooks, Charles L; Vieth, Michal

    2003-10-01

    The influence of various factors on the accuracy of protein-ligand docking is examined. The factors investigated include the role of a grid representation of protein-ligand interactions, the initial ligand conformation and orientation, the sampling rate of the energy hyper-surface, and the final minimization. A representative docking method is used to study these factors, namely, CDOCKER, a molecular dynamics (MD) simulated-annealing-based algorithm. A major emphasis in these studies is to compare the relative performance and accuracy of various grid-based approximations to explicit all-atom force field calculations. In these docking studies, the protein is kept rigid while the ligands are treated as fully flexible and a final minimization step is used to refine the docked poses. A docking success rate of 74% is observed when an explicit all-atom representation of the protein (full force field) is used, while a lower accuracy of 66-76% is observed for grid-based methods. All docking experiments considered a 41-member protein-ligand validation set. A significant improvement in accuracy (76 vs. 66%) for the grid-based docking is achieved if the explicit all-atom force field is used in a final minimization step to refine the docking poses. Statistical analysis shows that even lower-accuracy grid-based energy representations can be effectively used when followed with full force field minimization. The results of these grid-based protocols are statistically indistinguishable from the detailed atomic dockings and provide up to a sixfold reduction in computation time. For the test case examined here, improving the docking accuracy did not necessarily enhance the ability to estimate binding affinities using the docked structures. Copyright 2003 Wiley Periodicals, Inc.

  4. 77 FR 73286 - Codification of Animal Testing Policy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ... to post the test method on the animal testing Web site. In the final statement of policy, we refer to... case-by-case basis and, upon review, determine whether to post the test method on the animal testing... on a case-by- case basis and, upon review, determine whether to post the test method on the animal...

  5. Swyer Syndrome With Gonadoblastoma: A Clinicoradiological Approach.

    PubMed

    Agarwal, Arjit; Agarwal, Shubhra

    2017-01-01

    Primary amenorrhea is a common diagnostic challenge in the gynecology department, wherein there are numerous causes that need to be approached in a systematic manner. However, when a case with a pelvic lump or a solid pelvic mass presents to a gynecologist or a radiologist, the approach becomes difficult to justify amenorrhea and pelvic mass as a single entity. We present the case of a 36-year-old female with the complaints of primary amenorrhea with a pelvic mass. The case was approached keeping in view the diagnostic possibilities and applying the role of clinical, radiological, and laboratory analyses. The final diagnosis of Swyer syndrome with gonadoblastoma was made, and she was further subjected to operative resection and hormonal therapy. This study stresses on the approach to a case, wherein the diagnosis was based only on the clinician's acumen and the radiologist's expertise, providing a way to simplify the protocol in the evaluation of such types of cases.

  6. “I tried so many diets, now I want to do it differently”—A single case study on coaching for weight loss

    PubMed Central

    Stelter, Reinhard

    2015-01-01

    In this single case study, the author presented an in-depth description and analysis of a coaching intervention with focus on weight loss, conducted over 10 sessions in the course of 17 months. The client was a well-educated woman in her late 30s, who had tried many different forms of dieting over the years—with little and no lasting effect. In his coaching approach, the author went beyond a pure behavioural change model, that is, based on the Health Belief Model, and tried to take a whole-life perspective, where the client learned to link specific events and habits in her work life and everyday life with specific eating habits. In their collaborative practice, coach and coachee initiated changes both in regard to diet, physical activity, and healthy life style, in general. In a theoretical section, the change in understanding with regard to overeating was presented. Finally, an intra-active model—viewing the client as a self-reflective individual—was used as theoretical basis. A narrative analysis of the first session and a cross-session examination was presented to show, analyse, and understand the procedure of the coaching approach. Finally, the voice of the coachee was heard in regard to her personal experiences during the process. The data material was based on audio recordings of selected sessions, notes written by the coach from every session, and final written reflections by the coachee. PMID:26282867

  7. Selectivity in the inelastic rotational scattering of D2 and HD molecules from graphite: Similarities and differences respect to the H2 case

    NASA Astrophysics Data System (ADS)

    Rutigliano, Maria; Pirani, Fernando

    2018-03-01

    The inelastic scattering of D2 and HD molecules impinging on a graphite surface in well-defined initial roto-vibrational states has been studied by using the computational setup recently developed to characterize important selectivities in the molecular dynamics occurring at the gas-surface interface. In order to make an immediate comparison of determined elastic and inelastic scattering probabilities, we considered for D2 and HD molecules the same initial states, as well as the same collision energy range, previously selected for the investigation of H2 behaviour. The analysis of the back-scattered molecules shows that, while low-lying initial vibrational states are preserved, the medium-high initial ones give rise to final states covering the complete ladder of vibrational levels, although with different probability for the various cases investigated. Moreover, propensities in the formation of the final rotational states are found to depend strongly on the initial ones, on the collision energy, and on the isotopologue species.

  8. Court Decisions on Medical Malpractice in China After the New Tort Liability Law.

    PubMed

    Zhang, Kui; Li, Yuan; Fan, Fei; Liu, Xin; Deng, Zhen-Hua

    2016-09-01

    A new Tort Law of the People's Republic of China became effective on July 1, 2010. We undertook an analysis of medical malpractice lawsuits brought before regional courts in Beijing districts after this new Tort Liability Law went into effect. In total, 726 cases eventuating in a final verdict were collected from the Beijing district courts from 2011 to 2013 in this retrospective study; 83.7% of the 726 alleged instances of medical malpractice were confirmed to be malpractice by the final verdict. The disciplines most frequently involved with claims of medical malpractice were obstetrics and gynecology, the most frequent outcomes was death, and the most common types of case associated with malpractice was surgery related. The average length of time between the occurrence of the injury and closure of the claim was 9.2 months, and the average payment was ¥163,000. Since the introduction of the new Tort Liability Law, the average time to complete a litigation was shortened, but it has made little apparent difference otherwise.

  9. Lymphatic mapping for gastric adenocarcinoma.

    PubMed

    Hundley, Jon C; Shen, Perry; Shiver, Stephen A; Geisinger, Kim R; Levine, Edward A

    2002-11-01

    The role of lymphadenectomy for gastric carcinoma has been debated for decades. Lymphatic mapping has revolutionized the treatment of melanoma and breast cancer. However, its potential utility in guiding lymphadenectomy for gastric carcinoma is unknown. Therefore we initiated a trial to investigate lymphatic mapping for gastric carcinoma at Wake Forest University Baptist Medical Center. Lymphatic mapping for gastric carcinoma was attempted in 14 cases of gastric carcinoma. Mapping was performed by perilesional injection of isosulfan blue and the first node in the draining basin was harvested and sent fresh to pathology. Sentinel lymph nodes (SLNs) were evaluated by hematoxylin and eosin (H&E) staining. Immunohistochemical analysis was performed on all SLNs that were found to be negative on initial histologic studies. Radical gastrectomy with celiac node dissection was performed in all cases. SLNs were identified in 14 cases. In one case the technique was abandoned because of bulk nodal disease. The average number of SLNs found in each case was 2.8 with a range of one to five. Eight of 14 patients were found to have SLNs positive for metastatic carcinoma. In seven of these patients pathologic analysis of the final resection specimen confirmed the presence of nodal disease. In one case carcinoma was found in a SLN on touch preparation and no nodal disease was noted in the resection specimen. Immunohistochemical studies performed on SLNs found to be negative on initial H&E histologic analysis failed to reveal the presence of carcinoma. The overall sensitivity and specificity were found to be 72.7 and 75 per cent, respectively. Lymphatic mapping is technically possible in the setting of gastric carcinoma and SLNs can be successfully identified in the majority of cases. Upstaging occurred in one case which may have ramifications for adjuvant therapy. SLN positivity accurately predicts the presence of additional nodal disease beyond the SLN in the final resection specimen (positive predictive value 89%). However, SLN negativity does not definitively prove that the remaining nodal basin is free of disease (negative predictive value 50%). Lymphatic mapping for gastric carcinoma is a promising technique worthy of further investigation.

  10. Consumerism--Student: Legal Issues and Cases.

    ERIC Educational Resources Information Center

    Zabetakis, Steve

    The facts, issues, and final judgements of 53 court cases are presented in this compilation focusing on the legal aspects of the student consumerism movement. The first 18 cases cited deal with issues related to admissions, such as reverse discrimination, admission fees, residency, fraudulent misrepresentation, employment promise, contractual…

  11. 2015 Clean Air Act Vehicle and Engine Enforcement Case Resolutions

    EPA Pesticide Factsheets

    2015 Enforcement case resolutions such as expedited settlement agreements, administrative settlement agreements, administrative penalty orders, consent agreements and final orders, and consent decrees are listed by respondent name below.

  12. 2016 Clean Air Act Vehicle and Engine Enforcement Case Resolutions

    EPA Pesticide Factsheets

    2016 Enforcement case resolutions such as expedited settlement agreements, administrative settlement agreements, administrative penalty orders, consent agreements and final orders, and consent decrees are listed by respondent name below.

  13. 2018 Clean Air Act Vehicle and Engine Enforcement Case Resolutions

    EPA Pesticide Factsheets

    2018 Enforcement case resolutions such as expedited settlement agreements, administrative settlement agreements, administrative penalty orders, consent agreements and final orders, and consent decrees are listed by respondent name below.

  14. 2017 Clean Air Act Vehicle and Engine Enforcement Case Resolutions

    EPA Pesticide Factsheets

    2017 Enforcement case resolutions such as expedited settlement agreements, administrative settlement agreements, administrative penalty orders, consent agreements and final orders, and consent decrees are listed by respondent name below.

  15. Collaborative practices in unscheduled emergency care: role and impact of the emergency care practitioner—quantitative findings

    PubMed Central

    Cooper, Simon; O'Carroll, Judith; Jenkin, Annie; Badger, Beryl

    2007-01-01

    Objective To identify collaborative instances and hindrances and to produce a model of collaborative practice. Methods A 12 month (2005–6) mixed methods clinical case study in a large UK ambulance trust. Collaboration was measured through direct observational ratings of communication skills, teamwork and leadership with 24 multiprofessional emergency care practitioners (ECPs); interviews with 45 ECPs and stakeholders; and an audit of 611 patients. Results Quantitative observational ratings indicated that the higher the leadership rating the greater the communication ability (p⩽0.001) and teamwork (p⩽0.001), and the higher grade ECPs were rated more highly on their leadership performance. From the patient audit, influences and outputs of collaborative practice are revealed: mean time on scene was 47 mins; 62% were not conveyed; 38% were referred, mainly to accident and emergency; ECPs claimed to make the referral decision in 87% of cases with a successful referral in 96% of cases; and in 66% of cases ECPs claimed that their intervention prevented an acute trust admission. The qualitative interview findings, final collaborative model and recommendations are reported in another paper. Conclusions The collaborative performance of ECPs varies, but the ECPs' role does appear to have an impact on collaborative practices and patient care. Final recommendations are reported with the qualitative results elsewhere. PMID:17711938

  16. 77 FR 12556 - Certain Steel Nails From the People's Republic of China: Final Results and Final Partial...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ..., respectively. Case History On September 12, 2011, the Department published in the Federal Register the... Comment 6: Stanley's Surrogate Values A. Copper Plated Steel Welding Wire B. Sodium Sulfate C. Glass Balls...

  17. Repeatability of pleural adenosine deaminase measurements in diagnostic evaluation of pleural effusions.

    PubMed

    Kotsiou, Ourania S; Tzortzi, Panagiota; Beta, Rafailia A A; Kyritsis, Athanasios; Gourgoulianis, Konstantinos I

    2018-06-01

    A follow-up thoracentesis is proposed in suspected atypical tuberculosis cases. The study aimed to define the variability of pleural ADA values across repeated thoracenteses in different types of pleural effusions (PEs) and to evaluate whether ADA variance, in regard to the cutoff value of 40 U/L, affected final diagnosis. A total of 131 patients with PEs of various etiologies underwent three repeated thoracenteses. ADA values were subsequently estimated. 82% and 55% of patients had greater than 10% and 20% deviation from the highest ADA value, respectively. From those patients who had a variance of 20%, 36% had only increasing ADA values, while 19% had only decreasing values. Considering the cutoff value of 40 U/L, only in two cases, ADA decreased below this threshold, which concerned a man with tuberculous pleurisy and a woman with lymphoma both in the course of treatment. Furthermore, only in two cases with rising values, ADA finally exceeded the cutoff limit, which concerned a man with rheumatoid pleurisy and a man with tuberculous pleurisy. Surprisingly, malignant PEs (MPEs) showed a higher percentage of increasing values compared to all other exudates that did not, however, exceed the threshold. The determination of pleural ADA levels is a reproducible method for rapid tuberculosis diagnosis. The detected measurement deviations do not appear to affect final diagnosis. In specific situations, repeated ADA measurements may be valuable in directing further diagnostic evaluation. More investigation is needed to elucidate the possible prognostic significance of the increasing trend in ADA values in MPEs. © 2017 Wiley Periodicals, Inc.

  18. Patients’ Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings

    PubMed Central

    Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

    2016-01-01

    Background The contribution of patients’ non-medical characteristics to individual physicians’ decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients’ non-medical characteristics are presented at MDT meetings and how this information may affect the team’s final medical decisions. Design Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians’ verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. Results In the final sample of patients’ records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient’s age and his/her “likeability” were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients’ non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. Limitations The design of the study made it difficult to draw definite cause-and-effect conclusions. Conclusion The Social Representations approach suggests that patients’ non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians’ everyday professional practice. The links observed between patients’ attributes and the medical decisions made at these meetings show that these attributes should be taken into account in order to understand how medical decisions are reached in difficult situations of this kind. PMID:27167521

  19. 28 CFR 68.54 - Administrative review of a final order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 5 U.S.C. 557, to review any final order of an Administrative Law Judge in accordance with the... request for administrative review within ten (10) days of the date of entry of the Administrative Law... Administrative Hearing Officer may review an Administrative Law Judge's final order on his or her own initiative...

  20. 77 FR 46686 - Steel Nails From the People's Republic of China: Notice of Court Decision Not in Harmony With...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ...'s Republic of China: Notice of Court Decision Not in Harmony With Final Scope Ruling and Notice of... Corporation's toolkits from the People's Republic of China (``PRC''), pursuant to the CIT's remand order in... judgment in this case is not in harmony with the Department's final scope ruling and is amending its final...

  1. 28 CFR 68.54 - Administrative review of a final order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 5 U.S.C. 557, to review any final order of an Administrative Law Judge in accordance with the... Administrative Hearing Officer may review an Administrative Law Judge's final order on his or her own initiative... Administrative Law Judge's order. This notification shall state the issues to be reviewed. (b) Written and oral...

  2. 28 CFR 68.54 - Administrative review of a final order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 5 U.S.C. 557, to review any final order of an Administrative Law Judge in accordance with the... Administrative Hearing Officer may review an Administrative Law Judge's final order on his or her own initiative... Administrative Law Judge's order. This notification shall state the issues to be reviewed. (b) Written and oral...

  3. 28 CFR 68.54 - Administrative review of a final order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 5 U.S.C. 557, to review any final order of an Administrative Law Judge in accordance with the... Administrative Hearing Officer may review an Administrative Law Judge's final order on his or her own initiative... Administrative Law Judge's order. This notification shall state the issues to be reviewed. (b) Written and oral...

  4. 28 CFR 68.54 - Administrative review of a final order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 5 U.S.C. 557, to review any final order of an Administrative Law Judge in accordance with the... Administrative Hearing Officer may review an Administrative Law Judge's final order on his or her own initiative... Administrative Law Judge's order. This notification shall state the issues to be reviewed. (b) Written and oral...

  5. Pattern formation in rotating Bénard convection

    NASA Astrophysics Data System (ADS)

    Fantz, M.; Friedrich, R.; Bestehorn, M.; Haken, H.

    1992-12-01

    Using an extension of the Swift-Hohenberg equation we study pattern formation in the Bénard experiment close to the onset of convection in the case of rotating cylindrical fluid containers. For small Taylor numbers we emphasize the existence of slowly rotating patterns and describe behaviour exhibiting defect motion. Finally, we study pattern formation close to the Küppers-Lortz instability. The instability is nucleated at defects and proceeds through front propagation into the bulk patterns.

  6. Study Of Pre-Shaped Membrane Mirrors And Electrostatic Mirrors With Nonlinear-Optical Correction

    DTIC Science & Technology

    2002-01-01

    mirrors have been manufactured of glass-like material Zerodur with very low coefficient of linear expansion. They have a more light cellular construction...primary and flat secondary mirrors are both segmented ones. In the case of the primary mirror made of traditional materials such as Zerodur or fused...FINAL REPORT ISTC Project #2103p “Study of Pre-Shaped Membrane Mirrors and Electrostatic Mirrors with Nonlinear-Optical Correction” Manager

  7. THE DETERMINATION OF LEGAL FACTS AND ECONOMIC GUIDEPOSTS WITH RESPECT TO THE DISSEMINATION OF SCIENTIFIC AND EDUCATIONAL INFORMATION AS IT IS AFFECTED BY COPYRIGHT--A STATUS REPORT. FINAL REPORT.

    ERIC Educational Resources Information Center

    HEILPRIN, LAURENCE B.; SOPHAR, GERALD J.

    THE RESEARCH IN THIS REPORT IS CONCERNED WITH TWO AREAS--(1) STUDY OF THE COPYRIGHT PRACTICES OF LIBRARY ADMINISTRATORS RESPONSIBLE FOR PHOTODUPLICATION SERVICES AND THEIR INTERPRETATIONS OF THE "FAIR USE" ASPECT OF COPYRIGHT LAW IN PROVIDING SERVICE TO THEIR CLIENTS, AS WELL AS A STUDY OF WHAT FEDERAL STATUTE AND CASE LAW ACTUALLY…

  8. The Optokinetic Cervical Reflex (OKCR) in Pilots of High-Performance Aircraft.

    DTIC Science & Technology

    1997-04-01

    Coupled System virtual reality - the attempt to create a realistic, three-dimensional environment or synthetic immersive environment in which the user ...factors interface between the pilot and the flight environment. The final section is a case study of head- and helmet-mounted displays (HMD) and the impact...themselves as actually moving (flying) through a virtual environment. However, in the studies of Held, et al. (1975) and Young, et al. (1975) the

  9. Evaluating statistical and clinical significance of intervention effects in single-case experimental designs: an SPSS method to analyze univariate data.

    PubMed

    Maric, Marija; de Haan, Else; Hogendoorn, Sanne M; Wolters, Lidewij H; Huizenga, Hilde M

    2015-03-01

    Single-case experimental designs are useful methods in clinical research practice to investigate individual client progress. Their proliferation might have been hampered by methodological challenges such as the difficulty applying existing statistical procedures. In this article, we describe a data-analytic method to analyze univariate (i.e., one symptom) single-case data using the common package SPSS. This method can help the clinical researcher to investigate whether an intervention works as compared with a baseline period or another intervention type, and to determine whether symptom improvement is clinically significant. First, we describe the statistical method in a conceptual way and show how it can be implemented in SPSS. Simulation studies were performed to determine the number of observation points required per intervention phase. Second, to illustrate this method and its implications, we present a case study of an adolescent with anxiety disorders treated with cognitive-behavioral therapy techniques in an outpatient psychotherapy clinic, whose symptoms were regularly assessed before each session. We provide a description of the data analyses and results of this case study. Finally, we discuss the advantages and shortcomings of the proposed method. Copyright © 2014. Published by Elsevier Ltd.

  10. Patterns and correlates of co-occurrence among multiple types of child maltreatment

    PubMed Central

    Kim, Kihyun; Mennen, Ferol E.; Trickett, Penelope K.

    2017-01-01

    This study examined the patterns and correlates of the types of maltreatment experienced by adolescents aged 9–12, participating in an ongoing longitudinal study on the impact of neglect on children’s development. Using case record abstraction, the study compared the child protection classification and findings from the case record abstraction with regard to the rates of four types of maltreatment (i.e. physical, sexual, emotional abuse and neglect) as well as co-occurrence across multiple types of maltreatment. Next, the study examined the frequently observed patterns of child maltreatment. Finally, the study investigated whether aspects of caretaker functioning and the detailed incident characteristics in the cases of neglect differed by the number of different types of maltreatment the children experienced. Results showed significant discrepancies between the Child Protective Service classification and case record abstraction. Child Protective Service classification considerably underestimated the rate of co-occurrence across multiple types of maltreatment. Neglect accompanied by physical and emotional abuse was the most common form. Some of the caretaker functioning variables distinguished the number of types of maltreatment. Based on the findings, future-research directions and practice implication were discussed. PMID:29225485

  11. Thyrotropin receptor autoantibodies and early miscarriages in patients with Hashimoto thyroiditis: a case-control study.

    PubMed

    Toulis, Konstantinos A; Goulis, Dimitrios G; Tsolakidou, Konstantina; Hilidis, Ilias; Fragkos, Marios; Polyzos, Stergios A; Gerofotis, Antonios; Kita, Marina; Bili, Helen; Vavilis, Dimitrios; Daniilidis, Michail; Tarlatzis, Basil C; Papadimas, Ioannis

    2013-08-01

    We have previously hypothesized that early miscarriage in women with Hashimoto thyroiditis might be the result of a cross-reactivity process, in which blocking autoantibodies against thyrotropin receptor (TSHr-Ab) antagonize hCG action on its receptor on the corpus luteum. To test this hypothesis from the clinical perspective, we investigated the presence of TSHr-Ab in Hashimoto thyroiditis patients with apparently unexplained, first-trimester recurrent miscarriages compared to that in Hashimoto thyroiditis patients with documented normal fertility. A total of 86 subjects (43 cases and 43 age-matched controls) were finally included in a case-control study. No difference in the prevalence of TSHr-Ab positivity was detected between cases and controls (Fisher's exact test, p value = 1.00). In patients with recurrent miscarriages, TSHr-Ab concentrations did not predict the number of miscarriages (univariate linear regression, p value = 0.08). These results were robust in sensitivity analyses, including only cases with full investigation or those with three or more miscarriages. We conclude that no role could be advocated for TSHr-Ab in the aetiology of recurrent miscarriages in women with Hashimoto thyroiditis.

  12. Incarcerated medial epicondyle fracture following pediatric elbow dislocation: 11 cases.

    PubMed

    Dodds, Seth D; Flanagin, Brody A; Bohl, Daniel D; DeLuca, Peter A; Smith, Brian G

    2014-09-01

    To describe outcomes after surgical management of pediatric elbow dislocation with incarceration of the medial epicondyle. We conducted a retrospective case review of 11 consecutive children and adolescents with an incarcerated medial epicondyle fracture after elbow dislocation. All patients underwent open reduction internal fixation using a similar technique. We characterized outcomes at final follow-up. Average follow-up was 14 months (range, 4-56 mo). All patients had clinical and radiographic signs of healing at final follow-up. There was no radiographic evidence of loss of reduction at intervals or at final follow-up. There were no cases of residual deformity or valgus instability. Average final arc of elbow motion was 4° to 140°. All patients had forearm rotation from 90° supination to 90° pronation. Average Mayo elbow score was 99.5. Four of 11 patients had ulnar nerve symptoms postoperatively and 1 required a second operation for ulnar nerve symptoms. In addition, 1 required a second operation for flexion contracture release with excision of heterotopic ossification. Three patients had ulnar nerve symptoms at final follow-up. Two of these had mild paresthesia only and 1 had both mild paresthesia and weakness. Our results suggest that open reduction internal fixation of incarcerated medial epicondyle fractures after elbow dislocation leads to satisfactory motion and function; however, the injury carries a high risk for complications, particularly ulnar neuropathy. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  13. Application of the 2016 diagnostic approach for autoimmune encephalitis from Lancet Neurology to Chinese patients.

    PubMed

    Li, Lin; Sun, Lin; Du, Rong; Zheng, Yuanchu; Dai, Feifei; Ma, Qiuying; Wang, Jiawei

    2017-11-06

    A unified clinical approach to diagnose autoimmune encephalitis was published in Lancet Neurology in 2016. Purpose of our study is to examine the feasibility and reasonability of the 2016 "A clinical approach to diagnosis of autoimmune encephalitis" in China with a retrospective study. We retrospectively collected 95 cases of autoimmune encephalitis and non autoimmune encephalitis cases with detailed clinical data from Beijing Tongren Hospital and the China National Knowledge Infrastructure (CNKI). All cases were analysed stepwise according to the approach in Lancet Neurology to compare the new diagnosis with the final clinical diagnosis. The disease course of these 95 cases ranged from 2 to 540 days. Initial symptoms include fever, headache, seizure, mental and behavioral disorders, memory deterioration and illusion. Based on symptoms and signs when the patient came to the hospital, the sensitivity and specificity of criteria were as follows: possible autoimmune encephalitis (pAE) 84% and 94%, definite autoimmune limbic encephalitis (dALE) 38% and 96%, probable anti-N-methyl-D-aspartate receptor encephalitis (prNMDARE) 49% and 98%. The sensitivities of the above three criteria and the specificity of pAE were low during early disease stage, while the specificities of dALE and prNMDAER remained relatively high in different time periods. This new autoimmune encephalitis diagnostic approach can recognize possible autoimmune encephalitis. The chances of a case being autoimmune-mediated following classification as autoimmune encephalitis with the new criteria are high. The flowchart is recommended to use as a whole. At the early disease stage, criteria with low sensitivity and high specificity, such as dALE and prNMDARE, lead most cases to enter subsequent diagnosis steps, namely autoantibody detection in the flowchart. Final diagnoses can only be made by autoantibody tests. These factors may make it challenging for clinicians to make diagnosis promptly and to begin immune-modulating therapy immediately. Moreover, the criteria for patients with paraneoplastic syndromes (PNSs) should be considered to avoid diagnosis omission. For Chinese patients, a multi-centre, prospective study on the clinical manifestations, laboratory diagnostic technology, therapy, and prognosis is greatly needed.

  14. Milne problem for non-absorbing medium with extremely anisotropic scattering kernel in the case of specular and diffuse reflecting boundaries

    NASA Astrophysics Data System (ADS)

    Güleçyüz, M. Ç.; Şenyiğit, M.; Ersoy, A.

    2018-01-01

    The Milne problem is studied in one speed neutron transport theory using the linearly anisotropic scattering kernel which combines forward and backward scatterings (extremely anisotropic scattering) for a non-absorbing medium with specular and diffuse reflection boundary conditions. In order to calculate the extrapolated endpoint for the Milne problem, Legendre polynomial approximation (PN method) is applied and numerical results are tabulated for selected cases as a function of different degrees of anisotropic scattering. Finally, some results are discussed and compared with the existing results in literature.

  15. Omental fibromatosis treated by laparoscopic wide surgical resection.

    PubMed

    Martin, David; Muradbegovic, Mirza; Andrejevic-Blant, Snezana; Petermann, David; Di Mare, Luca

    2018-02-01

    The current report presents a case of an omental fibromatosis discovered incidentally in a 46-year-old woman with no particular medical history and few symptoms. A surgical biopsy was performed initially, and microscopic examination revealed myofibroblastic proliferation. After additional immunohistochemical and molecular analyses, omental fibromatosis was diagnosed. Omental fibromatosis, also called intra-abdominal desmoid, is a rare and benign tumour but can be locally aggressive. Majority of cases are asymptomatic, and difficult to diagnose based on clinical presentation and radiological investigation. Final diagnosis is usually made on histopathology and immunohistochemistry studies. Surgical wide excision is currently the treatment of choice.

  16. [Adrenoleukodystrophy: clinical and histopathological study of a case associated to the use of abortifacient agents in the second month of pregnancy].

    PubMed

    de Brito-Marques, P R; de Melo, R J; Barraquer i Bordas, L

    1992-06-01

    The authors report a case of adrenoleukodystrophy in a 8 years old male patient whose mother has taken several abortive drugs during the first three months of pregnancy. The disease was progressive starting with auditory, visual and mental disturbances, followed by neurovegetatives and motor changes with convulsion and fetal position. At the final stage the patient became blind, deaf, quadriplegic and dementiated. Death resulted from lung infection. The diagnosis was confirmed by the CSF, electrophysiological, radiological and necropsy findings. Necropsy changes in the brain and adrenal cortex are detailed.

  17. Study of denture-induced fibrous hyperplasia cases diagnosed from 1979 to 2001.

    PubMed

    Macedo Firoozmand, Leily; Dias Almeida, Janete; Guimarães Cabral, Luiz Antonio

    2005-01-01

    The purpose of this research was to study the cases of inflammatory fibrous hyperplasia (IFH) at the Clinic of Semiology, Department of Bioscience and Oral Diagnosis, São Jose dos Campos Dental School, State University of São Paulo, Brazil. A total of 141 clinical file cards indicating a final diagnosis of IFH, from the archives of the Department of Bioscience and Oral Diagnosis and dated from 1979 to 2001, were included in the study. Of these files, 50 indicated a diagnosis of denture-induced fibrous hyperplasia. Sex, age, race, duration, and clinical features that confirm their classification in the non-neoplastic proliferating process were analyzed statistically. Of the 50 analyzed cases of denture-induced lesion, 22% occurred in men and 78% in women. Patients in the age group of 41 to 50 years presented the highest frequency of the lesion. Inflammatory fibrous hyperplasia occurs more frequently in women (71.63%), and denture-induced lesions appear mainly in patients over 40 years of age (70% of cases). Patients with denture-induced hyperplasia reported pain associated with the lesion (70%).

  18. [Clinical and etiologic study of 90 cases of chronic diarrhea].

    PubMed

    Farfán Flores, G; Sánchez, G; Tello, R; Villanueva, G

    1993-01-01

    90 patients with chronic diarrhoea underwent this prospective study. They were seen in a private hospital of Lima during 1990 and 1991. According to a methodologic plan for determining sources and the diseases that originate chronic diarrhoea. In all patients hematologic, bioquimic, coprocultures, coproparasitologic exams were done, chest and intestinal transit X-rays. All underwent duodenal content culture. Colon X-ray in 25 cases; proctosigmoidoscopy in 14 and upper digestive endoscopy in 19 patients. Abdominal echography in 12 and TAC in 2 cases. The final results showed as determinant diseases for chronic diarrhoea, according to their frequency: enteroparasitosis (23.3%), functional digestive disorders (20.0%), intestinal bacterial overpopulation (15.5%) of unknown origin (8.8%), colon diverticulus (7.7%) proven and probably (5.5%), lactose intolerance (3.3%), diabetes mellitus (2.2%), and in one case (1.1%) the following: intestinal linfoma, pancreas malignancy, AIDS, colonic and deformation and megaloblastic anemia. The causes of chronic diarrhoea are several and multifactorals and in this study we prove the preeminence of the intestinal parasitosis, functional disorders and intestinal bacterial overpopulation and with less frequency other pathologies.

  19. 77 FR 51754 - Wooden Bedroom Furniture From the People's Republic of China: Final Results and Final Rescission...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    ... cases, and entertainment systems; (6) bedroom furniture made primarily of wicker, cane, osier, bamboo or...: Scope Ruling on a White Toy Box,'' dated July 6, 2009, the dimensional ranges used to identify the toy...

  20. Comparison of treatment plans: a retrospective study by the method of radiobiological evaluation

    NASA Astrophysics Data System (ADS)

    Puzhakkal, Niyas; Kallikuzhiyil Kochunny, Abdullah; Manthala Padannayil, Noufal; Singh, Navin; Elavan Chalil, Jumanath; Kulangarakath Umer, Jamshad

    2016-09-01

    There are many situations in radiotherapy where multiple treatment plans need to be compared for selection of an optimal plan. In this study we performed the radiobiological method of plan evaluation to verify the treatment plan comparison procedure of our clinical practice. We estimated and correlated various radiobiological dose indices with physical dose metrics for a total of 30 patients representing typical cases of head and neck, prostate and brain tumors. Three sets of plans along with a clinically approved plan (final plan) treated by either Intensity Modulated Radiation Therapy (IMRT) or Rapid Arc (RA) techniques were considered. The study yielded improved target coverage for final plans, however, no appreciable differences in doses and the complication probabilities of organs at risk were noticed. Even though all four plans showed adequate dose distributions, from dosimetric point of view, the final plan had more acceptable dose distribution. The estimated biological outcome and dose volume histogram data showed least differences between plans for IMRT when compared to RA. Our retrospective study based on 120 plans, validated the radiobiological method of plan evaluation. The tumor cure or normal tissue complication probabilities were found to be correlated with the corresponding physical dose indices.

  1. RapidSplint: virtual splint generation for orthognathic surgery - results of a pilot series.

    PubMed

    Adolphs, Nicolai; Liu, Weichen; Keeve, Erwin; Hoffmeister, Bodo

    2014-01-01

    Within the domain of craniomaxillofacial surgery, orthognathic surgery is a special field dedicated to the correction of dentofacial anomalies resulting from skeletal malocclusion. Generally, in such cases, an interdisciplinary orthodontic and surgical treatment approach is required. After initial orthodontic alignment of the dental arches, skeletal discrepancies of the jaws can be corrected by distinct surgical strategies and procedures in order to achieve correct occlusal relations, as well as facial balance and harmony within individualized treatment concepts. To transfer the preoperative surgical planning and reposition the mobilized dental arches with optimal occlusal relations, surgical splints are typically used. For this purpose, different strategies have been described which use one or more splints. Traditionally, these splints are manufactured by a dental technician based on patient-specific dental casts; however, computer-assisted technologies have gained increasing importance with respect to preoperative planning and its subsequent surgical transfer. In a pilot study of 10 patients undergoing orthognathic corrections by a one-splint strategy, two final occlusal splints were produced for each patient and compared with respect to their clinical usability. One splint was manufactured in the traditional way by a dental technician according to the preoperative surgical planning. After performing a CBCT scan of the patient's dental casts, a second splint was designed virtually by an engineer and surgeon working together, according to the desired final occlusion. For this purpose, RapidSplint, a custom-made software platform, was used. After post-processing and conversion of the datasets into .stl files, the splints were fabricated by the PolyJet procedure using photo polymerization. During surgery, both splints were inserted after mobilization of the dental arches then compared with respect to their clinical usability according to the occlusal fitting. Using the workflow described above, virtual splints could be designed and manufactured for all patients in this pilot study. Eight of 10 virtual splints could be used clinically to achieve and maintain final occlusion after orthognathic surgery. In two cases virtual splints were not usable due to insufficient occlusal fitting, and even two of the traditional splints were not clinically usable. In five patients where both types of splints were available, their occlusal fitting was assessed as being equivalent, and in one case the virtual splint showed even better occlusal fitting than the traditional splint. In one case where no traditional splint was available, the virtual splint proved to be helpful in achieving the final occlusion. In this pilot study it was demonstrated that clinically usable splints for orthognathic surgery can be produced by computer-assisted technology. Virtual splint design was realized by RapidSplint®, an in-house software platform which might contribute in future to shorten preoperative workflows for the production of orthognathic surgical splints.

  2. Measuring and Perceiving Changes in Oral Complexity, Accuracy and Fluency: Examining Instructed Learners' Short-Term Gains

    ERIC Educational Resources Information Center

    Tonkyn, Alan Paul

    2012-01-01

    This paper reports a case study of the nature and extent of progress in speaking skills made by a group of upper intermediate instructed learners, and also assessors' perceptions of that progress. Initial and final interview data were analysed using several measures of Grammatical and Lexical Complexity, Language Accuracy and Fluency. These…

  3. Evaluating Multi-Institutional Partnership Sustainability: A Case Study of Collaborative Workforce Development in Renewable Energy Assessment

    ERIC Educational Resources Information Center

    Diaz, John M.; Stallings, Kevin D.; KC, Birendra; Seekamp, Erin

    2015-01-01

    Partnership evaluation typically occurs during the final stages either to assess why a collaborative effort did not work or to identify the indicators of success. Partnerships are rarely evaluated at their incipient stage, which is a critical time to assess their potential for long-term sustainability. In this paper, we present an early-stage…

  4. Reflections on International Comparative Education Survey Methodology: A Case Study of the European Survey on Language Competences

    ERIC Educational Resources Information Center

    Ashton, Karen

    2016-01-01

    This paper reflects on the methodology used in international comparative education surveys by conducting a systematic review of the European Survey on Language Competences (ESLC). The ESLC was administered from February to March 2011, with final results released in June 2012. The survey tested approximately 55,000 students across 14 European…

  5. Sound Literature: The Pedagogy of Reconnection through Student-Authored Audiobooks in the Spanish Curriculum

    ERIC Educational Resources Information Center

    Lorenzo-Zamorano, Susana

    2015-01-01

    This article is based on a case study I presented at the elearning Symposium 2014 and focuses on an undergraduate project which had received the Teaching Enhancement and Student Success Fund at the University of Manchester two years before. The project was conceived as an outreach activity complementing the final year core language classes and…

  6. Using Constructivist Case Study Methodology to Understand Community Development Processes: Proposed Methodological Questions to Guide the Research Process

    ERIC Educational Resources Information Center

    Lauckner, Heidi; Paterson, Margo; Krupa, Terry

    2012-01-01

    Often, research projects are presented as final products with the methodologies cleanly outlined and little attention paid to the decision-making processes that led to the chosen approach. Limited attention paid to these decision-making processes perpetuates a sense of mystery about qualitative approaches, particularly for new researchers who will…

  7. Youth Corps Case Studies: The New York City Volunteer Corps Exit Report.

    ERIC Educational Resources Information Center

    Jaffe, Natalie; Freedman, Marc

    This exit report chronicles the last 20 months of the 3-year demonstration phase of the New York City Volunteer Corps (CVC), whose members worked in teams at various sites to either provide human services or do physical work. These final months were characterized by the following factors: (1) a change in Corps leadership; (2) concern about…

  8. Individual and Familial Correlates of Career Salience among Upwardly Mobile College Women. Final Report.

    ERIC Educational Resources Information Center

    Guttmacher, Mary Johnson

    A case study was conducted using a sample of 271 women selected from a state college by a stratified random cluster technique that approximates proportional representation of women in all four classes and all college majors. The data source was an extensive questionnaire designed to measure the attitudes and behavior of interest. The major…

  9. NASA Informal Education: Final Report. A Descriptive Analysis of NASA's Informal Education Portfolio: Preliminary Case Studies

    ERIC Educational Resources Information Center

    Rulf Fountain, Alyssa; Levy, Abigail Jurist

    2010-01-01

    This report was requested by the National Aeronautics and Space Administration's (NASA), Office of Education in July 2009 to evaluate the Informal Education Program. The goals of the evaluation were twofold: (1) to gain insight into its investment in informal education; and (2) to clarify existing distinctions between its informal education…

  10. Application of PBL in the Course Fluid and Electrical Drive Systems, Case Study: Manufacturing an Automated Punch Machine

    ERIC Educational Resources Information Center

    Sedaghat, Ahmad; AlJundub, Mohammad; Eilaghi, Armin; Bani-Hani, Ehab; Sabri, Farhad; Mbarki, Raouf; Assad, M. El Haj

    2017-01-01

    The PBL unit of fluid and electrical drive systems is taught in final semester of undergraduates in mechanical engineering department of the Australian College of Kuwait (ACK). The recent project on an automated punching machine is discovered more appealing to both students and instructors in triggering new ideas and satisfaction end results. In…

  11. Producing Multimodal Picture Books and Dramatic Performances in a Core French Classroom: An Exploratory Case Study

    ERIC Educational Resources Information Center

    Early, Margaret; Yeung, Cindy

    2009-01-01

    In a Grade 9 core French class, the teacher designed a multi-stage project in which students composed original children's stories in French; illustrated their stories to produce picture books; then, in groups, adapted one group member's story into a play script; and, finally, dramatized the scripts for children from the local French immersion…

  12. Drug Administration Errors in an Institution for Individuals with Intellectual Disability: An Observational Study

    ERIC Educational Resources Information Center

    van den Bemt, P. M. L. A.; Robertz, R.; de Jong, A. L.; van Roon, E. N.; Leufkens, H. G. M.

    2007-01-01

    Background: Medication errors can result in harm, unless barriers to prevent them are present. Drug administration errors are less likely to be prevented, because they occur in the last stage of the drug distribution process. This is especially the case in non-alert patients, as patients often form the final barrier to prevention of errors.…

  13. Quality Child Care for Infants and Toddlers: Case Studies of Three Community Strategies. Final Report.

    ERIC Educational Resources Information Center

    Paulsell, Diane; Nogales, Renee; Cohen, Julie

    To address the increasing child care needs of low-income families in the wake of welfare reform, federal and state governments have responded with increased funding for child care and for initiatives to improve quality. Some of these initiatives have been designed specifically to address the unique challenges of infant-toddler care. This report…

  14. Small Island States Green Energy Initiative. Final report

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

    Khattak, Nasir

    1999-10-15

    This report covers the activities carried out during a one year period from 7/15/99 to 7/15/00 as part of the Small Islands Green Energy Initiative. The three activities were: 1) Energy Ministerial conference in the Caribbean; 2) Training session on renewable energy for utility engineers; and 3) Case studies compilation on renewable energy in the Caribbean.

  15. Primary Trainee Teachers' Attitudes to and Use of Computer and Technology in Mathematics: The Case of Turkey

    ERIC Educational Resources Information Center

    Dogan, Mustafa

    2010-01-01

    This study explores Turkish primary mathematics trainee teachers' attitudes to computer and technology. A survey was conducted with a self constructed questionnaire. Piloting, factor and reliability ([alpha] = 0.94) analyses were performed. The final version of the questionnaire has three parts with a total of 48 questions including a Likert type…

  16. Violence Prevention in Schools: A Case Study of the Thurgood Marshall Academy Public Charter High School. Final Report

    ERIC Educational Resources Information Center

    Fontaine, Jocelyn; Debus-Sherrill, Sara; Downey, P. Mitchell; Lowry, Samantha S.

    2010-01-01

    This report is based on research conducted by the Urban Institute's Justice Policy Center on the violence prevention activities taking place at the Thurgood Marshall Academy Public Charter High School during the 2008-2009 school year. Based on an assessment of the school's violence prevention approach using qualitative and quantitative data from…

  17. The preparedness level of final year medical students for an adequate medical approach to emergency cases: computer-based medical education in emergency medicine

    PubMed Central

    2014-01-01

    Background We aimed to observe the preparedness level of final year medical students in approaching emergencies by computer-based simulation training and evaluate the efficacy of the program. Methods A computer-based prototype simulation program (Lsim), designed by researchers from the medical education and computer science departments, was used to present virtual cases for medical learning. Fifty-four final year medical students from Ondokuz Mayis University School of Medicine attended an education program on June 20, 2012 and were trained with Lsim. Volunteer attendants completed a pre-test and post-test exam at the beginning and end of the course, respectively, on the same day. Results Twenty-nine of the 54 students who attended the course accepted to take the pre-test and post-test exams; 58.6% (n = 17) were female. In 10 emergency medical cases, an average of 3.9 correct medical approaches were performed in the pre-test and an average of 9.6 correct medical approaches were performed in the post-test (t = 17.18, P = 0.006). Conclusions This study’s results showed that the readiness level of students for an adequate medical approach to emergency cases was very low. Computer-based training could help in the adequate approach of students to various emergency cases. PMID:24386919

  18. An application of a hybrid MCDM method for the evaluation of entrepreneurial intensity among the SMEs: a case study.

    PubMed

    Rostamzadeh, Reza; Ismail, Kamariah; Bodaghi Khajeh Noubar, Hossein

    2014-01-01

    This study presents one of the first attempts to focus on critical success factors influencing the entrepreneurial intensity of Malaysian small and medium sized enterprises (SMEs) as they attempt to expand internationally. The aim of this paper is to evaluate and prioritize the entrepreneurial intensity among the SMEs using multicriteria decision (MCDM) techniques. In this research FAHP is used for finding the weights of criteria and subcriteria. Then for the final ranking of the companies, VIKOR (in Serbian: VlseKriterijumska Optimizacija I Kompromisno Resenje) method was used. Also, as an additional tool, TOPSIS technique, is used to see the differences of two methods applied over the same data. 5 main criteria and 14 subcriteria were developed and implemented in the real-world cases. As the results showed, two ranking methods provided different ranking. Furthermore, the final findings of the research based on VIKOR and TOPSIS indicated that the firms A3 and A4 received the first rank, respectively. In addition, the firm A4 was known as the most entrepreneurial company. This research has been done in the manufacturing sector, but it could be also extended to the service sector for measurement.

  19. Use of Physiologically Based Pharmacokinetic (PBPK) Models ...

    EPA Pesticide Factsheets

    EPA announced the availability of the final report, Use of Physiologically Based Pharmacokinetic (PBPK) Models to Quantify the Impact of Human Age and Interindividual Differences in Physiology and Biochemistry Pertinent to Risk Final Report for Cooperative Agreement. This report describes and demonstrates techniques necessary to extrapolate and incorporate in vitro derived metabolic rate constants in PBPK models. It also includes two case study examples designed to demonstrate the applicability of such data for health risk assessment and addresses the quantification, extrapolation and interpretation of advanced biochemical information on human interindividual variability of chemical metabolism for risk assessment application. It comprises five chapters; topics and results covered in the first four chapters have been published in the peer reviewed scientific literature. Topics covered include: Data Quality ObjectivesExperimental FrameworkRequired DataTwo example case studies that develop and incorporate in vitro metabolic rate constants in PBPK models designed to quantify human interindividual variability to better direct the choice of uncertainty factors for health risk assessment. This report is intended to serve as a reference document for risk assors to use when quantifying, extrapolating, and interpretating advanced biochemical information about human interindividual variability of chemical metabolism.

  20. An Application of a Hybrid MCDM Method for the Evaluation of Entrepreneurial Intensity among the SMEs: A Case Study

    PubMed Central

    Ismail, Kamariah; Bodaghi Khajeh Noubar, Hossein

    2014-01-01

    This study presents one of the first attempts to focus on critical success factors influencing the entrepreneurial intensity of Malaysian small and medium sized enterprises (SMEs) as they attempt to expand internationally. The aim of this paper is to evaluate and prioritize the entrepreneurial intensity among the SMEs using multicriteria decision (MCDM) techniques. In this research FAHP is used for finding the weights of criteria and subcriteria. Then for the final ranking of the companies, VIKOR (in Serbian: VlseKriterijumska Optimizacija I Kompromisno Resenje) method was used. Also, as an additional tool, TOPSIS technique, is used to see the differences of two methods applied over the same data. 5 main criteria and 14 subcriteria were developed and implemented in the real-world cases. As the results showed, two ranking methods provided different ranking. Furthermore, the final findings of the research based on VIKOR and TOPSIS indicated that the firms A3 and A4 received the first rank, respectively. In addition, the firm A4 was known as the most entrepreneurial company. This research has been done in the manufacturing sector, but it could be also extended to the service sector for measurement. PMID:25197707

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