Infective endocarditis due to Enterobacter cloacae resistant to third- and fourth-generation cephalosporins.

PubMed

Yoshino, Yusuke; Okugawa, Shu; Kimura, Satoshi; Makita, Eiko; Seo, Kazunori; Koga, Ichiro; Matsunaga, Naohisa; Kitazawa, Takatoshi; Ota, Yasuo

2015-04-01

We report the case of using a long-term combination of meropenem and amikacin to treat infective endocarditis caused by Enterobacter cloacae resistant to third- and fourth-generation cephalosporins. Multi-drug resistant Gram-negative bacilli, such as the E. cloacae in our study, may become possible pathogens of infective endocarditis. Our experience with this case indicates that long-term use of a combination of β-lactam and aminoglycosides might represent a suitable management option for future infective endocarditis cases due to non-Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella spp. (HACEK group) Gram-negative bacilli such as ours. Copyright © 2012. Published by Elsevier B.V.

Eigenvalues of the Wentzell-Laplace operator and of the fourth order Steklov problems

NASA Astrophysics Data System (ADS)

Xia, Changyu; Wang, Qiaoling

2018-05-01

We prove a sharp upper bound and a lower bound for the first nonzero eigenvalue of the Wentzell-Laplace operator on compact manifolds with boundary and an isoperimetric inequality for the same eigenvalue in the case where the manifold is a bounded domain in a Euclidean space. We study some fourth order Steklov problems and obtain isoperimetric upper bound for the first eigenvalue of them. We also find all the eigenvalues and eigenfunctions for two kind of fourth order Steklov problems on a Euclidean ball.

Case Studies for Management Development in Bangladesh. Fourth Book. Parepared for the World Bank/Bangladesh Management Education and Training Project.

ERIC Educational Resources Information Center

McLean, Gary N.

This document contains five case studies of management and finance situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. One to four discussion questions follow each case study. The titles and authors of the case studies on management are: "Azir Ahmed & Co.,…

Obesity May Be Protective against Severe Perineal Lacerations

PubMed Central

Garretto, Diana; Lin, Brian B.; Syn, Helen L.; Judge, Nancy; Beckerman, Karen; Atallah, Fouad; Friedman, Arnold; Brodman, Michael; Bernstein, Peter S.

2016-01-01

Objective. To determine if there is an association between BMI and 3rd- or 4th-degree perineal lacerations in normal spontaneous and operative vaginal deliveries. Study Design. We performed a retrospective case control study using a large obstetric quality improvement database over a six-year period. Cases were identified as singleton gestations with third- and fourth-degree lacerations. Controls were obtained randomly from the database of patients without third- or fourth-degree lacerations in a 1 : 1 ratio. Univariate and multivariate logistic regression analyses were performed. Results. Of 32,607 deliveries, 22,011 (67.5%) charts with BMI documented were identified. Third- or fourth-degree lacerations occurred in 2.74% (n = 605) of patients. 37% (n = 223) were identified in operative vaginal deliveries. In the univariate analysis, obesity, older maternal age, non-Asian race, and birth weight <4000 g were all protective against 3rd- and 4th-degree lacerations. After controlling for age, race, mode of vaginal delivery, and birth weight, obesity remained significant. Conclusion. Being obese may protect against third- and fourth-degree lacerations independent of parity, race, birth weight, and mode of delivery. PMID:27274869

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…

First-trimester visualization of the fourth ventricle in fetuses with and without spina bifida.

PubMed

Solt, Ido; Acuna, Joann G; Adeniji, Beni A; Mirocha, James; Kim, Matthew J; Rotmensch, Siegfried

2011-12-01

The purpose of this study was to examine the efficacy of nonvisualization of the fourth ventricle for first-trimester detection of spina bifida. A total of 250 digitally stored sonographic examinations at gestational ages of 11 weeks to 13 weeks 6 days (245 normal and 5 randomly interspersed spina bifida cases) were retrospectively analyzed by 4 blinded reviewers for the presence or absence of the fourth ventricle followed by an anteroposterior ventricular dimension measurement. The ventricle size was related to the crown-rump length and gestational age by linear regression analysis and Pearson correlation. The fourth ventricle was identified in 971 of 1000 image readings (97.1%). False-negative and false-positive readings occurred in 11 of 20 (55.0%) and 20 of 980 (2.0%) cases, respectively (sensitivity, 0.45; specificity, 0.98.). False-negative and false-positive readings were evenly distributed throughout the gestational age range. When the ventricular size was measurable, its mean dimensions increased linearly with gestational age and were below the fifth percentile in 10 of 245 (4.0%) normal and 0 of 4 spina bifida cases, respectively. Intraclass correlation coefficient estimates were calculated based on the 2-way analysis of variance model and found to be 0.30 for a single rater and 0.64 for the mean of 4 raters. Nonvisualization of the first-trimester fourth ventricle is a less robust screening parameter for spina bifida than previously published.

Subependymomas: a clinicopathological study of 6 symptomatic cases.

PubMed

Limaïem, F; Bellil, S B H; Bellil, K; Chelly, I; Jemel, H; Haouet, S; Khaldi, M; Zitouna, M; Kchir, N

2008-10-01

Subependymomas are rare, slow-growing, ependymal neoplasms that commonly occur in the fourth or lateral ventricles. A retrospective study of 6 histologically proven subependymomas was undertaken to analyse their clinicopathological characteristics. There were five male and one female patients ranging in age from 11 to 50 years (mean 35.8 years). All patients were symptomatic at diagnosis. The most common clinical presentations included headache (n=6) and vomiting (n=3). Tumours were located in the lateral ventricle in five cases and in the fourth ventricle in one case. Magnetic resonance imaging detected obstructive hydrocephalus in all cases. Five patients underwent gross total resection and one patient had subtotal excision of the tumour. Histologically, all tumours were characterised by clustering of isomorphic cells arranged against a fibrillary background. Focal cystic degeneration was seen in 5 tumours. During the follow-up period, which ranged between 2 months and 10 years, all patients were symptom-free with no evidence of recurrence.

Search and Seizure of Students in Public Schools: 2002 Update of Fourth Amendment Cases.

ERIC Educational Resources Information Center

Stefkovich, Jacqueline A.

This paper presents court cases for the purpose of updating current knowledge on search and seizure of students in the school setting. These cases focus on the balance and interplay between students' Fourth Amendment rights and school administrators' obligations to maintain order and discipline in the schools. Part of this obligation implies…

The Effects of the Davis Symbol Mastery System to Assist a Fourth Grader with Dyslexia in Spelling: A Case Report

ERIC Educational Resources Information Center

Amsberry, Gianna; McLaughlin, T. F.; Derby, K. Mark; Waco, Teresa

2012-01-01

The purpose of this study was to determine the effectiveness of using the Davis Symbol Mastery Procedure for Words (Davis, 1994) for improving spelling skills. The participant was a fourth-grade male diagnosed with a significant learning disability. The intervention consisted of having the participant write each word, its definition, the word in a…

An outbreak of viral gastroenteritis on a cruise ship.

PubMed

McEvoy, M; Blake, W; Brown, D; Green, J; Cartwright, R

1996-12-06

Three hundred and seventy-eight passengers reported gastroenteritis during four cruises in the western Mediterranean on consecutive weeks of 1995. The rate at which cases were reported each day increased on the fourth cruise. The ship's owner commissioned an epidemiological investigation from the PHLS Communicable Disease Surveillance Centre. Cases reported explosive vomiting and diarrhoea, which lasted from 24 hours to five days, and were suggestive of viral gastroenteritis. No food handlers reported illness, but enquiries suggested that some had been ill and treated themselves. No bacterial pathogens were isolated from faecal specimens provided by cases or from water, food, and environmental samples taken from the galley. Small round structured viruses (SRSV) were identified by reverse transcriptase polymerase chain reaction in two faecal specimens and one specimen of vomit from people who became ill during the fourth cruise. SRSV was also identified in one faecal specimen by electron microscopy. Environmental inspection revealed inappropriate food handling, hygiene, and storage. During one 24 hour period no chlorine was detectable in the water. A case control study conducted on the fourth cruise sought details of exposure to various foodstuffs, unbottled water, and various parts of the ship. No significant associations were found between illness and any exposures. The evidence strongly suggested a continuing outbreak of SRSV infection transmitted from person to person. Some passengers remained on board for a second week and could have transmitted their infection to new arrivals. The ship was cleared and disinfected at the end of the fourth cruise in order to interrupt transmission. Fewer than 10 cases presented in each of the fifth and sixth cruises.

Academic Growth Trajectories of ELLs in NAEP Data: The Case of Fourth- and Eighth-Grade ELLs and Non-ELLs on Mathematics and Reading Tests

ERIC Educational Resources Information Center

Polat, Nihat; Zarecky-Hodge, Ashley; Schreiber, James B.

2016-01-01

Utilizing the National Assessment of Educational Progress (NAEP) data, this study examined (1) how fourth and eighth-grade ELLs' mathematics and reading scores on national tests compared to their non-ELL peers' scores over the testing period between 2003 and 2011, and (2) if gender and ethnicity contributed to variation in the growth patterns…

Rosette-forming glioneuronal tumor of the fourth ventricle.

PubMed

Preusser, Matthias; Dietrich, Wolfgang; Czech, Thomas; Prayer, Daniela; Budka, Herbert; Hainfellner, Johannes A

2003-11-01

Rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle has been reported recently as a novel type of primary CNS neoplasm. We present the case of a 35-year-old male patient with RGNT of the fourth ventricle. The tumor was found incidentally; the patient did not suffer from any neurological symptoms. The tumor mass involved the caudal cerebellar vermis, filled the fourth ventricle and protruded into the caudal part of the mesencephalic aquaeduct. Smaller tumor nodules were visible in the adjacent right cerebellar hemisphere. Histologically, prominent neurocytic rosettes with synaptophysin expression were embedded in a glial tumor component resembling pilocytic astrocytoma. Clinicopathological features of our case closely resemble those reported in the original description. Thus, our case confirms RGNT as a new distinct type of primary CNS neoplasm. Due to its distinct features, adoption of RGNT as a new entity into the WHO classification of tumors should be considered.

A Failure To Reproduce the Intermediate Effect in Clinical Case Recall.

ERIC Educational Resources Information Center

van de Wiel, Margaretha W. J.; And Others

In an attempt to replicate an earlier study by H. G. Schmidt, H. P. A. Boshuizen, and P. P. M. Hobus (1988), 96 students and physicians at the University of Limburg (Netherlands) studied 4 clinical cases, produced a diagnosis, and recalled each case. Subjects were 24 second-year, 24 fourth-year, and 24 sixth-year medical students and 24 internists…

Comparison of case-based and lecture-based learning in dental education using the SOLO taxonomy.

PubMed

Ilgüy, Mehmet; Ilgüy, Dilhan; Fişekçioğlu, Erdoğan; Oktay, Inci

2014-11-01

The aim of this study was to compare the impact of case-based learning (CBL) and lecture-based learning (LBL) on fourth-year dental students' clinical decision making by using the Structure of Observed Learning Outcome (SOLO) taxonomy. Participants in the study were fourth-year dental students (n=55) in academic year 2012-13 taught in a large-group LBL context and fourth-year dental students (n=54) in academic year 2013-14 taught with the CBL methodology; both took place in the oral diseases course at Yeditepe University Faculty of Dentistry, Istanbul, Turkey. All eligible students participated, for a 100 percent response rate. A real case was presented to the students in both groups to assess their clinical decision making on the topic of oral diseases. Their performance was evaluated with the SOLO taxonomy. Student t-test was used for statistical evaluation, and significance was set at the p<0.05 level. A statistically significant difference was found between the mean scores of the relational and extended abstract categories of the CBL and LBL groups (p<0.05). Students who were taught with CBL had higher scores at the top two levels of the SOLO taxonomy than students taught with LBL. These findings suggest that an integrated case-based curriculum may be effective in promoting students' deep learning and it holds promise for better integration of clinical cases likely to be encountered during independent practice.

The Impact of the Use of One-to-One Netbooks on Student Achievement, Teacher Practice, and Perceptions of Technology in a Fourth-Grade Bilingual Class

ERIC Educational Resources Information Center

Bukofser, J. Holly

2013-01-01

This research involved a 14-month qualitative case study of a fourth-grade bilingual class embarking on a one-to-one netbook computer initiative. Students in this program had unlimited use of the netbooks during the school day. The main foci of the data collected were student achievement, teacher instruction, and student and teacher perceptions of…

French Experience Before 1968. Case Studies on Innovation in Higher Education.

ERIC Educational Resources Information Center

Grignon, C.; Passeron, J. C.

This volume is the fourth in a series of case studies published by the Organization for Economic Cooperation and Development. Chapter 1 discusses the aims of the study, including the concepts of innovation and change, the role of pilot experiments in the development of the university system, and the methods used for this critical analysis of…

Pharmokinetics in Drug Therapy as a Required Undergraduate Course

ERIC Educational Resources Information Center

Schumacher, G. E.

1976-01-01

This course is offered in the third quarter of the fourth year of the five-year curriculum in pharmacology. The year includes (1) a 350-hour clinical clerkship, (2) two courses in "Case Studies in Drug Therapy," (3) one course in "Case Studies in Pharmacy Practice," and (4) professional electives. (LBH)

A Case Study of Violence Prevention in an Elementary School

ERIC Educational Resources Information Center

Crawford, Diane Lynn

2013-01-01

This case study was initiated to explore how 6 fourth-grade student mediators implemented an inner-city elementary school's violence prevention program based on peer mediation in the context of psychosocial theory. The participants were trained in conflict resolution to intervene with disputants who experienced unresolved disagreements. To…

Students with Reading Disabilities Participating in Literature Discussions: A Case Study

ERIC Educational Resources Information Center

O'Brien, Elysha Patino

2011-01-01

This qualitative case study addressed a lack of research concerning literature discussions for students with learning disabilities in reading. Fourth and fifth grade students with reading disabilities participated in twice-weekly literature discussions, 30-to-60 minutes each, for 12 weeks. The students attended a Title I school and most were…

Competition in the Cross-Channel Industry--A Case Study Exercise.

ERIC Educational Resources Information Center

Lyons, Adrian

1989-01-01

Presents a case study classroom exercise using the theme of price/non-price competition and based on a poster advertisement of the Eurotunnel. Recommends this exercise for use with fourth year General Certificate of Secondary Education (GCSE). Suggests the follow-up activities of class discussion and designing an advertising campaign. (KO)

Congenital cutaneous fistula at the sternoclavicular joint - Not a dermoid fistula but the remnant of the fourth branchial (pharyngeal) cleft ?

PubMed

Ohno, Michinobu; Kanamori, Yutaka; Tomonaga, Kotaro; Yamashita, Tatsuya; Migita, Misato; Takezoe, Toshiko; Watanabe, Toshihiko; Fuchimoto, Yasushi; Matsuoka, Kentaro

2015-12-01

A fourth branchial pouch remnant is well known as a pyriform sinus fistula. However, there has been no report of a fistula composed of the complete remnant of the fourth branchial apparatus. We experienced patients with a congenital lower neck cutaneous fistula which was thought to be the skin-side remnant of the fourth branchial cleft. Seven children were referred to our hospital from 2009 to 2015 for the treatment of a cutaneous fistula situated near the sternoclavicular joint. All of them were surgically resected and their pathological characteristics were examined. Clinical charts were retrospectively reviewed. In six cases, the left side was affected. All cutaneous fistulas had a small skin orifice near the sternoclavicular joint and they were situated at the anterior edge of the sternocleidomastoid muscle. Abscess formation was seen in four cases. Surgical resection was performed at the age of 6 months to 9 years. These fistulas ran deep into the subcutaneous tissue and had a blind end. Pathological examination showed that the epithelial layer was mainly composed of a stratified squamous epithelium. In two cases the epithelium was composed of ciliated columnar epithelium. Recurrence has not been observed in any of the cases. The seven cases had a common clinical feature and were a definite clinical entity. Judging from the characteristics of our cases and the previous literature, we concluded that this lower neck cutaneous fistula was most likely a congenital skin-side remnant of the fourth branchial cleft. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Recurrent neck infection with branchial arch fistula in children.

PubMed

Madana, J; Yolmo, Deeke; Kalaiarasi, R; Gopalakrishnan, S; Saxena, S K; Krishnapriya, S

2011-09-01

Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common than those of second arch and usually present with left thyroid lobe inflammation. The authors present their experience with 15 cases of pyriform sinus fistulae (PSF) of third branchial arch origin and 3 cases of fourth arch origin, all of which presented as recurrent neck infection mainly on the left side. A retrospective review of 18 cases of third and fourth arch fistulae treated at JIPMER from 2005 to 2010. This study includes 18 patients with PSF diagnosed by the existence of fistulous tract radiologically and intraoperatively with pathological correlation. Neck exploration with excision of tract and left hemithyroidectomy was performed in all cases. The patients consisted of 7 males and 11 females, and the ages ranged from 3 to 15 years. All of them presented with recurrent episodes of neck infection. Investigations performed include computed tomography (CT) fistulography, barium swallow and ultrasound which were useful in delineating pyriform sinus fistulous tract preoperatively. All cases were on the left side and the fistula was identified by barium swallow in 14 cases (80%), while intraoperative and pathologic confirmation of the tract was possible in all cases (100%). Neck exploration with an emphasis on complete exposure of the recurrent laryngeal nerve and exposure of the pyriform sinus opening to facilitate complete fistulous tract excision with left hemithyroidectomy was successful in all patients. A follow up period of 1-3 years showed no recurrence. Recurrent neck infection in a child should alert the physician to the possibility of an underlying pyriform sinus fistula of branchial origin and CT fistulography should be performed after the resolution of the neck infection to delineate the tract anatomically. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

Leadership Effectiveness and Instructional Supervision: The Case of the Failing Twin

ERIC Educational Resources Information Center

Bloom, Collette Madeleine

2011-01-01

This case study examines the leadership practices of an effective versus an ineffective elementary school principal. The background of this case involves two fourth grade teachers, each teaching one of a set of identical twins. Discrepancies in teaching and grading practices result in one twin failing. The decision-making choices of the principal…

Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case

DTIC Science & Technology

1992-10-01

Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case. This study... management information system to automate manual Naval aviation maintenance tasks-NALCOMIS. With the use of a fourth-generation programming language

Culturally and Linguistically Responsive Teaching in Practice: A Case Study of a Fourth-Grade Mainstream Classroom Teacher

ERIC Educational Resources Information Center

Zhang-Wu, Qianqian

2017-01-01

As a result of increases in immigration, more students from culturally and linguistically diverse backgrounds are entering K-12 classrooms in the United States. Thus, the need to study the education of diverse learners is intensified. Drawing upon semi-structured interviews, observations, and informal conversations, this case study examined how a…

Learning from Multiple Cases: A New Paradigm for Investigating the Effects of Clinical Experience on Knowledge Restructuring and Knowledge Acquisition.

ERIC Educational Resources Information Center

Boshuizen, Henny P. A.; Bongaerts, Maureen Machiels; van de Wiel, Margaretha W. J.; Schmidt, Henk G.

The effects of experience with a series of similar cases on the knowledge restructuring and learning from text were studied in a longitudinal design. Two groups of fourth-year medical students were confronted with a series of cases, part of them having the same underlying disease. The cases were interspersed with fillers, and each set of cases had…

Fourth Branchial Anomaly Presenting with a Lateral Neck Mass in a Neonate

PubMed Central

Yoo, Tae-Kyung; Kim, Soo-Hong; Kim, Ha-Shin; Park, Kwi-Won

2014-01-01

Branchial cleft anomalies are an important differential diagnosis in congenital neck masses in infants. The third and fourth branchial anomalies are rare branchial cleft anomalies, which are hard to differentiate. We report here an uncommon case of the fourth branchial anomaly that was presented as an asymptomatic neck mass in a neonate. PMID:26023505

Fourth branchial anomaly presenting with a lateral neck mass in a neonate.

PubMed

Yoo, Tae-Kyung; Kim, Soo-Hong; Kim, Ha-Shin; Kim, Hyun-Young; Park, Kwi-Won

2014-01-01

Branchial cleft anomalies are an important differential diagnosis in congenital neck masses in infants. The third and fourth branchial anomalies are rare branchial cleft anomalies, which are hard to differentiate. We report here an uncommon case of the fourth branchial anomaly that was presented as an asymptomatic neck mass in a neonate.

Using a Facebook Closed Group to Improve EFL Students' Writing

ERIC Educational Resources Information Center

Rodliyah, Rojab Siti

2016-01-01

This study investigates how social media, in this case Facebook, can be incorporated in ELT through e-dialogue journal writing shared in a Facebook closed group. Fifteen EFL students participated in this case study. They were second, third, and fourth year students of English Education Department of a university in Bandung, who voluntarily joined…

Learning to Feel Well at Jamtli Museum: A Case Study

ERIC Educational Resources Information Center

Hansen, Anna

2016-01-01

Approximately one-fourth of the population of Sweden will suffer from mental health problems at some point in their lives. This article shares a case study of collaboration between Jamtli Museum and a local hospital (K2) that aimed to provide adult learning opportunities for people with diverse mental health issues. Findings show some differences…

Branchial anomalies in children: A report of 105 surgical cases.

PubMed

Li, Wanpeng; Xu, Hongming; Zhao, Liming; Li, Xiaoyan

2018-01-01

Branchial anomalies (BAs) account for 20% of all congenital masses in children. We sought to review the incidence of involvement of individual anomalies, diagnostic methods, surgical treatment, and complications of BAs in children. In addition, we also classified our study and analyzed a congenital lower neck cutaneous fistula near the sternoclavicular joint that was thought to be the skin-side remnant of the fourth BAs. We conducted a retrospective analysis of 105 children who were referred to our hospital from June 2009 to December 2016 for the treatment of BAs. In this series, there were 51 males and 54 females. The age at the time of operation varied from 19 days to 13 years, and the mean age was 4.5 years. A total of 33 (31.4%) cases presented with first BAs, 13 (12.4%) presented with second BAs, and 59 (56.2%) presented with third and fourth BAs, including 6 cases of congenital lower neck cutaneous fistula. Fistulectomy under general anesthesia was performed on all of them. For postoperative complications, 2 cases had temporary facial paralysis, 1 case had permanent facial paralysis, 4 cases had temporary recurrent laryngeal nerve injury. Recurrence occurred in 2 patients with first BAs after medium follow-up time of 3.6 years (6 months-8 years). BAs are common congenital head and neck lesions in children, and there are four distinct types (first, second, third and fourth anomalies). The incidence of third and fourth BAs in Asia maybe higher when compared with literature reports, second BAs seem rare in this population, but more research is needed to confirm this perspective. Diagnosis is not difficult with a proper knowledge of the anatomy of the BAs. The surgical procedures should be tailored depending on the various types, and complete excision of the fistula is the key to prevent recurrence. Copyright © 2017 Elsevier B.V. All rights reserved.

De novo Craniopharyngioma of the Fourth Ventricle: Case Report and Review of Literature.

PubMed

Algahtani, Abdulhadi Y; Algahtani, Hussein A; Jamjoom, Abdulhakim B; Samkari, Alaa M; Marzuk, Yousef I

2018-01-01

Craniopharyngiomas usually involve the sella and suprasellar space. Their occurrence in the posterior fossa without extension to the suprasellar region is uncommon with only 16 cases reported in the literature. We report a case of a primary posterior fossa craniopharyngioma that was managed by complete excision with a good recovery. Our case was unique in that the craniopharyngioma occurred in the fourth ventricle and extended downward to the level of C1, a manifestation that was reported only twice in the past. The literature on the topic is reviewed.

Cross-Cultural Communication in Teacher Education: A Case Study of an Australian Pre-Service Teacher Placement in Liaoning, China

ERIC Educational Resources Information Center

Jin, Aijing; Cooper, Maxine; Golding, Barry

2016-01-01

This paper presents a case study of the experiences and reflections of four fourth year pre-service teachers from Federation University Australia who completed their three-week teaching placement in Anshan, Liaoning Province, China, in April 2014. The study also explores the perspectives and opinions of both the Chinese mentor teachers and Chinese…

Fourth-line rescue therapy with rifabutin in patients with three Helicobacter pylori eradication failures.

PubMed

Gisbert, J P; Castro-Fernandez, M; Perez-Aisa, A; Cosme, A; Molina-Infante, J; Rodrigo, L; Modolell, I; Cabriada, J L; Gisbert, J L; Lamas, E; Marcos, E; Calvet, X

2012-04-01

In some cases, Helicobacter pylori infection persists even after three eradication treatments. To evaluate the efficacy of an empirical fourth-line rescue regimen with rifabutin in patients with three eradication failures. Multicentre, prospective study. In whom the following three treatments had consecutively failed: first (PPI + clarithromycin + amoxicillin); second (PPI + bismuth + tetracycline + metronidazole); third (PPI + amoxicillin + levofloxacin). A fourth regimen with rifabutin (150 mg b.d.), amoxicillin (1 g b.d.) and a PPI (standard dose b.d.) was prescribed for 10 days. Eradication was confirmed by (13) C-urea breath test 4-8 weeks after therapy. Compliance and tolerance: Compliance was determined through questioning and recovery of empty medication envelopes. Adverse effects were evaluated using a questionnaire. One-hundred patients (mean age 50 years, 39% men, 31% peptic ulcer/69% functional dyspepsia) were included. Eight patients did not take the medication correctly (in six cases due to adverse effects). Per-protocol and intention-to-treat eradication rates were 52% (95% CI = 41-63%) and 50% (40-60%). Adverse effects were reported in 30 (30%) patients: nausea/vomiting (13 patients), asthenia/anorexia (8), abdominal pain (7), diarrhoea (5), fever (4), metallic taste (4), myalgia (4), hypertransaminasemia (2), leucopenia (<1,500 neutrophils) (2), thrombopenia (<150,000 platelets) (2), headache (1) and aphthous stomatitis (1). Myelotoxicity resolved spontaneously in all cases. Even after three previous H. pylori eradication failures, an empirical fourth-line rescue treatment with rifabutin may be effective in approximately 50% of the cases. Therefore, rifabutin-based rescue therapy constitutes a valid strategy after multiple previous eradication failures with key antibiotics, such as clarithromycin, metronidazole, tetracycline and levofloxacin. © 2012 Blackwell Publishing Ltd.

Teaching as Coaching: A Case Study of Awareness and Learning in Engineering Education

ERIC Educational Resources Information Center

Gynnild, Vidar; Holstad, Anders; Myrhaug, Dag

2007-01-01

This paper presents a number of case studies in Oceanography, an optional module in the third/fourth year of a Master of Science programme at Norwegian University of Science and Technology. The main objective was to gain more thorough insights into student learning by examining two sets of individual oral examinations. In addition, all students…

The Effects of CLIL on Oral Comprehension and Production: A Longitudinal Case Study

ERIC Educational Resources Information Center

Pérez Cañado, María Luisa; Lancaster, Nina Karen

2017-01-01

This article reports on the outcomes of a longitudinal case study to gauge the impact of content and language integrated learning (CLIL) on two of the least researched language skills: oral comprehension and production. It worked with 24 students in the fourth grade of Compulsory Secondary Education in a public school in Andalusia (southern Spain)…

A Case Study: The Implementation of a Problem-Solving Model with a Student with Reading Difficulties in Turkey

ERIC Educational Resources Information Center

Ozmen, E. Ruya; Doganay-Bilgi, Arzu

2016-01-01

The purpose of this case study was to improve the reading accuracy and reading comprehension of a 10-year-old fourth-grade female student with reading difficulties. For that purpose, the problem- solving model was implemented in four stages. These stages included problem identification, problem analysis, intervention, and evaluation. During the…

Posterior Fossa Craniotomy for Adherent Fourth Ventricle Neurocysticercosis.

PubMed

Franko, Lynze R; Pandian, Balaji; Gupta, Avneesh; Savastano, Luis E; Chen, Kevin S; Riddell, James; Orringer, Daniel A

2018-06-14

Neurocysticercosis (NCC) is an infectious helminthic disease often presenting in patients who have immigration or travel history from areas where NCC is endemic. Fourth ventricle cysts from NCC pose a unique treatment challenge, as there is little consensus on the best treatment. This case study describes the treatment of a patient with fourth ventricle neurocysticercosis (FVNCC), examines the therapeutic decision-making, and provides a video of a posterior fossa craniotomy (PFC) resection of a degenerative cyst. The patient presented with headache, dizziness, nausea, and memory difficulties. A fourth ventricle cyst consistent with NCC was found on magnetic resonance imaging, and serum enzyme-linked immunosorbent assay (ELISA) confirmed the diagnosis. The cyst was removed utilizing an open PFC followed by antihelminthic therapy and corticosteroids. There was resolution of symptoms at 9 mo postoperatively. Several treatment modalities have been proposed for isolated cysts in the fourth ventricle, including medication, ventriculoperitoneal shunt, endoscopic removal, and PFC. The treatment decision is complex, and there is little guidance on the best treatment choices. In this article, we describe treatment via PFC for an adherent FVNCC cyst.

Endodontic management of a mandibular third molar fused with a fourth molar.

PubMed

Turell, I L; Zmener, O

1999-05-01

Developmental anomalies in permanent molars frequently require surgical intervention. A case of a mandibular third molar fused with a fourth molar which was successfully treated with conservative endodontic therapy is reported.

Fourth-order convergence of a compact scheme for the one-dimensional biharmonic equation

NASA Astrophysics Data System (ADS)

Fishelov, D.; Ben-Artzi, M.; Croisille, J.-P.

2012-09-01

The convergence of a fourth-order compact scheme to the one-dimensional biharmonic problem is established in the case of general Dirichlet boundary conditions. The compact scheme invokes value of the unknown function as well as Pade approximations of its first-order derivative. Using the Pade approximation allows us to approximate the first-order derivative within fourth-order accuracy. However, although the truncation error of the discrete biharmonic scheme is of fourth-order at interior point, the truncation error drops to first-order at near-boundary points. Nonetheless, we prove that the scheme retains its fourth-order (optimal) accuracy. This is done by a careful inspection of the matrix elements of the discrete biharmonic operator. A number of numerical examples corroborate this effect. We also present a study of the eigenvalue problem uxxxx = νu. We compute and display the eigenvalues and the eigenfunctions related to the continuous and the discrete problems. By the positivity of the eigenvalues, one can deduce the stability of of the related time-dependent problem ut = -uxxxx. In addition, we study the eigenvalue problem uxxxx = νuxx. This is related to the stability of the linear time-dependent equation uxxt = νuxxxx. Its continuous and discrete eigenvalues and eigenfunction (or eigenvectors) are computed and displayed graphically.

Assessing Columbine's Impact on Students' Fourth Amendment Case Outcomes: Implications for Administrative Discretion and Decision Making

ERIC Educational Resources Information Center

Torres, Mario S., Jr.; Chen, Yihsuan

2006-01-01

This study examined Columbine's impact on case outcomes related to student searches and its implications for civil liberties and school leader discretion. Using data from 236 court cases since the U.S. Supreme Court ruling of New Jersey v. T.L.O. in 1985, critical search dimensions and outcomes (e.g., level of suspicion) were examined using…

The fourth national anti-tuberculosis drug resistance survey in Viet Nam.

PubMed

Nhung, N V; Hoa, N B; Sy, D N; Hennig, C M; Dean, A S

2015-06-01

Viet Nam's Fourth National Anti-Tuberculosis Drug Resistance Survey was conducted in 2011. To determine the prevalence of resistance to the four main first-line anti-tuberculosis drugs in Viet Nam. Eighty clusters were selected using a probability proportion to size approach. Drug susceptibility testing (DST) against the four main first-line anti-tuberculosis drugs was performed. A total of 1629 smear-positive tuberculosis (TB) patients were eligible for culture. Of these, DST results were available for 1312 patients, including 1105 new TB cases, 195 previously treated TB cases and 12 cases with an unknown treatment history. The proportion of cases with resistance to any drug was 32.7% (95%CI 29.1-36.5) among new cases and 54.2% (95%CI 44.3-63.7) among previously treated cases. The proportion of multidrug-resistant TB (MDR-TB) cases was 4.0% (95%CI 2.5-5.4) in new cases and 23.3 (95%CI 16.7-29.9) in previously treated cases. The fourth drug resistance survey in Viet Nam found that the proportion of MDR-TB among new and previously treated cases was not significantly different from that in the 2005 survey. The National TB Programme should prioritise the detection and treatment of MDR-TB to reduce transmission of MDR-TB in the community.

An Unusual Presentation of Neurocysticercosis: A Space-Occupying Lesion in the Fourth Ventricle Associated with Progressive Cognitive Decline.

PubMed

Kurz, Carolin; Schmidt, Veronika; Poppert, Holger; Wilkins, Patricia; Noh, John; Poppert, Sven; Schlegel, Jürgen; Delbridge, Claire; da Costa, Clarissa Prazeres; Winkler, Andrea S

2016-01-01

We communicate a case of a middle-aged Brazilian patient with an unusual presentation of fourth ventricular neurocysticercosis: occurrence of two intraventricular cysts at different locations in the brain within 2 years and cognitive decline as the only neurological symptom. Neurocysticercosis was confirmed by magnetic resonance imaging, serology, histology, and genetic analysis. Neurocysticercosis should be considered as a differential diagnosis in cases with atypical neurologic or psychiatric symptoms, atypical neuroimaging and travel history. Especially, fourth ventricular cysts carry the risk of obstructive hydrocephalus and brainstem compression and therefore should be extirpated completely. If complete removal of the cystic structures cannot be proven in cases with surgically treated neurocysticercosis, anthelminthic therapy and thorough follow-up examinations should be conducted. © The American Society of Tropical Medicine and Hygiene.

Four impacted fourth molars in a young patient: a case report

PubMed Central

CLEMENTINI, M.; OTTRIA, L.; PANDOLFI, C.; AGRESTINI, C.; BARLATTANI, A.

2013-01-01

Summary The occurrence of supernumerary teeth is a relatively uncommon dental anomaly and it’s rare for patients to have impacted fourth molars in all quadrant. Aim of this work is to describe the presence of bilateral fourth molars in the maxilla and the mandible in a young male patient aged 22 years came to our hospital with acute pericoronal infection around unerupted third inferior molars. Routine radiographic examination revealed impacted inferior third molars but also unerupted bilateral upper and inferior fourth molars. The acute infection was treated by local measures and the patient was subsequently admitted for removal of third and fourth impacted upper and lower molars under general anesthesia. PMID:23741604

Responses of Children in an Ethnically Diverse Elementary Classroom to the Use of Multicultural Cinderella Stories: A Qualitative Case Study

ERIC Educational Resources Information Center

Stout-Swain, Carolyn R.

2013-01-01

John Dewey believed that the foundation of education is built on social responsibility and democracy, and specifically proposed social change and thought of teachers essentially as social workers as a conduit to that change. In this qualitative case study, different cultures were introduced via literature to a group of fourth grade students in an…

"I Am Proud that I Did It and It's a Piece of Me": Digital Storytelling in the Foreign Language Classroom

ERIC Educational Resources Information Center

Castaneda, Martha E.

2013-01-01

This case study examines students' experiences regarding the infusion of digital storytelling in their high school fourth-year Spanish class. The aim of this case study is to determine if digital storytelling can be an effective tool for language learners to communicate emotion and present information to an audience. Sources of information for…

Learning to Mean in Spanish Writing: A Case Study of a Genre-Based Pedagogy for Standards-Based Writing Instruction

ERIC Educational Resources Information Center

Troyan, Francis J.

2016-01-01

This case study reports the results of a genre-based approach, which was used to explicitly teach the touristic landmark description to fourth-grade students of Spanish as a foreign language. The instructional model and unit of instruction were informed by the pedagogies of the Sydney School of Linguistics and an instructional model for…

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…

Integrating Complementary and Alternative Medicine Education Into the Pharmacy Curriculum

PubMed Central

Wallis, Marianne

2008-01-01

Objectives To evaluate the effectiveness of an integrated approach to the teaching of evidence-based complementary and alternative medicine (CAM) in a pharmacy curriculum. Design Evidence-based CAM education was integrated throughout the third, fourth, and fifth years of the pharmacy curriculum. Specifically, an introductory module focusing on CAM familiarization was added in the third year and integrated, evidence-based teaching related to CAM was incorporated into clinical topics through lectures and clinical case studies in the fourth and fifth years. Assessment Students' self-assessed and actual CAM knowledge increased, as did their use of evidence-based CAM resources. However, only 30% of the fourth-year students felt they had learned enough about CAM. Students preferred having CAM teaching integrated into the curriculum beginning in the first year rather than waiting until later in their education. Conclusion CAM education integrated over several years of study increases students' knowledge and application. PMID:19002274

Fourth branchial complex anomalies: a case series.

PubMed

Shrime, Mark; Kacker, Ashutosh; Bent, John; Ward, Robert F

2003-11-01

Anomalies of the fourth branchial arch complex are exceedingly rare, with approximately forty cases reported in the literature since 1972. The authors report experience with six fourth arch anomalies. Retrospective chart review of six consecutive patients presenting to the pediatric otolaryngology service at a tertiary care center with anomalies referable to the fourth branchial arch. All six patients presented within the first or second decade of life. All six had left-sided disease. Four patients presented with recurrent neck infection, one with asymptomatic cervical masses, and one with a neck mass and respiratory compromise. One patient had prior surgery presented with a recurrence. Diagnosis of fourth arch anomalies was suggested or confirmed by computed tomography and flexible laryngoscopy. Treatment was surgical in five patients; one patient is awaiting surgery. Surgical procedures included resection of the mass and endoscopic cauterization of the inner opening of the cyst. The presentation of a cervical mass, especially with recurrent infections and especially on the left side, in a child in the first or second decade of life heightens suspicion for an anomaly of the fourth branchial arch. Diagnosis can be difficult, but is aided by the use of flexible laryngoscopy, Computed tomography (CT) scanning and ultrasonography. Surgical resection of the cyst and cauterization of its pyriform sinus opening should be undertaken to minimize recurrence.

World Perspective Case Descriptions on Educational Programs for Adults: India.

ERIC Educational Resources Information Center

Jayagopal, R.; Burns, E. P.

Four adult education programs being conducted in India are described in the case studies in this packet. Two of the projects involve literacy; the third promotes literacy as one part of its community development program, and the fourth trains workers in hotel management and catering technology. The literacy programs are (1) development of a…

Biochemical studies on hepatic involvement in infectious mononucleosis

PubMed Central

Baron, D. N.; Bell, Joyce L.; Dunnet, W. N.

1965-01-01

Eighty cases of infectious mononucleosis have been investigated by serum enzyme studies and other liver function tests. Maximum abnormalities occurred between the second and fourth weeks of illness and all tests were usually normal by the sixth week. Serum isocitric dehydrogenase activity was increased in 93% of cases and serum glutamic-oxaloacetic transaminase in 74%. Conventional liver function tests were less sensitive. Serum bilirubin was above normal in 40% of cases; in 17% of cases the increase was sufficient to show as clinical jaundice. No patient has developed chronic hepatitis. PMID:14276157

Integrated mined-area reclamation and land-use planning. Volume 3C. A case study of surface mining and reclamation planning: Georgia Kaolin Company Clay Mines, Washington County, Georgia

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

Guernsey, J L; Brown, L A; Perry, A O

1978-02-01

This case study examines the reclamation practices of the Georgia Kaolin's American Industrial Clay Company Division, a kaolin producer centered in Twiggs, Washington, and Wilkinson Counties, Georgia. The State of Georgia accounts for more than one-fourth of the world's kaolin production and about three-fourths of U.S. kaolin output. The mining of kaolin in Georgia illustrates the effects of mining and reclaiming lands disturbed by area surface mining. The disturbed areas are reclaimed under the rules and regulations of the Georgia Surface Mining Act of 1968. The natural conditions influencing the reclamation methodologies and techniques are markedly unique from those ofmore » other mining operations. The environmental disturbances and procedures used in reclaiming the kaolin mined lands are reviewed and implications for planners are noted.« less

[Diagnosis and surgical operation for fourth branchial cleft anomalies].

PubMed

Zhu, Ting; Hua, Qingquan

2011-11-01

To explore diagnosis and surgical operation through analyzing clinical features of the fourth branchial cleft anomalies. Clinical materials of 10 patients with the fourth branchial cleft anomalies were retrospectively analyzed, and literatures were studied to explore the diagnosis, differential diagnosis and treatment methods of surgical operation; lesions of 10 patients were completely removed by surgical operation, and internal sinus was properly handled. All 10 cases were cured, no recurrence were observed during a follow-up of 1-3 years. 1 patient appeared low voice, and drinking cough, back to normality after 2 weeks; 1 patient appeared paralysis of left hypoglossal nerves, back to normality after 3 months. Recurrent deep neck abscess and chronic sinus infections of anterior area in the lower part of neck should be considered with the diagnosis of the fourth branchial cleft anomalies. Enhanced neck CT scan and barium sulfate meal examination aid to diagnosis, pathological examination can be confirmed. Complete surgical removal of lesions is an effective treatment of fourth branchial cleft anomalies, knowing of the courses of internal sinus and spread of infection, and use of principle of selective neck dissection is the key to ensure complete removal of lesions.

Preventing lower cranial nerve injuries during fourth ventricle tumor resection by utilizing intraoperative neurophysiological monitoring.

PubMed

Jahangiri, Faisal R; Minhas, Mazhar; Jane, John

2012-12-01

We present two cases illustrating the benefit of utilizing intraoperative neurophysiological monitoring (IONM) for prevention of injuries to the lower cranial nerves during fourth ventricle tumor resection surgeries. Multiple cranial nerve nuclei are located on the floor of the fourth ventricle with a high risk of permanent damage. Two male patients (ages 8 and 10 years) presented to the emergency department and had brain magnetic resonance imaging (MRI) scans showing brainstem/fourth ventricle tumors. During surgery, bilateral posterior tibial and median nerve somatosensory evoked potentials (SSEPs); four-limb and cranial nerves transcranial electrical motor evoked potentials (TCeMEPs); brainstem auditory evoked responses (BAERs); and spontaneous electromyography (s-EMG) were recorded. Electromyography (EMG) was monitored bilaterally from cranial nerves V VII, IX, X, XI, and XII. Total intravenous anesthesia was used. Neuromuscular blockade was used only for initial intubation. Pre-incision baselines were obtained with good morphology of waveforms. After exposure the floor of the fourth ventricle was mapped by triggered-EMG (t-EMG) using 0.4 to 1.0 mA. In both patients the tumor was entangled with cranial nerves VII to XII on the floor of the fourth ventricle. The surgeon made the decision not to resect the tumor in one case and limited the resection to 70% of the tumor in the second case on the basis of neurophysiological monitoring. This decision was made to minimize any post-operative neurological deficits due to surgical manipulation of the tumor involving the lower cranial nerves. Intraoperative spontaneous and triggered EMG was effectively utilized in preventing injuries to cranial nerves during surgical procedures. All signals remained stable during the surgical procedure. Postoperatively both patients were well with no additional cranial nerve weakness. At three months follow-up, the patients continued to have no deficits.

Novel presentation of a fourth branchial cleft anomaly in a male infant.

PubMed

Evans, Seth H; Marinello, Mark; Dodson, Kelley M

2010-01-01

Fourth branchial cleft anomalies are rare congenital disorders of the neck. We describe a case involving a unique presentation of this entity as well as a review of the literature concerning its management. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Exploring Student Perceptions of Self-Regulation as a Moderator for Successful Literacy Outcomes: A Multiple Case Study of Fourth-Grade Students

ERIC Educational Resources Information Center

Nellis, Theresa M.

2017-01-01

Self-regulation is a significant predictor of student academic performance, over those traditional measures of intelligence and socioeconomic status. The failure to develop these skills may produce students who are at a four-times greater risk of behavioral issues, school dropout, and poor academic performance. This multiple qualitative case study…

[Report of a case with Joubert syndrome and literature review].

PubMed

Yi, Ya-hui; Li, Gang; Lu, Zhong-lie; Zhou, Jian-sheng; Yao, Zhen-wei; Wang, Peng-fei; Yao, Jin-xiang

2011-12-01

To explore the clinical feature, imaging and their diagnostic value for Joubert syndrome (JS). The clinical data, imaging feature, and 31 references from China Biomedical literature database (CBMdise) were reviewed and analyzed. The age of onset of 32 patients including male 20 and female 12 ranged from 3 days to 6 years (mean 2.2 years). All the 32 patients with Joubert syndrome showed "slow growth" and "reduced muscle tension", 26 cases (81.3%) showed "gasp for breath", 26 cases (81.3%) showed "unusual motion of eyeball", 2 cases (6.3%) showed additional fingers (toes), 6 cases (18.8%) showed stretching tongue with agape. The typical imaging features of Joubert syndrome included "molar tooth sign", "midline cleavage" between cerebellar hemispheres and "bat-wing" like fourth ventricle, all the 32 patients with Joubert syndrome showed "midline cleavage", "molar tooth sign" was present in 29 cases (90.1%), and "bat-wing" like fourth ventricle in 30 cases (93.8%). Joubert syndrome is a rare congenital brain malformation. The typical clinical manifestations included "gasp for breath", "reduced tension of muscle", "slow growth" and "unusual motion of eyeball", and at the same time the patients had the following typical imaging features of brain: "molar tooth sign", "midline cleavage" and "bat-wing" like fourth ventricle.

Determination of HIV Status in African Adults With Discordant HIV Rapid Tests.

PubMed

Fogel, Jessica M; Piwowar-Manning, Estelle; Donohue, Kelsey; Cummings, Vanessa; Marzinke, Mark A; Clarke, William; Breaud, Autumn; Fiamma, Agnès; Donnell, Deborah; Kulich, Michal; Mbwambo, Jessie K K; Richter, Linda; Gray, Glenda; Sweat, Michael; Coates, Thomas J; Eshleman, Susan H

2015-08-01

In resource-limited settings, HIV infection is often diagnosed using 2 rapid tests. If the results are discordant, a third tie-breaker test is often used to determine HIV status. This study characterized samples with discordant rapid tests and compared different testing strategies for determining HIV status in these cases. Samples were previously collected from 173 African adults in a population-based survey who had discordant rapid test results. Samples were classified as HIV positive or HIV negative using a rigorous testing algorithm that included two fourth-generation tests, a discriminatory test, and 2 HIV RNA tests. Tie-breaker tests were evaluated, including rapid tests (1 performed in-country), a third-generation enzyme immunoassay, and two fourth-generation tests. Selected samples were further characterized using additional assays. Twenty-nine samples (16.8%) were classified as HIV positive and 24 of those samples (82.8%) had undetectable HIV RNA. Antiretroviral drugs were detected in 1 sample. Sensitivity was 8.3%-43% for the rapid tests; 24.1% for the third-generation enzyme immunoassay; 95.8% and 96.6% for the fourth-generation tests. Specificity was lower for the fourth-generation tests than the other tests. Accuracy ranged from 79.5% to 91.3%. In this population-based survey, most HIV-infected adults with discordant rapid tests were virally suppressed without antiretroviral drugs. Use of individual assays as tie-breaker tests was not a reliable method for determining HIV status in these individuals. More extensive testing algorithms that use a fourth-generation screening test with a discriminatory test and HIV RNA test are preferable for determining HIV status in these cases.

Long-Term Teacher Orchestration of Technology-Mediated Collaborative Inquiry

ERIC Educational Resources Information Center

Viilo, Marjut; Seitamaa-Hakkarainen, Pirita; Hakkarainen, Kai

2018-01-01

This explorative case study longitudinally examines teacher orchestration of an inquiry learning process in a technology-enhanced elementary classroom. A 13-month investigative study on cultural artifacts was conducted on 32 fourth grade students who progressed to the fifth grade during the project. The activities were mediated and documented…

ICT Student Teachers' Pedagogical Content Knowledge: A Case Study

ERIC Educational Resources Information Center

Yilmaz, Nuray Parlak

2016-01-01

This study aimed to identify the difficulties that information technology student teachers have in teaching concepts. This qualitative study was carried out with 12 student teachers. The student teachers were fourth-year students enrolled in the Special Teaching Methods II course in the spring semester of the 2010-2011 academic year. The research…

A fourth-order box method for solving the boundary layer equations

NASA Technical Reports Server (NTRS)

Wornom, S. F.

1977-01-01

A fourth order box method for calculating high accuracy numerical solutions to parabolic, partial differential equations in two variables or ordinary differential equations is presented. The method is the natural extension of the second order Keller Box scheme to fourth order and is demonstrated with application to the incompressible, laminar and turbulent boundary layer equations. Numerical results for high accuracy test cases show the method to be significantly faster than other higher order and second order methods.

First-trimester sonographic findings associated with a Dandy-Walker malformation and inferior vermian hypoplasia.

PubMed

Bornstein, Eran; Goncalves Rodríguez, José Luis; Álvarez Pavón, Erika Carolina; Quiroga, Héctor; Or, Drorit; Divon, Michael Y

2013-10-01

We report 2 cases in which first-trimester measurements of the intracranial translucency and the brain stem-to-occipital bone diameter were markedly enlarged. This finding was thought to represent an abnormal fourth ventricle-cisterna magna complex. Subsequently, the diagnoses of a Dandy-Walker malformation with partial vermian agenesis in 1 case and inferior vermian hypoplasia in the other were established and confirmed by either postmortem autopsy or postnatal magnetic resonance imaging. These cases suggest that evaluation of the fourth ventricle-cisterna magna complex, by measuring the intracranial translucency or brain stem-to-occipital bone diameter may identify some cases with structural malformations of the cerebellum as early as the first trimester.

A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses.

PubMed

Nasreldin, Magda H A; Ibrahim, Eman A; Saad El-Din, Somaia A

2016-01-01

Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations.

A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses

PubMed Central

Nasreldin, Magda H. A.; Ibrahim, Eman A.; Saad El-Din, Somaia A.

2016-01-01

Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations. PMID:26819565

Communications Style Guide. Fourth Edition

DTIC Science & Technology

2010-08-01

ethnography , phenomenological study , grounded theory study , and content analysis. You want to choose your research design based on your topic and how you...accessed 27 May 2008). 38 design or an historical research design. There are five basic types of qualitative research designs: case study ...suits the purpose of your study . Generally, while a student of MCU, you will use qualitative research

Methodological Issues in Comparative Educational Studies: The Case of the IEA Reading Literacy Study.

ERIC Educational Resources Information Center

Binkley, Marilyn, Ed.; And Others

This report discusses various methodological issues confronted in the Reading Literacy Study conducted under the auspices of the International Association for the Evaluation of Educational Achievement (IEA) and issues relating to analysis of the data. The study analyzed in the report involved fourth- and ninth-grade students (9-year-olds and…

The Effects of an Intervention Combining Peer Tutoring with Story Mapping on the Text Comprehension of Struggling Readers: A Case Report

ERIC Educational Resources Information Center

Grünke, Matthias; Leidig, Tatjana

2017-01-01

This single-case study tested a peer tutoring model using a visualizing strategy (story mapping) to teach struggling students better text comprehension. Three teams each consisting of a tutor and a tutee attending a fourth-grade general education classroom participated in the experiment. A short series of observations was carried out before and…

ELLs' Perceptions of Reading

ERIC Educational Resources Information Center

Howard, Rachael M.

2017-01-01

This research investigated reading support and book preferences of fourth grade English language learners (ELLs) who were struggling readers. This qualitative research focused on three case studies. Interviews were conducted to explore ELLs' perceptions on reading motivation, reading programs, and types of support they received. Descriptions of…

ELLs' Perceptions of Reading

ERIC Educational Resources Information Center

Howard, Rachael M.

2012-01-01

This research investigated reading support and book preferences of fourth grade English language learners (ELLs) who were struggling readers. This qualitative research focused on three case studies. Interviews were conducted to explore ELLs' perceptions on reading motivation, reading programs, and types of support they received. Descriptions of…

Assessment of knowledge and attitudes of dental students in regard to child abuse in Turkey.

PubMed

Hazar Bodrumlu, E; Avşar, A; Arslan, S

2018-02-01

Child abuse is a serious public problem. Signs of abuse are often present in the oro-facial region and dentists are in a strategic position to recognise and report suspected cases. The aim of this study was to investigate dental students' knowledge about and attitudes towards child abuse. This study was performed at the Faculty of Dentistry of the Ondokuz Mayis University. The data were collected through a self-report questionnaire administered to dental students (137 female/111 male) in three different dental classes (third, fourth and fifth study years) and grouped by considering those students who have been training in the school year of 2013. The definition of physical and social indicators of abuse, awareness regarding legal and ethical responsibilities, students' experience and requests made by students were evaluated by the students' response to questions put in the questionnaire. Descriptive statistics and chi-square tests were performed to analyse the questionnaire data. The questionnaire completion rate was 100%. About 67.74% of the third year, 40.71% of the fourth year and 16.67% of the fifth year believed that they could detect child abuse cases. However, results indicated a major lack of knowledge of social indicators, signs of physical abuse and reporting procedure amongst all respondents. The assessment of the total correct answers exhibited significant differences amongst third-, fourth- and fifth-year students' answers. Fifth-year students had the highest rate of correct responses (P < 0.05). Most students wanted to receive more knowledge about this topic. Dental students in Turkey are not sufficiently prepared for their role in diagnosing suspected cases of child abuse. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Case series: Endoscopic management of fourth branchial arch anomalies.

PubMed

Watson, G J; Nichani, J R; Rothera, M P; Bruce, I A

2013-05-01

Fourth branchial arch anomalies represent <1% of all branchial anomalies and present as recurrent neck infections or suppurative thyroiditis. Traditionally, management has consisted of treatment of the acute infection followed by hemithyroidectomy, surgical excision of the tract and obliteration of the opening in the pyriform fossa. Recently, it has been suggested that endoscopic obliteration of the sinus tract alone using laser, chemo or electrocautery is a viable alternative to open surgery. To determine the results of endoscopic obliteration of fourth branchial arch fistulae in children in our institute. Retrospective case note review of all children undergoing endoscopic treatment of fourth branchial arch anomalies in the last 7 years at the Royal Manchester Children's Hospital. Patient demographics, presenting symptoms, investigations and surgical technique were analysed. The primary and secondary outcome measures were resolution of recurrent infections and incidence of surgical complications, respectively. In total 5 cases were identified (4 females and 1 male) aged between 3 and 12 years. All presented with recurrent left sided neck abscesses. All children underwent a diagnostic laryngo-tracheo-bronchoscopy which identified a sinus in the apex of the left pyriform fossa. This was obliterated using electrocautery in 1 patient, CO₂ laser/Silver Nitrate chemocautery in 2 patients and Silver Nitrate chemocautery in a further 2 patients. There were no complications and no recurrences over a mean follow-up period of 25 months (range 11-41 months). Endoscopic obliteration of pyriform fossa sinus is a safe method for treating fourth branchial arch anomalies with no recurrence. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Learning to Construct Meaning from Text: A Case Study of the Relationship between a Tutor and an English Learner within a Response to Intervention Setting

ERIC Educational Resources Information Center

Jaeger, Elizabeth L.

2015-01-01

This case study describes the ways in which Sam, an English learner with weak comprehension, grew as a reader, student, and friend during his fourth grade year. Using the Interactive Model of Reading (Dis)ability and the RAND model of comprehension as a frame, Sam's experience in a Tier 2/3 tutorial program is examined. Over time, Sam (1) engaged…

The Dandy-Walker malformation. A review of 40 cases.

PubMed

Hirsch, J F; Pierre-Kahn, A; Renier, D; Sainte-Rose, C; Hoppe-Hirsch, E

1984-09-01

Forty cases of Dandy-Walker malformation referred to the Hôpital Necker Enfants-Malades between 1969 and 1982 have been reviewed. The incidence of the malformation in hydrocephalus was 2.4%. There was a slight, statistically insignificant, female prevalence. Hydrocephalus should not be included in the definition of the syndrome. In 80% of the cases, it was actually a post-natal complication of the malformation and most often developed within 3 months after birth. In 80% of the cases, a communication, although insufficient, was found between the dilated 4th ventricle and the subarachnoid space. Since this communication is probably established through the foramina of Luschka, the definition of the Dandy-Walker malformation should only include atresia of the foramen of Magendie. Associated brain and systemic malformations were numerous. Among facial anomalies, facial angiomas were found in 10% of our cases. The association of facial and cardiovascular anomalies favors the hypothesis that the onset of the malformation occurs between the formation and the migration of the cells of the neural crest (that is, between the 3rd and the 4th post-ovulatory week, earlier than previously thought). Except in selected patients, membrane excision has a high rate of failure and should be abandoned. Cyst-peritoneal shunting avoids the risk of an entrapped fourth ventricle and is presently the best surgical procedure. The overall mortality in this series was 12.5%. Intelligence quotients were over 80 in 60% of the patients. Other studies will be necessary to understand why the communication between the fourth ventricle and the subarachnoid spaces, sufficient in utero, usually becomes insufficient for a normal cerebrospinal fluid (CSF) circulation in the first months following birth. Two hypotheses are discussed: a change in CSF circulation, or bleeding in the dilated fourth ventricle during delivery.

[Fourth evaluation of the law on the review of termination of life on request and assisted suicide (Euthanasia Act)].

PubMed

van der Heide, A; Onwuteaka-Philipsen, B D; van Delden, J J M; Gevers, J K M; van der Maas, P J; van der Wal, G

2005-09-24

This fall, an extensive study will start to evaluate the Dutch Euthanasia Act. This law was enacted in 2002. According to this law, physicians must report cases of euthanasia and physician-assisted suicide. The cases are then judged by regional euthanasia review committees consisting of a lawyer, a physician and an ethicist. Only if they conclude that the case does not meet the requirements for prudent practice, it will be sent to the public prosecutor. The study will be focused on the practice of medical end-of-life decision-making, the functioning and effects of the Euthanasia Act, and opinions of physicians about the scope of the law and the demarcation between different end-of-life decisions. The study will comprise 4 sub-studies: a judicial evaluation, a death certificate study, a survey among physicians and a panel study among physicians, nurses, members of euthanasia review committees, lawyers and ethicists. This study is the fourth in a row of nationwide studies into end-of-life practices that have been performed since 1990. The previous studies contributed to the public debate about medical care at the end of life and to the development of policy in this field. It is expected that this study, by providing up-to-date information on and insight into end-of-life care in the Netherlands, will do the same.

Influence of Ethics Education on Moral Reasoning among Pre-Service Teacher Preparation and Social Work Students

ERIC Educational Resources Information Center

Salopek, Michelle M.

2013-01-01

This comparative case study examines the influence of ethics education on moral reasoning among pre-service teacher preparation and social work students. This study specifically investigates the ethical values of students enrolled in a teacher preparation and social work education program by their fourth year of study; the degree of ethical…

Case report 868. Congenital bilateral spondylolysis and spondylolisthesis of the fourth cervical vertebra.

PubMed

Jeyapalan, K; Chavda, S V

1994-10-01

A case of congenital bilateral spondylolysis of fourth cervical vertebra was reported and the characteristic radiological features shown. Although the diagnosis is often suggested by the plain films, demonstration of the typical CT findings is often necessary to reach a final diagnosis. Awareness of this entity and its specific radiological features will help to differentiate this relatively benign cervical anomaly from other, more ominous, unstable causes of cervical spondylolisthesis such as those related to acute cervical injury. It may also prevent any inappropriate treatment from being undertaken.

Morphological effects in children word reading: a priming study in fourth graders.

PubMed

Casalis, Séverine; Dusautoir, Marion; Colé, Pascale; Ducrot, Stéphanie

2009-09-01

A growing corpus of evidence suggests that morphology could play a role in reading acquisition, and that young readers could be sensitive to the morphemic structure of written words. In the present experiment, we examined whether and when morphological information is activated in word recognition. French fourth graders made visual lexical decisions to derived words preceded by primes sharing either a morphological or an orthographic relationship with the target. Results showed significant and equivalent facilitation priming effects in cases of morphologically and orthographically related primes at the shortest prime duration, and a significant facilitation priming effect in the case of only morphologically related primes at the longer prime duration. Thus, these results strongly suggest that a morphological level is involved in children's visual word recognition, although it is not distinct from the formal one at an early stage of word processing.

Congenital duodenal web (wind-soak variety) in the fourth part of the duodenum causing obstruction in a female child.

PubMed

Saha, N; Hasanuzaman, S M; Chowdhury, L H; Talukder, S A

2012-10-01

Delayed presentation of Duodenal Obstruction is a great diagnostic dilemma due to non-specific, varied & wide spectrum presentation. In this study, a 6 years female child presented with recurrent, intermittent, colicky abdominal pain with bilious vomiting, and occasional constipation from 9 months of her age, without having any significant family history or associated condition. She was initially diagnosed as a case of recurrent small bowel obstruction due to atypical variant of malrotation. But, after laparotomy, she was finally diagnosed as a case of recurrent duodenal obstruction due to Congenital Duodenal Web (Wind-Soak Variety) with a central hole in the fourth part of the duodenum. After uneventful recovery of post operative period the patient was discharged at 7th postoperative day & followed up upto 3 months. She had been found alright without any complication.

A case series of 12 patients with incidental asymptomatic Dandy-Walker syndrome and management.

PubMed

Jha, Vikas Chandra; Kumar, Raj; Srivastav, Arun Kumar; Mehrotra, Anant; Sahu, Rabi Narayan

2012-06-01

Incidentally detected asymptomatic Dandy-Walker syndrome (DWS) is sparsely reported in literature at extremes of age (from 1 to 75 years) in association with different diseases. Precipitating factors causing DWS in these cases to manifest in late adulthood are still unidentified. We tried to hypothesize the aetiology and the natural course of disease based on review of literature Twelve cases of asymptomatic DWS were selected retrospectively in this study while being treated for some unrelated disease over a period of 15 years. All the cases had vermian hypoplasia with sizeable fourth ventricular cyst (more than 3 cm), large posterior fossa and with no or borderline ventriculomegaly on CT/MRI. The age ranged from 1 to 65 years. Five cases presented with head injury and four cases presented with enlarged head size with suboccipital protuberance (noticed in children more than 5 years). Remaining cases presented with either occipital encephalocele or right trigeminal neuralgia or fixed atlantoaxial dislocation. They were asymptomatic for DWS following treatment of the presenting complaints on follow-up of average duration of 4.5 years. Presentation at extremes of age signifies that slow degenerative changes in communicating channels between fourth ventricular cyst and surrounding basal cisterns may cause asymptomatic DWS to manifest, but cases having good communication between these structures can remain asymptomatic throughout their life.

Sustainable potato production: global case studies

USDA-ARS?s Scientific Manuscript database

Potato (Solanum tuberosum L.) is grown in over 100 countries throughout the world. As a staple food, potato is the fourth most important crop after rice, wheat, and maize, and has historically contributed to food and nutrition security in the world. Global interest in potato increased sharply in 200...

Missing the Forest for the Trees

ERIC Educational Resources Information Center

Amaral, Olga Maia; Garrison, Leslie

2007-01-01

This case study examines the alignment between the Intended Curriculum, Implemented Curriculum and Achieved Curriculum of a fourth grade inquiry based unit, "Food Chains and Webs." Specifically addressed are how the curriculum was modified to meet state standards, how teachers were trained, and how assessment of curricular implementation was…

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.

Anorexia: an early sign of fourth ventricle astrocytoma in children.

PubMed

Leroy, Henri-Arthur; Baroncini, Marc; Delestret, Isabelle; Florent, Vincent; Vinchon, Matthieu

2014-12-01

Paediatric low-grade astrocytomas of the fourth ventricle are rare tumours, generally revealed by hydrocephalus. However, some patients present with a history of severe anorexia. It might be a harbinger, which if recognized, could lead to earlier diagnosis. We decided to examine our database in order to evaluate the incidence and signification of anorexia in this context. Retrospective monocentric study of cases of low-grade astrocytomas of the fourth ventricle operated between 1991 and 2012 in our paediatric neurosurgery department. We particularly observed the clinical presentation and long-term clinical, oncological and radiological evolution. Non-parametrical tests were used (Mann-Whitney, Fisher). We reviewed 34 cases, 31 pilocytic astrocytomas and 3 diffuse astrocytomas, 16 boys and 18 girls, (M/F ratio 0.89). Mean age at diagnosis was 8 years old. Seven presented with notable anorexia, the average BMI in this group was ≤2 standard deviation (SD); with clinical signs evolving for 11.5 months. Twenty-seven children had no anorexia; average BMI in this group was +1 SD, with clinical evolution for 6 months on an average of p < 0.05. We found no significant difference regarding hydrocephalus or tumour location. In all children with anorexia, body mass index improved markedly in the postoperative follow-up, which lasted, on average, for 6 years. Anorexia with stunted body weight curve is a non-exceptional presentation in children with low-grade astrocytomas of the fourth ventricle. Unexplained or atypical anorexia with negative etiologic assessment should prompt cerebral imaging. Clinical improvement after surgical resection, could suggest a possible interaction between tumour tissue and appetite-suppressing peptide secretion.

Blending Asynchronous Discussion Groups and Peer Tutoring in Higher Education: An Exploratory Study of Online Peer Tutoring Behaviour

ERIC Educational Resources Information Center

De Smet, Marijke; Van Keer, Hilde; Valcke, Martin

2008-01-01

In the present study cross-age peer tutoring was implemented in a higher education context. Fourth-year students (N=39) operated as online tutors to support freshmen in discussing cases and solving authentic problems. This study contributes to a better understanding of the supportive interventions of tutors in asynchronous discussion groups. Peer…

Metacognitive Scaffolds Improve Self-Judgments of Accuracy in a Medical Intelligent Tutoring System

ERIC Educational Resources Information Center

Feyzi-Behnagh, Reza; Azevedo, Roger; Legowski, Elizabeth; Reitmeyer, Kayse; Tseytlin, Eugene; Crowley, Rebecca S.

2014-01-01

In this study, we examined the effect of two metacognitive scaffolds on the accuracy of confidence judgments made while diagnosing dermatopathology slides in SlideTutor. Thirty-one (N = 31) first- to fourth-year pathology and dermatology residents were randomly assigned to one of the two scaffolding conditions. The cases used in this study were…

A Test of High-Order Thinking

ERIC Educational Resources Information Center

Libresco, Andrea S.

2007-01-01

In this article, the author presents a case study of three fourth grade teachers in New York, a state that administers an elementary social studies test, constructed by teachers, that relies on the use of documents in the majority of its questions. Throughout the 2002-2003 school year, the three teachers were observed during every unit of social…

Reasons for Vocabulary Attrition: Revisiting the State of the Art

ERIC Educational Resources Information Center

Alharthi, Thamer

2015-01-01

This paper reports on a one year, mixed-methods longitudinal case study investigating the neglected area of the perceived reasons why participants forget vocabulary knowledge. The participants were 43 fourth year male Saudi EFL majors at King Abdulaziz University KAU, Saudi Arabia. Quantitative and qualitative data including self-reported…

Due Process Hearing Case Study

ERIC Educational Resources Information Center

Bateman, David F.

2008-01-01

Greg is 13 years old, and currently in seventh grade; he entered an unnamed District ("the District") school in fourth grade as a student with a specific learning disability; he had been identified as eligible for special education programming and services during second grade. During fifth and sixth grade Greg was provided services…

Compensatory Education: Case Study

ERIC Educational Resources Information Center

Bateman, David F.

2007-01-01

Anna is a 13-year-old student who has a learning disability and is eligible for special education and related services. Anna's parents enrolled her in the Private Academy for fifth grade; her frustration, inappropriate behaviors, and inattention had increased during fourth grade. In its year-end report, the Private Academy described Anna's…

The Body as Evidence: Helping Clients Identify Decision-Making Roadblocks

ERIC Educational Resources Information Center

Synard, Jacqueline T.

2009-01-01

Grad school or Europe for a year? A highly motivated, fourth-year liberal arts student makes her decision but still has doubts. What roles do emotion and a client's personal history play in career counselling? The case study utilizes experiential process to uncover decision-making roadblocks.

Reshaping the Social Order: The Case of Gender Segregation.

ERIC Educational Resources Information Center

Lockheed, Marlaine E.

1986-01-01

Describes an experimental study of gender segregation in 38 fourth and fifth grade classrooms. Students working in small, experimental, mixed-sex, instructional groups engaged in more cross-sex interactions than students in control groups. Boys in experimental classrooms showed greater preference for working in cross-sex groups. (SA)

Students with Learning Disabilities in an Inclusive Writing Classroom

ERIC Educational Resources Information Center

Jacobs, Patricia; Fu, Danling

2014-01-01

This article presents a case study on two fourth grade students with learning disabilities in two different writing situations: writing for test preparation and writing for digital stories. The students' writing behaviors, processes, and products in these two settings are contrasted. The differences in the students' writing experiences suggest…

Elective Mutism--A Success Story.

ERIC Educational Resources Information Center

Caputo, Norma; Crawford, Margie

This paper presents a case study of successful intervention with a boy (in fourth grade at the time of the intervention) who would not speak in the school environment. Intervention involved medication with Fluoxetine to relieve anxiety, parental involvement, and a six-step behavioral therapy plan of gradually increasing speech demands in the…

Thymic cyst: a fourth branchial cleft anomaly.

PubMed

Nayan, Smriti; MacLean, Jonathan; Sommer, Doron

2010-01-01

We report a unique case of a fourth branchial cleft cyst found within the thymus of an adult patient. In the literature to date, there have been no reports of such a finding in the adult population. These anomalies can often cause recurrent acute suppurative thyroiditis or recurrent deep neck abscesses. Delay in recognizing the underlying etiology can lead to significant complications.

Dandy-Walker syndrome studied by computed tomography and pneumoencephalography

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

Masdeu, J.C.; Dobben, G.D.; Azar-Kia, B.

1983-04-01

Based on air studies, some authors have disputed the ability of computed tomography (CT) to diagnose posterior fossa cysts. The authors correlated the pneumoencephalographic, CT, and pathological findings in 4 patients with classic Dandy-Walker syndrome. Three cases had been misdiagnosed as retrocerebellar arachnoid cysts because the fourth ventricle was incorrectly considered normal on brow-up or erect air studies, reflecting the inability of such studies to evaluate an agenetic vermis and deficient posterior medullary velum which are characteristic of Dandy-Walker malformation. Careful correlation with autopsy findings showed that even with complete agenesis of the inferior vermis, if the slit between themore » cerebellar hemispheres is narrow, the fourth ventricle could be misinterpreted as normal on pneumoencephalography and sagittal CT. Radionuclide studies, a small amount of air, or metrizamide may be needed to determine whether the cyst communicates with the subarachnoid space.« less

A culture and power perspective on the management of health information technology in hospitals.

PubMed

Petersen, Lone Stub; Bertelsen, Pernille

2012-01-01

The three traditionally dominating professional hospital cultures - physicians, nurses and management - are challenged by the increasing use of health information technology (HIT) in health care. A fourth group of actors, the IT-professionals has become an exceedingly powerful player challenging the boundaries of the traditional hospital cultures. The hospital cultures are being redefined by and are redefining the technologies as well as the divisions of labour between the professional groups. The IT-professionals have become central actors in this and thereby they constitute a fourth powerful professional culture in the hospitals. This study draws out the phenomenon of IT-professionals as a fourth culture through a qualitative case study of both the IT-department and clinical and managerial hospital practices. The study finds evidence of how the IT-professionals and the IT-departments play a central part in the development of hospital practices constituting them as an influential culture and player in the hospitals. The tendency to see IT as merely infrastructure is hereby challenged and the conclusions demand further research into how to consider IT strategically in the hospitals, possibly pointing towards further user involvement in IT management.

United States History: From Community to Society. Unit Four: Revolutionary America. Grade Six. Project Social Studies.

ERIC Educational Resources Information Center

Minnesota Univ., Minneapolis. Project Social Studies Curriculum Center.

Revolution is the theme of this resource unit, which is the fourth in a social studies series designed for sixth grade students. In the first part of the unit, case studies are used to examine 18th century Boston, Williamsburg, and Philadelphia, contrasting them to 17th century Jamestown and Plymouth settlements. Emphasis is upon examining causes…

A Case Study of the Academic Achievement of African American Males in Single-Sex Classrooms in Rural South Carolina

ERIC Educational Resources Information Center

Pannell, Lynette Martin

2013-01-01

The purpose of this study was to investigate the differences of Measures of Academic Progress (MAP) scores between fourth-grade African American male students who were enrolled in single-sex classrooms and their counterparts who were enrolled in coeducational classrooms. The research provided descriptive data concerning one Title I school in rural…

Digital Educational Games and Mathematics. Results of a Case Study in Primary School Settings

ERIC Educational Resources Information Center

Fokides, Emmanuel

2018-01-01

The study presents the results of a project in which a series of digital games were used for teaching Mathematics to first, fourth, and sixth-grade primary school students (ages 6-7, 8-9, and 11-12). Mathematics was selected as the teaching subject because of the difficulties students face in understanding basic math concepts. Although digital…

A Test of Leading Explanations for the College Racial-Ethnic Achievement Gap: Evidence from a Longitudinal Case Study

ERIC Educational Resources Information Center

Martin, Nathan D.; Spenner, Kenneth I; Mustillo, Sarah A.

2017-01-01

In this study, we examined racial/ethnic differences in grade point average (GPA) among students at a highly selective, private university who were surveyed before matriculation and during the first, second and fourth college years, and assessed prominent explanations for the Black-White and Latino-White college achievement gap. We found that…

Adoption of 4G Mobile Services from the Female Student's Perspective: Case of Princess Nora University

ERIC Educational Resources Information Center

Rawashdeh, Awni

2015-01-01

The aim this study was to examine the relationship between the perceived usefulness, perceived ease of use, perceived entertainment, attitude and the users' intention toward using the fourth-generation (4G) wireless mobile services. Data of this study were collected by survey with a cross sectional approach. The data were analyzed with factor…

The Examining of Prospective Teachers? Views about Renewable and Non-Renewable Energy Sources: A Case Study of Turkey

ERIC Educational Resources Information Center

Hasiloglu, Mehmet Akif

2014-01-01

The aim of this study is to determine prospective teachers? views about renewable and non-renewable energy sources. To collect data, a questionnaire with 5 open-ended questions was conveyed to 463 prospective teachers selected from Agri Ibrahim Cecen University. The results showed that almost three fourths of the prospective teachers tend to…

Foundations for Success: Case Studies of How Urban School Systems Improve Student Achievement [and] Abstract.

ERIC Educational Resources Information Center

Snipes, Jason; Doolittle, Fred; Herlihy, Corinne

This report examines the experiences of three large urban school districts (and part of a fourth) that raised academic performance for their districts as a whole, while also reducing racial differences in achievement. Educational challenges included low achievement, political conflict, inexperienced teachers, low expectations, and lack of…

Talent Development as a University Mission: The Quadruple Helix

ERIC Educational Resources Information Center

Holm-Nielsen, Lauritz B.; Thorn, Kristian; Olesen, Jeppe Dorup; Huey, Tina

2013-01-01

In this paper, the authors discuss the rationale behind making talent development at the PhD, post-doctoral and early career levels an equal fourth pillar of the university's mission, alongside the more traditional pillars of the triple helix. Using Denmark and Aarhus University as a case study, the paper describes how increased institutional…

Children Writing for Themselves, Their Teacher, and the State in an Urban Classroom

ERIC Educational Resources Information Center

Dutro, Elizabeth; Kazemi, Elham; Balf, Ruth

2004-01-01

This paper presents case studies of four students' experiences with writing in a fourth/fifth grade classroom. The paper focuses on the following questions: What is the relationship between children's social and intellectual identities and their successes or struggles in writing? How do writing instruction and assessments mediate that…

Case Study: International High School at Langley Park

ERIC Educational Resources Information Center

Wassl, Frishtah; Wilkin, Christine; Ward, Maggie

2017-01-01

The International High School at Langley Park (IHSLP) opened during the 2015-2016 school year. By the fourth year of operation, the school will be home to 400 English language learners (ELLs) new to the United States. Working in partnership with the Internationals Network for Public Schools, the school is designed around the "HELLO…

Modelling Impacts of Climate Change: Case Studies using the New Generation of Erosion Models

USDA-ARS?s Scientific Manuscript database

Climate change is expected to impact upon a number of soil erosion drivers and processes, which should be taken into account when designing a modelling strategy. The fourth assessment report of the Intergovernmental Panel for Climate Change (IPCC) (Parry et al., 2007; Solomon et al., 2007) reviews a...

Multilingual Literacies: Invisible Representation of Literacy in a Rural Classroom

ERIC Educational Resources Information Center

Kiramba, Lydiah Kananu

2017-01-01

In many countries, educational policies typically mandate school activities that promote a homogeneous and narrow range of academic literacies for all learners despite the diverse nature of human learning. This ethnographic case study examines how a 12-year-old Kenyan fourth-grade student performing below average on all standardized tests used…

Breaking the Long Hours Culture.

ERIC Educational Resources Information Center

Kodz, J.; Kersley, B.; Strebler, M. T.; O'Regan, S.

Case studies of 12 leading British employers were driven by employers' interest in issues related to working long hours in light of introduction of the Working Time Directive, a European Community initiative enacted into British law that sets limits on working hours per week. Data showed over one-fourth of full-time employees worked over 48 hours…

The Theory of Biology and the Education of Biologists: A Case Study.

ERIC Educational Resources Information Center

Barnett, S. A.; And Others

1983-01-01

Questions on evolutionary theory and the philosophy of biology were given to zoology students at three levels: third-year undergraduates; fourth year, honours; and graduates. Responses were assessed independently by a zoologist, an educator, and a philosopher. No students had failed conventional courses, but each author failed nearly half the…

Historical Perspectives on Educational Policy in Canada: Issues, Debates and Case Studies.

ERIC Educational Resources Information Center

Stamp, Robert M.

1997-01-01

Publishes the academic papers first presented at Dalhousie University in October 1986 at the fourth biennial conference of the Canadian History of Education Association. Argues that this eclectic collection of conference papers does not bode well for an integrated book because the concerns of educational history and contemporary policymaking are…

Case Study of Fourth Grade Families and School Involvement

ERIC Educational Resources Information Center

Ugoala, Sandra Kay Womack

2014-01-01

Researchers and policy makers have established that family involvement is related to student academic performance. Family participation at a school in a southern state in the United States was declining after the third grade level, and educators at the school needed more information to address this problem. Self-efficacy and ecological theories of…

Gauging Ethical Deficits in Leadership and Student Discipline: An Analysis of Fourth Amendment Case Law

ERIC Educational Resources Information Center

Torres, Mario S., Jr.

2012-01-01

Recent studies of school discipline (Skiba, Michael, Nardo, & Peterson, 2002; see also, NAACP Legal Defense and Education Fund, n.d.) have called for greater scrutiny over treatment of students in varying demographic contexts. Minimal research, however, has grappled with the ethics of disciplinary practices using legal data. Utilizing…

The fourth branchial complex anomaly: a rare clinical entity.

PubMed

Patel, Alpen B; Hinni, Michael L

2011-01-01

Fourth branchial pouch anomalies are rare congenital disorders of the neck and are a consequence of abnormal development of the branchial apparatus during embryogenesis. Failure to appropriately recognize these anomalies may result in misdiagnosis, insufficient treatment, and continued recurrence. Here, we present an unique presentation of two cases, describe their diagnosis, clinical course, and management, and review the literature regarding these interesting anomalies.

The Fourth Branchial Complex Anomaly: A Rare Clinical Entity

PubMed Central

Patel, Alpen B.; Hinni, Michael L.

2011-01-01

Fourth branchial pouch anomalies are rare congenital disorders of the neck and are a consequence of abnormal development of the branchial apparatus during embryogenesis. Failure to appropriately recognize these anomalies may result in misdiagnosis, insufficient treatment, and continued recurrence. Here, we present an unique presentation of two cases, describe their diagnosis, clinical course, and management, and review the literature regarding these interesting anomalies. PMID:22937376

[Friedreich's disease in the department of neurology in Dakar].

PubMed

Ndiaye, M; Ndao, A K; Sene-Diouf, F; Diop, A G; Diagne, M; Thiam, A; Ndiaye, M M; Ndiaye, I P

2000-01-01

A retrospective study of Friedreich's ataxia was conducted from january 1960 to december 1997. Eighten cases had been collected. Friedreich's ataxia was the second disorder after Pierre Marie's ataxia among inherited ataxia. Parental consanguinity has been found in 27.77% of cases. The sex-ratio was 2.6 for males. 66,67% of Friedreich's ataxia cases began after 25 years. Clinical signs were: cerebellar ataxia, sensitive disorders in 70%, pyramidal syndrom and cardiomyopathy in 22.22%, bones dysmorphy in 50% of cases. Electromyography indicated severe axonopathy of members with decreased somesthesic potentials in six cases. Glycaemia was normal in all cases. Clinical future presented wide variation between one and fourth years old.

Branchial anomalies in children.

PubMed

Bajaj, Y; Ifeacho, S; Tweedie, D; Jephson, C G; Albert, D M; Cochrane, L A; Wyatt, M E; Jonas, N; Hartley, B E J

2011-08-01

Branchial cleft anomalies are the second most common head and neck congenital lesions seen in children. Amongst the branchial cleft malformations, second cleft lesions account for 95% of the branchial anomalies. This article analyzes all the cases of branchial cleft anomalies operated on at Great Ormond Street Hospital over the past 10 years. All children who underwent surgery for branchial cleft sinus or fistula from January 2000 to December 2010 were included in this study. In this series, we had 80 patients (38 female and 42 male). The age at the time of operation varied from 1 year to 14 years. Amongst this group, 15 patients had first branchial cleft anomaly, 62 had second branchial cleft anomaly and 3 had fourth branchial pouch anomaly. All the first cleft cases were operated on by a superficial parotidectomy approach with facial nerve identification. Complete excision was achieved in all these first cleft cases. In this series of first cleft anomalies, we had one complication (temporary marginal mandibular nerve weakness. In the 62 children with second branchial cleft anomalies, 50 were unilateral and 12 were bilateral. In the vast majority, the tract extended through the carotid bifurcation and extended up to pharyngeal constrictor muscles. Majority of these cases were operated on through an elliptical incision around the external opening. Complete excision was achieved in all second cleft cases except one who required a repeat excision. In this subgroup, we had two complications one patient developed a seroma and one had incomplete excision. The three patients with fourth pouch anomaly were treated with endoscopic assisted monopolar diathermy to the sinus opening with good outcome. Branchial anomalies are relatively common in children. There are three distinct types, first cleft, second cleft and fourth pouch anomaly. Correct diagnosis is essential to avoid inadequate surgery and multiple procedures. The surgical approach needs to be tailored to the type of anomaly of origin of the anomaly. Complete excision is essential for good outcomes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Effect of handoff skills training for students during the medicine clerkship: a quasi-randomized study.

PubMed

Reyes, Juan A; Greenberg, Larrie; Amdur, Richard; Gehring, James; Lesky, Linda G

2016-03-01

Continuity is critical for safe patient care and its absence is associated with adverse outcomes. Continuity requires handoffs between physicians, but most published studies of educational interventions to improve handoffs have focused primarily on residents, despite interns expected to being proficient. The AAMC core entrustable activities for graduating medical students includes handoffs as a milestone, but no controlled studies with students have assessed the impact of training in handoff skills. The purpose of this study was to assess the impact of an educational intervention to improve third-year medical student handoff skills, the durability of learned skills into the fourth year, and the transfer of skills from the simulated setting to the clinical environment. Trained evaluators used standardized patient cases and an observation tool to assess verbal handoff skills immediately post intervention and during the student's fourth-year acting internship. Students were also observed doing real time sign-outs during their acting internship. Evaluators assessed untrained control students using a standardized case and performing a real-time sign-out. Intervention students mean score demonstrated improvement in handoff skills immediately after the workshop (2.6-3.8; p < 0.0001) that persisted into their fourth year acting internship when compared to baseline performance (3.9-3.5; p = 0.06) and to untrained control students (3.5 vs. 2.5; p < 0.001, d = 1.2). Intervention students evaluated in the clinical setting also scored higher than control students when assessed doing real-time handoffs (3.8 vs. 3.3; p = 0.032, d = 0.71). These findings should be useful to others considering introducing handoff teaching in the undergraduate medical curriculum in preparation for post-graduate medical training. Trial Registration Number NCT02217241.

Exploration case studies

NASA Astrophysics Data System (ADS)

Underwood, Jimmy M.

1989-04-01

NASA's Office of Exploration has undertaken four case studies for prospective expansion of manned space activities beyond earth orbit. The subjects of these studies are (1) an expedition to the Martian moon Phobos; (2) a three-mission expedition to Mars; (3) the construction of a man-tended lunar observatory; and (4) the construction of a lunar outpost to serve as the basis for construction of a Martian outpost. The fourth alternative would follow the recommendation of the National Commission on Space for the creation of a 'bridge between worlds' in which explorers would develop ways in which to 'live off the land' in a space environment.

Functional Assessment of the Vanderbilt Multigrasp Myoelectric Hand: A Continuing Case Study

PubMed Central

Dalley, Skyler A.; Bennett, Daniel A.; Goldfarb, Michael

2015-01-01

This paper presents a case study involving the functional assessment of the Vanderbilt Multigrasp (VMG) hand prosthesis on a single transradial amputee subject. In particular, a transradial amputee subject performed the Southampton Hand Assessment Procedure (SHAP) using the hand prosthesis and multigrasp myoelectric controller in a series of experimental sessions occurring over a multi-week time span. The subject’s index of function (IoF) improved with each session, although essentially plateaued after the fourth session, resulting in a IoF score of 87, which compares favorably to SHAP scores published in previous studies. PMID:25571412

P16.30 4th ventricle glioblastoma

PubMed Central

Unal, E.; Isik, S.; Gurbuz, M.; Kilic, K.

2017-01-01

Abstract Introduction: We present the 2nd case ever known in English literature describing a glioblastoma of the fourth ventricle originating from cerebellar peduncle. CASE DESCIPTION: A 66 years old woman was admitted to hospital with dizziness and nausea for four months. An MRI scan showed fourth ventricle mass. First impression was an ependymoma due to MRI scan characteristics. Results: A surgery was performed and histopathology revealed Grade IV glial tumor. Radiotherapy was done. CONCLUSION: This report suggests that GBM can mimic every tumor in the CNS. Surgery is the best option for these tumors not only for aggressive behaviour of glioblastoma but also to prevent hydrocephalus and associated symptoms.

Findings of a Research on the Students' Use of Time. A Case Study of the Anadolu University Open Education Faculty in Turkey. Educational Research Publications No. 017.

ERIC Educational Resources Information Center

Demiray, Ugur

This study examines what fourth year Open Education Faculty students enrolled in economics and business administration education in Anadolu University's distance education program expect from their faculty in terms of leisure time activities and how they spend their leisure time. Additional questions addressed include the personal, social, and…

The existence of a real pole-free solution of the fourth order analogue of the Painlevé I equation

NASA Astrophysics Data System (ADS)

Claeys, T.; Vanlessen, M.

2007-05-01

We establish the existence of a real solution y(x, T) with no poles on the real line of the following fourth order analogue of the Painlevé I equation: \\[ \\begin{equation*}x=Ty-\\left(\\case 1 6 y^3+\\case{1}{24} (y_x^2+2yy_{xx}) +\\case {1}{240} y_{xxxx}\\right).\\end{equation*} \\] This proves the existence part of a conjecture posed by Dubrovin. We obtain our result by proving the solvability of an associated Riemann-Hilbert problem through the approach of a vanishing lemma. In addition, by applying the Deift/Zhou steepest-descent method to this Riemann-Hilbert problem, we obtain the asymptotics for y(x, T) as x → ±∞.

Simple resection arthroplasty for treatment of 4th and 5th tarsometatarsal joint problems. A technical tip and a small case series.

PubMed

Koenis, M J J; Louwerens, J W K

2015-03-01

Osteoarthritis, primary or secondary, of the fourth and/or fifth tarsometatarsal (TMT) joint is a rare condition. When conservative treatment fails or proves to be unacceptable for the patient, operative treatment is an option. In this article the technique of resection arthroplasty is described and a retrospective case series of 6 patients is presented. Three patients underwent tendon interposition arthroplasty after resection of the two joints and in the last three cases no interposition at all was performed. Results suggest that resection arthroplasty without interposition may be as effective as other operative treatment options for patients with fourth and fifth TMT pathology. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

The reception of relativity in China.

PubMed

Hu, Danian

2007-09-01

Having introduced the theory of relativity from Japan, the Chinese quickly and enthusiastically embraced it during the May Fourth Movement, virtually without controversy. This unique passion for and openness to relativity, which helped advance the study of theoretical physics in China in the 1930s, was gradually replaced by imported Soviet criticism after 1949. During the Cultural Revolution, radical Chinese ideologues sponsored organized campaigns against Einstein and relativity, inflicting serious damage on Chinese science and scientific education. China's economic reforms in the late 1970s empowered scientists and presented them with the opportunity to rehabilitate Einstein and call for social democracy. Einstein has since become the symbol in China of the unity of science and democracy, the two eminent objectives of the May Fourth Movement that remain to be achieved in full. Using the reception of relativity as a case study, the essay also discusses issues involving the historical study of modern Chinese science.

Hannah's Prior Knowledge about Chemicals: A Case Study of One Fourth-Grade Child

ERIC Educational Resources Information Center

Bretz, Stacey Lowery; Emenike, Mary Elizabeth

2012-01-01

Chemical principles are taught in elementary education across much of the United States because the "National Science Education Standards" include concepts about the nature of matter, states of matter, and changes in matter among other science concepts within the first to fifth grade levels. "Chemicals" is a word related to the nature of matter…

"It's Harder Than We Thought It Would Be": A Comparative Case Study of Expert-Novice Experimentation Strategies.

ERIC Educational Resources Information Center

Hmelo-Silver, Cindy E.; Nagarajan, Anandi; Day, Roger S.

2002-01-01

Compares a group of expert cancer researchers with four groups of fourth year medical students (the "novice" groups) engaged in the task of designing a clinical trial to test a new cancer drug using a computer-based modeling tool, the Oncology Thinking Cap. (Contains 24 references.) (Author/YDS)

Using Art Media during Prewriting: Helping Students with Dysgraphia Manage Idea Generation before Encoding Text

ERIC Educational Resources Information Center

Dunn, Michael

2013-01-01

Many students struggle with writing skills. This study focuses on three students (second and fourth grades) who were classified with a learning disability by their school. These children had writing goals and objectives (i.e., characteristics of having dysgraphia) included in their Individual Education Plan. In a single case design format, each…

First-Aid Algorithms in Dental Avulsion

ERIC Educational Resources Information Center

Baginska, Joanna; Wilczynska-Borawska, Magdalena

2012-01-01

Almost one fourth of traumatic dental injuries occur at schools or in their surroundings. Prevalence of tooth avulsion varies from 0.5% to 16% of all cases of dental trauma. Children with dental avulsion may seek help from school nurses so they should be able to provide first-aid treatment. However, many studies showed that the general level of…

State Actions To Restructure Schools: First Steps. Results in Education Series.

ERIC Educational Resources Information Center

David, Jane L.; And Others

The widening mismatch between the skills of the work force and the skill demands of the work place underlie the need for school restructuring. Fourth in a series, this document builds on and extends the issues discussed in the National Governors' Association's (NGA) previous publications and reports on case studies of early restructuring efforts…

Funding Early College High School: Hold Harmless or Shared Commitment

ERIC Educational Resources Information Center

Leonard, Jack

2013-01-01

Early college high schools are a promising but expensive pathway to college readiness. Most such schools are supported with state funds and/or grants. This descriptive case study presents an early college program, now in its fourth year in a traditional high school, in which the families, high school and local community college shared the entire…

Structure and Flow: Toward an Organic Approach to Critical Multiliteracies in a Writing Workshop

ERIC Educational Resources Information Center

Schaenen, Inda

2010-01-01

This qualitative case study reports on a three-year writing enrichment program among second, third, and fourth graders at a public urban elementary school in a medium-sized midwestern city. Designed as teacher research, the inquiry is a phenomenological examination of the experience of the workshop for its participants, including more than one…

Contexts Matter: Two Teachers' Language Arts Instruction in This High-Stakes Era

ERIC Educational Resources Information Center

Dooley, Caitlin McMunn; Assaf, Lori Czop

2009-01-01

This retrospective cross-case analysis compares two fourth-grade language arts teachers' beliefs and practices as they respond to an influx of high-stakes tests, including district-mandated benchmark testing systems. One teacher works in a suburban school, the other in an urban school. Results from the study show that the teachers' beliefs about…

National Income, Income Inequality, and the Importance of Schools: A Hierarchical Cross-National Comparison

ERIC Educational Resources Information Center

Chudgar, Amita; Luschei, Thomas F.

2009-01-01

The international and comparative education literature is not in agreement over the role of schools in student learning. The authors reexamine this debate across 25 diverse countries participating in the fourth-grade application of the 2003 Trends in International Mathematics and Science Study. The authors find the following: (a) In most cases,…

Literacy and Arts-Integrated Science Lessons Engage Urban Elementary Students in Exploring Environmental Issues

ERIC Educational Resources Information Center

Gray, P.; Elser, C. F.; Klein, J. L.; Rule, A. C.

2016-01-01

This descriptive case study examined student attitudes, writing skills and content knowledge of urban fourth and fifth graders (6 males, 9 female) during a six-week literacy, thinking skill, and art-integrated environmental science unit. Pre- and post-test questions were used to address knowledge of environmental problems and student environmental…

Traits and Talents of Giftedness in Minority and Low Socioeconomic Fourth Grade Students in a Georgia School District

ERIC Educational Resources Information Center

Smith, Andrea Ragon

2013-01-01

The potential traits and talents of giftedness in students are multidimensional; yet, some school districts in Georgia perpetuate barriers for students from minority and low socioeconomic backgrounds by relying solely on standardized test scores for gifted identification. The purpose of this case study was to explore the multidimensionality of…

Integrating Blended and Problem-Based Learning into an Architectural Housing Design Studio: A Case Study

ERIC Educational Resources Information Center

Bregger, Yasemin Alkiser

2017-01-01

This paper presents how a blended learning pedagogic model is integrated into an architectural design studio by adapting the problem-based learning process and housing issues in Istanbul Technical University (ITU), during fall 2015 and spring 2016 semesters for fourth and sixth level students. These studios collaborated with the "Introduction…

Resection of recurrent branchial cleft deformity using selective neck dissection technique.

PubMed

Cai, Qian; Pan, Yong; Xu, Yaodong; Liang, Faya; Huang, Xiaoming; Jiang, Xiaoyu; Han, Ping

2014-07-01

This study explores application of selective neck dissection technique in recurrent second, third, and fourth branchial cleft deformities. A total of 19 cases of recurrent second, third, and fourth branchial cleft deformities were treated using the selective neck dissection technique, during which the sternocleidomastoid muscle, cervical anterior muscle, and carotid sheath were contoured. The lesion above the prevertebral fascia was then resected en bloc. Finally, the opening of the internal fistula was ligated and sutured using the purse-string approach. Patients in this study had no injures to their internal carotid artery, jugular vein, vagus nerve, accessory nerve, hypoglossal nerve, or recurrent laryngeal nerve. There were also no complications such as poor wound healing. The patients were monitored for 7-73 months and showed no recurrences. Using selective neck dissection to treat second, third, and fourth branchial cleft deformities resulted in en bloc lesion resections and reduced the chance of recurrence. Contouring the sternocleidomastoid muscle, strap muscle, and carotid sheath is key to the surgical procedure, as it leads to en bloc lesion resection while retaining the recurrent laryngeal nerve and carotid sheath. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Liposarcoma of bone with osteosarcomatous foci: Case report and review of the literature

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

Downey, E.F. Jr.; Worsham, G.F.; Brower, A.C.

1982-03-01

A case of liposarcoma arising in bone with rare foci osteosarcoma is reported. In this case, the tumor metastasized to the lungs as osteosarcoma. This is the third documented case and the fourth known case in the literature. Its rarity is somewhat surprising considering the innumerable possibilities of differentiation of the mesenchyme elements present in the bone marrow.

Exploring a fourth dimension: spirituality as a resource for the couple therapist.

PubMed

Anderson, D A; Worthen, D

1997-01-01

This article explores ways in which the therapist's own spirituality can serve as a resource in couple therapy. Spirituality is defined as subjective engagement with a fourth, transcendent dimension of human experience. This engagement enhances human life and evokes corresponding behavior. Spiritually based therapy may be influenced by three assumptions: that God or a Divine Being exists, that human-kind yearns innately for connection with this Being, and that this Being is interested in humans and acts upon and within their relationships to promote beneficial change. In therapy these assumptions affect how the therapist listens and responds throughout sessions. The authors incorporate a case example illustrating the application of this fourth dimension in couple therapy.

Trigeminal neuralgia due to Dandy-Walker syndrome.

PubMed

Zhang, Wenhao; Chen, Minjie; Zhang, Weijie

2013-07-01

Trigeminal neuralgia (TN) is a common pain in the orofacial region. Dandy-Walker syndrome (DWS) is a congenital malformation of the cerebellar and the fourth ventricle foramina atresia. Dandy-Walker syndrome is rarely found in patients with TN. This article presents a 36-year-old man with the symptoms of typical TN. His physical examination was entirely normal. An enhanced magnetic resonance imaging was taken. Magnetic resonance imaging revealed the bilateral lateral ventricle, the fourth and third ventricle significantly enlarged with severe obstructive hydrocephalus, a huge posterior fossa cyst connected with the fourth ventricle, and hypoplastic vermis. The pain was controlled by Tegretol. The reported case suggests that DWS is an unusual cause of TN.

[With the fourth sentence of the First Chamber on wrongful birth: is it possible to start talking about "jurisprudence"?].

PubMed

de Angel Yágüez, Ricardo

2005-01-01

Chamber number 1 of the Spanish Supreme Court of Justice has announced its fourth wrongful birth case decision dated December 18, 2003. The issue is whether we can state that with these four rulings there is a genuine law of precedent, that is, reiterated doctrine of the Supreme Court of Justice on this matter (Article 1.6 of the Civil Code).

Recurrent thyroid abscess - Is it a fourth branchial archanomaly?

PubMed

Desai, A A; Pandya, V K; Chougule, Sachin; Nair, Unnikrishnnan

2006-04-01

Branchial fistulae are of congenital origin(6) and consists of skin lined tract opening internally at junction of cartilaginous and bony meatus in case of 1(st) arch anomaly, tonsillar fossa in case of 2(nd) arch, while 3(rd) and 4(th) arch sinuses have internal opening at level of pyriform sinus or below. A complete tract of 3(rd) or 4(th) arch fistulae is yet to be described. Fourth arch fistulae(1) have a distinct clinical pattern of internal opening at pyriform apex, are left sided and associated with suppurative thyroiditis(3), they manifest at a younger age and treatment involves excision of tract with ipsilateral thyroid lobectomy.

Método perturbativo aplicado a gravidade de quarta ordem e a relatividade geral corrigida pelo grupo de renormalização

NASA Astrophysics Data System (ADS)

Filho, Sebastião Mauro

2017-01-01

In this thesis we applied the perturbative method, on a classical level, to the fourth-order gravity and the Renormalization Group extended General Relativity (RGGR). We will consider auxiliary fields formulation for the general fourth-order gravity on an arbitrary curved back-ground to analyze the metric perturbations in this theory. The case of a Ricci-flat background was elaborated in detail. We noticed that the use of auxiliary fields helps to make the pertur-bative analysis easier and the results more clear. As an application we reconsider the stability problem of the Schwarzschild and Kerr black holes in the fourth-order gravity. We also used the perturbative method to develop the Newtonian and post-Newtonian limits of RGGR. In the Solar System, RGGR depends on a single dimensionless parameter 0, and this parameter is such that for 0 = 0 one fully recovers General Relativity in the Solar System. In order to study the Newtonian limit we used the conformal transformation technique and the dynamics of the Laplace-Runge-Lenz vector (LRL). In this way, we could estimate the upper bound for 0 within the Solar System in two case: the case where the external potential effect is considered and the another when it is not considered. Previously this parameter was constrained to be 0 < 10-21, without considering the external potential effect. However, as we showed, when such an effect is considered this bound increases by five orders of magnitude, O < 10-16. Moreover, we showed that under a certain approximation RGGR can be easily tested using the parametrized post-Newtonian (PPN) formalism.

Dark Coulomb binding of heavy neutrinos of fourth family

NASA Astrophysics Data System (ADS)

Belotsky, K. M.; Esipova, E. A.; Khlopov, M. Yu.; Laletin, M. N.

2015-11-01

Direct dark matter searches put severe constraints on the weakly interacting massive particles (WIMPs). These constraints cause serious troubles for the model of stable neutrino of fourth generation with mass around 50GeV. Though the calculations of primordial abundance of these particles make them in the charge symmetric case a sparse subdominant component of the modern dark matter, their presence in the universe would exceed the current upper limits by several orders of the magnitude. However, if quarks and leptons of fourth generation possess their own Coulomb-like y-interaction, recombination of pairs of heavy neutrinos and antineutrinos and their annihilation in the “neutrinium” atoms can play important role in their cosmological evolution, reducing their modern abundance far below the experimental upper limits. The model of stable fourth generation assumes that the dominant part of dark matter is explained by excessive Ū antiquarks, forming (ŪŪŪ)-- charged clusters, bound with primordial helium in nuclear-interacting O-helium (OHe) dark atoms. The y charge conservation implies generation of the same excess of fourth generation neutrinos, potentially dangerous WIMP component of this scenario. We show that due to y-interaction recombination of fourth neutrinos with OHe hides these WIMPs from direct WIMP searches, leaving the negligible fraction of free neutrinos, what makes their existence compatible with the experimental constraints.

Selective vs routine midline episiotomy for the prevention of third- or fourth-degree lacerations in nulliparous women.

PubMed

Rodriguez, Alexander; Arenas, Edgar A; Osorio, Alba L; Mendez, Omar; Zuleta, John J

2008-03-01

The purpose of this study was to determine whether selective midline episiotomy contributes to the prevention of third- or fourth-degree perineal lacerations. A randomized controlled clinical trial was performed with 446 nulliparous women with deliveries after 28 weeks of pregnancy. Patients were randomized to undergo either routine episiotomy or selective episiotomy. In the selective episiotomy group, episiotomies were performed only in cases of imminent lacerations, fetal distress, or forceps delivery. In the group of 223 patients who underwent routine episiotomy, 32 (14.3%) had third- or fourth-degree perineal lacerations, as compared to 15 (6.8%) in the group of 222 patients undergoing selective episiotomy (relative risk, 2.12; 95% confidence interval, 1.18-3.81). Only reduction in third-degree lacerations was significant when analyzed separately. Moreover, periurethral, labia minora, and superficial vaginal lacerations were significantly more frequent in the selective episiotomy group. The policy of performing selective midline episiotomy in nulliparous patients results in a reduction in the risk of third-degree perineal lacerations.

Lessons for PreK-3rd from Montgomery County Public Schools. An FCD Case Study

ERIC Educational Resources Information Center

Marietta, Geoff

2010-01-01

Reading achievement in the United States has stagnated. In 2009, only 33 percent of Fourth Graders were proficient or above in reading--a mere two percentage points higher than in 1998. At the same time, double-digit achievement gaps between African American and Latino/Hispanic students and their white counterparts have changed little in nearly…

"Si Se Puede" Latino Students Can Succeed in School: A Success Case Method Study

ERIC Educational Resources Information Center

Brenes, Manuel J.

2012-01-01

In public schools about one fourth of the students identify themselves as Latinos or of Hispanic origin. Unfortunately of those Latino children who began at the elementary level, only 40% of them will graduate from high school and about 11% of high school graduates will go on to postsecondary school. In order to improve these numbers, educators…

Carl: A Case Study of a Gifted Student with Challenging Social Behaviors

ERIC Educational Resources Information Center

Zapotocky, Robin

2014-01-01

Robin Zapotocky is a first-year teacher in a fifth-grade classroom at Cannaday Elementary in Mesquite ISD, Mesquite TX. She graduated from Baylor University in the gifted and elementary dual certificate program, and first met Carl when she was student teaching in a gifted and talented pullout program for third- and fourth-grade gifted students.…

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

ERIC Educational Resources Information Center

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

2004-01-01

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

A Case Study of Culturally Relevant School-Based Programming for First Nations Youth: Improved Relationships, Confidence and Leadership, and School Success

ERIC Educational Resources Information Center

Crooks, Claire V.; Burleigh, Dawn; Snowshoe, Angela; Lapp, Andrea; Hughes, Ray; Sisco, Ashley

2015-01-01

Schools are expected to promote social and emotional learning skills among youth; however, there is a lack of culturally-relevant programming available. The Fourth R: Uniting Our Nations programs for Aboriginal youth include strengths-based programs designed to promote healthy relationships and cultural connectedness, and improve school success…

[Clinical characteristics and surgical management in patients with third and fourth branchial anomalies].

PubMed

Li, Y X; He, X G; Wang, Y; Yang, X

2016-08-05

Objective: To analysize the clinical characteristics as well as the effect and methods of the surgical treatment in patiets with the third and fourth branchial anomalies. Method: The clinical data of 25 patients diagnosed as third and fourth branchial cleft fistula by pathological method were analyzed retrospectively.Two of 25 patients had undergone fistulectomy simply.Based on the embryologicc and anatomic features of branchial anomalies,23 of 25 patients had received different types of selective neck dissection.All of lesions were confirmed as branchial cleft fistula by pathology.All patients were received the examinations of Esophagus myelography,MRI and CT preoperatively. Result: The features of the third and the fourth bianchial fistula were as following:most patients suffered from recurrent neck abscess and had undergone incision and drainage. Esophagus myelography and CT were important auxiliary examination for branchial anomalies.No recurrent and complications were found in all patients by using treatment of selective neck dissection (23/25 cases) and fistulectomy simply(2/25 cases) within 12 to 36 months following-up,postoperatively. Conclusion: Branchial anomalies is characterized by recurrent acute abscess,acute thyroiditis or fistula secretion inferior to neck.Complete removal of branchial lesions and inflammatory granuloma using selective neck dissection is a safty and effective treatment for recurrent branchial anomalies. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Fourth order difference methods for hyperbolic IBVP's

NASA Technical Reports Server (NTRS)

Gustafsson, Bertil; Olsson, Pelle

1994-01-01

Fourth order difference approximations of initial-boundary value problems for hyperbolic partial differential equations are considered. We use the method of lines approach with both explicit and compact implicit difference operators in space. The explicit operator satisfies an energy estimate leading to strict stability. For the implicit operator we develop boundary conditions and give a complete proof of strong stability using the Laplace transform technique. We also present numerical experiments for the linear advection equation and Burgers' equation with discontinuities in the solution or in its derivative. The first equation is used for modeling contact discontinuities in fluid dynamics, the second one for modeling shocks and rarefaction waves. The time discretization is done with a third order Runge-Kutta TVD method. For solutions with discontinuities in the solution itself we add a filter based on second order viscosity. In case of the non-linear Burger's equation we use a flux splitting technique that results in an energy estimate for certain different approximations, in which case also an entropy condition is fulfilled. In particular we shall demonstrate that the unsplit conservative form produces a non-physical shock instead of the physically correct rarefaction wave. In the numerical experiments we compare our fourth order methods with a standard second order one and with a third order TVD-method. The results show that the fourth order methods are the only ones that give good results for all the considered test problems.

An unusual variety of simultaneous fracture dislocation pattern: medial swivel dislocation of talonavicular joint with displaced fractures of the fourth and fifth metatarsals.

PubMed

Inal, Sermet; Inal, Canan

2013-01-01

In published studies, a very rare, special type of Chopart dislocation termed a swivel dislocation has been reported. This injury is characterized by dislocation of the talonavicular joint, but the calcaneocuboid joint remains intact. The foot creates a typical rotational movement without inversion or eversion. The axis of rotation is the interosseous talocalcaneal ligament, which remains intact. We report the case of an 18-year-old male who had experienced a medial swivel dislocation of the talonavicular joint associated with displaced fractures of the fourth and fifth metatarsals. The occurrence, features, and method of treatment of this rare injury are presented. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Study on Treatment with Respect to Idiopathic Scoliosis

NASA Astrophysics Data System (ADS)

Takeuchi, Kenzen; Azegami, Hideyuki; Murachi, Shunji; Kitoh, Junzoh; Ishida, Yoshito; Kawakami, Noriaki; Makino, Mitsunori

A hypothesis that the thoracic idiopathic scoliosis is buckling phenomenon of the fourth mode induced by the growth of thoracic vertebral bodies was presented in the previous work by the authors using numerical simulations with finite element model of the spine. If the hypothesis is acceptable, sensitivity function with respect to the critical growth of thoracic vertebrae on the maximization problem of buckling load with the fourth buckling mode gives us useful information to improve and develop treatments for the idiopathic scoliosis. The numerical results analyzed by the finite element method demonstrated that the sensitivity function is high at the articular capsules of the intervertebral joints, the intervertebral disks, the costotransverse joints and the constovertebral joints around the apex of the curvature in the case of the thoracic idiopathic scoliosis.

LETTER: Study of combined NBI and ICRF enhancement of the D-3He fusion yield with a Fokker-Planck code

NASA Astrophysics Data System (ADS)

Azoulay, M.; George, M. A.; Burger, A.; Collins, W. E.; Silberman, E.

A two-dimensional bounce averaged Fokker-Planck code is used to study the fusion yield and the wave absorption by residual hydrogen ions in higher harmonic ICRF heating of D (120 keV) and 3He (80 keV) beams in the JT-60U tokamak. Both for the fourth harmonic resonance of 3He (ω = 4ωc3He(0), which is accompanied by the third harmonic resonance of hydrogen (ω = 3ωcH) at the low field side, and for the third harmonic resonance of 3He (ω = 4ωcD(0) = 3ωc3He(0)) = 2ωcH(0)), a few per cent of hydrogen ions are found to absorb a large fraction of the ICRF power and to degrade the fusion output power. In the latter case, D beam acceleration due to the fourth harmonic resonance in the 3He(D) regime can enhance the fusion yield more effectively. A discussion is given of the effect of D beam acceleration due to the fifth harmonic resonance (ω = 5ωcD) at the high field side in the case of ω = 4ωc3He(0) and of the optimization of the fusion yield in the case of lower electron density and higher electron temperature

Childhood headache attributed to airplane travel: a case report.

PubMed

Rogers, Kirsty; Rafiq, Nadia; Prabhakar, Prab; Ahmed, Mas

2015-05-01

Headache attributed to airplane flights is a rare form of headache disorder. This case study describes an 11-year-old girl with recurrent, severe, frontal headaches occurring during airplane travel. The episodes were associated with dizziness and facial pallor but no additional symptoms and showed spontaneous resolution on landing. Blood tests and imaging revealed no abnormalities. The present case fulfils the criteria for airplane headache recently included in the revised edition of the International Classification of Headache Disorders (ICHD-III Beta). Only a few cases of airplane headache have been reported in children. To our knowledge, this is the fourth case. We review the current literature on this rare syndrome and discuss various proposed pathophysiological mechanisms. © The Author(s) 2014.

Impact of constructivist pedagogy on science education

NASA Astrophysics Data System (ADS)

Chrishon-Ford, Grace E.

This study focused on how constructivist pedagogy impacts science achievement of the fourth grade students in an elementary Department of Defense School. Constructivism is a learning or meaning-making theory that offers an explanation of the nature of knowledge and how human beings learn. The population of this study was two fourth grade classes in an elementary Department of Defense District School. Data collection was accomplished in four ways: (1) focus group interviews of students, (2) individual interviews of students selected from the focus groups, (3) interviews of teachers, and (4) unobtrusive observations of science instruction. A six-step process was followed to gain entry for this study. The steps were my university dissertation committee, Department of Defense Education Activity Research Study Request, Endorsement and Agreement form to the Headquarters Office, school superintendent, school principal, teacher participants, and the final step was to seek parental approval of the fourth graders involved in the study. The findings from this study were an increase of 47% test scores; 57% revealed experiments/projects and 64% working on the computers in groups were the fun things; 100% student interaction; 100% student attentativeness; and 70% using other resources. Implications have demonstrated that the traditional classroom can be converted if the teachers and administrators would buy into the approach that this project demonstrated. As an advocate of the constructivist model the case study demonstrated students do indeed respond to the constructivist theory. If approached in a positive manner, it could be done in any kind of school setting.

Anatomic variants in Dandy-Walker complex.

PubMed

Jurcă, Maria Claudia; Kozma, Kinga; Petcheşi, CodruŢa Diana; Bembea, Marius; Pop, Ovidiu Laurean; MuŢiu, Gabriela; Coroi, Mihaela Cristiana; Jurcă, Alexandru Daniel; Dobjanschi, Luciana

2017-01-01

Dandy-Walker complex (DWC) is a malformative association of the central nervous system. DWC includes four different types: Dandy-Walker malformation (vermis agenesis or hypoplasia, cystic dilatation of the fourth ventricle and a large posterior fossa); Dandy-Walker variant (vermis hypoplasia, cystic dilatation of the fourth ventricle, normal posterior fossa); mega cysterna magna (large posterior fossa, normal vermis and fourth ventricle) and posterior fossa arachnoid cyst. We present and discuss four cases with different morphological and clinical forms of the Dandy-Walker complex. In all four cases, diagnosis was reached by incorporation of clinical (macrocephaly, seizures) and imaging [X-ray, computed tomography (CT), magnetic resonance imaging (MRI)] data. Two patients were diagnosed with Dandy-Walker complex, one patient was diagnosed with Dandy-Walker variant in a rare association with neurofibromatosis and one patient was diagnosed with a posterior fossa arachnoid cyst associated with left-sided Claude Bernard-Horner syndrome, congenital heart disease (coarctation of the aorta, mitral stenosis) and gastroesophageal reflux. In all forms of DWC, the clinical, radiological and functional manifestations are variable and require adequate diagnostic and therapeutic measures.

Anatomical reconstruction of the fourth brachymetatarsia with one-stage iliac bone and cartilage cap grafting.

PubMed

Woo, Sang Hyun; Bang, Chi Young; Ahn, Hee-Chan; Kim, Sung-Jung; Choi, Jun-Young

2017-05-01

We present a one-stage procedure for lengthening the fourth brachymetatarsia with autogenous iliac bone and cartilage cap grafting for the anatomical reconstruction of the metatarsophalangeal (MTP) joint METHODS: During the last 8 years, 56 feet in 41 patients with congenital brachymetatarsia of the fourth toe were corrected with a one-stage operation to reposition the articular cartilage cap to the distal part of interpositional iliac bone graft at the metatarsal epiphysis. The length of the harvested iliac bone graft was 22.9 mm on average. The mean fixation period was 58.5 days, and the mean gain in length and percentage increase was 20.9 mm and 39%, respectively. MRI showed a stable MTP joint over viable cartilage cap in 83.3% of the cases. Mean postoperative American Orthopedic Foot and Ankle Society lesser MTP-interphalangeal score was 82.0. Neither neurovascular impairment nor recurrence of brachymetatarsia occurred in the mean follow-up period of 43.6 months. All patients were satisfied with the postoperative cosmetic results. Thirteen patients (23.2%) complained of limited active dorsiflexion of the fourth toe, and extensor adhesion was released by extensor tenolysis in only one patient. In a single case of nonunion at the bone graft site, additional surgery was not necessary. Anatomical reconstruction of the fourth brachymetatarsia with one-stage interpositional iliac bone and cartilage cap grafting resulted in excellent cosmetic results and a physiologic MTP joint, providing the benefits of one-stage lengthening with a low complication rate. Therapeutic, IV. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Assessment of the calibration of periodontal diagnosis and treatment planning among dental students at three dental schools.

PubMed

Lane, Brittany A; Luepke, Paul; Chaves, Eros; Maupome, Gerardo; Eckert, George J; Blanchard, Steven; John, Vanchit

2015-01-01

Calibration in diagnosis and treatment planning is difficult to achieve due to variations that exist in clinical interpretation. To determine if dental faculty members are consistent in teaching how to diagnose and treat periodontal disease, variations among dental students can be evaluated. A previous study reported high variability in diagnoses and treatment plans of periodontal cases at Indiana University School of Dentistry. This study aimed to build on that one by extending the research to two additional schools: Marquette University School of Dentistry and West Virginia University School of Dentistry. Diagnosis and treatment planning by 40 third- and fourth-year dental students were assessed at each of the schools. Students were asked to select the diagnosis and treatment plans on a questionnaire pertaining to 11 cases. Their responses were compared using chi-square tests, and multirater kappa statistics were used to assess agreement between classes and between schools. Logistic regression models were used to evaluate the effects of school, class year, prior experience, and GPA/class rank on correct responses. One case had a statistically significant difference in responses between third- and fourth-year dental students. Kappas for school agreement and class agreement were low. The students from Indiana University had higher diagnosis and treatment agreements than the Marquette University students, and the Marquette students fared better than the West Virginia University students. This study can help restructure future periodontal courses for a better understanding of periodontal diagnosis and treatment planning.

Role of the husband's knowledge and behaviour in postnatal depression: a case study of an immigrant Pakistani woman.

PubMed

Khan, Tahir M; Arif, Noor Hayati B; Tahir, Humera; Anwar, Mudassir

2009-12-01

Objective This study aims to highlight the subjective experience of an immigrant Pakistani woman during postnatal depression (PND), with a special emphasis on the husband's knowledge and behaviour towards PND.Methods A face-to-face interview was conducted with a woman reporting symptoms of depression on the fourth day after delivery. She was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV)(1) and the Edinburgh Postnatal Depression Rating Scale (EPDRS).(2) The evaluations were completed by a qualified psychiatrist. The demographic information, personal and family medical history and attitude towards the child were the principal issues recorded. In addition, five items were used to evaluate the husband's knowledge about PND. The EPDRS differences before and after counselling were evaluated using a student t-test.Results The patient was 32 years old and this was her first experience of delivery by Caesarean section. The evaluation for depression confirmed the diagnosis of PND and she scored 16 on the EPDRS. The husband's knowledge of PND was poor.Conclusion This case study suggests that lack of social support and understanding appear to play a vital role in the persistence of symptoms of PND among new mothers. Therefore, counselling of couples may be an effective additional tool in treating PND.

A Better State of War: Surmounting the Ethical Cliff in Cyber Warfare

DTIC Science & Technology

2014-06-01

This study analyzes the emergent field of cyber warfare through the lens of commonly-accepted tenets of ethical warfare. By comparing the...foundational understanding of concepts that determine the justice of wars (jus ad bellum) and justice in war (jus en bello) with the capabilities cyber warfare offers...analyzing how cyber warfare affects each of the core concepts introduced above. The fourth chapter presents a case study that tests the theoretical

Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

ERIC Educational Resources Information Center

Roessler, Richard T.; Rubin, Stanford E.

2006-01-01

"Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

A Case of Duplicated Right Vertebral Artery.

PubMed

Motomura, Mayuko; Watanabe, Koichi; Tabira, Yoko; Iwanaga, Joe; Matsuuchi, Wakako; Yoshida, Daichi; Saga, Tsuyoshi; Yamaki, Koh-Ichi

2018-04-27

We encountered a case of duplicated right vertebral artery during an anatomical dissection course for medical students in 2015. Two vertebral arteries were found in the right neck of a 91-year-old female cadaver. The proximal leg of the arteries arose from the area between the right subclavian artery and the right common carotid artery that diverged from the brachiocephalic artery. The distal leg arose from the right subclavian artery as expected. The proximal leg entered the transverse foramen of the fourth cervical vertebra and the distal leg entered the transverse foramen of the sixth cervical vertebra. The two right vertebral arteries joined to form one artery just after the origin of the right vertebral artery of the brachiocephalic artery entered the transverse foramen of the fourth cervical vertebra. This artery then traveled up in the transverse foramina and became the basilar artery, joining with the left vertebral artery. We discuss the embryological origin of this case and review previously reported cases.

Online virtual-patient cases versus traditional problem-based learning in advanced pharmacy practice experiences.

PubMed

Al-Dahir, Sara; Bryant, Kendrea; Kennedy, Kathleen B; Robinson, Donna S

2014-05-15

To evaluate the efficacy of faculty-led problem-based learning (PBL) vs online simulated-patient case in fourth-year (P4) pharmacy students. Fourth-year pharmacy students were randomly assigned to participate in either online branched-case learning using a virtual simulation platform or a small-group discussion. Preexperience and postexperience student assessments and a survey instrument were completed. While there were no significant differences in the preexperience test scores between the groups, there was a significant increase in scores in both the virtual-patient group and the PBL group between the preexperience and postexperience tests. The PBL group had higher postexperience test scores (74.8±11.7) than did the virtual-patient group (66.5±13.6) (p=0.001). The PBL method demonstrated significantly greater improvement in postexperience test scores than did the virtual-patient method. Both were successful learning methods, suggesting that a diverse approach to simulated patient cases may reach more student learning styles.

Radiographic evaluation of root canal fillings accomplished by undergraduate dental students.

PubMed

Yavari, Hamidreza; Samiei, Mohammad; Shahi, Shahriar; Borna, Zahra; Abdollahi, Amir Ardalan; Ghiasvand, Negar; Shariati, Gholamreza

2015-01-01

The purpose of this study was to evaluate the radiographic quality of root canal fillings by fourth-, fifth-, and sixth-year undergraduate students at Tabriz Faculty of Dentistry between 2006 and 2012. A total of 1183 root canal fillings in 620 teeth were evaluated by two investigators (and in case of disagreement by a third investigator) regarding the presence or absence of under-fillings, over-fillings and perforations. For each tooth, preoperative, working and postoperative radiographs were checked. The Pearson's chi-square test was used for statistical evaluation of the data. Inter-examiner agreement was measured by Cohen's kappa (k) values. The level of significance was set at 0.05. Total frequencies of over-filling, under-filling and perforation were 5.6%, 20.4% and 1.9%, respectively. There were significant differences between frequencies of over- and under-fillings (P<0.05). Unacceptable quality, under- and over-fillings were detected in 27.9% of 1183 evaluated canals. The technical quality of root canal therapies performed by undergraduate dental students using step-back preparation and lateral compaction techniques was unacceptable in almost one-fourth of the cases.

Microbiology of third and fourth branchial pouch cysts.

PubMed

Pahlavan, Shane; Haque, Waqar; Pereira, Kevin; Larrier, Deidre; Valdez, Tulio A

2010-03-01

To identify the most common pathogens involved in infections of third and fourth branchial pouch cysts. Third and fourth branchial pouch cyst infections are an uncommon cause of anterior neck abscesses often confused with other entities, such as thyroglossal duct cysts and thyroid abscesses leading to misdiagnosis, recurrence, and increased morbidity related to a delay in diagnosis and appropriate treatment. Retrospective chart and literature review. Retrospective chart review case series of patients presenting to the Bobby R. Alford Department of Otolaryngology at Texas Children's Hospital from July 2004 to July 2008 with third and fourth branchial pouch cysts. A total of 11 patients were identified. All patients had left-sided lesions. Eikenella corrodens was found in 60% of cultures and was the most common organism identified in our patient group. Furthermore, 56% of the organisms isolated were anaerobic. All organisms with the exception of Staphylococcus aureus were identified as oral cavity flora. Third and fourth branchial pouch cysts provide a communication between the neck and the oral cavity through pyriform sinus tracts. The presence of oral cavity flora in a left anterior neck abscess should raise the suspicion of a branchial pouch anomaly, and subsequently alter therapeutic management.

Nasopharyngeal teratoma, congenital diaphragmatic hernia and Dandy-Walker malformation - a yet uncharacterized syndrome.

PubMed

Gupta, N; Shastri, S; Singh, P K; Jana, M; Mridha, A; Verma, G; Kabra, M

2016-11-01

An association of congenital diaphragmatic hernia, dandy walker malformation and nasopharyngeal teratoma is very rare. Here, we report a fourth case with this association where chromosomal microarray and whole exome sequencing (WES) was performed to understand the underlying genetic basis. Findings of few variants especially a novel variation in HIRA provided some insights. An association of congenital diaphragmatic hernia, dandy walker malformation and nasopharyngeal teratoma is very rare. Here, we report a fourth case with this association where chromosomal microarray and whole exome sequencing (WES) was performed to understand the underlying genetic basis. Findings of few variants especially a novel variation in HIRA provided some insights. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Belgian, French and Dutch midwife on trial: A critical case study.

PubMed

Eggermont, Marlies

2015-05-01

to develop juridical recommendations in order to avoid midwifery medical liability when providing intrapartum care. case law of the past 40 years concerning midwifery medical negligence when assisting labour/delivery in a hospital was analysed. Databases used were Jura and Judit (Belgium), Legifrance, Juricaf and Dalloz (France) and Recht, Rechtspraak (The Netherlands). A minority of cases were retrieved through contacts with insurance companies (only Belgium), lawyers and courts. law suits in Belgium, France and The Netherlands. the 100 analysed cases could be categorised into four types. The judicial assessment was focused on three domains of expertise of the midwife. Most cases involved interpreting fetal monitoring (47%), followed by recognising a specific pathology (32%) and responding to a complication (12%). A fourth type of case concerned exceeding the boundaries of the legal competencies of the midwife (9%). not identifying fetal distress through fetal monitoring was the most common cause of midwifery liability (15/47), followed by not recognising the symptoms of a pathology (10/32), particularly placental abruption and uterine rupture. Also an inaccurate response to complications (3/12) and evidently exceeding the professional competencies involved midwifery liability. achieving cardiotocograph interpretation skills is the first and most important recommendation. In pathologic cases, the midwife should immediately refer to an obstetrician, without any hesitation. The third recommendation is working in a team with the obstetrician. If the midwife has reasonable (evidence-based) doubts about the practice of the obstetrician, she should insist on re-assessment with respect to the boundaries of her competencies. The fourth recommendation concerns practising with knowledge of the client׳s/patient׳s medical record and updating the record with performances and observations. Consciously choosing the type of medical intervention in urgent cases of pathology is the final recommendation. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Fourth branchial cleft deformity with skin orifice: a series of 10 cases].

PubMed

Huang, S L; Zhang, B; Chen, L S; Liang, L; Luo, X N; Lu, Z M; Zhang, S Y

2016-10-07

Objective: To report rare cases of congenital neck cutaneous sinus with an orifice near the sternoclavicular joint and to investigate their origins and managements. Methods: A total of ten patients with congenital neck cutaneous sinus having an orifice near the sternoclavicular joint treated in the Guangdong General Hospital from January 2010 to June 2015 were retrospectively analyzed. Results: There four boys and six girls, aging from 11 months to 96 months with an average of 33.4 months, and they had a common feature showing a congenital cutaneous sinus with an orifice near sternoclavicular joint. Discharge of pus from the orifice or abscess formation was commonly seen soon after infection. With bacteriological study, staphylococcus aureus was positive in five cases and klebsiella pneumonia in a case. Another orifice of fistula/sinus was not depicted in pyriform with barium swallow X-ray in five cases Ultrasound studies of three cases demonstrated anechoic (i.e., nearly black) and solid-cystic lesion near sternoclavicular joint with posterior acoustic enhancement. Magnetic resonance imaging (MRI) showed isointensity of the lesion on T1 and T2 weighted images with heterogeneous enhancement and a close relationship with sternoclavicular joint. All patients underwent laryngoscopic examination, which showed no orifice of sinus in pyriform at same side. Surgical resection of fistula/sinus was performed in all cases. The lengths of the fistula varied from 5 mm to 22 mm with an average of 11 mm. Postoperative pathological examination showed all specimens were accordance with fistula. No complications were noticed. Recurrence was not observed in the cases by following-up of 6 months to 70 months (median: 33 months). Conclusion: Congenital neck cutaneous sinus with orifice near the sternoclavicular joint maybe a special clinical phenotype of the fourth branchial cleft sinus with skin orifice in cervicothoracic junction. Differential diagnoses between low cervical diseases are required. The curative treatment is a complete excision during inflammatory quiescent period.

Flavor changing neutral currents involving heavy quarks with four generations

NASA Astrophysics Data System (ADS)

Arhrib, Abdesslam; Hou, Wei-Shu

2006-07-01

We study various flavor changing neutral currents (FCNC) involving heavy quarks in the Standard Model (SM) with a sequential fourth generation. After imposing B→Xsγ, B→Xsl+l- and Z→bbar b constraints, we find Script B(Z→sbar b+bar sb) can be enhanced by an order of magnitude to 10-7, while t→cZ,cH decays can reach 10-6, which are orders of magnitude higher than three generation SM. However, these rates are still not observable for the near future. With the era of Large Hadron Collider approaching, we focus on FCNC decays involving fourth generation b' and t' quarks. We calculate the rates for loop induced FCNC decays b'→bZ, bH, bg, bγ, as well as t'→tZ, tH, tg, tγ. If |Vcb'| is of order |Vcb| simeq 0.04, tree level b'→cW decay would dominate, posing a challenge since b-tagging is less effective. For |Vcb'| << |Vcb|, b'→tW would tend to dominate, while b'→t'W* could also open for heavier b', leading to the possibility of quadruple-W signals via b'bar b'→bbar bW+W-W+W-. The FCNC b'→bZ,bH decays could still dominate if mb' is just above 200 GeV. For the case of t', in general t'→bW would be dominant, hence it behaves like a heavy top. For both b' and t', except for the intriguing light b' case, FCNC decays are typically in the 10-4-10-2 range, and are quite detectable at the LHC. For a possible future International Linear Collider, we find the associated production of FCNC e+e-→bbar s, tbar c are below sensitivity, while e+e-→b'bar b and t'bar t can be better probed. Tevatron Run-II can still probe the lighter b' or t' scenario. LHC would either discover the fourth generation and measure the FCNC rates, or rule out the fourth generation conclusively. If discovered, the ILC can study the b' or t' decay modes in detail.

Importance of curvature evaluation scale for predictive simulations of dynamic gas-liquid interfaces

NASA Astrophysics Data System (ADS)

Owkes, Mark; Cauble, Eric; Senecal, Jacob; Currie, Robert A.

2018-07-01

The effect of the scale used to compute the interfacial curvature on the prediction of dynamic gas-liquid interfaces is investigated. A new interface curvature calculation methodology referred to herein as the Adjustable Curvature Evaluation Scale (ACES) is proposed. ACES leverages a weighted least squares regression to fit a polynomial through points computed on the volume-of-fluid representation of the gas-liquid interface. The interface curvature is evaluated from this polynomial. Varying the least squares weight with distance from the location where the curvature is being computed, adjusts the scale the curvature is evaluated on. ACES is verified using canonical static test cases and compared against second- and fourth-order height function methods. Simulations of dynamic interfaces, including a standing wave and oscillating droplet, are performed to assess the impact of the curvature evaluation scale for predicting interface motions. ACES and the height function methods are combined with two different unsplit geometric volume-of-fluid (VoF) schemes that define the interface on meshes with different levels of refinement. We find that the results depend significantly on curvature evaluation scale. Particularly, the ACES scheme with a properly chosen weight function is accurate, but fails when the scale is too small or large. Surprisingly, the second-order height function method is more accurate than the fourth-order variant for the dynamic tests even though the fourth-order method performs better for static interfaces. Comparing the curvature evaluation scale of the second- and fourth-order height function methods, we find the second-order method is closer to the optimum scale identified with ACES. This result suggests that the curvature scale is driving the accuracy of the dynamics. This work highlights the importance of studying numerical methods with realistic (dynamic) test cases and that the interactions of the various discretizations is as important as the accuracy of one part of the discretization.

Symmetries and integrability of a fourth-order Euler-Bernoulli beam equation

NASA Astrophysics Data System (ADS)

Bokhari, Ashfaque H.; Mahomed, F. M.; Zaman, F. D.

2010-05-01

The complete symmetry group classification of the fourth-order Euler-Bernoulli ordinary differential equation, where the elastic modulus and the area moment of inertia are constants and the applied load is a function of the normal displacement, is obtained. We perform the Lie and Noether symmetry analysis of this problem. In the Lie analysis, the principal Lie algebra which is one dimensional extends in four cases, viz. the linear, exponential, general power law, and a negative fractional power law. It is further shown that two cases arise in the Noether classification with respect to the standard Lagrangian. That is, the linear case for which the Noether algebra dimension is one less than the Lie algebra dimension as well as the negative fractional power law. In the latter case the Noether algebra is three dimensional and is isomorphic to the Lie algebra which is sl(2,R). This exceptional case, although admitting the nonsolvable algebra sl(2,R), remarkably allows for a two-parameter family of exact solutions via the Noether integrals. The Lie reduction gives a second-order ordinary differential equation which has nonlocal symmetry.

The Attitudinal and Cognitive Effects of Planetarium Integration in Teaching Selected Astronomical Concepts to Fourth, Fifth, and Sixth-Grade Students

NASA Astrophysics Data System (ADS)

Twiest, Mark Gilbert

The purpose of this study was to investigate the attitudinal and cognitive differences among students in an astronomy curriculum which utilizes a planetarium in comparison to an astronomy curriculum which is presented solely in the classroom. The specific attitudes of interest in this study are those student attitudes toward science as a whole and toward astronomy in particular. Researcher developed attitude and astronomy achievement measures were developed and administered to 423 fourth, fifth, and sixth grade students in three schools. Pre and post test data were collected from students in this quasi-experimental design. Two way analysis of covariance techniques were used to analyze the independent variables of gender and treatment. Results revealed significant differences (p < .05) in student attitudes toward astronomy in the fourth grade favoring the control school students. No other significant differences in student attitudes were found with respect to treatment or gender. Achievement was analyzed at both the knowledge and comprehension levels. Significant differences (p <.05) in student achievement were found fourth and fifth grades with respect to knowledge level questions. In both instances these differences favored the control school setting. Significant differences (p <.05) in student achievement were found for comprehension level questions at every grade level. In this case the control school outperformed the experimental setting in the fourth and sixth grades. Fifth grade experimental setting students had significantly higher achievement on comprehension level questions. A significant interaction occurred between treatment and gender with respect to student attitudes toward astronomy in the fifth grade. A second significant interaction occurred between treatment and gender for knowledge level questions for sixth grade students. No other significant interactions were found between treatment and gender. Correlations between post test attitudes and achievement were also calculated for each grade level in both the control and experimental settings. Correlations remained below.2 in every instance except one. Post test correlations between attitudes overall and achievement in the control school's sixth grade were.54.

Making Sense of "The Boy Who Died": Tales of a Struggling Successful Writer

ERIC Educational Resources Information Center

Dutro, Elizabeth; Kazemi, Elham; Balf, Ruth

2006-01-01

This article presents a case study of a fourth grade boy's experiences in writing, preceding and following a story he wrote about a boy whose struggles in writing led directly to his death. We explore how Max's writing experiences related to his identity, specifically his sense of himself as a writer, his struggle to communicate his ideas, and his…

Reduction of smoking in Dutch adolescents over the past decade and its health gains: a repeated cross-sectional study.

PubMed

Gielkens-Sijstermans, Cindy M; Mommers, Monique A; Hoogenveen, Rudolf T; Feenstra, Talitha L; de Vreede, Jacqueline; Bovens, Fons M; van Schayck, Onno C

2010-04-01

Smoking is the main preventable lifestyle-related risk factor threatening human health. In this study, time trends in smoking behaviour between 1996 and 2005 among adolescents enrolled in secondary school were assessed. In 1996, 2001 and 2005, a survey was conducted in the south-eastern region of the Netherlands. All students in second and fourth year of secondary education (1996: n = 20 000; 2001: n = 27 500; 2005: n = 24 000) were asked to complete a questionnaire about their smoking behaviour. A simulation model was used to estimate lifetime health gains related to the observed trends. In 1996, 2001 and 2005, the number of questionnaires analysed were 13 554 (68%), 20 767 (76%) and 17 896 (75%), respectively. The results show a decrease in 'ever smoking' as well as 'current smoking' between 1996 and 2005. Among second year high school students, current smoking prevalence decreased from 22.2% in 1996 to 8.0% in 2005 (P(trend) < 0.001). Among fourth year students, current smoking declined from 37.5% in 1996 to 22.0% in 2005 (P(trend) < 0.001). Time trends were not influenced by gender or educational level. Model projections show that if these students not take up smoking later in life, 11 500 new cases of COPD, 3400 new cases of lung cancer and 1800 new cases of myocardial infarction could be prevented for the Dutch 13-year-olds. This study found that, in the past decade, smoking prevalence among adolescents has declined by almost 50%, potentially resulting in a considerable reduction in new cases of COPD or lung cancer.

Impact of hospitalizations for bronchiolitis in preterm infants on long-term health care costs in Italy: a retrospective case-control study.

PubMed

Roggeri, Daniela Paola; Roggeri, Alessandro; Rossi, Elisa; Cataudella, Salvatore; Martini, Nello

2016-01-01

Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy, based on administrative database analysis. The aim of this study was to evaluate differences in health care costs of preterm infants with and without early hospitalization for bronchiolitis. Preterm infants born in the period between January 1, 2009 and December 31, 2010 and hospitalized for bronchiolitis in the first year of life were selected from the ARNO Observatory database and observed for the first 4 years of life. These preterm infants were compared (paired 1-3) with preterm infants who were not hospitalized for bronchiolitis in the first year of life and with similar characteristics. Only direct health care costs reimbursed by the Italian National Health Service were considered for this study (drugs, hospitalizations, and diagnostic/therapeutic procedures). Of 40,823 newborns in the accrual period, 863 were preterm with no evidence of prophylaxis, and 22 preterm infants were hospitalized for bronchiolitis (cases) and paired with 62 controls. Overall, cases had 74% higher average cost per infant in the first 4 years of life than controls (18,624€ versus 10,189€, respectively). The major cost drivers were hospitalizations, accounting for >90% in both the populations. The increase in total yearly health care cost between cases and controls remained substantial even in the fourth year of life for all cost items. A relevant increase in hospitalizations and drug consumption linked to respiratory tract diseases was noted in infants hospitalized for bronchiolitis during the entire follow-up period. Preterm infants hospitalized for bronchiolitis in the first year of life were associated with increased resource consumption and costs throughout the entire period of observation; even in the fourth year, the difference versus paired controls was relevant.

Autoerotic deaths: four cases.

PubMed

Cooke, C T; Cadden, G A; Margolius, K A

1994-07-01

We describe the circumstances and post mortem medical findings of 4 unusual fatalities where death occurred during autoerotic practice. Three cases occurred in young to middle-aged men--hanging, electrocution and inhalation of a zucchini. The manner of death in each was accidental. The fourth case was an elderly man who died of ischemic heart disease, apparently whilst masturbating with a vacuum cleaner and a hair dryer.

Improved fourth-year medical student clinical decision-making performance as a resuscitation team leader after a simulation-based curriculum.

PubMed

Ten Eyck, Raymond P; Tews, Matthew; Ballester, John M; Hamilton, Glenn C

2010-06-01

To determine the impact of simulation-based instruction on student performance in the role of emergency department resuscitation team leader. A randomized, single-blinded, controlled study using an intention to treat analysis. Eighty-three fourth-year medical students enrolled in an emergency medicine clerkship were randomly allocated to two groups differing only by instructional format. Each student individually completed an initial simulation case, followed by a standardized curriculum of eight cases in either group simulation or case-based group discussion format before a second individual simulation case. A remote coinvestigator measured eight objective performance end points using digital recordings of all individual simulation cases. McNemar chi2, Pearson correlation, repeated measures multivariate analysis of variance, and follow-up analysis of variance were used for statistical evaluation. Sixty-eight students (82%) completed both initial and follow-up individual simulations. Eight students were lost from the simulation group and seven from the discussion group. The mean postintervention case performance was significantly better for the students allocated to simulation instruction compared with the group discussion students for four outcomes including a decrease in mean time to (1) order an intravenous line; (2) initiate cardiac monitoring; (3) order initial laboratory tests; and (4) initiate blood pressure monitoring. Paired comparisons of each student's initial and follow-up simulations demonstrated significant improvement in the same four areas, in mean time to order an abdominal radiograph and in obtaining an allergy history. A single simulation-based teaching session significantly improved student performance as a team leader. Additional simulation sessions provided further improvement compared with instruction provided in case-based group discussion format.

Green tea extract as a local drug therapy on periodontitis patients with diabetes mellitus: A randomized case-control study.

PubMed

Gadagi, Jayaprakash S; Chava, Vijay K; Reddy, Venkata Ramesh

2013-03-01

The green tea extract is a naturally occurring product having beneficial effects that counteract with the pathobiological features of periodontitis and diabetes mellitus. Hence, the present study was aimed at incorporation of green tea extract into hydroxylpropyl methylcellulose and investigates its efficacy in chronic periodontitis patients associated with and without diabetes mellitus. For the in vitro study, formulation of green tea strips and placebo strips, and analysis of drug release pattern from the green tea strips at different time intervals were performed. For the in vivo study, 50 patients (20-65 years), including 25 systemically healthy patients with chronic periodontitis (group 1) and 25 diabetic patients with chronic periodontitis (group 2) were enrolled. In each patient, test and control sites were identified for the placement of green tea and placebo strips, respectively. Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) were examined at baseline, first, second, third, and fourth weeks. Microbiological analysis for Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans was performed at baseline and fourth week. The in vitro study showed 10.67% green tea release at 30 min; thereafter, a slow release was noted till 120 min. Both groups showed significant reduction in GI scores at the test sites. Group 1 showed significant (P < 0.001) PPD reduction at different time intervals at the test sites. However, group 2 showed significant reduction from baseline (5.30 ± 0.70) to fourth week (3.5 ± 0.97). Statistically significant gain in CAL at the test sites was observed both in group 1 (1.33 mm) and group 2 (1.43 mm). The prevalence of P. gingivalis in group 1 test sites was significantly reduced from baseline (75%) to fourth week (25%). Local drug delivery using green tea extract could be used as an adjunct in the treatment of chronic periodontitis in diabetic and non-diabetic individuals.

Computer simulation results for bounds on the effective conductivity of composite media

NASA Astrophysics Data System (ADS)

Smith, P. A.; Torquato, S.

1989-02-01

This paper studies the determination of third- and fourth-order bounds on the effective conductivity σe of a composite material composed of aligned, infinitely long, identical, partially penetrable, circular cylinders of conductivity σ2 randomly distributed throughout a matrix of conductivity σ1. Both bounds involve the microstructural parameter ζ2 which is a multifold integral that depends upon S3, the three-point probability function of the composite. This key integral ζ2 is computed (for the possible range of cylinder volume fraction φ2) using a Monte Carlo simulation technique for the penetrable-concentric-shell model in which cylinders are distributed with an arbitrary degree of impenetrability λ, 0≤λ≤1. Results for the limiting cases λ=0 (``fully penetrable'' or randomly centered cylinders) and λ=1 (``totally impenetrable'' cylinders) compare very favorably with theoretical predictions made by Torquato and Beasley [Int. J. Eng. Sci. 24, 415 (1986)] and by Torquato and Lado [Proc. R. Soc. London Ser. A 417, 59 (1988)], respectively. Results are also reported for intermediate values of λ: cases which heretofore have not been examined. For a wide range of α=σ2/σ1 (conductivity ratio) and φ2, the third-order bounds on σe significantly improve upon second-order bounds which just depend upon φ2. The fourth-order bounds are, in turn, narrower than the third-order bounds. Moreover, when the cylinders are highly conducting (α≫1), the fourth-order lower bound provides an excellent estimate of the effective conductivity for a wide range of volume fractions.

Neuro-endoscopic management of intraventricular neurocysticercosis (NCC).

PubMed

Husain, M; Jha, D K; Rastogi, M; Husain, N; Gupta, R K

2007-01-01

Various approaches including endoscopy have been used for the treatment of intraventricular and cisternal NCC. We present our technique of Neuro-endoscopic management of intraventricular NCC. Twenty-one cases, 13 females and 8 males (age range 12-50 years; mean, 25.7 years), of intraventricular NCC [lateral (n = 6), third (n = 6), fourth (n = 10) ventricles including a patient with both lateral and third ventricular cysts] producing obstructive hydrocephalus formed the group of study. Gaab Universal Endoscope System along with 4 mm 0 degrees and 30 degrees rigid telescopes were used through a frontal burr-hole for removal of intraventricular including intra-fourth ventricular (n = 10) NCC. Endoscopic third ventriculostomy (ETV) was done for internal cerebrospinal fluid (CSF) diversion. Average follow up was 18 months. Complete (n = 18) or partial (n = 2) removal of NCC was done in 20 patients, while a cyst located at foramen of Monro slipped and migrated to occipital or temporal horn in 1 patient. Thirty-degree 4-mm rigid telescope provided excellent image quality with ability to address even intra-fourth ventricular NCC through the dilated aqueduct using a curved tip catheter. No patient required further surgery for their hydrocephalus. There was no operative complication and post-operative ventriculitis was not seen in any case despite partial removal of NCC. Neuro-endoscopic surgery is an effective treatment modality for patients with intraventricular NCC. It effectively restores CSF flow and is capable of removing cysts completely or partially from accessible locations causing mass effect. Partial removal or rupture of the cyst does not affect the clinical outcome of the patients.

Please, Don't Go! We've Only Just Begun: Voices of Non-Tenured Teachers in a Deprofessionalizing Career

ERIC Educational Resources Information Center

Gold, Jason H.

2016-01-01

This qualitative case study entails the voices of seven participants who are currently teaching in an elementary school setting (K-5), and an additional two participants, one who left student teaching prior to completion of her collegiate program and one who was released at the end of her fourth year of teaching. Albert Bandura's (1977)…

Proceedings of the Conference of the International Group for the Psychology of Mathematics Education (PME 20) (20th, Valencia, Spain, July 8-12, 1996). Volume 4.

ERIC Educational Resources Information Center

Puig, Luis, Ed.; Gutierrez, Angel, Ed.

The fourth volume of this proceedings contains full research articles. Papers include: (1) "Conceptual and procedural approaches to problem-solving" (Y. Mohammad-Yusof and D. Tall); (2)"Teaching differential equations to chemistry and biology students: An overview on methodology of qualitative research. A case study" (M. Moreno and C. Azcarate);…

Welded Titanium Case for Space-Probe Rocket Motor

NASA Technical Reports Server (NTRS)

Brothers, A. J.; Boundy, R. A.; Martens, H. E.; Jaffe, L. D.

1959-01-01

Early in 1958, the Jet Propulsion Laboratory of the California Institute of Technology was requested to participate in a lunar-probe mission code-named Juno II which would place a 15-lb Instrumented payload (Pioneer IV) in the vicinity of the moon. The vehicle was to use the same high-speed upper-stage assembly as flown on the successful Jupiter-C configuration; however, the first-stage booster was to be a Jupiter rather than a Redstone. An analysis of the intended flight and payload configuration Indicated that the feasibility of accomplishing the mission was questionable and that additional performance would have to be obtained if the mission was to be feasible. Since the most efficient way of Increasing the performance of a staged vehicle is to increase the performance of the last stage, a study of possible ways of doing this was made.. Because of the time schedule placed on this effort It was decided to reduce the weight of the fourth-stage rocket-motor case by substituting the annealed 6Al--4V titanium alloy for the Type 410 stainless steel. Although this introduced an unfamiliar material, It reduced the changes in design and fabrication techniques. This particular titanium alloy was chosen on the basis of previous tests which proved the suitability of the alloy as a pressure-vessel material when used at an annealed yield strength of about 120, 000 psi. The titanium-case fourth stage of Juno U is shown with the payload and on the missile in Fig. 1; the stainless-steel motor cases used in the Jupiter-C vehicle are shown in Fig. 2. The fourth-stage motor case has a diameter of 6 in., a length of approximately 38 in. center dot and a nominal cylindrical wall thickness of 0.025 in. As shown in Fig. 1, the case serves as the structural support of the payload and is aligned to the upper stage assembly through an alignment ring. The nozzle is threaded into the end of the motor case, and is of the ceramic-coated steel design. Figure 3 shows a comparison of the components used to make the stainless steel and the 6A1--4V titanium alloy cases. The forward dome and aft fitting for the stainless steel assembly were fabricated from a combination of forged, spun and machined parts.. In order to facilitate the fabrication of the titanium alloy motor ) these components were machined from a large-diameter billet.

Consensus training: an effective tool to minimize variations in periodontal diagnosis and treatment planning among dental faculty and students.

PubMed

John, Vanchit; Lee, Seung-Jun; Prakasam, Sivaraman; Eckert, George J; Maupome, Gerardo

2013-08-01

Considerable disagreements and variations exist in diagnosis and treatment planning of periodontal disease. Achieving high interrater periodontal diagnosis can prove challenging. The objectives of this study were to measure variations in periodontal diagnosis and treatment planning among predoctoral periodontics faculty members after consensus training and to compare such variation with those identified in third- and fourth-year dental students. Nine electronically stored case vignettes and survey instruments were made available to eighteen faculty members and twenty dental students under standardized conditions. A chi-square test was used to compare responses between groups, and multirater kappa tests were used to evaluate interrater agreement/reliability. Of the nine cases, only one differed between groups significantly in terms of treatment. Also, third-year students differed from fourth-year students on the diagnosis of aggressive periodontitis versus chronic periodontitis. Most respondents were able to distinguish clearly among diagnoses of chronic periodontitis, aggressive periodontitis, and gingivitis. This study established a baseline assessment of the current status of consensus after training. We will reassess variations after addressing the specific challenges identified. Programs designed and implemented to help decrease the variation in periodontal diagnosis and treatment planning among faculty members may ultimately translate into better agreement and better standardization of dental instruction.

Risk factors for the breakdown of perineal laceration repair after vaginal delivery.

PubMed

Williams, Meredith K; Chames, Mark C

2006-09-01

The purpose of this study was to identify risk factors that are associated with the breakdown of perineal laceration repair in the postpartum period. We conducted a retrospective, case-control study to review perineal laceration repair breakdown in patients who were delivered between September 1995 and February 2005 at the University of Michigan. Bivariate analysis with chi-square test and t-test and stepwise logistic regression analysis were performed. Fifty-nine cases and 118 control deliveries were identified from a total of 14,124 vaginal deliveries. Risk factors were longer second stage of labor (142 vs 87 minutes; P = .001), operative vaginal delivery (odds ratio, 3.6; 95% CI, 1.8-7.3), mediolateral episiotomy (odds ratio, 6.9; 95% CI, 2.6-18.7), third- or fourth-degree laceration (odds ratio, 3.1; 95% CI, 1.5-6.4), and meconium-stained amniotic fluid (odds ratio, 3.0; 95% CI, 1.1-7.9). Previous vaginal delivery was protective (odds ratio, 0.38; 95% CI, 0.18-0.84). Logistic regression showed the most significant factor to be an interaction between operative vaginal delivery and mediolateral episiotomy (odd ratio, 6.36; 95% CI, 2.18-18.57). The most significant events were mediolateral episiotomy, especially in conjunction with operative vaginal delivery, third- and fourth-degree lacerations, and meconium.

[Teratoma and medulloblastoma of the cerebellum: a case].

PubMed

Boudawara, T; Boudawara, M Z; Sellami, M H; Ben Mansour, H; Jlidi, R

1999-01-01

The majority of intracranial teratoma are localized in pineal and sellar regions. In cerebellum, the teratoma is quite rare, the association with medulloblastoma is exceptional and was differentiated from medullomyoblastoma. We report one case of 5 years old boy with intracranial hypertension for 3 months. The cerebral computed tomography showed a tumor in the fourth ventricle. The histologic study of surgical specimens found a proliferation of component of medulloblastoma adjacent to mature teratoma with smooth and striated muscles, chondroid component, adipose tissue and epithelial elements. Our objective is to discuss the diagnosis, the hitogenesis and the prognosis of this tumor.

Time-stable boundary conditions for finite-difference schemes solving hyperbolic systems: Methodology and application to high-order compact schemes

NASA Technical Reports Server (NTRS)

Carpenter, Mark H.; Gottlieb, David; Abarbanel, Saul

1993-01-01

We present a systematic method for constructing boundary conditions (numerical and physical) of the required accuracy, for compact (Pade-like) high-order finite-difference schemes for hyperbolic systems. First, a roper summation-by-parts formula is found for the approximate derivative. A 'simultaneous approximation term' (SAT) is then introduced to treat the boundary conditions. This procedure leads to time-stable schemes even in the system case. An explicit construction of the fourth-order compact case is given. Numerical studies are presented to verify the efficacy of the approach.

Birth order and risk of hepatocellular carcinoma in chronic carriers of hepatitis B virus: a case-control study in The Gambia.

PubMed

Shimakawa, Yusuke; Lemoine, Maud; Bottomley, Christian; Njai, Harr Freeya; Ndow, Gibril; Jatta, Abdoulie; Tamba, Saydiba; Bojang, Lamin; Taal, Makie; Nyan, Ousman; D'Alessandro, Umberto; Njie, Ramou; Thursz, Mark; Hall, Andrew J

2015-10-01

Early age at infection with Hepatitis B virus (HBV) increases the risk of chronic infection. Moreover, early HBV infection may further independently increase the risk of hepatocellular carcinoma (HCC) beyond its effect on chronicity. The distribution of birth order, a proxy for mode and timing of HBV transmission, was compared in The Gambia between hepatitis B surface antigen (HBsAg)-positive HCC cases recruited from hospitals (n = 72) and two HBsAg-positive control groups without HCC: population-based controls from a community HBV screening (n = 392) and hospital-based controls (n = 63). HCC risk decreased with increasing birth order in the population-based case-control analysis. Using first birth order as the reference, the odds ratios were 0.52 (95% CI: 0.20-1.36), 0.52 (0.17-1.56), 0.57 (0.16-2.05) and 0.14 (0.03-0.64) for second, third, fourth and greater than fourth birth order respectively (P = 0.01). A similar inverse association was observed in the hospital-based case-control comparison (P = 0.04). Compared to controls, HCC cases had earlier birth order, a proxy for young maternal age and maternal HBV viraemia at birth. This finding suggests that in chronic HBV carriers perinatal mother-to-infant transmission may increase HCC risk more than horizontal transmission. Providing HBV vaccine within 24 h of birth to interrupt perinatal transmission might reduce the incidence of HCC in The Gambia. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Second Mesiobuccal Canal Treatment in a Predoctoral Dental Clinic: A Retrospective Clinical Study.

PubMed

Coelho, Marcelo Santos; Parker, Jeffrey M; Tawil, Peter Z

2016-06-01

The aim of this retrospective clinical study was to evaluate the location and treatment of second canals in mesiobuccal roots (MB2) of first and second maxillary molars in a predoctoral endodontic clinic by the graduating classes of 2008 to 2015. These results were compared to similar clinical studies. Included in the study were 368 root canal treatments performed by 310 third- and fourth-year dental students at one U.S. dental school. All cases were done under faculty supervision, and the students were instructed to use dental loupe magnification. Students' evaluation sheets were used to deteremine the total MB2 canals treated in first and second maxillary molars. The results showed that, overall, 72.55% of the teeth had an MB2 canal treated. The frequency was higher in first molars (75.91%) than in second molars (56.92%) (p<0.05). Third-year students were able to detect 39 MB2 canals in 57 maxillary molars (68.42%), while fourth-year students detected 228 MB2 canals in 311 teeth (73.31%) (p>0.05). Under proper supervision by experienced endodontists, these dental students were capable of treating MB2 canals in maxillary molars. The frequency of MB2 canals located and treated by dental students with the assistance of experienced professionals was higher in first than in second molars. No significant difference was found between third- and fourth-year students. The incidence of MB2 canals located and treated in this study was found to be similar to that in other clinical studies.

Expertise in Auditing: Case Representation Differences between Economy Students, Novice, Intermediate and Expert Auditors.

ERIC Educational Resources Information Center

Vaatstra, Rina F.; And Others

Medical expertise research methods were used to explore the relationship between auditing expertise and case representation. Subjects were 8 first-year economy students, 8 fourth-year auditing students, 8 postgraduate students in auditing, and 8 experienced auditors in the Netherlands, ranging in experience from only a limited knowledge of…

Violence and School Safety. Case Citations, 2002.

ERIC Educational Resources Information Center

Russo, Charles J., Ed.; Mawdsley, Ralph D., Ed.

This publication highlights and explains some 400 court cases from 2002 involving issues of school violence and safety. It is divided into four sections, or topics: (1) "The Fourth Amendment: Search and Seizure" (R. Mawdsley); (2) "Negligence" (W. Evans, Jr.); (3) "Assault on School Personnel" (M. Yates); and (4) "Drugs and Weapons in Schools" (M.…

Influence Factors Regarding the Effectiveness of Automated Ballistic Comparison on 0.38 Special Caliber Bullets and Cartridge Cases.

PubMed

Dos Santos, Lehi Sudy; Vieira Muterlle, Palloma

2018-03-01

Factors influencing effectiveness of automated comparisons, test-fired bullets, and cartridge cases from 0.38 Special revolvers were logged into the Evofinder ® Ballistic ID System. Tests were performed as follows: First test correlated test-fires of the same type, second test compared different types of ammunition components, third test replicated the second test in a larger database, and fourth test replicated the third test with students having no previous firearm identification experience. System effectiveness with projectiles in the first test was 0.89. With cartridge cases, effectiveness was 0.79 with combined results, but analysis of separate results by breech face and firing pin revealed low effectiveness by breech face (0.40). In the second, third, and fourth tests, effectiveness with projectiles were 0.61, 0.51, and 0.44. In addition, these tests had effectiveness with cartridge cases equivalent to 0.55, 0.43, and 0.44. Results are useful to establish routine protocols, system improvements, or comparative assessment of other electronic systems. © 2018 American Academy of Forensic Sciences.

Electroencephalography in ellipsoidal geometry with fourth-order harmonics.

PubMed

Alcocer-Sosa, M; Gutierrez, D

2016-08-01

We present a solution to the electroencephalographs (EEG) forward problem of computing the scalp electric potentials for the case when the head's geometry is modeled using a four-shell ellipsoidal geometry and the brain sources with an equivalent current dipole (ECD). The proposed solution includes terms up to the fourth-order ellipsoidal harmonics and we compare this new approximation against those that only considered up to second- and third-order harmonics. Our comparisons use as reference a solution in which a tessellated volume approximates the head and the forward problem is solved through the boundary element method (BEM). We also assess the solution to the inverse problem of estimating the magnitude of an ECD through different harmonic approximations. Our results show that the fourth-order solution provides a better estimate of the ECD in comparison to lesser order ones.

[Application of role-play simulation in pre-clinical practice of the fourth grade students in department of endodontics].

PubMed

Zhu, Lin-lin; Qiu, Li-hong; Qu, Liu; Xue, Ming; Yan, Lu

2014-10-01

To apply role- play simulation in pre-clinical practice of the fourth grade students in department of endodontics. Thirty-two students were randomly divided into 2 groups, there were 16 students in each group. Students in one group were taught with role-play simulation while the other group with lecture-based learning method. The teaching effect was measured with examination and questionnaire survey. The data was analyzed by using SPSS 17.0 software package. There were no significant differences in basic knowledge, case analysis and oral examination between 2 groups (P>0.05), but there was significant difference in history taking and medical records writing, practical examination and total scores between 2 groups (P<0.05). The role-play simulation was generally approved by both teachers and students in experimental group. The abilities of the fourth grade students can be developed by role-play simulation in different aspects. Role-play simulation can be applied in pre-clinical practice of the fourth grade students in department of endodontics.

Dietary intake of choline and neural tube defects in Mexican Americans.

PubMed

Lavery, Amy M; Brender, Jean D; Zhao, Hongwei; Sweeney, Anne; Felkner, Marilyn; Suarez, Lucina; Canfield, Mark A

2014-06-01

Low maternal intake of dietary choline and betaine (a choline derivative) has recently been investigated as a possible risk factor for neural tube defects (NTDs). This case-control study examined the NTD risk associated with choline and betaine in 409 Mexican-American women who gave birth during 1995 to 2000 in the 14-county border region of Texas. Using data from the food frequency questionnaire and the lowest quartiles of intake as the reference categories, a protective association was suggested between higher intakes of choline and betaine and NTD risk although the 95% confidence intervals for all risk estimates included 1.0. For choline intake in the second, third, and fourth quartiles, adjusted odds ratios were 1.2, 0.80, and 0.89, respectively. Betaine appeared more protective with odds ratios of 0.62, 0.73, and 0.61, respectively, for the second, third, and fourth quartiles of intake. Study findings suggest that dietary betaine may help to prevent NTDs. © 2014 Wiley Periodicals, Inc.

New daily persistent headache: clinical and serological characteristics in a retrospective study.

PubMed

Meineri, P; Torre, E; Rota, E; Grasso, E

2004-10-01

We present a retrospective clinical study of 18 cases of new daily persistent headache (NDPH), a rare chronic headache, included in the fourth chapter of the II IHS classification; the pathophysiology of NDPH is unknown but a link with viral infections (especially Epstein-Barr virus (EBV)) has been suggested. Comparing our series with the other two published until now, we did not find any particular difference, as regards to clinical aspects. However, our laboratory tests show a recent herpes simplex virus infection in 42% and cytomegalovirus in 11% of cases; moreover we could not find any EBV infection. Our data suggest that viruses other than EBV can play a role in NDPH.

A two-step, fourth-order method with energy preserving properties

NASA Astrophysics Data System (ADS)

Brugnano, Luigi; Iavernaro, Felice; Trigiante, Donato

2012-09-01

We introduce a family of fourth-order two-step methods that preserve the energy function of canonical polynomial Hamiltonian systems. As is the case with linear mutistep and one-leg methods, a prerogative of the new formulae is that the associated nonlinear systems to be solved at each step of the integration procedure have the very same dimension of the underlying continuous problem. The key tools in the new methods are the line integral associated with a conservative vector field (such as the one defined by a Hamiltonian dynamical system) and its discretization obtained by the aid of a quadrature formula. Energy conservation is equivalent to the requirement that the quadrature is exact, which turns out to be always the case in the event that the Hamiltonian function is a polynomial and the degree of precision of the quadrature formula is high enough. The non-polynomial case is also discussed and a number of test problems are finally presented in order to compare the behavior of the new methods to the theoretical results.

Periodic orbits in the restricted four-body problem with two equal masses

NASA Astrophysics Data System (ADS)

Burgos-García, Jaime; Delgado, Joaquín

2013-06-01

The restricted (equilateral) four-body problem consists of three bodies of masses m 1, m 2 and m 3 (called primaries) lying in a Lagrangian configuration of the three-body problem i.e., they remain fixed at the apices of an equilateral triangle in a rotating coordinate system. A massless fourth body moves under the Newtonian gravitation law due to the three primaries; as in the restricted three-body problem (R3BP), the fourth mass does not affect the motion of the three primaries. In this paper we explore symmetric periodic orbits of the restricted four-body problem (R4BP) for the case of two equal masses where they satisfy approximately the Routh's critical value. We will classify them in nine families of periodic orbits. We offer an exhaustive study of each family and the stability of each of them.

Solvability of a fourth-order boundary value problem with periodic boundary conditions II

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

Gupta, Chaitan P.

1991-01-01

Lemore » t f : [ 0 , 1 ] × R 4 → R be a function satisfying Caratheodory's conditions and e ( x ) ∈ L 1 [ 0 , 1 ] . This paper is concerned with the solvability of the fourth-order fully quasilinear boundary value problem d 4 u d x 4 + f ( x , u ( x ) , u ′ ( x ) , u ″ ( x ) , u ‴ ( x ) ) = e ( x ) ,    0 < x < 1 , with u ( 0 ) − u ( 1 ) = u ′ ( 0 ) − u ′ ( 1 ) = u ″ ( 0 ) - u ″ ( 1 ) = u ‴ ( 0 ) - u ‴ ( 1 ) = 0 . This problem was studied earlier by the author in the special case when f was of the form f ( x , u ( x ) ) , i.e., independent of u ′ ( x ) , u ″ ( x ) , u ‴ ( x ) . It turns out that the earlier methods do not apply in this general case. The conditions need to be related to both of the linear eigenvalue problems d 4 u d x 4 = λ 4 u and d 4 u d x 4 = − λ 2 d 2 u d x 2 with periodic boundary conditions.« less

Radiographic Evaluation of Root Canal Fillings Accomplished by Undergraduate Dental Students

PubMed Central

Yavari, Hamidreza; Samiei, Mohammad; Shahi, Shahriar; Borna, Zahra; Abdollahi, Amir Ardalan; Ghiasvand, Negar; Shariati, Gholamreza

2015-01-01

Introduction: The purpose of this study was to evaluate the radiographic quality of root canal fillings by fourth-, fifth-, and sixth-year undergraduate students at Tabriz Faculty of Dentistry between 2006 and 2012. Methods and Materials: A total of 1183 root canal fillings in 620 teeth were evaluated by two investigators (and in case of disagreement by a third investigator) regarding the presence or absence of under-fillings, over-fillings and perforations. For each tooth, preoperative, working and postoperative radiographs were checked. The Pearson’s chi-square test was used for statistical evaluation of the data. Inter-examiner agreement was measured by Cohen’s kappa (k) values. The level of significance was set at 0.05. Results: Total frequencies of over-filling, under-filling and perforation were 5.6%, 20.4% and 1.9%, respectively. There were significant differences between frequencies of over- and under-fillings (P<0.05). Unacceptable quality, under- and over-fillings were detected in 27.9% of 1183 evaluated canals. Conclusion: The technical quality of root canal therapies performed by undergraduate dental students using step-back preparation and lateral compaction techniques was unacceptable in almost one-fourth of the cases. PMID:25834598

ASRM Case Insulation development

NASA Technical Reports Server (NTRS)

Tam, W. F. S.; Bell, M.

1993-01-01

The ASRM Case Insulation Program used design of experiments to develop a high performance case insulation. The program traded-off more than thirty properties in areas of ablation performance, material properties, processibility, bonding/aging. Kevlar pulp was found to be the most significant factor. The low-molecular weight ethylene propylene diene monomer, EPDM was the second most significant factor. The curative was the third most significant factor. The tackifier was the fourth most significant factor. The stripwinding process for applying the insulation onto the case inner surfaces was also studied. The parameters selected for experiment were extruder speed, upper roller temperature and extruder nozzle temperature. The extrudability results showed that non-Kevlar filled formulations displayed optimum edges but poor thickness continuity. High Kevlar filled formulations displayed optimum thickness continuity but poor strip edge ratings.

ASRM Case Insulation development

NASA Astrophysics Data System (ADS)

Tam, W. F. S.; Bell, M.

1993-06-01

The ASRM Case Insulation Program used design of experiments to develop a high performance case insulation. The program traded-off more than thirty properties in areas of ablation performance, material properties, processibility, bonding/aging. Kevlar pulp was found to be the most significant factor. The low-molecular weight ethylene propylene diene monomer, EPDM was the second most significant factor. The curative was the third most significant factor. The tackifier was the fourth most significant factor. The stripwinding process for applying the insulation onto the case inner surfaces was also studied. The parameters selected for experiment were extruder speed, upper roller temperature and extruder nozzle temperature. The extrudability results showed that non-Kevlar filled formulations displayed optimum edges but poor thickness continuity. High Kevlar filled formulations displayed optimum thickness continuity but poor strip edge ratings.

The Correlation between the Fourth Grade Students' Level of Functional Literacy and Metacognitive Awareness

ERIC Educational Resources Information Center

Özenç, Emine Gül; Dikici, Hidayet

2016-01-01

The present study aims at presenting the relationship between the fourth grade primary school students' level of functional literacy and metacognitive awareness. The study group of the research is made up of 406 fourth grade students attending school during 2015-2016 academic year in Nigde. This study adopts survey model and its data collection…

Side-specific effect of yolk testosterone elevation on second-to-fourth digit ratio in a wild passerine

NASA Astrophysics Data System (ADS)

Nagy, Gergely; Blázi, György; Hegyi, Gergely; Török, János

2016-02-01

Second-to-fourth digit ratio is a widely investigated sexually dimorphic morphological trait in human studies and could reliably indicate the prenatal steroid environment. Conducting manipulative experiments to test this hypothesis comes up against ethical limits in humans. However, oviparous tetrapods may be excellent models to experimentally investigate the effects of prenatal steroids on offspring second-to-fourth digit ratio. In this field study, we injected collared flycatcher ( Ficedula albicollis) eggs with physiological doses of testosterone. Fledglings from eggs with elevated yolk testosterone, regardless of their sex, had longer second digits on their left feet than controls, while the fourth digit did not differ between groups. Therefore, second-to-fourth digit ratio was higher in the testosterone-injected group, but only on the left foot. This is the first study which shows experimentally that early testosterone exposure can affect second-to-fourth digit ratio in a wild population of a passerine bird.

Ten years of experience with third and fourth branchial remnants.

PubMed

Liberman, Moishe; Kay, Saundra; Emil, Sherif; Flageole, Hélène; Nguyen, Luong T; Tewfik, Ted L; Oudjhane, Kamal; Laberge, Jean-Martin

2002-05-01

Third and fourth branchial remnants may result in cysts and abscesses that are in close contact with the thyroid gland. These anomalies are rare and often present diagnostic and therapeutic challenges. The charts of patients diagnosed with a branchial anomaly between July 1991 and July 2001 at the Montreal Children's Hospital were reviewed. All cases of third and fourth branchial remnants or pyriform sinus fistulae were identified. Clinical presentation, imaging, treatment, and outcome were recorded. Eight patients with a third or fourth branchial anomaly were identified and ranged in age from birth to 13 years. All anomalies were left sided. Presenting symptoms consisted of an asymptomatic cervical mass (n = 1), an infected mass (n = 5), neonatal respiratory distress (n = 1), and 1 incidental cyst found on magnetic resonance imaging. Ultrasonography was useful in suggesting the diagnosis in 7 cases. Barium swallow was performed in 3 patients with 2 positive results. Pharyngoscopy results showed the internal opening in 2 of 7 patients. A portion of the thyroid gland was resected in 6 patients. One patient has not yet undergone a definitive procedure. There was 1 recurrence in a patient whose pathology did not confirm a branchial remnant. The diagnosis and management of pyriform sinus anomalies are challenging. Ultrasound scan, computed tomography scan, barium swallow, and pharyngoscopy are all useful. The portion of thyroid involved in the fistula must be excised en bloc with the inflammatory mass, and the tract should be ligated at the level of the pharynx to minimize recurrence. Copyright 2002, Elsevier Science (USA). All rights reserved.

Resolution of precocious puberty following resection of fourth ventricular medulloblastoma: case report.

PubMed

Medina, Renata G; Dempsher, David P; Gauvain, Karen M; Geller, Thomas J; Elbabaa, Samer K

2015-09-01

Medulloblastoma is a malignant embryonal tumor that arises in the cerebellum and invades the fourth ventricle, often resulting in obstructive hydrocephalus. Patients typically present with symptoms related to increased intracranial pressure and cerebellar dysfunction. The authors report a rare case of classic medulloblastoma with central precocious puberty (CPP) as its only presenting symptom. A 7-year-old boy with no prior history of medulloblastoma presented with Tanner Stage IV testicular enlargement and a 4-month history of acne and pubic hair. Laboratory tests of blood samples demonstrated highly elevated luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. Admission MRI of the brain revealed a mass in the posterior fossa, which bordered and compressed the fourth ventricle. The patient also exhibited mild lateral and third ventriculomegaly. Surgical options were discussed with the neurosurgical department. A suboccipital craniotomy and C-1 laminectomy were performed. A large mass was seen arising from the inferior surface of the vermis, and lying within the fourth ventricle. Gross-total microsurgical resection of the mass was performed. Histopathological investigation characterized the tumor as classic medulloblastoma. Follow-up laboratory tests of blood samples demonstrated a reduction of LH, FSH, and testosterone back to prepubertal levels. The patient then began radiation and chemotherapy. This report demonstrates that mild obstructive hydrocephalus due to a posterior fossa tumor may present with unexpected symptoms, such as CPP. To the authors' knowledge, precocious puberty has not yet been associated with medulloblastoma, although it has been found with other posterior fossa tumors. Extensive imaging of the CNS for patients presenting with CPP is recommended.

The Interpretation of a Knowledge Claim in the Recognition of Prior Learning (RPL) and the Impact of This on RPL Practice

ERIC Educational Resources Information Center

de Graaff, Frederika

2014-01-01

The question addressed in this paper is: what does a knowledge claim consist of in the context of the Recognition of Prior Learning (RPL)? The research comprises a case study of RPL applicants' entry into a postgraduate diploma (a fourth-year programme) in project management. The focus is on the knowledge claims made as part of the RPL application…

Underlying Reasons for Success and Failure of Terrorist Attacks: Selected Case Studies

DTIC Science & Technology

2007-06-04

acquired materials during residence in North Carolina. May have been self- financed . No known dry runs or weapons tests. Two working weapons...Apparently self- financed (total cost less than 8K pounds; possibly AQ directed, inspired, or unaffiliated Jun 28 may have been a dry run Four...the heart of the city’s government district and is within walking distance of the Ministries of Health & Welfare, Foreign Affairs, Finance , and

Dual Toxin-Producing Strain of Clostridium botulinum Type Bf Isolated from a California Patient with Infant Botulism

PubMed Central

Barash, Jason R.; Arnon, Stephen S.

2004-01-01

A retrospective study of Clostridium botulinum strains isolated from patients from California with infant botulism identified the fourth known C. botulinum strain that produces both type B and type F botulinum toxins. This unique strain represented 0.12% of the California infant botulism case isolates from 1976 to 2003. The relative concentrations of type B and F toxins produced were temperature dependent. PMID:15071029

Management of Foramen Magnum Meningioma During Pregnancy: Literature Review and Case Report.

PubMed

Casabella, Amanda M; Urakov, Timur M; Basil, Gregory; Morcos, Jacques J

2017-01-01

Foramen magnum meningiomas are very rare and challenging lesions. Their presentation in women during pregnancy tremendously complicates the course of gestation. Conservative management is always the first option, but in cases of a deteriorating clinical picture, there are currently no clear guidelines on best management. A woman presents in the 30th week of pregnancy with pain and progressive numbness in right posterior aspect of neck and right arm. Foramen magnum meningioma was diagnosed and successful surgical resection was performed with intraoperative fetal hearth monitoring and three fourths prone position of the patient. We believe a three fourths prone position of a pregnant patient is safe and adequate for the far-lateral exposure of craniocervical lesions. Rapid growing of tumor can be precipitated by steroids management during pregnancy. Published by Elsevier Inc.

Fourth branchial cleft anomaly: management strategy in acute presentation.

PubMed

Carta, Filippo; Sionis, Sara; Mascia, Luigi; Puxeddu, Roberto

2014-09-01

Branchial malformations are common congenital head and neck lesions usually diagnosed in childhood during the first decade of life. Acute presentation is usually managed with conservative protocols before a definitive surgical procedure although the risk of life-treating septic complications may influence the physician's decision. Surgery is the treatment of choice with the removal of the lesion alone, nevertheless more aggressive approaches must be considered in complicated cases. Selective neck dissection including the removal of part of the thyroid lobe with the congenital lesion should be considered as the "ultima ratio" treatment to avoid recurrence. We reviewed literature and report our experience concerning two patients with fourth branchial cleft sinus. A three-year-old child with a clinical history of recurrent neck abscess was referred to our department after several drainages performed in another centre. A three-year-old child referred to our department for a left side lower primary neck abscess. In both cases the diagnosis of a complicated fourth cleft remnant was confirmed by rigid endoscopic visualization of the mucosal orifice of the sinus in the pyriform fossa. Surgical management during acute presentation was challenging; in one patient the early fasciitis required an emergency procedure to remove the infected sinus that were strictly adherent to the deep vascular-nervous axis. Surgery was the definitive treatment in both cases and at 12 and 25 months follow-up respectively no recurrences were observed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

State of Indiana v. Jamie L. Curtis: "The Case of the Questionable Book Bag Search."

ERIC Educational Resources Information Center

Leming, Robert S.; And Others

These materials include the script for a mock trial in which students are asked to role play the participants in a case based on the facts of New Jersey v. T.L.O., 469 U.S. 325 (1985). The case raised questions involving a students' rights to protection against unreasonable searches and seizures under the Fourth Amendment and schools' needs to…

Searches of Students' Cell Phones: Case Analysis and Best Practices

ERIC Educational Resources Information Center

Nowak, Benjamin; Glenn, William J.

2017-01-01

Lower courts are beginning to grapple with challenges to students' Fourth Amendment right to be free from unreasonable search and seizure as it relates to the digital environment, cell phones in particular. Recently, lower courts in several states have applied standards set forth decades ago to decide cases involving searches of students' mobile…

Gender Bias in the Diagnosis of a Geriatric Standardized Patient: A Potential Confounding Variable

ERIC Educational Resources Information Center

Lewis, Roya; Lamdan, Ruth M.; Wald, David; Curtis, Michael

2006-01-01

Background: Gender bias has been reported in the diagnosis and treatment of patients with a variety of illnesses. In the context of our 10-station fourth year Objective Structured Clinical Evaluation, we queried whether this could influence diagnosis in a geriatric case. Case writers hypothesized that, due to this bias, the female standardized…

A Comparison of Two Methods of Teaching Library Information Skills to Fourth Graders.

ERIC Educational Resources Information Center

Wallis, Judith

The purpose of this study was to determine if there was a significant difference in low socioeconomic fourth graders' retention of library information skills who are taught these skills in isolation and those who are taught within the context of a Social Studies lesson. Two groups of fourth graders participated. Library information skills lessons…

Simulation study of the ROMPS robot control system

NASA Technical Reports Server (NTRS)

Nguyen, Charles C.; Liu, HUI-I.

1994-01-01

This is a report presenting the progress of a research grant funded by NASA for work performed from June 1, 1993 to August 1, 1993. The report deals with the Robot Operated Material Processing System (ROMPS). It presents results of a computer simulation study conducted to investigate the performance of the control systems controlling the azimuth, elevation, and radial axes of the ROMPS and its gripper. Four study cases are conducted. The first case investigates the control of free motion of the three areas. In the second case, the compliant motion in the elevation axis with the wrist compliant device is studied in terms of position accuracy and impact forces. The third case focuses on the behavior of the control system in controlling the robot motion along the radial axis when pulling the pallet out of the rack. In the fourth case, the compliant motion of the gripper grasping a solid object under the effect of the gripper passive compliance is studied in terms of position accuracy and contact forces. For each of the above cases, a set of PIR gains will be selected to optimize the controller performance and computer simulation results will be presented and discussed.

Intracranial translucency as a sonographic marker for detecting open spina bifida at 11-13+6 weeks scan: Our experience.

PubMed

Teegala, Madhavi L; Vinayak, Dhamangaonkar G

2017-01-01

The fourth ventricle, seen as intracranial translucency (IT) at 11-13 +6 weeks, has been reported to be obliterated in cases of open spina bifida (OSB). Our aim was to assess its role in detecting OSB at 11-13 +6 weeks. This prospective study was conducted at foetal medicine unit from January 2014 to June 2015. All women who underwent both first and mid-trimester scan in our unit were included in the study. IT was categorized as normal, obliterated or not clear. Spine was examined during both scans. Totally, 341 cases were included in the study. IT was found to be obliterated in four cases and not clear in one case. There was demonstrable OSB at 11-13 +6 weeks in two cases, at 15-16 weeks in two cases and at 24 weeks in one case. In the remaining 336 cases with normal IT, spine was found to be normal at target scan. Mid-sagittal view of face that is routinely used to measure nuchal translucency (NT) can also be used to detect OSB. It is feasible to integrate IT into the routine 11-13 +6 weeks scan.

[Archives of "comprehensive approach on asbestos-related diseases" supported by the "special coordination funds for promoting science and technology (H18-1-3-3-1)"-- overview of group research project, care and specimen registration, cellular characteristics of mesothelioma and immunological effects of asbestos].

PubMed

Otsuki, Takemi; Nakano, Takashi; Hasegawa, Seiki; Okada, Morihito; Tsujimura, Tohru; Sekido, Yoshitaka; Toyokuni, Shinya; Nishimoto, Hiroshi; Fukuoka, Kazuya; Tanaka, Fumihiro; Kumagai, Naoko; Maeda, Megumi; Nishimura, Yasumitsu

2011-05-01

The research project entitled "Comprehensive approach on asbestos-related diseases" supported by the "Special Coordination Funds for Promoting Science and Technology (H18-1-3-3-1)" began in 2006 and was completed at the end of the Japanese fiscal year of 2010. This project included four parts; (1) malignant mesothelioma (MM) cases and specimen registration, (2) development of procedures for the early diagnosis of MM, (3) commencement of clinical investigations including multimodal approaches, and (4) basic research comprising three components; (i) cellular and molecular characterization of mesothelioma cells, (ii) immunological effects of asbestos, and (iii) elucidation of asbestos-induced carcinogenesis using animal models. In this special issue of the Japanese Journal of Hygiene, we briefly introduce the achievements of our project. The second and third parts and the third component of the fourth part are described in other manuscripts written by Professors Fukuoka, Hasegawa, and Toyokuni. In this manuscript, we introduce a brief summary of the first part "MM cases and specimen registration", the first component of the fourth part "Cellular and molecular characterization of mesothelioma cells" and the second component of the fourth part "Immunological effects of asbestos". In addition, a previous special issue presented by the Study Group of Fibrous and Particulate Substances (SGFPS) (chaired by Professor Otsuki, Kawasaki Medical School, Japan) for the Japanese Society of Hygiene and published in Environmental Health and Preventive Medicine Volume 13, 2008, included reviews of the aforementioned first component of the fourth part of the project. Taken together, our project led medical investigations regarding asbestos and MM progress and contributed towards the care and examination of patients with asbestos-related diseases during these five years. Further investigations are required to facilitate the development of preventive measures and the cure of asbestos-related diseases, particularly in Japan, where asbestos-related diseases are predicted to increase in the next 10 to 20 years.

Thyroidal abscesses in third and fourth branchial anomalies: not only a paediatric diagnosis.

PubMed

Kruijff, Schelto; Sywak, Mark S; Sidhu, Stan B; Shun, Albert; Novakovic, Daniel; Lee, James C; Delbridge, Leigh W

2015-01-01

Acute suppurative thyroiditis and recurrent abscess formation due to third and fourth branchial anomalies typically present in children. However, thyroid abscesses in branchial anomalies may occur in adulthood as well. Failure to recognize and delayed drainage of a neck abscess may lead to a fulminant life-threatening outcome. This is a retrospective case series. The study group comprised all patients presenting over a 12-month period from January to December 2012 with thyroid abscesses and a branchial cleft anomaly in two centres, one adult and the other paediatric. Patient demographics, clinical presentation, imaging, surgical management, definitive histology and outcomes were documented. Five patients were identified with a history of thyroid abscesses. Only one was a child (aged 9 years) with the other four being adults (aged 20, 34, 37 and 41 years). All patients had third or fourth left branchial cleft anomalies, presenting as suppurative thyroiditis with a left-sided thyroid abscess. Management options ranged from abscess drainage on initial presentation, primary thyroid lobectomy or delayed thyroid lobectomy following abscess drainage. Acute suppurative thyroidits and thyroid abscesses is not just a paediatric diagnosis but may present at any age. In both children and adults, a thyroid abscess almost always arises from branchial cleft anomalies. © 2014 Royal Australasian College of Surgeons.

Central tarsal bone fracture in the border collie.

PubMed

Guilliard, M

2007-07-01

Fracture of the plantar process of the central tarsal bone together with a dorsomedial displacement of the body of the bone was seen in six border collies. All injuries occurred during free exercise, with no extrinsic trauma. Three dogs had concomitant tarsal fractures. Primary treatment was by lag screwing the central tarsal bone to the fourth tarsal bone. All cases eventually made an excellent recovery. The superficial radiographic appearance was of a luxation of the bone as reported in a previous series, but appraisal of the radiographs showed evidence of fracture in all cases. A cadaver study to assess the mechanism of luxation showed that it is unlikely to occur naturally.

[Dental periimplantitis distinctive features diagnostic in cases of minimal thyroid insufficiency].

PubMed

Shcherbakov, M V; Golovina, E S; Gil'miiarova, F N

2008-01-01

There were disclosed syndrome of minimal thyroid insufficiency in each fourth patient with dental periimplantitis and absence of thyroid gland dysfunction in case of mucositis of periimplantitis origin. The data were presented of minimal thyroid insufficiency manifestations in cases of inflammatory complications of dental implantations the indicator of which was the content of overall and free thyroxin in oral fluid. There were determined common and differentiating peculiarities of oral fluid homeostasis in cases of dental periimplantitis and mucositis of periimplantitis origin.

Dandy-Walker syndrome with duplex kidney abnormalities in trisomy 18 - A rare case report.

PubMed

Wang, Tun-Jun; Li, Yi-Ying; Wu, Wan-Ju; Lin, Chi-Kang; Wang, Chun-Kai; Wang, Chen-Yu; Hwang, Kwei-Shuai; Su, Her-Young

2017-10-01

Trisomy 18 is one of the major numerical chromosomal disorders. The incidence of trisomy 18 is approximately one in 6000 live births. Dandy-Walker malformation (DWM) is the most common congenital malformation of the cerebellum, with an incidence of about one in 5000 live births. The incidence of trisomy 18 associated with DWM is rare and long-term survival rate is very low. A case involving a 39-year-old pregnant female with a case of trisomy 18 associated with DWM. The incidence of trisomy 18 associated with DWM is rare, and our report presents an unusual case that supplements our knowledge of this condition. We report a case involving a 39-year-old pregnant female with a case of trisomy 18 associated with Dandy-Walker malformation (DWM). Fetal ultrasonography showed hypoplasia of the cerebellar vermis and dilatation of the fourth ventricle and was characterized by an enlarged posterior fossa. Fetal magnetic resonance imaging showed inferior vermian hypoplasia and a large posterior fossa cyst communicating with the fourth ventricle causing high insertion of the torcular herophili, which was compatible with DWM. Furthermore, the karyotyping report revealed trisomy 18. The incidence of trisomy 18 associated with DWM is rare, and our report presents an unusual case that supplements our knowledge of this condition. Copyright © 2017. Published by Elsevier B.V.

An Interesting Case of Tolosa-Hunt Syndrome in a Young Male.

PubMed

Murtaza, Ghulam; Konowitz, Nicholas; Lu, Hannah; Faqah, Anadil; Kuruvilla, Aneesh

2017-01-01

Tolosa-Hunt syndrome is a rare disease with a limited number of cases reported in the literature. It typically presents with orbital pain associated with palsy of the third, fourth, or sixth cranial nerve. We present an interesting case of Tolosa-Hunt syndrome in a young male who responded well to high-dose steroids and in a few days had significant improvement in his retro-orbital pain and ocular movements.

[Monkeypox: second human case observed in Ivory Coast (rural health sector of Daloa].

PubMed

Merouze, F; Lesoin, J J

1983-01-01

A second case of human monkeypox (world fifty-forth case) has been observed in Ivory Coast (rural health sector of Daloa). A three years old girl presented a major pox-like eruption which evolved to recovery. The authors describe the eruption, the evolution of the sickness, and the scars observed at the fourth month after recovery. It has not been possible to prove neither animal-human nor interhuman contagion.

An Action Research Study Using the Music Model of Academic Motivation to Increase Reading Motivation in a Fourth-Grade Classroom

ERIC Educational Resources Information Center

Williams, Angela W.

2013-01-01

This study involved examination of the processes employed in tailoring fourth-grade reading instruction to increase levels of student motivation. A participatory action research approach was utilized to design and conduct reading instruction that fourth-grade students perceived to be motivating. The reading instructional program was designed using…

An Exploratory Study of the Relationships between Reading Comprehension Competence, Reading Attitude and the Vividness of Mental Imagery among Turkish Fourth-Grade Students

ERIC Educational Resources Information Center

Kocaarslan, Mustafa

2016-01-01

This study aimed to establish the possible relationships between reading comprehension competence, reading attitude and the vividness of mental imagery among Turkish fourth-grade students. Participants were fourth grade students, selected using convenience sampling from two different public schools (n=103) in Bartin, Turkey. The research was…

Innovative instructional strategy using cinema films in an undergraduate nursing course.

PubMed

Hyde, Norlyn B; Fife, Elizabeth

2005-01-01

Educators can develop innovative instructional strategies to engage students within the philosophical framework of Constructivism. To that end, the authors used films--Hollywood movies--to enhance their curriculum on neurological and psychopathological illnesses. During the fourth quarter of a seven-quarter associate degree nursing program, students developed case studies of the disorders portrayed in selected films. The authors outline the methods used to implement this approach and discuss evaluations from student and faculty perspectives.

Building America Case Study: Side-by-Side Testing of Water Heating Systems: Results from 2013-2014 Evaluation Final Report, Cocoa, FL

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

Rothgeb, Stacey K; Colon, C.; Martin, E.

The Florida Solar Energy Center (FSEC) has completed a fourth year-long evaluation on residential hot water heating systems in a laboratory environment (east central Florida, hot-humid climate). This report contains a summary of research activities regarding the evaluation of two residential electric heat pump water heaters (HPWHs), a solar thermal system utilizing a polymer glazed absorber and a high efficiency natural gas system.

Building America Case Study: Side-by-Side Testing of Water Heating Systems: Results from the 2013–2014 Evaluation Final Report

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

C. Colon and E. Martin

The Florida Solar Energy Center (FSEC) has completed a fourth year-long evaluation on residential hot water heating systems in a laboratory environment (east central Florida, hot-humid climate). This report contains a summary of research activities regarding the evaluation of two residential electric heat pump water heaters (HPWHs), a solar thermal system utilizing a polymer glazed absorber and a high efficiency natural gas system.

The Case of the Disappearing "Peanuts."

ERIC Educational Resources Information Center

Carter, Glenda; Jones, M. Gail

1994-01-01

Presents a series of investigations focusing on the biodegradable packing materials ("peanuts"), which provide a method for exploring science through experimentation. These activities can help fourth through sixth graders sharpen their critical thinking and science process skills. (PR)

Computation of three-dimensional compressible boundary layers to fourth-order accuracy on wings and fuselages

NASA Technical Reports Server (NTRS)

Iyer, Venkit

1990-01-01

A solution method, fourth-order accurate in the body-normal direction and second-order accurate in the stream surface directions, to solve the compressible 3-D boundary layer equations is presented. The transformation used, the discretization details, and the solution procedure are described. Ten validation cases of varying complexity are presented and results of calculation given. The results range from subsonic flow to supersonic flow and involve 2-D or 3-D geometries. Applications to laminar flow past wing and fuselage-type bodies are discussed. An interface procedure is used to solve the surface Euler equations with the inviscid flow pressure field as the input to assure accurate boundary conditions at the boundary layer edge. Complete details of the computer program used and information necessary to run each of the test cases are given in the Appendix.

Intravenous human immunoglobulin for treatment of folliculitis decalvans.

PubMed

Ismail, Nuriah; Ralph, Nicola; Murphy, Gillian

2015-10-01

We report a case of folliculitis decalvans (FD) successfully treated with intravenous human immunoglobulin (HIG). Many conventional treatments with topical agents and oral antibiotics had failed to achieve disease remission, treatment with HIG at a dose of 2 g/kg for the first month, reduced to 1 g/kg for second to fourth months was therefore started, which resulted in rapid improvement and ultimately complete resolution of FD. Clinical improvement was noted after the first infusion of HIG and remission of inflammation was achieved after the fourth infusion. Disease remission was sustained for six months following the last HIG infusion. The exact mechanism of action of HIG is poorly understood. However, it is thought to act as an immunomodulatory agent by altering different components of immune functions. To our knowledge, this is the first case reported in the literature of FD successfully treated with intravenous HIG.

Speech by Drew S. Days, III at the University of Wisconsin Fourth Annual Conference on Equal Employment and Affirmative Action.

ERIC Educational Resources Information Center

Days, Drew S., III

This speech focuses upon the issues involved in several recent court rulings against affirmative action programs. Among the cases reviewed are "Weber v. Kaiser Aluminum," concerned with the hiring of minority employees at a plant in Gramercy, Louisiana; two cases, in Tampa and Detroit, challenging police department hiring and promotion…

Searching of Students after "New Jersey v. T.L.O."

ERIC Educational Resources Information Center

Van Geel, Tyll

The Supreme Court in 1985 first addressed the issue of balance between a student's right to privacy as stated in the Fourth Amendment and school officials' need to maintain safety. This chapter summarizes the case, explores the meaning of the court opinion, and briefly discusses other issues. The case involved a 14-year-old girl (T.L.O.) whose…

Thermodynamic and classical instability of AdS black holes in fourth-order gravity

NASA Astrophysics Data System (ADS)

Myung, Yun Soo; Moon, Taeyoon

2014-04-01

We study thermodynamic and classical instability of AdS black holes in fourth-order gravity. These include the BTZ black hole in new massive gravity, Schwarzschild-AdS black hole, and higher-dimensional AdS black holes in fourth-order gravity. All thermo-dynamic quantities which are computed using the Abbot-Deser-Tekin method are used to study thermodynamic instability of AdS black holes. On the other hand, we investigate the s-mode Gregory-Laflamme instability of the massive graviton propagating around the AdS black holes. We establish the connection between the thermodynamic instability and the GL instability of AdS black holes in fourth-order gravity. This shows that the Gubser-Mitra conjecture holds for AdS black holes found from fourth-order gravity.

The Effects of Running Club Membership on Fourth Graders' Achievement of Connecticut State Standard for the Mile Run

ERIC Educational Resources Information Center

Foshay, John D.; Patterson, Melissa

2010-01-01

The purpose of this study was to investigate the effects of a running club on the mile run times of fourth grade students. The study was conducted in a suburban elementary school setting in central Connecticut with a student body of 400. The participants for the study included 59 fourth grade students, 30 of whom were boys and 29 of whom were…

Equitable science education in urban middle schools: Do reform efforts make a difference?

NASA Astrophysics Data System (ADS)

Hewson, Peter W.; Butler Kahle, Jane; Scantlebury, Kathryn; Davies, Darleen

2001-12-01

A central commitment of current reforms in science education is that all students, regardless of culture, gender, race, and/ or socioeconomic status, are capable of understanding and doing science. The study Bridging the Gap: Equity in Systemic Reform assessed equity in systemic reform using a nested research design that drew on both qualitative and quantitative methodologies. As part of the study, case studies were conducted in two urban middle schools in large Ohio cities. The purpose of the case studies was to identify factors affecting equity in urban science education reform. Data were analyzed using Kahle's (1998) equity metric. That model allowed us to assess progress toward equity using a range of research-based indicators grouped into three categories critical for equitable education: access to, retention in, and achievement in quality science education. In addition, a fourth category was defined for systemic indicators of equity. Analyses indicated that the culture and climate of the case study schools differentially affected their progress toward equitable reform in science education.

Harnessing Social Networks along with Consumer-Driven Electronic Communication Technologies to Identify and Engage Members of 'Hard-to-Reach' Populations: A Methodological Case Report

PubMed Central

2010-01-01

Background Sampling in the absence of accurate or comprehensive information routinely poses logistical, ethical, and resource allocation challenges in social science, clinical, epidemiological, health service and population health research. These challenges are compounded if few members of a target population know each other or regularly interact. This paper reports on the sampling methods adopted in ethnographic case study research with a 'hard-to-reach' population. Methods To identify and engage a small yet diverse sample of people who met an unusual set of criteria (i.e., pet owners who had been treating cats or dogs for diabetes), four sampling strategies were used. First, copies of a recruitment letter were posted in pet-friendly places. Second, information about the study was diffused throughout the study period via word of mouth. Third, the lead investigator personally sent the recruitment letter via email to a pet owner, who then circulated the information to others, and so on. Fourth, veterinarians were enlisted to refer people who had diabetic pets. The second, third and fourth strategies rely on social networks and represent forms of chain referral sampling. Results Chain referral sampling via email proved to be the most efficient and effective, yielding a small yet diverse group of respondents within one month, and at negligible cost. Conclusions The widespread popularity of electronic communication technologies offers new methodological opportunities for researchers seeking to recruit from hard-to-reach populations. PMID:20089187

Harnessing social networks along with consumer-driven electronic communication technologies to identify and engage members of 'hard-to-reach' populations: a methodological case report.

PubMed

Rock, Melanie J

2010-01-20

Sampling in the absence of accurate or comprehensive information routinely poses logistical, ethical, and resource allocation challenges in social science, clinical, epidemiological, health service and population health research. These challenges are compounded if few members of a target population know each other or regularly interact. This paper reports on the sampling methods adopted in ethnographic case study research with a 'hard-to-reach' population. To identify and engage a small yet diverse sample of people who met an unusual set of criteria (i.e., pet owners who had been treating cats or dogs for diabetes), four sampling strategies were used. First, copies of a recruitment letter were posted in pet-friendly places. Second, information about the study was diffused throughout the study period via word of mouth. Third, the lead investigator personally sent the recruitment letter via email to a pet owner, who then circulated the information to others, and so on. Fourth, veterinarians were enlisted to refer people who had diabetic pets. The second, third and fourth strategies rely on social networks and represent forms of chain referral sampling. Chain referral sampling via email proved to be the most efficient and effective, yielding a small yet diverse group of respondents within one month, and at negligible cost. The widespread popularity of electronic communication technologies offers new methodological opportunities for researchers seeking to recruit from hard-to-reach populations.

Intraventricular meningiomas: a clinicopathological study and review.

PubMed

Bhatoe, Harjinder S; Singh, Prakash; Dutta, Vibha

2006-03-15

Intraventricular meningiomas are rare tumors. The origin of these tumors can be traced to embryological invagination of arachnoid cells into the choroid plexus. The authors analyzed data that they had collected to study the clinicopathological aspects and review the origin, presentation, imaging, and management of these tumors. In this retrospective analysis, the authors describe the cases of 12 patients who had received a diagnosis of intraventricular meningioma and underwent surgery for the tumors. Nine of these patients were men and three were women. Features of neurofibromatosis Type 2 were present in two of the women. Nine of the tumors were located in the lateral ventricles, one was in the third ventricle, and two were in the fourth ventricle. Raised intracranial pressure (ICP) was the universal presentation in all the patients, and the preoperative diagnoses were confirmed on neuroimaging studies. Excision was performed using the parietooccipital (trigonal) approach for lateral ventricle tumors, the transcortical-transventricular route for the third ventricle tumor, and suboccipital craniectomy for fourth ventricle tumors. Postoperatively, one patient died and the others experienced resolution of their symptoms. Histopathological features of these tumors were similar to those seen in meningiomas in other locations. Intraventricular meningiomas are slow-growing tumors that become large prior to detection. Although they are commonly seen in the lateral ventricles, they occur in the third and fourth ventricles as well. Presentation is in the form of raised ICP with no localizing features; therefore the diagnosis is based on imaging studies. Hydrocephalus occurs due to obstruction of cerebrospinal fluid pathways. Excision requires planning to avoid eloquent cortex incision. The histopathological features are varied, although most of the tumors in the study were angiomatous meningiomas. These tumors are no different histologically from tumors that are dural in origin. No recurrence has been reported.

The Analysis of Fourth Grade Primary Students' Reader Self-Perceptions in Terms of Gender and Preschool Educational Background

ERIC Educational Resources Information Center

Sagirli, Muhittin; Okur, Burçin

2017-01-01

The aim of this study was to analyse perceptions of fourth grade primary school students on their reading ability. In study, screening model was used as a quantitative research method. The sample of this research was selected by convenience sampling. The sample consisted of 556 fourth grade students who received education in 8 public schools in…

Knowledge of risk factors and the periodontal disease-systemic link in dental students' clinical decisions.

PubMed

Friesen, Lynn Roosa; Walker, Mary P; Kisling, Rebecca E; Liu, Ying; Williams, Karen B

2014-09-01

This study evaluated second-, third-, and fourth-year dental students' ability to identify systemic conditions associated with periodontal disease, risk factors most important for referral, and medications with an effect on the periodontium and their ability to apply this knowledge to make clinical decisions regarding treatment and referral of periodontal patients. A twenty-one question survey was administered at one U.S. dental school in the spring semester of 2012 to elicit the students' knowledge and confidence regarding clinical reasoning. The response rate was 86 percent. Periodontal risk factors were accurately selected by at least 50 percent of students in all three classes; these were poorly controlled diabetes, ≥6 mm pockets posteriorly, and lack of response to previous non-surgical therapy. Confidence in knowledge, knowledge of risk factors, and knowledge of medications with an effect on the periodontium improved with training and were predictive of better referral decision making. The greatest impact of training was seen on the students' ability to make correct decisions about referral and treatment for seven clinical scenarios. Although the study found a large increase in the students' abilities from the second through fourth years, the mean of 4.6 (out of 7) for the fourth-year students shows that, on average, those students missed correct treatment or referral on more than two of seven clinical cases. These results suggest that dental curricula should emphasize more critical decision making with respect to referral and treatment criteria in managing the periodontal patient.

Student responses to the introduction of case-based learning and practical activities into a theoretical obstetrics and gynaecology teaching programme

PubMed Central

Massonetto, Júlio Cesar; Marcellini, Cláudio; Assis, Paulo Sérgio Ribeiro; de Toledo, Sérgio Floriano

2004-01-01

Background The fourth-year Obstetrics and Gynaecology course at our institution had previously been taught using theory classes alone. A new teaching model was introduced to provide a better link with professional practice. We wished to evaluate the impact of the introduction of case discussions and other practical activities upon students' perceptions of the learning process. Methods Small-group discussions of cases and practical activities were introduced for the teaching of a fourth-year class in 2003 (Group II; 113 students). Comparisons were made with the fourth-year class of 2002 (Group I; 108 students), from before the new programme was introduced. Students were asked to rate their satisfaction with various elements of the teaching programme. Statistical differences in their ratings were analysed using the chi-square and Bonferroni tests. Results Group II gave higher ratings to the clarity of theory classes and lecturers' teaching abilities (p < 0.05) and lecturers' punctuality (p < 0.001) than did Group I. Group II had greater belief that the knowledge assessment tests were useful (p < 0.001) and that their understanding of the subject was good (p < 0.001) than did Group I. Group II gave a higher overall rating to the course (p < 0.05) than did Group I. However, there was no difference in the groups' assessments of the use made of the timetabled hours available for the subject or lecturers' concern for students' learning. Conclusions Students were very receptive to the new teaching model. PMID:15569385

Quantitative CT Measures of Bronchiectasis in Smokers.

PubMed

Diaz, Alejandro A; Young, Thomas P; Maselli, Diego J; Martinez, Carlos H; Gill, Ritu; Nardelli, Pietro; Wang, Wei; Kinney, Gregory L; Hokanson, John E; Washko, George R; San Jose Estepar, Raul

2017-06-01

Bronchiectasis is frequent in smokers with COPD; however, there are only limited data on objective assessments of this process. The objective was to assess bronchovascular morphology, calculate the ratio of the diameters of bronchial lumen and adjacent artery (BA ratio), and identify those measurements able to discriminate bronchiectasis. We collected quantitative CT (QCT) measures of BA ratios, peak wall attenuation, wall thickness (WT), wall area, and wall area percent (WA%) at matched fourth through sixth airway generations in 21 ever smokers with bronchiectasis (cases) and 21 never-smoking control patients (control airways). In cases, measurements were collected at both bronchiectatic and nonbronchiectatic airways. Logistic analysis and the area under receiver operating characteristic curve (AUC) were used to assess the predictive ability of QCT measurements for bronchiectasis. The whole-lung and fourth through sixth airway generation BA ratio, WT, and WA% were significantly greater in bronchiectasis cases than control patients. The AUCs for the BA ratio to predict bronchiectasis ranged from 0.90 (whole lung) to 0.79 (fourth-generation). AUCs for WT and WA% ranged from 0.72 to 0.75 and from 0.71 to 0.75. The artery diameters but not bronchial diameters were smaller in bronchiectatic than both nonbronchiectatic and control airways (P < .01 for both). Smoking-related increases in the BA ratio appear to be driven by reductions in vascular caliber. QCT measures of BA ratio, WT, and WA% may be useful to objectively identify and quantify bronchiectasis in smokers. ClinicalTrials.gov; No.: NCT00608764; URL: www.clinicaltrials.gov. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Tobacco Cessation and Prevention Practices Reported by Second and Fourth Year Students at US Medical Schools

PubMed Central

Brooks, Daniel R.; Powers, Catherine A.; Brooks, Katie R.; Rigotti, Nancy A.; Bognar, Bryan; McIntosh, Scott; Zapka, Jane

2008-01-01

Background Tobacco dependence counseling is recommended to be included as core curriculum for US medical students. To date, there has been little information on students’ self-reported skills and practice opportunities to provide 5A’s (Ask, Advise, Assess, Assist, and Arrange) counseling for tobacco cessation. Methods We conducted anonymous surveys of second year and fourth year students at multiple US medical schools between February 2004 and March 2005 (overall response rate 70%). We report on the tobacco control practices of the 860 second year and 827 fourth year students completing the survey. Measurements and Main Results Fourth year students reported multiple opportunities to learn tobacco counseling in case-based discussions, simulated patient encounters, and clinical skills courses. They reported more instruction in family medicine (79%) and Internal Medicine (70%) than Pediatrics (54%), Obstetrics/Gynecology (41%), and Surgery clerkships (16%). Compared with asking patients about smoking, advising smokers to quit, and assessing patient willingness to quit, fourth year students were less likely to have multiple practice opportunities to assist the patient with a quit plan and arrange follow-up contact. More than half of second year students reported multiple opportunities for asking patients about smoking but far fewer opportunities for practicing the other 4 As. Conclusions By the beginning of their fourth year, most students in this group of medical schools reported multiple opportunities for training and practicing basic 5A counseling, although clear deficits for assisting patients with a quit plan and arranging follow-up care exist. Addressing these deficits and integrating tobacco teaching through tailored specific instruction across all clerkships, particularly in Surgery, Pediatrics, and Obstetrics/Gynecology is a challenge for medical school education. PMID:18612747

Emerging Threat to America: Non-State Entities Fighting Fourth Generation Warfare in Mexico

DTIC Science & Technology

2010-09-01

has become embedded into towns and cities, as is the case in Juarez, Mexico. The resources dedicated to supporting the Mexican government efforts...date plans from Southern Command (SOUTHCOM) in regards to policies for dealing with Mexico.3 In the case of Mexico, only the North America Free...guidance is used in development of the theater engagement plan for other nations to include: Colombia, Iraq, Afghanistan, and Sudan. In these cases

[Obsessive-compulsive symptoms, tics, stereotypic movements or need for absolute consistency? The occurrence of repetitive activities in patients with pervasive developmental disorders--case studies].

PubMed

Bryńska, Anita; Lipińska, Elzbieta; Matelska, Monika

2011-01-01

Repetitive and stereotyped behaviours in the form of stereotyped interests or specific routine activities are one ofthe diagnostic criteria in pervasive developmental disorders. The occurrence of repetitive behaviours in patients with pervasive developmental disorders is a starting point for questions about the type and classification criteria of such behaviours. The aim of the article is to present case studies of patients with pervasive developmental disorders and co-morbid symptoms in the form of routine activities, tics, obsessive-compulsive symptoms or stereotyped behaviours. The first case study describes a patient with Asperger's syndrome and obsessive compulsive symptoms. The diagnostic problems regarding complex motor tics are discussed in the second case study which describes a patient with Asperger's syndrome and Gilles de la Tourette syndrome. The third and fourth case study describes mono-zygotic twins with so called High Functioning Autism whose repetitive activities point to either obsessive compulsive symptoms, stereotypic movements, need for absolute consistency or echopraxia. The possible comorbidity of pervasive developmental disorders and symptoms in the form of repetitive behaviours, possible interactions as well as diagnostic challenges is discussed in the article.

Inner ear abnormalities in patients with Goldenhar syndrome.

PubMed

Bisdas, Sotirios; Lenarz, Minoo; Lenarz, Thomas; Becker, Hartmut

2005-05-01

The objective of this study is to investigate the inner ear malformations in patients with Goldenhar syndrome and to hypothesize the potential embryopathogenesis of these malformations. Retrospective case review. Tertiary referral center. Fourteen patients with Goldenhar syndrome. Each patient underwent hearing tests and high-resolution computed tomography (CT) of the temporal bone. In six patients, magnetic resonance imaging of the temporal bone also was performed. Among the 14 patients with Goldenhar syndrome, 13 had outer and middle ear anomalies and 5 (36%) had inner ear malformations, including one case of common cavity. Our observations regarding inner ear anomalies in Goldenhar syndrome correlate with the reported cases in the literature and may help to hypothesize the embryological origin of these malformations, which can caused by an early developmental arrest in the fourth gestational week. Specialists evaluating patients with Goldenhar syndrome should be aware of the possibility of inner ear malformations, which could be diagnosed earlier with appropriate imaging studies.

A Unique Instrumental Malfunction during Robotic Prostatectomy

PubMed Central

Park, Sung Yul; Ahn, Jenny Jin-Kyung; Jeong, Wooju; Ham, Won Sik

2010-01-01

Over the past decade, the introduction of robotics in the field of medicine has provided a new approach to patients requiring surgery, and both its advantages and disadvantages are currently under study by many groups worldwide. The use of robotics has especially been considered by the urological community as a treatment option in radical prostatectomy. The current case report is one in which the da Vinci Surgical System™, with fourth arm use was employed in radical prostatectomy. This case presents a unique occurrence in which a bolt of the Prograsper forcep became loose during an operation, leading to diminished device functionality and later impedance of its removal. A circumstance such as this has not previously been reported, so we introduce for other robotic surgeons our unique instrumental malfunction case during a robotic prostatectomy. PMID:20046531

"Acquired" Dandy-Walker malformation and cerebellar hemorrhage: Usefulness of serial MRI.

PubMed

Pichiecchio, Anna; Decio, Alice; Di Perri, Carol; Parazzini, Cecilia; Rossi, Andrea; Signorini, Sabrina

2016-01-01

Neuroimaging plays a fundamental role in the diagnosis of Dandy Walker malformation (DWM), a posterior fossa anomaly that is usually associated with genetic abnormalities, but may rarely be ascribed to acquired causes. Here, we report the clinical history and neuroimaging studies of a child with a complex cardiac malformation, developmental delay, and oculomotor anomalies whose neuroimaging findings were consistent with an acquired form of DWM. Fetal MRI at gestational weeks 27 and 31 showed cerebellar and vermis hypoplasia and fourth ventricle enlargement, together with hemosiderin deposits on the cerebellar hemispheric surface, but without significant vermian rotation. Postnatal MRIs at 5 days and 13 months revealed progressive counter-clockwise rotation of the hypoplastic cerebellar vermis with cystic dilation of the fourth ventricle, eventually leading to a full-blown DWM. This case strengthens the opinion that DWM is a heterogeneous condition, and may support the hypothesis that acquired meningeal abnormalities in the form of cortico-pial hemosiderosis may play a role in the development of DWM. This case also demonstrates that serial neuroimaging plays a key role in the correct diagnosis of posterior fossa malformations, whose prognosis is difficult to establish on second trimester fetal MRI and requires longer clinical follow-up. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Collapsing glomerulopathy, the Saudi Arabian scenario

PubMed Central

Husain, Sufia

2017-01-01

Objectives: To compare the clinico-pathological features of collapsing glomerulopathy (CG) at a tertiary hospital in Saudi Arabia with the world literature. Methods: In a retrospective study, all biopsy-diagnosed cases of CG between 2004-2015 were identified and analyzed, at King Khalid University Hospital, King Saud University, Riyadh. The clinico-pathological findings along with prognosis were reviewed and compared with the reported literature. Results: Thirty-one CG patients were identified, most were adult males. All the CG cases were idiopathic, all Arabs, none HIV positive, none of African descent, and none with a history of drug abuse. The number of glomeruli with collapsing lesions per biopsy ranged from 1 to 9. Other types of FSGS lesions (not otherwise specified and perihilar) were also noted. There was extensive podocyte effacement. Upon treatment, remission (complete/partial) was noted in almost half the patients; around one fourth did not respond to treatment; and one fourth progressed to end stage kidney disease (ESKD). The median time taken to develop ESKD from the time of biopsy diagnosis was 23 months. Conclusion: The clinico-pathological and prognostic correlates of CG in Saudi Arabia are comparable with that of the world literature. The management protocol at our center is the same as that practiced in different parts of the world, and the prognosis is overall poor. PMID:28439601

The Effect of Using Computer Games in Teaching Mathematics on Developing the Number Sense of Fourth Grade Students

ERIC Educational Resources Information Center

Nejem, Khamis Mousa; Muhanna, Wafa

2013-01-01

The purpose of this study was to investigate the effect of using computer games in teaching mathematics on developing the number sense of fourth grade students. To achieve this purpose a study sample of (81) students was selected from the fourth grade. This sample was divided into two groups. One group was randomly chosen to be the experimental…

Validating the Vocabulary Levels Test with Fourth and Fifth Graders to Identify Students At-Risk in Vocabulary Development Using a Quasiexperimental Single Group Design

ERIC Educational Resources Information Center

Dunn, Suzanna

2012-01-01

This quasiexperimental single group design study investigated the validity of the Vocabulary Levels Test (VLT) to identify fourth and fifth grade students who are at-risk in vocabulary development. The subjects of the study were 88 fourth and fifth grade students at one elementary school in Washington State. The Group Reading Assessment and…

The Army’s National Training Center: A Case Study in Management of a Large Defense Project

DTIC Science & Technology

1983-04-26

34Desining . . .," op cit, p. 130. IT. M3l Ior-ritc’h and C. K. Prahalad , "Managing Multi-Organization Enterprises: The Emerging Strategic Frontier...Rational Altor TModel "assumes that what must be explained is an action, i.e., behavior that reflects purpose or intention .Ŗ It assumes "that what human...a fourth element is essential to the success of large-scale commerciali- zation programs: a favorable corporate strategic environment. This element

Nanoethics, Science Communication, and a Fourth Model for Public Engagement.

PubMed

Miah, Andy

2017-01-01

This paper develops a fourth model of public engagement with science, grounded in the principle of nurturing scientific agency through participatory bioethics. It argues that social media is an effective device through which to enable such engagement, as it has the capacity to empower users and transforms audiences into co-producers of knowledge, rather than consumers of content. Social media also fosters greater engagement with the political and legal implications of science, thus promoting the value of scientific citizenship. This argument is explored by considering the case of nanoscience and nanotechnology, as an exemplar for how emerging technologies may be handled by the scientific community and science policymakers.

Validity and reliability of chronic tic disorder and obsessive-compulsive disorder diagnoses in the Swedish National Patient Register.

PubMed

Rück, Christian; Larsson, K Johan; Lind, Kristina; Perez-Vigil, Ana; Isomura, Kayoko; Sariaslan, Amir; Lichtenstein, Paul; Mataix-Cols, David

2015-06-22

The usefulness of cases diagnosed in administrative registers for research purposes is dependent on diagnostic validity. This study aimed to investigate the validity and inter-rater reliability of recorded diagnoses of tic disorders and obsessive-compulsive disorder (OCD) in the Swedish National Patient Register (NPR). Chart review of randomly selected register cases and controls. 100 tic disorder cases and 100 OCD cases were randomly selected from the NPR based on codes from the International Classification of Diseases (ICD) 8th, 9th and 10th editions, together with 50 epilepsy and 50 depression control cases. The obtained psychiatric records were blindly assessed by 2 senior psychiatrists according to the criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and ICD-10. Positive predictive value (PPV; cases diagnosed correctly divided by the sum of true positives and false positives). Between 1969 and 2009, the NPR included 7286 tic disorder and 24,757 OCD cases. The vast majority (91.3% of tic cases and 80.1% of OCD cases) are coded with the most recent ICD version (ICD-10). For tic disorders, the PPV was high across all ICD versions (PPV=89% in ICD-8, 86% in ICD-9 and 97% in ICD-10). For OCD, only ICD-10 codes had high validity (PPV=91-96%). None of the epilepsy or depression control cases were wrongly diagnosed as having tic disorders or OCD, respectively. Inter-rater reliability was outstanding for both tic disorders (κ=1) and OCD (κ=0.98). The validity and reliability of ICD codes for tic disorders and OCD in the Swedish NPR is generally high. We propose simple algorithms to further increase the confidence in the validity of these codes for epidemiological research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Third and fourth degree perineal tears--the risk of recurrence in subsequent pregnancy.

PubMed

Yogev, Yariv; Hiersch, Liran; Maresky, Lance; Wasserberg, Nir; Wiznitzer, Arnon; Melamed, Nir

2014-01-01

To assess the risk of recurrence of third- and fourth-degree perineal tears (34DPT) and to determine whether previous 34DPT is an independent risk factor for 34DPT in subsequent deliveries. The study group included all women who had a vaginal delivery complicated by 34DPT (2000-2012, N = 356) and subsequently delivered again in the same medical center (N = 204). The rate of recurrence of 34DPT was compared with a control group of women who had a previous vaginal delivery not complicated by 34DPT (N = 58 581) and had a subsequent delivery in the same time period (N = 23 045). Women in the past-34DPT group had a higher rate of CS (18.6% versus 10.1%, p < 0.001), fetal head in occiput-posterior position (POP; 2.5% versus 0.7%, p = 0.004) and mediolateral episiotomy (25.5% versus 19.4%, p = 0.03). Women in the past-34DPT group had a higher rate of 34DPT in the subsequent delivery (2.0% versus 0.3%, p < 0.001). The rate of recurrence of 34DPT was considerably higher among women with past fourth-degree tear versus women with past third-degree tear (22.2% versus 1.0%, p < 0.001). 34DPT in previous pregnancy is independently associated with increased risk of 34DPT in subsequent delivery (OR = 4.6, 95%-CI 1.3-15.3). Women who experienced 34DPT in their previous pregnancy have an increased risk for recurrence of 34DPT in subsequent pregnancy, especially in cases of past fourth-degree tears.

The Emergence of a Fourth Type of Public Forum: Is the Quasi-Nonpublic Forum a New Paradigm for Student Free Speech Cases?

ERIC Educational Resources Information Center

Lugg, Elizabeth T.; Paterson, Frances R. A.

This paper is a presentation, in outline form, of the development of the "quasi-nonpublic forum," where cases involving student free speech push the envelope of what is acceptable under Constitutional law and what is appropriate/acceptable student behavior under constraints set by school regulations. Context is set by presenting court…

Plasma carotenoids and breast cancer risk in the Cancer Prevention Study II Nutrition Cohort.

PubMed

Wang, Ying; Gapstur, Susan M; Gaudet, Mia M; Furtado, Jeremy D; Campos, Hannia; McCullough, Marjorie L

2015-09-01

Several circulating carotenoids have been inversely associated with postmenopausal breast cancer risk in large cohort studies and a pooled analysis. Whether associations differ by tumor or participant characteristics remains unclear. We investigated the associations of plasma carotenoids with postmenopausal breast cancer risk overall and by estrogen receptor (ER) status, tumor stage, smoking status, and body mass index, in a case-control study nested in the Cancer Prevention Study II Nutrition Cohort. A total of 496 invasive breast cancer cases diagnosed between blood draw in 1998-2001 and June 30, 2007 and matched 1:1 with controls on race, birth date, and blood draw date were included. Multivariable-adjusted conditional and unconditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Plasma α-carotene above the lowest quartile was associated with significant 40-43% lower risk of invasive breast cancer risk (fourth vs. first quartile OR 0.60, 95% CI 0.41-0.87, P-trend = 0.037) after adjustment for multiple covariates. This inverse association was strengthened after further adjustment for other plasma carotenoids and total fruit and vegetable intake (fourth vs. first quartile OR 0.50, 95% CI 0.29-0.85, P-trend = 0.041). Other plasma carotenoids or total carotenoids were not associated with breast cancer risk. The inverse association of α-carotene with breast cancer remained for ER+, but not for ER- tumors, although test for heterogeneity was not statistically significant (P-heterogeneity = 0.49). These results suggest that higher plasma α-carotene is associated with lower risk of invasive breast cancer.

Provision of oral hygiene services as a potential method for preventing periodontal disease and control hypertension and diabetes in a community health centre in Korea.

PubMed

Kim, Nam-Hee; Lee, Ga-Yeong; Park, Su-Kyung; Kim, Yeun-Ju; Lee, Min-Young; Kim, Chun-Bae

2018-05-01

This study aimed to evaluate the effects of a community-based oral hygiene service on general and periodontal health indicators of patients with hypertension and type 2 diabetes mellitus visiting a community health centre in Korea. The study used a one-group pretest-posttest and interrupted time-series design. A total of 151 participants (45% male), with a mean age of 63 ± 8.4 years, were included in the study; these included patients with hypertension (62%), diabetes (12%) and both hypertension and diabetes (26%). Two dental hygienists dedicated 2 days per week to this project, providing oral hygiene services to 10-13 participants per day. Four oral hygiene service sessions were provided per patient. The objective oral hygiene status and subjective self-reported periodontal status were compared before and after the service. The changes in blood pressure and glycosylated haemoglobin levels were also assessed. A lower frequency of subjective swelling was reported at the fourth session (37.9%) compared to the first (55.6%) session. Further, significantly fewer cases of calculus and bleeding were observed (p < .05), and significantly more patients reported having no gum problems at the fourth session (43.1% vs. 27.2%; p < .05) than at the first session. Finally, the participants maintained stable blood pressures at each of the four sessions, and their glycosylated haemoglobin levels were significantly lower at the fourth session. In conclusion, the findings of this study suggest that community oral hygiene services provided by dental hygienists can promote objective oral hygiene and subjective periodontal status in the local community, and may help in the control of hypertension and diabetes. © 2017 John Wiley & Sons Ltd.

A Pregnant Pause?

ERIC Educational Resources Information Center

Zirkel, Perry A.

2001-01-01

In a case involving a swim-team student's mandatory pregnancy test and a varsity coach's mishandling of confidentiality, the Third Circuit Court of Appeals awarded the coach qualified immunity, while rejecting the student's Fourth and First Amendment claims. Discretion and legal counsel would have helped. (MLH)

Wolfram Syndrome presenting with optic atrophy and diabetes mellitus: two case reports

PubMed Central

2009-01-01

Wolfram syndrome is the constellation of juvenile onset diabetes mellitus and optic atrophy, known as DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy, and Deafness). Patients demonstrate diabetes mellitus followed by optic atrophy in the first decade, diabetes insipidus and sensorineural deafness in the second decade, dilated renal outflow tracts early in the third decade, and multiple neurological abnormalities early in the fourth decade. This study reports two siblings with late diagnosed wolfram syndrome with diabetes insipidus, diabetes mellitus, optic atrophy, deafness and severe urological abnormalities. In conclusion, cases having early onset insulin-dependent diabetes mellitus and optic atrophy together need to be evaluated with respect to Wolfram. PMID:20062605

Periosteal ganglia: CT and MR imaging features.

PubMed

Abdelwahab, I F; Kenan, S; Hermann, G; Klein, M J; Lewis, M M

1993-07-01

The imaging features of four cases of periosteal ganglia were studied. Three lesions were located over the proximal shaft of the tibia, in proximity to the pes anserinus. The fourth lesion involved the distal shaft of the ulna. Three lesions had different degrees of external cortical erosion, scalloping, and thick spicules of periosteal bone on plain radiographs. The bone adjacent to the fourth lesion was not involved. Computed tomography (CT) showed these lesions to be sharply defined soft-tissue masses abutting the periosteum. All of the lesions had the same attenuation as fluid. Magnetic resonance (MR) imaging revealed the ganglia to be sharply defined masses that were isointense compared with neighboring muscles on T1-weighted images. There was markedly increased signal intensity compared with that of fat on T2-weighted images. The signal intensity on both types of images was homogeneous. The MR imaging features were consistent with the fluid nature of the lesions. Under the appropriate clinical circumstances, the MR imaging and CT features of periosteal ganglia are diagnostic.

Adult manifestation of the Dandy-Walker syndrome. Report of two cases with review of the literature.

PubMed

Unsgaard, G; Sand, T; Støvring, J; Ringkjøb, R

1987-01-01

Two cases of Dandy-Walker syndrome that became manifest in adult life are reported. A review of the literature of Dandy-Walker syndrome revealed 13 additional cases with onset in adult life and three cases that could not be differentiated from arachnoid cysts. While shunting is the primary treatment in infantile Dandy-Walker, the usual treatment of adult Dandy-Walker has been excision of the membrane covering the enlarged fourth ventricle. The outcome of our two cases treated with membrane excision indicates that primary shunting should also be tried in adult Dandy-Walker.

Occupational Asthma in Antibiotic Manufacturing Workers: Case Reports and Systematic Review

PubMed Central

Díaz Angulo, Sara; Szram, Joanna; Welch, Jenny; Cannon, Julie; Cullinan, Paul

2011-01-01

Background. The risks of occupational asthma (OA) from antibiotics are uncertain. We report 4 new cases and a systematic review of the literature. Methods. Cases were identified through a specialist clinic, each underwent specific provocation testing (SPT). We subsequently reviewed the published literature. Results. The patients were employed in the manufacture of antibiotics; penicillins were implicated in three cases, in the fourth erythromycin, not previously reported to cause OA. In two, there was evidence of specific IgE sensitisation. At SPT each developed a late asthmatic reaction and increased bronchial hyperresponsiveness. 36 case reports have been previously published, 26 (citing penicillins or cephalosporins). Seven cross-sectional workplace-based surveys found prevalences of 5–8%. Conclusions. OA in antibiotic manufacturers may be more common than is generally recognised. Its pathogenesis remains unclear; immunological tests are of uncertain value and potential cases require confirmation with SPT. Further study of its frequency, mechanisms, and diagnosis is required. PMID:21603168

The Contribution of Executive Functions to Narrative Writing in Fourth Grade Children

ERIC Educational Resources Information Center

Drijbooms, Elise; Groen, Margriet A.; Verhoeven, Ludo

2015-01-01

The present study investigated the contribution of executive functions to narrative writing in fourth grade children, and evaluated to what extent executive functions contribute differentially to different levels of narrative composition. The written skills of 102 Dutch children in fourth grade were assessed using a narrative picture-elicitation…

Extrinsic Motivators Affecting Fourth-Grade Students' Interest and Enrollment in an Instrumental Music Program

ERIC Educational Resources Information Center

Vasil, Martina

2013-01-01

The purpose of this study was to investigate fourth-grade students' extrinsic motivators for joining and continuing in a school instrumental music program. Three research questions were investigated: (a) What extrinsic motivators have influenced fourth-grade students' initial interest and continuing participation in an instrumental music program?…

Bullying Prevention in the Elementary Classroom Using Social Skills

ERIC Educational Resources Information Center

Anderson, Stacie; Swiatowy, Colleen

2008-01-01

Our action research project report provided students with social skills training to effectively handle bullying situations in the fourth grade. Our study involved 70 fourth-grade students and began Monday, January 14, 2008 and concluded Friday, May 2, 2008. The behaviors documented from the fourth grade students were name calling, exclusion,…

Examining Variations in Fourth-Grade Children's Participation in School Breakfast and Lunch Programs by Student and Program Demographics

ERIC Educational Resources Information Center

Guinn, Caroline H.; Baxter, Suzanne Domel; Finney, Christopher J.; Hitchcock, David B.

2013-01-01

Purpose/Objectives: Analyses were conducted to examine variations in fourth-grade children's participation in school-breakfast and school-lunch programs by weekday, month, socioeconomic status, absenteeism, gender, and school-breakfast location. Methods: Fourth-grade children were participants in a dietary-reporting validation study during either…

Reading Achievement of U.S. Fourth-Grade Students in an International Context: First Look at the Progress in International Reading Literacy Study (PIRLS) 2016 and ePIRLS 2016. NCES 2018-017

ERIC Educational Resources Information Center

Warner-Griffin, Catharine; Liu, Huili; Tadler, Chrystine; Herget, Debbie; Dalton, Ben

2017-01-01

The Progress in International Reading Literacy Study (PIRLS) is an international assessment of student performance in reading literacy at the fourth grade. PIRLS measures students in the fourth year of formal schooling because this is typically when students' learning transitions from a focus on "learning to read" to a focus on…

Intracranial translucency as a sonographic marker for detecting open spina bifida at 11–13+6 weeks scan: Our experience

PubMed Central

Teegala, Madhavi L; Vinayak, Dhamangaonkar G

2017-01-01

Aims and Objectives: The fourth ventricle, seen as intracranial translucency (IT) at 11–13+6 weeks, has been reported to be obliterated in cases of open spina bifida (OSB). Our aim was to assess its role in detecting OSB at 11–13+6 weeks. Materials and Methods: This prospective study was conducted at foetal medicine unit from January 2014 to June 2015. All women who underwent both first and mid-trimester scan in our unit were included in the study. IT was categorized as normal, obliterated or not clear. Spine was examined during both scans. Results: Totally, 341 cases were included in the study. IT was found to be obliterated in four cases and not clear in one case. There was demonstrable OSB at 11–13+6 weeks in two cases, at 15–16 weeks in two cases and at 24 weeks in one case. In the remaining 336 cases with normal IT, spine was found to be normal at target scan. Conclusion: Mid-sagittal view of face that is routinely used to measure nuchal translucency (NT) can also be used to detect OSB. It is feasible to integrate IT into the routine 11–13+6 weeks scan. PMID:29379237

Primary Total Hip Arthroplasty With Fourth-Generation Ceramic-on-Ceramic: Analysis of Complications in 939 Consecutive Cases Followed for 2-10 Years.

PubMed

Buttaro, Martin A; Zanotti, Gerardo; Comba, Fernando M; Piccaluga, Francisco

2017-02-01

Delta ceramics may be the bearing of choice for younger and active patients due to its improved toughness and wear characteristics, provided there is no risk of fracture. However, ceramic fracture is the most serious complication related to this type of bearing. Although millions of Delta ceramics have been implanted worldwide, short to midterm results have been scarcely reported in the literature. The purpose of this study was to report the complication rate at short to midterm follow-up associated with the bearing surface used in a series of primary total hip arthroplasties with Delta ceramic-on-ceramic bearings performed in a single institution. A total of 939 cases (880 patients) undergoing primary total hip arthroplasty with fourth-generation Delta ceramic-on-ceramic bearings were retrospectively reviewed. They were followed for an average of 5.3 years (2-10 years). One hip experienced a liner fracture, 2 cups presented early loosening due to friction between the acetabular screw and the backside of the liner, one femoral ball head had a fracture; one case of squeaking was reported, which is impending revision. Considering revision or impending revision in relationship with the bearing surface as the end point, the mean survival rate was 99.3% (confidence interval 95%, 98.3%-99.7%) at 2-10 years. This study showed a low rate of ceramic fracture compared with others; however, it was much higher than the complication rate presented by the manufacturers. The complications observed were directly related to technical errors that surgeons should avoid when using this type of surface. Copyright © 2016 Elsevier Inc. All rights reserved.

Sixth- and eighth-order Hermite integrator for N-body simulations

NASA Astrophysics Data System (ADS)

Nitadori, Keigo; Makino, Junichiro

2008-10-01

We present sixth- and eighth-order Hermite integrators for astrophysical N-body simulations, which use the derivatives of accelerations up to second-order ( snap) and third-order ( crackle). These schemes do not require previous values for the corrector, and require only one previous value to construct the predictor. Thus, they are fairly easy to implement. The additional cost of the calculation of the higher-order derivatives is not very high. Even for the eighth-order scheme, the number of floating-point operations for force calculation is only about two times larger than that for traditional fourth-order Hermite scheme. The sixth-order scheme is better than the traditional fourth-order scheme for most cases. When the required accuracy is very high, the eighth-order one is the best. These high-order schemes have several practical advantages. For example, they allow a larger number of particles to be integrated in parallel than the fourth-order scheme does, resulting in higher execution efficiency in both general-purpose parallel computers and GRAPE systems.

Connection between quantum systems involving the fourth Painlevé transcendent and k-step rational extensions of the harmonic oscillator related to Hermite exceptional orthogonal polynomial

NASA Astrophysics Data System (ADS)

Marquette, Ian; Quesne, Christiane

2016-05-01

The purpose of this communication is to point out the connection between a 1D quantum Hamiltonian involving the fourth Painlevé transcendent PIV, obtained in the context of second-order supersymmetric quantum mechanics and third-order ladder operators, with a hierarchy of families of quantum systems called k-step rational extensions of the harmonic oscillator and related with multi-indexed Xm1,m2,…,mk Hermite exceptional orthogonal polynomials of type III. The connection between these exactly solvable models is established at the level of the equivalence of the Hamiltonians using rational solutions of the fourth Painlevé equation in terms of generalized Hermite and Okamoto polynomials. We also relate the different ladder operators obtained by various combinations of supersymmetric constructions involving Darboux-Crum and Krein-Adler supercharges, their zero modes and the corresponding energies. These results will demonstrate and clarify the relation observed for a particular case in previous papers.

Impact of a Revised Curriculum Focusing on Clinical Neurology and Musculoskeletal Care on a Required Fourth-Year Medical Student Physical Medicine and Rehabilitation Clerkship

PubMed Central

Faulk, Clinton E.; Harrell, Kelly M.; Lawson, Luan E.; Moore, Daniel P.

2016-01-01

Background. A Required Fourth-Year Medical Student Physical Medicine and Rehabilitation (PM&R) Clerkship was found to increase students' knowledge of PM&R; however the students' overall rotation evaluations were consistently lower than the other 8 required clerkships at the medical school. Objective. To describe the impact of a revised curriculum based upon Entrustable Professional Activities and focusing on basic pain management, musculoskeletal care, and neurology. Setting. Academic Medical Center. Participants. 73 fourth-year medical students. Methods. The curriculum changes included a shift in the required readings from rehabilitation specific topics toward more general content in the areas of clinical neurology and musculoskeletal care. Hands-on workshops on neurological and musculoskeletal physical examination techniques, small group case-based learning, an anatomy clinical correlation lecture, and a lecture on pain management were integrated into the curriculum. Main Outcome Measurements. Student evaluations of the clerkship. Results. Statistically significant improvements were found in the students' evaluations of usefulness of lecturers, development of patient interviewing skills, and diagnostic and patient management skills (p ≤ 0.05). Conclusions. This study suggests that students have a greater satisfaction with a required PM&R clerkship when lecturers utilize a variety of pedagogic methods to teach basic pain, neurology and musculoskeletal care skills in the rehabilitation setting rather than rehabilitation specific content. PMID:28025624

Impact of a Revised Curriculum Focusing on Clinical Neurology and Musculoskeletal Care on a Required Fourth-Year Medical Student Physical Medicine and Rehabilitation Clerkship.

PubMed

Norbury, John W; Faulk, Clinton E; Harrell, Kelly M; Lawson, Luan E; Moore, Daniel P

2016-01-01

Background . A Required Fourth-Year Medical Student Physical Medicine and Rehabilitation (PM&R) Clerkship was found to increase students' knowledge of PM&R; however the students' overall rotation evaluations were consistently lower than the other 8 required clerkships at the medical school. Objective . To describe the impact of a revised curriculum based upon Entrustable Professional Activities and focusing on basic pain management, musculoskeletal care, and neurology. Setting . Academic Medical Center. Participants . 73 fourth-year medical students. Methods . The curriculum changes included a shift in the required readings from rehabilitation specific topics toward more general content in the areas of clinical neurology and musculoskeletal care. Hands-on workshops on neurological and musculoskeletal physical examination techniques, small group case-based learning, an anatomy clinical correlation lecture, and a lecture on pain management were integrated into the curriculum. Main Outcome Measurements . Student evaluations of the clerkship. Results . Statistically significant improvements were found in the students' evaluations of usefulness of lecturers, development of patient interviewing skills, and diagnostic and patient management skills ( p ≤ 0.05). Conclusions . This study suggests that students have a greater satisfaction with a required PM&R clerkship when lecturers utilize a variety of pedagogic methods to teach basic pain, neurology and musculoskeletal care skills in the rehabilitation setting rather than rehabilitation specific content.

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.

Adiposity, lipogenesis, and fatty acid composition of subcutaneous and intramuscular adipose tissues of Brahman and Angus crossbred cattle.

PubMed

Campbell, E M G; Sanders, J O; Lunt, D K; Gill, C A; Taylor, J F; Davis, S K; Riley, D G; Smith, S B

2016-04-01

The objective of this study was to demonstrate differences in aspects of adipose tissue cellularity, lipid metabolism, and fatty and cholesterol composition in Angus and Brahman crossbred cattle. We hypothesized that in vitro measures of lipogenesis would be greater in three-fourths Angus progeny than in three-fourths Brahman progeny, especially in intramuscular (i.m.) adipose tissue. Progeny ( = 227) were fed a standard, corn-based diet for approximately 150 d before slaughter. Breed was considered to be the effect of interest and was forced into the model. There were 9 breed groups including all 4 kinds of three-fourths Angus calves: Angus bulls Angus-sired F cows ( = 32), Angus bulls Brahman-sired F cows ( = 20), Brahman-sired F bulls Angus cows ( = 24), and Angus-sired F bulls Angus cows ( = 20). There were all 4 kinds of three-fourths Brahman calves: Brahman bulls Brahman-sired F cows ( = 21), Brahman bulls Angus-sired F cows ( = 43), Brahman-sired F bulls Brahman cows ( = 26), and Angus-sired F bulls Brahman cows ( = 13). Additionally, F calves (one-half Brahman and one-half Angus) were produced only from Brahman-sired F bulls Angus-sired F cows ( = 28). Contrasts were calculated when breed was an important fixed effect, using the random effect family(breed) as the error term. Most contrasts were nonsignificant ( > 0.10). Those that were significant ( < 0.05) included cholesterol concentration of subcutaneous (s.c.) adipose tissue (three-fourths Angus > F, three-fourths Brahman > F, and three-fourths crossbred progeny combined > F), s.c. adipocyte volume (three-fourths Angus > F and three-fourths bloods combined > F), lipogenesis from acetate in s.c. adipose tissue (three-fourths Brahman calves from Brahman dams > three-fourths Brahman calves from F dams), and percentage 18:3-3 in s.c. adipose tissue (three-fourths Brahman calves from Brahman-sired F dams < three-fourths Brahman calves from Angus-sired F dams). Intramuscular adipocyte volume ( < 0.001) was less in three-fourths Brahman cattle than in three-fourths Angus cattle. Additionally, several differences were observed in i.m. adipose tissue that were consistent with this being a less-developed adipose tissue in three-fourths Brahman cattle than in three-fourths Angus cattle.

[Colon transverse volvulus; a case report].

PubMed

Ramírez-Wiella-Schwuchow, G; Villanueva-Sáenz, E; Bolaños-Badillo, L E; García-Hernández, L A

2009-01-01

Colon transverse volvulus is an uncommon pathology which is associate with alterations of the colonic motility, mental disorders and congenital anomalies of the fixation of the colon sistem. Up to 1994, 72 cases has been reported in world-wide literature. To report a case of colon transverse volvulus and the treatment. A female 46 years old who show intense abdominal pain 2 days of evolution. The physical exploration show important abdominal distension and pain in left inferior quadrant. The Rx of abdomen with gas absence in rectal descendent colon and ampula with level and important distension of proximal colon. Colonoscopic study with impossibility to advance endoscopy throw colon transverse by zone of stenosis, wasn't made a contrast study, underwent laparotomy of urgency, it was done right hemicolectomy and ileocoloanastomosis with good evolution and given of discharge fourth postsurgical day. This possibility is due to have in mind diagnoses, the treatment is surgical secondary to a high index of recidivate, nevertheless recommends the colonoscopy study accomplishment in order to discard obstructive injuries mainly cancer.

Suicidal Decapitation by Hanging-A Population-based Study.

PubMed

Byard, Roger W; Gilbert, John D

2018-05-01

A prospective study was undertaken at Forensic Science SA over a 15-year period from July 2002 to June 2017 for all cases of adult (>18 years) suicidal hangings with decapitation. A total of 1446 cases of suicidal hangings were identified from a general population of approximately 1.5 million (1206 males-age range 18-97 years, average 42.6; and 240 females-age range 18-96 years, average 40.1). Only three cases of decapitation were found, all from long-drop hangings; these consisted of three males (ages 32-55 years; average 45 years). Spinal transections had occurred between the first and second, second and third, and third and fourth cervical vertebrae, respectively. In this study, the number of suicidal hangings with decapitation represented only 0.2% of the total number of hangings. These events are therefore extremely rare, most likely due to most suicidal hangings occurring from relatively low levels in a domestic environment. © 2017 American Academy of Forensic Sciences.

Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011): User's Manual for the ECLS-K:2011 Kindergarten-Fourth Grade Data File and Electronic Codebook, Public Version. NCES 2018-032

ERIC Educational Resources Information Center

Tourangeau, Karen; Nord, Christine; Lê, Thanh; Wallner-Allen, Kathleen; Vaden-Kiernan, Nancy; Blaker, Lisa; Najarian, Michelle

2018-01-01

This manual provides guidance and documentation for users of the longitudinal kindergarten-fourth grade (K-4) data file of the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011). It mainly provides information specific to the fourth-grade round of data collection. The first chapter provides an overview of the…

Differentiated Jurisprudence? Examining Students' Fourth Amendment Court Decisions by Region of Country

ERIC Educational Resources Information Center

Torres, Mario S., Jr.

2012-01-01

This study examined federal and state court decisions related to student Fourth Amendment rights following the "New Jersey v. T.L.O." ruling in 1985. There has been minimal research in judicial treatment of students' Fourth Amendment rights across regions of the country and less to what extent regional rulings implicitly or explicitly…

Breast Cancer Screening Knowledge and Skills of Students upon Entering and Exiting a Medical School.

ERIC Educational Resources Information Center

Kann, P. Elizabeth; Lane, Dorothy S.

1998-01-01

A study compared the breast cancer screening knowledge of 27 medical students in first and fourth years. In the fourth year additional questions were asked about training and training needs. Although students performed significantly better on knowledge-based questions in the fourth year, considerable room for improvement remained. Most students…

Poor Children's Fourth-Grade Slump.

ERIC Educational Resources Information Center

Chall, Jeanne S.; Jacobs, Vicki A.

2003-01-01

In a study of second, fourth, and sixth graders who completed reading and language tests over 2 years, low-income second and third graders achieved as well as their normative peers on all subtests. However, around fourth grade, their reading scores began to decline. One possible cause for this slump may stem from lack of fluency and automaticity.…

Availability and Use of Informational Texts in Second-, Third-, and Fourth-Grade Classrooms

ERIC Educational Resources Information Center

Jeong, Jongseong; Gaffney, Janet S.; Choi, Jin-Oh

2010-01-01

A sharp increase in the proportion of informational text with the corresponding expansion of cognitive demands and conceptual structures is a widely held explanation for the decline in reading achievement at the fourth-grade level. In this study, differences in the proportion of informational text across the second, third, and fourth grades were…

Rare association between cystic fibrosis, Chiari I malformation, and hydrocephalus in a baby: a case report and review of the literature

PubMed Central

2011-01-01

Introduction Cystic fibrosis, an epithelial cell transport disorder caused by mutations of the cystic fibrosis transmembrane conductance regulator gene, is not generally associated with malformations of the central nervous system. We review eight previously published reports detailing an infrequent association between cystic fibrosis and Chiari I malformation. Case presentation To the best of our knowledge, our report describes only the ninth case of a baby presenting with a new diagnosis of cystic fibrosis and Chiari I malformation, in this case in a 10-month-old, full-term Caucasian baby boy from the United States of America. Neurosurgical consultation was obtained for associated developmental delay, macrocephaly, bulging anterior fontanel, and papilledema. An MRI scan demonstrated an extensive Chiari I malformation with effacement of the fourth ventricle, obliteration of the outlets of the fourth ventricle and triventricular hydrocephalus without aqueductal stenosis. Our patient was taken to the operating room for ventriculoperitoneal shunt placement. Conclusions It is possible that the cystic fibrosis transmembrane conductance regulator gene may play a previously unrecognized role in central nervous system development; alternatively, this central nervous system abnormality may have been acquired due to constant valsalva from recurrent coughing or wheezing or metabolic and electrolyte imbalances that occur characteristically in cystic fibrosis. PMID:21838874

2D kinematic signatures of boxy/peanut bulges

NASA Astrophysics Data System (ADS)

Iannuzzi, Francesca; Athanassoula, E.

2015-07-01

We study the imprints of boxy/peanut structures on the 2D line-of-sight kinematics of simulated disc galaxies. The models under study belong to a family with varying initial gas fraction and halo triaxiality, plus few other control runs with different structural parameters; the kinematic information was extracted using the Voronoi-binning technique and parametrized up to the fourth order of a Gauss-Hermite series. Building on a previous work for the long-slit case, we investigate the 2D kinematic behaviour in the edge-on projection as a function of the boxy/peanut strength and position angle; we find that for the strongest structures the highest moments show characteristic features away from the mid-plane in a range of position angles. We also discuss the masking effect of a classical bulge and the ambiguity in discriminating kinematically this spherically symmetric component from a boxy/peanut bulge seen end-on. Regarding the face-on case, we extend existing results to encompass the effect of a second buckling and find that this phenomenon spurs an additional set of even deeper minima in the fourth moment. Finally, we show how the results evolve when inclining the disc away from perfectly edge-on and face-on. The behaviour of stars born during the course of the simulations is discussed and confronted to that of the pre-existing disc. The general aim of our study is providing a handle to identify boxy/peanut structures and their properties in latest generation Integral Field Unit observations of nearby disc galaxies.

Observing, studying, and managing for change: Proceedings of the Fourth Interagency Conference on Research in the Watersheds

USGS Publications Warehouse

Medley, C. Nicholas; Patterson, Glenn; Parker, Melanie J.

2011-01-01

These proceedings contain the abstracts, manuscripts, and posters of presentations given at the Fourth Interagency Conference on Research in the Watersheds—Observing, Studying, and Managing for Change, held at the Westmark Hotel in Fairbanks, Alaska, September 26–30, 2011. The conference was jointly hosted by the Bureau of Land Management and the National Park Service.Watersheds face resource impacts driven by accelerated change related to land use, population, and climate. About every three years a conference is held to bring together watershed researchers, observers, and managers to share scientific advances and management strategies. This year, the Fourth ICRW took a wider perspective on watershed science and examined some pressing issues of watershed science and management in our largest and perhaps most vulnerable state, Alaska. The purpose of the conference was to better understand the processes driving change and help managers incorporate societal needs and scientific uncertainty in the management of natural resources.The conference echoed similar themes to the last, highlighting the challenges of managing watersheds based on available science when considerably uncertainty remains regarding the hypothesized relationships between observed environmental changes and their ultimate effects. For example, while the scientific case for anthropogenic climate change has been well presented, confirming possible cause and effect relationships between climatic change and physical and ecological impacts in highly variable, natural systems continues to represent a scientific challenge. This goal becomes even more difficult when superimposed upon a long history of natural resource and land management practices that have fundamentally changed the physical, chemical and biological processes important in maintaining naturally functioning ecosystems. Designing and implementing studies to better understand watersheds and clearly communicating the findings to decisionmakers will be the primary challenge for natural resource scientists and managers into the foreseeable future.

Head and Neck Ultrasound Education-A Multimodal Educational Approach in the Predoctoral Setting: A Pilot Study.

PubMed

Bernard, Stewart; Richardson, Clare; Hamann, Carsten R; Lee, Steve; Dinh, Vi Am

2015-08-01

With the increased implementation of ultrasound in medical education, it is important to continually improve instructional methods. In this study, we demonstrate that by augmenting the traditional methods of instructor demonstration and student practice on a healthy volunteer with additional modalities, such as didactic presentation, simulated pathologic cases, and simulated procedures, students gain a more comprehensive understanding of and confidence in ultrasound technique and pathology. A multimodal curriculum was developed and applied to head and neck ultrasound sessions of our institution's Ultrasound Symposium. Participants were asked to fill out surveys rating each instructional modality as well as preinstructional and postinstructional confidence. The survey results were divided into a group of first- and second-year medical students who had previous ultrasound training and a group of third- and fourth-year students who were ultrasound "naïve." The survey showed that the first- and second-year student group (n = 8) had an average preinstructional confidence of 4.14/10 compared to 1.44/10 in the third- and fourth-year student group (n = 9) (P = .003). Following the instructional sessions, the students' confidence increased respectively to 8.14/10 and 7.78/10 (P= .53), showing a 4.00 (96%) increase in the first- and second-year group and a 6.34 (440%) increase in the third- and fourth-year group. The combined results of all student teaching modality ratings showed that instructor demonstration was rated the highest (9.47) and computerized simulation lowest (8.25). Overall, our study shows that multimodal ultrasound instruction was beneficial in increasing both ultrasound-trained and ultrasound-naïve medical students' confidence in head and neck ultrasound. © 2015 by the American Institute of Ultrasound in Medicine.

Greater occipital nerve block in the treatment of triptan-overuse headache: A randomized comparative study.

PubMed

Karadaş, Ö; Özön, A Ö; Özçelik, F; Özge, A

2017-04-01

This study aims to investigate the efficiency of a single and repeated greater occipital nerve (GON) block using lidocaine in the treatment of triptan-overuse headache (TOH), whose importance has increased lately. In the study, 105 consecutive subjects diagnosed with TOH were evaluated. The subjects were randomized into three groups. In Group 1 (n=35), only triptan was abruptly withdrawn. In Group 2 (n=35), triptan was abruptly withdrawn and single GON block was performed. In Group 3 (n=35), triptan was abruptly withdrawn and three-stage GON block was performed. All patients were injected bilaterally with a total amount of 5 cc 1% lidocaine in each stage. During follow-up, the number of headache days per month, the severity of pain (VAS), the number of triptans used, and hsCRP and IL-6 levels were recorded three times; in the pretreatment period, in the second month post-treatment, and in the fourth month post-treatment. They were then compared. There was a statistically significant difference in the post-treatment fourth month in comparison with the pretreatment period in Group 3 (P<.05). Compared to Group 1, the number of headache days, VAS, and decrease in triptan need in Group 3 was statistically significant compared to Group 2 (P<.05). Compared to pretreatment, in the fourth month post-treatment, both hsCRP and IL-6 levels were lower only in Group 3 (P<.05). We are of the opinion that repeated GON block in addition to the discontinuation of medication has significant efficacy for TOH cases. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Melorheostosis of the hand with complicating bony spur formation and bursal inflammation: diagnosis and treatment.

PubMed

Ameen, S; Nagy, L; Gerich, U; Anderson, S E

2002-08-01

A 37-year old woman presented with intolerable pain associated with a slowly growing mass on the dorsum of the right hand. The radiographs were characteristic of melorheostosis involving the third and fourth metacarpals, with a cortical bony projection extending from the base of the third metacarpal eroding slightly into the fourth metacarpal, associated with bursal formation. Magnetic resonance imaging (MRI) demonstrated an inflamed bursal collection adjacent to the spur. This region corresponded to the patient's severe clinical, focal pain. To our knowledge, this is the first case report in which melorheostosis of the hand has been associated with bony spur formation and complicated by an inflamed bursa.

Constitutional Concerns in Drug Testing of Public Employees.

ERIC Educational Resources Information Center

Allred, Stephen

1987-01-01

Examines Fourth Amendment legal issues involved in drug testing of public employees. Discusses several recent court cases involving probable cause and reasonable suspicion to determine appropriate standards for individual situations. Outlines implications for public employers. Blanket drug testing is not permissable, though job applicants have…

Delayed management of traumatic bilateral cervical facet dislocation: surgical strategy. Report of three cases.

PubMed

Bartels, Ronald H M A; Donk, Roland

2002-10-01

Postinjury cervical spine instability typically requires surgical treatment in the acute or semiacute stage. The authors, however, report on three patients with older (> 8 weeks) untreated bilateral cervical facet dislocation. In two patients they attempted a classic anterior-posterior-anterior approach but failed. The misalignment in the second stage of the procedure could not be corrected, and they had to add a fourth, posterior, stage. To avoid the fourth stage, thereby reducing operating time and risk of neurological damage while turning the patient, they propose the following sequence: 1) a posterior approach to perform a complete facetectomy bilaterally with no attempt to reduce the dislocation; 2) an anterior microscopic discectomy with reduction of the dislocation and anterior fixation; and 3) posterior fixation. This sequence of procedures was successfully performed in the third patient. Based on this experience, they suggest that in cases of nonacute bilateral cervical facet dislocations the operating sequence should be posterior-anterior-posterior.

Economic Cost and Burden of Dengue in the Philippines

PubMed Central

Edillo, Frances E.; Halasa, Yara A.; Largo, Francisco M.; Erasmo, Jonathan Neil V.; Amoin, Naomi B.; Alera, Maria Theresa P.; Yoon, In-Kyu; Alcantara, Arturo C.; Shepard, Donald S.

2015-01-01

Dengue, the world's most important mosquito-borne viral disease, is endemic in the Philippines. During 2008–2012, the country's Department of Health reported an annual average of 117,065 dengue cases, placing the country fourth in dengue burden in southeast Asia. This study estimates the country's annual number of dengue episodes and their economic cost. Our comparison of cases between active and passive surveillance in Punta Princesa, Cebu City yielded an expansion factor of 7.2, close to the predicted value (7.0) based on the country's health system. We estimated an annual average of 842,867 clinically diagnosed dengue cases, with direct medical costs (in 2012 US dollars) of $345 million ($3.26 per capita). This is 54% higher than an earlier estimate without Philippines-specific costs. Ambulatory settings treated 35% of cases (representing 10% of direct costs), whereas inpatient hospitals served 65% of cases (representing 90% of direct costs). The economic burden of dengue in the Philippines is substantial. PMID:25510723

Economic cost and burden of dengue in the Philippines.

PubMed

Edillo, Frances E; Halasa, Yara A; Largo, Francisco M; Erasmo, Jonathan Neil V; Amoin, Naomi B; Alera, Maria Theresa P; Yoon, In-Kyu; Alcantara, Arturo C; Shepard, Donald S

2015-02-01

Dengue, the world's most important mosquito-borne viral disease, is endemic in the Philippines. During 2008-2012, the country's Department of Health reported an annual average of 117,065 dengue cases, placing the country fourth in dengue burden in southeast Asia. This study estimates the country's annual number of dengue episodes and their economic cost. Our comparison of cases between active and passive surveillance in Punta Princesa, Cebu City yielded an expansion factor of 7.2, close to the predicted value (7.0) based on the country's health system. We estimated an annual average of 842,867 clinically diagnosed dengue cases, with direct medical costs (in 2012 US dollars) of $345 million ($3.26 per capita). This is 54% higher than an earlier estimate without Philippines-specific costs. Ambulatory settings treated 35% of cases (representing 10% of direct costs), whereas inpatient hospitals served 65% of cases (representing 90% of direct costs). The economic burden of dengue in the Philippines is substantial. © The American Society of Tropical Medicine and Hygiene.

Learning by Choosing: Fourth Graders Use of an Online Multimedia Tutoring System for Math Problem Solving

ERIC Educational Resources Information Center

Maloy, Robert W.; Razzaq, Leena; Edwards, Sharon A.

2014-01-01

This study explored the use of an online mathematics tutoring system in eight fourth grade classrooms in two Massachusetts communities--a small rural city with a low 2010 Adequate Yearly Progress (AYP) math performance rating and a small suburban district with a high 2010 AYP math performance rating. 165 fourth graders completed 11 modules…

Technology Integration in Third, Fourth and Fifth Grade Classrooms in a Florida School District

ERIC Educational Resources Information Center

Pittman, Tiffani; Gaines, Trudi

2015-01-01

Third, fourth and fifth grade teachers have the potential to shape the way their students will begin to view and use technology. This study investigated the nature of technology usage among third, fourth and fifth grade teachers in a Florida school district as well as the relationship between the level of technology usage factors such as available…

Evaluating Science Education Reform via Fourth-Grade Students' Image of Science Teaching

ERIC Educational Resources Information Center

Yilmaz, Hulya; Turkmen, Hakan; Pedersen, Jon E.

2008-01-01

The purpose of this study was to investigate fourth-grade students image of current science teaching by using a Draw-A-Science-Teacher-Test Checklist (DASTT-C), and give a glance whether the new restructured science education reform in Turkey is implemented successfully or not. Fifty-five (34 girls and 21 boys) fourth-grade students from three…

Cervical Mullerian adenosarcoma with heterologous sarcomatous overgrowth: a fourth case and review of literature.

PubMed

Patrelli, Tito Silvio; Gizzo, Salvatore; Di Gangi, Stefania; Guidi, Giorgia; Rondinelli, Mario; Nardelli, Giovanni Battista

2011-06-11

Uterine sarcomas are relatively rare tumors that account for approximately 1-3% of female genital tract malignancies and between 4-9% of uterine cancers. Less than 8% of all cases are Mullerian adenosarcoma, a distinctive uterine neoplasm characterized by a benign, but occasionally atypical, epithelial and a malignant, usually low-grade, stromal component, both of which should be integral and neoplastic constituents of the tumor. Mullerian adenosarcoma with sarcomatous overgrowth (MASO) is a very aggressive variant, associated with post-operative recurrence, metastases, even when diagnosed in early stage. We present a fourth MASO case derived from uterine cervix in a 72-year-old woman with metrorrhagia and a polypoid mass protruding through the cervical ostium. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, systematic pelvic lymph node dissection, omental biopsy and appendectomy were performed. Surgery treatment was associated with adjuvant whole-pelvis radiation (45 Gy) and adjuvant chemotherapy (cisplatin/ifosfamide). After nine months of follow up, the patient was free of tumor. The rarity of MASO of the cervix involves a management difficult. Most authors recommend total abdominal hysterectomy, usually accompanied by bilateral salpingo-oophorectomy. There is no common agreement on staging by lymphadenectomy during primary surgery and adjuvant chemo-radio therapy.

Fourth near-infrared optical window for assessment of bone and other tissues

NASA Astrophysics Data System (ADS)

Sordillo, Diana C.; Sordillo, Laura A.; Sordillo, Peter P.; Alfano, Robert R.

2016-02-01

Recently, additional near-infrared (NIR) optical windows beyond the conventional first therapeutic window have been utilized for deep tissue imaging through scattering media. Biomedical applications using a second optical window (1100 to 1300 nm) and a third (1600 to 1870 nm) are emerging. A fourth window (2100 to 2300 nm) has been largely ignored due to high water absorption and a lack of high sensitivity imaging detectors and ultrafast laser sources. In this study, optical properties of bone in this fourth NIR optical window, were investigated. Results were compared to those seen at the first, second and third windows, and are consistent with our previous work on malignant and benign breast and prostate tissues. Bone and malignant tissues showed highest uptake in the third and fourth windows. As collagen is a major chromophore with prominent spectral peaks between 2100 and 2300 nm, it may be that the fourth optical window is particularly useful for studying tissues with a higher collagen content, such as bone or malignant tumors.

Defensive responses by a social caterpillar are tailored to different predators and change with larval instar and group size

NASA Astrophysics Data System (ADS)

McClure, Melanie; Despland, Emma

2011-05-01

Gregariousness in animals is widely accepted as a behavioral adaptation for protection from predation. However, predation risk and the effectiveness of a prey's defense can be a function of several other factors, including predator species and prey size or age. The objective of this study was to determine if the gregarious habit of Malacosoma disstria caterpillars is advantageous against invertebrate natural enemies, and whether it is through dilution or cooperative defenses. We also examined the effects of larval growth and group size on the rate and success of attacks. Caterpillars of M. disstria responded with predator-specific behaviors, which led to increased survival. Evasive behaviors were used against stinkbugs, while thrashing by fourth instar caterpillars and holding on to the silk mat by second instar caterpillars was most efficient against spider attacks. Collective head flicking and biting by groups of both second and fourth instar caterpillars were observed when attacked by parasitoids. Increased larval size decreased the average number of attacks by spiders but increased the number of attacks by both stinkbugs and parasitoids. However, increased body size decreased the success rate of attacks by all three natural enemies and increased handling time for both predators. Larger group sizes did not influence the number of attacks from predators but increased the number of attacks and the number of successful attacks from parasitoids. In all cases, individual risk was lower in larger groups. Caterpillars showed collective defenses against parasitoids but not against the walking predators. These results show that caterpillars use different tactics against different natural enemies. Overall, these tactics are both more diverse and more effective in fourth instar than in second instar caterpillars, confirming that growth reduces predation risk. We also show that grouping benefits caterpillars through dilution of risk, and, in the case of parasitoids, through group defenses. The decreased tendency to aggregate in the last larval instar may therefore be linked to decreasing predation risk.

[The growth of attenuated strains of canine parvovirus, mink enteritis virus, feline panleukopenia virus, and rabies virus on various types of cell cultures].

PubMed

Zuffa, T

1987-10-01

The growth characteristics were studied in the attenuated strains of canine parvovirus CPVA-BN 80/82, mink enteritis virus MEVA-BN 63/82 and feline panleucopenia virus FPVA-BN 110/83 on the stable feline kidney cell line FE, and in the attenuated canine distemper virus CDV-F-BN 10/83 on chicken embryo cell cultures (KEB) and cultures of the stable cell line VERO. When the FE cultures were infected with different parvoviruses in cell suspension at MOI 2-4 TKID50 per cell, the first multiplication of the intracellular virus was recorded 20 hours p. i. In the canine parvovirus, the content of intracellular and extracellular virus continued increasing parallelly until the fourth day; then, from the fourth to the sixth day, the content of extracellular virus still increased whereas that of intracellular virus fell rapidly. In the case of the mink enteritis virus the release of the virus into the culture medium continued parallelly with the production of the cellular virus until the sixth day. In the case of the feline panleucopenia virus the values concerning free virus and virus bound to cells were lower, starting from the second day p. i. When KEB or VERO cultures were infected in cell suspension with the canine distemper virus at MOI about 0.004 per 1 cell, the replicated intracellular virus was first recorded in the KEB cultures five hours after infection but in the VERO cultures only 20 hours after infection, with a timely release of the virus into the culture medium in both kinds of tissue. In the KEB and VERO cultures the highest values of infection titres were recorded on the fourth day p. i., the course of virus multiplication on the cells being parallel with its release into the culture medium.

An aggressive vertebral hemangioma in pregnancy: a case report

PubMed Central

2014-01-01

Introduction Pregnancy-related compressive myelopathy secondary to vertebral hemangioma is a rare occurrence and its treatment antepartum is rare. Case presentation A 19-year-old North African woman in her 38th week of pregnancy presented with paraplegia that progressed within 2 days after a rapidly progressive weakness of her lower limbs. Magnetic resonance imaging studies showed compression of her spinal cord in front of the fourth thoracic vertebra for suspected tuberculous spondylitis. A Caesarean section was done followed by corpectomy with a bone graft because we intraoperatively discovered a vertebral hemangioma. Pathology showed an aggressive hemangioma. Conclusion At any term of pregnancy, extensive neurological involvement which is rapidly progressive due to compression should be considered for immediate decompression. PMID:24943121

Testing the Limits on Drug Limits.

ERIC Educational Resources Information Center

Dowling-Sendor, Benjamin

2001-01-01

In an Oklahoma case, absence of a documented drug problem among students in nonathletic extracurricular activities led the10th Circuit Court to strike down the district's policy as unreasonable and unconstitutional. Imposing random, suspicionless drug-testing policies for all students attending school might violate the Fourth Amendment. (MLH)

Perspective of the Graduating Medical Student: The Ideal Curriculum for the Fourth Year of Undergraduate Medical Education.

PubMed

Andrews, Mary A; Paolino, Nathalie D; DeZee, Kent J; Hemann, Brian

2016-11-01

To explore medical students' perspective regarding the fourth year of medical school and common educational activities thereof. The authors surveyed students graduating in 2012 with a military service obligation about the importance of common fourth-year activities, the proportion of the fourth year devoted to these activities, and important considerations for the fourth-year curriculum. The authors calculated mean importance scores for educational activities and mean proportions of the fourth year that should be devoted to certain activities. Two reviewers independently coded free-text answers to identify and calculate frequencies for common themes. The response rate was 40% (376/942). Participants rated activities related to improving clinical skills and securing the residency of their choice as more than activities such as learning business skills, conducting research, and studying basic sciences. Participants indicated that electives and direct patient care should comprise the majority of the fourth year and frequently mentioned improving specialty-specific clinical skills, pursuing personal medical interests, and taking time to relax as important fourth-year themes. Students value activities related to securing and succeeding in their chosen residency and the opportunity to pursue electives and take vacation. Faculty should consider the student perspective when reforming curricula. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

First-aid algorithms in dental avulsion.

PubMed

Baginska, Joanna; Wilczynska-Borawska, Magdalena

2012-04-01

Almost one fourth of traumatic dental injuries occur at schools or in their surroundings. Prevalence of tooth avulsion varies from 0.5% to 16% of all cases of dental trauma. Children with dental avulsion may seek help from school nurses so they should be able to provide first-aid treatment. However, many studies showed that the general level of knowledge of medical staff concerning tooth avulsion is unsatisfactory and that it could be improved by educational activities. This article attempts to give short algorithms of first-aid management of avulsed tooth.

High-order dispersion in chirped-pulse oscillators.

PubMed

Kalashnikov, Vladimir L; Fernández, Alma; Apolonski, Alexander

2008-03-17

The effects of high-order dispersion on a chirped-pulse oscillator operating in the positive dispersion regime were studied both theoretically and experimentally. It was found that odd and negative even high-order dispersions impair the oscillator stability owing to resonance with the dispersion waves, but can broaden the spectrum as in the case of continuum generation in the fibers. Positive fourth-order dispersion enhances the stability and shifts the stability range into negative dispersion. The destabilization mechanism was found to be a parametrical instability which causes noisy mode locking around zero dispersion.

ABR Core examination preparation: results of a survey of fourth-year radiology residents who took the 2013 examination.

PubMed

Shetty, Anup S; Grajo, Joseph R; Decker, Summer; Heitkamp, Darel E; DeStigter, Kristen K; Mezwa, Duane G; Deitte, Lori

2015-01-01

A survey was administered to fourth-year radiology residents after receiving their results from the first American Board of Radiology (ABR) Core examination in 2013. The purpose was to gather information regarding resources and study strategies to share with program directors and future resident classes. An online survey was distributed to examinees nationwide. The survey included free-response and multiple choice questions that covered examination results, perceived value of enumerated study resources, case-based and didactic teaching conferences, board reviews, study materials for noninterpretive skills, multidisciplinary conference attendance, and free-form comments. Two hundred sixty-six of 1186 residents who took the Core examination responded to the survey. Some resources demonstrated a significant difference in perceived value between residents who passed the examination and residents who failed, including internal board reviews (1.10, P < .01), daily didactic conferences (1.51, P < .01), and daily case conferences (1.43, P < .01). Residents who passed reported that conferences and review sessions at their institutions were modified with multiple choice questions, audience response, and integration of clinical physics and patient safety topics compared to residents who failed. Radiology residents and residency programs have adapted their preparations for the ABR Core examination in a variety of ways. Certain practices and study tools, including daily conferences and internal board reviews, had greater perceived value by residents who passed the examination than by residents who failed. This survey provides insights that can be used to assess and modify current preparation strategies for the ABR Core examination. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

High adherence to the Western, Prudent, and Mediterranean dietary patterns and risk of gastric adenocarcinoma: MCC-Spain study.

PubMed

Castelló, Adela; Fernández de Larrea, Nerea; Martín, Vicente; Dávila-Batista, Verónica; Boldo, Elena; Guevara, Marcela; Moreno, Víctor; Castaño-Vinyals, Gemma; Gómez-Acebo, Inés; Fernández-Tardón, Guillermo; Peiró, Rosana; Olmedo-Requena, Rocío; Capelo, Rocio; Navarro, Carmen; Pacho-Valbuena, Silvino; Pérez-Gómez, Beatriz; Kogevinas, Manolis; Pollán, Marina; Aragonés, Nuria

2018-05-01

The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology. MCC-Spain is a multicase-control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns-derived in another Spanish case-control study-with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models. A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratio fourth_vs._first_quartile (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratio second_vs._first_quartile (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratio fourth_vs._first_quartile (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors. Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma.

Potential Protective Effects of Probiotics and Prebiotics Against Colorectal Cancer

NASA Astrophysics Data System (ADS)

Allsopp, Philip; Rowland, Ian

Colorectal cancer (CRC) is the fourth most frequent cause of cancer related mortality in the world. Approximately 944,000 new cases were diagnosed globally in 2000 and this accounts for 9.2% of all new cancer cases (IARC, 2000). In Western societies namely Europe, North America and Australasia, it is the second most prevalent cancer after lung/breast (Boyle and Langman, 2000). About 363,000 new cases were reported in Europe in 2000 and it affects 6% of men and women by age 75, in almost equal proportion.

Properties of inductive reasoning.

PubMed

Heit, E

2000-12-01

This paper reviews the main psychological phenomena of inductive reasoning, covering 25 years of experimental and model-based research, in particular addressing four questions. First, what makes a case or event generalizable to other cases? Second, what makes a set of cases generalizable? Third, what makes a property or predicate projectable? Fourth, how do psychological models of induction address these results? The key results in inductive reasoning are outlined, and several recent models, including a new Bayesian account, are evaluated with respect to these results. In addition, future directions for experimental and model-based work are proposed.

The fourth dimension in simulation surgery for craniofacial surgical procedures.

PubMed

Kurihara, T

2001-03-01

The intracranial volume was measured in all 18 cases of craniosynostosis and craniofacial synostosis with 3DCT using a modification of Miyake's formula, with a 6 years' follow-up. 1: There were no cases where the intracranial volume was less than the modified Miyake's formula. 2: Total cranial reshaping, compared to the local forehead advancement, was effective in increasing the intracranial cavity and growth postoperatively. 3: In cases of craniofacial synostosis, there is a possibility that mental retardation will develop if the intracranial volume tends to increase rapidly and more than expected.

Effects of Training in Problem Solving on the Problem-Solving Abilities of Gifted Fourth Graders: A Comparison of the Future Problem Solving and Instrumental Enrichment Programs.

ERIC Educational Resources Information Center

Dufner, Hillrey A.; Alexander, Patricia A.

The differential effects of two different types of problem-solving training on the problem-solving abilities of gifted fourth graders were studied. Two successive classes of gifted fourth graders from Weslaco Independent School District (Texas) were pretested with the Coloured Progressive Matrices (CPM) and Thinking Creatively With Pictures…

The Effects of Background Music in the Classroom on the Productivity, Motivation, and Behavior of Fourth Grade Students

ERIC Educational Resources Information Center

White, Kevin N.

2007-01-01

Many students in a fourth grade classroom at Logan Elementary School are expressing numerous types of negative behaviors, are not motivated to learn, and do not stay on-task. In an effort to change these students, an action research study was conducted that implemented background music in the classroom. There were ten fourth grade students who…

Comparative effectiveness of fourth-line anti-hypertensive agents in resistant hypertension: A systematic review and meta-analysis.

PubMed

Sinnott, Sarah-Jo; Tomlinson, Laurie A; Root, Adrian A; Mathur, Rohini; Mansfield, Kathryn E; Smeeth, Liam; Douglas, Ian J

2017-02-01

Aim We assessed the effectiveness of fourth-line mineralocorticoid receptor antagonists in comparison with other fourth-line anti-hypertensive agents in resistant hypertension. Methods and results We systematically searched Medline, EMBASE and the Cochrane library from database inception until January 2016. We included randomised and non-randomised studies that compared mineralocorticoid receptor antagonists with other fourth-line anti-hypertensive agents in patients with resistant hypertension. The outcome was change in systolic blood pressure, measured in the office, at home or by ambulatory blood pressure monitoring. Secondary outcomes were changes in serum potassium and occurrence of hyperkalaemia. We used random effects models and assessed statistical heterogeneity using the I 2 test and corresponding 95% confidence intervals. From 2,506 records, 5 studies met our inclusion criteria with 755 included patients. Two studies were randomised and three were non-randomised. Comparative fourth-line agents included bisoprolol, doxazosin, furosemide and additional blockade of the renin angiotensin-aldosterone system. Using data from randomised studies, mineralocorticoid receptor antagonists reduced blood pressure by 7.4 mmHg (95%CI 3.2 - 11.6) more than the active comparator. When limited to non-randomised studies, mineralocorticoid receptor antagonists reduced blood pressure by 11.9 mmHg (95% CI 9.3 - 14.4) more than the active comparator. Conclusion On the basis of this meta-analysis, mineralocorticoid receptor antagonists reduce blood pressure more effectively than other fourth-line agents in resistant hypertension. Effectiveness stratified by ethnicity and comorbidities, in addition to information on clinical outcomes such as myocardial infarction and stroke, now needs to be determined.

Dandy-Walker Malformation Presenting with Affective Symptoms.

PubMed

Batmaz, Mert; Balçik, Zeynep Ezgi; Özer, Ürün; Hamurişçi Yalçin, Burcu; Özen, Şakir

2017-09-01

Dandy-Walker malformation is defined by enlarged posterior fossa, cystic dilatation of the fourth ventricle, and cerebellar hypoplasia. Although developmental delay and mental retardation are common in Dandy-Walker malformation cases, other comorbid psychiatric conditions have been rarely reported. There are limited numbers of case reports about comorbidity of bipolar disorder with Dandy-Walker malformation in the literature. Herein, a Dandy-Walker malformation case presenting affective symptoms is reported, and psychiatric symptoms which might be seen in this rare malformation are discussed along with diagnosis, treatment, and follow-up processes. A 27-year-old male patient, hospitalized for compulsory treatment, had been diagnosed with Dandy-Walker malformation in childhood. First complaints were attention deficiency, behavioral problems, learning difficulties; and manic and depressive episodes have occurred during follow-ups. He recently complained of decreased need for sleep, irritability, and increased speed of thought, and psychiatric examination was consistent with manic episode. Cranial computed tomography (CT) revealed bilateral ventriculomegaly, enlarged third and fourth ventricles with posterior fossa cyst, and cerebellar hypoplasia. His treatment included 30 mg/day aripiprazole, 1000 mg/day valproic acid, 200 mg/day quetiapine, 4 mg/day biperiden, and 100 mg/month paliperidone palmitate. Beside its traditional role in the regulation of coordination and motor functions, cerebellum is increasingly emphasized for its involvement in the mood regulation. Thus, as seen in Dandy-Walker malformation, cerebellar anomalies are suggested to play a role in the pathophysiology of mood disorders. Further studies are needed to better understand the relationship between mood disorders and cerebellum. Moreover, treatment options should be considered carefully in terms of resistance to treatment and potential side effects, for psychiatric disorders occurring in these cases; and detailed examinations, including cranial imaging, would be beneficial in bipolar cases with early onset, unresponsiveness to treatment, presenting atypical symptoms, mental retardation, and developmental delay as well as neurological symptoms and signs.

Dandy-Walker Malformation Presenting with Affective Symptoms

PubMed Central

BATMAZ, Mert; BALÇIK, Zeynep Ezgi; ÖZER, Ürün; HAMURİŞÇİ YALÇIN, Burcu; ÖZEN, Şakir

2017-01-01

Dandy-Walker malformation is defined by enlarged posterior fossa, cystic dilatation of the fourth ventricle, and cerebellar hypoplasia. Although developmental delay and mental retardation are common in Dandy-Walker malformation cases, other comorbid psychiatric conditions have been rarely reported. There are limited numbers of case reports about comorbidity of bipolar disorder with Dandy-Walker malformation in the literature. Herein, a Dandy-Walker malformation case presenting affective symptoms is reported, and psychiatric symptoms which might be seen in this rare malformation are discussed along with diagnosis, treatment, and follow-up processes. A 27-year-old male patient, hospitalized for compulsory treatment, had been diagnosed with Dandy-Walker malformation in childhood. First complaints were attention deficiency, behavioral problems, learning difficulties; and manic and depressive episodes have occurred during follow-ups. He recently complained of decreased need for sleep, irritability, and increased speed of thought, and psychiatric examination was consistent with manic episode. Cranial computed tomography (CT) revealed bilateral ventriculomegaly, enlarged third and fourth ventricles with posterior fossa cyst, and cerebellar hypoplasia. His treatment included 30 mg/day aripiprazole, 1000 mg/day valproic acid, 200 mg/day quetiapine, 4 mg/day biperiden, and 100 mg/month paliperidone palmitate. Beside its traditional role in the regulation of coordination and motor functions, cerebellum is increasingly emphasized for its involvement in the mood regulation. Thus, as seen in Dandy-Walker malformation, cerebellar anomalies are suggested to play a role in the pathophysiology of mood disorders. Further studies are needed to better understand the relationship between mood disorders and cerebellum. Moreover, treatment options should be considered carefully in terms of resistance to treatment and potential side effects, for psychiatric disorders occurring in these cases; and detailed examinations, including cranial imaging, would be beneficial in bipolar cases with early onset, unresponsiveness to treatment, presenting atypical symptoms, mental retardation, and developmental delay as well as neurological symptoms and signs. PMID:29033643

Enhancing the performance of gastrointestinal tumour board by improving documentation.

PubMed

Alsuhaibani, Roaa Saleh; Alzahrani, Hajer; Algwaiz, Ghada; Alfarhan, Haneen; Alolayan, Ashwaq; Abdelhafiz, Nafisa; Ali, Yosra; Jazieh, Abdul Rahman

2018-01-01

Tumour board contributes to providing better patient care by using a multidisciplinary team approach. In the efforts of evaluating the performance of the gastrointestinal tumour board at our institution, it was difficult to assess past performance due to lack of proper use of standardised documentation tool. This project aimed at improving adherence to the documentation tool and its recommendations in order to obtain performance measures for the tumour board. A multidisciplinary team and a plan were developed to improve documentation. Four rapid improvement cycles, Plan-Do-Study-Act (PDSA) cycles, were conducted. The first cycle focused on updating the case discussion summary form (CDSF) based on experts' input and previous identified deficiencies to enhance documentation and improve performance. The second PDSA cycle aimed at incorporating the CDSF into the electronic medical records system and assessing its functionality. The third cycle was to orient and train staff on using the form and launching it. The fourth PDSA cycle aimed at assessing the ability to obtain tumour board performance measures. Adherence to completion of the CDSF improved from 82% (baseline) to 94% after the fourth PDSA cycle. Over 104 consecutive cases discussed in the tumour board between January and July 2016 and 76 cases discussed in 2015, results were as follows: adherence to National Comprehensive Cancer Network guidelines in 2016 was observed in 141 (95%) recommendations, while it was observed in 90 (92%) recommendations in 2015. Changes in the management plans were observed in 37 (36%) cases in 2016 and in 6 (8%) cases in 2015. Regarding tumour board recommendations, 87% were done within 3 months of tumour board discussion in 2016, while 69% were done in 2015. Implementing electronic standardised documentation tool improved communication among the team and enabled getting accurate data about performance measures of the tumour board with positive impact on healthcare process and outcomes.

Comment on "Universal relation between skewness and kurtosis in complex dynamics"

NASA Astrophysics Data System (ADS)

Celikoglu, Ahmet; Tirnakli, Ugur

2015-12-01

In a recent paper [M. Cristelli, A. Zaccaria, and L. Pietronero, Phys. Rev. E 85, 066108 (2012), 10.1103/PhysRevE.85.066108], the authors analyzed the relation between skewness and kurtosis for complex dynamical systems, and they identified two power-law regimes of non-Gaussianity, one of which scales with an exponent of 2 and the other with 4 /3 . They concluded that the observed relation is a universal fact in complex dynamical systems. In this Comment, we test the proposed universal relation between skewness and kurtosis with a large number of synthetic data, and we show that in fact it is not a universal relation and originates only due to the small number of data points in the datasets considered. The proposed relation is tested using a family of non-Gaussian distribution known as q -Gaussians. We show that this relation disappears for sufficiently large datasets provided that the fourth moment of the distribution is finite. We find that kurtosis saturates to a single value, which is of course different from the Gaussian case (K =3 ), as the number of data is increased, and this indicates that the kurtosis will converge to a finite single value if all moments of the distribution up to fourth are finite. The converged kurtosis value for the finite fourth-moment distributions and the number of data points needed to reach this value depend on the deviation of the original distribution from the Gaussian case.

Kinetics studies of the reactions of main fourth-period monocations (Ga+, Ge+, As+, and Se+) with methyl fluoride.

PubMed

Barrientos, Carmen; Rayón, Víctor Manuel; Largo, Antonio; Sordo, José Ángel; Redondo, Pilar

2013-08-22

Thermodynamics and kinetics theoretical studies on the gas-phase reactions of fluoromethane with main fourth-period monocations (Ga(+), Ge(+), As(+), and Se(+)) have been carried out. Density functional theory (in particular mPW1K functional) was employed in the description of the potential energy surfaces, and refinement of the energies were done at the CCSD(T) level. The reaction rate constants were estimated using variational/conventional microcanonical transition state theory. From a thermodynamic viewpoint, the fluorine abstraction product is predicted for Ga(+) and Ge(+), whereas for As(+) and Se(+) the elimination product, MCH2(+) (M = As, Se) + HF, is the preferred one. Nevertheless, the most favorable channel for the reactions of CH3F with Ga(+) and Se(+) cations present a net activation barrier. In the case of Ga(+), the reaction proceeds via an addition channel forming the adduct complex, CH3FGa(+), whereas for Se(+) no reaction is found, in agreement with the experiments. The predicted reaction rate constants are in reasonable good agreement with the experimental values available. Apart from the harpoon-like mechanism, our results suggest that an oxidative addition mechanism seems to play a relevant role.

Dynamic analysis of spiral bevel and hypoid gears with high-order transmission errors

NASA Astrophysics Data System (ADS)

Yang, J. J.; Shi, Z. H.; Zhang, H.; Li, T. X.; Nie, S. W.; Wei, B. Y.

2018-03-01

A new gear surface modification methodology based on curvature synthesis is proposed in this study to improve the transmission performance. The generated high-order transmission error (TE) for spiral bevel and hypoid gears is proved to reduce the vibration of geared-rotor system. The method is comprised of the following steps: Firstly, the fully conjugate gear surfaces with pinion flank modified according to the predesigned relative transmission movement are established based on curvature correction. Secondly, a 14-DOF geared-rotor system model considering backlash nonlinearity is used to evaluate the effect of different orders of TE on the dynamic performance a hypoid gear transmission system. For case study, numerical simulation is performed to illustrate the dynamic response of hypoid gear pair with parabolic, fourth-order and sixth-order transmission error derived. The results show that the parabolic TE curve has higher peak to peak amplitude compared to the other two types of TE. Thus, the excited dynamic response also shows larger amplitude at response peaks. Dynamic responses excited by fourth and sixth order TE also demonstrate distinct response components due to their different TE period which is expected to generate different sound quality or other acoustic characteristics.

Is college education an equalizer for social disparities in health literacy? A case study in Shanghai, China.

PubMed

Hu, Anning; Yang, Xiaozhao Yousef

2017-11-01

The aim of the study was to illustrate the immediate effect of the college education process (across college grades) on the strength of association between parental education and college attendees' health literacy. Cross-sectional analysis was conducted based on data from a random sample of students in one university in Shanghai, China ( N = 574). Exploratory factor analysis was used to generate factors of different dimensions of health literacy. Ordinary least square regression models were estimated to investigate how college education process alters the family-based disparity in health literacy. The link between parental education and health-related skills did not vary significantly across grades of participants, but participants in their third ( p < 0.05) and fourth year ( p < 0.001) revealed a significantly weaker association between health-promoting proactivity and parental education, relative to the first-year counterparts. Also, the impact of parental education on health-related attitudes significantly declined among the fourth-year seniors, compared with first-year students ( p < 0.05). Higher education experience is an important mechanism to alleviate the socioeconomic gap in health literacy. Such an equalizer effect, nevertheless, is contingent on the particular dimensions of health literacy.

Antibiotic treatment for the sexual partners of women with bacterial vaginosis.

PubMed

Amaya-Guio, Jairo; Viveros-Carreño, David Andres; Sierra-Barrios, Eloisa Mercedes; Martinez-Velasquez, Mercy Yolima; Grillo-Ardila, Carlos F

2016-10-01

Bacterial vaginosis (BV) is an infection that has a prevalence between 10% to 50% worlwide. BV results in an imbalance of the normal vaginal flora. Microorganisms associated with BV have been isolated from the normal flora of the male genital tract, and their presence could be related to the recurrence of BV after antibiotic treatment. Therefore, the treatment of sexual partners could decrease the recurrence of infection and possibly the burden of the disease. To assess the effectiveness in women and the safety in men of concurrent antibiotic treatment for the sexual partners of women treated for BV. We searched the Cochrane Sexually Transmitted Infections Group Specialized Register (23 July 2016), CENTRAL (1991 to 23 July 2016), MEDLINE (1946 to 23 July 2016), Embase (1974 to 23 July 2016), LILACS (1982 to 23 July 2016), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (23 July 2016), ClinicalTrials.gov (23 July 2016) and the Web of Science™ (2001 to 23 July 2016). We also handsearched conference proceedings, contacted trial authors and reviewed the reference lists of retrieved studies. Randomized controlled trials (RCTs) that compared the concurrent use of any antibiotic treatment with placebo, no intervention or any other intervention by the sexual partners of women treated for BV. Three review authors independently assessed trials for inclusion, extracted data and assessed the risk of bias in the included studies. We resolved any disagreements through consensus. We assessed the quality of the evidence using the GRADE approach. Seven RCTs (1026 participants) met our inclusion criteria, and pharmaceutical industry funded four of these trials. Five trials (854 patients) compared any antibiotic treatment of sexual partners with placebo. Based on high quality evidence, antibiotic treatment does not increase the rate of clinical or symptomatic improvement in women during the first week (risk ratio (RR) 0.99, 95% confidence interval (CI) 0.96 to 1.03; 712 participants, four studies; RR 1.06, 95% CI 1.00 to 1.12; 577 patients, three studies, respectively), between the first and fourth week (RR 1.02, 95% CI 0.94 to 1.11; 590 participants, three studies; RR 0.93, 95% CI 0.84 to 1.03; 444 participants, two studies; respectively) or after the fourth week (RR 0.98, 95% CI 0.90 to 1.07; 572 participants, four studies; RR 1.03, 95% CI 0.90 to 1.17; 296 participants, two studies; respectively). Antibiotic treatment does not led to a lower recurrence during the first and fourth week (RR 1.28, 95% CI 0.68 to 2.43; 218 participants, one study; low quality evidence) or after the fourth week of treatment (RR 1.00, 95% CI 0.67 to 1.52; 372 participants, three studies; low quality evidence) in women, but increases the frequency of adverse events (most frequently gastrointestinal symptoms) reported by sexual partners (RR 2.55, 95% CI 1.55 to 4.18; 477 participants, three studies; low quality evidence). Two trials (172 participants) compared any antibiotic treatment for sexual partners with no intervention. When we compared it with no intervention, the effects of antibiotic treatment on recurrence rate after the fourth week (RR 1.71, 95% CI 0.65 to 4.55; 51 participants, one study), clinical improvement between the first and fourth week (RR 0.93, 95% CI 0.70 to 1.25; 152 participants, two studies) and symptomatic improvement after the fourth week (RR 0.66, 95% CI 0.39 to 1.11; 70 participants, one study) were imprecise and there were no differences between groups. We downgraded the quality of the evidence to low or very low. High quality evidence shows that antibiotic treatment for sexual partners of women with BV, compared with placebo, does not increase the rate of clinical or symptomatic improvement during the first, between the first and fourth or after the fourth week into the women. Low quality evidence suggests that antibiotic treatment does not led to a lower recurrence rate during the first and fourth or after the fourth week of treatment into the women, but increases the frequency of adverse events reported by sexual partners. Finally, compared with no intervention, antibiotic treatment does not decrease the recurrence rate after the fourth week and does not increase the frequency of clinical or symptomatic improvement between the first and fourth or after the fourth week into the women, respectively.

Concussion assessment and management knowledge among chiropractic fourth year interns and residents

PubMed Central

Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell

2016-01-01

Objectives: To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. Methods: A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Results: Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator’s reports on medical students and residents. Several knowledge gaps were identified in the sample population. Conclusion: The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents. PMID:28065987

Concussion assessment and management knowledge among chiropractic fourth year interns and residents.

PubMed

Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell

2016-12-01

To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator's reports on medical students and residents. Several knowledge gaps were identified in the sample population. The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents.

Numerical solutions of acoustic wave propagation problems using Euler computations

NASA Technical Reports Server (NTRS)

Hariharan, S. I.

1984-01-01

This paper reports solution procedures for problems arising from the study of engine inlet wave propagation. The first problem is the study of sound waves radiated from cylindrical inlets. The second one is a quasi-one-dimensional problem to study the effect of nonlinearities and the third one is the study of nonlinearities in two dimensions. In all three problems Euler computations are done with a fourth-order explicit scheme. For the first problem results are shown in agreement with experimental data and for the second problem comparisons are made with an existing asymptotic theory. The third problem is part of an ongoing work and preliminary results are presented for this case.

Affective Temporality: Towards a Fourth Wave

ERIC Educational Resources Information Center

Chamberlain, Prudence

2016-01-01

This article considers the way in which the wave has been constructed as a negative means by which to understand feminism, making a case for reconceptualising the wave as an "affective temporality". Focusing on both feeling and historically specific forms of activism, the article suggests that the wave should not be considered as…

The Principal's Legal Handbook. Fourth Edition

ERIC Educational Resources Information Center

Lane, Kenneth, Ed.; Gooden, Mark, Ed.; Mead, Julie, Ed.; Pauken, Patrick, Ed.; Eckes, Suzanne, Ed.

2008-01-01

The Principal's Legal Handbook contains information and recommendations for practice in four areas. Section 1, "Students and the Law," yields interesting and informative answers on a number of issues related to students and the law: recent issues in schools relative to students' rights; the use of technology; and the latest case law and…

Introduction: Are the Public Schools "Detectably" Safe?

ERIC Educational Resources Information Center

Zirkel, Perry A.

2000-01-01

In the April 1999 issue of this journal, Michael Ferraraccio argues that the justifications advanced for using metal detectors in schools are not sufficiently compelling to outweigh students' Fourth Amendment privacy rights. In the accompanying Counterpoint, Robert Johnson cites lower court cases to support the constitutionality of their used on a…

Utility of Inferential Norming with Smaller Sample Sizes

ERIC Educational Resources Information Center

Zhu, Jianjun; Chen, Hsin-Yi

2011-01-01

We examined the utility of inferential norming using small samples drawn from the larger "Wechsler Intelligence Scales for Children-Fourth Edition" (WISC-IV) standardization data set. The quality of the norms was estimated with multiple indexes such as polynomial curve fit, percentage of cases receiving the same score, average absolute…

Rape on College Campuses: Reform through Title IX.

ERIC Educational Resources Information Center

Steinberg, Terry Nicole

1991-01-01

This article first, analyzes the growing problem of campus rape; second, evaluates some college rape reduction programs; third, uses case law to demonstrate that rape should be considered sex discrimination under Title IX; and, fourth, suggests an amendment to Title IX, defining rape as sex discrimination. Appropriate implementation measures by…

The Second-to-Fourth Digit Ratio in Cryptorchidism: A Case-Control Study

PubMed Central

Hwang, Hawook; Jo, Hyun Wook; Yun, Bongju; Kim, Taewoo; Yu, Daeseon; Park, Jinsung; Kim, Dae Kyeng

2014-01-01

Purpose The homeobox (Hox) genes a and d controlling limb and genital development influence the digit ratio and the fetal production of testicular androgen, which may result in testicular descent in boys. To assess whether the digit ratio reflects disease status, we investigated the second and fourth finger lengths in children with cryptorchidism, in children with hydrocele as a disease control, and in healthy controls (boys and girls). Materials and Methods One hundred ninety-six children (46 with cryptorchidism, 50 with hydrocele, 50 healthy boys, and 50 healthy girls) who were 6 to 23 months of age were prospectively enrolled. Digit lengths were measured by 2 investigators, and the mean value was recorded. Results The second-to-fourth digit ratios (2D:4Ds) of the left hand in the cryptorchidism group, hydrocele group, healthy boys, and healthy girls were 0.958, 0.956, 0.950, and 0.956, respectively. The 2D:4D values of the right hand were 0.946, 0.945, 0.952, and 0.969, respectively. The right and left 2D:4D ratios were not significantly different among groups. The 2D:4D of both hands was not related to age, weight, or height. Conclusions According to these results, the 2D:4D was not significantly different in boys with cryptorchidism than in boys with hydrocele or in healthy controls (boys and girls) and failed to reflect disease conditions in the infant period. PMID:24578812

A resident conference for systems-based practice and practice-based learning.

PubMed

Sultana, Carmen J; Baxter, Jason K

2011-02-01

Improving patient safety and quality of care is part of systems-based practice and practice-based learning for residents. We expanded our obstetrics and gynecology department's regularly scheduled morbidity and mortality conferences to teach quality assurance concepts based on patient care on obstetrics and gynecology fourth-year resident rotations. Obstetrics and gynecology fourth-year residents on one of the two rotations each presented and analyzed a systems-based problem they encountered during patient care. They used an online learning module and proposed solutions, many of which were effectively implemented. Over 5 years, case presentations from 33 conferences were available with problems identified in emergency preparedness, coordination of care, scheduling and supervision, communication, medical practice, documentation, and lack of equipment or facilities. Twenty-two of the suggested solutions were partially or totally implemented. Barriers to implementation were identified. In conclusion, a conference presentation by fourth-year residents can identify patient safety problems, aid in their resolution, and suggest changes to patient care while teaching the principles of systems-based practice and practice-based learning.

[Staple fixation for the treatment of hamate metacarpal joint injury].

PubMed

Tang, Yang-Hua; Zeng, Lin-Ru; Huang, Zhong-Ming; Yue, Zhen-Shuang; Xin, Da-Wei; Xu, Can-Da

2014-03-01

To investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury. From May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method. All incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case. The application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

Performance of Fourth-Grade Students in the 2012 NAEP Computer-Based Writing Pilot Assessment: Scores, Text Length, and Use of Editing Tools. Working Paper Series. NCES 2015-119

ERIC Educational Resources Information Center

White, Sheida; Kim, Young Yee; Chen, Jing; Liu, Fei

2015-01-01

This study examined whether or not fourth-graders could fully demonstrate their writing skills on the computer and factors associated with their performance on the National Assessment of Educational Progress (NAEP) computer-based writing assessment. The results suggest that high-performing fourth-graders (those who scored in the upper 20 percent…

Mesothelioma associated with the shipbuilding industry in coastal Virginia.

PubMed

Tagnon, I; Blot, W J; Stroube, R B; Day, N E; Morris, L E; Peace, B B; Fraumeni, J F

1980-11-01

A case-control study was undertaken to clarify reasons for a four-fold increased incidence of mesothelioma discovered among white males in coastal Tidewater, Va., from 1972 to 1978. Sixty-one cases were identified. Interviews with next of kin revealed that the excess was linked to employment in area shipyards. Three-fourths of the cases had been employed in the shipbuilding industry, nearly all beginning employment prior to 1950. Most were career employees, but an increased risk was also found among those who worked only temporarily, mainly during World War II, and were reportedly exposed to asbestos. More of the cases than controls were pipecoverers or pipefitters, but cases were reported to work in a variety of shipyard trades. Few of the mesothelioma cases were heavy smokers, a trend that may be related in part to the competing risks for fatal diseases caused by the interactions of smoking and asbestos exposure. Information obtained by interview for five of the six white females diagnosed with mesothelioma revealed that the husband of four had been employed in the shipbuilding industry.

Departmentalization and Twenty-First Century Skills

ERIC Educational Resources Information Center

Watts, Toy Coles

2012-01-01

The purpose of this study was to investigate the relationship between school organizational style and student outcomes. The research questions that guided this study were, "Is there a difference in mathematical performance of fourth graders who receive departmentalized instruction as compared to fourth grade students who receive…

Incidence of occult athlete's foot in swimmers.

PubMed

Attye, A; Auger, P; Joly, J

1990-09-01

Athlete's foot is a dermatophytic infection frequently found in adults. This disease is, in some cases, asymptomatic. In order to evaluate the incidence of subclinical infection, we obtained 300 toe-web samples from the fourth interdigital space of 150 regular swimmers. More over, 66 specimens from the pool area were analysed. The method used was the carpet technique described by Mariat et al. (10). The fungal isolates were identified according to standard methods. A list of epidemiological data was completed for every swimmer. In our results, 22 swimmers had positive cultures (15%), 8 of these cases had no lesions (36%). They included 7 infections with Trichophyton mentagrophytes (87.5%) and one with T. rubrum (12.5%). We observed one case with a dual infection. Only one sample from the inanimate environment was positive. This study showed a significant incidence of occult athlete's foot in swimmers. To control this endemic problem, adequate preventive measures must be taken.

Primary Intraosseous Adenoid Cystic Carcinoma of the Mandible: A Comprehensive Review With Analysis of 2 Additional Cases.

PubMed

Hu, Hong Ying; Liu, Yuan Yuan; Wang, Hu; Jiang, Meng

2017-08-01

Primary intraosseous adenoid cystic carcinoma (IACC) of the mandible is poorly understood because of its rarity. This study performed a comprehensive literature review on IACC of the mandible. Forty-five cases of IACC reported in the literature and 2 additional cases in the authors' hospital were reviewed. IACC of the mandible generally occurred in the fourth to sixth decades, with no meaningful gender predilection. Pain and swelling were the most common clinical manifestations. Radical surgery combined with postsurgical radiotherapy was recommended as the best treatment. The diagnosis of IACC should be based on clinical, radiologic, and pathologic examinations. Radical surgery combined with postsurgical radiotherapy seems to be the best treatment. In addition, the histologic subtype of the tumor is an important prognostic factor in patients with IACC. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Colloid cyst and multiple meningiomata in Gorlin syndrome.

PubMed

Li, Yan-Lin; Kwok, Stephen Kai-Yan; Shiu, Kenneth Chun-Kit

2018-01-01

A middle-aged man presented with syncope and confusion. Neuroimaging revealed a third ventricular mass with obstructive hydrocephalus and bilateral convexity meningiomata. The masses were excised and pathology showed a colloid cyst and WHO grade 1 meningiomata respectively. Multisystem workup confirmed Gorlin syndrome. To our knowledge, this is the fourth reported case of Gorlin syndrome associated with colloid cyst, and the first case where multiple meningiomata are also present. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Sirenomelia Sequence: A Case History

PubMed Central

Fadhlaoui, Anis; Khrouf, Mohamed; Gaigi, Soumaya; Zhioua, Fethi; Chaker, Anis

2010-01-01

We report a case of sirenomelia sequence observed in an incident of preterm labor during the 29th gestational week. According to some authors, this syndrome should be classified separately from caudal regression syndrome and is likely to be the result of an abnormality taking place during the fourth gestational week, causing developmental abnormalities in the lower extremities, pelvis, genitalia, urinary tract and digestive organs. Despite recent progress in pathology, the etiopathogenesis of sirenomelia is still debated. PMID:21769253

Relations of Friends' Activities to Friendship Quality

ERIC Educational Resources Information Center

Mathur, Ravisha; Berndt, Thomas J.

2006-01-01

Two studies were conducted to examine age and sex differences in friends' activities and relations of participation in these activities to perceived friendship quality. In Study 1, 52 fourth and eighth graders were asked open-ended questions about activities they do with their best friends. In Study 2, 105 fourth and eighth graders reported both…

Supporting Fourth Graders' Ability to Interpret Graphs through Real-Time Graphing Technology: A Preliminary Study

ERIC Educational Resources Information Center

Deniz, Hasan; Dulger, Mehmet F.

2012-01-01

This study examined to what extent inquiry-based instruction supported with real-time graphing technology improves fourth grader's ability to interpret graphs as representations of physical science concepts such as motion and temperature. This study also examined whether there is any difference between inquiry-based instruction supported with…

UNDERSTANDING THE FOURTH GRADE SLUMP IN CREATIVE THINKING. FINAL REPORT.

ERIC Educational Resources Information Center

TORRANCE, E. PAUL

STUDIES OF CREATIVITY AND OF PSYCHOLOGICAL DISTURBANCES IN CHILDREN HAVE SUGGESTED THE PRESENCE OF SLUMPS (OR INVERSIONS) WHICH MAY BE CORRELATED WITH DEVELOPMENTAL TRANSITIONS. THE MOST NOTABLE OF THESE OCCURS AT ABOUT THE FOURTH GRADE AND IS THE OBJECT OF THIS STUDY. THREE SETS OF INVESTIGATIONS WERE UNDERTAKEN--(1) A STUDY OF CREATIVE…

The effects of computer-assisted instruction on the mathematics performance and classroom behavior of children with ADHD.

PubMed

Mautone, Jennifer A; DuPaul, George J; Jitendra, Asha K

2005-08-01

The present study examines the effects of computer-assisted instruction (CAI) on the mathematics performance and classroom behavior of three second-through fourth-grade students with ADHD. A controlled case study is used to evaluate the effects of the computer software on participants' mathematics performance and on-task behavior. Participants' mathematics achievement improve and their on-task behavior increase during the CAI sessions relative to independent seatwork conditions. In addition, students and teachers consider CAI to be an acceptable intervention for some students with ADHD who are having difficulty with mathematics. Implications of these results for practice and research are discussed.

On Critical Behaviour in Systems of Hamiltonian Partial Differential Equations.

PubMed

Dubrovin, Boris; Grava, Tamara; Klein, Christian; Moro, Antonio

2015-01-01

We study the critical behaviour of solutions to weakly dispersive Hamiltonian systems considered as perturbations of elliptic and hyperbolic systems of hydrodynamic type with two components. We argue that near the critical point of gradient catastrophe of the dispersionless system, the solutions to a suitable initial value problem for the perturbed equations are approximately described by particular solutions to the Painlevé-I (P[Formula: see text]) equation or its fourth-order analogue P[Formula: see text]. As concrete examples, we discuss nonlinear Schrödinger equations in the semiclassical limit. A numerical study of these cases provides strong evidence in support of the conjecture.

Bilinear forms and soliton solutions for a fourth-order variable-coefficient nonlinear Schrödinger equation in an inhomogeneous Heisenberg ferromagnetic spin chain or an alpha helical protein

NASA Astrophysics Data System (ADS)

Yang, Jin-Wei; Gao, Yi-Tian; Wang, Qi-Min; Su, Chuan-Qi; Feng, Yu-Jie; Yu, Xin

2016-01-01

In this paper, a fourth-order variable-coefficient nonlinear Schrödinger equation is studied, which might describe a one-dimensional continuum anisotropic Heisenberg ferromagnetic spin chain with the octuple-dipole interaction or an alpha helical protein with higher-order excitations and interactions under continuum approximation. With the aid of auxiliary function, we derive the bilinear forms and corresponding constraints on the variable coefficients. Via the symbolic computation, we obtain the Lax pair, infinitely many conservation laws, one-, two- and three-soliton solutions. We discuss the influence of the variable coefficients on the solitons. With different choices of the variable coefficients, we obtain the parabolic, cubic, and periodic solitons, respectively. We analyse the head-on and overtaking interactions between/among the two and three solitons. Interactions between a bound state and a single soliton are displayed with different choices of variable coefficients. We also derive the quasi-periodic formulae for the three cases of the bound states.

Phase-contrast cerebrospinal fluid flow magnetic resonance imaging in qualitative evaluation of patency of CSF flow pathways prior to infusion of chemotherapeutic and other agents into the fourth ventricle.

PubMed

Patel, Rajan P; Sitton, Clark W; Ketonen, Leena M; Hou, Ping; Johnson, Jason M; Romo, Seferino; Fletcher, Stephen; Shah, Manish N; Kerr, Marcia; Zaky, Wafik; Rytting, Michael E; Khatua, Soumen; Sandberg, David I

2018-03-01

Nuclear medicine studies have previously been utilized to assess for blockage of cerebrospinal fluid (CSF) flow prior to intraventricular chemotherapy infusions. To assess CSF flow without nuclear medicine studies, we obtained cine phase-contrast MRI sequences that assess CSF flow from the fourth ventricle down to the sacrum. In three clinical trials, 18 patients with recurrent malignant posterior fossa tumors underwent implantation of a ventricular access device (VAD) into the fourth ventricle, either with or without simultaneous tumor resection. Prior to infusing therapeutic agents into the VAD, cine MRI phase-contrast CSF flow sequences of the brain and total spine were performed. Velocity encoding (VENC) of 5 and 10 cm/s was used to confirm CSF flow from the fourth ventricular outlets to the cervical, thoracic, and lumbar spine. Qualitative CSF flow was characterized by neuroradiologists as present or absent. All 18 patients demonstrated CSF flow from the outlets of the fourth ventricle down to the sacrum with no evidence of obstruction. One of these patients, after disease progression, subsequently showed obstruction of CSF flow. No patient required a nuclear medicine study to assess CSF flow prior to initiation of infusions. Fourteen patients have received infusions to date, and none has had neurological toxicity. CSF flow including the fourth ventricle and the total spine can be assessed noninvasively with phase-contrast MRI sequences. Advantages over nuclear medicine studies include avoiding both an invasive procedure and radiation exposure.

Subjective and Quantitative Measurement of Wavefront Aberrations in Nuclear Cataracts – A Retrospective Case Controlled Study

PubMed Central

Wali, Upender K.; Bialasiewicz, Alexander A.; Al-Kharousi, Nadia; Rizvi, Syed G.; Baloushi, Habiba

2009-01-01

Purpose: To measure, quantify and compare Ocular Aberrations due to nuclear cataracts. Setting: Department of ophthalmology and school for ophthalmic technicians, college of medicine and health sciences, Sultan Qaboos University, Muscat, Oman. Design: Retrospective case controlled study. Methods: 113 eyes of 77 patients with nuclear cataract (NC) were recruited from outpatient clinic of a major tertiary referral center for Ophthalmology. Patients having NC with no co-existing ocular pathologies were selected. All patients were subjected to wavefront aberrometry (make) using Hartmann-Shack (HS) aberrometer. Consents were taken from all patients. Higher order Aberrations (HOA) were calculated with Zernike polynomials up to the fourth order. For comparison 28 eyes of 15 subjects with no lenticular opacities (control group) were recruited and evaluated in an identical manner. No pupillary mydriasis was done in both groups. Results: Total aberrations were almost six times higher in NC group compared to control (normal) subjects. The HOA were 21 times higher in NC group, and coma was significantly higher in NC eyes compared to normal (control) group. The pupillary diameter was significantly larger in control group (5.48mm ± 1.0024, p<.001) compared to NC (3.05mm ± 1.9145) subjects (probably due to younger control age group). Amongst Zernike coefficients up to fourth order, two polynomials, defocus (Z20) and spherical aberration (Z42) were found to be significantly greater amongst NC group, compared to normal control group. Conclusion: Nuclear cataracts predominantly produce increased defocus and spherical aberrations. This could explain visual symptoms like image deterioration in spite of normal Visual acuity. PMID:20142953

When foods become remedies in ancient Greece: The curious case of garlic and other substances

PubMed Central

Totelin, Laurence

2015-01-01

Ethnopharmacological relevance The debate on the food-drug continuum could benefit from a historical dimension. This study aims at showing this through one case: the food-drug continuum in Greece in the fifth- and fourth-century BCE. I suggest that at the time the boundary between food and drug – and that between dietetics and pharmacology – was rather blurred. Materials and methods I study definitions of ‘food’ and ‘medicine’ in texts from the fifth- and fourth-century BCE: the Hippocratic texts, the botanical treatises of Theophrastus and the pseudo-Aristotelian Problems. To illustrate these abstract definitions, I focus on two substances: garlic and silphium. Results and discussion The Hippocratics were writing in a context of increased professionalization and masculinization of medicine, a context in which dietetics became the most prestigious branch of medicine, praised above pharmacology and surgery. While medicine was becoming more specialised, professionalised and masculine, it avoided becoming too conspicuously so. The Hippocratic authors sometimes noted that medical discoveries are serendipitous and can be made by anyone, whether medically trained or not. By doing so, they allowed themselves to integrate common knowledge and practice into their writings. Conclusion In the context of the professionalization of ancient medicine, the Hippocratic authors started to address the difference between food and medicine. They saw, however, some advantage in acknowledging the continuum between food and medicine. Scholars should avoid drawing too strict a boundary between ancient dietetics and pharmacology and should instead adopt a multi-disciplinary approach to the therapeutics of the Hippocratic texts. PMID:25173971

Clinical importance of caffeine dependence and abuse.

PubMed

Ogawa, Naoshi; Ueki, Hirofumi

2007-06-01

Caffeine is the most widely consumed psychoactive substance and is a legal stimulant that is readily available to children. Caffeine has occasionally been considered a drug of abuse and the potential for dependence on caffeine has been debated. Presently, due to a paucity of clinical evidence on caffeine dependence or abuse, no such diagnosis is included in the Diagnostic and Statistical Manual of Mental Disorder-fourth edition. The authors present two cases of abuse or dependence on the caffeine contained in 'eutrophic' (energy/nutritional) beverages or caffeine preparations, followed by a review of clinical studies demonstrating evidence that some people can manifest a clinical syndrome of caffeine dependence or abuse. The cases suggest that caffeine can produce a clinical dependence syndrome similar to those produced by other psychoactive substances and has a potential for abuse. In a recent study using a structured interview and the Diagnostic and Statistical Manual of Mental Disorder-fourth edition criteria for substance dependence and abuse, a subset of the general population was found to demonstrate caffeine dependence or caffeine abuse. Therefore, the authors propose that companies or businesses manufacturing or marketing caffeine or products containing caffeine must meet the following guidelines: (i) clearly indicate the caffeine content of products containing comparatively higher quantities of caffeine; (ii) warn that such products should be avoided by infants and children wherever possible, and inform adult consumers about the precise quantity of caffeine that is considered safe for consumption; and (iii) clearly state that consuming large quantities of caffeine and the long-term use of caffeine carry health risks.

A Study of Manifestations of Extrapulmonary Tuberculosis in the ENT Region.

PubMed

Akkara, Stani Ajay; Singhania, Ankit; Akkara, Ajay George; Shah, Arti; Adalja, Mayur; Chauhan, Nirali

2014-01-01

Though tuberculosis (TB) primarily affects lungs, extra pulmonary tuberculosis (EPTB) is also common, especially in high disease load areas and mainly manifests in ENT region. To study the different manifestations of tuberculosis in ENT region in terms of presentation, disease process, treatment and outcome. Records of patients diagnosed and treated for TB in the ENT region at our institute's DOTS centre for a two and half year period were analysed for presenting complaints, examination findings, diagnostic features, treatment modes and outcome. Out of 3750 cases diagnosed as TB, 230 had EPTB. 211 cases had ENT manifestations. Majority of the cases were male and in the fourth decade of life. Commonest manifestation was cervical lymphadenopathy with 201 cases. Fine needle aspiration cytology was mostly diagnostic and category I anti TB treatment (AKT) achieved cure. The six cases of TB otitis media presented with ear discharge, sometimes bloody and had varied tympanic membrane findings and facial palsy in two cases with different types and degrees of hearing loss. Diagnosis was confirmed by histology of tissue removed during surgery. Patients completed category I AKT. Hearing and facial palsy did not improve. There were three cases of TB laryngitis and one of nasal TB both of which were confirmed by tissue diagnosis and responded well to AKT. Most of the results in the present study conform to findings of other studies. High degree of suspicion is necessary to reach diagnosis. Category I AKT is effective. Some cases may require surgery.

Comparison of two case-based learning conditions with real patients in teaching occupational medicine.

PubMed

Braeckman, Lutgart; 't Kint, Lode; Bekaert, Micheline; Cobbaut, Luc; Janssens, Heidi

2014-04-01

To investigate the impact of three different training formats in occupational medicine (OM) on perceptions and performance of undergraduate students. A comparative study which included all fourth-year medical students was conducted over a three-year period. The year group in 2010 (211 students) received paper case studies followed by one small group session. The format used in 2011 actively engaged 188 students in the learning process by adding collaborative work and group discussions to the written information. In 2012, the approach comprised no longer constructed text cases but 212 students encountered real patients. Students' perceptions were obtained by questionnaire. Their learning performance was assessed through review of written reports and score on oral presentations. Statistical differences in ratings were analyzed using Fisher's exact and Kruskal-Wallis tests. All three formats were found to equally achieve the stated learning objectives. The year groups with incorporation of active learning strategies and patient contacts had significant better test performance compared to those receiving only written case studies. Real patient students gave statistically significant higher rates for relevance, authenticity and appropriate difficulty level of the training than did students who discussed written case studies. Both approaches with augmented interaction in 2011 and 2012, improved performance and satisfaction among students. However, students valued the use of real patients higher than paper-form cases.

Clinical anatomy e-cases: a five-year follow-up of learning analytics.

PubMed

Perumal, Vivek; Butson, Russell; Blyth, Phil; Daniel, Ben

2017-01-27

This article explores the development and user experiences of a supplementary e-learning resource (clinical anatomy e-cases) for medical students, across a five-year teaching period. A series of online supplementary e-learning resources (the clinical anatomy e-cases) were developed and introduced to the regional and clinical anatomy module of the medicine course. Usage analytics were collected online from a cohort of third-year medical students and analysed to gain a better understanding of how students utilised these resources. Key results showed that the students used the supplementary learning resource during and outside regular teaching hours that includes a significant access during holidays. Analysis also suggested that the resources were frequently accessed during examination periods and during subsequent clinical study years (fourth or fifth years of medicine course). Increasing interest and positive feedback from students has led to the development of a further series of e-cases. Tailor-made e-learning resources promote clinical anatomy learning outside classroom hours and make supplementary learning a 24/7 task.

Apatinib treatment combined with chemotherapy for advanced epithelial ovarian cancer: a case report.

PubMed

Deng, Linghui; Wang, Yue; Lu, Wenbin; Liu, Qian; Wu, Jie; Jin, Jianhua

2017-01-01

Apatinib is a novel oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor-2, which has been proved by clinical trials to be effective and safe for patients with chemotherapy-refractory gastric cancer. To date, there is no study or case report on apatinib treatment for patients with ovarian cancer. Here, we present the case of a 50-year-old Chinese woman with advanced ovarian cancer, who received apatinib at a daily dose of 500 mg for 28 days per cycle after failure of fourth-line chemotherapy. Favorable oncologic outcome was achieved in this case after treatment with apatinib. The patient's progression-free survival is now 11.3 months, and she is taking apatinib and capecitabine as maintenance treatment. The common side effect of apatinib was fatigue; however, the toxicity of apatinib was controllable and tolerable. Thus, apatinib may be an option for chemotherapy-refractory advanced epithelial ovarian cancer, but this still warrants further investigation.

Acoustic Studies of New Materials: Quasicrystals, Low-Loss Glasses, and High Tc Superconductors

DTIC Science & Technology

1990-08-01

REFEREED JOURNALS TECHNICAL REPORTS PUBLISHED 1. NSF Final Progress Report 2. Tania Slawecki M.S. Thesis "Measuring fourth sound in silica aerogel " 3...Pennsylvania State University The Graduate School Department of Physics Measuring Fourth Sound in Silica Aerogel A Thesis in Physics by Tania Maria...Slawecki Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science December 1989 Abstract Measuring Fourth Sound in Silica

Socio-demographic and academic correlates of clinical reasoning in a dental school in South Africa.

PubMed

Postma, T C; White, J G

2017-02-01

There are no empirical studies that describe factors that may influence the development of integrated clinical reasoning skills in dental education. Hence, this study examines the association between outcomes of clinical reasoning in relation with differences in instructional design and student factors. Progress test scores, including diagnostic and treatment planning scores, of fourth and fifth year dental students (2009-2011) at the University of Pretoria, South Africa served as the outcome measures in stepwise linear regression analyses. These scores were correlated with the instructional design (lecture-based teaching and learning (LBTL = 0) or case-based teaching and learning (CBTL = 1), students' grades in Oral Biology, indicators of socio-economic status (SES) and gender. CBTL showed an independent association with progress test scores. Oral Biology scores correlated with diagnostic component scores. Diagnostic component scores correlated with treatment planning scores in the fourth year of study but not in the fifth year of study. 'SES' correlated with progress test scores in year five only, while gender showed no correlation. The empirical evidence gathered in this study provides support for scaffolded inductive teaching and learning methods to develop clinical reasoning skills. Knowledge in Oral Biology and reading skills may be important attributes to develop to ensure that students are able to reason accurately in a clinical setting. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A prospective study of serum soluble CD30 concentration and risk of non-Hodgkin lymphoma

PubMed Central

Lan, Qing; Martinez-Maza, Otoniel; Oken, Martin M.; Hocking, William; Huang, Wen-Yi; Baris, Dalsu; Conde, Betty; Rothman, Nathaniel

2009-01-01

Prediagnostic serum concentration of soluble CD30 (sCD30), a marker for chronic B-cell stimulation, has been associated with increased risk of developing AIDS-related non-Hodgkin lymphoma (NHL) in a recent study of HIV+ patients. To investigate among healthy persons whether serum sCD30 is associated with NHL risk, we carried out a nested case-control study within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. There was a strong dose-response relationship between prediagnostic sCD30 concentration and NHL risk among 234 cases and 234 individually matched controls (odds ratio [95% confidence interval] for second, third, and fourth quartiles vs first quartile: 1.4 [0.8-2.6], 2.2 [1.2-4.1], 4.1 [2.2-7.8]; Ptrend < .001), which persisted among cases diagnosed 6 to 10 years after providing a blood sample. Given that a similar relationship has been observed among HIV+ patients, our findings suggest that chronic B-cell stimulation may be an important mechanism involved in B-cell lymphomagenesis among severely immunocompromised and healthy populations alike. PMID:19638620

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.

Therapeutic efficacy of eprinomectin extended-release injection against induced infections of developing (fourth-stage larvae) and adult nematode parasites of cattle.

PubMed

Rehbein, S; Baggott, D G; Royer, G C; Yoon, S; Cramer, L G; Soll, M D

2013-03-01

The therapeutic efficacy of eprinomectin in an extended-release injection (ERI) formulation was evaluated against induced infections of developing fourth-stage larval or adult gastrointestinal and pulmonary nematodes of cattle in a series of six studies under two identical protocols (three each for developing fourth-stage larvae or adults) conducted in the USA, Germany or the UK (two studies at each location, one per stage). Each study initially included 16 nematode-free cattle. The cattle were of various breeds or crosses, weighed 109-186.5 kg prior to treatment, and were approximately 4-7 months old. The animals were blocked based on pre-treatment bodyweight and then randomly allocated to treatment: eprinomectin ERI vehicle (control) at 1 mL/50 kg body weight or eprinomectin 5% ERI at 1 mL/50 kg bodyweight (1.0 mg eprinomectin/kg) for a total of eight and eight animals in each group. Treatments were administered once on Day 0 by subcutaneous injection in front of the shoulder. In each study, cattle were infected with a combination of infective third-stage larvae or eggs of gastrointestinal and pulmonary nematodes. Inoculation was scheduled so that the nematodes were expected to be fourth-stage larvae or adults at the time of treatment. For parasite recovery, all study animals were humanely euthanized and necropsied 14-15 (adult infections) or 21-22 days after treatment (developing fourth-stage larval infections). When compared with the vehicle-treated control counts, efficacy of eprinomectin ERI against developing fourth-stage larvae and adults was ≥98% (p<0.05) for the following nematodes: Dictyocaulus viviparus, Bunostomum phlebotomum, Cooperia curticei, C. oncophora, C. surnabada, C. punctata, Haemonchus contortus, H. placei, Nematodirus helvetianus, Oesophagostomum radiatum, Oes. venulosum, Ostertagia leptospicularis, O. ostertagi, O. circumcincta, O. pinnata, O. trifurcata (developing fourth-stage larval infections only), Strongyloides papillosus, Trichostrongylus axei, T. colubriformis, and Trichuris ovis (adult infections only). All animals accepted the treatment well. No adverse reaction to treatments was observed in any animal in any study. Copyright © 2012 Elsevier B.V. All rights reserved.

A Study of Attitudes in an All Boys' School.

ERIC Educational Resources Information Center

Tickner, Anne-Marie

This study examined the effect of single-sex schooling on the academic and social development of boys. An extensive literature review presents the conflicting results of studies of various issues related to single-sex education. Subjects of the present study were 39 boys in a fourth grade class at a boys school and 23 boys in a fourth grade class…

Journeys, Adventures, Bridges and Puzzles: A case study approach to understanding teachers' conceptions of STEM

NASA Astrophysics Data System (ADS)

Kenney, Meghan

Legislative changes and discussions about the United States falling further and further behind other nations in science, technology, engineering, and math (STEM) achievement are growing. As they grow, STEM instruction in elementary school has earned its place as a national area of interest in education. In the case of Ivory School District, teachers are being asked to radically change their daily practices by consistently implementing inquiry-based STEM experiences in their classrooms. As such, teachers are being asked to scale a divide between the district expectations and their knowledge and experience. Many fourth grade educators are teachers who have been trained as generalists and typically do not have specific background or experience in the philosophy, instructional strategies, or content associated with STEM. Using a prototype approach, this study aims to understand how such teachers conceptualize STEM instruction and the relationship between their experience and conceptions.

Probing a four flavor vis-a-vis three flavor neutrino mixing for ultrahigh energy neutrino signals at a 1 km2 detector

NASA Astrophysics Data System (ADS)

Pandey, Madhurima; Majumdar, Debasish; Dutta Banik, Amit

2018-05-01

We consider a four-flavor scenario for the neutrinos where an extra sterile neutrino is introduced to the three families of active neutrinos and study the deviation from the three-flavor scenario in the ultrahigh-energy (UHE) regime. We calculate the possible muon and shower yields at a 1 km2 detector such as IceCube for these neutrinos from distant UHE sources, e.g., gamma-ray bursts, etc. Similar estimations for muon and shower yields are also obtained for the three-flavor case. Comparing the two results, we find considerable differences between the yields for these two cases. This can be useful for probing the existence of a fourth sterile component using UHE neutrino flux.

Slow-roll approximation in loop quantum cosmology

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

Luc, Joanna; Mielczarek, Jakub, E-mail: joanna.luc@uj.edu.pl, E-mail: jakub.mielczarek@uj.edu.pl

The slow-roll approximation is an analytical approach to study dynamical properties of the inflationary universe. In this article, systematic construction of the slow-roll expansion for effective loop quantum cosmology is presented. The analysis is performed up to the fourth order in both slow-roll parameters and the parameter controlling the strength of deviation from the classical case. The expansion is performed for three types of the slow-roll parameters: Hubble slow-roll parameters, Hubble flow parameters and potential slow-roll parameters. An accuracy of the approximation is verified by comparison with the numerical phase space trajectories for the case with a massive potential term.more » The results obtained in this article may be helpful in the search for the subtle quantum gravitational effects with use of the cosmological data.« less

Teachers' Classroom Assessment Practices and Fourth-Graders' Reading Literacy Achievements: An International Study

ERIC Educational Resources Information Center

Hao, Shiqi; Johnson, Robert L.

2013-01-01

This study, through multilevel analyses of the data of four English-speaking nations (i.e., Canada, England, New Zealand and the United States) from the Progress in International Reading Literacy Study (PIRLS) 2001 database, investigated the relationship between teachers' uses of various types of classroom assessments and their fourth-graders'…

Breather solutions of a fourth-order nonlinear Schrödinger equation in the degenerate, soliton, and rogue wave limits

NASA Astrophysics Data System (ADS)

Chowdury, Amdad; Krolikowski, Wieslaw; Akhmediev, N.

2017-10-01

We present one- and two-breather solutions of the fourth-order nonlinear Schrödinger equation. With several parameters to play with, the solution may take a variety of forms. We consider most of these cases including the general form and limiting cases when the modulation frequencies are 0 or coincide. The zero-frequency limit produces a combination of breather-soliton structures on a constant background. The case of equal modulation frequencies produces a degenerate solution that requires a special technique for deriving. A zero-frequency limit of this degenerate solution produces a rational second-order rogue wave solution with a stretching factor involved. Taking, in addition, the zero limit of the stretching factor transforms the second-order rogue waves into a soliton. Adding a differential shift in the degenerate solution results in structural changes in the wave profile. Moreover, the zero-frequency limit of the degenerate solution with differential shift results in a rogue wave triplet. The zero limit of the stretching factor in this solution, in turn, transforms the triplet into a singlet plus a low-amplitude soliton on the background. A large value of the differential shift parameter converts the triplet into a pure singlet.

Breather solutions of a fourth-order nonlinear Schrödinger equation in the degenerate, soliton, and rogue wave limits.

PubMed

Chowdury, Amdad; Krolikowski, Wieslaw; Akhmediev, N

2017-10-01

We present one- and two-breather solutions of the fourth-order nonlinear Schrödinger equation. With several parameters to play with, the solution may take a variety of forms. We consider most of these cases including the general form and limiting cases when the modulation frequencies are 0 or coincide. The zero-frequency limit produces a combination of breather-soliton structures on a constant background. The case of equal modulation frequencies produces a degenerate solution that requires a special technique for deriving. A zero-frequency limit of this degenerate solution produces a rational second-order rogue wave solution with a stretching factor involved. Taking, in addition, the zero limit of the stretching factor transforms the second-order rogue waves into a soliton. Adding a differential shift in the degenerate solution results in structural changes in the wave profile. Moreover, the zero-frequency limit of the degenerate solution with differential shift results in a rogue wave triplet. The zero limit of the stretching factor in this solution, in turn, transforms the triplet into a singlet plus a low-amplitude soliton on the background. A large value of the differential shift parameter converts the triplet into a pure singlet.

Pernicious anaemia in triplets. A case report and literature review.

PubMed

Masnou, Helena; Domènech, Eugeni; Navarro-Llavat, Mercè; Zabana, Yamile; Mañosa, Míriam; García-Planella, Esther; Gassull, Miquel A

2007-12-01

Pernicious anemia is the most common cause of vitamin B12 deficiency in adults. This entity is associated with chronic atrophic gastritis. We report a case of pernicious anaemia in triplets. We also report a fourth case of cobalamin deficiency with antibodies against intrinsic factor and anti parietal cell antigen negative antibodies in a sibling. The present article reviews the pediatric presentation of pernicious anemia and highlights the possible existence of familial aggregation. Furthermore, the need for systematic familial screening and the usefulness of an endoscopic follow-up program in patients with pernicious anemia are evaluated.

A Third Branchial Pouch Cyst Presenting as Stridor in a Child

PubMed Central

Wasson, Joseph; Blaney, Sean; Simo, Ricard

2007-01-01

We present a rare case of a third branchial pouch cyst in an 18-month-old child, presenting with stridor and a lateral cervical cystic mass. Differences in the anatomical course of third and fourth branchial cysts, and histological differences between branchial pouch and branchial cleft cysts are discussed. PMID:17316513

Search and Seizure in the Public Schools

ERIC Educational Resources Information Center

Medlin, Kay Cowden

1976-01-01

The protection afforded a minor student by the fourth amendment is perhaps open to some speculation due to his age and the unique situation presented by the school environment. The search and seizure issue is discussed in terms of the findings in several court cases. For journal availability see HE 508 741. (LBH)

Institute for Computational Mechanics in Propulsion (ICOMP) fourth annual review, 1989

NASA Technical Reports Server (NTRS)

1990-01-01

The Institute for Computational Mechanics in Propulsion (ICOMP) is operated jointly by Case Western Reserve University and the NASA Lewis Research Center. The purpose of ICOMP is to develop techniques to improve problem solving capabilities in all aspects of computational mechanics related to propulsion. The activities at ICOMP during 1989 are described.

School Compost Programs: Pathways to Success

ERIC Educational Resources Information Center

Schumpert, Kary; Dietz, Cyndra

2012-01-01

After the oft-repeated three Rs (reduce, reuse, recycle) comes the lesser-known but equally important fourth R: rot. In this case, rot means compost. Classrooms, schools, and school districts can use a number of methods to establish a compost program. The finished product is a valuable soil amendment that adds fertility to local farmland, school…

78 FR 2416 - Notice of Issuance of Final Determination Concerning Rybix® (Tramadol Hydrochloride) Tablets

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... for the management of moderate to moderately severe pain in adults. The active pharmaceutical... fiberboard drums. The fourth stage of French manufacturing is packaging in child- resistant blister packs...) in the case of an article which consists in whole or in part of materials from another country or...

Making the Case for Exploratory World Language Instruction in Catholic Elementary Schools through University Partnerships

ERIC Educational Resources Information Center

Burke, Brigid M.; Howard, Eric D.

2017-01-01

As a result of a university partnership, elementary students at two midwest Catholic elementary schools have been provided with exploratory world language instruction (FLEX) from pre-service teachers. To investigate students' attitudes and learning of Spanish, researchers interviewed second and fourth graders. The students' parents and pre-service…

Multi-scale Eulerian model within the new National Environmental Modeling System

NASA Astrophysics Data System (ADS)

Janjic, Zavisa; Janjic, Tijana; Vasic, Ratko

2010-05-01

The unified Non-hydrostatic Multi-scale Model on the Arakawa B grid (NMMB) is being developed at NCEP within the National Environmental Modeling System (NEMS). The finite-volume horizontal differencing employed in the model preserves important properties of differential operators and conserves a variety of basic and derived dynamical and quadratic quantities. Among these, conservation of energy and enstrophy improves the accuracy of nonlinear dynamics of the model. Within further model development, advection schemes of fourth order of formal accuracy have been developed. It is argued that higher order advection schemes should not be used in the thermodynamic equation in order to preserve consistency with the second order scheme used for computation of the pressure gradient force. Thus, the fourth order scheme is applied only to momentum advection. Three sophisticated second order schemes were considered for upgrade. Two of them, proposed in Janjic(1984), conserve energy and enstrophy, but with enstrophy calculated differently. One of them conserves enstrophy as computed by the most accurate second order Laplacian operating on stream function. The other scheme conserves enstrophy as computed from the B grid velocity. The third scheme (Arakawa 1972) is arithmetic mean of the former two. It does not conserve enstrophy strictly, but it conserves other quadratic quantities that control the nonlinear energy cascade. Linearization of all three schemes leads to the same second order linear advection scheme. The second order term of the truncation error of the linear advection scheme has a special form so that it can be eliminated by simply preconditioning the advected quantity. Tests with linear advection of a cone confirm the advantage of the fourth order scheme. However, if a localized, large amplitude and high wave-number pattern is present in initial conditions, the clear advantage of the fourth order scheme disappears. In real data runs, problems with noisy data may appear due to mountains. Thus, accuracy and formal accuracy may not be synonymous. The nonlinear fourth order schemes are quadratic conservative and reduce to the Arakawa Jacobian in case of non-divergent flow. In case of general flow the conservation properties of the new momentum advection schemes impose stricter constraint on the nonlinear cascade than the original second order schemes. However, for non-divergent flow, the conservation properties of the fourth order schemes cannot be proven in the same way as those of the original second order schemes. Therefore, nonlinear tests were carried out in order to check how well the fourth order schemes control the nonlinear energy cascade. In the tests nonlinear shallow water equations are solved in a rotating rectangular domain (Janjic, 1984). The domain is covered with only 17 x 17 grid points. A diagnostic quantity is used to monitor qualitative changes in the spectrum over 116 days of simulated time. All schemes maintained meaningful solutions throughout the test. Among the second order schemes, the best result was obtained with the scheme that conserved enstrophy as computed by the second order Laplacian of the stream function. It was closely followed by the Arakawa (1972) scheme, while the remaining scheme was distant third. The fourth order schemes ranked in the same order, and were competitive throughout the experiments with their second order counterparts in preventing accumulation of energy at small scales. Finally, the impact was examined of the fourth order momentum advection on global medium range forecasts. The 500 mb anomaly correlation coefficient is used as a measure of success of the forecasts. Arakawa, A., 1972: Design of the UCLA general circulation model. Tech. Report No. 7, Department of Meteorology, University of California, Los Angeles, 116 pp. Janjic, Z. I., 1984: Non-linear advection schemes and energy cascade on semi-staggered grids. Monthly Weather Review, 112, 1234-1245.

Spatial solitons and stability in the one-dimensional and the two-dimensional generalized nonlinear Schrödinger equation with fourth-order diffraction and parity-time-symmetric potentials

NASA Astrophysics Data System (ADS)

Tiofack, C. G. L.; Ndzana, F., II; Mohamadou, A.; Kofane, T. C.

2018-03-01

We investigate the existence and stability of solitons in parity-time (PT )-symmetric optical media characterized by a generic complex hyperbolic refractive index distribution and fourth-order diffraction (FOD). For the linear case, we demonstrate numerically that the FOD parameter can alter the PT -breaking points. For nonlinear cases, the exact analytical expressions of the localized modes are obtained both in one- and two-dimensional nonlinear Schrödinger equations with self-focusing and self-defocusing Kerr nonlinearity. The effect of FOD on the stability structure of these localized modes is discussed with the help of linear stability analysis followed by the direct numerical simulation of the governing equation. Examples of stable and unstable solutions are given. The transverse power flow density associated with these localized modes is also discussed. It is found that the relative strength of the FOD coefficient can utterly change the direction of the power flow, which may be used to control the energy exchange among gain or loss regions.

Radiologically occult medulloblastoma with hydrocephalus: case report.

PubMed

Honma, Hirokuni; Ogiwara, Hideki

2017-09-01

There have been no reports of occult medulloblastoma nor noncommunicating hydrocephalus due to radiologically occult brain tumors. Herein, we report radiologically occult medulloblastoma with noncommunicating hydrocephalus. A 3-year-old boy presented with macrocephaly, visual field constriction, and papilledema. Neuroimagings showed enlargement of the ventricles without any mass lesions. The CT cisternography did not show influx of the contrast into the ventricles, which suggested local cerebrospinal fluid (CSF) circulatory disturbance at the outlet of the fourth ventricle. Due to possible obstructive nature of hydrocephalus, endoscopic third ventriculostomy (ETV) was performed. Three months after the ETV, he presented with repeated vomiting. Neuroimagings showed a 3-cm fourth ventricular mass with progressive hydrocephalus. Surgical resection was performed, which revealed the pathology was medulloblastoma. We report the case of radiologically occult medulloblastoma which was demonstrated radiologically in the follow-up period of ETV for noncommunicating hydrocephalus of uncertain etiology. This is the first description of a radiologically occult medulloblastoma and also the first description of an occult brain tumor with noncommunicating hydrocephalus. The occult brain tumor may be included in the etiology of hydrocephalus.

Use of an online curriculum to teach delirium to fourth-year medical students: a comparison with lecture format.

PubMed

Chao, Serena H; Brett, Belle; Wiecha, John M; Norton, Lisa E; Levine, Sharon A

2012-07-01

Web-based learning methods are being used increasingly to teach core curriculum in medical school clerkships, but few studies have compared the effectiveness of online methods with that of live lectures in teaching the same topics to students. Boston University School of Medicine has implemented an online, case-based, interactive curriculum using videos and text to teach delirium to fourth-year medical students during their required 1-month Geriatrics and Home Medical Care clerkship. A control group of 56 students who received a 1-hour live delirium lecture only was compared with 111 intervention group students who completed the online delirium curriculum only. Evaluation consisted of a short-answer test with two cases given as a pre- and posttest to both groups. The total possible maximum test score was 34 points, and the lowest possible score was -8 points. Mean pre- and posttest scores were 10.5 ± 4.0 and 12.7 ± 4.4, respectively, in the intervention group and 9.9 ± 3.5 and 11.2 ± 4.5, respectively, in the control group. The intervention group had statistically significant improvement between the pre- and posttest scores (2.21-point difference; P < .001), as did the control group (1.36-point difference; P = .03); the difference in test score improvement between the two groups was not statistically significant. An interactive case-based online curriculum in delirium is as effective as a live lecture in teaching delirium, although neither of these educational methods alone produces robust increases in knowledge. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Takotsubo cardiomyopathy associated with cardiac arrest following cardiac surgery: new variants of an unusual syndrome.

PubMed

Vernick, William J; Hargrove, W Clark; Augoustides, John G; Horak, Jiri

2010-11-01

Takotsubo cardiomyopathy is increasingly being recognized in the perioperative period. To date, there have been only three previous cases involving cardiac surgery reported and this represents the fourth case. The precise mechanism remains elusive, and there is no definitive management strategy. It appears that the syndromes course in cardiac surgical patients is self-limited. This syndrome must now be considered in the differential diagnosis of postcardiotomy cardiac failure. © 2010 Wiley Periodicals, Inc.

Acoustic Studies of New Materials: Quasicrystals, Low-Loss Glasses, and High Tc Superconductors

DTIC Science & Technology

1991-12-18

Progress Report, 1989 2. Tania Slawecki, M.S. Thesis Measuring fourth sound in silica aerogel 3. Chang Yu, Ph.D. Thesis A high Q resonant photoacoustic...Pennsylvania State University The Graduate School Department of Physics Measuring Fourth Sound in Silica Aerogel A Thesis in Physics by Tania Maria...Slawecki Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science December 1989 Abstract Measuring Fourth Sound in Silica

Effects of intra-fourth ventricle injection of crocin on capsaicin-induced orofacial pain in rats.

PubMed

Tamaddonfard, Esmaeal; Tamaddonfard, Sina; Pourbaba, Salar

2015-01-01

Crocin, a constituent of saffron and yellow gardenia, possesses anti-nociceptive effects. In the present study, we investigated the effects of intra-fourth ventricle injection of crocin in a rat model of orofacial pain. The contribution of opioid system was assessed using intra-fourth ventricle injection of naloxone, an opioid receptor antagonist. A guide cannula was implanted into the fourth ventricle of brain in anesthetized rats. Orofacial pain was induced by subcutaneous (s.c.) injection of capsaicin (1.5 µg/20 µl) into the right vibrissa pad. The time spent face rubbing/grooming was recorded for a period of 20 min. Locomotor activity was measured using an open-field test. Intra-fourth ventricle injection of crocin (10 and 40 µg/rat) and morphine (10 and 40 µg/rat) and their co-administration (2.5 and 10 µg/rat of each) suppressed capsaicin-induced orofacial pain. The analgesic effect induced by 10 µg/rat of morphine, but not crocin (10 µg/rat), was prevented by 20 µg/rat of naloxone pretreatment. The above-mentioned chemical compounds did not affect locomotor activity. The results of this study showed that the injection of crocin into the cerebral fourth ventricle attenuates capsaicin-induced orofacial pain in rats. The anti-nociceptive effect of crocin was not attributed to the central opioid receptors.

Metric for strong intrinsic fourth-order phonon anharmonicity

NASA Astrophysics Data System (ADS)

Yue, Sheng-Ying; Zhang, Xiaoliang; Qin, Guangzhao; Phillpot, Simon R.; Hu, Ming

2017-05-01

Under the framework of Taylor series expansion for potential energy, we propose a simple and robust metric, dubbed "regular residual analysis," to measure the fourth-order phonon anharmonicity in crystals. The method is verified by studying the intrinsic strong higher-order anharmonic effects in UO2 and CeO2. Comparison of the thermal conductivity results, which calculated by the anharmonic lattice dynamics method coupled with the Boltzmann transport equation and the spectral energy density method coupled with ab initio molecular dynamics simulation further validates our analysis. Analysis of the bulk Si and Ge systems confirms that the fourth-order phonon anharmonicity is enhanced and cannot be neglected at high enough temperatures, which agrees with a previous study where the four-phonon scattering was explicitly determined. This metric will facilitate evaluating and interpreting the lattice thermal conductivity of crystals with strong fourth-order phonon anharmonicity.

The impact of a science-based integrated instructional protocol on the motivation, reading comprehension, and science achievement of fourth and fifth graders

NASA Astrophysics Data System (ADS)

Stephens, Kathy E.

The purpose of this study was to determine the impact of implementing an integrated instructional protocol of science-based informational texts as teacher read alouds, student independent reading, and written journal responses on motivation, reading comprehension, and science achievement of fourth- and fifth-grade students with attention to specific student groups, including gender and ethnicities. A mixed methods research design included a 12-week intervention conducted with 68 fourth and fifth graders and 30 nonintervention fourth and fifth graders. Participating fourth and fifth graders completed the comprehension subtest of the Gates-MacGinitie Reading Test ([GMRT] MacGinitie, MacGinitie, Maria, & Dreyer, 2000) and the Texas Assessment of Knowledge and Skills ([TAKS] Texas Education Agency [TEA], 2005a). The Reading Survey of the Motivation to Read Profile ([MRP], Gambrell, Palmer, Codling, & Mazzoni, 1996) served as another quantitative data source. Qualitative data sources included classroom observations, key informant interviews, and student journal entries. The GMRT results indicated that the intervention fourth graders demonstrated the largest growth in reading comprehension achievement. Significant differences were noted by GMRT results between the intervention and nonintervention fourth graders. A significant difference was found between fourth-grade males and females on the GMRT, with a larger gain posted by the females. No significant differences were found on the GMRT in fifth grade Reading TAKS results indicated a significant difference between intervention fourth-grade Hispanic and African American students, while fifth-grade Science TAKS results indicated no significant differences. The MRP Reading Survey results indicated no significant differences; however, fourth-grade Hispanic and fifth-grade male students demonstrated significant growth. Classroom observations documented the progress of the 12-week intervention; 9 primary instructional and behavioral themes with 40 subcategories were discovered using open coding (Berg, 2004). Data were collected from the MRP Conversational Interview (Gambrell et al., 1996) with 12 key informants, and their journal entries provided evidence of the impact of the instructional protocol. Findings from this study seemed to confirm that students may experience improvement in reading comprehension after participation in an integrated instructional protocol. Findings also suggested gaps in minority ethnicities may be minimized, while female students continued to outscore male students.

Cranio-orbital primary intraosseous haemangioma.

PubMed

Gupta, T; Rose, G E; Manisali, M; Minhas, P; Uddin, J M; Verity, D H

2013-11-01

Primary intraosseous haemangioma (IOH) is a rare benign neoplasm presenting in the fourth and fifth decades of life. The spine and skull are the most commonly involved, orbital involvement is extremely rare. We describe six patients with cranio-orbital IOH, the largest case series to date. Retrospective review of six patients with histologically confirmed primary IOH involving the orbit. Clinical characteristics, imaging features, approach to management, and histopathological findings are described. Five patients were male with a median age of 56. Pain and diplopia were the most common presenting features. A characteristic 'honeycomb' pattern on CT imaging was demonstrated in three of the cases. Complete surgical excision was performed in all cases with presurgical embolisation carried out in one case. In all the cases, histological studies identified cavernous vascular spaces within the bony tissue. These channels were lined by single layer of cytologically normal endothelial cells. IOCH of the cranio-orbital region is rare; in the absence of typical imaging features, the differential diagnosis includes chondroma, chondrosarcoma, bony metastasis, and lymphoma. Surgical excision may be necessary to exclude more sinister pathology. Intraoperative haemorrhage can be severe and may be reduced by preoperative embolisation.

Infinite hierarchy of nonlinear Schrödinger equations and their solutions.

PubMed

Ankiewicz, A; Kedziora, D J; Chowdury, A; Bandelow, U; Akhmediev, N

2016-01-01

We study the infinite integrable nonlinear Schrödinger equation hierarchy beyond the Lakshmanan-Porsezian-Daniel equation which is a particular (fourth-order) case of the hierarchy. In particular, we present the generalized Lax pair and generalized soliton solutions, plane wave solutions, Akhmediev breathers, Kuznetsov-Ma breathers, periodic solutions, and rogue wave solutions for this infinite-order hierarchy. We find that "even- order" equations in the set affect phase and "stretching factors" in the solutions, while "odd-order" equations affect the velocities. Hence odd-order equation solutions can be real functions, while even-order equation solutions are always complex.

The block adaptive multigrid method applied to the solution of the Euler equations

NASA Technical Reports Server (NTRS)

Pantelelis, Nikos

1993-01-01

In the present study, a scheme capable of solving very fast and robust complex nonlinear systems of equations is presented. The Block Adaptive Multigrid (BAM) solution method offers multigrid acceleration and adaptive grid refinement based on the prediction of the solution error. The proposed solution method was used with an implicit upwind Euler solver for the solution of complex transonic flows around airfoils. Very fast results were obtained (18-fold acceleration of the solution) using one fourth of the volumes of a global grid with the same solution accuracy for two test cases.

Reading Fluency as an Indicator of Reading Comprehension

ERIC Educational Resources Information Center

Basaran, Mustafa

2013-01-01

This study examined the relationship between fourth grade primary school students' reading habits/conditions/ situations and their comprehension regarding what they read. For this purpose, a correlational survey method was used in the study. 90 fourth-grade students who were attending a state primary school in the center of Ku¨tahya participated…

Student-Described Engagement with Text: Insights Are Discovered from Fourth Graders

ERIC Educational Resources Information Center

Weih, Timothy G.

2014-01-01

This article reports on a research study investigating student-described engagement with self-selected text in a classroom where a core reading program (in the context of this study meaning instruction based primarily on manuals and commercial textbooks) comprised the majority of their literacy instruction. Fourth grade students were invited to…

Peace and World Order Studies: A Curriculum Guide. Fourth Edition.

ERIC Educational Resources Information Center

Wien, Barbara J., Ed.

The fourth edition of this curriculum guide will help college, university, and secondary school educators design and update courses, familiarize themselves with new literature and resources, and plan and justify new academic programs in the study of global problems. While syllabus categories remain the same as in previous editions, several new…

Cognitive Processing and Mathematical Achievement: A Study with Schoolchildren between Fourth and Sixth Grade of Primary Education

ERIC Educational Resources Information Center

Iglesias-Sarmiento, Valentin; Deano, Manuel

2011-01-01

This investigation analyzed the relation between cognitive functioning and mathematical achievement in 114 students in fourth, fifth, and sixth grades. Differences in cognitive performance were studied concurrently in three selected achievement groups: mathematical learning disability group (MLD), low achieving group (LA), and typically achieving…

Detention as a Deterrent for Late Assignments: A Study.

ERIC Educational Resources Information Center

Conover, Pamela J.

To gauge the impact of after-school student detention on punctual completion of homework, on detained student grades, and on student self-esteem, fourth- through sixth-grade students from a school with an after-school detention policy for late or incomplete assignments were studied. Interviews were conducted with the four fourth-, fifth-, and…

The Relationship between Good Readers' Attention, Reading Fluency and Reading Comprehension

ERIC Educational Resources Information Center

Yildiz, Mustafa; Çetinkaya, Ezgi

2017-01-01

This study aimed to examine the relationship between fourth-graders' reading fluency, reading comprehension and attention. It was conducted using the relational screening model and included 132 fourth-graders with grade level adequate reading skills. The study results showed that good readers' attention had significant effects on reading speed,…

Incidence and Outcomes of Patients With Oral Cavity Squamous Cell Carcinoma and Fourth Primary Tumors: A Long-term Follow-up Study in a Betel Quid Chewing Endemic Area.

PubMed

Adel, Mohamad; Liao, Chun-Ta; Lee, Li-Yu; Hsueh, Chuen; Lin, Chien-Yu; Fan, Kang-Hsing; Wang, Hung-Ming; Ng, Shu-Hang; Lin, Chih-Hung; Tsao, Chung-Kan; Huang, Shiang-Fu; Kang, Chung-Jan; Fang, Ku-Hao; Wang, Yu-Chien; Chang, Kai-Ping; Fang, Tuan-Jen; Yang, Lan Yan; Yen, Tzu-Chen

2016-03-01

The aim of this study was to explore the incidence and outcomes of patients with oral cavity squamous cell carcinoma (OSCC) and fourth primary tumors (PTs) in a betel-chewing endemic area.We retrospectively examined the records of 1836 OSCC patients who underwent radical tumor resection between 1996 and 2014. The outcome measures included the incidence and number of multiple PTs, the main risk factors, and their associations with overall survival (OS).Of the 1836 patients, 1400 (76.3%) had a single PT, 344 (18.7%) a second PT, 67 (3.6%) a third PT, and 25 (1.4%) a fourth PT. Univariate analyses (log-rank test) identified the following factors as significantly associated with a fourth PT: simultaneous first and second PTs, betel quid chewing, buccal subsite, and pT3-4 status. After allowance for the potential confounding effect of other risk factors, all of these factors retained their independent prognostic significance in stepwise multivariate analyses, the only exception being betel chewing. The incidences of second, third, and fourth PTs at 5 and 10 years were 20.2%/34.6%, 4.0%/8.6%, and 1.0%/2.3%, respectively. The 5 and 10-year OS rates (calculated from the diagnosis of each PTs) for patients with a single, second, third, and fourth PTs were 68%/61%, 43%/37%, 45%/39%%, and 30%/30%, respectively (P < 0.0001). Among patients with a fourth PT, those who underwent radical surgery showed a significantly higher 3-year OS than those who did not (57% vs 13%; P = 0.0442).Fourth PTs are rarely observed in OSCC patients in a betel quid-chewing endemic area. Long-term survival rates of patients treated with radical surgery seems acceptable, being 4-fold higher than their counterparts.

A Scale Development for 21st Century Skills of Primary School Students: A Validity and Reliability Study

ERIC Educational Resources Information Center

Boyaci, S. Dilek Belet; Atalay, Nurhan

2016-01-01

The objective of the present study is to develop a measurement tool to assess 21st Century learning and innovation skills of primary school students. Study data was collected from 632 fourth grade students in five different primary schools during 2014-2015 academic year and data obtained from 609 fourth grade students were utilized in the study.…

A Two-Dimensional Fourth-Order CESE Method for the Euler Equations on Triangular Unstructured Meshes (Post-Print)

DTIC Science & Technology

2012-01-12

include area code) 661 275-5649 Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. 239.18 A Two-Dimensional Fourth-Order CESE Method for the...remark that Eq. (4) is a special case of Eq. (5) with A = N . Similarly, the Taylor expansion of fluxes can be expressed as ∂ Cfx ,yi ∂xI∂yJ∂tK (x, y, t) = A...x2′ , y2′) and within t n − 1/2 ≤ t ≤ tn, the flux fx,yi can be expressed as (fx,yi ) ∗ = A ∑ a=0 A−a ∑ b=0 A−a−b ∑ c=0 ∂a+b+ cfx ,yi ∂xa∂yb∂tc ∆xa∆yb

Monte Carlo simulation on the effect of different approaches to thalassaemia on gene frequency.

PubMed

Habibzadeh, F; Yadollahie, M

2006-01-01

We used computer simulation to determine variation in gene, heterozygous and homozygous frequencies induced by 4 different approaches to thalassaemia. These were: supportive therapy only; treat homozygous patients with a hypothetical modality phenotypically only; abort all homozygous fetuses; and prevent marriage between gene carriers. Gene frequency becomes constant with the second or the fourth strategy, and falls over time with the first or the third strategy. Heterozygous frequency varies in parallel with gene frequency. Using the first strategy, homozygous frequency falls over time; with the second strategy it becomes constant; and with the third and fourth strategies it falls to zero after the first generation. No matter which strategy is used, the population gene frequency, in the worst case, will remain constant over time.

Direct mass limits for chiral fourth-generation quarks in all mixing scenarios.

PubMed

Flacco, Christian J; Whiteson, Daniel; Tait, Tim M P; Bar-Shalom, Shaouly

2010-09-10

Present limits on chiral fourth-generation quark masses mb' and mt' are broadly generalized and strengthened by combining both t' and b' decays and considering a full range of t' and b' flavor-mixing scenarios with the lighter generations (to 1-‖V44‖2≈10(-13)). Various characteristic mass-splitting choices are considered. With mt'>mb' we find that CDF Collaboration limits on the b' mass vary by no more than 10%-20% with any choice of flavor mixing, while for the t' mass, we typically find stronger bounds, in some cases up to mt'>430  GeV. For mb'>mt', we find mb'>380-430  GeV, depending on the flavor mixing and the size of the mt'-mb' mass splitting.

Neuroimaging parameters in early open spina bifida detection. Further benefit in first trimester screening?

PubMed

Iliescu, D; Comănescu, A; Antsaklis, P; Tudorache, Stefania; Ghiluşi, Mirela; Comănescu, Violeta; Paulescu, Daniela; Ceauşu, Iuliana; Antsaklis, A; Novac, Liliana; Cernea, N

2011-01-01

Morphological investigation of the central nervous system (CNS) in fetuses with positive markers for open spina bifida (OSB) detection, visualized by ultrasound during the first trimester of pregnancy. Data from fetuses that underwent routine first trimester ultrasound scan in our center during September 2007-March 2011 and presented abnormal aspects of the fourth ventricle, also referred as intracranial translucency (IT), provided the morphological support to evaluate CNS features. A neuro-histological study of posterior cerebral fossa illustrated anatomical features of the structures involved in the sonographic first trimester detection of neural tube defects. Abnormal IT aspects were found in OSB cases examined in the first trimester, but also in other severe cerebral abnormalities. Brain stem antero-posterior diameter (BS) and brain stem to occipital bone (BSOB) ratio may be more specific for OSB detection. Correlations between histological aspects of posterior brain fossa and ultrasound standard assessment have been made; highlighting the anatomical features involved by the new techniques developed for OSB early detection. Preliminary results show that modern sonographic protocols are capable to detect abnormalities in the morphometry of the posterior brain. First trimester fourth ventricle abnormalities should be followed by careful CNS evaluation because are likely to appear in OSB affected fetuses, but also in other CNS severe anomalies; in such cases, normal BS and BSOB ratio may serve as indirect argument for spine integrity, if specificity is confirmed in large series of fetuses.

Fourth-Grade Primary School Students' Thought Processes and Challenges Encountered during the Butter Beans Problem

ERIC Educational Resources Information Center

Sahin, Neslihan; Eraslan, Ali

2017-01-01

In parallel with mathematical modeling studies that have gradually drawn interest in recent years, the aim of this study is to investigate the thought processes of fourth-grade students in the Butter Beans Problem and to identify possible challenges in this process. For this purpose, a qualitative study was conducted at a university-foundation…

Burnout, depression and suicidal ideation in dental students.

PubMed

Galán, Fernando; Ríos-Santos, José-Vicente; Polo, Juan; Rios-Carrasco, Blanca; Bullón, Pedro

2014-05-01

To investigate the prevalence, gender influence, and relationships between burnout, depression and suicidal ideation within the last year among second, fourth and fifth-year dental students. A cross-sectional study was carried out in 212 dental students enrolled in the second, fourth and fifth years at the School of Dentistry of Seville using the Maslach Burnout Inventory-Student Survey and the MBI-Human Services Survey, the "Patient Health Questionnaire-2", and the "Questions about Suicidal Ideation and Attempted Suicide". The response rate among dental students was 80%. Burnout prevalence in dental students was higher in second and fourth years than in fifth year (p = 0.059 and p = 0.003, respectively). Depression prevalence in the fourth year approached significance (p = 0.051). Prevalence of suicidal ideation within the past year was higher, yet not reaching significance, in fourth year. No gender-related differences were found. A significant association was observed between burnout and depression, and between depression and suicidal ideation (p < 0.001), but no association was found between burnout and suicidal ideation. This study has brought our attention to the high prevalence of burnout and depression, and reported for the first time the prevalence of suicidal ideation among dental students in preclinical and clinical years.

Back to the basic sciences: an innovative approach to teaching senior medical students how best to integrate basic science and clinical medicine.

PubMed

Spencer, Abby L; Brosenitsch, Teresa; Levine, Arthur S; Kanter, Steven L

2008-07-01

Abraham Flexner persuaded the medical establishment of his time that teaching the sciences, from basic to clinical, should be a critical component of the medical student curriculum, thus giving rise to the "preclinical curriculum." However, students' retention of basic science material after the preclinical years is generally poor. The authors believe that revisiting the basic sciences in the fourth year can enhance understanding of clinical medicine and further students' understanding of how the two fields integrate. With this in mind, a return to the basic sciences during the fourth year of medical school may be highly beneficial. The purpose of this article is to (1) discuss efforts to integrate basic science into the clinical years of medical student education throughout the United States and Canada, and (2) describe the highly developed fourth-year basic science integration program at the University of Pittsburgh School of Medicine. In their critical review of medical school curricula of 126 U.S. and 17 Canadian medical schools, the authors found that only 19% of U.S. medical schools and 24% of Canadian medical schools require basic science courses or experiences during the clinical years, a minor increase compared with 1985. Curricular methods ranged from simple lectures to integrated case studies with hands-on laboratory experience. The authors hope to advance the national discussion about the need to more fully integrate basic science teaching throughout all four years of the medical student curriculum by placing a curricular innovation in the context of similar efforts by other U.S. and Canadian medical schools.

Oral Pyogenic Granuloma Associated With a Dental Implant Treated With an Er:YAG Laser: A Case Report.

PubMed

Kaya, Alper; Ugurlu, Faysal; Basel, Bilal; Sener, Cem B

2015-12-01

A pyogenic granuloma is a tumorlike proliferation that occurs slightly more often in females, frequently involving the gingiva in the maxillary region. Clinically, it presents as a sessile or pedunculated exophytic mass with a smooth or lobulated surface, which tends to bleed easily. Its color can range from pink to dark red. The most common treatment is surgical excision. This case report presents a pyogenic granuloma that formed around an implant 7 years after its insertion. Pyogenic granulomas associated with dental implants are extremely rare; this is the fourth reported case and the first case of pyogenic granuloma to be treated with an Er:YAG laser.

Short fourth and fifth metacarpals in a case of idiopathic primary hypoparathyroidism

PubMed Central

Valizadeh, Neda; Mehdizadeh, Alireza; Nazarbaghi, Surena

2013-01-01

Shortening of metacarpals is a useful diagnostic marker in patients with pseudohypoparathyroidism type Ia (PHP-Ia) with Albright's hereditary osteodystrophy (AHO) phenotype or pseudopseudohypoparathyroidism (PPHP). There are very rare reports of metacarpals shortening in idiopathic primary hypoparathyroidism (IPH) cases in the literature. Here we described a young woman with IPH who presented with hypocalcaemia and generalized tonic-clonic seizure. She had shortening of forth and fifth metacarpals which was prominent in her right hand. Based on our finding and other previous case reports we conclude that metarpals shortening is not a specific finding of PHP-Ia or PPHP and it may be found in IPH cases. PMID:24083181

Smoking-related Attitudes and Behaviors of Parents of Fourth Grade Students.

ERIC Educational Resources Information Center

Gordon, Leonard V.; Haynes, Donald K.

1981-01-01

A study was done to determine the smoking habits and attitudes of parents of fourth grade students. The results indicate that cigarette smoking parents who participated in the school-home smoker education program reported smoking fewer cigarettes. (JN)

Macular auto-fluorescence is a follow-up parameter for cystoids macular edema.

PubMed

Zhang, XinYuan; Gong, XiaoHong; Wang, YanHong; Wang, NingLi

2015-08-01

This study aimed to evaluate if macular autofluorescence (MAF) is a valuable, non-invasive follow-up parameter for cystoid macular edema. A total of 71 eyes (71 cases) with cystoid macular edema (CME) were included in the study. Macular pigment (MP) was evaluated using HRA2 (infrared) IF and FA models. The density of MP was graded into three categories: without, partial, and normal amount of MP. A comparison was made between the baseline (before the first administration) level and at the fourth month, following three consecutive intravitreal lucentis injections every month. The morphology and distribution of MAF, and the density and distribution of MP were regarded as the main outcome measures. At the baseline visit, all eyes with CME had petaloid/irregular-shaped MAF in the macular area (100%). No MAF was detected in the control eyes (0). There was significant difference in MAF between the CME and normal groups (P=0.000). At the fourth monthly visit, normal levels of MP density without MAF was detected in 68 eyes (95.8%) with the best corrected spectacular visual acuity increasing to at least 1 line accordingly. We conclude that macular MAF can be used as a follow-up parameter for patients with CME. MP and MAF can indirectly reflect the fovea cone function.

Plate Fixation With Autogenous Calcaneal Dowel Grafting Proximal Fourth and Fifth Metatarsal Fractures: Technique and Case Series.

PubMed

Seidenstricker, Chad L; Blahous, Edward G; Bouché, Richard T; Saxena, Amol

Metaphyseal and proximal diaphyseal fractures of the lateral column metatarsals can have problems with healing. In particular, those involving the fifth metatarsal have been associated with a high nonunion rate with nonoperative treatment. Although intramedullary screw fixation results in a high union rate, delayed healing and complications can occur. We describe an innovative technique to treat both acute and chronic injuries involving the metatarsal base from the metaphysis to the proximal diaphyseal bone of the fourth and fifth metatarsals. The surgical technique involves evacuation of sclerotic bone at the fracture site, packing the fracture site with compact cancellous bone, and plate fixation. In our preliminary results, 4 patients displayed 100% radiographic union at a mean of 4.75 (range 4 to 6) weeks with no incidence of refracture, at a mean follow-up point of 3.5 (range 1 to 5) years. The early results with our small series suggest that this technique is a useful treatment choice for metaphyseal and proximal diaphyseal fractures of the fourth and fifth metatarsals. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Migrating pharyngeal foreign bodies: a series of four cases of saw-toothed fish bones.

PubMed

Chung, Sung Min; Kim, Han Su; Park, Eun Hee

2008-09-01

Pharyngeal foreign bodies are common problems seen at emergency rooms or ENT outpatient clinics, and fish bones are the most common foreign bodies encountered in East Asia and in Korea. One of the rare complications of a swallowed sharp fish bone is its migration from the site of entry into the subcutaneous tissues of the neck. We present four unusual cases of ingested fish bones that migrated out of the upper digestive tract to the neck. In the first case, this caused a recurrent deep neck infection for 2 years; in the second case, there was penetration of the facial artery; in the third case, there was a hematoma of the floor of the mouth; in the fourth case, there was a retropharyngeal abscess.

Anorexia nervosa versus bulimia nervosa: differences based on retrospective correlates in a case-control study.

PubMed

Machado, Bárbara C; Gonçalves, Sónia F; Martins, Carla; Brandão, Isabel; Roma-Torres, António; Hoek, Hans W; Machado, Paulo P

2016-06-01

This study is the result of two Portuguese case-control studies that examined the replication of retrospective correlates and preceding life events in anorexia nervosa (AN) and bulimia nervosa (BN) development. This study aims to identify retrospective correlates that distinguish AN and BN METHOD: A case-control design was used to compare a group of women who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N = 98) and BN (N = 79) with healthy controls (N = 86) and with other psychiatric disorders (N = 68). Each control group was matched with AN patients regarding age and parental social categories. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview. Compared to AN, women with BN reported significantly higher rates of paternal high expectations, excessive family importance placed on fitness/keeping in shape, and negative consequences due to adolescent overweight and adolescent objective overweight. Overweight during adolescence emerged as the most relevant retrospective correlate in the distinction between BN and AN participants. Family expectations and the importance placed on keeping in shape were also significant retrospective correlates in the BN group.

Comparison of the efficacy of aroma-acupressure and aromatherapy for the treatment of dementia-associated agitation.

PubMed

Yang, Man-Hua; Lin, Li-Chan; Wu, Shiao-Chi; Chiu, Jen-Hwey; Wang, Pei-Ning; Lin, Jaung-Geng

2015-03-29

One of the most common symptoms observed in patients with dementia is agitation, and several non-pharmacological treatments have been used to control this symptom. However, because of limitations in research design, the benefit of non-pharmacological treatments has only been demonstrated in certain cases. The purpose of this study was to compare aroma-acupressure and aromatherapy with respect to their effects on agitation in patients with dementia. In this experimental study, the participants were randomly assigned to three groups: 56 patients were included in the aroma-acupressure group, 73 patients in the aromatherapy group, and 57 patients in the control group who received daily routine as usual without intervention. The Cohen-Mansfield Agitation Inventory (CMAI) scale and the heart rate variability (HRV) index were used to assess differences in agitation. The CMAI was used in the pre-test, post-test and post-three-week test, and the HRV was used in the pre-test, the post-test and the post-three-week test as well as every week during the four-week interventions. The CMAI scores were significantly lower in the aroma-acupressure and aromatherapy groups compared with the control group in the post-test and post-three-week assessments. Sympathetic nervous activity was significantly lower in the fourth week in the aroma-acupressure group and in the second week in the aromatherapy group, whereas parasympathetic nervous activity increased from the second week to the fourth week in the aroma-acupressure group and in the fourth week in the aromatherapy group. Aroma-acupressure had a greater effect than aromatherapy on agitation in patients with dementia. However, agitation was improved in both of the groups, which allowed the patients with dementia to become more relaxed. Future studies should continue to assess the benefits of aroma-acupressure and aromatherapy for the treatment of agitation in dementia patients. ChiCTR-TRC-14004810; Date of registration: 2014/6/12.

Dream Team--The Case of an Undergraduate Surgical Talent Development Project

ERIC Educational Resources Information Center

Jensen, Rune Dall; Ljungmann, Ken; Christensen, Mette Krogh; Møldrup, Ulla; Grøndal, Anne Krogh; Mogensen, Mads Filtenborg; Seyer-Hansen, Mikkel

2016-01-01

To be successful, a surgeon must master a variety of skills. To meet the high demand for surgical expertise, an extracurricular undergraduate project was launched. The extracurricular project consists of hands-on laparoscopic training and a mentorship programme. The project aims to find the best surgical talents among fourth-year medical students.…

What Form of Mathematics Are Assessments Assessing? The Case of Multiplication and Division in Fourth Grade NAEP Items

ERIC Educational Resources Information Center

Kosko Karl W.; Singh, Rashmi

2018-01-01

Multiplicative reasoning is a key concept in elementary school mathematics. Item statistics reported by the National Assessment of Educational Progress (NAEP) assessment provide the best current indicator for how well elementary students across the U.S. understand this, and other concepts. However, beyond expert reviews and statistical analysis,…

Effects of Singapore's Model Method on Elementary Student Problem Solving Performance: Single Subject Research

ERIC Educational Resources Information Center

Mahoney, Kevin

2012-01-01

This research investigation examined the effects of Singapore's Model Method, also known as "model drawing" or "bar modeling" on the word problem-solving performance of American third and fourth grade students. Employing a single-case design, a researcher-designed teaching intervention was delivered to a child in third…

CHALLENGES AND OPPORTUNITIES FOR EMISSION REDUCTIONS FROM THE COAL-FIRED POWER SECTOR IN GROWING ECONOMIES: THE CASE OF COAL-FIRED ELECTRIC UTILITY PLANTS IN RUSSIA

EPA Science Inventory

China, Russia and India together contribute over one-fourth of the total global greenhouse gas emissions from the combustion of fossil-fuels. This paper focuses on the Russian coal-fired power sector, and identifies potential opportunities for reducing emissions. The Russian powe...

50 CFR 34.5 - Distribution of revenues.

Code of Federal Regulations, 2010 CFR

2010-10-01

... within such county. (2) An amount equal to three-fourths of one per centum of the fair market value, as... market value will not be less than the amount paid on the adjusted cost basis as in effect at that time. Actual cost, or appraised value in case of donation, will be used for lands acquired during fiscal year...

50 CFR 34.5 - Distribution of revenues.

Code of Federal Regulations, 2014 CFR

2014-10-01

... within such county. (2) An amount equal to three-fourths of one per centum of the fair market value, as... market value will not be less than the amount paid on the adjusted cost basis as in effect at that time. Actual cost, or appraised value in case of donation, will be used for lands acquired during fiscal year...

50 CFR 34.5 - Distribution of revenues.

Code of Federal Regulations, 2013 CFR

2013-10-01

... within such county. (2) An amount equal to three-fourths of one per centum of the fair market value, as... market value will not be less than the amount paid on the adjusted cost basis as in effect at that time. Actual cost, or appraised value in case of donation, will be used for lands acquired during fiscal year...

50 CFR 34.5 - Distribution of revenues.

Code of Federal Regulations, 2012 CFR

2012-10-01

... within such county. (2) An amount equal to three-fourths of one per centum of the fair market value, as... market value will not be less than the amount paid on the adjusted cost basis as in effect at that time. Actual cost, or appraised value in case of donation, will be used for lands acquired during fiscal year...

50 CFR 34.5 - Distribution of revenues.

Code of Federal Regulations, 2011 CFR

2011-10-01

... within such county. (2) An amount equal to three-fourths of one per centum of the fair market value, as... market value will not be less than the amount paid on the adjusted cost basis as in effect at that time. Actual cost, or appraised value in case of donation, will be used for lands acquired during fiscal year...

Drug Testing and Searches in Public Schools: A Legal Analysis.

ERIC Educational Resources Information Center

Minnesota House of Representatives, St. Paul. Research Dept.

This document examines the Fourth Amendment as the source of search and seizure law; drug testing of school employees; and drug testing searches of students. The United States Supreme Court case that established the two-part test to determine the legality of a student search is discussed, three separate student drug testing programs that have been…

Supernumerary maxillary and Mandibular Fourth Molars.

DTIC Science & Technology

1981-09-23

9-109, 1963. 11. Gorlin, R.J.; Pindborg, J.J.; and Cohen, M.M., Jr.: Syndromes of the Head and Neck , 2nd ed., New York, 1976, McGraw-Hill Book...Hyperdontia:Report of case. JADA 79: 1191-1192, 1969. 5. Sicher, H. (ed.): Orban’s Oral Histology and Embryology , ed. 5, St. Louis, 1962, The C.V. Mosby Co

Constructing and Modeling Algebraic Statements in the Multiplicative Domain: Investigating Fourth-Grade Student and Teacher Learning

ERIC Educational Resources Information Center

Grandau, Laura

2013-01-01

This study of fourth-grade students and teachers explores mathematics teaching and learning that focuses on discovering and modeling algebraic relationships. The study has two parts: an investigation of how students learn to construct algebraic statements and models for comparisons and measurement situations in the multiplicative domain, and an…

Enhancing Fourth Grade Students' Writing Achievement through Purposeful Experiential Learning: An Action Research Study

ERIC Educational Resources Information Center

McManus, Michael S.; Thiamwong, Ladda

2015-01-01

This study focuses on the effects of involving fourth grade students in an experiential learning task that improves the school and requires the students to call on community agency, area business, and high school student support. Data related to students' learning were collected by using evaluative writing surveys, student and parent conferences,…

Teaching Reading Skills to Learning-Disabled Fourth to Sixth Graders through Content Areas.

ERIC Educational Resources Information Center

Leung, Esther K.

The study examined the value of teaching reading skills to learning disabled (LD) fourth to sixth graders through the content areas. Four LD resource teachers implemented the year-long program with 12 experimental and 10 control subjects. Experimental subjects were taught specific reading skills through their Social Studies and/or Science…

Emergent Understandings: Multilingual Fourth Grade Students Generating Close Readings and Multimodal Responses to Global and Informational Texts

ERIC Educational Resources Information Center

Hasty, Michelle Medlin; Fain, Jeanne Gilliam

2014-01-01

In this paper, the authors present findings from a yearlong ethnographic research study that examines the development of critical literacy within two urban fourth grade classrooms in Tennessee. This study examines how young second language learners in English-dominant classrooms learn to read critically, write, and construct multimodal…

Incidence of type 2 diabetes in Mexico: results of the Mexico City Diabetes Study after 18 years of follow-up.

PubMed

González-Villalpando, Clicerio; Dávila-Cervantes, Claudio Alberto; Zamora-Macorra, Mireya; Trejo-Valdivia, Belem; González-Villalpando, María Elena

2014-01-01

To estimate the incidence of type 2 diabetes (T2D) in Mexican population. Population based prospective study. At baseline (1990), the population at risk (1939 non-diabetic adults 35-64 years) was evaluated with oral glucose tolerance test. Subsequent similar evaluations were done (1994, 1998, 2008). American Diabetes Association diagnostic criteria were applied. The period of observation was 27842 person-years, the cumulative incidence of T2D was 14.4 and 13.7 per 1000 person-years for men and women, respectively. Incidence was 15.8, 15.7 and 12.7 per 1 000 person-years for the second (1994), third (1998) and fourth (2008) follow-up phases, respectively. The mean age at diagnosis was 44 years for prevalent cases and 56 years for incident cases. This is the first estimate of long-term incidence of T2D in Mexican population. The incidence is among the highest reported worldwide. It remained with few changes throughout the study period.

Successful nonoperative treatment of a three-column thoracic fracture in a patient with ankylosing spondylitis: existence and clinical significance of the fourth column of the spine.

PubMed

Shen, Francis H; Samartzis, Dino

2007-07-01

A case report. To report the successful nonoperative management of a patient with progressive ankylosing spondylitis who sustained a three-column flexion-distraction injury of the upper thoracic spine with an intact sternal-rib complex, thereby emphasizing the existence and clinical relevance of the fourth-column concept in such patients. Three-column injuries of the cervical and lumbar spine are typically unstable and require surgical stabilization. Patients with ankylosing spondylitis are at an increase risk to sustain three-column injuries of the spine due to their progressive inflammatory disease, a state that renders the spine brittle and alters its biomechanical function. A fourth-column model of the thoracic spine has been proposed and incorporates the sternal-rib complex; however, such a model has rarely been addressed in the literature and its role regarding three-column upper thoracic spine injury with an intact sternal-rib complex in patients with ankylosing spondylitis is unknown. METHODS.: A 68-year-old white man with ankylosing spondylitis and Pickwickian body habitus sustained a three-column flexion-distraction injury at T5 following a ground-level fall. The patient complained of midthoracic back pain; however, he was neurologically intact and ambulated without aids. Because of the patient's numerous active medical issues that substantially increased his perioperative risks combined with symptomatic improvement of his pain, the patient refused surgical stabilization. In addition, because of the patient's body habitus and pulmonary issues, external brace immobilization was not tolerated. At 17 months of follow-up, the patient remained neurologically intact, ambulated well, his midthoracic back pain had subsided, and no progressive kyphosis was noted. This case confirms the existence and clinical relevance of the fourth column of the thoracic spine and its role in providing added spinal stability in the patient with ankylosing spondylitis. As such, it is still possible to achieve a favorable clinical outcome in a select subpopulation of patients with ankylosing spondylitis that sustain three-column flexion-distraction injuries who are neurologically intact and are not candidates for surgical stabilization.

[Vulvar squamous cell carcinoma in young women with HPV negative].

PubMed

Gómez-Alarcon, A; Gómez-García, M T; García-de la-Torre, J P; Del Valle-Morón, M; Arones-Collantes, M A; González-de Merlo, G

2016-03-01

The vulvar cancer is the fourth more frequent neoplasia after the endometrial, cervix and ovarian cancer. Normally, it has been related to old women of ages from 70 to 80 years old. Rarely, it has been detected cases in adult or young women. However, its incidence has been increased in the last years and in more early years. It is for this change in the incidence and its appearance in early years why a possible etiology has been looked for, opening different hypothesis that go from that related to the HPV to those that study an inflammatory chronic process as the basis for the carcinogenesis. In this article, it has been presented the case of a woman who is 34 years old with negative VPH that made her debut with epidermoid carcinoma of the vulva moderately different and on purpose of the case, we do a revision of the literature existent. Vulvar cancer diagnosed in young women as in older, but with different trends, risk factors and natural history. The case reported here escapes the theories studied so far so needed new lines of inquiry to investigate this form of presentation young woman, without HPV infection.

Efficacy, acceptability and cost effectiveness of four therapeutic agents for treatment of scabies.

PubMed

Abdel-Raheem, Talal A; Méabed, Eman M H; Nasef, Ghada A; Abdel Wahed, Wafaa Y; Rohaim, Rania M A

2016-10-01

The aim of this study is to evaluate four drug regimens for treatment of scabies as regard their efficacy, acceptability and cost effectiveness. Two hundred cases with ordinary scabies were randomized into four groups. First group received ivermectin 200 μg/kg body weight single oral dose, repeated after one week. The second received benzyl benzoate 20% cream. The third received permethrin 2.5%-5% lotion, whereas the fourth group received 5-10% sulfur ointment. Topical treatments were applied for five consecutive nights. Patients were followed up for two weeks for cure rate and adverse effects. At the end of the study, permethrin provided a significant efficacy of 88% and acceptability in 100% of cases, but had higher cost to treat one case (20.25 LE). Ivermectin provided efficacy and acceptability rates of 84% and 96%, respectively, and had a cheaper cost (9.5 LE). Benzyl benzoate provided 80% for both rates and was the cheapest drug. Sulfur ointment provided the least rates, and it was the most expensive. Treatment choice will depend on the age, the general condition of cases, patient compliance to topical treatment and his ability to stick to its roles, and the economic condition of the patient.

A Comparison of the Influences of Verbal-Successive and Spatial-Simultaneous Factors on Achieving Readers in Fourth and Fifth Grade: A Multivariate Correlational Study.

ERIC Educational Resources Information Center

Solan, Harold A.

1987-01-01

This study involving 38 normally achieving fourth and fifth grade children confirmed previous studies indicating that both spatial-simultaneous (in which perceived stimuli are totally available at one point in time) and verbal-successive (information is presented in serial order) cognitive processing are important in normal learning. (DB)

Is There a Drop in Normative Clearsightedness in Sixth Grade? Study of Internality and Normative Clearsightedness in Fourth to Seventh Graders

ERIC Educational Resources Information Center

Bigot, Johann; Pichot, Nathalie; Teste, Benoit

2004-01-01

Numerous studies have demonstrated a decrease in the expression of internality in French sixth graders as compared to fifth graders. The present study examines normative clearsightedness in addition to internality across four French school grades (fourth to seventh). The results confirmed the sixth-grade drop in internality and showed that the…

Homologous prominence non-radial eruptions: A case study

NASA Astrophysics Data System (ADS)

Duchlev, P.; Koleva, K.; Madjarska, M. S.; Dechev, M.

2016-10-01

The present study provides important details on homologous eruptions of a solar prominence that occurred in active region NOAA 10904 on 2006 August 22. We report on the pre-eruptive phase of the homologous feature as well as the kinematics and the morphology of a forth from a series of prominence eruptions that is critical in defining the nature of the previous consecutive eruptions. The evolution of the overlying coronal field during homologous eruptions is discussed and a new observational criterion for homologous eruptions is provided. We find a distinctive sequence of three activation periods each of them containing pre-eruptive precursors such as a brightening and enlarging of the prominence body followed by small surge-like ejections from its southern end observed in the radio 17 GHz. We analyse a fourth eruption that clearly indicates a full reformation of the prominence after the third eruption. The fourth eruption although occurring 11 h later has an identical morphology, the same angle of propagation with respect to the radial direction, as well as similar kinematic evolution as the previous three eruptions. We find an important feature of the homologous eruptive prominence sequence that is the maximum height increase of each consecutive eruption. The present analysis establishes that all four eruptions observed in Hα are of confined type with the third eruption undergoing a thermal disappearance during its eruptive phase. We suggest that the observation of the same direction of the magnetic flux rope (MFR) ejections can be consider as an additional observational criterion for MFR homology. This observational indication for homologous eruptions is important, especially in the case of events of typical or poorly distinguishable morphology of eruptive solar phenomena.

Intake of red meat and heterocyclic amines, metabolic pathway genes and bladder cancer risk

PubMed Central

Lin, Jie; Forman, Michele R.; Wang, Jianming; Grossman, H. Barton; Chen, Meng; Dinney, Colin P.; Hawk, Ernest T.; Wu, Xifeng

2012-01-01

We analyzed the association between meat intake, heterocyclic amines (HCAs) and bladder cancer (BC) risk in a large case-control study comprised of 884 BC cases and 878 healthy controls, recruited from 1999 to 2009. Epidemiologic and dietary data were collected via an in-person interview. Compared to the lowest quartile of red meat intake, the odds ratios (ORs) for the second, third and fourth quartiles were 1.17 (95% CI: 0.87–1.58), 1.47 (95% CI: 1.09–1.99) and 1.95 (95% CI: 1.41–2.68), respectively, (p-for trend <0.001). In a subset of participants with intakes of HCAs available, compared with those with the lowest quartile of intake, the ORs for the second, third and fourth quartiles were 1.47 (95% CI: 0.60–3.64), 2.58 (95% CI: 1.09–6.11) and 3.32 (95% CI: 1.37–8.01), respectively, (p for trend <0.001). In cumulative analysis of SNPs in the pathway, compared with subjects carrying 0–4 unfavorable genotypes, subjects carrying 5 and 6 or more unfavorable genotypes were at 1.60-fold (95% CI: 1.20–2.12) and 2.37-fold (95% CI: 1.82–3.10) increased risk, respectively. Moreover, subjects carrying six or more unfavorable genotypes and whose red meat intake was in the highest quartile were at 5.09-fold increased risk (95% CI: 2.89–8.96; p < 0.001). These results strongly support that high red meat intake, high intake of HCAs and carrying high number of unfavorable genotypes in the HCA metabolic pathways are associated with increased risk of BC in the study population. PMID:22261697

Arthrodesis after failed knee arthroplasty. A nationwide multicenter investigation of 91 cases.

PubMed

Knutson, K; Hovelius, L; Lindstrand, A; Lidgren, L

1984-12-01

Ninety-one patients with attempted arthrodesis after failed knee arthroplasty were identified in a prospective nationwide study of knee arthroplasties performed from October 1975 through January 1982 in Sweden. The study included 43 hinged or stabilized, 34 bi- or tricompartment, and 14 unicompartment endoprostheses. Three-fourths of the failures were caused by infections. At follow-up evaluation, two patients had expired from infection and four patients had amputations. Fusion was achieved in only 50% of 108 attempts in 91 knees. Patients with unstable joints had limited function. The fusion rate was relatively high after unicompartment endoprostheses, in cases with sustained rigid fixation, or in cases where infection was brought under control at arthrodesis. Rigid fixation was best achieved with an external double frame or an intramedullary nail. Repeated attempts were worthwhile. Removal of all foreign material, eradication of the infectious lesion, and an arthrodesis performed in a one- or two-stage procedure with insertion of gentamicin beads seemed to be the best way to combat infection. The treatment of prosthetic failures should be referred to centers with special interest in knee arthroplasty.

[Work disability in public press professions].

PubMed

Akermann, S

2002-09-01

In this study more than 1,000 cases of long-term disability among members of the press and media were evaluated. Mental disorders were the main cause of disability in almost every fourth case. In women psychiatric illnesses were even more important. The most common diagnosis was that of a depressive disorder which accounted for more than half of all psychiatric cases. The causes of disability of other insurance systems such as the German social security scheme and the pension and disability plan for the medical profession were compared. Mental illnesses are the leading cause of disability in white collar workers and orthopaedic illnesses, especially disorders of the vertebral column, are the leading cause in blue collar workers, as one might have expected. In females mental disorders are even more common than in men whereas men tend to have more cardiovascular problems than women. In this study also some interesting features regarding disability caused by various illnesses after long-term follow-up were found. This opens unknown perspectives allowing new assessment of diseases and eventually will enable the actuary to price medical diagnoses for disability insurance.

Burnout, depression and suicidal ideation in dental students

PubMed Central

Ríos-Santos, José V.; Polo, Juan; Rios-Carrasco, Blanca; Bullón, Pedro

2014-01-01

Objectives: To investigate the prevalence, gender influence, and relationships between burnout, depression and suicidal ideation within the last year among second, fourth and fifth-year dental students. Study Design: A cross-sectional study was carried out in 212 dental students enrolled in the second, fourth and fifth years at the School of Dentistry of Seville using the Maslach Burnout Inventory-Student Survey and the MBI-Human Services Survey, the “Patient Health Questionnaire-2”, and the “Questions about Suicidal Ideation and Attempted Suicide”. Results: The response rate among dental students was 80%. Burnout prevalence in dental students was higher in second and fourth years than in fifth year (p= 0.059 and p= 0.003, respectively). Depression prevalence in the fourth year approached significance (p= 0.051). Prevalence of suicidal ideation within the past year was higher, yet not reaching significance, in fourth year. No gender-related differences were found. A significant association was observed between burnout and depression, and between depression and suicidal ideation (p< 0.001), but no association was found between burnout and suicidal ideation. Conclusions: This study has brought our attention to the high prevalence of burnout and depression, and reported for the first time the prevalence of suicidal ideation among dental students in preclinical and clinical years. Key words:Burnout, depression, suicidal ideation, dental students. PMID:24121916

Pneumatosis cystoides intestinalis, four cases of a rare disease.

PubMed

Rennenberg, R J M W; Koek, G H; Van Hootegem, Ph; Stockbrügger, R W

2002-03-01

Pneumatosis cystoides intestinalis (PCI) is a disease in which small gas-filled cysts appear in the intestinal wall. Four cases presented here demonstrate the diversity of the associated diseases. In two of the patients constipation probably played a role; in the third patient decreased colonic motility, elevated intestinal pressure and increased mucosal permeability in the context of enteritis treated with codeine was the underlying problem; in the fourth high protein feeding and bowel ischaemia was diagnosed. Various aetiologies are presented in the literature. There is no specific history and physical or laboratory findings do not help to diagnose PCI. Plain abdominal film, ultrasound, computer tomography, magnetic resonance imaging, barium contrast studies and/or endoscopy may be necessary for diagnosis. Therapy is based on enhancing partial oxygen pressure in the bowel wall. PCI usually runs a benign course.

The effect of apatinib in the treatment of metastatic renal cell carcinoma: a case report and review of the literature.

PubMed

Bi, Jinling; Liu, Haiyuan; Huang, Yong

2017-01-01

The aim of this study was to explore the effect of apatinib in the treatment of metastatic renal cell carcinoma (mRCC) and related adverse events. A case of mRCC was reported which recurred after surgery and roferon treatment. The patient was treated with apatinib at a dose of 500 mg orally, twice daily, 28 days/cycle. The metastatic lesions improved based on computed tomography after apatinib administration in the fourth and eighth month. The progression-free survival of the patient had increased almost to 8 months. The patient showed a good tolerance with only an adverse effect of mild-to-moderate hand-foot syndrome which was managed well. Apatinib is an option for mRCC after previous treatment. However, more and larger trials are still needed.

Efficacy of enamel matrix protein applied to spontaneous periodontal disease in two dogs.

PubMed

Watanabe, Kazuhiro; Kikuchi, Masahiro; Okumura, Masahiro; Kadosawa, Tsuyoshi; Fujinaga, Toru

2003-09-01

Enamel matrix protein (EMP) was applied for regeneration of periodontal tissue in 2 dogs with spontaneous periodontal disease. Case 1 had bony resorption around the root and root apex of the maxillary fourth premolars. Case 2 had vertical resorption of bone between the mandibular first and second molars. A flap was formed in the buccal gingiva, and EMP was applied onto the surface of the exposed root. One or 4 months postoperatively, increased bone level and clinical attachment were recognized. EMP was therefore suggested to be effective to induce regeneration of periodontal tissues in the cases with periodontal disease.

Welded Titanium Case for Space-Probe Rocket Motor

NASA Technical Reports Server (NTRS)

Brothers, A. J.; Boundy, R. A.; Martens, H. E.; Jaffe, L. D.

1959-01-01

The high strength-to-weight ratio of titanium alloys suggests their use for solid-propellant rocket-motor cases for high-performance orbiting or space-probe vehicles. The paper describes the fabrication of a 6-in.-diam., 0.025-in.-wall rocket-motor from the 6A1-4V titanium alloy. The rocket-motor case, used in the fourth stage of a successful JPL-NASA lunar-probe flight, was constructed using a design previously proven satisfactory for Type 410 stainless steel. The nature and scope of the problems peculiar to the use of the titanium alloy, which effected an average weight saving of 34%, are described.

Possible role of hypercoagulability in calciphylaxis: review of the literature.

PubMed

Harris, Ryan Jeffrey; Cropley, Thomas George

2011-02-01

The role of a hypercoagulable state in the pathogenesis of calciphylaxis has yet to be determined. We sought to find evidence of an association between hypercoagulability and calciphylaxis. We reviewed the primary literature for review articles, studies, and case reports that discussed or demonstrated a possible relationship between calciphylaxis and a hypercoagulable state. Review of the primary literature showed that in cases of calciphylaxis with reported levels of protein C and S, 38% of the patients had decreased protein C levels and 43% had decreased levels of protein S. From review of case reports, 3 cases of improvement of skin lesions with low molecular weight heparin treatment, and a fourth case of healing of skin lesions with tissue plasminogen activator treatment, were found. Calciphylaxis was also found in a patient with antiphospholipid antibody syndrome, and a patient with cryofibrinogenemia had clinical and histologic findings consistent with possible calciphylaxis. A limited number of reports were available for review. Our review of the literature found sufficient evidence to suggest a possible role of a hypercoagulable state in the pathogenesis of calciphylaxis. A prospective study with serial testing of all relevant clotting factors in patients with calciphylaxis is needed to more definitively establish this role. Copyright © 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Acute HIV infection (AHI) in a specialized clinical setting: case-finding, description of virological, epidemiological and clinical characteristics.

PubMed

Ammassari, Adriana; Abbate, Isabella; Orchi, Nicoletta; Pinnetti, Carmela; Rozera, Gabriella; Libertone, Raffaella; Pierro, Paola; Martini, Federico; Puro, Vincenzo; Girardi, Enrico; Antinori, Andrea; Capobianchi, Maria Rosaria

2014-01-01

Diagnosis of HIV infection during early stages is mandatory to catch up with the challenge of limiting HIV viral replication and reservoirs formation, as well as decreasing HIV transmissions by immediate cART initiation. Aims were to describe (a) virological characteristics of AHI identified, (b) epidemiological and clinical factors associated with being diagnosed with AHI. Cross-sectional, retrospective study. All individuals diagnosed with AHI according to Fiebig's staging between Jan 2013 and Mar 2014 at the INMI "L. Spallanzani" were included. Serum samples reactive to a fourth generation HIV-1/2 assay (Architect HIV Ag/Ab Combo, Abbott) were retested with another fourth generation assay (VIDAS DUO HIV Ultra, Biomérieux) and underwent confirmation with HIV-1 WB (New Lav I Bio-Rad) and/or with Geenius confirmatory assay (Bio-Rad). WHO criteria (two env products reactivity) were used to establish positivity of confirmatory assays. In case of clinically suspected AHI, HIV-1 RNA (Real time, Abbott) and p24 assay (VIDAS HIV P24 Bio-Rad) were also performed. Avidity test was carried out, on confirmed positive samples lacking p31 reactivity, to discriminate between recent (true Fiebig V phase) and late infections; to avoid possible misclassifications, clinical data were also used. Demographic, epidemiological, clinical and laboratory data are routinely, and anonymously recorded in the SENDIH and SIREA studies. During the study period, we observed 483 newly HIV diagnosed individuals, of whom 40 were identified as AHI (8.3%). Fiebig classification showed: 7 stage II/III, 13 stage IV, 20 stage V. Demographic, epidemiological, and clinical characteristics of patients are shown in the Table. Overall, the study population had a median S/Co ratio at fourth generation EIA (Architect) of 49.50 (IQR, 23.54-98.05): values were significantly lower in Fiebig II-IV than in Fiebig V (38.68 [IQR, 20.08-54.84] vs 75.72 [IQR, 42.66-249.80], p=0.01). Overall, median HIV-1 RNA was 5.44 log copies/mL (IQR, 4.29-6.18) and the value observed in Fiebig phase II-IV was higher than that found in Fiebig stage V (6.10 [IQR, 5.49-7.00] vs 4.69 [3.71-5.44], p<0.001). Median CD4+ cell count was 596/mmc (IQR, 410-737). cART was started in 26 patients: TDF/FTC/DRV/r/RAL=18; TDF/FTC/DRV/r=2; TDF/FTC/ATV/r=2; TDF+FTC+EFV=2; TDF/FTC/RAL=1; DRV/r+RAL=1. Integration of careful epidemiological investigation, partner notification, and technical advances in virological testing are key elements in AHI case-finding. Significant differences were found between Fiebig stages II-IV and Fiebig V with regard to virological exams.

Investigating Changing in Social Studies Textbooks of Public Review (Basic Fourth and Fifth) Based on the Emphasis on Critical Thinking Skills Facione in the Last Three Decades

ERIC Educational Resources Information Center

Aghababaeian, Parinaz; Moghaddam, Shams Aldin Hashemi; Nateghi, Faezeh; Faghihi, Alireza

2017-01-01

This study investigated the changes in public school social studies textbooks in general period of Iran (fourth and fifth grades) based on the emphasis on Facione critical thinking skills in the past three decades. In this study, content analysis of qualitative and quantitative methods was used to evaluate changes in textbook. For this purpose,…

Measurement of Shear Elastic Moduli in Quasi-Incompressible Soft Solids

NASA Astrophysics Data System (ADS)

Rénier, Mathieu; Gennisson, Jean-Luc; Barrière, Christophe; Catheline, Stefan; Tanter, Mickaël; Royer, Daniel; Fink, Mathias

2008-06-01

Recently a nonlinear equation describing the plane shear wave propagation in isotropic quasi-incompressible media has been developed using a new expression of the strain energy density, as a function of the second, third and fourth order shear elastic constants (respectively μ, A, D) [1]. In such a case, the shear nonlinearity parameter βs depends only from these last coefficients. To date, no measurement of the parameter D have been carried out in soft solids. Using a set of two experiments, acoustoelasticity and finite amplitude shear waves, the shear elastic moduli up to the fourth order of soft solids are measured. Firstly, this theoretical background is applied to the acoustoelasticity theory, giving the variations of the shear wave speed as a function of the stress applied to the medium. From such variations, both linear (μ) and third order shear modulus (A) are deduced in agar-gelatin phantoms. Experimentally the radiation force induced by a focused ultrasound beam is used to generate quasi-plane linear shear waves within the medium. Then the shear wave propagation is imaged with an ultrafast ultrasound scanner. Secondly, in order to give rise to finite amplitude plane shear waves, the radiation force generation technique is replaced by a vibrating plate applied at the surface of the phantoms. The propagation is also imaged using the same ultrafast scanner. From the assessment of the third harmonic amplitude, the nonlinearity parameter βS is deduced. Finally, combining these results with the acoustoelasticity experiment, the fourth order modulus (D) is deduced. This set of experiments provides the characterization, up to the fourth order, of the nonlinear shear elastic moduli in quasi-incompressible soft media. Measurements of the A moduli reveal that while the behaviors of both soft solids are close from a linear point of view, the corresponding nonlinear moduli A are quite different. In a 5% agar-gelatin phantom, the fourth order elastic constant D is found to be 30±10 kPa.

Fibularis tertius: revisiting the anatomy.

PubMed

Rourke, K; Dafydd, H; Parkin, I G

2007-11-01

Fibularis tertius (FT) may be used during reconstructive surgery and muscle transposition with retention of function. The muscle was examined in both lower limbs of 41 cadavers. Measurements were made of muscle belly length and width, tendon length and width, and the size of the origin on the fibula. Tendon insertion, nerve and blood supplies were also examined. FT was absent in five (6.1%) lower limbs of three (7.3%) subjects. The size of its origin demonstrated inter- and intra-individual variation. FT arose from the distal fibula and on average occupied (28.4 +/- 9.1)% (mean +/- S. D.) of the total shaft length. In all cases the tendon inserted into the dorsal surface of the shafts of both the fourth and fifth metatarsals. A small nerve branch consistently arose from the deep fibular nerve near the origin of extensor digitorum longus. The nerve ran parallel to the length of this muscle, between it and extensor hallucis longus, before piercing FT. Anatomy textbooks describe FT as inserting into the fifth metatarsal only. This study, supported by data from previous reports, suggests that the "textbook" accounts of FT should be updated to record that most commonly its tendon reaches both the fourth and fifth metatarsals.

Energy crops on landfills: functional, environmental, and costs analysis of different landfill configurations.

PubMed

Pivato, Alberto; Garbo, Francesco; Moretto, Marco; Lavagnolo, Maria Cristina

2018-02-09

The cultivation of energy crops on landfills represents an important challenge for the near future, as the possibility to use devalued sites for energy production is very attractive. In this study, four scenarios have been assessed and compared with respect to a reference case defined for northern Italy. The scenarios were defined taking into consideration current energy crops issues. In particular, the first three scenarios were based on energy maximisation, phytotreatment ability, and environmental impact, respectively. The fourth scenario was a combination of these characteristics emphasised by the previous scenarios. A multi-criteria analysis, based on economic, energetic, and environmental aspects, was performed. From the analysis, the best scenario resulted to be the fourth, with its ability to pursue several objectives simultaneously and obtain the best score relatively to both environmental and energetic criteria. On the contrary, the economic criterion emerges as weak, as all the considered scenarios showed some limits from this point of view. Important indications for future designs can be derived. The decrease of leachate production due to the presence of energy crops on the top cover, which enhances evapotranspiration, represents a favourable but critical aspect in the definition of the results.

The rapid disintegration of projections: the West Antarctic Ice Sheet and the intergovernmental panel on climate change.

PubMed

O'Reilly, Jessica; Oreskes, Naomi; Oppenheimer, Michael

2012-10-01

How and why did the scientific consensus about sea level rise due to the disintegration of the West Antarctic Ice Sheet (WAIS), expressed in the third Intergovernmental Panel on Climate Change (IPCC) assessment, disintegrate on the road to the fourth? Using ethnographic interviews and analysis of IPCC documents, we trace the abrupt disintegration of the WAIS consensus. First, we provide a brief historical overview of scientific assessments of the WAIS. Second, we provide a detailed case study of the decision not to provide a WAIS prediction in the Fourth Assessment Report. Third, we discuss the implications of this outcome for the general issue of scientists and policymakers working in assessment organizations to make projections. IPCC authors were less certain about potential WAIS futures than in previous assessment reports in part because of new information, but also because of the outcome of cultural processes within the IPCC, including how people were selected for and worked together within their writing groups. It became too difficult for IPCC assessors to project the range of possible futures for WAIS due to shifts in scientific knowledge as well as in the institutions that facilitated the interpretations of this knowledge.

Summary of the Fourth AIAA CFD Drag Prediction Workshop

NASA Technical Reports Server (NTRS)

Vassberg, John C.; Tinoco, Edward N.; Mani, Mori; Rider, Ben; Zickuhr, Tom; Levy, David W.; Brodersen, Olaf P.; Eisfeld, Bernhard; Crippa, Simone; Wahls, Richard A.;

Branchial fistula arising from pyriform fossa: CT diagnosis of a case and discussion of radiological features.

PubMed

Chauhan, Narvir Singh; Sharma, Yash Paul; Bhagra, Tilak; Sud, Bindu

2012-01-01

Anomalies of third or fourth branchial apparatus origin are very uncommon and present as recurrent neck infections or thyroiditis with a predominant left-sided involvement. Radiological diagnosis requires a high index of suspicion and is critical for initiation of proper treatment. We describe a case of branchial sinus of pyriform fossa with external fistulization that presented in adulthood and was diagnosed on computed tomographic scan. The radiological features of this rare anomaly are revisited. Copyright © 2012 Elsevier Inc. All rights reserved.

Closed circuit steam cooled turbine shroud and method for steam cooling turbine shroud

DOEpatents

Burdgick, Steven Sebastian; Sexton, Brendan Francis; Kellock, Iain Robertson

2002-01-01

A turbine shroud cooling cavity is partitioned to define a plurality of cooling chambers for sequentially receiving cooling steam and impingement cooling of the radially inner wall of the shoud. An impingement baffle is provided in each cooling chamber for receiving the cooling media from a cooling media inlet in the case of the first chamber or from the immediately upstream chamber in the case of the second through fourth chambers and includes a plurality of impingement holes for effecting the impingement cooling of the shroud inner wall.

[The fourth horseman: The yellow fever].

PubMed

Vallejos-Parás, Alfonso; Cabrera-Gaytán, David Alejandro

2017-01-01

Dengue virus three, Chikunguya and Zika have entered the national territory through the south of the country. Cases and outbreaks of yellow fever have now been identified in the Americas where it threatens to expand. Although Mexico has a robust epidemiological surveillance system for vector-borne diseases, our country must be alert in case of its possible introduction into the national territory. This paper presents theoretical assumptions based on factual data on the behavior of yellow fever in the Americas, as well as reflections on the epidemiological surveillance of vector-borne diseases.

Aggressive Angiomyxoma of the Vulva Mimicking Clitoromegaly in a Young Child.

PubMed

Kawamura, Masataka; Matsumoto, Fumi; Matsui, Futoshi; Yazawa, Koji; Shimada, Kenji

2017-03-01

Aggressive angiomyxoma (AAM) is a rare soft tissue tumor of mesenchymal origin that chiefly involves the vulvar and perineal region. In 90% of cases, AAM presents in women of reproductive age with a peak incidence in the fourth decade of life. To date, AAM of the vulva in young children and infancy has never been reported. We present a case of AAM of the vulva that was initially interpreted as clitoromegaly in a 3-year-old girl. Copyright © 2016 Elsevier Inc. All rights reserved.

An Analysis of the Relationships between Taiwanese Eighth and Fourth Graders' Motivational Beliefs and Science Achievement in TIMSS 2011

ERIC Educational Resources Information Center

Liou, Pey-Yan; Liu, Eric Zhi-Feng

2015-01-01

The purpose of this study is to examine the issues of students' motivational beliefs in science learning and their relations with science achievement. Data of Taiwanese fourth and eighth graders from the Trends in International Mathematics and Science Study 2011 were examined. Students' self-concept and intrinsic interest as motivational beliefs,…

Use of Digital Stories to Develop Listening Comprehension Skills

ERIC Educational Resources Information Center

Cigerci, Fatih Mehmet; Gultekin, Mehmet

2017-01-01

The aim of this study was to determine the effect of digital stories on the Turkish (mother language) listening skills of fourth grade students. The study used a mixed methods and was conducted in two fourth grade classrooms (ages 9-10 years) in a primary school in Eskisehir city, Turkey, during the 2014-2015 spring semester. During the 8-week…

The Effect of Guided Reading on Literacy Achievement of Third and Fourth Grade Students

ERIC Educational Resources Information Center

Gregory, Brandon

2017-01-01

Literacy, the ability to read and write, is of great importance to the success of students throughout their lives. The problem the study addressed was low literacy achievement levels of third and fourth grade students. The information gained from this study was important because it helped staff members at the research site identify the impact of…

TIMSS and PIRLS 2011: Relationships among Reading, Mathematics, and Science Achievement at the Fourth Grade--Implications for Early Learning

ERIC Educational Resources Information Center

Martin, Michael O., Ed.; Mullis, Ina V. S., Ed.

2013-01-01

TIMSS (Trends in International Mathematics and Science Study) is an international assessment of mathematics and science at the fourth and eighth grades that has been conducted every four years since 1995, with the most recent assessment in 2011. PIRLS (Progress in International Reading Literacy Study) is an international assessment of reading…

A Study of the Effectiveness of a Character Education Program to Prevent Bullying in Fourth and Seventh Grade

ERIC Educational Resources Information Center

Shapiro, Deborah J.

2012-01-01

The purpose of this study is to assess whether bullying behaviors were impacted by the character education curriculum "Character Counts!" in fourth and seventh grade students. More specifically, over time are the perceptions that the students had of bullying behaviors impacted and is there a difference between the perceptions that boys…

The Effect of Teacher and Student Characteristics on TIMSS 2011 Mathematics Achievement of Fourth- and Eighth-Grade Students in Turkey

ERIC Educational Resources Information Center

Yalcin, Seher; Demirtasli, Rahime Nükhet; Dibek, Munevver Ilgun; Yavuz, Hatice Cigdem

2017-01-01

This study investigated effect of student- and school-level variables on mathematics achievement of fourth- and eighth-grade students using the Trends in International Mathematics and Science Study (TIMSS) 2011 data of Turkey. The common variables addressed in student and school questionnaires were compared. Due to nested structure of the TIMSS…

Increasing Social Awareness and Geographical Skills of Fourth Grade Students with Technology, On-Line Communications, and Cooperative Activities.

ERIC Educational Resources Information Center

Parr, Dorothy T.

A practicum was designed to interest and motivate students to participate in social studies, an area in which lack of motivation has caused many elementary students to do poorly. An active learning, cooperative, and collaborative approach to social studies was taken with a class of 30 fourth graders. Through cooperative learning, simulated…

A Pilot Study to Investigate the Effectiveness of Multimedia CD-ROM vis-a-vis Traditional Print-Based Technology in Teaching Fourth-Grade Children

ERIC Educational Resources Information Center

Shana, Zuhrieh A.

2009-01-01

The purpose of this study was to examine the degree of effectiveness of multimedia technology in teaching in comparison to the traditional print-based teaching methods. Multimedia CD was designed to teach the second semester unit of science and Islamic studies for the fourth graders. The unit's content was the same in the print-based teaching…

Prompting methods affect the accuracy of children's school lunch recalls.

PubMed

Baxter, S D; Thompson, W O; Davis, H C

2000-08-01

To evaluate the feasibility of implementing 3 specific prompting methods among students in the first and fourth grades (mean age = 7.2 and 10.1 years, respectively), to validate recall accuracy of first- and fourth-grade students against observation, to develop a single measure of inaccuracy that cumulated errors in reporting food items and amounts without allowing underreporting and overreporting to cancel each other, and to establish information regarding the measure of inaccuracy for use in future studies. Children were interviewed the morning after they were observed eating lunch provided by the school. Interviews included free recall, nonsuggestive prompted recall, and specific prompted recall (either preference, food category, or visual). Ninety-six children (48 students per grade) were studied--32 per the specific prompting method--stratified by grade, sex, and ethnicity (African-American or white). Specific prompting method was randomly assigned to children within strata. Food items were categorized and weighted as: combination entree = 2, condiments = 1/3, and other = 1. To calculate inaccuracy of recall, absolute differences between amounts reported and observed eaten were calculated for each item and then multiplied by each item's weight; these values were then summed across all items for each child. Inaccuracy of recall was determined before specific prompting and after specific prompting and for the difference (inaccuracy after specific prompting minus inaccuracy before specific prompting). Before specific prompting, median inaccuracy was 2.7 servings for the 48 first-grade students and 1.7 servings for the 48 fourth-grade students. The median difference in inaccuracy from before to after specific prompting was 0 for both grades. Specific prompting increased recall accuracy for 9 first-graders and 12 fourth-graders, but decreased recall accuracy for 21 first-graders and 7 fourth-graders, and did not change recall accuracy for 18 first-graders and 29 fourth-graders. Among children whose recall accuracy increased after specific prompting, 5 first-graders and 8 fourth-graders received prompting for food category. Among first-grade students, specific prompting (either preference, food category, or visual) may hurt more than help recall accuracy. Among fourth-grade students, prompting for food category yields small gains in recall accuracy with minimal losses. Validation studies are needed with larger sample sizes to determine prompting methods that produce more accurate dietary recalls from children of various socioeconomic status groups, other racial/ethnic groups, and at other meals.

Apparent cooperativity of amino acid transport in Halobacterium halobium - Effect of electrical potential

NASA Technical Reports Server (NTRS)

Lanyi, J. K.

1978-01-01

Active serine accumulation in cell envelope vesicles from Halobacterium halobium proceeds by co-transport with Na(+) and can be induced by either transmembrane electrical potential or transmembrane Na(+) concentration difference. It was shown earlier that in the former case the initial transport rate is a fourth-power function of the magnitude of the electrochemical potential difference of sodium ions, and in the latter, a second-power function. A possible interpretation of this finding is cooperativity of sodium-transporting sites in the transport carrier. When both kinds of driving force are imposed simultaneously on the vesicles, fourth-power dependence on the total potential difference of sodium ions is obtained, suggesting that the transport carrier is regulated by the electrical potential. Heat treatment of the vesicles at 48 C partially inactivates transport and abolishes this effect of the electrical potential.

Chromomagnetic and chromoelectric dipole moments in the 4GTHDM

NASA Astrophysics Data System (ADS)

Hernández-Juárez, A.; Tavares, G.; Moyotl, A.

2017-10-01

The contributions to the chromomagnetic (CMDM) and chromoelectric (CEDM) dipole moments of the top quark are calculated in framework of the two-Higgs doublet model with a sequential fourth family. We only consider the contributions arising from the neutral scalar bosons H 0 and A 0, whereas the contribution of the charged scalar will be analyzed elsewhere. For the scalar boson masses we consider the degenerate case, with 200 GeV < mϕ < 500 GeV, while for the mass of the fourth family up quark we consider the interval 400 GeV < m t 4 < 600 GeV. It is found that the CMDM and CEDM are specially sensitive when mϕ is about 600 GeV and can reach the sizes of |at | ˜ 10-5 and |dt | ˜ 10-24 e cm, respectively.

A randomized controlled trial to examine the effectiveness of case management model for community dwelling older persons with mild dementia in Hong Kong.

PubMed

Lam, Linda C W; Lee, Jenny S W; Chung, Jenny C C; Lau, Anna; Woo, Jean; Kwok, Timothy C Y

2010-04-01

To evaluate a case management (CM) model for people with mild dementia, whereby resources within the family and in the community were mobilized and optimally used. Community dwelling psychiatric and geriatrics outpatients with mild dementia were randomized to receive CM by a trained occupational therapist for 4 months (CM group, N = 59) or usual care only (control group, N = 43). Primary outcome indicators included the Zarit Burden Scale (ZBI), General Health Questionnaire (GHQ), and Personal Well-Being Index for Adult (PWI-A) of the family caregivers. Secondary outcome indicators included the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Personal Well-Being Index for Intellectually Disabled (PWI-ID) of the demented subjects as measured at fourth and twelfth months. CSDDis reduced in the CM group at fourth month, but not at twelfth month. The changes in outcome variables of persons with dementia did not differ between the groups (Mann-Whitney U-test, p > 0.05). At follow-up, CM group used more day care and domestic helpers than control group (chi (2), p > 0.05). Case management for Chinese persons with mild dementia outpatients did not show significant effects in reducing caregiver burden, but encouraged family caregivers to seek external support.

[Contraception with levonorgestrel (Norplant) subcutaneous implants. African experience in Burkina Faso].

PubMed

Koné, B; Lankoandé, J; Ouédraogo, C M; Ouédraogo, A; Bonané, B; Dao, B; Sanou, J

1999-02-01

The subcutaneous implants from the levonorgestrel (Norplant) has been introduced in Burkina Faso in September 1992 within the context of a project assisted by a non-governmental organization (the Population Council). The aim was to reinforce the family planning programme in Burkina Faso by increasing the number of family planning methods available for the clients. 4 years after its introduction, we propose to make a report of our experience in terms of the contraception through subcutaneous implants in order to better set up an IEC campaign on this method. Within 4 years, 1,660 users benefitted from that contraceptive method. They were housewives in 65% of the cases. The age-group of 30-34 years old most used this method with 28.6%. Multipares most benefitted from this method with 64.3%. In 72% of the cases, the insertion was made during the premenstrual period. On the whole, 247 withdrawals have been made before the fourth years for various reasons. Among those reasons are cycle disorders (60 withdrawals), medical reasons (53 withdrawals), personal conveniences (47 withdrawals), weight gaining (14 withdrawals), failures (2 withdrawals). Regarding the side effects, they were mainly represented by the menstrual cycle disorders such as amenorrhoea, spotting, hypermenorrhoea in 51% of the cases. A good information and sensitization campaign should reduce the number of implants withdrawals before the fourth year of use. Moreover, a perfect knowledge of contraindications is indispensable before any prescription.

Competency to stand trial evaluations in a multicultural population: Associations between psychiatric, demographic, and legal factors.

PubMed

Paradis, Cheryl M; Owen, Elizabeth; Solomon, Linda Z; Lane, Benjamin; Gulrajani, Chinmoy; Fullar, Michael; Perry, Alan; Rai, Sasha; Lavy, Tamar; McCullough, Gene

2016-01-01

Data were examined from an archival sample of Competency to Stand Trial (CST) reports of 200 consecutive New York City pre-trial defendants evaluated over a five-month period. Approximately a fourth of defendants in the present study were immigrants; many required the assistance of interpreters. The examiners conducting the CST evaluation diagnosed approximately half of the defendants with a primary diagnosis of a psychotic disorder and deemed over half not competent. Examiners reached the same conclusion about competency in 96% of cases, about the presence of a psychotic disorder in 91% of cases, and affective disorder in 85% of cases. No significant differences between psychologists and psychiatrists were found for rates of competency/incompetency opinions. Compared to those deemed competent, defendants deemed not competent had significantly higher rates of prior psychiatric hospitalization and diagnosis of psychotic illness at the time of the CST evaluation but lower rates of reported substance abuse. Copyright © 2016 Elsevier Ltd. All rights reserved.

SRM attrition rate study of the aft motor case segments due to water impact cavity collapse loading

NASA Technical Reports Server (NTRS)

Crockett, C. D.

1976-01-01

The attrition assessment of the aft segments of Solid Rocket Motor due to water impact requires the establishment of a correlation between loading occurrences and structural capability. Each discrete load case, as identified by the water impact velocities and angle, varies longitudinally and radially in magnitude and distribution of the external pressure. The distributions are further required to be shifted forward or aft one-fourth the vehicle diameter to assure minimization of the effect of test instrumentation location for the load determinations. The asymmetrical load distributions result in large geometric nonlinearities in structural response. The critical structural response is progressive buckling of the case. Discrete stiffeners have been added to these aft segments to aid in gaining maximum structural capability for minimum weight addition for resisting these loads. This report presents the development of the attrition assessment of the aft segments and includes the rationale for eliminating all assessable conservatisms from this assessment.

Short-Term Acceptability of the Woman's Condom among Married Couples in Shanghai

PubMed Central

Wu, Junqing; Huang, Zirong

2016-01-01

Background. The Woman's Condom, a second-generation female condom designed for acceptability, is poised for introduction in China. Method. This single-arm study was conducted among 60 couples in China in 2010 to assess acceptability of the Woman's Condom. Results. Male participants reported that ease of handling, inserting, and removing the device improved significantly from first to fourth use. Female and male participants reported that comfort during insertion, feel of lubricant during insertion, comfort/fit of outer ring during use, and overall comfort improved significantly from first to fourth use. Further, at fourth use, female participants reported significant improvement in the comfort of the feel of the condom material and lubricant. Female and male participants reported that satisfaction with stability and sensation during sex and ability to achieve orgasm improved significantly from first to fourth use. At fourth use, female participants reported statistically significant improvement in sensation compared to using nothing. A majority of participants (78%) stated that they would use the Woman's Condom in the future, primarily due to its dual protection profile. Conclusion. This study has shown that, in China, the Woman's Condom appears to be acceptable to married couples. User experience contributes to improvement in many aspects of device acceptability. PMID:27547481

Research knowledge in undergraduate school in Brazil: a comparison between medical and law students.

PubMed

Reis Filho, Antonio José Souza; Andrade, Bruno Bezerril; Mendonça, Vitor Rosa Ramos de; Barral-Netto, Manoel

2010-09-01

Exposure to science education during college may affect a student's profile, and research experience may be associated with better professional performance. We hypothesized that the impact of research experience obtained during graduate study differs among professional curricula and among graduate courses. A validated multiple-choice questionnaire concerning scientific concepts was given to students in the first and fourth years of medical and law school at a public Brazilian educational institution. Medical students participated more frequently in introductory scientific programs than law students, and this trend increased from the first to the fourth years of study. In both curricula, fourth-year students displayed a higher percentage of correct answers than first-year students. A higher proportion of fourth-year students correctly defined the concepts of scientific hypothesis and scientific theory. In the areas of interpretation and writing of scientific papers, fourth-year students, in both curricula, felt more confident than first-year students. Although medical students felt less confident in planning and conducting research projects than law students, they were more involved in research activities. Medical graduation seems to favor the development of critical scientific maturity than law graduation. Specific policy in medical schools is a reasonable explanation for medical students' participation in more scientific activities.

Five years audit for presence of toxic agents/drug of abuse at autopsy.

PubMed

Ali, S Muhammad Aijaz; Khalil, Inayatur-ur-Rehman; Saeed, Ahmed; Hussain, Zahid

2003-09-01

To know the frequency of fatal poisoning in Peshawar regarding the toxic agents mostly involved and yearwise percentage. To know the age group and the gender that is most vulnerable to fatal poisoning. Non-interventional (descriptive) type. This study was conducted over a period of five years (1997-2001) at Forensic Medicine Department, Khyber Medical College, Peshawar. The study included 3508 autopsies conducted at Khyber Medical College, Peshawar. Out of these, 52 cases were those caused by fatal poisoning. These were analyzed according to age, gender and the toxic agent involved. t-test was applied as the test of significance. Poisoning was the cause of death in 1.48% of the total autopsies conducted during the five years. Males were more involved than the females, 90.38 %. Suicidal poisoning was present in 17.30% of the total cases and accidental poisoning was found in 80.72% cases, while homicidal cases were 1.29% only. Diacetylmorphine (heroin) was the most commonly involved agent, 65.38 %, of the total cases. The incidence of poisoning was more during the third and fourth decades of life. Diacetylmorphine (heroin) was the main causative agent involved in young males due to accidental over- dosage. Accidental and suicidal deaths should not be considered as inevitable. More elaborative studies are required in this area of recent research to adopt appropriate and adequate measures to save precious lives.

Traveling waves and conservation laws for highly nonlinear wave equations modeling Hertz chains

NASA Astrophysics Data System (ADS)

Przedborski, Michelle; Anco, Stephen C.

2017-09-01

A highly nonlinear, fourth-order wave equation that models the continuum theory of long wavelength pulses in weakly compressed, homogeneous, discrete chains with a general power-law contact interaction is studied. For this wave equation, all solitary wave solutions and all nonlinear periodic wave solutions, along with all conservation laws, are derived. The solutions are explicitly parameterized in terms of the asymptotic value of the wave amplitude in the case of solitary waves and the peak of the wave amplitude in the case of nonlinear periodic waves. All cases in which the solution expressions can be stated in an explicit analytic form using elementary functions are worked out. In these cases, explicit expressions for the total energy and total momentum for all solutions are obtained as well. The derivation of the solutions uses the conservation laws combined with an energy analysis argument to reduce the wave equation directly to a separable first-order differential equation that determines the wave amplitude in terms of the traveling wave variable. This method can be applied more generally to other highly nonlinear wave equations.

Efficacy and Safety of Daikenchuto for Constipation and Dose-Dependent Differences in Clinical Effects.

PubMed

Hirose, Tatsuya; Shinoda, Yasutaka; Kuroda, Ayaka; Yoshida, Aya; Mitsuoka, Machiko; Mori, Kouki; Kawachi, Yuki; Moriya, Akihiro; Tanaka, Kouji; Takeda, Atsuko; Yoshimura, Tomoaki; Sugiyama, Tadashi

2018-01-01

Daikenchuto (DKT) is a Kampo medicine used for the treatment of constipation. In this study, we evaluated the effectiveness of DKT against constipation. Thirty-three patients administered DKT for constipation were selected and divided into low-dose (7.5 g DKT; n = 22) and high-dose (15 g DKT; n = 11) groups. We retrospectively evaluated weekly defaecation frequency, side effects, and clinical laboratory data. Median defaecation frequencies after DKT administration (5, 5.5, 5, and 8 for the first, second, third, and fourth weeks, resp.) were significantly higher than that before DKT administration (2) in all 33 cases ( P < 0.01). One case (3%) of watery stool, one case of loose stools (3%), and no cases of abdominal pain (0%) were observed. Median defaecation frequencies in the high-dose group (7 and 9) were significantly higher than those in the low-dose group (4 and 3) in the first ( P = 0.0133) and second ( P = 0.0101) weeks, respectively. There was no significant change in clinical laboratory values. We suggest that DKT increases defaecation frequency and is safe for treating constipation.

Discrimination Evidence for Examining Fourth Grade Students' Learning Disability Problems

ERIC Educational Resources Information Center

Hassan, Abdulhameed S.; Al-Harthy, Ibrahim S.

2014-01-01

This study investigated the ability of discriminate variables (perceptual-motor, hyperactivity disorder, neurological and psychological skills) to distinguish between normal (n = 68) and students with learning disabilities (n = 72) in fourth grade. Three instruments were developed: perceptual-motor scale, hyperactivity disorder scale, skills test…

Future mobility demand in megaregions : a national study with a focus on the Gulf Coast.

DOT National Transportation Integrated Search

2013-09-01

About three fourth of national population and wealth are concentered in the 11 megaregional areas that occupy one fourth of the land areas in the US. NHTS reveal that megaregions also concentrate current and future mobility demand. This report presen...

Computational considerations for the simulation of shock-induced sound

NASA Technical Reports Server (NTRS)

Casper, Jay; Carpenter, Mark H.

1996-01-01

The numerical study of aeroacoustic problems places stringent demands on the choice of a computational algorithm, because it requires the ability to propagate disturbances of small amplitude and short wavelength. The demands are particularly high when shock waves are involved, because the chosen algorithm must also resolve discontinuities in the solution. The extent to which a high-order-accurate shock-capturing method can be relied upon for aeroacoustics applications that involve the interaction of shocks with other waves has not been previously quantified. Such a study is initiated in this work. A fourth-order-accurate essentially nonoscillatory (ENO) method is used to investigate the solutions of inviscid, compressible flows with shocks in a quasi-one-dimensional nozzle flow. The design order of accuracy is achieved in the smooth regions of a steady-state test case. However, in an unsteady test case, only first-order results are obtained downstream of a sound-shock interaction. The difficulty in obtaining a globally high-order-accurate solution in such a case with a shock-capturing method is demonstrated through the study of a simplified, linear model problem. Some of the difficult issues and ramifications for aeroacoustics simulations of flows with shocks that are raised by these results are discussed.

Controlled-Root Approach To Digital Phase-Locked Loops

NASA Technical Reports Server (NTRS)

Stephens, Scott A.; Thomas, J. Brooks

1995-01-01

Performance tailored more flexibly and directly to satisfy design requirements. Controlled-root approach improved method for analysis and design of digital phase-locked loops (DPLLs). Developed rigorously from first principles for fully digital loops, making DPLL theory and design simpler and more straightforward (particularly for third- or fourth-order DPLL) and controlling performance more accurately in case of high gain.

New Safety Policy Reduces Injuries by One-Fourth | Poster

Cancer.gov

By Terri Bray, Dave Heimbrook, Craig Reynolds, and Robert Wiltrout, Guest Writers Whether in a research laboratory or an operations environment, past performance is frequently reviewed to plan for future improvements. Such was the case last year when management recognized the need to change the policy on the minimum set of personal protective equipment (PPE) to be worn in the