Guidelines for Repackaging Multi-Media Resources.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Asian Centre for Educational Innovation for Development.

This manual outlines a general procedure for deciding whether or not a multimedia package should be adapted or repackaged to meet local needs, reviews both general and specific factors to be considered in repackaging materials, describes the process of repackaging, and outlines procedures for the try-out, evaluation, and renewal of repackaged…

47 CFR 1.526 - Records to be maintained locally for public inspection by commercial applicants, permittees and...

Code of Federal Regulations, 2010 CFR

2010-10-01

... inspection by commercial applicants, permittees and licensees. 1.526 Section 1.526 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Broadcast Applications and Proceedings General Filing Requirements § 1.526 Records to be maintained locally for public inspection by commercial applicants...

Locality-preserving logical operators in topological stabilizer codes

NASA Astrophysics Data System (ADS)

Webster, Paul; Bartlett, Stephen D.

2018-01-01

Locality-preserving logical operators in topological codes are naturally fault tolerant, since they preserve the correctability of local errors. Using a correspondence between such operators and gapped domain walls, we describe a procedure for finding all locality-preserving logical operators admitted by a large and important class of topological stabilizer codes. In particular, we focus on those equivalent to a stack of a finite number of surface codes of any spatial dimension, where our procedure fully specifies the group of locality-preserving logical operators. We also present examples of how our procedure applies to codes with different boundary conditions, including color codes and toric codes, as well as more general codes such as Abelian quantum double models and codes with fermionic excitations in more than two dimensions.

Reagan National Airport : limited opportunities to improve airlines' compliance with noise abatement procedures

DOT National Transportation Integrated Search

2000-06-01

Local airport procedures and federal laws contain a number of provisions designed in part to limit aircraft noise at Reagan National. First, a nighttime noise procedure imposed by the airport authority generally permits flight operations between 10 p...

Effective local anesthesia for onabotulinumtoxin A injections to treat hyperhidrosis associated with traumatic amputation.

PubMed

Shi, Lucy L; Sargen, Michael R; Chen, Suephy C; Arbiser, Jack L; Pollack, Brian P

2016-06-15

Botulinum toxin type A (BTX-A) injections are an effective treatment for controlling hyperhidrosis at sites of amputation. Hyperesthesia associated with amputated limbs is a major barrier to performing this procedure under local anesthesia. To present a novel method for improving local anesthesia with BTX-A injections. Methods & A 29-year-old military veteran with a below-the-knee amputation of his right leg was suffering from amputation site hyperhidrosis, which was impeding his ability to comfortably wear a prosthesis. Prior to presenting to our clinic, the patient received one treatment of BTX-A injections to his amputation stump while under general anesthesia for surgical repair of trauma-related injuries. In our dermatology clinic, we repeated the procedure using topical lidocaine-prilocaine (30 gm total) for local anesthesia. This provided effective relief of hyperhidrosis for 6 months, but the procedure was very painful (9/10 intensity). We repeated the same procedure 6 months later, using ice in addition to topical lidocaine-prilocaine (30 gm) for local anesthesia; this resulted in reduced pain (3/10 intensity) for the patient. We suggest using ice in combination with a topical anesthetic as an effective method for pain control that avoids general anesthesia in treating amputation-associated hyperhidrosis.

An iterative procedure for obtaining maximum-likelihood estimates of the parameters for a mixture of normal distributions

NASA Technical Reports Server (NTRS)

Peters, B. C., Jr.; Walker, H. F.

1978-01-01

This paper addresses the problem of obtaining numerically maximum-likelihood estimates of the parameters for a mixture of normal distributions. In recent literature, a certain successive-approximations procedure, based on the likelihood equations, was shown empirically to be effective in numerically approximating such maximum-likelihood estimates; however, the reliability of this procedure was not established theoretically. Here, we introduce a general iterative procedure, of the generalized steepest-ascent (deflected-gradient) type, which is just the procedure known in the literature when the step-size is taken to be 1. We show that, with probability 1 as the sample size grows large, this procedure converges locally to the strongly consistent maximum-likelihood estimate whenever the step-size lies between 0 and 2. We also show that the step-size which yields optimal local convergence rates for large samples is determined in a sense by the 'separation' of the component normal densities and is bounded below by a number between 1 and 2.

An iterative procedure for obtaining maximum-likelihood estimates of the parameters for a mixture of normal distributions, 2

NASA Technical Reports Server (NTRS)

Peters, B. C., Jr.; Walker, H. F.

1976-01-01

The problem of obtaining numerically maximum likelihood estimates of the parameters for a mixture of normal distributions is addressed. In recent literature, a certain successive approximations procedure, based on the likelihood equations, is shown empirically to be effective in numerically approximating such maximum-likelihood estimates; however, the reliability of this procedure was not established theoretically. Here, a general iterative procedure is introduced, of the generalized steepest-ascent (deflected-gradient) type, which is just the procedure known in the literature when the step-size is taken to be 1. With probability 1 as the sample size grows large, it is shown that this procedure converges locally to the strongly consistent maximum-likelihood estimate whenever the step-size lies between 0 and 2. The step-size which yields optimal local convergence rates for large samples is determined in a sense by the separation of the component normal densities and is bounded below by a number between 1 and 2.

7 CFR 246.5 - Selection of local agencies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 4 2011-01-01 2011-01-01 false Selection of local agencies. 246.5 Section 246.5... State and Local Agency Eligibility § 246.5 Selection of local agencies. (a) General. This section sets forth the procedures the State agency shall perform in the selection of local agencies and the expansion...

Surgical Approach and Anesthetic Modality for Carpal Tunnel Release: A Nationwide Database Study With Health Care Cost Implications.

PubMed

Foster, Brock D; Sivasundaram, Lakshmanan; Heckmann, Nathanael; Cohen, Jeremiah R; Pannell, William C; Wang, Jeffrey C; Ghiassi, Alidad

2017-03-01

Background: Carpal tunnel release (CTR) is commonly performed for carpal tunnel syndrome once conservative treatment has failed. Operative technique and anesthetic modality vary by surgeon preference and patient factors. However, CTR practices and anesthetic trends have, to date, not been described on a nationwide scale in the United States. Methods: The PearlDiver Patient Records Database was used to search Current Procedural Terminology codes for elective CTR from 2007 to 2011. Anesthetic modality (eg, general and regional anesthesia vs local anesthesia) and surgical approach (eg, endoscopic vs open) were recorded for this patient population. Cost analysis, patient demographics, regional variation, and annual changes in CTR surgery were evaluated. Results: We identified 86 687 patients who underwent carpal tunnel surgery during this 5-year time period. In this patient sample, 80.5% of CTR procedures were performed using general or regional anesthesia, compared with 19.5% of procedures performed using local anesthesia; 83.9% of all CTR were performed in an open fashion, and 16.1% were performed using an endoscopic technique. Endoscopic surgery was on average $794 more expensive than open surgery, and general or regional anesthesia was $654 more costly than local anesthesia. Conclusions: In the United States, open CTR under local anesthesia is the most cost-effective way to perform a CTR. However, only a small fraction of elective CTR procedures are performed with this technique, representing a potential area for significant health care cost savings. In addition, regional and age variations exist in procedure and anesthetic type utilized.

Numerical 3+1 General Relativistic Magnetohydrodynamics: A Local Characteristic Approach

NASA Astrophysics Data System (ADS)

Antón, Luis; Zanotti, Olindo; Miralles, Juan A.; Martí, José M.; Ibáñez, José M.; Font, José A.; Pons, José A.

2006-01-01

We present a general procedure to solve numerically the general relativistic magnetohydrodynamics (GRMHD) equations within the framework of the 3+1 formalism. The work reported here extends our previous investigation in general relativistic hydrodynamics (Banyuls et al. 1997) where magnetic fields were not considered. The GRMHD equations are written in conservative form to exploit their hyperbolic character in the solution procedure. All theoretical ingredients necessary to build up high-resolution shock-capturing schemes based on the solution of local Riemann problems (i.e., Godunov-type schemes) are described. In particular, we use a renormalized set of regular eigenvectors of the flux Jacobians of the relativistic MHD equations. In addition, the paper describes a procedure based on the equivalence principle of general relativity that allows the use of Riemann solvers designed for special relativistic MHD in GRMHD. Our formulation and numerical methodology are assessed by performing various test simulations recently considered by different authors. These include magnetized shock tubes, spherical accretion onto a Schwarzschild black hole, equatorial accretion onto a Kerr black hole, and magnetized thick disks accreting onto a black hole and subject to the magnetorotational instability.

Comparison of local and general anaesthesia for arthrocentesis of the temporomandibular joint.

PubMed

Tuz, H H; Baslarli, O; Adiloglu, S; Gokturk, T; Meral, S E

2016-10-01

Arthrocentesis of the temporomandibular joint is an effective treatment for some disorders, and is usually done under local anaesthesia. We know of few studies that have compared the ease of arthrocentesis and its outcomes under local or general anaesthesia, so we studied 32 patients (n=16 in each group). Postoperative oedema and pain, maximum mouth opening, duration of arthrocentesis, and ease of operation were assessed to compare the relative effectiveness of the two types of anaesthetic. Scores for duration of arthrocentesis (p=0.003) and ease of procedure (0.004) differed significantly, while the other results were similar in the two groups. We noticed some superior outcomes when the procedure was done under general anaesthesia, but because of its limitations, selection of patients becomes more important. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

An iterative procedure for obtaining maximum-likelihood estimates of the parameters for a mixture of normal distributions

NASA Technical Reports Server (NTRS)

Peters, B. C., Jr.; Walker, H. F.

1975-01-01

A general iterative procedure is given for determining the consistent maximum likelihood estimates of normal distributions. In addition, a local maximum of the log-likelihood function, Newtons's method, a method of scoring, and modifications of these procedures are discussed.

Model-based local density sharpening of cryo-EM maps

PubMed Central

Jakobi, Arjen J; Wilmanns, Matthias

2017-01-01

Atomic models based on high-resolution density maps are the ultimate result of the cryo-EM structure determination process. Here, we introduce a general procedure for local sharpening of cryo-EM density maps based on prior knowledge of an atomic reference structure. The procedure optimizes contrast of cryo-EM densities by amplitude scaling against the radially averaged local falloff estimated from a windowed reference model. By testing the procedure using six cryo-EM structures of TRPV1, β-galactosidase, γ-secretase, ribosome-EF-Tu complex, 20S proteasome and RNA polymerase III, we illustrate how local sharpening can increase interpretability of density maps in particular in cases of resolution variation and facilitates model building and atomic model refinement. PMID:29058676

5 CFR 911.102 - General definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false General definitions. 911.102 Section 911.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PROCEDURES FOR STATES AND LOCALITIES TO REQUEST INDEMNIFICATION § 911.102 General definitions. In...

5 CFR 911.102 - General definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false General definitions. 911.102 Section 911.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PROCEDURES FOR STATES AND LOCALITIES TO REQUEST INDEMNIFICATION § 911.102 General definitions. In...

5 CFR 911.102 - General definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false General definitions. 911.102 Section 911.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PROCEDURES FOR STATES AND LOCALITIES TO REQUEST INDEMNIFICATION § 911.102 General definitions. In...

5 CFR 911.102 - General definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false General definitions. 911.102 Section 911.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PROCEDURES FOR STATES AND LOCALITIES TO REQUEST INDEMNIFICATION § 911.102 General definitions. In...

5 CFR 911.102 - General definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false General definitions. 911.102 Section 911.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) PROCEDURES FOR STATES AND LOCALITIES TO REQUEST INDEMNIFICATION § 911.102 General definitions. In...

The feasibility of laparoscopic extraperitoneal hernia repair under local anesthesia.

PubMed

Ferzli, G; Sayad, P; Vasisht, B

1999-06-01

Laparoscopic preperitoneal herniorrhaphy has the advantage of being a minimally invasive procedure with a recurrence rate comparable to open preperitoneal repair. However, surgeons have been reluctant to adopt this procedure because it requires general anesthesia. In this report, we describe the technique used in the laparoscopic repair of inguinal hernias under local anesthesia using the preperitoneal approach. We also report our results with 10 inguinal hernias repaired using the same technique. Ten patients underwent their primary inguinal hernia repairs under local anesthesia. None were converted to general anesthesia. Four patients received a small amount of intravenous sedation. Three patients had bilateral hernias. There were five direct and eight indirect hernias. The average operative time was 47 min. The average lidocaine usage was 28 cc. All patients were discharged within a few hours of the surgery. There were no complications. Follow-up has ranged from 1 to 6 months. There has been no recurrences to date. The extraperitoneal laparoscopic repair of inguinal hernia is feasible under local anesthesia. This technique adds a new treatment option in the management of bilateral inguinal hernias, particularly in the population where general anesthesia is contraindicated or even for patients who are reluctant to receive general or epidural anesthesia.

Removal of a fractured needle during inferior alveolar nerve block: two case reports.

PubMed

You, Jae-Seek; Kim, Su-Gwan; Oh, Ji-Su; Choi, Hae-In; Jih, Myeong-Kwan

2017-09-01

The inferior alveolar nerve block is the most common method of local anesthesia for intraoral surgery at the posterior mandibular region. However, unexpected complications may occur when administering the local anesthesia. One of these uncommon complications is the fracture of the needle. If the injection needle is broken during the surgery, it should be removed immediately. However, this is one of the most difficult procedures. In this report, we present two cases of needle fracture during the procedure, and its successful removal under general/local anesthesia administration.

28 CFR 35.136 - Service animals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Service animals. 35.136 Section 35.136... LOCAL GOVERNMENT SERVICES General Requirements § 35.136 Service animals. (a) General. Generally, a public entity shall modify its policies, practices, or procedures to permit the use of a service animal...

28 CFR 35.136 - Service animals.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Service animals. 35.136 Section 35.136... LOCAL GOVERNMENT SERVICES General Requirements § 35.136 Service animals. (a) General. Generally, a public entity shall modify its policies, practices, or procedures to permit the use of a service animal...

28 CFR 35.136 - Service animals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Service animals. 35.136 Section 35.136... LOCAL GOVERNMENT SERVICES General Requirements § 35.136 Service animals. (a) General. Generally, a public entity shall modify its policies, practices, or procedures to permit the use of a service animal...

28 CFR 35.136 - Service animals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Service animals. 35.136 Section 35.136... LOCAL GOVERNMENT SERVICES General Requirements § 35.136 Service animals. (a) General. Generally, a public entity shall modify its policies, practices, or procedures to permit the use of a service animal...

43 CFR 1882.3 - Application procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... MANAGEMENT, DEPARTMENT OF THE INTERIOR GENERAL MANAGEMENT (1000) FINANCIAL ASSISTANCE, LOCAL GOVERNMENTS Mineral Development Impact Relief Loans § 1882.3 Application procedures. No later than October 1 of the... economic impacts suffered as a result of the leasing and development of Federal mineral deposits. (e) An...

7 CFR 2200.10 - Restrictions on lobbying.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Restrictions on lobbying. 2200.10 Section 2200.10 Agriculture Regulations of the Department of Agriculture (Continued) LOCAL TELEVISION LOAN GUARANTEE BOARD ACCESS TO LOCAL TELEVISION SIGNALS GUARANTEED LOAN PROGRAM; GENERAL POLICIES AND PROCEDURES § 2200.10...

Cultivating a "chairside manner": dental hypnosis, patient management psychology, and the origins of behavioral dentistry in America, 1890-1910.

PubMed

Andrick, John M

2013-01-01

Discussions regarding the use of hypnotism in dentistry featured prominently in dental journals and society proceedings during the decades around the turn of the twentieth century. Many dentists used hypnotic suggestion either as the sole anesthetic for extractions or in conjunction with local and general anesthetics for excavation and cavity filling. With the heralding of humanitarian dentistry and improved local anesthesia around 1905, a number of dentists advocated using suggestion psychology to calm nervous patients and increase their comfort and satisfaction levels while undergoing dental procedures. The practice of hypnotic suggestion with local and general anesthesia in providing patients with increasingly painless procedures constituted the earliest variety of behavioral dentistry, a discipline not fully developed until the closing decades of the twentieth century. Hypnosis and suggestion became driving forces for psychological applications in the formative years of behavioral dentistry. © 2013 Wiley Periodicals, Inc.

49 CFR 520.4 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF TRANSPORTATION PROCEDURES FOR CONSIDERING ENVIRONMENTAL IMPACTS General § 520.4 Applicability... to have a significant effect on the environment. (c) Continuing actions. This part applies to any... of general revenue sharing funds, distributed under the State and Local Fiscal Assistance Act of 1972...

7 CFR 2200.4 - Authority of the Board.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Authority of the Board. 2200.4 Section 2200.4 Agriculture Regulations of the Department of Agriculture (Continued) LOCAL TELEVISION LOAN GUARANTEE BOARD ACCESS TO LOCAL TELEVISION SIGNALS GUARANTEED LOAN PROGRAM; GENERAL POLICIES AND PROCEDURES § 2200.4...

7 CFR 2200.3 - Composition of the Board.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Composition of the Board. 2200.3 Section 2200.3 Agriculture Regulations of the Department of Agriculture (Continued) LOCAL TELEVISION LOAN GUARANTEE BOARD ACCESS TO LOCAL TELEVISION SIGNALS GUARANTEED LOAN PROGRAM; GENERAL POLICIES AND PROCEDURES § 2200.3...

Utility of an airframe referenced spatial auditory display for general aviation operations

NASA Astrophysics Data System (ADS)

Naqvi, M. Hassan; Wigdahl, Alan J.; Ranaudo, Richard J.

2009-05-01

The University of Tennessee Space Institute (UTSI) completed flight testing with an airframe-referenced localized audio cueing display. The purpose was to assess its affect on pilot performance, workload, and situational awareness in two scenarios simulating single-pilot general aviation operations under instrument meteorological conditions. Each scenario consisted of 12 test procedures conducted under simulated instrument meteorological conditions, half with the cue off, and half with the cue on. Simulated aircraft malfunctions were strategically inserted at critical times during each test procedure. Ten pilots participated in the study; half flew a moderate workload scenario consisting of point to point navigation and holding pattern operations and half flew a high workload scenario consisting of non precision approaches and missed approach procedures. Flight data consisted of aircraft and navigation state parameters, NASA Task Load Index (TLX) assessments, and post-flight questionnaires. With localized cues there was slightly better pilot technical performance, a reduction in workload, and a perceived improvement in situational awareness. Results indicate that an airframe-referenced auditory display has utility and pilot acceptance in general aviation operations.

Near patient testing in general practice: attitudes of general practitioners and practice nurses, and quality assurance procedures carried out.

PubMed Central

Hilton, S; Rink, E; Fletcher, J; Sibbald, B; Freeling, P; Szczepura, A; Davies, C; Stilwell, J

1994-01-01

BACKGROUND. The evaluation of near patient testing in British general practice has largely been confined to studies examining individual tests or comparing equipment. AIM. This study set out to determine the attitudes of practice staff to near patient testing, and the extent to which staff undertook quality assessment. METHOD. Four types of near patient testing machines were introduced into 12 general practices in two regions of England, south west Thames and west Midlands. General practitioner and practice nurse attitudes to near patient testing were assessed by semi-structured interview before and six months after the introduction of the machines. The extent to which routine quality assurance procedures were carried out within the surgery and as part of local and national schemes was examined. RESULTS. Although 80% of general practitioners anticipated changing patient management with near patient testing, only two fifths reported having done so after six months. Nurses generally were enthusiastic at the outset, although one third were unhappy about incorporating near patient testing into their work schedules. Time pressure was the most important factor restricting uptake of near patient testing. Nurses performed quality control regularly but complete local external quality assurance procedures were established in only half the practices. All the practices participated in a national scheme for cholesterol assays. CONCLUSION. General practitioners in this study did not find near patient testing a very useful addition to their resources. Pressure on nurses' time was the most frequently reported limitation. PMID:7748669

Optical urethrotomy under local anaesthesia is a feasible option in urethral stricture disease.

PubMed

Munks, D G; Alli, M O; Goad, E H Abdel

2010-01-01

The aim of our study was to assess the feasibility of performing optical urethrotomy for urethral stricture disease under local anaesthesia. A total of 33 patients with radiologically proven urethral stricture underwent optical urethrotomy by a single operator under local anaesthesia. Of these patients, 23 (70%) had stricture involving the corpora spongiosum and 18 (55%) of the patients were dependent on supra-pubic catheters. The procedure was successful in 30 cases (91%). The procedure was very well tolerated (average visual analogue pain score of 2/10) with an extremely low complication rate. The large number of patients with urethral stricture disease and the premium on operating time on formal theatre slates encouraged us to perform these procedures under local anaesthetic. Although most patients had severe stricture disease, the majority of cases were successful and very well tolerated. Optical urethrotomy under local anesthesia could be a viable option in the absence of formal theatre time and the facilities to perform general anaesthesia.

44 CFR 65.14 - Remapping of areas for which local flood protection systems no longer provide base flood protection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... local flood protection systems no longer provide base flood protection. 65.14 Section 65.14 Emergency... § 65.14 Remapping of areas for which local flood protection systems no longer provide base flood protection. (a) General. (1) This section describes the procedures to follow and the types of information...

44 CFR 65.14 - Remapping of areas for which local flood protection systems no longer provide base flood protection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... local flood protection systems no longer provide base flood protection. 65.14 Section 65.14 Emergency... § 65.14 Remapping of areas for which local flood protection systems no longer provide base flood protection. (a) General. (1) This section describes the procedures to follow and the types of information...

44 CFR 65.14 - Remapping of areas for which local flood protection systems no longer provide base flood protection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... local flood protection systems no longer provide base flood protection. 65.14 Section 65.14 Emergency... § 65.14 Remapping of areas for which local flood protection systems no longer provide base flood protection. (a) General. (1) This section describes the procedures to follow and the types of information...

Development and application of a local linearization algorithm for the integration of quaternion rate equations in real-time flight simulation problems

NASA Technical Reports Server (NTRS)

Barker, L. E., Jr.; Bowles, R. L.; Williams, L. H.

1973-01-01

High angular rates encountered in real-time flight simulation problems may require a more stable and accurate integration method than the classical methods normally used. A study was made to develop a general local linearization procedure of integrating dynamic system equations when using a digital computer in real-time. The procedure is specifically applied to the integration of the quaternion rate equations. For this application, results are compared to a classical second-order method. The local linearization approach is shown to have desirable stability characteristics and gives significant improvement in accuracy over the classical second-order integration methods.

7 CFR 2200.2 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Purpose and scope. 2200.2 Section 2200.2 Agriculture Regulations of the Department of Agriculture (Continued) LOCAL TELEVISION LOAN GUARANTEE BOARD ACCESS TO LOCAL TELEVISION SIGNALS GUARANTEED LOAN PROGRAM; GENERAL POLICIES AND PROCEDURES § 2200.2 Purpose and scope. This...

7 CFR 2200.6 - Meetings and actions of the Board.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Meetings and actions of the Board. 2200.6 Section 2200.6 Agriculture Regulations of the Department of Agriculture (Continued) LOCAL TELEVISION LOAN GUARANTEE BOARD ACCESS TO LOCAL TELEVISION SIGNALS GUARANTEED LOAN PROGRAM; GENERAL POLICIES AND PROCEDURES...

28 CFR 513.43 - Inmate access to certain Bureau Program Statements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Statements. 513.43 Section 513.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL... simple local access procedures described in this section to review certain Bureau Program Statements... 28 CFR), local access is available through the institution law library. (b) For a current Bureau...

Fiscal Procedures for Special Education Pupil Reimbursement. Revised for 1998-99 School Year.

ERIC Educational Resources Information Center

Illinois State Board of Education, Springfield. Center for Fiscal and Shared Services.

This handbook is a compilation of fiscal procedures and instructions to assist Illinois local education agencies in claiming reimbursement for special education services for the 1998-99 school year. It contains: (1) general instructions for completing the Special Education Pupil Reimbursement form; (2) instructions for filling out sections…

Spokane Community College Library Public Services Handbook. (Interlibrary Loans).

ERIC Educational Resources Information Center

Waesche, Betty; McLane, Sara

General and specific interlibrary loan (ILL) policies and procedures used by this library are described, as well as the duties and responsibilities of library staff members who work with interlibrary loans. Included are locally developed forms for in-person and phone requests, handouts, a flowchart of the procedures followed when an interlibrary…

12 CFR 308.107 - Document discovery.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Document discovery. 308.107 Section 308.107... PRACTICE AND PROCEDURE General Rules of Procedure § 308.107 Document discovery. (a) Parties to proceedings set forth at § 308.01 of the Uniform Rules and as provided in the Local Rules may obtain discovery...

12 CFR 308.107 - Document discovery.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Document discovery. 308.107 Section 308.107... PRACTICE AND PROCEDURE General Rules of Procedure § 308.107 Document discovery. (a) Parties to proceedings set forth at § 308.01 of the Uniform Rules and as provided in the Local Rules may obtain discovery...

12 CFR 308.107 - Document discovery.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Document discovery. 308.107 Section 308.107... PRACTICE AND PROCEDURE General Rules of Procedure § 308.107 Document discovery. (a) Parties to proceedings set forth at § 308.01 of the Uniform Rules and as provided in the Local Rules may obtain discovery...

12 CFR 308.107 - Document discovery.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Document discovery. 308.107 Section 308.107... PRACTICE AND PROCEDURE General Rules of Procedure § 308.107 Document discovery. (a) Parties to proceedings set forth at § 308.01 of the Uniform Rules and as provided in the Local Rules may obtain discovery...

12 CFR 308.107 - Document discovery.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Document discovery. 308.107 Section 308.107... PRACTICE AND PROCEDURE General Rules of Procedure § 308.107 Document discovery. (a) Parties to proceedings set forth at § 308.01 of the Uniform Rules and as provided in the Local Rules may obtain discovery...

28 CFR 36.605 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

28 CFR 36.605 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

28 CFR 36.605 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

28 CFR 36.605 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

28 CFR 36.606 - Procedure following preliminary denial of certification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Local Building Codes § 36.606 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a Preliminary determination to deny certification of a code under § 36.604... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

45 CFR 98.14 - Plan process.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND General Application Procedures § 98.14 Plan process. In the development of each Plan, as required pursuant to § 98.17... Federal, State, and local child care and early childhood development programs, including such programs for...

45 CFR 98.14 - Plan process.

Code of Federal Regulations, 2012 CFR

2012-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND General Application Procedures § 98.14 Plan process. In the development of each Plan, as required pursuant to § 98.17... Federal, State, and local child care and early childhood development programs, including such programs for...

45 CFR 98.14 - Plan process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND General Application Procedures § 98.14 Plan process. In the development of each Plan, as required pursuant to § 98.17... Federal, State, and local child care and early childhood development programs, including such programs for...

45 CFR 98.14 - Plan process.

Code of Federal Regulations, 2011 CFR

2011-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND General Application Procedures § 98.14 Plan process. In the development of each Plan, as required pursuant to § 98.17... Federal, State, and local child care and early childhood development programs, including such programs for...

45 CFR 98.14 - Plan process.

Code of Federal Regulations, 2013 CFR

2013-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND General Application Procedures § 98.14 Plan process. In the development of each Plan, as required pursuant to § 98.17... Federal, State, and local child care and early childhood development programs, including such programs for...

Postanesthetic ulceration of palate: A rare complication.

PubMed

Gupta, Ramesh; Garg, Meenu; Pawah, Salil; Gupta, Ajay

2016-01-01

The routine dental practice involves various dental procedures which needs the application of local anesthetics. Generally, there are very few complications associated with these procedures. Complications such as tissue necrosis can occur following the rapid injection of local anesthetic solutions. Palate is a favorable site for soft tissue lesions, various factors such as direct effects of the drug, blanching of the tissues during injection, a relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate.

Postanesthetic ulceration of palate: A rare complication

PubMed Central

Gupta, Ramesh; Garg, Meenu; Pawah, Salil; Gupta, Ajay

2016-01-01

The routine dental practice involves various dental procedures which needs the application of local anesthetics. Generally, there are very few complications associated with these procedures. Complications such as tissue necrosis can occur following the rapid injection of local anesthetic solutions. Palate is a favorable site for soft tissue lesions, various factors such as direct effects of the drug, blanching of the tissues during injection, a relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate. PMID:28163486

Multilevel decomposition approach to integrated aerodynamic/dynamic/structural optimization of helicopter rotor blades

NASA Technical Reports Server (NTRS)

Walsh, Joanne L.; Young, Katherine C.; Pritchard, Jocelyn I.; Adelman, Howard M.; Mantay, Wayne R.

1994-01-01

This paper describes an integrated aerodynamic, dynamic, and structural (IADS) optimization procedure for helicopter rotor blades. The procedure combines performance, dynamics, and structural analyses with a general purpose optimizer using multilevel decomposition techniques. At the upper level, the structure is defined in terms of local quantities (stiffnesses, mass, and average strains). At the lower level, the structure is defined in terms of local quantities (detailed dimensions of the blade structure and stresses). The IADS procedure provides an optimization technique that is compatible with industrial design practices in which the aerodynamic and dynamic design is performed at a global level and the structural design is carried out at a detailed level with considerable dialogue and compromise among the aerodynamic, dynamic, and structural groups. The IADS procedure is demonstrated for several cases.

Localized diabatization applied to excitons in molecular crystals

NASA Astrophysics Data System (ADS)

Jin, Zuxin; Subotnik, Joseph E.

2017-06-01

Traditional ab initio electronic structure calculations of periodic systems yield delocalized eigenstates that should be understood as adiabatic states. For example, excitons are bands of extended states which superimpose localized excitations on every lattice site. However, in general, in order to study the effects of nuclear motion on exciton transport, it is standard to work with a localized description of excitons, especially in a hopping regime; even in a band regime, a localized description can be helpful. To extract localized excitons from a band requires essentially a diabatization procedure. In this paper, three distinct methods are proposed for such localized diabatization: (i) a simple projection method, (ii) a more general Pipek-Mezey localization scheme, and (iii) a variant of Boys diabatization. Approaches (i) and (ii) require localized, single-particle Wannier orbitals, while approach (iii) has no such dependence. These methods should be very useful for studying energy transfer through solids with ab initio calculations.

Articaine: a review of its use for local and regional anesthesia

PubMed Central

Snoeck, Marc

2012-01-01

Articaine is an intermediate-potency, short-acting amide local anesthetic with a fast metabolism due to an ester group in its structure. It is effective with local infiltration or peripheral nerve block in dentistry, when administered as a spinal, epidural, ocular, or regional nerve block, or when injected intravenously for regional anesthesia. In comparative trials, its clinical effects were not generally significantly different from those of other short-acting local anesthetics like lidocaine, prilocaine, and chloroprocaine, and there is no conclusive evidence demonstrating above-average neurotoxicity. Articaine proved to be suitable and safe for procedures requiring a short duration of action in which a fast onset of anesthesia is desired, eg, dental procedures and ambulatory spinal anesthesia, in normal and in special populations. PMID:22915899

Safety of liposuction using exclusively tumescent local anesthesia in 3,240 consecutive cases.

PubMed

Habbema, Louis

2009-11-01

Many surgeons consider liposuction using tumescent local anesthesia (TLA) to be a safe technique, but when TLA has been combined with other techniques, such as general anesthesia or intravenous medication, or when the guidelines associated with TLA have been violated, serious complications and deaths have occurred. This has resulted in uncertainty concerning the safety of liposuction using TLA, which this article seeks to resolve. To investigate whether liposuction using TLA is a safe procedure. The same surgeon performed liposuction using exclusively TLA in 3,240 procedures. Detailed records were kept of the complications that occurred. In a series of 3,240 procedures, no deaths occurred, and no complications requiring hospitalization were experienced. In nine cases, complications developed that needed further action. Liposuction using exclusively TLA is a proven safe procedure provided that the existing guidelines are meticulously followed.

[Perioperative use of medical hypnosis. Therapy options for anaesthetists and surgeons].

PubMed

Hermes, D; Trübger, D; Hakim, S G; Sieg, P

2004-04-01

Surgical treatment of patients under local anaesthesia is quite commonly restricted by limited compliance from the patient. An alternative to treatment under pharmacological sedation or general anaesthesia could be the application of medical hypnosis. With this method, both suggestive and autosuggestive procedures are used for anxiolysis, relaxation, sedation and analgesia of the patient. During a 1-year period of first clinical application, a total of 207 surgical procedures on a non-selected collective of 174 patients were carried out under combined local anaesthesia and medical hypnosis. Medical hypnosis proved to be a standardisable and reliable method by which remarkable improvements in treatment conditions for both patient and surgeons were achievable. Medical hypnosis is not considered to be a substitute for conscious sedation or general anaesthesia but a therapeutic option equally interesting for anaesthesists and surgeons.

Summary of State Policy Regulations for Public Sector Labor Relations: Statutes, Attorney Generals' Opinions and Selected Court Decisions.

ERIC Educational Resources Information Center

Labor Management Services Administration (DOL), Washington, DC. Div. of Public Employee Labor Relations.

This chart represents a state-by-state compilation of the numerous statutes, executive orders, attorney general opinions, and court decisions which govern state and local government labor relations. Where available, information on each authority includes: (1) administrative body, (2) bargaining rights, (3) recognition rights and procedure, (4)…

Levels of Stress among General Practitioners, Students and Specialists In Pediatric Dentistry during Dental Treatment.

PubMed

Davidovich, E; Pessov, Y; Baniel, A; Ram, D

2015-01-01

To assess self-reported stress during the performance of different procedures in pediatric dentistry, according to the professional experience of the dentists. During the years 2010 to 2011, an anonymous survey was administered by means of an internet link, and by distribution at professional meetings of dentists . No statistically significant differences in stress were reported for maxilla and mandibular procedures. Placement of a rubber dam was rated as the most stressful procedure among dental students. For general practitioners and specialists, injection of local anesthesia to an anxious child was the most stressful procedure, regardless of age, sex, or years of professional experience. A negative correlation was found between years of experience and level of stress for all the procedures surveyed, but not for the use of nitrous oxide. No differences were found between male and female dentists in stress scores for any of the procedures. Higher rates of stress during operative procedures were reported among dental students than among experienced dentists. Anxiety of the pediatric patients, but not the location of the procedure: maxillary or mandibular, affected the dentists' reported level of stress.

16 CFR 4.9 - The public record.

Code of Federal Regulations, 2012 CFR

2012-01-01

... opinions, orders, statements of policy and interpretations, administrative staff manuals, general... policies and interpretations, its nonadjudicative procedures, its rules of practice for adjudicative... connection with proceedings before other federal agencies or state or local government bodies; (vi...

16 CFR 4.9 - The public record.

Code of Federal Regulations, 2013 CFR

2013-01-01

... opinions, orders, statements of policy and interpretations, administrative staff manuals, general... policies and interpretations, its nonadjudicative procedures, its rules of practice for adjudicative... connection with proceedings before other federal agencies or state or local government bodies; (vi...

16 CFR 4.9 - The public record.

Code of Federal Regulations, 2011 CFR

2011-01-01

... opinions, orders, statements of policy and interpretations, administrative staff manuals, general... policies and interpretations, its nonadjudicative procedures, its rules of practice for adjudicative... connection with proceedings before other federal agencies or state or local government bodies; (vi...

A semi-direct procedure using a local relaxation factor and its application to an internal flow problem

NASA Technical Reports Server (NTRS)

Chang, S. C.

1984-01-01

Generally, fast direct solvers are not directly applicable to a nonseparable elliptic partial differential equation. This limitation, however, is circumvented by a semi-direct procedure, i.e., an iterative procedure using fast direct solvers. An efficient semi-direct procedure which is easy to implement and applicable to a variety of boundary conditions is presented. The current procedure also possesses other highly desirable properties, i.e.: (1) the convergence rate does not decrease with an increase of grid cell aspect ratio, and (2) the convergence rate is estimated using the coefficients of the partial differential equation being solved.

Percutaneous Curettage and Continuous Irrigation for MRSA Lumbar Spondylodiscitis: A Report of Three Cases

PubMed Central

Yamagami, Yoshiki; Shibuya, Sei; Komatsubara, Satoshi; Yamamoto, Tetsuji; Arima, Nobuo

2009-01-01

There has been a recent increase in pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) associated with an increasing number of compromised patients. As long as serious paralysis is absent, we recommend percutaneous curettage and continuous irrigation as an effective treatment for MRSA lumbar spondylodiscitis. Under local anesthesia, the affected lumbar discs were curetted using percutaneous nucleotomy, and tubes were placed for continuous irrigation. The period of continuous irrigation was generally 2 weeks. Infection was controlled after one procedure in two cases and after two procedures in one case. Postoperative radiography and magnetic resonance imaging (MRI) showed callus formation, normalized signal intensity in vertebral bodies, and regression of abscesses. Open surgery under general anesthesia has been considered risky in patients with poor performance status or old age. The present method, which is an application of needle biopsy, can be performed under local anesthesia and is minimally invasive. PMID:19718264

The numerical evaluation of maximum-likelihood estimates of the parameters for a mixture of normal distributions from partially identified samples

NASA Technical Reports Server (NTRS)

Walker, H. F.

1976-01-01

Likelihood equations determined by the two types of samples which are necessary conditions for a maximum-likelihood estimate are considered. These equations, suggest certain successive-approximations iterative procedures for obtaining maximum-likelihood estimates. These are generalized steepest ascent (deflected gradient) procedures. It is shown that, with probability 1 as N sub 0 approaches infinity (regardless of the relative sizes of N sub 0 and N sub 1, i=1,...,m), these procedures converge locally to the strongly consistent maximum-likelihood estimates whenever the step size is between 0 and 2. Furthermore, the value of the step size which yields optimal local convergence rates is bounded from below by a number which always lies between 1 and 2.

[Neuraxial anesthesia after local anesthesia for management of percutaneous vertebroplasty complication during vertebroplasty].

PubMed

Balkarlı, Hüseyin; Kılıç, Mesut; Öztürk, İbrahim

Percutaneous vertebroplasty is a relatively safe, simple and commonly performed interventional procedure for the management of vertebral compression fractures. However, serious complications are rarely reported in the procedure. Those are pulmonary embolism, severe infection, paraplegia and an occurrence of a new fracture in an adjacent vertebra after vertebroplasty. Acute complications are generally associated with the procedure. We present the case of neuraxial anesthesia, developed after local anesthesia with 8mL of 2% prilocaine, in a 68-year-old woman who underwent percutaneous vertebroplasty after an osteoporotic collapsed fracture in the L 1 vertebra due to trauma. To our knowledge, this is the first case in the literature. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Neuraxial anesthesia after local anesthesia for management of percutaneous vertebroplasty complication during vertebroplasty.

PubMed

Balkarlı, Hüseyin; Kılıç, Mesut; Öztürk, İbrahim

Percutaneous vertebroplasty is a relatively safe, simple and commonly performed interventional procedure for the management of vertebral compression fractures. However, serious complications are rarely reported in the procedure. Those are pulmonary embolism, severe infection, paraplegia and an occurrence of a new fracture in an adjacent vertebra after vertebroplasty. Acute complications are generally associated with the procedure. We present the case of neuraxial anesthesia, developed after local anesthesia with 8mL of 2% prilocaine, in a 68-year-old woman who underwent percutaneous vertebroplasty after an osteoporotic collapsed fracture in the L 1 vertebra due to trauma. To our knowledge, this is the first case in the literature. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

The use of optimization techniques to design controlled diffusion compressor blading

NASA Technical Reports Server (NTRS)

Sanger, N. L.

1982-01-01

A method for automating compressor blade design using numerical optimization, and applied to the design of a controlled diffusion stator blade row is presented. A general purpose optimization procedure is employed, based on conjugate directions for locally unconstrained problems and on feasible directions for locally constrained problems. Coupled to the optimizer is an analysis package consisting of three analysis programs which calculate blade geometry, inviscid flow, and blade surface boundary layers. The optimizing concepts and selection of design objective and constraints are described. The procedure for automating the design of a two dimensional blade section is discussed, and design results are presented.

Alternative practices of achieving anaesthesia for dental procedures: a review.

PubMed

Angelo, Zavattini; Polyvios, Charalambous

2018-04-01

Managing pain and anxiety in patients has always been an essential part of dentistry. To prevent pain, dentists administer local anaesthesia (LA) via a needle injection. Unfortunately, anxiety and fear that arise prior to and/or during injection remains a barrier for many children and adults from receiving dental treatment. There is a constant search for techniques to alleviate the invasive and painful nature of the needle injection. In recent years, researchers have developed alternative methods which enable dental anaesthesia to be less invasive and more patient-friendly. The aim of this review is to highlight the procedures and devices available which may replace the conventional needle-administered local anaesthesia. The most known alternative methods in providing anaesthesia in dentistry are: topical anaesthesia, electronic dental anaesthesia, jet-injectors, iontophoresis, and computerized control local anaesthesia delivery systems. Even though these procedures are well accepted by patients to date, it is the authors' opinion that the effectiveness practicality of such techniques in general dentistry is not without limitations.

Alternative practices of achieving anaesthesia for dental procedures: a review

PubMed Central

2018-01-01

Managing pain and anxiety in patients has always been an essential part of dentistry. To prevent pain, dentists administer local anaesthesia (LA) via a needle injection. Unfortunately, anxiety and fear that arise prior to and/or during injection remains a barrier for many children and adults from receiving dental treatment. There is a constant search for techniques to alleviate the invasive and painful nature of the needle injection. In recent years, researchers have developed alternative methods which enable dental anaesthesia to be less invasive and more patient-friendly. The aim of this review is to highlight the procedures and devices available which may replace the conventional needle-administered local anaesthesia. The most known alternative methods in providing anaesthesia in dentistry are: topical anaesthesia, electronic dental anaesthesia, jet-injectors, iontophoresis, and computerized control local anaesthesia delivery systems. Even though these procedures are well accepted by patients to date, it is the authors' opinion that the effectiveness practicality of such techniques in general dentistry is not without limitations. PMID:29744382

Real-time realizations of the Bayesian Infrasonic Source Localization Method

NASA Astrophysics Data System (ADS)

Pinsky, V.; Arrowsmith, S.; Hofstetter, A.; Nippress, A.

2015-12-01

The Bayesian Infrasonic Source Localization method (BISL), introduced by Mordak et al. (2010) and upgraded by Marcillo et al. (2014) is destined for the accurate estimation of the atmospheric event origin at local, regional and global scales by the seismic and infrasonic networks and arrays. The BISL is based on probabilistic models of the source-station infrasonic signal propagation time, picking time and azimuth estimate merged with a prior knowledge about celerity distribution. It requires at each hypothetical source location, integration of the product of the corresponding source-station likelihood functions multiplied by a prior probability density function of celerity over the multivariate parameter space. The present BISL realization is generally time-consuming procedure based on numerical integration. The computational scheme proposed simplifies the target function so that integrals are taken exactly and are represented via standard functions. This makes the procedure much faster and realizable in real-time without practical loss of accuracy. The procedure executed as PYTHON-FORTRAN code demonstrates high performance on a set of the model and real data.

Transient Gratings, Four-Wave Mixing and Polariton Effects in Nonlinear Optics

DTIC Science & Technology

1991-06-01

w, are. under some very general conditions, equal to the Fourier transform of the TG signal 1361. The possibility of exciton localization l37-3...which is tile analogue of the Anderson electron localization , could also be probed ideally by the grating technique 1401. In this review we develop a...often handled using, at mean-tield t heor ilie local -tield approximation) I 7). -lI. Our -,encral formialism reduce,, to these commnon procedureN xxci he

Localized diabatization applied to excitons in molecular crystals

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

Jin, Zuxin; Subotnik, Joseph E.

Traditional ab initio electronic structure calculations of periodic systems yield delocalized eigenstates that should be understood as adiabatic states. For example, excitons are bands of extended states which superimpose localized excitations on every lattice site. However, in general, in order to study the effects of nuclear motion on exciton transport, it is standard to work with a localized description of excitons, especially in a hopping regime; even in a band regime, a localized description can be helpful. To extract localized excitons from a band requires essentially a diabatization procedure. In this paper, three distinct methods are proposed for such localizedmore » diabatization: (i) a simple projection method, (ii) a more general Pipek-Mezey localization scheme, and (iii) a variant of Boys diabatization. Approaches (i) and (ii) require localized, single-particle Wannier orbitals, while approach (iii) has no such dependence. Lastly, these methods should be very useful for studying energy transfer through solids with ab initio calculations.« less

Localized diabatization applied to excitons in molecular crystals

DOE PAGES

Jin, Zuxin; Subotnik, Joseph E.

2017-06-28

Traditional ab initio electronic structure calculations of periodic systems yield delocalized eigenstates that should be understood as adiabatic states. For example, excitons are bands of extended states which superimpose localized excitations on every lattice site. However, in general, in order to study the effects of nuclear motion on exciton transport, it is standard to work with a localized description of excitons, especially in a hopping regime; even in a band regime, a localized description can be helpful. To extract localized excitons from a band requires essentially a diabatization procedure. In this paper, three distinct methods are proposed for such localizedmore » diabatization: (i) a simple projection method, (ii) a more general Pipek-Mezey localization scheme, and (iii) a variant of Boys diabatization. Approaches (i) and (ii) require localized, single-particle Wannier orbitals, while approach (iii) has no such dependence. Lastly, these methods should be very useful for studying energy transfer through solids with ab initio calculations.« less

Percutaneous achillotomy in the treatment of congenital clubfoot: should it be performed in the operating theater or the polyclinic?

PubMed

Tuhanioğlu, Ümit; Oğur, Hasan U; Seyfettinoğlu, Fırat; Çiçek, Hakan; Tekbaş, Volkan T; Kapukaya, Ahmet

2018-06-19

The aim of this study was to compare the efficacy, advantages, and complications of percutaneous achillotomy in the treatment of clubfoot with the Ponseti method when performed to two different groups under general anesthesia or polyclinic conditions with local anesthesia. A retrospective evaluation was made of 96 patients treated for clubfoot in our clinic between January 2013 and June 2016. Fifty-seven patients were separated into two groups according to whether the achillotomy was performed in polyclinic conditions with local anesthesia or under general anesthesia following serial plaster casting with the Ponseti method. The characteristics of age distribution, mean week of tenotomy, side, and sex were similar in both groups. No statistically significant difference was determined between the two groups in respect to complication and recurrence. The durations of hospitalization-observation, separation from the mother, and fasting were found to be statistically significantly shorter in local anesthesia group. Although the performance of percutaneous achillotomy with local or general anesthesia has different advantages, it can be considered that especially in centers with high patient circulation, achillotomy with local anesthesia can be more preferable to general anesthesia because it is practical and quick, does not require a long period of fasting or hospitalization, and has a similar complication rate to general anesthesia procedures.

48 CFR 231.603 - Requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Requirements. 231.603... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With State, Local, and Federally Recognized Indian Tribal Governments 231.603 Requirements. Under 10 U.S.C...

48 CFR 231.603 - Requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Requirements. 231.603... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With State, Local, and Federally Recognized Indian Tribal Governments 231.603 Requirements. Under 10 U.S.C...

48 CFR 231.603 - Requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Requirements. 231.603... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With State, Local, and Federally Recognized Indian Tribal Governments 231.603 Requirements. Under 10 U.S.C...

48 CFR 231.603 - Requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Requirements. 231.603... OF DEFENSE GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With State, Local, and Federally Recognized Indian Tribal Governments 231.603 Requirements. Under 10 U.S.C...

[Surgical manegement of breast cancer].

PubMed

Bussmann, J F; Trede, M

1975-12-18

A survey of common operative methods in carcinoma of the breast is given. The own procedure in localized and generalized stages of the disease is presented. Simple mastectomy plus axillary dissection has according to our experience proven to be the method of choice.

Equipment management user's handbook for property custodians

NASA Technical Reports Server (NTRS)

1993-01-01

The NASA Equipment Management User's Handbook for Property Custodians is issued as an instructional guide for personnel designated as property custodians and technical personnel involved in the acquisition, management, and use of NASA-owned equipment. This handbook provides general information and basic operational procedures for processing equipment transactions through the agency-wide NASA Equipment Management System (NEMS). Each NASA installation must prepare supplementary instructions for local requirements beyond the scope of NASA-wide policies and procedures contained herein, or as specified for local implementation in NHB 4200.1, 'NASA Equipment Management Manual.' NHB 4200.1 sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for the acquisition, management, and use of NASA-owned equipment. This handbook is a controlled document, issued in loose-leaf form and revised by page changes. Additional copies for internal use may be obtained through normal distribution.

47 CFR 1.917 - Who may sign applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Wireless Radio Services... territories of the United States, their political subdivisions, the District of Columbia, and units of local... administrative sanctions, including revocation of station license pursuant to 312(a)(1) of the Communications Act...

Age as a Determinant to Select an Anesthesia Method for Tympanostomy Tube Insertion in a Pediatric Population

PubMed Central

Jung, Kihwan; Kim, Hojong

2015-01-01

Background and Objectives To evaluate the relationship between age and anesthesia method used for tympanostomy tube insertion (TTI) and to provide evidence to guide the selection of an appropriate anesthesia method in children. Subjects and Methods We performed a retrospective review of children under 15 years of age who underwent tympanostomy tube insertion (n=159) or myringotomy alone (n=175) under local or general anesthesia by a single surgeon at a university-based, secondary care referral hospital. Epidermiologic data between local and general anesthesia groups as well as between TTI and myringotomy were analyzed. Medical costs were compared between local and general anesthesia groups. Results Children who received local anesthesia were significantly older than those who received general anesthesia. Unilateral tympanostomy tube insertion was performed more frequently under local anesthesia than bilateral. Logistic regression modeling showed that local anesthesia was more frequently applied in older children (odds ratio=1.041) and for unilateral tympanostomy tube insertion (odds ratio=8.990). The cut-off value of age for local anesthesia was roughly 5 years. Conclusions In a pediatric population at a single medical center, age and whether unilateral or bilateral procedures were required were important factors in selecting an anesthesia method for tympanostomy tube insertion. Our findings suggest that local anesthesia can be preferentially considered for children 5 years of age or older, especially in those with unilateral otitis media with effusion. PMID:26185791

Preoperative Medical Evaluation: Part 1: General Principles and Cardiovascular Considerations

PubMed Central

Becker, Daniel E

2009-01-01

A thorough assessment of a patient's medical status is standard practice when dental care is provided. Although this is true for procedures performed under local anesthesia alone, the information gathered may be viewed somewhat differently if the dentist is planning to use sedation or general anesthesia as an adjunct to dental treatment. This article is the first of a 2-part sequence and will address general principles and cardiovascular considerations. A second article will address pulmonary, metabolic, and miscellaneous disorders. PMID:19769423

Design and Application of a Larval Fish Trap

DTIC Science & Technology

1994-05-01

Sedimentation processes should be grouped into the broad categories of *local’ and *general" processes. Local processes are those occurring over a relatively...in terms of group symbols and typical group nanie, by a field expedient procedure that uses the USCS. Soils possessing characteristics of two groups ...are designated by combinations of group symbols. For example, a GW-GC soil is a well- graded gravel-sand mixture with clay binder. A wetland soil may

Division File of Extension Research Materials; Additions During 1968.

ERIC Educational Resources Information Center

Byrn, Darcie, Comp.

In this annotated bibliography of acquisitions during 1968 appear 265 Extension studies on administrative organization and management; training and staff development; mobilizing participation in Extension work; local leadership; program content and planning procedures; general effectiveness and progress in Extension; teaching methods, techniques,…

48 CFR 31.205-15 - Fines, penalties, and mischarging costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial... violations of, or failure of the contractor to comply with, Federal, State, local, or foreign laws and... of the contract or written instructions from the contracting officer. (b) Costs incurred in...

Fluorescent labeling of tetracysteine-tagged proteins in intact cells.

PubMed

Hoffmann, Carsten; Gaietta, Guido; Zürn, Alexander; Adams, Stephen R; Terrillon, Sonia; Ellisman, Mark H; Tsien, Roger Y; Lohse, Martin J

2010-09-01

In this paper, we provide a general protocol for labeling proteins with the membrane-permeant fluorogenic biarsenical dye fluorescein arsenical hairpin binder-ethanedithiol (FlAsH-EDT₂). Generation of the tetracysteine-tagged protein construct by itself is not described, as this is a protein-specific process. This method allows site-selective labeling of proteins in living cells and has been applied to a wide variety of proteins and biological problems. We provide here a generally applicable labeling procedure and discuss the problems that can occur as well as general considerations that must be taken into account when designing and implementing the procedure. The method can even be applied to proteins with expression below 1 pmol mg⁻¹ of protein, such as G protein-coupled receptors, and it can be used to study the intracellular localization of proteins as well as functional interactions in fluorescence resonance energy transfer experiments. The labeling procedure using FlAsH-EDT₂ as described takes 2-3 h, depending on the number of samples to be processed.

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

This paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility strives to use spot prices which maximize itsmore » revenues from any given Small Power Producing Facility, SPPF, a schedule while respecting the general regulatory and contractual framework. the proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

The present paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility will strive to use spot prices whichmore » maximize its revenues from any given Small Power Producing Facility, SPPF, schedule while respecting the general regulatory and contractual framework. The proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

Systemic inflammatory response after endoscopic (TEP) vs Shouldice groin hernia repair.

PubMed

Schwab, R; Eissele, S; Brückner, U B; Gebhard, F; Becker, H P

2004-08-01

Endoscopic techniques are commonly used for many different types of surgery. It is claimed that videoendoscopic procedures have the advantage of being less traumatic and of offering higher postoperative patient comfort than conventional open techniques. The extent of tissue trauma can be evaluated on the basis of the inflammatory response observed in the wake of surgery. Available studies that have compared endoscopic and conventional techniques suggest that endoscopic cholecystectomy, laparoscopic colorectal resection, and thoracoscopic pulmonary resection have immunologic advantages over conventional approaches. The objective of this prospective study was to determine whether endoscopic hernia repair techniques are also preferable to conventional procedures and to what extent the anesthetic technique (local or general anesthesia) influences the postoperative inflammatory response. For this purpose, biochemical monitoring of cytokine activity [C-reactive protein (CRP), prostaglandin F1alpha (PGF1alpha), neopterin, interleukin-6 (IL-6)] was done prospectively in 101 patients [totally extraperitoneal approach (TEP) n=32, unilateral n=12, bilateral n=20; Shouldice n=69, local anesthesia (LA) n=23, general anesthesia (GA) n=46] before and until 3 days after surgery. The parameters IL-6 and PGF1alpha suggested that the immune trauma immediately after surgery was significantly higher in the group of patients with endoscopic hernia repair than in the group of patients who received a Shouldice repair. No significant differences were observed after the first postoperative day. A comparison between the TEP group and the patients who received conventional surgery under local anesthesia showed that the TEP approach was also associated with a higher postoperative neopterin level. Within the first 3 days after surgical intervention, bilateral endoscopic hernia repair induced no significantly higher inflammatory response than the surgical treatment of unilateral conditions. The anesthetic procedure that was used in the Shouldice operation had no significant effect on inflammatory response. Unlike other types of endoscopic surgery, the repair of groin hernias using an endoscopic technique cannot be regarded as a minimally invasive procedure that is less traumatic than conventional approaches. Instead, the conventional Shouldice procedure appears to cause the lowest inflammatory response and to be the least traumatic approach to hernia repair, especially when it is performed under local anesthesia.

Methemoglobin Levels in Generally Anesthetized Pediatric Dental Patients Receiving Prilocaine Versus Lidocaine

PubMed Central

Gutenberg, Lauren L.; Chen, Jung-Wei; Trapp, Larry

2013-01-01

The purpose of this study was to measure and compare peak methemoglobin levels and times to peak methemoglobin levels following the use of prilocaine and lidocaine in precooperative children undergoing comprehensive dental rehabilitation under general anesthesia. Ninety children, 3–6 years of age, undergoing dental rehabilitation under general anesthesia were enrolled and randomly assigned into 3 equal groups: group 1, 4% prilocaine plain, 5 mg/kg; group 2, 2% lidocaine with 1 : 100,000 epinephrine, 2.5 mg/kg; and group 3, no local anesthetic. Subjects in groups 1 and 2 were administered local anesthetic prior to restorative dental treatment. Methemoglobin levels (SpMET) were measured and recorded throughout the procedure using a Masimo Radical-7 Pulse Co-Oximeter (Masimo Corporation, Irvine, Calif, RDS-1 with SET software with methemoglobin interface). Data were analyzed using chi-square, one-way analysis of variance (ANOVA), and Pearson correlation (significance of P < .05). Group 1 had a significantly higher mean peak SpMET level at 3.55% than groups 2 and 3 at 1.63 and 1.60%, respectively. The mean time to peak SpMET was significantly shorter for group 3 at 29.50 minutes than that of group 1 at 62.73 and group 2 at 57.50 minutes. Prilocaine, at 5 mg/kg in pediatric dental patients, resulted in significantly higher peak SpMET levels than lidocaine and no local anesthetic. In comparison to no local anesthetic, the administration of prilocaine and lidocaine caused peak SpMET levels to occur significantly later in the procedure. PMID:24010987

Global Properties of Fully Convective Accretion Disks from Local Simulations

NASA Astrophysics Data System (ADS)

Bodo, G.; Cattaneo, F.; Mignone, A.; Ponzo, F.; Rossi, P.

2015-08-01

We present an approach to deriving global properties of accretion disks from the knowledge of local solutions derived from numerical simulations based on the shearing box approximation. The approach consists of a two-step procedure. First, a local solution valid for all values of the disk height is constructed by piecing together an interior solution obtained numerically with an analytical exterior radiative solution. The matching is obtained by assuming hydrostatic balance and radiative equilibrium. Although in principle the procedure can be carried out in general, it simplifies considerably when the interior solution is fully convective. In these cases, the construction is analogous to the derivation of the Hayashi tracks for protostars. The second step consists of piecing together the local solutions at different radii to obtain a global solution. Here we use the symmetry of the solutions with respect to the defining dimensionless numbers—in a way similar to the use of homology relations in stellar structure theory—to obtain the scaling properties of the various disk quantities with radius.

Local versus general anesthesia for external dacryocystorhinostomy in young patients.

PubMed

Ciftci, Ferda; Pocan, Sibel; Karadayi, Koray; Gulecek, Oguz

2005-05-01

To compare the effectiveness, complications, and patient acceptance of local anesthesia with general anesthesia in young patients for external dacryocystorhinostomy (DCR). Data were prospectively collected over an 8-year period (1996-2004) on young patients (mean age: 22.64+/-1.71) undergoing external DCR in Gulhane Military Medical Academy. Patients were randomly allocated in two groups: general anesthesia (GA) and local anesthesia (LA). Of the 480 DCR procedures, 182 were performed with general anesthesia (44 bilateral), 298 were performed with local anesthesia (32 bilateral). Visual analogue scales were recorded in the postoperative 2-hour period. Postoperative nausea and vomiting (PONV), epistaxis, length of hospital stay, and intraoperative bleeding were noted. Patients in both groups reported being comfortable during and immediately after surgery. Only 2 patients in the LA group required additional local anesthetic because of pain. Intraoperative bleeding was lower in the LA group. Analgesic requirement and signs of nausea and vomiting in the GA group were higher in the early postoperative period (p<0.05). The incidence of PONV was higher (p<0.05) in the GA group. Postoperative epistaxis was observed in 12 patients in the GA group and just 2 patients in the LA group. Length of hospital stay was 2.29+/-0.46 days in the GA group, and 1.23+/-0.42 days in the LA group (p<0.01). Local anesthesia in DCR is safe and comfortable when proper anatomical approach to nerve blocks is performed correctly. Local anesthesia in young patients undergoing external DCR is a good alternative because it is cost-effective and it eliminates the complications of general anesthesia.

In Vivo Recording of Neural and Behavioral Correlates of Anesthesia Induction, Reversal, and Euthanasia in Cephalopod Molluscs.

PubMed

Butler-Struben, Hanna M; Brophy, Samantha M; Johnson, Nasira A; Crook, Robyn J

2018-01-01

Cephalopod molluscs are among the most behaviorally and neurologically complex invertebrates. As they are now included in research animal welfare regulations in many countries, humane and effective anesthesia is required during invasive procedures. However, currently there is no evidence that agents believed to act as anesthetics produce effects beyond immobility. In this study we demonstrate, for the first time, that two of the most commonly used agents in cephalopod general anesthesia, magnesium chloride and ethanol, are capable of producing strong and reversible blockade of afferent and efferent neural signal; thus they are genuine anesthetics, rather than simply sedating agents that render animals immobile but not insensible. Additionally, we demonstrate that injected magnesium chloride and lidocaine are effective local anesthetic agents. This represents a considerable advance for cephalopod welfare. Using a reversible, minimally invasive recording procedure, we measured activity in the pallial nerve of cuttlefish ( Sepia bandensis ) and octopus ( Abdopus aculeatus, Octopus bocki ), during induction and reversal for five putative general anesthetic and two local anesthetic agents. We describe the temporal relationship between loss of behavioral responses (immobility), loss of efferent neural signal (loss of "consciousness") and loss of afferent neural signal (anesthesia) for general anesthesia, and loss of afferent signal for local anesthesia. Both ethanol and magnesium chloride were effective as bath-applied general anesthetics, causing immobility, complete loss of behavioral responsiveness and complete loss of afferent and efferent neural signal. Cold seawater, diethyl ether, and MS-222 (tricaine) were ineffective. Subcutaneous injection of either lidocaine or magnesium chloride blocked behavioral and neural responses to pinch in the injected area, and we conclude that both are effective local anesthetic agents for cephalopods. Lastly, we demonstrate that a standard euthanasia protocol-immersion in isotonic magnesium chloride followed by surgical decerebration-produced no behavioral response and no neural activity during surgical euthanasia. Based on these data, we conclude that both magnesium chloride and ethanol can function as general anesthetic agents, and lidocaine and magnesium chloride can function as local anesthetic agents for cephalopod molluscs.

In Vivo Recording of Neural and Behavioral Correlates of Anesthesia Induction, Reversal, and Euthanasia in Cephalopod Molluscs

PubMed Central

Butler-Struben, Hanna M.; Brophy, Samantha M.; Johnson, Nasira A.; Crook, Robyn J.

2018-01-01

Cephalopod molluscs are among the most behaviorally and neurologically complex invertebrates. As they are now included in research animal welfare regulations in many countries, humane and effective anesthesia is required during invasive procedures. However, currently there is no evidence that agents believed to act as anesthetics produce effects beyond immobility. In this study we demonstrate, for the first time, that two of the most commonly used agents in cephalopod general anesthesia, magnesium chloride and ethanol, are capable of producing strong and reversible blockade of afferent and efferent neural signal; thus they are genuine anesthetics, rather than simply sedating agents that render animals immobile but not insensible. Additionally, we demonstrate that injected magnesium chloride and lidocaine are effective local anesthetic agents. This represents a considerable advance for cephalopod welfare. Using a reversible, minimally invasive recording procedure, we measured activity in the pallial nerve of cuttlefish (Sepia bandensis) and octopus (Abdopus aculeatus, Octopus bocki), during induction and reversal for five putative general anesthetic and two local anesthetic agents. We describe the temporal relationship between loss of behavioral responses (immobility), loss of efferent neural signal (loss of “consciousness”) and loss of afferent neural signal (anesthesia) for general anesthesia, and loss of afferent signal for local anesthesia. Both ethanol and magnesium chloride were effective as bath-applied general anesthetics, causing immobility, complete loss of behavioral responsiveness and complete loss of afferent and efferent neural signal. Cold seawater, diethyl ether, and MS-222 (tricaine) were ineffective. Subcutaneous injection of either lidocaine or magnesium chloride blocked behavioral and neural responses to pinch in the injected area, and we conclude that both are effective local anesthetic agents for cephalopods. Lastly, we demonstrate that a standard euthanasia protocol—immersion in isotonic magnesium chloride followed by surgical decerebration—produced no behavioral response and no neural activity during surgical euthanasia. Based on these data, we conclude that both magnesium chloride and ethanol can function as general anesthetic agents, and lidocaine and magnesium chloride can function as local anesthetic agents for cephalopod molluscs. PMID:29515454

42 CFR 488.11 - State survey agency functions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false State survey agency functions. 488.11 Section 488... (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General Provisions § 488.11 State survey agency functions. State and local agencies that have agreements under section 1864...

42 CFR 488.11 - State survey agency functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false State survey agency functions. 488.11 Section 488... (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General Provisions § 488.11 State survey agency functions. State and local agencies that have agreements under section 1864...

42 CFR 488.11 - State survey agency functions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false State survey agency functions. 488.11 Section 488... (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General Provisions § 488.11 State survey agency functions. State and local agencies that have agreements under section 1864...

42 CFR 488.11 - State survey agency functions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false State survey agency functions. 488.11 Section 488... (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General Provisions § 488.11 State survey agency functions. State and local agencies that have agreements under section 1864...

Guidelines for developing or supplementing natural photo series.

Treesearch

Wayne G. Maxwell; Franklin Ward

1980-01-01

These guidelines provide the land manager with procedures for making local supplements to General Technical Report PNW-105, "Photo Series for Quantifying Natural Forest Residues in Common Vegetation Types of the Pacific Northwest"; the process used to photograph and measure residues and summarize the data is described.

Two-qubit quantum cloning machine and quantum correlation broadcasting

NASA Astrophysics Data System (ADS)

Kheirollahi, Azam; Mohammadi, Hamidreza; Akhtarshenas, Seyed Javad

2016-11-01

Due to the axioms of quantum mechanics, perfect cloning of an unknown quantum state is impossible. But since imperfect cloning is still possible, a question arises: "Is there an optimal quantum cloning machine?" Buzek and Hillery answered this question and constructed their famous B-H quantum cloning machine. The B-H machine clones the state of an arbitrary single qubit in an optimal manner and hence it is universal. Generalizing this machine for a two-qubit system is straightforward, but during this procedure, except for product states, this machine loses its universality and becomes a state-dependent cloning machine. In this paper, we propose some classes of optimal universal local quantum state cloners for a particular class of two-qubit systems, more precisely, for a class of states with known Schmidt basis. We then extend our machine to the case that the Schmidt basis of the input state is deviated from the local computational basis of the machine. We show that more local quantum coherence existing in the input state corresponds to less fidelity between the input and output states. Also we present two classes of a state-dependent local quantum copying machine. Furthermore, we investigate local broadcasting of two aspects of quantum correlations, i.e., quantum entanglement and quantum discord, defined, respectively, within the entanglement-separability paradigm and from an information-theoretic perspective. The results show that although quantum correlation is, in general, very fragile during the broadcasting procedure, quantum discord is broadcasted more robustly than quantum entanglement.

Intraoperative anaphylaxis: verba volant, scripta manent!

PubMed

Bilò, M B; Cinti, B; Chiarello, M; Bonifazi, F; Moneret-Vautrin, D A

2005-11-01

We describe a case of intraoperative gelatine-induced anaphylaxis whose diagnosis was delayed as the use of gelatine during surgical procedures was omitted for two times in patient's medical records. The subject is a 66-year old woman, with a negative medical history of atopy, food and drug allergy, with arterial hypertension on a course of beta-blockers and with bladder carcinoma requiring surgery. The patient had tolerated both general and local anaesthesia on several previous occasions. On the first occasion she experienced arterial fibrillation secondary to a severe episode of hypotension following local anaesthesia, while on a course of beta-blockers. On the second occasion she developed a very severe episode of hypotension followed by the outbreak of a generalised rash during general anaesthesia. The tryptase sera level was 109 mg/L one hour after the reaction had subsided, while the basal values were normal. On the third occasion the patient redeveloped severe hypotension and a generalised rash during general anaesthesia. The allergological work-up was negative, except for intradermal test with gelatine. A study of the intra-cellular cytokines in blood lymphocytes showed a production of IL4 from CD4+ lymphocytes after stimulation by gelatine. The patient underwent a successive surgical procedure without any adverse event.

Strong disorder real-space renormalization for the many-body-localized phase of random Majorana models

NASA Astrophysics Data System (ADS)

Monthus, Cécile

2018-03-01

For the many-body-localized phase of random Majorana models, a general strong disorder real-space renormalization procedure known as RSRG-X (Pekker et al 2014 Phys. Rev. X 4 011052) is described to produce the whole set of excited states, via the iterative construction of the local integrals of motion (LIOMs). The RG rules are then explicitly derived for arbitrary quadratic Hamiltonians (free-fermions models) and for the Kitaev chain with local interactions involving even numbers of consecutive Majorana fermions. The emphasis is put on the advantages of the Majorana language over the usual quantum spin language to formulate unified RSRG-X rules.

Office microlaparoscopic ovarian drilling (OMLOD) versus conventional laparoscopic ovarian drilling (LOD) for women with polycystic ovary syndrome.

PubMed

Salah, Imaduldin M

2013-02-01

This was a prospective controlled study to compare the beneficial effects of office microlaparoscopic ovarian drilling (OMLOD) under augmented local anesthesia, as a new modality treatment option, compared to those following ovarian drilling with the conventional traditional 10-mm laparoscope (laparoscopic ovarian drilling, LOD) under general anesthesia. The study included 60 anovulatory women with polycystic ovary syndrome (PCOS) who underwent OMLOD (study group) and 60 anovulatory PCOS women, in whom conventional LOD using 10-mm laparoscope under general anesthesia was performed (comparison group). Transvaginal ultrasound scan and blood sampling to measure the serum concentrations of LH, FSH, testosterone and androstenedione were performed before and after the procedure. Intraoperative and postoperative pain scores in candidate women were evaluated during the office microlaparoscopic procedure, in addition to the number of candidates who needed extra analgesia. Women undergoing OMLOD showed good intraoperative and postoperative pain scores. The number of patients discharged within 2 h after the office procedure was significantly higher, without the need for postoperative analgesia in most patients. The LH:FSH ratio, mean serum concentrations of LH and testosterone and free androgen index decreased significantly after both OMLOD and LOD. The mean ovarian volume decreased significantly (P < 0.05) a year after both OMLOD and LOD. There were no significant differences in those results after both procedures. Intra- and postoperatively augmented local anesthesia allows outpatient bilateral ovarian drilling by microlaparoscopy without general anesthesia. The high pregnancy rate, the simplicity of the method and the faster discharge time offer a new option for patients with PCOS who are resistant to clomiphene citrate. Moreover, ovarian drilling could be performed simultaneously during the routine diagnostic microlaparoscopy and integrated into the fertility workup of these patients.

Outcomes of hypnosis combined with local anesthesia during inguinal repair: a pilot study.

PubMed

Romain, B; Rodriguez, M; Story, F; Delhorme, J-B; Brigand, C; Rohr, S

2017-02-01

To evaluate the usefulness and outcomes of hypnosis associated with local anesthesia during inguinal hernia repair procedure, notably on post-operative pain. A prospective study included patients operated on inguinal hernia repair according to Lichtenstein technique from January 2013 to September 2014. The cohort was divided into three groups (group 1: local anesthesia; group 2: hypnosis and local anesthesia; and group 3: general anesthesia). A questionnaire was filled by each participant before and after surgery. Pre-operative apprehension, pain at hospital discharge, surgeon comfort during procedure, immediate satisfaction after hospital discharge, and satisfaction at 1 month after surgery were evaluated. A total of 103 patients were included in this study (group 1: n = 55; group 2: n = 35; and group 3: n = 13). Pre-operative apprehension and pain at hospital discharge's scores were significantly higher in the group 3 than in the groups 1 and 2 (p < 0.001). Pain at hospital discharge was significantly lower in the group 2 than in the group 1 (p = 0.03). Pre-operative apprehension, surgeon comfort during procedure, immediate satisfaction after hospital discharge, and satisfaction at 1 month after surgery were similar between groups 1 and 2. Hypnosis combined with local anesthesia is a feasible technique which allows extending inguinal hernia repair to a large population. There is no complication associated with its use.

24 CFR 570.489 - Program administrative requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... advance in accordance with Treasury Circular 1075 (31 CFR part 205). The State shall use procedures to.... (2) Interest on advances. Interest earned by units of general local government on grant funds before... assurance that there has been public disclosure of the conflict and a description of how the public...

California School Accounting Manual, 1988 Edition.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento.

This report presents the procedure for the accounting methods employed by California school districts for income and expenditures in instructional and support programs. The report has seven parts: (1) an introduction to accounting in local educational agencies; (2) general and subsidiary ledger accounting; (3) revenues and other financing sources;…

12 CFR 109.102 - Discovery.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 1 2013-01-01 2013-01-01 false Discovery. 109.102 Section 109.102 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY RULES OF PRACTICE AND PROCEDURE IN ADJUDICATORY PROCEEDINGS Local Rules § 109.102 Discovery. (a) In general. A party may take the deposition of an...

12 CFR 509.102 - Discovery.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 6 2013-01-01 2012-01-01 true Discovery. 509.102 Section 509.102 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY RULES OF PRACTICE AND PROCEDURE IN ADJUDICATORY PROCEEDINGS Local Rules § 509.102 Discovery. (a) In general. A party may take the deposition of an...

12 CFR 509.102 - Discovery.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 6 2014-01-01 2012-01-01 true Discovery. 509.102 Section 509.102 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY RULES OF PRACTICE AND PROCEDURE IN ADJUDICATORY PROCEEDINGS Local Rules § 509.102 Discovery. (a) In general. A party may take the deposition of an...

12 CFR 509.102 - Discovery.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Discovery. 509.102 Section 509.102 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY RULES OF PRACTICE AND PROCEDURE IN ADJUDICATORY PROCEEDINGS Local Rules § 509.102 Discovery. (a) In general. A party may take the deposition of an...

12 CFR 509.102 - Discovery.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 6 2012-01-01 2012-01-01 false Discovery. 509.102 Section 509.102 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY RULES OF PRACTICE AND PROCEDURE IN ADJUDICATORY PROCEEDINGS Local Rules § 509.102 Discovery. (a) In general. A party may take the deposition of an...

12 CFR 109.102 - Discovery.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 1 2014-01-01 2014-01-01 false Discovery. 109.102 Section 109.102 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY RULES OF PRACTICE AND PROCEDURE IN ADJUDICATORY PROCEEDINGS Local Rules § 109.102 Discovery. (a) In general. A party may take the deposition of an...

12 CFR 109.102 - Discovery.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 1 2012-01-01 2012-01-01 false Discovery. 109.102 Section 109.102 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY RULES OF PRACTICE AND PROCEDURE IN ADJUDICATORY PROCEEDINGS Local Rules § 109.102 Discovery. (a) In general. A party may take the deposition of an...

12 CFR 509.102 - Discovery.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Discovery. 509.102 Section 509.102 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY RULES OF PRACTICE AND PROCEDURE IN ADJUDICATORY PROCEEDINGS Local Rules § 509.102 Discovery. (a) In general. A party may take the deposition of an...

Local Influence and Robust Procedures for Mediation Analysis

ERIC Educational Resources Information Center

Zu, Jiyun; Yuan, Ke-Hai

2010-01-01

Existing studies of mediation models have been limited to normal-theory maximum likelihood (ML). Because real data in the social and behavioral sciences are seldom normally distributed and often contain outliers, classical methods generally lead to inefficient or biased parameter estimates. Consequently, the conclusions from a mediation analysis…

Local representation of the electronic dielectric response function

DOE PAGES

Lu, Deyu; Ge, Xiaochuan

2015-12-11

We present a local representation of the electronic dielectric response function, based on a spatial partition of the dielectric response into contributions from each occupied Wannier orbital using a generalized density functional perturbation theory. This procedure is fully ab initio, and therefore allows us to rigorously define local metrics, such as “bond polarizability,” on Wannier centers. We show that the locality of the bare response function is determined by the locality of three quantities: Wannier functions of the occupied manifold, the density matrix, and the Hamiltonian matrix. Furthermore, in systems with a gap, the bare dielectric response is exponentially localized,more » which supports the physical picture of the dielectric response function as a collection of interacting local responses that can be captured by a tight-binding model.« less

8 CFR 1003.40 - Local operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Local operating procedures. 1003.40 Section... PROVISIONS EXECUTIVE OFFICE FOR IMMIGRATION REVIEW Immigration Court-Rules of Procedure § 1003.40 Local... establish local operating procedures, provided that: (a) Such operating procedure(s) shall not be...

8 CFR 1003.40 - Local operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Local operating procedures. 1003.40 Section... PROVISIONS EXECUTIVE OFFICE FOR IMMIGRATION REVIEW Immigration Court-Rules of Procedure § 1003.40 Local... establish local operating procedures, provided that: (a) Such operating procedure(s) shall not be...

The use of local anesthesia during dental rehabilitations: a survey of AAPD members.

PubMed

Townsend, Janice A; Martin, Ashla; Hagan, Joseph L; Needleman, Howard

2013-01-01

The purpose of this study was to document current practices among pediatric and general dentists who are members of the American Academy of Pediatric Dentistry (AAPD) regarding the use of local anesthesia (LA) on children undergoing dental rehabilitation under general anesthesia (GA). A survey was administered via e-mail to AAPD members to document the use of LA during dental rehabilitations under GA and the rationales for its use. A total of 952 of 5,599 members responded to this survey; 79 percent of respondents use LA at least part of the time during dental rehabilitations under GA. "Improved patient recovery" was the most commonly cited rationale for administering LA. Extraction of permanent and primary teeth were the two most common procedures cited for the use of LA, respectively. There is no consensus among the respondents on the use of local anesthesia during dental rehabilitation under general anesthesia, but the majority responded that it does play a role in their perioperative patient management.

On the stabilization of decentralized control systems.

NASA Technical Reports Server (NTRS)

Wang, S.-H.; Davison, E. J.

1973-01-01

This paper considers the problem of stabilizing a linear time-variant multivariable system by using several local feedback control laws. Each local feedback control law depends only on partial system outputs. A necessary and sufficient condition for the existence of local control laws with dynamic compensation to stabilize a given system is derived. This condition is stated in terms of a new notion, called fixed modes, which is a natural generalization of the well-known concept of uncontrollable modes and unobservable modes that occur in centralized control system problems. A procedure that constructs a set of stabilizing feedback control laws is given.

Geometrical correction factors for heat flux meters

NASA Technical Reports Server (NTRS)

Baumeister, K. J.; Papell, S. S.

1974-01-01

General formulas are derived for determining gage averaging errors of strip-type heat flux meters used in the measurement of one-dimensional heat flux distributions. The local averaging error e(x) is defined as the difference between the measured value of the heat flux and the local value which occurs at the center of the gage. In terms of e(x), a correction procedure is presented which allows a better estimate for the true value of the local heat flux. For many practical problems, it is possible to use relatively large gages to obtain acceptable heat flux measurements.

Preventive Analgesia by Local Anesthetics: The Reduction of Postoperative Pain by Peripheral Nerve Blocks and Intravenous Drugs

PubMed Central

Barreveld, Antje; Witte, Jürgen; Chahal, Harkirat; Durieux, Marcel E.; Strichartz, Gary

2012-01-01

The use of local anesthetics to reduce acute postoperative pain has a long history, but recent reports have not been systematically reviewed. In addition, the need to include only those clinical studies that meet minimum standards for randomization and blinding must be adhered to. In this review we have applied stringent clinical study design standards to identify publications on the use of perioperative local anesthetics. We first examined several types of peripheral nerve blocks, covering a variety of surgical procedures, and second, for effects of intentionally administered IV local anesthetic (lidocaine) for suppression of postoperative pain. Thirdly, we have examined publications in which vascular concentrations of local anesthetics were measured at different times after peripheral nerve block procedures, noting the incidence when those levels reached ones achieved during intentional IV administration. Importantly, the very large number of studies using neuraxial blockade techniques (epidural, spinal) has not been included in this review but will be dealt with separately in a later review. The overall results showed a strongly positive effect of local anesthetics, by either route, for suppressing postoperative pain scores and analgesic (opiate) consumption. In only a few situations were the effects equivocal. Enhanced effectiveness with the addition of adjuvants was not uniformly apparent. The differential benefits between drug delivery before, during, or immediately after a surgical procedure are not obvious, and a general conclusion is that the significant antihyperalgesic effects occur when the local anesthetic is present during the acute postoperative period, and its presence during surgery is not essential for this action. PMID:23408672

Local infiltrative anesthesia for transaxillary subpectoral breast implants.

PubMed

Mottura, A A

1995-01-01

Breast augmentations using a transaxillary subpectoral approach are usually performed under general anesthesia. This article describes a technique that uses local infiltrative anesthesia in breast augmentation, adenomastectomies with immediate breast reconstruction, and when placing breast expansors. Large anesthetic solutions with vasoconstrictor and long-acting effects are prepared. The axila, the subpectoral space, and a surrounding area of 3 cm outside the demarcation limits are infiltrated. Minimal bleeding, long-lasting effects, and a considerable postoperative analgesic effect are some of the advantages of this procedure.

Bleeding control in endoscopic sinus surgery: a systematic review of the literature.

PubMed

Rodriguez Valiente, A; Roldan Fidalgo, A; Laguna Ortega, D

2013-12-01

In the literature various methods are described to reduce bleeding in endoscopic sinus surgery. Scientific evidence and results were gathered and analysed to determine the effectiveness of the various methods used. A total of 20 articles fulfilled the inclusion criteria. Two retrospective articles studied the differences between local and general anaesthesia. Three articles analysed the use of local methods to control bleeding. The majority of the articles analysed the use of different systemic drugs to control intraoperative bleeding. Certain procedures, such as the reverse Trendelenburg position, the use of high doses of epinephrine, the infiltration of phenylephrine and lidocaine into the pterygopalatine fossa, the preoperative use of prednisone, and the control of the heart rate (with dexmedetomidine or remifentanil), appear to reduce the intraoperative blood loss and/or improve the visualisation of the surgical field. However, the evidence supporting these conclusions is poor. The benefits of other procedures, such as the preoperative use of β-blockers, antihypertensive agents, and surgical pledgets with oxymetazoline, phenylephrine, or cocaine, for bleeding control are not evidenced in the literature. In addition, the literature does not present any evidence on the benefits of local anaesthesia compared with general anaesthesia or the use of propofol compared to inhaled analgesics in terms of intraoperative bleeding or complication rates.

Analysis of colonoscopic perforations at a local clinic and a tertiary hospital.

PubMed

Sagawa, Toshihiko; Kakizaki, Satoru; Iizuka, Haruhisa; Onozato, Yasuhiro; Sohara, Naondo; Okamura, Shinichi; Mori, Masatomo

2012-09-21

To define the clinical characteristics, and to assess the management of colonoscopic complications at a local clinic. A retrospective review of the medical records was performed for the patients with iatrogenic colon perforations after endoscopy at a local clinic between April 2006 and December 2010. Data obtained from a tertiary hospital in the same region were also analyzed. The underlying conditions, clinical presentations, perforation locations, treatment types (operative or conservative) and outcome data for patients at the local clinic and the tertiary hospital were compared. A total of 10  826 colonoscopies, and 2625 therapeutic procedures were performed at a local clinic and 32  148 colonoscopies, and 7787 therapeutic procedures were performed at the tertiary hospital. The clinic had no perforations during diagnostic colonoscopy and 8 (0.3%) perforations were determined to be related to therapeutic procedures. The perforation rates in each therapeutic procedure were 0.06% (1/1609) in polypectomy, 0.2% (2/885) in endoscopic mucosal resection (EMR), and 3.8% (5/131) in endoscopic submucosal dissection (ESD). Perforation rates for ESD were significantly higher than those for polypectomy or EMR (P < 0.01). All of these patients were treated conservatively. On the other hand, three (0.01%) perforation cases were observed among the 24  361 diagnostic procedures performed, and these cases were treated with surgery in a tertiary hospital. Six perforations occurred with therapeutic endoscopy (perforation rate, 0.08%; 1 per 1298 procedures). Perforation rates for specific procedure types were 0.02% (1 per 5500) for polypectomy, 0.17% (1 per 561) for EMR, 2.3% (1 per 43) for ESD in the tertiary hospital. There were no differences in the perforation rates for each therapeutic procedure between the clinic and the tertiary hospital. The incidence of iatrogenic perforation requiring surgical treatment was quite low in both the clinic and the tertiary hospital. No procedure-related mortalities occurred. Performing closure with endoscopic clipping reduced the C-reactive protein (CRP) titers. The mean maximum CRP titer was 2.9 ± 1.6 mg/dL with clipping and 9.7 ± 6.2 mg/dL without clipping, respectively (P < 0.05). An operation is indicated in the presence of a large perforation, and in the setting of generalized peritonitis or ongoing sepsis. Although we did not experience such case in the clinic, patients with large perforations should be immediately transferred to a tertiary hospital. Good relationships between local clinics and nearby tertiary hospitals should therefore be maintained. It was therefore found to be possible to perform endoscopic treatment at a local clinic when sufficient back up was available at a nearby tertiary hospital.

Use of 0.5% bupivacaine with buprenorphine in minor oral surgical procedures.

PubMed

Nagpal, Varun; Kaur, Tejinder; Kapila, Sarika; Bhullar, Ramandeep Singh; Dhawan, Amit; Kaur, Yashmeet

2017-01-01

Minor oral surgical procedures are the most commonly performed procedures by oral and maxillofacial surgeons. Performance of painless surgical procedure is highly appreciated by the patients and is possible through the use of local anesthesia, conscious sedation or general anesthesia. Postoperative pain can also be controlled by the use of opioids, as opioid receptors exist in the peripheral nervous system and offers the possibility of providing postoperative analgesia in the surgical patient. The present study compares the efficacy of 0.5% bupivacaine versus 0.5% bupivacaine with 0.3 mg buprenorphine in minor oral surgical procedures. The present study was conducted in 50 patients who required minor oral surgical procedures under local anesthesia. Two types of local anesthetic solutions were used- 0.5% bupivacaine with 1:200000 epinephrine in group I and a mixture of 39 ml of 0.5% bupivacaine with epinephrine 1:200000 and 1 ml of 300 μg buprenorphine (3 μg/kg)in group II. Intraoperative and postoperative evaluation was carried out for both the anesthetic solutions. The mean duration of postoperative analgesia in bupivacaine group (508.92 ± 63.30 minutes) was quite less than the buprenorphine combination group (1840.84 ± 819.51 minutes). The mean dose of postoperative analgesic medication in bupivacaine group (1.64 ± 0.99 tablets) was higher than buprenorphine combination group (0.80 ± 1.08 tablets). There was no significant difference between the two groups regarding the onset of action of the anesthetic effect and duration of anesthesia. Buprenorphine can be used in combination with bupivacaine for patients undergoing minor oral surgical procedures to provide postoperative analgesia for a longer duration.

Fluorescent labeling of tetracysteine-tagged proteins in intact cells

PubMed Central

Hoffmann, Carsten; Gaietta, Guido; Zürn, Alexander; Adams, Stephen R; Terrillon, Sonia; Ellisman, Mark H; Tsien, Roger Y; Lohse, Martin J

2011-01-01

In this paper, we provide a general protocol for labeling proteins with the membrane-permeant fluorogenic biarsenical dye fluorescein arsenical hairpin binder–ethanedithiol (FlAsH-EDT2). Generation of the tetracysteine-tagged protein construct by itself is not described, as this is a protein-specific process. This method allows site-selective labeling of proteins in living cells and has been applied to a wide variety of proteins and biological problems. We provide here a generally applicable labeling procedure and discuss the problems that can occur as well as general considerations that must be taken into account when designing and implementing the procedure. The method can even be applied to proteins with expression below 1 pmol mg−1 of protein, such as G protein–coupled receptors, and it can be used to study the intracellular localization of proteins as well as functional interactions in fluorescence resonance energy transfer experiments. The labeling procedure using FlAsH-EDT2 as described takes 2–3 h, depending on the number of samples to be processed. PMID:20885379

2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

Code of Federal Regulations, 2010 CFR

2010-01-01

... Contents A. General B. Definitions 1. Billed central services 2. Allocated central services 3. Agency or...; a description of the procedures (methodology) used to charge the costs of each service to users... revenues (including imputed revenues) generated by the service to the allowable costs of the service, as...

Validity and Reliability of Criterion-Referenced Measures: Issues and Procedures for Special Educators.

ERIC Educational Resources Information Center

Harris, Larry P.; Wolf, Steven R.

1979-01-01

The article focuses on the controversy over norm-referenced v criterion-referenced measures (CRM) in assessment of learning disorders. The authors contend that while the reliability of CRMs is generally indisputable, the validity of measures designed from local curricula is still dependent on the intuitive judgments of teachers. (Author/SBH)

36 CFR 1211.615 - Procedure for effecting compliance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ADMINISTRATION GENERAL RULES NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING... or local law. (b) Noncompliance with § 1211.115. If an applicant fails or refuses to furnish an assurance or otherwise fails or refuses to comply with a requirement imposed by or pursuant to § 1211.115...

36 CFR 1211.615 - Procedure for effecting compliance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ADMINISTRATION GENERAL RULES NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING... or local law. (b) Noncompliance with § 1211.115. If an applicant fails or refuses to furnish an assurance or otherwise fails or refuses to comply with a requirement imposed by or pursuant to § 1211.115...

36 CFR § 1211.615 - Procedure for effecting compliance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ADMINISTRATION GENERAL RULES NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING... or local law. (b) Noncompliance with § 1211.115. If an applicant fails or refuses to furnish an assurance or otherwise fails or refuses to comply with a requirement imposed by or pursuant to § 1211.115...

36 CFR 1211.615 - Procedure for effecting compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ADMINISTRATION GENERAL RULES NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING... or local law. (b) Noncompliance with § 1211.115. If an applicant fails or refuses to furnish an assurance or otherwise fails or refuses to comply with a requirement imposed by or pursuant to § 1211.115...

36 CFR 1211.615 - Procedure for effecting compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ADMINISTRATION GENERAL RULES NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING... or local law. (b) Noncompliance with § 1211.115. If an applicant fails or refuses to furnish an assurance or otherwise fails or refuses to comply with a requirement imposed by or pursuant to § 1211.115...

Guide to Effective Business Practices in Buying School Supplies, Instructional Materials, Equipment and Services.

ERIC Educational Resources Information Center

Association of School Business Officials International, Reston, VA.

This guide to effective business practices is intended to assist schools in establishing general policies and procedures for buying supplies, instructional materials, equipment, and services. Federal, state, and local laws must be considered in addition to the recommendations made in this report. Practical guidelines are given for selecting…

40 CFR 63.99 - Delegated Federal authorities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... been delegated to the air pollution control agencies in each State under the procedures described in... 26 Pulp & Paper II (Combustion sources) MM X X X 27 Generic MACT: Control Devices SS X X X Eq. Leaks... of 40 CFR Part 63 General Provisions Authorities to State and Local Air Pollution Control Agencies...

Quantitative local analysis of nonlinear systems

NASA Astrophysics Data System (ADS)

Topcu, Ufuk

This thesis investigates quantitative methods for local robustness and performance analysis of nonlinear dynamical systems with polynomial vector fields. We propose measures to quantify systems' robustness against uncertainties in initial conditions (regions-of-attraction) and external disturbances (local reachability/gain analysis). S-procedure and sum-of-squares relaxations are used to translate Lyapunov-type characterizations to sum-of-squares optimization problems. These problems are typically bilinear/nonconvex (due to local analysis rather than global) and their size grows rapidly with state/uncertainty space dimension. Our approach is based on exploiting system theoretic interpretations of these optimization problems to reduce their complexity. We propose a methodology incorporating simulation data in formal proof construction enabling more reliable and efficient search for robustness and performance certificates compared to the direct use of general purpose solvers. This technique is adapted both to region-of-attraction and reachability analysis. We extend the analysis to uncertain systems by taking an intentionally simplistic and potentially conservative route, namely employing parameter-independent rather than parameter-dependent certificates. The conservatism is simply reduced by a branch-and-hound type refinement procedure. The main thrust of these methods is their suitability for parallel computing achieved by decomposing otherwise challenging problems into relatively tractable smaller ones. We demonstrate proposed methods on several small/medium size examples in each chapter and apply each method to a benchmark example with an uncertain short period pitch axis model of an aircraft. Additional practical issues leading to a more rigorous basis for the proposed methodology as well as promising further research topics are also addressed. We show that stability of linearized dynamics is not only necessary but also sufficient for the feasibility of the formulations in region-of-attraction analysis. Furthermore, we generalize an upper bound refinement procedure in local reachability/gain analysis which effectively generates non-polynomial certificates from polynomial ones. Finally, broader applicability of optimization-based tools stringently depends on the availability of scalable/hierarchial algorithms. As an initial step toward this direction, we propose a local small-gain theorem and apply to stability region analysis in the presence of unmodeled dynamics.

GLOBAL PROPERTIES OF FULLY CONVECTIVE ACCRETION DISKS FROM LOCAL SIMULATIONS

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

Bodo, G.; Ponzo, F.; Rossi, P.

2015-08-01

We present an approach to deriving global properties of accretion disks from the knowledge of local solutions derived from numerical simulations based on the shearing box approximation. The approach consists of a two-step procedure. First, a local solution valid for all values of the disk height is constructed by piecing together an interior solution obtained numerically with an analytical exterior radiative solution. The matching is obtained by assuming hydrostatic balance and radiative equilibrium. Although in principle the procedure can be carried out in general, it simplifies considerably when the interior solution is fully convective. In these cases, the construction ismore » analogous to the derivation of the Hayashi tracks for protostars. The second step consists of piecing together the local solutions at different radii to obtain a global solution. Here we use the symmetry of the solutions with respect to the defining dimensionless numbers—in a way similar to the use of homology relations in stellar structure theory—to obtain the scaling properties of the various disk quantities with radius.« less

Local versus general anesthesia for transcatheter aortic valve implantation (TAVR)--systematic review and meta-analysis.

PubMed

Fröhlich, Georg M; Lansky, Alexandra J; Webb, John; Roffi, Marco; Toggweiler, Stefan; Reinthaler, Markus; Wang, Duolao; Hutchinson, Nevil; Wendler, Olaf; Hildick-Smith, David; Meier, Pascal

2014-03-10

The hypothesis of this study was that local anesthesia with monitored anesthesia care (MAC) is not harmful in comparison to general anesthesia (GA) for patients undergoing Transcatheter Aortic Valve Implantation (TAVR).TAVR is a rapidly spreading treatment option for severe aortic valve stenosis. Traditionally, in most centers, this procedure is done under GA, but more recently procedures with MAC have been reported. This is a systematic review and meta-analysis comparing MAC versus GA in patients undergoing transfemoral TAVR. Trials were identified through a literature search covering publications from 1 January 2005 through 31 January 2013. The main outcomes of interest of this literature meta-analysis were 30-day overall mortality, cardiac-/procedure-related mortality, stroke, myocardial infarction, sepsis, acute kidney injury, procedure time and duration of hospital stay. A random effects model was used to calculate the pooled relative risks (RR) with 95% confidence intervals. Seven observational studies and a total of 1,542 patients were included in this analysis. None of the studies were randomized. Compared to GA, MAC was associated with a shorter hospital stay (-3.0 days (-5.0 to -1.0); P = 0.004) and a shorter procedure time (MD -36.3 minutes (-58.0 to -15.0 minutes); P <0.001). Overall 30-day mortality was not significantly different between MAC and GA (RR 0.77 (0.38 to 1.56); P = 0.460), also cardiac- and procedure-related mortality was similar between both groups (RR 0.90 (0.34 to 2.39); P = 0.830). These data did not show a significant difference in short-term outcomes for MAC or GA in TAVR. MAC may be associated with reduced procedural time and shorter hospital stay. Now randomized trials are needed for further evaluation of MAC in the setting of TAVR.

Local anesthesia for inguinal hernia repair step-by-step procedure.

PubMed Central

Amid, P K; Shulman, A G; Lichtenstein, I L

1994-01-01

OBJECTIVE. The authors introduce a simple six-step infiltration technique that results in satisfactory local anesthesia and prolonged postoperative analgesia, requiring a maximum of 30 to 40 mL of local anesthetic solution. SUMMARY BACKGROUND DATA. For the last 20 years, more than 12,000 groin hernia repairs have been performed under local anesthesia at the Lichtenstein Hernia Institute. Initially, field block was the mean of achieving local anesthesia. During the last 5 years, a simple infiltration technique has been used because the field block was more time consuming and required larger volume of the local anesthetic solution. Furthermore, because of the blind nature of the procedure, it did not always result in satisfactory anesthesia and, at times, accidental needle puncture of the ilioinguinal nerve resulted in prolonged postoperative pain, burning, or electric shock sensation within the field of the ilioinguinal nerve innervation. METHODS. More than 12,000 patients underwent operations in a private practice setting in general hospitals. RESULTS. For 2 decades, more than 12,000 adult patients with reducible groin hernias satisfactorily underwent operations under local anesthesia without complications. CONCLUSIONS. The preferred choice of anesthesia for all reducible adult inguinal hernia repair is local. It is safe, simple, effective, and economical, without postanesthesia side effects. Furthermore, local anesthesia administered before the incision produces longer postoperative analgesia because local infiltration, theoretically, inhibits build-up of local nociceptive molecules and, therefore, there is better pain control in the postoperative period. Images Figure 1. Figure 2. PMID:7986138

General phase spaces: from discrete variables to rotor and continuum limits

NASA Astrophysics Data System (ADS)

Albert, Victor V.; Pascazio, Saverio; Devoret, Michel H.

2017-12-01

We provide a basic introduction to discrete-variable, rotor, and continuous-variable quantum phase spaces, explaining how the latter two can be understood as limiting cases of the first. We extend the limit-taking procedures used to travel between phase spaces to a general class of Hamiltonians (including many local stabilizer codes) and provide six examples: the Harper equation, the Baxter parafermionic spin chain, the Rabi model, the Kitaev toric code, the Haah cubic code (which we generalize to qudits), and the Kitaev honeycomb model. We obtain continuous-variable generalizations of all models, some of which are novel. The Baxter model is mapped to a chain of coupled oscillators and the Rabi model to the optomechanical radiation pressure Hamiltonian. The procedures also yield rotor versions of all models, five of which are novel many-body extensions of the almost Mathieu equation. The toric and cubic codes are mapped to lattice models of rotors, with the toric code case related to U(1) lattice gauge theory.

Rényi squashed entanglement, discord, and relative entropy differences

NASA Astrophysics Data System (ADS)

Seshadreesan, Kaushik P.; Berta, Mario; Wilde, Mark M.

2015-10-01

The squashed entanglement quantifies the amount of entanglement in a bipartite quantum state, and it satisfies all of the axioms desired for an entanglement measure. The quantum discord is a measure of quantum correlations that are different from those due to entanglement. What these two measures have in common is that they are both based upon the conditional quantum mutual information. In Berta et al (2015 J. Math. Phys. 56 022205), we recently proposed Rényi generalizations of the conditional quantum mutual information of a tripartite state on ABC (with C being the conditioning system), which were shown to satisfy some properties that hold for the original quantity, such as non-negativity, duality, and monotonicity with respect to local operations on the system B (with it being left open to show that the Rényi quantity is monotone with respect to local operations on system A). Here we define a Rényi squashed entanglement and a Rényi quantum discord based on a Rényi conditional quantum mutual information and investigate these quantities in detail. Taking as a conjecture that the Rényi conditional quantum mutual information is monotone with respect to local operations on both systems A and B, we prove that the Rényi squashed entanglement and the Rényi quantum discord satisfy many of the properties of the respective original von Neumann entropy based quantities. In our prior work (Berta et al 2015 Phys. Rev. A 91 022333), we also detailed a procedure to obtain Rényi generalizations of any quantum information measure that is equal to a linear combination of von Neumann entropies with coefficients chosen from the set \\{-1,0,1\\}. Here, we extend this procedure to include differences of relative entropies. Using the extended procedure and a conjectured monotonicity of the Rényi generalizations in the Rényi parameter, we discuss potential remainder terms for well known inequalities such as monotonicity of the relative entropy, joint convexity of the relative entropy, and the Holevo bound.

Models for nearly every occasion: Part I - One box models.

PubMed

Hewett, Paul; Ganser, Gary H

2017-01-01

The standard "well mixed room," "one box" model cannot be used to predict occupational exposures whenever the scenario involves the use of local controls. New "constant emission" one box models are proposed that permit either local exhaust or local exhaust with filtered return, coupled with general room ventilation or the recirculation of a portion of the general room exhaust. New "two box" models are presented in Part II of this series. Both steady state and transient models were developed. The steady state equation for each model, including the standard one box steady state model, is augmented with an additional factor reflecting the fraction of time the substance was generated during each task. This addition allows the easy calculation of the average exposure for cyclic and irregular emission patterns, provided the starting and ending concentrations are zero or near zero, or the cumulative time across all tasks is long (e.g., several tasks to a full shift). The new models introduce additional variables, such as the efficiency of the local exhaust to immediately capture freshly generated contaminant and the filtration efficiency whenever filtered exhaust is returned to the workspace. Many of the model variables are knowable (e.g., room volume and ventilation rate). A structured procedure for calibrating a model to a work scenario is introduced that can be applied to both continuous and cyclic processes. The "calibration" procedure generates estimates of the generation rate and all of remaining unknown model variables.

Wavelets and distributed approximating functionals

NASA Astrophysics Data System (ADS)

Wei, G. W.; Kouri, D. J.; Hoffman, D. K.

1998-07-01

A general procedure is proposed for constructing father and mother wavelets that have excellent time-frequency localization and can be used to generate entire wavelet families for use as wavelet transforms. One interesting feature of our father wavelets (scaling functions) is that they belong to a class of generalized delta sequences, which we refer to as distributed approximating functionals (DAFs). We indicate this by the notation wavelet-DAFs. Correspondingly, the mother wavelets generated from these wavelet-DAFs are appropriately called DAF-wavelets. Wavelet-DAFs can be regarded as providing a pointwise (localized) spectral method, which furnishes a bridge between the traditional global methods and local methods for solving partial differential equations. They are shown to provide extremely accurate numerical solutions for a number of nonlinear partial differential equations, including the Korteweg-de Vries (KdV) equation, for which a previous method has encountered difficulties (J. Comput. Phys. 132 (1997) 233).

Recovery process and determinants of adverse event occurrence in bronchoscopic procedures performed under general anaesthesia.

PubMed

Özden Omaygenç, Derya; Ünal, Nermin; Edipoğlu, Saadet İpek; Barca Şeker, Tuğçe; Özgül, Mehmet Akif; Turan, Demet; Özdemir, Cengiz; Karaca, İbrahim Oğuz; Çetinkaya, Erdoğan

2018-04-16

Regarding the fact that rigid bronchoscopy is generally performed under general anaesthesia and this patient subgroup is remarkably morbid, encountering procedure and/or anaesthesia related complications are highly likely. Here, we aimed to assess factors influencing recovery and detect possible determinants of adverse event occurrence during these operations performed in a tertiary referral centre. Eighty-one consecutive ASA I-IV patients were recruited for this investigation. In the operating theatre after induction of anaesthesia and advancement of the device, maintenance was provided with total intravenous anaesthesia. Neuromuscular blockage was invariably administered, and patients were ventilated manually. In addition to preoperative demographic and procedural characteristics, perioperative hemodynamic variables, recovery times and observed adverse events were noted. Basic demographic properties, ASA and Mallampati scores, and procedure specific variables as lesion localization, lesion and procedure type were comparable among groups assembled with reference to event occurrence. Patients who had experienced adverse event had higher heart rates. Recovery times were comparable between Event (-) and Event (+) groups. Relationship of recovery process were individually tested with all variables and only lesion type was detected to have an effect on respiration and extubation times. Among all parameters only procedural time seemed to be associated with adverse event occurrence (mins, 22.9 ± 11.9 vs 41.6 ± 28.8, P < .001). Recovery times related with return of spontaneous respiration were significantly lower in procedures performed for treatment of tumoral diseases in this study and procedure length was determined to be the ultimate factor which had an impact on adverse event occurrence. © 2018 John Wiley & Sons Ltd.

Physics architecture

NASA Astrophysics Data System (ADS)

Konopleva, Nelly

2017-03-01

Fundamental physical theory axiomatics is closely connected with methods of experimental measurements. The difference between the theories using global and local symmetries is explained. It is shown that symmetry group localization leads not only to the change of the relativity principle, but to the fundamental modification of experimental programs testing physical theory predictions. It is noticed that any fundamental physical theory must be consistent with the measurement procedures employed for its testing. These ideas are illustrated by events of my biography connected with Yang-Mills theory transformation from an ordinary phenomenological model to a fundamental physical theory based on local symmetry principles like the Einsteinian General Relativity. Baldin position in this situation is demonstrated.

Local and general anesthesia in the laparoscopic preperitoneal hernia repair.

PubMed

Frezza, E E; Ferzli, G

2000-01-01

The extraperitoneal laparoscopic approach (EXTRA) has been shown to be an effective and safe repair for primary (PIH), recurrent (RIH) and bilateral hernia (BIH). There is very little data examining the merits of laparoscopic repair for hernias under local anesthesia. In this' paper, we compare EXTRA performed under both general and local anesthesia. This nonrandomized prospective study was performed selectively on a male population only. Patients with associated pulmonary disease and high risk for general surgery were selected. Patients with recurrence and previous abdominal operations were excluded to decrease confounding variables in the study. A Prolene mesh was used in all patients. Between May 1997 and September 1998, 92 male patients underwent the repair of 107 groin hernias using the EXTRA technique. The procedure was explained to them, and different anesthesia options were given. Fourteen of these repairs were performed under local anesthesia and 93 under general anesthesia. Of the 10 patients who underwent a repair under local anesthesia, there were 8 indirect, 5 direct and 1 pantaloon. The mean age was 53 years. In the group of general anesthesia, the types of hernias repaired were 45 indirect, 30 direct and 11 pantaloon. The mean age was 45 years. The mean follow-up was 15 months. Each patient was sent home the same day. Two peritoneal tears were recorded in the first group. The operative time was longer in the local group (47 +/- 11 vs 18 +/- 3). None of the patients required conversion to an open technique or change of anesthesia. No recurrences were found in either group. The average time of return to work and regular activity was 3.5 +/- 1 and 3 +/- 1 days, respectively. There appears to be no significant difference in recurrence and complication rates when the EXTRA is performed under local anesthesia as compared to general. Blunt dissection of the preperitoneal space does not trigger pain and does not require lidocaine injection. The most painful area is the peritoneal reflection over the cord structure. The laparoscopic repair under local anesthesia represents an advantage in the repair of the inguinal hernia, particularly in the population where general anesthesia is contraindicated.

A flexible motif search technique based on generalized profiles.

PubMed

Bucher, P; Karplus, K; Moeri, N; Hofmann, K

1996-03-01

A flexible motif search technique is presented which has two major components: (1) a generalized profile syntax serving as a motif definition language; and (2) a motif search method specifically adapted to the problem of finding multiple instances of a motif in the same sequence. The new profile structure, which is the core of the generalized profile syntax, combines the functions of a variety of motif descriptors implemented in other methods, including regular expression-like patterns, weight matrices, previously used profiles, and certain types of hidden Markov models (HMMs). The relationship between generalized profiles and other biomolecular motif descriptors is analyzed in detail, with special attention to HMMs. Generalized profiles are shown to be equivalent to a particular class of HMMs, and conversion procedures in both directions are given. The conversion procedures provide an interpretation for local alignment in the framework of stochastic models, allowing for clear, simple significance tests. A mathematical statement of the motif search problem defines the new method exactly without linking it to a specific algorithmic solution. Part of the definition includes a new definition of disjointness of alignments.

Integrated aerodynamic/dynamic/structural optimization of helicopter rotor blades using multilevel decomposition

NASA Technical Reports Server (NTRS)

Walsh, Joanne L.; Young, Katherine C.; Pritchard, Jocelyn I.; Adelman, Howard M.; Mantay, Wayne R.

1995-01-01

This paper describes an integrated aerodynamic/dynamic/structural (IADS) optimization procedure for helicopter rotor blades. The procedure combines performance, dynamics, and structural analyses with a general-purpose optimizer using multilevel decomposition techniques. At the upper level, the structure is defined in terms of global quantities (stiffness, mass, and average strains). At the lower level, the structure is defined in terms of local quantities (detailed dimensions of the blade structure and stresses). The IADS procedure provides an optimization technique that is compatible with industrial design practices in which the aerodynamic and dynamic designs are performed at a global level and the structural design is carried out at a detailed level with considerable dialog and compromise among the aerodynamic, dynamic, and structural groups. The IADS procedure is demonstrated for several examples.

[Bronchoscopy in ventilated patients: full narcosis or local anesthesia?].

PubMed

Konrad, F; Wiedeck, H; Winter, H; Kilian, J

1990-04-01

In a prospective, randomised trial bronchoscopy was performed either in local anaesthesia (LA) or general anaesthesia, each on 15 ventilated patients. LA was carried out with oxybuprocain-hydrochloride 1% in repeated doses injected into the trachea and main bronchi, general anaesthesia with midazolam, piritramide and vecuronium bromide. Measurements were performed before, 3 minutes after induction of anaesthesia, immediately after bronchoscopy and 15 and 60 minutes after bronchoscopy. There was no effect on cardiocirculatory function during bronchoscopy in both groups, but we found a decrease in paO2 from 97 to 80 mmHg (median) after application of LA. Subsequent bronchoscopy did not significantly influence paO2. The present study shows that in ventilation patients undergoing fibreoptic bronchoscopy, the application of LA will usually result in a decline of arterial oxygen tension. This procedure should therefore only be performed if general anaesthesia is undesirable, as e.g. in patients being weaned from ventilation.

Effects of Ignoring Item Interaction on Item Parameter Estimation and Detection of Interacting Items

ERIC Educational Resources Information Center

Chen, Cheng-Te; Wang, Wen-Chung

2007-01-01

This study explores the effects of ignoring item interaction on item parameter estimation and the efficiency of using the local dependence index Q[subscript 3] and the SAS NLMIXED procedure to detect item interaction under the three-parameter logistic model and the generalized partial credit model. Through simulations, it was found that ignoring…

40 CFR 63.99 - Delegated Federal authorities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... delegated to the air pollution control agencies in each State under the procedures described in this subpart... (Combustion sources) MM X X X 27 Generic MACT: Control Devices SS X X X Eq. Leaks—Level 1 TT X X X Eq. Leaks... of 40 CFR Part 63 General Provisions Authorities to State and Local Air Pollution Control Agencies...

General anaesthesia for deep brain stimulator electrode insertion in Parkinson's disease.

PubMed

Sutcliffe, A J; Mitchell, R D; Gan, Y C; Mocroft, A P; Nightingale, P

2011-03-01

This paper compares the use of general and local anaesthetic in patients having deep brain stimulator (DBS) surgery. It is a retrospective case note study of 46 patients treated consecutively with subthalamic nucleus stimulation for Parkinson's disease as practise changed in a Neurosurgical unit. The first 20 patients (LA group) had permanent electrodes placed under local anaesthesia. The remaining 26 patients (GA group) had the entire procedure under general anaesthesia. The groups were similar for age, sex, duration of Parkinson's disease and preoperative levodopa requirement. The clinical results were similar in that within each group, the reduction in levodopa was not only clinically but also statistically significant (p < 0.001 for both, paired t test): for the LA group, the 6-month requirement was 39.4% (29.5-52.6%) of the preoperative requirement and for the GA group, the 6-month requirement was 32.3% (25.2-41.5%) of the preoperative requirement. The reduction in levodopa was maintained at 1 year. Of note, duration of surgery and length of stay were reduced. The mean duration of surgery was 8.2 h (7.8-8.6) for the LA group and 7.5 h (7.2-7.8) for the GA group (p = 0.003). The geometric mean of length of hospital stay was 5.4 days(4.6-6.3) for the LA group and 3.8 days (3.4-4.4) for the GA group (p = 0.001) There was no difference in electrophysiological recording. This study describes benefits in the GA group for the entire procedure of STN DBS. In these samples, there was no difference in the adverse effects seen in patients undergoing deep brain stimulator insertion with general anaesthetic compared with local anaesthetic. The use of general anaesthetic did not detract from the known benefits of surgery.

A simplified open gastrostomy under local anesthesia.

PubMed

Zickler, R W; Barbagiovanni, J T; Swan, K G

2001-08-01

Revision of the standard gastrostomy is often necessary in patients with neuromuscular disorders. These patients pose many anesthetic risks that frequently preclude the use of general anesthesia, intravenous sedation, or endoscopy. Modification of the Stamm gastrostomy enables it to be performed comfortably and readily under local anesthesia. The modification proposed passes the gastrostomy tube through the omentum en route to the abdominal wall. This ensures a seal to the surgical site, eliminates the need for tacking sutures, and allows for a smaller midline incision. These factors greatly reduce the discomfort of the procedure allowing it to be easily accomplished under local anesthesia. This technique of open gastrostomy under local anesthesia has been used in more than 35 patients over the past 10 years with no documented leaks.

Complex-time singularity and locality estimates for quantum lattice systems

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

Bouch, Gabriel

2015-12-15

We present and prove a well-known locality bound for the complex-time dynamics of a general class of one-dimensional quantum spin systems. Then we discuss how one might hope to extend this same procedure to higher dimensions using ideas related to the Eden growth process and lattice trees. Finally, we demonstrate with a specific family of lattice trees in the plane why this approach breaks down in dimensions greater than one and prove that there exist interactions for which the complex-time dynamics blows-up in finite imaginary time. .

A Shared Memory Algorithm and Proof for the Generalized Alternative Construct in CSP (Communicating Sequential Processes)

DTIC Science & Technology

1987-06-01

shared variables. This will be discussed later. One procedure merits special attention. CheckAndCommit(m, g ,): INTEGER is called by process P, (I...denotes the local process) to check that "valid" communications can take place between P, using guard g , and Pm (m denotes the remote process). If so, P...local guard gi. By matching we mean gj contains an 1/O operation with P. By compatible we mean g , and gj do not both contain input (output) commands

[Peritonitis in diverticulitis: the Bern concept].

PubMed

Seiler, C A; Brügger, L; Maurer, C A; Renzulli, P; Büchler, M W

1998-01-01

The colon is the most frequent origine for a diffuse peritonitis and diverticular perforation is again the most common source of a spontaneous secondary peritonitis. This paper first focuses on the treatment of peritonitis and secondly on the strategies of source control in peritonitis with special emphasis on the tactics (primary anastomosis vs. Hartmann procedure with colostomy) for surgical source control. Prospective analysis of 404 patients suffering from peritonitis (11/93-2/98), treated with an uniform treatment concept including early operation, source control and extensive intraoperative lavage (20 to 30 liters) as a standard procedure. Other treatment measures were added in special indications "on demand" only. Peritonitis was graded with the Mannheim Peritonitis Index (MPI). Tactics of source control in peritonitis due to diverticulitis were performed according to "general condition" respectively the MPI of the patient. The 404 patients averaged a MPI of 19 (0-35) in "local" peritonitis and a MPI of 26 (11-43) in "diffuse" peritonitis. The colon as a source of peritonitis resulted in MPI of 16 (0-33) in the case of "local" respectively 27 (11-43) in "diffuse" peritonitis. From 181 patients suffering from diverticulitis 144 needed an operation and in 78 (54%) peritonitis was present. Fourty-six percent (36) of the patients suffered from "local", 54% (42) from "diffuse" peritonitis. Resection with primary anastomosis was performed in 26% (20/78) whereas in 74% (58/78) of the patients a Hartmann procedure with colostomy was performed. The correlating MPI was 16 (0-28) vs. 23 (16-27) respectively. The analysis of complications and mortality based on the MPI showed a decent discrimination potential for primary anastomosis vs Hartmann procedure: morbidity 35% vs. 41%; reoperation 5% vs. 5%; mortality 0% vs. 14%. In case of peritonitis due to diverticulitis the treatment of peritonitis comes first. Thanks to advances in intensive care and improved anti-inflammatory care, a more conservative surgical concept nowadays is accepted. In the case of diverticulitis the MPI is helpful to choose between primary anastomosis vs. Hartmann procedure with colostomy as source control. The MPI includes the "general condition" of the patient into the tactical decision how to attain source control.

Image guidance doses delivered during radiotherapy: Quantification, management, and reduction: Report of the AAPM Therapy Physics Committee Task Group 180.

PubMed

Ding, George X; Alaei, Parham; Curran, Bruce; Flynn, Ryan; Gossman, Michael; Mackie, T Rock; Miften, Moyed; Morin, Richard; Xu, X George; Zhu, Timothy C

2018-05-01

With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients. We briefly review the dose to radiotherapy (RT) patients resulting from different image guidance procedures and list typical organ doses resulting from MV and kV image acquisition procedures. We provide recommendations for managing the imaging dose, including different methods for its calculation, and techniques for reducing it. The recommended threshold beyond which imaging dose should be considered in the treatment planning process is 5% of the therapeutic target dose. Although the imaging dose resulting from current kV acquisition procedures is generally below this threshold, the ALARA principle should always be applied in practice. Medical physicists should make radiation oncologists aware of the imaging doses delivered to patients under their care. Balancing ALARA with the requirement for effective target localization requires that imaging dose be managed based on the consideration of weighing risks and benefits to the patient. © 2018 American Association of Physicists in Medicine.

A family of dynamic models for large-eddy simulation

NASA Technical Reports Server (NTRS)

Carati, D.; Jansen, K.; Lund, T.

1995-01-01

Since its first application, the dynamic procedure has been recognized as an effective means to compute rather than prescribe the unknown coefficients that appear in a subgrid-scale model for Large-Eddy Simulation (LES). The dynamic procedure is usually used to determine the nondimensional coefficient in the Smagorinsky (1963) model. In reality the procedure is quite general and it is not limited to the Smagorinsky model by any theoretical or practical constraints. The purpose of this note is to consider a generalized family of dynamic eddy viscosity models that do not necessarily rely on the local equilibrium assumption built into the Smagorinsky model. By invoking an inertial range assumption, it will be shown that the coefficients in the new models need not be nondimensional. This additional degree of freedom allows the use of models that are scaled on traditionally unknown quantities such as the dissipation rate. In certain cases, the dynamic models with dimensional coefficients are simpler to implement, and allow for a 30% reduction in the number of required filtering operations.

Mini-Craniotomy Under Local Anesthesia for Chronic Subdural Hematoma: An Effective Choice for Elderly Patients and for Patients in a Resource-Strained Environment.

PubMed

Mahmood, Shaikh Danish; Waqas, Muhammad; Baig, Mirza Zain; Darbar, Aneela

2017-10-01

Mini-craniotomy for chronic subdural hematoma (CSDH) is associated with lower rates of recurrence. However, the procedure is performed mostly with the patient under general anesthesia (GA) and therefore frequently requires an intensive care unit (ICU) facility, especially in the elderly population. Because of the unavailability of ICU beds, and to avoid GA, we started to perform this procedure with the patient under local anesthesia (LA). This was a retrospective medical chart review conducted in the section of Neurosurgery at the Aga Khan Hospital in Karachi, Pakistan. The study duration was 1 year. We included patients aged 55 years or older undergoing surgery for CSDH. Clinical characteristics, hospital stay, and recurrence rates were compared between 2 groups, local versus general anesthesia. Thirty-five patients underwent mini-craniotomy for CSDH in the study period. Sixteen patients underwent mini-craniotomy under LA versus 19 patients for GA. Median age for the LA group was 67 years compared with 70 years in the GA group. Four patients from the LA group experienced postoperative complications versus 7 from the GA group. Only one patient in the LA group required an ICU bed in the postoperative period. There was no recurrence in LA group. The overall recurrence was 2.86%. Mini-craniotomy for CSDH under LA is an equally effective procedure compared with mini-craniotomy under GA. In addition, it minimizes the risks of GA in the elderly population and obviates the need of a postoperative ICU bed. It also reduces operative time and hospital stay as compared with GA. Copyright © 2017 Elsevier Inc. All rights reserved.

Anatomy and Pathophysiology of Spinal Cord Injury Associated With Regional Anesthesia and Pain Medicine: 2015 Update.

PubMed

Neal, Joseph M; Kopp, Sandra L; Pasternak, Jeffrey J; Lanier, William L; Rathmell, James P

2015-01-01

In March 2012, the American Society of Regional Anesthesia and Pain Medicine convened its second Practice Advisory on Neurological Complications in Regional Anesthesia and Pain Medicine. This update is based on the proceedings of that conference and relevant information published since its conclusion. This article updates previously described information on the pathophysiology of spinal cord injury and adds new material on spinal stenosis, blood pressure control during neuraxial blockade, neuraxial injury subsequent to transforaminal procedures, cauda equina syndrome/local anesthetic neurotoxicity/arachnoiditis, and performing regional anesthetic or pain medicine procedures in patients concomitantly receiving general anesthesia or deep sedation. Recommendations are based on extensive review of research on humans or employing animal models, case reports, pathophysiology research, and expert opinion. The pathophysiology of spinal cord injury associated with regional anesthetic techniques is reviewed in depth, including that related to mechanical trauma from direct needle/catheter injury or mass lesions, spinal cord ischemia or vascular injury from direct needle/catheter trauma, and neurotoxicity from local anesthetics, adjuvants, or antiseptics. Specific recommendations are offered that may reduce the likelihood of spinal cord injury associated with regional anesthetic or interventional pain medicine techniques. The practice advisory's recommendations may, in select cases, reduce the likelihood of injury. However, many of the described injuries are neither predictable nor preventable based on our current state of knowledge. Since publication of initial recommendations in 2008, new information has enhanced our understanding of 5 specific entities: spinal stenosis, blood pressure control during neuraxial anesthesia, neuraxial injury subsequent to transforaminal techniques, cauda equina syndrome/local anesthetic neurotoxicity/arachnoiditis, and performing regional anesthetic or pain procedures in patients concomitantly receiving general anesthesia or deep sedation.

Office-based andrology and male infertility procedures—a cost-effective alternative

PubMed Central

Alom, Manaf; Ziegelmann, Matthew; Savage, Josh; Miest, Tanner; Köhler, Tobias S.

2017-01-01

Background From 2014–2016, our clinical practice progressively incorporated several male infertility and andrology procedures performed under local anesthesia, including circumcision, hydrocelectomy, malleable penile prostheses, orchiectomy, penile plication, spermatocelectomy, testicular prostheses, varicocelectomy, vasectomy reversal (VR), and testicular and microepididymal sperm aspiration (TESE/MESA). Given the observed outcomes and potential financial and logistical benefits of this approach for surgeons and patients, we sought to describe our initial experience. Methods A retrospective analysis was performed of all andrologic office-based (local anesthesia only) and select OR (general or monitored anesthesia care) procedures performed from 2014–2016. Financial and outcomes analyses were performed for infertility cases due to the homogeneity of payment modalities and number of cases available. Demographic, clinicopathologic, and procedural costs (direct and indirect) were reviewed and compared. Results A total of 32 VRs, 24 hydrocelectomies, 24 TESEs, 10 circumcisions, 9 MESA/TESEs, 4 spermatocelectomies, 3 orchiectomies (1 inguinal), 2 microTESEs, 2 testicular prostheses, 1 malleable penile prosthesis, 1 penile plication, and 1 varicocelectomy. Compared to the OR, male infertility procedures performed in the clinic with local anesthesia were performed for a fraction of the cost: MESA/TESE (78% reduction), TESE (89% reduction), and VR (62% reduction). All office-based procedures were completed successfully without significant modifications to technique. Outcomes were similar between the office and OR including operative time (VR: 181 vs. 190 min, P=0.34), rate of vasoepididymostomy (VE) (23% vs. 32%, P=0.56), total sperm counts (72.2 vs. 50.9 million, P=0.56), and successful sperm retrieval (MESA/TESE 100% vs. 100%, P=1.00; TESE 80% vs. 100%, P=0.36). To our knowledge, the current study also represents the first report of office-based VE under local anesthesia alone. For hydrocelectomy procedures, recurrence (4%) and hematoma (4%) rates were low (mean 4.2 months follow-up), although this likely relates to modifications with technique and not the anesthesia or operative setting. Overall, when given the choice, 86% of patients chose an office-based approach over the OR. Conclusions Office-based andrology procedures using local anesthesia may be successfully performed without compromising surgical technique or outcomes. This approach significantly reduces costs for patients and the overall healthcare system and has become our treatment modality of choice. PMID:28904909

Expanded function allied dental personnel and dental practice productivity and efficiency.

PubMed

Beazoglou, Tryfon J; Chen, Lei; Lazar, Vickie F; Brown, L Jackson; Ray, Subhash C; Heffley, Dennis R; Berg, Rob; Bailit, Howard L

2012-08-01

This study examined the impact of expanded function allied dental personnel on the productivity and efficiency of general dental practices. Detailed practice financial and clinical data were obtained from a convenience sample of 154 general dental practices in Colorado. In this state, expanded function dental assistants can provide a wide range of reversible dental services/procedures, and dental hygienists can give local anesthesia. The survey identified practices that currently use expanded function allied dental personnel and the specific services/procedures delegated. Practice productivity was measured using patient visits, gross billings, and net income. Practice efficiency was assessed using a multivariate linear program, Data Envelopment Analysis. Sixty-four percent of the practices were found to use expanded function allied dental personnel, and on average they delegated 31.4 percent of delegatable services/procedures. Practices that used expanded function allied dental personnel treated more patients and had higher gross billings and net incomes than those practices that did not; the more services they delegated, the higher was the practice's productivity and efficiency. The effective use of expanded function allied dental personnel has the potential to substantially expand the capacity of general dental practices to treat more patients and to generate higher incomes for dental practices.

Welfare Reform: Federal Oversight of State and Local Contracting Can Be Strengthened. Report to Congressional Requesters.

ERIC Educational Resources Information Center

Nilsen, Sigurd R.

The General Accounting Office (GAO) reviewed existing procedures to manage Temporary Assistance for Needy Families (TANF) contracting and also identified problems with regard to management of TANF contracting. The major data collection activities were as follows: (1) a national survey of all 50 states, the District of Columbia, and the 10 counties…

Successfully Automating Library Consortia: Procedures To Facilitate Governance, Management and Cooperation. DataResearch Automation Guide Series, Number Three.

ERIC Educational Resources Information Center

Data Research Associates, Inc., St. Louis, MO.

Sharing a local automated library system will generally reduce the costs of automation for each participating library and will facilitate the sharing of resources. To set up a consortium, libraries must first identify and agree on governance issues and methods for dealing with these issues. Issues range from ownership, management, and location of…

The Utility of Local Anesthesia for Neurosurgical Interventions in a Low-Resource Setting: A Case Series.

PubMed

Eaton, Jessica; Hanif, Asma Bilal; Mzumara, Suzgisam; Charles, Anthony

2018-05-01

Trauma is a major contributor to global morbidity and mortality, and injury to the central nervous system is the most common cause of death in these patients. While the provision of surgical services is being recognized as essential to global public health efforts, specialty areas such as neurosurgery remain overlooked. This is a retrospective case review of patients with operable lesions, such as extra-axial hematomas and unstable depressed skull fractures that underwent neurosurgical interventions under local anesthesia. A total of 13 patients underwent neurosurgical intervention under local anesthesia. Two and three patients with burr hole decompression of epidural and subdural hematomas, respectively; seven patients had elevation of depressed skull fractures and lastly one patient had an aspiration of a brain abscess. All patients survived with and without residual neurological deficits. Access to resources and staff required to deliver general anesthesia is challenging in resource-poor settings. We have therefore begun performing emergent interventions under local anesthesia, with or without conscious sedation. While some patients had some minor residual weakness after the procedure, the degree of neurological deficit was improved from that observed before the procedure in all patients.

Profile local linear estimation of generalized semiparametric regression model for longitudinal data.

PubMed

Sun, Yanqing; Sun, Liuquan; Zhou, Jie

2013-07-01

This paper studies the generalized semiparametric regression model for longitudinal data where the covariate effects are constant for some and time-varying for others. Different link functions can be used to allow more flexible modelling of longitudinal data. The nonparametric components of the model are estimated using a local linear estimating equation and the parametric components are estimated through a profile estimating function. The method automatically adjusts for heterogeneity of sampling times, allowing the sampling strategy to depend on the past sampling history as well as possibly time-dependent covariates without specifically model such dependence. A [Formula: see text]-fold cross-validation bandwidth selection is proposed as a working tool for locating an appropriate bandwidth. A criteria for selecting the link function is proposed to provide better fit of the data. Large sample properties of the proposed estimators are investigated. Large sample pointwise and simultaneous confidence intervals for the regression coefficients are constructed. Formal hypothesis testing procedures are proposed to check for the covariate effects and whether the effects are time-varying. A simulation study is conducted to examine the finite sample performances of the proposed estimation and hypothesis testing procedures. The methods are illustrated with a data example.

The Role of Interventional Oncology in the Management of Lung Cancer

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

Duka, Ejona, E-mail: ejonaduka@hotmail.com; Ierardi, Anna Maria, E-mail: amierardi@yahoo.it; Floridi, Chiara, E-mail: chiara.floridi@gmail.com

Interventional radiological procedures for diagnosis and treatment of lung cancer have become increasingly important. Imaging-guided percutaneous biopsy has become the modality of choice for diagnosing lung cancer, and in the era of target therapies, it is an useful tool to define earlier patient-specific tumor phenotypes. In functionally inoperable patients, especially the ablative procedures are potentially curative alternatives to surgery. In addition to thermally ablative treatment, selective chemoembolization by a vascular access allows localized therapy. These treatments are considered for patients in a reduced general condition which does not allow systemic chemotherapy. The present article reviews the role of interventional oncologymore » in the management of primary lung cancer, focusing on the state of the art for each procedure.« less

Numerical analysis of a main crack interactions with micro-defects/inhomogeneities using two-scale generalized/extended finite element method

NASA Astrophysics Data System (ADS)

Malekan, Mohammad; Barros, Felício B.

2017-12-01

Generalized or extended finite element method (G/XFEM) models the crack by enriching functions of partition of unity type with discontinuous functions that represent well the physical behavior of the problem. However, this enrichment functions are not available for all problem types. Thus, one can use numerically-built (global-local) enrichment functions to have a better approximate procedure. This paper investigates the effects of micro-defects/inhomogeneities on a main crack behavior by modeling the micro-defects/inhomogeneities in the local problem using a two-scale G/XFEM. The global-local enrichment functions are influenced by the micro-defects/inhomogeneities from the local problem and thus change the approximate solution of the global problem with the main crack. This approach is presented in detail by solving three different linear elastic fracture mechanics problems for different cases: two plane stress and a Reissner-Mindlin plate problems. The numerical results obtained with the two-scale G/XFEM are compared with the reference solutions from the analytical, numerical solution using standard G/XFEM method and ABAQUS as well, and from the literature.

The pros and cons of outpatient breast biopsy.

PubMed

Lou, M A; Mandal, A K; Alexander, J L

1976-06-01

A review of the 130 breast biopsies performed on women during the past three years at the Martin Luther King, Jr, General Hospital showed that 90 were performed on outpatients and 40 on inpatients. Of the 90 outpatient procedures, 61 were under local anesthesia and 29 under general. Only three outpatient biopsy specimens were malignant and required subsequent patient admission to the hospital for mastectomy at an interval of 9 to 14 days. In all three, the axillary nodes were uninvolved. In two, no residual tumor was found in the mastectomy specimen.

Entanglement and nonclassical properties of hypergraph states

NASA Astrophysics Data System (ADS)

Gühne, Otfried; Cuquet, Martí; Steinhoff, Frank E. S.; Moroder, Tobias; Rossi, Matteo; Bruß, Dagmar; Kraus, Barbara; Macchiavello, Chiara

2014-08-01

Hypergraph states are multiqubit states that form a subset of the locally maximally entangleable states and a generalization of the well-established notion of graph states. Mathematically, they can conveniently be described by a hypergraph that indicates a possible generation procedure of these states; alternatively, they can also be phrased in terms of a nonlocal stabilizer formalism. In this paper, we explore the entanglement properties and nonclassical features of hypergraph states. First, we identify the equivalence classes under local unitary transformations for up to four qubits, as well as important classes of five- and six-qubit states, and determine various entanglement properties of these classes. Second, we present general conditions under which the local unitary equivalence of hypergraph states can simply be decided by considering a finite set of transformations with a clear graph-theoretical interpretation. Finally, we consider the question of whether hypergraph states and their correlations can be used to reveal contradictions with classical hidden-variable theories. We demonstrate that various noncontextuality inequalities and Bell inequalities can be derived for hypergraph states.

The Effect of General Statistical Fiber Misalignment on Predicted Damage Initiation in Composites

NASA Technical Reports Server (NTRS)

Bednarcyk, Brett A.; Aboudi, Jacob; Arnold, Steven M.

2014-01-01

A micromechanical method is employed for the prediction of unidirectional composites in which the fiber orientation can possess various statistical misalignment distributions. The method relies on the probability-weighted averaging of the appropriate concentration tensor, which is established by the micromechanical procedure. This approach provides access to the local field quantities throughout the constituents, from which initiation of damage in the composite can be predicted. In contrast, a typical macromechanical procedure can determine the effective composite elastic properties in the presence of statistical fiber misalignment, but cannot provide the local fields. Fully random fiber distribution is presented as a special case using the proposed micromechanical method. Results are given that illustrate the effects of various amounts of fiber misalignment in terms of the standard deviations of in-plane and out-of-plane misalignment angles, where normal distributions have been employed. Damage initiation envelopes, local fields, effective moduli, and strengths are predicted for polymer and ceramic matrix composites with given normal distributions of misalignment angles, as well as fully random fiber orientation.

Couplings of gravitational currents with Chern-Simons gravities

NASA Astrophysics Data System (ADS)

Ertem, Ümit; Açık, Özgür

2013-02-01

The coupling of conserved p-brane currents with non-Abelian gauge theories is done consistently by using Chern-Simons forms. Conserved currents localized on p-branes that have a gravitational origin can be constructed from Killing-Yano forms of the underlying spacetime. We propose a generalization of the coupling procedure with Chern-Simons gravities to the case of gravitational conserved currents. In odd dimensions, the field equations of coupled Chern-Simons gravities that describe the local curvature on p-branes are obtained. In special cases of three and five dimensions, the field equations are investigated in detail.

Effect of gage size on the measurement of local heat flux. [formulas for determining gage averaging errors

NASA Technical Reports Server (NTRS)

Baumeister, K. J.; Papell, S. S.

1973-01-01

General formulas are derived for determining gage averaging errors of strip-type heat flux meters used in the measurement of one-dimensional heat flux distributions. In addition, a correction procedure is presented which allows a better estimate for the true value of the local heat flux. As an example of the technique, the formulas are applied to the cases of heat transfer to air slot jets impinging on flat and concave surfaces. It is shown that for many practical problems, the use of very small heat flux gages is often unnecessary.

Time-dependent grid adaptation for meshes of triangles and tetrahedra

NASA Technical Reports Server (NTRS)

Rausch, Russ D.

1993-01-01

This paper presents in viewgraph form a method of optimizing grid generation for unsteady CFD flow calculations that distributes the numerical error evenly throughout the mesh. Adaptive meshing is used to locally enrich in regions of relatively large errors and to locally coarsen in regions of relatively small errors. The enrichment/coarsening procedures are robust for isotropic cells; however, enrichment of high aspect ratio cells may fail near boundary surfaces with relatively large curvature. The enrichment indicator worked well for the cases shown, but in general requires user supervision for a more efficient solution.

Neuralgias of the Head: Occipital Neuralgia

PubMed Central

2016-01-01

Occipital neuralgia is defined by the International Headache Society as paroxysmal shooting or stabbing pain in the dermatomes of the greater or lesser occipital nerve. Various treatment methods exist, from medical treatment to open surgical procedures. Local injection with corticosteroid can improve symptoms, though generally only temporarily. More invasive procedures can be considered for cases that do not respond adequately to medical therapies or repeated injections. Radiofrequency lesioning of the greater occipital nerve can relieve symptoms, but there is a tendency for the pain to recur during follow-up. There also remains a substantial group of intractable patients that do not benefit from local injections and conventional procedures. Moreover, treatment of occipital neuralgia is sometimes challenging. More invasive procedures, such as C2 gangliotomy, C2 ganglionectomy, C2 to C3 rhizotomy, C2 to C3 root decompression, neurectomy, and neurolysis with or without sectioning of the inferior oblique muscle, are now rarely performed for medically refractory patients. Recently, a few reports have described positive results following peripheral nerve stimulation of the greater or lesser occipital nerve. Although this procedure is less invasive, the significance of the results is hampered by the small sample size and the lack of long-term data. Clinicians should always remember that destructive procedures carry grave risks: once an anatomic structure is destroyed, it cannot be easily recovered, if at all, and with any destructive procedure there is always the risk of the development of painful neuroma or causalgia, conditions that may be even harder to control than the original complaint. PMID:27051229

Neuralgias of the Head: Occipital Neuralgia.

PubMed

Choi, Il; Jeon, Sang Ryong

2016-04-01

Occipital neuralgia is defined by the International Headache Society as paroxysmal shooting or stabbing pain in the dermatomes of the greater or lesser occipital nerve. Various treatment methods exist, from medical treatment to open surgical procedures. Local injection with corticosteroid can improve symptoms, though generally only temporarily. More invasive procedures can be considered for cases that do not respond adequately to medical therapies or repeated injections. Radiofrequency lesioning of the greater occipital nerve can relieve symptoms, but there is a tendency for the pain to recur during follow-up. There also remains a substantial group of intractable patients that do not benefit from local injections and conventional procedures. Moreover, treatment of occipital neuralgia is sometimes challenging. More invasive procedures, such as C2 gangliotomy, C2 ganglionectomy, C2 to C3 rhizotomy, C2 to C3 root decompression, neurectomy, and neurolysis with or without sectioning of the inferior oblique muscle, are now rarely performed for medically refractory patients. Recently, a few reports have described positive results following peripheral nerve stimulation of the greater or lesser occipital nerve. Although this procedure is less invasive, the significance of the results is hampered by the small sample size and the lack of long-term data. Clinicians should always remember that destructive procedures carry grave risks: once an anatomic structure is destroyed, it cannot be easily recovered, if at all, and with any destructive procedure there is always the risk of the development of painful neuroma or causalgia, conditions that may be even harder to control than the original complaint.

Taboo Search: An Approach to the Multiple Minima Problem

NASA Astrophysics Data System (ADS)

Cvijovic, Djurdje; Klinowski, Jacek

1995-02-01

Described here is a method, based on Glover's taboo search for discrete functions, of solving the multiple minima problem for continuous functions. As demonstrated by model calculations, the algorithm avoids entrapment in local minima and continues the search to give a near-optimal final solution. Unlike other methods of global optimization, this procedure is generally applicable, easy to implement, derivative-free, and conceptually simple.

Financial aspects of sentinel lymph node biopsy in early breast cancer.

PubMed

Severi, S; Gazzoni, E; Pellegrini, A; Sansovini, M; Raulli, G; Corbelli, C; Altini, M; Paganelli, G

2012-02-01

At present, early breast cancer is treated with conservative surgery of the primary lesion (BCS) along with axillary staging by sentinel lymph node biopsy (SLNB). Although the scintigraphic method is standardized, its surgical application is different for patient compliance, work organization, costs, and diagnosis related group (DRG) reimbursements. We compared four surgical protocols presently used in our region: (A) traditional BCS with axillary lymph node dissection (ALND); (B) BCS with SLNB and concomitant ALND for positive sentinel nodes (SN); (C) BCS and SLNB under local anaesthesia with subsequent ALND under general anaesthesia according to the SN result; (D) SLNB under local anaesthesia with subsequent BCS under local anaesthesia for negative SN, or ALND under general anaesthesia for positive SN. For each protocol, patient compliance, use of consumables, resources and time spent by various dedicated professionals, were analyzed. Furthermore, a detailed breakdown of 1-/2-day hospitalization costs was calculated using specific DRGs. We reported a mean costs variation that ranged from 1,634 to 2,221 Euros (protocols C and D). The number of procedures performed and the pathologists' results are the most significant variables affecting the rate of DRG reimbursements, that were the highest for protocol D and the lowest for protocol B. In our experience protocol C is the most suitable in terms of patient compliance, impact of surgical procedures, and work organization, and is granted by an appropriate DRG. We observed that a multidisciplinary approach enhances overall patient care and that a revaluation of DRG reimbursements is opportune.

33 CFR 230.20 - Integration with State and local procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Integration with State and local procedures. 230.20 Section 230.20 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.20 Integration with State and local procedures...

[Prevention of infectious endocarditis].

PubMed

Etienne, J

1994-01-01

An antibiotic prophylaxis of infective endocarditis is recommended in patients at high risk for infective endocarditis (patients with valvular prosthesis, or cyanogen congenital or obstructive cardiac defect) or those with aortic, mitral or tricuspid valvulopathy, a non-cyanogen congenital or obstructive cardiac defect. Dental procedures (except treatment for superficial decay and preparation for the fitting of prostheses to teeth with intact pulp) are to be carried out under local antisepsis and a prophylactic antibiotics, such as 3 g of oral amoxicillin or in case of allergy to penicillin, 600 mg of clindamycin or 1g of pristinamycin, administered one hour prior to the procedure. A similar prophylaxis is recommended for the procedures on the upper respiratory tract. Amoxicillin, or vancomycin or teicoplanin are recommended for procedures under general anaesthesia. For surgery on the intestinal or urogenital tract, regimens combine amoxicillin with gentamicin, or in case of allergy to penicillin, vancomycin or teicoplanin with gentamicin.

Retrospective Evaluation of Safety, Efficacy and Risk Factors for Pneumothorax in Simultaneous Localizations of Multiple Pulmonary Nodules Using Hook Wire System.

PubMed

Zhong, Yan; Xu, Xiao-Quan; Pan, Xiang-Long; Zhang, Wei; Xu, Hai; Yuan, Mei; Kong, Ling-Yan; Pu, Xue-Hui; Chen, Liang; Yu, Tong-Fu

2017-09-01

To evaluate the safety and efficacy of the hook wire system in the simultaneous localizations for multiple pulmonary nodules (PNs) before video-assisted thoracoscopic surgery (VATS), and to clarify the risk factors for pneumothorax associated with the localization procedure. Between January 2010 and February 2016, 67 patients (147 nodules, Group A) underwent simultaneous localizations for multiple PNs using a hook wire system. The demographic, localization procedure-related information and the occurrence rate of pneumothorax were assessed and compared with a control group (349 patients, 349 nodules, Group B). Multivariate logistic regression analyses were used to determine the risk factors for pneumothorax during the localization procedure. All the 147 nodules were successfully localized. Four (2.7%) hook wires dislodged before VATS procedure, but all these four lesions were successfully resected according to the insertion route of hook wire. Pathological diagnoses were acquired for all 147 nodules. Compared with Group B, Group A demonstrated significantly longer procedure time (p < 0.001) and higher occurrence rate of pneumothorax (p = 0.019). Multivariate logistic regression analysis indicated that position change during localization procedure (OR 2.675, p = 0.021) and the nodules located in the ipsilateral lung (OR 9.404, p < 0.001) were independent risk factors for pneumothorax. Simultaneous localizations for multiple PNs using a hook wire system before VATS procedure were safe and effective. Compared with localization for single PN, simultaneous localizations for multiple PNs were prone to the occurrence of pneumothorax. Position change during localization procedure and the nodules located in the ipsilateral lung were independent risk factors for pneumothorax.

Delayed hypersensitivity reaction of the knee after injection of arthroscopy portals with bupivacaine (marcaine)

PubMed

Craft, D V; Good, R P

1994-06-01

The number of arthroscopic procedures performed annually for the management of intraarticular injuries has grown at an exponential rate. Whether done with the patient under general anesthesia or local anesthesia supplemented with intravenous sedation, it is common practice to postoperatively inject each portal as well as the joint with a local anesthetic to provide pain relief in the transition to the recovery room and discharge after outpatient surgery. To our knowledge, no previous reports of localized urticaria and delayed hypersensitivity reaction have been reported in the postarthroscopy setting. We are reporting a case of delayed hypersensitivity reaction and urticaria of the knee that presented after bupivacaine (Marcaine) injection of arthroscopic portals after routine meniscectomy.

Automating approximate Bayesian computation by local linear regression.

PubMed

Thornton, Kevin R

2009-07-07

In several biological contexts, parameter inference often relies on computationally-intensive techniques. "Approximate Bayesian Computation", or ABC, methods based on summary statistics have become increasingly popular. A particular flavor of ABC based on using a linear regression to approximate the posterior distribution of the parameters, conditional on the summary statistics, is computationally appealing, yet no standalone tool exists to automate the procedure. Here, I describe a program to implement the method. The software package ABCreg implements the local linear-regression approach to ABC. The advantages are: 1. The code is standalone, and fully-documented. 2. The program will automatically process multiple data sets, and create unique output files for each (which may be processed immediately in R), facilitating the testing of inference procedures on simulated data, or the analysis of multiple data sets. 3. The program implements two different transformation methods for the regression step. 4. Analysis options are controlled on the command line by the user, and the program is designed to output warnings for cases where the regression fails. 5. The program does not depend on any particular simulation machinery (coalescent, forward-time, etc.), and therefore is a general tool for processing the results from any simulation. 6. The code is open-source, and modular.Examples of applying the software to empirical data from Drosophila melanogaster, and testing the procedure on simulated data, are shown. In practice, the ABCreg simplifies implementing ABC based on local-linear regression.

Costs optimization in anaesthesia.

PubMed

Martelli, Alessandra

2015-04-27

The aim of this study is to analyze the direct cost of different anaesthetic techniques used within the Author's hospital setting and compare with costs reported in the literature. Mean cost of drugs and devices used in our local Department of Anaesthesia was considered in the present study. All drugs were supplied by the in-house Pharmacy Service of Parma's General Hospital. All calculation have been made using an hypothetical ASA1 patient weighting 70 kg. The quality of consumption and cost of inhalation anaesthesia with sevoflurane or desflurane at different fresh gas flow were analyzed, and the cost of total venous anaesthesia (TIVA) using propofol and remifentanil with balanced anaesthesia were also analyzed. In addition, direct costs of general, spinal and sciatic-femoral nerve block anaesthesia used for common plastic surgery procedures were assessed. The results of our study show that the cost of inhalational anaesthesia decreases using fresh gas flow below 1L, and the use of desflurane is more expensive. In our Hospital, the cost of TIVA is more or less equivalent to the costs of balanced anaesthesia with sevoflurane in surgical procedure lasting more than five hours. The direct cost was lower for the spinal anaesthesia compared with general anaesthesia and sciatic- femoral nerve block for some surgical procedures. (www.actabiomedica.it).

A review of techniques of induced abortion.

PubMed

Hepburn, S

1981-04-01

Various techniques are available for inducing abortion. Evacuation of the uterus through the vagina is generally the preferred method in first trimester pregnancies. Dilation of the cervical canal by inserting rod dilators or laminaria tents allows the withdrawal of the fetus. Suction procedures (vacuum aspiration, uterine aspiration, or suction curettage) are possible since the decidua are separable from the basal layer of endometrium. This removal by force does not damage other maternal tissue. A cannula is introduced into the uterine cavity through the dilated cervix and its operator is then connected to a pump by way of a flexible tube which delivers negative pressure of about 600 mm of mercury. When the fetus is withdrawn, the uterus is felt to contract onto the cannula. The average time for this procedure is 5 minutes. Surgical curettage or dilatation and evacuation first dilates the cervical canal and then removes fetal parts and tissue from ovum forceps; a sharp curette does the rest. Anesthesia for these procedures may be general, local, or spinal. The techniques of menstrual regulation is used before pregnancy can be confirmed. However with the advent of the RIA test for the beta subunit of HCG this procedure is rarely indicated. Induction of premature labor is used in the later 1/2 of the second trimester and utilizes prostaglandins. Intraamniobor usually begins within 24 hours. Hysterotomy and hysterectomy are surgical procedures used in abortions.

Outcomes following implementation of a pediatric procedural sedation guide for referral to general anesthesia for magnetic resonance imaging studies.

PubMed

Grunwell, Jocelyn R; Marupudi, Neelima K; Gupta, Rohan V; Travers, Curtis D; McCracken, Courtney E; Williamson, Julie L; Stockwell, Jana A; Fortenberry, James D; Couloures, Kevin; Cravero, Joseph; Kamat, Pradip P

2016-06-01

Guidelines for referral of children to general anesthesia (GA) to complete MRI studies are lacking. We devised a pediatric procedural sedation guide to determine whether a pediatric procedural sedation guide would decrease serious adverse events and decrease failed sedations requiring rescheduling with GA. We constructed a consensus-based sedation guide by combining a retrospective review of reasons for referral of children to GA (n = 221) with published risk factors associated with the inability to complete the MRI study with sedation. An interrupted time series analysis of 11 530 local sedation records from the Pediatric Sedation Research Consortium between July 2008 and March 2013, adjusted for case-mix differences in the pre- and postsedation guide cohorts, evaluated whether a sedation guide resulted in decreased severe adverse events (SAE) and failed sedation rates. A significant increase in referrals to GA following implementation of a sedation guide occurred (P < 0.001), and fewer children with an ASA-PS class ≥III were sedated using procedural sedation (P < 0.001). There was no decrease in SAE (P = 0.874) or in SAE plus airway obstruction with concurrent hypoxia (P = 0.435). There was no change in the percentage of failed sedations (P = 0.169). More studies are needed to determine the impact of a sedation guide on pediatric procedural sedation services. © 2016 John Wiley & Sons Ltd.

Towards loop quantum gravity without the time gauge.

PubMed

Cianfrani, Francesco; Montani, Giovanni

2009-03-06

The Hamiltonian formulation of the Holst action is reviewed and it provides a solution of second-class constraints corresponding to a generic local Lorentz frame. Within this scheme the form of rotation constraints can be reduced to a Gauss-like one by a proper generalization of Ashtekar-Barbero-Immirzi connections. This result emphasizes that the loop quantum gravity quantization procedure can be applied when the time-gauge condition does not stand.

HOSPITAL VARIATION IN SPHINCTER PRESERVATION FOR ELDERLY RECTAL CANCER PATIENTS

PubMed Central

Dodgion, Christopher M.; Neville, Bridget A; Lipsitz, Stuart R.; Schrag, Deborah; Breen, Elizabeth; Zinner, Michael J.; Greenberg, Caprice C.

2014-01-01

Purpose To evaluate hospital variation in the use of low anterior resection (LAR), local excision (LE) and abdominoperineal resection (APR) in the treatment of rectal cancer in elderly patients. Methods Using SEER-Medicare linked data, we identified 4,959 stage I–III rectal cancer patients over age 65 diagnosed from 2000–2005 who underwent operative intervention at one of 370 hospitals. We evaluated the distribution of hospital-specific procedure rates and used generalized mixed models with random hospital effects to examine the influence of patient characteristics and hospital on operation type, using APR as a reference. Results The median hospital performed APR on 33% of elderly rectal cancer patients. Hospital was a stronger predictor of LAR receipt than any patient characteristic, explaining 32% of procedure choice, but not a strong predictor of LE, explaining only 3.8%. Receipt of LE was primarily related to tumor size and tumor stage, which, combined, explained 31% of procedure variation. Conclusions Receipt of local excision is primarily determined by patient characteristics. In contrast, the hospital where surgery is performed significantly influences whether a patient undergoes an LAR or APR. Understanding the factors that cause this institutional variation is crucial to ensuring equitable availability of sphincter preservation. PMID:24750983

1,000 consecutive cases of laser-assisted liposuction and suction-assisted lipectomy managed with local anesthesia.

PubMed

Chia, Christopher T; Theodorou, Spero J

2012-08-01

Advances in suction-assisted lipectomy (SAL) include improved instrumentation, better understanding of fluid dynamics, and an improved concept of appropriate indications. The tumescent technique uses subcutaneous injection of isotonic fluid containing vasoconstrictive and analgesic agents and is proved to be safe, with low morbidity and mortality rates. Laser-assisted liposuction (LAL) using local infiltration of an anesthetic and no general anesthesia or sedation has been developed, with claims of fat destruction and skin tightening. This study aimed to review 1,000 consecutive cases of LAL and SAL performed with the patient under local anesthesia and to determine whether this represents a safe technique with few complications. During a period of 22 months, 581 consecutive patients (486 females and 95 males) underwent 1,000 LAL/SAL operations, 545 of whom had multiple procedures performed. None of the patients had a body mass index (BMI) higher than 30 kg/m2. The patients ranged in age from 18 to 62 years. The fat aspirate ranged from 50 to 1,400 ml. Patients were given an oral sedative, an antibiotic, and an analgesic. Ringer's lactate solution containing lidocaine and epinephrine was injected into the subcutaneous space. The 1,064-nm and/or 1,320-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used for laser lipolysis followed by SAL using standard and/or power-assisted liposuction (PAL) cannulas. The treated areas included the neck, triceps, male breast, midback, flanks, axilla, abdomen, mons pubis, thighs, presacrum, and knees. No patient was administered intravenous sedation or general anesthesia. The average number of areas treated was 1.8, and no major complications or mortalities were observed. There were three burns, two infections, one hematoma, and one seroma. A total of 73 secondary procedures were performed (7.3%). No tertiary procedures were required. For appropriately selected patients, comparable results can be obtained with an excellent safety profile and short recovery period using LAL and SAL with the patient under local anesthesia. The awake patient is able to participate in body positioning and to provide physiologic monitoring. No major complications occurred in this series. The burn and hematoma complications occurred in the first 25 cases and may have been related to a learning curve. One case of cellulitis occurred in the triceps region, and a second infection occurred in the abdomen. Both responded to antibiotics. Altogether, 73 touch-up procedures (7.3%) were performed. The amounts of fat removal were comparable with the volumes obtained using traditional liposuction. In conclusion, this series demonstrated that LAL/SAL using local anesthesia is a safe procedure for selected patients, with acceptably low morbidity and revision rates. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.

The effects of local nitroglycerin on the surgical delay procedure in prefabricated flaps by vascular implant in rats.

PubMed

Sá, Jairo Zacchê de; Aguiar, José Lamartine de Andrade; Cruz, Adriana Ferreira; Schuler, Alexandre Ricardo Pereira; Lima, José Ricardo Alves de; Marques, Olga Martins

2012-12-01

To evaluate the effect of local nitroglycerin on the viable area of a prefabricated flap for vascular implant in rats, and to investigate the surgical delay procedure. A femoral pedicle was implanted under the skin of the abdominal wall in forty Wistar rats. The animals were divided into four groups of ten: group 1 - without surgical delay procedure and local nitroglycerin; group 2 - with surgical delay procedure, but without local nitroglycerin; group 3 - without surgical delay procedure, but with local nitroglycerin; and group 4 - with simultaneous surgical delay procedure and local nitroglycerin. The percentages of the viable areas, in relation to the total flap, were calculated using AutoCAD R 14. The mean percentage value of the viable area was 8.9% in the group 1. 49.4% in the group 2; 8.4% in the group 3 and 1.1% in the group 4. There was significant difference between groups 1 and 2 (p=0.005), 1 and 4 (p=0.024), 2 and 3 (p=0.003), 2 and 4 (p=0.001). These results support the hypothesis that the closure of the arterial venous channels is responsible for the phenomenon of surgical delay procedure. Local nitroglycerin did not cause an increase in the prefabricated viable flap area by vascular implantation and decreased the viable flap area that underwent delay procedures.

TU-H-CAMPUS-IeP1-03: Comparison of Monte Carlo Simulation and Conversion Factor Based Method On Estimation of Effective Dose in Pediatric Patients Undergoing Interventional Cardiac Procedures

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

Leung, K; Wong, M; Ng, Y

Purpose: Interventional cardiac procedures utilize frequent fluoroscopy and cineangiography, which impose considerable radiation risk to patients, especially pediatric patients. Accurate calculation of effective dose is important in order to estimate cancer risk over the rest of their lifetime. This study evaluates the difference in effective dose calculated by Monte Carlo simulation with those estimated by locally-derived conversion factors (CF-local) and by commonly quoted conversion factors from Karambatsakidou et al (CF-K). Methods: Effective dose (E),of 12 pediatric patients, age between 2.5–19 years old, who had undergone interventional cardiac procedures, were calculated using PCXMC-2.0 software. Tube spectrum, irradiation geometry, exposure parameters andmore » dose-area product (DAP) of each projection were included in the software calculation. Effective doses for each patient were also estimated by two Methods: 1) CF-local: conversion factor derived locally by generalizing results of 12 patients, multiplied by DAP of each patient gives E-local. 2) CF-K: selected factor from above-mentioned literature, multiplied by DAP of each patient gives E-K. Results: Mean of E, E-local and E-K were 16.01 mSv, 16.80 mSv and 22.25 mSv respectively. A deviation of −29.35% to +34.85% between E and E-local, while a greater deviation of −28.96% to +60.86% between E and EK were observed. E-K overestimated the effective dose for patients at age 7.5–19. Conclusion: Effective dose obtained by conversion factors is simple and quick to estimate radiation risk of pediatric patients. This study showed that estimation by CF-local may bear an error of 35% when compared with Monte Carlo calculation. If using conversion factors derived by other studies may result in an even greater error, of up to 60%, due to factors that are not catered for in the estimation, including patient size, projection angles, exposure parameters, tube filtration, etc. Users must be aware of these potential inaccuracies when simple conversion method is employed.« less

Stochastic control system parameter identifiability

NASA Technical Reports Server (NTRS)

Lee, C. H.; Herget, C. J.

1975-01-01

The parameter identification problem of general discrete time, nonlinear, multiple input/multiple output dynamic systems with Gaussian white distributed measurement errors is considered. The knowledge of the system parameterization was assumed to be known. Concepts of local parameter identifiability and local constrained maximum likelihood parameter identifiability were established. A set of sufficient conditions for the existence of a region of parameter identifiability was derived. A computation procedure employing interval arithmetic was provided for finding the regions of parameter identifiability. If the vector of the true parameters is locally constrained maximum likelihood (CML) identifiable, then with probability one, the vector of true parameters is a unique maximal point of the maximum likelihood function in the region of parameter identifiability and the constrained maximum likelihood estimation sequence will converge to the vector of true parameters.

The mean field theory in EM procedures for blind Markov random field image restoration.

PubMed

Zhang, J

1993-01-01

A Markov random field (MRF) model-based EM (expectation-maximization) procedure for simultaneously estimating the degradation model and restoring the image is described. The MRF is a coupled one which provides continuity (inside regions of smooth gray tones) and discontinuity (at region boundaries) constraints for the restoration problem which is, in general, ill posed. The computational difficulty associated with the EM procedure for MRFs is resolved by using the mean field theory from statistical mechanics. An orthonormal blur decomposition is used to reduce the chances of undesirable locally optimal estimates. Experimental results on synthetic and real-world images show that this approach provides good blur estimates and restored images. The restored images are comparable to those obtained by a Wiener filter in mean-square error, but are most visually pleasing.

Achilles tenotomy as an office procedure and current practising trends among New Zealand orthopaedic surgeons.

PubMed

Agius, Lewis; Wickham, Angus; Walker, Cameron; Knudsen, Joshua

2018-05-18

Percutaneous Achilles tenotomy (PAT) is performed during the final phase of casting with Ponseti method. Several settings have been proposed as venues for this procedure, however it is increasingly being performed in theatre under a general anaesthetic (GA). General anaesthesia, however, is expensive and not without risks. The purpose of the present study was to compare results of outpatient releases to theatre releases, and assess current practising trends among orthopaedic surgeons. Retrospective comparison of patients with idiopathic clubfoot managed by Ponseti method who had Achilles tenotomy performed in outpatient clinic and in theatre. Surveys were sent to all POSNZ members to determine current practising trends in New Zealand. Parental satisfaction surveys were performed. Comparative cost analysis was performed using hospital billing information. The current study includes 64 idiopathic congenital clubfeet (19 bilateral cases). PAT was performed on 26 clubfeet under local anaesthetic in an outpatient setting, and 33 clubfeet under GA in a theatre setting. There was no significant difference for post-operative complications, or recurrence (p=0.67). Those in theatre group were exposed to a greater number of general anaesthetics before the age of four. Among practising New Zealand paediatric orthopaedic surgeons, 77.78% perform this in theatre under general anaesthesia, while only 22.22% perform PAT in outpatient clinic. The main barriers included concerns regarding pain control, concerns regarding incomplete release, concerns regarding distress to family and concerns regarding sterility. Parental satisfaction surveys found pain management to be excellent. Financial data was analysed and indicative costs were $6,061 NZD per procedure in theatre, compared to $378 NZD per procedure in clinic. PAT performed in a clinic setting is both safe and efficacious with results comparative to that performed in theatre. There was no difference in post-operative complications or recurrence. Parental satisfaction to this procedure is excellent. There are significant financial advantages. Based on this data, our institution now performs all releases in an outpatient setting.

Anchor Node Localization for Wireless Sensor Networks Using Video and Compass Information Fusion

PubMed Central

Pescaru, Dan; Curiac, Daniel-Ioan

2014-01-01

Distributed sensing, computing and communication capabilities of wireless sensor networks require, in most situations, an efficient node localization procedure. In the case of random deployments in harsh or hostile environments, a general localization process within global coordinates is based on a set of anchor nodes able to determine their own position using GPS receivers. In this paper we propose another anchor node localization technique that can be used when GPS devices cannot accomplish their mission or are considered to be too expensive. This novel technique is based on the fusion of video and compass data acquired by the anchor nodes and is especially suitable for video- or multimedia-based wireless sensor networks. For these types of wireless networks the presence of video cameras is intrinsic, while the presence of digital compasses is also required for identifying the cameras' orientations. PMID:24594614

2-Point microstructure archetypes for improved elastic properties

NASA Astrophysics Data System (ADS)

Adams, Brent L.; Gao, Xiang

2004-01-01

Rectangular models of material microstructure are described by their 1- and 2-point (spatial) correlation statistics of placement of local state. In the procedure described here the local state space is described in discrete form; and the focus is on placement of local state within a finite number of cells comprising rectangular models. It is illustrated that effective elastic properties (generalized Hashin Shtrikman bounds) can be obtained that are linear in components of the correlation statistics. Within this framework the concept of an eigen-microstructure within the microstructure hull is useful. Given the practical innumerability of the microstructure hull, however, we introduce a method for generating a sequence of archetypes of eigen-microstructure, from the 2-point correlation statistics of local state, assuming that the 1-point statistics are stationary. The method is illustrated by obtaining an archetype for an imaginary two-phase material where the objective is to maximize the combination C_{xxxx}^{*} + C_{xyxy}^{*}

Broadcast control of air traffic

NASA Technical Reports Server (NTRS)

Litchford, G. B.

1971-01-01

Concepts of increased pilot participation in air traffic control are presented. The design of an air traffic control system for pilot usage is considered. The operating and safety benefits of LF/VLF approaches in comparison to current nonprecision approach procedures and systems are discussed. With a good national system plan, flight testing and validation, and the use of local differential, or general diurnal, corrections, the LF/VLF system would provide service superior to that presently available.

40 CFR 1506.2 - Elimination of duplication with State and local procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Elimination of duplication with State and local procedures. 1506.2 Section 1506.2 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY OTHER REQUIREMENTS OF NEPA § 1506.2 Elimination of duplication with State and local procedures. (a...

40 CFR 1506.2 - Elimination of duplication with State and local procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Elimination of duplication with State and local procedures. 1506.2 Section 1506.2 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY OTHER REQUIREMENTS OF NEPA § 1506.2 Elimination of duplication with State and local procedures. (a...

Process Synchronization and Data Communication between Processes in Real Time Local Area Networks.

DTIC Science & Technology

1985-12-01

52 APPENDIX A: PROCEDURE MAKETABLE .............. 54 APPENDIX B: PROCEDURE MAKEMESSAGE ............. 56 APPENDIX C: PROCEDURE...item. The relation table is built by the driver during system initialization by the procedure maketable , see Appendix A. This procedure reads the file... MAKETABLE Procedure maketable is the first procedure called by the driver. It sets up the relation table in local RAM of SBC 1 by reading the information

Impact of paracervical block on postabortion pain in patients undergoing abortion under general anesthesia.

PubMed

Lazenby, Gweneth B; Fogelson, Nicholas S; Aeby, Tod

2009-12-01

Paracervical block is used as a way to decrease postoperative pain in patients having abortions under general anesthesia. To date, no studies have evaluated the efficacy of this practice. Patients were recruited from a university-based family planning clinic. Seventy-two patients seeking abortion under general anesthesia were enrolled into the single-blinded study. Thirty-nine patients were randomized to receive a paracervical block, and 33 were randomized to no local anesthesia. The patients completed a demographic survey and visual analog pain scales for pain prior to and at several time points after the procedure. Data regarding the need for additional pain medications postoperatively were recorded. Analysis of variance single factor and two-sample one-sided t test were used in data analysis. Experimental and control groups were similar in all measured demographic characteristics. They were also similar in gestational age, number of laminaria required, preoperative dilation, operative time, estimated blood loss and reported complications. Postoperative pain was not significantly affected by placement of a paracervical block prior to abortion under general anesthesia. The need for postoperative pain medication during recovery was similar between groups. This study does not support the hypothesized benefit of local anesthesia prior to surgical abortion under general anesthesia to reduce postoperative pain.

Representing and comparing protein structures as paths in three-dimensional space

PubMed Central

Zhi, Degui; Krishna, S Sri; Cao, Haibo; Pevzner, Pavel; Godzik, Adam

2006-01-01

Background Most existing formulations of protein structure comparison are based on detailed atomic level descriptions of protein structures and bypass potential insights that arise from a higher-level abstraction. Results We propose a structure comparison approach based on a simplified representation of proteins that describes its three-dimensional path by local curvature along the generalized backbone of the polypeptide. We have implemented a dynamic programming procedure that aligns curvatures of proteins by optimizing a defined sum turning angle deviation measure. Conclusion Although our procedure does not directly optimize global structural similarity as measured by RMSD, our benchmarking results indicate that it can surprisingly well recover the structural similarity defined by structure classification databases and traditional structure alignment programs. In addition, our program can recognize similarities between structures with extensive conformation changes that are beyond the ability of traditional structure alignment programs. We demonstrate the applications of procedure to several contexts of structure comparison. An implementation of our procedure, CURVE, is available as a public webserver. PMID:17052359

Adoptive cell therapy with autologous tumor-infiltrating lymphocytes and high-dose interleukin-2 for metastatic melanoma: The surgeon’s perspective

PubMed Central

ZIPPEL, DOUGLAS B.; BESSER, MICHAL; SHAPIRA, RONI; BEN-NUN, ALON; GOITEIN, DAVID; DAVIDSON, TIMA; TREVES, ABRAHAM J.; MARKEL, GAL; SCHACHTER, JACOB; PAPA, MOSHE Z.

2012-01-01

Tumor-infiltrating lymphocytes (TILs) are produced by resecting tumor tissue and growing and expanding ex vivo large quantities of autologous T cells. Once the TILs are ready for infusion, the patient undergoes a non-myeloablative lympho-depleting course of chemotherapy and subsequent TIL infusion with high-dose bolus IL-2. This study reviews the surgical experience of the TIL program at the Chaim Sheba Cancer Research Center in Israel. Eligible patients underwent surgical consultation to determine what tumorectomy would be beneficial for harvesting appropriate tissue. Factors involved in the decision included tumor mass size, location and morbidity of the procedure. Between January 2006 and May 2010, 44 patients underwent 47 procedures of adoptive transfer of TILs. Three patients underwent the procedure twice for recurrence after initial good responses, including an additional surgical procedure to produce fresh tumor. Thirty-seven excisions were with general anesthesia and 10 were with local anesthesia. Of the 37 general anesthesia procedures, 27 were open procedures involving a thoracotomy, a laparotomy or dissection of a major lymph node basin. Ten used minimally invasive techniques such as thorascopy or laparoscopy. Tumorectomy sites included 18 lymph node metastasis, 13 subcutaneous nodules, 11 lung specimens and 5 abdominal visceral metastasis including 2 liver lesions. Surgical mortality and major morbidity was 0%. Minor morbidity included only wound complications. Maximal number of TILs were derived from lymph node specimens, while liver metastasis procured the fewest TILs. Adoptive cell transfer technology affords a maximal tumor response with minimal surgical morbidity in metastatic patients. PMID:22969990

[Ten years of destructive eyeball surgery in Lomé].

PubMed

Vonor, K; Amedome, K M; Dzidzinyo, K; Ayena, K D; Santos, M K A; Maneh, N; Tete, Y; Balo, K P

2015-01-01

Destructive surgery of the eyeball comprises radical procedures - evisceration, enucleation, and exenteration - with various indications. The purpose of this study was to determine the features of these procedures in Lomé. We conducted a retrospective study reviewing records for all patients undergoing these procedures in 3 ophthalmic centers in Lomé in the decade from 2002 through 2011. Of 6240 eye operations, 76 involved one of these three procedures, for a frequency of 1.2%. Patients' mean age was 40.1 ± 26.9 years (range: 1 day to 91 years). The sex ratio (of men to women) was 1.2. The principal indications were staphyloma (38%), ocular and orbital tumors (30%), and phthisis bulbi (24%). Retinoblastoma was the leading type of ocular/orbital tumor (52%). Local anesthesia was performed in 64% of cases, and general anesthesia in 36%. Evisceration was practiced in 67% of cases, enucleation in 24%, and exenteration in 9%. An ocular prosthesis was placed in 46%. Staphyloma was the leading indication for destructive surgery. Given the damage of this type of procedure, primary prevention is important, including early and adequate management of ocular conditions.

An Improved Nested Sampling Algorithm for Model Selection and Assessment

NASA Astrophysics Data System (ADS)

Zeng, X.; Ye, M.; Wu, J.; WANG, D.

2017-12-01

Multimodel strategy is a general approach for treating model structure uncertainty in recent researches. The unknown groundwater system is represented by several plausible conceptual models. Each alternative conceptual model is attached with a weight which represents the possibility of this model. In Bayesian framework, the posterior model weight is computed as the product of model prior weight and marginal likelihood (or termed as model evidence). As a result, estimating marginal likelihoods is crucial for reliable model selection and assessment in multimodel analysis. Nested sampling estimator (NSE) is a new proposed algorithm for marginal likelihood estimation. The implementation of NSE comprises searching the parameters' space from low likelihood area to high likelihood area gradually, and this evolution is finished iteratively via local sampling procedure. Thus, the efficiency of NSE is dominated by the strength of local sampling procedure. Currently, Metropolis-Hasting (M-H) algorithm and its variants are often used for local sampling in NSE. However, M-H is not an efficient sampling algorithm for high-dimensional or complex likelihood function. For improving the performance of NSE, it could be feasible to integrate more efficient and elaborated sampling algorithm - DREAMzs into the local sampling. In addition, in order to overcome the computation burden problem of large quantity of repeating model executions in marginal likelihood estimation, an adaptive sparse grid stochastic collocation method is used to build the surrogates for original groundwater model.

The generalized quadratic knapsack problem. A neuronal network approach.

PubMed

Talaván, Pedro M; Yáñez, Javier

2006-05-01

The solution of an optimization problem through the continuous Hopfield network (CHN) is based on some energy or Lyapunov function, which decreases as the system evolves until a local minimum value is attained. A new energy function is proposed in this paper so that any 0-1 linear constrains programming with quadratic objective function can be solved. This problem, denoted as the generalized quadratic knapsack problem (GQKP), includes as particular cases well-known problems such as the traveling salesman problem (TSP) and the quadratic assignment problem (QAP). This new energy function generalizes those proposed by other authors. Through this energy function, any GQKP can be solved with an appropriate parameter setting procedure, which is detailed in this paper. As a particular case, and in order to test this generalized energy function, some computational experiments solving the traveling salesman problem are also included.

Procedures for risk management and a review of crisis referrals from the MindSpot Clinic, a national service for the remote assessment and treatment of anxiety and depression.

PubMed

Nielssen, Olav; Dear, Blake F; Staples, Lauren G; Dear, Rebecca; Ryan, Kathryn; Purtell, Carol; Titov, Nickolai

2015-12-01

The MindSpot Clinic (MindSpot) provides remote screening assessments and therapist-guided treatment for anxiety and depression to adult Australians. Most patients are self-referred. The purpose of this study was to report on the procedures followed to maintain the safety of patients and to examine the circumstances of urgent referrals to local services made by this remote mental health service. A description of the procedures used to manage risk, and an audit of case summaries of patients who were urgently referred for crisis intervention. The reported measures were scores on self-report scales of psychological distress (K-10) and depression (PHQ-9), the number reporting suicidal thoughts and plans, and the number of acute referrals. A total of 9061 people completed assessments and consented for analysis of their data in the year from 1 July, 2013 to 30 June, 2014. Of these, 2599 enrolled in online treatment at MindSpot, and the remainder were supported to access local mental health services. Suicidal thoughts were reported by 2366 (26.1 %) and suicidal plans were reported by 213 (2.4 %). There were 51 acute referrals, of whom 19 (37.3 %) lived in regional or remote locations. The main reason for referral was the patients' self-report of imminent suicidal intent. The police were notified in three cases, and in another case an ambulance attended after the patient reported taking an overdose. For the remaining acute referrals, MindSpot therapists were able to identify a local mental health service or a general practitioner, confirm receipt of a written case summary, and confirm that the patient had been contacted, or that the local service intended to contact the patient. Around 0.6 % of the people seeking assessment or treatment by MindSpot were referred to local mental health services for urgent face to face care. The procedures for identifying and managing those patients were satisfactory, and in every case, either emergency services or local mental health services were able to take over the patient's care. This review suggests that the uncertainty associated with taking responsibility for the remote treatment of patients who disclose active suicidal plans is not a major impediment to providing direct access online treatment for severe forms of anxiety and depression.

Nationwide price variability for an elective, outpatient imaging procedure.

PubMed

Pasalic, Dario; Lingineni, Ravi K; Cloft, Harry J; Kallmes, David F

2015-05-01

Out-of pocket expenses for common medical tests and procedures will become increasingly relevant as high-deductible insurance plans gain widespread adoption. The purpose of this study was to determine the variability of pricing for an outpatient, noncontrast knee MRI, based on geographic location and population. We randomly chose nonhospital outpatient radiology centers in each state's highest-population locality, based on a list generated from the ACR MRI Accreditation Program database. The presence of ≥2 and a maximum of 3 centers within a given locality was required for inclusion. Using a standardized script, we contacted centers by phone to determine the lowest, out-of-pocket, bundled cost (technical fee plus professional fee). The median (interquartile range) costs were calculated within each locality and region, including Midwest, Northeast, South, and West regions. A generalized linear model and Spearman's rank correlation were used to determine the association between cost and region, and cost and population, respectively. A total of 122 outpatient centers from 43 cities were analyzed. Costs ranged from $259 to $2,042 across all centers. For centers within a locality, the difference between the minimum and maximum costs among centers ranged from $1,592 to $0; median cost differences between localities ranged from $1,488 to $325. Median cost for the West, Northeast, Midwest, and South region was $690, $500, $550, and $550, respectively (P = .849). Median cost was inversely correlated with population density (ρ = -0.417 [correlation coefficient], P = .005). Out-of-pocket costs for an outpatient knee MRI vary substantially across imaging centers, both locally and nationally. Cost tends to decrease with increasing local population. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Teaching Civil Procedure with the Aid of Local Tort Litigation.

ERIC Educational Resources Information Center

Anderson, Lloyd C.; Kirkwood, Charles E.

1987-01-01

A course in civil procedure using local tort litigation and classroom simulation of the trial has been enthusiastically recevied by students and useful in teaching appropriate procedure, sequencing, questioning, and professional cooperation. (MSE)

Accreditation of a screening method for non-dioxin-like polychlorinated biphenyl detection in fishery products according to European legislation.

PubMed

Serpe, F P; Russo, R; Ambrosio, L; Esposito, M; Severino, L

2013-06-01

European Commission Regulation 882/2004/EC requires that official control laboratories for foodstuffs in the member states are certified according to UNI EN ISO/IEC 17025:2005 (general requirement for the competence of calibration and testing laboratories). This mandatory requirement has resulted in a continuous adaptation and development of analytical procedures. The aim of this study was to develop a method for semiquantitative screening of polychlorinated biphenyls in fish for human consumption. According to the Commission Decision 657/2002/CE, the detection capability, the precision, the selectivity-specificity, and applicability-ruggedness-stability were determined to validate the method. Moreover, trueness was verified. This procedure resulted in rapid execution, which allowed immediate and effective intervention by the local health authorities to protect the health of consumers. Finally, the procedure has been recognized by the Italian accrediting body, ACCREDIA.

[Descriptive analysis of work and trends in anaesthesiology from 2005 to 2006: quantitative and qualitative aspects of effects and evaluation of anaesthesia].

PubMed

Majstorović, Branislava M; Simić, Snezana; Milaković, Branko D; Vucović, Dragan S; Aleksić, Valentina V

2010-01-01

In anaesthesiology, economic aspects have been insufficiently studied. The aim of this paper was the assessment of rational choice of the anaesthesiological services based on the analysis of the scope, distribution, trend and cost. The costs of anaesthesiological services were counted based on "unit" prices from the Republic Health Insurance Fund. Data were analysed by methods of descriptive statistics and statistical significance was tested by Student's t-test and chi2-test. The number of general anaesthesia was higher and average time of general anaesthesia was shorter, without statistical significance (t-test, p = 0.436) during 2006 compared to the previous year. Local anaesthesia was significantly higher (chi2-test, p = 0.001) in relation to planned operation in emergency surgery. The analysis of total anaesthesiological procedures revealed that a number of procedures significantly increased in ENT and MFH surgery, and ophthalmology, while some reduction was observed in general surgery, orthopaedics and trauma surgery and cardiovascular surgery (chi2-test, p = 0.000). The number of analgesia was higher than other procedures (chi2-test, p = 0.000). The structure of the cost was 24% in neurosurgery, 16% in digestive (general) surgery,14% in gynaecology and obstetrics, 13% in cardiovascular surgery and 9% in emergency room. Anaesthesiological services costs were the highest in neurosurgery, due to the length anaesthesia, and digestive surgery due to the total number of general anaesthesia performed. It is important to implement pharmacoeconomic studies in all departments, and to separate the anaesthesia services for emergency and planned operations. Disproportions between the number of anaesthesia, surgery interventions and the number of patients in surgical departments gives reason to design relation database.

Local Stretching Theories

DTIC Science & Technology

2010-06-24

diffusivity of the scalar. (If the scalar is heat, then the Schmidt number becomes the Prandtl number.) Momentum diffuses significantly faster than the...derive the Cramér function explicitly in the simple case where the xi have a Bernoulli distribution, though the general formula for S may be derived by...an analogous procedure. 5 Large deviation CLT for the Bernoulli distribution Let xi have the PDF of a fair coin, p(xi) = 1 2δ(xi + 1) + 1 2δ(xi − 1

Incidence of surgical-site infections and the validity of the National Nosocomial Infections Surveillance System risk index in a general surgical ward in Santa Cruz, Bolivia.

PubMed

Soleto, Lorena; Pirard, Marianne; Boelaert, Marleen; Peredo, Remberto; Vargas, Reinerio; Gianella, Alberto; Van der Stuyft, Patrick

2003-01-01

To estimate the frequency of and risk factors for surgical-site infections (SSIs) in Bolivia, and to study the performance of the National Nosocomial Infections Surveillance (NNIS) System risk index in a developing country. A prospective study with patient follow-up until the 30th postoperative day. A general surgical ward of a public hospital in Santa Cruz, Bolivia. Patients admitted to the ward between July 1998 and June 1999 on whom surgical procedures were performed. Follow-up was complete for 91.5% of 376 surgical procedures. The overall SSI rate was 12%. Thirty-four (75.6%) of the 45 SSIs were culture positive. A logistic regression model retained an American Society of Anesthesiologists score of more than 1 (odds ratio [OR], 1.87), a not-clean wound class (OR, 2.28), a procedure duration of more than 1 hour (OR, 1.81), and drain (OR, 1.98) as independent risk factors for SSI. There was no significant association between the NNIS System risk index and SSI rates. However, a "local" risk index constructed with the above cutoff points showed a linear trend with SSI (P < .001) and a relative risk of 3.18 for risk class 3 versus a class of less than 3. SSIs cause considerable morbidity in Santa Cruz. Appropriate nosocomial infection surveillance and control should be introduced. The NNIS System risk index did not discriminate between patients at low and high risk for SSI in this hospital setting, but a risk score based on local cutoff points performed substantially better.

Comparison of local versus general anesthesia in patients undergoing transcatheter aortic valve replacement: A meta-analysis.

PubMed

Villablanca, Pedro A; Mohananey, Divyanshu; Nikolic, Katarina; Bangalore, Sripal; Slovut, David P; Mathew, Verghese; Thourani, Vinod H; Rode's-Cabau, Josep; Núñez-Gil, Iván J; Shah, Tina; Gupta, Tanush; Briceno, David F; Garcia, Mario J; Gutsche, Jacob T; Augoustides, John G; Ramakrishna, Harish

2018-02-01

Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. We comprehensively searched EMBASE, PubMed, and Web of Science. Effect sizes were summarized using risk ratios (RRs) difference of the mean (DM), and 95% CIs (confidence intervals) for dichotomous and continuous variables respectively. Twenty-six studies and 10,572 patients were included in the meta-analysis. The use of LA for TAVR was associated with lower overall 30-day mortality (RR, 0.73; 95% CI, 0.57-0.93; P = 0.01), use of inotropic/vasopressor drugs (RR, 0.45; 95% CI, 0.28-0.72; P < 0.001), hospital length of stay (LOS) (DM, -2.09; 95% CI, -3.02 to -1.16; P < 0.001), intensive care unit LOS (DM, -0.18; 95% CI, -0.31 to -0.04; P = 0.01), procedure time (DM, -25.02; 95% CI, -32.70 to -17.35; P < 0.001); and fluoroscopy time (DM, -1.63; 95% CI, -3.02 to -0.24; P = 0.02). No differences were observed between LA and GA for stroke, cardiovascular mortality, myocardial infarction, permanent pacemaker implantation, acute kidney injury, paravalvular leak, vascular complications, major bleeding, procedural success, conduction abnormalities, and annular rupture. Our meta-analysis suggests that use of LA for TAVR is associated with a lower 30-day mortality, shorter procedure time, fluoroscopy time, ICU LOS, hospital length of stay, and reduced need for inotropic support. © 2017 Wiley Periodicals, Inc.

Development and verification of global/local analysis techniques for laminated composites

NASA Technical Reports Server (NTRS)

Thompson, Danniella Muheim; Griffin, O. Hayden, Jr.

1991-01-01

A two-dimensional to three-dimensional global/local finite element approach was developed, verified, and applied to a laminated composite plate of finite width and length containing a central circular hole. The resulting stress fields for axial compression loads were examined for several symmetric stacking sequences and hole sizes. Verification was based on comparison of the displacements and the stress fields with those accepted trends from previous free edge investigations and a complete three-dimensional finite element solution of the plate. The laminates in the compression study included symmetric cross-ply, angle-ply and quasi-isotropic stacking sequences. The entire plate was selected as the global model and analyzed with two-dimensional finite elements. Displacements along a region identified as the global/local interface were applied in a kinematically consistent fashion to independent three-dimensional local models. Local areas of interest in the plate included a portion of the straight free edge near the hole, and the immediate area around the hole. Interlaminar stress results obtained from the global/local analyses compares well with previously reported trends, and some new conclusions about interlaminar stress fields in plates with different laminate orientations and hole sizes are presented for compressive loading. The effectiveness of the global/local procedure in reducing the computational effort required to solve these problems is clearly demonstrated through examination of the computer time required to formulate and solve the linear, static system of equations which result for the global and local analyses to those required for a complete three-dimensional formulation for a cross-ply laminate. Specific processors used during the analyses are described in general terms. The application of this global/local technique is not limited software system, and was developed and described in as general a manner as possible.

General paediatric surgery for patients aged under 5 years: a 5-year experience at a district general hospital.

PubMed

Kwok, C-S; Gordon, A C

2016-09-01

Introduction The gradual shift of general paediatric surgery (GPS) provision from district general hospitals (DGH) to specialised units is well recognised in the UK. The consequences of centralisation include a reduction in exposure to GPS for current surgical trainees. The GPS practice of a DGH is examined here. Methods All operations performed on children aged under 5 years over a 5-year period were identified using the local electronic operation database. Electronic hospital records and clinic letters were accessed to collect data on demographics, operations performed and outcome measures. Results 472 GPS operations were performed on children between the age of 22 days and 5 years between 2009 and 2014, of which 43 were on an emergency basis and 105 were performed on patients aged less than 1 year. Three patients were admitted following day case surgery. Six patients were readmitted within 30 days. Complication rates for all procedures and the four most common procedures were similar to those found in published literature. Conclusions GPS for patients aged less than 5 years is comparatively safe in the DGH setting. The training opportunities available at DGHs are invaluable to surgical trainees and vital for sustaining the future provision of GPS by such hospitals.

Evaluation of peak picking quality in LC-MS metabolomics data.

PubMed

Brodsky, Leonid; Moussaieff, Arieh; Shahaf, Nir; Aharoni, Asaph; Rogachev, Ilana

2010-11-15

The output of LC-MS metabolomics experiments consists of mass-peak intensities identified through a peak-picking/alignment procedure. Besides imperfections in biological samples and instrumentation, data accuracy is highly dependent on the applied algorithms and their parameters. Consequently, quality control (QC) is essential for further data analysis. Here, we present a QC approach that is based on discrepancies between replicate samples. First, the quantile normalization of per-sample log-signal distributions is applied to each group of biologically homogeneous samples. Next, the overall quality of each replicate group is characterized by the Z-transformed correlation coefficients between samples. This general QC allows a tuning of the procedure's parameters which minimizes the inter-replicate discrepancies in the generated output. Subsequently, an in-depth QC measure detects local neighborhoods on a template of aligned chromatograms that are enriched by divergences between intensity profiles of replicate samples. These neighborhoods are determined through a segmentation algorithm. The retention time (RT)-m/z positions of the neighborhoods with local divergences are indicative of either: incorrect alignment of chromatographic features, technical problems in the chromatograms, or to a true biological discrepancy between replicates for particular metabolites. We expect this method to aid in the accurate analysis of metabolomics data and in the development of new peak-picking/alignment procedures.

14 CFR 325.4 - State and local participation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false State and local participation. 325.4... PROCEEDINGS) PROCEDURAL REGULATIONS ESSENTIAL AIR SERVICE PROCEDURES § 325.4 State and local participation. (a... addressed to: (1) The chief executive of the principal city, or other unit of local government at the...

Multi-level adaptive finite element methods. 1: Variation problems

NASA Technical Reports Server (NTRS)

Brandt, A.

1979-01-01

A general numerical strategy for solving partial differential equations and other functional problems by cycling between coarser and finer levels of discretization is described. Optimal discretization schemes are provided together with very fast general solvers. It is described in terms of finite element discretizations of general nonlinear minimization problems. The basic processes (relaxation sweeps, fine-grid-to-coarse-grid transfers of residuals, coarse-to-fine interpolations of corrections) are directly and naturally determined by the objective functional and the sequence of approximation spaces. The natural processes, however, are not always optimal. Concrete examples are given and some new techniques are reviewed. Including the local truncation extrapolation and a multilevel procedure for inexpensively solving chains of many boundary value problems, such as those arising in the solution of time-dependent problems.

[The potential of general magnetic therapy for the rehabilitation of the patients presenting with hemorrhagic forms of erysipelas].

PubMed

Kuzovleva, E V

2014-01-01

The objective of the present study was to evaluate the possibility and effectiveness of the application of general magnetic therapy for the combined treatment and rehabilitation of the patients presenting with hemorrhagic forms of erysipelas. A total of 102 patients were examined and treated; they were divided into two (control and study) groups matched for age and the main clinical manifestations of the disease. All the patients were given basal therapy, those in the study group were additionally treated using general magnetic therapy. It was shown that the inclusion of this procedure in the combined treatment of hemorrhagic forms of erysipelas promoted rapid and well-apparent elimination of the local inflammatory process, reduced oedema of the affected extremity, improved tissue trophicity, and stimulated microcirculation.

European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project: Results from the treatment of mucosal cancers.

PubMed

Plaschke, Christina Caroline; Bertino, Giulia; McCaul, James A; Grau, Juan J; de Bree, Remco; Sersa, Gregor; Occhini, Antonio; Groselj, Ales; Langdon, Cristobal; Heuveling, Derrek A; Cemazar, Maja; Strojan, Primoz; Leemans, C Rene; Benazzo, Marco; De Terlizzi, Francesca; Wessel, Irene; Gehl, Julie

2017-12-01

Electrochemotherapy is an effective local treatment for cutaneous tumours and metastases. In this prospective trial, six European institutions investigated electrochemotherapy in recurrent, mucosal head and neck tumours. Forty-three patients with recurrent mucosal head and neck tumours and no further curative or reasonably effective palliative treatment options were enrolled and treated with electrochemotherapy. Patients were treated in general anaesthesia using intravenous or local injection of bleomycin followed by delivery of electric pulses to the tumour area. Primary end-point was local tumour response. Secondary end-points were safety and toxicity, overall and progression free survival, and quality-of-life. Thirty-seven patients were evaluable for tumour response, pain score, side-effects and quality of life questionnaires. Six patients were not evaluable due to lost follow-up, disease progression or death before evaluation. Intention to treat analysis revealed an objective response of 56% (complete response 8 (19%), partial response 16 (37%), stable disease 10 (23%), progressive disease 3 (7%), and not evaluable 6 (14%)). Three patients (7%) remained in complete response at 30, 34, and 84 months post-treatment. The treatment procedure was generally well tolerated. Swelling of the mucosa was observed in the first days after treatment. Pain and use of pain medication rose temporarily; fatigue and dysphagia were also noted in the quality of life assessment. Electrochemotherapy can be applied to mucosal head and neck recurrent tumours accessible to the procedure with promising objective response, survival and toxicity profile. Attention should be paid to post-treatment swelling and planning of pain medication. These favourable results indicate that electrochemotherapy could play a role in patients with recurrent head and neck cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

7 CFR 610.25 - Subcommittees and Local Working Groups.

Code of Federal Regulations, 2010 CFR

2010-01-01

... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

7 CFR 610.25 - Subcommittees and Local Working Groups.

Code of Federal Regulations, 2012 CFR

2012-01-01

... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

7 CFR 610.25 - Subcommittees and Local Working Groups.

Code of Federal Regulations, 2014 CFR

2014-01-01

... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

7 CFR 610.25 - Subcommittees and Local Working Groups.

Code of Federal Regulations, 2013 CFR

2013-01-01

... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

7 CFR 610.25 - Subcommittees and Local Working Groups.

Code of Federal Regulations, 2011 CFR

2011-01-01

... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

An unusual cause of post-operative orbital edema in a child after general anesthesia

PubMed Central

Tobias, Joseph D.; Jagannathan, Narasimhan; Sawardekar, Amod; Bhalla, Tarun

2011-01-01

We present an unusual ocular complication during the perioperative period, bilateral orbital edema in an otherwise healthy child after an outpatient surgical procedure. Ocular complications under general anesthesia remain a rare event. When periorbital edema is present, the appropriate work-up includes ruling out the potential for an allergic event by reviewing the medications administered and serum tryptase testing. Ophthalmology consultation should be considered to exclude pathology native to the eye itself. An allergist may assist in confirming a diagnosis and for allergic testing, if indicated. In our patient, the eventual diagnosis of exclusion was that of a localized reaction to the cellophane-based eye tape. PMID:21655032

An unusual cause of post-operative orbital edema in a child after general anesthesia.

PubMed

Tobias, Joseph D; Jagannathan, Narasimhan; Sawardekar, Amod; Bhalla, Tarun

2011-01-01

We present an unusual ocular complication during the perioperative period, bilateral orbital edema in an otherwise healthy child after an outpatient surgical procedure. Ocular complications under general anesthesia remain a rare event. When periorbital edema is present, the appropriate work-up includes ruling out the potential for an allergic event by reviewing the medications administered and serum tryptase testing. Ophthalmology consultation should be considered to exclude pathology native to the eye itself. An allergist may assist in confirming a diagnosis and for allergic testing, if indicated. In our patient, the eventual diagnosis of exclusion was that of a localized reaction to the cellophane-based eye tape.

“Awake” intraoperative functional MRI (ai-fMRI) for mapping the eloquent cortex: Is it possible in awake craniotomy?☆

PubMed Central

Lu, Jun-Feng; Zhang, Han; Wu, Jin-Song; Yao, Cheng-Jun; Zhuang, Dong-Xiao; Qiu, Tian-Ming; Jia, Wen-Bin; Mao, Ying; Zhou, Liang-Fu

2012-01-01

As a promising noninvasive imaging technique, functional MRI (fMRI) has been extensively adopted as a functional localization procedure for surgical planning. However, the information provided by preoperative fMRI (pre-fMRI) is hampered by the brain deformation that is secondary to surgical procedures. Therefore, intraoperative fMRI (i-fMRI) becomes a potential alternative that can compensate for brain shifts by updating the functional localization information during craniotomy. However, previous i-fMRI studies required that patients be under general anesthesia, preventing the wider application of such a technique as the patients cannot perform tasks unless they are awake. In this study, we propose a new technique that combines awake surgery and i-fMRI, named “awake” i-fMRI (ai-fMRI). We introduced ai-fMRI to the real-time localization of sensorimotor areas during awake craniotomy in seven patients. The results showed that ai-fMRI could successfully detect activations in the bilateral primary sensorimotor areas and supplementary motor areas for all patients, indicating the feasibility of this technique in eloquent area localization. The reliability of ai-fMRI was further validated using intraoperative stimulation mapping (ISM) in two of the seven patients. Comparisons between the pre-fMRI-derived localization result and the ai-fMRI derived result showed that the former was subject to a heavy brain shift and led to incorrect localization, while the latter solved that problem. Additionally, the approaches for the acquisition and processing of the ai-fMRI data were fully illustrated and described. Some practical issues on employing ai-fMRI in awake craniotomy were systemically discussed, and guidelines were provided. PMID:24179766

Training radial basis function networks for wind speed prediction using PSO enhanced differential search optimizer

PubMed Central

2018-01-01

This paper presents an integrated hybrid optimization algorithm for training the radial basis function neural network (RBF NN). Training of neural networks is still a challenging exercise in machine learning domain. Traditional training algorithms in general suffer and trap in local optima and lead to premature convergence, which makes them ineffective when applied for datasets with diverse features. Training algorithms based on evolutionary computations are becoming popular due to their robust nature in overcoming the drawbacks of the traditional algorithms. Accordingly, this paper proposes a hybrid training procedure with differential search (DS) algorithm functionally integrated with the particle swarm optimization (PSO). To surmount the local trapping of the search procedure, a new population initialization scheme is proposed using Logistic chaotic sequence, which enhances the population diversity and aid the search capability. To demonstrate the effectiveness of the proposed RBF hybrid training algorithm, experimental analysis on publicly available 7 benchmark datasets are performed. Subsequently, experiments were conducted on a practical application case for wind speed prediction to expound the superiority of the proposed RBF training algorithm in terms of prediction accuracy. PMID:29768463

Defining surfaces for skewed, highly variable data

USGS Publications Warehouse

Helsel, D.R.; Ryker, S.J.

2002-01-01

Skewness of environmental data is often caused by more than simply a handful of outliers in an otherwise normal distribution. Statistical procedures for such datasets must be sufficiently robust to deal with distributions that are strongly non-normal, containing both a large proportion of outliers and a skewed main body of data. In the field of water quality, skewness is commonly associated with large variation over short distances. Spatial analysis of such data generally requires either considerable effort at modeling or the use of robust procedures not strongly affected by skewness and local variability. Using a skewed dataset of 675 nitrate measurements in ground water, commonly used methods for defining a surface (least-squares regression and kriging) are compared to a more robust method (loess). Three choices are critical in defining a surface: (i) is the surface to be a central mean or median surface? (ii) is either a well-fitting transformation or a robust and scale-independent measure of center used? (iii) does local spatial autocorrelation assist in or detract from addressing objectives? Published in 2002 by John Wiley & Sons, Ltd.

Training radial basis function networks for wind speed prediction using PSO enhanced differential search optimizer.

PubMed

Rani R, Hannah Jessie; Victoire T, Aruldoss Albert

2018-01-01

This paper presents an integrated hybrid optimization algorithm for training the radial basis function neural network (RBF NN). Training of neural networks is still a challenging exercise in machine learning domain. Traditional training algorithms in general suffer and trap in local optima and lead to premature convergence, which makes them ineffective when applied for datasets with diverse features. Training algorithms based on evolutionary computations are becoming popular due to their robust nature in overcoming the drawbacks of the traditional algorithms. Accordingly, this paper proposes a hybrid training procedure with differential search (DS) algorithm functionally integrated with the particle swarm optimization (PSO). To surmount the local trapping of the search procedure, a new population initialization scheme is proposed using Logistic chaotic sequence, which enhances the population diversity and aid the search capability. To demonstrate the effectiveness of the proposed RBF hybrid training algorithm, experimental analysis on publicly available 7 benchmark datasets are performed. Subsequently, experiments were conducted on a practical application case for wind speed prediction to expound the superiority of the proposed RBF training algorithm in terms of prediction accuracy.

Effect of raw materials and hardening process on hardness of manually forged knife

NASA Astrophysics Data System (ADS)

Balkhaya, Suwarno

2017-06-01

Knives are normally made by forging process either using a machine or traditional method by means of hammering process. This present work was conducted to study the effects of steel raw materials and hardening process on the hardness of manually forged knives. The knife samples were made by traditional hammering (forging) process done by local blacksmith. Afterward, the samples were heat treated with two different hardening procedures, the first was based on the blacksmith procedure and the second was systematically done at the laboratory. The forging was done in the temperature ranged between 900-950°C, while the final temperature ranged between 650-675°C. The results showed that knives made of spring steel and heat treated in simulated condition at the laboratory obtained higher level of hardness, i.e. 62 HRC. In general, knives heat treated by local blacksmith had lower level of hardness that those obtained from simulated condition. Therefore, we concluded that the traditional knife quality in term of hardness can be improved by optimizing the heat treatment schedule.

Endovascular embolization for the management of inferior alveolar artery bleeding after a third molar extraction: A case report.

PubMed

Bianchi, Bernardo; Varazzani, Anea; Ferri, Anea; Menozzi, Roberto; Sesenna, Enrico

2016-03-01

Removal of third molars is a common surgical procedure with low complication rates. Localized alveolar osteitis, infection, bleeding, and paresthesia are the four most common postoperative complications of third molar extraction reported in the literature. Postoperative severe hemorrhages are rare and are usually related to inferior alveolar artery damage. Although most bleeding is usually managed effectively by local compression or packing of the socket, even life-threatening complications may occur. Endovascular embolization has been rarely reported as treatment for such a complication and represents an ideal solution, with a low complication rate and excellent control of bleeding. The authors report a case of potentially life-threatening hemorrhage continuing 4 days after extraction of the mandibular right third molar, resulting in significant anemia (Hb 6.6 g/dL) and treated successfully with endovascular embolization of the inferior alveolar artery. The authors consider it important for general practitioners to know this treatment and how to manage this rare complication in the correct way, saving time if satisfactory hemostasis cannot be reached with common procedures.

Colostomy in neonates under local anaesthesia: indications, technique and outcome.

PubMed

Lukong, Christopher Suiye; Jabo, Basheer Abdullahi; Mfuh, Anita Yafeh

2012-01-01

Colostomy is a resuscitative procedure in paediatric surgical practice. In critical patients, mortality may be high, if general anaesthesia is used. Local anaesthesia may be an alternative in this group of neonates. The aim of this article was to evaluate the indications, the technique and outcome of colostomy in neonates under local anaesthesia. A prospective analysis of 38 neonates who had colostomy under local anaesthesia, from July 2008 to September 2011, in our centre. There were 34 boys and 4 girls. The median age was 4 days (range 2-11 days),and all presented in a critical state. The indication for colostomy was anorectal malformation 37 (97.4%) and colonic atresia 1 (2.6%). COLOSTOMY: sigmoid 7 (18.4%), descending 29 (76.3%), transverse 2 (5.3%). The median duration of the procedure was 45 minutes (range 30-60 minutes). The hospital stay was 7-15 days (median 7 days) and cost of treatment 7000-7500 Naira (median 7500 Naira = $50). There were 5 (13.2%) early complications, namely, skin excoriation 2, superficial site infection 2, and bowel evisceration 1; mortality was 2 (5.3%). The late complications were stomal stenosis 1 (2.6%), colostomy diarrhoea 2 (5.3%), and parastomal hernia 2 (5.3%). 25 (65.7%) had colostomy takedown and 13 (34%) were yet to have colostomy takedown. Follow-up was for 1-2 years. None of the patients had a permanent colostomy. Colostomy in neonates under local anaesthesia is feasible, safe and cost-effective. The outcome is good and may be used when neonatal anaesthetic expertise and intensive care facilities are lacking.

40 CFR 47.130 - Performance of grant.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and additional funding may be awarded for continuations. (c) Procurement procedures, which are found in 40 CFR part 33 for all recipients other than State and local governments. Procurement procedures for State and local governments are described in 40 CFR part 31. These procedures include provisions...

Generalized non-local surface susceptibility model and Fresnel coefficients for the characterization of periodic metafilms with bianisotropic scatterers

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

Dimitriadis, Alexandros I., E-mail: aldimitr@ee.auth.gr; Kantartzis, Nikolaos V., E-mail: kant@auth.gr; Tsiboukis, Theodoros D., E-mail: tsibukis@auth.gr

2015-01-15

Highlights: •Formulas for E/M fields radiated by continuous surface polarization distributions. •Non-local effective surface susceptibility model for periodic metafilms. •Generalized reflection and transmission coefficients for an arbitrary metafilm. •Successful treatment of non-planar scatterer arrays and spatial dispersion effects. -- Abstract: A non-local surface susceptibility model for the consistent description of periodic metafilms formed by arbitrarily-shaped, electrically-small, bianisotropic scatterers is developed in this paper. The rigorous scheme is based on the point-dipole approximation technique and is valid for any polarization and propagation direction of an electromagnetic wave impinging upon the metafilm, unlike existing approaches whose applicability is practically confined to verymore » specific cases of incidence. Next, the universal form of the resulting surface susceptibility matrix is employed for the derivation of the generalized Fresnel coefficients for such surfaces, which enable the comprehensive interpretation of several significant, yet relatively unexamined, physical interactions. Essentially, these coefficients include eight distinct terms, corresponding to the co-polarized and cross-polarized reflection and transmission coefficients for the two orthogonal eigenpolarizations of a linearly-polarized incident plane wave. The above formulas are, then, utilized for the prediction of the scattering properties of metafilms with different planar and non-planar resonators, which are characterized via the featured model and two previously reported local ones. Their comparison with numerical simulation outcomes substantiates the merits of the proposed method, reveals important aspects of the underlying physics, and highlights the differences between the various modeling procedures.« less

Surgical Fires in Otolaryngology: A Systematic and Narrative Review.

PubMed

Day, Andrew T; Rivera, Erika; Farlow, Janice L; Gourin, Christine G; Nussenbaum, Brian

2018-04-01

Objective To bring attention to the epidemiology, prevention, management, and consequences of surgical fires in otolaryngology by reviewing the literature. Data Sources PubMed, EMBASE, Web of Science, and Scopus. Review Methods Comprehensive search terms were developed, and searches were performed from data source inception through August 2016. A total of 4506 articles were identified; 2351 duplicates were removed; and 2155 titles and abstracts were independently reviewed. Reference review was also performed. Eligible manuscripts described surgical fires involving patients undergoing otolaryngologic procedures. Results Seventy-two articles describing 87 otolaryngologic surgical fire cases were identified. These occurred during oral cavity or oropharyngeal procedures (11%), endoscopic laryngotracheal procedures (25%), tracheostomies (36%), "other" general anesthesia procedures (3%), and monitored anesthesia care or local procedures (24%). Oxidizing agents consisted of oxygen alone (n = 63 of 81, 78%), oxygen and nitric oxide (n = 17 of 81, 21%), and room air (n = 1 of 81, 1%). The fractional inspired oxygen delivered was >30% in 97% of surgical fires in non-nitrous oxide general anesthesia cases (n = 35 of 36). Laser-safe tubes were used in only 12% of endoscopic laryngotracheal cases with endotracheal tube descriptions (n = 2 of 17). Eighty-six percent of patients experienced acute complications (n = 76 of 87), including 1 intraoperative death, and 22% of patients (n = 17 of 77) experienced long-term complications. Conclusion Surgical fires in otolaryngology persist despite aggressive multi-institutional efforts to curb their incidence. Guideline recommendations to minimize the concentration of delivered oxygen and use laser-safe tubes when indicated were not observed in many cases. Improved institutional fire safety practices are needed nationally and internationally.

Utility of Indocyanine Green Fluorescence Imaging for Intraoperative Localization in Reoperative Parathyroid Surgery.

PubMed

Sound, Sara; Okoh, Alexis; Yigitbas, Hakan; Yazici, Pinar; Berber, Eren

2015-10-27

Due to the variations in anatomic location, the identification of parathyroid glands may be challenging. Although there have been advances in preoperative imaging modalities, there is still a need for an accurate intraoperative guidance. Indocyanine green (ICG) is a new agent that has been used for intraoperative fluorescence imaging in a number of general surgical procedures. Its utility for parathyroid localization in humans has not been reported in the literature. We report 3 patients who underwent reoperative neck surgery for primary hyperparathyroidism. Using a video-assisted technique with intraoperative ICG fluorescence imaging, the parathyroid glands were recognized and removed successfully in all cases. Surrounding soft tissue structures remained nonfluorescent, and could be distinguished from the parathyroid glands. This report suggests a potential utility of ICG imaging in intraoperative localization of parathyroid glands in reoperative neck surgery. Future work is necessary to assess its benefit for first-time parathyroid surgery. © The Author(s) 2015.

Cascading and local-field effects in non-linear optics revisited: a quantum-field picture based on exchange of photons.

PubMed

Bennett, Kochise; Mukamel, Shaul

2014-01-28

The semi-classical theory of radiation-matter coupling misses local-field effects that may alter the pulse time-ordering and cascading that leads to the generation of new signals. These are then introduced macroscopically by solving Maxwell's equations. This procedure is convenient and intuitive but ad hoc. We show that both effects emerge naturally by including coupling to quantum modes of the radiation field that are initially in the vacuum state to second order. This approach is systematic and suggests a more general class of corrections that only arise in a QED framework. In the semi-classical theory, which only includes classical field modes, the susceptibility of a collection of N non-interacting molecules is additive and scales as N. Second-order coupling to a vacuum mode generates an effective retarded interaction that leads to cascading and local field effects both of which scale as N(2).

Automatic finger joint synovitis localization in ultrasound images

NASA Astrophysics Data System (ADS)

Nurzynska, Karolina; Smolka, Bogdan

2016-04-01

A long-lasting inflammation of joints results between others in many arthritis diseases. When not cured, it may influence other organs and general patients' health. Therefore, early detection and running proper medical treatment are of big value. The patients' organs are scanned with high frequency acoustic waves, which enable visualization of interior body structures through an ultrasound sonography (USG) image. However, the procedure is standardized, different projections result in a variety of possible data, which should be analyzed in short period of time by a physician, who is using medical atlases as a guidance. This work introduces an efficient framework based on statistical approach to the finger joint USG image, which enables automatic localization of skin and bone regions, which are then used for localization of the finger joint synovitis area. The processing pipeline realizes the task in real-time and proves high accuracy when compared to annotation prepared by the expert.

Spatio-temporal control of gene expression and cancer treatment using magnetic resonance imaging-guided focused ultrasound.

PubMed

Moonen, Chrit T W

2007-06-15

Local temperature elevation may be used for tumor ablation, gene expression, drug activation, and gene and/or drug delivery. High-intensity focused ultrasound (HIFU) is the only clinically viable technology that can be used to achieve a local temperature increase deep inside the human body in a noninvasive way. Magnetic resonance imaging (MRI) guidance of the procedure allows in situ target definition and identification of nearby healthy tissue to be spared. In addition, MRI can be used to provide continuous temperature mapping during HIFU for spatial and temporal control of the heating procedure and prediction of the final lesion based on the received thermal dose. The primary purpose of the development of MRI-guided HIFU was to achieve safe noninvasive tissue ablation. The technique has been tested extensively in preclinical studies and is now accepted in the clinic for ablation of uterine fibroids. MRI-guided HIFU for ablation shows conceptual similarities with radiation therapy. However, thermal damage generally shows threshold-like behavior, with necrosis above the critical thermal dose and full recovery below. MRI-guided HIFU is being clinically evaluated in the cancer field. The technology also shows great promise for a variety of advanced therapeutic methods, such as gene therapy. MR-guided HIFU, together with the use of a temperature-sensitive promoter, provides local, physical, and spatio-temporal control of transgene expression. Specially designed contrast agents, together with the combined use of MRI and ultrasound, may be used for local gene and drug delivery.

Buckling Behavior of Compression-Loaded Composite Cylindrical Shells with Reinforced Cutouts

NASA Technical Reports Server (NTRS)

Hilburger, Mark W.; Starnes, James H., Jr.

2002-01-01

Results from a numerical study of the response of thin-wall compression-loaded quasi-isotropic laminated composite cylindrical shells with reinforced and unreinforced square cutouts are presented. The effects of cutout reinforcement orthotropy, size, and thickness on the nonlinear response of the shells are described. A high-fidelity nonlinear analysis procedure has been used to predict the nonlinear response of the shells. The analysis procedure includes a nonlinear static analysis that predicts stable response characteristics of the shells and a nonlinear transient analysis that predicts unstable dynamic buckling response characteristics. The results illustrate how a compression-loaded shell with an unreinforced cutout can exhibit a complex nonlinear response. In particular, a local buckling response occurs in the shell near the cutout and is caused by a complex nonlinear coupling between local shell-wall deformations and in-plane destabilizing compression stresses near the cutout. In general, the addition of reinforcement around a cutout in a compression-loaded shell can retard or eliminate the local buckling response near the cutout and increase the buckling load of the shell, as expected. However, results are presented that show how certain reinforcement configurations can actually cause an unexpected increase in the magnitude of local deformations and stresses in the shell and cause a reduction in the buckling load. Specific cases are presented that suggest that the orthotropy, thickness, and size of a cutout reinforcement in a shell can be tailored to achieve improved response characteristics.

The effective local potential method: Implementation for molecules and relation to approximate optimized effective potential techniques

NASA Astrophysics Data System (ADS)

Izmaylov, Artur F.; Staroverov, Viktor N.; Scuseria, Gustavo E.; Davidson, Ernest R.; Stoltz, Gabriel; Cancès, Eric

2007-02-01

We have recently formulated a new approach, named the effective local potential (ELP) method, for calculating local exchange-correlation potentials for orbital-dependent functionals based on minimizing the variance of the difference between a given nonlocal potential and its desired local counterpart [V. N. Staroverov et al., J. Chem. Phys. 125, 081104 (2006)]. Here we show that under a mildly simplifying assumption of frozen molecular orbitals, the equation defining the ELP has a unique analytic solution which is identical with the expression arising in the localized Hartree-Fock (LHF) and common energy denominator approximations (CEDA) to the optimized effective potential. The ELP procedure differs from the CEDA and LHF in that it yields the target potential as an expansion in auxiliary basis functions. We report extensive calculations of atomic and molecular properties using the frozen-orbital ELP method and its iterative generalization to prove that ELP results agree with the corresponding LHF and CEDA values, as they should. Finally, we make the case for extending the iterative frozen-orbital ELP method to full orbital relaxation.

Irreparable Radial Nerve Palsy Due to Delayed Diagnostic Management of a Giant Lipoma at the Proximal Forearm Resulting in a Triple Tendon Transfer Procedure: Case report and Brief Review of Literature

PubMed Central

Schmidt, Ingo

2017-01-01

Background: Non-traumatic radial nerve palsy (RNP) caused by local tumors is a rare and uncommon entity. Methods: A 62-year-old female presented with a left non-traumatic RNP, initially starting with weakness only. It was caused by a benign giant lipoma at the proximal forearm that was misdiagnosed over a period of 2 years. The slowly growth of the tumor led to an irreparable overstretching-related partial nerve disruption. For functional recovery of the patient, a triple tendon transfer procedure had to be performed. Results: Four months after surgery, the patient was completely able to perform her activities of daily living again. At the 10-months follow-up, strength of wrist extension, thumb's extension and abduction, and long fingers II-V extension had all improved to grade 4 in Medical Research Council scale (0-5). In order to restore motion, the patient reported that she would undergo the same triple tendon transfer procedure a second time where necessary. Due to the initially misdiagnosed tumor, there was an overall delayed duration of time for functional recovery of the patient. Conclusion: The triple tendon transfer procedure offers a useful and reliable method to restore functionality for patients sustaining irreparable RNP. However, it must be noted critically with our patient that this procedure probably would have been avoided. Initially, there was weakness only by entrapment of the radial nerve. RNP caused by local tumors are uncommon but known from the literature, and so it should be considered generally in differential diagnosis of non-traumatic RNP. PMID:28979592

Retrospective Evaluation of Dental Treatment under General Anaesthesia.

PubMed

Özkan, Ahmet Selim; Erdoğan, Mehmet Ali; Şanlı, Mukadder; Kaçmaz, Osman; Durmuş, Mahmut; Çolak, Cemil

2015-10-01

Most dental procedures can be performed with local anaesthesia, however noncompliant paediatric patients, patients with mental retardation or psychiatric disorders, severe anxiety, severe craniofacial anomalies and orofacial trauma may need general anaesthesia. In these patients accompanying central nervous system diseases and airway problems increase the risk of complications. Anaesthesia records of 467 cases of dental surgery performed under general anaesthesia between 2011-2014 is reported with information from the recent literature. In the study, 467 cases of dental procedures performed under general anaesthesia were taken from the İnönü University of Medicine, Dentistry Disabled Treatment Centre, after approval of the İnönü University Faculty of Medicine Ethics Committee. Demographic data, ASA classification, Mallampati (MP) score, duration of surgery, type of intubation and difficulties, comorbid diseases, premedication application, endocarditis prophylaxis, recovery time, analgesia and reasons for general anaesthesia were recorded as mean±standard deviation (SD) or as a number. The mean age of the patients was 16.78±12 years and the female/male ratio was 277/190 (59.3%/40.7%). Of the 467 patients, 219 (46.9%) were classified as ASA I, 234 (50.1%) as ASA II and 14 (3%) as ASA III. Furthermore, 182 (38.9%) patients with mental retardation, 33 (7.1%) with cerebral palsy and 28 (6%) with autism were identified. The mean operative time was 114.53±35.4 min, and the average recovery time 40.4±6 was min. Of the endotracheal intubations 277 (59.3%) were oral, 82 (17.6%) were nasal, and 108 (23.1%) were nasal with the help of fibreoptics. Difficult intubation was observed in 20 (4.3%) patients. The MP score was 1 in 397 (85%) patients, 2 in 50 (10.7%) patients, 3 in 18 (3.9%) patients and 4 in 2 (0.4%) patients. General anaesthesia was applied because of cooperation difficulties in 213 (45.6%), mental retardation in 182 (38.9%), autism in 28 (5.9%), schizophrenia in 7 (1.7%) and jaw surgery in 37 (7.9%) patients. Local infiltration was used for analgesia in 141 (30.2%), morphine in 12 (2.6%), tramadol in 3 (0.6%) and paracetamol in 311 (66.6%) patients. Endocarditis prophylaxis was employed in 36 (7.7%) cases. General anaesthesia in dental procedures is becoming increasingly common. Anaesthetic management is important due to the frequency of genetic syndromes and mental retardation. In the anaesthetic management of these patients, strategies for the patient should be identified, the process should be implemented in the operating room and preparations should be made with risk analyses.

Spectral Upscaling for Graph Laplacian Problems with Application to Reservoir Simulation

DOE PAGES

Barker, Andrew T.; Lee, Chak S.; Vassilevski, Panayot S.

2017-10-26

Here, we consider coarsening procedures for graph Laplacian problems written in a mixed saddle-point form. In that form, in addition to the original (vertex) degrees of freedom (dofs), we also have edge degrees of freedom. We extend previously developed aggregation-based coarsening procedures applied to both sets of dofs to now allow more than one coarse vertex dof per aggregate. Those dofs are selected as certain eigenvectors of local graph Laplacians associated with each aggregate. Additionally, we coarsen the edge dofs by using traces of the discrete gradients of the already constructed coarse vertex dofs. These traces are defined on themore » interface edges that connect any two adjacent aggregates. The overall procedure is a modification of the spectral upscaling procedure developed in for the mixed finite element discretization of diffusion type PDEs which has the important property of maintaining inf-sup stability on coarse levels and having provable approximation properties. We consider applications to partitioning a general graph and to a finite volume discretization interpreted as a graph Laplacian, developing consistent and accurate coarse-scale models of a fine-scale problem.« less

28 CFR 65.85 - Procedures for State or local governments applying for funding.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Procedures for State or local governments applying for funding. 65.85 Section 65.85 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.85 Procedures for State or...

28 CFR 65.85 - Procedures for State or local governments applying for funding.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Procedures for State or local governments applying for funding. 65.85 Section 65.85 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.85 Procedures for State or...

28 CFR 65.85 - Procedures for State or local governments applying for funding.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procedures for State or local governments applying for funding. 65.85 Section 65.85 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.85 Procedures for State or...

28 CFR 65.85 - Procedures for State or local governments applying for funding.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Procedures for State or local governments applying for funding. 65.85 Section 65.85 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.85 Procedures for State or...

28 CFR 65.85 - Procedures for State or local governments applying for funding.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Procedures for State or local governments applying for funding. 65.85 Section 65.85 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.85 Procedures for State or...

36 CFR 64.6 - Application procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Application procedures. State and local units of government applying for grants under this program will comply... Circulars 74-4 (Cost Principles Applicable to Grants and Contracts with State and Local Governments) and OMB Circular No. A-102 (Uniform Administrative Requirements for Grants-in-Aid to State and local governments...

36 CFR 64.6 - Application procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Application procedures. State and local units of government applying for grants under this program will comply... Circulars 74-4 (Cost Principles Applicable to Grants and Contracts with State and Local Governments) and OMB Circular No. A-102 (Uniform Administrative Requirements for Grants-in-Aid to State and local governments...

36 CFR 64.6 - Application procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Application procedures. State and local units of government applying for grants under this program will comply... Circulars 74-4 (Cost Principles Applicable to Grants and Contracts with State and Local Governments) and OMB Circular No. A-102 (Uniform Administrative Requirements for Grants-in-Aid to State and local governments...

36 CFR 64.6 - Application procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Application procedures. State and local units of government applying for grants under this program will comply... Circulars 74-4 (Cost Principles Applicable to Grants and Contracts with State and Local Governments) and OMB Circular No. A-102 (Uniform Administrative Requirements for Grants-in-Aid to State and local governments...

47 CFR 8.14 - General formal complaint procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false General formal complaint procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general pleading...

47 CFR 8.14 - General formal complaint procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false General formal complaint procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general pleading...

47 CFR 8.14 - General formal complaint procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false General formal complaint procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general pleading...

47 CFR 8.14 - General formal complaint procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false General formal complaint procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general pleading...

Perceptions of good medical practice in the NHS: a survey of senior health professionals.

PubMed

Hutchinson, A; Williams, M; Meadows, K; Barbour, R S; Jones, R

1999-12-01

To categorize senior health professionals' experience with poor medical practice in hospitals and in general practice, to describe perceptions which senior NHS staff have of good medical practice, and to describe how problems of poor medical practice are currently managed. A postal questionnaire survey. The questionnaire sought perceptions of good medical practice, asked participants to characterise deviations from good practice, and to describe experience with managing poor performance at the time of the introduction of the General Medical Council (GMC) performance procedures. A range of NHS settings in the UK: hospital trusts, health authorities/boards, local medical committees, community health councils. Senior health professionals involved in the management of medical professional performance. Perceptions of what constitutes good medical practice. Most respondents considered that persistent problems related to clinical practice (diagnosis, management, and outcome and prescribing) would require local management and, possibly, referral to the GMC performance procedures. Informal mechanisms, including informal discussion, education, training, and work shifting, were the most usual means of handling a doctor whose performance was poor. Many took a less serious view of deficiencies in performance on manner and attitude and communication, although consultation skills rather than technical skills comprised the greatest number of complaints about doctors. Senior NHS professionals seem reluctant to consider persistently poor consultation skills in the same critical light as they do persistently poor technical practice. These attitudes may need to change with the implementation of clinical governance and updated guidance from the GMC on what constitutes good medical practice.

4 CFR 28.9 - Procedures; general.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false Procedures; general. 28.9 Section 28.9 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL APPEALS BOARD; PROCEDURES APPLICABLE TO CLAIMS CONCERNING EMPLOYMENT PRACTICES AT THE GOVERNMENT ACCOUNTABILITY OFFICE...

32 CFR 516.77 - Procedures for exemption.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PUBLIC RELATIONS LITIGATION Soldiers Summoned To Serve on State and Local Juries § 516.77 Procedures for exemption. (a) Active duty soldiers served with a summons to serve on a state or local jury will promptly... responsible state or local officials whenever a soldier summoned for jury duty is exempt. The notification...

Design optimization of the sensor spatial arrangement in a direct magnetic field-based localization system for medical applications.

PubMed

Marechal, Luc; Shaohui Foong; Zhenglong Sun; Wood, Kristin L

2015-08-01

Motivated by the need for developing a neuronavigation system to improve efficacy of intracranial surgical procedures, a localization system using passive magnetic fields for real-time monitoring of the insertion process of an external ventricular drain (EVD) catheter is conceived and developed. This system operates on the principle of measuring the static magnetic field of a magnetic marker using an array of magnetic sensors. An artificial neural network (ANN) is directly used for solving the inverse problem of magnetic dipole localization for improved efficiency and precision. As the accuracy of localization system is highly dependent on the sensor spatial location, an optimization framework, based on understanding and classification of experimental sensor characteristics as well as prior knowledge of the general trajectory of the localization pathway, for design of such sensing assemblies is described and investigated in this paper. Both optimized and non-optimized sensor configurations were experimentally evaluated and results show superior performance from the optimized configuration. While the approach presented here utilizes ventriculostomy as an illustrative platform, it can be extended to other medical applications that require localization inside the body.

4 CFR 28.12 - General Counsel procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false General Counsel procedures. 28.12 Section 28.12 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL APPEALS BOARD; PROCEDURES APPLICABLE TO CLAIMS CONCERNING EMPLOYMENT PRACTICES AT THE GOVERNMENT ACCOUNTABILITY OFFICE...

32 CFR 1648.5 - Procedures during personal appearance before the local board.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Procedures during personal appearance before the... SELECTIVE SERVICE SYSTEM CLASSIFICATION BY LOCAL BOARD § 1648.5 Procedures during personal appearance before... personal appearances. Only those members of the board before whom the registrant appears shall classify him...

Focal cryotherapy: step by step technique description

PubMed Central

Redondo, Cristina; Srougi, Victor; da Costa, José Batista; Baghdad, Mohammed; Velilla, Guillermo; Nunes-Silva, Igor; Bergerat, Sebastien; Garcia-Barreras, Silvia; Rozet, François; Ingels, Alexandre; Galiano, Marc; Sanchez-Salas, Rafael; Barret, Eric; Cathelineau, Xavier

2017-01-01

ABSTRACT Introduction and objective: Focal cryotherapy emerged as an efficient option to treat favorable and localized prostate cancer (PCa). The purpose of this video is to describe the procedure step by step. Materials and methods: We present the case of a 68 year-old man with localized PCa in the anterior aspect of the prostate. Results: The procedure is performed under general anesthesia, with the patient in lithotomy position. Briefly, the equipment utilized includes the cryotherapy console coupled with an ultrasound system, argon and helium gas bottles, cryoprobes, temperature probes and an urethral warming catheter. The procedure starts with a real-time trans-rectal prostate ultrasound, which is used to outline the prostate, the urethra and the rectal wall. The cryoprobes are pretested and placed in to the prostate through the perineum, following a grid template, along with the temperature sensors under ultrasound guidance. A cystoscopy confirms the right positioning of the needles and the urethral warming catheter is installed. Thereafter, the freeze sequence with argon gas is started, achieving extremely low temperatures (-40°C) to induce tumor cell lysis. Sequentially, the thawing cycle is performed using helium gas. This process is repeated one time. Results among several series showed a biochemical disease-free survival between 71-93% at 9-70 month- follow-up, incontinence rates between 0-3.6% and erectile dysfunction between 0-42% (1–5). Conclusions: Focal cryotherapy is a feasible procedure to treat anterior PCa that may offer minimal morbidity, allowing good cancer control and better functional outcomes when compared to whole-gland treatment. PMID:28727387

Focal cryotherapy: step by step technique description.

PubMed

Redondo, Cristina; Srougi, Victor; da Costa, José Batista; Baghdad, Mohammed; Velilla, Guillermo; Nunes-Silva, Igor; Bergerat, Sebastien; Garcia-Barreras, Silvia; Rozet, François; Ingels, Alexandre; Galiano, Marc; Sanchez-Salas, Rafael; Barret, Eric; Cathelineau, Xavier

2017-01-01

Focal cryotherapy emerged as an efficient option to treat favorable and localized prostate cancer (PCa). The purpose of this video is to describe the procedure step by step. We present the case of a 68 year-old man with localized PCa in the anterior aspect of the prostate. The procedure is performed under general anesthesia, with the patient in lithotomy position. Briefly, the equipament utilized includes the cryotherapy console coupled with an ultrasound system, argon and helium gas bottles, cryoprobes, temperature probes and an urethral warming catheter. The procedure starts with a real-time trans-rectal prostate ultrasound, which is used to outline the prostate, the urethra and the rectal wall. The cryoprobes are pretested and placed in to the prostate through the perineum, following a grid template, along with the temperature sensors under ultrasound guidance. A cystoscopy confirms the right positioning of the needles and the urethral warming catheter is installed. Thereafter, the freeze sequence with argon gas is started, achieving extremely low temperatures (-40ºC) to induce tumor cell lysis. Sequentially, the thawing cycle is performed using helium gas. This process is repeated one time. Results among several series showed a biochemical disease-free survival between 71-93% at 9-70 month- follow-up, incontinence rates between 0-3.6% and erectile dysfunction between 0-42% (1-5). Focal cryotherapy is a feasible procedure to treat anterior PCa that may offer minimal morbidity, allowing good cancer control and better functional outcomes when compared to whole-gland treatment. Copyright® by the International Brazilian Journal of Urology.

Endovascular Repair of Contained Rupture of the Thoracic Aorta

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

Morgan, Robert; Loosemore, Tom; Belli, Anna-Maria

Purpose: To assess the efficacy of stent-grafts for the treatment of acute rupture of the thoracic aorta. Methods: Four patients with acute contained ruptures of the thoracic aorta were treated by insertion of stent-grafts. The underlying aortic lesions were aneurysm, acute aortic ulcer, acute type B dissection and giant cell aortitis. The procedures were performed under general anesthesia in three patients and local anesthesia in one patient. Results: All stent-grafts were successfully deployed. All patients survived the procedure and are now alive and well at follow-up (mean 6.3 months, range 44 days-16 months). One patient underwent a second stent proceduremore » 10 days after the first procedure because of a proximal endoleak. All hemothoraces have resolved. There were no complications. Conclusion:Treatment of acute contained ruptures of the thoracic aorta by the insertion of stent-grafts is feasible. The technical success rates,complication rates and patient survival compare favorably with emergency surgery.« less

Office-based Management of Recurrent Respiratory Papilloma.

PubMed

Motz, Kevin M; Hillel, Alexander T

2016-06-01

This review will highlight the indications and benefits of office-based therapy for recurrent respiratory papillomatosis (RRP) and discuss the utilization of photo-dynamic lasers and adjuvant medical therapy in office-based settings. Office-based management of RRP allows for more timely interventions, is preferred by the majority of patients, and negates the risk of general anesthesia. Current literature argues for the utilization of KTP laser over CO 2 laser for office-based treatment of RRP. Medical therapies for RRP are limited, but agents such as bevacizumab are promising and have been shown to reduce disease burden. Medical therapies that can induce disease remission are still needed. Office-based procedures save time and healthcare expenses compared to like procedures in the operating room. However, the increased frequency for office-based procedures predicts similar overall healthcare costs for office-based and OR laser excision of RRP. Office-based management of RRP is a feasible and well-tolerated strategy in appropriately selected patients with adequate local anesthesia.

Vocal local versus pharmacological treatments for pain management in tubal ligation procedures in rural Kenya: a non-inferiority trial.

PubMed

Keogh, Sarah C; Fry, Kenzo; Mbugua, Edwin; Ayallo, Mark; Quinn, Heidi; Otieno, George; Ngo, Thoai D

2014-02-04

Vocal local (VL) is a non-pharmacological pain management technique for gynecological procedures. In Africa, it is usually used in combination with pharmacological analgesics. However, analgesics are associated with side-effects, and can be costly and subject to frequent stock-outs, particularly in remote rural settings. We compared the effectiveness of VL + local anesthesia + analgesics (the standard approach), versus VL + local anesthesia without analgesics, on pain and satisfaction levels for women undergoing tubal ligations in rural Kenya. We conducted a site-randomised non-inferiority trial of 884 women receiving TLs from 40 Marie Stopes mobile outreach sites in Kisii and Machakos Districts. Twenty sites provided VL + local anesthesia + analgesics (control), while 20 offered VL + local anesthesia without additional analgesics (intervention). Pain was measured using a validated 11-point Numeric Rating Scale; satisfaction was measured using 11-point scales. A total of 461 women underwent tubal ligations with VL + local anesthesia, while 423 received tubal ligations with VL + local anesthesia + analgesics. The majority were aged ≥30 years (78%), and had >3 children (99%). In a multivariate analysis, pain during the procedure was not significantly different between the two groups. The pain score after the procedure was significantly lower in the intervention group versus the control group (by 0.40 points; p = 0.041). Satisfaction scores were equally high in both groups; 96% would recommend the procedure to a friend. VL + local anesthesia is as effective as VL + local anesthesia + analgesics for pain management during tubal ligation in rural Kenya. Avoiding analgesics is associated with numerous benefits including cost savings and fewer issues related to the maintenance, procurement and monitoring of restricted opioid drugs, particularly in remote low-resource settings where these systems are weak. Pan-African Clinical Trials Registry PACTR201304000495942.

Variational tricomplex of a local gauge system, Lagrange structure and weak Poisson bracket

NASA Astrophysics Data System (ADS)

Sharapov, A. A.

2015-09-01

We introduce the concept of a variational tricomplex, which is applicable both to variational and nonvariational gauge systems. Assigning this tricomplex with an appropriate symplectic structure and a Cauchy foliation, we establish a general correspondence between the Lagrangian and Hamiltonian pictures of one and the same (not necessarily variational) dynamics. In practical terms, this correspondence allows one to construct the generating functional of a weak Poisson structure starting from that of a Lagrange structure. As a byproduct, a covariant procedure is proposed for deriving the classical BRST charge of the BFV formalism by a given BV master action. The general approach is illustrated by the examples of Maxwell’s electrodynamics and chiral bosons in two dimensions.

Relationship of procedural numbers with meaningful procedural autonomy in general surgery residents.

PubMed

Stride, Herbert P; George, Brian C; Williams, Reed G; Bohnen, Jordan D; Eaton, Megan J; Schuller, Mary C; Zhao, Lihui; Yang, Amy; Meyerson, Shari L; Scully, Rebecca; Dunnington, Gary L; Torbeck, Laura; Mullen, John T; Mandell, Samuel P; Choti, Michael; Foley, Eugene; Are, Chandrakanth; Auyang, Edward; Chipman, Jeffrey; Choi, Jennifer; Meier, Andreas; Smink, Douglas; Terhune, Kyla P; Wise, Paul; DaRosa, Debra; Soper, Nathaniel; Zwischenberger, Jay B; Lillemoe, Keith; Fryer, Jonathan P

2018-03-01

Concerns exist regarding the competency of general surgery graduates with performing core general surgery procedures. Current competence assessment incorporates minimal procedural numbers requirements. Based on the Zwisch scale we evaluated the level of autonomy achieved by categorical PGY1-5 general surgery residents at 14 U.S. general surgery resident training programs between September 1, 2015 and December 31, 2016. With 5 of the most commonly performed core general surgery procedures, we correlated the level of autonomy achieved by each resident with the number of procedures they had performed before the evaluation period, with the intent of identifying specific target numbers that would correlate with the achievement of meaningful autonomy for each procedure with most residents. Whereas a definitive target number was identified for laparoscopic appendectomy (i.e. 25), for the other 4 procedures studied (i.e. laparoscopic cholecystectomy, 52; open inguinal hernia repair, 42; ventral hernia repair, 35; and partial colectomy, 60), target numbers identified were less definitive and/or were higher than many residents will experience during their surgical residency training. We conclude that procedural target numbers are generally not effective in predicting procedural competence and should not be used as the basis for determining residents' readiness for independent practice. Copyright © 2017. Published by Elsevier Inc.

29 CFR 1926.1406 - Assembly/Disassembly-employer procedures-general requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 8 2012-07-01 2012-07-01 false Assembly/Disassembly-employer procedures-general... CONSTRUCTION Cranes and Derricks in Construction § 1926.1406 Assembly/Disassembly—employer procedures—general requirements. (a) When using employer procedures instead of manufacturer procedures for assembly/disassembly...

29 CFR 1926.1406 - Assembly/Disassembly-employer procedures-general requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 8 2014-07-01 2014-07-01 false Assembly/Disassembly-employer procedures-general... CONSTRUCTION Cranes and Derricks in Construction § 1926.1406 Assembly/Disassembly—employer procedures—general requirements. (a) When using employer procedures instead of manufacturer procedures for assembly/disassembly...

29 CFR 1926.1406 - Assembly/Disassembly-employer procedures-general requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 8 2013-07-01 2013-07-01 false Assembly/Disassembly-employer procedures-general... CONSTRUCTION Cranes and Derricks in Construction § 1926.1406 Assembly/Disassembly—employer procedures—general requirements. (a) When using employer procedures instead of manufacturer procedures for assembly/disassembly...

29 CFR 1926.1406 - Assembly/Disassembly-employer procedures-general requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 8 2011-07-01 2011-07-01 false Assembly/Disassembly-employer procedures-general... CONSTRUCTION Cranes and Derricks in Construction § 1926.1406 Assembly/Disassembly—employer procedures—general requirements. (a) When using employer procedures instead of manufacturer procedures for assembly/disassembly...

Business plan to establish a CT colonography service.

PubMed

Fajardo, Laurie L; Hurley, James P; Brown, Bruce P; Summers, Robert W; McDaniel, R Donald

2006-03-01

The authors describe the University of Iowa Department of Radiology's business planning process to initiate a new service in computed tomographic colonography (CTC). Also known as virtual colonoscopy, CTC is a noninvasive technology that offers less risk, and potentially similar sensitivity and specificity, than conventional optical colonoscopy (OC). Although not currently covered by all insurance payers, about a year ago, the Centers for Medicare and Medicaid Services instituted temporary Current Procedural Terminology codes (Category III) for CTC. In locales where the procedure is not covered by insurers, it is likely to be sought by patients willing to pay out of pocket to undergo noninvasive cancer screening as an alternative to OC. Thus, CTC could become the preferred method of colon cancer surveillance by insurance providers in the near future. In developing the business plan, the authors reviewed pertinent scientific and clinical data to evaluate the need for and efficacy of CTC. Local market data were used to estimate patient and procedure volumes and utilization. The authors modeled financial expectations with respect to return on investment on the basis of recently reported models specific to CTC, resource requirements, and the operational impact of the new service on existing hospital and departmental clinical functions. Because there are few local providers of CTC in the authors' region, the business plan also included a publicity campaign and plan to market the new service, stimulate general public interest early, and differentiate the program as a leader in applying this unique new technology to promote cancer screening. Finally, the planning committee acknowledged and accommodated needs specific to the missions of an academic medical center with respect to research and education in designing the new service.

Office-based treatment of glottal dysplasia and papillomatosis with the 585-nm pulsed dye laser and local anesthesia.

PubMed

Zeitels, Steven M; Franco, Ramon A; Dailey, Seth H; Burns, James A; Hillman, Robert E; Anderson, R Rox

2004-04-01

Treatment of glottal papillomatosis and dysplasia was mirror-guided and performed in surgeons' offices in the 19th century. It migrated to the operating room in the 20th century to accommodate direct laryngoscopic surgery, which required assistants to administer anesthesia and procedural support. Presently, the primary treatment goals, which are disease regression and voice restoration or maintenance, are tempered by the morbidity of general anesthesia and potential treatment-induced vocal deterioration. In fact, general anesthesia has been appropriately considered to be an acceptable source of morbidity for the promise of a precise procedure, which usually ensures airway safety and an optimal vocal outcome. However, patients with recurrent glottal papillomatosis and keratosis with dysplasia are typically monitored with various degrees of watchful waiting until there is a subjective judgment (on the part of the patient and surgeon) that the disease is more of a liability than is the procedure to treat it. Innovations in the 585-nm pulsed dye laser delivery system have allowed for its use in the clinic with local anesthesia through the working channel of a flexible fiberoptic laryngoscope. A prospective assessment was done on 51 patients in 82 cases of recurrent glottal papillomatosis (30) and dysplasia (52). All individuals had previously undergone microlaryngoscopic management with histopathologic evaluation. Five procedures could not be completed because of impaired exposure (2) or discomfort (3). Of those patients who could be treated, there was at least a 50% disease involution in 68 of 77 cases (88%) and 25% to 50% disease regression in the remaining 9 (12%). Patient self-assessment of the voice revealed that 34 of 77 were improved, 39 were unchanged, 4 were slightly worse, and none were substantially worse. These data confirm that diseased mucosa can be normalized without resection or substantial loss of vocal function. The putative mechanisms, which vary according to the fluence (energy) delivered by the laser, are photoangiolysis of sublesional microcirculation. denaturing of epithelial basement membrane linking proteins, and cellular destruction. Furthermore, this relatively safe, effective technique allowed for treatment of many patients (in a clinic setting) in whom classic surgery-related morbidity would have often delayed intervention.

On the description of conical intersections—A continuous representation of the local topography of seams of conical intersection of three or more electronic states: A generalization of the two state result

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

Zhu, Xiaolei, E-mail: virtualzx@gmail.com; Yarkony, David R., E-mail: yarkony@jhu.edu

2014-11-07

For conical intersections of two states (I,J = I + 1) the vectors defining the branching or g-h plane, the energy difference gradient vector g{sup I,J}, and the interstate coupling vector h{sup I,J}, can be made orthogonal by a one parameter rotation of the degenerate electronic eigenstates. The representation obtained from this rotation is used to construct the parameters that describe the vicinity of the conical intersection seam, the conical parameters, s{sup I,J}{sub x} (R), s{sup I,J}{sub y} (R), g{sup I,J}(R), and h{sup I,J}(R). As a result of the orthogonalization these parameters can be made continuous functions of R, themore » internuclear coordinates. In this work we generalize this notion to construct continuous parametrizations of conical intersection seams of three or more states. The generalization derives from a recently introduced procedure for using non-degenerate electronic states to construct coupled diabatic states that represent adiabatic states coupled by conical intersections. The procedure is illustrated using the seam of conical intersections of three states in parazolyl as an example.« less

Mediterranean Cyclones in a changing climate. First statistical results

NASA Astrophysics Data System (ADS)

Tous, M.; Genoves, A.; Campins, J.; Picornell, M. A.; Jansa, A.; Mizuta, R.

2009-09-01

The Mediterranean storms play an important role in weather and climate. Their influence in determining the local weather is known; heavy precipitation systems and strong wind cases are often related to the presence of a cyclone in the Mediterranean. From a large-scale point of view, the Mediterranean storm track has importance in the vertical and horizontal transfers of heat and water vapour towards the Eastern regions. For all of these reasons, any future change related to the intensity, frequency or tracks of these storms can be important for both the local weather and local climate, at least, in the countries around the basin. The Mediterranean cyclones constitute a study subject of increasing interest. Some climatologies from long series of re-analyses, like ERA15, NCEP/NCAR and ERA40, or from operational and high resolution analysis systems, like HIRLAM_INM and ECMWF, have allowed to define the main characteristics of these storms. Generally speaking, the Mediterranean storms have the characteristics of extratropical storms, showing smaller sizes and shorter life cycles than those ones developed in other maritime areas of the world. Moreover, the influence of the land areas and high mountains around the basin and the large-scale heat releases have been revealed as key factors for understanding their genesis and rates of development. In spite of the fact that probably the existing automatic procedures include some large scale assumptions, which may not the best for the correct detection and tracking the Mediterranean storms, these procedures can provide a first and almost necessary step, from a statistical/climatological point of view, specially taking into account both the current resolution of the existent global re-analysis series and global climatic models and the state-of-the art about Mediterranean cyclones. A cyclone detection and tracking procedure, originally designed for the description of Mediterranean storms, has been applied to the low resolution (1.5 degrees lat-lon) outputs of the JMA-GSM climate general circulation model. Preliminary results are here presented. Two different periods have been analysed. The first period, covering 1979-2002 has been compared with the previously computed ERA-40 climatology of cyclones. Results agree reasonably well with those obtained from ERA-40, providing confidence to the current climate simulation of JMA-GSM. Once validated the model from the perspective of cyclonic climatology under current climate conditions, the same procedure is applied to a scenario period (2075-2099) to investigate possible changes in cyclonic activity linked to climate change.

10 CFR 1021.300 - General requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false General requirements. 1021.300 Section 1021.300 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NATIONAL ENVIRONMENTAL POLICY ACT IMPLEMENTING PROCEDURES Implementing Procedures § 1021.300 General requirements. (a) DOE shall determine, under the procedures in the...

Refractive index of B1-xGaxN semiconductors

NASA Astrophysics Data System (ADS)

Vyas, P. S.; Baria, J. K.; Jivani, A. R.; Gajjar, P. N.; Jani, A. R.

2013-06-01

A theoretical procedure is presented for the study of refractive index of ternary alloy B1-xGaxN. The calculations based on the pseudopotential formalism in which local potential coupled with the virtual crystal approximation (VCA) is applied to evaluate energy band gap at point X on the Jones-zone face, refractive index for the entire range of the alloy composition x of the ternary alloy B1-xGaxN. To include exchange and correlation effects, local field correction function due to Nagy is employed. Our results for parent compounds are compared to experiment and other available theoretical findings and showed generally good agreement. During present study it is found that the refractive index of the ternary alloy B1-xGaxN has minimum value at gallium concentration x = 0.4.

General rigid motion correction for computed tomography imaging based on locally linear embedding

NASA Astrophysics Data System (ADS)

Chen, Mianyi; He, Peng; Feng, Peng; Liu, Baodong; Yang, Qingsong; Wei, Biao; Wang, Ge

2018-02-01

The patient motion can damage the quality of computed tomography images, which are typically acquired in cone-beam geometry. The rigid patient motion is characterized by six geometric parameters and are more challenging to correct than in fan-beam geometry. We extend our previous rigid patient motion correction method based on the principle of locally linear embedding (LLE) from fan-beam to cone-beam geometry and accelerate the computational procedure with the graphics processing unit (GPU)-based all scale tomographic reconstruction Antwerp toolbox. The major merit of our method is that we need neither fiducial markers nor motion-tracking devices. The numerical and experimental studies show that the LLE-based patient motion correction is capable of calibrating the six parameters of the patient motion simultaneously, reducing patient motion artifacts significantly.

Local Education Agency Planning Analyst's Procedures. A Vocational Education Planning System for Local School Districts. Volume III.

ERIC Educational Resources Information Center

Goldman, Charles I.

The manual is part of a series to assist in planning procedures for local and State vocational agencies. It details steps required to process a local education agency's data after the data have been coded onto keypunch forms. Program, course, and overhead data are input into a computer data base and error checks are performed. A computer model is…

Requests for electroencephalography in a district general hospital: retrospective and prospective audit

PubMed Central

Smith, D; Bartolo, R; Pickles, R M; Tedman, B M

2001-01-01

Objectives To determine the number of inappropriate requests for electroencephalography (EEG) and whether guidelines on use could reduce this number. Design Audit with retrospective and prospective components. Setting EEG department in district general hospital and centre for neurology and neurosurgery. Participants Retrospective: 368 at the general hospital and 143 patients at the neurology centre. Prospective: 241 patients undergoing EEG at the general hospital. Interventions Guidelines for EEG issued to users of service at the general hospital. Outcomes Retrospective: differences in requesting practice, result in different clinical scenarios, relative roles of procedure, clinical acumen in establishing diagnosis, usefulness of procedure. Prospective: change of requesting practice, impact on use. Results There were considerable differences in requesting practice. Non-specialists seem to use EEG as a diagnostic tool, especially in patients with “funny turns,” when it is much more likely to yield potentially misleading than clinically useful information. The overall proportion of procedures considered to influence management, to be justifiable, and to be inappropriate were 16% (59), 28.3% (104), and 55.7% (205), respectively. In the prospective study the total number of requests was significantly reduced (χ2=33.85, df=5, P<0.0001), mainly because of fewer requests in patients with non-specific “funny turns” (χ2=21.90, df=6, P=0.0013). There was a concomitant change in the usefulness of EEG (χ2 =26.99, df=2, P<0.0001). Conclusions This original audit informed clinical practice and had potential benefits for patients, clinicians, and provision of service. Systematic replication of this project, possibly on a regional basis, could result in financial savings, which would allow development of accessible local neurophysiology services. What is already known on this topicThere is unrestricted access to EEG in most district general hospitals throughout the United KingdomThe combination of equivocal symptoms and non-specific abnormalities carries a risk of misdiagnosis of epilepsyWhat this study addsAn audit of requests for EEG showed that a large proportion were inappropriate, mainly because of the prevalent misconception that the procedure could prove or exclude a diagnosis of epilepsy in patients with “funny turns”After intervention with clinicians, which used an educative approach, there was a considerable and sustained change in requesting practice PMID:11312226

Globalization and its discontents: challenges to developmental theory and practice in Africa.

PubMed

Super, Charles M; Harkness, Sara

2008-04-01

The three contributions to this Special Section on Culture and Human Development are summarized and critiqued. In considering the nature of contemporary psychological science, as well as applications to early childhood care and development, education to prevent HIV/AIDS, and formal academic education, the various authors are in general agreement on the limitations of current knowledge as it applies to African populations. There is also a common focus on the promise of scientific procedures that take seriously the importance of local understandings, institutions, and social settings.

Nonisothermal fluctuating hydrodynamics and Brownian motion

NASA Astrophysics Data System (ADS)

Falasco, G.; Kroy, K.

2016-03-01

The classical theory of Brownian dynamics follows from coarse graining the underlying linearized fluctuating hydrodynamics of the solvent. We extend this procedure to globally nonisothermal conditions, requiring only a local thermal equilibration of the solvent. Starting from the conservation laws, we establish the stochastic equations of motion for the fluid momentum fluctuations in the presence of a suspended Brownian particle. These are then contracted to the nonisothermal generalized Langevin description of the suspended particle alone, for which the coupling to stochastic temperature fluctuations is found to be negligible under typical experimental conditions.

7 CFR 245.7 - Hearing procedure for families and local educational agencies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REDUCED PRICE MEALS AND FREE MILK IN SCHOOLS § 245.7 Hearing procedure for families and local educational... agency with respect to an application the family has made for free or reduced price meals or for free... free or reduced price meal or for free milk. The hearing procedure shall provide for both the family...

7 CFR 245.7 - Hearing procedure for families and local educational agencies.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REDUCED PRICE MEALS AND FREE MILK IN SCHOOLS § 245.7 Hearing procedure for families and local educational... agency with respect to an application the family has made for free or reduced price meals or for free... free or reduced price meal or for free milk. The hearing procedure shall provide for both the family...

20 CFR 667.600 - What local area, State and direct recipient grievance procedures must be established?

Code of Federal Regulations, 2010 CFR

2010-04-01

... INVESTMENT ACT Grievance Procedures, Complaints, and State Appeals Processes § 667.600 What local area, State... awards Title I funds must provide the information referred to in paragraph (b)(1) of this section to... violation to submit the grievance to a binding arbitration procedure, if a collective bargaining agreement...

20 CFR 667.600 - What local area, State and direct recipient grievance procedures must be established?

Code of Federal Regulations, 2011 CFR

2011-04-01

... INVESTMENT ACT Grievance Procedures, Complaints, and State Appeals Processes § 667.600 What local area, State... awards Title I funds must provide the information referred to in paragraph (b)(1) of this section to... violation to submit the grievance to a binding arbitration procedure, if a collective bargaining agreement...

The effect on outcome of peribulbar anaesthesia in conjunction with general anesthesia for vitreoretinal surgery.

PubMed

Ghali, A M; El Btarny, A M

2010-03-01

The purpose of this study was to evaluate peri-operative outcome after vitreoretinal surgery when peribulbar anaesthesia is combined with general anaesthesia. Sixty adult patients undergoing elective primary retinal detachment surgery with scleral buckling or an encircling procedure received either peribulbar anaesthesia in conjunction with general anaesthesia or general anaesthesia alone. For peribulbar anaesthesia a single percutaneous injection of 5-7 ml of local anaesthetic solution (0.75% ropivacaine with hyaluronidase 15 iu.ml(-1)) was used. The incidence of intra-operative oculocardiac reflex and surgical bleeding interfering with the surgical field, postoperative pain and analgesia requirements, and postoperative nausea and vomiting were recorded. In the block group there was a lower incidence of oculocardiac reflex and surgical bleeding intra-operatively. Patients in the block group also had better postoperative analgesia and a lower incidence of postoperative nausea and vomiting compared with the group without a block. The use of peribulbar anaesthesia in conjunction with general anesthesia was superior to general anaesthesia alone for vitreoretinal surgery with scleral buckling.

Predictive procedure for compensatory hyperhidrosis before sympathectomy: preliminary findings.

PubMed

Jeong, Jin Yong; Park, Hyung Joo; Park, Jae Kil; Jo, Keon Hyeon; Wang, Young Pil; Lee, Jongho; Shin, Jae Seong

2014-08-01

Compensatory hyperhidrosis is one of the most common and serious adverse effects following sympathectomy. We performed a local anesthetic procedure that predicts the occurrence and severity of compensatory hyperhidrosis, and evaluated the feasibility, safety, and efficacy of the procedure. From July 2009 to July 2010, 20 patients with severe primary palmar hyperhidrosis underwent predictive procedures. A sympathetic nerve block was obtained via thoracoscopic approach under local anesthesia. The patients were evaluated for compensatory hyperhidrosis 1 week after the procedure before deciding whether to proceed with sympathectomy. Of the 20 patients, 17 patients proceeded with sympathectomy and 3 refused the final procedure. Following sympathectomy, the occurrence and severity of compensatory hyperhidrosis in the remaining 17 patients were statistically analyzed with two tailed paired t test, and there is no significant difference between the predictive and final procedures (t = 1.69, df = 16, p > 0.1). Predictive procedure using local anesthesia to detect compensatory hyperhidrosis before sympathectomy may be useful for helping patients to decide whether to undergo the operation. Georg Thieme Verlag KG Stuttgart · New York.

Multi-Objective Community Detection Based on Memetic Algorithm

PubMed Central

2015-01-01

Community detection has drawn a lot of attention as it can provide invaluable help in understanding the function and visualizing the structure of networks. Since single objective optimization methods have intrinsic drawbacks to identifying multiple significant community structures, some methods formulate the community detection as multi-objective problems and adopt population-based evolutionary algorithms to obtain multiple community structures. Evolutionary algorithms have strong global search ability, but have difficulty in locating local optima efficiently. In this study, in order to identify multiple significant community structures more effectively, a multi-objective memetic algorithm for community detection is proposed by combining multi-objective evolutionary algorithm with a local search procedure. The local search procedure is designed by addressing three issues. Firstly, nondominated solutions generated by evolutionary operations and solutions in dominant population are set as initial individuals for local search procedure. Then, a new direction vector named as pseudonormal vector is proposed to integrate two objective functions together to form a fitness function. Finally, a network specific local search strategy based on label propagation rule is expanded to search the local optimal solutions efficiently. The extensive experiments on both artificial and real-world networks evaluate the proposed method from three aspects. Firstly, experiments on influence of local search procedure demonstrate that the local search procedure can speed up the convergence to better partitions and make the algorithm more stable. Secondly, comparisons with a set of classic community detection methods illustrate the proposed method can find single partitions effectively. Finally, the method is applied to identify hierarchical structures of networks which are beneficial for analyzing networks in multi-resolution levels. PMID:25932646

Multi-objective community detection based on memetic algorithm.

PubMed

Wu, Peng; Pan, Li

2015-01-01

Community detection has drawn a lot of attention as it can provide invaluable help in understanding the function and visualizing the structure of networks. Since single objective optimization methods have intrinsic drawbacks to identifying multiple significant community structures, some methods formulate the community detection as multi-objective problems and adopt population-based evolutionary algorithms to obtain multiple community structures. Evolutionary algorithms have strong global search ability, but have difficulty in locating local optima efficiently. In this study, in order to identify multiple significant community structures more effectively, a multi-objective memetic algorithm for community detection is proposed by combining multi-objective evolutionary algorithm with a local search procedure. The local search procedure is designed by addressing three issues. Firstly, nondominated solutions generated by evolutionary operations and solutions in dominant population are set as initial individuals for local search procedure. Then, a new direction vector named as pseudonormal vector is proposed to integrate two objective functions together to form a fitness function. Finally, a network specific local search strategy based on label propagation rule is expanded to search the local optimal solutions efficiently. The extensive experiments on both artificial and real-world networks evaluate the proposed method from three aspects. Firstly, experiments on influence of local search procedure demonstrate that the local search procedure can speed up the convergence to better partitions and make the algorithm more stable. Secondly, comparisons with a set of classic community detection methods illustrate the proposed method can find single partitions effectively. Finally, the method is applied to identify hierarchical structures of networks which are beneficial for analyzing networks in multi-resolution levels.

A two-phase micromorphic model for compressible granular materials

NASA Astrophysics Data System (ADS)

Paolucci, Samuel; Li, Weiming; Powers, Joseph

2009-11-01

We introduce a new two-phase continuum model for compressible granular material based on micromorphic theory and treat it as a two-phase mixture with inner structure. By taking an appropriate number of moments of the local micro scale balance equations, the average phase balance equations result from a systematic averaging procedure. In addition to equations for mass, momentum and energy, the balance equations also include evolution equations for microinertia and microspin tensors. The latter equations combine to yield a general form of a compaction equation when the material is assumed to be isotropic. When non-linear and inertial effects are neglected, the generalized compaction equation reduces to that originally proposed by Bear and Nunziato. We use the generalized compaction equation to numerically model a mixture of granular high explosive and interstitial gas. One-dimensional shock tube and piston-driven solutions are presented and compared with experimental results and other known solutions.

21 CFR 25.15 - General procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false General procedures. 25.15 Section 25.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration § 25.15 General procedures. (a) All...

Inverse scattering transform analysis of rogue waves using local periodization procedure

NASA Astrophysics Data System (ADS)

Randoux, Stéphane; Suret, Pierre; El, Gennady

2016-07-01

The nonlinear Schrödinger equation (NLSE) stands out as the dispersive nonlinear partial differential equation that plays a prominent role in the modeling and understanding of the wave phenomena relevant to many fields of nonlinear physics. The question of random input problems in the one-dimensional and integrable NLSE enters within the framework of integrable turbulence, and the specific question of the formation of rogue waves (RWs) has been recently extensively studied in this context. The determination of exact analytic solutions of the focusing 1D-NLSE prototyping RW events of statistical relevance is now considered as the problem of central importance. Here we address this question from the perspective of the inverse scattering transform (IST) method that relies on the integrable nature of the wave equation. We develop a conceptually new approach to the RW classification in which appropriate, locally coherent structures are specifically isolated from a globally incoherent wave train to be subsequently analyzed by implementing a numerical IST procedure relying on a spatial periodization of the object under consideration. Using this approach we extend the existing classifications of the prototypes of RWs from standard breathers and their collisions to more general nonlinear modes characterized by their nonlinear spectra.

Inverse scattering transform analysis of rogue waves using local periodization procedure

PubMed Central

Randoux, Stéphane; Suret, Pierre; El, Gennady

2016-01-01

The nonlinear Schrödinger equation (NLSE) stands out as the dispersive nonlinear partial differential equation that plays a prominent role in the modeling and understanding of the wave phenomena relevant to many fields of nonlinear physics. The question of random input problems in the one-dimensional and integrable NLSE enters within the framework of integrable turbulence, and the specific question of the formation of rogue waves (RWs) has been recently extensively studied in this context. The determination of exact analytic solutions of the focusing 1D-NLSE prototyping RW events of statistical relevance is now considered as the problem of central importance. Here we address this question from the perspective of the inverse scattering transform (IST) method that relies on the integrable nature of the wave equation. We develop a conceptually new approach to the RW classification in which appropriate, locally coherent structures are specifically isolated from a globally incoherent wave train to be subsequently analyzed by implementing a numerical IST procedure relying on a spatial periodization of the object under consideration. Using this approach we extend the existing classifications of the prototypes of RWs from standard breathers and their collisions to more general nonlinear modes characterized by their nonlinear spectra. PMID:27385164

Structure Modulates Similarity-Based Interference in Sluicing: An Eye Tracking study

PubMed Central

Harris, Jesse A.

2015-01-01

In cue-based content-addressable approaches to memory, a target and its competitors are retrieved in parallel from memory via a fast, associative cue-matching procedure under a severely limited focus of attention. Such a parallel matching procedure could in principle ignore the serial order or hierarchical structure characteristic of linguistic relations. I present an eye tracking while reading experiment that investigates whether the sentential position of a potential antecedent modulates the strength of similarity-based interference, a well-studied effect in which increased similarity in features between a target and its competitors results in slower and less accurate retrieval overall. The manipulation trades on an independently established Locality bias in sluiced structures to associate a wh-remnant (which ones) in clausal ellipsis with the most local correlate (some wines), as in The tourists enjoyed some wines, but I don't know which ones. The findings generally support cue-based parsing models of sentence processing that are subject to similarity-based interference in retrieval, and provide additional support to the growing body of evidence that retrieval is sensitive to both the structural position of a target antecedent and its competitors, and the specificity or diagnosticity of retrieval cues. PMID:26733893

Is local anesthesia the optimum strategy in retrograde transcatheter aortic valve implantation? A systematic review and meta-analysis.

PubMed

O' Sullivan, Katie E; Bracken-Clarke, Darragh; Segurado, Ricardo; Barry, Mitchel; Sugrue, Declan; Flood, Georgina; Hurley, John

2014-09-01

Retrograde transcatheter aortic valve implantation (TAVI) can be performed under local anesthesia (LA) or general anesthesia (GA); however, a wide variation in practice exists. PubMed was searched between 2009 and 2013. Data were extracted from eligible studies. Random-effects meta-analysis was performed using DerSimonian Laird between-study variance. There was no statistically significant difference identified between groups based on age or EuroSCORE. There was no statistically significant difference seen in all-cause mortality, or complication rates between groups. Mean procedural duration was 36 minutes shorter in the LA group (p = 0.001). There was increased vasopressor use in the GA group (odds ratio 3.92; p = 0.017). Mean hospital stay was 3.41 days shorter in the LA group (p = 0.018). Results suggest that the use of LA for retrograde TAVI is feasible. There are several potential benefits associated, shorter procedural duration, and hospital stay with lower vasopressor requirements. Further studies and randomized trials are mandatory to confirm the presented findings and to identify those patients for whom LA would be appropriate. Georg Thieme Verlag KG Stuttgart · New York.

Rates of surgery for frozen shoulder: an experience in England.

PubMed

Kwaees, Tariq A; Charalambous, Charalambos P

2015-01-01

the aim of this study was to identify the incidence of surgical treatment for frozen shoulder in a western population. patients included in this study all resided within a well-defined area in the North West of England, all had surgery for frozen shoulder over a 3-year period and were identified from theatre logbooks of two local hospitals. Cases having surgery for shoulder stiffness other than frozen shoulder were excluded. Local and national population size estimates were based on data obtained from the UK Office for National Statistics. 117 patients underwent surgery for frozen shoulder during the period examined; of these 101 had arthroscopic arthrolysis and 16 had manipulation under anaesthesia. The overall incidence of frozen shoulder surgery was calculated at 2.67 procedures per 10,000 general population per year, and at 7.55 for those aged 40-60. surgical intervention for frozen shoulder is common, estimated at over 14,180 cases per year in England. Given the variation in costs associated with arthroscopic arthrolysis and manipulation under anaesthesia, comparative studies of the cost effectiveness of the two procedures would be of great value. 2C (outcome research).

Background of SAM atom-fraction profiles

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

Ernst, Frank

Atom-fraction profiles acquired by SAM (scanning Auger microprobe) have important applications, e.g. in the context of alloy surface engineering by infusion of carbon or nitrogen through the alloy surface. However, such profiles often exhibit an artifact in form of a background with a level that anti-correlates with the local atom fraction. This article presents a theory explaining this phenomenon as a consequence of the way in which random noise in the spectrum propagates into the discretized differentiated spectrum that is used for quantification. The resulting model of “energy channel statistics” leads to a useful semi-quantitative background reduction procedure, which ismore » validated by applying it to simulated data. Subsequently, the procedure is applied to an example of experimental SAM data. The analysis leads to conclusions regarding optimum experimental acquisition conditions. The proposed method of background reduction is based on general principles and should be useful for a broad variety of applications. - Highlights: • Atom-fraction–depth profiles of carbon measured by scanning Auger microprobe • Strong background, varies with local carbon concentration. • Needs correction e.g. for quantitative comparison with simulations • Quantitative theory explains background. • Provides background removal strategy and practical advice for acquisition.« less

[Nursing care in fluorescein angiography].

PubMed

Santos-Blanco, Feliciano

2008-01-01

Fluoresceinic angiography of the ocular fundus is a diagnostic technique to study retinal and choroidal circulation. This technique consists of parenteral administration of 500 mg of sodium fluorescein 10% and photographing the fluorescence in the eye vessels. Although this substance is fairly safe, it may also produce mild, moderate or severe local and/or general adverse reactions. The nursing process is routinely used in hospital units but not always in outpatient clinics, even through the use of invasive procedures with intravenous medication administration is common. Therefore, nurses, as those reponsible for intravenous administration, should use the nursing process to guarantee the quality of care required by the patient. To do this, we describe an individualized care plan based on evaluation by Marjorie Gordon's functional health patterns, NANDA's nursing diagnoses Taxonomy II, Nursing Outcomes Classification (NOC), Nursing Interventions Classifications (NIC) and potential complications of the procedure.

Anesthetic management of pediatric patients with Sturge-Weber syndrome: our experience and a review of the literature.

PubMed

Khanna, Puneet; Ray, Bikash Ranjan; Govindrajan, Srinivas Rhagvan; Sinha, Renu; Chandralekha; Talawar, Praveen

2015-12-01

Sturge-Weber syndrome (SWS) is a rare sporadic congenital neurocutaneous syndrome which is characterized by vascular malformation involving the brain, face and eye. The anesthetic management is complicated by its localized as well as systemic manifestations, associated anomalies and difficult airway due to the presence of angiomas of the oral cavity and airway. We retrospective analyzed the perioperative anesthetic management of children with SWS undergoing ophthalmic surgery and reviewed the literature. Medical records and anesthetic charts of all the children with SWS who had undergone an ophthalmic procedure under general anesthesia during the past 6 years were reviewed. Information related to the demographic profile, preoperative evaluation, anesthetic techniques, and perioperative complications were collected and analyzed. Forty children with SWS received general anesthesia for an ophthalmic procedure within the 6-year period. The median age of the children was 3 years. 30 (92.5%) children had facial port-wine staining, 10 (25%) had facial hypertrophy, 15 (37.5%) had a history of convulsion and 4 (10%) children had mental retardation. Inhalational induction was performed in 34 (85%) children (sevoflurane 82.8%). A laryngeal mask airway (LMA) and endotracheal tube were used in 32 (80%) and 5 (12.5%) cases, respectively. One patient had difficult mask ventilation and difficult LMA insertion. There was no significant problem in any of the other children. Preoperative evaluation with airway assessment should be performed with the knowledge of local and systemic manifestation of the syndrome. Proconvulsant and anticonvulsant properties of the anesthetics, as well as drug interactions of antiepileptic medications should be considered when planning anesthesia. Avoiding a rise in intracranial and intraocular pressures, vigilant intraoperative monitoring and postoperative care are the key for conducting safe anesthesia in these children. For ophthalmic procedures, LMAs can be used for airway maintenance with minimal complications in children with SWS.

Local Linear Regression for Data with AR Errors.

PubMed

Li, Runze; Li, Yan

2009-07-01

In many statistical applications, data are collected over time, and they are likely correlated. In this paper, we investigate how to incorporate the correlation information into the local linear regression. Under the assumption that the error process is an auto-regressive process, a new estimation procedure is proposed for the nonparametric regression by using local linear regression method and the profile least squares techniques. We further propose the SCAD penalized profile least squares method to determine the order of auto-regressive process. Extensive Monte Carlo simulation studies are conducted to examine the finite sample performance of the proposed procedure, and to compare the performance of the proposed procedures with the existing one. From our empirical studies, the newly proposed procedures can dramatically improve the accuracy of naive local linear regression with working-independent error structure. We illustrate the proposed methodology by an analysis of real data set.

Randomized clinical trial of local anesthetic versus a combination of local anesthetic with self-hypnosis in the management of pediatric procedure-related pain.

PubMed

Liossi, Christina; White, Paul; Hatira, Popi

2006-05-01

A prospective controlled trial was conducted to compare the efficacy of an analgesic cream (eutectic mixture of local anesthetics, or EMLA) with a combination of EMLA with hypnosis in the relief of lumbar puncture-induced pain and anxiety in 45 pediatric cancer patients (age 6-16 years). The study also explored whether young patients can be taught and can use hypnosis independently as well as whether the therapeutic benefit depends on hypnotizability. Patients were randomized to 1 of 3 groups: local anesthetic, local anesthetic plus hypnosis, and local anesthetic plus attention. Results confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety and less procedure-related pain and anxiety and that they were rated as demonstrating less behavioral distress during the procedure. The level of hypnotizability was significantly associated with the magnitude of treatment benefit, and this benefit was maintained when patients used hypnosis independently. 2006 APA, all rights reserved

A model for food and stimulus changes that signal time-based contingency changes.

PubMed

Cowie, Sarah; Davison, Michael; Elliffe, Douglas

2014-11-01

When the availability of reinforcers depends on time since an event, time functions as a discriminative stimulus. Behavioral control by elapsed time is generally weak, but may be enhanced by added stimuli that act as additional time markers. The present paper assessed the effect of brief and continuous added stimuli on control by time-based changes in the reinforcer differential, using a procedure in which the local reinforcer ratio reversed at a fixed time after the most recent reinforcer delivery. Local choice was enhanced by the presentation of the brief stimuli, even when the stimulus change signalled only elapsed time, but not the local reinforcer ratio. The effect of the brief stimulus presentations on choice decreased as a function of time since the most recent stimulus change. We compared the ability of several versions of a model of local choice to describe these data. The data were best described by a model which assumed that error in discriminating the local reinforcer ratio arose from imprecise discrimination of reinforcers in both time and space, suggesting that timing behavior is controlled not only by discrimination elapsed time, but by discrimination of the reinforcer differential in time. © Society for the Experimental Analysis of Behavior.

Local Infiltration Analgesia for Postoperative Pain Control following Total Hip Arthroplasty: A Systematic Review

PubMed Central

McCarthy, Denise; Iohom, Gabriella

2012-01-01

Local infiltration analgesia (LIA) is an analgesic technique that has gained popularity since it was first brought to widespread attention by Kerr and Kohan in 2008. The technique involves the infiltration of a large volume dilute solution of a long-acting local anesthetic agent, often with adjuvants (e.g., epinephrine, ketorolac, an opioid), throughout the wound at the time of surgery. The analgesic effect duration can then be prolonged by the placement of a catheter to the surgical site for postoperative administration of further local anesthetic. The technique has been adopted for use for postoperative analgesia following a range of surgical procedures (orthopedic, general, gynecological, and breast surgeries). The primary objective of this paper was to determine, based on the current evidence, if LIA is superior when compared to no intervention, placebo, and alternative analgesic methods in patients following total hip arthroplasty, in terms of certain outcome measures. The outcomes considered were postoperative analgesia scores, joint function/rehabilitation, and length of hospital stay. Secondary objectives were to review available evidence and current knowledge regarding the pharmacokinetics of local anesthetic and adjuvant drugs when administered in this way and the occurrence of adverse events. PMID:22829813

Reliability and cost-effectiveness of complete lymph node dissection under tumescent local anaesthesia vs. general anaesthesia: a retrospective analysis in patients with malignant melanoma AJCC stage III.

PubMed

Stoffels, I; Dissemond, J; Schulz, A; Hillen, U; Schadendorf, D; Klode, J

2012-02-01

Complete lymph node dissection (CLND) in melanoma patients with a positive sentinel lymph node (SLN) is currently being debated, as it is a cost-intensive surgical intervention with potentially high morbidity. This clinical study seeks to clarify the effectiveness, reliability and cost-effectiveness of CLND performed under tumescent local anaesthesia (TLA) compared with procedures under general anaesthesia (GA). We retrospectively analysed the data from 60 patients with primary malignant melanoma American Joint Committee on Cancer stage III who underwent CLND. Altogether 26 (43.3%) patients underwent CLND under TLA and 34 (56.7%) patients underwent CLND under GA. Fifteen of 43 (34.9%) patients had a complication, such as development of seromas and/or wound infections. The rate of complications was 25.0% (3/12) in the axilla subgroup and 28.6% (4/14) in the groin subgroup of the TLA group. In the GA group, the complication rate was 31.3% (5/16) in the axilla subgroup and 44.4% (8/18) in the groin subgroup. The costs for CLND were significantly less for the CLND in a procedure room performed under TLA (mean €67.26) compared with CLND in an operating room under GA (mean €676.20, P < 0.0001). In conclusion, this study confirms that TLA is an excellent, safe, effective and cost-efficient alternative to GA for CLND in melanoma patients. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

Reliability and cost-effectiveness of sentinel lymph node excision under local anaesthesia versus general anaesthesia for malignant melanoma: a retrospective analysis in 300 patients with malignant melanoma AJCC Stages I and II.

PubMed

Stoffels, I; Dissemond, J; Körber, A; Hillen, U; Poeppel, T; Schadendorf, D; Klode, J

2011-03-01

Sentinel lymph node excision (SLNE) for the detection of regional nodal metastases and staging of malignant melanoma has resulted in some controversies in international discussions, as it is a cost-intensive surgical intervention with potentially significant morbidity. The present retrospective study seeks to clarify the effectiveness and reliability of SLNE performed under tumescent local anaesthesia (TLA) and whether SLNE performed under TLA can reduce costs and morbidity. Therefore, our study is a comparison of SLNE performed under TLA and general anaesthesia (GA). We retrospectively analysed data from 300 patients with primary malignant melanoma with a Breslow index of ≥1.0 mm. Altogether, 211 (70.3%) patients underwent SLNE under TLA and 89 (29.7%) patients underwent SLNE under GA. A total of 637 sentinel lymph nodes (SLN) were removed. In the TLA group 1.98 SLN/patient and in the GA group 2.46 SLN/patient were removed (median value). Seventy patients (23.3%) had a positive SLN. No major complications occurred. The costs for SLNE were significantly less for the SLNE in a procedures room performed under TLA (mean € 30.64) compared with SLNE in an operating room under GA (mean € 326.14, P<0.0001). In conclusion, SLNE performed under TLA is safe, reliable, and cost-efficient and could become the new gold standard in sentinel lymph node diagnostic procedures. © 2010 The Authors. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology.

78 FR 47047 - Proposed Policy for Discontinuance of Certain Instrument Approach Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... procedures. Localizer procedures. TACAN procedures. Standard Instrument Arrivals (STARs). Standard Instrument... Policy for Discontinuance of Certain Instrument Approach Procedures AGENCY: Federal Aviation... facilitates the introduction of area navigation (RNAV) instrument approach procedures over the past decade...

Speech coding at low to medium bit rates

NASA Astrophysics Data System (ADS)

Leblanc, Wilfred Paul

1992-09-01

Improved search techniques coupled with improved codebook design methodologies are proposed to improve the performance of conventional code-excited linear predictive coders for speech. Improved methods for quantizing the short term filter are developed by employing a tree search algorithm and joint codebook design to multistage vector quantization. Joint codebook design procedures are developed to design locally optimal multistage codebooks. Weighting during centroid computation is introduced to improve the outlier performance of the multistage vector quantizer. Multistage vector quantization is shown to be both robust against input characteristics and in the presence of channel errors. Spectral distortions of about 1 dB are obtained at rates of 22-28 bits/frame. Structured codebook design procedures for excitation in code-excited linear predictive coders are compared to general codebook design procedures. Little is lost using significant structure in the excitation codebooks while greatly reducing the search complexity. Sparse multistage configurations are proposed for reducing computational complexity and memory size. Improved search procedures are applied to code-excited linear prediction which attempt joint optimization of the short term filter, the adaptive codebook, and the excitation. Improvements in signal to noise ratio of 1-2 dB are realized in practice.

Output Containment Control of Linear Heterogeneous Multi-Agent Systems Using Internal Model Principle.

PubMed

Zuo, Shan; Song, Yongduan; Lewis, Frank L; Davoudi, Ali

2017-01-04

This paper studies the output containment control of linear heterogeneous multi-agent systems, where the system dynamics and even the state dimensions can generally be different. Since the states can have different dimensions, standard results from state containment control do not apply. Therefore, the control objective is to guarantee the convergence of the output of each follower to the dynamic convex hull spanned by the outputs of leaders. This can be achieved by making certain output containment errors go to zero asymptotically. Based on this formulation, two different control protocols, namely, full-state feedback and static output-feedback, are designed based on internal model principles. Sufficient local conditions for the existence of the proposed control protocols are developed in terms of stabilizing the local followers' dynamics and satisfying a certain H∞ criterion. Unified design procedures to solve the proposed two control protocols are presented by formulation and solution of certain local state-feedback and static output-feedback problems, respectively. Numerical simulations are given to validate the proposed control protocols.

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

Filip, Radim; Marek, Petr; Fiurasek, Jaromir

We analyze a reversibility of optimal Gaussian 1{yields}2 quantum cloning of a coherent state using only local operations on the clones and classical communication between them and propose a feasible experimental test of this feature. Performing Bell-type homodyne measurement on one clone and anticlone, an arbitrary unknown input state (not only a coherent state) can be restored in the other clone by applying appropriate local unitary displacement operation. We generalize this concept to a partial reversal of the cloning using only local operations and classical communication (LOCC) and we show that this procedure converts the symmetric cloner to an asymmetricmore » cloner. Further, we discuss a distributed LOCC reversal in optimal 1{yields}M Gaussian cloning of coherent states which transforms it to optimal 1{yields}M{sup '} cloning for M{sup '}

User's manual for the national water information system of the U.S. Geological Survey: Ground-water site-inventory system

USGS Publications Warehouse

,

2004-01-01

The Ground-Water Site-Inventory (GWSI) System is a ground-water data storage and retrieval system that is part of the National Water Information System (NWIS) developed by the U.S. Geological Survey (USGS). The NWIS is a distributed water database in which data can be processed over a network of workstations and file servers at USGS offices throughout the United States. This system comprises the GWSI, the Automated Data Processing System (ADAPS), the Water-Quality System (QWDATA), and the Site-Specific Water-Use Data System (SWUDS). The GWSI System provides for entering new sites and updating existing sites within the local database. In addition, the GWSI provides for retrieving and displaying ground-water and sitefile data stored in the local database. Finally, the GWSI provides for routine maintenance of the local and national data records. This manual contains instructions for users of the GWSI and discusses the general operating procedures for the programs found within the GWSI Main Menu.

User's Manual for the National Water Information System of the U.S. Geological Survey: Ground-water site-inventory system

USGS Publications Warehouse

,

2005-01-01

The Ground-Water Site-Inventory (GWSI) System is a ground-water data storage and retrieval system that is part of the National Water Information System (NWIS) developed by the U.S. Geological Survey (USGS). The NWIS is a distributed water database in which data can be processed over a network of workstations and file servers at USGS offices throughout the United States. This system comprises the GWSI, the Automated Data Processing System (ADAPS), the Water-Quality System (QWDATA), and the Site- Specific Water-Use Data System (SWUDS). The GWSI System provides for entering new sites and updating existing sites within the local database. In addition, the GWSI provides for retrieving and displaying groundwater and Sitefile data stored in the local database. Finally, the GWSI provides for routine maintenance of the local and national data records. This manual contains instructions for users of the GWSI and discusses the general operating procedures for the programs found within the GWSI Main Menu.

Localized lossless authentication watermark (LAW)

NASA Astrophysics Data System (ADS)

Celik, Mehmet U.; Sharma, Gaurav; Tekalp, A. Murat; Saber, Eli S.

2003-06-01

A novel framework is proposed for lossless authentication watermarking of images which allows authentication and recovery of original images without any distortions. This overcomes a significant limitation of traditional authentication watermarks that irreversibly alter image data in the process of watermarking and authenticate the watermarked image rather than the original. In particular, authenticity is verified before full reconstruction of the original image, whose integrity is inferred from the reversibility of the watermarking procedure. This reduces computational requirements in situations when either the verification step fails or the zero-distortion reconstruction is not required. A particular instantiation of the framework is implemented using a hierarchical authentication scheme and the lossless generalized-LSB data embedding mechanism. The resulting algorithm, called localized lossless authentication watermark (LAW), can localize tampered regions of the image; has a low embedding distortion, which can be removed entirely if necessary; and supports public/private key authentication and recovery options. The effectiveness of the framework and the instantiation is demonstrated through examples.

Liver biopsy under hypnosis.

PubMed

Adams, P C; Stenn, P G

1992-09-01

Two patients underwent outpatient percutaneous liver biopsy under hypnosis without complications. One patient had severe anxiety about the procedure because of a previous adverse experience with liver biopsy and the other had a history of severe allergy to local anesthesia. Both patients had undergone a session of hypnosis at least once prior to the biopsy. One received no local anesthetic and the other received 1% lidocaine as a local anesthetic. Both patients were completely cooperative during the procedure with the required respiratory maneuvers. Both patients stated that they were aware of the procedure under hypnosis but described no pain and would be most willing to have the procedure done under hypnosis in the future. Hypnosis can be a useful method of preparing carefully selected patients for percutaneous liver biopsy.

Comparison of the efficacy of articaine and prilocaine local anaesthesia for pulpotomy of maxillary and mandibular primary molars.

PubMed

Yilmaz, Y; Eyuboglu, O; Keles, S

2011-06-01

The aim of this study was to compare the local anaesthetic efficacy of articaine HCl and prilocaine HCl during an operative procedure after their administration by either mandibular nerve block or maxillary infiltration. The study was a double-blind clinical study which comprised 162 children (81 boys and 81 girls), who required a pulpotomy on their primary molars. Pain-related behaviours were used to assess the severity of pain during the injection of either prilocaine HCl or articaine HCl and the operative procedures following either a maxillary infiltration or mandibular nerve block of the two local anaesthetic agents. The frequencies of post-procedural adverse events in the prilocaine and articaine anaesthetised groups were also determined. Significantly more discomfort (p<0.05) was observed following maxillary infiltration compared to mandibular nerve block. There were no significant differences in the pain-related behaviours scores between the two local anaesthetic agents administered during the dental operative procedures, except for the removal of the coronal pulp. For this latter procedure, the pain-related behaviour score was 1.5- times higher in the prilocain-anaesthetised children than in the articaine-anaesthetised children. The frequencies of post- procedural adverse events in the prilocaine-treated children were similar to those found in the articaine-treated children. We concluded that local anaesthesia following mandibular nerve block is more effective than that following maxillary infiltration in 6-8-year-old children. However, the intensity of pain that was experienced by the children during administration of either prilocaine or articaine and some of the dental procedures after their administration were similar.

Are paediatric operations evidence based? A prospective analysis of general surgery practice in a teaching paediatric hospital.

PubMed

Zani-Ruttenstock, Elke; Zani, Augusto; Bullman, Emma; Lapidus-Krol, Eveline; Pierro, Agostino

2015-01-01

Paediatric surgical practice should be based upon solid scientific evidence. A study in 1998 (Baraldini et al., Pediatr Surg Int) indicated that only a quarter of paediatric operations were supported by the then gold standard of evidence based medicine (EBM) which was defined by randomized controlled trials (RCTs). The aim of the current study was to re-evaluate paediatric surgical practice 16 years after the previous study in a larger cohort of patients. A prospective observational study was performed in a tertiary level teaching hospital for children. The study was approved by the local research ethics board. All diagnostic and therapeutic procedures requiring a general anaesthetic carried out over a 4-week period (24 Feb 2014-22 Mar 2014) under the general surgery service or involving a general paediatric surgeon were included in the study. Pubmed and EMBASE were used to search in the literature for the highest level of evidence supporting the recorded procedures. Evidence was classified according to the Oxford Centre for Evidence Based Medicine (OCEBM) 2009 system as well as according to the classification used by Baraldini et al. Results was compared using Χ (2) test. P < 0.05 was considered statistically significant. During the study period, 126 operations (36 different types) were performed on 118 patients. According to the OCEBM classification, 62 procedures (49 %) were supported by systematic reviews of multiple homogeneous RCTs (level 1a), 13 (10 %) by individual RCTs (level 1b), 5 (4 %) by systematic reviews of cohort studies (level 2a), 11 (9 %) by individual cohort studies, 1 (1 %) by systematic review of case-control studies (level 3a), 14 (11 %) by case-control studies (level 3b), 9 (7 %) by case series (type 4) and 11 procedures (9 %) were based on expert opinion or deemed self-evident interventions (type 5). High level of evidence (OCEBM level 1a or 1b or level I according to Baraldini et al. PSI 1998) supported 75 (60 %) operations in the current study compared to 18 (26 %) in the study of 1998 (P < 0.0001). The present study shows that nowadays a remarkable number of paediatric surgical procedures are supported by high level of evidence. Despite this improvement in evidence-based paediatric surgical practice, more than a third of the procedures still lack sufficient evidence-based literature support. More RCTs are warranted to support and direct paediatric surgery practice according to the principals of EBM.

[Plastic surgery treatment techniques for interdisciplinary therapy of pressure sores].

PubMed

Müller, Karin; Becker, Frederic; Pfau, Matthias; Werdin, Frank

2017-06-01

Pressure sores in geriatric patients represent a challenge for all disciplines involved in the treatment process; however, the prerequisite for successful treatment is the elaboration of an interdisciplinary treatment concept. The treatment goals should be adapted to the individual needs of the patients including the life situation, general condition and local findings. In addition to general basic operative techniques, such as wound cleansing and conditioning, plastic and reconstructive surgery provides a wide range of highly specialized operative techniques for the treatment of these patients by which a definitive defect coverage can be achieved. The aim of this article is to raise awareness for these complex and highly specialized procedures for all disciplines participating in the treatment in order to improve the interdisciplinary cooperation and ultimately the quality of treatment.

Problem of intraoperative anatomical shift in image-guided surgery

NASA Astrophysics Data System (ADS)

Nauta, Haring J.; Bonnen, J. G.

1998-06-01

Experience with image guided, frameless stereotactic neurosurgery shows that intraoperative brain position shifts can be large enough to be problematic, and can occur in different directions at different directions at different stages of an operation. An understanding of the behavior of shifts will allow the surgeon to make the most appropriate use of the image guidance by first minimizing the shift itself, and then anticipating and compensating for any influence the remaining shift will have on the accuracy of the guidance. Three types of shift are described. Type I shift is a local outward bulging that occurs after the skull and dura are opened but before a mass lesion is resected. Type II shift is a local collapse of the brain tissue into the space previously occupied by the tumor. Type III shift is related to loss of cerebrospinal fluid or brain dehydration and is a generalized, more symmetric loss of brain volume. Strategies to minimize these types of shift include appropriate use of medical measures to reduce brain swelling early in the procedure without producing so much brain dehydration that Type II shift is accentuated later in the procedure. Other strategies include mechanical stabilization of brain position with retractors. Anticipating shift, the neurosurgeon should use the guidance as far as possible to map key boundaries early in the procedure before shift becomes more pronounced. Ultimately, however, the correction for the problem of intraoperative brain shift will require the ability to update the imaging data during the surgery.

Characterization of biofilms with a fiber optic spectrometer

NASA Astrophysics Data System (ADS)

Krautwald, S.; Tonyali, A.; Fellerhoff, B.; Franke, Hilmar; Tamachkiarov, A.; Griebe, T.; Flemming, H. C.

2000-12-01

Optical sensing is one promising approach to monitor bioflims in an early stage. Generally, natural bioflims are quite inhomogeneous, therefore we start the investigation with suspensions of dead bacteria in water as a simple model for a bioflim. An experimental arrangement based on a white light fiber optic spectrometer is used for measuring the density of a thin film with a local resolution in the order of several tim. The method is applied with model biofilms. In a computer controlled procedure reflectance spectra may be recorded at different positions in the x-y plane. Scanning through thin suspension regions of bacteria between glass plates allows an estimation of the refractive index of bacteria. Taking advantage of the light collecting property of the glass substrate a simple measurement of the fluorescence with local resolution is demonstrated as well.

Nonuniform fluids in the grand canonical ensemble

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

Percus, J.K.

1982-01-01

Nonuniform simple classical fluids are considered quite generally. The grand canonical ensemble is particularly suitable, conceptually, in the leading approximation of local thermodynamics, which figuratively divides the system into approximately uniform spatial subsystems. The procedure is reviewed by which this approach is systematically corrected for slowly varying density profiles, and a model is suggested that carries the correction into the domain of local fluctuations. The latter is assessed for substrate bounded fluids, as well as for two-phase interfaces. The peculiarities of the grand ensemble in a two-phase region stem from the inherent very large number fluctuations. A primitive model showsmore » how these are quenched in the canonical ensemble. This is taken advantage of by applying the Kac-Siegert representation of the van der Waals decomposition with petit canonical corrections, to the two-phase regime.« less

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

PubMed

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

2016-01-01

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

Prioritizing quality improvement in general surgery.

PubMed

Schilling, Peter L; Dimick, Justin B; Birkmeyer, John D

2008-11-01

Despite growing interest in quality improvement, uncertainty remains about which procedures offer the most room for improvement in general surgery. In this context, we sought to describe the relative contribution of different procedures to overall morbidity, mortality, and excess length of stay in general surgery. Using data from the American College of Surgeons' National Surgery Quality Improvement Program (ACS-NSQIP), we identified all patients undergoing a general surgery procedure in 2005 and 2006 (n=129,233). Patients were placed in 36 distinct procedure groups based on Current Procedural Terminology codes. We first examined procedure groups according to their relative contribution to overall morbidity and mortality. We then assessed procedure groups according to their contribution to overall excess length of stay. Ten procedure groups alone accounted for 62% of complications and 54% of excess hospital days. Colectomy accounted for the greatest share of adverse events, followed by small intestine resection, inpatient cholecystectomy, and ventral hernia repair. In contrast, several common procedures contributed little to overall morbidity and mortality. For example, outpatient cholecystectomy, breast procedures, thyroidectomy, parathyroidectomy, and outpatient inguinal hernia repair together accounted for 34% of procedures, but only 6% of complications (and only 4% of major complications). These same procedures accounted for < 1% of excess hospital days. A relatively small number of procedures account for a disproportionate share of the morbidity, mortality, and excess hospital days in general surgery. Focusing quality improvement efforts on these procedures may be an effective strategy for improving patient care and reducing cost.

28 CFR 91.62 - Preparing an Environmental Assessment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... environmental analysis. Any state or local environmental impact review requirements should also be incorporated... laws and regulations as well as similar state and local environmental impact review requirements. (e... FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental Review Procedures...

34 CFR 222.120 - When is a local educational agency exempt from withholding of payments?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Related Procedures for Indian Policies and Procedures § 222.120 When is a local educational agency exempt... in attendance at the LEA. (Authority: 20 U.S.C. 7703(a), 7704(c), (d)(2) and (e)(8)) ...

Effect of bariatric surgery on future general surgical procedures.

PubMed

Kini, Subhash; Kannan, Umashankkar

2011-04-01

Bariatric surgery is now accepted as a safe and effective procedure for morbid obesity. The frequency of bariatric procedures is increasing with the adoption of the laparoscopic approach. The general surgeons will be facing many more of such patients presenting with common general surgical problems. Many of the general surgeons, faced with such situations, may not be aware of the changes in the gastrointestinal anatomy following bariatric procedures and management of these clinical situations will therefore present diagnostic and therapeutic challenges. We hereby present a review of management of few common general surgical problems in patients with a history of bariatric surgery.

41 CFR 105-50.001-3 - Unit of general local government.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Unit of general local... TECHNICAL SERVICES TO STATE AND LOCAL UNITS OF GOVERNMENT § 105-50.001-3 Unit of general local government. Unit of general local government means any city, county, town, parish, village, or other general...

An iterative procedure for obtaining maximum-likelihood estimates of the parameters for a mixture of normal distributions, Addendum

NASA Technical Reports Server (NTRS)

Peters, B. C., Jr.; Walker, H. F.

1975-01-01

New results and insights concerning a previously published iterative procedure for obtaining maximum-likelihood estimates of the parameters for a mixture of normal distributions were discussed. It was shown that the procedure converges locally to the consistent maximum likelihood estimate as long as a specified parameter is bounded between two limits. Bound values were given to yield optimal local convergence.

48 CFR 307.104 - General procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false General procedures. 307... ACQUISITION PLANNING ACQUISITION PLANNING Acquisition Planning 307.104 General procedures. (a) Each contracting activity shall prepare an Annual Acquisition Plan (AAP) as far in advance of each fiscal year as...

10 CFR 590.301 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false General. 590.301 Section 590.301 Energy DEPARTMENT OF ENERGY (CONTINUED) NATURAL GAS (ECONOMIC REGULATORY ADMINISTRATION) ADMINISTRATIVE PROCEDURES WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Procedures § 590.301 General. The procedures of this...

10 CFR 590.301 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false General. 590.301 Section 590.301 Energy DEPARTMENT OF ENERGY (CONTINUED) NATURAL GAS (ECONOMIC REGULATORY ADMINISTRATION) ADMINISTRATIVE PROCEDURES WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Procedures § 590.301 General. The procedures of this...

A Method of Relating General Circulation Model Simulated Climate to the Observed Local Climate. Part I: Seasonal Statistics.

NASA Astrophysics Data System (ADS)

Karl, Thomas R.; Wang, Wei-Chyung; Schlesinger, Michael E.; Knight, Richard W.; Portman, David

1990-10-01

Important surface observations such as the daily maximum and minimum temperature, daily precipitation, and cloud ceilings often have localized characteristics that are difficult to reproduce with the current resolution and the physical parameterizations in state-of-the-art General Circulation climate Models (GCMs). Many of the difficulties can be partially attributed to mismatches in scale, local topography. regional geography and boundary conditions between models and surface-based observations. Here, we present a method, called climatological projection by model statistics (CPMS), to relate GCM grid-point flee-atmosphere statistics, the predictors, to these important local surface observations. The method can be viewed as a generalization of the model output statistics (MOS) and perfect prog (PP) procedures used in numerical weather prediction (NWP) models. It consists of the application of three statistical methods: 1) principle component analysis (FICA), 2) canonical correlation, and 3) inflated regression analysis. The PCA reduces the redundancy of the predictors The canonical correlation is used to develop simultaneous relationships between linear combinations of the predictors, the canonical variables, and the surface-based observations. Finally, inflated regression is used to relate the important canonical variables to each of the surface-based observed variables.We demonstrate that even an early version of the Oregon State University two-level atmospheric GCM (with prescribed sea surface temperature) produces free-atmosphere statistics than can, when standardized using the model's internal means and variances (the MOS-like version of CPMS), closely approximate the observed local climate. When the model data are standardized by the observed free-atmosphere means and variances (the PP version of CPMS), however, the model does not reproduce the observed surface climate as well. Our results indicate that in the MOS-like version of CPMS the differences between the output of a ten-year GCM control run and the surface-based observations are often smaller than the differences between the observations of two ten-year periods. Such positive results suggest that GCMs may already contain important climatological information that can be used to infer the local climate.

77 FR 4203 - Energy Conservation Program: Test Procedures for General Service Fluorescent Lamps, General...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-27

...On September 14, 2011, the U.S. Department of Energy (DOE) issued a notice of proposed rulemaking (NOPR) to amend the test procedures for general service fluorescent lamps (GSFLs), general service incandescent lamps (GSILs), and incandescent reflector lamps (IRLs). That proposed rulemaking serves as the basis for today's action. DOE is amending its test procedures for GSFLs and GSILs established under the Energy Policy and Conservation Act (EPCA). DOE is not amending in this final rule the existing test procedure for IRLs established under EPCA. For GSFLs and GSILs, DOE is updating several references to the industry standards referenced in DOE's test procedures. DOE is also establishing a lamp lifetime test procedure for GSILs. These test procedures also provide the protocols upon which the Federal Trade Commission bases its energy guide label for these products. DOE's review of the GSFL, GSIL, and IRL test procedures fulfills the EPCA requirement that DOE review test procedures for all covered products at least once every seven years.

Models for nearly every occasion: Part III - One box decreasing emission models.

PubMed

Hewett, Paul; Ganser, Gary H

2017-11-01

New one box "well-mixed room" decreasing emission (DE) models are introduced that allow for local exhaust or local exhaust with filtered return, as well the recirculation of a filtered (or cleaned) portion of the general room ventilation. For each control device scenario, a steady state and transient model is presented. The transient equations predict the concentration at any time t after the application of a known mass of a volatile substance to a surface, and can be used to predict the task exposure profile, the average task exposure, as well as peak and short-term exposures. The steady state equations can be used to predict the "average concentration per application" that is reached whenever the substance is repeatedly applied. Whenever the beginning and end concentrations are expected to be zero (or near zero) the steady state equations can also be used to predict the average concentration for a single task with multiple applications during the task, or even a series of such tasks. The transient equations should be used whenever these criteria cannot be met. A structured calibration procedure is proposed that utilizes a mass balance approach. Depending upon the DE model selected, one or more calibration measurements are collected. Using rearranged versions of the steady state equations, estimates of the model variables-e.g., the mass of the substance applied during each application, local exhaust capture efficiency, and the various cleaning or filtration efficiencies-can be calculated. A new procedure is proposed for estimating the emission rate constant.

Building a Sustainable Global Surgery Nonprofit Organization at an Academic Institution.

PubMed

Frisella, Margaret M

Surgical Outreach for the Americas is a 501(c)3 nonprofit organization providing surgical care to those in need in developing countries of the Western Hemisphere. Every year since its inception in 2008, teams of surgeons, nurses, and allied health professionals have traveled to areas of need and performed primarily hernia repair surgeries for those without access to affordable health care. Surgical Outreach for the Americas (SOfA) began as a general concept based on World Health Organization statistics claiming that 11% of the global burden of disease can be resolved via surgery. Armed with this information, a group of compassionate and selfless health care professionals planned the first trip, to the Dominican Republic, in January 2009. Building on what was first just an ambition to help others, we now also train surgeons, surgery residents, and nurses in the countries we serve. To date, SOfA has successfully treated 734 patients, with 899 total surgical procedures performed (693 of these under general anesthesia). These procedures include inguinal hernia, umbilical hernia, testicular masses, orchiectomies, and various general surgical procedures. Through the efforts of a great many talented individuals and robust fundraising efforts, the SOfA message continues to gain momentum. SOfA not only considers the health and well-being of the disadvantaged through capacity-building efforts but strives to educate and improve the skills of health care professionals in the countries we visit. Our goal is to increase the number of missions each year and begin a 2-fold educational program that (a) provides surgical resident education through participation in mission work and (b) provides local surgeon education in the areas served. Copyright © 2016. Published by Elsevier Inc.

47 CFR 36.377 - Category 1-Local business office expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Category 1-Local business office expense. 36.377 Section 36.377 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES JURISDICTIONAL SEPARATIONS PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND...

Gauge symmetry and constraints structure for topologically massive AdS gravity: a symplectic viewpoint

NASA Astrophysics Data System (ADS)

Rodríguez-Tzompantzi, Omar; Escalante, Alberto

2018-05-01

By applying the Faddeev-Jackiw symplectic approach we systematically show that both the local gauge symmetry and the constraint structure of topologically massive gravity with a cosmological constant Λ , elegantly encoded in the zero-modes of the symplectic matrix, can be identified. Thereafter, via a suitable partial gauge-fixing procedure, the time gauge, we calculate the quantization bracket structure (generalized Faddeev-Jackiw brackets) for the dynamic variables and confirm that the number of physical degrees of freedom is one. This approach provides an alternative to explore the dynamical content of massive gravity models.

Development of a composite geodetic structure for space construction, phase 2

NASA Technical Reports Server (NTRS)

1981-01-01

Primary physical and mechanical properties were defined for pultruded hybrid HMS/E-glass P1700 rod material used for the fabrication of geodetic beams. Key properties established were used in the analysis, design, fabrication, instrumentation, and testing of a geodetic parameter cylinder and a lattice cone closeout joined to a short cylindrical geodetic beam segment. Requirements of structural techniques were accomplished. Analytical procedures were refined and extended to include the effect of rod dimensions for the helical and longitudinal members on local buckling, and the effect of different flexural and extensional moduli on general instability buckling.

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

Barr, Jonathan L.; Taira, Randal Y.; Orr, Heather M.

The purpose of this document is to describe the operating concepts, capabilities, and benefits of RAMS including descriptions of how the system implementations can improve emergency response, damage assessment, task prioritization, and situation awareness. This CONOPS provides general information on operational processes and procedures required to utilize RAMS, and expected performance benefits of the system. The primary audiences for this document are the end users of RAMS (including flight operators and incident commanders) and the RAMS management team. Other audiences include interested offices within the Department of Homeland Security (DHS), and officials from other state and local jurisdictions who wantmore » to implement similar systems.« less

Simulating Local Area Network Protocols with the General Purpose Simulation System (GPSS)

DTIC Science & Technology

1990-03-01

generation 15 3.1.2 Frame delivery . 15 3.2 Model artifices 16 3.3 Model variables 17 3.4 Simulation results 18 4. EXTERNAL PROCEDURES USED IN SIMULATION 19...46 15. Token Ring: Frame generation process 47 16. Token Ring: Frame delivery process 48 17 . Token Ring: Mean transfer delay vs mean throughput 49...assumed to be zero were replaced by the maximum values specified in the ANSI 802.3 standard (viz &MI=6, &M2=3, &M3= 17 , &D1=18, &D2=3, &D4=4, &D7=3, and

Complications of bariatric surgery--What the general surgeon needs to know.

PubMed

Healy, Paul; Clarke, Christopher; Reynolds, Ian; Arumugasamy, Mayilone; McNamara, Deborah

2016-04-01

Obesity is an important cause of physical and psychosocial morbidity and it places a significant burden on health system costs and resources. Worldwide an estimated 200 million people over 20 years are obese and in the U.K. the Department of Health report that 61.3% of people in the U.K. are either overweight or obese. Surgery for obesity (bariatric surgery) is being performed with increasing frequency in specialist centres both in the U.K. and Ireland and abroad due to the phenomenon of health tourism. Its role and success in treating medical conditions such as diabetes mellitus and hypertension in obese patients will likely lead to an even greater number of bariatric surgery procedures being performed. Patients with early postoperative complications may be managed in specialist centres but patients with later complications, occurring months or years after surgery, may present to local surgical units for assessment and management. This review will highlight the late complications of the 3 most commonly performed bariatric surgery procedures that the emergency general surgeon may encounter. It will also highlight the complications that require urgent intervention by the emergency general surgeon and those that can be safely referred to a bariatric surgeon for further management after initial assessment and investigations. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Context-aware and locality-constrained coding for image categorization.

PubMed

Xiao, Wenhua; Wang, Bin; Liu, Yu; Bao, Weidong; Zhang, Maojun

2014-01-01

Improving the coding strategy for BOF (Bag-of-Features) based feature design has drawn increasing attention in recent image categorization works. However, the ambiguity in coding procedure still impedes its further development. In this paper, we introduce a context-aware and locality-constrained Coding (CALC) approach with context information for describing objects in a discriminative way. It is generally achieved by learning a word-to-word cooccurrence prior to imposing context information over locality-constrained coding. Firstly, the local context of each category is evaluated by learning a word-to-word cooccurrence matrix representing the spatial distribution of local features in neighbor region. Then, the learned cooccurrence matrix is used for measuring the context distance between local features and code words. Finally, a coding strategy simultaneously considers locality in feature space and context space, while introducing the weight of feature is proposed. This novel coding strategy not only semantically preserves the information in coding, but also has the ability to alleviate the noise distortion of each class. Extensive experiments on several available datasets (Scene-15, Caltech101, and Caltech256) are conducted to validate the superiority of our algorithm by comparing it with baselines and recent published methods. Experimental results show that our method significantly improves the performance of baselines and achieves comparable and even better performance with the state of the arts.

Hypnosis for cataract surgery in an American Society of Anesthesiologists physical status IV patient.

PubMed

Kiss, G; Butler, J

2011-11-01

A 73-year-old morbidly obese female patient (weight 125 kg, height 156 cm) was scheduled for cataract surgery of her right eye. Due to a number of severe co-morbidities general anaesthesia was contraindicated. However the patient was very anxious and requested sedation if the procedure was to be undertaken under local anaesthesia. She responded very positively to the proposal of utilising perioperative hypnosis. Hypnotic induction was achieved with the heavy eyelid technique, putting the patient into trance within 30 seconds. Continuous relaxing suggestions as described by the patient herself the day before surgery were used to maintain the trance state. She later reported that she was not aware of being in the operating room, but experienced profound relaxation during the procedure. Perioperative hypnosis proved to be a satisfactory option for sedation in this high-risk patient and should be actively considered for similar easily suggestible patients who are undergoing minor surgery.

Development of alternative data analysis techniques for improving the accuracy and specificity of natural resource inventories made with digital remote sensing data

NASA Technical Reports Server (NTRS)

Lillesand, T. M.; Meisner, D. E. (Principal Investigator)

1980-01-01

An investigation was conducted into ways to improve the involvement of state and local user personnel in the digital image analysis process by isolating those elements of the analysis process which require extensive involvement by field personnel and providing means for performing those activities apart from a computer facility. In this way, the analysis procedure can be converted from a centralized activity focused on a computer facility to a distributed activity in which users can interact with the data at the field office level or in the field itself. A general image processing software was developed on the University of Minnesota computer system (Control Data Cyber models 172 and 74). The use of color hardcopy image data as a primary medium in supervised training procedures was investigated and digital display equipment and a coordinate digitizer were procured.

Rectus sheath block: successful use in the chronic pain management of pediatric abdominal wall pain.

PubMed

Skinner, Adam V; Lauder, Gillian R

2007-12-01

Seven pediatric patients (aged 11-16 years) with chronic abdominal wall pain are presented who gained significant relief from a rectus sheath block (RSB). We describe the case histories and review the relevant literature for this technique. The etiology of the abdominal wall pain was considered to be abdominal cutaneous nerve entrapment, iatrogenic peripheral nerve injury, myofascial pain syndrome or was unknown. All patients showed significant initial improvement in pain and quality of life. Three patients required only the RSB to enable them to be pain-free and return to normal schooling and physical activities. Two children received complete relief for more than 1 year. In the majority of cases, the procedure was carried out under general anesthesia as a daycase procedure. Local anesthetic and steroids were used. This is the first report of the successful use of this technique in the chronic pain management setting in children.

5 CFR 178.208 - Applicability of general procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Applicability of general procedures. 178.208 Section 178.208 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS... Applicability of general procedures. When not in conflict with this subpart, the provisions of subpart A of this...

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

PubMed

Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

2012-12-01

Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

20 CFR 422.130 - Claim procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Employees' Benefits SOCIAL SECURITY ADMINISTRATION ORGANIZATION AND PROCEDURES General Procedures § 422.130 Claim procedure. (a) General. The Social Security Administration provides facilities for the public to... station of the Social Security Administration, from the Division of Foreign Claims, Post Office Box 1756...

Coding of procedures documented by general practitioners in Swedish primary care-an explorative study using two procedure coding systems

PubMed Central

2012-01-01

Background Procedures documented by general practitioners in primary care have not been studied in relation to procedure coding systems. We aimed to describe procedures documented by Swedish general practitioners in electronic patient records and to compare them to the Swedish Classification of Health Interventions (KVÅ) and SNOMED CT. Methods Procedures in 200 record entries were identified, coded, assessed in relation to two procedure coding systems and analysed. Results 417 procedures found in the 200 electronic patient record entries were coded with 36 different Classification of Health Interventions categories and 148 different SNOMED CT concepts. 22.8% of the procedures could not be coded with any Classification of Health Interventions category and 4.3% could not be coded with any SNOMED CT concept. 206 procedure-concept/category pairs were assessed as a complete match in SNOMED CT compared to 10 in the Classification of Health Interventions. Conclusions Procedures documented by general practitioners were present in nearly all electronic patient record entries. Almost all procedures could be coded using SNOMED CT. Classification of Health Interventions covered the procedures to a lesser extent and with a much lower degree of concordance. SNOMED CT is a more flexible terminology system that can be used for different purposes for procedure coding in primary care. PMID:22230095

Step by Step: Biology Undergraduates’ Problem-Solving Procedures during Multiple-Choice Assessment

PubMed Central

Prevost, Luanna B.; Lemons, Paula P.

2016-01-01

This study uses the theoretical framework of domain-specific problem solving to explore the procedures students use to solve multiple-choice problems about biology concepts. We designed several multiple-choice problems and administered them on four exams. We trained students to produce written descriptions of how they solved the problem, and this allowed us to systematically investigate their problem-solving procedures. We identified a range of procedures and organized them as domain general, domain specific, or hybrid. We also identified domain-general and domain-specific errors made by students during problem solving. We found that students use domain-general and hybrid procedures more frequently when solving lower-order problems than higher-order problems, while they use domain-specific procedures more frequently when solving higher-order problems. Additionally, the more domain-specific procedures students used, the higher the likelihood that they would answer the problem correctly, up to five procedures. However, if students used just one domain-general procedure, they were as likely to answer the problem correctly as if they had used two to five domain-general procedures. Our findings provide a categorization scheme and framework for additional research on biology problem solving and suggest several important implications for researchers and instructors. PMID:27909021

Building thermography as a tool in energy audits and building commissioning procedure

NASA Astrophysics Data System (ADS)

Kauppinen, Timo

2007-04-01

A Building Commissioning-project (ToVa) was launched in Finland in the year 2003. A comprehensive commissioning procedure, including the building process and operation stage was developed in the project. This procedure will confirm the precise documentation of client's goals, definition of planning goals and the performance of the building. It is rather usual, that within 1-2 years after introduction the users complain about the defects or performance malfunctions of the building. Thermography is one important manual tool in verifying the thermal performance of the building envelope. In this paper the results of one pilot building (a school) will be presented. In surveying the condition and energy efficiency of buildings, various auxiliary means are needed. We can compare the consumption data of the target building with other, same type of buildings by benchmarking. Energy audit helps to localize and determine the energy saving potential. The most general and also most effective auxiliary means in monitoring the thermal performance of building envelopes is an infrared camera. In this presentation some examples of the use of thermography in energy audits are presented.

Magnetic resonance imaging-radioguided occult lesion localization (ROLL) in breast cancer using Tc-99m macro-aggregated albumin and distilled water control.

PubMed

Philadelpho Arantes Pereira, Fernanda; Martins, Gabriela; Gregorio Calas, Maria Julia; Fonseca Torres de Oliveira, Maria Veronica; Gasparetto, Emerson Leandro; Barbosa da Fonseca, Lea Mirian

2013-09-18

Magnetic resonance imaging (MRI) guided wire localization presents several challenges apart from the technical difficulties. An alternative to this conventional localization method using a wire is the radio-guided occult lesion localization (ROLL), more related to safe surgical margins and reductions in excision volume. The purpose of this study was to establish a safe and reliable magnetic resonance imaging-radioguided occult lesion localization (MRI-ROLL) technique and to report our initial experience with the localization of nonpalpable breast lesions only observed on MRI. Sixteen women (mean age 53.2 years) with 17 occult breast lesions underwent radio-guided localization in a 1.5-T MR system using a grid-localizing system. All patients had a diagnostic MRI performed prior to the procedure. An intralesional injection of Technetium-99m macro-aggregated albumin followed by distilled water was performed. After the procedure, scintigraphy was obtained. Surgical resection was performed with the help of a gamma detector probe. The lesion histopathology and imaging concordance; the procedure's positive predictive value (PPV), duration time, complications, and accuracy; and the rate of exactly excised lesions evaluated with MRI six months after the surgery were assessed. One lesion in one patient had to be excluded because the radioactive substance came back after the injection, requiring a wire placement. Of the remaining cases, there were four malignant lesions, nine benign lesions, and three high-risk lesions. Surgical histopathology and imaging findings were considered concordant in all benign and high-risk cases. The PPV of MRI-ROLL was greater if the indication for the initial MR examination was active breast cancer. The median procedure duration time was 26 minutes, and all included procedures were defined as accurate. The exact and complete lesion removal was confirmed in all (100%) patients who underwent six-month postoperative MRI (50%). MRI-ROLL offers a precise, technically feasible, safe, and rapid means for performing preoperative MRI localizations in the breast.

Comments on localized and integral localized approximations in spherical coordinates

NASA Astrophysics Data System (ADS)

Gouesbet, Gérard; Lock, James A.

2016-08-01

Localized approximation procedures are efficient ways to evaluate beam shape coefficients of laser beams, and are particularly useful when other methods are ineffective or inefficient. Comments on these procedures are, however, required in order to help researchers make correct decisions concerning their use. This paper has the flavor of a short review and takes the opportunity to attract the attention of the readers to a required refinement of terminology.

Item Purification in Differential Item Functioning Using Generalized Linear Mixed Models

ERIC Educational Resources Information Center

Liu, Qian

2011-01-01

For this dissertation, four item purification procedures were implemented onto the generalized linear mixed model for differential item functioning (DIF) analysis, and the performance of these item purification procedures was investigated through a series of simulations. Among the four procedures, forward and generalized linear mixed model (GLMM)…

Generalized Appended Product Indicator Procedure for Nonlinear Structural Equation Analysis.

ERIC Educational Resources Information Center

Wall, Melanie M.; Amemiya, Yasuo

2001-01-01

Considers the estimation of polynomial structural models and shows a limitation of an existing method. Introduces a new procedure, the generalized appended product indicator procedure, for nonlinear structural equation analysis. Addresses statistical issues associated with the procedure through simulation. (SLD)

Students’ Algebraic Thinking Process in Context of Point and Line Properties

NASA Astrophysics Data System (ADS)

Nurrahmi, H.; Suryadi, D.; Fatimah, S.

2017-09-01

Learning of schools algebra is limited to symbols and operating procedures, so students are able to work on problems that only require the ability to operate symbols but unable to generalize a pattern as one of part of algebraic thinking. The purpose of this study is to create a didactic design that facilitates students to do algebraic thinking process through the generalization of patterns, especially in the context of the property of point and line. This study used qualitative method and includes Didactical Design Research (DDR). The result is students are able to make factual, contextual, and symbolic generalization. This happen because the generalization arises based on facts on local terms, then the generalization produced an algebraic formula that was described in the context and perspective of each student. After that, the formula uses the algebraic letter symbol from the symbol t hat uses the students’ language. It can be concluded that the design has facilitated students to do algebraic thinking process through the generalization of patterns, especially in the context of property of the point and line. The impact of this study is this design can use as one of material teaching alternative in learning of school algebra.

Direct Injection of Blood Products Versus Gelatin Sponge as a Technique for Local Hemostasis

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

Haaga, John; Rahim, Shiraz, E-mail: Shiraz.rahim@uhhospitals.org

PurposeTo provide a method of reducing risk of minimally invasive procedures on patients with abnormal hemostasis and evaluate efficacy of direct fresh frozen plasma injection through a procedure needle tract compared to Gelfoam (gelatin sponge) administration.Materials and MethodsEighty patients with elevated international standardized ratio (INR) undergoing minimally invasive procedures using imaging guidance were selected retrospectively. Forty patients had received Gelfoam as a means of tract embolization during the procedure. The other 40 received local fresh frozen plasma (FFP) through the needle tract. The number of complications and clinically significant bleeding events were recorded. A threshold of 30 cc of blood lossmore » after a procedure was used to identify excess bleeding.ResultsNo patients experienced clinically significant bleeding after administration of FFP. Five patients experienced postoperative drops in hemoglobin or hematomas after administration of Gelfoam.ConclusionLocal injection of blood products can reduce postprocedure bleeding in patients undergoing minimally invasive procedures and provides a safe alternative to the use of synthetic fibrin plugs.« less

7 CFR 1940.406 - Real estate settlement procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 13 2013-01-01 2013-01-01 false Real estate settlement procedures. 1940.406 Section... AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL Truth in Lending-Real Estate Settlement Procedures § 1940.406 Real estate settlement procedures. (a) General. This section provides the instructions...

7 CFR 1940.406 - Real estate settlement procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 13 2014-01-01 2013-01-01 true Real estate settlement procedures. 1940.406 Section... AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL Truth in Lending-Real Estate Settlement Procedures § 1940.406 Real estate settlement procedures. (a) General. This section provides the instructions...

7 CFR 1940.406 - Real estate settlement procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 13 2012-01-01 2012-01-01 false Real estate settlement procedures. 1940.406 Section... AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL Truth in Lending-Real Estate Settlement Procedures § 1940.406 Real estate settlement procedures. (a) General. This section provides the instructions...

7 CFR 1940.406 - Real estate settlement procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 13 2011-01-01 2009-01-01 true Real estate settlement procedures. 1940.406 Section... AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL Truth in Lending-Real Estate Settlement Procedures § 1940.406 Real estate settlement procedures. (a) General. This section provides the instructions...

32 CFR 1648.5 - Procedures during personal appearance before the local board.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SELECTIVE SERVICE SYSTEM CLASSIFICATION BY LOCAL BOARD § 1648.5 Procedures during personal appearance before... classification; direct attention to any information in his file; and present such further information as he... prohibited in proceedings before the board. This does not prevent the registrant or Selective Service from...

32 CFR 144.6 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF THE ARMED FORCES ON STATE AND LOCAL JURIES § 144.6 Procedures. The Secretaries of the Military... summoned to perform State or local jury duty, the Secretary concerned, or the official to whom such authority has been delegated, shall decide if such jury duty would: (1) Interfere unreasonably with the...

Running Head: Feasibility of Blood Management. Feasibility Study of a Blood Management Program in the Mike O’Callaghan Federal Hospital

DTIC Science & Technology

2009-06-02

transition to bloodless surgery (Northeast Baptist Hospital, 2008). The newsletter also included a transcript from a local news story on their...and Procedures Several locally developed instructions address procedures that have the potential to facilitate blood management efforts. Appendix B... local Blood Management 19 instruction developed by the Operating Room Services personnel, details the guidelines for using the Cell Saver

Homogenized description and retrieval method of nonlinear metasurfaces

NASA Astrophysics Data System (ADS)

Liu, Xiaojun; Larouche, Stéphane; Smith, David R.

2018-03-01

A patterned, plasmonic metasurface can strongly scatter incident light, functioning as an extremely low-profile lens, filter, reflector or other optical device. When the metasurface is patterned uniformly, its linear optical properties can be expressed using effective surface electric and magnetic polarizabilities obtained through a homogenization procedure. The homogenized description of a nonlinear metasurface, however, presents challenges both because of the inherent anisotropy of the medium as well as the much larger set of potential wave interactions available, making it challenging to assign effective nonlinear parameters to the otherwise inhomogeneous layer of metamaterial elements. Here we show that a homogenization procedure can be developed to describe nonlinear metasurfaces, which derive their nonlinear response from the enhanced local fields arising within the structured plasmonic elements. With the proposed homogenization procedure, we are able to assign effective nonlinear surface polarization densities to a nonlinear metasurface, and link these densities to the effective nonlinear surface susceptibilities and averaged macroscopic pumping fields across the metasurface. These effective nonlinear surface polarization densities are further linked to macroscopic nonlinear fields through the generalized sheet transition conditions (GSTCs). By inverting the GSTCs, the effective nonlinear surface susceptibilities of the metasurfaces can be solved for, leading to a generalized retrieval method for nonlinear metasurfaces. The application of the homogenization procedure and the GSTCs are demonstrated by retrieving the nonlinear susceptibilities of a SiO2 nonlinear slab. As an example, we investigate a nonlinear metasurface which presents nonlinear magnetoelectric coupling in near infrared regime. The method is expected to apply to any patterned metasurface whose thickness is much smaller than the wavelengths of operation, with inclusions of arbitrary geometry and material composition, across the electromagnetic spectrum.

Multiple subpial transection for intractable partial epilepsy: an international meta-analysis.

PubMed

Spencer, Susan S; Schramm, Johannes; Wyler, Allen; O'Connor, Michael; Orbach, Darren; Krauss, Gregory; Sperling, Michael; Devinsky, Orrin; Elger, Christian; Lesser, Ronald; Mulligan, Lisa; Westerveld, Michael

2002-02-01

Because the number and variety of patients at any single facility is not sufficient for clinical or statistical analysis, data from six major epilepsy centers that performed multiple subpial transections (MSTs) for medically intractable epilepsy were collected. A meta-analysis was performed to elucidate the indications and outcome, and to assess the results of the procedure. Overall, 211 patients were represented with data regarding preoperative evaluation, procedures, seizure types and frequencies before and after surgery, postoperative deficits, and demographic information. Fifty-three patients underwent MST without resection. In patients with MST plus resection, excellent outcome (>95% reduction in seizure frequency) was obtained in 87% of patients for generalized seizures, 68% for complex partial seizures, and 68% for simple partial seizures. For the patients who underwent MST without resection, the rate of excellent outcome was only slightly lower, at 71% for generalized, 62% for complex partial, and 63% for simple partial seizures. EEG localization, age at epilepsy onset, duration of epilepsy, and location of MST were not significant predictors of outcome for any kinds of seizures after MST, with or without resection. New neurologic deficits were found in 47 patients overall, comparable in MST with resection (23%) or without (19%). These preliminary results suggest that MST has efficacy by itself, with minimal neurologic compromise, in cases in which resective surgery cannot be used to treat uncontrolled epilepsy. MST should be investigated as a stand-alone procedure to allow further development of criteria and predictive factors for outcome.

Procedures for the use of aircraft in wildlife biotelemetry studies

USGS Publications Warehouse

Gilmer, David S.; Cowardin, Lewis M.; Duval, Renee L.; Mechlin, Larry M.; Shaiffer, Charles W.; Kuechle, V.B.

1981-01-01

This is a report on the state of the art methodology and on questions that arise while one is preparing to use aircraft in a biotelemetry study. In general the first step in preparing to mount an antenna on an aircraft is to consult with a certified aircraft mechanic. Aircraft certification is discussed to provide background information concerning the role of the Federal Aviation Administration (FAA) in regulating the use of biotelemetry antennas on aircraft. However, approval of any specific design of antenna mount rests with local FAA authority. Airplane and helicopter antenna attachments are described. Performance of the receiving antenna system is discussed with emphasis on how variables as aircraft type and antenna configuration may influence reception. The side-looking vs. front-looking antenna configuration and the VHF vs. HF frequency band are generally recommended for most aerial tracking studies. Characteristics of receivers, transmitters, and antennas that might influence tracking are discussed. Specific topics such as calibration of receivers and transmitter quality control are considered. Suggestions in preparing for and conducting tracking flights that will improve overall efficiency and safety are presented. Search techniques, including procedures for conducting large and specific area surveys as well as methods to improve and evaluate search efficiency, are discussed. A concluding section considers special topics such as low-level operations and the use of helicopters. Diagrams of antenna mounts, equipment check-off lists, and antenna test procedures are included as appendices.

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

A survey on the utility of the USEPA CADDIS stressor identification procedure.

PubMed

Harwood, John J; Stroud, Robert Adam

2012-06-01

The Environmental Protection Agency (EPA) has made available on the worldwide web a systematic stream stressor identification procedure, the "Causal Analysis/Diagnosis Decision Information System" or CADDIS. We report here the results of a survey of regulators and scientists in 11 states who use CADDIS or another stressor identification procedure in their work. The 13 survey questions address guidelines as to what impairment scenarios to approach with stressor identification, what information is needed to perform stressor identification, and what the stakeholder role is in performing stressor identification. At the time of this survey (the summer of 2009), the EPA CADDIS website was less commonly used among the state regulators surveyed than the published EPA stressor identification document on which it is based. The respondents generally find the EPA stressor identification procedure useful and capable of being adapted to their individual needs. Survey respondents all use stressor identification in their Total Maximum Daily Load work, but also in a wide variety of other applications. All the "types of evidence" included in the CADDIS stressor identification procedure are used by the practitioners surveyed with the exception of the results of ecological simulation models. While the CADDIS documentation encourages the involvement of stakeholders in stressor identification, most respondents do not assemble stakeholder teams of local officials and citizens to participate in stressor analyses.

Local wound infiltration plus transversus abdominis plane (TAP) block versus local wound infiltration in laparoscopic colorectal surgery and ERAS program.

PubMed

Pedrazzani, Corrado; Menestrina, Nicola; Moro, Margherita; Brazzo, Gianluca; Mantovani, Guido; Polati, Enrico; Guglielmi, Alfredo

2016-11-01

Few data are available on TAP block in laparoscopic colorectal surgery and ERAS program. The aim of this prospective study was to evaluate local wound infiltration plus TAP block compared to local wound infiltration in the management of postoperative pain, nausea and vomiting, ileus and use of opioids in the context of laparoscopic colorectal surgery and ERAS program. From March 2014 to March 2015, 48 patients were treated by laparoscopic resection and ERAS program for colorectal cancer and diverticular disease at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust. Among these, 24 patients received local wound infiltration plus TAP block (TAP block group) and 24 patients received local wound infiltration (control group). No differences were observed in baseline patient characteristics, clinical variables and surgical procedures between the two groups. Local wound infiltration plus TAP block allowed to achieve pain control despite a reduced use of opioid analgesics (P = 0.009). The adoption of TAP block resulted beneficial on the prevention of postoperative nausea (P = 0.002) and improvement of essential outcomes of ERAS program as recovery of bowel function (P = 0.005), urinary catheter removal (P = 0.003) and capability to tolerate oral diet (P = 0.027). TAP block plus local wound infiltration in the setting of laparoscopic colorectal surgery and ERAS program guarantees a reduced use of opioid analgesics and good pain control allowing the improvement of essential items of enhanced recovery pathways.

13 CFR 115.65 - General PSB procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Preferred Surety Bond (PSB) Guarantees § 115.65 General PSB procedures. (a) Retention of information. A PSB... Surety must request job status reports from Obligees in accordance with its own procedures. (c...

A general ansatz for constructing quasi-diabatic states in electronically excited aggregated systems

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

Liu, Wenlan; Köhn, Andreas; InnovationLab GmbH, Speyerer St. 4, D-69115 Heidelberg

2015-08-28

We present a general method for analyzing the character of singly excited states in terms of charge transfer (CT) and locally excited (LE) configurations. The analysis is formulated for configuration interaction singles (CIS) singly excited wave functions of aggregate systems. It also approximately works for the second-order approximate coupled cluster singles and doubles and the second-order algebraic-diagrammatic construction methods [CC2 and ADC(2)]. The analysis method not only generates a weight of each character for an excited state, but also allows to define the related quasi-diabatic states and corresponding coupling matrix elements. In the character analysis approach, we divide the targetmore » system into domains and use a modified Pipek-Mezey algorithm to localize the canonical MOs on each domain, respectively. The CIS wavefunction is then transformed into the localized basis, which allows us to partition the wavefunction into LE configurations within domains and CT configuration between pairs of different domains. Quasi-diabatic states are then obtained by mixing excited states subject to the condition of maximizing the weight of one single LE or CT configuration (localization in configuration space). Different aims of such a procedure are discussed, either the construction of pure LE and CT states for analysis purposes (by including a large number of excited states) or the construction of effective models for dynamics calculations (by including a restricted number of excited states). Applications are given to LE/CT mixing in π-stacked systems, charge-recombination matrix elements in a hetero-dimer, and excitonic couplings in multi-chromophoric systems.« less

A review of specialties performing temporal artery biopsies in Ontario: a retrospective cohort study

PubMed Central

Margolin, Edward A.

2015-01-01

Background Temporal artery biopsy is the gold standard for the diagnosis of giant cell arteritis, but the numbers and types of surgical specialists performing temporal artery biopsies are unknown. The goal of this study was to determine which surgical specialists performed temporal artery biopsies and how geographic location influenced this trend over a period of 10 years. Methods This retrospective cohort study included all physicians practising in Ontario from 2002 to 2013. Using comprehensive physician services data from the IntelliHEALTH Medical Services database, physicians performing temporal artery biopsies were identified by the Ontario Health Insurance Plan billing code submitted for remuneration. Physicians were categorized by specialty and geographic Local Health Integration Unit. Results A total of 9958 patients underwent a temporal artery biopsy during the study period: the biopsies were performed by 11 different subspecialties. The number of patients undergoing a temporal artery biopsy declined over the 10-year study period. Most procedures were performed by general surgeons (38.1%), followed by ophthalmologists (31.0%) and plastic surgeons (23.6%). Ophthalmologists performed more temporal artery biopsies per person compared with general surgeons, but significantly more general surgeons performed at least 1 biopsy. There was significant variation based on geographic location: plastic surgeons performed the most biopsies in regions with a population of more than 1 million people, and general surgeons performed most of the biopsies in rural areas. Interpretation Geographic location heavily influenced which specialty was most likely to perform temporal artery biopsies. General surgery, ophthalmology and plastic surgery emerged as leaders in this area, and their residency programs should include formal training in this procedure in their curricula. PMID:26442226

Online and offline tools for head movement compensation in MEG.

PubMed

Stolk, Arjen; Todorovic, Ana; Schoffelen, Jan-Mathijs; Oostenveld, Robert

2013-03-01

Magnetoencephalography (MEG) is measured above the head, which makes it sensitive to variations of the head position with respect to the sensors. Head movements blur the topography of the neuronal sources of the MEG signal, increase localization errors, and reduce statistical sensitivity. Here we describe two novel and readily applicable methods that compensate for the detrimental effects of head motion on the statistical sensitivity of MEG experiments. First, we introduce an online procedure that continuously monitors head position. Second, we describe an offline analysis method that takes into account the head position time-series. We quantify the performance of these methods in the context of three different experimental settings, involving somatosensory, visual and auditory stimuli, assessing both individual and group-level statistics. The online head localization procedure allowed for optimal repositioning of the subjects over multiple sessions, resulting in a 28% reduction of the variance in dipole position and an improvement of up to 15% in statistical sensitivity. Offline incorporation of the head position time-series into the general linear model resulted in improvements of group-level statistical sensitivity between 15% and 29%. These tools can substantially reduce the influence of head movement within and between sessions, increasing the sensitivity of many cognitive neuroscience experiments. Copyright © 2012 Elsevier Inc. All rights reserved.

A nanodiamond-fluorescein conjugate for cell studies

NASA Astrophysics Data System (ADS)

Pedroso-Santana, Seidy; Fleitas-Salazar, Noralvis; Sarabia-Sainz, Andrei; Silva-Campa, Erika; Burgara-Estrella, Alexel; Angulo-Molina, Aracely; Melendrez, Rodrigo; Pedroza-Montero, Martin; Riera, Raul

2018-03-01

The use of nanodiamonds in studies with living systems generally involves the modification of their surfaces with functional groups. Fluorescent molecules can be attached to these groups, so that one can know the exact position of the particles in each moment of the interaction with the cells. Here we modify the surface of detonation nanodiamonds and nitrogen-vacancy center nanodiamonds using carboxylation and hydroxylation procedures. Subsequent reactions with silicates and cysteine, before addition of fluorescein allow to obtain fluorescent nano-conjugates. We used confocal microscopy to observe the position of nanodiamonds interacting with HeLa cells. At 3 h post-incubation the green fluorescence is localized in extracellular rounded like-vesicles assemblies while at 24 h the conjugates can be observed inside the cells. The measurement of the fluorescence emitted by both conjugates allowed to find an enhanced emission of fluorescein isothiocyanate (FITC) when the nitrogen-vacancy center is present. We propose the existence of a fluorescence enhancement by electron transference process. The procedure described in this work allows the functionalization of nanodiamonds with FITC and other molecules using functional surface groups and small size mediators. Also, as was proved in our work, the nanodiamond-fluorescein conjugates can be used to track nanoparticles position within the cell. Localization studies are particularly important for drug delivery applications of nanodiamonds.

Effect of Damping and Yielding on the Seismic Response of 3D Steel Buildings with PMRF

PubMed Central

Haldar, Achintya; Rodelo-López, Ramon Eduardo; Bojórquez, Eden

2014-01-01

The effect of viscous damping and yielding, on the reduction of the seismic responses of steel buildings modeled as three-dimensional (3D) complex multidegree of freedom (MDOF) systems, is studied. The reduction produced by damping may be larger or smaller than that of yielding. This reduction can significantly vary from one structural idealization to another and is smaller for global than for local response parameters, which in turn depends on the particular local response parameter. The uncertainty in the estimation is significantly larger for local response parameter and decreases as damping increases. The results show the limitations of the commonly used static equivalent lateral force procedure where local and global response parameters are reduced in the same proportion. It is concluded that estimating the effect of damping and yielding on the seismic response of steel buildings by using simplified models may be a very crude approximation. Moreover, the effect of yielding should be explicitly calculated by using complex 3D MDOF models instead of estimating it in terms of equivalent viscous damping. The findings of this paper are for the particular models used in the study. Much more research is needed to reach more general conclusions. PMID:25097892

The Effects of Cryotherapy on Proprioception System

PubMed Central

Furmanek, Mariusz Paweł; Słomka, Kajetan; Juras, Grzegorz

2014-01-01

Proprioception plays an important role in the complex mechanism of joint control. Contemporary sport activities impose extremely high physical demands on athletes. Winter sports are played in areas with excessively low temperatures. Moreover, many athletes are subjected to treatments that involve local lowering of the body temperature before, during, and after physical activity. This work reviews the current knowledge regarding the influence of local cryotherapy on the proprioception system. The reviewed literature identified several tests that evaluate different aspects of proprioception. There is no universally agreed protocol, or clear set of criteria for test conditions. The outcomes of different tests and assessments of cryotherapy procedures using different cold modalities are poorly correlated. In general, the published results on the mechanism of cryotherapy effects on proprioception are not uniquely conclusive and are frequently contradictory. Additional high-quality research is required to explicitly answer the following questions: (1) whether local cryotherapy influences all aspects of proprioception; (2) whether the current methods of evaluation are adequate for the exploration of the relationship between cryotherapy and proprioception; and (3) whether the application of local cryotherapy is safe for athletes regarding proprioception. The review clearly showed that there is no comprehensive model relating cryotherapy and proprioception. PMID:25478573

The effects of cryotherapy on proprioception system.

PubMed

Furmanek, Mariusz Paweł; Słomka, Kajetan; Juras, Grzegorz

2014-01-01

Proprioception plays an important role in the complex mechanism of joint control. Contemporary sport activities impose extremely high physical demands on athletes. Winter sports are played in areas with excessively low temperatures. Moreover, many athletes are subjected to treatments that involve local lowering of the body temperature before, during, and after physical activity. This work reviews the current knowledge regarding the influence of local cryotherapy on the proprioception system. The reviewed literature identified several tests that evaluate different aspects of proprioception. There is no universally agreed protocol, or clear set of criteria for test conditions. The outcomes of different tests and assessments of cryotherapy procedures using different cold modalities are poorly correlated. In general, the published results on the mechanism of cryotherapy effects on proprioception are not uniquely conclusive and are frequently contradictory. Additional high-quality research is required to explicitly answer the following questions: (1) whether local cryotherapy influences all aspects of proprioception; (2) whether the current methods of evaluation are adequate for the exploration of the relationship between cryotherapy and proprioception; and (3) whether the application of local cryotherapy is safe for athletes regarding proprioception. The review clearly showed that there is no comprehensive model relating cryotherapy and proprioception.

Buckling Behavior of Compression-Loaded Composite Cylindrical Shells With Reinforced Cutouts

NASA Technical Reports Server (NTRS)

Hilburger, Mark W.; Sarnes, James H., Jr.

2004-01-01

Results from a numerical study of the response of thin-walled compression-loaded quasi-isotropic laminated composite cylindrical shells with unreinforced and reinforced square cutouts are presented. The effects of cutout reinforcement orthotropy, size, and thickness on the nonlinear response of the shells are described. A nonlinear analysis procedure has been used to predict the nonlinear response of the shells. The results indicate that a local buckling response occurs in the shell near the cutout when subjected to load and is caused by a nonlinear coupling between local shell-wall deformations and in-plane destabilizing compression stresses near the cutout. In general, reinforcement around a cutout in a compression-loaded shell is shown to retard or eliminate the local buckling response near the cutout and increase the buckling load of the shell. However, some results show that certain reinforcement configurations can cause an unexpected increase in the magnitude of local deformations and stresses in the shell and cause a reduction in the buckling load. Specific cases are presented that suggest that the orthotropy, thickness, and size of a cutout reinforcement in a shell can be tailored to achieve improved buckling response characteristics.

Effect of damping and yielding on the seismic response of 3D steel buildings with PMRF.

PubMed

Reyes-Salazar, Alfredo; Haldar, Achintya; Rodelo-López, Ramon Eduardo; Bojórquez, Eden

2014-01-01

The effect of viscous damping and yielding, on the reduction of the seismic responses of steel buildings modeled as three-dimensional (3D) complex multidegree of freedom (MDOF) systems, is studied. The reduction produced by damping may be larger or smaller than that of yielding. This reduction can significantly vary from one structural idealization to another and is smaller for global than for local response parameters, which in turn depends on the particular local response parameter. The uncertainty in the estimation is significantly larger for local response parameter and decreases as damping increases. The results show the limitations of the commonly used static equivalent lateral force procedure where local and global response parameters are reduced in the same proportion. It is concluded that estimating the effect of damping and yielding on the seismic response of steel buildings by using simplified models may be a very crude approximation. Moreover, the effect of yielding should be explicitly calculated by using complex 3D MDOF models instead of estimating it in terms of equivalent viscous damping. The findings of this paper are for the particular models used in the study. Much more research is needed to reach more general conclusions.

Combined spinal epidural anesthesia in achondroplastic dwarf for femur surgery

PubMed Central

Bakhshi, Rochana Girish; Jagtap, Sheetal R.

2011-01-01

Achondroplasia is the commonest form of short-limbed dwarfism and occurs in 1:26,000-40,000 live births. This is an autosomal dominant disorder with abnormal endochondral ossification whereas periosteal and intramembranous ossification are normal. The basic abnormality is a disturbance of cartilage formation mainly at the epiphyseal growth plates and at the base of the skull. The anesthetic management of achondroplastic dwarfs is a challenge to the anesthesiologist. Both regional as well as general anesthesia have their individual risks and consequences. We report a case of an achondroplastic dwarf in whom combined spinal epidural anesthesia was used for fixation of a fractured femur. The patient had undergone previous femur surgery under general anesthesia since he had been informed that spinal anesthesia could be very problematic. There was no technical difficulty encountered during the procedure and an adequate level was achieved with low-dose local anesthetics without any problem. Postoperative pain relief was offered for three consecutive postoperative days using epidural tramadol. We discuss the anesthetic issues and highlight the role of combined spinal epidural anesthesia with low-dose local anesthetics in this patient. This approach also helped in early ambulation and postoperative pain relief. PMID:24765361

The needs of denture-brushing in geriatrics: clinical aspects and perspectives.

PubMed

Berteretche, Marie-Violaine; Mastari, Fatima; Nicolas, Emmanuel; Hüe, Olivier

2012-06-01

Oral and denture hygiene are often defective in particular with dependent persons such as geriatric subjects. The reasons are the lack of hygiene education of the subjects or those caring for them. Consequently, oral hygiene is often neglected, resulting in poor oral health and an increase in the presence of local or general infections. This paper is a report of brushing effectiveness on microbial biofilm deposits on dentures of subjects participating in a specific oral hygiene programme. Thirty-nine dentures of 30 subjects were assessed for 2 weeks following an educational brushing programme. Microbial biofilm was recovered using fluoresceine and then scanned and quantified by 'Mesurim' software three times: before study, after 1 and 2 weeks. The repeated measurement procedures showed a decrease in the percentage of biofilm present (F = 15, p < 0.001) whatever the type of denture (partial or complete) and for all biomaterials. Regular denture-brushing can improve local hygiene. Consequently, decreasing the biofilm surface can reduce the prevalence of oral pathogens, thereby contributing to the general prevention of the risks of infections such as pneumotisis. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Vaccine allergy and pseudo-allergy.

PubMed

Ponvert, Claude; Scheinmann, Pierre

2003-01-01

Allergic and pseudo-allergic reactions to vaccines frequently involve the skin, and can be generalized systemic symptoms (urticaria/angioedema, serum sickness, flares of eczema) or localized at the sites of vaccination (persistent nodules, abcesses, granulomas). Diagnosis of Arthus-type reactions is based on clinical history and specific IgM/IgG anti-toxoid determination. For other local reactions, diagnostic value of non-immediate responses in skin tests varies with clinical symptoms and substances involved. Immediate responses in skin tests and specific IgE determination have good diagnostic and/or predictive value in anaphylaxis and immediate/accelerated urticaria/angioedema to toxoid-, pneumococcus-, and egg- and gelatin-containing vaccines. Diagnosis of reactions to dextran in BCG is based on specific IgM/IgG determination. Most non-immediate generalized reactions result from non-specific inflammation, except for gelatin-containing vaccines, but the diagnostic value of immuno-allergological tests with the vaccines and gelatin are controversial. Withholding booster injections is advised if specific IgM/IgG levels are high. If the levels are low, sequential injections of vaccines containing a single vaccinating agent are usually tolerated. However, injections of the vaccine should be performed using a " desensitization " procedure in patients reporting anaphylaxis and immediate/accelerated urticaria/angioedema.

Electrochemotherapy under tumescent local anesthesia for the treatment of cutaneous metastases.

PubMed

Kendler, Michael; Micheluzzi, Martin; Wetzig, Tino; Simon, Jan C

2013-07-01

The surgical management of cutaneous metastasis (CM) is challenging, particularly in elderly patients, in whom general anesthesia can be difficult because of comorbidity. To test the effectiveness of tumescent local anesthesia (TLA) to achieve adequate anesthesia during the treatment of extensive CM with electrochemotherapy (ECT), previously only performed under general anesthesia. We conducted five ECT treatments of CM with intralesional bleomycin under TLA. We examined pain scores before, during, and after treatment; analgesic use; and side effects. The intention of the treatment was palliative in all cases. We treated four patients (ages 75-88) with CM with a mean area of 126 cm(2) (range 12-198 cm(2) ) with 356 mL of TLA per treatment (range 180-450 mL). The ECT treatment under TLA demonstrated that anesthesia was adequate, with moderate pain during and slight pain after the procedure as measured on a visual analog scale (VAS). In this proof-of-principle study, we demonstrated that ECT can be performed under TLA; TLA might be a useful new anesthesia option for patients treated with ECT. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Optimization of the kernel functions in a probabilistic neural network analyzing the local pattern distribution.

PubMed

Galleske, I; Castellanos, J

2002-05-01

This article proposes a procedure for the automatic determination of the elements of the covariance matrix of the gaussian kernel function of probabilistic neural networks. Two matrices, a rotation matrix and a matrix of variances, can be calculated by analyzing the local environment of each training pattern. The combination of them will form the covariance matrix of each training pattern. This automation has two advantages: First, it will free the neural network designer from indicating the complete covariance matrix, and second, it will result in a network with better generalization ability than the original model. A variation of the famous two-spiral problem and real-world examples from the UCI Machine Learning Repository will show a classification rate not only better than the original probabilistic neural network but also that this model can outperform other well-known classification techniques.

[Electrocautery snare efficacy in head and neck lesion treatment].

PubMed

Saito, Koichiro; Inagaki, Koji; Naganishi, Hideki; Takaoka, Takuji; Isogai, Yutaka; Ogawa, Kaoru

2009-11-01

The electrocautery snare has been widely used in gastroenterology and to remove bronchial and urinary bladder lesions, but rarely in head and lesion electrocautery. Since October 2006, we have used this instrument to treat 17 head and neck granuloma, papilloma, cyst, and cancer lesions under local or general anesthesia. Lesions were localized in the larynx, oropharynx, hypopharynx, or tracheostoma. The snare was used through a rhinolaryngovideoscope in most cases with a current of 15-30 watts produced by an electrosurgical generator. All procedures were easy, quick and successful, with minimal bleeding. No severe adverse effects were seen in any of our cases. The electrocautery snare was extremely useful in treating pedunculated lesions and in removing epiglottic cysts with a clear margin after excision of the mass without bleeding. Our results indicate the electrocautery snare to be useful and safe in treating selected head and neck lesion cases.

Coordinate transformations and gauges in the relativistic astronomical reference systems

NASA Astrophysics Data System (ADS)

Tao, J.-H.; Huang, T.-Y.; Han, C.-H.

2000-11-01

This paper applies a fully post-Newtonian theory (Damour et al. 1991, 1992, 1993, 1994) to the problem of gauge in relativistic reference systems. Gauge fixing is necessary when the precision of time measurement and application reaches 10-16 or better. We give a general procedure for fixing the gauges of gravitational potentials in both the global and local coordinate systems, and for determining the gauge functions in all the coordinate transformations. We demonstrate that gauge fixing in a gravitational N-body problem can be solved by fixing the gauge of the self-gravitational potential of each body and the gauge function in the coordinate transformation between the global and local coordinate systems. We also show that these gauge functions can be chosen to make all the coordinate systems harmonic or any as required, no matter what gauge is chosen for the self-gravitational potential of each body.

Rats do not respond differently in the presence of stimuli signaling wheel-running reinforcers of different durations.

PubMed

Belke, Terry W

2007-05-01

Rats were exposed to a fixed interval 30 s schedule that produced opportunities to run of equal or unequal durations to assess the effect of differences in duration on responding. Each duration was signaled by a different stimulus. Wheel-running reinforcer duration pairs were 30 s 30 s, 50 s 10 s, and 55 s 5 s. An analysis of median postreinforcement pause duration and mean local lever-pressing rates broken down by previous reinforcer duration and duration of signaled upcoming reinforcer showed that postreinforcement pause duration was affected by the duration of the previous reinforcer but not by the stimulus signaling the duration of the upcoming reinforcer. Local lever-pressing rates were not affected by either previous or upcoming reinforcer duration. In general, the results are consistent with indifference between these durations obtained using a concurrent choice procedure.

Large data series: Modeling the usual to identify the unusual

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

Downing, D.J.; Fedorov, V.V.; Lawkins, W.F.

{open_quotes}Standard{close_quotes} approaches such as regression analysis, Fourier analysis, Box-Jenkins procedure, et al., which handle a data series as a whole, are not useful for very large data sets for at least two reasons. First, even with computer hardware available today, including parallel processors and storage devices, there are no effective means for manipulating and analyzing gigabyte, or larger, data files. Second, in general it can not be assumed that a very large data set is {open_quotes}stable{close_quotes} by the usual measures, like homogeneity, stationarity, and ergodicity, that standard analysis techniques require. Both reasons dictate the necessity to use {open_quotes}local{close_quotes} data analysismore » methods whereby the data is segmented and ordered, where order leads to a sense of {open_quotes}neighbor,{close_quotes} and then analyzed segment by segment. The idea of local data analysis is central to the study reported here.« less

Computational Aerothermodynamic Simulation Issues on Unstructured Grids

NASA Technical Reports Server (NTRS)

Gnoffo, Peter A.; White, Jeffery A.

2004-01-01

The synthesis of physical models for gas chemistry and turbulence from the structured grid codes LAURA and VULCAN into the unstructured grid code FUN3D is described. A directionally Symmetric, Total Variation Diminishing (STVD) algorithm and an entropy fix (eigenvalue limiter) keyed to local cell Reynolds number are introduced to improve solution quality for hypersonic aeroheating applications. A simple grid-adaptation procedure is incorporated within the flow solver. Simulations of flow over an ellipsoid (perfect gas, inviscid), Shuttle Orbiter (viscous, chemical nonequilibrium) and comparisons to the structured grid solvers LAURA (cylinder, Shuttle Orbiter) and VULCAN (flat plate) are presented to show current capabilities. The quality of heating in 3D stagnation regions is very sensitive to algorithm options in general, high aspect ratio tetrahedral elements complicate the simulation of high Reynolds number, viscous flow as compared to locally structured meshes aligned with the flow.

27 CFR 17.3 - Alternate methods or procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Alternate methods or... PRODUCTS General Provisions § 17.3 Alternate methods or procedures. (a) General. The appropriate TTB officer may approve the use of an alternate method or procedure in lieu of a method or procedure...

Hybrid General Pattern Search and Simulated Annealing for Industrail Production Planning Problems

NASA Astrophysics Data System (ADS)

Vasant, P.; Barsoum, N.

2010-06-01

In this paper, the hybridization of GPS (General Pattern Search) method and SA (Simulated Annealing) incorporated in the optimization process in order to look for the global optimal solution for the fitness function and decision variables as well as minimum computational CPU time. The real strength of SA approach been tested in this case study problem of industrial production planning. This is due to the great advantage of SA for being easily escaping from trapped in local minima by accepting up-hill move through a probabilistic procedure in the final stages of optimization process. Vasant [1] in his Ph. D thesis has provided 16 different techniques of heuristic and meta-heuristic in solving industrial production problems with non-linear cubic objective functions, eight decision variables and 29 constraints. In this paper, fuzzy technological problems have been solved using hybrid techniques of general pattern search and simulated annealing. The simulated and computational results are compared to other various evolutionary techniques.

Pattern formation in mass conserving reaction-diffusion systems

NASA Astrophysics Data System (ADS)

Brauns, Fridtjof; Halatek, Jacob; Frey, Erwin

We present a rigorous theoretical framework able to generalize and unify pattern formation for quantitative mass conserving reaction-diffusion models. Mass redistribution controls chemical equilibria locally. Separation of diffusive mass redistribution on the level of conserved species provides a general mathematical procedure to decompose complex reaction-diffusion systems into effectively independent functional units, and to reveal the general underlying bifurcation scenarios. We apply this framework to Min protein pattern formation and identify the mechanistic roles of both involved protein species. MinD generates polarity through phase separation, whereas MinE takes the role of a control variable regulating the existence of MinD phases. Hence, polarization and not oscillations is the generic core dynamics of Min proteins in vivo. This establishes an intrinsic mechanistic link between the Min system and a broad class of intracellular pattern forming systems based on bistability and phase separation (wave-pinning). Oscillations are facilitated by MinE redistribution and can be understood mechanistically as relaxation oscillations of the polarization direction.

Nocebo-induced hyperalgesia during local anesthetic injection.

PubMed

Varelmann, Dirk; Pancaro, Carlo; Cappiello, Eric C; Camann, William R

2010-03-01

Common practice during local anesthetic injection is to warn the patient using words such as: "You will feel a big bee sting; this is the worst part." Our hypothesis was that using gentler words for administration of the local anesthetic improves pain perception and patient comfort. One hundred forty healthy women at term gestation requesting neuraxial analgesia were randomized to either a "placebo" ("We are going to give you a local anesthetic that will numb the area and you will be comfortable during the procedure") or "nocebo" ("You are going to feel a big bee sting; this is the worst part of the procedure") group. Pain was assessed immediately after the local anesthetic skin injection using verbal analog scale scores of 0 to 10. Median verbal analog scale pain scores were lower when reassuring words were used compared with the harsher nocebo words (3 [2-4] vs 5 [3-6]; P < 0.001). Our data suggest that using gentler, more reassuring words improves the subjective experience during invasive procedures.

Face expressive lifting (FEL): an original surgical concept combined with bipolar radiofrequency.

PubMed

Divaris, Marc; Blugerman, Guillermo; Paul, Malcolm D

2014-01-01

Aging can lead to changes in facial expressions, transforming the positive youth expression of happiness to negative expressions as sadness, tiredness, and disgust. Local skin distension is another consequence of aging, which can be difficult to treat with rejuvenation procedures. The "face expressive lifting" (FEL) is an original concept in facial rejuvenation surgery. On the one hand, FEL integrates established convergent surgical techniques aiming to correct the age-related negative facial expressions. On the other hand, FEL incorporates novel bipolar RF technology aiming to correct local skin distension. One hundred twenty-six patients underwent FEL procedure. Facial expression and local skin distension were assessed with 2 years follow-up. There was a correction of negative facial expression for 96 patients (76 %) and a tightening of local skin distension in 100 % of cases. FEL is an effective procedure taking into account and able to correct both age-related negative changes in facial expression and local skin distension using radiofrequency. Level of Evidence: Level IV, therapeutic study.

Factors Affecting Utilization of Information Output of Computer-Based Modeling Procedures in Local Government Organizations.

ERIC Educational Resources Information Center

Komsky, Susan

Fiscal Impact Budgeting Systems (FIBS) are sophisticated computer based modeling procedures used in local government organizations, whose results, however, are often overlooked or ignored by decision makers. A study attempted to discover the reasons for this situation by focusing on four factors: potential usefulness, faith in computers,…

Solutions to Kuessner's integral equation in unsteady flow using local basis functions

NASA Technical Reports Server (NTRS)

Fromme, J. A.; Halstead, D. W.

1975-01-01

The computational procedure and numerical results are presented for a new method to solve Kuessner's integral equation in the case of subsonic compressible flow about harmonically oscillating planar surfaces with controls. Kuessner's equation is a linear transformation from pressure to normalwash. The unknown pressure is expanded in terms of prescribed basis functions and the unknown basis function coefficients are determined in the usual manner by satisfying the given normalwash distribution either collocationally or in the complex least squares sense. The present method of solution differs from previous ones in that the basis functions are defined in a continuous fashion over a relatively small portion of the aerodynamic surface and are zero elsewhere. This method, termed the local basis function method, combines the smoothness and accuracy of distribution methods with the simplicity and versatility of panel methods. Predictions by the local basis function method for unsteady flow are shown to be in excellent agreement with other methods. Also, potential improvements to the present method and extensions to more general classes of solutions are discussed.

40 CFR 610.40 - General.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false General. 610.40 Section 610.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria General Vehicle Test Procedures § 610.40 General. Two...

40 CFR 610.40 - General.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false General. 610.40 Section 610.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria General Vehicle Test Procedures § 610.40 General. Two...

40 CFR 610.40 - General.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false General. 610.40 Section 610.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria General Vehicle Test Procedures § 610.40 General. Two...

40 CFR 610.40 - General.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false General. 610.40 Section 610.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria General Vehicle Test Procedures § 610.40 General. Two...

40 CFR 610.40 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false General. 610.40 Section 610.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria General Vehicle Test Procedures § 610.40 General. Two...

Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study.

PubMed

Jensen, Anders Torp; Jensen, Simon Storgård; Worsaae, Nils

2016-06-01

This retrospective clinical study aims to evaluate complications after augmentation of localized bone defects of the alveolar ridge. From standardized registrations, the following complications related to bone augmentation procedures were recorded: soft tissue dehiscence, infection, sensory disturbance, additional augmentation procedures needed, and early implant failure. A total of 223 patients (132 women, 91 men; mean age 23.5 years; range 17-65 years) with 331 bone defects had bone augmentation performed into which 350 implants were placed. Soft tissue dehiscence occurred in 1.7 % after GBR procedures, 25.9 % after staged horizontal ridge augmentation, and 18.2 % after staged vertical ridge augmentation. Infections were diagnosed in 2 % after GBR procedures, 12.5 % after sinus floor elevation (SFE) (transcrestal technique), 5 % after staged SFE, 11 % after staged horizontal ridge augmentation, and 9 % after staged vertical ridge augmentation. Additional augmentation procedures were needed in 2 % after GBR procedures, 37 % after staged horizontal ridge augmentation, and 9 % after staged vertical ridge augmentation. A total of six early implant failures occurred (1.7 %), four after GBR procedures (1.6 %), and two (12 %) after staged vertical ridge augmentation. Predictable methods exist to augment localized defects in the alveolar ridge, as documented by low complication rates and high early implant survival rates.

Paediatric minor oral surgical procedures under inhalation sedation and general anaesthetic: a comparison of variety and duration of treatment.

PubMed

Foley, J

2008-03-01

To develop baseline data in relation to paediatric minor oral surgical procedures undertaken with both general anaesthesia and nitrous oxide inhalation sedation within a Hospital Dental Service. Data were collected prospectively over a three-year period from May 2003 to June 2006 for patients attending the Departments of Paediatric Dentistry, Dundee Dental Hospital and Ninewells Hospital, NHS Tayside, Great Britain, for all surgical procedures undertaken with either inhalation sedation or general anaesthetic. Both operator status and the procedure being undertaken were noted. In addition, the operating time was recorded. Data for 166 patients (F: 102; M: 64) with a median age of 12.50 (inter-quartile range 10.00, 14.20) years showed that 195 surgical procedures were undertaken. Of these 160 and 35 were with general anaesthetic and sedation respectively. The surgical removal of impacted, carious and supernumerary unit(s) accounted for 53.8% of all procedures, whilst the exposure of impacted teeth and soft tissue surgery represented 34.9% and 11.3% of procedures respectively. The median surgical time for techniques undertaken with sedation was 30.00 (inter-quartile range 25.00, 43.50) minutes whilst that for general anaesthetic was similar at 30.00 (inter-quartile range 15.25, 40.00) minutes (not statistically significant, (Mann Whitney U, W = 3081.5, P = 0.331). The majority of paediatric minor oral surgical procedures entail surgical exposure or removal of impacted teeth. The median treatment time for most procedures undertaken with either general anaesthetic or nitrous oxide sedation was 30 minutes.

Malfunction and failure of robotic systems during general surgical procedures.

PubMed

Agcaoglu, Orhan; Aliyev, Shamil; Taskin, Halit Eren; Chalikonda, Sricharan; Walsh, Matthew; Costedio, Meagan M; Kroh, Matthew; Rogula, Tomasz; Chand, Bipan; Gorgun, Emre; Siperstein, Allan; Berber, Eren

2012-12-01

There has been recent interest in using robots for general surgical procedures. This shift in technique raises the issue of patient safety with automated instrumentation. Although the safety of robotics has been established for urologic procedures, there are scant data on its use in general surgical procedures. The aim of this study is to analyze the incidence of robotic malfunction and its consequences for general surgical procedures. All robotic general surgical procedures performed at a tertiary center between 2008 and 2011 were reviewed from institutional review board (IRB)-approved prospective databases. A total of 223 cases were done robotically, including 102 endocrine, 83 hepatopancreaticobiliary, 17 upper gastrointestinal, and 21 lower gastrointestinal colorectal procedures. There were 10 cases of robotic malfunction (4.5%). These failures were related to robotic instruments (n = 4), optical system (n = 3), robotic arms (n = 2), and robotic console (n = 1). None of these failures led to adverse patient consequences or conversion to open. Six (2.7%) cases were converted to open due to bleeding (n = 3), difficult dissection plane (n = 1), invasion of tumor to surrounding structures (n = 1), and intolerance of pneumoperitoneum due to CO(2) retention (n = 1). There was no mortality, and morbidity was 1% (n = 2). To our knowledge, this is the largest North American report to date on robotic general surgical procedures. Our results show that robotic malfunction occurs in a minority of cases, with no adverse consequences. We believe that awareness of these failures and knowing how to troubleshoot are important to maintain the efficiency of these procedures.

31 CFR 50.9 - Procedure for requesting general interpretations of statute.

Code of Federal Regulations, 2012 CFR

2012-07-01

... TERRORISM RISK INSURANCE PROGRAM General Provisions § 50.9 Procedure for requesting general interpretations... request an interpretation of the Act or regulations by writing to the Terrorism Risk Insurance Program...

31 CFR 50.9 - Procedure for requesting general interpretations of statute.

Code of Federal Regulations, 2011 CFR

2011-07-01

... TERRORISM RISK INSURANCE PROGRAM General Provisions § 50.9 Procedure for requesting general interpretations... request an interpretation of the Act or regulations by writing to the Terrorism Risk Insurance Program...

31 CFR 50.9 - Procedure for requesting general interpretations of statute.

Code of Federal Regulations, 2013 CFR

2013-07-01

... TERRORISM RISK INSURANCE PROGRAM General Provisions § 50.9 Procedure for requesting general interpretations... request an interpretation of the Act or regulations by writing to the Terrorism Risk Insurance Program...

31 CFR 50.9 - Procedure for requesting general interpretations of statute.

Code of Federal Regulations, 2014 CFR

2014-07-01

... TERRORISM RISK INSURANCE PROGRAM General Provisions § 50.9 Procedure for requesting general interpretations... request an interpretation of the Act or regulations by writing to the Terrorism Risk Insurance Program...

Acceptance of general personality interpretations prior to and after receipt of diagnostic feedback supposedly based on psychological, graphological, and astrological assessment procedures.

PubMed

Snyder, C R; Larsen, D L; Bloom, L J

1976-04-01

There was no difference in the acceptance of a general personality interpretation supposedly based on psychological, graphological, or astrological assessment procedures. Ss told that their general personality interpretation was based on one of the three assessment procedures, however, accepted the interpretation to a greater degree than did Ss told the interpretation was "generally true of people." S faith in all assessment procedures and perceived diagnostician skill increased significantly from before to after receipt of the diagnostic feedback. Ss elicited a halo response after they had received the interpretation, such that they generated a highly consistent positive (or negative) view of the assessment procedures and diagnostician skills. Implications of results from this acceptance paradigm were discussed for diagnosticians and therapists.

28 CFR 51.16 - Distinction between changes in procedure and changes in substance.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED General... Attorney General to interpose an objection to a procedure for instituting a change affecting voting does...

28 CFR 51.16 - Distinction between changes in procedure and changes in substance.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED General... Attorney General to interpose an objection to a procedure for instituting a change affecting voting does...

Verification of GCM-generated regional seasonal precipitation for current climate and of statistical downscaling estimates under changing climate conditions

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

Busuioc, A.; Storch, H. von; Schnur, R.

Empirical downscaling procedures relate large-scale atmospheric features with local features such as station rainfall in order to facilitate local scenarios of climate change. The purpose of the present paper is twofold: first, a downscaling technique is used as a diagnostic tool to verify the performance of climate models on the regional scale; second, a technique is proposed for verifying the validity of empirical downscaling procedures in climate change applications. The case considered is regional seasonal precipitation in Romania. The downscaling model is a regression based on canonical correlation analysis between observed station precipitation and European-scale sea level pressure (SLP). Themore » climate models considered here are the T21 and T42 versions of the Hamburg ECHAM3 atmospheric GCM run in time-slice mode. The climate change scenario refers to the expected time of doubled carbon dioxide concentrations around the year 2050. Generally, applications of statistical downscaling to climate change scenarios have been based on the assumption that the empirical link between the large-scale and regional parameters remains valid under a changed climate. In this study, a rationale is proposed for this assumption by showing the consistency of the 2 x CO{sub 2} GCM scenarios in winter, derived directly from the gridpoint data, with the regional scenarios obtained through empirical downscaling. Since the skill of the GCMs in regional terms is already established, it is concluded that the downscaling technique is adequate for describing climatically changing regional and local conditions, at least for precipitation in Romania during winter.« less

In vitro fertilisation in a small unit in the NHS

PubMed Central

Bromwich, Peter; Walker, Andrew; Kennedy, Stephen; Wiley, Mary; Little, David; Ross, Caroline; Sargent, Ian; Bellinger, Joan; O'Reilly, Helen; Lopez-Bernal, Andres; Brice, Amy L; Barlow, David

1988-01-01

In vitro fertilisation is one of the most effective new treatments for infertility, but financial restrictions have made it impossible for it to be widely carried out in the National Health Service. We report on the establishment of a small, largely self funded, unit that was set up with the help of the local health service management. All cycles are programmed so that most work is carried out during the working week; oocyte recoveries are performed as outpatient procedures without general anaesthesia and guided by ultrasound. Roughly a tenth of treatment cycles and roughly a fifth of embryo transfers resulted in a clinical pregnancy. PMID:3126964

The role of ethnography in STI and HIV/AIDS education and promotion with traditional healers in Zimbabwe

PubMed Central

Simmons, David

2011-01-01

This article explores the utility of ethnography in accounting for healers’ understandings of HIV/AIDS—and more generally sexually transmitted infections—and the planning of HIV/AIDS education interventions targeting healers in urban Zimbabwe. I argue that much of the information utilized for planning and implementing such programs is actually based on rapid research procedures (usually single-method survey-based approaches) that do not fully capture healers’ explanatory frameworks. This incomplete information then becomes authoritative knowledge about local ‘traditions' and forms the basis for the design and implementation of training programs. Such decontextualization may, in turn, affect program effectiveness. PMID:21343161

Promoting Spontaneous Second Harmonic Generation through Organogelation.

PubMed

Marco, A Belén; Aparicio, Fátima; Faour, Lara; Iliopoulos, Konstantinos; Morille, Yohann; Allain, Magali; Franco, Santiago; Andreu, Raquel; Sahraoui, Bouchta; Gindre, Denis; Canevet, David; Sallé, Marc

2016-07-27

An organogelator based on the Disperse Red nonlinear optical chromophore was synthesized according to a simple and efficient three-step procedure. The supramolecular gel organization leads to xerogels which display a spontaneous second harmonic generation (SHG) response without any need for preprocessing, and this SHG activity appears to be stable over several months. These findings, based on an intrinsic structural approach, are supported by favorable intermolecular supramolecular interactions, which promote a locally non-centrosymmetric NLO-active organization. This is in sharp contrast with most materials designed for SHG purposes, which generally require the use of expensive or heavy-to-handle external techniques for managing the dipoles' alignment.

Constructing Standards: A Study of Nurses Negotiating with Multiple Modes of Knowledge

ERIC Educational Resources Information Center

Nes, Sturle; Moen, Anne

2010-01-01

Purpose: The aim of the paper is to explore how multiple modes of knowledge play out in the consolidation of nursing procedures in construction of "local universality". The paper seeks to explore processes where nurses negotiate universal procedures that are to become local standards in a hospital. Design/methodology/approach: The paper…

34 CFR 222.94 - What provisions must be included in a local educational agency's Indian policies and procedures?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false What provisions must be included in a local educational agency's Indian policies and procedures? 222.94 Section 222.94 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION...

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

PubMed

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

2018-03-20

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

Local and gauge invariant observables in gravity

NASA Astrophysics Data System (ADS)

Khavkine, Igor

2015-09-01

It is well known that general relativity (GR) does not possess any non-trivial local (in a precise standard sense) and diffeomorphism invariant observable. We propose a generalized notion of local observables, which retain the most important properties that follow from the standard definition of locality, yet is flexible enough to admit a large class of diffeomorphism invariant observables in GR. The generalization comes at a small price—that the domain of definition of a generalized local observable may not cover the entire phase space of GR and two such observables may have distinct domains. However, the subset of metrics on which generalized local observables can be defined is in a sense generic (its open interior is non-empty in the Whitney strong topology). Moreover, generalized local gauge invariant observables are sufficient to separate diffeomorphism orbits on this admissible subset of the phase space. Connecting the construction with the notion of differential invariants gives a general scheme for defining generalized local gauge invariant observables in arbitrary gauge theories, which happens to agree with well-known results for Maxwell and Yang-Mills theories.

Three-year audit and cost assessment of open abdominal aortic aneurysm repair in a district general hospital.

PubMed

El Kafsi, J; Wake, J; Lintott, P; Northeast, A; McLaren, A

2009-11-01

The aims of this study were to audit the outcome of elective open abdominal aortic aneurysm (AAA) repair in a district general hospital, as well as investigate the true costs for this procedure in relation to the national tariff. A database is maintained on AAA surgery in the trust. Data were supplemented by drawing information from blood bank and clinical notes. Patients with symptomatic or emergency aneurysms were excluded. Data from January 2005 to December 2007 were obtained on demographics, morbidity, 30-day mortality and blood usage. Costs were obtained from the trust finance department. Between January 2005 and December 2007, 79 elective AAA procedures were undertaken. Median age was 75 years (range, 52-85 years), median aneurysm size was 63 mm (range, 42-105 mm) and median ITU stay was 3 days (range, 1-41 days). Major morbidity rate was 20.3% (16 of 79 patients) and 30-day mortality overall was 5.1% (4 of 79 patients). Average cost per case was pound15,012.91 (range, pound4,040.03- pound82,158.00), when National Tariff is pound6,722.00 ( pound5,649.00 x local Market Forces Factor of 1.19). Loss per case for our trust was pound8,290.91 with a total annual loss of pound218,299.56. Morbidity and mortality in this district general hospital compare well with national studies; however, the total cost is far in excess of the national tariff.

Systems development and difficulties in implementing procedures for elder abuse prevention among private community general support centers in Japan.

PubMed

Nakanishi, Miharu; Nakashima, Taeko; Yamaoka, Yukako; Hada, Keiko; Tanaka, Hideaki

2014-01-01

The present study examines differences in systems development and difficulties in implementing procedures for elder abuse prevention in 1,119 private and 606 public community general support centers under the public long-term care insurance program in Japan. The private community general support centers showed more difficulty implementing procedures than the public community general support centers. Controlling for the type of municipality, progress in systems development did not differ between the private and public community general support centers. Further research should examine how the characteristics of municipal governments are related to systems development in community general support centers.

47 CFR 1.1621 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Definitions. 1.1621 Section 1.1621 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Random Selection Procedures for Mass Media Services General Procedures § 1.1621 Definitions. (a) Medium of mass communications means...

47 CFR 1.1621 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Definitions. 1.1621 Section 1.1621 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Random Selection Procedures for Mass Media Services General Procedures § 1.1621 Definitions. (a) Medium of mass communications means...

15 CFR 904.216 - Prehearing conferences.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures General § 904.216 Prehearing conferences. (a) Prior to any hearing... evidence; (5) The procedure, course, and conduct of the administrative proceeding; (6) The distribution to...

15 CFR 904.200 - Scope and applicability.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures General § 904.200 Scope and applicability. (a) This subpart sets forth the procedures governing the conduct of hearings and the issuance of initial and final...

40 CFR 6.203 - Public participation.

Code of Federal Regulations, 2014 CFR

2014-07-01

....203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROCEDURES FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS EPA's NEPA Environmental Review Procedures § 6.203 Public participation. (a) General requirements. (1) The procedures in...

40 CFR 6.203 - Public participation.

Code of Federal Regulations, 2013 CFR

2013-07-01

....203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROCEDURES FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS EPA's NEPA Environmental Review Procedures § 6.203 Public participation. (a) General requirements. (1) The procedures in...

40 CFR 6.203 - Public participation.

Code of Federal Regulations, 2011 CFR

2011-07-01

....203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROCEDURES FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS EPA's NEPA Environmental Review Procedures § 6.203 Public participation. (a) General requirements. (1) The procedures in...

40 CFR 6.203 - Public participation.

Code of Federal Regulations, 2010 CFR

2010-07-01

....203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROCEDURES FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS EPA's NEPA Environmental Review Procedures § 6.203 Public participation. (a) General requirements. (1) The procedures in...

40 CFR 6.203 - Public participation.

Code of Federal Regulations, 2012 CFR

2012-07-01

....203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROCEDURES FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS EPA's NEPA Environmental Review Procedures § 6.203 Public participation. (a) General requirements. (1) The procedures in...

Therapy of hearing disorders - conservative procedures

PubMed Central

Plontke, Stefan

2005-01-01

A wide range of therapeutic strategies are available for the therapy of hearing disorders including pharmaceutical, acoustic, electrical, surgical, radiological, cognitive-behavioural and so-called "alternative" strategies. This review focuses on general conservative strategies and specific therapeutic approaches mainly for inner ear disorders, whereas surgical and device-based therapies including hearing aids and cochlear implants are described in other chapters in this volume. In addition to the systemic medication-based therapies for the treatment of hearing disorders, the rapidly growing field of local drug delivery to the inner ear as a promising therapeutic strategy is discussed on the background of unresolved issues. After description of non-drug-based therapeutic procedures, the conservative therapy of specific diseases and syndromes is reviewed. In general, there is a major discrepancy between promising animal studies up to regeneration and stem-cell transplantation, and uncontrolled experimental studies in humans on the one hand and the shortage of randomized controlled clinical trials with a high level of evidence on the other hand. Therefore, the review and comments on published clinical studies should assist the reader in making his/her own decision about the effectiveness of various, especially pharmaceutical treatments. From a critical analysis - particularly of the clinical studies presented - conclusions are drawn for the therapy of hearing disorders in the future. PMID:22073049

Analytical and experimental study of vibrations in a gear transmission

NASA Technical Reports Server (NTRS)

Choy, F. K.; Ruan, Y. F.; Zakrajsek, J. J.; Oswald, Fred B.; Coy, J. J.

1991-01-01

An analytical simulation of the dynamics of a gear transmission system is presented and compared to experimental results from a gear noise test rig at the NASA Lewis Research Center. The analytical procedure developed couples the dynamic behaviors of the rotor-bearing-gear system with the response of the gearbox structure. The modal synthesis method is used in solving the overall dynamics of the system. Locally each rotor-gear stage is modeled as an individual rotor-bearing system using the matrix transfer technique. The dynamics of each individual rotor are coupled with other rotor stages through the nonlinear gear mesh forces and with the gearbox structure through bearing support systems. The modal characteristics of the gearbox structure are evaluated using the finite element procedure. A variable time steping integration routine is used to calculate the overall time transient behavior of the system in modal coordinates. The global dynamic behavior of the system is expressed in a generalized coordinate system. Transient and steady state vibrations of the gearbox system are presented in the time and frequency domains. The vibration characteristics of a simple single mesh gear noise test rig is modeled. The numerical simulations are compared to experimental data measured under typical operating conditions. The comparison of system natural frequencies, peak vibration amplitudes, and gear mesh frequencies are generally in good agreement.

Awake Intradural Spinal Tumor Resection; Case Report and Literature Review.

PubMed

Shtaya, Anan; Luong, Chan Bao; Pereira, Erlick

2018-06-01

Meningioma is a common slow-growing spinal tumor with a predilection for intradural occurrence. Patients usually present with pain followed by ataxia and sensory and sphincter problems. The gold standard treatment in these cases is gross total microsurgical resection under general anesthesia. However, there exist high-anesthetic-risk patients unsuitable for general anesthesia. Performing spinal surgeries under local anesthesia and sedation has been reported, albeit rarely for mostly minimally invasive procedures but not for open intradural pathologies. We report a 63-year-old woman with critical aortic stenosis, coronary artery disease, and severe chronic obstructive airways disease who presented with 10 months' history of worsening back pain and bilateral leg pain, ataxia, hyperreflexia in lower limbs, as well as altered lower limb sensation. Magnetic resonance imaging revealed a contrast-enhancing intradural lesion at T6/7 with severe spinal cord compression. However, the patient was American Society of Anesthesiologists class IV and her cardiac disease was not amenable to intervention. She underwent thoracic laminectomy and excision of the tumor under local anesthesia and sedation with no significant complications and clinical improvement. Our illustrative case and literature review suggest that using local anesthesia and sedation to perform spinal surgeries including intradural tumors is possible even in high-risk patients with good outcome. Our American Society of Anesthesiologists class IV patient tolerated the surgery well with gross total tumor resection and subsequent resolution of the symptoms. Copyright © 2018 Elsevier Inc. All rights reserved.

47 CFR 36.391 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Corporate Operations Expense § 36.391 General. Corporate Operations Expenses are included in the following account: General and...

The efficacy of music therapy.

PubMed

Wakim, Judith H; Smith, Stephanie; Guinn, Cherry

2010-08-01

Undergoing a procedure that requires anesthesia can be anxiety provoking. Anxiety is associated with increases in heart rate and blood pressure and other changes that can have a negative impact preoperatively; during the induction, maintenance, and emergence phases of anesthesia; and postoperatively. Music therapy is a nonpharmacological intervention that has the ability to reduce anxiety levels in some patients. This review presents research studies that have been conducted on the effects of music therapy for patients in different clinical settings. In general, the majority of the published articles reviewed revealed that listening to music was beneficial to the patient no matter the setting. Offering a music selection to patients before anesthesia could enhance its positive effect. Perianesthesia nurses could easily develop a protocol for different situations where patients will be exposed to interventions where the use of general or local anesthesia is expected. (c) 2010 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Thermal shock tests to qualify different tungsten grades as plasma facing material

NASA Astrophysics Data System (ADS)

Wirtz, M.; Linke, J.; Loewenhoff, Th; Pintsuk, G.; Uytdenhouwen, I.

2016-02-01

The electron beam device JUDITH 1 was used to establish a testing procedure for the qualification of tungsten as plasma facing material. Absorbed power densities of 0.19 and 0.38 GW m-2 for an edge localized mode-like pulse duration of 1 ms were chosen. Furthermore, base temperatures of room temperature, 400 °C and 1000 °C allow investigating the thermal shock performance in the brittle, ductile and high temperature regime. Finally, applying 100 pulses under all mentioned conditions helps qualifying the general damage behaviour while with 1000 pulses for the higher power density the influence of thermal fatigue is addressed. The investigated reference material is a tungsten product produced according to the ITER material specifications. The obtained results provide a general overview of the damage behaviour with quantified damage characteristics and thresholds. In particular, it is shown that the damage strongly depends on the microstructure and related thermo-mechanical properties.

47 CFR 1.1623 - Probability calculation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Probability calculation. 1.1623 Section 1.1623 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Random Selection Procedures for Mass Media Services General Procedures § 1.1623 Probability calculation. (a) All calculations shall be...

47 CFR 1.1601 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Scope. 1.1601 Section 1.1601 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Random Selection Procedures for Mass Media Services General Procedures § 1.1601 Scope. The provisions of this subpart, and the provisions...

47 CFR 1.1602 - Designation for random selection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Designation for random selection. 1.1602 Section 1.1602 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Random Selection Procedures for Mass Media Services General Procedures § 1.1602 Designation for random selection...

47 CFR 1.1602 - Designation for random selection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Designation for random selection. 1.1602 Section 1.1602 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Random Selection Procedures for Mass Media Services General Procedures § 1.1602 Designation for random selection...

47 CFR 1.1601 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Scope. 1.1601 Section 1.1601 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Random Selection Procedures for Mass Media Services General Procedures § 1.1601 Scope. The provisions of this subpart, and the provisions...

32 CFR 218.2 - General procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... GUIDANCE FOR THE DETERMINATION AND REPORTING OF NUCLEAR RADIATION DOSE FOR DOD PARTICIPANTS IN THE ATMOSPHERIC NUCLEAR TEST PROGRAM (1945-1962) § 218.2 General procedures. The following procedures govern the... exposure. (c) Qualitatively assess the radiation environment in order to delineate contaminated areas. If...

32 CFR 218.2 - General procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... GUIDANCE FOR THE DETERMINATION AND REPORTING OF NUCLEAR RADIATION DOSE FOR DOD PARTICIPANTS IN THE ATMOSPHERIC NUCLEAR TEST PROGRAM (1945-1962) § 218.2 General procedures. The following procedures govern the... exposure. (c) Qualitatively assess the radiation environment in order to delineate contaminated areas. If...

32 CFR 218.2 - General procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... GUIDANCE FOR THE DETERMINATION AND REPORTING OF NUCLEAR RADIATION DOSE FOR DOD PARTICIPANTS IN THE ATMOSPHERIC NUCLEAR TEST PROGRAM (1945-1962) § 218.2 General procedures. The following procedures govern the... exposure. (c) Qualitatively assess the radiation environment in order to delineate contaminated areas. If...

32 CFR 218.2 - General procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... GUIDANCE FOR THE DETERMINATION AND REPORTING OF NUCLEAR RADIATION DOSE FOR DOD PARTICIPANTS IN THE ATMOSPHERIC NUCLEAR TEST PROGRAM (1945-1962) § 218.2 General procedures. The following procedures govern the... exposure. (c) Qualitatively assess the radiation environment in order to delineate contaminated areas. If...

22 CFR 401.10 - General rule.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true General rule. 401.10 Section 401.10 Foreign Relations INTERNATIONAL JOINT COMMISSION, UNITED STATES AND CANADA RULES OF PROCEDURE General § 401.10 General rule. The Commission may, at any time, adopt any procedure which it deems expedient and necessary...

28 CFR 40.13 - Review by the Attorney General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Review by the Attorney General. 40.13... Procedures for Obtaining Certification of a Grievance Procedure § 40.13 Review by the Attorney General. The Attorney General shall review and respond to each application as promptly as the circumstances, including...

Step by Step: Biology Undergraduates' Problem-Solving Procedures during Multiple-Choice Assessment.

PubMed

Prevost, Luanna B; Lemons, Paula P

2016-01-01

This study uses the theoretical framework of domain-specific problem solving to explore the procedures students use to solve multiple-choice problems about biology concepts. We designed several multiple-choice problems and administered them on four exams. We trained students to produce written descriptions of how they solved the problem, and this allowed us to systematically investigate their problem-solving procedures. We identified a range of procedures and organized them as domain general, domain specific, or hybrid. We also identified domain-general and domain-specific errors made by students during problem solving. We found that students use domain-general and hybrid procedures more frequently when solving lower-order problems than higher-order problems, while they use domain-specific procedures more frequently when solving higher-order problems. Additionally, the more domain-specific procedures students used, the higher the likelihood that they would answer the problem correctly, up to five procedures. However, if students used just one domain-general procedure, they were as likely to answer the problem correctly as if they had used two to five domain-general procedures. Our findings provide a categorization scheme and framework for additional research on biology problem solving and suggest several important implications for researchers and instructors. © 2016 L. B. Prevost and P. P. Lemons. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

A Fast Proceduere for Optimizing Thermal Protection Systems of Re-Entry Vehicles

NASA Astrophysics Data System (ADS)

Ferraiuolo, M.; Riccio, A.; Tescione, D.; Gigliotti, M.

The aim of the present work is to introduce a fast procedure to optimize thermal protection systems for re-entry vehicles subjected to high thermal loads. A simplified one-dimensional optimization process, performed in order to find the optimum design variables (lengths, sections etc.), is the first step of the proposed design procedure. Simultaneously, the most suitable materials able to sustain high temperatures and meeting the weight requirements are selected and positioned within the design layout. In this stage of the design procedure, simplified (generalized plane strain) FEM models are used when boundary and geometrical conditions allow the reduction of the degrees of freedom. Those simplified local FEM models can be useful because they are time-saving and very simple to build; they are essentially one dimensional and can be used for optimization processes in order to determine the optimum configuration with regard to weight, temperature and stresses. A triple-layer and a double-layer body, subjected to the same aero-thermal loads, have been optimized to minimize the overall weight. Full two and three-dimensional analyses are performed in order to validate those simplified models. Thermal-structural analyses and optimizations are executed by adopting the Ansys FEM code.

Cosmetic websites Scotland: legal or lurid.

PubMed

Gunn, Eilidh G M; Loh, Charles Yuen Yung; Athanassopoulos, Thanassi

2014-08-01

The provision of cosmetic interventions and their advertising have recently come under intense scrutiny in the wake of the PIP scandal and Keogh report. A study of Scottish websites offering esthetic procedures was conducted to determine adherence to the advertising standards and regulations currently in place. Regulations are provided by the Advertising Standards Authority, Committee on Advertising Practice, Independent Healthcare Advisory Services and General Medical Council. An Internet search was then conducted to search for providers of non-surgical and surgical cosmetic procedures. Overall 125 websites were reviewed. 109 local and 16 national with 17 websites associated with cosmetic surgeons. 26 websites failed to adhere to regulations. Failure was related to advertising of POM on the homepage or dropdown menu (20), offering enticements inappropriately (6). 26.6% of websites did not display qualifications of the practitioners. Only 16.6% of websites described the specific and the non-specific side effects of "anti-wrinkle injections" and only 12.5% mentioned alternative treatments. The majority of websites reviewed adhered to current advertising standards. Plastic surgeons provide a small percentage of cosmetic procedures. Greater regulation at the point of product entry and of all esthetic practitioners is required. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Oral surgery in patients under antithrombotic therapy: perioperative bleeding as a significant risk factor for postoperative hemorrhage.

PubMed

Rocha, Amanda L; Souza, Alessandra F; Martins, Maria A P; Fraga, Marina G; Travassos, Denise V; Oliveira, Ana C B; Ribeiro, Daniel D; Silva, Tarcília A

2018-01-01

: To investigate perioperative and postoperative bleeding, complications in patients under therapy with anticoagulant or antiplatelet drugs submitted to oral surgery. To evaluate the risk of bleeding and safety for dental surgery, a retrospective chart review was performed. Medical and dental records of patients taking oral antithrombotic drugs undergoing dental surgery between 2010 and 2015 were reviewed. Results were statistically analyzed using Fisher's exact test, t test or the χ test. One hundred and seventy-nine patients underwent 293 surgical procedures. A total of eight cases of perioperative and 12 episodes of postoperative bleeding were documented. The complications were generally managed with local measures and did not require hospitalization. We found significant association of postoperative hemorrhage with increased perioperative bleeding (P = 0.043) and combination of anticoagulant and antiplatelet therapy (P < 0.001). The chance of postoperative hemorrhage for procedures with increased perioperative bleeding is 8.8 times bigger than procedures without perioperative bleeding. Dental surgery in patients under antithrombotic therapy might be carried out without altering the regimen because of low risk of perioperative and postoperative bleeding. However, patients with increased perioperative bleeding should be closely followed up because of postoperative complications risk.

Early Detection and Intervention of ASD: A European Overview

PubMed Central

Narzisi, Antonio; García-Primo, Patricia; Kawa, Rafal

2017-01-01

Over the last several years there has been an increasing focus on early detection of Autism Spectrum Disorder (ASD), not only from the scientific field but also from professional associations and public health systems all across Europe. Not surprisingly, in order to offer better services and quality of life for both children with ASD and their families, different screening procedures and tools have been developed for early assessment and intervention. However, current evidence is needed for healthcare providers and policy makers to be able to implement specific measures and increase autism awareness in European communities. The general aim of this review is to address the latest and most relevant issues related to early detection and treatments. The specific objectives are (1) analyse the impact, describing advantages and drawbacks, of screening procedures based on standardized tests, surveillance programmes, or other observational measures; and (2) provide a European framework of early intervention programmes and practices and what has been learnt from implementing them in public or private settings. This analysis is then discussed and best practices are suggested to help professionals, health systems and policy makers to improve their local procedures or to develop new proposals for early detection and intervention programmes. PMID:29194420

WSSDA's Guide to Parliamentary Procedures. Revised

ERIC Educational Resources Information Center

Randolph, Mary

2004-01-01

This guide to parliamentary procedures is presented by the Washington State School Directors' Association (WSSDA) for use by local school boards within the State of Washington. Parliamentary law and parliamentary procedure is the key to order and to provide justice and fairness to all. Through both formal and informal parliamentary procedures,…

Global/local processing of hierarchical visual stimuli in a conflict-choice task by capuchin monkeys (Sapajus spp.).

PubMed

Truppa, Valentina; Carducci, Paola; De Simone, Diego Antonio; Bisazza, Angelo; De Lillo, Carlo

2017-03-01

In the last two decades, comparative research has addressed the issue of how the global and local levels of structure of visual stimuli are processed by different species, using Navon-type hierarchical figures, i.e. smaller local elements that form larger global configurations. Determining whether or not the variety of procedures adopted to test different species with hierarchical figures are equivalent is of crucial importance to ensure comparability of results. Among non-human species, global/local processing has been extensively studied in tufted capuchin monkeys using matching-to-sample tasks with hierarchical patterns. Local dominance has emerged consistently in these New World primates. In the present study, we assessed capuchins' processing of hierarchical stimuli with a method frequently adopted in studies of global/local processing in non-primate species: the conflict-choice task. Different from the matching-to-sample procedure, this task involved processing local and global information retained in long-term memory. Capuchins were trained to discriminate between consistent hierarchical stimuli (similar global and local shape) and then tested with inconsistent hierarchical stimuli (different global and local shapes). We found that capuchins preferred the hierarchical stimuli featuring the correct local elements rather than those with the correct global configuration. This finding confirms that capuchins' local dominance, typically observed using matching-to-sample procedures, is also expressed as a local preference in the conflict-choice task. Our study adds to the growing body of comparative studies on visual grouping functions by demonstrating that the methods most frequently used in the literature on global/local processing produce analogous results irrespective of extent of the involvement of memory processes.

Transthoracic Adrenal Biopsy Procedure Using Artificial Carbon Dioxide Pneumothorax as Outpatient Procedure

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

Favelier, Sylvain; Guiu, Severine; Cherblanc, Violaine

2013-08-01

Many routes have been described for percutaneous adrenal gland biopsy. They require either a complex non-axial path or a long hydrodissection or even pass through an organ thereby increasing complications. We describe here an approach using an artificially-induced carbon dioxide (CO{sub 2}) pneumothorax, performed as an outpatient procedure in a 57-year-old woman. Under local anaesthesia, 200 ml of CO{sub 2} was injected in the pleural space through a Veress needle under computed tomography fluoroscopy, to clear the lung parenchyma from the biopsy route. Using this technique, transthoracic adrenal biopsy can be performed under simple local anaesthesia as an safely outpatientmore » procedure.« less

The influence of location of local anesthesia and complexity/duration of restorative treatment on children's behavior during dental treatment.

PubMed

Davidovich, Esti; Wated, Alham; Shapira, Joseph; Ram, Diana

2013-01-01

The purpose of this study was to investigate whether the region of local anesthetic injection and the complexity and duration of restorative treatment were associated with children's behavior during and immediately after dental treatment. This study examined 90 children, divided into two age groups (2-3.5 years old and >3.5-5.5 years old), who underwent dental treatment while lightly sedated. The region of local anesthesia (maxillary infiltration or mandibular block), complexity and duration of treatment, and behavior during and after treatment were assessed. Children's behavior during and after dental treatment, within and between age groups, was not found to be associated with the region of local anesthesia or complexity of treatment. For both age groups, more children exhibited negative behaviors during treatment when procedures exceeded 30 minutes. For younger children, more negative behaviors were also observed after longer vs shorter procedures. Treatment duration, not the region of local anesthesia or complexity of treatment, was associated with children's behavior during and after dental procedures.

47 CFR 1.915 - General application requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... all Wireless Radio Services, station licenses, as defined in section 308(a) of the Communications Act... 1.915 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.915 General...

47 CFR 1.915 - General application requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... all Wireless Radio Services, station licenses, as defined in section 308(a) of the Communications Act... 1.915 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.915 General...

15 CFR 904.100 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Civil Penalties § 904.100 General. This subpart sets forth the procedures governing NOAA administrative proceedings for the assessment of civil penalties under the statutes cited in § 904.1(c). ...

15 CFR 904.100 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Civil Penalties § 904.100 General. This subpart sets forth the procedures governing NOAA administrative proceedings for the assessment of civil penalties under the statutes cited in § 904.1(c). ...