The effect of simple nitrogen fertilizer recommendation strategies on product carbon footprint and gross margin of wheat and maize production in the North China Plain.

PubMed

Ha, Nan; Feike, Til; Back, Hans; Xiao, Haifeng; Bahrs, Enno

2015-11-01

Overuse of nitrogen (N) fertilizer constitutes the major issue of current crop production in China, exerting a substantial effect on global warming through massive emission of greenhouse gas (GHG). Despite the ongoing effort, which includes the promotion of technologically sophisticated N management schemes, farmers' N rates maintain at excessive rates. Therefore the current study tests three simple and easily to apply N fertilizer recommendation strategies, which could be implemented on large scale through the existing agricultural advisory system of China, at comparatively low cost. Building on a detailed crop production dataset of 65 winter wheat (WW) and summer maize (SM) producing farm households of the North China Plain, scenario analysis is applied. The effects of the three N strategies under constant and changing yield levels on product carbon footprint (PCF) and gross margin (GM) are determined for the production condition of every individual farm household. The N fixed rate strategy realized the highest improvement potential in PCF and GM in WW; while the N coefficient strategy performed best in SM. The analysis furthermore revealed that improved N management has a significant positive effect on PCF, but only a marginal and insignificant effect on GM. On the other side, a potential 10% yield loss would have only a marginal effect on PCF, but a detrimental effect on farmers' income. With farmers currently applying excessive N rates as "cheap insurance" against potential N limitation, it will be of vital importance to avoid any yield reductions (caused by N limitation) and respective severe financial losses, when promoting and implementing advanced fertilization strategies. To achieve this, it is furthermore recommended to increase the price of fertilizer, improve the agricultural extensions system, and recognize farmers' fertilizer related decision-making processes as key research areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer

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

Ng, Michael, E-mail: mng@radoncvic.com.au; Leong, Trevor; University of Melbourne

2012-08-01

Purpose: To develop a high-resolution target volume atlas with intensity-modulated radiotherapy (IMRT) planning guidelines for the conformal treatment of anal cancer. Methods and Materials: A draft contouring atlas and planning guidelines for anal cancer IMRT were prepared at the Australasian Gastrointestinal Trials Group (AGITG) annual meeting in September 2010. An expert panel of radiation oncologists contoured an anal cancer case to generate discussion on recommendations regarding target definition for gross disease, elective nodal volumes, and organs at risk (OARs). Clinical target volume (CTV) and planning target volume (PTV) margins, dose fractionation, and other IMRT-specific issues were also addressed. A steeringmore » committee produced the final consensus guidelines. Results: Detailed contouring and planning guidelines and a high-resolution atlas are provided. Gross tumor and elective target volumes are described and pictorially depicted. All elective regions should be routinely contoured for all disease stages, with the possible exception of the inguinal and high pelvic nodes for select, early-stage T1N0. A 20-mm CTV margin for the primary, 10- to 20-mm CTV margin for involved nodes and a 7-mm CTV margin for the elective pelvic nodal groups are recommended, while respecting anatomical boundaries. A 5- to 10-mm PTV margin is suggested. When using a simultaneous integrated boost technique, a dose of 54 Gy in 30 fractions to gross disease and 45 Gy to elective nodes with chemotherapy is appropriate. Guidelines are provided for OAR delineation. Conclusion: These consensus planning guidelines and high-resolution atlas complement the existing Radiation Therapy Oncology Group (RTOG) elective nodal ano-rectal atlas and provide additional anatomic, clinical, and technical instructions to guide radiation oncologists in the planning and delivery of IMRT for anal cancer.« less

77 FR 77160 - Self-Regulatory Organizations; Chicago Mercantile Exchange Inc.; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... Liquidity Factor of CME's CDS Margin Methodology December 21, 2012. Pursuant to Section 19(b)(1) of the.... * * * * * CME CDS Liquidity Margin Factor Calculation Methodology The Liquidity Factor will be calculated as the... Liquidity Factor using the current Gross Notional Function with the following modifications: (1) the...

77 FR 59231 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-26

... Margining of Segregated Futures Customer Accounts on a Gross Basis September 20, 2012. Pursuant to Section... Change The proposed rule change would allow OCC to become compliant with Commodity Futures Trading Commission (``CFTC'') Rule 39.13(g)(8)(i) which requires the margining of segregated futures customer...

Identifying cost-minimizing strategies for guaranteeing target dairy income over feed cost via use of the Livestock Gross Margin dairy insurance program.

PubMed

Valvekar, M; Cabrera, V E; Gould, B W

2010-07-01

Milk and feed price volatility are the major source of dairy farm risk. Since August 2008 a new federally reinsured insurance program has been available to many US dairy farmers to help minimize the negative effects of adverse price movements. This insurance program is referred to as Livestock Gross Margin Insurance for Dairy Cattle. Given the flexibility in contract design, the dairy farmer has to make 3 critical decisions when purchasing this insurance: 1) the percentage of monthly milk production to be covered, 3) declared feed equivalents used to produce this milk, and 3) the level of gross margin not covered by insurance (i.e., deductible). The objective of this analysis was to provide an optimal strategy of how a dairy farmer could incorporate this insurance program to help manage the variability in net farm income. In this analysis we assumed that a risk-neutral dairy farmer wants to design an insurance contract such that a target guaranteed income over feed cost is obtained at least cost. We undertook this analysis for a representative Wisconsin dairy farm (herd size: 120 cows) producing 8,873 kg (19,545 lb) of milk/cow per year. Wisconsin statistical data indicates that dairy farms of similar size must require an income over feed cost of at least $110/Mg ($5/cwt) of milk to be profitable during the coverage period. Therefore, using data for the July 2009 insurance contract to insure $110/Mg of milk, the least cost contract was found to have a premium of $1.22/Mg ($0.055/cwt) of milk produced insuring approximately 52% of the production with variable monthly production covered during the period of September 2009 to June 2010. This premium represented 1.10% of the desired IOFC. We compared the above optimal strategy with an alternative nonoptimal strategy, defined as a contract insuring the same proportion of milk as the optimal (52%) but with a constant amount insured across all contract months. The premium was found to be almost twice the level obtained under the cost-minimizing solution representing 1.9% of the insured amount. Our model identifies the lowest cost insurance contract for a desired target guaranteed income over feed cost. Copyright (c) 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Patents and profits: A disparity of manufacturing margins in the tenofovir value chain.

PubMed

Walwyn, David

2013-03-01

Registered in 2001, tenofovir disoproxil fumarate (TDF) has quickly become a mainstay of first line regimens for the treatment of HIV. Initially only available in developed countries at a cost of US$5 000 per person per year (ppy), Gilead's Access Programme (GAP) has extended the use of the product to 2.4 million patients in low and middle income countries. The programme has two components: distribution of the branded product at reduced prices and licensing partnerships with generic manufacturers. The licensing partnerships now supply 75% of the market by volume, at a treatment cost of US$57 ppy (1% of the branded cost). From Gilead's perspective, GAP must be considered a huge success. It has enabled the company to maintain high prices in developed countries whilst reducing its input costs and deflecting criticism of its failure to provide essential medicines for the poor, hence risking the possibility of compulsory licensing. Over the period 2001 to 2011, TDF in its various forms has generated for Gilead more than US$31 billion revenue at a gross margin of 80%, equivalent to a gross profit of US$25 billion. Analysis of the TDF value chain, from preparation of the active pharmaceutical ingredient (API) to sale of the formulated product, shows that manufacturing margins are highly skewed in favour of the originator, with the latter's profit being US$3.2 billion vs. US$4 million for API manufacturers and US$39 million for formulators (2011). The data argues for a more rational approach to drug pricing including possible regulation in developed countries and more sustainable margins for the generic producers.

46 CFR 171.124 - Watertight integrity above the margin line in a vessel less than 100 gross tons.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 100 gross tons. (a) Each hatch exposed to the weather must be watertight; except that, the following hatches may be weathertight: (1) Each hatch on a watertight trunk that extends at least 12 inches (30.5 centimeters) above the weather deck. (2) Each hatch in a cabin top. (3) Each hatch on a vessel that operates...

46 CFR 171.124 - Watertight integrity above the margin line in a vessel less than 100 gross tons.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 100 gross tons. (a) Each hatch exposed to the weather must be watertight; except that, the following hatches may be weathertight: (1) Each hatch on a watertight trunk that extends at least 12 inches (30.5 centimeters) above the weather deck. (2) Each hatch in a cabin top. (3) Each hatch on a vessel that operates...

46 CFR 171.124 - Watertight integrity above the margin line in a vessel less than 100 gross tons.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 100 gross tons. (a) Each hatch exposed to the weather must be watertight; except that, the following hatches may be weathertight: (1) Each hatch on a watertight trunk that extends at least 12 inches (30.5 centimeters) above the weather deck. (2) Each hatch in a cabin top. (3) Each hatch on a vessel that operates...

46 CFR 171.124 - Watertight integrity above the margin line in a vessel less than 100 gross tons.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 100 gross tons. (a) Each hatch exposed to the weather must be watertight; except that, the following hatches may be weathertight: (1) Each hatch on a watertight trunk that extends at least 12 inches (30.5 centimeters) above the weather deck. (2) Each hatch in a cabin top. (3) Each hatch on a vessel that operates...

46 CFR 171.124 - Watertight integrity above the margin line in a vessel less than 100 gross tons.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 100 gross tons. (a) Each hatch exposed to the weather must be watertight; except that, the following hatches may be weathertight: (1) Each hatch on a watertight trunk that extends at least 12 inches (30.5 centimeters) above the weather deck. (2) Each hatch in a cabin top. (3) Each hatch on a vessel that operates...

Favorable Local Control From Consolidative Radiation Therapy in High-Risk Neuroblastoma Despite Gross Residual Disease, Positive Margins, or Nodal Involvement

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

Ferris, Matthew J., E-mail: mjferri@emory.edu; Winship Cancer Institute, Emory University, Atlanta, Georgia; Danish, Hasan

Purpose: To report the influence of radiation therapy (RT) dose and surgical pathology variables on disease control and overall survival (OS) in patients treated for high-risk neuroblastoma at a single institution. Methods and Materials: We conducted a retrospective study of 67 high-risk neuroblastoma patients who received RT as part of definitive management from January 2003 until May 2014. Results: At a median follow-up of 4.5 years, 26 patients (38.8%) failed distantly; 4 of these patients also failed locally. One patient progressed locally without distant failure. Local control was 92.5%, and total disease control was 59.5%. No benefit was demonstrated for RT doses over 21.6 Gymore » with respect to local relapse–free survival (P=.55), disease-free survival (P=.22), or OS (P=.72). With respect to local relapse–free survival, disease-free survival, and OS, no disadvantage was seen for positive lymph nodes on surgical pathology, positive surgical margins, or gross residual disease. Of the patients with gross residual disease, 75% (6 of 8) went on to have no evidence of disease at time of last follow-up, and the 2 patients who failed did so distantly. Conclusions: Patients with high-risk neuroblastoma in this series maintained excellent local control, with no benefit demonstrated for radiation doses over 21.6 Gy, and no disadvantage demonstrated for gross residual disease after surgery, positive surgical margins, or pathologic lymph node positivity. Though the limitations of a retrospective review for an uncommon disease must be kept in mind, with small numbers in some of the subgroups, it seems that dose escalation should be considered only in exceptional circumstances.« less

Assessment of the economic viability of goat management systems in Goma Sub County and Mukono Town Council in Mukono District, Uganda.

PubMed

Mwebe, Robert; Ejobi, Francis; Laker, Christopher Dennis

2011-04-01

This study sought to assess the profitability of the goat enterprises under different management systems. The research covered two selected sub-counties of Mukono District (Goma and Mukono Town Council). A total of 888 goats from 129 herds/farms were studied. Descriptive statistical and gross margins analyses were performed. The management system of goats in the two sub-counties was mainly by tethering. Most of the goats kept were adult female goats. Most farmers had small herds and did not keep records. Male goats were more valued on average among the crossbred goats. In the exotic types, the adult female goats were valued on average. Local goats fetch low prices. With respect to gross margins, that free range had incurred more losses, while tethering made most profits followed by zero grazing and zero grazing combined with tethering, respectively, without considering the non-monetary aspects. Farmers using the tethering management system, encountered most of the problems of lack of pastures and veterinary services. The farmers required assistance from different donors, through provision of hybrid goats and improvement of veterinary services. The management system for goat keeping in the study area was poor, especially among local breed goat farmers who use tethering management system, though it had high gross margin. There is a need to educate farmers on proper goat husbandry and provision of some farm inputs.

Margins in Skin Excision Biopsies: Principles and Guidelines

PubMed Central

Ranjan, Richa; Singh, Lavleen; Arava, Sudheer K; Singh, Manoj Kumar

2014-01-01

Skin biopsies are usually undertaken to confirm a clinical diagnosis, to remove a lesion, and to determine the adequacy of excised tissue margin. A surgical margin is technically defined as the “edge” of the tissue removed. The term is especially pertinent when the tissue excised is suspected of being involved by a malignant process. One of the most important predictive and prognostic factors of a malignant lesion is whether the margins of the resected specimen are involved by the tumor or not. The purpose of this review is to provide an insight into grossing of a skin biopsy specimen with emphasis on techniques and reporting of excision biopsy margins. PMID:25484385

Subprimal purchasing and merchandising decisions for pork: relationship to retail value.

PubMed

Lorenzen, C L; Walter, J P; Dockerty, T R; Griffin, D B; Johnson, H K; Savell, J W

1996-01-01

To assess retail value and profitability, cutting test data were obtained in a simulated retail cutting room for boxed pork subprimals, bone-in loins (n = 180), boneless loins (n = 94), Boston butts (n = 148), fresh hams (n = 28), and boneless hams (n = 23). Processing times (seconds) and retail weights (kilograms) were used to determine relative value. Cutting style affected (P < .05) value differential (US$/subprimal) for bone-in and boneless loins. When cutting styles within subprimals were pooled, value differential was affected (P < .05) by purchasing specification for bone-in loins, boneless loins, Boston butts, and inside fresh hams. Processing bone-in loins to a boneless end point produced a greater (P < .05) value differential and percentage of gross margin than a bone-in retail end point. Bone-in loins fabricated to a boneless retail end point produced a greater (P < .05) value differential and percentage of gross margin than boneless loins fabricated to the same end point. The increase in retail value can be attributed to the increased number and weight of retail cuts produced from bone-in loins. The thick, boneless loin cutting style produced a greater (P < .05) value differential and percentage of gross margin as a result of a lower (P < .05) cost of fabrication and increased value of retail cuts than the thin, boneless cutting style. In general, boneless pork cutting methods were more profitable than bone-in cutting methods regardless of subprimal.

[Target volume margins for lung cancer: internal target volume/clinical target volume].

PubMed

Jouin, A; Pourel, N

2013-10-01

The aim of this study was to carry out a review of margins that should be used for the delineation of target volumes in lung cancer, with a focus on margins from gross tumour volume (GTV) to clinical target volume (CTV) and internal target volume (ITV) delineation. Our review was based on a PubMed literature search with, as a cornerstone, the 2010 European Organisation for Research and Treatment of Cancer (EORTC) recommandations by De Ruysscher et al. The keywords used for the search were: radiotherapy, lung cancer, clinical target volume, internal target volume. The relevant information was categorized under the following headings: gross tumour volume definition (GTV), CTV-GTV margin (first tumoural CTV then nodal CTV definition), in field versus elective nodal irradiation, metabolic imaging role through the input of the PET scanner for tumour target volume and limitations of PET-CT imaging for nodal target volume definition, postoperative radiotherapy target volume definition, delineation of target volumes after induction chemotherapy; then the internal target volume is specified as well as tumoural mobility for lung cancer and respiratory gating techniques. Finally, a chapter is dedicated to planning target volume definition and another to small cell lung cancer. For each heading, the most relevant and recent clinical trials and publications are mentioned. Copyright © 2013. Published by Elsevier SAS.

Global budgets in Maryland: early evidence on revenues, expenses, and margins in regulated and unregulated services.

PubMed

Malmmose, Margit; Mortensen, Karoline; Holm, Claus

2018-04-02

Maryland implemented one of the most aggressive payment innovations the nation has seen in several decades when it introduced global budgets in all its acute care hospitals in 2014. Prior to this, a pilot program, total patient revenue (TPR), was established for 8 rural hospitals in 2010. Using financial hospital report data from the Health Services Cost Review Commission from 2007 to 2013, we examined the hospitals' financial results including revenue, costs, and profit/loss margins to explore the impact of the adoption of the TPR pilot global budget program relative to the remaining hospitals in the state. We analyze financial results for both regulated (included in the global budget and subject to rate-setting) and unregulated services in order to capture a holistic image of the hospitals' actual revenue, cost and margin structures. Common size and difference-in-differences analyses of the data suggest that regulated profit ratios for treatment hospitals increased (from 5% in 2007 to 8% in 2013) and regulated expense-to-gross patient revenue ratios decreased (75% in 2007 and 68% in 2013) relative to the controls. Simultaneously, the profit margins for treatment hospitals' unregulated services decreased (- 12% in 2007 and - 17% in 2013), which reduced the overall margin significantly. This analysis therefore indicates cost shifting and less profit gain from the program than identified by solely focusing on the regulated margins.

Yield and Economic Performance of Organic and Conventional Cotton-Based Farming Systems – Results from a Field Trial in India

PubMed Central

Forster, Dionys; Andres, Christian; Verma, Rajeev; Zundel, Christine; Messmer, Monika M.; Mäder, Paul

2013-01-01

The debate on the relative benefits of conventional and organic farming systems has in recent time gained significant interest. So far, global agricultural development has focused on increased productivity rather than on a holistic natural resource management for food security. Thus, developing more sustainable farming practices on a large scale is of utmost importance. However, information concerning the performance of farming systems under organic and conventional management in tropical and subtropical regions is scarce. This study presents agronomic and economic data from the conversion phase (2007–2010) of a farming systems comparison trial on a Vertisol soil in Madhya Pradesh, central India. A cotton-soybean-wheat crop rotation under biodynamic, organic and conventional (with and without Bt cotton) management was investigated. We observed a significant yield gap between organic and conventional farming systems in the 1st crop cycle (cycle 1: 2007–2008) for cotton (−29%) and wheat (−27%), whereas in the 2nd crop cycle (cycle 2: 2009–2010) cotton and wheat yields were similar in all farming systems due to lower yields in the conventional systems. In contrast, organic soybean (a nitrogen fixing leguminous plant) yields were marginally lower than conventional yields (−1% in cycle 1, −11% in cycle 2). Averaged across all crops, conventional farming systems achieved significantly higher gross margins in cycle 1 (+29%), whereas in cycle 2 gross margins in organic farming systems were significantly higher (+25%) due to lower variable production costs but similar yields. Soybean gross margin was significantly higher in the organic system (+11%) across the four harvest years compared to the conventional systems. Our results suggest that organic soybean production is a viable option for smallholder farmers under the prevailing semi-arid conditions in India. Future research needs to elucidate the long-term productivity and profitability, particularly of cotton and wheat, and the ecological impact of the different farming systems. PMID:24324659

Yield and economic performance of organic and conventional cotton-based farming systems--results from a field trial in India.

PubMed

Forster, Dionys; Andres, Christian; Verma, Rajeev; Zundel, Christine; Messmer, Monika M; Mäder, Paul

2013-01-01

The debate on the relative benefits of conventional and organic farming systems has in recent time gained significant interest. So far, global agricultural development has focused on increased productivity rather than on a holistic natural resource management for food security. Thus, developing more sustainable farming practices on a large scale is of utmost importance. However, information concerning the performance of farming systems under organic and conventional management in tropical and subtropical regions is scarce. This study presents agronomic and economic data from the conversion phase (2007-2010) of a farming systems comparison trial on a Vertisol soil in Madhya Pradesh, central India. A cotton-soybean-wheat crop rotation under biodynamic, organic and conventional (with and without Bt cotton) management was investigated. We observed a significant yield gap between organic and conventional farming systems in the 1(st) crop cycle (cycle 1: 2007-2008) for cotton (-29%) and wheat (-27%), whereas in the 2(nd) crop cycle (cycle 2: 2009-2010) cotton and wheat yields were similar in all farming systems due to lower yields in the conventional systems. In contrast, organic soybean (a nitrogen fixing leguminous plant) yields were marginally lower than conventional yields (-1% in cycle 1, -11% in cycle 2). Averaged across all crops, conventional farming systems achieved significantly higher gross margins in cycle 1 (+29%), whereas in cycle 2 gross margins in organic farming systems were significantly higher (+25%) due to lower variable production costs but similar yields. Soybean gross margin was significantly higher in the organic system (+11%) across the four harvest years compared to the conventional systems. Our results suggest that organic soybean production is a viable option for smallholder farmers under the prevailing semi-arid conditions in India. Future research needs to elucidate the long-term productivity and profitability, particularly of cotton and wheat, and the ecological impact of the different farming systems.

Mixed crop-livestock systems: an economic and environmental-friendly way of farming?

PubMed

Ryschawy, J; Choisis, N; Choisis, J P; Joannon, A; Gibon, A

2012-10-01

Intensification and specialisation of agriculture in developed countries enabled productivity to be improved but had detrimental impacts on the environment and threatened the economic viability of a huge number of farms. The combination of livestock and crops, which was very common in the past, is assumed to be a viable alternative to specialised livestock or cropping systems. Mixed crop-livestock systems can improve nutrient cycling while reducing chemical inputs and generate economies of scope at farm level. Most assumptions underlying these views are based on theoretical and experimental evidence. Very few assessments of their environmental and economic advantages have nevertheless been undertaken in real-world farming conditions. In this paper, we present a comparative assessment of the environmental and economic performances of mixed crop-livestock farms v. specialised farms among the farm population of the French 'Coteaux de Gascogne'. In this hilly region, half of the farms currently use a mixed crop-livestock system including beef cattle and cash crops, the remaining farms being specialised in either crops or cattle. Data were collected through an exhaustive survey of farms located in our study area. The economic performances of farming systems were assessed on 48 farms on the basis of (i) overall gross margin, (ii) production costs and (iii) analysis of the sensitivity of gross margins to fluctuations in the price of inputs and outputs. The environmental dimension was analysed through (i) characterisation of farmers' crop management practices, (ii) analysis of farm land use diversity and (iii) nitrogen farm-gate balance. Local mixed crop-livestock farms did not have significantly higher overall gross margins than specialised farms but were less sensitive than dairy and crop farms to fluctuations in the price of inputs and outputs considered. Mixed crop-livestock farms had lower costs than crop farms, while beef farms had the lowest costs as they are grass-based systems. Concerning crop management practices, our results revealed an intensification gradient from low to high input farming systems. Beyond some general trends, a wide range of management practices and levels of intensification were observed among farms with a similar production system. Mixed crop-livestock farms were very heterogeneous with respect to the use of inputs. Nevertheless, our study revealed a lower potential for nitrogen pollution in mixed crop-livestock and beef production systems than in dairy and crop farming systems. Even if a wide variability exists within system, mixed crop-livestock systems appear to be a way for an environmental and economical sustainable agriculture.

Gigantism of the lower limb in Klippel-Trenaunay syndrome: anatomy of the lateral marginal vein.

PubMed

Abdul-Rahman, N R; Mohammad, K F; Ibrahim, S

2009-06-01

The Klippel-Trenaunay syndrome is a combination of venous and capillary malformations associated with soft tissue and/or bony limb hypertrophy, with or without lymphatic malformations. Although persistent foetal veins are rare, the persistence of the lateral marginal vein is a common association in this syndrome. It results in venous hypertension, which gives rise to venous varicosities, which are commonly seen in this syndrome. This is a case report of a 28-year-old man with Klippel-Trenaunay syndrome, with persistence of the lateral marginal vein, affecting his right lower limb. He was treated with an above-knee amputation. The amputated limb was dissected to demonstrate the anatomy of the lateral marginal vein. To the best of the authors' knowledge, the gross anatomy of the lateral marginal vein has not been previously reported.

Infrared thermography and thermocouple mapping of radiofrequency renal ablation to assess treatment adequacy and ablation margins.

PubMed

Ogan, Kenneth; Roberts, William W; Wilhelm, David M; Bonnell, Leonard; Leiner, Dennis; Lindberg, Guy; Kavoussi, Louis R; Cadeddu, Jeffrey A

2003-07-01

The primary disadvantage of renal tumor RF ablation is the inability to monitor the intraoperative propagation of the RF lesion with real-time imaging. We sought to assess whether adequately lethal temperatures are obtained at the margins of the intended ablation zone using laparoscopic thermography to monitor radiofrequency (RF) lesions in real time, thermocouple measurements, and histopathologic evaluation. Renal RF lesions were created under direct laparoscopic vision in the upper (1 cm diameter) and lower (2 cm) poles of the right kidney in 5 female pigs. The RF lesions were produced with the RITA generator and probe, set at 105 degrees C for 5-minute ablations. During RF treatment, a laparoscopic infrared (IR) camera measured the surface parenchymal temperatures, as did multiple thermocouples. The pigs were then either immediately killed (n = 3) or allowed to live for 2 weeks (n = 2). The kidneys were removed to correlate the temperature measurements with histologic analysis of the ablated lesion. Using a threshold temperature of greater than 70 degrees C for visual "temperature" color change, the IR camera identified the region of pathologic necrosis of the renal parenchyma during RF ablation. Thermocouple measurements demonstrated that the temperatures at the intended ablation radius reached 77.5 degrees C at the renal surface and 83.7 degrees C centrally, and temperatures 5 mm beyond the set radius reached 52.6 degrees C at the surface and 47.7 degrees C centrally. The average diameter of the gross lesion on the surface of the kidney measured 17.1 mm and 22.4 mm for 1-cm and 2-cm ablations, respectively. These surface measurements correlated with an average diameter of 16.1 mm and 15.9 mm (1-cm and 2-cm ablations, respectively) as measured with the IR camera. All cells within these ablation zones were nonviable by nicotinamide adenine dinucleotide diaphorase analysis. The average depth of the lesions measured 19 mm (1-cm ablation) and 25 mm (2-cm ablation) on gross histologic examination. The laparoscopic IR camera is able to monitor the surface renal temperatures during RF treatment. Thermocouple measurements during RF ablation confirmed the thermographic findings and demonstrated that lethal temperatures at the margin of the intended treatment zone are routinely obtained and that a rapid decline in temperature occurs beyond the predicted ablation margin.

Energy data report: prices and margins of No. 2 distillate fuel oil. Monthly report, January 1982

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

Whatley, A.

1982-03-22

Data are presented on the average prices and gross margins for the refining, reselling, and retailing sectors of the No. 2 distillate fuel oil market. Data are tabulated on prices and sales volumes of No. 2 fuel oil and No. 2 diesel fuel for residential, industrial/commercial, institutional/utility, other ultimate consumer sales, and nonultimate consumer sales. A brief discussion of the sampling and estimation procedures used in this report appears in the appendix.

Energy data report: prices and margins of No. 2 distillate fuel oil. Monthly report, October 1982

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

Whatley, A.

1982-12-20

Data are presented on the average prices and gross margins for the refining, reselling, and retailing sectors of the No. 2 distillate fuel oil market. Data are tabulated on prices and sales volumes of No. 2 fuel oil and No. 2 diesel fuel for residential, industrial/commercial, institutional/utility, other ultimate consumer sales, and nonultimate consumer sales. A brief discussion of the sampling and estimation procedures used in this report appears in the appendix.

Energy data report: prices and margins of No. 2 distillate fuel oil. Monthly report, November 1982

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

Whatley, A.

1983-01-18

Data are presented on the average prices and gross margins for the refining, reselling, and retailing sectors of the No. 2 distillate fuel oil market. Data are tabulated on prices and sales volumes of No. 2 fuel oil and No. 2 diesel fuel for residential, industrial/commercial, institutional/utility, other ultimate consumer sales, and nonultimate consumer sales. A brief discussion of the sampling and estimation procedures used in this report appears in the appendix.

Energy data report: prices and margins of No. 2 distillate fuel oil. Monthly report, December 1981

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

Whatley, A.

1982-02-22

Data are presented on the average prices and gross margins for the refining, reselling, and retailing sectors of the No. 2 distillate fuel oil market. Data are tabulated on prices and sales volumes of No. 2 fuel oil and No. 2 diesel fuel for residential, industrial/commercial, institutional/utility, other ultimate consumer sales, and nonultimate consumer sales. A brief discussion of the sampling and estimation procedures used in this report appears in the appendix.

Effect of Radiotherapy Dose and Volume on Relapse in Merkel Cell Cancer of the Skin

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

Foote, Matthew, E-mail: matthew_foote@health.qld.gov.a; Harvey, Jennifer; Porceddu, Sandro

Purpose: To assess the effect of radiotherapy (RT) dose and volume on relapse patterns in patients with Stage I-III Merkel cell carcinoma (MCC). Patients and Methods: This was a retrospective analysis of 112 patients diagnosed with MCC between January 2000 and December 2005 and treated with curative-intent RT. Results: Of the 112 evaluable patients, 88% had RT to the site of primary disease for gross (11%) or subclinical (78%) disease. Eighty-nine percent of patients had RT to the regional lymph nodes; in most cases (71%) this was for subclinical disease in the adjuvant or elective setting, whereas 21 patients (19%)more » were treated with RT to gross nodal disease. With a median follow-up of 3.7 years, the 2-year and 5-year overall survival rates were 72% and 53%, respectively, and the 2-year locoregional control rate was 75%. The in-field relapse rate was 3% for primary disease, and relapse was significantly lower for patients receiving {>=}50Gy (hazard ratio [HR] = 0.22; 95% confidence interval [CI], 0.06-0.86). Surgical margins did not affect the local relapse rate. The in-field relapse rate was 11% for RT to the nodes, with dose being significant for nodal gross disease (HR = 0.24; 95% CI, 0.07-0.87). Patients who did not receive elective nodal RT had a much higher rate of nodal relapse compared with those who did (HR = 6.03; 95% CI, 1.34-27.10). Conclusion: This study indicates a dose-response for subclinical and gross MCC. Doses of {>=}50Gy for subclinical disease and {>=}55Gy for gross disease should be considered. The draining nodal basin should be treated in all patients.« less

Not just a fallback food: global patterns of insect consumption related to geography, not agriculture.

PubMed

Lesnik, Julie J

2017-07-08

Insects as food are often viewed as fallback resources and associated with marginal environments. This study investigates the relationship between insect consumption and noncultivated landscapes as well as with other independent variables including latitude, area, population, and gross domestic product. Data were obtained from online databases including the World List of Edible Insects, the World Bank, and the World Factbook. A logistic regression model found that latitude could correctly predict the presence of edible insects 80% of the time and that arable land and gross domestic product showed no effect. Spearman rank-order correlation with number of insect species found significant relationships between area and population (but not density) and per capita gross domestic product as well as latitude. Further analysis of latitude using paired Mann-Whitney tests identified a general gradient pattern in reduction of edible insects with increased latitude. Results suggest that insect consumption represents a dynamic human-environment interaction, whereby insects are utilized in some of the world's lushest environments as well as areas where people have had great impact on the ecosystem. The concept that insects are a fallback food is an oversimplification that is likely rooted in Western bias against this food source. © 2017 Wiley Periodicals, Inc.

Dairy goat kids fed liquid diets in substitution of goat milk and slaughtered at different ages: an economic viability analysis using Monte Carlo techniques.

PubMed

Knupp, L S; Veloso, C M; Marcondes, M I; Silveira, T S; Silva, A L; Souza, N O; Knupp, S N R; Cannas, A

2016-03-01

The aim of this study was to analyze the economic viability of producing dairy goat kids fed liquid diets in alternative of goat milk and slaughtered at two different ages. Forty-eight male newborn Saanen and Alpine kids were selected and allocated to four groups using a completely randomized factorial design: goat milk (GM), cow milk (CM), commercial milk replacer (CMR) and fermented cow colostrum (FC). Each group was then divided into two groups: slaughter at 60 and 90 days of age. The animals received Tifton hay and concentrate ad libitum. The values of total costs of liquid and solid feed plus labor, income and average gross margin were calculated. The data were then analyzed using the Monte Carlo techniques with the @Risk 5.5 software, with 1000 iterations of the variables being studied through the model. The kids fed GM and CMR generated negative profitability values when slaughtered at 60 days (US$ -16.4 and US$ -2.17, respectively) and also at 90 days (US$ -30.8 and US$ -0.18, respectively). The risk analysis showed that there is a 98% probability that profitability would be negative when GM is used. In this regard, CM and FC presented low risk when the kids were slaughtered at 60 days (8.5% and 21.2%, respectively) and an even lower risk when animals were slaughtered at 90 days (5.2% and 3.8%, respectively). The kids fed CM and slaughtered at 90 days presented the highest average gross income (US$ 67.88) and also average gross margin (US$ 18.43/animal). For the 60-day rearing regime to be economically viable, the CMR cost should not exceed 11.47% of the animal-selling price. This implies that the replacer cannot cost more than US$ 0.39 and 0.43/kg for the 60- and 90-day feeding regimes, respectively. The sensitivity analysis showed that the variables with the greatest impact on the final model's results were animal selling price, liquid diet cost, final weight at slaughter and labor. In conclusion, the production of male dairy goat kids can be economically viable when the kids diet consists mainly of either cow milk or fermented colostrum, especially when kids are slaughtered at 90 days of age.

The Use of a Lidar Forward-Looking Turbulence Sensor for Mixed-Compression Inlet Unstart Avoidance and Gross Weight Reduction on a High Speed Civil Transport

NASA Technical Reports Server (NTRS)

Soreide, David; Bogue, Rodney K.; Ehernberger, L. J.; Seidel, Jonathan

1997-01-01

Inlet unstart causes a disturbance akin to severe turbulence for a supersonic commercial airplane. Consequently, the current goal for the frequency of unstarts is a few times per fleet lifetime. For a mixed-compression inlet, there is a tradeoff between propulsion system efficiency and unstart margin. As the unstart margin decreases, propulsion system efficiency increases, but so does the unstart rate. This paper intends to first, quantify that tradeoff for the High Speed Civil Transport (HSCT) and second, to examine the benefits of using a sensor to detect turbulence ahead of the airplane. When the presence of turbulence is known with sufficient lead time to allow the propulsion system to adjust the unstart margin, then inlet un,starts can be minimized while overall efficiency is maximized. The NASA Airborne Coherent Lidar for Advanced In-Flight Measurements program is developing a lidar system to serve as a prototype of the forward-looking sensor. This paper reports on the progress of this development program and its application to the prevention of inlet unstart in a mixed-compression supersonic inlet. Quantified benefits include significantly reduced takeoff gross weight (TOGW), which could increase payload, reduce direct operating costs, or increase range for the HSCT.

Differential Impact of Close Surgical Margin on Local Recurrence According to Primary Tumor Size in Oral Squamous Cell Carcinoma.

PubMed

Jang, Jeon Yeob; Choi, Nayeon; Ko, Young-Hyeh; Chung, Man Ki; Son, Young-Ik; Baek, Chung-Hwan; Baek, Kwan-Hyuck; Jeong, Han-Sin

2017-06-01

The extent of surgical safety margin (gross tumor border to resection margin) in oral cancer surgery remains unclear, and no study has determined the differential impact of close surgical margin and microscopic extension according to primary tumor size in oral cancers. We retrospectively analyzed the clinical data of 325 patients with surgically treated oral cavity squamous cell carcinomas to determine the effect of a close surgical margin (<5 mm) (cSM 5 ) on local recurrence. In addition, the depth of microscopic tumor infiltration was determined in 90 available surgical specimens. The cSM 5 was not related to the risk of local tumor recurrence in early-stage oral cancer, while it significantly increased the rate of local tumor recurrence in resectable advanced-stage oral cancers (hazard ratio 3.157, 95 % confidence interval 1.050-9.407, p = 0.041). Addition of postoperative adjuvant radiation to early-stage tumors with cSM 5 did not further reduce the local recurrence rate compared to surgery alone. The depth of microscopic tumor extension from the gross tumor border was significantly associated with primary tumor thickness (ρ = 0.390, p < 0.001) and tumor sizes (ρ = 0.308, p = 0.003), which was a median (range) of 0.84 (0.14-2.32) mm in T1, 1.06 (0.20-4.34) mm in T2, and 1.77 (0.13-4.70) mm in T3-4. The cSM 5 was a significant risk factor for local recurrence only in advanced oral cancers, but not in early-stage tumors, where microscopic tumor extension was not beyond 3 mm in T1 tumors. Thus, the extent of surgical safety margin can be redefined according to the primary tumor size.

77 FR 67036 - Self-Regulatory Organizations; The Options Clearing Corporation; Order Approving Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

... Organizations; The Options Clearing Corporation; Order Approving Proposed Rule Change, as Modified by Amendment No. 1 Thereto, Relating to the Margining of Segregated Futures Customer Accounts on a Gross Basis November 2, 2012. I. Introduction On September 14, 2012, The Options Clearing Corporation (``OCC'') filed...

Outcomes of Sinonasal Cancer Treated With Proton Therapy

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

Dagan, Roi, E-mail: rdagan@floridaproton.org; Department of Radiation Oncology, University of Florida, Jacksonville, Florida; Bryant, Curtis

Purpose: To report disease outcomes after proton therapy (PT) for sinonasal cancer. Methods and Materials: Eighty-four adult patients without metastases received primary (13%) or adjuvant (87%) PT for sinonasal cancers (excluding melanoma, sarcoma, and lymphoma). Common histologies were olfactory neuroblastoma (23%), squamous cell carcinoma (22%), and adenoid cystic carcinoma (17%). Advanced stage (T3 in 25% and T4 in 69%) and high-grade histology (51%) were common. Surgical procedures included endoscopic resection alone (45%), endoscopic resection with craniotomy (12%), or open resection (30%). Gross residual disease was present in 26% of patients. Most patients received hyperfractionated PT (1.2 Gy [relative biological effectiveness (RBE)] twicemore » daily, 99%) and chemotherapy (75%). The median PT dose was 73.8 Gy (RBE), with 85% of patients receiving more than 70 Gy (RBE). Prognostic factors were analyzed using Kaplan-Meier analysis and proportional hazards regression for multiple regression. Dosimetric parameters were evaluated using logistic regression. Serious, late grade 3 or higher toxicity was reported using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4. The median follow-up was 2.4 years for all patients and 2.7 years among living patients. Results: The local control (LC), neck control, freedom from distant metastasis, disease-free survival, cause-specific survival, and overall survival rates were 83%, 94%, 73%, 63%, 70%, and 68%, respectively, at 3 years. Gross total resection and PT resulted in a 90% 3-year LC rate. The 3-year LC rate was 61% for primary radiation therapy and 59% for patients with gross disease. Gross disease was the only significant factor for LC on multivariate analysis, whereas grade and continuous LC were prognostic for overall survival. Six of 12 local recurrences were marginal. Dural dissemination represented 26% of distant recurrences. Late toxicity occurred in 24% of patients (with grade 3 or higher unilateral vision loss in 2%). Conclusions: Dose-intensified, hyperfractionated PT with or without concurrent chemotherapy results in excellent LC after gross total resection, and results in patients with gross disease are encouraging. Patients with high-grade histology are at greater risk of death from distant dissemination. Continuous LC is a major determinant of survival justifying aggressive local therapy in nearly all cases.« less

Strategies for managing margins.

PubMed

2012-08-01

Potential Medicare and Medicaid reimbursement cuts have made it critical for home health agencies to manage their gross and net operating profit margins. Agencies need to develop tools to analyze their margins and make sure they are following best practices. Try as you may, your agency might still face the question, "Why am I not meeting my budget?" Get some answers in this session from David Berman and Andrea L. Devoti. Berman is a principal at Simione Healthcare Consultants in Hamden, CT, where he is responsible for merchant acquisitions, business valuation due diligence, and oversight of the financial monitor benchmarking tool besides serving as interim chief financial officer. Devoti is chairman of the NAHC board and President & CEO of Neighborhood Health Visiting Nurse Association in West Chester PA.

Predictors for microinvasion of small hepatocellular carcinoma ≤ 2 cm.

PubMed

Yamashita, Yo-ichi; Tsuijita, Eiji; Takeishi, Kazuki; Fujiwara, Megumu; Kira, Shinsuke; Mori, Masaki; Aishima, Shinichi; Taketomi, Akinobu; Shirabe, Ken; Ishida, Terutoshi; Maehara, Yoshihiko

2012-06-01

Hepatocellular carcinoma (HCC) ≤ 2 cm in diameter is considered to have a low potential for malignancy. A retrospective review was undertaken of 149 patients with primary solitary HCC ≤ 2 cm who underwent initial hepatic resection between 1994 and 2010. The independent predictors of the microinvasion (MI) such as portal venous, hepatic vein, or bile duct infiltration and/or intrahepatic metastasis were identified by multivariate analysis. Prognosis of patients with HCC ≤ 2 cm accompanied by MI was compared to that of patients with HCC ≤ 2 cm without MI. Forty-three patients with HCC ≤ 2 cm had MI in patients (28.9%). Three independent predictors of the MI were revealed: invasive gross type (simple nodular type with extranodular growth or confluent multinodular type), des-γ-carboxy prothrombin (DCP) >100 mAU/ml, and poorly differentiated. Disease-free survival rates of patients with HCC ≤ 2 cm with MI (3 year 44%) were significantly worse than those for HCC ≤ 2 cm without MI (3 year 72%). This disadvantage of disease-free survival rate of patients with HCC ≤ 2 cm with MI could be dissolved by hepatic resection with a wide tumor margin of ≥ 5 mm (P = 0.04). Even in cases of HCC ≤ 2 cm, patients who are suspected of having invasive gross type tumors in preoperative imaging diagnosis or who have a high DCP level (>100 mAU/ml) are at risk for MI. Therefore, in such patients, hepatic resection with a wide tumor margin should be recommended.

78 FR 61437 - Self-Regulatory Organizations; Chicago Mercantile Exchange Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-03

... derivatives markets, promoting the prompt and accurate clearance of transactions and protecting investors and... concentration charge for market exposure as a function of absolute Spread DV01 (a portfolio sensitivity to 1... portfolio's market risk rather than its gross notional as the basis for determining the margins associated...

[Gross characteristics of placentas from an assisted reproduction program].

PubMed

Tabs, Dunja; Vejnović, Tihomir; Lalosević, Dusan; Radunović, Nebojsa

2006-01-01

Even though placentas from assisted reproduction programs often differ from placentas of women who conceived naturally, they are rarely examined. The aim of our investigation was to determine some gross characteristics of placentas of women who conceived with assisted reproduction. We examined 30 placentas from an assisted reproduction program (20 from in vitro fertilization and 10 from intrauterine insemination) and 30 placentas of women who conceived naturally. All women were age matched. All the women were at term. The mean weight of placentas from assisted reproduction program was 573 g and of those after natural conception--582.67g. The mean length of the umbilical cords was 64.3cm after assisted reproduction and 66.3cm after natural conception. The mean placenta thickness after assisted reproduction was 2,22 cm and after natural conception 2.28 cm. Eight placentas of the study group had a marginal insertion of the umbilical cord, which lead to a statistically significant difference when compared to placentas of women who conceived naturally: chi-square = 7.07; p>0.01. Marginal cord insertion into the placenta after assisted reproduction is also often described in the literature (as a possible "consequence" of embryo-transfer). There were no statistically significant differences in the mean weight and dimensions of placentas, length of the umbilical cord, gross pathological features of placentas and cords, mean birth weight of babies and placental/fetal ratios between women from assisted reproduction program and those who conceived naturally.

Economic Evaluation of the Production Magnesium Oxide Nanoparticles via Liquid-Phase Route

NASA Astrophysics Data System (ADS)

Nandiyanto, A. B. D.; Fariansyah, R.; Ramadhan, M. F.; Abdullah, A. G.; Widiaty, I.

2018-02-01

The purpose of this study was to evaluate the production of magnesium oxide (MgO) nanoparticles. The evaluation was done in two perspectives: engineering and economic evaluation. The engineering perspective concerned about the analysis of the production rate based on the available apparatuses and raw materials, completed with mass balance calculation. The economic analysis was conducted based on several economic parameters: gross profit margin (GPM), internal return rate (IRR), payback period (PBP), cumulative net present value (CNPV), break even point (BEP), and profit to investment (PI). The engineering perspective showed that the production of MgO is feasibly done in small scale industry. This is verified by the potential production using current available apparatuses and raw materials in the market. Economic analysis obtained that the present project is profitable. But, for some cases, further studies must be done to get the present production process is attractive for investor.

Creation and implementation of an effective physician compensation methodology for a nonprofit medical foundation.

PubMed

Ferch, A W

2000-01-01

The foundation has determined that the adjusted gross billing methodology is a viable method to be considered for a nonprofit medical foundation in compensating physicians. The foundation continues to experiment with the margin formula and is exploring other potential formulas, but believes with certain modifications the percentage of adjusted gross billing methodology can be effective and useful because of its simplicity, ease of administration, and motivational effect on the physicians. The primary improvement to the model needed would be the ability to adjust the formula on a frequent basis for individual practice variations. Modifications will continue to be made as circumstances change, but the basic principles will remain constant.

Retroperitoneal sarcoma (RPS) high risk gross tumor volume boost (HR GTV boost) contour delineation agreement among NRG sarcoma radiation and surgical oncologists.

PubMed

Baldini, Elizabeth H; Bosch, Walter; Kane, John M; Abrams, Ross A; Salerno, Kilian E; Deville, Curtiland; Raut, Chandrajit P; Petersen, Ivy A; Chen, Yen-Lin; Mullen, John T; Millikan, Keith W; Karakousis, Giorgos; Kendrick, Michael L; DeLaney, Thomas F; Wang, Dian

2015-09-01

Curative intent management of retroperitoneal sarcoma (RPS) requires gross total resection. Preoperative radiotherapy (RT) often is used as an adjuvant to surgery, but recurrence rates remain high. To enhance RT efficacy with acceptable tolerance, there is interest in delivering "boost doses" of RT to high-risk areas of gross tumor volume (HR GTV) judged to be at risk for positive resection margins. We sought to evaluate variability in HR GTV boost target volume delineation among collaborating sarcoma radiation and surgical oncologist teams. Radiation planning CT scans for three cases of RPS were distributed to seven paired radiation and surgical oncologist teams at six institutions. Teams contoured HR GTV boost volumes for each case. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. HRGTV boost volume contour agreement between the seven teams was "substantial" or "moderate" for all cases. Agreement was best on the torso wall posteriorly (abutting posterior chest abdominal wall) and medially (abutting ipsilateral para-vertebral space and great vessels). Contours varied more significantly abutting visceral organs due to differing surgical opinions regarding planned partial organ resection. Agreement of RPS HRGTV boost volumes between sarcoma radiation and surgical oncologist teams was substantial to moderate. Differences were most striking in regions abutting visceral organs, highlighting the importance of collaboration between the radiation and surgical oncologist for "individualized" target delineation on the basis of areas deemed at risk and planned resection.

Metastasis Infiltration: An Investigation of the Postoperative Brain-Tumor Interface

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

Raore, Bethwel; Schniederjan, Matthew; Prabhu, Roshan

Purpose: This study aims to evaluate brain infiltration of metastatic tumor cells past the main tumor resection margin to assess the biological basis for the use of stereotactic radiosurgery treatment of the tumor resection cavity and visualized resection edge or clinical target volume. Methods and Materials: Resection margin tissue was obtained after gross total resection of a small group of metastatic lesions from a variety of primary sources. The tissue at the border of the tumor and brain tissue was carefully oriented and processed to evaluate the presence of tumor cells within brain tissue and their distance from the resectionmore » margin. Results: Microscopic assessment of the radially oriented tissue samples showed no tumor cells infiltrating the surrounding brain tissue. Among the positive findings were reactive astrocytosis observed on the brain tissue immediately adjacent to the tumor resection bed margin. Conclusions: The lack of evidence of metastatic tumor cell infiltration into surrounding brain suggests the need to target only a narrow depth of the resection cavity margin to minimize normal tissue injury and prevent treatment size-dependent stereotactic radiosurgery complications.« less

Effects of finishing/polishing techniques on microleakage of resin-modified glass ilonomer cement restorations.

PubMed

Yap, Adrian U J; Yap, W Y; Yeo, Egwin J C; Tan, Jane W S; Ong, Debbie S B

2003-01-01

This study investigated the effect of finishing/polishing techniques on the microleakage of resin-modified glass ionomer restorations. Class V preparations were made on the buccal and lingual/palatal surfaces of freshly extracted teeth. The cavities on each tooth were restored with Fuji II LC (FT [GC]) and Photac-Fil Quick (PF [3M-ESPE]) according to manufacturers' instructions. Immediately after light-polymerization, gross finishing was done with eight-fluted tungsten carbide burs. The teeth were then randomly divided into four groups and finishing/polishing was done with one of the following systems: (a) Robot Carbides (RC); (b) Super-Snap system (SS); (c) OneGloss (OG) and (d) CompoSite Polishers (CS). The sample size for each material-finishing/polishing system combination was eight. After finishing/polishing, the teeth were stored in distilled water at 37 degrees C for one week. The root apices were then sealed with acrylic and two coats of varnish was applied 1 mm beyond the restoration margins. The teeth were subsequently subjected to dye penetration testing (0.5% basic fuchsin), sectioned and scored. Data was analyzed using Kruskal-Wallis and Mann-Whitney U tests at a significance level of 0.05. Results of statistical analysis were as follows: Enamel margins: PF-OG

Post-early cretaceous landform evolution along the western margin of the banca~nnia trough, western nsw

USGS Publications Warehouse

Gibson, D.L.

2000-01-01

Previously undated post-Devonian sediments outcropping north of Fowlers Gap station near the western margin of the Bancannia Trough are shown by plant macro- and microfossil determinations to be of Early Cretaceous (most likely Neocomian and/or Aptian) age, and thus part of the Eromanga Basin. They are assigned to the previously defined Telephone Creek Formation. Study of the structural configuration of this unit and the unconformably underlying Devonian rocks suggests that the gross landscape architecture of the area results from post-Early Cretaceous monoclinal folding along blind faults at the western margin of the trough, combined with the effects of differential erosion. This study shows that, while landscape evolution in the area has been dynamic, the major changes that have occurred are on a geological rather than human timescale.

Malaysia Country Analysis Brief

EIA Publications

2017-01-01

Malaysia's energy industry is a critical sector of growth for the entire economy, and it makes up almost 20% of the total gross domestic product. New tax and investment incentives, starting in 2010, aim to promote oil and natural gas exploration and development in the country's deepwater and marginal fields as well as promote energy efficiency measures and use of alternative energy sources. These fiscal incentives are part of the country's economic transformation program to leverage its resources and geographic location to be one of Asia's top energy players by 2020. Another key pillar in Malaysia's energy strategy is to become a regional oil and natural gas storage, trading, and development hub that will attract technical expertise and downstream services that can compete in Asia.

Design Data Collection with Skylab Microwave Radiometer-Scatterometer S-193, Volume 1

NASA Technical Reports Server (NTRS)

Moore, R. K.; Ulaby, F. T. (Principal Investigator)

1975-01-01

The author has identified the following significant results. Observations with S-193 have provided radar design information for systems to be flown on spacecraft, but only at 13.9 GHz and for land areas over the United States and Brazil plus a few other areas of the world for which this kind of analysis was not made. Observations only extended out to about 50 deg angle of incidence. The value of a sensor with such a gross resolution for most overland resource and status monitoring systems seems marginal, with the possible exception of monitoring soil moisture and major vegetation variations. The complementary nature of the scatterometer and radiometer systems was demonstrated by the correlation analysis. Although radiometers must have spatial resolutions dictated by antenna size, radars can use synthetic aperture techniques to achieve much finer resolutions. Multiplicity of modes in the S-193 sensors complicated both the system development and its employment. An attempt was made in the design of the S-193 to arrange optimum integration times for each angle and type of measurement. This unnecessarily complicated the design of the instrument, since the gains in precision achieved in this way were marginal. Either a software-controllable integration time or a set of only two or three integration times would have been better.

Economic (gross cost) analysis of systematically implementing a programme of advance care planning in three Irish nursing homes.

PubMed

O'Sullivan, Ronan; Murphy, Aileen; O'Caoimh, Rónán; Cornally, Nicola; Svendrovski, Anton; Daly, Brian; Fizgerald, Carol; Twomey, Cillian; McGlade, Ciara; Molloy, D William

2016-04-26

Although advance care planning (ACP) and the use of advanced care directives (ACD) and end-of-life care plans are associated with a reduction in inappropriate hospitalisation, there is little evidence supporting the economic benefits of such programmes. We assessed the economic impact (gross savings) of the Let Me Decide (LMD) ACP programme in Ireland, specifically the impact on hospitalisations, bed days and location of resident deaths, before and after systematic implementation of the LMD-ACP combined with a palliative care education programme. The LMD-ACP was introduced into three long-term care (LTC) facilities in Southern Ireland and outcomes were compared pre and post implementation. In addition, 90 staff were trained in a palliative care educational programme. Economic analysis including probabilistic sensitivity analysis was performed. The uptake of an ACD or end-of-life care post-implementation rose from 25 to 76%. Post implementation, there were statistically significant decreases in hospitalisation rates from baseline (hospitalisation incidents declined from 27.8 to 14.6%, z = 3.96, p < 0.001; inpatient hospital days reduced from 0.54 to 0.36%, z = 8.85, p < 0.001). The percentage of hospital deaths also decreased from 22.9 to 8.4%, z = 3.22, p = 0.001. However, length of stay (LOS) increased marginally (7-9 days). Economic analysis suggested a cost-reduction related to reduced hospitalisations ranging between €10 and €17.8 million/annum and reduction in ambulance transfers, estimated at €0.4 million/annum if these results were extrapolated nationally. When unit costs and LOS estimates were varied in scenario analyses, the expected cost reduction owing to reduced hospitalisations, ranged from €17.7 to €42.4 million nationally. Implementation of the LMD-ACP (ACD/end-of-life care plans combined with palliative care education) programme resulted in reduced rates of hospitalisation. Despite an increase in LOS, likely reflecting more complex care needs of admitted residents, gross costs were reduced and scenario analysis projected large annual savings if these results were extrapolated to the wider LTC population in Ireland.

Terahertz reflectometry imaging for low and high grade gliomas

NASA Astrophysics Data System (ADS)

Ji, Young Bin; Oh, Seung Jae; Kang, Seok-Gu; Heo, Jung; Kim, Sang-Hoon; Choi, Yuna; Song, Seungri; Son, Hye Young; Kim, Se Hoon; Lee, Ji Hyun; Haam, Seung Joo; Huh, Yong Min; Chang, Jong Hee; Joo, Chulmin; Suh, Jin-Suck

2016-10-01

Gross total resection (GTR) of glioma is critical for improving the survival rate of glioma patients. One of the greatest challenges for achieving GTR is the difficulty in discriminating low grade tumor or peritumor regions that have an intact blood brain barrier (BBB) from normal brain tissues and delineating glioma margins during surgery. Here we present a highly sensitive, label-free terahertz reflectometry imaging (TRI) that overcomes current key limitations for intraoperative detection of World Health Organization (WHO) grade II (low grade), and grade III and IV (high grade) gliomas. We demonstrate that TRI provides tumor discrimination and delineation of tumor margins in brain tissues with high sensitivity on the basis of Hematoxylin and eosin (H&E) stained image. TRI may help neurosurgeons to remove gliomas completely by providing visualization of tumor margins in WHO grade II, III, and IV gliomas without contrast agents, and hence, improve patient outcomes.

Effects of milk yield on biological efficiency and profit of beef production from birth to slaughter.

PubMed

Miller, S P; Wilton, J W; Pfeiffer, W C

1999-02-01

Effect of milk yield (MY) on biological efficiency and gross margin as an indicator of profit potential of beef production from birth to slaughter was determined. Data included 9 yr of spring-born single male calves. Biological efficiency was calculated as carcass weight/total feed energy intake, including nonlactating and lactating intakes of cow and creep and feedlot intakes of calf. Slaughter end point was finish constant at 9 mm of fat thickness. Gross margin was determined as returns minus feed costs. Three breeding systems were analyzed: purebred Hereford (HE), large rotational (LR), and small rotational (SR). Analyses were performed separately by breeding system when differences in the effect of MY among breeding systems were significant. Increased MY was associated with increased preweaning gain (P < .001), increased weight at start of feedlot trial (P < .001), and increased hot carcass weight (P < .05). No significant (P > .10) effect of MY on age at slaughter or on carcass weight per day of age at slaughter was found. Increased MY was associated with increased cow lactating energy intake (P < .10) and negatively associated with calf creep intake (P < .01). No effects of MY on intake of the cow during the nonlactating period, calf feedlot intake, or total feed intake were found. Increased MY was associated with a reduction in backfat thickness of the cow during the lactating period (P < .01) with no change in body weight. In the subsequent nonlactating period, increasing MY was associated with increased backfat thickness (P < .10) and body weight (P < .05). No effect of MY on change in backfat or weight of cow from calving to the end of the next nonlactating period was found. No effect of MY on biological efficiency to slaughter was detected. Milk yield was positively associated with gross margin from birth to slaughter (P < .05); results were similar when cow feed prices were reduced by 30%. Increased MY was associated with increased biological efficiency to weaning in HE (P < .01) and SR (P < .10), with no effect found in LR. When feeding cows to requirements, milk yield has a positive effect on the profit potential of beef production from birth to slaughter.

Adenoid cystic carcinoma of the skull base: results with an aggressive multidisciplinary approach.

PubMed

Ramakrishna, Rohan; Raza, Shaan M; Kupferman, Michael; Hanna, Ehab; DeMonte, Franco

2016-01-01

OBJECT Adenoid cystic carcinoma (ACC) is a locally aggressive tumor of salivary gland origin. Little data exist to guide treatment when this tumor extends to involve the structures of the skull base. METHODS Fifty-one patients with a diagnosis of ACC affecting the skull base were identified from a prospective database at MD Anderson Cancer Center (from 1992 to 2010). RESULTS Median follow-up for study patients was 6.75 years. The 5- and 10-year overall survival (OS) rates were 78% and 50%, respectively. Sixty-six percent of patients had progression of their disease. The 5- and 10-year progression-free survival (PFS) rates were 46.7% and 21.0%, respectively. Gross-total resection was achieved in 75% of patients, with 49% having microscopically negative margins at the time of first operation. On univariate analysis, resections with microscopically negative margins were associated with a significant OS advantage (20.1 ± 3.3 years) compared with resections that left residual disease, even if microscopic (10.3 ± 1.6 years, p = 0.035). In patients who underwent reoperation, the effect persisted, with improved OS in those with negative margins (21.4 ± 0.0 vs 16.7 ± 4.0 years, p = 0.06). The use of adjuvant radiotherapy was associated with an OS advantage (16.2 ± 2.5 vs 5.5 ± 2.2 years, p = 0.03) at initial diagnosis and improved PFS (7.8 ± 1.0 vs 2.1 ± 0.62 years, p = 0.005), whereas repeat irradiation provided no benefit. The use of adjuvant chemotherapy at diagnosis or at recurrence was not associated with any significant advantage. Multivariate analysis revealed margin-negative resection at initial operation and at recurrence retained OS significance, even after controlling for age, radiation therapy, and T stage. CONCLUSIONS ACC of the skull base is best treated with a multidisciplinary approach aimed at maximal, safe resection. Adjuvant radiotherapy should be offered, whereas chemotherapy does not confer benefit.

Radiation Therapy for Control of Soft-Tissue Sarcomas Resected With Positive Margins

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

DeLaney, Thomas F.; Kepka, Lucyna; Goldberg, Saveli I.

Purpose: Positive margins (PM) remain after surgery in some soft-tissue sarcoma (STS) patients. We investigated the efficacy of radiation therapy (RT) in STS patients with PM. Methods and Materials: A retrospective chart review was performed on 154 patients with STS at various anatomic sites with PM, defined as tumor on ink, who underwent RT with curative intent between 1970 and 2001. Local control (LC), disease-free survival (DFS), and overall survival (OS) rates were evaluated by univariate (log-rank) and multivariate analysis of prognostic and treatment factors. Results: At 5 years, actuarial LC, DFS, and OS rates were: 76%, 46.7%, and 65.2%,more » respectively. LC was highest with extremity lesions (p < 0.01), radiation dose >64 Gy (p < 0.05), microscopically (vs. grossly visible) positive margin (p = 0.03), and superficial lesions (p = 0.05). Patients receiving >64 Gy had higher 5-year LC, DFS, and OS rates of 85%, 52.1%, and 67.8% vs. 66.1%, 41.8%, and 62.9% if {<=}64 Gy, p < 0.04. OS was worse in patients with G2/G3 tumors with local failure (LF), p < 0.001. Other known prognostic factors, including grade, stage, size, and age (>50), also significantly influenced OS. By multivariate analysis, the best predictors of LC were site (extremity vs. other), p < 0.01 and dose (>64 vs. {<=}64 Gy), p < 0.05; the best predictors for OS were size, p < 0.001, gross vs. microscopic PM, p < 0.05, and LF, p < 0.01. Conclusion: Local control is achieved in most PM STS patients undergoing RT. Doses >64 Gy, superficial location, and extremity site are associated with improved LC. OS is worse in patients with tumors with lesions >5 cm, grossly positive margins, and after local failure.« less

Dermatofibrosarcoma Protuberans: Long-term Outcomes of 53 Patients Treated With Conservative Surgery and Radiation Therapy

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

Castle, Katherine O.; Guadagnolo, B. Ashleigh, E-mail: aguadagn@mdanderson.org; Tsai, C. Jillian

Purpose: To evaluate outcomes of conservative surgery and radiation therapy (RT) treatment in patients with dermatofibrosarcoma protuberans. Methods and Materials: We retrospectively reviewed the medical records of 53 consecutive dermatofibrosarcoma protuberans patients treated with surgery and preoperative or postoperative radiation therapy between 1972 and 2010. Median tumor size was 4 cm (range, 1-25 cm). Seven patients (13%) were treated with preoperative RT (50-50.4 Gy) and 46 patients (87%) with postoperative RT (60-66 Gy). Of the 46 patients receiving postoperative radiation, 3 (7%) had gross disease, 14 (30%) positive margins, 26 (57%) negative margins, and 3 (7%) uncertain margin status. Radiationmore » dose ranged from 50 to 66 Gy (median dose, 60 Gy). Results: At a median follow-up time of 6.5 years (range, 0.5 months-23.5 years), 2 patients (4%) had disease recurrence, and 3 patients (6%) had died. Actuarial overall survival was 98% at both 5 and 10 years. Local control was 98% and 93% at 5 and 10 years, respectively. Disease-free survival was 98% and 93% at 5 and 10 years, respectively. The presence of fibrosarcomatous change was not associated with increased risk of local or distant relapse (P=.43). One of the patients with a local recurrence had gross residual disease at the time of RT and despite RT to 65 Gy developed both an in-field recurrence and a nodal and distant recurrence 3 months after RT. The other patient with local recurrence was found to have in-field recurrence 10 years after initial treatment. Thirteen percent of patients had an RT complication at 5 and 10 years, and 9% had a moderate or severe complication at 5 and 10 years. Conclusions: Dermatofibrosarcoma protuberans is a radioresponsive disease with excellent local control after conservative surgery and radiation therapy. Adjuvant RT should be considered for patients with large or recurrent tumors or when attempts at wide surgical margins would result in significant morbidity.« less

Hardwood sawmill downtime costs

Treesearch

Jan Wiedenbeck; Kyle Blackwell

2003-01-01

How time flies when you don't pay attention to it. With hardwood sawmill operating costs ranging from $4 to $25 per operating minute ($95/MBF to $335/MBF) and gross profit margins ranging from $0.10/BF to $0.35/BF, five extra minutes of downtime per day will cost a sawmill that produces an average of 20,000 BF per day (5 MMBF annually) between $21 and $73 per day...

Dryland Salinity in the North Stirling Land Conservation District, Western Australia: Simulation and Management Options

NASA Astrophysics Data System (ADS)

Gomboso, J.; Ghassemi, F.; Appleyard, S. J.

1997-01-01

The North Stirling Land Conservation District consists of approximately 100,000 hectares north of the Stirling Range National Park, Western Australia. Clearing of land for agriculture occurred in the 1960's and early 1970's. The groundwater is highly saline, and, since clearing, the water table has risen by as much as 12 m; it is now generally less than 3 m below ground level throughout the area. The rise in groundwater levels following clearing and the use of crops and pastures requiring low water use have caused dramatic secondary salinisation over a short period of time. Groundwater flow was simulated with models of steady-state and transient groundwater flow. By incorporating economic simulations with the calibrated transient hydrogeological model, estimates of the expected gross margin losses were made. Three salinity-management strategies were simulated. Results indicate that 1) under the `do-nothing' strategy, future gross margins are expected to decline; 2) under the agronomic strategy, the rate of water-table rise would be reduced and foregone agricultural production losses would be less than the `do-nothing' strategy; and 3) under the agroforestry strategy, the water table is expected to decline in the long term, which would increase future agricultural production levels and, hence, profitability.

Strategic planning by independent community pharmacies.

PubMed

Harrison, Donald L

2005-01-01

(1) To assess the degree and level of use of the strategic planning process (none, partly, fully) by independent community pharmacy owners/managers and (2) to evaluate the relationships between independent community pharmacy owners/managers' level of strategic planning and indicators of pharmacy performance; including new and refill prescriptions filled, gross margin, rated patient care performance, rated dispensing performance, rated non-pharmacy performance, and rated financial performance. Cross-sectional study. United States. Nationwide random sample of 1,250 owners/managers of independent community pharmacies. Mailed survey. Quality of strategic planning conducted; pharmacy performance measures. Only 141 of 527 (26.8%) usable responses indicated use of some (77 pharmacies, 54.6%) or all (64 pharmacies, 45.4%) of the seven steps typical of strategic planning. Significant associations were observed between the level of strategic planning use and all pharmacy performance variables assessed, including indicators such as greater numbers of new and refill prescriptions dispensed, gross margins, patient care performance, dispensing performance, non-pharmacy performance, and financial performance. Greater ratings of pharmacy performance were significantly associated with the level of strategic planning use. Respondents who fully used strategic planning had significantly higher indicators than partial users; respondents who partly used the process had significantly higher ratings than respondents who did not conduct strategic planning.

Radiofrequency ablation for hepatocellular carcinoma measuring 2 cm or smaller: results and risk factors for local recurrence.

PubMed

Kono, Masashi; Inoue, Tatsuo; Kudo, Masatoshi; Chishina, Hirokazu; Arizumi, Tadaaki; Takita, Masahiro; Kitai, Satoshi; Yada, Norihisa; Hagiwara, Satoru; Minami, Yasunori; Ueshima, Kazuomi; Nishida, Naoshi; Murakami, Takamichi

2014-01-01

The purpose of this study was to evaluate the risk factors for local recurrence with radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) measuring ≤2 cm. This study involved 234 patients with 274 HCCs measuring ≤2 cm who had undergone RFA as the initial treatment. The mean tumor diameter was 1.478 cm. The median follow-up period was 829 days. We evaluated the post-RFA cumulative local recurrence rate and analyzed the risk factors contributing to clinical outcomes. Cumulative local recurrence rates were 9, 19 and 19% at 1, 2 and 3 years, respectively. Among the 145 cases with a complete safety margin (SM) after RFA, only 4 developed local tumor recurrence and the cumulative rates of local tumor recurrence at 1, 2 and 3 years were 2, 3 and 3%, respectively. Among the 129 cases with incomplete SM, local tumor recurrence developed in 34 and the cumulative rates of local tumor progression at 1, 2 and 3 years were 14, 36 and 36%, respectively. In multivariate analysis, significant risk factors were tumor location (liver surface), irregular gross type and SM <5 mm. Even with HCC measuring ≤2 cm, location and gross type of tumor should be carefully evaluated before RFA is performed.

4D-Listmode-PET-CT and 4D-CT for optimizing PTV margins in gastric lymphoma : Determination of intra- and interfractional gastric motion.

PubMed

Reinartz, Gabriele; Haverkamp, Uwe; Wullenkord, Ramona; Lehrich, Philipp; Kriz, Jan; Büther, Florian; Schäfers, Klaus; Schäfers, Michael; Eich, Hans Theodor

2016-05-01

New imaging protocols for radiotherapy in localized gastric lymphoma were evaluated to optimize planning target volume (PTV) margin and determine intra-/interfractional variation of the stomach. Imaging of 6 patients was explored prospectively. Intensity-modulated radiotherapy (IMRT) planning was based on 4D/3D imaging of computed tomography (CT) and positron-emission tomography (PET)-CT. Static and motion gross tumor volume (sGTV and mGTV, respectively) were distinguished by defining GTV (empty stomach), clinical target volume (CTV = GTV + 5 mm margin), PTV (GTV + 10/15/20/25 mm margins)  plus paraaortic lymph nodes and proximal duodenum. Overlap of 4D-Listmode-PET-based mCTV with 3D-CT-based PTV (increasing margins) and V95/D95 of mCTV were evaluated. Gastric shifts were determined using online cone-beam CT. Dose contribution to organs at risk was assessed. The 4D data demonstrate considerable intra-/interfractional variation of the stomach, especially along the vertical axis. Conventional 3D-CT planning utilizing advancing PTV margins of 10/15/20/25 mm resulted in rising dose coverage of mCTV (4D-Listmode-PET-Summation-CT) and rising D95 and V95 of mCTV. A PTV margin of 15 mm was adequate in 3 of 6 patients, a PTV margin of 20 mm was adequate in 4 of 6 patients, and a PTV margin of 25 mm was adequate in 5 of 6 patients. IMRT planning based on 4D-PET-CT/4D-CT together with online cone-beam CT is advisable to individualize the PTV margin and optimize target coverage in gastric lymphoma.

Econometric analysis on the impact of macroeconomic variables toward financial performance: A case of Malaysian public listed logistics companies

NASA Astrophysics Data System (ADS)

Zakariah, Sahidah; Pyeman, Jaafar; Ghazali, Rahmat; Rahman, Ibrahim A.; Rashid, Ahmad Husni Mohd; Shamsuddin, Sofian

2014-12-01

The primary concern of this study is to analyse the impact against macroeconomic variables upon the financial performance, particularly in the case of public listed logistics companies in Malaysia. This study incorporated five macroeconomic variables and four proxies of financial performance. The macroeconomic variables selected are gross domestic product (GDP), total trade (XM), foreign direct investment (FDI), inflation rate (INF), and interest rate (INT). This study is extended to the usage of ratio analysis to predict financial performance in relation to the changes upon macroeconomic variables. As such, this study selected four (4) ratios as proxies to financial performance, which is Operating Profit Margin (OPM), Net Profit Margin (NPM), Return on Asset (ROA), Return on Equity (ROE). The findings of this study may appear non-controversial to some, but it resulted in the following important consensus; (1) GDP is found to be highly impacting NPM and least of ROA, (2) XM has high positive impact on OPM and least on ROE, (3) FDI appear to have insignificant impact towards NPM, and (4) INF and INT show similar negative impact on financial performance, precisely highly negative on OPM and least on ROA. Such findings also conform to the local logistic industry settings, specifically in regards to public listed logistics companies in relation to its financial performance.

Intensity-modulated radiotherapy (IMRT) in pediatric low-grade glioma.

PubMed

Paulino, Arnold C; Mazloom, Ali; Terashima, Keita; Su, Jack; Adesina, Adekunle M; Okcu, M Faith; Teh, Bin S; Chintagumpala, Murali

2013-07-15

The objective of this study was to evaluate local control and patterns of failure in pediatric patients with low-grade glioma (LGG) who received treatment with intensity-modulated radiation therapy (IMRT). In total, 39 children received IMRT after incomplete resection or disease progression. Three methods of target delineation were used. The first was to delineate the gross tumor volume (GTV) and add a 1-cm margin to create the clinical target volume (CTV) (Method 1; n = 19). The second was to add a 0.5-cm margin around the GTV to create the CTV (Method 2; n = 6). The prescribed dose to the GTV was the same as dose to the CTV for both Methods 1 and 2 (median, 50.4 grays [Gy]). The final method was dose painting, in which a GTV was delineated with a second target volume (2TV) created by adding 1 cm to the GTV (Method 3; n = 14). Different doses were prescribed to the GTV (median, 50.4 Gy) and the 2TV (median, 41.4 Gy). The 8-year progression-free and overall survival rates were 78.2% and 93.7%, respectively. Seven failures occurred, all of which were local in the high-dose (≥95%) region of the IMRT field. On multivariate analysis, age ≤5 years at time of IMRT had a detrimental impact on progression-free survival. IMRT provided local control rates comparable to those provided by 2-dimensional and 3-dimensional radiotherapy. Margins ≥1 cm added to the GTV may not be necessary, because excellent local control was achieved by adding a 0.5-cm margin (Method 2) and by dose painting (Method 3). © 2013 American Cancer Society.

Current Dosing Paradigm for Stereotactic Radiosurgery Alone After Surgical Resection of Brain Metastases Needs to Be Optimized for Improved Local Control

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

Prabhu, Roshan; Shu, Hui-Kuo; Winship Cancer Institute, Emory University, Atlanta, GA

2012-05-01

Purpose: To describe the use of radiosurgery (RS) alone to the resection cavity after resection of brain metastases as an alternative to adjuvant whole-brain radiotherapy (WBRT). Methods and Materials: Sixty-two patients with 64 cavities were treated with linear accelerator-based RS alone to the resection cavity after surgical removal of brain metastases between March 2007 and August 2010. Fifty-two patients (81%) had a gross total resection. Median cavity volume was 8.5 cm{sup 3}. Forty-four patients (71%) had a single metastasis. Median marginal and maximum doses were 18 Gy and 20.4 Gy, respectively. Sixty-one cavities (95%) had gross tumor volume to planningmore » target volume expansion of {>=}1 mm. Results: Six-month and 1-year actuarial local recurrence rates were 14% and 22%, respectively, with a median follow-up period of 9.7 months. Six-month and 1-year actuarial distant brain recurrence, total intracranial recurrence, and freedom from WBRT rates were 31% and 51%, 41% and 63%, and 91% and 74%, respectively. The symptomatic cavity radiation necrosis rate was 8%, with 2 patients (3%) undergoing surgery. Of the 11 local failures, 8 were in-field, 1 was marginal, and 2 were both (defined as in-field if {>=}90% of recurrence within the prescription isodose and marginal if {>=}90% outside of the prescription isodose). Conclusions: The high rate of in-field cavity failure suggests that geographic misses with highly conformal RS are not a major contributor to local recurrence. The current dosing regimen derived from Radiation Therapy Oncology Group protocol 90-05 should be optimized in this patient population before any direct comparison with WBRT.« less

Engineering Analysis and Economic Evaluation of the Synthesis of Composite CuO/ZnO/ZrO2 Nanocatalyst

NASA Astrophysics Data System (ADS)

Nandiyanto, A. B. D.; Hayati, W. R.; Aziz, T. A.; Ragadhita, R.; Abdullah, A. G.; Widiaty, I.

2018-02-01

The purpose of this study was to evaluate the synthesis process of composite CuO/ZnO/ZrO2 (CZZ) nanocatalyst. The CZZ nanocatalyst is used as a catalyst in the hydrogenation reaction, which is used to convert harmful CO2 gas into liquid fuels such as methanol. In this study, CZZ produced using the sol-gel autocombustion method was selected as a model of the production procedure. The evaluation was conducted into two factors: engineering and economic analysis. Engineering analysis was analyzed based on the available apparatuses and raw materials in online web. Then, these data were used and compared with the mass balance approximation. The economic analysis was done using several economic parameters, including such as gross margin, internal rate return, payback period, cumulative net value, break even point (BEP), profitability index on sales to investment. Engineering analysis showed the present method can be applied using available apparatuses and raw materials in market. Economic analysis result confirmed that the present project is profitable. The analysis concluded that the present project for the production of CZZ nanocatalyst is prospective in small scale industry and profitable (by positive values in all economic parameters).

Integration of production and financial models to analyse the financial impact of livestock diseases: a case study of Schmallenberg virus disease on British and French dairy farms

PubMed Central

Häsler, Barbara; Alarcon, Pablo; Raboisson, Didier; Waret-Szkuta, Agnes; Rushton, Jonathan

2015-01-01

Aims and objectives The aim of the study was to investigate and compare the financial impact of Schmallenberg disease for different dairy production types in the United Kingdom and France. Materials and methods Integrated production and financial models for dairy cattle were developed and applied to Schmallenberg virus (SBV) disease in a British and French context. The five main production systems that prevail in these two countries were considered. Their respective gross margins measuring the holding's profitability were calculated based on public benchmarking, literature and expert opinion data. A partial budget analysis was performed within each production model to estimate the impact of SBV in the systems modelled. Two disease scenarios were simulated: low impact and high impact. Results The model gross margin obtained per cow space and year ranged from £1014 to £1484 for the UK and from £1037 to £1890 for France depending on the production system considered. In the UK, the net SBV disease costs in £/cow space/year for an average dairy farm with 100 milking spaces were estimated between £16.3 and £51.4 in the high-impact scenario and between £8.2 and £25.9 in the low-impact scenario. For France, the net SBV disease costs in £/cow space/year ranged from £19.6 to £48.6 in the high-impact scenario and £9.7 to £22.8 in the low-impact scenario, respectively. Conclusion The study illustrates how the combination of production and financial models allows assessing disease impact taking into account differing management and husbandry practices and associated price structures in the dairy sector. It supports decision-making of farmers and veterinarians who are considering disease control measures as it provides an approach to estimate baseline disease impact in common dairy production systems in the UK and France. PMID:26392883

The relationship of hospital ownership and service composition to hospital charges

PubMed Central

Eskoz, Robin; Peddecord, K. Michael

1985-01-01

The relationship of hospital ownership and service composition to hospital charges was examined for 456 general acute hospitals in California. Ancillary services had higher profit margins, both gross and net profits, than daily hospital services. Ancillary services accounted for 55.3 percent of total patient revenue. Charges per day were 23 percent higher for ancillary services than for daily hospital services. Net profits for daily and ancillary services were lowest at county hospitals. Proprietary hospitals had the highest net profits for total ancillary services and the highest mean charges. Not-for-profit hospitals had the highest profit margins for daily hospital services. Neither direct nor total costs for ancillary services were significantly different among ownership groups, although direct costs for daily hospital services were significantly higher at proprietary hospitals. PMID:10311161

Incidental Prostate Adenocarcinoma in Cystoprostatectomy Specimens: Partial Versus Complete Prostate Sampling.

PubMed

Filter, Emily R; Gabril, Manal Y; Gomez, Jose A; Wang, Peter Z T; Chin, Joseph L; Izawa, Jonathan; Moussa, Madeleine

2017-08-01

The rate of incidental prostate adenocarcinoma (PCa) detection in radical cystoprostatectomy (RCP) varies widely, ranging from 15% to 54%. Such variability may be explained by institutional differences in prostate grossing protocols. Either partial or complete submission of the prostate gland in RCP may result in detection of clinically insignificant or significant incidental PCa. The aim of the study was to compare the clinical significance of PCa in RCP specimens in partial versus complete sampling. Seventy-two out of 158 RCP cases showed incidental PCa. The pathologic features, including Gleason score, margin status, extraprostatic extension (EPE), seminal vesicle invasion (SVI), PCa stage, and tumor volume, were assessed. The 72 cases were divided into partial (n = 21, 29.1%) and complete sampling (n = 51, 70.8%) groups. EPE was detected in 13/72 (18.1%) with 11/13 (84.6%) cases in the complete group. Positive margins were present in 11/72 (15.3%) with 9/11 (81.8%) in the complete group. SVI was detected in 4/72 (5.6%) with 3/4 (75.0%) in the complete group. Overall, 4/72 (5.6%) had a Gleason score >7, all of which were in the complete group. Our data suggest that complete sampling of the prostate may be the ideal approach to grossing RCP specimens, allowing for greater detection of clinically significant incidental PCa.

75 FR 9257 - SBA Lender Risk Rating System

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-01

... Liquidation Rate; 3. Gross Delinquency Rate; 4. Gross Past-Due Rate; 5. Six (6) Month Net Flow Indicator; 6.... The statistical analysis performed showed that incorporating the Portfolio Size/Age component improved...) Month Delinquency Rate; 3. Gross Delinquency Rate; 4. Gross Past-Due Rate; 5. Average Small Business...

The impact of public expenditure on undernourishment distribution in Mexico.

PubMed

Moreno-Macías, Lidia; Palma-Solís, Marco; Zapata-Vázquez, Rita E

2013-09-01

The status of undernourishment in children under the age of five in Mexico is open to debate. Linked to poverty, underweight and stunting, the rates of undernourishment are reported to be diminishing, although poverty remains an incessant problem. This study was done to determine whether there is an association between public expenditure and underweight and stunting distribution in Mexico based on data from the 2006 health and population census and from macroeconomic, social, and demographic variables. We used principal component analysis to reduce the number of variables and analyze their behavior. Multiple regressions showed that underweight and stunting are significantly associated with the marginalization index, support from the Sistema Nacional para el Desarrollo Integral de la Familia (DIF) supplies and breakfast program, the gross domestic product per capita, and expenditure from the Opportunities program. Further, public expenditure aimed to combat undernourishment is inadequately oriented to address the needs of the poor.

Gross-alpha and gross-beta activities in airborne particulate samples. Analysis and prediction models.

PubMed

Dueñas, C; Fernández, M C; Carretero, J; Liger, E; Cañete, S

2001-04-01

Measurements of gross-alpha and gross-beta activities were made every week during the years 1992-1997 for airborne particulate samples collected using air filters at a clear site. The data are sufficiently numerous to allow the examination of variations in time and by these measurements to establish several features that should be important in understanding any trends of atmospheric radioactivity. Two models were used to predict the gross-alpha and gross-beta activities. A good agreement between the results of these models and the measurements was highlighted.

Earthquake stress drops, ambient tectonic stresses and stresses that drive plate motions

USGS Publications Warehouse

Hanks, T.C.

1977-01-01

A variety of geophysical observations suggests that the upper portion of the lithosphere, herein referred to as the elastic plate, has long-term material properties and frictional strength significantly greater than the lower lithosphere. If the average frictional stress along the non-ridge margin of the elastic plate is of the order of a kilobar, as suggested by the many observations of the frictional strength of rocks at mid-crustal conditions of pressure and temperature, the only viable mechanism for driving the motion of the elastic plate is a basal shear stress of several tens of bars. Kilobars of tectonic stress are then an ambient, steady condition of the earth's crust and uppermost mantle. The approximate equality of the basal shear stress and the average crustal earthquake stress drop, the localization of strain release for major plate margin earthquakes, and the rough equivalence of plate margin slip rates and gross plate motion rates suggest that the stress drops of major plate margin earthquakes are controlled by the elastic release of the basal shear stress in the vicinity of the plate margin, despite the existence of kilobars of tectonic stress existing across vertical planes parallel to the plate margin. If the stress differences available to be released at the time of faulting are distributed in a random, white fasbion with a mean-square value determined by the average earthquake stress drop, the frequency of occurrence of constant stress drop earthquakes will be proportional to reciprocal faulting area, in accordance with empirically known frequency of occurrence statistics. ?? 1977 Birkha??user Verlag.

SU-F-J-130: Margin Determination for Hypofractionated Partial Breast Irradiation

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

Geady, C; Keller, B; Hahn, E

2016-06-15

Purpose: To determine the Planning Target Volume (PTV) margin for Hypofractionated Partial Breast Irradiation (HPBI) using the van Herk formalism (M=2.5∑+0.7σ). HPBI is a novel technique intended to provide local control in breast cancer patients not eligible for surgical resection, using 40 Gy in 5 fractions prescribed to the gross disease. Methods: Setup uncertainties were quantified through retrospective analysis of cone-beam computed tomography (CBCT) data sets, collected prior to (prefraction) and after (postfraction) treatment delivery. During simulation and treatment, patients were immobilized using a wing board and an evacuated bag. Prefraction CBCT was rigidly registered to planning 4-dimensional computed tomographymore » (4DCT) using the chest wall and tumor, and translational couch shifts were applied as needed. This clinical workflow was faithfully reproduced in Pinnacle (Philips Medical Systems) to yield residual setup and intrafractional error through translational shifts and rigid registrations (ribs and sternum) of prefraction CBCT to 4DCT and postfraction CBCT to prefraction CBCT, respectively. All ten patients included in this investigation were medically inoperable; the median age was 84 (range, 52–100) years. Results: Systematic (and random) setup uncertainties (in mm) detected for the left-right, craniocaudal and anteroposterior directions were 0.4 (1.5), 0.8 (1.8) and 0.4 (1.0); net uncertainty was determined to be 0.7 (1.5). Rotations >2° in any axis occurred on 8/72 (11.1%) registrations. Conclusion: Preliminary results suggest a non-uniform setup margin (in mm) of 2.2, 3.3 and 1.7 for the left-right, craniocaudal and anteroposterior directions is required for HPBI, given its immobilization techniques and online setup verification protocol. This investigation is ongoing, though published results from similar studies are consistent with the above findings. Determination of margins in breast radiotherapy is a paradigm shift, but a necessary step in moving towards hypofractionated regiments, which may ultimately redefine the standard of care for this select patient population.« less

Individualized Margins in 3D Conformal Radiotherapy Planning for Lung Cancer: Analysis of Physiological Movements and Their Dosimetric Impacts

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

Germain, Francois; Beaulieu, Luc; Fortin, Andre

2008-04-01

In conformal radiotherapy planning for lung cancer, respiratory movements are not taken into account when a single computed tomography (CT) scan is performed. This study examines tumor movements to design individualized margins to account for these movements and evaluates their dosimetric impacts on planning volume. Fifteen patients undergoing CT-based planning for radical radiotherapy for localized lung cancer formed the study cohort. A reference plan was constructed based on reference gross, clinical, and planning target volumes (rGTV, rCTV, and rPTV, respectively). The reference plans were compared with individualized plans using individualized margins obtained by using 5 serial CT scans to generatemore » individualized target volumes (iGTV, iCTV, and iPTV). Three-dimensional conformal radiation therapy was used for plan generation using 6- and 23-MV photon beams. Ten plans for each patient were generated and dose-volume histograms (DVHs) were calculated. Comparisons of volumetric and dosimetric parameters were performed using paired Student t-tests. Relative to the rGTV, the total volume occupied by the superimposed GTVs increased progressively with each additional CT scans. With the use of all 5 scans, the average increase in GTV was 52.1%. For the plans with closest dosimetric coverage, target volume was smaller (iPTV/rPTV ratio 0.808) but lung irradiation was only slightly decreased. Reduction in the proportion of lung tissue that received 20 Gy or more outside the PTV (V20) was observed both for 6-MV plans (-0.73%) and 23-MV plans (-0.65%), with p = 0.02 and p = 0.04, respectively. In conformal RT planning for the treatment of lung cancer, the use of serial CT scans to evaluate respiratory motion and to generate individualized margins to account for these motions produced only a limited lung sparing advantage.« less

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

Consonni, Stefano; LEAP - Laboratorio Energia Ambiente Piacenza, Via Bixio 27, 29100 Piacenza; Vigano, Federico, E-mail: federico.vigano@polimi.it

Highlights: > The amount of waste available for energy recovery is significantly higher than the Unsorted Residual Waste (URW). > Its energy potential is always higher than the complement to 100% of the Source Separation Level (SSL). > Increasing SSL has marginal effects on the potential for energy recovery. > Variations in the composition of the waste fed to WtE plants affect only marginally their performances. > A large WtE plant with a treatment capacity some times higher than a small plant achieves electric efficiency appreciably higher. - Abstract: This article is part of a set of six coordinated papersmore » reporting the main findings of a research project carried out by five Italian universities on 'Material and energy recovery in Integrated Waste Management Systems (IWMS)'. An overview of the project and a summary of the most relevant results can be found in the introductory article of the series. This paper describes the work related to the evaluation of mass and energy balances, which has consisted of three major efforts (i) development of a model for quantifying the energy content and the elemental compositions of the waste streams appearing in a IWMS; (ii) upgrade of an earlier model to predict the performances of Waste-to-Energy (WtE) plants; (iii) evaluation of mass and energy balances of all the scenarios and the recovery paths considered in the project. Results show that not only the amount of material available for energy recovery is significantly higher than the Unsorted Residual Waste (URW) left after Separate Collection (SC), because selection and recycling generate significant amounts of residues, but its heating value is higher than that of the original, gross waste. Therefore, the energy potential of what is left after recycling is always higher than the complement to 100% of the Source Separation Level (SSL). Also, increasing SSL has marginal effects on the potential for energy recovery: nearly doubling SSL (from 35% to 65%) reduces the energy potential only by one fourth. Consequently, even at high SSL energy recovery is a fundamental step of a sustainable waste management system. Variations of SSL do bring about variations of the composition, heating value and moisture content of the material fed to WtE plants, but these variations (i) are smaller than one can expect; (ii) have marginal effects on the performances of the WtE plant. These considerations suggest that the mere value of SSL is not a good indicator of the quality of the waste management system, nor of its energy and environmental outcome. Given the well-known dependence of the efficiency of steam power plants with their power output, the efficiency of energy recovery crucially depends on the size of the IWMS served by the WtE plant. A fivefold increase of the amount of gross waste handled in the IWMS (from 150,000 to 750,000 tons per year of gross waste) allows increasing the electric efficiencies of the WtE plant by about 6-7 percentage points (from 21-23% to 28.5% circa).« less

Multi-year double cropping biochar field trials in Nepal: Finding the optimal biochar dose through agronomic trials and cost-benefit analysis.

PubMed

Pandit, Naba Raj; Mulder, Jan; Hale, Sarah E; Zimmerman, Andrew R; Pandit, Bishnu Hari; Cornelissen, Gerard

2018-05-15

Poor water and nutrient retention are the major soil fertility limitations in the low productivity agricultural soils of Nepal. The addition of biochar to these soils is one way these hindrances can be overcome. In the present study, six different biochar doses (control, 5 t ha -1 , 10 t ha -1 , 15 t ha -1 , 25 t ha -1 and 40 t ha -1 ) were applied to a moderately acidic silty loam soil from Rasuwa, Nepal and the effects on soil physicochemical properties and maize and mustard yield over three years (i.e., six cropping seasons), were investigated. Biochar addition did not show significant effects on maize and mustard grain yield in the first year, however significant positive effects (p < 0.01) were observed during the second and third years. During the second year, maize grain yield significantly increased by 50%, 47% and 93% and mustard grain yield by 96%, 128% and 134% at 15 t ha -1 , 25 t ha -1 and 40 t ha -1 of biochar respectively. A similar significant increase in yield of both crops was observed in the third year. Yields for both maize and mustard correlated significantly (p < 0.001) with plant available P, K + , pH, total OC%, CEC, base saturation, and increased as a function of biochar addition. On the basis of the measured crop yields for the various biochar doses, a cost-benefit analysis was carried out, and gross margin was calculated to optimize biochar dose for local farming practice. Total costs included financial cost (farm input, labor and biochar production cost), health cost and methane emission cost during biochar production. Health costs were a minor factor (<2% of total biochar preparation cost), whereas methane emission costs were significant (up to 30% of biochar cost, depending on the C price). Total income comprised sale of crops and carbon sequestration credits. The cost-benefit analysis showed that the optimal biochar application dose was 15 t ha -1 for all C price scenarios, increasing gross margin by 21% and 53%, respectively, for 0 and 42 US$ per ton CO 2 price scenarios. In the current situation, only the 0 US$ price scenario is realistic for rural farmers in Nepal, but this still gives benefits of biochar amendment, which are capped at a 15 t ha -1 biochar addition. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Strategies for time of culling in control of paratuberculosis in dairy herds.

PubMed

Kudahl, A B; Nielsen, S S; Ostergaard, S

2011-08-01

Effect of time for culling cows infected with Mycobacterium avium ssp. paratuberculosis on prevalence and profitability was identified through simulations. Seven test-and-cull strategies with different culling criteria and no attempts to close infection routes were compared with strategies with (1) no control and (2) closure of infection routes and no culling. The effects on true prevalence and gross margin were evaluated in a herd with typical reproduction management (heat detection rate of 38%). This was repeated in a herd with poor reproduction management (heat detection rate of 28%), because poor reproduction leads to lack of replacement animals, which was hypothesized to affect the economic effects of culling. Effects of varying prices of milk, replacement heifers, and hourly wages were also evaluated. The simulated results predicted that immediate culling after the first positive antibody ELISA test would be the most effective culling strategy to reduce prevalence. However, closing transmission routes was even more effective in reducing the prevalence. In the first 3 to 6 yr, all test-and-cull strategies reduced gross margin by US$5 to 55/stall per year. These losses were fully compensated by increased gross margin in yr 6 to 19. In the short run (7 yr with typical reproduction and 10 yr with poor reproduction), it was most profitable to cull test-positive cows when their milk yield decreased below 85% of that expected according to their parity and lactation stage, especially in herds with poor reproduction management. However, this strategy only stabilized the prevalence and did not reduce it. In the long term (>7 yr from implementation of a strategy), it was most profitable to cull cows immediately or as soon as possible after testing positive the first time. Varying milk prices did not affect the ranking between the different culling strategies. Increased market price (20%) of replacement heifers made all culling strategies less profitable and made culling based on a milk yield criterion the most profitable culling strategy for a longer period (11 to 13 yr). A 20% reduction in heifer price made immediate culling after a positive test the most profitable strategy overall in herds with typical reproduction, and after 9 yr in herd with poor reproduction. To conclude, the ideal culling strategy depends on the aim of intervention, the time horizon, and the reproductive capabilities combined with prices of replacement animals. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Determination of safe margin in the surgical pathologic specimens of non-small cell carcinoma of the lung.

PubMed

Feizi, Iraj; Sokouti, Mohsen; Golzari, Samad E J; Gojazede, Morteza; Farahnak, Mohammad Reza; Hashemzadeh, Shahriar; Rahimi-Rad, Mohammad Hossein

2013-01-01

Local recurrences of the tumor at the surgical margin are serious problems in pulmonary resections for lung cancer. The aim of this study is to determine the involved margins and safe distances of the resection sites from tumor for prevention of local recurrences. In this prospective study, 66 patients operated for non-small cell lung carcinoma (NSCLC) from Jan 2006 to Sep 2008 were evaluated. After performing pulmonary resections, multiple biopsies were taken up from 5 mm (A), 10 mm (B), 15 mm (C), and 20 mm (D) distance from tumor. The specimens were studied histopathologically. From a total of66 patients with NSCLC admitted to our referral hospital, 25 (38%) had adenocarcinoma, 18 (27.3%) squamous cell carcinoma, 5 (7.5%) large cell carcinoma, 4 (6%) bronchoalveolar cell carcinoma, 4 (6%) adenoid cystic carcinoma, 3 (4.6%) malignant carcinoid tumor and 7 (10.6%) had metastasis. The most common symptoms were dyspnea and cough. Histopathologically tumor positive margins were found in 84.8% (A), 10.6% (B), 4.5% (C), and 0% (D). There was a significant statistically difference between tumor involvement at distances 5 mm (A) versus 10-20 mm (B-D) (P <0.001). A 20 mm distance from the gross tumor is considered as a safe surgical margin in any type of malignant pulmonary resections for prevention of local surgical recurrences if there was no pathologic examination before surgery.

Developmental outcome of levetiracetam, its major metabolite in humans, 2-pyrrolidinone N-butyric acid, and its enantiomer (R)-alpha-ethyl-oxo-pyrrolidine acetamide in a mouse model of teratogenicity.

PubMed

Isoherranen, Nina; Spiegelstein, Ofer; Bialer, Meir; Zhang, Jing; Merriweather, Michelle; Yagen, Boris; Roeder, Michael; Triplett, Aleata A; Schurig, Volker; Finnell, Richard H

2003-10-01

The purpose of this study was to test the teratogenic potential of the antiepileptic drug (AED) levetiracetam (LEV), its major metabolite in humans, 2-pyrrolidone-N-butyric acid (PBA), and enantiomer, (R)-alpha-ethyl-oxo-pyrrolidine acetamide (REV), in a well-established mouse model. All compounds were administered by intraperitoneal injections once daily to SWV/Fnn mice on gestational days 8-1/2 to 12-1/2. LEV was administered at doses of 600, 1,200, and 2,000 mg/kg/day, piracetam (PIR) and PBA, at 600 and 1,200 mg/kg/day, and REV, at 600 mg/kg/day. On gestational day 18(1/2), fetuses were examined for gross external malformations and prepared for skeletal analysis by using Alizarin Red S staining. No significant gross external malformations were observed in any of the study groups. Fetal weights were significantly reduced in most study groups. Resorption rates were significantly increased only in the 2,000-mg/kg/day LEV group. The overall incidence of skeletal abnormalities and specifically of hypoplastic phalanges was significantly increased in both PBA treatments and in the intermediate 1,200-mg/kg/day LEV group. In contrast to that in humans, 24-h urinary excretion analysis in mice showed that 65-100% of the LEV doses were excreted unchanged, whereas only 4% was excreted as the metabolite PBA. Results of this study demonstrate that both LEV and its major metabolite in humans, PBA, do not induce major structural malformations in developing SWV/Fnn embryos and suggest that they provide a margin of reproductive safety for the pregnant epileptic population when compared with other AEDs tested in this mouse model.

Re-irradiation Using Intensity-modulated Radiotherapy for Recurrent and Second Primary Head and Neck Cancer.

PubMed

Choi, Seo Hee; Chang, Jee Suk; Choi, Jinhyun; Park, So Hyun; Keum, Ki Chang; Park, Kyung Ran; Lee, Chang Geol

2018-05-01

Information on re-irradiation (re-RT) for recurrent and second primary head and neck cancer is limited. Herein, a description of our long-term experience of re-RT for previously irradiated head and neck cancer is provided. A retrospective review was performed for 73 consecutive patients re-irradiated for head and neck cancer between 2006 and 2015. Re-RT targets encompassed only the recurrent gross tumor and had tight margins (5-10 mm). Salvage surgery was performed on 28 (38%) patients before re-RT and 53 (73%) patients received chemotherapy concurrent with re-RT. The median interval between initial and re-RT was 31 months and the median cumulative dose of the two irradiations was 126 Gy (biologically equivalent to 2 Gy fractionation). With a median survival of 33 months, locoregional recurrence after re-RT developed in 37 patients (51%; 25 infield, 12 outfield). In multivariate analysis, higher re-RT dose (≥66 Gy), longer time interval (>2 years), and use of concurrent chemotherapy were associated with improved locoregional recurrence-free survival (all p<0.05). Additionally, performance status, additional surgical resection, and longer interval were associated with better overall survival (p=0.006, 0.021, 0.004, respectively). Clinically significant acute and late toxicities occurred in 14% and 22% of evaluable patients, but no grade 5 toxicity was observed. Moderate safety and acceptable toxicity was found after re-RT using tight margins, sufficient radiation dose, and daily image guidance. Encouraging local control and survival were obtained, similar to historical data using 1-2 cm margins. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

DVH- and NTCP-based dosimetric comparison of different longitudinal margins for VMAT-IMRT of esophageal cancer.

PubMed

Münch, S; Oechsner, M; Combs, S E; Habermehl, D

2017-08-15

To cover the microscopic tumor spread in squamous cell carcinoma of the esophagus (SCC), longitudinal margins of 3-4 cm are used for radiotherapy (RT) protocols. However, smaller margins of 2-3 cm might be reasonable when advanced diagnostic imaging is integrated into target volume delineation. Purpose of this study was to compare the dose distribution and deposition to the organs at risk (OAR) for different longitudinal margins using a DVH- and NTCP-based approach. Ten patients with SCC of the middle or lower third were retrospectively selected. Three planning target volumes (PTV) with longitudinal margins of 4 cm, 3 cm and 2 cm and an axial margin of 1.5 cm to the gross target volume (GTV) were defined for each patient. For each PTV two treatment plans with total doses of 41.4 Gy (neoadjuvant treatment) and 50.4 Gy (definite treatment) were calculated. Dose to the lungs, heart, myelon and liver were then evaluated and compared between different PTVs. When using a longitudinal margin of 3 cm instead of 4 cm, all dose parameters (Dmin, Dmean, Dmedian and V5-V35), except Dmax could be significantly reduced for the lungs. Regarding the heart, a significant reduction was seen for Dmean and V5, but not for Dmin, Dmax, Dmedian and V10-V35. When comparing a longitudinal margin of 4 cm to a longitudinal margin of 2 cm, a significant difference was calculated for Dmin, Dmean, Dmedian and V5-V35 of the lungs and for Dmax, Dmean and V5-V35 of the heart. Nevertheless, no difference was seen for median heart dose. An additional dose reduction for V10 of the heart was achieved for definite treatment plans when using a longitudinal margin of 3 cm. The NTCP-based risk of pneumonitis was significantly reduced by a margin reduction to 2 cm for neoadjuvant and definite treatment plans. Reduction of longitudinal margins from 4 cm to 3 cm can significantly reduce the dose to lungs and Dmean of the heart. Despite clinical benefit and oncologic outcome remain unclear, reduction of the longitudinal margins might provide the opportunity to reduce side effects of chemoradiation (CRT) for SCC in upcoming studies.

Interobserver delineation variation in lung tumour stereotactic body radiotherapy

PubMed Central

Persson, G F; Nygaard, D E; Hollensen, C; Munck af Rosenschöld, P; Mouritsen, L S; Due, A K; Berthelsen, A K; Nyman, J; Markova, E; Roed, A P; Roed, H; Korreman, S; Specht, L

2012-01-01

Objectives In radiotherapy, delineation uncertainties are important as they contribute to systematic errors and can lead to geographical miss of the target. For margin computation, standard deviations (SDs) of all uncertainties must be included as SDs. The aim of this study was to quantify the interobserver delineation variation for stereotactic body radiotherapy (SBRT) of peripheral lung tumours using a cross-sectional study design. Methods 22 consecutive patients with 26 tumours were included. Positron emission tomography/CT scans were acquired for planning of SBRT. Three oncologists and three radiologists independently delineated the gross tumour volume. The interobserver variation was calculated as a mean of multiple SDs of distances to a reference contour, and calculated for the transversal plane (SDtrans) and craniocaudal (CC) direction (SDcc) separately. Concordance indexes and volume deviations were also calculated. Results Median tumour volume was 13.0 cm3, ranging from 0.3 to 60.4 cm3. The mean SDtrans was 0.15 cm (SD 0.08 cm) and the overall mean SDcc was 0.26 cm (SD 0.15 cm). Tumours with pleural contact had a significantly larger SDtrans than tumours surrounded by lung tissue. Conclusions The interobserver delineation variation was very small in this systematic cross-sectional analysis, although significantly larger in the CC direction than in the transversal plane, stressing that anisotropic margins should be applied. This study is the first to make a systematic cross-sectional analysis of delineation variation for peripheral lung tumours referred for SBRT, establishing the evidence that interobserver variation is very small for these tumours. PMID:22919015

Focal Radiation Therapy Dose Escalation Improves Overall Survival in Locally Advanced Pancreatic Cancer Patients Receiving Induction Chemotherapy and Consolidative Chemoradiation

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

Krishnan, Sunil, E-mail: skrishnan@mdanderson.org; Chadha, Awalpreet S.; Suh, Yelin

2016-03-15

Purpose: To review outcomes of locally advanced pancreatic cancer (LAPC) patients treated with dose-escalated intensity modulated radiation therapy (IMRT) with curative intent. Methods and Materials: A total of 200 patients with LAPC were treated with induction chemotherapy followed by chemoradiation between 2006 and 2014. Of these, 47 (24%) having tumors >1 cm from the luminal organs were selected for dose-escalated IMRT (biologically effective dose [BED] >70 Gy) using a simultaneous integrated boost technique, inspiration breath hold, and computed tomographic image guidance. Fractionation was optimized for coverage of gross tumor and luminal organ sparing. A 2- to 5-mm margin around the gross tumor volume wasmore » treated using a simultaneous integrated boost with a microscopic dose. Overall survival (OS), recurrence-free survival (RFS), local-regional and distant RFS, and time to local-regional and distant recurrence, calculated from start of chemoradiation, were the outcomes of interest. Results: Median radiation dose was 50.4 Gy (BED = 59.47 Gy) with a concurrent capecitabine-based (86%) regimen. Patients who received BED >70 Gy had a superior OS (17.8 vs 15.0 months, P=.03), which was preserved throughout the follow-up period, with estimated OS rates at 2 years of 36% versus 19% and at 3 years of 31% versus 9% along with improved local-regional RFS (10.2 vs 6.2 months, P=.05) as compared with those receiving BED ≤70 Gy. Degree of gross tumor volume coverage did not seem to affect outcomes. No additional toxicity was observed in the high-dose group. Higher dose (BED) was the only predictor of improved OS on multivariate analysis. Conclusion: Radiation dose escalation during consolidative chemoradiation therapy after induction chemotherapy for LAPC patients improves OS and local-regional RFS.« less

Analysing reduced tillage practices within a bio-economic modelling framework.

PubMed

Townsend, Toby J; Ramsden, Stephen J; Wilson, Paul

2016-07-01

Sustainable intensification of agricultural production systems will require changes in farm practice. Within arable cropping systems, reducing the intensity of tillage practices (e.g. reduced tillage) potentially offers one such sustainable intensification approach. Previous researchers have tended to examine the impact of reduced tillage on specific factors such as yield or weed burden, whilst, by definition, sustainable intensification necessitates a system-based analysis approach. Drawing upon a bio-economic optimisation model, 'MEETA', we quantify trade-off implications between potential yield reductions, reduced cultivation costs and increased crop protection costs. We extend the MEETA model to quantify farm-level net margin, in addition to quantifying farm-level gross margin, net energy, and greenhouse gas emissions. For the lowest intensity tillage system, zero tillage, results demonstrate financial benefits over a conventional tillage system even when the zero tillage system includes yield penalties of 0-14.2% (across all crops). Average yield reductions from zero tillage literature range from 0 to 8.5%, demonstrating that reduced tillage offers a realistic and attainable sustainable intensification intervention, given the financial and environmental benefits, albeit that yield reductions will require more land to compensate for loss of calories produced, negating environmental benefits observed at farm-level. However, increasing uptake of reduced tillage from current levels will probably require policy intervention; an extension of the recent changes to the CAP ('Greening') provides an opportunity to do this.

Architecture and fiber type of the pyramidalis muscle.

PubMed

Lovering, Richard M; Anderson, Larry D

2008-12-01

The paired pyramidalis muscles are small triangular-shaped muscles that lie between the anterior surface of the rectus abdominus and the posterior surface of the rectus sheath. The precise function of pyramidalis muscles is unclear, but together the muscles are thought to tense the linea alba. The muscles are not always present, or are often unilateral, and vary greatly in size. Their wider inferior margins attach to the pubic symphyses and pubic crests, whereas their narrow superior margins attach to the linea alba. The gross anatomy and innervation of the pyramidalis muscles has been described by others, but their architecture and fiber type have not been determined in previous publications. The purpose of the present paper was therefore to investigate these parameters and place the findings into context for the literature available on this muscle. An example of bilateral pyramidalis muscles was recently encountered in a male cadaver that provided ample tissue for an analysis of its architecture and fiber type. The muscle mass, muscle length, fiber length, and pennation angle of muscle fibers were measured to ascertain physiological cross-sectional area and thereby estimate force production. Fiber type composition was also examined using immunofluorescent labeling. The results show that this is a muscle of mixed fiber type composition, similar to the rectus abdominus, and that the estimated forces generated by this muscle are relatively small.

The Gross Anatomy Course: An Analysis of Its Importance

ERIC Educational Resources Information Center

Bockers, Anja; Jerg-Bretzke, Lucia; Lamp, Christoph; Brinkmann, Anke; Traue, Harald C.; Bockers, Tobias M.

2010-01-01

The gross anatomy dissection course is a cost-intensive piece of undergraduate medical education that students and professionals alike describe as very important within the overall medical curriculum. We sought to understand more explicitly students' valuation of gross anatomy as an "important" course and so developed a quantitative…

The prediction of gross calorific value using infrared (IR) spectroscopy and multivariate analysis

Treesearch

Chi-Leung So; Thomas L. Eberhardt

2011-01-01

The gross calorific value (GCV) of a fuel, also known as the higher heating value (HHV) or gross heat of combustion, is the amount of heat released by a specified quantity (initially at 25°C) once it is com-busted and the products returned to that temperature. Fuwape (1989) noted that extractive-free wood from Gmelina arborea (Roxb), a hardwood, had a lower gross heat...

Gross-beta activity in ground water: natural sources and artifacts of sampling and laboratory analysis

USGS Publications Warehouse

Welch, Alan H.

1995-01-01

Gross-beta activity has been used as an indicator of beta-emitting isotopes in water since at least the early 1950s. Originally designed for detection of radioactive releases from nuclear facilities and weapons tests, analysis of gross-beta activity is widely used in studies of naturally occurring radioactivity in ground water. Analyses of about 800 samples from 5 ground-water regions of the United States provide a basis for evaluating the utility of this measurement. The data suggest that measured gross-beta activities are due to (1) long-lived radionuclides in ground water, and (2) ingrowth of beta-emitting radionuclides during holding times between collection of samples and laboratory measurements.Although40K and228Ra appear to be the primary sources of beta activity in ground water, the sum of40K plus228Ra appears to be less than the measured gross-beta activity in most ground-water samples. The difference between the contribution from these radionuclides and gross-beta activity is most pronounced in ground water with gross-beta activities > 10 pCi/L, where these 2 radionuclides account for less than one-half the measured ross-beta activity. One exception is groundwater from the Coastal Plain of New Jersey, where40K plus228Ra generally contribute most of the gross-beta activity. In contrast,40K and228Ra generally contribute most of beta activity in ground water with gross-beta activities < 1 pCi/L.The gross-beta technique does not measure all beta activity in ground water. Although3H contributes beta activity to some ground water, it is driven from the sample before counting and therefore is not detected by gross-beta measurements. Beta-emitting radionuclides with half-lives shorter than a few days can decay to low values between sampling and counting. Although little is known about concentrations of most short-lived beta-emitting radionuclides in environmental ground water (water unaffected by direct releases from nuclear facilities and weapons tests), their activities are expected to be low.Ingrowth of beta-emitting radionuclides during sample holding times can contribute to gross-beta activity, particularly in ground water with gross-beta activities > 10 pCi/L. Ingrowth of beta-emitting progeny of238U, specifically234Pa and234Th, contributes much of the measured gross-beta activity in ground water from 4 of the 5 areas studied. Consequently, gross-beta activity measurements commonly overestimate the abundance of beta-emitting radionuclides actually present in ground water. Differing sample holding times before analysis lead to differing amounts of ingrowth of the two progeny. Therefore, holding times can affect observed gross-beta measurements, particularly in ground water with238U activities that are moderate to high compared with the activity of40K plus228Ra. Uncertainties associated with counting efficiencies for beta particles with different energies further complicate the interpretation of gross-beta measurements.

Pathology report assessment of incidental gallbladder carcinoma diagnosed from cholecystectomy specimens: results of a French multicentre survey.

PubMed

Chatelain, Denis; Fuks, David; Farges, Olivier; Attencourt, Christophe; Pruvot, François René; Regimbeau, Jean-Marc

2013-12-01

To assess the accuracy of pathology reports on gallbladder specimens from patients operated on for incidental gallbladder carcinoma. Demographic data, details on pathological reports including gross and microscopic features section were recorded in 100 selected patients with incidental gallbladder carcinoma diagnosed from 2004 to 2007. Pathology reports had a conventional format in 93% of cases, without any standardization. Turnaround time ranged from 1 to 35 days. Frozen sections were performed in 20% of cases. The reports failed to give information on prognostic histological factors: exact tumour site (missing in 55% of cases), depth of tumour infiltration within the gallbladder wall (missing in 10%), surgical margins (missing in 40% for the cystic duct margin), tumour differentiation (missing in 28%), vascular invasion (missing in 52%) and perineural invasion (missing in 51%). Lymph node status could be assessed in 44% of cases. Distances between the tumour and the cystic duct and circumferential margins were not specified in 68% and 84% of cases. Only 29% of the reports clearly stated the pTNM stage in the conclusion section. The pT stage with margin status and tumour site was only mentioned in 30% of the reports. Pathology reports on gallbladder carcinoma from participating centres frequently lacked important information on key prognostic histological factors. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Spatially explicit integrated modeling and economic valuation of climate driven land use change and its indirect effects.

PubMed

Bateman, Ian; Agarwala, Matthew; Binner, Amy; Coombes, Emma; Day, Brett; Ferrini, Silvia; Fezzi, Carlo; Hutchins, Michael; Lovett, Andrew; Posen, Paulette

2016-10-01

We present an integrated model of the direct consequences of climate change on land use, and the indirect effects of induced land use change upon the natural environment. The model predicts climate-driven shifts in the profitability of alternative uses of agricultural land. Both the direct impact of climate change and the induced shift in land use patterns will cause secondary effects on the water environment, for which agriculture is the major source of diffuse pollution. We model the impact of changes in such pollution on riverine ecosystems showing that these will be spatially heterogeneous. Moreover, we consider further knock-on effects upon the recreational benefits derived from water environments, which we assess using revealed preference methods. This analysis permits a multi-layered examination of the economic consequences of climate change, assessing the sequence of impacts from climate change through farm gross margins, land use, water quality and recreation, both at the individual and catchment scale. Copyright © 2016 Elsevier Ltd. All rights reserved.

Data Validation Package, June 2016 Groundwater Sampling at the Hallam, Nebraska, Decommissioned Reactor Site, August 2016

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

Surovchak, Scott; Miller, Michele

The 2008 Long-Term Surveillance Plan [LTSP] for the Decommissioned Hallam Nuclear Power Facility, Hallam, Nebraska (http://www.lm.doe.gov/Hallam/Documents.aspx) requires groundwater monitoring once every 2 years. Seventeen monitoring wells at the Hallam site were sampled during this event as specified in the plan. Planned monitoring locations are shown in Attachment 1, Sampling and Analysis Work Order. Water levels were measured at all sampled wells and at two additional wells (6A and 6B) prior to the start of sampling. Additionally, water levels of each sampled well were measured at the beginning of sampling. See Attachment 2, Trip Report, for additional details. Sampling and analysismore » were conducted as specified in Sampling and Analysis Plan for U.S. Department of Energy Office of Legacy Management Sites (LMS/PRO/S04351, continually updated, http://energy.gov/lm/downloads/sampling-and-analysis-plan-us-department- energy-office-legacy-management-sites). Gross alpha and gross beta are the only parameters that were detected at statistically significant concentrations. Time/concentration graphs of the gross alpha and gross beta data are included in Attachment 3, Data Presentation. The gross alpha and gross beta activity concentrations observed are consistent with values previously observed and are attributed to naturally occurring radionuclides (e.g., uranium and uranium decay chain products) in the groundwater.« less

Analytical Assessment of a Gross Leakage Event Within the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS)

NASA Technical Reports Server (NTRS)

Holt, James M.; Clanton, Stephen E.

1999-01-01

Results of the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS) gross leakage analysis are presented for evaluating total leakage flowrates and volume discharge caused by a gross leakage event (i.e. open boundary condition). A Systems Improved Numerical Differencing Analyzer and Fluid Integrator (SINDA/FLUINT) thermal hydraulic mathematical model (THMM) representing the Node 2 IATCS was developed to simulate system performance under steady-state nominal conditions as well as the transient flow effects resulting from an open line exposed to ambient. The objective of the analysis was to determine the adequacy of the leak detection software in limiting the quantity of fluid lost during a gross leakage event to within an acceptable level.

Analytical Assessment of a Gross Leakage Event Within the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS)

NASA Technical Reports Server (NTRS)

Holt, James M.; Clanton, Stephen E.

2001-01-01

Results of the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS) gross leakage analysis are presented for evaluating total leakage flow rates and volume discharge caused by a gross leakage event (i.e. open boundary condition). A Systems Improved Numerical Differencing Analyzer and Fluid Integrator (SINDA85/FLUINT) thermal hydraulic mathematical model (THMM) representing the Node 2 IATCS was developed to simulate system performance under steady-state nominal conditions as well as the transient flow effect resulting from an open line exposed to ambient. The objective of the analysis was to determine the adequacy of the leak detection software in limiting the quantity of fluid lost during a gross leakage event to within an acceptable level.

Future and Advances in Endoscopy

PubMed Central

Elahi, Sakib F.; Wang, Thomas D.

2012-01-01

The future of endoscopy will be dictated by rapid technological advances in the development of light sources, optical fibers, and miniature scanners that will allow for images to be collected in multiple spectral regimes, with greater tissue penetration, and in three dimensions. These engineering breakthroughs will be integrated with novel molecular probes that are highly specific for unique proteins to target diseased tissues. Applications include early cancer detection by imaging molecular changes that occur before gross morphological abnormalities, personalized medicine by visualizing molecular targets specific to individual patients, and image guided therapy by localizing tumor margins and monitoring for recurrence. PMID:21751414

Confirmatory Factor Analysis of the Test of Gross Motor Development-2

ERIC Educational Resources Information Center

Wong, Ka Yee Allison; Cheung, Siu Yin

2010-01-01

The purpose of this study was to examine the underlying structure of the second edition of the Test of Gross Motor Development-2 (Ulrich, 2000) as applied to Chinese children. The Test of Gross Motor Development-2 was administered to 626 Hong Kong Chinese children. The outlier test with standard scoring was utilized. After data screening, a total…

Motor skills of toddlers with autism spectrum disorders.

PubMed

Lloyd, Meghann; MacDonald, Megan; Lord, Catherine

2013-03-01

With increased interest in the early diagnosis and treatment of children with autism spectrum disorders (ASD), more attention has been called to the motor skills of very young children with ASD. This study describes the gross and fine motor skills of a cross-sectional group of 162 children with ASD between the ages of 12 and 36 months, as well as a subset of 58 children followed longitudinally. Gross motor and fine motor age equivalent scores were obtained for all children. A 'motor difference' variable was calculated for each child's gross and fine motor skills by taking the absolute difference of the children's age equivalent motor score and their respective chronological age. In Study 1 (the cross-sectional analysis), ANCOVA (co-varied for nonverbal problem solving) revealed significant group differences in the gross motor and fine motor age difference variables. Post-hoc analysis revealed that gross motor and fine motor differences became significantly greater with each 6-month period of chronological age. In Study 2, 58 children were measured twice, an average of 12 months apart. Results indicate that the gross motor and fine motor difference scores significantly increased between the first and second measurements. The importance of addressing motor development in early intervention treatments is discussed.

Evaluation of a simplified gross thrust calculation method for a J85-21 afterburning turbojet engine in an altitude facility

NASA Technical Reports Server (NTRS)

Baer-Riedhart, J. L.

1982-01-01

A simplified gross thrust calculation method was evaluated on its ability to predict the gross thrust of a modified J85-21 engine. The method used tailpipe pressure data and ambient pressure data to predict the gross thrust. The method's algorithm is based on a one-dimensional analysis of the flow in the afterburner and nozzle. The test results showed that the method was notably accurate over the engine operating envelope using the altitude facility measured thrust for comparison. A summary of these results, the simplified gross thrust method and requirements, and the test techniques used are discussed in this paper.

Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis.

PubMed

Lucas, Barbara R; Elliott, Elizabeth J; Coggan, Sarah; Pinto, Rafael Z; Jirikowic, Tracy; McCoy, Sarah Westcott; Latimer, Jane

2016-11-29

Gross motor skills are fundamental to childhood development. The effectiveness of current physical therapy options for children with mild to moderate gross motor disorders is unknown. The aim of this study was to systematically review the literature to investigate the effectiveness of conservative interventions to improve gross motor performance in children with a range of neurodevelopmental disorders. A systematic review with meta-analysis was conducted. MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PEDro, Cochrane Collaboration, Google Scholar databases and clinical trial registries were searched. Published randomised controlled trials including children 3 to ≤18 years with (i) Developmental Coordination Disorder (DCD) or Cerebral Palsy (CP) (Gross Motor Function Classification System Level 1) or Developmental Delay or Minimal Acquired Brain Injury or Prematurity (<30 weeks gestational age) or Fetal Alcohol Spectrum Disorders; and (ii) receiving non-pharmacological or non-surgical interventions from a health professional and (iii) gross motor outcomes obtained using a standardised assessment tool. Meta-analysis was performed to determine the pooled effect of intervention on gross motor function. Methodological quality and strength of meta-analysis recommendations were evaluated using PEDro and the GRADE approach respectively. Of 2513 papers, 9 met inclusion criteria including children with CP (n = 2) or DCD (n = 7) receiving 11 different interventions. Only two of 9 trials showed an effect for treatment. Using the least conservative trial outcomes a large beneficial effect of intervention was shown (SMD:-0.8; 95% CI:-1.1 to -0.5) with "very low quality" GRADE ratings. Using the most conservative trial outcomes there is no treatment effect (SMD:-0.1; 95% CI:-0.3 to 0.2) with "low quality" GRADE ratings. Study limitations included the small number and poor quality of the available trials. Although we found that some interventions with a task-orientated framework can improve gross motor outcomes in children with DCD or CP, these findings are limited by the very low quality of the available evidence. High quality intervention trials are urgently needed.

Infectious hematopoietic necrosis virus (IHNV) outbreak in farmed rainbow trout in Iran: Viral isolation, pathological findings, molecular confirmation, and genetic analysis.

PubMed

Ahmadivand, Sohrab; Soltani, Mehdi; Mardani, Karim; Shokrpoor, Sara; Hassanzadeh, Reza; Ahmadpoor, Mehran; Rahmati-Holasoo, Hooman; Meshkini, Saeid

2017-02-02

Infectious hematopoietic necrosis virus (IHNV) is the etiological agent of a contagious disease (IHN) mainly in salmonid fish. In the present study, we isolated and identified IHNV in trout fry from Iranian trout farms with unexplained high mortality in 2016. The affected fry showed cumulative mortality of 90% with the gross pathological signs including exophthalmia and hemorrhage of the eye, skin darkening, abdominal distension, ulceration of the snout, and the visceral pallor and yellowish fluid in the intestine. Histopathological examination revealed marked necrosis in the anterior kidney, liver and spleen with the intracytoplasmic inclusion bodies in the liver sections. Also, intranuclear inclusion body and marginated chromatin were observable in the hematopoietic cells of the kidney. The homogenates tissues of infected fry induced IHNV-positive cytopathic effects (CPE) in EPC cells and confirmed by RT-PCR reactions and sequencing. Phylogenetic analysis revealed the Iranian IHNV isolates belonged to the European (E) genogroup with 100% identity to some Italian isolates. This is the first report of IHNV infection in farmed trout fry in Iran describing the viral isolation, clinical symptoms, histopathological findings, molecular confirmation, and genetic analysis suggestion of the specific country of origin. Copyright © 2016 Elsevier B.V. All rights reserved.

[Evaluating cost/equity in the Colombian health system, 1998-2005].

PubMed

Eslava-Schmalbach, Javier; Barón, Gilberto; Gaitán-Duarte, Hernando; Alfonso, Helman; Agudelo, Carlos; Sánchez, Carolina

2008-01-01

An economic analysis of cost-equity (from society's viewpoint) for evaluating the impact of Law 100/93 in Colombia between 1998 and 2005. An economic analysis compared costs and equity in health in Colombia between 1998 and 2005. Data was taken from the Colombian Statistics' Administration Department ( Departamento Administrativo Nacional de Estadistica - DANE) and from national demographic and health surveys carried out in 2000 and 2005. Information regarding costs was taken from the National Health Accounts' System. Inequity in Health was considered in line with the Inequity in Health Index (IHI). Incremental and average cost-equity analysis covered three sub-periods; 1998-1999 (during which time per capita gross internal product became reduced in Colombia ), 2000-2001 (during which time total health expense became reduced) and 2001 -2005. An unstable tendency for inequity in health becoming reduced during the period was revealed. There was an inverse relationship between IHI and public health spending and a direct relationship between out-of-pocket spending on health and equity in health (Spearman, p<0.05). The second period had the best incremental cost-equity ratio. Fluctuations in IHI and marginal cost-equity during the periods being analysed suggested that health spending depended on equity in health in Colombia during the period being studied.

Trade-Offs between Economic and Environmental Impacts of Introducing Legumes into Cropping Systems

PubMed Central

Reckling, Moritz; Bergkvist, Göran; Watson, Christine A.; Stoddard, Frederick L.; Zander, Peter M.; Walker, Robin L.; Pristeri, Aurelio; Toncea, Ion; Bachinger, Johann

2016-01-01

Europe's agriculture is highly specialized, dependent on external inputs and responsible for negative environmental impacts. Legume crops are grown on less than 2% of the arable land and more than 70% of the demand for protein feed supplement is imported from overseas. The integration of legumes into cropping systems has the potential to contribute to the transition to a more resource-efficient agriculture and reduce the current protein deficit. Legume crops influence the production of other crops in the rotation making it difficult to evaluate the overall agronomic effects of legumes in cropping systems. A novel assessment framework was developed and applied in five case study regions across Europe with the objective of evaluating trade-offs between economic and environmental effects of integrating legumes into cropping systems. Legumes resulted in positive and negative impacts when integrated into various cropping systems across the case studies. On average, cropping systems with legumes reduced nitrous oxide emissions by 18 and 33% and N fertilizer use by 24 and 38% in arable and forage systems, respectively, compared to systems without legumes. Nitrate leaching was similar with and without legumes in arable systems and reduced by 22% in forage systems. However, grain legumes reduced gross margins in 3 of 5 regions. Forage legumes increased gross margins in 3 of 3 regions. Among the cropping systems with legumes, systems could be identified that had both relatively high economic returns and positive environmental impacts. Thus, increasing the cultivation of legumes could lead to economic competitive cropping systems and positive environmental impacts, but achieving this aim requires the development of novel management strategies informed by the involvement of advisors and farmers. PMID:27242870

Trade-Offs between Economic and Environmental Impacts of Introducing Legumes into Cropping Systems.

PubMed

Reckling, Moritz; Bergkvist, Göran; Watson, Christine A; Stoddard, Frederick L; Zander, Peter M; Walker, Robin L; Pristeri, Aurelio; Toncea, Ion; Bachinger, Johann

2016-01-01

Europe's agriculture is highly specialized, dependent on external inputs and responsible for negative environmental impacts. Legume crops are grown on less than 2% of the arable land and more than 70% of the demand for protein feed supplement is imported from overseas. The integration of legumes into cropping systems has the potential to contribute to the transition to a more resource-efficient agriculture and reduce the current protein deficit. Legume crops influence the production of other crops in the rotation making it difficult to evaluate the overall agronomic effects of legumes in cropping systems. A novel assessment framework was developed and applied in five case study regions across Europe with the objective of evaluating trade-offs between economic and environmental effects of integrating legumes into cropping systems. Legumes resulted in positive and negative impacts when integrated into various cropping systems across the case studies. On average, cropping systems with legumes reduced nitrous oxide emissions by 18 and 33% and N fertilizer use by 24 and 38% in arable and forage systems, respectively, compared to systems without legumes. Nitrate leaching was similar with and without legumes in arable systems and reduced by 22% in forage systems. However, grain legumes reduced gross margins in 3 of 5 regions. Forage legumes increased gross margins in 3 of 3 regions. Among the cropping systems with legumes, systems could be identified that had both relatively high economic returns and positive environmental impacts. Thus, increasing the cultivation of legumes could lead to economic competitive cropping systems and positive environmental impacts, but achieving this aim requires the development of novel management strategies informed by the involvement of advisors and farmers.

Contribution of FDOPA PET to radiotherapy planning for advanced glioma

NASA Astrophysics Data System (ADS)

Dowson, Nicholas; Fay, Michael; Thomas, Paul; Jeffree, Rosalind; McDowall, Robert; Winter, Craig; Coulthard, Alan; Smith, Jye; Gal, Yaniv; Bourgeat, Pierrick; Salvado, Olivier; Crozier, Stuart; Rose, Stephen

2014-03-01

Despite radical treatment with surgery, radiotherapy and chemotherapy, advanced gliomas recur within months. Geographic misses in radiotherapy planning may play a role in this seemingly ineluctable recurrence. Planning is typically performed on post-contrast MRIs, which are known to underreport tumour volume relative to FDOPA PET scans. FDOPA PET fused with contrast enhanced MRI has demonstrated greater sensitivity and specificity than MRI alone. One sign of potential misses would be differences between gross target volumes (GTVs) defined using MRI alone and when fused with PET. This work examined whether such a discrepancy may occur. Materials and Methods: For six patients, a 75 minute PET scan using 3,4-dihydroxy-6-18F-fluoro-L-phynel-alanine (18F-FDOPA) was taken within 2 days of gadolinium enhanced MRI scans. In addition to standard radiotherapy planning by an experienced radiotherapy oncologist, a second gross target volume (GTV) was defined by an experienced nuclear medicine specialist for fused PET and MRI, while blinded to the radiotherapy plans. The volumes from standard radiotherapy planning were compared to the PET defined GTV. Results: The comparison indicated radiotherapy planning would change in several cases if FDOPA PET data was available. PET-defined contours were external to 95% prescribed dose for several patients. However, due to the radiotherapy margins, the discrepancies were relatively small in size and all received a dose of 50 Gray or more. Conclusions: Given the limited size of the discrepancies it is uncertain that geographic misses played a major role in patient outcome. Even so, the existence of discrepancies indicates that FDOPA PET could assist in better defining margins when planning radiotherapy for advanced glioma, which could be important for highly conformal radiotherapy plans.

Contribution of draft cattle to rural livelihoods in a district of southeastern Uganda endemic for bovine parasitic diseases: an economic evaluation.

PubMed

Okello, Walter O; Muhanguzi, Dennis; MacLeod, Ewan T; Welburn, Susan C; Waiswa, Charles; Shaw, Alexandra P

2015-11-05

A study was conducted in Tororo District in eastern Uganda to assess the socio-economic contribution of draft cattle to rural livelihoods. The aim of the study was to empirically quantify the economic value of draft cattle thus contributing to understanding the impact of endemic parasitic diseases of cattle on livestock productivity and subsequently household income, labor and food security. A total of 205 draft cattle keeping households (n = 205) were randomly selected and structured household questionnaires were administered, focusing on work oxen use, productivity, inputs and outputs. The data obtained was analyzed using standard statistical methods and used to calculate the gross margin from the draft cattle enterprise. Secondary data were obtained from focus group discussions and key informant interviews and these were analyzed using Bayesian methods. The study showed that, apart from being labor saving, the use of animal traction is highly profitable with the gross margin per year from the use of draft cattle amounting to 245 United States dollars per work oxen owning household. The cash obtained from hiring out draft animals was equivalent to nearly a quarter of the average local household's monetary receipts. It also revealed that endemic bovine parasitic diseases such as trypanosomiasis and tick-borne diseases reduced draft cattle output by 20.9 % and potential household income from the use of draft oxen by 32.2 %. The presence of endemic cattle diseases in rural Uganda is adversely affecting the productivity of draft cattle, which in turn affects household income, labor and ultimately food security. This study highlights the contribution of draft cattle to rural livelihoods, thus increasing the expected impact of cost-effective control strategies of endemic production limiting livestock diseases in Uganda.

The anatomy and histology of the bicipital tunnel of the shoulder.

PubMed

Taylor, Samuel A; Fabricant, Peter D; Bansal, Manjula; Khair, M Michael; McLawhorn, Alexander; DiCarlo, Edward F; Shorey, Mary; O'Brien, Stephen J

2015-04-01

The bicipital tunnel is the extra-articular, fibro-osseous structure that encloses the long head of the biceps tendon. Twelve cadaveric shoulder specimens underwent in situ casting of the bicipital tunnel with methyl methacrylate cement to demonstrate structural competence (n = 6) and en bloc harvest with gross and histologic evaluation (n = 6). The percentage of empty tunnel was calculated histologically by subtracting the proportion of cross-sectional area of the long head of the biceps tendon from that of the bicipital tunnel for each zone. Cement casting demonstrated that the bicipital tunnel was a closed space. Zone 1 extended from the articular margin to the distal margin of the subscapularis tendon. Zone 2 extended from the distal margin of the subscapularis tendon to the proximal margin of the pectoralis major tendon. Zone 3 was the subpectoral region. Zones 1 and 2 were both enclosed by a dense connective tissue sheath and demonstrated the presence of synovium. Zone 3 had significantly greater percentage of empty tunnel than zones 1 and 2 did (P < .01). The bicipital tunnel is a closed space with 3 distinct zones. Zones 1 and 2 have similar features, including the presence of synovium, but differ from zone 3. A significant bottleneck occurs between zone 2 and zone 3, most likely at the proximal margin of the pectoralis major tendon. The bicipital tunnel is a closed space where space-occupying lesions may produce a bicipital tunnel syndrome. Careful consideration should be given to surgical techniques that decompress both zones 1 and 2 of the bicipital tunnel. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Systematic review and meta-analysis of the effect of equine assisted activities and therapies on gross motor outcome in children with cerebral palsy.

PubMed

Tseng, Sung-Hui; Chen, Hung-Chou; Tam, Ka-Wai

2013-01-01

To evaluate the literature on the efficacy of equine assisted activities and therapies (EAAT) on gross motor outcomes representing the ICF component of body functions and activity in children with cerebral palsy (CP). We conducted a systematic review and meta-analysis of randomized controlled trials and observational studies of hippotherapy (HPOT) and therapeutic horseback riding (TR) for children with spastic CP. Gross motor outcomes, assessed via muscle activity and muscle tone, gait, posture and Gross Motor Function Measures (GMFM) were evaluated. Five TR studies and nine HPOT studies were included. Our meta-analysis indicated that short-term HPOT (total riding time 8-10 min) significantly reduced asymmetrical activity of the hip adductor muscles. HPOT could improve postural control in children with spastic CP, GMFCS level < 5. However, the evidence did not show a statistically significant effect on GMFM after long-term HPOT or TR (total riding time, 8-22 h) in children with spastic CP. This systematic review found insufficient evidence to support the claim that long-term TR or HPOT provide a significant benefit to children with spastic CP. We found no statistically significant evidence of either therapeutic effect or maintenance effects on the gross motor activity status in CP children.

Application of Green Net Metropolitan Product to Measure ...

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (USEPA) has been increasingly incorporating the concept of sustainability in its research programs. One facet of this research is the quantitative assessment of the sustainability of urban systems in light of several multidisciplinary sustainability metrics. In this work, we explore the estimation of economic measure of sustainability for Chicago Metropolitan Area (CMA) based on Green Net Metropolitan Product (GNMP), by adapting the economic models of sustainability at the macroeconomic level to regional sustainability. GNMP aims at amending the limitations of Net Domestic Product (NDP), a classical indicator of economic wellbeing, which fails to account for the degradation of environmental and natural resources caused by economic activities. We collect data for computing GNMP from publicly available secondary sources on variables such as gross metropolitan product, net income, emissions, solid waste, etc. In estimating GNMP for CMA, we have accounted for the damage costs associated with pollution emissions based on marginal damage values obtained from the literature using benefit transfers method. In addition, we attempt at accounting for the marginal value of depletion of natural resources in the CMA in terms of water depletion and changes in urban ecosystems such as green spaces. We account for the marginal damage cost associated with solid waste generation. It is expected the preliminary results of this exploration se

75 FR 13610 - Office of New Reactors; Interim Staff Guidance on Implementation of a Seismic Margin Analysis for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... Staff Guidance on Implementation of a Seismic Margin Analysis for New Reactors Based on Probabilistic... Seismic Margin Analysis for New Reactors Based on Probabilistic Risk Assessment,'' (Agencywide Documents.../COL-ISG-020 ``Implementation of a Seismic Margin Analysis for New Reactors Based on Probabilistic Risk...

Determination of gross alpha and gross beta in soil around repository facility at Bukit Kledang, Perak, Malaysia

NASA Astrophysics Data System (ADS)

Adziz, Mohd Izwan Abdul; Siong, Khoo Kok

2018-04-01

Recently, the Long Term Storage Facility (LTSF) in Bukit Kledang, Perak, Malaysia, has been upgraded to repository facility upon the completion of decontamination and decommissioning (D&D) process. Thorium waste and contaminated material that may contain some minor amounts of thorium hydroxide were disposed in this facility. This study is conducted to determine the concentrations of gross alpha and gross beta radioactivities in soil samples collected around the repository facility. A total of 12 soil samples were collected consisting 10 samples from around the facility and 2 samples from selected residential area near the facility. In addition, the respective dose rates were measured 5 cm and 1 m above the ground by using survey meter with Geiger Muller (GM) detector and Sodium Iodide (NaI) detector. Soil samples were collected using hand auger and then were taken back to the laboratory for further analysis. Samples were cleaned, dried, pulverized and sieved prior to analysis. Gross alpha and gross beta activity measurements were carried out using gas flow proportional counter, Canberra Series 5 XLB - Automatic Low Background Alpha and Beta Counting System. The obtained results show that, the gross alpha and gross beta activity concentration ranged from 1.55 to 5.34 Bq/g with a mean value of 3.47 ± 0.09 Bq/g and 1.64 to 5.78 Bq/g with a mean value of 3.49 ± 0.09 Bq/g, respectively. These results can be used as an additional data to represent terrestrial radioactivity baseline data for Malaysia environment. This estimation will also serve as baseline for detection of any future related activities of contamination especially around the repository facility area.

Gross Motor Skills and Cardiometabolic Risk in Children: A Mediation Analysis.

PubMed

Burns, Ryan D; Brusseau, Timothy A; Fu, You; Hannon, James C

2017-04-01

The purpose of this study was to examine the linear relationship between gross motor skills and cardiometabolic risk, with aerobic fitness as a mediator variable, in low-income children from the United States. Participants were a convenience sample of 224 children (mean ± SD age = 9.1 ± 1.1 yr; 129 girls and 95 boys) recruited from five low-income elementary schools from the Mountain West Region of the United States. Gross motor skills were assessed using the Test for Gross Motor Development, 3rd Edition. Gross motor skills were analyzed using a locomotor skill, a ball skill, and a total gross motor skill score. Aerobic fitness was assessed using the Progressive Aerobic Cardiovascular Endurance Run that was administered during physical education class. A continuous and age- and sex-adjusted metabolic syndrome score (MetS) was calculated from health and blood marker measurements collected in a fasted state before school hours. Total effects, average direct effects, and indirect effects (average causal mediation effect) were calculated using a bootstrap mediation analysis method via a linear regression algorithm. The average causal mediation effect of gross locomotor skills on MetS scores, using aerobic fitness as the mediator variable, was statistically significant (β = -0.055, 95% confidence interval = -0.097 to -0.021, P = 0.003). The model explained approximately 17.5% of the total variance in MetS with approximately 43.7% of the relationship between locomotor skills and MetS mediated through aerobic fitness. Ball skills did not significantly relate with cardiometabolic risk. There is a significant relationship between gross locomotor skills and cardiometabolic risk that is partially mediated through aerobic fitness in a sample of low-income children from the United States.

Robust Flutter Margin Analysis that Incorporates Flight Data

NASA Technical Reports Server (NTRS)

Lind, Rick; Brenner, Martin J.

1998-01-01

An approach for computing worst-case flutter margins has been formulated in a robust stability framework. Uncertainty operators are included with a linear model to describe modeling errors and flight variations. The structured singular value, mu, computes a stability margin that directly accounts for these uncertainties. This approach introduces a new method of computing flutter margins and an associated new parameter for describing these margins. The mu margins are robust margins that indicate worst-case stability estimates with respect to the defined uncertainty. Worst-case flutter margins are computed for the F/A-18 Systems Research Aircraft using uncertainty sets generated by flight data analysis. The robust margins demonstrate flight conditions for flutter may lie closer to the flight envelope than previously estimated by p-k analysis.

Spontaneous movements of preterm infants is associated with outcome of gross motor development.

PubMed

Miyagishima, Saori; Asaka, Tadayoshi; Kamatsuka, Kaori; Kozuka, Naoki; Kobayashi, Masaki; Igarashi, Lisa; Hori, Tsukasa; Tsutsumi, Hiroyuki

2018-04-30

We conducted a longitudinal cohort study to analyze the relationship between outcome of gross motor development in preterm infants and factors that might affect their development. Preterm infants with a birth weight of <1500 g were recruited. We measured spontaneous antigravity limbs movements by 3D motion capture system at 3 months corrected age. Gross motor developmental outcomes at 6 and 12 months corrected age were evaluated using the Alberta Infant Motor Scale (AIMS). Statistical analysis was carried out by canonical correlation analysis. Eighteen preterm infants were included. In the 6 months corrected age analysis, spontaneous movement had a major effect on Prone and Sitting at 6 months corrected age of AIMS. In the 12 months corrected age analysis, spontaneous movement had a major effect on Sitting and Standing at 12 months corrected age of AIMS. In preterm infants, better antigravity spontaneous movements at 3 months corrected age were significantly correlated with better gross motor development at 6 or 12 months corrected age. Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Examining the margins: a concept analysis of marginalization.

PubMed

Vasas, Elyssa B

2005-01-01

The aim of this analysis is to explore the concept of social marginalization for the purpose of concept development. Specifically, the article intends to clarify the relationship between health disparities and marginalization and generate knowledge about working with people who are socially marginalized. Concept development evolved from the critical analysis of relevant literature generated through searches of nursing and social science databases. Literature was organized thematically and themes related to marginalization as a social process were included and analyzed. The article explores the challenges of using marginalization as an independent concept and suggests areas for future inquiry and research.

Combined Recipe for Clinical Target Volume and Planning Target Volume Margins

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

Stroom, Joep, E-mail: joep.stroom@fundacaochampalimaud.pt; Gilhuijs, Kenneth; Vieira, Sandra

2014-03-01

Purpose: To develop a combined recipe for clinical target volume (CTV) and planning target volume (PTV) margins. Methods and Materials: A widely accepted PTV margin recipe is M{sub geo} = aΣ{sub geo} + bσ{sub geo}, with Σ{sub geo} and σ{sub geo} standard deviations (SDs) representing systematic and random geometric uncertainties, respectively. On the basis of histopathology data of breast and lung tumors, we suggest describing the distribution of microscopic islets around the gross tumor volume (GTV) by a half-Gaussian with SD Σ{sub micro}, yielding as possible CTV margin recipe: M{sub micro} = ƒ(N{sub i}) × Σ{sub micro}, with N{sub i}more » the average number of microscopic islets per patient. To determine ƒ(N{sub i}), a computer model was developed that simulated radiation therapy of a spherical GTV with isotropic distribution of microscopic disease in a large group of virtual patients. The minimal margin that yielded D{sub min} <95% in maximally 10% of patients was calculated for various Σ{sub micro} and N{sub i}. Because Σ{sub micro} is independent of Σ{sub geo}, we propose they should be added quadratically, yielding for a combined GTV-to-PTV margin recipe: M{sub GTV-PTV} = √([aΣ{sub geo}]{sup 2} + [ƒ(N{sub i})Σ{sub micro}]{sup 2}) + bσ{sub geo}. This was validated by the computer model through numerous simultaneous simulations of microscopic and geometric uncertainties. Results: The margin factor ƒ(N{sub i}) in a relevant range of Σ{sub micro} and N{sub i} can be given by: ƒ(N{sub i}) = 1.4 + 0.8log(N{sub i}). Filling in the other factors found in our simulations (a = 2.1 and b = 0.8) yields for the combined recipe: M{sub GTV-PTV} = √((2.1Σ{sub geo}){sup 2} + ([1.4 + 0.8log(N{sub i})] × Σ{sub micro}){sup 2}) + 0.8σ{sub geo}. The average margin difference between the simultaneous simulations and the above recipe was 0.2 ± 0.8 mm (1 SD). Calculating M{sub geo} and M{sub micro} separately and adding them linearly overestimated PTVs by on average 5 mm. Margin recipes based on tumor control probability (TCP) instead of D{sub min} criteria yielded similar results. Conclusions: A general recipe for GTV-to-PTV margins is proposed, which shows that CTV and PTV margins should be added in quadrature instead of linearly.« less

Aggressive resection at the infiltrative margins of glioblastoma facilitated by intraoperative fluorescein guidance.

PubMed

Neira, Justin A; Ung, Timothy H; Sims, Jennifer S; Malone, Hani R; Chow, Daniel S; Samanamud, Jorge L; Zanazzi, George J; Guo, Xiaotao; Bowden, Stephen G; Zhao, Binsheng; Sheth, Sameer A; McKhann, Guy M; Sisti, Michael B; Canoll, Peter; D'Amico, Randy S; Bruce, Jeffrey N

2017-07-01

OBJECTIVE Extent of resection is an important prognostic factor in patients undergoing surgery for glioblastoma (GBM). Recent evidence suggests that intravenously administered fluorescein sodium associates with tumor tissue, facilitating safe maximal resection of GBM. In this study, the authors evaluate the safety and utility of intraoperative fluorescein guidance for the prediction of histopathological alteration both in the contrast-enhancing (CE) regions, where this relationship has been established, and into the non-CE (NCE), diffusely infiltrated margins. METHODS Thirty-two patients received fluorescein sodium (3 mg/kg) intravenously prior to resection. Fluorescence was intraoperatively visualized using a Zeiss Pentero surgical microscope equipped with a YELLOW 560 filter. Stereotactically localized biopsy specimens were acquired from CE and NCE regions based on preoperative MRI in conjunction with neuronavigation. The fluorescence intensity of these specimens was subjectively classified in real time with subsequent quantitative image analysis, histopathological evaluation of localized biopsy specimens, and radiological volumetric assessment of the extent of resection. RESULTS Bright fluorescence was observed in all GBMs and localized to the CE regions and portions of the NCE margins of the tumors, thus serving as a visual guide during resection. Gross-total resection (GTR) was achieved in 84% of the patients with an average resected volume of 95%, and this rate was higher among patients for whom GTR was the surgical goal (GTR achieved in 93.1% of patients, average resected volume of 99.7%). Intraoperative fluorescein staining correlated with histopathological alteration in both CE and NCE regions, with positive predictive values by subjective fluorescence evaluation greater than 96% in NCE regions. CONCLUSIONS Intraoperative administration of fluorescein provides an easily visualized marker for glioma pathology in both CE and NCE regions of GBM. These findings support the use of fluorescein as a microsurgical adjunct for guiding GBM resection to facilitate safe maximal removal.

Independent Predictors of Prognosis Based on Oral Cavity Squamous Cell Carcinoma Surgical Margins.

PubMed

Buchakjian, Marisa R; Ginader, Timothy; Tasche, Kendall K; Pagedar, Nitin A; Smith, Brian J; Sperry, Steven M

2018-05-01

Objective To conduct a multivariate analysis of a large cohort of oral cavity squamous cell carcinoma (OCSCC) cases for independent predictors of local recurrence (LR) and overall survival (OS), with emphasis on the relationship between (1) prognosis and (2) main specimen permanent margins and intraoperative tumor bed frozen margins. Study Design Retrospective cohort study. Setting Tertiary academic head and neck cancer program. Subjects and Methods This study included 426 patients treated with OCSCC resection between 2005 and 2014 at University of Iowa Hospitals and Clinics. Patients underwent excision of OCSCC with intraoperative tumor bed frozen margin sampling and main specimen permanent margin assessment. Multivariate analysis of the data set to predict LR and OS was performed. Results Independent predictors of LR included nodal involvement, histologic grade, and main specimen permanent margin status. Specifically, the presence of a positive margin (odds ratio, 6.21; 95% CI, 3.3-11.9) or <1-mm/carcinoma in situ margin (odds ratio, 2.41; 95% CI, 1.19-4.87) on the main specimen was an independent predictor of LR, whereas intraoperative tumor bed margins were not predictive of LR on multivariate analysis. Similarly, independent predictors of OS on multivariate analysis included nodal involvement, extracapsular extension, and a positive main specimen margin. Tumor bed margins did not independently predict OS. Conclusion The main specimen margin is a strong independent predictor of LR and OS on multivariate analysis. Intraoperative tumor bed frozen margins do not independently predict prognosis. We conclude that emphasis should be placed on evaluating the main specimen margins when estimating prognosis after OCSCC resection.

Gross-Pitaevski map as a chaotic dynamical system.

PubMed

Guarneri, Italo

2017-03-01

The Gross-Pitaevski map is a discrete time, split-operator version of the Gross-Pitaevski dynamics in the circle, for which exponential instability has been recently reported. Here it is studied as a classical dynamical system in its own right. A systematic analysis of Lyapunov exponents exposes strongly chaotic behavior. Exponential growth of energy is then shown to be a direct consequence of rotational invariance and for stationary solutions the full spectrum of Lyapunov exponents is analytically computed. The present analysis includes the "resonant" case, when the free rotation period is commensurate to 2π, and the map has countably many constants of the motion. Except for lowest-order resonances, this case exhibits an integrable-chaotic transition.

DC-9 Flight Demonstration Program with Refanned JT8D Engines. Volume 3; Performance and Analysis

NASA Technical Reports Server (NTRS)

1975-01-01

The JT8D-109 engine has a sea level static, standard day bare engine takeoff thrust of 73,840 N. At sea level standard day conditions the additional thrust of the JT8D-109 results in 2,040 kg additional takeoff gross weight capability for a given field length. Range loss of the DC-9 Refan airplane for long range cruise was determined. The Refan airplane demonstrated stall, static longitudinal stability, longitudinal control, longitudinal trim, minimum control speeds, and directional control characteristics similar to the DC-9-30 production airplane and complied with airworthiness requirements. Cruise, climb, and thrust reverser performance were evaluated. Structural and dynamic ground test, flight test and analytical results substantiate Refan Program requirements that the nacelle, thrust reverser hardware, and the airplane structural modifications are flightworthy and certifiable and that the airplane meets flutter speed margins. Estimated unit cost of a DC-9 Refan retrofit program is 1.338 million in mid-1975 dollars with about an equal split in cost between airframe and engine.

Samuel D. Gross, the Writing of American Surgical History.

PubMed

Rutkow, Ira

2015-12-01

To explore the details of Samuel D. Gross's achievements as America's foremost historian of medicine in the mid-nineteenth century. The life of Samuel D. Gross, the most renowned of the nation's surgeons in the nineteenth century, has been extensively researched and celebrated. Despite the long-standing interest in Gross's accomplishments, there is an important and influential aspect of his career that has been forgotten. Gross was the country's first surgical historian and his boosting of the popular image of the knife bearer was crucial to shaping the future of the craft, in particular surgery's rise as a respected specialty within the whole of medicine. An analysis of the published medical literature and unpublished documents relating to Samuel D. Gross and his status as the country's earliest historian of surgery. At a time when surgery was not considered a separate branch of medicine but a mere technical mode of treatment, Gross's efforts in medical and surgical history provided a much needed boost to surgeons in their pursuit of self-confidence and self-respect. Although Gross's accomplishments as a medical historian have been overlooked, it is undeniable that he was America's pioneer surgical historian and, as such, afforded surgeons their earliest measure of self-esteem, a critical attribute that was indispensable for the rise of surgery as a distinguished profession.

Effects of gross motor function and manual function levels on performance-based ADL motor skills of children with spastic cerebral palsy.

PubMed

Park, Myoung-Ok

2017-02-01

[Purpose] The purpose of this study was to determine effects of Gross Motor Function Classification System and Manual Ability Classification System levels on performance-based motor skills of children with spastic cerebral palsy. [Subjects and Methods] Twenty-three children with cerebral palsy were included. The Assessment of Motor and Process Skills was used to evaluate performance-based motor skills in daily life. Gross motor function was assessed using Gross Motor Function Classification Systems, and manual function was measured using the Manual Ability Classification System. [Results] Motor skills in daily activities were significantly different on Gross Motor Function Classification System level and Manual Ability Classification System level. According to the results of multiple regression analysis, children categorized as Gross Motor Function Classification System level III scored lower in terms of performance based motor skills than Gross Motor Function Classification System level I children. Also, when analyzed with respect to Manual Ability Classification System level, level II was lower than level I, and level III was lower than level II in terms of performance based motor skills. [Conclusion] The results of this study indicate that performance-based motor skills differ among children categorized based on Gross Motor Function Classification System and Manual Ability Classification System levels of cerebral palsy.

Development of a murine model of blunt hepatic trauma.

PubMed

Nemzek-Hamlin, Jean A; Hwang, Haejin; Hampel, Joseph A; Yu, Bi; Raghavendran, Krishnan

2013-10-01

Despite the prevalence of blunt hepatic trauma in humans, there are few rodent models of blunt trauma that can be used to study the associated inflammatory responses. We present a mouse model of blunt hepatic trauma that was created by using a cortical contusion device. Male mice were anesthetized with ketamine-xylazine-buprenorphine and placed in left lateral recumbency. A position of 2 mm ventral to the posterior axillary line and 5 mm caudal to the costal margin on the right side was targeted for impact. An impact velocity of 6 m/s and a piston depth of 12 mm produced a consistent pattern of hepatic injury with low mortality. All mice that recovered from anesthesia survived without complication for the length of the study. Mice were euthanized at various time points (n = 5 per group) until 7 d after injury for gross examination and collection of blood and peritoneal lavage fluids. Some mice were reanesthetized for serial monitoring of hepatic lesions via MRI. At 2 h after trauma, mice consistently displayed laceration, hematoma, and discoloration of the right lateral and caudate liver lobes, with intraabdominal hemorrhage but no other gross injuries. Blood and peritoneal lavage fluid were collected from all mice for cytokine analysis. At 2 h after trauma, there were significant increases in plasma IL10 as well as peritoneal lavage fluid IL6 and CXCL1/KC; however, these levels decreased within 24 h. At 7 d after trauma, the mice had regained body weight, and the hepatic lesions, which initially had increased in size during the first 48 h, had returned to their original size. In summary, this technique produced a reliable, low mortality, murine model that recreates features of blunt abdominal liver injury in human subjects with similar acute inflammatory response.

Bird impact analysis package for turbine engine fan blades

NASA Technical Reports Server (NTRS)

Hirschbein, M. S.

1982-01-01

A computer program has been developed to analyze the gross structural response of turbine engine fan blades subjected to bird strikes. The program couples a NASTRAN finite element model and modal analysis of a fan blade with a multi-mode bird impact analysis computer program. The impact analysis uses the NASTRAN blade model and a fluid jet model of the bird to interactively calculate blade loading during a bird strike event. The analysis package is computationaly efficient, easy to use and provides a comprehensive history of the gross structual blade response. Example cases are presented for a representative fan blade.

Relation between hand function and gross motor function in full term infants aged 4 to 8 months.

PubMed

Nogueira, Solange F; Figueiredo, Elyonara M; Gonçalves, Rejane V; Mancini, Marisa C

2015-01-01

In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. RESULTS revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development.

Increasing the value of health research in the WHO African Region beyond 2015--reflecting on the past, celebrating the present and building the future: a bibliometric analysis.

PubMed

Uthman, Olalekan A; Wiysonge, Charles Shey; Ota, Martin O; Nicol, Mark; Hussey, Gregory D; Ndumbe, Peter M; Mayosi, Bongani M

2015-03-13

To assess the profile and determinants of health research productivity in Africa since the onset of the new millennium. Bibliometric analysis. In November 2014, we searched PubMed for articles published between 2000 and 2014 from the WHO African Region, and obtained country-level indicators from World Bank data. We used Poisson regression to examine time trends in research publications and negative binomial regression to explore determinants of research publications. We identified 107,662 publications, with a median of 727 per country (range 25-31,757). Three countries (South Africa, Nigeria and Kenya) contributed 52% of the publications. The number of publications increased from 3623 in 2000 to 12,709 in 2014 (relative growth 251%). Similarly, the per cent share of worldwide research publications per year increased from 0.7% in 2000 to 1.3% in 2014. The trend analysis was also significant to confirm a continuous increase in health research publications from Africa, with productivity increasing by 10.3% per year (95% CIs +10.1% to +10.5%). The only independent predictor of publication outputs was national gross domestic product. For every one log US$ billion increase in gross domestic product, research publications rose by 105%: incidence rate ratio (IRR=2.05, 95% CI 1.39 to 3.04). The association of private health expenditure with publications was only marginally significant (IRR=1.86, 95% CI 1.00 to 3.47). There has been a significant improvement in health research in the WHO African Region since 2000, with some individual countries already having strong research profiles. Countries of the region should implement the WHO Strategy on Research for Health: reinforcing the research culture (organisation); focusing research on key health challenges (priorities); strengthening national health research systems (capacity); encouraging good research practice (standards); and consolidating linkages between health research and action (translation). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Increasing the value of health research in the WHO African Region beyond 2015—reflecting on the past, celebrating the present and building the future: a bibliometric analysis

PubMed Central

Uthman, Olalekan A; Wiysonge, Charles Shey; Ota, Martin O; Nicol, Mark; Hussey, Gregory D; Ndumbe, Peter M; Mayosi, Bongani M

2015-01-01

Objective To assess the profile and determinants of health research productivity in Africa since the onset of the new millennium. Design Bibliometric analysis. Data collection and synthesis In November 2014, we searched PubMed for articles published between 2000 and 2014 from the WHO African Region, and obtained country-level indicators from World Bank data. We used Poisson regression to examine time trends in research publications and negative binomial regression to explore determinants of research publications. Results We identified 107 662 publications, with a median of 727 per country (range 25–31 757). Three countries (South Africa, Nigeria and Kenya) contributed 52% of the publications. The number of publications increased from 3623 in 2000 to 12 709 in 2014 (relative growth 251%). Similarly, the per cent share of worldwide research publications per year increased from 0.7% in 2000 to 1.3% in 2014. The trend analysis was also significant to confirm a continuous increase in health research publications from Africa, with productivity increasing by 10.3% per year (95% CIs +10.1% to +10.5%). The only independent predictor of publication outputs was national gross domestic product. For every one log US$ billion increase in gross domestic product, research publications rose by 105%: incidence rate ratio (IRR=2.05, 95% CI 1.39 to 3.04). The association of private health expenditure with publications was only marginally significant (IRR=1.86, 95% CI 1.00 to 3.47). Conclusions There has been a significant improvement in health research in the WHO African Region since 2000, with some individual countries already having strong research profiles. Countries of the region should implement the WHO Strategy on Research for Health: reinforcing the research culture (organisation); focusing research on key health challenges (priorities); strengthening national health research systems (capacity); encouraging good research practice (standards); and consolidating linkages between health research and action (translation). PMID:25770227

A time series analysis of transportation energy use per dollar of gross domestic product

DOT National Transportation Integrated Search

2009-06-01

Transportation energy use relative to gross domestic product (GDP) has been declining within the past decade. However, the total transportation energy consumed (see figure 1) shows only a more recent decline. To see clearly the long-term decline, the...

The Impact of Taxes on Competition for CEOs.

PubMed

Krenn, Peter

2017-07-03

This paper contributes to the question of how taxation of corporate profits and wages affects competition among firms for highly skilled human resources such as CEOs. Use of a theoretical model shows that wage taxes can have a substantial impact on the outcome of such a competition if marginal tax rates are different as in an international labor market. Further, the paper shows that increasing the wage tax rate unilaterally can have an ambiguous effect on observed gross compensation levels. However, in a local labor market for CEOs, observed gross fixed salaries should decline in the wage tax rate. Tax effects in a market for CEOs is a particularly interesting topic because recent developments with respect to compensation practices of top-level managers have opened a public debate about the use of instruments for regulating compensation of those managers. Furthermore, many countries around the world use tax incentives in order to facilitate immigration of highly skilled human resources. The investigation follows an analytical economics-based approach by extending an LEN model with elements of competition for scarce human resources and income taxation. It investigates the impact of differential taxation on the competition between two firms for the exclusive service of a unique, highly skilled CEO.

Engineering and Economic Analysis of an Advanced Ultra-Supercritical Pulverized Coal Power Plant with and without Post-Combustion Carbon Capture Task 7. Design and Economic Studies

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

Booras, George; Powers, J.; Riley, C.

2015-09-01

This report evaluates the economics and performance of two A-USC PC power plants; Case 1 is a conventionally configured A-USC PC power plant with superior emission controls, but without CO 2 removal; and Case 2 adds a post-combustion carbon capture (PCC) system to the plant from Case 1, using the design and heat integration strategies from EPRI’s 2015 report, “Best Integrated Coal Plant.” The capture design basis for this case is “partial,” to meet EPA’s proposed New Source Performance Standard, which was initially proposed as 500 kg-CO 2/MWh (gross) or 1100 lb-CO 2/MWh (gross), but modified in August 2015 tomore » 635 kg-CO 2/MWh (gross) or 1400 lb-CO 2/MWh (gross). This report draws upon the collective experience of consortium members, with EPRI and General Electric leading the study. General Electric provided the steam cycle analysis as well as v the steam turbine design and cost estimating. EPRI performed integrated plant performance analysis using EPRI’s PC Cost model.« less

An empirical analysis of the cost of rearing dairy heifers from birth to first calving and the time taken to repay these costs.

PubMed

Boulton, A C; Rushton, J; Wathes, D C

2017-08-01

Rearing quality dairy heifers is essential to maintain herds by replacing culled cows. Information on the key factors influencing the cost of rearing under different management systems is, however, limited and many farmers are unaware of their true costs. This study determined the cost of rearing heifers from birth to first calving in Great Britain including the cost of mortality, investigated the main factors influencing these costs across differing farming systems and estimated how long it took heifers to repay the cost of rearing on individual farms. Primary data on heifer management from birth to calving was collected through a survey of 101 dairy farms during 2013. Univariate followed by multivariable linear regression was used to analyse the influence of farm factors and key rearing events on costs. An Excel spreadsheet model was developed to determine the time it took for heifers to repay the rearing cost. The mean±SD ages at weaning, conception and calving were 62±13, 509±60 and 784±60 days. The mean total cost of rearing was £1819±387/heifer with a mean daily cost of £2.31±0.41. This included the opportunity cost of the heifer and the mean cost of mortality, which ranged from £103.49 to £146.19/surviving heifer. The multivariable model predicted an increase in mean cost of rearing of £2.87 for each extra day of age at first calving and a decrease in mean cost of £6.06 for each percentile increase in time spent at grass. The model also predicted a decrease in the mean cost of rearing in autumn and spring calving herds of £273.20 and £288.56, respectively, compared with that in all-year-round calving herds. Farms with herd sizes⩾100 had lower mean costs of between £301.75 and £407.83 compared with farms with <100 milking cows. The mean gross margin per heifer was £441.66±304.56 (range £367.63 to £1120.08), with 11 farms experiencing negative gross margins. Most farms repaid the cost of heifer rearing in the first two lactations (range 1 to 6 lactations) with a mean time from first calving until breaking even of 530±293 days. The results of the economic analysis suggest that management decisions on key reproduction events and grazing policy significantly influence the cost of rearing and the time it takes for heifers to start making a profit for the farm.

Divergence of fine and gross motor skills in prelingually deaf children: implications for cochlear implantation.

PubMed

Horn, David L; Pisoni, David B; Miyamoto, Richard T

2006-08-01

The objective of this study was to assess relations between fine and gross motor development and spoken language processing skills in pediatric cochlear implant users. The authors conducted a retrospective analysis of longitudinal data. Prelingually deaf children who received a cochlear implant before age 5 and had no known developmental delay or cognitive impairment were included in the study. Fine and gross motor development were assessed before implantation using the Vineland Adaptive Behavioral Scales, a standardized parental report of adaptive behavior. Fine and gross motor scores reflected a given child's motor functioning with respect to a normative sample of typically developing, normal-hearing children. Relations between these preimplant scores and postimplant spoken language outcomes were assessed. In general, gross motor scores were found to be positively related to chronologic age, whereas the opposite trend was observed for fine motor scores. Fine motor scores were more strongly correlated with postimplant expressive and receptive language scores than gross motor scores. Our findings suggest a disassociation between fine and gross motor development in prelingually deaf children: fine motor skills, in contrast to gross motor skills, tend to be delayed as the prelingually deaf children get older. These findings provide new knowledge about the links between motor and spoken language development and suggest that auditory deprivation may lead to atypical development of certain motor and language skills that share common cortical processing resources.

Integrated Flight-propulsion Control Concepts for Supersonic Transport Airplanes

NASA Technical Reports Server (NTRS)

Burcham, Frank W., Jr.; Gilyard, Glenn B.; Gelhausen, Paul A.

1990-01-01

Integration of propulsion and flight control systems will provide significant performance improvements for supersonic transport airplanes. Increased engine thrust and reduced fuel consumption can be obtained by controlling engine stall margin as a function of flight and engine operating conditions. Improved inlet pressure recovery and decreased inlet drag can result from inlet control system integration. Using propulsion system forces and moments to augment the flight control system and airplane stability can reduce the flight control surface and tail size, weight, and drag. Special control modes may also be desirable for minimizing community noise and for emergency procedures. The overall impact of integrated controls on the takeoff gross weight for a generic high speed civil transport is presented.

Soil moisture in relation to geologic structure and lithology, northern California

NASA Technical Reports Server (NTRS)

Rich, E. I. (Principal Investigator)

1980-01-01

The author has identified the following significant results. Structural features in the Norther California Coast Ranges are clearly discernable on Nite-IR images and some of the structural linears may results in an extension of known faults within the region. The Late Mesozoic marine sedimentary rocks along the western margin of the Sacramento Valley are clearly defined on the Nite-IR images and in a gross way individual layers of sandstone can be differentiated from shale. Late Pleistocene alluvial fans are clearly differentiated from second generation Holocene fans on the basis of tonal characteristics. Although the tonal characteristics change with the seasons, the differentiation of the two sets of fans is still possible.

The relationship between body mass index and gross motor development in children aged 3 to 5 years.

PubMed

Nervik, Deborah; Martin, Kathy; Rundquist, Peter; Cleland, Joshua

2011-01-01

To investigate the relationship between obesity and gross motor development in children who are developing typically and determine whether body mass index (BMI) predicts difficulty in gross motor skills. BMIs were calculated and gross motor skills examined in 50 children who were healthy aged 3 to 5 years using the Peabody Developmental Motor Scales, 2nd edition (PDMS-2). Pearson chi-square statistic and stepwise linear hierarchical regression were used for analysis. A total of 24% of the children were overweight/obese, whereas 76% were found not to be overweight/obese. Fifty-eight percent of the overweight/obese group scored below average on the PDMS-2 compared to 15% of the nonoverweight group. Association between BMI and gross motor quotients was identified with significance of less than 0.002. Regression results were nonsignificant with all 50 subjects, yet showed significance (P = 0.018) when an outlier was excluded. Children aged 3 to 5 years with high BMIs may have difficulty with their gross motor skills. Further research is needed.

Patterns of Intraosseous Recurrence After Stereotactic Body Radiation Therapy for Coxal Bone Metastasis.

PubMed

Ito, Kei; Shimizuguchi, Takuya; Nihei, Keiji; Furuya, Tomohisa; Ogawa, Hiroaki; Tanaka, Hiroshi; Sasai, Keisuke; Karasawa, Katsuyuki

2018-01-01

To analyze the detailed pattern of intraosseous failure after stereotactic body radiation therapy (SBRT) for coxal bone metastasis. Patients treated with SBRT to coxal bone metastasis were identified by retrospective chart review. The SBRT doses were 30 Gy or 35 Gy in 5 fractions. A margin of 5 to 10 mm was added to the gross tumor volume to create the clinical target volume. We evaluated the presence or absence of intraosseous recurrence using magnetic resonance imaging. Intraosseous recurrences were assessed as "in-field" or "marginal/out-of-field." In addition, we measured the distance between the center of the recurrent tumor and the nearest edge of the initial bone metastasis in cases of marginal/out-of-field recurrence. Seventeen patients treated for 17 coxal bone metastases were included. Median age was 64 years (range, 48-79 years). Coxal lesions involved the ilium in 14 cases, pubis in 3, and ischium in 4 (3 lesions crossed over multiple regions). Patients most commonly had renal cell carcinoma (29.4%), followed by lung, hepatic cell, and colorectal cancers (23.5%, 11.8%, and 11.8%, respectively). Median follow-up after SBRT was 13 months (range, 2-44 months). Among all 17 cases, 7 cases developed 8 intraosseous recurrences, including in-field recurrence in 1 case and marginal/out-of-field recurrences in 7 cases. Median time to intraosseous recurrence was 10 months (range, 2-35 months). Among 7 cases with marginal/out-of-field recurrence, mean distance to the center of the recurrent tumor from the nearest edge of the initial bone metastasis was 34 mm (range, 15-55 mm). Most recurrences were observed out-of-field in the same coxal bone. These results suggest that defining the optimal clinical target volume in SBRT for coxal bone metastasis to obtain sufficient local tumor control is difficult. Copyright © 2017 Elsevier Inc. All rights reserved.

Multiple two-dimensional versus three-dimensional PTV definition in treatment planning for conformal radiotherapy.

PubMed

Stroom, J C; Korevaar, G A; Koper, P C; Visser, A G; Heijmen, B J

1998-06-01

To demonstrate the need for a fully three-dimensional (3D) computerized expansion of the gross tumour volume (GTV) or clinical target volume (CTV), as delineated by the radiation oncologist on CT slices, to obtain the proper planning target volume (PTV) for treatment planning according to the ICRU-50 recommendations. For 10 prostate cancer patients two PTVs have been determined by expansion of the GTV with a 1.5 cm margin, i.e. a 3D PTV and a multiple 2D PTV. The former was obtained by automatically adding the margin while accounting in 3D for GTV contour differences in neighbouring slices. The latter was generated by automatically adding the 1.5 cm margin to the GTV in each CT slice separately; the resulting PTV is a computer simulation of the PTV that a radiation oncologist would obtain with (the still common) manual contouring in CT slices. For each patient the two PTVs were compared to assess the deviations of the multiple 2D PTV from the 3D PTV. For both PTVs conformal plans were designed using a three-field technique with fixed block margins. For each patient dose-volume histograms and tumour control probabilities (TCPs) of the (correct) 3D PTV were calculated, both for the plan designed for this PTV and for the treatment plan based on the (deviating) 2D PTV. Depending on the shape of the GTV, multiple 2D PTV generation could locally result in a 1 cm underestimation of the GTV-to-PTV margin. The deviations occurred predominantly in the cranio-caudal direction at locations where the GTV contour shape varies significantly from slice to slice. This could lead to serious underdosage and to a TCP decrease of up to 15%. A full 3D GTV-to-PTV expansion should be applied in conformal radiotherapy to avoid underdosage.

Limited Margin Radiation Therapy for Children and Young Adults With Ewing Sarcoma Achieves High Rates of Local Tumor Control

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

Talleur, Aimee C.; Navid, Fariba; Spunt, Sheri L.

Purpose: To determine the rate of local failure using focal conformal, limited margin radiation therapy (RT) and dose escalation for tumors ≥8 cm (greatest dimension at diagnosis) in children and young adults with Ewing sarcoma (EWS). Methods and Materials: Eligible patients with EWS were treated on a phase 2 institutional trial of focal conformal, limited margin RT using conformal or intensity modulated techniques. The treatment volume incorporated a 1-cm constrained margin around the gross tumor. Unresected tumors, <8 cm at diagnosis, received a standard dose of 55.8 Gy and tumors ≥8 cm, an escalated dose to 64.8 Gy. Patients with microscopic residual disease after resectionmore » received adjuvant RT to 50.4 Gy. Adjuvant brachytherapy was permitted in selected patients. Results: Forty-five patients were enrolled: 26 with localized and 19 with metastatic disease. Median (range) age, tumor size, and follow-up were 13.0 years (2.9-24.7 years), 9.0 cm (2.4-17.0 cm), and 54.5 months (1.9-122.2 months), respectively. All patients received systemic chemotherapy. The median (range) RT dose for all patients was 56.1 Gy (45-65.5 Gy). Seventeen patients received adjuvant, 16 standard-dose, and 12 escalated-dose RT. Failures included 1 local, 10 distant, and 1 local/distant. The estimated 10-year cumulative incidence of local failure was 4.4% ± 3.1%, with no statistical difference seen between RT treatment groups and no local failures in the escalated-dose RT treatment group. Conclusions: Treatment with focal conformal, limited margin RT, including dose escalation for larger tumors, provides favorable local tumor control in EWS.« less

Bounded Linear Stability Margin Analysis of Nonlinear Hybrid Adaptive Control

NASA Technical Reports Server (NTRS)

Nguyen, Nhan T.; Boskovic, Jovan D.

2008-01-01

This paper presents a bounded linear stability analysis for a hybrid adaptive control that blends both direct and indirect adaptive control. Stability and convergence of nonlinear adaptive control are analyzed using an approximate linear equivalent system. A stability margin analysis shows that a large adaptive gain can lead to a reduced phase margin. This method can enable metrics-driven adaptive control whereby the adaptive gain is adjusted to meet stability margin requirements.

Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation.

PubMed

Ji, Kai; Zhao, Lujun; Yang, Chengwen; Meng, Maobin; Wang, Ping

2012-11-27

To quantify the incidental irradiation dose to esophageal lymph node stations when irradiating T1-4N0M0 thoracic esophageal squamous cell carcinoma (ESCC) patients with a dose of 60 Gy/30f. Thirty-nine patients with medically inoperable T1-4N0M0 thoracic ESCC were treated with three-dimensional conformal radiation (3DCRT) with involved-field radiation (IFI). The conformal clinical target volume (CTV) was re-created using a 3-cm margin in the proximal and distal direction beyond the barium esophagogram, endoscopic examination and CT scan defined the gross tumor volume (GTV) and a 0.5-cm margin in the lateral and anteroposterior directions of the CT scan-defined GTV. The PTV encompassed 1-cm proximal and distal margins and 0.5-cm radial margin based on the CTV. Nodal regions were delineated using the Japanese Society for Esophageal Diseases (JSED) guidelines and an EORTC-ROG expert opinion. The equivalent uniform dose (EUD) and other dosimetric parameters were calculated for each nodal station. Nodal regions with a metastasis rate greater than 5% were considered a high-risk lymph node subgroup. Under a 60 Gy dosage, the median D mean and EUD was greater than 40 Gy in most high-risk nodal regions except for regions of 104, 106tb-R in upper-thoracic ESCC and 101, 104-R, 105, 106rec-L, 2, 3&7 in middle-thoracic ESCC and 107, 3&7 in lower-thoracic ESCC. In the regions with an EUD less than 40 Gy, most incidental irradiation doses were significantly associated with esophageal tumor length and location. Lymph node stations near ESCC receive considerable incidental irradiation doses with involved-field irradiation that may contribute to the elimination of subclinical lesions.

Range expansion potential of two co-occurring invasive vines to marginal habitats in Turkey

NASA Astrophysics Data System (ADS)

Farooq, Shahid; Tad, Sonnur; Onen, Huseyin; Gunal, Hikmet; Caldiran, Ugur; Ozaslan, Cumali

2017-10-01

Niche distribution models accurately predict the potential distribution range of invasive plants into new habitats based on their climatic requirements in the native regions. However, these models usually ignore the marginal habitats which can limit the distribution of exotic plants. We therefore tested the seedling survival, growth and nutrient acquisition capabilities of two co-occurring invasive vines [Persicaria perfoliata (L.) H. Gross and Sicyos angulatus L.] in three different manipulative greenhouse experiments to infer their range expansion potential to marginal habitats in Turkey. First experiment included five different moisture availability regimes (100, 75, 50, 25 and 12.5% available water), second experiment consisted of four different salinity levels (0, 3, 6 and 12 dSm-1 soil salinity) and third experiment had four different soil textures (clay-1, clay-2, sandy loam and silt-clay-loam). Seedling mortality was only observed under extreme moisture deficiency in both plant species, while most of the transplanted seedlings of both species did not survive under 6 and 12 dSm-1 salinity levels. Soil textures had no effect on seedling survival. POLPE better tolerated low moisture availability and high salinity compared to SIYAN. Biomass production in both plant species was linearly reduced with increasing salinity and moisture deficiency. SIYAN invested more resources towards shoot, accumulated higher K and P, whereas POLPE maintained higher root-to-shoot ratio under all experimental conditions. Both plant species employed different strategies to cope with adverse environmental conditions, but failed to persist under high soil salinity and moisture deficiency. Our study suggest that both plant species have limited potential of range expansion to marginal habitats and will be limited to moist and humid areas only. Therefore, further research activities should be concentrated in these regions to develop effective management strategies against both species.

Worst-Case Flutter Margins from F/A-18 Aircraft Aeroelastic Data

NASA Technical Reports Server (NTRS)

Lind, Rick; Brenner, Marty

1997-01-01

An approach for computing worst-case flutter margins has been formulated in a robust stability framework. Uncertainty operators are included with a linear model to describe modeling errors and flight variations. The structured singular value, micron, computes a stability margin which directly accounts for these uncertainties. This approach introduces a new method of computing flutter margins and an associated new parameter for describing these margins. The micron margins are robust margins which indicate worst-case stability estimates with respect to the defined uncertainty. Worst-case flutter margins are computed for the F/A-18 SRA using uncertainty sets generated by flight data analysis. The robust margins demonstrate flight conditions for flutter may lie closer to the flight envelope than previously estimated by p-k analysis.

Clinical outcomes of stage I and IIA non-small cell lung cancer patients treated with stereotactic body radiotherapy using a real-time tumor-tracking radiotherapy system.

PubMed

Katoh, Norio; Soda, Itaru; Tamamura, Hiroyasu; Takahashi, Shotaro; Uchinami, Yusuke; Ishiyama, Hiromichi; Ota, Kiyotaka; Inoue, Tetsuya; Onimaru, Rikiya; Shibuya, Keiko; Hayakawa, Kazushige; Shirato, Hiroki

2017-01-05

To investigate the clinical outcomes of stage I and IIA non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT) using a real-time tumor-tracking radiotherapy (RTRT) system. Patterns-of-care in SBRT using RTRT for histologically proven, peripherally located, stage I and IIA NSCLC was retrospectively investigated in four institutions by an identical clinical report format. Patterns-of-outcomes was also investigated in the same manner. From September 2000 to April 2012, 283 patients with 286 tumors were identified. The median age was 78 years (52-90) and the maximum tumor diameters were 9 to 65 mm with a median of 24 mm. The calculated biologically effective dose (10) at the isocenter using the linear-quadratic model was from 66 Gy to 126 Gy with a median of 106 Gy. With a median follow-up period of 28 months (range 0-127), the overall survival rate for the entire group, for stage IA, and for stage IB + IIA was 75%, 79%, and 65% at 2 years, and 64%, 70%, and 50% at 3 years, respectively. In the multivariate analysis, the favorable predictive factor was female for overall survival. There were no differences between the clinical outcomes at the four institutions. Grade 2, 3, 4, and 5 radiation pneumonitis was experienced by 29 (10.2%), 9 (3.2%), 0, and 0 patients. The subgroup analyses revealed that compared to margins from gross tumor volume (GTV) to planning target volume (PTV) ≥ 10 mm, margins < 10 mm did not worsen the overall survival and local control rates, while reducing the risk of radiation pneumonitis. This multi-institutional retrospective study showed that the results were consistent with the recent patterns-of-care and patterns-of-outcome analysis of SBRT. A prospective study will be required to evaluate SBRT using a RTRT system with margins from GTV to PTV < 10mm.

Verification of Dose Distribution in Carbon Ion Radiation Therapy for Stage I Lung Cancer

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

Irie, Daisuke; Saitoh, Jun-ichi, E-mail: junsaito@gunma-u.ac.jp; Shirai, Katsuyuki

Purpose: To evaluate robustness of dose distribution of carbon-ion radiation therapy (C-ion RT) in non-small cell lung cancer (NSCLC) and to identify factors affecting the dose distribution by simulated dose distribution. Methods and Materials: Eighty irradiation fields for delivery of C-ion RT were analyzed in 20 patients with stage I NSCLC. Computed tomography images were obtained twice before treatment initiation. Simulated dose distribution was reconstructed on computed tomography for confirmation under the same settings as actual treatment with respiratory gating and bony structure matching. Dose-volume histogram parameters, such as %D95 (percentage of D95 relative to the prescribed dose), were calculated.more » Patients with any field for which the %D95 of gross tumor volume (GTV) was below 90% were classified as unacceptable for treatment, and the optimal target margin for such cases was examined. Results: Five patients with a total of 8 fields (10% of total number of fields analyzed) were classified as unacceptable according to %D95 of GTV, although most patients showed no remarkable change in the dose-volume histogram parameters. Receiver operating characteristic curve analysis showed that tumor displacement and change in water-equivalent pathlength were significant predictive factors of unacceptable cases (P<.001 and P=.002, respectively). The main cause of degradation of the dose distribution was tumor displacement in 7 of the 8 unacceptable fields. A 6-mm planning target volume margin ensured a GTV %D95 of >90%, except in 1 extremely unacceptable field. Conclusions: According to this simulation analysis of C-ion RT for stage I NSCLC, a few fields were reported as unacceptable and required resetting of body position and reconfirmation. In addition, tumor displacement and change in water-equivalent pathlength (bone shift and/or chest wall thickness) were identified as factors influencing the robustness of dose distribution. Such uncertainties should be regarded in planning.« less

Relation between hand function and gross motor function in full term infants aged 4 to 8 months

PubMed Central

Nogueira, Solange F.; Figueiredo, Elyonara M.; Gonçalves, Rejane V.; Mancini, Marisa C.

2015-01-01

Background: In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. Objective: To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. Method: The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. Results: Results revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. Conclusion: The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development. PMID:25714437

Constraints and efficiency of cattle marketing in semiarid pastoral system in Kenya.

PubMed

Onono, Joshua Orungo; Amimo, Joshua Oluoch; Rushton, Jonathan

2015-04-01

Livestock keeping is regarded as a store of wealth for pastoralists in Kenya, besides their social and cultural functions. The objective of this study was to prioritize constraints to cattle marketing in a semiarid pastoral area of Narok in Kenya and to analyze efficiency of cattle marketing in transit markets located in Garissa, Kajiado and Narok counties. Primary data collection from traders was done through participatory interviews and market surveys, while time series market price data were obtained from secondary sources. Five focus group interviews were organized with a total of 61 traders in markets from Narok County, while a total of 187 traders who purchased cattle from transit markets provided data on a number of cattle purchased, purpose of purchase, buying prices and mode of transport. Market performance was analyzed through trader's market share, gross margins, Gini coefficient and coefficient of correlation between time series price data. The marketing constraints which were ranked high included lack of market for meat, trekking of cattle to markets, lack of price information and occurrence of diseases. About 10 % of traders purchased over 50 % of cattle which were supplied in markets, revealing a high concentration index. Further, a gross marketing margin per cattle purchased was positive in all markets revealing profitability. Moderate correlation coefficients existed between time series market price data for cattle purchased from Ewaso Ngiro and Mulot markets (r = 0.5; p < 0.05), while those between Dagoretti and Garissa markets were weak (r = 0.2; p > 0.05). The integration of markets, occurrence of diseases and trekking of cattle to markets are factors which may increase a risk of infectious disease spread. These results call for support of disease surveillance activities within markets in pastoral areas so that farms and systems which are connected are protected from threats of infectious diseases.

Evaluation of the ablation margin of hepatocellular carcinoma using CEUS-CT/MR image fusion in a phantom model and in patients.

PubMed

Li, Kai; Su, Zhongzhen; Xu, Erjiao; Huang, Qiannan; Zeng, Qingjing; Zheng, Rongqin

2017-01-19

To assess the accuracy of contrast-enhanced ultrasound (CEUS)-CT/MR image fusion in evaluating the radiofrequency ablative margin (AM) of hepatocellular carcinoma (HCC) based on a custom-made phantom model and in HCC patients. Twenty-four phantoms were randomly divided into a complete ablation group (n = 6) and an incomplete ablation group (n = 18). After radiofrequency ablation (RFA), the AM was evaluated using ultrasound (US)-CT image fusion, and the results were compared with the AM results that were directly measured in a gross specimen. CEUS-CT/MR image fusion and CT-CT / MR-MR image fusion were used to evaluate the AM in 37 tumors from 33 HCC patients who underwent RFA. The sensitivity, specificity, and accuracy of US-CT image fusion for evaluating AM in the phantom model were 93.8, 85.7 and 91.3%, respectively. The maximal thicknesses of the residual AM were 3.5 ± 2.0 mm and 3.2 ± 2.0 mm in the US-CT image fusion and gross specimen, respectively. No significant difference was observed between the US-CT image fusion and direct measurements of the AM of HCC. In the clinical study, the success rate of the AM evaluation was 100% for both CEUS-CT/MR and CT-CT/MR-MR, and the duration was 8.5 ± 2.8 min (range: 4-12 min) and 13.5 ± 4.5 min (range: 8-16 min) for CEUS-CT/MR and CT-CT/MR-MR, respectively. The sensitivity, specificity, and accuracy of CEUS-CT/MR imaging for evaluating the AM were 100.0, 80.0, and 90.0%, respectively. A phantom model composed of carrageenan gel and additives was suitable for the evaluation of HCC AM. CEUS-CT/MR image fusion can be used to evaluate HCC AM with high accuracy.

Flexible Strategies for Coping with Rainfall Variability: Seasonal Adjustments in Cropped Area in the Ganges Basin

PubMed Central

Siderius, Christian; Biemans, Hester; van Walsum, Paul E. V.; van Ierland, Ekko C.; Kabat, Pavel; Hellegers, Petra J. G. J.

2016-01-01

One of the main manifestations of climate change will be increased rainfall variability. How to deal with this in agriculture will be a major societal challenge. In this paper we explore flexibility in land use, through deliberate seasonal adjustments in cropped area, as a specific strategy for coping with rainfall variability. Such adjustments are not incorporated in hydro-meteorological crop models commonly used for food security analyses. Our paper contributes to the literature by making a comprehensive model assessment of inter-annual variability in crop production, including both variations in crop yield and cropped area. The Ganges basin is used as a case study. First, we assessed the contribution of cropped area variability to overall variability in rice and wheat production by applying hierarchical partitioning on time-series of agricultural statistics. We then introduced cropped area as an endogenous decision variable in a hydro-economic optimization model (WaterWise), coupled to a hydrology-vegetation model (LPJmL), and analyzed to what extent its performance in the estimation of inter-annual variability in crop production improved. From the statistics, we found that in the period 1999–2009 seasonal adjustment in cropped area can explain almost 50% of variability in wheat production and 40% of variability in rice production in the Indian part of the Ganges basin. Our improved model was well capable of mimicking existing variability at different spatial aggregation levels, especially for wheat. The value of flexibility, i.e. the foregone costs of choosing not to crop in years when water is scarce, was quantified at 4% of gross margin of wheat in the Indian part of the Ganges basin and as high as 34% of gross margin of wheat in the drought-prone state of Rajasthan. We argue that flexibility in land use is an important coping strategy to rainfall variability in water stressed regions. PMID:26934389

Long-term follow-up and salvage surgery in patients with T2N0M0 squamous cell carcinoma of the glottic larynx who received concurrent chemoradiation therapy with carboplatin (CBDCA) - AUC 1.5 vs AUC 2.0.

PubMed

Furusaka, Tohru; Matsuda, Hiroshi; Saito, Tsutomu; Katsura, Yoshihisa; Ikeda, Minoru

2012-11-01

Patients who received concurrent chemoradiation therapy with carboplatin were followed up on a long-term basis. In 25 patients treated with carboplatin at an AUC of 2.0 mg/ml, the complete response (CR), 10-year survival, and 10-year larynx preservation rates were 96.0%, 91.1%, and 75.2%, respectively, and the safety margin for partial laryngectomy was 4 mm from the gross tumor. To perform long-term follow-up of the therapeutic outcomes of concurrent chemoradiation therapy and salvage surgery to determine the additive and synergistic effects of anticancer drugs combined with chemoradiotherapy. Fifty male patients (aged 33-76 years) with untreated T2N0M0 squamous cell carcinoma of the glottic larynx were included. Carboplatin was intravenously administered once a week for 4 weeks. Radiotherapy was delivered by an external beam of 4 MV linac X-ray (total = 66 Gy). The AUC 1.5 combination group showed overall response, CR, 5-year survival, 10-year survival, 5-year larynx preservation, and 10-year larynx preservation rates of 100.0%, 68.0%, 83.4%, 77.0%, 75.2%, and 75.2%, respectively. The AUC 2.0 combination group showed corresponding rates of 100%, 96.0%, 95.7%, 91.1%, 82.9%, and 72.7%, respectively. The most common side effects of grade 3 or more were leukopenia, neutropenia, and mucositis (stomatitis), and all were reversible. Thirteen patients (52.0%) in the AUC 1.5 combination group and nine patients (36.0%) in the AUC 2.0 combination group required salvage surgery. Histologically, concurrent chemoradiation therapy with carboplatin caused more severe cancer tissue degeneration. Pathological examinations indicated that the safety margin for partial laryngectomy was 4 mm from the gross tumor.

Computerized margin and texture analyses for differentiating bacterial pneumonia and invasive mucinous adenocarcinoma presenting as consolidation.

PubMed

Koo, Hyun Jung; Kim, Mi Young; Koo, Ja Hwan; Sung, Yu Sub; Jung, Jiwon; Kim, Sung-Han; Choi, Chang-Min; Kim, Hwa Jung

2017-01-01

Radiologists have used margin characteristics based on routine visual analysis; however, the attenuation changes at the margin of the lesion on CT images have not been quantitatively assessed. We established a CT-based margin analysis method by comparing a target lesion with normal lung attenuation, drawing a slope to represent the attenuation changes. This approach was applied to patients with invasive mucinous adenocarcinoma (n = 40) or bacterial pneumonia (n = 30). Correlations among multiple regions of interest (ROIs) were obtained using intraclass correlation coefficient (ICC) values. CT visual assessment, margin and texture parameters were compared for differentiating the two disease entities. The attenuation and margin parameters in multiple ROIs showed excellent ICC values. Attenuation slopes obtained at the margins revealed a difference between invasive mucinous adenocarcinoma and pneumonia (P<0.001), and mucinous adenocarcinoma produced a sharply declining attenuation slope. On multivariable logistic regression analysis, pneumonia had an ill-defined margin (odds ratio (OR), 4.84; 95% confidence interval (CI), 1.26-18.52; P = 0.02), ground-glass opacity (OR, 8.55; 95% CI, 2.09-34.95; P = 0.003), and gradually declining attenuation at the margin (OR, 12.63; 95% CI, 2.77-57.51, P = 0.001). CT-based margin analysis method has a potential to act as an imaging parameter for differentiating invasive mucinous adenocarcinoma and bacterial pneumonia.

What is the best surgical margin for a Basal cell carcinoma: a meta-analysis of the literature.

PubMed

Gulleth, Yusuf; Goldberg, Nelson; Silverman, Ronald P; Gastman, Brian R

2010-10-01

Current management of basal cell carcinoma is surgical excision. Most resections use predetermined surgical margins. The basis of ideal resection margins is almost completely from retrospective data and mainly from small case series. This article presents a systematic analysis from a large pool of data to provide a better basis of determining ideal surgical margin. A systematic analysis was performed on data from 89 articles from a larger group of 973 articles selected from the PubMed database. Relevant inclusion and exclusion criteria were applied to all articles reviewed and the data were entered into a database for statistical analysis. The total number of lesions analyzed was 16,066; size ranged from 3 to 30 mm (mean, 11.7 ± 5.9 mm). Surgical margins ranged from 1 to 10 mm (mean, 3.9 ± 1.4 mm). Negative surgical margins ranged 45 to 100 percent (mean, 86 ± 12 percent). Recurrence rates for 5-, 4-, 3-, and 2-mm surgical margins were 0.39, 1.62, 2.56, and 3.96 percent, respectively. Pooled data for incompletely excised margins have an average recurrence rate of 27 percent. A 3-mm surgical margin can be safely used for nonmorpheaform basal cell carcinoma to attain 95 percent cure rates for lesions 2 cm or smaller. A positive pathologic margin has an average recurrence rate of 27 percent.

Whole blood analysis rotor assembly having removable cellular sedimentation bowl

DOEpatents

Burtis, C.A.; Johnson, W.F.

1975-08-26

A rotor assembly for performing photometric analyses using whole blood samples is described. Following static loading of a gross blood sample within a centrally located, removable, cell sedimentation bowl, the red blood cells in the gross sample are centrifugally separated from the plasma, the plasm displaced from the sedimentation bowl, and measured subvolumes of plasma distributed to respective sample analysis cuvettes positioned in an annular array about the rotor periphery. Means for adding reagents to the respective cuvettes are also described. (auth)

Prospective Analysis of Surgical Bone Margins After Partial Foot Amputation in Diabetic Patients Admitted With Moderate to Severe Foot Infections.

PubMed

Schmidt, Brian M; McHugh, Jonathan B; Patel, Rajiv M; Wrobel, James S

2018-04-01

Osteomyelitis is common in diabetic foot infections and medical management can lead to poor outcomes. Surgical management involves sending histopathologic and microbiologic specimens which guides future intervention. We examined the effect of obtainment of surgical margins in patients undergoing forefoot amputations to identify patient characteristics associated with outcomes. Secondary aims included evaluating interobserver reliability of histopathologic data at both the distal-to and proximal-to surgical bone margin. Data were prospectively collected on 72 individuals and was pooled for analysis. Standardized method to retrieve intraoperative bone margins was established. A univariate analysis was performed. Negative outcomes, including major lower extremity amputation, wound dehiscence, reulceration, reamputation, or death were recorded. Viable proximal margins were obtained in 63 out of 72 cases (87.5%). Strong interobserver reliability of histopathology was recorded. Univariate analysis demonstrated preoperative platelets, albumin, probe-to-bone testing, absolute toe pressures, smaller wound surface area were associated with obtaining viable margins. Residual osteomyelitis resulted in readmission 2.6 times more often and more postoperative complications. Certain patients were significantly different in the viable margin group versus dirty margin group. High interobserver reliability was demonstrated. Obtainment of viable margins resulted in reduced rates of readmission and negative outcomes. Prognostic, Level I: Prospective.

Analysis of System Margins on Missions Utilizing Solar Electric Propulsion

NASA Technical Reports Server (NTRS)

Oh, David Y.; Landau, Damon; Randolph, Thomas; Timmerman, Paul; Chase, James; Sims, Jon; Kowalkowski, Theresa

2008-01-01

NASA's Jet Propulsion Laboratory has conducted a study focused on the analysis of appropriate margins for deep space missions using solar electric propulsion (SEP). The purpose of this study is to understand the links between disparate system margins (power, mass, thermal, etc.) and their impact on overall mission performance and robustness. It is determined that the various sources of uncertainty and risk associated with electric propulsion mission design can be summarized into three relatively independent parameters 1) EP Power Margin, 2) Propellant Margin and 3) Duty Cycle Margin. The overall relationship between these parameters and other major sources of uncertainty is presented. A detailed trajectory analysis is conducted to examine the impact that various assumptions related to power, duty cycle, destination, and thruster performance including missed thrust periods have on overall performance. Recommendations are presented for system margins for deep space missions utilizing solar electric propulsion.

Material and energy recovery in integrated waste management systems: the potential for energy recovery.

PubMed

Consonni, Stefano; Viganò, Federico

2011-01-01

This article is part of a set of six coordinated papers reporting the main findings of a research project carried out by five Italian universities on "Material and energy recovery in Integrated Waste Management Systems (IWMS)". An overview of the project and a summary of the most relevant results can be found in the introductory article of the series. This paper describes the work related to the evaluation of mass and energy balances, which has consisted of three major efforts (i) development of a model for quantifying the energy content and the elemental compositions of the waste streams appearing in a IWMS; (ii) upgrade of an earlier model to predict the performances of Waste-to-Energy (WtE) plants; (iii) evaluation of mass and energy balances of all the scenarios and the recovery paths considered in the project. Results show that not only the amount of material available for energy recovery is significantly higher than the Unsorted Residual Waste (URW) left after Separate Collection (SC), because selection and recycling generate significant amounts of residues, but its heating value is higher than that of the original, gross waste. Therefore, the energy potential of what is left after recycling is always higher than the complement to 100% of the Source Separation Level (SSL). Also, increasing SSL has marginal effects on the potential for energy recovery: nearly doubling SSL (from 35% to 65%) reduces the energy potential only by one fourth. Consequently, even at high SSL energy recovery is a fundamental step of a sustainable waste management system. Variations of SSL do bring about variations of the composition, heating value and moisture content of the material fed to WtE plants, but these variations (i) are smaller than one can expect; (ii) have marginal effects on the performances of the WtE plant. These considerations suggest that the mere value of SSL is not a good indicator of the quality of the waste management system, nor of its energy and environmental outcome. Given the well-known dependence of the efficiency of steam power plants with their power output, the efficiency of energy recovery crucially depends on the size of the IWMS served by the WtE plant. A fivefold increase of the amount of gross waste handled in the IWMS (from 150,000 to 750,000 tons per year of gross waste) allows increasing the electric efficiencies of the WtE plant by about 6-7 percentage points (from 21-23% to 28.5% circa). Copyright © 2011 Elsevier Ltd. All rights reserved.

Close Margins Less Than 2 mm Are Not Associated With Higher Risks of 10-Year Local Recurrence and Breast Cancer Mortality Compared With Negative Margins in Women Treated With Breast-Conserving Therapy.

PubMed

Tyler, Susan; Truong, Pauline T; Lesperance, Mary; Nichol, Alan; Baliski, Chris; Warburton, Rebecca; Tyldesley, Scott

2018-03-13

The 2014 Society of Surgical Oncology-American Society for Radiation Oncology consensus suggested "no ink on tumor" is a sufficient surgical margin for invasive breast cancer treated with breast-conserving surgery (BCS). Whether close margins <2 mm are associated with inferior outcomes remains controversial. This study evaluated 10-year outcomes by margin status in a population-based cohort treated with BCS and adjuvant radiation therapy (RT). The subjects were 10,863 women with invasive cancer categorized as pT1 to T3, any N, and M0 referred from 2001 to 2011, an era in which the institutional policy was to re-excise close or positive margins, except in select cases. All women underwent BCS and whole-breast RT with or without boost RT. Local recurrence (LR) and breast cancer-specific survival (BCSS) were examined using competing-risk analysis in cohorts with negative (≥2 mm; n = 9241, 85%), close (<2 mm; n = 1310, 12%), or positive (tumor touching ink; n = 312, 3%) margins. Multivariable analysis and matched-pair analysis were performed. The median follow-up period was 8 years. Systemic therapy was used in 87% of patients. Boost RT was used in 34.1%, 76.9%, and 79.5% of patients with negative, close, and positive margins, respectively. In the negative, close, and positive margin cohorts, the 10-year cumulative incidence of LR was 1.8%, 2.0%, and 1.1%, respectively (P = .759). Corresponding BCSS estimates were 93.9%, 91.8%, and 87.9%, respectively (P < .001). On multivariable analysis, close margins were not associated with increased LR (hazard ratio, 1.25; 95% confidence interval 0.79-1.97; P = .350) or reduced BCSS (hazard ratio, 1.25; 95% confidence interval 0.98-1.58, P = .071) relative to negative margins. On matched-pair analysis, close margin cases had similar LR (P = .114) and BCSS (P = .100) to negative margin controls. Select cases with close or positive margins in this population-based analysis had similar LR and BCSS to cases with negative margins. While these findings do not endorse omitting re-excision for all cases, the data support a policy of accepting carefully selected cases with close margins for adjuvant RT without re-excision. Copyright © 2018 Elsevier Inc. All rights reserved.

Inter- and intra-observer variation in soft-tissue sarcoma target definition.

PubMed

Roberge, D; Skamene, T; Turcotte, R E; Powell, T; Saran, N; Freeman, C

2011-08-01

To evaluate inter- and intra-observer variability in gross tumor volume definition for adult limb/trunk soft tissue sarcomas. Imaging studies of 15 patients previously treated with preoperative radiation were used in this study. Five physicians (radiation oncologists, orthopedic surgeons and a musculoskeletal radiologist) were asked to contour each of the 15 tumors on T1-weighted, gadolinium-enhanced magnetic resonance images. These contours were drawn twice by each physician. The volume and center of mass coordinates for each gross tumor volume were extracted and a Boolean analysis was performed to measure the degree of volume overlap. The median standard deviation in gross tumor volumes across observers was 6.1% of the average volume (range: 1.8%-24.9%). There was remarkably little variation in the 3D position of the gross tumor volume center of mass. For the 15 patients, the standard deviation of the 3D distance between centers of mass ranged from 0.06 mm to 1.7 mm (median 0.1mm). Boolean analysis demonstrated that 53% to 90% of the gross tumor volume was common to all observers (median overlap: 79%). The standard deviation in gross tumor volumes on repeat contouring was 4.8% (range: 0.1-14.4%) with a standard deviation change in the position of the center of mass of 0.4mm (range: 0mm-2.6mm) and a median overlap of 93% (range: 73%-98%). Although significant inter-observer differences were seen in gross tumor volume definition of adult soft-tissue sarcoma, the center of mass of these volumes was remarkably consistent. Variations in volume definition did not correlate with tumor size. Radiation oncologists should not hesitate to review their contours with a colleague (surgeon, radiologist or fellow radiation oncologist) to ensure that they are not outliers in sarcoma gross tumor volume definition. Protocols should take into account variations in volume definition when considering tighter clinical target volumes. Copyright © 2011 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Disease Extent at Secondary Cytoreductive Surgery is Predictive of Progression-free and Overall Survival in Advanced Stage Ovarian Cancer: an NRG Oncology/Gynecologic Oncology Group study

PubMed Central

Rose, Peter G.; Java, James J.; Morgan, Mark A.; Secord, Angeles Alvarez; Kesterson, Joshua P.; Stehman, Frederick B.; Warshal, David P.; Creasman, William T.; Hanjani, Parviz; Morris, Robert T.; Copeland, Larry J.

2017-01-01

Purpose GOG 152 was a randomized trial of secondary cytoreductive surgery (SCS) in patients with suboptimal residual disease (residual tumor nodule >1 cm in greatest diameter) following primary cytoreductive surgery for advanced stage ovarian cancer. The current analysis was undertaken to evaluate the impact of disease findings at SCS on progression-free survival (PFS) and overall survival (OS). Methods Among the 550 patients enrolled on GOG-152, two-hundred-sixteen patients were randomly assigned following 3 cycles of cisplatin and paclitaxel to receive SCS. In 15 patients (7%) surgery was declined or contraindicated. In the remaining 201 patients the operative and pathology reports were utilized to classify their disease status at the beginning of SCS as; no gross disease/microscopically negative N= 40 (19.9%), no gross disease/microscopically positive N= 8 (4.0%), and gross disease N=153 (76.1%). Results The median PFS for patients with no gross disease/microscopically negative was 16.1 months, no gross disease/microscopically positive was 13.5 months and for gross disease was 11.7 months, p=0.002. The median OS for patients with no gross disease/microscopically negative was 51.5 months, no gross disease/microscopically positive was 42.6 months and for gross disease was 34.9 months, p=0.018. Conclusion Although as previously reported SCS did not change PFS or OS, for those who underwent the procedure, their operative and pathologic findings were predictive of PFS and OS. Surgical/pathological residual disease is a biomarker of response to chemotherapy and predictive of PFS and OS. PMID:27692669

The Prognostic Value of Varying Definitions of Positive Resection Margin in Patients with Colorectal Cancer Liver Metastases.

PubMed

Wang, Jane; Margonis, Georgios Antonios; Amini, Neda; Andreatos, Nikolaos; Yuan, Chunhui; Damaskos, Christos; Antoniou, Efstathios; Garmpis, Nikolaos; Buettner, Stefan; Barbon, Carlotta; Deshwar, Amar; He, Jin; Burkhart, Richard; Pawlik, Timothy M; Wolfgang, Christopher L; Weiss, Matthew J

2018-04-09

Varying definitions of resection margin clearance are currently employed among patients with colorectal cancer liver metastases (CRLM). Specifically, a microscopically positive margin (R1) has alternatively been equated with an involved margin (margin width = 0 mm) or a margin width < 1 mm. Consequently, patients with a margin width of 0-1 mm (sub-mm) are inconsistently classified in either the R0 or R1 categories, thus obscuring the prognostic implications of sub-mm margins. Six hundred thirty-three patients who underwent resection of CRLM were identified. Both R1 definitions were alternatively employed and multivariable analysis was used to determine the predictive power of each definition, as well as the prognostic implications of a sub-mm margin. Five hundred thirty-nine (85.2%) patients had a margin width ≥ 1 mm, 42 had a sub-mm margin width, and 52 had an involved margin (0 mm). A margin width ≥ 1 mm was associated with improved survival vs. a sub-mm margin (65 vs. 36 months; P = 0.03) or an involved margin (65 vs. 33 months; P < 0.001). No significant difference in survival was detected between patients with involved vs. sub-mm margins (P = 0.31). A sub-mm margin and an involved margin were both independent predictors of worse OS (HR 1.66, 1.04-2.67; P = 0.04, and HR 2.14, 1.46-3.16; P < 0.001, respectively) in multivariable analysis. Importantly, after combining the two definitions, patients with either an involved margin or a sub-mm margin were associated with worse OS in multivariable analysis (HR 1.94, 1.41-2.65; P < 0.001). Patients with involved or sub-mm margins demonstrated a similar inferior OS vs. patients with a margin width > 1 mm. Consequently, a uniform definition of R1 as a margin width < 1 mm should perhaps be employed by future studies.

[Formaldehyde-reducing efficiency of a newly developed dissection-table-connected local ventilation system in the gross anatomy laboratory room].

PubMed

Shinoda, Koh; Oba, Jun

2010-03-01

In compliance with health and safety management guidelines against harmful formaldehyde (FA) levels in the gross anatomy laboratory, we newly developed a dissection-table-connected local ventilation system in 2006. The system was composed of (1) a simple plenum-chambered dissection table with low-cost filters, (2) a transparent vinyl flexible duct for easy mounting and removal, which connects the table and the exhaust pipe laid above the ceiling, and (3) an intake creating a downward-flow of air, which was installed on the ceiling just above each table. The dissection table was also designed as a separate-component system, of which the upper plate and marginal suction inlets can be taken apart for cleaning after dissection, and equipped with opening/closing side-windows for picking up materials dropped during dissection and a container underneath the table to receive exudate from the cadaver through a waste-fluid pipe. The local ventilation system dramatically reduced FA levels to 0.01-0.03 ppm in the gross anatomy laboratory room, resulting in no discomforting FA smell and irritating sensation while preserving the student's view of room and line of flow as well as solving the problems of high maintenance cost, sanitation issues inside the table, and working-inconvenience during dissection practice. Switching ventilation methods or power-modes, the current local ventilation system was demonstrated to be more than ten times efficient in FA reduction compared to the whole-room ventilation system and suggested that 11 m3/min/table in exhaust volume should decrease FA levels in both A- and B-measurements to less than 0.1 ppm in 1000 m3 space containing thirty-one 3.5%-FA-fixed cadavers.

Policy Innovation and Tertiary Education Graduation Rates: A Cross-Country Analysis

ERIC Educational Resources Information Center

Delaney, Jennifer A.; Yu, Patricia

2013-01-01

This study extends Trow's theory of higher education development to examine changes in national-level tertiary education graduation rates. Applying Trow's framework we arrive at three stages: (1) elite systems with gross tertiary graduation rates less than 15%, (2) massified systems with gross tertiary graduation rates between 15% and 50%, and (3)…

Parametric sensitivity analysis of an agro-economic model of management of irrigation water

NASA Astrophysics Data System (ADS)

El Ouadi, Ihssan; Ouazar, Driss; El Menyari, Younesse

2015-04-01

The current work aims to build an analysis and decision support tool for policy options concerning the optimal allocation of water resources, while allowing a better reflection on the issue of valuation of water by the agricultural sector in particular. Thus, a model disaggregated by farm type was developed for the rural town of Ait Ben Yacoub located in the east Morocco. This model integrates economic, agronomic and hydraulic data and simulates agricultural gross margin across in this area taking into consideration changes in public policy and climatic conditions, taking into account the competition for collective resources. To identify the model input parameters that influence over the results of the model, a parametric sensitivity analysis is performed by the "One-Factor-At-A-Time" approach within the "Screening Designs" method. Preliminary results of this analysis show that among the 10 parameters analyzed, 6 parameters affect significantly the objective function of the model, it is in order of influence: i) Coefficient of crop yield response to water, ii) Average daily gain in weight of livestock, iii) Exchange of livestock reproduction, iv) maximum yield of crops, v) Supply of irrigation water and vi) precipitation. These 6 parameters register sensitivity indexes ranging between 0.22 and 1.28. Those results show high uncertainties on these parameters that can dramatically skew the results of the model or the need to pay particular attention to their estimates. Keywords: water, agriculture, modeling, optimal allocation, parametric sensitivity analysis, Screening Designs, One-Factor-At-A-Time, agricultural policy, climate change.

Reduction of Net Erosion of High-Z Divertor Surface by Local Redeposition in DIII-D

NASA Astrophysics Data System (ADS)

Stangeby, P. C.

2012-10-01

Utilizing the unique capability to expose material samples to well characterized diverted plasmas, recent DIII-D measurements have confirmed theoretical expectations of the relative net and gross erosion rates of molybdenum in the divertor region. Knowledge of these erosion rates is important for predicting first wall lifetime in future fusion devices. Theory suggests that the net erosion rate will be much less than gross erosion due to prompt local deposition of eroded ions by gyro-orbit motion, the strong E-field toward the target and friction with the fast plasma flow toward the target. However, experimental evidence to date has been contradictory. The results here, which are the most definitive to date, are consistent with the basic theoretical predictions. The net and gross erosion rates were measured utilizing 1-cm and 1-mm diameter Mo samples that are mounted on the DIII-D Divertor Material Evaluation System (DiMES) system and simultaneously exposed near the attached outer strike point of an L-mode plasma for 4 s. Due to the spatial extent of the re-deposition, the larger sample gives the net erosion while the smaller sample is indicative of the gross erosion. Post-mortem ion beam analysis (RBS) of the larger sample, indicates a 2.9 nm film thickness reduction (or 0.72 nm/s net erosion rate). Similar analysis of the smaller sample yields a 1.3 nm/s gross erosion rate, consistent with spectroscopic measurements of Mo I emission. The net to gross erosion ratio of 0.56 is consistent with calculations using a modeling package including REDEP/WBS and OEDGE codes. Using as input the measured plasma density and temperature profiles from divertor Langmuir probes, these codes estimate a net to gross erosion ratio of 0.46. Details of the modeling and implications for future devices will be discussed.

Effects of genotype and population density on growth performance, carcass characteristics, and cost-benefits of broiler chickens in north central Nigeria.

PubMed

Yakubu, Abdulmojeed; Ayoade, John A; Dahiru, Yakubu M

2010-04-01

The influence of genotype and stocking densities on growth performance, carcass qualities, and cost-benefits of broilers were examined in a 28-day trial. Two hundred and seven 4-week-old birds each of Anak Titan and Arbor Acre hybrid broiler types were randomly assigned to three stocking density treatments of 8.3, 11.1, and 14.3 birds/m(2) in a 2 x 3 factorial arrangement. Final body weight, average weekly body weight and average weekly feed intake were affected (P < 0.05) by strain, with higher means recorded for Arbor Acres. However, average weekly body weight gain and feed conversion ratio were similar (P > 0.05) in both genetic groups. The effect of placement density on some growth parameters did not follow a linear trend. Arbor Acres had significantly (P < 0.05) higher relative (%) fasted body, carcass, back, neck, and wing weights compared to Anak Titans. Housing density effect (P < 0.05) was observed for relative (%) fasted body, shank, and wing weights of birds. However, the relative weights of visceral organs of birds were not significantly (P > 0.05) influenced by genotype and housing density. The economic analysis revealed that higher gross margin was recorded for Arbor Acres compared to Anak Titans (euro 2.76 versus euro 2.19; P < 0.05, respectively). Conversely, stocking rate did not exert any influence (P > 0.05) on profit margin. Genotype x stocking density interaction effect was significant for some of the carcass indices investigated. It is concluded that under sub-humid conditions of a tropical environment, the use of Arbor Acre genetic type as well as a placement density of 14.3 birds/m(2) appeared to be more profitable.

Local control after intensity-modulated radiotherapy for head-and-neck rhabdomyosarcoma.

PubMed

Curtis, Amarinthia E; Okcu, M Fatih; Chintagumpala, Murali; Teh, Bin S; Paulino, Arnold C

2009-01-01

To examine the patterns of failure in patients treated with intensity-modulated radiotherapy (IMRT) for head-and-neck rhabdomyosarcoma (RMS). Between 1998 and 2005, 19 patients with a diagnosis of head-and-neck RMS received IMRT at The Methodist Hospital. There were 11 male and 8 female patients, with a median age of 6 years at time of irradiation. Tumor location was parameningeal in 7, orbital in 6, and other head-and-neck RMS in 6. Chemotherapy was given to all patients, with vincristine, actinomycin D, and cyclophosphamide being the most common regimen (n = 18). The median prescribed dose was 5040 cGy. The clinical target volume included the gross tumor volume with a 1.5-cm margin. The median duration of follow-up for surviving patients was 56 months. The 4-year overall survival and local control rates were 76% and 92.9%, respectively. One patient developed a local failure in the high-dose region of the radiation field; there were no marginal failures. Distant metastasis was seen in 4 patients. Overall survival was 42.9% for parameningeal sites and 100% for other sites (p < 0.01). Late toxicities were seen in 7 patients. Two secondary malignancies occurred in 1 child with embryonal RMS of the face and a p53 mutation. Local control was excellent in patients receiving IMRT for head-and-neck RMS. Patterns of local failure reveal no marginal failures in this group of patients.

Gross mismatch between thermal tolerances and environmental temperatures in a tropical freshwater snail: climate warming and evolutionary implications.

PubMed

Polgar, Gianluca; Khang, Tsung Fei; Chua, Teddy; Marshall, David J

2015-01-01

The relationship between acute thermal tolerance and habitat temperature in ectotherm animals informs about their thermal adaptation and is used to assess thermal safety margins and sensitivity to climate warming. We studied this relationship in an equatorial freshwater snail (Clea nigricans), belonging to a predominantly marine gastropod lineage (Neogastropoda, Buccinidae). We found that tolerance of heating and cooling exceeded average daily maximum and minimum temperatures, by roughly 20°C in each case. Because habitat temperature is generally assumed to be the main selective factor acting on the fundamental thermal niche, the discordance between thermal tolerance and environmental temperature implies trait conservation following 'in situ' environmental change, or following novel colonisation of a thermally less-variable habitat. Whereas heat tolerance could relate to an historical association with the thermally variable and extreme marine intertidal fringe zone, cold tolerance could associate with either an ancestral life at higher latitudes, or represent adaptation to cooler, higher-altitudinal, tropical lotic systems. The broad upper thermal safety margin (difference between heat tolerance and maximum environmental temperature) observed in this snail is grossly incompatible with the very narrow safety margins typically found in most terrestrial tropical ectotherms (insects and lizards), and hence with the emerging prediction that tropical ectotherms, are especially vulnerable to environmental warming. A more comprehensive understanding of climatic vulnerability of animal ectotherms thus requires greater consideration of taxonomic diversity, ecological transition and evolutionary history. Copyright © 2014 Elsevier Ltd. All rights reserved.

The relationship between spasticity and gross motor capability in nonambulatory children with spastic cerebral palsy.

PubMed

Katusic, Ana; Alimovic, Sonja

2013-09-01

Spasticity has been considered as a major impairment in cerebral palsy (CP), but the relationship between this impairment and motor functions is still unclear, especially in the same group of patients with CP. The aim of this investigation is to determine the relationship between spasticity and gross motor capability in nonambulatory children with spastic CP. Seventy-one children (30 boys, 41 girls) with bilateral spastic cerebral palsy and with Gross Motor Function Classification System (GMFCS) levels IV (n=34) and V (n=37) were included in the study. The spasticity level in lower limbs was evaluated using the Modified Modified Ashworth Scale and the gross motor function with the Gross Motor Function Measure (GMFM-88). Spearman's correlation analysis was used to determine the nature and the strength of the relationship. The results showed a moderate correlation between spasticity and gross motor skills (ρ=0.52 for the GMFCS level; ρ=0.57 for the GMFM-88), accounting for less than 30% of the explained variance. It seems that spasticity is just one factor among many others that could interfere with gross motor skills, even in children with severe forms of spastic CP. Knowledge of the impact of spasticity on motor skills may be useful in the setting of adequate rehabilitation strategies for nonambulatory children with spastic CP.

Tracheal reconstruction with autogenous jejunal microsurgical transfer.

PubMed

Jones, R E; Morgan, R F; Marcella, K L; Mills, S E; Kron, I L

1986-06-01

Tracheal defects due to stricture formation, tracheomalacia, and neoplasms can present difficult reconstructive problems. Tracheal defects were surgically created in 6 dogs and primarily reconstructed with microsurgical free tissue transfer of autogenous jejunal segments. Primary healing was accomplished in all dogs without severe air leakage or infection. Bronchoscopy demonstrated no substantial secretions or tracheal narrowing. Gross pathological examination of the trachea revealed no evidence of tracheal disruption or infection. Direct measurements revealed no major tracheal narrowing. Microscopic examination demonstrated normal jejunal mucosa with a minimal amount of inflammatory change at the margins of the reconstruction at 6 weeks. Microvascular free tissue transfer of jejunal segments to correct cervical tracheal defects can readily be accomplished with excellent healing and maintenance of the tracheal lumen in dogs.

Gross hematuria and urinary retention among men from a nationally representative survey in Sierra Leone.

PubMed

Patel, Hiten D; Kamara, Thaim B; Kushner, Adam L; Groen, Reinou S; Allaf, Mohamad E

2014-06-01

To estimate the prevalence of gross hematuria and urinary retention among men in Sierra Leone and report on barriers to care and associated disability. Gross hematuria and urinary retention are classic urologic complaints that require medical attention for significant underlying pathology, but their burden has not been quantified in a developing country. A cluster randomized, cross-sectional household survey was administered in Sierra Leone using the Surgeons OverSeas Assessment of Surgical need tool as a verbal head-to-toe examination. A total of 2 respondents in each of 25 households in 75 clusters were surveyed to assess surgical needs. Data on questions related to blood from the penis and the inability to urinate for men>12 years were included in the present analysis to determine the period and point prevalence of hematuria and urinary retention. From 3645 total respondents, 1054 (28.9%) were men>12 years included in the analysis. Period and point prevalence of gross hematuria were 21.8 per 1000 (95% confidence interval [CI] 13.0-30.7) and 12.3 per 1000 (95% CI 5.7-19.0), respectively, and for urinary retention, they were 19.9 per 1000 (95% CI 11.5-28.4) and 4.7 per 1000 (95% CI 0.5-8.9), respectively. Lack of financial resources was the major barrier to care. Disability assessment showed 19.1% were not able to work as a result of urinary retention, and 34.8% felt ashamed of their gross hematuria. The results provide a prevalence estimate of gross hematuria and urinary retention for men in Sierra Leone. Accessible medical and surgical care will be critical for early intervention and management. Copyright © 2014 Elsevier Inc. All rights reserved.

NDARC NASA Design and Analysis of Rotorcraft - Input, Appendix 4

NASA Technical Reports Server (NTRS)

Johnson, Wayne

2016-01-01

The NDARC code performs design and analysis tasks. The design task involves sizing the rotorcraft to satisfy specified design conditions and missions. The analysis tasks can include off-design mission performance analysis, flight performance calculation for point operating conditions, and generation of subsystem or component performance maps. The principal tasks (sizing, mission analysis, flight performance analysis) are shown in the figure as boxes with heavy borders. Heavy arrows show control of subordinate tasks. The aircraft description consists of all the information, input and derived, that denes the aircraft. The aircraft consists of a set of components, including fuselage, rotors, wings, tails, and propulsion. This information can be the result of the sizing task; can come entirely from input, for a fixed model; or can come from the sizing task in a previous case or previous job. The aircraft description information is available to all tasks and all solutions. The sizing task determines the dimensions, power, and weight of a rotorcraft that can perform a specified set of design conditions and missions. The aircraft size is characterized by parameters such as design gross weight, weight empty, rotor radius, and engine power available. The relations between dimensions, power, and weight generally require an iterative solution. From the design flight conditions and missions, the task can determine the total engine power or the rotor radius (or both power and radius can be fixed), as well as the design gross weight, maximum takeoff weight, drive system torque limit, and fuel tank capacity. For each propulsion group, the engine power or the rotor radius can be sized. Missions are defined for the sizing task, and for the mission performance analysis. A mission consists of a number of mission segments, for which time, distance, and fuel burn are evaluated. For the sizing task, certain missions are designated to be used for design gross weight calculations; for transmission sizing; and for fuel tank sizing. The mission parameters include mission takeoff gross weight and useful load. For specified takeoff fuel weight with adjustable segments, the mission time or distance is adjusted so the fuel required for the mission equals the takeoff fuel weight. The mission iteration is on fuel weight or energy. Flight conditions are specified for the sizing task, and for the flight performance analysis. For the sizing task, certain flight conditions are designated to be used for design gross weight calculations; for transmission sizing; for maximum takeoff weight calculations; and for anti-torque or auxiliary thrust rotor sizing. The flight condition parameters include gross weight and useful load. For flight conditions and mission takeoff, the gross weight can be maximized, such that the power required equals the power available. A flight state is defined for each mission segment and each flight condition. The aircraft performance can be analyzed for the specified state, or a maximum effort performance can be identified. The maximum effort is specified in terms of a quantity such as best endurance or best range, and a variable such as speed, rate of climb, or altitude.

The Impact of Taxes on Competition for CEOs

PubMed Central

Krenn, Peter

2017-01-01

Abstract This paper contributes to the question of how taxation of corporate profits and wages affects competition among firms for highly skilled human resources such as CEOs. Use of a theoretical model shows that wage taxes can have a substantial impact on the outcome of such a competition if marginal tax rates are different as in an international labor market. Further, the paper shows that increasing the wage tax rate unilaterally can have an ambiguous effect on observed gross compensation levels. However, in a local labor market for CEOs, observed gross fixed salaries should decline in the wage tax rate. Tax effects in a market for CEOs is a particularly interesting topic because recent developments with respect to compensation practices of top-level managers have opened a public debate about the use of instruments for regulating compensation of those managers. Furthermore, many countries around the world use tax incentives in order to facilitate immigration of highly skilled human resources. The investigation follows an analytical economics-based approach by extending an LEN model with elements of competition for scarce human resources and income taxation. It investigates the impact of differential taxation on the competition between two firms for the exclusive service of a unique, highly skilled CEO. PMID:29097851

Abutment Disconnection/Reconnection Affects Peri-implant Marginal Bone Levels: A Meta-Analysis.

PubMed

Koutouzis, Theofilos; Gholami, Fatemeh; Reynolds, John; Lundgren, Tord; Kotsakis, Georgios A

Preclinical and clinical studies have shown that marginal bone loss can be secondary to repeated disconnection and reconnection of abutments that affect the peri-implant mucosal seal. The aim of this systematic review and meta-analysis was to evaluate the impact of abutment disconnections/reconnections on peri-implant marginal bone level changes. To address this question, two reviewers independently performed an electronic search of three major databases up to October 2015 complemented by manual searches. Eligible articles were selected on the basis of prespecified inclusion and exclusion criteria after a two-phase search strategy and assessed for risk of bias. A random-effects meta-analysis was performed for marginal bone loss. The authors initially identified 392 titles and abstracts. After evaluation, seven controlled clinical studies were included. Qualitative assessment of the articles revealed a trend toward protective marginal bone level preservation for implants with final abutment placement (FAP) at the time of implant placement compared with implants for which there were multiple abutment placements (MAP). The FAP group exhibited a marginal bone level change ranging from 0.08 to 0.34 mm, whereas the MAP group exhibited a marginal bone level change ranging from 0.09 to 0.55 mm. Meta-analysis of the seven studies reporting on 396 implants showed significantly greater bone loss in cases of multiple abutment disconnections/reconnections. The weighted mean difference in marginal bone loss was 0.19 mm (95% confidence interval, 0.06-0.32 mm), favoring bone preservation in the FAP group. Within the limitations of this meta-analysis, abutment disconnection and reconnection significantly affected peri-implant marginal bone levels. These findings pave the way for revisiting current restorative protocols at the restorative treatment planning stage to prevent incipient marginal bone loss.

[Planning of esthetic oral rehabilitation according to correlative analysis of clinical and morphological features of the marginal gingiva].

PubMed

Stafeev, A A; Zinov'ev, G I; Drozdov, D D

2015-01-01

The orthopedic restoration and related to its clinical stages (preparation, gingival retraction, impression) is often associated with complications which arise from the marginal gingiva. The technology of indirect ceramic restoration requires an assessment of the clinical and morphological parameters of periodontal tissues. The study outlines correlation between the type of periodontal histhology and inflammatory and degenerative complications that has been established after the analysis of morphofunctional state of periodontal tissue. Results of clinical studies and correlation analysis of clinical and morphological parameters of marginal gingiva has shown that important parameter influencing the choice of manufacturing technology are the position of restoration margin relatively to marginal gingiva and periodontal morphotype.

Immunohistochemistry Analysis of CD44, EGFR, and p16 in Oral Cavity and Oropharyngeal Squamous Cell Carcinoma.

PubMed

Cohen, Erin R; Reis, Isildinha M; Gomez, Carmen; Pereira, Lutecia; Freiser, Monika E; Hoosien, Gia; Franzmann, Elizabeth J

2017-08-01

Objectives We analyze the relationship between CD44, epidermal growth factor receptor (EGFR), and p16 expression in oral cavity and oropharyngeal cancers in a diverse population. We also describe whether particular patterns of staining are associated with progression-free survival and overall survival. Study Design Prospective study, single-blind to pathologist and laboratory technologist. Setting Hospital based. Subjects and Methods Immunohistochemistry, comprising gross staining and cellular expression, was performed and interpreted in a blinded fashion on 24 lip/oral cavity and 40 oropharyngeal cancer specimens collected between 2007 and 2012 from participants of a larger study. Information on overall survival and progression-free survival was obtained from medical records. Results Nineteen cases were clinically p16 positive, 16 of which were oropharyngeal. Oral cavity lesions were more likely to exhibit strong CD44 membrane staining ( P = .0002). Strong CD44 membrane and strong EGFR membrane and/or cytoplasmic staining were more common in p16-negative cancers ( P = .006). Peripheral/mixed gross p16 staining pattern was associated with worse survival than the universal staining on univariate and multivariate analyses ( P = .006, P = .030). This held true when combining gross and cellular localization for p16. For CD44, universal gross staining demonstrated poorer overall survival compared with the peripheral/mixed group ( P = .039). CD44 peripheral/mixed group alone and when combined with universal p16 demonstrated the best survival on multivariate analysis ( P = .010). Conclusion In a diverse population, systematic analysis applying p16, CD44, and EGFR gross staining and cellular localization on immunohistochemistry demonstrates distinct patterns that may have prognostic potential exceeding current methods. Larger studies are warranted to investigate these findings further.

GTX Reference Vehicle Structural Verification Methods and Weight Summary

NASA Technical Reports Server (NTRS)

Hunter, J. E.; McCurdy, D. R.; Dunn, P. W.

2002-01-01

The design of a single-stage-to-orbit air breathing propulsion system requires the simultaneous development of a reference launch vehicle in order to achieve the optimal mission performance. Accordingly, for the GTX study a 300-lb payload reference vehicle was preliminary sized to a gross liftoff weight (GLOW) of 238,000 lb. A finite element model of the integrated vehicle/propulsion system was subjected to the trajectory environment and subsequently optimized for structural efficiency. This study involved the development of aerodynamic loads mapped to finite element models of the integrated system in order to assess vehicle margins of safety. Commercially available analysis codes were used in the process along with some internally developed spread-sheets and FORTRAN codes specific to the GTX geometry for mapping of thermal and pressure loads. A mass fraction of 0.20 for the integrated system dry weight has been the driver for a vehicle design consisting of state-of-the-art composite materials in order to meet the rigid weight requirements. This paper summarizes the methodology used for preliminary analyses and presents the current status of the weight optimization for the structural components of the integrated system.

GTX Reference Vehicle Structural Verification Methods and Weight Summary

NASA Technical Reports Server (NTRS)

Hunter, J. E.; McCurdy, D. R.; Dunn, P. W.

2002-01-01

The design of a single-stage-to-orbit air breathing propulsion system requires the simultaneous development of a reference launch vehicle in order to achieve the optimal mission performance. Accordingly, for the GTX study a 300-lb payload reference vehicle was preliminarily sized to a gross liftoff weight (GLOW) of 238,000 lb. A finite element model of the integrated vehicle/propulsion system was subjected to the trajectory environment and subsequently optimized for structural efficiency. This study involved the development of aerodynamic loads mapped to finite element models of the integrated system in order to assess vehicle margins of safety. Commercially available analysis codes were used in the process along with some internally developed spreadsheets and FORTRAN codes specific to the GTX geometry for mapping of thermal and pressure loads. A mass fraction of 0.20 for the integrated system dry weight has been the driver for a vehicle design consisting of state-of-the-art composite materials in order to meet the rigid weight requirements. This paper summarizes the methodology used for preliminary analyses and presents the current status of the weight optimization for the structural components of the integrated system.

Economic Performance and Sustainability of a Novel Intercropping System on the North China Plain

PubMed Central

Huang, Chengdong; Liu, Quanqing; Heerink, Nico; Stomph, TjeerdJan; Li, Baoshen; Liu, Ruili; Zhang, Hongyan; Wang, Chong; Li, Xiaolin; Zhang, Chaochun; van der Werf, Wopke; Zhang, Fusuo

2015-01-01

Double cropping of wheat and maize is common on the North China Plain, but it provides limited income to rural households due to the small farm sizes in the region. Local farmers in Quzhou County have therefore innovated their production system by integration of watermelon as a companion cash crop into the system. We examine the economic performance and sustainability of this novel intercropping system using crop yield data from 2010 to 2012 and farm household survey data collected in 2012. Our results show that the gross margin of the intercropping system exceeded that of the double cropping system by more than 50% in 2012. Labor use in the intercropping system was more than three times that in double cropping. The lower returns per labor hour in intercropping, however, exceeded the average off-farm wage in the region by a significant margin. Nutrient surpluses and irrigation water use are significant larger under the intercropping system. We conclude that the novel wheat-maize/watermelon intercropping system contributes to rural poverty alleviation and household-level food security, by raising farm incomes and generating more employment, but needs further improvement to enhance its sustainability. PMID:26275297

Economic Performance and Sustainability of a Novel Intercropping System on the North China Plain.

PubMed

Huang, Chengdong; Liu, Quanqing; Heerink, Nico; Stomph, TjeerdJan; Li, Baoshen; Liu, Ruili; Zhang, Hongyan; Wang, Chong; Li, Xiaolin; Zhang, Chaochun; van der Werf, Wopke; Zhang, Fusuo

2015-01-01

Double cropping of wheat and maize is common on the North China Plain, but it provides limited income to rural households due to the small farm sizes in the region. Local farmers in Quzhou County have therefore innovated their production system by integration of watermelon as a companion cash crop into the system. We examine the economic performance and sustainability of this novel intercropping system using crop yield data from 2010 to 2012 and farm household survey data collected in 2012. Our results show that the gross margin of the intercropping system exceeded that of the double cropping system by more than 50% in 2012. Labor use in the intercropping system was more than three times that in double cropping. The lower returns per labor hour in intercropping, however, exceeded the average off-farm wage in the region by a significant margin. Nutrient surpluses and irrigation water use are significant larger under the intercropping system. We conclude that the novel wheat-maize/watermelon intercropping system contributes to rural poverty alleviation and household-level food security, by raising farm incomes and generating more employment, but needs further improvement to enhance its sustainability.

Economic Implications of Widespread Expansion of Frozen Section Margin Analysis to Guide Surgical Resection in Women With Breast Cancer Undergoing Breast-Conserving Surgery.

PubMed

Boughey, Judy C; Keeney, Gary L; Radensky, Paul; Song, Christine P; Habermann, Elizabeth B

2016-04-01

In the current health care environment, cost effectiveness is critically important in policy setting and care of patients. This study performed a health economic analysis to assess the implications to providers and payers of expanding the use of frozen section margin analysis to minimize reoperations for patients undergoing breast cancer lumpectomy. A health care economic impact model was built to assess annual costs associated with breast lumpectomy procedures with and without frozen section margin analysis to avoid reoperation. If frozen section margin analysis is used in 20% of breast lumpectomies and under a baseline assumption that 35% of initial lumpectomies without frozen section analysis result in reoperations, the potential annual cost savings are $18.2 million to payers and $0.4 million to providers. Under the same baseline assumption, if 100% of all health care facilities adopted the use of frozen section margin analysis for breast lumpectomy procedures, the potential annual cost savings are $90.9 million to payers and $1.8 million to providers. On the basis of 10,000 simulations, use of intraoperative frozen section margin analysis yields cost saving for payers and is cost neutral to slightly cost saving for providers. This economic analysis indicates that widespread use of frozen section margin evaluation intraoperatively to guide surgical resection in breast lumpectomy cases and minimize reoperations would be beneficial to cost savings not only for the patient but also for payers and, in most cases, for providers. Copyright © 2016 by American Society of Clinical Oncology.

Xp11.2 translocation tumor: a rare cause of gross hematuria.

PubMed

Asaki, Howard E; Moshero, Gianni; Stanton, Melissa L; Humphreys, Mitchell R

2014-02-01

Xp11.2 translocation tumor is a rare but aggressive form of renal cell carcinoma that predominantly occurs in children but also may be found in young adults. Because this type of cancer is diagnosed via histologic and chromosomal analysis, clinicians should consider translocation tumor in the differential diagnosis of patients with renal lesions and gross hematuria.

Statistical uncertainty of eddy flux-based estimates of gross ecosystem carbon exchange at Howland Forest, Maine

Treesearch

S.C. Hagen; B.H. Braswell; E. Linder; S. Frolking; A.D. Richardson; David Hollinger. D.Y; Hollinger. D.Y

2006-01-01

We present an uncertainty analysis of gross ecosystem carbon exchange (GEE) estimates derived from 7 years of continuous eddy covariance measurements of forest atmosphere CO2 fluxes at Howland Forest, Maine, USA. These data, which have high temporal resolution, can be used to validate process modeling analyses, remote sensing assessments, and field surveys. However,...

Groundwater nitrate contamination: Factors and indicators

PubMed Central

Wick, Katharina; Heumesser, Christine; Schmid, Erwin

2012-01-01

Identifying significant determinants of groundwater nitrate contamination is critical in order to define sensible agri-environmental indicators that support the design, enforcement, and monitoring of regulatory policies. We use data from approximately 1200 Austrian municipalities to provide a detailed statistical analysis of (1) the factors influencing groundwater nitrate contamination and (2) the predictive capacity of the Gross Nitrogen Balance, one of the most commonly used agri-environmental indicators. We find that the percentage of cropland in a given region correlates positively with nitrate concentration in groundwater. Additionally, environmental characteristics such as temperature and precipitation are important co-factors. Higher average temperatures result in lower nitrate contamination of groundwater, possibly due to increased evapotranspiration. Higher average precipitation dilutes nitrates in the soil, further reducing groundwater nitrate concentration. Finally, we assess whether the Gross Nitrogen Balance is a valid predictor of groundwater nitrate contamination. Our regression analysis reveals that the Gross Nitrogen Balance is a statistically significant predictor for nitrate contamination. We also show that its predictive power can be improved if we account for average regional precipitation. The Gross Nitrogen Balance predicts nitrate contamination in groundwater more precisely in regions with higher average precipitation. PMID:22906701

A method for identifying EMI critical circuits during development of a large C3

NASA Astrophysics Data System (ADS)

Barr, Douglas H.

The circuit analysis methods and process Boeing Aerospace used on a large, ground-based military command, control, and communications (C3) system are described. This analysis was designed to help identify electromagnetic interference (EMI) critical circuits. The methodology used the MIL-E-6051 equipment criticality categories as the basis for defining critical circuits, relational database technology to help sort through and account for all of the approximately 5000 system signal cables, and Macintosh Plus personal computers to predict critical circuits based on safety margin analysis. The EMI circuit analysis process systematically examined all system circuits to identify which ones were likely to be EMI critical. The process used two separate, sequential safety margin analyses to identify critical circuits (conservative safety margin analysis, and detailed safety margin analysis). These analyses used field-to-wire and wire-to-wire coupling models using both worst-case and detailed circuit parameters (physical and electrical) to predict circuit safety margins. This process identified the predicted critical circuits that could then be verified by test.

Multivariate Analysis, Retrieval, and Storage System (MARS). Volume 6: MARS System - A Sample Problem (Gross Weight of Subsonic Transports)

NASA Technical Reports Server (NTRS)

Hague, D. S.; Woodbury, N. W.

1975-01-01

The Mars system is a tool for rapid prediction of aircraft or engine characteristics based on correlation-regression analysis of past designs stored in the data bases. An example of output obtained from the MARS system, which involves derivation of an expression for gross weight of subsonic transport aircraft in terms of nine independent variables is given. The need is illustrated for careful selection of correlation variables and for continual review of the resulting estimation equations. For Vol. 1, see N76-10089.

Calorimetric analysis of fungal degraded wood

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

Blankenhorn, P.R.; Baldwin, R.C.; Merrill, W. Jr.

1980-01-01

Endothermic transition and gross heat of combustion of aspenwood subjected to degradation by Lenzites trabea and Polyporus versicolor were determined by using differential scanning calorimetry (DSC) and an adiabatic O bomb. Endothermic peak areas of undegraded and fungi-degraded wood differed from each other at all levels of weight loss. The regression analysis of the DSC data vs. weight loss revealed a significant relations, although not highly correlated, for P. versicolor-degraded specimens and a nonsignificant relation for L. trabea-degraded specimens; weight loss and gross heat of combustion values of degraded specimens were significantly correlated.

Analysis of the crime scene model using three objects from the collection of the Hans Gross Museum of Criminology of the University of Graz.

PubMed

Elek, Lydia

2016-01-01

As part of the collection in the Hans Gross Museum of Criminology in Graz there are still three crime scene reliefs; two of which were made by Hans Gross himself. The practical purpose of these criminal landscape models is something one could speculate about, but such models may have been useful in two fields: in the criminal lab and in the courtroom. To see the reliefs in a scientific experimental context as well as under the aspects of artwork and topography is as essential as emphasizing their genuine military character.

Applied Time Domain Stability Margin Assessment for Nonlinear Time-Varying Systems

NASA Technical Reports Server (NTRS)

Kiefer, J. M.; Johnson, M. D.; Wall, J. H.; Dominguez, A.

2016-01-01

The baseline stability margins for NASA's Space Launch System (SLS) launch vehicle were generated via the classical approach of linearizing the system equations of motion and determining the gain and phase margins from the resulting frequency domain model. To improve the fidelity of the classical methods, the linear frequency domain approach can be extended by replacing static, memoryless nonlinearities with describing functions. This technique, however, does not address the time varying nature of the dynamics of a launch vehicle in flight. An alternative technique for the evaluation of the stability of the nonlinear launch vehicle dynamics along its trajectory is to incrementally adjust the gain and/or time delay in the time domain simulation until the system exhibits unstable behavior. This technique has the added benefit of providing a direct comparison between the time domain and frequency domain tools in support of simulation validation. This technique was implemented by using the Stability Aerospace Vehicle Analysis Tool (SAVANT) computer simulation to evaluate the stability of the SLS system with the Adaptive Augmenting Control (AAC) active and inactive along its ascent trajectory. The gains for which the vehicle maintains apparent time-domain stability defines the gain margins, and the time delay similarly defines the phase margin. This method of extracting the control stability margins from the time-domain simulation is relatively straightforward and the resultant margins can be compared to the linearized system results. The sections herein describe the techniques employed to extract the time-domain margins, compare the results between these nonlinear and the linear methods, and provide explanations for observed discrepancies. The SLS ascent trajectory was simulated with SAVANT and the classical linear stability margins were evaluated at one second intervals. The linear analysis was performed with the AAC algorithm disabled to attain baseline stability margins. At each time point, the system was linearized about the current operating point using Simulink's built-in solver. Each linearized system in time was evaluated for its rigid-body gain margin (high frequency gain margin), rigid-body phase margin, and aero gain margin (low frequency gain margin) for each control axis. Using the stability margins derived from the baseline linearization approach, the time domain derived stability margins were determined by executing time domain simulations in which axis-specific incremental gain and phase adjustments were made to the nominal system about the expected neutral stability point at specific flight times. The baseline stability margin time histories were used to shift the system gain to various values around the zero margin point such that a precise amount of expected gain margin was maintained throughout flight. When assessing the gain margins, the gain was applied starting at the time point under consideration, thereafter following the variation in the margin found in the linear analysis. When assessing the rigid-body phase margin, a constant time delay was applied to the system starting at the time point under consideration. If the baseline stability margins were correctly determined via the linear analysis, the time domain simulation results should contain unstable behavior at certain gain and phase values. Examples will be shown from repeated simulations with variable added gain and phase lag. Faithfulness of margins calculated from the linear analysis to the nonlinear system will be demonstrated.

Validating the Rett Syndrome Gross Motor Scale.

PubMed

Downs, Jenny; Stahlhut, Michelle; Wong, Kingsley; Syhler, Birgit; Bisgaard, Anne-Marie; Jacoby, Peter; Leonard, Helen

2016-01-01

Rett syndrome is a pervasive neurodevelopmental disorder associated with a pathogenic mutation on the MECP2 gene. Impaired movement is a fundamental component and the Rett Syndrome Gross Motor Scale was developed to measure gross motor abilities in this population. The current study investigated the validity and reliability of the Rett Syndrome Gross Motor Scale. Video data showing gross motor abilities supplemented with parent report data was collected for 255 girls and women registered with the Australian Rett Syndrome Database, and the factor structure and relationships between motor scores, age and genotype were investigated. Clinical assessment scores for 38 girls and women with Rett syndrome who attended the Danish Center for Rett Syndrome were used to assess consistency of measurement. Principal components analysis enabled the calculation of three factor scores: Sitting, Standing and Walking, and Challenge. Motor scores were poorer with increasing age and those with the p.Arg133Cys, p.Arg294* or p.Arg306Cys mutation achieved higher scores than those with a large deletion. The repeatability of clinical assessment was excellent (intraclass correlation coefficient for total score 0.99, 95% CI 0.93-0.98). The standard error of measurement for the total score was 2 points and we would be 95% confident that a change 4 points in the 45-point scale would be greater than within-subject measurement error. The Rett Syndrome Gross Motor Scale could be an appropriate measure of gross motor skills in clinical practice and clinical trials.

The role of adjuvant treatment in early-stage oral cavity squamous cell carcinoma: An international collaborative study.

PubMed

Fridman, Eran; Na'ara, Shorook; Agarwal, Jaiprakash; Amit, Moran; Bachar, Gideon; Villaret, Andrea Bolzoni; Brandao, Jose; Cernea, Claudio R; Chaturvedi, Pankaj; Clark, Jonathan; Ebrahimi, Ardalan; Fliss, Dan M; Jonnalagadda, Sashikanth; Kohler, Hugo F; Kowalski, Luiz P; Kreppel, Matthias; Liao, Chun-Ta; Patel, Snehal G; Patel, Raj P; Robbins, K Thomas; Shah, Jatin P; Shpitzer, Thomas; Yen, Tzu-Chen; Zöller, Joachim E; Gil, Ziv

2018-05-14

Up to half of patients with oral cavity squamous cell carcinoma (OCSCC) have stage I to II disease. When adequate resection is attained, no further treatment is needed; however, re-resection or radiotherapy may be indicated for patients with positive or close margins. This multicenter study evaluated the outcomes and role of adjuvant treatment in patients with stage I to II OCSCC. Overall survival (OS), disease-specific survival, local-free survival, and disease-free survival rates were calculated with Kaplan-Meier analysis. Of 1257 patients with T1-2N0M0 disease, 33 (2.6%) had positive margins, and 205 (16.3%) had close margins. The 5-year OS rate was 80% for patients with clear margins, 52% for patients with close margins, and 63% for patients with positive margins (P < .0001). In a multivariate analysis, age, depth of invasion, and margins were independent predictors of outcome. Close margins were associated with a >2-fold increase in the risk of recurrence (P < .0001). The multivariate analysis revealed that adjuvant treatment significantly improved the outcomes of patients with close/positive margins (P = .002 to .03). Patients with stage I to II OCSCC and positive/close margins have poor long-term outcomes. For this population, adjuvant treatment may be associated with improved survival. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Robot-assisted radical prostatectomy: Multiparametric MR imaging-directed intraoperative frozen-section analysis to reduce the rate of positive surgical margins.

PubMed

Petralia, Giuseppe; Musi, Gennaro; Padhani, Anwar R; Summers, Paul; Renne, Giuseppe; Alessi, Sarah; Raimondi, Sara; Matei, Deliu V; Renne, Salvatore L; Jereczek-Fossa, Barbara A; De Cobelli, Ottavio; Bellomi, Massimo

2015-02-01

To investigate whether use of multiparametric magnetic resonance (MR) imaging-directed intraoperative frozen-section (IFS) analysis during nerve-sparing robot-assisted radical prostatectomy reduces the rate of positive surgical margins. This retrospective analysis of prospectively acquired data was approved by an institutional ethics committee, and the requirement for informed consent was waived. Data were reviewed for 134 patients who underwent preoperative multiparametric MR imaging (T2 weighted, diffusion weighted, and dynamic contrast-material enhanced) and nerve-sparing robot-assisted radical prostatectomy, during which IFS analysis was used, and secondary resections were performed when IFS results were positive for cancer. Control patients (n = 134) matched for age, prostate-specific antigen level, and stage were selected from a pool of 322 patients who underwent nerve-sparing robot-assisted radical prostatectomy without multiparametric MR imaging and IFS analysis. Rates of positive surgical margins were compared by means of the McNemar test, and a multivariate conditional logistic regression model was used to estimate the odds ratio of positive surgical margins for patients who underwent MR imaging and IFS analysis compared with control subjects. Eighteen patients who underwent MR imaging and IFS analysis underwent secondary resections, and 13 of these patients were found to have negative surgical margins at final pathologic examination. Positive surgical margins were found less frequently in the patients who underwent MR imaging and IFS analysis than in control patients (7.5% vs 18.7%, P = .01). When the differences in risk factors are taken into account, patients who underwent MR imaging and IFS had one-seventh the risk of having positive surgical margins relative to control patients (adjusted odds ratio: 0.15; 95% confidence interval: 0.04, 0.61). The significantly lower rate of positive surgical margins compared with that in control patients provides preliminary evidence of the positive clinical effect of multiparametric MR imaging-directed IFS analysis for patients who undergo prostatectomy. © RSNA, 2014.

H. Pylori as a predictor of marginal ulceration: A nationwide analysis.

PubMed

Schulman, Allison R; Abougergi, Marwan S; Thompson, Christopher C

2017-03-01

Helicobacter pylori has been implicated as a risk factor for development of marginal ulceration following gastric bypass, although studies have been small and yielded conflicting results. This study sought to determine the relationship between H. pylori infection and development of marginal ulceration following bariatric surgery in a nationwide analysis. This was a retrospective cohort study using the 2012 Nationwide Inpatient Sample (NIS) database. Discharges with ICD-9-CM code indicating marginal ulceration and a secondary ICD-9-CM code for bariatric surgery were included. Primary outcome was incidence of marginal ulceration. A stepwise forward selection model was used to build the multivariate logistic regression model based on known risk factors. A P value of 0.05 was considered significant. There were 253,765 patients who met inclusion criteria. Prevalence of marginal ulceration was 3.90%. Of those patients found to have marginal ulceration, 31.20% of patients were H. pylori-positive. Final multivariate regression analysis revealed that H. pylori was the strongest independent predictor of marginal ulceration. H. pylori is an independent predictor of marginal ulceration using a large national database. Preoperative testing for and eradication of H. pylori prior to bariatric surgery may be an important preventive measure to reduce the incidence of ulcer development. © 2017 The Obesity Society.

Relationship between Gross Motor Capacity and Daily-Life Mobility in Children with Cerebral Palsy

ERIC Educational Resources Information Center

Smits, Dirk-Wouter; Gorter, Jan Willem; Ketelaar, Marjolijn; van Schie, Petra Em; Dallmeijer, Annet J.; Lindeman, Eline; Jongmans, Marian J.

2010-01-01

Aim: The aim of this study was to examine the relationship between gross motor capacity and daily-life mobility in children with cerebral palsy (CP) and to explore the moderation of this relationship by the severity of CP. Method: Cross-sectional analysis in a cohort study with a clinic-based sample of children with CP (n=116; 76 males, 40…

Macroscopic Rotator Cuff Tendinopathy and Histopathology Do Not Predict Repair Outcomes of Rotator Cuff Tears.

PubMed

Sethi, Paul M; Sheth, Chirag D; Pauzenberger, Leo; McCarthy, Mary Beth R; Cote, Mark P; Soneson, Emma; Miller, Seth; Mazzocca, Augustus D

2018-03-01

Numerous studies have identified factors that may affect the chances of rotator cuff healing after surgery. Intraoperative tendon quality may be used to predict healing and to determine type of repair and/or consideration of augmentation. There are no data that correlate how gross tendon morphology and degree of tendinopathy affect patient outcome or postoperative tendon healing. Purpose/Hypothesis: The purposes of this study were to (1) compare the gross appearance of the tendon edge during arthroscopic rotator cuff repair with its histological degree of tendinopathy and (2) determine if gross appearance correlated with postoperative repair integrity. The hypothesis was that gross (macroscopic) tendon with normal thickness, no delamination, and elastic tissue before repair would have a correlation with low Bonar scores, higher postoperative American Shoulder and Elbow Surgeons (ASES) scores, and increased rates of postoperative tendon healing on ultrasound. Cross-sectional study; Level of evidence, 3. A total of 105 patients undergoing repair of medium-size (1-3 cm) full-thickness rotator cuff tears were enrolled in the study. Intraoperatively, the supraspinatus tendon was rated on thickness, fraying, and stiffness. Tendon tissue was recovered for histological analysis based on the Bonar scoring system. Postoperative ASES and ultrasound assessment of healing were obtained 1 year after repair. Correlation between gross appearance of the tendon and rotator cuff histology was determined. Of the 105 patients, 85 were followed the study to completion. The mean age of the patients was 61.6 years; Bonar score, 7.5; preoperative ASES score, 49; and postoperative ASES score, 86. Ninety-one percent of repairs were intact on ultrasound. Gross appearance of torn rotator cuff tendon tissue did not correlate with histological appearance. Neither histological (Bonar) score nor gross appearance correlated with multivariate analysis of ASES score, postoperative repair status, or demographic data. The degree of tendinopathy did not correlate with morphological appearance of the tendon. Neither of these parameters correlated with healing or patient outcome. This study suggests that the degree of tendinopathy, unlike muscle atrophy, may not be predictive of outcomes and that, on appearance, poor quality tendon has adequate healing capacity. Therefore, abnormal gross tendon appearance should not affect the repair effort or technique.

Copula Multivariate analysis of Gross primary production and its hydro-environmental driver; A BIOME-BGC model applied to the Antisana páramos

NASA Astrophysics Data System (ADS)

Minaya, Veronica; Corzo, Gerald; van der Kwast, Johannes; Galarraga, Remigio; Mynett, Arthur

2014-05-01

Simulations of carbon cycling are prone to uncertainties from different sources, which in general are related to input data, parameters and the model representation capacities itself. The gross carbon uptake in the cycle is represented by the gross primary production (GPP), which deals with the spatio-temporal variability of the precipitation and the soil moisture dynamics. This variability associated with uncertainty of the parameters can be modelled by multivariate probabilistic distributions. Our study presents a novel methodology that uses multivariate Copulas analysis to assess the GPP. Multi-species and elevations variables are included in a first scenario of the analysis. Hydro-meteorological conditions that might generate a change in the next 50 or more years are included in a second scenario of this analysis. The biogeochemical model BIOME-BGC was applied in the Ecuadorian Andean region in elevations greater than 4000 masl with the presence of typical vegetation of páramo. The change of GPP over time is crucial for climate scenarios of the carbon cycling in this type of ecosystem. The results help to improve our understanding of the ecosystem function and clarify the dynamics and the relationship with the change of climate variables. Keywords: multivariate analysis, Copula, BIOME-BGC, NPP, páramos

REPORT FOR COMMERCIAL GRADE NICKEL CHARACTERIZATION AND BENCHMARKING

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

None

2012-12-20

Oak Ridge Associated Universities (ORAU), under the Oak Ridge Institute for Science and Education (ORISE) contract, has completed the collection, sample analysis, and review of analytical results to benchmark the concentrations of gross alpha-emitting radionuclides, gross beta-emitting radionuclides, and technetium-99 in commercial grade nickel. This report presents methods, change management, observations, and statistical analysis of materials procured from sellers representing nine countries on four continents. The data suggest there is a low probability of detecting alpha- and beta-emitting radionuclides in commercial nickel. Technetium-99 was not detected in any samples, thus suggesting it is not present in commercial nickel.

Effectiveness of navigation-guided cyst aspiration before resection of large cystic brain tumors: a proof of concept for more radical surgery.

PubMed

Roh, Tae Hoon; Sung, Kyoung Su; Kang, Seok-Gu; Moon, Ju Hyung; Kim, Eui Hyun; Kim, Sun Ho; Chang, Jong Hee

2017-10-01

Resection of tumors close to the corticospinal tract (CST) carries a high risk of damage to the CST. For cystic tumors, aspirating the cyst before resection may reduce the risk of damage to vital structures. This study evaluated the effectiveness of cyst aspiration, by comparing the results before and after aspiration of diffusion tensor image (DTI) tractography. This study enrolled 23 patients with large cystic brain tumors (>20 cm 3 ) between 2012 and 2016. All underwent magnetic resonance imaging (MRI), including DTI tractography, followed by navigation-guided aspiration of the cyst and subsequent tumor resection via craniotomy. Distances between the tumor margin and CST before and after cyst aspiration, volume reduction, and postoperative outcomes were assessed. Median tumor volume decreased from 88 cm 3 (range, 25-153) to 29 cm 3 (range, 20-80) and distances between tumor margins and the CST increased from 5.7 mm (range, 0.6-22.0) to 14.8 mm (range, 0.6-41.4) after aspiration. Neurological symptoms of patients immediately improved after cyst aspiration. All patients, except for one with a secondary glioblastoma, underwent gross total resection of the tumor. No neurological deterioration was observed after tumor resection. Navigation-guided cyst aspiration followed by resection is a useful and safe procedure for brain tumors with large cystic components. Cyst aspiration resulted in expansion of the compressed brain tissue between the tumor margins and vital structures, making maximal safe resection possible.

One-millimeter cancer-free margin is curative for colorectal liver metastases: a propensity score case-match approach.

PubMed

Hamady, Zaed Z R; Lodge, J Peter A; Welsh, Fenella K; Toogood, Giles J; White, Alan; John, Timothy; Rees, Myrddin

2014-03-01

To investigate the influence of clear surgical resection margin width on disease recurrence rate after intentionally curative resection of colorectal liver metastases. There is consensus that a histological positive resection margin is a predictor of disease recurrence after resection of colorectal liver metastases. The dispute, however, over the width of cancer-free resection margin required is ongoing. Analysis of observational prospectively collected data for 2715 patients who underwent primary resection of colorectal liver metastases from 2 major hepatobiliary units in the United Kingdom. Histological cancer-free resection margin was classified as positive (if cancer cells present at less than 1 mm from the resection margin) or negative (if the distance between the cancer and the margin is 1 mm or more). The negative margin was further classified according to the distance from the tumor in millimeters. Predictors of disease-free survival were analyzed in univariate and multivariate analyses. A case-match analysis by a propensity score method was undertaken to reduce bias. A 1-mm cancer-free resection margin was sufficient to achieve 33% 5-year overall disease-free survival. Extra margin width did not add disease-free survival advantage (P > 0.05). After the propensity case-match analysis, there is no statistical difference in disease-free survival between patients with negative narrow and wider margin clearance [hazard ratio (HR) 1.0; 95% (confidence interval) CI: 0.9-1.2; P = 0.579 at 5-mm cutoff and HR 1.1; 95% CI: 0.96-1.3; P = 0.149 at 10-mm cutoff]. Patients with extrahepatic disease and positive lymph node primary tumor did not have disease-free survival advantage despite surgical margin clearance (9 months for <1-mm vs 12 months for ≥1-mm margin clearance; P = 0.062). One-mm cancer-free resection margin achieved in patients with colorectal liver metastases should now be considered the standard of care.

A Mid-IR Multivariate Analysis Study on the Gross Calorific Value in Longleaf Pine: Impact on Correlations with Lignin and Extractive Contents

Treesearch

Chi-Leung So; Thomas L. Eberhardt

2013-01-01

Twenty 70-year-old longleaf pine trees from a spacing, thinning, and pruning study were harvested, from which samples were analyzed for gross calorific value (GCV). A strong correlation was found between GCV and extractive contents for the unextracted wood samples. Although lignin content should impact GCV, no correlation was found between the variation in GCV with...

Concurrent validity between instruments of assessment of motor development in infants exposed to HIV.

PubMed

Siegle, Cristhina Bonilha Huster; Dos Santos Cardoso de Sá, Cristina

2018-02-01

Exposure to HIV during pregnancy is a risks to development. Exposed child should have assessed its development since birth. Alberta Infant Motor Scale is a tool which assess gross motor skills, with easy application and low cost. Up to now, this scale had not proven its validity for the population exposed to HIV. It's necessary to compare its with a gold standard tool, Bayley scale, which assess gross and fine motor skills, has a high cost and longer application time required. Studies compare results of Alberta with Bayley's total motor score (gross + fine). However, it's also necessary to compare Alberta's result with only Bayley's gross motor result, because it's what both evaluate in common. to verify the concurrent validity of AIMS in infants exposed to HIV; to verify the correlation of AIMS and BSITD III for this population and to compare if these coefficients differ in the central age groups and extremities of the AIMS. 82 infants exposed to HIV evaluated in 1st, 2nd, 3rd, 4th, 8th, 12th, 15th, 16th, 17th and 18th months, with Alberta Infant Motor Scale and Bayley Scale (motor subscale). For analysis of concurrent validity, results of raw scores of the scales were compared with the correlation analysis. First analysis: Alberta's score with Bayley's total (gross + fine) motor score. Second analysis: Alberta's score with Bayley's gross motor score. In the first correlation analysis, results were: r = 0.62 in 1 st month, r = 0.64 in 2nd month, r = 0.08 in 3rd month, r = 0.45 in 4th month; r = 0.62 in 8th month, r = 0.60 in the 12th month. In the second correlation analysis, results were: r = 0.69 in 1 st month; r = 0.58 in 2nd month; r = 0.25 in 3rd month; r = 0.45 in the 4th month; r = 0.77 in 8th month; r = 0.73 in 12th month. Analyzes of the 15th, 16th, 17th and 18th months couldn't be performed because at these ages all the children had already reached the maximum score in the AIMS. Results were significant and indicate correlation between scales. Found results agree with other studies that found high correlations between the scales in premature and risk groups. However, these studies compare results of gross motor skills assessments with gross and fine motor skills assessments. Our results show that correlation only between the gross motor skills have higher coefficient values, and we believe this is the best way to compare the scales, with what both assessed in common. Alberta scale has correlation with Bayley scale in assessing of children exposed to HIV, and can be a substitute to Bayley in assessing of these children. Results are stronger when comparing only what both scales assess in common. Copyright © 2018 Elsevier Inc. All rights reserved.

Natural radionuclides in waste water discharged from coal-fired power plants in Serbia.

PubMed

Janković, Marija M; Todorović, Dragana J; Sarap, Nataša B; Krneta Nikolić, Jelena D; Rajačić, Milica M; Pantelić, Gordana K

2016-12-01

Investigation of the natural radioactivity levels in water around power plants, as well as in plants, coal, ash, slag and soil, and to assess the associated radiation hazard is becoming an emerging and interesting topic. This paper is focused on the results of the radioactivity analysis in waste water samples from five coal-fired power plants in Serbia (Nikola Tesla A, Nikola Tesla B, Kolubara, Morava and Kostolac), which were analyzed in the period 2003-2015. River water samples taken upstream and downstream from the power plants, drain water and overflow water were analyzed. In the water samples gamma spectrometry analysis was performed as well as determination of gross alpha and beta activity. Natural radionuclide 40 K was detected by gamma spectrometry, while the concentrations of other radionuclides, 226 Ra, 235 U and 238 U, usually were below the minimum detection activity (MDA). 232 Th and artificial radionuclide 137 Cs were not detected in these samples. Gross alpha and beta activities were determined by the α/β low level proportional counter Thermo Eberline FHT 770 T. In the analyzed samples, gross alpha activity ranged from MDA to 0.47 Bq L - 1 , while the gross beta activity ranged from MDA to 1.55 Bq L - 1 .

Municipal solid waste development phases: Evidence from EU27.

PubMed

Vujić, Goran; Gonzalez-Roof, Alvaro; Stanisavljević, Nemanja; Ragossnig, Arne M

2015-12-01

Many countries in the European Union (EU) have very developed waste management systems. Some of its members have managed to reduce their landfilled waste to values close to zero during the last decade. Thus, European Union legislation is very stringent regarding waste management for their members and candidate countries, too. This raises the following questions: Is it possible for developing and developed countries to comply with the European Union waste legislation, and under what conditions? How did waste management develop in relation to the economic development in the countries of the European Union? The correlation between waste management practices and economic development was analysed for 27 of the European Union Member States for the time period between 1995 and 2007. In addition, a regression analysis was performed to estimate landfilling of waste in relation to gross domestic product for every country. The results showed a strong correlation between the waste management variables and the gross domestic product of the EU27 members. The definition of the municipal solid waste management development phases followed a closer analysis of the relation between gross domestic product and landfilled waste. The municipal solid waste management phases are characterised by high landfilling rates at low gross domestic product levels, and landfilling rates near zero at high gross domestic product levels. Hence the results emphasize the importance of wider understanding of what is required for developing countries to comply with the European Union initiatives, and highlight the importance of allowing developing countries to make their own paths of waste management development. © The Author(s) 2015.

Supporting local farming communities and crop production resilience to climate change through giant reed (Arundo donax L.) cultivation: An Italian case study.

PubMed

Bonfante, A; Impagliazzo, A; Fiorentino, N; Langella, G; Mori, M; Fagnano, M

2017-12-01

Bioenergy crops are well known for their ability to reduce greenhouse gas emissions and increase the soil carbon stock. Although such crops are often held to be in competition with food crops and thus raise the question of current and future food security, at the same time mitigation measures are required to tackle climate change and sustain local farming communities and crop production. However, in some cases the actions envisaged for specific pedo-climatic conditions are not always economically sustainable by farmers. In this frame, energy crops with high environmental adaptability and yields, such as giant reed (Arundo donax L.), may represent an opportunity to improve farm incomes, making marginal areas not suitable for food production once again productive. In so doing, three of the 17 Sustainable Development Goals (SDGs) of the United Nations would be met, namely SDG 2 on food security and sustainable agriculture, SDG 7 on reliable, sustainable and modern energy, and SDG 13 on action to combat climate change and its impacts. In this work, the response of giant reed in the marginal areas of an agricultural district of southern Italy (Destra Sele) and expected farm incomes under climate change (2021-2050) are evaluated. The normalized water productivity index of giant reed was determined (WP; 30.1gm -2 ) by means of a SWAP agro-hydrological model, calibrated and validated on two years of a long-term field experiment. The model was used to estimate giant reed response (biomass yield) in marginal areas under climate change, and economic evaluation was performed to determine expected farm incomes (woodchips and chopped forage). The results show that woodchip production represents the most profitable option for farmers, yielding a gross margin 50% lower than ordinary high-input maize cultivation across the study area. Copyright © 2017 Elsevier B.V. All rights reserved.

Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation

PubMed Central

2012-01-01

Background To quantify the incidental irradiation dose to esophageal lymph node stations when irradiating T1-4N0M0 thoracic esophageal squamous cell carcinoma (ESCC) patients with a dose of 60 Gy/30f. Methods Thirty-nine patients with medically inoperable T1–4N0M0 thoracic ESCC were treated with three-dimensional conformal radiation (3DCRT) with involved-field radiation (IFI). The conformal clinical target volume (CTV) was re-created using a 3-cm margin in the proximal and distal direction beyond the barium esophagogram, endoscopic examination and CT scan defined the gross tumor volume (GTV) and a 0.5-cm margin in the lateral and anteroposterior directions of the CT scan-defined GTV. The PTV encompassed 1-cm proximal and distal margins and 0.5-cm radial margin based on the CTV. Nodal regions were delineated using the Japanese Society for Esophageal Diseases (JSED) guidelines and an EORTC-ROG expert opinion. The equivalent uniform dose (EUD) and other dosimetric parameters were calculated for each nodal station. Nodal regions with a metastasis rate greater than 5% were considered a high-risk lymph node subgroup. Results Under a 60 Gy dosage, the median Dmean and EUD was greater than 40 Gy in most high-risk nodal regions except for regions of 104, 106tb-R in upper-thoracic ESCC and 101, 104-R, 105, 106rec-L, 2, 3&7 in middle-thoracic ESCC and 107, 3&7 in lower-thoracic ESCC. In the regions with an EUD less than 40Gy, most incidental irradiation doses were significantly associated with esophageal tumor length and location. Conclusions Lymph node stations near ESCC receive considerable incidental irradiation doses with involved-field irradiation that may contribute to the elimination of subclinical lesions. PMID:23186308

Retrieval analysis of ceramic-coated metal-on-polyethylene total hip replacements.

PubMed

Khatkar, Harman; Hothi, Harry; de Villiers, Danielle; Lausmann, Christian; Kendoff, Daniel; Gehrke, Thorsten; Skinner, John; Hart, Alister

2017-06-01

Ceramic coatings have been used in metal-on-polyethylene (MOP) hips to reduce the risk of wear and also infection; the clinical efficacy of this remains unclear. This retrieval study sought to better understand the performance of coated bearing surfaces. Forty-three coated MOP components were analysed post-retrieval for evidence of coating loss and gross polyethylene wear. Coating loss was graded using a visual semi-quantitative protocol. Evidence of gross polyethylene wear was determined by radiographic analysis and visual inspection of the retrieved implants. All components with gross polyethylene wear (n = 10) were revised due to a malfunctioning acetabular component; 35 % (n = 15) of implants exhibited visible coating loss and the incidence of polyethylene wear in samples with coating loss was 54 %, significantly (p = 0.02) elevated compared to samples with intact coatings (14 %). In this study we found evidence of coating loss on metal femoral heads which was associated with increased wear of the corresponding polyethylene acetabular cups.

Treatment of salivary gland neoplasms with fast neutron radiotherapy.

PubMed

Douglas, James G; Koh, Wui-jin; Austin-Seymour, Mary; Laramore, George E

2003-09-01

To evaluate the efficacy of fast neutron radiotherapy for the treatment of salivary gland neoplasms. Retrospective analysis. University of Washington Cancer Center, Neutron Facility, Seattle. The medical records of 279 patients treated with curative intent using fast neutron radiotherapy at the University of Washington Cancer Center were reviewed. Of the 279 patients, 263 had evidence of gross residual disease at the time of treatment (16 had no evidence of gross residual disease), 141 had tumors of a major salivary gland, and 138 had tumors of minor salivary glands. The median follow-up period was 36 months (range, 1-142 months). Local-regional control, cause-specific survival, and freedom from metastasis. The 6-year actuarial cause-specific survival rate was 67%. Multivariate analysis revealed that low group stage (I-II) disease, minor salivary sites, lack of skull base invasion, and primary disease were associated with a statistically significant improvement in cause-specific survival. The 6-year actuarial local-regional control rate was 59%. Multivariate analysis revealed size 4 cm or smaller, lack of base of skull invasion, prior surgical resection, and no previous radiotherapy to have a statistically significant improved local-regional control. Sixteen patients without evidence of gross residual disease had a 100% 6-year actuarial local-regional control. The 6-year actuarial freedom from metastasis rate was 64%. Factors associated with decreased development of systemic metastases included negative lymph nodes at the time of treatment and lack of base of skull involvement. The 6-year actuarial rate of development of grade 3 or 4 long-term toxicity (using the Radiation Therapy Oncology Group and European Organization for Research on the Treatment of Cancer criteria) was 10%. No patient experienced grade 5 toxic effects. Neuron radiotherapy is an effective treatment for patients with salivary gland neoplasms who have gross residual disease and achieves excellent local-regional control in patients without evidence of gross disease.

Lithosphere structure and subsidence evolution of the conjugate S-African and Argentine margins

NASA Astrophysics Data System (ADS)

Dressel, Ingo; Scheck-Wenderoth, Magdalena; Cacace, Mauro; Götze, Hans-Jürgen; Franke, Dieter

2016-04-01

The bathymetric evolution of the South Atlantic passive continental margins is a matter of debate. Though it is commonly accepted that passive margins experience thermal subsidence as a result of lithospheric cooling as well as load induced subsidence in response to sediment deposition it is disputed if the South Atlantic passive margins were affected by additional processes affecting the subsidence history after continental breakup. We present a subsidence analysis along the SW African margin and offshore Argentina and restore paleobathymetries to assess the subsidence evolution of the margin. These results are discussed with respect to mechanisms behind margin evolution. Therefore, we use available information about the lithosphere-scale present-day structural configuration of these margins as a starting point for the subsidence analysis. A multi 1D backward modelling method is applied to separate individual subsidence components such as the thermal- as well as the load induced subsidence and to restore paleobathymetries for the conjugate margins. The comparison of the restored paleobathymetries shows that the conjugate margins evolve differently: Continuous subsidence is obtained offshore Argentina whereas the subsidence history of the SW African margin is interrupted by phases of uplift. This differing results for both margins correlate also with different structural configurations of the subcrustal mantle. In the light of these results we discuss possible implications for uplift mechanisms.

Outcomes in a series of 103 retroperitoneal sarcomas.

PubMed

Pierie, J-P E N; Betensky, R A; Choudry, U; Willett, C G; Souba, W W; Ott, M J

2006-12-01

To report the effect on outcome of selection in patients receiving intra-operative electron beam radiation (IOERT) and external beam radiation therapy (EBRT). One hundred and three patients treated for primary RS were studied. Median follow-up was 27 months. Clinical presentation, tumor characteristics, and treatment methods were analyzed to determine impact on survival and recurrence and if selection was occurring. Mean age was 55+/-17 years. Mean tumor size was 15+/-6cm and 88 were high-grade. Complete gross tumor resection (CR) occurred in 62 patients and improved survival vs. both debulking (p=0.0005) and biopsy (p<0.0001). The 5- and 10-year survival rates were 62% and 52% for those with CR vs. 29% and 20% after incomplete resection. Among the 62 CR patients, there was selection to receive additional EBRT+/-IOERT in patients with high-grade tumors (p=0.005) and/or microscopically positive margins (p=0.011). In these high-risk patients there was a trend for IOERT to further augment survival vs. EBRT alone and to increase the time to both local and distant recurrences (p=0.036). Complete gross resection is the primary form of curative treatment for retroperitoneal sarcomas. Selection led to patients with high-risk tumors receiving additional radiation therapy. There appears to be a beneficial effect of IOERT plus EBRT in these high-risk patients after complete tumor resection.

The productivity of small animal species in small-scale mixed farming systems in subtropical Bolivia.

PubMed

Paterson, R T; Joaquín, N; Chamón, K; Palomino, E

2001-02-01

The productivity of the scavenging, small animal species (chickens, ducks, pigs, hair sheep and guinea-pigs) commonly found on small-scale farms at the forest margin in subtropical Bolivia was monitored over a full year. Chickens and guinea-pigs were kept mainly for home consumption, while ducks and pigs were kept mainly for sale. Sheep served both purposes, depending upon the family requirements. In the absence of veterinary treatment, the productivity varied greatly between farms. Pigs gave the greatest gross return, but received the largest amount of supplementary feed. Under the existing system, chickens, ducks and sheep all gave similar gross returns per breeding female, although chickens produced good returns and made a large contribution to the family diet where the reproductive efficiency was high and the chick mortality was low. Mortality resulting from disease was a major problem in poultry, while internal parasites appeared to be important limiting factors in pigs and sheep. Guinea-pigs showed no major problems apart from theft, and were an important dietary component for immigrant families from the highlands of the country. Small animal species have largely been ignored by agricultural research and development activities in Bolivia and elsewhere. They currently make significant contributions to the livelihoods of poor people in terms of both income and food security, and this could be greatly increased by simple improvements in animal husbandry.

Modulation stability analysis of exact multidimensional solutions to the generalized nonlinear Schrödinger equation and the Gross-Pitaevskii equation using a variational approach.

PubMed

Petrović, Nikola Z; Aleksić, Najdan B; Belić, Milivoj

2015-04-20

We analyze the modulation stability of spatiotemporal solitary and traveling wave solutions to the multidimensional nonlinear Schrödinger equation and the Gross-Pitaevskii equation with variable coefficients that were obtained using Jacobi elliptic functions. For all the solutions we obtain either unconditional stability, or a conditional stability that can be furnished through the use of dispersion management.

Climate change impairs processes of soil and plant N cycling in European beech forests on marginal soil

NASA Astrophysics Data System (ADS)

Tejedor, Javier; Gasche, Rainer; Gschwendtner, Silvia; Leberecht, Martin; Bimüller, Carolin; Kögel-Knabner, Ingrid; Pole, Andrea; Schloter, Michael; Rennenberg, Heinz; Simon, Judy; Hanewinkel, Marc; Baltensweiler, Andri; Bilela, Silvija; Dannenmann, Michael

2014-05-01

Beech forests of Central Europe are covering large areas with marginal calcareous soils, but provide important ecological services and represent a significant economical value. The vulnerability of these ecosystems to projected climate conditions (higher temperatures, increase of extreme drought and precipitation events) is currently unclear. Here we present comprehensive data on the influence of climate change conditions on ecosystem performance, considering soil nitrogen biogeochemistry, soil microbiology, mycorrhiza ecology and plant physiology. We simultaneously quantified major plant and soil gross N turnover processes by homogenous triple 15N isotope labeling of intact beech natural regeneration-soil-microbe systems. This isotope approach was combined with a space for time climate change experiment, i.e. we transferred intact beech seedling-soil-microbe mesocosms from a slope with N-exposure (representing present day climate conditions) to a slope with S exposure (serving as a warmer and drier model climate for future conditions). Transfers within N slope served as controls. After an equilibration period of 1 year, three isotope labeling/harvest cycles were performed. Reduced soil water content resulted in a persistent decline of ammonia oxidizing bacteria in soil (AOB). Consequently, we found a massive five-fold reduction of gross nitrification in the climate change treatment and a subsequent strong decline in soil nitrate concentrations as well as nitrate uptake by microorganisms and beech. Because nitrate was the major nutrient for beech in this forest type with little importance of ammonium and amino acids, this resulted in a strongly reduced performance of beech natural regeneration with reduced N content, N metabolite concentrations and plant biomass. These findings provided an explanation for a large-scale decline of distribution of beech forests on calcareous soils in Europe by almost 80% until 2080 predicted by statistical modeling. Hence, we question the sustainability of such forests under projected climate change conditions, but also discuss potential mitigation and adaptation options. Important comment: The topic of this abstract is subject to a press embargo, because it is in review at a Nature Journal

Third-party reimbursement for generic prescription drugs: The prevalence of below-cost reimbursement in an environment of maximum allowable cost-based reimbursement.

PubMed

Murry, Logan; Gerleman, Brandon; Urick, Benjamin; Urmie, Julie

2018-05-31

To examine average prescription gross margin (GM) for prescriptions and to evaluate the prevalence of below-cost reimbursement for generic prescriptions across different third-party payers and therapeutic categories. A retrospective descriptive study using 2015 dispensing data from a single independently owned pharmacy in Iowa. To calculate GM, the pharmacy's actual acquisition cost was subtracted from the third-party reimbursement rate for each generic prescription. The frequency of negative GMs was calculated for the top 6 plans and the top 10 therapeutic categories by prescription volume. A single, independently owned community pharmacy in Iowa. Prescription dispensing records for the pharmacy's largest private and public payers by prescription volume. Gross margins were calculated on a payer and United States Pharmacopeia (USP) medication category level. GM for generic prescriptions reimbursed under cost for specific payers and USP medication categories. The 2015 prescription volume for the study pharmacy was 70,866 prescriptions, of which 88% were generic. For all prescriptions, the mean GM was $6.63 per prescription, and the median GM was $3.49 per prescription. Generic medications had a mean GM of $4.66 (median, $2.86), and brand name medications had a mean GM of $21.83 (median, $16.15). The percentage of generic prescriptions paid below acquisition cost was 15.1% overall and ranged from 4.1% for Iowa Medicaid to 25.9% for one of the private payers. The most common USP medication category by prescription volume was cardiovascular agents, representing 25.2% of generic prescriptions. For the 10.9% of these prescriptions reimbursed below cost, the mean GM was -$6.80. The 2 USP medication categories with the largest negative mean GM for generic prescriptions were analgesics and anticonvulsants, with mean GMs of -$10.10 and -$11.30, respectively. The current maximum allowable cost-based reimbursement system often results in inadequate payment for generic prescription drugs. The amount of underpayment varies substantially by payer and therapeutic class. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Assessing the spatial impact of climate on wheat productivity and the potential value of climate forecasts at a regional level

NASA Astrophysics Data System (ADS)

Wang, Enli; Xu, J.; Jiang, Q.; Austin, J.

2009-03-01

Quantification of the spatial impact of climate on crop productivity and the potential value of seasonal climate forecasts can effectively assist the strategic planning of crop layout and help to understand to what extent climate risk can be managed through responsive management strategies at a regional level. A simulation study was carried out to assess the climate impact on the performance of a dryland wheat-fallow system and the potential value of seasonal climate forecasts in nitrogen management in the Murray-Darling Basin (MDB) of Australia. Daily climate data (1889-2002) from 57 stations were used with the agricultural systems simulator (APSIM) to simulate wheat productivity and nitrogen requirement as affected by climate. On a good soil, simulated grain yield ranged from <2 t/ha in west inland to >7 t/ha in the east border regions. Optimal nitrogen rates ranged from <60 kgN/ha/yr to >200 kgN/ha/yr. Simulated gross margin was in the range of -20/ha to 700/ha, increasing eastwards. Wheat yield was closely related to rainfall in the growing season and the stored soil moisture at sowing time. The impact of stored soil moisture increased from southwest to northeast. Simulated annual deep drainage ranged from zero in western inland to >200 mm in the east. Nitrogen management, optimised based on ‘perfect’ knowledge of daily weather in the coming season, could add value of 26˜79/ha compared to management optimised based on historical climate, with the maximum occurring in central to western part of MDB. It would also reduce the nitrogen application by 5˜25 kgN/ha in the main cropping areas. Comparison of simulation results with the current land use mapping in MDB revealed that the western boundary of the current cropping zone approximated the isolines of 160 mm of growing season rainfall, 2.5t/ha of wheat grain yield, and 150/ha of gross margin in QLD and NSW. In VIC and SA, the 160-mm isohyets corresponded relatively lower simulated yield due to less stored soil water. Impacts of other factors like soil types were also discussed.

Evaluation of calving seasons and marketing strategies in Northern Great Plains beef enterprises. II. Retained ownership systems.

PubMed

Reisenauer Leesburg, V L; Tess, M W; Griffith, D

2007-09-01

Two bioeconomic computer models were used to evaluate calving seasons in combination with calf marketing strategies for a range-based cow-calf enterprise in the Northern Great Plains. Calving seasons studied were spring (SP, calving beginning March 15 and weaning October 31), spring with calf mortality increased by 5% (SP-IM), summer (SU, calving beginning May 15 and weaning December 31), summer with early weaning (SU-EW, calving beginning May 15 and weaning October 31), and fall (FA, calving beginning August 15 and weaning February 1). Marketing scenarios for steer calves and nonreplacement heifer calves were as follows: sold after weaning (WS), backgrounded in Montana and sold as feeder cattle (WBS), backgrounded in Montana and then fed to slaughter BW in Nebraska (WBFS), and shipped to Nebraska at weaning and fed to slaughter BW (WFS). Quarterly inflation-adjusted cattle and feedstuff prices were representative of the 1990s cattle cycle. Cumulative gross margin (CGM), the sum of ranch gross margin and net return from retained ownership was used to compare systems. At the peak of the cattle cycle, all forms of retained ownership (WBS, WBFS, WFS) were profitable for all calving seasons, but during the descending phase, only WBS increased CGM markedly over WS for SU-EW. At the cycle valley, retained ownership was not profitable for SP and SP-IM, whereas WBFS and WFS were profitable for SU and SU-EW, and all forms of retained ownership were profitable for FA. During the ascending phase, retained ownership was profitable for all calving season-marketing combinations. Systems with the greatest CGM at each phase of the cattle cycle were FA-WFS, SP-WBS, FA-WFS, and FA-WFS at the peak, descending, valley, and ascending phases, respectively. In beef enterprises representative of the Northern Great Plains, with a restricted grazing season and limited access to low-cost, good-quality grazeable forage, no single calving season and no single combination of calving season and calf marketing is expected to be superior throughout the cattle cycle. Fall calving systems most often benefit from retained ownership through slaughter.

Flight investigation of the effect of tail boom strakes on helicopter directional control

NASA Technical Reports Server (NTRS)

Kelly, Henry L.; Crowell, Cynthia A.; Yenni, Kenneth R.; Lance, Michael B.

1993-01-01

A joint U.S. Army/NASA flight investigation was conducted utilizing a single-rotor helicopter to determine the effectiveness of horizontally mounted tail boom strakes on directional controllability and tail rotor power during low-speed, crosswind operating conditions. Three configurations were investigated: (1) baseline (strakes off), (2) single strake (strake at upper shoulder on port side of boom), and (3) double strake (upper strake plus a lower strake on same side of boom). The strakes were employed as a means to separate airflow over the tail boom and change fuselage yawing moments in a direction to improve the yaw control margin and reduce tail rotor power. Crosswind data were obtained in 5-knot increments of airspeed from 0 to 35 knots and in 30 deg increments of wind azimuth from 0 deg to 330 deg. At the most critical wind azimuth and airspeed in terms of tail rotor power, the strakes improved the pedal margin by 6 percent of total travel and reduced tail rotor power required by 17 percent. The increase in yaw control and reduction in tail rotor power offered by the strakes can expand the helicopter operating envelope in terms of gross weight and altitude capability. The strakes did not affect the flying qualities of the vehicle at airspeeds between 35 and 100 knots.

Osteosarcoma of the maxilla with concurrent osteoma in a southern sea otter (Enhydra lutris nereis)

USGS Publications Warehouse

Fernandez, J. Rodriguez-Ramos; Thomas, N.J.; Dubielzig, R.R.; Drees, R.

2012-01-01

Southern sea otters (Enhydra lutris nereis) are threatened marine mammals that belong to the family Mustelidae and are native to the coast of Central California. Neoplasia is reported infrequently in seaotters. An adult female free-ranging southern sea otter was found alive at Pebble Beach, Monterey County, California, on January 1st, 1994 and died soon after capture. The carcass was submitted to the US Geological Survey – National Wildlife Health Center for necropsy examination. Grossly, a mass with rubbery texture was firmly attached to the left maxillary region of the skull and the nasopharynx was occluded by soft neoplastic tissue. Post-mortem skull radiographs showed an oval, smoothly marginated mineralized opaque mass centered on the left maxilla, extending from the canine tooth to caudal to the molar and replacing portions of the zygomatic arch and palatine and temporal bones. The majority of the mass protruded laterally from the maxilla and was characterized by central homogeneous mineral opacity. Microscopically, the mass was characterized by fully differentiated lamellar non-osteonal bone that expanded beyond the margins of the adjacent normal osteonal bone. Sections of the nasopharyngeal mass were comprised of moderately pleomorphic cells with bony stroma. Gross, microscopical and radiological findings were compatible with maxillary osteosarcoma with concurrent osteoma.

Gross and microscopic observations on the lingual structure of the Florida Manatee Trichechus manatus latirostris.

PubMed

Levin, M J; Pfeiffer, C J

2002-10-01

The tongue of the Florida manatee (Trichechus manatus latirostris) was studied macroscopically, light and electron microscopically. The tongue was slender, muscular and firmly fixed in the oral cavity; only the cranial tip was free and mobile. Numerous filiform papillae were distributed over the dorsal surface of the rostral tongue. Multiple raised, round fungiform-like papillae were distributed over most of the dorsum. Typical fungiform papillae were restricted to the lateral margins of the tongue. Foliate papillae, presenting as multi-fossulate openings, were noted on the caudolateral margins. Open pits were located on the dorsocaudal surface and lateral walls. Microscopic examination showed that most of the lingual dorsum was covered with a thick stratified squamous epithelium. Open pits led to well-developed mucous salivary glands. Glands within the foliate papillae were mostly mucous, although some seromucous glands were present. Taste buds were restricted to the epithelium of the foliate papillae. Throughout the tongue, striated muscle was abundant below the epithelium. Blood vessels, lymph channels and nerve fibres were freely distributed throughout the intermuscular stroma. Nerve fibres reacted positively with neurone specific enolase (NSE) antibody throughout the tongue, including nerve bundles, glands and taste buds. Clear to translucent vacuoles were found juxtaposed to nuclei in the stratum spinosum in the foliate papillae epithelium.

Systematic reviews: I. The correlation between laboratory tests on marginal quality and bond strength. II. The correlation between marginal quality and clinical outcome.

PubMed

Heintze, Siegward D

2007-01-01

An accepted principle in restorative dentistry states that restorations should be placed with the best marginal quality possible to avoid postoperative sensitivity, marginal discoloration, and secondary caries. Different laboratory methods claim to predict the clinical performance of restorative materials, for example, tests of bond strength and microleakage and gap analysis. The purpose of this review was twofold: (1) find studies that correlated the results of bond strength tests with either microleakage or gap analysis for the same materials, and (2) find studies that correlated the results of microleakage and/or gaps with the clinical parameters for the same materials. Furthermore, influencing factors on the results of the laboratory tests were reviewed and assessed. For the first question, searches for studies were conducted in the MEDLINE database and IADR/AADR abtracts online with specific search and inclusion criteria. The outcome for each study was assessed on the basis of the statistical test applied in the study, and finally the number of studies with or without correlation was compiled. For the second question, results of the quantitative marginal analysis of Class V restorations published by the University of Zürich with the same test protocol and prospective clinical trials were searched that investigated the same materials for at least 2 years in Class V cavities. Pearson correlation coefficients were calculated for pooled data of materials and clinical outcome parameters such as retention loss, marginal discoloration, marginal integrity, and secondary caries. For the correlation of dye penetration and clinical outcome, studies on Class V restorations published by the same research institute were searched in MEDLINE that examined the same adhesive systems as the selected clinical trials. For the correlation bond strength/microleakage, 30 studies were included into the review, and for the correlation bond strength/gap analysis 18 studies. For both topics, about 80% of the studies revealed that there was no correlation between the two methods. For the correlation quantitative marginal analysis/clinical outcome, data were compared to the clinical outcome of 11 selected clinical studies. In only 2 out of the 11 studies (18%) did the clinical outcome match the prognosis based on the laboratory tests; the remaining studies did not show any correlation. When pooling data on 20 adhesive systems, no correlation was found between the percentage of continuous margin of restorations placed in extracted premolars and the percentage of teeth that showed no retention loss in clinical studies, no discoloured margins, acceptable margins, or absence of secondary caries. With regard to the correlation of dye penetration and clinical studies, no sufficient number of studies was found that matched the inclusion criteria. However, literature data suggest that there is no correlation between microleakage data as measured in the laboratory and clinical parameters. The results of bond strength tests did not correlate with laboratory tests that evaluated the marginal seal of restorations such as microleakage or gap analysis. The quantitative marginal analysis of Class V fillings in the laboratory was unable to predict the performance of the same materials in vivo. Therefore, microleakage tests or the quantitative marginal analysis should be abandoned and research should focus on laboratory tests that are validated with regard to their ability to satisfactorily predict the clinical performance of restorative materials.

[A new technique for ensuring negative surgical margins during partial nephrectomy: the ex vivo ultrasound control].

PubMed

Desmonts, A; Tillou, X; Le Gal, S; Secco, M; Orczyk, C; Bensadoun, H; Doerfler, A

2013-10-01

To evaluate the feasibility and the efficiency of intraoperative ex vivo ultrasound of resection margins in patients undergoing partial nephrectomy by urologist. Patients undergoing partial nephrectomy from July 2010 to November 2012 for T1-T2 renal tumors were included in analysis. Tumor margin status was immediately determined by ex vivo ultrasound done by the surgeon himself. Results were compared with margin status on definitive pathological evaluation. A total of 26 men and 15 women with a median age of 61 (30-82) years old were included in analysis. Intraoperative ex vivo ultrasound revealed negative surgical margins in 38 cases and positive margins in two. Final pathological results revealed negative margins in all except one case. Ultrasound sensitivity and specificity were 100% and 97%, respectively. Mean ultrasound duration was 1minute±1. Mean tumor and margin sizes were 3.4±1.8cm and 2.38±1.76mm, respectively. Intraoperative ex vivo ultrasound of resection margins in patients undergoing partial nephrectomy by a urologist seemed to be feasible, efficient and easy. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Meta-analysis of studies with bivariate binary outcomes: a marginal beta-binomial model approach

PubMed Central

Chen, Yong; Hong, Chuan; Ning, Yang; Su, Xiao

2018-01-01

When conducting a meta-analysis of studies with bivariate binary outcomes, challenges arise when the within-study correlation and between-study heterogeneity should be taken into account. In this paper, we propose a marginal beta-binomial model for the meta-analysis of studies with binary outcomes. This model is based on the composite likelihood approach, and has several attractive features compared to the existing models such as bivariate generalized linear mixed model (Chu and Cole, 2006) and Sarmanov beta-binomial model (Chen et al., 2012). The advantages of the proposed marginal model include modeling the probabilities in the original scale, not requiring any transformation of probabilities or any link function, having closed-form expression of likelihood function, and no constraints on the correlation parameter. More importantly, since the marginal beta-binomial model is only based on the marginal distributions, it does not suffer from potential misspecification of the joint distribution of bivariate study-specific probabilities. Such misspecification is difficult to detect and can lead to biased inference using currents methods. We compare the performance of the marginal beta-binomial model with the bivariate generalized linear mixed model and the Sarmanov beta-binomial model by simulation studies. Interestingly, the results show that the marginal beta-binomial model performs better than the Sarmanov beta-binomial model, whether or not the true model is Sarmanov beta-binomial, and the marginal beta-binomial model is more robust than the bivariate generalized linear mixed model under model misspecifications. Two meta-analyses of diagnostic accuracy studies and a meta-analysis of case-control studies are conducted for illustration. PMID:26303591

Clinical and semiquantitative marginal analysis of four tooth-coloured inlay systems at 3 years.

PubMed

Gladys, S; Van Meerbeek, B; Inokoshi, S; Willems, G; Braem, M; Lambrechts, P; Vanherle, G

1995-12-01

The marginal quality of four tooth-coloured inlay systems was clinically investigated and subjected to computer-aided semiquantitative marginal analysis under scanning electron microscopy (SEM) after 3 years of clinical service. Three of the restoration types were made using the Cerec CAD-CAM apparatus: one was milled from preformed glass ceramic blocks, and the two other inlay types were milled from preformed porcelain blocks. The fourth system was based on an experimental indirect resin composite inlay system. Each inlay type was luted with a different luting resin composite. The clinical evaluation was performed with a mirror and explorer by two clinicians separately, and the marginal analysis was conducted microscopically on replicas (SEM x 200). After 3 years in situ, all the restorations were clinically acceptable. No recurrent caries was observed. Marginal analysis under SEM detected a high percentage of submargination for all four systems, which suggests that their respective resin composite luting agents were all subject to wear. The percentage of marginal fractures on the enamel side as well as on the inlay side did not increase dramatically compared to the 6-month results. The first recall after 6 months of clinical service indicated how tooth-coloured inlays behave at their margins. The 3-year results confirmed the early findings, indicating that wear of resin composite lutes is important and present in all systems. The two ceramic materials showed a similar behaviour at the margins. The resin composite inlay performed better at the inlay site than at the enamel site.

Origin of Tumor Recurrence After Intensity Modulated Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma

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

Raktoe, Sawan A.S.; Dehnad, Homan, E-mail: h.dehnad@umcutrecht.nl; Raaijmakers, Cornelis P.J.

Purpose: To model locoregional recurrences of oropharyngeal squamous cell carcinomas (OSCC) treated with primary intensity modulated radiation therapy (IMRT) in order to find the origins from which recurrences grow and relate their location to original target volume borders. Methods and Materials: This was a retrospective analysis of OSCC treated with primary IMRT between January 2002 and December 2009. Locoregional recurrence volumes were delineated on diagnostic scans and coregistered rigidly with treatment planning computed tomography scans. Each recurrence was analyzed with two methods. First, overlapping volumes of a recurrence and original target were measured ('volumetric approach') and assessed as 'in-field', 'marginal',more » or 'out-field'. Then, the center of mass (COM) of a recurrence volume was assumed as the origin from where a recurrence expanded, the COM location was compared with original target volume borders and assessed as 'in-field', 'marginal', or 'out-field'. Results: One hundred thirty-one OSCC were assessed. For all patients alive at the end of follow-up, the mean follow-up time was 40 months (range, 12-83 months); 2 patients were lost to follow-up. The locoregional recurrence rate was 27%. Of all recurrences, 51% were local, 23% were regional, and 26% had both local and regional recurrences. Of all recurrences, 74% had imaging available for assessment. Regarding volumetric analysis of local recurrences, 15% were in-field gross tumor volume (GTV), and 65% were in-field clinical tumor volume (CTV). Using the COM approach, we found that 70% of local recurrences were in-field GTV and 90% were in-field CTV. Of the regional recurrences, 25% were volumetrically in-field GTV, and using the COM approach, we found 54% were in-field GTV. The COM of local out-field CTV recurrences were maximally 16 mm outside CTV borders, whereas for regional recurrences, this was 17 mm. Conclusions: The COM model is practical and specific for recurrence assessment. Most recurrences originated in the GTV. This suggests radioresistance in certain tumor parts.« less

Structural equation modeling of motor impairment, gross motor function, and the functional outcome in children with cerebral palsy.

PubMed

Park, Eun-Young; Kim, Won-Ho

2013-05-01

Physical therapy intervention for children with cerebral palsy (CP) is focused on reducing neurological impairments, improving strength, and preventing the development of secondary impairments in order to improve functional outcomes. However, relationship between motor impairments and functional outcome has not been proved definitely. This study confirmed the construct of motor impairment and performed structural equation modeling (SEM) between motor impairment, gross motor function, and functional outcomes of regarding activities of daily living in children with CP. 98 children (59 boys, 39 girls) with CP participated in this cross-sectional study. Mean age was 11 y 5 mo (SD 1 y 9 mo). The Manual Muscle Test (MMT), the Modified Ashworth Scale (MAS), range of motion (ROM) measurement, and the selective motor control (SMC) scale were used to assess motor impairments. Gross motor function and functional outcomes were measured using the Gross Motor Function Measure (GMFM) and the Functional Skills domain of the Pediatric Evaluation of Disability Inventory (PEDI) respectively. Measurement of motor impairment was consisted of strength, spasticity, ROM, and SMC. The construct of motor impairment was confirmed though an examination of a measurement model. The proposed SEM model showed good fit indices. Motor impairment effected gross motor function (β=-.0869). Gross motor function and motor impairment affected functional outcomes directly (β=0.890) and indirectly (β=-0.773) respectively. We confirmed that the construct of motor impairment consist of strength, spasticity, ROM, and SMC and it was identified through measurement model analysis. Functional outcomes are best predicted by gross motor function and motor impairments have indirect effects on functional outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Productivity Analysis of Chennai Automotive Industry Cluster

NASA Astrophysics Data System (ADS)

Bhaskaran, E.

2014-07-01

Chennai, also called the Detroit of India, is India's second fastest growing auto market and exports auto components and vehicles to US, Germany, Japan and Brazil. For inclusive growth and sustainable development, 250 auto component industries in Ambattur, Thirumalisai and Thirumudivakkam Industrial Estates located in Chennai have adopted the Cluster Development Approach called Automotive Component Cluster. The objective is to study the Value Chain, Correlation and Data Envelopment Analysis by determining technical efficiency, peer weights, input and output slacks of 100 auto component industries in three estates. The methodology adopted is using Data Envelopment Analysis of Output Oriented Banker Charnes Cooper model by taking net worth, fixed assets, employment as inputs and gross output as outputs. The non-zero represents the weights for efficient clusters. The higher slack obtained reveals the excess net worth, fixed assets, employment and shortage in gross output. To conclude, the variables are highly correlated and the inefficient industries should increase their gross output or decrease the fixed assets or employment. Moreover for sustainable development, the cluster should strengthen infrastructure, technology, procurement, production and marketing interrelationships to decrease costs and to increase productivity and efficiency to compete in the indigenous and export market.

PAX5 methylation detection by droplet digital PCR for ultra-sensitive deep surgical margins analysis of head and neck squamous cell carcinoma

PubMed Central

Hayashi, Masamichi; Guerrero-Preston, Rafael; Sidransky, David; Koch, Wayne M.

2015-01-01

Molecular deep surgical margin analysis has been shown to predict locoregional recurrences of head and neck squamous cell carcinoma (HNSCC). In order to improve the accuracy and versatility of the analysis, we used a highly tumor-specific methylation marker and highly sensitive detection technology to test DNA from surgical margins. Histologically cancer-negative deep surgical margin samples were prospectively collected from 82 eligible HNSCC surgeries by an imprinting procedure (n=75) and primary tissue collection (n=70). Bisulfite treated DNA from each sample was analyzed by both conventional quantitative methylation-specific polymerase chain reaction (QMSP) and QMSP by droplet digital PCR (ddQMSP) targeting PAX5 gene promoter methylation. The association between the presence of PAX5 methylation and locoregional recurrence free survival (LRFS) was evaluated. PAX5 methylation was found in 68.0% (51/75) of tumors in the imprint samples and 71.4% (50/70) in the primary tissue samples. Among cases which did not have postoperative radiation, (n=31 in imprint samples, n=29 in tissue samples), both conventional QMSP and ddQMSP revealed that PAX5 methylation positive margins was significantly associated with poor LRFS by univariate analysis. In particular, ddQMSP increased detection of the PAX5 marker from 29% to 71% in the non-radiated imprint cases. Also, PAX5 methylated imprint margins were an excellent predictor of poor LRFS (HR=3.89, 95%CI:1.19-17.52, P=0.023) by multivariate analysis. PAX5 methylation appears to be an excellent tumor-specific marker for molecular deep surgical margin analysis of HNSCC. Moreover, the ddQMSP assay displays increased sensitivity for methylation marker detection. PMID:26304463

Relationship Between Broiler Body Weights, Eimeria maxima Gross Lesion Scores, and Microscores in Three Anticoccidial Sensitivity Tests.

PubMed

Barrios, Miguel A; Da Costa, Manuel; Kimminau, Emily; Fuller, Lorraine; Clark, Steven; Pesti, Gene; Beckstead, Robert

2017-06-01

Anticoccidial sensitivity tests (ASTs) serve to determine the efficacy of anticoccidial drugs against Eimeria field isolates in a controlled laboratory setting. The most commonly measured parameters are body weight gain, feed conversion ratio, gross intestinal lesion scores, and mortality. Due to the difficulty in reliably scoring gross lesion scores of Eimeria maxima , microscopic analysis of intestinal scrapings (microscores) can be used in the field to indicate the presence of this particular Eimeria. The goal of this study was to determine the relationship between E. maxima microscores and broiler body weights and gross E. maxima lesion scores in three ASTs. Day-old broiler chicks were raised for 12 days on a standard corn-soy diet. On Day 12, chicks were placed in Petersime batteries and treatment diets were provided. There were six birds per pen, four pens per treatment, and 12 treatments, for a total of 288 chicks per AST. The treatments were as follows: 1) nonmedicated, noninfected; 2) nonmedicated, infected; 3) lasalocid, infected; 4) salinomycin, infected; 5) diclazuril, infected; 6) monensin, infected; 7) decoquinate, infected; 8) narasin + nicarbazin, infected; 9) narasin, infected; 10) nicarbazin, infected; 11) robenidine, infected; and 12) zoalene, infected. On Day 14, chicks were challenged with an Eimeria field isolate by oral gavage. On Day 20, broilers were weighed, and gross lesion scores and microscores were classified from 0 to 4 depending on the severity of the gross lesion scores and E. maxima microscores. Data from three trials using different field isolates were statistically analyzed using a logarithmic regression model. There was no relationship (P = 0.1224) between microscores and body weight gain. There was a positive relationship between microscores and gross lesion scores (P = 0.004). However, there was also an interaction between isolate and treatment (P < 0.0001). Lastly, the interaction between isolate and gross lesion scores (P = 0.0041) demonstrates that the significance of the relationship between microscores and gross lesion scores may be dependent on pathogenicity of the challenge Eimeria or the amount of E. maxima in the inoculum.

Determination of natural radioactivity by gross alpha and beta measurements in ground water samples.

PubMed

Turhan, S; Ozçitak, E; Taşkin, H; Varinlioğlu, A

2013-06-01

In this study, the activity concentrations of the gross α and β in ground water samples collected from the different drilled wells in Nevşehir province were measured to assess annual effective dose due to the ingestion of the water samples. Nevşehir province is one of the major cities of Cappadocia Region which is a popular tourist destination as it has many areas with unique geological, historic, and cultural features. Sampling and measurements were carried out in the autumn of 2011 and the spring of 2012. The values of the activity concentrations of the gross α and β measured in the water samples ranged from 80 to 380 mBq L(-1) with a mean of 192 mBq L(-1) and 120-3470 mBq L(-1) with a mean of 579 mBq L(-1) respectively. All values of the gross α were lower than the limit value of 500 mBq L(-1) while two ground water samples were found to have gross β activity concentrations of greater than 1000 mBq L(-1). Therefore two water samples were the subject of further radioisotope-specific analysis. The obtained result indicated that the elevated activity concentrations of the gross β in these water samples are dominated by (40)K activity. Annual effective doses ranged from 0.04 to 0.20 mSv y(-1). Copyright © 2013 Elsevier Ltd. All rights reserved.

Effect of Laparoscopic-Assisted Resection vs Open Resection of Stage II or III Rectal Cancer on Pathologic Outcomes

PubMed Central

Fleshman, James; Branda, Megan; Sargent, Daniel J.; Boller, Anne Marie; George, Virgilio; Abbas, Maher; Peters, Walter R.; Maun, Dipen; Chang, George; Herline, Alan; Fichera, Alessandro; Mutch, Matthew; Wexner, Steven; Whiteford, Mark; Marks, John; Birnbaum, Elisa; Margolin, David; Larson, David; Marcello, Peter; Posner, Mitchell; Read, Thomas; Monson, John; Wren, Sherry M.; Pisters, Peter W. T.; Nelson, Heidi

2016-01-01

IMPORTANCE Evidence about the efficacy of laparoscopic resection of rectal cancer is incomplete, particularly for patients with more advanced-stage disease. OBJECTIVE To determine whether laparoscopic resection is noninferior to open resection, as determined by gross pathologic and histologic evaluation of the resected proctectomy specimen. DESIGN, SETTING, AND PARTICIPANTS A multicenter, balanced, noninferiority, randomized trial enrolled patients between October 2008 and September 2013. The trial was conducted by credentialed surgeons from 35 institutions in the United States and Canada. A total of 486 patients with clinical stage II or III rectal cancer within 12 cm of the anal verge were randomized after completion of neoadjuvant therapy to laparoscopic or open resection. INTERVENTIONS Standard laparoscopic and open approaches were performed by the credentialed surgeons. MAIN OUTCOMES AND MEASURES The primary outcome assessing efficacy was a composite of circumferential radial margin greater than 1 mm, distal margin without tumor, and completeness of total mesorectal excision. A 6%noninferiority margin was chosen according to clinical relevance estimation. RESULTS Two hundred forty patients with laparoscopic resection and 222 with open resection were evaluable for analysis of the 486 enrolled. Successful resection occurred in 81.7%of laparoscopic resection cases (95%CI, 76.8%–86.6%) and 86.9%of open resection cases (95%CI, 82.5%–91.4%) and did not support noninferiority (difference, −5.3%; 1-sided 95%CI, −10.8%to ∞; P for noninferiority = .41). Patients underwent low anterior resection (76.7%) or abdominoperineal resection (23.3%). Conversion to open resection occurred in 11.3%of patients. Operative time was significantly longer for laparoscopic resection (mean, 266.2 vs 220.6 minutes; mean difference, 45.5 minutes; 95%CI, 27.7–63.4; P < .001). Length of stay (7.3 vs 7.0 days; mean difference, 0.3 days; 95%CI, −0.6 to 1.1), readmission within 30 days (3.3%vs 4.1%; difference, −0.7%; 95%CI, −4.2%to 2.7%), and severe complications (22.5%vs 22.1%; difference, 0.4%; 95%CI, −4.2%to 2.7%) did not differ significantly. Quality of the total mesorectal excision specimen in 462 operated and analyzed surgeries was complete (77%) and nearly complete (16.5%) in 93.5%of the cases. Negative circumferential radial margin was observed in 90% of the overall group (87.9% laparoscopic resection and 92.3%open resection; P = .11). Distal margin result was negative in more than 98%of patients irrespective of type of surgery (P = .91). CONCLUSIONS AND RELEVANCE Among patients with stage II or III rectal cancer, the use of laparoscopic resection compared with open resection failed to meet the criterion for noninferiority for pathologic outcomes. Pending clinical oncologic outcomes, the findings do not support the use of laparoscopic resection in these patients. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00726622 PMID:26441179

Observation of lunar radon emanation with the Apollo 15 alpha particle spectrometer.

NASA Technical Reports Server (NTRS)

Gorenstein, P.; Bjorkholm, P.

1972-01-01

The alpha particle spectrometer, a component of the orbital Sim Bay group of 'geochemistry' experiments on Apollo 15, was designed to detect alpha particles emitted during the decay of isotopes of radon gas and her daughter products. The purpose was to measure the gross activity of radon on the lunar surface and to find possible regions of increased local activity. Results are presented from a partial analysis of Apollo 15 data. For the moon as a whole, Rn220 was not observed and the upper limit on its decay rate above the lunar surface is 0.00038 disintegrations/sq cm-sec. Rn222 was marginally observed. Possible variations of radon activity on the lunar surface are being investigated. Po210 (a daughter product of Rn222) has been detected in a broad region from west of Mare Crisium to the Van de Graaff-Orlov region. The observed count rate is (4.6 plus or minus 1.4) x 0.001 disintegrations/sq cm-sec. The observed level of Po210 activity is in excess of the amount that would be in equilibrium with Rn222 by about an order of magnitude. This implies that larger levels of radon emanation have occurred on the moon within a time scale of 10 to 100 years.

Tissue preservation with mass spectroscopic analysis: Implications for cancer diagnostics.

PubMed

Hall, O Morgan; Peer, Cody J; Figg, William D

2018-05-17

Surgical intervention is a common treatment modality for localized cancer. Post-operative analysis involves evaluation of surgical margins to assess whether all malignant tissue has been resected because positive surgical margins lead to a greater likelihood of recurrence. Secondary treatments are utilized to minimize the negative effects of positive surgical margins. Recently, in Science Translational Medicine, Zhang et al describe a new mass spectroscopic technique that could potentially decrease the likelihood of positive surgical margins. Their nondestructive in vivo tissue sampling leads to a highly accurate and rapid cancer diagnosis with great precision between healthy and malignant tissue. This new tool has the potential to improve surgical margins and accelerate cancer diagnostics by analyzing biomolecular signatures of various tissues and diseases.

Dosage analysis of cancer predisposition genes by multiplex ligation-dependent probe amplification

PubMed Central

Bunyan, D J; Eccles, D M; Sillibourne, J; Wilkins, E; Thomas, N Simon; Shea-Simonds, J; Duncan, P J; Curtis, C E; Robinson, D O; Harvey, J F; Cross, N C P

2004-01-01

Multiplex ligation-dependent probe amplification (MLPA) is a recently described method for detecting gross deletions or duplications of DNA sequences, aberrations which are commonly overlooked by standard diagnostic analysis. To determine the incidence of copy number variants in cancer predisposition genes from families in the Wessex region, we have analysed the hMLH1 and hMSH2 genes in patients with hereditary nonpolyposis colorectal cancer (HNPCC), BRCA1 and BRCA2 in families with hereditary breast/ovarian cancer (BRCA) and APC in patients with familial adenomatous polyposis coli (FAP). Hereditary nonpolyposis colorectal cancer (n=162) and FAP (n=74) probands were fully screened for small mutations, and cases for which no causative abnormality were found (HNPCC, n=122; FAP, n=24) were screened by MLPA. Complete or partial gene deletions were identified in seven cases for hMSH2 (5.7% of mutation-negative HNPCC; 4.3% of all HNPCC), no cases for hMLH1 and six cases for APC (25% of mutation negative FAP; 8% of all FAP). For BRCA1 and BRCA2, a partial mutation screen was performed and 136 mutation-negative cases were selected for MLPA. Five deletions and one duplication were found for BRCA1 (4.4% of mutation-negative BRCA cases) and one deletion for BRCA2 (0.7% of mutation-negative BRCA cases). Cost analysis indicates it is marginally more cost effective to perform MLPA prior to point mutation screening, but the main advantage gained by prescreening is a greatly reduced reporting time for the patients who are positive. These data demonstrate that dosage analysis is an essential component of genetic screening for cancer predisposition genes. PMID:15475941

Gross motor development in full-term Greek infants assessed by the Alberta Infant Motor Scale: reference values and socioeconomic impact.

PubMed

Syrengelas, Dimitrios; Kalampoki, Vassiliki; Kleisiouni, Paraskevi; Konstantinou, Dimitrios; Siahanidou, Tania

2014-07-01

The aims of this study were to investigate gross motor development in Greek infants and establish AIMS percentile curves and to examine possible association of AIMS scores with socioeconomic parameters. Mean AIMS scores of 1068 healthy Greek full-term infants were compared at monthly age level with the respective mean scores of the Canadian normative sample. In a subgroup of 345 study participants, parents provided, via interview, information about family socioeconomic status. Multiple linear regression analysis was performed to evaluate the relationship of infant motor development with socioeconomic parameters. Mean AIMS scores did not differ significantly between Greek and Canadian infants in any of the 19 monthly levels of age. In multiple linear regression analysis, the educational level of the mother and also whether the infant was being raised by grandparents/babysitter were significantly associated with gross motor development (p=0.02 and p<0.001, respectively), whereas there was no significant correlation of mean AIMS scores with gender, birth order, maternal age, paternal educational level and family monthly income. Gross motor development of healthy Greek full-term infants, assessed by AIMS during the first 19months of age, follows a similar course to that of the original Canadian sample. Specific socioeconomic factors are associated with the infants' motor development. Copyright © 2014 Elsevier Ltd. All rights reserved.

Read margin analysis of crossbar arrays using the cell-variability-aware simulation method

NASA Astrophysics Data System (ADS)

Sun, Wookyung; Choi, Sujin; Shin, Hyungsoon

2018-02-01

This paper proposes a new concept of read margin analysis of crossbar arrays using cell-variability-aware simulation. The size of the crossbar array should be considered to predict the read margin characteristic of the crossbar array because the read margin depends on the number of word lines and bit lines. However, an excessively high-CPU time is required to simulate large arrays using a commercial circuit simulator. A variability-aware MATLAB simulator that considers independent variability sources is developed to analyze the characteristics of the read margin according to the array size. The developed MATLAB simulator provides an effective method for reducing the simulation time while maintaining the accuracy of the read margin estimation in the crossbar array. The simulation is also highly efficient in analyzing the characteristic of the crossbar memory array considering the statistical variations in the cell characteristics.

High sensitivity of metal footprint to national GDP in part explained by capital formation

NASA Astrophysics Data System (ADS)

Zheng, Xinzhu; Wang, Ranran; Wood, Richard; Wang, Can; Hertwich, Edgar G.

2018-04-01

Global metal ore extraction tripled between 1970 and 2010 as metals are widely used in new infrastructure and advanced technology. Meanwhile, the energy and environmental costs of metal mining increase as lower ore grades are being exploited. The domestic use of metals has been found to reach a plateau when gross domestic product reaches US15,000 per person. Here we present a quantification of the annual metal footprint (that is, the amount of metal ore extracted to satisfy the final demand of a country, including metals used abroad to produce goods that are then imported, and excluding metals used domestically to produce exports) for 43 large economies during 1995-2013. We use a panel analysis to assess short-term drivers of changes in metal footprint, and find that a 1% rise in gross domestic product raises the metal footprint by as much as 1.9% in the same year. Further, every percentage point increase in gross capital formation as a share of gross domestic product increased the metal footprint by 2% when controlling for gross domestic product. Other socioeconomic variables did not significantly influence the metal footprint. Finding ways to break the strong coupling of economic development and investment with metal ore extraction may be required to ensure resource access and a low-carbon future.

Economics of on-farm production and use of vegetable oils for fuel

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

McIntosh, C.S.; Withers, R.V.; Smith, S.M.

1982-01-01

The technology of oilseed processing, on a small scale, is much simpler than that for ethanol production. This, coupled with the fact that most energy intensive farm operations use diesel powered equipment, has created substantial interest in vegetable oils as an alternative source of liquid fuel for agriculture. The purpose of this study was to estimate the impact on gross margins resulting from vegetable oil production and utilization in two case study areas, Latah and Power Counties, in Iadho. The results indicate that winter rape oil became a feasible alternative to diesel when the price of diesel reached $0.84 permore » liter in the Latah County model. A diesel price of $0.85 per liter was required in the Power County model before it became feasible to produce sunflower oil for fuel. 5 tables.« less

Evaluation of margins in head and neck squamous cell carcinoma from the surgeon's perspective.

PubMed

Baumeister, Philipp; Baumüller, Konstantin; Harréus, Ulrich; Reiter, Maximilian; Welz, Christian

2018-05-01

The surgeon's evaluation of resection status based on frozen section analysis during operation and pathological examination of resected specimens often differ. For this study, we recapitulated the surgeon's perspective during an operation, accordingly classified the evaluation of margins by the surgeon, and analyzed its impact on the outcome compared with the pathological results. This was a retrospective analysis. As data sources, paper-based and digital patient files, as well as the Munich Cancer Registry database were used. Three hundred ninety-six cases were included in this analysis. Only the evaluation of margins by the surgeon influenced local control, and the pathological results influenced disease-free survival (DFS). Surprisingly, margins of >5 mm of normal tissue to cancer growth led to local control and overall survival (OS) significantly worse than 1 to 5-mm resections. The evaluation of margins by the surgeon is of significant importance for local control and OS. It is largely based on frozen section analysis, which, therefore, should be used whenever possible. © 2018 Wiley Periodicals, Inc.

Outcomes for Spine Stereotactic Body Radiation Therapy and an Analysis of Predictors of Local Recurrence

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

Bishop, Andrew J.; Tao, Randa; Rebueno, Neal C.

Purpose: To investigate local control, survival outcomes, and predictors of local relapse for patients treated with spine stereotactic body radiation therapy. Methods and Materials: We reviewed the records of 332 spinal metastases consecutively treated with stereotactic body radiation therapy between 2002 and 2012. The median follow-up for all living patients was 33 months (range, 0-111 months). Endpoints were overall survival and local control (LC); recurrences were classified as either in-field or marginal. Results: The 1-year actuarial LC and overall survival rates were 88% and 64%, respectively. Patients with local relapses had poorer dosimetric coverage of the gross tumor volume (GTV) compared withmore » patients without recurrence (minimum dose [Dmin] biologically equivalent dose [BED] 23.9 vs 35.1 Gy, P<.001; D98 BED 41.8 vs 48.1 Gy, P=.001; D95 BED 47.2 vs 50.5 Gy, P=.004). Furthermore, patients with marginal recurrences had poorer prescription coverage of the GTV (86% vs 93%, P=.01) compared with those with in-field recurrences, potentially because of more upfront spinal canal disease (78% vs 24%, P=.001). Using a Cox regression univariate analysis, patients with a GTV BED Dmin ≥33.4 Gy (median dose) (equivalent to 14 Gy in 1 fraction) had a significantly higher 1-year LC rate (94% vs 80%, P=.001) compared with patients with a lower GTV BED Dmin; this factor was the only significant variable on multivariate Cox analysis associated with LC (P=.001, hazard ratio 0.29, 95% confidence interval 0.14-0.60) and also was the only variable significant in a separate competing risk multivariate model (P=.001, hazard ratio 0.30, 95% confidence interval 0.15-0.62). Conclusions: Stereotactic body radiation therapy offers durable control for spinal metastases, but there is a subset of patients that recur locally. Patients with local relapse had significantly poorer tumor coverage, which was likely attributable to treatment planning directives that prioritized the spinal cord constraints over tumor coverage. When possible, we recommend maintaining a GTV Dmin above 14 Gy in 1 fraction and 21 Gy in 3 fractions.« less

System design requirements for advanced rotary-wing agricultural aircraft

NASA Technical Reports Server (NTRS)

Lemont, H. E.

1979-01-01

Helicopter aerial dispersal systems were studied to ascertain constraints to the system, the effects of removal of limitations (technical and FAA regulations), and subsystem improvements. Productivity indices for the aircraft and swath effects were examined. Typical missions were formulated through conversations with operators, and differing gross weight aircraft were synthesized to perform these missions. Economic analysis of missions and aircraft indicated a general correlation of small aircraft (3000 lb gross weight) suitability for small fields (25 acres), and low dispersion rates (less than 32 lb/acre), with larger aircraft (12,000 lb gross weight) being more favorable for bigger fields (200 acres) and heavier dispersal rates (100 lb/acre). Operator problems, possible aircraft and system improvements, and selected removal of operating limitations were reviewed into recommendations for future NASA research items.

Pricing products: juxtaposing affordability with quality appeal.

PubMed

1984-01-01

Choosing appropriate product prices is 1 of the most crucial steps in creating an effective contraceptive social marketing (CSM) sales campaign. The Social Marketing Forum conducted an informal survey of social marketing project managers, international contractors, and marketing consultants to determine how CSM programs cope with pricing problems and ways to circumvent some obstacles. According to Diana Altman, a family planning consultant, low prices that make products available to needy individuals are more important than the program's self sufficiency, yet if prices are too low, consumers think the products were unusable in the US and thus were dumped on local markets. Other key factors include commercial competition, spiraling inflation rates, and problems with rising prices and retailer/distributor margins. A sampling of per capita gross national products indicates the poverty level of most CSM projects' target market. Consequently, CSM projects must set low pices, regardless of program operating costs. The goal often is to increase the demand and availability for contraceptives. The fact that social marketing products must pass through retail networks to reach consumers complicates the pricing equation. To deal with the problem, India's Nirodh program gives a 25% margin to distributors/wholesalers, compared to 6% offered on most other goods. Retailers also receive a 25% margin, more than double the commercial rate. Once prices are set, increases pose hazards. Local government approval often is a prerequisite and can require lengthy negotiations. Market studies remain a valuable approach to effective pricing, according to PNA's Mallamad and other research consultants. They cite such effective research strategies as test marketing products and asking consumers how prices affect buying habits. Further, CSM projects can jump over some pricing hurdles through creative marketing. An effective pricing strategy alone cannot produce a successful CSM program. Pricing must accompany such factors as strong advertising, committed management, and adept salespersons.

[Health insurance in the contributive and subsidized regimes and its impact on the service providers].

PubMed

Prada, Luis M

2004-01-01

The performance of 18 private Health-promoting (EPS) and Family Compensation (CCF) entities, as well as their general balances for 1997, 1998 and 1999, were studied to determine the profit margins achieved by EPS's in their work of administering health insurance. The average behavior of each EPS balance sheet was analyzed to reduce the effect produced by extreme cases; each EPS's value was thus weighted by the number of its affiliated people. The expected behavior of the costs and expenses of companies whose main business is providing health insurance could thus become determined. The main source of operational income for a private EPS is the contributive regime's per capita unit of payment (UPC). Subsidized regime participation and that of other sources of income has decreased year by year. By contrast, public EPS's have shown decreasing participation in income obtained from UPC (contributive and subsidized) and growing dependence on other sources of income; this can be interpreted as being a symptom of weak commercial management. According to the balance sheets provided by the SNS, the EPS (public, private and Family Compensation entities), including the Social Security Institute (ISS), together obtained a total of 4.18 billion pesos operational income in 1999, an increase of 21.7% as compared to 1998. Income received from the ISS amounted to 1.93 billion dollars in 1999 (46% of the total). At 2000 prices, the total amount of operational income was 4.54 billion pesos in 1999 (15.6% real increase). Taking the behavior of 4 EPS's as our reference point (Sanitas, Humana Vivir, Coomeva and Famisanar), it can be concluded that an EPS whose main business is health insurance needs a 17.2% gross margin to cover its operational and non-operational costs and a 1.1% margin before tax.

Meta-analysis of studies with bivariate binary outcomes: a marginal beta-binomial model approach.

PubMed

Chen, Yong; Hong, Chuan; Ning, Yang; Su, Xiao

2016-01-15

When conducting a meta-analysis of studies with bivariate binary outcomes, challenges arise when the within-study correlation and between-study heterogeneity should be taken into account. In this paper, we propose a marginal beta-binomial model for the meta-analysis of studies with binary outcomes. This model is based on the composite likelihood approach and has several attractive features compared with the existing models such as bivariate generalized linear mixed model (Chu and Cole, 2006) and Sarmanov beta-binomial model (Chen et al., 2012). The advantages of the proposed marginal model include modeling the probabilities in the original scale, not requiring any transformation of probabilities or any link function, having closed-form expression of likelihood function, and no constraints on the correlation parameter. More importantly, because the marginal beta-binomial model is only based on the marginal distributions, it does not suffer from potential misspecification of the joint distribution of bivariate study-specific probabilities. Such misspecification is difficult to detect and can lead to biased inference using currents methods. We compare the performance of the marginal beta-binomial model with the bivariate generalized linear mixed model and the Sarmanov beta-binomial model by simulation studies. Interestingly, the results show that the marginal beta-binomial model performs better than the Sarmanov beta-binomial model, whether or not the true model is Sarmanov beta-binomial, and the marginal beta-binomial model is more robust than the bivariate generalized linear mixed model under model misspecifications. Two meta-analyses of diagnostic accuracy studies and a meta-analysis of case-control studies are conducted for illustration. Copyright © 2015 John Wiley & Sons, Ltd.

Stability analysis of fuzzy parametric uncertain systems.

PubMed

Bhiwani, R J; Patre, B M

2011-10-01

In this paper, the determination of stability margin, gain and phase margin aspects of fuzzy parametric uncertain systems are dealt. The stability analysis of uncertain linear systems with coefficients described by fuzzy functions is studied. A complexity reduced technique for determining the stability margin for FPUS is proposed. The method suggested is dependent on the order of the characteristic polynomial. In order to find the stability margin of interval polynomials of order less than 5, it is not always necessary to determine and check all four Kharitonov's polynomials. It has been shown that, for determining stability margin of FPUS of order five, four, and three we require only 3, 2, and 1 Kharitonov's polynomials respectively. Only for sixth and higher order polynomials, a complete set of Kharitonov's polynomials are needed to determine the stability margin. Thus for lower order systems, the calculations are reduced to a large extent. This idea has been extended to determine the stability margin of fuzzy interval polynomials. It is also shown that the gain and phase margin of FPUS can be determined analytically without using graphical techniques. Copyright © 2011 ISA. Published by Elsevier Ltd. All rights reserved.

The Generalized Roy Model and the Cost-Benefit Analysis of Social Programs.

PubMed

Eisenhauer, Philipp; Heckman, James J; Vytlacil, Edward

2015-04-01

The literature on treatment effects focuses on gross benefits from program participation. We extend this literature by developing conditions under which it is possible to identify parameters measuring the cost and net surplus from program participation. Using the generalized Roy model, we nonparametrically identify the cost, benefit, and net surplus of selection into treatment without requiring the analyst to have direct information on the cost. We apply our methodology to estimate the gross benefit and net surplus of attending college.

The Generalized Roy Model and the Cost-Benefit Analysis of Social Programs*

PubMed Central

Eisenhauer, Philipp; Heckman, James J.; Vytlacil, Edward

2015-01-01

The literature on treatment effects focuses on gross benefits from program participation. We extend this literature by developing conditions under which it is possible to identify parameters measuring the cost and net surplus from program participation. Using the generalized Roy model, we nonparametrically identify the cost, benefit, and net surplus of selection into treatment without requiring the analyst to have direct information on the cost. We apply our methodology to estimate the gross benefit and net surplus of attending college. PMID:26709315

Program budgeting and marginal analysis: a case study in chronic airflow limitation.

PubMed

Crockett, A; Cranston, J; Moss, J; Scown, P; Mooney, G; Alpers, J

1999-01-01

Program budgeting and marginal analysis is a method of priority-setting in health care. This article describes how this method was applied to the management of a disease-specific group, chronic airflow limitation. A sub-program flow chart clarified the major cost drivers. After assessment of the technical efficiency of the sub-programs and careful and detailed analysis, incremental and decremental wish lists of activities were established. Program budgeting and marginal analysis provides a framework for rational resource allocation. The nurturing of a vigorous program management group, with members representing all participants in the process (including patients/consumers), is the key to a successful outcome.

Relationship between dairy cow genetic merit and profit on commercial spring calving dairy farms.

PubMed

Ramsbottom, G; Cromie, A R; Horan, B; Berry, D P

2012-07-01

Because not all animal factors influencing profitability can be included in total merit breeding indices for profitability, the association between animal total merit index and true profitability, taking cognisance of all factors associated with costs and revenues, is generally not known. One method to estimate such associations is at the herd level, associating herd average genetic merit with herd profitability. The objective of this study was to primarily relate herd average genetic merit for a range of traits, including the Irish total merit index, with indicators of performance, including profitability, using correlation and multiple regression analyses. Physical, genetic and financial performance data from 1131 Irish seasonal calving pasture-based dairy farms were available following edits; data on some herds were available for more than 1 year of the 3-year study period (2007 to 2009). Herd average economic breeding index (EBI) was associated with reduced herd average phenotypic milk yield but with greater milk composition, resulting in higher milk prices. Moderate positive correlations (0.26 to 0.61) existed between genetic merit for an individual trait and average herd performance for that trait (e.g. genetic merit for milk yield and average per cow milk yield). Following adjustment for year, stocking rate, herd size and quantity of purchased feed in the multiple regression analysis, average herd EBI was positively and linearly associated with net margin per cow and per litre as well as gross revenue output per cow and per litre. The change in net margin per cow per unit change in the total merit index was €1.94 (s.e. = 0.42), which was not different from the expectation of €2. This study, based on a large data set of commercial herds with accurate information on profitability and genetic merit, confirms that, after accounting for confounding factors, the change in herd profitability per unit change in herd genetic merit for the total merit index is within expectations.

Exploring the Interaction of Motor and Social Skills With Autism Severity Using the SFARI Dataset.

PubMed

Colombo-Dougovito, Andrew M; Reeve, Ronald E

2017-04-01

Social communicative deficits and stereotyped or repetitive interests or behaviors are the defining features of autism spectrum disorder (ASD). A growing body of research suggests that gross motor deficits are also present in most children with ASD. This study sought to understand how pediatric ASD severity is related to motor skills and social skills. A multivariate analysis of variance analysis of 483 children with autism ( N = 444) and ASD ( N = 39) revealed a nonsignificant difference between groups. Results suggest little difference between severity groups on gross motor and social skills within the limited age range of the participants (about 5.6 years of age).

Utilizing Flight Data to Update Aeroelastic Stability Estimates

NASA Technical Reports Server (NTRS)

Lind, Rick; Brenner, Marty

1997-01-01

Stability analysis of high performance aircraft must account for errors in the system model. A method for computing flutter margins that incorporates flight data has been developed using robust stability theory. This paper considers applying this method to update flutter margins during a post-flight or on-line analysis. Areas of modeling uncertainty that arise when using flight data with this method are investigated. The amount of conservatism in the resulting flutter margins depends on the flight data sets used to update the model. Post-flight updates of flutter margins for an F/A-18 are presented along with a simulation of on-line updates during a flight test.

Engineering analysis division internal note. OFT-1 margin assessment. [results of analysis to determine space shuttle subsystem margins for orbital flight test

NASA Technical Reports Server (NTRS)

Austin, L. D., Jr.

1977-01-01

The results are documented of an analysis conducted to determine space shuttle vehicle (SSV) subsystem margins for the reference flight profile for the first orbital flight test (OFT-1). In general, the results show increased margins for the OFT-1 indicators when compared to Mission 3A resutls. The inclusion of element and wing aerodynamic variations on OFT-1, in combination with winds and systems dispersions, resulted in the forward Z (FTO1) attach load indicator exceeding specified limits. The inboard and outboard elevon hinge moment margins (9 percent and 3 percent, respectively) on OFT-1 reflect values consistent with the load relief requirements dictated by elevon hinge moment variations. All other structural load indicators for OFT-1 had margins in excess of 10 percent. The SSV first stage stagnation heating indicators for OFT-1 were about 45 percent less than for Mission 3A. The hydraulic systems demands for both missions were essentially the same. The results also show OFT-1 performance requirements from the consideration of winds and dispersions to be approximately 3,300 lbs greater than Mission 3A.

Effectiveness of catch basins equipped with hoods in retaining gross solids and hydrocarbons in highway runoff, Southeast Expressway, Boston, Massachusetts, 2008-09

USGS Publications Warehouse

Smith, Kirk P.

2011-01-01

Stormwater mobilizes litter and other debris along the roadway where it is transported to the highway drainage systems. Initial treatment for stormwater runoff typically is provided by catch basins in highway settings. Modification of catch basins to include hoods that cover the catch-basin outlet is intended to enhance catch-basin performance by retaining floatable debris and various hydrophobic organic compounds that tend to float on the water surface within the sump of the catch basin. The effectiveness of six deep-sump off-line catch basins equipped with hoods in reducing the mass of gross solids greater than 0.25 inches in diameter and concentrations of oil and grease (OG) and total petroleum hydrocarbons (TPH) was examined along the Southeast Expressway, in Boston, Massachusetts. Two deep-sump catch basins were equipped with cast-iron hoods. Three were equipped with molded plastic hoods, known as an Eliminator, and a single catch basin was equipped with a fiberglass anti-siphoning hood, known as a Snout. Samples of gross solids greater than 0.25 inches in diameter, excluding gravel and metallic materials, were routinely collected for a 6-month period from a collection structure mounted at the end of each catch-basin outlet pipe. After about 6 months, all floatable, saturated low-density and high-density solids were removed from each catch basin. In addition to the collection of samples of gross solids, samples of sump water from five catch basins and flow-weighted composite samples of stormwater from the outlet of one catch basin were collected and analyzed for concentrations of OG and TPH. A mass balance approach was used to assess the effectiveness of each catch basin equipped with a hood in retaining gross solids. The effectiveness of the deep-sump catch basins fitted with one of three types of hoods in retaining gross solids ranged from 27 to 52 percent. From 45 to 90 percent of the gross solids collected from the catch-basin sumps were composed of materials made of high-density plastics that did not float in water, and as a result, the effect that the catch-basin hoods had on these materials likely was marginal. The effectiveness for the deep-sump hooded catch basins, excluding the mass of high-density materials identified in the solids collected from the outlet pipe and the sump of the catch basins, ranged from 13 to 38 percent. The effectiveness for each catch basin, based solely on the material that remained floating at the end of the monitoring period, was less than 11 percent; however, these values likely underestimate the effectiveness of the hooded catch basins because much of the low-density material collected from the sumps may have been retained as floatable material before it was saturated and settled during non-storm conditions. The effectiveness of the catch basins equipped with hoods in reducing gross solids was not greatly different among the three types of hoods tested in this study. Concentrations of OG and TPH collected from the water surface of the catch-basins varied from catch basin to catch basin and were similar to concentrations of flow-weighted composite samples collected during storms. Comparisons indicate concentrations of OG and TPH in flow-weighted composite samples collected at the outlet of a catch basin equipped with an Eliminator hood were not substantially different from concentrations of the respective constituents in flow-weighted composite samples collected during a previous study from catch basins containing cast-iron hoods in the same study area. The similarity between these flow-weighted concentrations and the concentrations of the respective constituents in a vertical profile sample collected from the catch-basin sump indicates that OG and TPH are emulsified in the sump of each catch basin during storms and circumvent the hoods.

Evaluation of marginal fit of two all-ceramic copings with two finish lines

PubMed Central

Subasi, Gulce; Ozturk, Nilgun; Inan, Ozgur; Bozogullari, Nalan

2012-01-01

Objectives: This in-vitro study investigated the marginal fit of two all-ceramic copings with 2 finish line designs. Methods: Forty machined stainless steel molar die models with two different margin designs (chamfer and rounded shoulder) were prepared. A total of 40 standardized copings were fabricated and divided into 4 groups (n=10 for each finish line-coping material). Coping materials tested were IPS e.max Press and Zirkonzahn; luting agent was Variolink II. Marginal fit was evaluated after cementation with a stereomicroscope (Leica MZ16). Two-way analysis of variance and Tukey-HSD test were performed to assess the influence of each finish line design and ceramic type on the marginal fit of 2 all-ceramic copings (α =.05). Results: Two-way analysis of variance revealed no statistically significant differences for marginal fit relative to finish lines (P=.362) and ceramic types (P=.065). Conclusion: Within the limitations of this study, both types of all-ceramic copings demonstrated that the mean marginal fit was considered acceptable for clinical application (⩽120 μm). PMID:22509119

Moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults.

PubMed

da Silva, Jaqueline Aragoni; da Silva, Kelly Samara; Del Duca, Giovani Firpo; Dos Santos, Priscila Cristina; Wolker, Sofia; de Oliveira, Elusa Santina Antunes; de Barros, Mauro Virgílio Gomes; Nahas, Markus Vinicius

2016-06-01

To investigate the moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults. Secondary analysis of the survey "Lifestyle and leisure habits of industry workers" (n=46,981), conducted in 24 Brazilian states (2006-2008). Self-reported information was collected with a previously tested questionnaire. Crude and adjusted logistic regression models were applied to analyze the association between sociodemographic variables (sex, age, marital status, number of children, education, country area and company size) and active commuting to work in different strata of gross family income. To test the moderating effect, an interaction analysis was applied. The proportion of active commuters among low-, medium- and high-income workers was 40.7% (95%CI:40.0%;41.5%), 27.0% (95%CI:26.3;27.6%) and 11.1%, (95%CI:10.5%;11.7%), respectively. The moderating effect of gross family income was confirmed. Men were more likely (OR:1.22 95%CI:1.12;1.32) to commute actively than women among low-income individuals. Active commuting was less likely among older workers in low-(OR30-39:0.90 95%CI: 0.83;0.98; OR≥40: 0.76 95%CI: 0.68;0.85) and medium-income strata (OR30-39:0.87 95%CI:0.80;0.95; OR≥40:0.84 95%CI:0.76;0.93) and among married individuals in high-income strata (OR:0.72 95%IC:0.61;0.84). Adults with lower education (ORhigh:10.80 95%CI:8.47;13.77), working in the south (ORhigh:1.93 95%CI:1.53;2.44) and in small companies (ORlow:2.50 95%CI:2.28;2.74) were more likely to commute actively; however, the magnitude of these associations differed at each income strata. There was an inverse association between gross family income and active commuting. Gross family income acts as a moderator of the association between demographic indicators and active commuting. Copyright © 2016 Elsevier Inc. All rights reserved.

The Role of Margin in Link Design and Optimization

NASA Technical Reports Server (NTRS)

Cheung, K.

2015-01-01

Link analysis is a system engineering process in the design, development, and operation of communication systems and networks. Link models that are mathematical abstractions representing the useful signal power and the undesirable noise and attenuation effects (including weather effects if the signal path transverses through the atmosphere) that are integrated into the link budget calculation that provides the estimates of signal power and noise power at the receiver. Then the link margin is applied which attempts to counteract the fluctuations of the signal and noise power to ensure reliable data delivery from transmitter to receiver. (Link margin is dictated by the link margin policy or requirements.) A simple link budgeting approach assumes link parameters to be deterministic values typically adopted a rule-of-thumb policy of 3 dB link margin. This policy works for most S- and X-band links due to their insensitivity to weather effects. But for higher frequency links like Ka-band, Ku-band, and optical communication links, it is unclear if a 3 dB link margin would guarantee link closure. Statistical link analysis that adopted the 2-sigma or 3-sigma link margin incorporates link uncertainties in the sigma calculation. (The Deep Space Network (DSN) link margin policies are 2-sigma for downlink and 3-sigma for uplink.) The link reliability can therefore be quantified statistically even for higher frequency links. However in the current statistical link analysis approach, link reliability is only expressed as the likelihood of exceeding the signal-to-noise ratio (SNR) threshold that corresponds to a given bit-error-rate (BER) or frame-error-rate (FER) requirement. The method does not provide the true BER or FER estimate of the link with margin, or the required signalto-noise ratio (SNR) that would meet the BER or FER requirement in the statistical sense. In this paper, we perform in-depth analysis on the relationship between BER/FER requirement, operating SNR, and coding performance curve, in the case when the channel coherence time of link fluctuation is comparable or larger than the time duration of a codeword. We compute the "true" SNR design point that would meet the BER/FER requirement by taking into account the fluctuation of signal power and noise power at the receiver, and the shape of the coding performance curve. This analysis yields a number of valuable insights on the design choices of coding scheme and link margin for the reliable data delivery of a communication system - space and ground. We illustrate the aforementioned analysis using a number of standard NASA error-correcting codes.

Impact of Resection Margin Distance on Survival of Pancreatic Cancer: A Systematic Review and Meta-Analysis

PubMed Central

Kim, Kyung Su; Kwon, Jeanny; Kim, Kyubo; Chie, Eui Kyu

2017-01-01

Purpose While curative resection is the only chance of cure in pancreatic cancer, controversies exist about the impact of surgical margin status on survival. Non-standardized pathologic report and different criteria on the R1 status made it difficult to implicate adjuvant therapy after resection based on the margin status. We evaluated the influence of resection margins on survival by meta-analysis. Materials and Methods We thoroughly searched electronic databases of PubMed, EMBASE, and Cochrane Library. We included studies reporting survival outcomes with different margin status: involved margin (R0 mm), margin clearance with ≤ 1 mm (R0-1 mm), and margin with > 1 mm (R>1 mm). Hazard ratio (HR) for overall survival was extracted, and a random-effects model was used for pooled analysis. Results A total of eight retrospective studies involving 1,932 patients were included. Pooled HR for overall survival showed that patients with R>1 mm had reduced risk of death than those with R0-1 mm (HR, 0.74; 95% confidence interval [CI], 0.61 to 0.88; p=0.001). In addition, patients with R0-1 mm had reduced risk of death than those with R0 mm (HR, 0.81; 95% CI, 0.72 to 0.91; p < 0.001). There was no heterogeneity between the included studies (I2 index, 42% and 0%; p=0.10 and p=0.82, respectively). Conclusion Our results suggest that stratification of the patients based on margin status is warranted in the clinical trials assessing the role of adjuvant treatment for pancreatic cancer. PMID:27561314

Analysis of vertical marginal discrepancy in feldspathic porcelain crowns manufactured with different CAD/CAM systems: Closed and open.

PubMed

Kricheldorf, Fabio; Bueno, Cleuber Rodrigo de Souza; Amaral, Wilson da Silva; Junior, Joel Ferreira Santiago; Filho, Hugo Nary

2018-01-01

The objective of this study is to compare the marginal adaptation of feldspathic porcelain crowns using two computer-aided design/computer-aided manufacturing systems, one of them is open and the other is closed. Twenty identical titanium abutments were divided into two groups: open system (OS), where ceramic crowns were created using varied equipment and software, and closed system (CS), where ceramic crowns were created using the CEREC system. Through optical microscopy analysis, we assess the marginal adaptation of the prosthetic interfaces. The data were subjected to the distribution of normality and variance. The t -test was used for the analysis of the comparison factor between the groups, and the one-way ANOVA was used to compare the variance of crown analysis regions within the group. A significance level of 5% was considered for the analyses. There was a significant difference between the systems ( P = 0.007), with the CS group having the higher mean (23.75 μm ± 3.05) of marginal discrepancy when compared to the open group (17.94 μm ± 4.77). Furthermore, there were no differences in marginal discrepancy between the different points between the groups ( P ≥ 0.05). The studied groups presented results within the requirements set out in the literature. However, the OS used presented better results in marginal adaptation.

The impact of frozen sections on final surgical margins in squamous cell carcinoma of the oral cavity and lips: a retrospective analysis over an 11 years period

PubMed Central

2011-01-01

Background Taking intraoperative frozen sections (FS) is a widely used procedure in oncologic surgery. However so far no evidence of an association of FS analysis and premalignant changes in the surgical margin exists. Therefore, the aim of this study was to evaluate the impact of FS on different categories of the final margins of squamous cell carcinoma (SCC) of the oral cavity and lips. Methods FS, pT-stage, grading, and tumor localization of 178 patients with SCC of the oral cavity and lips were compared by uni- and multivariate analysis in patients with positive, dysplastic and negative surgical margin status. Results Performed on 111 patients (62.4%), intraoperative FS did not have any statistically significant influence on final margin status, independent of whether it was positive (p = 0.40), dysplastic (p = 0.70), or negative (p = 0.70). Positive surgical margins in permanent sections were significantly associated with pT4-tumors (OR 5.61, p = 0.001). The chance for negative margins in permanent sections was significantly higher in tumors located in the tongue (OR 4.70, p = 0.01). Conclusions Our data suggests that intraoperative FS in SCC can be useful in selected cases. However it is not advisable as a routine approach. PMID:22208692

Independent Component Analysis of Textures

NASA Technical Reports Server (NTRS)

Manduchi, Roberto; Portilla, Javier

2000-01-01

A common method for texture representation is to use the marginal probability densities over the outputs of a set of multi-orientation, multi-scale filters as a description of the texture. We propose a technique, based on Independent Components Analysis, for choosing the set of filters that yield the most informative marginals, meaning that the product over the marginals most closely approximates the joint probability density function of the filter outputs. The algorithm is implemented using a steerable filter space. Experiments involving both texture classification and synthesis show that compared to Principal Components Analysis, ICA provides superior performance for modeling of natural and synthetic textures.

Structure of the North American Atlantic Continental Margin.

ERIC Educational Resources Information Center

Klitgord, K. K.; Schlee, J. S.

1986-01-01

Offers explanations on the origin of the North American Atlantic continental margin. Provides an analysis and illustrations of structural and strategraphic elements of cross sections of the Atlantic continental margin. Also explains the operations and applications of seismic-relection profiles in studying ocean areas. (ML)

Analysis of Proteins of Mouse Sarcoma Pseudotype Viruses: Type-Specific Radioimmunoassays for Ecotropic Virus p30's

PubMed Central

Kennel, Stephen J.; Tennant, Raymond W.

1979-01-01

Murine sarcoma virus pseudotypes were prepared by infection of nonproducer cells (A1-2), which were transformed by the Gazdar strain of mouse sarcoma virus, with Gross (N-tropic), WN1802B (B-tropic), or Moloney (NB-tropic) viruses. The respective host range pseudotype sarcoma viruses were defined by the titration characteristics on cells with the appropriate Fv-1 genotype. Proteins from virus progeny were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Bands present in both the 65,000- and the 10,000- to 20,000- molecular-weight regions of the gel distinguished the pseudotype viruses from their respective helpers. Furthermore, two protein bands were noted in the p30 region of murine sarcoma virus (Gross), one corresponding to Gross virus p30, and another of slightly slower mobility. However, since the mobility of the putative sarcoma p30 is nearly indentical to that of WN1802B, its presence could not be established by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Type-specific radioimmunoassays for Gross virus p30 and for WN1802B p30 were applied for analysis of pseudotype preparations, and among several ecotropic viruses tested, only the homologous virus scored in the respective assay. By use of these assays, pseudotype viruses were found to contain only 8 to 48% helper-specific p30's; the remainder is presumably derived from the sarcoma virus. Images PMID:90164

Intra-surgical total and re-constructible pathological prostate examination for safer margins and nerve preservation (Istanbul preserve).

PubMed

Öbek, Can; Saglican, Yesim; Ince, Umit; Argun, Omer Burak; Tuna, Mustafa Bilal; Doganca, Tunkut; Tufek, Ilter; Keskin, Selcuk; Kural, Ali Riza

2018-04-01

To demonstrate a novel frozen section analysis technique during robot assisted radical prostatectomy with 2 distinct advantages: evaluation of the entire circumference and easier reconstruction for whole mount evaluation. Istanbul Preserve was performed on patients who underwent robotic prostatectomy with nerve sparing between 10/2014 and 7/2016. Gland was sectioned at 3-4mm intervals from apex to bladder neck. Entire tissue representing margins (except for the most anterior portion) was circumferentially excised and microscopically analyzed. In margin positivity, approach was individualized based on extent of positive margin and Gleason pattern. A matched cohort was established for comparison. Retrospective analysis of a prospectively maintained database was performed. Impact of FSA on PSM rate was primarily assessed. Data on 170 patients was analyzed. Positive surgical margin was reported in 56(33%) on frozen section. Neurovascular bundle was partially or totally resected in 79% and 18%. Conversion of positive margin to negative was achieved in 85%. Overall positive margin rate decreased from 22.5% to 7.5%. Nerve sparing increased from 87% to 93%. Location of positive margin at frozen was at the neurovascular bundle area in 39%; thus Istanbul Preserve detected 61% additional margin positivity compared to other techniques. Reconstruction for whole mount was easy. Istanbul Preserve is a novel technique for intraoperative FSA during RARP allowing for microscopic examination of the entire prostate for margin status and easy re-construction for whole mount examination. It guarantees safer margins together with increased rate of nerve sparing. Copyright © 2017 Elsevier Inc. All rights reserved.

An analysis of reflective writing early in the medical curriculum: The relationship between reflective capacity and academic achievement.

PubMed

Ottenberg, Abigale L; Pasalic, Dario; Bui, Gloria T; Pawlina, Wojciech

2016-07-01

To examine the relationship between reflection, gender, residency choice, word count, and academic achievement among medical students. A modified version of the Reflection Evaluation for Learners' Enhanced Competencies Tool (REFLECT) was developed and used for this study (Cronbach's alpha of 0.86 with an intraclass correlation coefficient [ICC] of 0.68). This was applied to writing samples about professionalism in gross anatomy from first-year medical students between 2005 and 2011. Four analysts reviewed and scored written reflections independently. Composite reflection scores were compared with gender, residency choice, length of written reflection, NBME® Gross Anatomy and Embryology Subject Examination scores, and final gross anatomy course. Total of 319 written reflections were evaluated. Female students who pursued medicine specialties had the highest composite reflection scores (87 [27.2%]). Word count frequently correlated with reflection score (p < 0.0001). Students who performed well on the NBME® Gross Anatomy and Embryology Subject Examination tended to achieve high anatomy course grades (p < 0.0001). There was no statistically significant relationship between composite reflection scores and NBME® Gross Anatomy and Embryology Subject Examination scores (p = 0.16) or anatomy course grades (p = 0.90). This study suggests there are likely no correlations between reflective capacity and academic performance on tests of medical knowledge administered early in the medical curriculum.

Contributing Factors Analysis for the Changes of the Gross Motor Function in Children With Spastic Cerebral Palsy After Physical Therapy

PubMed Central

Yi, Tae Im; Kim, Sung Heon; Han, Kyung Hee

2013-01-01

Objective To investigate the factors which contribute to the improvements of the gross motor function in children with spastic cerebral palsy after physical therapy. Methods The subjects were 45 children with spastic cerebral palsy with no previous botulinum toxin injection or operation history within 6 months. They consisted of 24 males (53.3%) and 21 females (46.7%), and the age of the subjects ranged from 2 to 6 years, with the mean age being 41±18 months. The gross motor function was evaluated by Gross Motor Function Measure (GMFM)-88 at the time of admission and discharge, and then, the subtractions were correlated with associated factors. Results The GMFM-88 was increased by 7.17±3.10 through 52±16 days of physical therapy. The more days of admission, the more improvements of GMFM-88 were attained. The children with initial GMFM-88 values in the middle range showed more improvements in GMFM-88 (p<0.05). The children without dysphagia and children with less spasticity of lower extremities also showed more improvements in GMFM-88 (p<0.05). Conclusion We can predict the improvements of the gross motor function after physical therapy according to the days of admission, initial GMFM-88, dysphagia, and spasticity of lower extremities. Further controlled studies including larger group are necessary. PMID:24236252

A novel method to quantify and compare anatomical shape: application in cervix cancer radiotherapy

NASA Astrophysics Data System (ADS)

Oh, Seungjong; Jaffray, David; Cho, Young-Bin

2014-06-01

Adaptive radiation therapy (ART) had been proposed to restore dosimetric deficiencies during treatment delivery. In this paper, we developed a technique of Geometric reLocation for analyzing anatomical OBjects' Evolution (GLOBE) for a numerical model of tumor evolution under radiation therapy and characterized geometric changes of the target using GLOBE. A total of 174 clinical target volumes (CTVs) obtained from 32 cervical cancer patients were analyzed. GLOBE consists of three main steps; step (1) deforming a 3D surface object to a sphere by parametric active contour (PAC), step (2) sampling a deformed PAC on 642 nodes of icosahedron geodesic dome for reference frame, and step (3) unfolding 3D data to 2D plane for convenient visualization and analysis. The performance was evaluated with respect to (1) convergence of deformation (iteration number and computation time) and (2) accuracy of deformation (residual deformation). Based on deformation vectors from planning CTV to weekly CTVs, target specific (TS) margins were calculated on each sampled node of GLOBE and the systematic (Σ) and random (σ) variations of the vectors were calculated. Population based anisotropic (PBA) margins were generated using van Herk's margin recipe. GLOBE successfully modeled 152 CTVs from 28 patients. Fast convergence was observed for most cases (137/152) with the iteration number of 65 ± 74 (average ± STD) and the computation time of 13.7 ± 18.6 min. Residual deformation of PAC was 0.9 ± 0.7 mm and more than 97% was less than 3 mm. Margin analysis showed random nature of TS-margin. As a consequence, PBA-margins perform similarly to ISO-margins. For example, PBA-margins for 90% patients' coverage with 95% dose level is close to 13 mm ISO-margins in the aspect of target coverage and OAR sparing. GLOBE demonstrates a systematic analysis of tumor motion and deformation of patients with cervix cancer during radiation therapy and numerical modeling of PBA-margin on 642 locations of CTV surface.

Wavelet Filtering to Reduce Conservatism in Aeroservoelastic Robust Stability Margins

NASA Technical Reports Server (NTRS)

Brenner, Marty; Lind, Rick

1998-01-01

Wavelet analysis for filtering and system identification was used to improve the estimation of aeroservoelastic stability margins. The conservatism of the robust stability margins was reduced with parametric and nonparametric time-frequency analysis of flight data in the model validation process. Nonparametric wavelet processing of data was used to reduce the effects of external desirableness and unmodeled dynamics. Parametric estimates of modal stability were also extracted using the wavelet transform. Computation of robust stability margins for stability boundary prediction depends on uncertainty descriptions derived from the data for model validation. F-18 high Alpha Research Vehicle aeroservoelastic flight test data demonstrated improved robust stability prediction by extension of the stability boundary beyond the flight regime.

Determination of the origin of elevated uranium at a Former Air Force Landfill using non-parametric statistics analysis and uranium isotope ratio analysis

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

Weismann, J.; Young, C.; Masciulli, S.

2007-07-01

Lowry Air Force Base (Lowry) was closed in September 1994 as part of the Base Realignment and Closure (BRAC) program and the base was transferred to the Lowry Redevelopment Authority in 1995. As part of the due diligence activities conducted by the Air Force, a series of remedial investigations were conducted across the base. A closed waste landfill, designated Operable Unit 2 (OU 2), was initially assessed in a 1990 Remedial Investigation (RI; [1]). A Supplemental Remedial Investigation was conducted in 1995 [2] and additional studies were conducted in a 1998 Focused Feasibility Study. [3] The three studies indicated thatmore » gross alpha, gross beta, and uranium concentrations were consistently above regulatory standards and that there were detections of low concentrations other radionuclides. Results from previous investigations at OU 2 have shown elevated gross alpha, gross beta, and uranium concentrations in groundwater, surface water, and sediments. The US Air Force has sought to understand the provenance of these radionuclides in order to determine if they could be due to leachates from buried radioactive materials within the landfill or whether they are naturally-occurring. The Air Force and regulators agreed to use a one-year monitoring and sampling program to seek to explain the origins of the radionuclides. Over the course of the one-year program, dissolved uranium levels greater than the 30 {mu}g/L Maximum Contaminant Level (MCL) were consistently found in both up-gradient and down-gradient wells at OU 2. Elevated Gross Alpha and Gross Beta measurements that were observed during prior investigations and confirmed during the LTM were found to correlate with high dissolved uranium content in groundwater. If Gross Alpha values are corrected to exclude uranium and radon contributions in accordance with US EPA guidance, then the 15 pCi/L gross alpha level is not exceeded. The large dataset also allowed development of gross alpha to total uranium correlation factors so that gross alpha action levels can be applied to future long-term landfill monitoring to track radiological conditions at lower cost. Ratios of isotopic uranium results were calculated to test whether the elevated uranium displayed signatures indicative of military use. Results of all ratio testing strongly supports the conclusion that the uranium found in groundwater, surface water, and sediment at OU 2 is naturally-occurring and has not undergone anthropogenic enrichment or processing. U-234:U-238 ratios also show that a disequilibrium state, i.e., ratio greater than 1, exists throughout OU 2 which is indicative of long-term aqueous transport in aged aquifers. These results all support the conclusion that the elevated uranium observed at OU 2 is due to the high concentrations in the regional watershed. Based on the results of this monitoring program, we concluded that the elevated uranium concentrations measured in OU 2 groundwater, surface water, and sediment are due to the naturally-occurring uranium content of the regional watershed and are not the result of waste burials in the former landfill. Several lines of evidence indicate that natural uranium has been naturally concentrated beneath OU 2 in the geologic past and the higher of uranium concentrations in down-gradient wells is the result of geochemical processes and not the result of a uranium ore disposal. These results therefore provide the data necessary to support radiological closure of OU 2. (authors)« less

Long-term disease control and toxicity outcomes following surgery and intensity modulated radiation therapy (IMRT) in pediatric craniopharyngioma.

PubMed

Greenfield, Brad J; Okcu, Mehmet F; Baxter, Patricia A; Chintagumpala, Murali; Teh, Bin S; Dauser, Robert C; Su, Jack; Desai, Snehal S; Paulino, Arnold C

2015-02-01

To report long-term progression-free survival (PFS) and late-toxicity outcomes in pediatric craniopharyngioma patients treated with IMRT. Twenty-four children were treated with IMRT to a median dose of 50.4Gy (range, 49.8-54Gy). The clinical target volume (CTV) was the gross tumor volume (GTV) with a 1cm margin. The planning target volume (PTV) was the CTV with a 3-5mm margin. Median follow-up was 107.3months. The 5- and 10-year PFS rates were 65.8% and 60.7%. The 5- and 10-year cystic PFS rates were 70.2% and 65.2% while the 5- and 10-year solid PFS were the same at 90.7%. Endocrinopathy was seen in 42% at initial diagnosis and in 74% after surgical intervention, prior to IMRT. Hypothalamic dysfunction and visual deficits were associated with increasing PTV and number of surgical interventions. IMRT is a viable treatment option for pediatric craniopharyngioma. Despite the use of IMRT, majority of the craniopharyngioma patients experienced long-term toxicity, many of which present prior to radiotherapy. Limitations of retrospective analyses on small patient cohort elicit the need for a prospective multi-institutional study to determine the absolute benefit of IMRT in pediatric craniopharyngioma. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Pathoanatomical preparation and reporting for dysplasias and cancers of the cervix uteri: cervical biopsy, conization, radical hysterectomy and exenteration].

PubMed

Horn, L-C; Einenkel, J; Höckel, M; Kölbl, H; Kommoss, F; Lax, S F; Reich, O; Riethdorf, L; Schmidt, D

2007-07-01

A careful macroscopic description with selection of representative tissue for histological examination is required for quality assurance, for assessing prognostic factors and for answering legal questions in (pre)cancerous lesions of the cervix uteri. Exact and standardized gross inspection and preparation are decisive for the quality of the histopathological statement. The extent of cervical carcinomas should be given in three dimensions, including the relative depth of invasion into the cervical wall. The report should include size, type (according to the WHO classification) and grading of the tumor, the presence of lymphatic as well as blood vessel invasion and perineural involvement. The statement for resection margins should include the vaginal, parametrial, rectal and vesical directions. It is also mandatory to document the number of lymph nodes with metastatic disease in relation to the total number of nodes investigated. The staging should follow the TNM system. In the handling of conisation specimens, it is important to appropriately document localization, horizontal expansion, depth of invasion including microinvasion of any dysplastic or malignant lesions. Clockwise dissection of the conisation specimen, total submission, and step sections are recommended. The preparation of exenteration specimens is a highly skilled job: the exact tumor dimension should be given in its relation to all resected organs and structures with special focus on resection margins.

Prevention of Radiochemotherapy-Induced Esophagitis With Glutamine: Results of a Pilot Study

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

Algara, Manuel; Universitat Pompeu Fabra, Barcelona; Rodriguez, Nuria

2007-10-01

Purpose: To assess the usefulness of oral glutamine to prevent radiochemotherapy-induced esophagitis in patients with lung cancer, and to determine the dosimetric parameter predictive of esophagitis. Methods and Materials: Seventy-five patients were enrolled; 34.7% received sequential radiochemotherapy, and 65.3% received concomitant radiochemotherapy. Every patient received prophylactic glutamine powder in doses of 10 g/8 h. Prescribed radiation doses were 45-50 Gy to planning target volume (PTV)1 (gross tumor volume plus wide margins) and 65-70 Gy to PTV2 (reduced margins). The primary endpoint was the incidence of Grade 2 or greater acute esophagitis. Results: No patient experienced glutamine intolerance or glutamine-related toxicity.more » Seventy-three percent of patients who received sequential chemotherapy and 49% of those who received concomitant chemotherapy did not present any form of esophagitis. V50 was the dosimetric parameter with better correlation between esophagitis and its duration. A V50 of {<=}30% had a 22% risk of esophagitis Grade {>=}2, which increased to 71% with a V50 of >30% (p = 0.0009). Conclusions: The use of oral glutamine may have an important role in the prevention of esophageal complications of concomitant radiochemotherapy in lung cancer patients. However, randomized trials are needed to corroborate that effect. V50 is the dosimetric parameter with better correlation with esophagitis grade and duration.« less

Comparing diet, oral hygiene and caries status of adult methamphetamine users and nonusers: a pilot study.

PubMed

Morio, Kimberly A; Marshall, Teresa A; Qian, Fang; Morgan, Teresa A

2008-02-01

Methamphetamine users are reported to have marginal dietary habits and high caries rates. The authors compared retrospective dietary patterns, oral hygiene behaviors and current oral health status of methamphetamine users and nonusers in a pilot study. Eighteen adults with a history of methamphetamine use (methamphetamine users) and 18 age- and sex-matched control subjects (nonusers) completed retrospective questionnaires concerning meal patterns, food group intakes, beverage habits, oral hygiene behaviors, smoking behaviors and drug use. The authors performed oral examinations to identify the number of remaining teeth, the number of teeth with obvious decay and presence of visible plaque. Methamphetamine users were more likely to snack without eating defined meals (P = .026), consume regular soda pop (that is, carbonated beverage with sugar) (P = .018), never brush their teeth (P < .001) and smoke (P < .001) than were nonusers. Users had more visible plaque (P < .001), fewer molars (P = .001) and more decay on anterior teeth (P < .001), premolars (P < .001) and molars (P < .001) than did nonusers. The results of this pilot study are consistent with anecdotal reports; methamphetamine users have more gross caries than do nonusers. Marginal dietary and oral hygiene behaviors associated with methamphetamine use likely increase caries risk. Patients at risk or suspected of using methamphetamine require detailed oral hygiene instruction and extensive dietary counseling.

Seismic signals of snow-slurry lahars in motion: 25 September 2007, Mt Ruapehu, New Zealand

NASA Astrophysics Data System (ADS)

Cole, S. E.; Cronin, S. J.; Sherburn, S.; Manville, V.

2009-05-01

Detection of ground shaking forms the basis of many lahar-warning systems. Seismic records of two lahar types at Ruapehu, New Zealand, in 2007 are used to examine their nature and internal dynamics. Upstream detection of a flow depends upon flow type and coupling with the ground. 3-D characteristics of seismic signals can be used to distinguish the dominant rheology and gross physical composition. Water-rich hyperconcentrated flows are turbulent; common inter-particle and particle-substrate collisions engender higher energy in cross-channel vibrations relative to channel-parallel. Plug-like snow-slurry lahars show greater energy in channel-parallel signals, due to lateral deposition insulating channel margins, and low turbulence. Direct comparison of flow size must account for flow rheology; a water-rich lahar will generate signals of greater amplitude than a similar-sized snow-slurry flow.

Conservative treatment for breast cancer. Complications requiring reconstructive surgery

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

Bostwick, J. 3d.; Paletta, C.; Hartrampf, C.R.

Women who select conservative treatment for carcinoma of the breast (tumor excision followed by supervoltage radiation therapy) place a premium on breast preservation and aesthetics. When local control fails and they require a mastectomy, or when the aesthetic appearance is unacceptable, they may request breast reconstruction. The goal of this study is to evaluate a series of 10 patients who required reconstructive breast surgery after complications of conservative treatment. Patient classification: I. Breast or chest wall necrosis (3). II. Breast fibrosis and gross asymmetry (3). III. Local recurrence of breast cancer (5). IV. Positive margins after the initial lumpectomy (1).more » The mean age was 34 years. Radiation dosage average was 5252 rads with two patients receiving iridium-192 implant boosts. The reconstructive management was complex and usually required a major musculocutaneous flap because of the radiation effects.« less

Estimating pharmacy level prescription drug acquisition costs for third-party reimbursement.

PubMed

Kreling, D H; Kirk, K W

1986-07-01

Accurate payment for the acquisition costs of drug products dispensed is an important consideration in a third-party prescription drug program. Two alternative methods of estimating these costs among pharmacies were derived and compared. First, pharmacists were surveyed to determine the purchase discounts offered to them by wholesalers. A 10.00% modal and 11.35% mean discount resulted for 73 responding pharmacists. Second, cost-plus percents derived from gross profit margins of wholesalers were calculated and applied to wholesaler product costs to estimate pharmacy level acquisition costs. Cost-plus percents derived from National Median and Southwestern Region wholesaler figures were 9.27% and 10.10%, respectively. A comparison showed the two methods of estimating acquisition costs would result in similar acquisition cost estimates. Adopting a cost-plus estimating approach is recommended because it avoids potential pricing manipulations by wholesalers and manufacturers that would negate improvements in drug product reimbursement accuracy.

Evaluation of marginal failures of dental composite restorations by acoustic emission analysis.

PubMed

Gu, Ja-Uk; Choi, Nak-Sam

2013-01-01

In this study, a nondestructive method based on acoustic emission (AE) analysis was developed to evaluate the marginal failure states of dental composite restorations. Three types of ring-shaped substrates, which were modeled after a Class I cavity, were prepared from polymethyl methacrylate, stainless steel, and human molar teeth. A bonding agent and a composite resin were applied to the ring-shaped substrates and cured by light exposure. At each time-interval measurement, the tooth substrate presented a higher number of AE hits than polymethyl methacrylate and steel substrates. Marginal disintegration estimations derived from cumulative AE hits and cumulative AE energy parameters showed that a signification portion of marginal gap formation was already realized within 1 min at the initial light-curing stage. Estimation based on cumulative AE energy gave a higher level of marginal failure than that based on AE hits. It was concluded that the AE analysis method developed in this study was a viable approach in predicting the clinical survival of dental composite restorations efficiently within a short test period.

Street Sex Work: Re/Constructing Discourse from Margin to Center

ERIC Educational Resources Information Center

McCracken, Jill Linnette

2009-01-01

Newspaper media create interpretations of marginalized groups that require rhetorical analysis so that we can better understand these representations. This article focuses on how newspaper articles create interpretations of sex work that affect both the marginalized and mainstream communities. My ethnographic case study argues that the material…

On Time Delay Margin Estimation for Adaptive Control and Optimal Control Modification

NASA Technical Reports Server (NTRS)

Nguyen, Nhan T.

2011-01-01

This paper presents methods for estimating time delay margin for adaptive control of input delay systems with almost linear structured uncertainty. The bounded linear stability analysis method seeks to represent an adaptive law by a locally bounded linear approximation within a small time window. The time delay margin of this input delay system represents a local stability measure and is computed analytically by three methods: Pade approximation, Lyapunov-Krasovskii method, and the matrix measure method. These methods are applied to the standard model-reference adaptive control, s-modification adaptive law, and optimal control modification adaptive law. The windowing analysis results in non-unique estimates of the time delay margin since it is dependent on the length of a time window and parameters which vary from one time window to the next. The optimal control modification adaptive law overcomes this limitation in that, as the adaptive gain tends to infinity and if the matched uncertainty is linear, then the closed-loop input delay system tends to a LTI system. A lower bound of the time delay margin of this system can then be estimated uniquely without the need for the windowing analysis. Simulation results demonstrates the feasibility of the bounded linear stability method for time delay margin estimation.

Robust Stability Analysis of the Space Launch System Control Design: A Singular Value Approach

NASA Technical Reports Server (NTRS)

Pei, Jing; Newsome, Jerry R.

2015-01-01

Classical stability analysis consists of breaking the feedback loops one at a time and determining separately how much gain or phase variations would destabilize the stable nominal feedback system. For typical launch vehicle control design, classical control techniques are generally employed. In addition to stability margins, frequency domain Monte Carlo methods are used to evaluate the robustness of the design. However, such techniques were developed for Single-Input-Single-Output (SISO) systems and do not take into consideration the off-diagonal terms in the transfer function matrix of Multi-Input-Multi-Output (MIMO) systems. Robust stability analysis techniques such as H(sub infinity) and mu are applicable to MIMO systems but have not been adopted as standard practices within the launch vehicle controls community. This paper took advantage of a simple singular-value-based MIMO stability margin evaluation method based on work done by Mukhopadhyay and Newsom and applied it to the SLS high-fidelity dynamics model. The method computes a simultaneous multi-loop gain and phase margin that could be related back to classical margins. The results presented in this paper suggest that for the SLS system, traditional SISO stability margins are similar to the MIMO margins. This additional level of verification provides confidence in the robustness of the control design.

Margins in extra-abdominal desmoid tumors: a comparative analysis.

PubMed

Leithner, Andreas; Gapp, Markus; Leithner, Katharina; Radl, Roman; Krippl, Peter; Beham, Alfred; Windhager, Reinhard

2004-06-01

The main treatment of extra-abdominal desmoid tumors remains surgery, but recurrence rates up to 80% are reported. The impact of microscopic surgical margin status according to the Enneking classification system is discussed controversially. Therefore, the authors screened the published literature for reliable data on the importance of a wide or radical excision of extra-abdominal desmoid tumors. All studies with more than ten patients, a surgical treatment only, and margin status stated were included. Only 12 out of 49 identified studies fulfilled the inclusion criteria. One hundred fifty-two primary tumors were excised with wide or radical microscopic surgical margins, while in 260 cases a marginal or intralesional excision was performed. In the first group 41 patients (27%) and in the second one 187 patients (72%) developed a recurrence. Therefore, microscopic surgical margin status according to the Enneking classification system is a significant prognostic factor (P < 0.001). The data of this review underline the strategy of a wide or radical local excision as the treatment of choice. Furthermore, as a large number of studies had to be excluded from this analysis, exact microscopic surgical margin status should be provided in future studies in order to allow comparability. . Copyright 2004 Wiley-Liss, Inc.

Bounded Linear Stability Analysis - A Time Delay Margin Estimation Approach for Adaptive Control

NASA Technical Reports Server (NTRS)

Nguyen, Nhan T.; Ishihara, Abraham K.; Krishnakumar, Kalmanje Srinlvas; Bakhtiari-Nejad, Maryam

2009-01-01

This paper presents a method for estimating time delay margin for model-reference adaptive control of systems with almost linear structured uncertainty. The bounded linear stability analysis method seeks to represent the conventional model-reference adaptive law by a locally bounded linear approximation within a small time window using the comparison lemma. The locally bounded linear approximation of the combined adaptive system is cast in a form of an input-time-delay differential equation over a small time window. The time delay margin of this system represents a local stability measure and is computed analytically by a matrix measure method, which provides a simple analytical technique for estimating an upper bound of time delay margin. Based on simulation results for a scalar model-reference adaptive control system, both the bounded linear stability method and the matrix measure method are seen to provide a reasonably accurate and yet not too conservative time delay margin estimation.

Gross motor function change after multilevel soft tissue release in children with cerebral palsy.

PubMed

Chang, Chia-Hsieh; Chen, Yu-Ying; Yeh, Kuo-Kuang; Chen, Chia-Ling

2017-06-01

Improving motor function is a major goal of therapy for children with cerebral palsy (CP). However, changes in motor function after orthopedic surgery for gait disorders are seldom discussed. This study aimed to evaluate the postoperative changes in gross motor function and to investigate the prognostic factors for such changes. We prospectively studied 25 children with CP (4-12 years) who were gross motor function classification system (GMFCS) level II to IV and and underwent bilateral multilevel soft-tissue release for knee flexion gait. Patients were evaluated preoperatively and at 6 weeks and 3 and 6 months postoperatively for Gross Motor Function Measure (GMFM-66), range of motion, spasticity, and selective motor control. The associations between change in GMFM-66 score and possible factors were analyzed. 25 children with gross motor function level II to IV underwent surgery at a mean age of 8.6 years (range, 4-12 years). Mean GMFM-66 score decreased from 55.9 at baseline to 54.3 at 6-weeks postoperatively and increased to 57.5 at 6-months postoperatively (p < 0.05). Regression analysis revealed better gross motor function level and greater surgical reduction of spasticity were predictors for decreased GMFM-66 score at 6-weeks postoperatively. Younger age was a predictor for increased GMFM-66 score at 6-months postoperatively. Reduction of contracture and spasticity and improvement of selective motor control were noted after surgery in children with CP. However, a down-and-up course of GMFM-66 score was noted. It is emphasized that deterioration of motor function in children with ambulatory ability and the improvement in young children after orthopedic surgery for gait disorders. case series, therapeutic study, level 4. Copyright © 2017 Chang Gung University. Published by Elsevier B.V. All rights reserved.

Gross violation of human rights and inequality in city of São Paulo, Southeastern Brazil.

PubMed

Ruotti, Caren; Freitas, Taís Viudes de; Almeida, Juliana Feliciano de; Peres, Maria Fernanda Tourinho

2009-06-01

To analyze the profile of gross human rights violations, and the relationship between these violations and socioeconomic and demographic indicators. Cross-sectional ecological study of 96 census districts of the city of São Paulo (Southeastern Brazil) in the year 2000. The data used came from the gross human rights violations database maintained by the Núcleo de Estudos de Violência (Center for the Study of Violence) at the Universidade de São Paulo. This database contains information on all the cases of summary executions, lynching and police violence reported on the written press. Socioeconomic and demographic data were obtained from the 2000 Census carried out by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics). A descriptive analysis of the data was carried out, and the association between the dependent variable - gross human rights violations (number of police violence victims, lynching episodes and summary executions) -, and different socioeconomic and demographic variables was tested. In order to test this association the Spearman's correlation test was used. The correlations between gross human rights violations and the socioeconomic and demographic indicators were statistically significant, except for the urbanization rate and the hospital beds per 1000 inhabitants. The strongest correlations were found between the dependent variable and the following variables: size of the resident population (r=0,693), proportion of youths aged from 15 to 24 years (r=0,621), and proportion of household heads with no education or with up to three years of schooling (r=0,590). Gross human rights violations more markedly occur in the population with the worst living conditions. Therefore, in a scenario in which inequality in attaining social and economic rights is directly superposed to the violation of civil rights, the violence cycle is intensified and perpetuated.

Gross Instability After Hip Arthroscopy: An Analysis of Case Reports Evaluating Surgical and Patient Factors.

PubMed

Yeung, Marco; Memon, Muzammil; Simunovic, Nicole; Belzile, Etienne; Philippon, Marc J; Ayeni, Olufemi R

2016-06-01

Gross hip instability is a rare complication after hip arthroscopy, and there is limited literature surrounding this topic. This systematic review investigates cases of gross hip instability after arthroscopy and discusses the risk factors associated with this complication. A systematic search was performed in duplicate for studies investigating gross hip instability after hip arthroscopy up to October 2015. Study parameters including sample size, mechanism and type of dislocation, surgical procedure details, patient characteristics, postoperative rehabilitation protocol, and level of evidence were analyzed. The systematic review identified 9 case reports investigating gross hip instability after hip arthroscopy (10 patients). Anterior dislocation occurred in 66.7% of patients, and most injuries occurred with a low-energy mechanism. Common surgical factors cited included unrepaired capsulotomy (77.8%) and iliopsoas release (33.3%), whereas patient factors included female gender (77.8%), acetabular dysplasia (22.2%), and general ligamentous laxity (11.1%). Postoperative restrictions and protocols were variable and inconsistently reported, and their relation to post-arthroscopy instability was difficult to ascertain. This systematic review discussed various patient, surgical, and postoperative risk factors of gross hip instability after arthroscopy. Patient characteristics such as female gender, hip dysplasia, and ligamentous laxity may be risk factors for post-arthroscopy dislocation. Similarly, surgical risk factors for iatrogenic hip instability may include unrepaired capsulotomies and iliopsoas debridement, although the role of capsular closure in iatrogenic instability is not clear. The influences of postoperative restrictions and protocols on dislocation are also unclear in the current literature. Surgeons should be cognizant of these risk factors when performing hip arthroscopy and be mindful that these factors appear to occur in combination. Level IV, systematic review of Level IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Fine and gross motor skills differ between healthy-weight and obese children.

PubMed

Gentier, Ilse; D'Hondt, Eva; Shultz, Sarah; Deforche, Benedicte; Augustijn, Mireille; Hoorne, Sofie; Verlaecke, Katja; De Bourdeaudhuij, Ilse; Lenoir, Matthieu

2013-11-01

Within the obesity literature, focus is put on the link between weight status and gross motor skills. However, research on fine motor skills in the obese (OB) childhood population is limited. Therefore, the present study focused on possible weight related differences in gross as well as fine motor skill tasks. Thirty-four OB children (12 ♀ and 22 ♂, aged 7-13 years) were recruited prior to participating in a multidisciplinary treatment program at the Zeepreventorium (De Haan, Belgium). Additionally, a control group of 34 age and gender-matched healthy-weight (HW) children was included in the study. Anthropometric measures were recorded and gross and fine motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2). Results were analyzed by independent samples t-tests, multivariate analysis of variance, and a chi-squared test. Being OB was detrimental for all subtests evaluating gross motor skill performance (i.e., upper-limb coordination, bilateral coordination, balance, running speed and agility, and strength). Furthermore, OB children performed worse in fine motor precision and a manual dexterity task, when compared to their HW peers. No group differences existed for the fine motor integration task. Our study provides evidence that lower motor competence in OB children is not limited to gross motor skills alone; OB children are also affected by fine motor skill problems. Further investigation is warranted to provide possible explanations for these differences. It is tentatively suggested that OB children experience difficulties with the integration and processing of sensory information. Future research is needed to explore whether this assumption is correct and what the underlying mechanism(s) could be. Copyright © 2013 Elsevier Ltd. All rights reserved.

Assessment of global motor performance and gross and fine motor skills of infants attending day care centers.

PubMed

Souza, Carolina T; Santos, Denise C C; Tolocka, Rute E; Baltieri, Letícia; Gibim, Nathália C; Habechian, Fernanda A P

2010-01-01

To analyze the global motor performance and the gross and fine motor skills of infants attending two public child care centers full-time. This was a longitudinal study that included 30 infants assessed at 12 and 17 months of age with the Motor Scale of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). This scale allows the analysis of global motor performance, fine and gross motor performance, and the discrepancy between them. The Wilcoxon test and Spearman's correlation coefficient were used. Most of the participants showed global motor performance within the normal range, but below the reference mean at 12 and 17 months, with 30% classified as having "suspected delays" in at least one of the assessments. Gross motor development was poorer than fine motor development at 12 and at 17 months of age, with great discrepancy between these two subtests in the second assessment. A clear individual variability was observed in fine motor skills, with weak linear correlation between the first and the second assessment of this subtest. A lower individual variability was found in the gross motor skills and global motor performance with positive moderate correlation between assessments. Considering both performance measurements obtained at 12 and 17 months of age, four infants were identified as having a "possible delay in motor development". The study showed the need for closer attention to the motor development of children who attend day care centers during the first 17 months of life, with special attention to gross motor skills (which are considered an integral part of the child's overall development) and to children with suspected delays in two consecutive assessments.

OCT structure, COB location and magmatic type of the SE Brazilian & S Angolan margins from integrated quantitative analysis of deep seismic reflection and gravity anomaly data

NASA Astrophysics Data System (ADS)

Cowie, L.; Kusznir, N. J.; Horn, B.

2013-12-01

Knowledge of ocean-continent transition (OCT) structure, continent-ocean boundary (COB) location and magmatic type are of critical importance for understanding rifted continental margin formation processes and in evaluating petroleum systems in deep-water frontier oil and gas exploration. The OCT structure, COB location and magmatic type of the SE Brazilian and S Angolan rifted continental margins are much debated; exhumed and serpentinised mantle have been reported at these margins. Integrated quantitative analysis using deep seismic reflection data and gravity inversion have been used to determine OCT structure, COB location and magmatic type for the SE Brazilian and S Angolan margins. Gravity inversion has been used to determine Moho depth, crustal basement thickness and continental lithosphere thinning. Residual Depth Anomaly (RDA) analysis has been used to investigate OCT bathymetric anomalies with respect to expected oceanic bathymetries and subsidence analysis has been used to determine the distribution of continental lithosphere thinning. These techniques have been validated on the Iberian margin for profiles IAM9 and ISE-01. In addition a joint inversion technique using deep seismic reflection and gravity anomaly data has been applied to the ION-GXT BS1-575 SE Brazil and ION-GXT CS1-2400 S Angola. The joint inversion method solves for coincident seismic and gravity Moho in the time domain and calculates the lateral variations in crustal basement densities and velocities along profile. Gravity inversion, RDA and subsidence analysis along the S Angolan ION-GXT CS1-2400 profile has been used to determine OCT structure and COB location. Analysis suggests that exhumed mantle, corresponding to a magma poor margin, is absent beneath the allochthonous salt. The thickness of earliest oceanic crust, derived from gravity and deep seismic reflection data is approximately 7km. The joint inversion predicts crustal basement densities and seismic velocities which are slightly less than expected for 'normal' oceanic crust. The difference between the sediment corrected RDA and that predicted from gravity inversion crustal thickness variation implies that this margin is experiencing ~300m of anomalous uplift attributed to mantle dynamic uplift. Gravity inversion, RDA and subsidence analysis have also been used to determine OCT structure and COB location along the ION-GXT BS1-575 profile, crossing the Sao Paulo Plateau and Florianopolis Ridge of the SE Brazilian margin. Gravity inversion, RDA and subsidence analysis predict the COB to be located SE of the Florianopolis Ridge. Analysis shows no evidence for exhumed mantle on this margin profile. The joint inversion technique predicts normal oceanic basement seismic velocities and densities and beneath the Sao Paulo Plateau and Florianopolis Ridge predicts crustal basement thicknesses between 10-15km. The Sao Paulo Plateau and Florianopolis Ridge are separated by a thin region of crustal basement beneath the salt interpreted as a regional transtensional structure. Sediment corrected RDAs and gravity derived 'synthetic' RDAs are of a similar magnitude on oceanic crust, implying negligible mantle dynamic topography.

CO2 laser versus cold steel margin analysis following endoscopic excision of glottic cancer

PubMed Central

2014-01-01

Objective To compare the suitability of CO2 laser with steel instruments for margin excision in transoral laser microsurgery. Methods Prospective randomized blinded study. Patients with glottic cancer undergoing laser resection were randomized to margin excision by either steel instruments or CO2 laser. Margins were analyzed for size, interpretability and degree of artifact by a pathologist who was blinded to technique. Results 45 patients were enrolled in the study with 226 total margins taken. 39 margins taken by laser had marked artifact and 0 were uninterpretable. 20 margins taken by steel instruments had marked artifact, and 2 were uninterpretable. Controlling for margin size, the laser technique was associated with increasing degrees of margin artifact (p = 0.210), but there was no difference in crude rates of uninterpretability (p = 0.24). Conclusion Laser margin excision is associated with a greater degree of artifact than steel instrument excision, but was not associated with higher rate of uninterpretability. PMID:24502856

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

none,

Oak Ridge Associated Universities (ORAU), under the Oak Ridge Institute for Science and Education (ORISE) contract, collected split surface water samples with Nuclear Fuel Services (NFS) representatives on June 12, 2013. Representatives from the U.S. Nuclear Regulatory Commission (NRC) and the Tennessee Department of Environment and Conservation were also in attendance. Samples were collected at four surface water stations, as required in the approved Request for Technical Assistance number 11-018. These stations included Nolichucky River upstream (NRU), Nolichucky River downstream (NRD), Martin Creek upstream (MCU), and Martin Creek downstream (MCD). Both ORAU and NFS performed gross alpha and gross betamore » analyses, and Table 1 presents the comparison of results using the duplicate error ratio (DER), also known as the normalized absolute difference. A DER ≤ 3 indicates at a 99% confidence interval that split sample results do not differ significantly when compared to their respective one standard deviation (sigma) uncertainty (ANSI N42.22). The NFS split sample report specifies 95% confidence level of reported uncertainties (NFS 2013). Therefore, standard two sigma reporting values were divided by 1.96. In conclusion, most DER values were less than 3 and results are consistent with low (e.g., background) concentrations. The gross beta result for sample 5198W0014 was the exception. The ORAU gross beta result of 6.30 ± 0.65 pCi/L from location NRD is well above NFS's non-detected result of 1.56 ± 0.59 pCi/L. NFS's data package includes no detected result for any radionuclide at location NRD. At NRC's request, ORAU performed gamma spectroscopic analysis of sample 5198W0014 to identify analytes contributing to the relatively elevated gross beta results. This analysis identified detected amounts of naturally-occurring constituents, most notably Ac-228 from the thorium decay series, and does not suggest the presence of site-related contamination.« less

A primer on marginal effects-part II: health services research applications.

PubMed

Onukwugha, E; Bergtold, J; Jain, R

2015-02-01

Marginal analysis evaluates changes in a regression function associated with a unit change in a relevant variable. The primary statistic of marginal analysis is the marginal effect (ME). The ME facilitates the examination of outcomes for defined patient profiles or individuals while measuring the change in original units (e.g., costs, probabilities). The ME has a long history in economics; however, it is not widely used in health services research despite its flexibility and ability to provide unique insights. This article, the second in a two-part series, discusses practical issues that arise in the estimation and interpretation of the ME for a variety of regression models often used in health services research. Part one provided an overview of prior studies discussing ME followed by derivation of ME formulas for various regression models relevant for health services research studies examining costs and utilization. The current article illustrates the calculation and interpretation of ME in practice and discusses practical issues that arise during the implementation, including: understanding differences between software packages in terms of functionality available for calculating the ME and its confidence interval, interpretation of average marginal effect versus marginal effect at the mean, and the difference between ME and relative effects (e.g., odds ratio). Programming code to calculate ME using SAS, STATA, LIMDEP, and MATLAB are also provided. The illustration, discussion, and application of ME in this two-part series support the conduct of future studies applying the concept of marginal analysis.

SU-E-T-605: RapidArc Combined with DIBH Technique for Thoracic Esophageal Carcinoma: The Potential Value of Target Immobilization and Reduced Lung Density in Dose Escalation.

PubMed

Yin, Y; Liu, T; Zhai, D

2012-06-01

To compare the dosimetric benefits of Rapidarc (RA) combined with deep inspiration breath-hold (DIBH) with those of other standard techniques, including free breathing (FB) during fixed-field intensity modulated radiation therapy (IMRT) and dual arc RA, in the treatment of patients with thoracic esophageal carcinoma (EC). Ten patients with EC underwent computed tomography (CT) scans under 2 respiration conditions: free-breathing (FB) and DIBH. These scans were used to generate 3-dimensional conformal treatment plans. For breath-hold scans, the patients were brought to reproducible respiration levels using active breathing control (ABC) maneuvers. Planning target volumes (PTVs) for FB plans included a 0.5 cm margin for setup plus a 1 cm margin equal to the extent of tumor motion for respiration. PTVs for DIBH plans included a 0.5 cm margin for setup error and a 0.5 cm margin for residual uncertainty in tumor position. Using a dose level of 60 Gy to the PTV, three treatment plans were generated: IMRT-FB, RA-FB and RA-ABC, and the target and normal tissue volumes were compared, as were the dosimetry parameters. On average, the DIBH technique resulted in increased lung volumes compared with FB techniques. There was no significant differences in gross tumor volume between the two breathing states (p > 0.05); but PTV and heart volume were larger for FB than for DIBH (p < 0.05). The overall CI and HI for the RA-ABC plan was slightly inferior to those of the IMRT- FB and RA-FB plans (p < 0.05 each). With DIBH, the heart was partly out of the beam portals and the average mean heart dose was reduced. Compared with conventional FB, RA combined with DIBH significantly reduced cardiac and pulmonary doses without compromising the target coverage and may reduce treatment toxicity, enabling dose escalation in future prospective studies of patients with EC. © 2012 American Association of Physicists in Medicine.

Effect of resealing on microleakage of resin composite restorations in relationship to margin design and composite type

PubMed Central

Antonson, Sibel A.; Yazici, A. Ruya; Okte, Zeynep; Villalta, Patricia; Antonson, Donald E.; Hardigan, Patrick C.

2012-01-01

Objective: To determine the relationship between margin preparation design and resin-composite type on microleakage with or without re-application of surface-penetrating sealant. Methods: Class-I resin-composite restorations were completed for 128 extracted human molars. Half of the margins were beveled, the other half, butt-joint. Half of each group was restored with Filtek-Supreme (FS), the other half with Esthet-X (EX) using their respective adhesive systems. Margins were etched and sealed with a surface-penetrating sealant, Fortify. The samples were stored in water 24h, and thermocycled (5,000 cycles, 5°C–55°C). Then, samples were abraded using a toothbrush machine (6,000 strokes). Half of the restorations from each sealant group (n=16) were resealed, and the other half had no further treatment. Thermocycling and tooth brushing were repeated. The samples were sealed with nail polish, immersed in methylene-blue for 8h, sectioned, and magnified digital photographs were taken. Three examiners assessed dye penetration. A 2×2×2 multi-layered Chi-Square analysis, using Cochran-Mantel-Haenszel test was conducted for statistical analysis. Results: No difference was observed between sealed and resealed FS and EX restorations with butt-joint margins. In beveled margins, resealing caused significantly less microleakage (P<.01). No differences were found between restorations either sealed or resealed with bevel margins. In butt-joint margins, at the leakage level deeper than 2/3 of the preparation depth, resealed FS showed less microleakage than EX resealed restorations (P<.01). Conclusion: Resealing reduced microleakage in bevel margins, however, in butt-joint margins resealing did not affect the leakage. A significant statistical relationship exists between and within resealing, margin preparation design, type of composite, and microleakage. PMID:23077418

Optimum Component Design in N-Stage Series Systems to Maximize the Reliability Under Budget Constraint

DTIC Science & Technology

2003-03-01

27 2.8.5 Marginal Analysis Method...Figure 11 Improved Configuration of Figure 10; Increases Basic System Reliability..... 26 Figure 12 Example of marginal analysis ...View of Main Book of Software ............................................................... 51 Figure 20 The View of Data Worksheet

Estimation Of TMDLs And Margin Of Safety Under Conditions Of Uncertainty

EPA Science Inventory

In TMDL development, an adequate margin of safety (MOS) is required in the calculation process to provide a cushion needed because of uncertainties in the data and analysis. Current practices, however, rarely factor analysis' uncertainty in TMDL development and the MOS is largel...

Antiretrovirals for low income countries: an analysis of the commercial viability of a highly competitive market

PubMed Central

2013-01-01

Background The price of antiretroviral drugs (ARVs) in low income countries declined steadily in recent years. This raises concerns about the commercial viability of the market of ARVs in low income countries. Methods Using 2 costing scenarios, we modeled the production cost of the most commonly used ARVs in low income countries in 2010 and 2012, and assessed whether, at the median price paid by low income countries, their manufacturers would still make profits. By interviews we consulted 11 generic manufacturers on the current state of the ARV market, and on what would be required to ensure their continued commitment to supply ARVs to low income countries. Results Using the lowest prices for active pharmaceutical ingredients (API) quoted to WHO, and applying published assumptions about the production cost of ARVs, our baseline estimate was that Indian generic manufacturers would have made profits on only 1 out of 13 formulations of ARVs in both 2010 and 2012, and publicly owned manufacturers would have made profits on 5 and 3 out of 13 formulations in 2010 and 2012, respectively. We needed to assume a 20% and a 40% lower API cost for our model to predict that publicly owned and Indian manufacturers, respectively, would make profits on the sale of the majority of their ARVs. Between 2010 and 2012, we estimate that - across the ARV portfolio - the gross profit on sales of ARVs to low income countries decreased with between 6% and 7% of their sales price. Generic manufacturers consider that current prices are unsustainable. They suggested amendments to the tender procedures, simplified regulatory procedures, improved forecasting, and simplification of the ARV guidelines as critical improvements to maintain a viable ARV market. Conclusions While recent price decreases indicate that there is still space for price reduction, our estimate that gross profit margin on sales decreased by 6 to 7% between 2010 and 2012 lends credibility to assertions by generic manufacturers that the ARV market in low income countries is under considerable price pressure. This might create problems for the quality and/or the continued supply of ARVs to low income countries. PMID:23410145

Surprises in low-dimensional correlated systems

NASA Astrophysics Data System (ADS)

Lin, Hsiu-Hau

In this thesis, correlation effects in low-dimensional systems were studied. In particular, we focus on two systems: a point-contact in the quantum-Hall regime under the influence of ac drive and quasi-one-dimensional ladder materials with generic interactions in weak coupling. Powerful techniques, including renormalization group, quantum field theory, operator product expansions, bosonization,...etc., were employed to extract surprising physics out of these strongly fluctuating systems. We first study the effect of an ac drive on the current-voltage (I-V) characteristics of a tunnel junction between two fractional Quantum Hall fluids at filling nu-1 an odd integer. In a semi-classical limit, the tunneling current exhibits mode-locking, which corresponds to plateaus in the I-V curve at integer multiples of I = ef , with f the ac drive frequency. However, the full quantum model exhibits rounded plateaus centered around the quantized current values due to quantum fluctuations. The locations of these plateaus can serve as an indirect hint of fractional charges. Switching attentions to quasi-one-dimensional coupled-chain systems, we present a systematic weak-coupling renormalization group (RG) technique and find that generally broad regions of the phase space of the ladder materials are unstable to pairing, usually with approximate d-wave symmetry. The dimensional crossovers from 1D to 2D were also discussed. Carbon nanotubes as possible candidates that display such unconventional pairing and interesting physics in weak coupling were discussed. Quite surprisingly, a hidden symmetry was found in the weakly-coupled two-leg ladder. A perturbative renormalization group analysis reveals that at half-filling the model scales onto an exactly soluble SO(8) symmetric Gross-Neveu model. Integrability of the Gross-Neveu model is employed to extract the exact energies, degeneracies and quantum numbers of all the low energy excited states, which fall into degenerate SO(8) multiplets. For generic physical interactions, there are four robust phases which have different SO(8) symmetries but share a common SO(5) symmetry. The effects of marginal chiral interactions were discussed at the end. Finally, we summarize our main results and discuss related open questions for future study.

Antiretrovirals for low income countries: an analysis of the commercial viability of a highly competitive market.

PubMed

Nakakeeto, Olive N; Elliott, Brian V

2013-02-15

The price of antiretroviral drugs (ARVs) in low income countries declined steadily in recent years. This raises concerns about the commercial viability of the market of ARVs in low income countries. Using 2 costing scenarios, we modeled the production cost of the most commonly used ARVs in low income countries in 2010 and 2012, and assessed whether, at the median price paid by low income countries, their manufacturers would still make profits. By interviews we consulted 11 generic manufacturers on the current state of the ARV market, and on what would be required to ensure their continued commitment to supply ARVs to low income countries. Using the lowest prices for active pharmaceutical ingredients (API) quoted to WHO, and applying published assumptions about the production cost of ARVs, our baseline estimate was that Indian generic manufacturers would have made profits on only 1 out of 13 formulations of ARVs in both 2010 and 2012, and publicly owned manufacturers would have made profits on 5 and 3 out of 13 formulations in 2010 and 2012, respectively. We needed to assume a 20% and a 40% lower API cost for our model to predict that publicly owned and Indian manufacturers, respectively, would make profits on the sale of the majority of their ARVs. Between 2010 and 2012, we estimate that--across the ARV portfolio--the gross profit on sales of ARVs to low income countries decreased with between 6% and 7% of their sales price. Generic manufacturers consider that current prices are unsustainable. They suggested amendments to the tender procedures, simplified regulatory procedures, improved forecasting, and simplification of the ARV guidelines as critical improvements to maintain a viable ARV market. While recent price decreases indicate that there is still space for price reduction, our estimate that gross profit margin on sales decreased by 6 to 7% between 2010 and 2012 lends credibility to assertions by generic manufacturers that the ARV market in low income countries is under considerable price pressure. This might create problems for the quality and/or the continued supply of ARVs to low income countries.

29 CFR 779.259 - What is included in annual gross volume.

Code of Federal Regulations, 2013 CFR

2013-07-01

... whole. The computation of the annual gross volume of sales or business of the enterprise is made... Coverage Annual Gross Volume of Sales Made Or Business Done § 779.259 What is included in annual gross volume. (a) The annual gross volume of sales made or business done of an enterprise consists of its gross...

29 CFR 779.259 - What is included in annual gross volume.

Code of Federal Regulations, 2012 CFR

2012-07-01

... whole. The computation of the annual gross volume of sales or business of the enterprise is made... Coverage Annual Gross Volume of Sales Made Or Business Done § 779.259 What is included in annual gross volume. (a) The annual gross volume of sales made or business done of an enterprise consists of its gross...

26 CFR 1.832-1 - Gross income.

Code of Federal Regulations, 2010 CFR

2010-04-01

... deposit premiums received, but not assessments, shall be excluded from gross income. Gross income does not... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Gross income. 1.832-1 Section 1.832-1 Internal... TAXES Other Insurance Companies § 1.832-1 Gross income. (a) Gross income as defined in section 832(b)(1...

Evaluation of the marginal fit of single-unit, complete-coverage ceramic restorations fabricated after digital and conventional impressions: A systematic review and meta-analysis.

PubMed

Tsirogiannis, Panagiotis; Reissmann, Daniel R; Heydecke, Guido

2016-09-01

In existing published reports, some studies indicate the superiority of digital impression systems in terms of the marginal accuracy of ceramic restorations, whereas others show that the conventional method provides restorations with better marginal fit than fully digital fabrication. Which impression method provides the lowest mean values for marginal adaptation is inconclusive. The findings from those studies cannot be easily generalized, and in vivo studies that could provide valid and meaningful information are limited in the existing publications. The purpose of this study was to systematically review existing reports and evaluate the marginal fit of ceramic single-tooth restorations after either digital or conventional impression methods by combining the available evidence in a meta-analysis. The search strategy for this systematic review of the publications was based on a Population, Intervention, Comparison, and Outcome (PICO) framework. For the statistical analysis, the mean marginal fit values of each study were extracted and categorized according to the impression method to calculate the mean value, together with the 95% confidence intervals (CI) of each category, and to evaluate the impact of each impression method on the marginal adaptation by comparing digital and conventional techniques separately for in vitro and in vivo studies. Twelve studies were included in the meta-analysis from the 63 identified records after database searching. For the in vitro studies, where ceramic restorations were fabricated after conventional impressions, the mean value of the marginal fit was 58.9 μm (95% CI: 41.1-76.7 μm), whereas after digital impressions, it was 63.3 μm (95% CI: 50.5-76.0 μm). In the in vivo studies, the mean marginal discrepancy of the restorations after digital impressions was 56.1 μm (95% CI: 46.3-65.8 μm), whereas after conventional impressions, it was 79.2 μm (95% CI: 59.6-98.9 μm) No significant difference was observed regarding the marginal discrepancy of single-unit ceramic restorations fabricated after digital or conventional impressions. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

"Doing School": A New Unit of Analysis for Schools Serving Marginalized Students

ERIC Educational Resources Information Center

Atkinson, Helen

2009-01-01

This study asserts a new unit of analysis for school reform that goes beyond the mental representations of individuals, beyond the isolated lesson, and beyond the confines of a school building. I argue that the special case of expanding time and space as a method of engagement for marginalized students requires that the unit of analysis change to…

Position Between Trunk and Pelvis During Gait Depending on the Gross Motor Function Classification System.

PubMed

Sanz-Mengibar, Jose Manuel; Altschuck, Natalie; Sanchez-de-Muniain, Paloma; Bauer, Christian; Santonja-Medina, Fernando

2017-04-01

To understand whether there is a trunk postural control threshold in the sagittal plane for the transition between the Gross Motor Function Classification System (GMFCS) levels measured with 3-dimensional gait analysis. Kinematics from 97 children with spastic bilateral cerebral palsy from spine angles according to Plug-In Gait model (Vicon) were plotted relative to their GMFCS level. Only average and minimum values of the lumbar spine segment correlated with GMFCS levels. Maximal values at loading response correlated independently with age at all functional levels. Average and minimum values were significant when analyzing age in combination with GMFCS level. There are specific postural control patterns in the average and minimum values for the position between trunk and pelvis in the sagittal plane during gait, for the transition among GMFCS I-III levels. Higher classifications of gross motor skills correlate with more extended spine angles.

Bioenergy Potential from Food Waste in California

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

Breunig, Hanna M.; Jin, Ling; Robinson, Alastair

This paper presents the first detailed analysis of monthly food waste generation in California at a county level, and its potential contribution to the state's energy production. Scenarios that rely on excess capacity at existing anaerobic digester (AD) and solid biomass combustion facilities, and alternatives that allow for new facility construction, are developed and modeled. Potential monthly electricity generation from the conversion of gross food waste using a combination of AD and combustion varies from 420 to 700 MW, averaging 530 MW. At least 66% of gross high moisture solids and 23% of gross low moisture solids can be treatedmore » using existing county infrastructure, and this fraction increases to 99% of high moisture solids and 55% of low moisture solids if waste can be shipped anywhere within the state. Biogas flaring practices at AD facilities can reduce potential energy production by 10 to 40%.« less

The value of volume and growth measurements in timber sales management of the National Forests

NASA Technical Reports Server (NTRS)

Lietzke, K. R.

1977-01-01

This paper summarizes work performed in the estimation of gross social value of timber volume and growth rate information used in making regional harvest decisions in the National Forest System. A model was developed to permit parametric analysis. The problem is formulated as one of finding optimal inventory holding patterns. Public timber management differs from other inventory holding problems in that the inventory, itself, generates value over time in providing recreational, aesthetic and environmental goods. 'Nontimber' demand estimates are inferred from past Forest Service harvest and sales levels. The solution requires a description of the harvest rates which maintain the optimum inventory level. Gross benefits of the Landsat systems are estimated by comparison with Forest Service information gathering models. Gross annual benefits are estimated to be $5.9 million for the MSS system and $7.2 million for the TM system.

Impact of life expectancy, literacy rate, opened unemployment rate and gross domestic regional income per capita on poverty in the districts/city in Central Sulawesi Province

NASA Astrophysics Data System (ADS)

Tombolotutu, A. D.; Djirimu, M. A.; Lutfi, M.; Anggadini, F.

2018-05-01

Research was conducted in several districts/city in Central Sulawesi Province in order to determine the effect of life expectancy, literacy rate, opened unemployment rate, and gross domestic regional income per capita on poverty at the districts/city in the province. The analysis used is Panel Data Regression. The results show that first, life expectancy and gross domestic regional income have a negative and significant impact on the poverty level in the districts/city in the Province. Second, the opened unemployment rate has a positive and significant effect on the poverty level in the districts/city in the province. Third, literacy rates show a positive effect and insignificant effect on the poverty level in the districts/city in the Province of Central Sulawesi. Fourth, these four variables simultaneously affect the poverty in the districts/city in Central Sulawesi

Evaluation of the marginal fit of metal copings fabricated on three different marginal designs using conventional and accelerated casting techniques: an in vitro study.

PubMed

Vaidya, Sharad; Parkash, Hari; Bhargava, Akshay; Gupta, Sharad

2014-01-01

Abundant resources and techniques have been used for complete coverage crown fabrication. Conventional investing and casting procedures for phosphate-bonded investments require a 2- to 4-h procedure before completion. Accelerated casting techniques have been used, but may not result in castings with matching marginal accuracy. The study measured the marginal gap and determined the clinical acceptability of single cast copings invested in a phosphate-bonded investment with the use of conventional and accelerated methods. One hundred and twenty cast coping samples were fabricated using conventional and accelerated methods, with three finish lines: Chamfer, shoulder and shoulder with bevel. Sixty copings were prepared with each technique. Each coping was examined with a stereomicroscope at four predetermined sites and measurements of marginal gaps were documented for each. A master chart was prepared for all the data and was analyzed using Statistical Package for the Social Sciences version. Evidence of marginal gap was then evaluated by t-test. Analysis of variance and Post-hoc analysis were used to compare two groups as well as to make comparisons between three subgroups . Measurements recorded showed no statistically significant difference between conventional and accelerated groups. Among the three marginal designs studied, shoulder with bevel showed the best marginal fit with conventional as well as accelerated casting techniques. Accelerated casting technique could be a vital alternative to the time-consuming conventional casting technique. The marginal fit between the two casting techniques showed no statistical difference.

Effect of a new physiotherapy concept on bone mineral density, muscle force and gross motor function in children with bilateral cerebral palsy.

PubMed

Stark, C; Nikopoulou-Smyrni, P; Stabrey, A; Semler, O; Schoenau, E

2010-06-01

The purpose of this study was to determine the effect of a new physiotherapy concept on bone density, muscle force and motor function in bilateral spastic cerebral palsy children. In a retrospective data analysis 78 children were analysed. The concept included whole body vibration, physiotherapy, resistance training and treadmill training. The concept is structured in two in-patient stays and two periods of three months home-based vibration training. Outcome measures were dual-energy x-ray absorption (DXA), Leonardo Tilt Table and a modified Gross Motor Function Measure before and after six months of training. Percent changes were highly significant for bone mineral density, -content, muscle mass and significant for angle of verticalisation, muscle force and modified Gross Motor Function Measure after six months training. The new physiotherapy concept had a significant effect on bone mineral density, muscle force and gross motor function in bilateral spastic cerebral palsy children. This implicates an amelioration in all International Classification of Functioning, Disability and Health levels. The study serves as a basis for future research on evidence based paediatric physiotherapy taking into account developmental implications.

Profitability analysis in the hospital industry.

PubMed Central

Cleverley, W O

1978-01-01

Measures of marginal profit are derived for the two payment classes--cost payers and charge payers--that the hospital industry must consider in profitability analysis, i.e., prediction of the excess of revenue over expenses. Two indexes of profitability, use when payment mix is constant and when it is nonconstant, respectively, are derived from the two marginal profit measures, and one of them is shown to be a modification of the contribution margin, the conventional measure of profitability used in general industry. All three measures--the contribution margin and the two new indexes of profitability--are used to estimate changes in net income resulting from changes in patient volume with and without accompanying changes in payment mix. The conventional measure yields large overestimates of expected excess revenue. PMID:632101

Analysis of identified iron meteoroids: Possible relation with M-type Earth-crossing asteroids?

NASA Astrophysics Data System (ADS)

Revelle, D. O.; Ceplecha, Z.

1994-12-01

We have used two different techniques to analyze the U. S. Prairie Network (PN) fireballs in order to search for possible nickel-iron meteoroids. The first approach used is that of ReVelle and Rajan which is similar to the analysis carried out earlier by Wetherill and ReVelle in a series of papers relating first to the chondrites and later to fireballs of cometary origin. The second approach is a new technique developed by Ceplecha and co-workers that can simultaneously determine the presence and location of gross fragmentation events and also determine an effective ablation parameter during the fireball entry. Using this combined approach we have determined that seven fireballs among the 287 that were analyzed are likely to be iron in composition. Using the method of Ceplecha we have determined that none of these objects experienced any gross fragmentation events during their entry to the atmosphere and most of the meteoroids also exhibited rather large ablation coefficients during entry as well, a feature that is also characteristic of the ReVelle and Rajan approach. For all of these objects for which we currently have available data, we have determined that gross fragmentation events did not occur during the entry.

TU-AB-303-06: Does Online Adaptive Radiation Therapy Mean Zero Margin for Intermediate-Risk Prostate Cancer? An Intra-Fractional Seminal Vesicles Motion Analysis

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

Sheng, Y; Li, T; Lee, W

Purpose: To provide benchmark for seminal vesicles (SVs) margin selection to account for intra-fractional motion; and to investigate the effectiveness of two motion surrogates in predicting intra-fractional SV underdosage. Methods: 9 prostate SBRT patients were studied; each has five pairs of pre-treatment and post-treatment cone-beam CTs (CBCTs). Each pair of CBCTs was registered based on fiducial markers in the prostate. To provide “ground truth” for coverage evaluation, all pre-treatment SVs were expanded with isotropic margin of 1,2,3,5 and 8mm, and their overlap with post-treatment SVs were used to quantify intra-fractional coverage. Two commonly used motion surrogates, the center-of-mass (COM) andmore » the border of contour (the most distal points in SI/AP/LR directions) were evaluated using Receiver-Operating Characteristic (ROC) analyses for predicting SV underdosage due to intra-fractional motion. Action threshold of determining underdosage for each surrogate was calculated by selecting the optimal balancing between sensitivity and specificity. For comparison, margin for each surrogate was also calculated based on traditional margin recipe. Results: 90% post-treatment SV coverage can be achieved in 47%, 82%, 91%, 98% and 98% fractions for 1,2,3,5 and 8mm margins. 3mm margin ensured the 90% intra-fractional SV coverage in 90% fractions when prostate was aligned. The ROC analysis indicated the AUC for COM and border were 0.88 and 0.72. The underdosage threshold was 2.9mm for COM and 4.1mm for border. The Van Herk’s margin recipe recommended 0.5, 0 and 1.8mm margin in LR, AP and SI direction based on COM and for border, the corresponding margin was 2.1, 4.5 and 3mm. Conclusion: 3mm isotropic margin is the minimum required to mitigate the intra-fractional SV motion when prostate is aligned. ROC analysis reveals that both COM and border are acceptable predictors for SV underdosage with 2.9mm and 4.1mm action threshold. Traditional margin calculation is less reliable for this application. This work is partially supported a master research grant from Varian Medical Systems.« less

Mexican Americans in Higher Education: Cultural Adaptation and Marginalization as Predictors of College Persistence Intentions and Life Satisfaction

ERIC Educational Resources Information Center

Ojeda, Lizette; Castillo, Linda G.; Rosales Meza, Rocío; Piña-Watson, Brandy

2014-01-01

This study examined how college persistence intentions and life satisfaction influenced by acculturation, enculturation, White marginalization, and Mexican American marginalization among 515 Mexican American college students. The utility of a path analysis model was supported. Enculturation positively predicted persistence and life satisfaction.…

MRI Evaluation of Resection Margins in Bone Tumour Surgery

PubMed Central

Traore, Sidi Yaya; Lecouvet, Frédéric; Galant, Christine

2014-01-01

In 12 patients operated on for bone sarcoma resection, a postoperative magnetic resonance imaging of the resection specimens was obtained in order to assess the surgical margins. Margins were classified according to MRI in R0, R1, and R2 by three independent observers: a radiologist and two orthopaedic surgeons. Final margin evaluation (R0, R1, and R2) was assessed by a confirmed pathologist. Agreement for margin evaluation between the pathologist and the radiologist was perfect (κ = 1). Agreement between the pathologist and an experienced orthopaedic surgeon was very good while it was fair between the pathologist and a junior orthopaedic surgeon. MRI should be considered as a tool to give quick information about the adequacy of margins and to help the pathologist to focus on doubtful areas and to spare time in specimen analysis. But it may not replace the pathological evaluation that gives additional information about tumor necrosis. This study shows that MRI extemporaneous analysis of a resection specimen may be efficient in bone tumor oncologic surgery, if made by an experienced radiologist with perfect agreement with the pathologist. PMID:24976785

OCT structure, COB location and magmatic type of the S Angolan & SE Brazilian margins from integrated quantitative analysis of deep seismic reflection and gravity anomaly data

NASA Astrophysics Data System (ADS)

Cowie, Leanne; Kusznir, Nick; Horn, Brian

2014-05-01

Integrated quantitative analysis using deep seismic reflection data and gravity inversion have been applied to the S Angolan and SE Brazilian margins to determine OCT structure, COB location and magmatic type. Knowledge of these margin parameters are of critical importance for understanding rifted continental margin formation processes and in evaluating petroleum systems in deep-water frontier oil and gas exploration. The OCT structure, COB location and magmatic type of the S Angolan and SE Brazilian rifted continental margins are much debated; exhumed and serpentinised mantle have been reported at these margins. Gravity anomaly inversion, incorporating a lithosphere thermal gravity anomaly correction, has been used to determine Moho depth, crustal basement thickness and continental lithosphere thinning. Residual Depth Anomaly (RDA) analysis has been used to investigate OCT bathymetric anomalies with respect to expected oceanic bathymetries and subsidence analysis has been used to determine the distribution of continental lithosphere thinning. These techniques have been validated for profiles Lusigal 12 and ISE-01 on the Iberian margin. In addition a joint inversion technique using deep seismic reflection and gravity anomaly data has been applied to the ION-GXT BS1-575 SE Brazil and ION-GXT CS1-2400 S Angola deep seismic reflection lines. The joint inversion method solves for coincident seismic and gravity Moho in the time domain and calculates the lateral variations in crustal basement densities and velocities along the seismic profiles. Gravity inversion, RDA and subsidence analysis along the ION-GXT BS1-575 profile, which crosses the Sao Paulo Plateau and Florianopolis Ridge of the SE Brazilian margin, predict the COB to be located SE of the Florianopolis Ridge. Integrated quantitative analysis shows no evidence for exhumed mantle on this margin profile. The joint inversion technique predicts oceanic crustal thicknesses of between 7 and 8 km thickness with normal oceanic basement seismic velocities and densities. Beneath the Sao Paulo Plateau and Florianopolis Ridge, joint inversion predicts crustal basement thicknesses between 10-15km with high values of basement density and seismic velocities under the Sao Paulo Plateau which are interpreted as indicating a significant magmatic component within the crustal basement. The Sao Paulo Plateau and Florianopolis Ridge are separated by a thin region of crustal basement beneath the salt interpreted as a regional transtensional structure. Sediment corrected RDAs and gravity derived "synthetic" RDAs are of a similar magnitude on oceanic crust, implying negligible mantle dynamic topography. Gravity inversion, RDA and subsidence analysis along the S Angolan ION-GXT CS1-2400 profile suggests that exhumed mantle, corresponding to a magma poor margin, is absent..The thickness of earliest oceanic crust, derived from gravity and deep seismic reflection data, is approximately 7km consistent with the global average oceanic crustal thicknesses. The joint inversion predicts a small difference between oceanic and continental crustal basement density and seismic velocity, with the change in basement density and velocity corresponding to the COB independently determined from RDA and subsidence analysis. The difference between the sediment corrected RDA and that predicted from gravity inversion crustal thickness variation implies that this margin is experiencing approximately 500m of anomalous uplift attributed to mantle dynamic uplift.

Risk Preference of Farmer Beef Cattle Smallholder in West Java

NASA Astrophysics Data System (ADS)

Arief, H.; Fitriani, A.

2018-02-01

Beef cattle farm is an economic activity that its correlation relatively high with ecology condition, ever more its activity be dominated by smallholder with farm scale of 1—3 head beef cattle, so the capital of feeder cattle are component production costs relatively large. By doing so, lose one head of cattle means losing some of the capital that had been invested in its farm. This condition has implications for the behavior of farmers in managing its farm. The farmers in the decision-making act reluctant to risk so there is a bit of a program or package of new technologies to improve the performance of farm rejected. Therefore, this study analyzed the preferences of farmers against risks, and find out the socio-economic conditions that be the deciding factor on farmer preference for risk.The method used was a survey with multistage random sampling. The numbers of samples in this study were 150 people from three different areas, namely: District of Bandung, Subang, and Pangandaran (South Ciamis). Data analysis model used in relation to this research problem was the model’s utility function and Component Factor Analysis (CFA). The results showed that the overall breeders had a reluctant attitude to risk (risk averter). This is indicated by the value of x3, namely -63,692.693 < 0; and socio-economic factors that determine the preference of farmers against risk are age, education, and experience for farm management; while the business scale factor, number of dependents, and ownership determine the size of the gross margin.

Study of a safety margin system for powered-lift STOL aircraft

NASA Technical Reports Server (NTRS)

Heffley, R. K.; Jewell, W. F.

1978-01-01

A study was conducted to explore the feasibility of a safety margin system for powered-lift aircraft which require a backside piloting technique. The objective of the safety margin system was to present multiple safety margin criteria as a single variable which could be tracked manually or automatically and which could be monitored for the purpose of deriving safety margin status. The study involved a pilot-in-the-loop analysis of several safety margin system concepts and a simulation experiment to evaluate those concepts which showed promise of providing a good solution. A system was ultimately configured which offered reasonable compromises in controllability, status information content, and the ability to regulate the safety margin at some expense of the allowable low speed flight path envelope.

Energy distribution analysis in boosted HCCI-like / LTGC engines – Understanding the trade-offs to maximize the thermal efficiency

DOE PAGES

Dernotte, Jeremie; Dec, John E.; Ji, Chunsheng

2015-04-14

A detailed understanding of the various factors affecting the trends in gross-indicated thermal efficiency with changes in key operating parameters has been carried out, applied to a one-liter displacement single-cylinder boosted Low-Temperature Gasoline Combustion (LTGC) engine. This work systematically investigates how the supplied fuel energy splits into the following four energy pathways: gross-indicated thermal efficiency, combustion inefficiency, heat transfer and exhaust losses, and how this split changes with operating conditions. Additional analysis is performed to determine the influence of variations in the ratio of specific heat capacities (γ) and the effective expansion ratio, related to the combustion-phasing retard (CA50), onmore » the energy split. Heat transfer and exhaust losses are computed using multiple standard cycle analysis techniques. Furthermore, the various methods are evaluated in order to validate the trends.« less

A comparative analysis of primary and secondary Gleason pattern predictive ability for positive surgical margins after radical prostatectomy.

PubMed

Sfoungaristos, S; Kavouras, A; Kanatas, P; Polimeros, N; Perimenis, P

2011-01-01

To compare the predictive ability of primary and secondary Gleason pattern for positive surgical margins in patients with clinically localized prostate cancer and a preoperative Gleason score ≤ 6. A retrospective analysis of the medical records of patients undergone a radical prostatectomy between January 2005 and October 2010 was conducted. Patients' age, prostate volume, preoperative PSA, biopsy Gleason score, the 1st and 2nd Gleason pattern were entered a univariate and multivariate analysis. The 1st and 2nd pattern were tested for their ability to predict positive surgical margins using receiver operating characteristic curves. Positive surgical margins were noticed in 56 cases (38.1%) out of 147 studied patients. The 2nd pattern was significantly greater in those with positive surgical margins while the 1st pattern was not significantly different between the 2 groups of patients. ROC analysis revealed that area under the curve was 0.53 (p=0.538) for the 1st pattern and 0.60 (p=0.048) for the 2nd pattern. Concerning the cases with PSA <10 ng/ml, it was also found that only the 2nd pattern had a predictive ability (p=0.050). When multiple logistic regression analysis was conducted it was found that the 2nd pattern was the only independent predictor. The second Gleason pattern was found to be of higher value than the 1st one for the prediction of positive surgical margins in patients with preoperative Gleason score ≤ 6 and this should be considered especially when a neurovascular bundle sparing radical prostatectomy is planned, in order not to harm the oncological outcome.

GIS-based multicriteria overlay analysis in soil-suitability evaluation for cotton (Gossypium spp.): A case study in the black soil region of Central India

NASA Astrophysics Data System (ADS)

Walke, N.; Obi Reddy, G. P.; Maji, A. K.; Thayalan, S.

2012-04-01

In this study an attempt was made to characterize the soils of the Ringanbodi watershed, Nagpur district, Maharashtra, Central India, for soil-suitability evaluation for cotton using geographic information system (GIS)-based multicriteria overlay analysis techniques. The study shows that 8 soil series and 16 soil series associations in the study area and soils were classified into three orders, i.e., Entisol, Inceptisol, and Vertisol. The analysis reveals that the soil associations E-F, F-G, G-H, and H-G are "moderately suitable" (S2), D-E are "marginally to moderately suitable," and C-D are marginally (S3) suitable. However, soils B-C are "not suitable" to "marginally suitable" (N2-S3) and A-B are "unsuitable" (N2) for cultivation of cotton. The area analysis shows that for a cotton crop an area about 966.7 ha (49.1%) of TGA is moderately suitable and classified as S2. An area about 469.9 ha (23.8%) of TGA is marginal to moderately suitable (S3-S2). The marginally suitable soils for cotton are classified as S3 and cover an area about 35.2 ha (1.8%) of TGA. However, a 172.3 ha (8.7%) area is not suitable (N2) to marginally suitable (S3) and a 326.9 (16.6%) area is not suitable (N2) for cotton because of uncorrectable factors like soil depth, slope, etc. The study demonstrated that GIS-based multicriteria overlay analysis of soil thematic parameters will be of immense help in soil-suitability evaluation for cotton.

The economic efficiency of conservation measures for amphibians in organic farming--results from bio-economic modelling.

PubMed

Schuler, Johannes; Sattler, Claudia; Helmecke, Angela; Zander, Peter; Uthes, Sandra; Bachinger, Johann; Stein-Bachinger, Karin

2013-01-15

This paper presents a whole farm bio-economic modelling approach for the assessment and optimisation of amphibian conservation conditions applied at the example of a large scale organic farm in North-Eastern Germany. The assessment focuses mainly on the habitat quality as affected by conservation measures such as through specific adapted crop production activities (CPA) and in-field buffer strips for the European tree frog (Hyla arborea), considering also interrelations with other amphibian species (i.e. common spadefoot toad (Pelobates fuscus), fire-bellied toad (Bombina bombina)). The aim of the approach is to understand, analyse and optimize the relationships between the ecological and economic performance of an organic farming system, based on the expectation that amphibians are differently impacted by different CPAs. The modelling system consists of a set of different sub-models that generate a farm model on the basis of environmentally evaluated CPAs. A crop-rotation sub-model provides a set of agronomically sustainable crop rotations that ensures overall sufficient nitrogen supply and controls weed, pest and disease infestations. An economic sub-model calculates the gross margins for each possible CPA including costs of inputs such as labour and machinery. The conservation effects of the CPAs are assessed with an ecological sub-model evaluates the potential negative or positive effect that each work step of a CPA has on amphibians. A mathematical programming sub-model calculates the optimal farm organization taking into account the limited factors of the farm (e.g. labour, land) as well as ecological improvements. In sequential model runs, the habitat quality is to be improved by the model, while the highest possible gross margin is still to be achieved. The results indicate that the model can be used to show the scope of action that a farmer has to improve habitat quality by reducing damage to amphibian population on its land during agricultural activities. Thereby, depending on the level of habitat quality that is aimed at, different measures may provide the most efficient solution. Lower levels of conservation can be achieved with low-cost adapted CPAs, such as an increased cutting height, reduced sowing density and grubbing instead of ploughing. Higher levels of conservation require e.g. grassland-like managed buffer strips around ponds in sensible areas, which incur much higher on-farm conservation costs. Copyright © 2012 Elsevier Ltd. All rights reserved.

An integrated modelling and multicriteria analysis approach to managing nitrate diffuse pollution: 2. A case study for a chalk catchment in England.

PubMed

Koo, B K; O'Connell, P E

2006-04-01

The site-specific land use optimisation methodology, suggested by the authors in the first part of this two-part paper, has been applied to the River Kennet catchment at Marlborough, Wiltshire, UK, for a case study. The Marlborough catchment (143 km(2)) is an agriculture-dominated rural area over a deep chalk aquifer that is vulnerable to nitrate pollution from agricultural diffuse sources. For evaluation purposes, the catchment was discretised into a network of 1 kmx1 km grid cells. For each of the arable-land grid cells, seven land use alternatives (four arable-land alternatives and three grassland alternatives) were evaluated for their environmental and economic potential. For environmental evaluation, nitrate leaching rates of land use alternatives were estimated using SHETRAN simulations and groundwater pollution potential was evaluated using the DRASTIC index. For economic evaluation, economic gross margins were estimated using a simple agronomic model based on nitrogen response functions and agricultural land classification grades. In order to see whether the site-specific optimisation is efficient at the catchment scale, land use optimisation was carried out for four optimisation schemes (i.e. using four sets of criterion weights). Consequently, four land use scenarios were generated and the site-specifically optimised land use scenario was evaluated as the best compromise solution between long term nitrate pollution and agronomy at the catchment scale.

Process for the recycling of alkaline and zinc-carbon spent batteries

NASA Astrophysics Data System (ADS)

Ferella, Francesco; De Michelis, Ida; Vegliò, Francesco

In this paper a recycling process for the recovery of zinc and manganese from spent alkaline and zinc-carbon batteries is proposed. Laboratory tests are performed to obtain a purified pregnant solution from which metallic zinc (purity 99.6%) can be recovered by electrolysis; manganese is recovered as a mixture of oxides by roasting of solid residue coming from the leaching stage. Nearly 99% of zinc and 20% of manganese are extracted after 3 h, at 80 °C with 10% w/v pulp density and 1.5 M sulphuric acid concentration. The leach liquor is purified by a selective precipitation of iron, whereas metallic impurities, such as copper, nickel and cadmium are removed by cementation with zinc powder. The solid residue of leaching is roasted for 30 min at 900 °C, removing graphite completely and obtaining a mixture of Mn 3O 4 and Mn 2O 3 with 70% grade of Mn. After that a technical-economic assessment is carried out for a recycling plant with a feed capacity of 5000 t y -1 of only alkaline and zinc-carbon batteries. This analysis shows the economic feasibility of that plant, supposing a battery price surcharge of 0.5 € kg -1, with a return on investment of 34.5%, gross margin of 35.8% and around 3 years payback time.

Multigenic Control of Pod Shattering Resistance in Chinese Rapeseed Germplasm Revealed by Genome-Wide Association and Linkage Analyses

PubMed Central

Liu, Jia; Wang, Jun; Wang, Hui; Wang, Wenxiang; Zhou, Rijin; Mei, Desheng; Cheng, Hongtao; Yang, Juan; Raman, Harsh; Hu, Qiong

2016-01-01

The majority of rapeseed cultivars shatter seeds upon maturity especially under hot-dry and windy conditions, reducing yield and gross margin return to growers. Here, we identified quantitative trait loci (QTL) for resistance to pod shatter in an unstructured diverse panel of 143 rapeseed accessions, and two structured populations derived from bi-parental doubled haploid (DH) and inter-mated (IF2) crosses derived from R1 (resistant to pod shattering) and R2 (prone to pod shattering) accessions. Genome-wide association analysis identified six significant QTL for resistance to pod shatter located on chromosomes A01, A06, A07, A09, C02, and C05. Two of the QTL, qSRI.A09 delimited with the SNP marker Bn-A09-p30171993 (A09) and qSRI.A06 delimited with the SNP marker Bn-A06-p115948 (A06) could be repeatedly detected across environments in a diversity panel, DH and IF2 populations, suggesting that at least two loci on chromosomes A06 and A09 were the main contributors to pod shatter resistance in Chinese germplasm. Significant SNP markers identified in this study especially those that appeared repeatedly across environments provide a cost-effective and an efficient method for introgression and pyramiding of favorable alleles for pod shatter resistance via marker-assisted selection in rapeseed improvement programs. PMID:27493651

Effectiveness of Gross Model-Based Emotion Regulation Strategies Training on Anger Reduction in Drug-Dependent Individuals and its Sustainability in Follow-up.

PubMed

Massah, Omid; Sohrabi, Faramarz; A'azami, Yousef; Doostian, Younes; Farhoudian, Ali; Daneshmand, Reza

2016-03-01

Emotion plays an important role in adapting to life changes and stressful events. Difficulty regulating emotions is one of the problems drug abusers often face, and teaching these individuals to express and manage their emotions can be effective on improving their difficult circumstances. The present study aimed to determine the effectiveness of the Gross model-based emotion regulation strategies training on anger reduction in drug-dependent individuals. The present study had a quasi-experimental design wherein pretest-posttest evaluations were applied using a control group. The population under study included addicts attending Marivan's methadone maintenance therapy centers in 2012 - 2013. Convenience sampling was used to select 30 substance-dependent individuals undergoing maintenance treatment who were then randomly assigned to the experiment and control groups. The experiment group received its training in eight two-hour sessions. Data were analyzed using analysis of co-variance and paired t-test. There was significant reduction in anger symptoms of drug-dependent individuals after gross model based emotion regulation training (ERT) (P < 0.001). Moreover, the effectiveness of the training on anger was persistent in the follow-up period. Symptoms of anger in drug-dependent individuals of this study were reduced by gross model-based emotion regulation strategies training. Based on the results of this study, we may conclude that the gross model based emotion regulation strategies training can be applied alongside other therapies to treat drug abusers undergoing rehabilitation.

Toddle temporal-spatial deviation index: Assessment of pediatric gait.

PubMed

Cahill-Rowley, Katelyn; Rose, Jessica

2016-09-01

This research aims to develop a gait index for use in the pediatric clinic as well as research, that quantifies gait deviation in 18-22 month-old children: the Toddle Temporal-spatial Deviation Index (Toddle TDI). 81 preterm children (≤32 weeks) with very-low-birth-weights (≤1500g) and 42 full-term TD children aged 18-22 months, adjusted for prematurity, walked on a pressure-sensitive mat. Preterm children were administered the Bayley Scales of Infant Development-3rd Edition (BSID-III). Principle component analysis of TD children's temporal-spatial gait parameters quantified raw gait deviation from typical, normalized to an average(standard deviation) Toddle TDI score of 100(10), and calculated for all participants. The Toddle TDI was significantly lower for preterm versus TD children (86 vs. 100, p=0.003), and lower in preterm children with <85 vs. ≥85 BSID-III motor composite scores (66 vs. 89, p=0.004). The Toddle TDI, which by design plateaus at typical average (BSID-III gross motor 8-12), correlated with BSID-III gross motor (r=0.60, p<0.001) and not fine motor (r=0.08, p=0.65) in preterm children with gross motor scores ≤8, suggesting sensitivity to gross motor development. The Toddle TDI demonstrated sensitivity and specificity to gross motor function in very-low-birth-weight preterm children aged 18-22 months, and has been potential as an easily-administered, revealing clinical gait metric. Copyright © 2016 Elsevier B.V. All rights reserved.

Cervical and Incisal Marginal Discrepancy in Ceramic Laminate Veneering Materials: A SEM Analysis

PubMed Central

Ranganathan, Hemalatha; Ganapathy, Dhanraj M.; Jain, Ashish R.

2017-01-01

Context: Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. Aims: This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. Settings and Design: This was an experimental, single-blinded, in vitro trial. Subjects and Methods: Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. Statistical Analysis Used: ANOVA and post hoc Tukey honest significant difference (HSD) tests were used for statistical analysis. Results: The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. Conclusion: This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups. PMID:28839415

Associations of Gross Motor Delay, Behavior, and Quality of Life in Young Children With Autism Spectrum Disorder.

PubMed

Hedgecock, James B; Dannemiller, Lisa A; Shui, Amy M; Rapport, Mary Jane; Katz, Terry

2018-04-01

Young children with autism spectrum disorder (ASD) often have gross motor delays that may accentuate problem daytime behavior and health-related quality of life (QoL). The objective of this study was to describe the degree of gross motor delays in young children with ASD and associations of gross motor delays with problem daytime behavior and QoL. The primary hypothesis was that Gross motor delays significantly modifies the associations between internalizing or externalizing problem daytime behavior and QoL. This study used a cross-sectional, retrospective analysis. Data from 3253 children who were 2 to 6 years old and who had ASD were obtained from the Autism Speaks Autism Treatment Network and analyzed using unadjusted and adjusted linear regression. Measures included the Vineland Adaptive Behavior Scales, 2nd edition, gross motor v-scale score (VABS-GM) (for Gross motor delays), the Child Behavior Checklist (CBCL) (for Problem daytime behavior), and the Pediatric Quality of Life Inventory (PedsQL) (for QoL). The mean VABS-GM was 12.12 (SD = 2.2), representing performance at or below the 16th percentile. After adjustment for covariates, the internalizing CBCL t score decreased with increasing VABS-GM (β = - 0.64 SE = 0.12). Total and subscale PedsQL scores increased with increasing VABS-GM (for total score: β = 1.79 SE = 0.17; for subscale score: β = 0.9-2.66 SE = 0.17-0.25). CBCL internalizing and externalizing t scores decreased with increasing PedsQL total score (β = - 0.39 SE = 0.01; β = - 0.36 SE = 0.01). The associations between CBCL internalizing or externalizing t scores and PedsQL were significantly modified by VABSGM (β = - 0.026 SE = 0.005]; β = - 0.019 SE = 0.007). The study lacked ethnic and socioeconomic diversity. Measures were collected via parent report without accompanying clinical assessment. Cross motor delay was independently associated with Problem daytime behavior and QoL in children with ASD. Gross motor delay modified the association between Problem daytime behavior and QoL. Children with ASD and co-occurring internalizing Problem daytime behavior had greater Gross motor delays than children without internalizing Problem daytime behavior; therefore, these children may be most appropriate for early physical therapist evaluation.

Incidence and location of positive surgical margin among open, laparoscopic and robot-assisted radical prostatectomy in prostate cancer patients: a single institutional analysis.

PubMed

Koizumi, Atsushi; Narita, Shintaro; Nara, Taketoshi; Takayama, Koichiro; Kanda, Sohei; Numakura, Kazuyuki; Tsuruta, Hiroshi; Maeno, Atsushi; Huang, Mingguo; Saito, Mitsuru; Inoue, Takamitsu; Tsuchiya, Norihiko; Satoh, Shigeru; Nanjo, Hiroshi; Habuchi, Tomonori

2018-06-19

To evaluate the positive surgical margin rates and locations in radical prostatectomy among three surgical approaches, including open radical prostatectomy, laparoscopic radical prostatectomy and robot-assisted radical prostatectomy. We retrospectively reviewed clinical outcomes at our institution of 450 patients who received radical prostatectomy. Multiple surgeons were involved in the three approaches, and a single pathologist conducted the histopathological diagnoses. Positive surgical margin rates and locations among the three approaches were statistically assessed, and the risk factors of positive surgical margin were analyzed. This study included 127, 136 and 187 patients in the open radical prostatectomy, laparoscopic radical prostatectomy and robot-assisted radical prostatectomy groups, respectively. The positive surgical margin rates were 27.6% (open radical prostatectomy), 18.4% (laparoscopic radical prostatectomy) and 13.4% (robot-assisted radical prostatectomy). In propensity score-matched analyses, the positive surgical margin rate in the robot-assisted radical prostatectomy was significantly lower than that in the open radical prostatectomy, whereas there was no significant difference in the positive surgical margin rates between robot-assisted radical prostatectomy and laparoscopic radical prostatectomy. In the multivariable analysis, PSA level at diagnosis and surgical approach (open radical prostatectomy vs robot-assisted radical prostatectomy) were independent risk factors for positive surgical margin. The apex was the most common location of positive surgical margin in the open radical prostatectomy and laparoscopic radical prostatectomy groups, whereas the bladder neck was the most common location in the robot-assisted radical prostatectomy group. The significant difference of positive surgical margin locations continued after the propensity score adjustment. Robot-assisted radical prostatectomy may potentially achieve the lowest positive surgical margin rate among three surgical approaches. The bladder neck was the most common location of positive surgical margin in robot-assisted radical prostatectomy and apex in open radical prostatectomy and laparoscopic radical prostatectomy. Although robot-assisted radical prostatectomy may contribute to the reduction of positive surgical margin, dissection of the bladder neck requires careful attention to avoid positive surgical margins.

Landscape History of Grosses Moos, NW Swiss Alpine Foreland.

NASA Astrophysics Data System (ADS)

Joanna Heer, Aleksandra; Adamiec, Grzegorz; Veit, Heinz; May, Jan-Hendrik; Novenko, Elena; Hajdas, Irka

2017-04-01

The western Swiss Plateau with Lake Neuchâtel is part of the alpine foreland and among the key areas for the reconstruction of environmental changes since the last postglacial. This study was carried out in a landscape located NE of the lake and called Grosses Moos (The Large Fen) - currently designated the Swiss largest, continuous farming area, after the fen was drained in course of landscape engineering projects performed in Switzerland at the end of the 19th century. The study contributes new results from nine excavations of littoral ridges identified in Grosses Moos, and integrates sedimentology, paleo-environmental analysis and three independent chronological methods. Radiocarbon dating, pollen analysis and optically stimulated luminescence (OSL) were applied to the sediments. While pollen and radiocarbon follow the standard procedures, the evaluation of the luminescence age estimates demanded adjustment according to the physical and microdosimetric properties of the alpine quartz, and consideration of the peculiarities of the changing littoral environments of Grosses Moos. The Grosses Moos landscape developed on the temporary surface of the post-Last Glacial sedimentary infill of the over-deepened glacial Aare valley. In this study the landscape history has been fitted into the existing supraregional time scales of NGRIP, the Swiss bio-zones system and the human history based on archaeological and historic records and covers a time span of up to 15'000 yr b2k. The wide-ranging suite of geomorphic features and sedimentary sequences, including littoral lake sediments, beach ridges, dunes, palaeo-channels, peat and colluvial deposits, enable the extensive reconstruction of spatially and temporally variable natural shaping processes. In addition, our results indicate remobilization of soil, colluvium, and sediment due to human settlement activities since the Neolithic - with an important increase in sediment load and spatial variability since the Bronze Age woodland clearings in the River Aare Valley and around the Lake Neuchâtel. The development of several dune belts in the study area are attributed to various periods since the Lateglacial, e.g. the turn of the Holocene, the lake level drop in the Mid-Holocene, and the beginning of the Little Ice Age, and can thus be related to surprisingly varied environmental conditions. Despite the eventful past of the Grosses Moos, a Holocene Luvisol has preserved until recently on top of the oldest dune belt called Isleren Dune.

Circumferential resection margin (CRM) positivity after MRI assessment and adjuvant treatment in 189 patients undergoing rectal cancer resection.

PubMed

Simpson, G S; Eardley, N; McNicol, F; Healey, P; Hughes, M; Rooney, P S

2014-05-01

The management of rectal cancer relies on accurate MRI staging. Multi-modal treatments can downstage rectal cancer prior to surgery and may have an effect on MRI accuracy. We aim to correlate the findings of MRI staging of rectal cancer with histological analysis, the effect of neoadjuvant therapy on this and the implications of circumferential resection margin (CRM) positivity following neoadjuvant therapy. An analysis of histological data and radiological staging of all cases of rectal cancer in a single centre between 2006 and 2011 were conducted. Two hundred forty-one patients had histologically proved rectal cancer during the study period. One hundred eighty-two patients underwent resection. Median age was 66.6 years, and male to female ratio was 13:5. R1 resection rate was 11.1%. MRI assessments of the circumferential resection margin in patients without neoadjuvant radiotherapy were 93.6 and 88.1% in patients who underwent neoadjuvant radiotherapy. Eighteen patients had predicted positive margins following chemoradiotherapy, of which 38.9% had an involved CRM on histological analysis. MRI assessment of the circumferential resection margin in rectal cancer is associated with high accuracy. Neoadjuvant chemoradiotherapy has a detrimental effect on this accuracy, although accuracy remains high. In the presence of persistently predicted positive margins, complete resection remains achievable but may necessitate a more radical approach to resection.

Influence of Manufacturing Methods of Implant-Supported Crowns on External and Internal Marginal Fit: A Micro-CT Analysis.

PubMed

Moris, Izabela C M; Monteiro, Silas Borges; Martins, Raíssa; Ribeiro, Ricardo Faria; Gomes, Erica A

2018-01-01

To evaluate the influence of different manufacturing methods of single implant-supported metallic crowns on the internal and external marginal fit through computed microtomography. Forty external hexagon implants were divided into 4 groups ( n = 8), according to the manufacturing method: GC, conventional casting; GI, induction casting; GP, plasma casting; and GCAD, CAD/CAM machining. The crowns were attached to the implants with insertion torque of 30 N·cm. The external (vertical and horizontal) marginal fit and internal fit were assessed through computed microtomography. Internal and external marginal fit data ( μ m) were submitted to a one-way ANOVA and Tukey's test ( α = .05). Qualitative evaluation of the images was conducted by using micro-CT. The statistical analysis revealed no significant difference between the groups for vertical misfit ( P = 0.721). There was no significant difference ( P > 0.05) for the internal and horizontal marginal misfit in the groups GC, GI, and GP, but it was found for the group GCAD ( P ≤ 0.05). Qualitative analysis revealed that most of the samples of cast groups exhibited crowns underextension while the group GCAD showed overextension. The manufacturing method of the crowns influenced the accuracy of marginal fit between the prosthesis and implant. The best results were found for the crowns fabricated through CAD/CAM machining.

Excess Capacity in China’s Power Systems: A Regional Analysis

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

Lin, Jiang; Liu, Xu; Karl, Fredrich

2016-11-01

This paper examines China’s regional electricity grids using a reliability perspective, which is commonly measured in terms of a reserve margin. Our analysis shows that at the end of 2014, the average reserve margin for China as a whole was roughly 28%, almost twice as high as a typical planning reserve margin in the U.S. However, this national average masks huge variations in reserve margins across major regional power grid areas: the northeastern region has the highest reserve margin of over 60%, followed by the northwestern region at 49%, and the southern grid area at 35%. In this analysis, wemore » also examined future reserve margins for regional electricity grids in China under two scenarios: 1) a low scenario of national annual electricity consumption growth rates of 1.5% between 2015 and 2020 and 1.0% between 2020 and 2025, and 2) a high scenario of annual average growth rates of 3.0% and 2.0%, respectively. Both scenarios suggest that the northeastern, northwestern, and southern regions have significant excess generation capacity, and that this excess capacity situation will continue over the next decade without regulatory intervention. The northern and central regions could have sufficient generation capacity to 2020, but may require additional resources in a higher growth scenario. The eastern region requires new resources by 2020 in both scenarios.« less

Factors affecting surgical margin recurrence after hepatectomy for colorectal liver metastases.

PubMed

Akyuz, Muhammet; Aucejo, Federico; Quintini, Cristiano; Miller, Charles; Fung, John; Berber, Eren

2016-06-01

Hepatic recurrence after resection of colorectal liver metastasis (CLM) occurs in 50% of patients during follow-up, with 2.8% to 13.9% presenting with surgical margin recurrence (SMR). The aim of this study is to analyze factors that related to SMR in patients with CLM undergoing hepatectomy. Demographics, clinical and survival data of patients who underwent hepatectomy were identified from a prospectively maintained, institutional review board (IRB)-approved database between 2000 and 2012. Statistical analysis was performed using univariate Kaplan Meier and Cox proportional hazard model. There were 85 female and 121 male patients who underwent liver resection for CLM. An R0 resection was performed in 157 (76%) patients and R1 resection in 49. SMR was detected in 32 patients (15.5%) followed up for a median of 29 months (range, 3-121 months). A half of these patients had undergone R1 (n=16) and another half R0 resection (n=16). Tumor size, preoperative carcinoembryonic antigen (CEA) level and margin status were associated with SMR on univariate analysis. On multivariate analysis, a positive surgical margin was the only independent predictor of SMR. The receipt of adjuvant chemotherapy did not affect margin recurrence. SMR was an independent risk factor associated with worse disease-free (DFS) and overall survival (OS). This study shows that SMR, which can be detected in up to 15.5% of patients after liver resection for CLM, adversely affects DFS and OS. The fact that a positive surgical margin was the only predictive factor for SMR in these patients underscores the importance of achieving negative margins during hepatectomy.

A study of the mutational landscape of pediatric-type follicular lymphoma and pediatric nodal marginal zone lymphoma.

PubMed

Ozawa, Michael G; Bhaduri, Aparna; Chisholm, Karen M; Baker, Steven A; Ma, Lisa; Zehnder, James L; Luna-Fineman, Sandra; Link, Michael P; Merker, Jason D; Arber, Daniel A; Ohgami, Robert S

2016-10-01

Pediatric-type follicular lymphoma and pediatric marginal zone lymphoma are two of the rarest B-cell lymphomas. These lymphomas occur predominantly in the pediatric population and show features distinct from their more common counterparts in adults: adult-type follicular lymphoma and adult-type nodal marginal zone lymphoma. Here we report a detailed whole-exome deep sequencing analysis of a cohort of pediatric-type follicular lymphomas and pediatric marginal zone lymphomas. This analysis revealed a recurrent somatic variant encoding p.Lys66Arg in the transcription factor interferon regulatory factor 8 (IRF8) in 3 of 6 cases (50%) of pediatric-type follicular lymphoma. This specific point mutation was not detected in pediatric marginal zone lymphoma or in adult-type follicular lymphoma. Additional somatic point mutations in pediatric-type follicular lymphoma were observed in genes involved in transcription, intracellular signaling, and cell proliferation. In pediatric marginal zone lymphoma, no recurrent mutation was identified; however, somatic point mutations were observed in genes involved in cellular adhesion, cytokine regulatory elements, and cellular proliferation. A somatic variant in AMOTL1, a recurrently mutated gene in splenic marginal zone lymphoma, was also identified in a case of pediatric marginal zone lymphoma. The overall non-synonymous mutational burden was low in both pediatric-type follicular lymphoma and pediatric marginal zone lymphoma (4.6 mutations per exome). Altogether, these findings support a distinctive genetic basis for pediatric-type follicular lymphoma and pediatric marginal zone lymphoma when compared with adult subtypes and to one another. Moreover, identification of a recurrent point mutation in IRF8 provides insight into a potential driver mutation in the pathogenesis of pediatric-type follicular lymphoma with implications for novel diagnostic or therapeutic strategies.

A study of the mutational landscape of pediatric-type follicular lymphoma and pediatric nodal marginal zone lymphoma

PubMed Central

Ozawa, Michael G; Bhaduri, Aparna; Chisholm, Karen M; Baker, Steven A; Ma, Lisa; Zehnder, James L; Luna-Fineman, Sandra; Link, Michael P; Merker, Jason D; Arber, Daniel A; Ohgami, Robert S

2016-01-01

Pediatric-type follicular lymphoma and pediatric marginal zone lymphoma are two of the rarest B-cell lymphomas. These lymphomas occur predominantly in the pediatric population and show features distinct from their more common counterparts in adults: adult-type follicular lymphoma and adult-type nodal marginal zone lymphoma. Here we report a detailed whole-exome deep sequencing analysis of a cohort of pediatric-type follicular lymphomas and pediatric marginal zone lymphomas. This analysis revealed a recurrent somatic variant encoding p.Lys66Arg in the transcription factor interferon regulatory factor 8 (IRF8) in 3 of 6 cases (50%) of pediatric-type follicular lymphoma. This specific point mutation was not detected in pediatric marginal zone lymphoma or in adult-type follicular lymphoma. Additional somatic point mutations in pediatric-type follicular lymphoma were observed in genes involved in transcription, intracellular signaling, and cell proliferation. In pediatric marginal zone lymphoma, no recurrent mutation was identified; however, somatic point mutations were observed in genes involved in cellular adhesion, cytokine regulatory elements, and cellular proliferation. A somatic variant in AMOTL1, a recurrently mutated gene in splenic marginal zone lymphoma, was also identified in a case of pediatric marginal zone lymphoma. The overall non-synonymous mutational burden was low in both pediatric-type follicular lymphoma and pediatric marginal zone lymphoma (4.6 mutations per exome). Altogether, these findings support a distinctive genetic basis for pediatric-type follicular lymphoma and pediatric marginal zone lymphoma when compared with adult subtypes and to one another. Moreover, identification of a recurrent point mutation in IRF8 provides insight into a potential driver mutation in the pathogenesis of pediatric-type follicular lymphoma with implications for novel diagnostic or therapeutic strategies. PMID:27338637

Marginal and Random Intercepts Models for Longitudinal Binary Data with Examples from Criminology

ERIC Educational Resources Information Center

Long, Jeffrey D.; Loeber, Rolf; Farrington, David P.

2009-01-01

Two models for the analysis of longitudinal binary data are discussed: the marginal model and the random intercepts model. In contrast to the linear mixed model (LMM), the two models for binary data are not subsumed under a single hierarchical model. The marginal model provides group-level information whereas the random intercepts model provides…

Marginal lands for biocontrol and ecosystem services: Where to enhance and what do we put there?

USDA-ARS?s Scientific Manuscript database

Analysis of the Coastal Plain of Georgia, USA identified over 300,000 hectares of marginal land. There is a potential to grow other non-commodity native plants in marginal areas that have the potential to improve the diversity of the landscape and promote ecosystem services. Bioenergy feedstocks are...

Constructions of Difference and Deficit, a Case Study: Nicaraguan Families and Children on the Margins in Costa Rica

ERIC Educational Resources Information Center

Purcell-Gates, Victoria

2014-01-01

This analysis examines the nexus of marginalization and education, particularly the literacy potential and achievement of young children from socially and politically marginalized communities. Drawing on data from a study of literacy practice among Nicaraguan immigrants in Costa Rica and the schooling of the Nicaraguan children in Costa Rican…

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

Dernotte, Jeremie; Dec, John E.; Ji, Chunsheng

A detailed understanding of the various factors affecting the trends in gross-indicated thermal efficiency with changes in key operating parameters has been carried out, applied to a one-liter displacement single-cylinder boosted Low-Temperature Gasoline Combustion (LTGC) engine. This work systematically investigates how the supplied fuel energy splits into the following four energy pathways: gross-indicated thermal efficiency, combustion inefficiency, heat transfer and exhaust losses, and how this split changes with operating conditions. Additional analysis is performed to determine the influence of variations in the ratio of specific heat capacities (γ) and the effective expansion ratio, related to the combustion-phasing retard (CA50), onmore » the energy split. Heat transfer and exhaust losses are computed using multiple standard cycle analysis techniques. Furthermore, the various methods are evaluated in order to validate the trends.« less

26 CFR 1.61-1 - Gross income.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Gross income. 1.61-1 Section 1.61-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Definition of Gross Income, Adjusted Gross Income, and Taxable Income § 1.61-1 Gross...

Effects of land use change on soil gross nitrogen transformation rates in subtropical acid soils of Southwest China.

PubMed

Xu, Yongbo; Xu, Zhihong

2015-07-01

Land use change affects soil gross nitrogen (N) transformations, but such information is particularly lacking under subtropical conditions. A study was carried out to investigate the potential gross N transformation rates in forest and agricultural (converted from the forest) soils in subtropical China. The simultaneously occurring gross N transformations in soil were quantified by a (15)N tracing study under aerobic conditions. The results showed that change of land use types substantially altered most gross N transformation rates. The gross ammonification and nitrification rates were significantly higher in the agricultural soils than in the forest soils, while the reverse was true for the gross N immobilization rates. The higher total carbon (C) concentrations and C / N ratio in the forest soils relative to the agricultural soils were related to the greater gross N immobilization rates in the forest soils. The lower gross ammonification combined with negligible gross nitrification rates, but much higher gross N immobilization rates in the forest soils than in the agricultural soils suggest that this may be a mechanism to effectively conserve available mineral N in the forest soils through increasing microbial biomass N, the relatively labile organic N. The greater gross nitrification rates and lower gross N immobilization rates in the agricultural soils suggest that conversion of forests to agricultural soils may exert more negative effects on the environment by N loss through NO3 (-) leaching or denitrification (when conditions for denitrification exist).

Climate Change Impairs Nitrogen Cycling in European Beech Forests.

PubMed

Dannenmann, Michael; Bimüller, Carolin; Gschwendtner, Silvia; Leberecht, Martin; Tejedor, Javier; Bilela, Silvija; Gasche, Rainer; Hanewinkel, Marc; Baltensweiler, Andri; Kögel-Knabner, Ingrid; Polle, Andrea; Schloter, Michael; Simon, Judy; Rennenberg, Heinz

2016-01-01

European beech forests growing on marginal calcareous soils have been proposed to be vulnerable to decreased soil water availability. This could result in a large-scale loss of ecological services and economical value in a changing climate. In order to evaluate the potential consequences of this drought-sensitivity, we investigated potential species range shifts for European beech forests on calcareous soil in the 21st century by statistical species range distribution modelling for present day and projected future climate conditions. We found a dramatic decline by 78% until 2080. Still the physiological or biogeochemical mechanisms underlying the drought sensitivity of European beech are largely unknown. Drought sensitivity of beech is commonly attributed to plant physiological constraints. Furthermore, it has also been proposed that reduced soil water availability could promote nitrogen (N) limitation of European beech due to impaired microbial N cycling in soil, but this hypothesis has not yet been tested. Hence we investigated the influence of simulated climate change (increased temperatures, reduced soil water availability) on soil gross microbial N turnover and plant N uptake in the beech-soil interface of a typical mountainous beech forest stocking on calcareous soil in SW Germany. For this purpose, triple 15N isotope labelling of intact beech seedling-soil-microbe systems was combined with a space-for-time climate change experiment. We found that nitrate was the dominant N source for beech natural regeneration. Reduced soil water content caused a persistent decline of ammonia oxidizing bacteria and therefore, a massive attenuation of gross nitrification rates and nitrate availability in the soil. Consequently, nitrate and total N uptake of beech seedlings were strongly reduced so that impaired growth of beech seedlings was observed already after one year of exposure to simulated climatic change. We conclude that the N cycle in this ecosystem and here specifically nitrification is vulnerable to reduced water availability, which can directly lead to nutritional limitations of beech seedlings. This tight link between reduced water availability, drought stress for nitrifiers, decreased gross nitrification rates and nitrate availability and finally nitrate uptake by beech seedlings could represent the Achilles' heel for beech under climate change stresses.

Climate Change Impairs Nitrogen Cycling in European Beech Forests

PubMed Central

Dannenmann, Michael; Bilela, Silvija; Gasche, Rainer; Hanewinkel, Marc; Baltensweiler, Andri; Kögel-Knabner, Ingrid; Polle, Andrea; Schloter, Michael; Simon, Judy; Rennenberg, Heinz

2016-01-01

European beech forests growing on marginal calcareous soils have been proposed to be vulnerable to decreased soil water availability. This could result in a large-scale loss of ecological services and economical value in a changing climate. In order to evaluate the potential consequences of this drought-sensitivity, we investigated potential species range shifts for European beech forests on calcareous soil in the 21st century by statistical species range distribution modelling for present day and projected future climate conditions. We found a dramatic decline by 78% until 2080. Still the physiological or biogeochemical mechanisms underlying the drought sensitivity of European beech are largely unknown. Drought sensitivity of beech is commonly attributed to plant physiological constraints. Furthermore, it has also been proposed that reduced soil water availability could promote nitrogen (N) limitation of European beech due to impaired microbial N cycling in soil, but this hypothesis has not yet been tested. Hence we investigated the influence of simulated climate change (increased temperatures, reduced soil water availability) on soil gross microbial N turnover and plant N uptake in the beech-soil interface of a typical mountainous beech forest stocking on calcareous soil in SW Germany. For this purpose, triple 15N isotope labelling of intact beech seedling-soil-microbe systems was combined with a space-for-time climate change experiment. We found that nitrate was the dominant N source for beech natural regeneration. Reduced soil water content caused a persistent decline of ammonia oxidizing bacteria and therefore, a massive attenuation of gross nitrification rates and nitrate availability in the soil. Consequently, nitrate and total N uptake of beech seedlings were strongly reduced so that impaired growth of beech seedlings was observed already after one year of exposure to simulated climatic change. We conclude that the N cycle in this ecosystem and here specifically nitrification is vulnerable to reduced water availability, which can directly lead to nutritional limitations of beech seedlings. This tight link between reduced water availability, drought stress for nitrifiers, decreased gross nitrification rates and nitrate availability and finally nitrate uptake by beech seedlings could represent the Achilles’ heel for beech under climate change stresses. PMID:27410969

Negative Stress Margins - Are They Real?

NASA Technical Reports Server (NTRS)

Raju, Ivatury S.; Lee, Darlene S.; Mohaghegh, Michael

2011-01-01

Advances in modeling and simulation, new finite element software, modeling engines and powerful computers are providing opportunities to interrogate designs in a very different manner and in a more detailed approach than ever before. Margins of safety are also often evaluated using local stresses for various design concepts and design parameters quickly once analysis models are defined and developed. This paper suggests that not all the negative margins of safety evaluated are real. The structural areas where negative margins are frequently encountered are often near stress concentrations, point loads and load discontinuities, near locations of stress singularities, in areas having large gradients but with insufficient mesh density, in areas with modeling issues and modeling errors, and in areas with connections and interfaces, in two-dimensional (2D) and three-dimensional (3D) transitions, bolts and bolt modeling, and boundary conditions. Now, more than ever, structural analysts need to examine and interrogate their analysis results and perform basic sanity checks to determine if these negative margins are real.

Cross-Continuum Tool Is Associated with Reduced Utilization and Cost for Frequent High-Need Users

PubMed Central

Hardin, Lauran; Kilian, Adam; Muller, Leslie; Callison, Kevin; Olgren, Michael

2017-01-01

Introduction High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services. Methods Using a pre-/post-test design in which each subject served as his/her own historical control, this quality improvement project focused on determining if the interdisciplinary intervention called CCM© had an impact on healthcare utilization and costs for HNHC patients. We conducted the analysis between November 2012 and December 2015 at Mercy Health Saint Mary’s, a Midwestern urban hospital with greater than 80,000 annual emergency department (ED) visits. All referred patients with three or more hospital visits (ED or inpatient [IP]) in the 12 months prior to initiation of a CCM© (n=339) were included in the study. Individualized CCMs© were created and made available in the electronic medical record (EMR) to all healthcare providers. We compared utilization, cost, social, and healthcare access variables from the EMR and cost-accounting system for 12 months before and after CCMs© implementation. We used both descriptive and limited inferential statistics. Results ED mean visits decreased 43% (p<0.001), inpatient mean admissions decreased 44% (p<0.001), outpatient mean visits decreased 17% (p<0.001), computed tomography mean scans decreased 62% (p<0.001), and OBS/IP length of stay mean days decreased 41% (p<0.001). Gross charges decreased 45% (p<0.001), direct expenses decreased 47% (p<0.001), contribution margin improved by 11% (p=0.002), and operating margin improved by 73% (p<0.001). Patients with housing increased 14% (p<0.001), those with primary care increased 15% (p<0.001), and those with insurance increased 16% (p<0.001). Conclusion Individualized CCMs© for a select group of patients are associated with decreased healthcare system overutilization and cost of care. PMID:28210351

Cross-Continuum Tool Is Associated with Reduced Utilization and Cost for Frequent High-Need Users.

PubMed

Hardin, Lauran; Kilian, Adam; Muller, Leslie; Callison, Kevin; Olgren, Michael

2017-02-01

High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services. Using a pre-/post-test design in which each subject served as his/her own historical control, this quality improvement project focused on determining if the interdisciplinary intervention called CCM© had an impact on healthcare utilization and costs for HNHC patients. We conducted the analysis between November 2012 and December 2015 at Mercy Health Saint Mary's, a Midwestern urban hospital with greater than 80,000 annual emergency department (ED) visits. All referred patients with three or more hospital visits (ED or inpatient [IP]) in the 12 months prior to initiation of a CCM© (n=339) were included in the study. Individualized CCMs© were created and made available in the electronic medical record (EMR) to all healthcare providers. We compared utilization, cost, social, and healthcare access variables from the EMR and cost-accounting system for 12 months before and after CCMs© implementation. We used both descriptive and limited inferential statistics. ED mean visits decreased 43% (p<0.001), inpatient mean admissions decreased 44% (p<0.001), outpatient mean visits decreased 17% (p<0.001), computed tomography mean scans decreased 62% (p<0.001), and OBS/IP length of stay mean days decreased 41% (p<0.001). Gross charges decreased 45% (p<0.001), direct expenses decreased 47% (p<0.001), contribution margin improved by 11% (p=0.002), and operating margin improved by 73% (p<0.001). Patients with housing increased 14% (p<0.001), those with primary care increased 15% (p<0.001), and those with insurance increased 16% (p<0.001). Individualized CCMs© for a select group of patients are associated with decreased healthcare system overutilization and cost of care.

A pathologist-designed imaging system for anatomic pathology signout, teaching, and research.

PubMed

Schubert, E; Gross, W; Siderits, R H; Deckenbaugh, L; He, F; Becich, M J

1994-11-01

Pathology images are derived from gross surgical specimens, light microscopy, immunofluorescence, electron microscopy, molecular diagnostic gels, flow cytometry, image analysis data, and clinical laboratory data in graphic form. We have implemented a network of desktop personal computers (PCs) that allow us to easily capture, store, and retrieve gross and microscopic, anatomic, and research pathology images. System architecture involves multiple image acquisition and retrieval sites and a central file server for storage. The digitized images are conveyed via a local area network to and from image capture or display stations. Acquisition sites consist of a high-resolution camera connected to a frame grabber card in a 486-type personal computer, equipped with 16 MB (Table 1) RAM, a 1.05-gigabyte hard drive, and a 32-bit ethernet card for access to our anatomic pathology reporting system. We have designed a push-button workstation for acquiring and indexing images that does not significantly interfere with surgical pathology sign-out. Advantages of the system include the following: (1) Improving patient care: the availability of gross images at time of microscopic sign-out, verification of recurrence of malignancy from archived images, monitoring of bone marrow engraftment and immunosuppressive intervention after bone marrow/solid organ transplantation on repeat biopsies, and ability to seek instantaneous consultation with any pathologist on the network; (2) enhancing the teaching environment: building a digital surgical pathology atlas, improving the availability of images for conference support, and sharing cases across the network; (3) enhancing research: case study compilation, metastudy analysis, and availability of digitized images for quantitative analysis and permanent/reusable image records for archival study; and (4) other practical and economic considerations: storing case requisition images and hand-drawn diagrams deters the spread of gross room contaminants and results in considerable cost savings in photographic media for conferences, improved quality assurance by porting control stains across the network, and a multiplicity of other advantages that enhance image and information management in pathology.

36 CFR 13.1102 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... under 100 tons gross (U.S. System) or 2,000 tons gross (International Convention System) engaged in... less than 200 tons gross (U.S. Tonnage “Simplified Measurement System”) and not more than 24 meters (79... means any motor vessel of at least 100 tons gross (U.S. System) or 2,000 tons gross (International...

36 CFR 13.1102 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... under 100 tons gross (U.S. System) or 2,000 tons gross (International Convention System) engaged in... less than 200 tons gross (U.S. Tonnage “Simplified Measurement System”) and not more than 24 meters (79... means any motor vessel of at least 100 tons gross (U.S. System) or 2,000 tons gross (International...

Activity and Safety of Inhaled Itraconazole Nanosuspension in a Model Pulmonary Aspergillus fumigatus Infection in Inoculated Young Quails.

PubMed

Wlaź, Piotr; Knaga, Sebastian; Kasperek, Kornel; Wlaź, Aleksandra; Poleszak, Ewa; Jeżewska-Witkowska, Grażyna; Winiarczyk, Stanisław; Wyska, Elżbieta; Heinekamp, Thorsten; Rundfeldt, Chris

2015-08-01

Pulmonary aspergillosis is frequently reported in parrots, falcons, and other birds held in captivity. Inhalation is the main route of infection for Aspergillus fumigatus, resulting in both acute and chronic disease conditions. Itraconazole (ITRA) is an antifungal commonly used in birds, but its administration requires repeated oral dosing, and the safety margin is narrow. To investigate the efficacy of inhaled ITRA, six groups of ten young quails (Coturnix japonica) were inoculated intratracheally with 5 × 10(6) spores (3 groups) or 5 × 10(7) spores (3 groups). Animals were exposed to nebulized ITRA nanosuspension as 10 % suspension or 4 % suspension, once daily for 30 min, starting 2 h after inoculation for 6 days. Control groups were exposed to nebulized saline for the same period of time. Survival and clinical scores were evaluated, and animals were subjected to gross pathology. In control animals, aspergillosis resulted in systemic disease without pulmonary or air sac granulomas. Animals died from multiple organ failure. Inhalation of 10 % ITRA nanosuspension blocked lethality and prevented disease-related symptoms in the quails exposed to the low dose of spores, while the disease course in quails inoculated with the high-spore dose was retarded. Inhalation of 4 % ITRA nanosuspension was less effective. Both inhalations were well tolerated, and gross pathology did not reveal signs of local toxicity. The data indicate that inhaled administration of 10 % ITRA nanosuspension is capable of alleviating an acute A. fumigatus infection in quails. A lower ITRA concentration may be only active in chronic pulmonary aspergillosis.

Spatially explicit simulation of peatland hydrology and carbon dioxide exchange: Influence of mesoscale topography

NASA Astrophysics Data System (ADS)

Sonnentag, O.; Chen, J. M.; Roulet, N. T.; Ju, W.; Govind, A.

2008-06-01

Carbon dynamics in peatlands are controlled, in large part, by their wetness as defined by water table depth and volumetric liquid soil moisture content. A common type of peatland is raised bogs that typically have a multiple-layer canopy of vascular plants over a Sphagnum moss ground cover. Their convex form restricts water supply to precipitation and water is shed toward the margins, usually by lateral subsurface flow. The hydraulic gradient for lateral subsurface flow is governed by the peat surface topography at the mesoscale (˜200 m to 5 km). To investigate the influence of mesoscale topography on wetness, evapotranspiration (ET), and gross primary productivity (GPP) in a bog during the snow-free period, we compare the outputs of a further developed version of the daily Boreal Ecosystem Productivity Simulator (BEPS) with observations made at the Mer Bleue peatland, located near Ottawa, Canada. Explicitly considering mesoscale topography, simulated total ET and GPP correlate well with measured ET (r = 0.91) and derived gross ecosystem productivity (GEP; r = 0.92). Both measured ET and derived GEP are simulated similarly well when mesoscale topography is neglected, but daily simulated values are systematically underestimated by about 10% and 12% on average, respectively, due to greater wetness resulting from the lack of lateral subsurface flow. Owing to the differences in moss surface conductances of water vapor and carbon dioxide with increasing moss water content, the differences in the spatial patterns of simulated total ET and GPP are controlled by the mesotopographic position of the moss ground cover.

Anatomical study of the articular branches innervated the hip and knee joint with reference to mechanism of referral pain in hip joint disease patients.

PubMed

Sakamoto, Junya; Manabe, Yoshitaka; Oyamada, Joichi; Kataoka, Hideki; Nakano, Jiro; Saiki, Kazunobu; Okamoto, Keishi; Tsurumoto, Toshiyuki; Okita, Minoru

2018-07-01

Referred pain in the anterior knee joint is the most common symptom in hip disease patients. The development of referred pain is considered to be related to dichotomizing peripheral sensory fibers. However, no gross anatomical findings identify any dichotomizing fibers innervating both the hip and knee joints. We dissected the femoral and obturator nerves in human cadavers to investigate the distribution of the articular branches in the hip and knee joints. Fourteen embalmed left lower limbs from 14 Japanese adult cadavers (five from females, nine from males, average age 73.8 ± 14.1 years) were observed macroscopically. The articular branches of the femoral and obturator nerves were dissected at the anterior margin of the groin toward the thigh region. After dissections of the articular nerves of the hip joints, the femoral and obturator nerves were exposed from proximally to distally to identify the articular nerves of the knee joints. The branching pattern of the articular branches in the hip and knee joints was recorded. In six of 14 limbs (42.9%), the femoral nerve supplied articular branches to the anteromedial aspect of both the hip and knee joints. These articular branches were derived from the same bundle of femoral nerve. These gross anatomical findings suggested that dichotomizing peripheral sensory fibers innervate the hip and knee joints and these could relate to the referred pain confirmed in the anterior knee joints of patients with hip disease. Clin. Anat. 31:705-709, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

Comparative assessment of marginal accuracy of grade II titanium and Ni–Cr alloy before and after ceramic firing: An in vitro study

PubMed Central

Patil, Abhijit; Singh, Kishan; Sahoo, Sukant; Suvarna, Suraj; Kumar, Prince; Singh, Anupam

2013-01-01

Objective: The aims of the study are to assess the marginal accuracy of base metal and titanium alloy casting and to evaluate the effect of repeated ceramic firing on the marginal accuracy of base metal and titanium alloy castings. Materials and Methods: Twenty metal copings were fabricated with each casting material. Specimens were divided into 4 groups of 10 each representing base metal alloys castings without (Group A) and with metal shoulder margin (Group B), titanium castings without (Group C) and with metal shoulder margin (Group D). The measurement of fit of the metal copings was carried out before the ceramic firing at four different points and the same was followed after porcelain build-up. Results: Significant difference was found when Ni–Cr alloy samples were compared with Grade II titanium samples both before and after ceramic firings. The titanium castings with metal shoulder margin showed highest microgap among all the materials tested. Conclusions: Based on the results that were found and within the limitations of the study design, it can be concluded that there is marginal discrepancy in the copings made from Ni–Cr and Grade II titanium. This marginal discrepancy increased after ceramic firing cycles for both Ni–Cr and Grade II titanium. The comparative statistical analysis for copings with metal-collar showed maximum discrepancy for Group D. The comparative statistical analysis for copings without metal-collar showed maximum discrepancy for Group C. PMID:24926205

Scanning electron microscope analysis of gunshot defects to bone: an underutilized source of information on ballistic trauma.

PubMed

Rickman, John M; Smith, Martin J

2014-11-01

Recent years have seen increasing involvement by forensic anthropologists in the interpretation of skeletal trauma. With regard to ballistic injuries, there is now a large literature detailing gross features of such trauma; however, less attention has been given to microscopic characteristics. This article presents analysis of experimentally induced gunshot trauma in animal bone (Bos taurus scapulae) using full metal jacket (FMJ), soft point (SP), and captive bolt projectiles. The results were examined using scanning electron microscopy (SEM). Additional analysis was conducted on a purported parietal gunshot lesion in a human cranial specimen. A range of features was observed in these samples suggesting that fibrolamellar bone response to projectile impact is analogous to that observed in synthetic composite laminates. The results indicate that direction of bullet travel can be discerned microscopically even when it is ambiguous on gross examination. It was also possible to distinguish SP from FMJ lesions. SEM analysis is therefore recommended as a previously underexploited tool in the analysis of ballistic trauma. © 2014 American Academy of Forensic Sciences.

A model using marginal efficiency of investment to analyse carbon and nitrogen interactions in terrestrial ecosystems (ACONITE Version 1)

NASA Astrophysics Data System (ADS)

Thomas, R. Q.; Williams, M.

2014-04-01

Carbon (C) and nitrogen (N) cycles are coupled in terrestrial ecosystems through multiple processes including photosynthesis, tissue allocation, respiration, N fixation, N uptake, and decomposition of litter and soil organic matter. Capturing the constraint of N on terrestrial C uptake and storage has been a focus of the Earth System modelling community. However there is little understanding of the trade-offs and sensitivities of allocating C and N to different tissues in order to optimize the productivity of plants. Here we describe a new, simple model of ecosystem C-N cycling and interactions (ACONITE), that builds on theory related to plant economics in order to predict key ecosystem properties (leaf area index, leaf C : N, N fixation, and plant C use efficiency) using emergent constraints provided by marginal returns on investment for C and/or N allocation. We simulated and evaluated steady-state ecosystem stocks and fluxes in three different forest ecosystems types (tropical evergreen, temperate deciduous, and temperate evergreen). Leaf C : N differed among the three ecosystem types (temperate deciduous < tropical evergreen < temperature evergreen), a result that compared well to observations from a global database describing plant traits. Gross primary productivity (GPP) and net primary productivity (NPP) estimates compared well to observed fluxes at the simulation sites. Simulated N fixation at steady-state, calculated based on relative demand for N and the marginal return on C investment to acquire N, was an order of magnitude higher in the tropical forest than in the temperate forest, consistent with observations. A sensitivity analysis revealed that parameterization of the relationship between leaf N and leaf respiration had the largest influence on leaf area index and leaf C : N. Also, a widely used linear leaf N-respiration relationship did not yield a realistic leaf C : N, while a more recently reported non-linear relationship performed better. A parameter governing how photosynthesis scales with day length had the largest influence on total vegetation C, GPP, and NPP. Multiple parameters associated with photosynthesis, respiration, and N uptake influenced the rate of N fixation. Overall, our ability to constrain leaf area index and have spatially and temporally variable leaf C : N helps address challenges for ecosystem and Earth System models. Furthermore, the simple approach with emergent properties based on coupled C-N dynamics has potential for use in research that uses data-assimilation methods to integrate data on both the C and N cycles to improve C flux forecasts.

A model using marginal efficiency of investment to analyze carbon and nitrogen interactions in terrestrial ecosystems (ACONITE Version 1)

NASA Astrophysics Data System (ADS)

Thomas, R. Q.; Williams, M.

2014-09-01

Carbon (C) and nitrogen (N) cycles are coupled in terrestrial ecosystems through multiple processes including photosynthesis, tissue allocation, respiration, N fixation, N uptake, and decomposition of litter and soil organic matter. Capturing the constraint of N on terrestrial C uptake and storage has been a focus of the Earth System Modeling community. However, there is little understanding of the trade-offs and sensitivities of allocating C and N to different tissues in order to optimize the productivity of plants. Here we describe a new, simple model of ecosystem C-N cycling and interactions (ACONITE), that builds on theory related to plant economics in order to predict key ecosystem properties (leaf area index, leaf C : N, N fixation, and plant C use efficiency) based on the outcome of assessments of the marginal change in net C or N uptake associated with a change in allocation of C or N to plant tissues. We simulated and evaluated steady-state ecosystem stocks and fluxes in three different forest ecosystems types (tropical evergreen, temperate deciduous, and temperate evergreen). Leaf C : N differed among the three ecosystem types (temperate deciduous < tropical evergreen < temperature evergreen), a result that compared well to observations from a global database describing plant traits. Gross primary productivity (GPP) and net primary productivity (NPP) estimates compared well to observed fluxes at the simulation sites. Simulated N fixation at steady-state, calculated based on relative demand for N and the marginal return on C investment to acquire N, was an order of magnitude higher in the tropical forest than in the temperate forest, consistent with observations. A sensitivity analysis revealed that parameterization of the relationship between leaf N and leaf respiration had the largest influence on leaf area index and leaf C : N. A parameter governing how photosynthesis scales with day length had the largest influence on total vegetation C, GPP, and NPP. Multiple parameters associated with photosynthesis, respiration, and N uptake influenced the rate of N fixation. Overall, our ability to constrain leaf area index and allow spatially and temporally variable leaf C : N can help address challenges simulating these properties in ecosystem and Earth System models. Furthermore, the simple approach with emergent properties based on coupled C-N dynamics has potential for use in research that uses data-assimilation methods to integrate data on both the C and N cycles to improve C flux forecasts.

Writing Stories, Rewriting Identities: Using Journalism Education and Mobile Technologies to Empower Marginalized High School Students

ERIC Educational Resources Information Center

Cybart-Persenaire, Alena; Literat, Ioana

2018-01-01

This study examines the impact that producing a print newspaper using cell phones had on marginalized students in a high school journalism classroom. Analysis of data from participant observation, artifact analysis and student interviews revealed that a) students negotiated cell phone use for educational purposes, despite school bans on such…

Flight-determined stability analysis of multiple-input-multiple-output control systems

NASA Technical Reports Server (NTRS)

Burken, John J.

1992-01-01

Singular value analysis can give conservative stability margin results. Applying structure to the uncertainty can reduce this conservatism. This paper presents flight-determined stability margins for the X-29A lateral-directional, multiloop control system. These margins are compared with the predicted unscaled singular values and scaled structured singular values. The algorithm was further evaluated with flight data by changing the roll-rate-to-aileron command-feedback gain by +/- 20 percent. Minimum eigenvalues of the return difference matrix which bound the singular values are also presented. Extracting multiloop singular values from flight data and analyzing the feedback gain variations validates this technique as a measure of robustness. This analysis can be used for near-real-time flight monitoring and safety testing.

Flight-determined stability analysis of multiple-input-multiple-output control systems

NASA Technical Reports Server (NTRS)

Burken, John J.

1992-01-01

Singular value analysis can give conservative stability margin results. Applying structure to the uncertainty can reduce this conservatism. This paper presents flight-determined stability margins for the X-29A lateral-directional, multiloop control system. These margins are compared with the predicted unscaled singular values and scaled structured singular values. The algorithm was further evaluated with flight data by changing the roll-rate-to-aileron-command-feedback gain by +/- 20 percent. Also presented are the minimum eigenvalues of the return difference matrix which bound the singular values. Extracting multiloop singular values from flight data and analyzing the feedback gain variations validates this technique as a measure of robustness. This analysis can be used for near-real-time flight monitoring and safety testing.

29 CFR 794.122 - Ascertainment of “annual” gross sales volume.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Ascertainment of âannualâ gross sales volume. 794.122... Annual Gross Volume of Sales § 794.122 Ascertainment of “annual” gross sales volume. The annual gross volume of sales of an enterprise engaged in the wholesale or bulk distribution of petroleum products...

Risk Informed Margins Management as part of Risk Informed Safety Margin Characterization

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

Curtis Smith

2014-06-01

The ability to better characterize and quantify safety margin is important to improved decision making about Light Water Reactor (LWR) design, operation, and plant life extension. A systematic approach to characterization of safety margins and the subsequent margin management options represents a vital input to the licensee and regulatory analysis and decision making that will be involved. In addition, as research and development in the LWR Sustainability (LWRS) Program and other collaborative efforts yield new data, sensors, and improved scientific understanding of physical processes that govern the aging and degradation of plant SSCs needs and opportunities to better optimize plantmore » safety and performance will become known. To support decision making related to economics, readability, and safety, the Risk Informed Safety Margin Characterization (RISMC) Pathway provides methods and tools that enable mitigation options known as risk informed margins management (RIMM) strategies.« less

Material identification of real impact sounds: effects of size variation in steel, glass, wood, and plexiglass plates.

PubMed

Giordano, Bruno L; McAdams, Stephen

2006-02-01

Identification of the material of struck objects of variable size was investigated. Previous studies on this issue assumed recognition to be based on acoustical measures of damping. This assumption was tested, comparing the power of a damping measure in explaining identification data with that of several other acoustical descriptors. Listeners' performance was perfect with respect to gross material categories (steel-glass and wood-plexiglass) comprising materials of vastly different mechanical properties. Impaired performance was observed for materials within the same gross category, identification being based on the size of the objects alone. The damping descriptor accounted for the identification of the gross categories. However other descriptors such as signal duration explained the results equally well. Materials within the same gross category were identified mainly on the basis of signal frequency. Overall poor support for the relevance of damping to material perception was found. An analysis of the acoustical support for perfect material identification was carried out. Sufficient acoustical information for perfect performance was found. Thus, procedural biases for the origin of the effects of size could be discarded, pointing toward their cognitive, rather than methodological nature. Identification performance was explained in terms of the regularities of the everyday acoustical environment.

An Analysis of Cost Analysis Methods Used during Contract Evaluation and Source Selection in Government Contracting.

DTIC Science & Technology

1986-12-01

optimal value can be stated as, Marginal Productivity of Marginal Productivity of Good A Good B " Price of Good A Price of Good B This...contractor proposed production costs could be used. _11 i4 W Vi..:. II. CONTRACT PROPOSAL EVALUATION A. PRICE ANALYSIS Price analysis, in its broadest sense...enters the market with a supply function represented by line S2, then the new price will be reestablished at price OP2 and quantity OQ2. Price

Positive Surgical Margins in Favorable-Stage Differentiated Thyroid Cancer.

PubMed

Mercado, Catherine E; Drew, Peter A; Morris, Christopher G; Dziegielewski, Peter T; Mendenhall, William M; Amdur, Robert J

2018-04-16

The significance of positive margin in favorable-stage well-differentiated thyroid cancer is controversial. We report outcomes of positive-margin patients with a matched-pair comparison to a negative-margin group. A total of 25 patients with classic-histology papillary or follicular carcinoma, total thyroidectomy +/- node dissection, stage T1-3N0-1bM0, positive surgical margin at primary site, adjuvant radioactive iodine (I-131), and age older than 18 years were treated between 2003 and 2013. Endpoints were clinical and biochemical (thyroglobulin-only) recurrence-free survival. Matched-pair analysis involved a 1:1 match with negative-margin cases matched for overall stage and I-131 dose. Recurrence-free survival in positive-margin patients was 71% at 10 years. No patient was successfully salvaged with additional treatment. Only 1 patient died of thyroid cancer. Recurrence-free survival at 10 years was worse with a positive (71%) versus negative (90%) margin (P=0.140). Cure with a microscopically positive margin was suboptimal (71%) despite patients having classic-histology papillary and follicular carcinoma, favorable stage, and moderate-dose I-131 therapy.

Effectiveness of Gross Model-Based Emotion Regulation Strategies Training on Anger Reduction in Drug-Dependent Individuals and its Sustainability in Follow-up

PubMed Central

Massah, Omid; Sohrabi, Faramarz; A’azami, Yousef; Doostian, Younes; Farhoudian, Ali; Daneshmand, Reza

2016-01-01

Background Emotion plays an important role in adapting to life changes and stressful events. Difficulty regulating emotions is one of the problems drug abusers often face, and teaching these individuals to express and manage their emotions can be effective on improving their difficult circumstances. Objectives The present study aimed to determine the effectiveness of the Gross model-based emotion regulation strategies training on anger reduction in drug-dependent individuals. Patients and Methods The present study had a quasi-experimental design wherein pretest-posttest evaluations were applied using a control group. The population under study included addicts attending Marivan’s methadone maintenance therapy centers in 2012 - 2013. Convenience sampling was used to select 30 substance-dependent individuals undergoing maintenance treatment who were then randomly assigned to the experiment and control groups. The experiment group received its training in eight two-hour sessions. Data were analyzed using analysis of co-variance and paired t-test. Results There was significant reduction in anger symptoms of drug-dependent individuals after gross model based emotion regulation training (ERT) (P < 0.001). Moreover, the effectiveness of the training on anger was persistent in the follow-up period. Conclusions Symptoms of anger in drug-dependent individuals of this study were reduced by gross model-based emotion regulation strategies training. Based on the results of this study, we may conclude that the gross model based emotion regulation strategies training can be applied alongside other therapies to treat drug abusers undergoing rehabilitation. PMID:27162759

Gender and Physics: A Theoretical Analysis.

ERIC Educational Resources Information Center

Rolin, Kristina

2001-01-01

Argues that objections raised by Koertge, Gross and Levitt, and Weinberg against feminist scholarship are unwarranted. The concept of gender, as it has been developed in feminist theory, is key to understanding why the first objection is misguided. Social analysis of scientific knowledge is key to understanding why the second and third objections…

Factors affecting surgical margin recurrence after hepatectomy for colorectal liver metastases

PubMed Central

Akyuz, Muhammet; Aucejo, Federico; Quintini, Cristiano; Miller, Charles; Fung, John

2016-01-01

Background Hepatic recurrence after resection of colorectal liver metastasis (CLM) occurs in 50% of patients during follow-up, with 2.8% to 13.9% presenting with surgical margin recurrence (SMR). The aim of this study is to analyze factors that related to SMR in patients with CLM undergoing hepatectomy. Methods Demographics, clinical and survival data of patients who underwent hepatectomy were identified from a prospectively maintained, institutional review board (IRB)-approved database between 2000 and 2012. Statistical analysis was performed using univariate Kaplan Meier and Cox proportional hazard model. Results There were 85 female and 121 male patients who underwent liver resection for CLM. An R0 resection was performed in 157 (76%) patients and R1 resection in 49. SMR was detected in 32 patients (15.5%) followed up for a median of 29 months (range, 3–121 months). A half of these patients had undergone R1 (n=16) and another half R0 resection (n=16). Tumor size, preoperative carcinoembryonic antigen (CEA) level and margin status were associated with SMR on univariate analysis. On multivariate analysis, a positive surgical margin was the only independent predictor of SMR. The receipt of adjuvant chemotherapy did not affect margin recurrence. SMR was an independent risk factor associated with worse disease-free (DFS) and overall survival (OS). Conclusions This study shows that SMR, which can be detected in up to 15.5% of patients after liver resection for CLM, adversely affects DFS and OS. The fact that a positive surgical margin was the only predictive factor for SMR in these patients underscores the importance of achieving negative margins during hepatectomy. PMID:27294032

Prognostic significance of positive circumferential resection margin in esophageal cancer: a systematic review and meta-analysis.

PubMed

Wu, Jie; Chen, Qi-Xun; Teng, Li-song; Krasna, Mark J

2014-02-01

To assess the prognostic significance of positive circumferential resection margin on overall survival in patients with esophageal cancer, a systematic review and meta-analysis was performed. Studies were identified from PubMed, EMBASE, and Web of Science. Survival data were extracted from eligible studies to compare overall survival in patients with a positive circumferential resection margin with patients having a negative circumferential resection margin according to the Royal College of Pathologists (RCP) criteria and the College of American Pathologists (CAP) criteria. Survival data were pooled with hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs). A random-effects model meta-analysis on overall survival was performed. The pooled HRs for survival were 1.510 (95% CI, 1.329-1.717; p<0.001) and 2.053 (95% CI, 1.597-2.638; p<0.001) according to the RCP and CAP criteria, respectively. Positive circumferential resection margin was associated with worse survival in patients with T3 stage disease according to the RCP (HR, 1.381; 95% CI, 1.028-1.584; p=0.001) and CAP (HR, 2.457; 95% CI, 1.902-3.175; p<0.001) criteria, respectively. Positive circumferential resection margin was associated with worse survival in patients receiving neoadjuvant therapy according to the RCP (HR, 1.676; 95% CI, 1.023-2.744; p=0.040) and CAP (HR, 1.847; 95% CI, 1.226-2.78; p=0.003) criteria, respectively. Positive circumferential resection margin is associated with poor prognosis in patients with esophageal cancer, particularly in patients with T3 stage disease and patients receiving neoadjuvant therapy. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy.

PubMed

Franki, Inge; Van den Broeck, Christine; De Cat, Josse; Tijhuis, Wieke; Molenaers, Guy; Vanderstraeten, Guy; Desloovere, Kaat

2014-10-01

A pilot study to compare the effectiveness of an individual therapy program with the effects of a general physical therapy program. A randomized, single-blind cross-over design. Ten ambulant children with bilateral spastic cerebral palsy, age four to nine years. Participants were randomly assigned into a ten-week individually defined, targeted or a general program, followed by a cross-over. Evaluation was performed using the Gross Motor Function Measure-88 and three-dimensional gait analysis. General outcome parameters were Gross Motor Function Measure-88 scores, time and distance parameters, gait profile score and movement analysis profiles. Individual goal achievement was evaluated using z-scores for gait parameters and Goal Attainment Scale for gross motor function. No significant changes were observed regarding gross motor function. Only after individualized therapy, step- and stride-length increased significantly (p = 0.022; p = 0.017). Change in step-length was higher after the individualized program (p = 0.045). Within-group effects were found for the pelvis in transversal plane after the individualized program (p = 0.047) and in coronal plane after the general program (p = 0.047). Between-program differences were found for changes in the knee in sagittal plane, in the advantage of the individual program (p = 0.047). A median difference in z-score of 0.279 and 0.419 was measured after the general and individualized program, respectively. Functional goal attainment was higher after the individual therapy program compared with the general program (48 to 43.5). The results indicate slightly favorable effects towards the individualized program. To detect clinically significant changes, future studies require a minimal sample size of 72 to 90 participants. © The Author(s) 2014.

The role of tectonic inheritance in the morphostructural evolution of the Galicia continental margin and adjacent abyssal plains from digital bathymetric model (DBM) analysis (NW Spain)

NASA Astrophysics Data System (ADS)

Maestro, A.; Jané, G.; Llave, E.; López-Martínez, J.; Bohoyo, F.; Druet, M.

2018-06-01

The identification of recent major tectonic structures in the Galicia continental margin and adjacent abyssal plains was carried out by means of a quantitative analysis of the linear structures having bathymetric expression on the seabed. It was possible to identify about 5800 lineaments throughout the entire study area, of approximately 271,500 km2. Most lineaments are located in the Charcot and Coruña highs, in the western sector of the Galicia Bank, in the area of the Marginal Platforms and in the northern sector of the margin. Analysis of the lineament orientations shows a predominant NE-SW direction and three relative maximum directions: NW-SE, E-W and N-S. The total length of the lineaments identified is over 44,000 km, with a mode around 5000 m and an average length of about 7800 m. In light of different tectonic studies undertaken in the northwestern margin of the Iberian Peninsula, we establish that the lineaments obtained from analysis of the digital bathymetric model of the Galicia continental margin and adjacent abyssal plains would correspond to fracture systems. In general, the orientation of lineaments corresponds to main faults, tectonic structures following the directions of ancient faults that resulted from late stages of the Variscan orogeny and Mesozoic extension phases related to Triassic rifting and Upper Jurassic to Early Cretaceous opening of the North Atlantic Ocean. The N-S convergence between Eurasian and African plates since Palaeogene times until the Miocene, and NW-SE convergence from Neogene to present, reactivated the Variscan and Mesozoic fault systems and related physiography.

Loss of Coolant Accident (LOCA) / Emergency Core Coolant System (ECCS Evaluation of Risk-Informed Margins Management Strategies for a Representative Pressurized Water Reactor (PWR)

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

Szilard, Ronaldo Henriques

A Risk Informed Safety Margin Characterization (RISMC) toolkit and methodology are proposed for investigating nuclear power plant core, fuels design and safety analysis, including postulated Loss-of-Coolant Accident (LOCA) analysis. This toolkit, under an integrated evaluation model framework, is name LOCA toolkit for the US (LOTUS). This demonstration includes coupled analysis of core design, fuel design, thermal hydraulics and systems analysis, using advanced risk analysis tools and methods to investigate a wide range of results.

Evaluation of marginal and internal adaptation of hybrid and nanoceramic systems with microcomputed tomography: An in vitro study.

PubMed

Yildirim, Güler; Uzun, Ismail H; Keles, Ali

2017-08-01

The accuracy of recently introduced chairside computer-aided design and computer-aided manufacturing (CAD-CAM) blocks is not well established, and marginal integrity and internal adaptation are not known. The purpose of this in vitro study was to evaluate the marginal and internal adaptation of hybrid and nanoceramics using microcomputed tomography (μ-CT). The marginal and internal adaptation of 3 polymer-infiltrated ceramic-network (PICN) materials (Vita Enamic [VE]; Lava Ultimate [LU]; Vita Suprinity [VS]) were compared with lithium disilicate (IPS e.max.CAD, IPS). Ninety-six specimens (48 dies and 48 crowns) were prepared (n=12 each group) using a chairside CAD-CAM system. The restorations were scanned with μ-CT, with 160 measurements made for each crown, and used in 2-dimensional (2D) analysis. The marginal adaptation of marginal discrepancy (MD), absolute marginal discrepancy (AMD), internal adaptation of shoulder area (SA), axial space (AS), and occlusal space (OS) were compared using appropriate statistical analysis methods (α=.05). Cement volumes were compared using 3D analysis. The IPS blocks showed higher MD (130 μm), AMD (156 μm), SA (111 μm) (P<.05), AS (52 μm), and OS (192 μm) than the other blocks (P<.01). The adaptation values of VS were significantly lower than those of the IPS block (P<.05). The adaption values of the LU and VE blocks were significantly lower than those of others (P<.01) but were statistically similar to one another (P>.05). IPS had the largest cement space at 18 mm 3 (P<.01). The marginal and internal adaptation values were within a clinically acceptable range for all 3 hybrids and nanoceramics tested. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Comparative planning evaluation of intensity-modulated radiotherapy techniques for complex lung cancer cases.

PubMed

Yartsev, Slav; Chen, Jeff; Yu, Edward; Kron, Tomas; Rodrigues, George; Coad, Terry; Trenka, Kristina; Wong, Eugene; Bauman, Glenn; Dyk, Jake Van

2006-02-01

Lung cancer treatment can be one of the most challenging fields in radiotherapy. The aim of the present study was to compare different modalities of radiation delivery based on a balanced scoring scheme for target coverage and normal tissue avoidance. Treatment plans were developed for 15 patients with stage III inoperable non-small cell lung cancer using 3D conformal technique and intensity-modulated radiotherapy (IMRT). Elective nodal irradiation was included for all cases to create the most challenging scenarios with large target volumes. A 2 cm margin was used around the gross tumour volume (GTV) to generate PTV2 and 1cm margin around elective nodes for PTV1 resulting in PTV1 volumes larger than 1000 cm(3) in 13 of the 15 patients. 3D conformal and IMRT plans were generated on a commercial treatment planning system (TheraPlan Plus, Nucletron) with various combinations of beam energies and gantry angles. A 'dose quality factor' (DQF) was introduced to correlate the plan quality with patient specific parameters. A good correlation was found between the quality of the plans and the overlap between PTV1 and lungs. The patient feature factor (PFF), which is a product of several pertinent characteristics, was introduced to facilitate the choice of a particular technique for a particular patient. This approach may allow the evaluation of different treatment options prior to actual planning, subject to validation in larger prospective data sets.

Retroperitoneal liposarcomas: the experience of a tertiary Asian center

PubMed Central

2011-01-01

Background Liposarcoma is the single most common soft tissue sarcoma in the retroperitoneum. Materials and methods A retrospective review of patients with primary retroperitoneal liposarcoma treated between June 1990 and June 2005 were conducted to evaluate the clinical results of resection for retroperitoneal liposarcomas (RPLS) and the prognostic factors for disease recurrence and patient survival in an Asian population. Results Twenty-one patients operated on for curative intent (12 Males, 9 Females; mean age: 52.4 years) were evaluated. Of these, 13 presented with tumors that were well differentiated (61.9%), 4 (19.0%) with myxoid/round cell, 3 (14.3%) with dedifferentiated and 1(4.8%) with pleomorphic morphology. The median tumor burden was 36 cm (9-83). Median follow-up time was 62 months. There was no peri-operative mortality and morbidity occurred in 6(28.6%) patients. Surgical margins were involved in 10(47.6%) patients. Resection of contiguous organs was required in 15(71.4%) to achieve gross surgical margins. Eleven out of the 21(52%) of the patients had recurrence of the tumor. Median disease-free survival was 19 months and the overall 3- and 5-year survival rate was 87% and 49% respectively. Conclusion An aggressive surgical approach in both primary and recurrent RPLS in our institution is associated with 3- and 5-year survival rate of 87% and 49% respectively. Contiguous organ resection is often required to achieve local control. PMID:21284868

Reproducibility of lung tumor position and reduction of lung mass within the planning target volume using active breathing control (ABC).

PubMed

Cheung, Patrick C F; Sixel, Katharina E; Tirona, Romeo; Ung, Yee C

2003-12-01

The active breathing control (ABC) device allows for temporary immobilization of respiratory motion by implementing a breath hold at a predefined relative lung volume and air flow direction. The purpose of this study was to quantitatively evaluate the ability of the ABC device to immobilize peripheral lung tumors at a reproducible position, increase total lung volume, and thereby reduce lung mass within the planning target volume (PTV). Ten patients with peripheral non-small-cell lung cancer tumors undergoing radiotherapy had CT scans of their thorax with and without ABC inspiration breath hold during the first 5 days of treatment. Total lung volumes were determined from the CT data sets. Each peripheral lung tumor was contoured by one physician on all CT scans to generate gross tumor volumes (GTVs). The lung density and mass contained within a 1.5-cm PTV margin around each peripheral tumor was calculated using CT numbers. Using the center of the GTV from the Day 1 ABC scan as the reference, the displacement of subsequent GTV centers on Days 2 to 5 for each patient with ABC applied was calculated in three dimensions. With the use of ABC inspiration breath hold, total lung volumes increased by an average of 42%. This resulted in an average decrease in lung mass of 18% within a standard 1.5-cm PTV margin around the GTV. The average (+/- standard deviation) displacement of GTV centers with ABC breath hold applied was 0.3 mm (+/- 1.8 mm), 1.2 mm (+/- 2.3 mm), and 1.1 mm (+/- 3.5 mm) in the lateral direction, anterior-posterior direction, and superior-inferior direction, respectively. Results from this study indicate that there remains some inter-breath hold variability in peripheral lung tumor position with the use of ABC inspiration breath hold, which prevents significant PTV margin reduction. However, lung volumes can significantly increase, thereby decreasing the mass of lung within a standard PTV.

Determination of Internal Target Volume for Radiation Treatment Planning of Esophageal Cancer by Using 4-Dimensional Computed Tomography (4DCT)

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

Chen, Xiaojian; Lu, Haijun; Radiation Oncology Center, Affiliated Hospital of Medical College, Qingdao University, Qingdao

2014-09-01

Purpose: To determine an efficient strategy for the generation of the internal target volume (ITV) for radiation treatment planning for esophageal cancer using 4-dimensional computed tomography (4DCT). Methods and Materials: 4DCT sets acquired for 20 patients with esophageal carcinoma were analyzed. Each of the 4DCT sets was binned into 10 respiratory phases. For each patient, the gross tumor volume (GTV) was delineated on the 4DCT set at each phase. Various strategies to derive ITV were explored, including the volume from the maximum intensity projection (MIP; ITV{sub M}IP), unions of the GTVs from selected multiple phases ITV2 (0% and 50% phases), ITV3 (ITV2more » plus 80%), and ITV4 (ITV3 plus 60%), as well as the volumes expanded from ITV2 and ITV3 with a uniform margin. These ITVs were compared to ITV10 (the union of the GTVs for all 10 phases) and the differences were measured with the overlap ratio (OR) and relative volume ratio (RVR) relative to ITV10 (ITVx/ITV10). Results: For all patients studied, the average GTV from a single phase was 84.9% of ITV10. The average ORs were 91.2%, 91.3%, 94.5%, and 96.4% for ITV{sub M}IP, ITV2, ITV3, and ITV4, respectively. Low ORs were associated with irregular breathing patterns. ITV3s plus 1 mm uniform margins (ITV3+1) led to an average OR of 98.1% and an average RVR of 106.4%. Conclusions: The ITV generated directly from MIP underestimates the range of the respiration motion for esophageal cancer. The ITV generated from 3 phases (ITV3) may be used for regular breathers, whereas the ITV generated from 4 phases (ITV4) or ITV3 plus a 1-mm uniform margin may be applied for irregular breathers.« less

Determination of internal target volume for radiation treatment planning of esophageal cancer by using 4-dimensional computed tomography (4DCT).

PubMed

Chen, Xiaojian; Lu, Haijun; Tai, An; Johnstone, Candice; Gore, Elizabeth; Li, X Allen

2014-09-01

To determine an efficient strategy for the generation of the internal target volume (ITV) for radiation treatment planning for esophageal cancer using 4-dimensional computed tomography (4DCT). 4DCT sets acquired for 20 patients with esophageal carcinoma were analyzed. Each of the 4DCT sets was binned into 10 respiratory phases. For each patient, the gross tumor volume (GTV) was delineated on the 4DCT set at each phase. Various strategies to derive ITV were explored, including the volume from the maximum intensity projection (MIP; ITV_MIP), unions of the GTVs from selected multiple phases ITV2 (0% and 50% phases), ITV3 (ITV2 plus 80%), and ITV4 (ITV3 plus 60%), as well as the volumes expanded from ITV2 and ITV3 with a uniform margin. These ITVs were compared to ITV10 (the union of the GTVs for all 10 phases) and the differences were measured with the overlap ratio (OR) and relative volume ratio (RVR) relative to ITV10 (ITVx/ITV10). For all patients studied, the average GTV from a single phase was 84.9% of ITV10. The average ORs were 91.2%, 91.3%, 94.5%, and 96.4% for ITV_MIP, ITV2, ITV3, and ITV4, respectively. Low ORs were associated with irregular breathing patterns. ITV3s plus 1 mm uniform margins (ITV3+1) led to an average OR of 98.1% and an average RVR of 106.4%. The ITV generated directly from MIP underestimates the range of the respiration motion for esophageal cancer. The ITV generated from 3 phases (ITV3) may be used for regular breathers, whereas the ITV generated from 4 phases (ITV4) or ITV3 plus a 1-mm uniform margin may be applied for irregular breathers. Copyright © 2014 Elsevier Inc. All rights reserved.

Different CAD/CAM-processing routes for zirconia restorations: influence on fitting accuracy.

PubMed

Kohorst, Philipp; Junghanns, Janet; Dittmer, Marc P; Borchers, Lothar; Stiesch, Meike

2011-08-01

The aim of the present in vitro study was to evaluate the influence of different processing routes on the fitting accuracy of four-unit zirconia fixed dental prostheses (FDPs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM). Three groups of zirconia frameworks with ten specimens each were fabricated. Frameworks of one group (CerconCAM) were produced by means of a laboratory CAM-only system. The other frameworks were made with different CAD/CAM systems; on the one hand by in-laboratory production (CerconCAD/CAM) and on the other hand by centralized production in a milling center (Compartis) after forwarding geometrical data. Frameworks were then veneered with the recommended ceramics, and marginal accuracy was determined using a replica technique. Horizontal marginal discrepancy, vertical marginal discrepancy, absolute marginal discrepancy, and marginal gap were evaluated. Statistical analyses were performed by one-way analysis of variance (ANOVA), with the level of significance chosen at 0.05. Mean horizontal discrepancies ranged between 22 μm (CerconCAM) and 58 μm (Compartis), vertical discrepancies ranged between 63 μm (CerconCAD/CAM) and 162 μm (CerconCAM), and absolute marginal discrepancies ranged between 94 μm (CerconCAD/CAM) and 181 μm (CerconCAM). The marginal gap varied between 72 μm (CerconCAD/CAM) and 112 μm (CerconCAM, Compartis). Statistical analysis revealed that, with all measurements, the marginal accuracy of the zirconia FDPs was significantly influenced by the processing route used (p < 0.05). Within the limitations of this study, all restorations showed a clinically acceptable marginal accuracy; however, the results suggest that the CAD/CAM systems are more precise than the CAM-only system for the manufacture of four-unit FDPs.

Estimation of Inherent Safety Margins in Loaded Commercial Spent Nuclear Fuel Casks

DOE PAGES

Banerjee, Kaushik; Robb, Kevin R.; Radulescu, Georgeta; ...

2016-06-15

We completed a novel assessment to determine the unquantified and uncredited safety margins (i.e., the difference between the licensing basis and as-loaded calculations) available in as-loaded spent nuclear fuel (SNF) casks. This assessment was performed as part of a broader effort to assess issues and uncertainties related to the continued safety of casks during extended storage and transportability following extended storage periods. Detailed analyses crediting the actual as-loaded cask inventory were performed for each of the casks at three decommissioned pressurized water reactor (PWR) sites to determine their characteristics relative to regulatory safety criteria for criticality, thermal, and shielding performance.more » These detailed analyses were performed in an automated fashion by employing a comprehensive and integrated data and analysis tool—Used Nuclear Fuel-Storage, Transportation & Disposal Analysis Resource and Data System (UNF-ST&DARDS). Calculated uncredited criticality margins from 0.07 to almost 0.30 Δk eff were observed; calculated decay heat margins ranged from 4 to almost 22 kW (as of 2014); and significant uncredited transportation dose rate margins were also observed. The results demonstrate that, at least for the casks analyzed here, significant uncredited safety margins are available that could potentially be used to compensate for SNF assembly and canister structural performance related uncertainties associated with long-term storage and subsequent transportation. The results also suggest that these inherent margins associated with how casks are loaded could support future changes in cask licensing to directly or indirectly credit the margins. Work continues to quantify the uncredited safety margins in the SNF casks loaded at other nuclear reactor sites.« less

Evaluation and comparison of the marginal adaptation of two different substructure materials.

PubMed

Karaman, Tahir; Ulku, Sabiha Zelal; Zengingul, Ali Ihsan; Guven, Sedat; Eratilla, Veysel; Sumer, Ebru

2015-06-01

In this study, we aimed to evaluate the amount of marginal gap with two different substructure materials using identical margin preparations. Twenty stainless steel models with a chamfer were prepared with a CNC device. Marginal gap measurements of the galvano copings on these stainless steel models and Co-Cr copings obtained by a laser-sintering method were made with a stereomicroscope device before and after the cementation process and surface properties were evaluated by scanning electron microscopy (SEM). A dependent t-test was used to compare the mean of the two groups for normally distributed data, and two-way variance analysis was used for more than two data sets. Pearson's correlation analysis was also performed to assess relationships between variables. According to the results obtained, the marginal gap in the galvano copings before cementation was measured as, on average, 24.47 ± 5.82 µm before and 35.11 ± 6.52 µm after cementation; in the laser-sintered Co-Cr structure, it was, on average, 60.45 ± 8.87 µm before and 69.33 ± 9.03 µm after cementation. A highly significant difference (P<.001) was found in marginal gap measurements of galvano copings and a significant difference (P<.05) was found in marginal gap measurements of the laser-sintered Co-Cr copings. According to the SEM examination, surface properties of laser sintered Co-Cr copings showed rougher structure than galvano copings. The galvano copings showed a very smooth surface. Marginal gaps values of both groups before and after cementation were within the clinically acceptable level. The smallest marginal gaps occurred with the use of galvano copings.

Evaluation and comparison of the marginal adaptation of two different substructure materials

PubMed Central

Karaman, Tahir; Ulku, Sabiha Zelal; Zengingul, Ali Ihsan; Eratilla, Veysel; Sumer, Ebru

2015-01-01

PURPOSE In this study, we aimed to evaluate the amount of marginal gap with two different substructure materials using identical margin preparations. MATERIALS AND METHODS Twenty stainless steel models with a chamfer were prepared with a CNC device. Marginal gap measurements of the galvano copings on these stainless steel models and Co-Cr copings obtained by a laser-sintering method were made with a stereomicroscope device before and after the cementation process and surface properties were evaluated by scanning electron microscopy (SEM). A dependent t-test was used to compare the mean of the two groups for normally distributed data, and two-way variance analysis was used for more than two data sets. Pearson's correlation analysis was also performed to assess relationships between variables. RESULTS According to the results obtained, the marginal gap in the galvano copings before cementation was measured as, on average, 24.47 ± 5.82 µm before and 35.11 ± 6.52 µm after cementation; in the laser-sintered Co-Cr structure, it was, on average, 60.45 ± 8.87 µm before and 69.33 ± 9.03 µm after cementation. A highly significant difference (P<.001) was found in marginal gap measurements of galvano copings and a significant difference (P<.05) was found in marginal gap measurements of the laser-sintered Co-Cr copings. According to the SEM examination, surface properties of laser sintered Co-Cr copings showed rougher structure than galvano copings. The galvano copings showed a very smooth surface. CONCLUSION Marginal gaps values of both groups before and after cementation were within the clinically acceptable level. The smallest marginal gaps occurred with the use of galvano copings. PMID:26140178

Positive surgical margins after robotic assisted radical prostatectomy: a multi-institutional study.

PubMed

Patel, Vipul R; Coelho, Rafael F; Rocco, Bernardo; Orvieto, Marcelo; Sivaraman, Ananthakrishnan; Palmer, Kenneth J; Kameh, Darien; Santoro, Luigi; Coughlin, Geoff D; Liss, Michael; Jeong, Wooju; Malcolm, John; Stern, Joshua M; Sharma, Saurabh; Zorn, Kevin C; Shikanov, Sergey; Shalhav, Arieh L; Zagaja, Gregory P; Ahlering, Thomas E; Rha, Koon H; Albala, David M; Fabrizio, Michael D; Lee, David I; Chauhan, Sanket

2011-08-01

Positive surgical margins are an independent predictive factor for biochemical recurrence after radical prostatectomy. We analyzed the incidence of and associative factors for positive surgical margins in a multi-institutional series of 8,418 robotic assisted radical prostatectomies. We analyzed the records of 8,418 patients who underwent robotic assisted radical prostatectomy at 7 institutions. Of the patients 323 had missing data on margin status. Positive surgical margins were categorized into 4 groups, including apex, bladder neck, posterolateral and multifocal. The records of 6,169 patients were available for multivariate analysis. The variables entered into the logistic regression models were age, body mass index, preoperative prostate specific antigen, biopsy Gleason score, prostate weight and pathological stage. A second model was built to identify predictive factors for positive surgical margins in the subset of patients with organ confined disease (pT2). The overall positive surgical margin rate was 15.7% (1,272 of 8,095 patients). The positive surgical margin rate for pT2 and pT3 disease was 9.45% and 37.2%, respectively. On multivariate analysis pathological stage (pT2 vs pT3 OR 4.588, p<0.001) and preoperative prostate specific antigen (4 or less vs greater than 10 ng/ml OR 2.918, p<0.001) were the most important independent predictive factors for positive surgical margins after robotic assisted radical prostatectomy. Increasing prostate weight was associated with a lower risk of positive surgical margins after robotic assisted radical prostatectomy (OR 0.984, p<0.001) and a higher body mass index was associated with a higher risk of positive surgical margins (OR 1.032, p<0.001). For organ confined disease preoperative prostate specific antigen was the most important factor that independently correlated with positive surgical margins (4 or less vs greater than 10 ng/ml OR 3.8, p<0.001). The prostatic apex followed by a posterolateral site was the most common location of positive surgical margins after robotic assisted radical prostatectomy. Factors that correlated with cancer aggressiveness, such as pathological stage and preoperative prostate specific antigen, were the most important factors independently associated with an increased risk of positive surgical margins after robotic assisted radical prostatectomy. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Prevalence and predictive factors for the detection of carcinoma in cavity margin performed at the time of breast lumpectomy.

PubMed

Tengher-Barna, Iulia; Hequet, Delphine; Reboul-Marty, Jeanne; Frassati-Biaggi, Annonciade; Seince, Nathalie; Rodrigues-Faure, Anabela; Uzan, Michèle; Ziol, Marianne

2009-02-01

Margin resection status is a major risk factor for the development of local recurrence in breast conservation therapy for carcinoma. Tumor bed excision sent as separate orientated cavity margins represents a tool to verify the completeness of the carcinoma resection. We aimed to (1) determine the prevalence of positive cavity margin and its influence on subsequent surgical treatment and (2) identify potential predictive factors for positive cavity margins. From 2003 to 2006, 107 (57 years; 30-88) consecutive patients who underwent a lumpectomy for carcinoma with four orientated cavity margins for carcinoma were selected. Preoperative clinical, radiological and histological data, perioperative macroscopic characteristics and definitive histological analysis results were recorded. Lumpectomy or cavity margins were considered as positive when the distance from carcinoma to the margin was less than or equal to 3 mm. Histological examination of cavity margins showed carcinoma in 38 patients (35%), therefore modifying subsequent surgical therapy in 33 cases. Examination of the cavity margins led (1) to avoiding surgical re-excision in 20 cases (lumpectomy margins were positive and the cavity margins negative), (2) to performing a mastectomy or a re-excision in 13 cases (carcinoma was detected in the cavity margins although the lumpectomy margins were negative or tumor size was superior to 3 cm). Between preoperative and perioperative parameters, US scan and macroscopic size of the tumor were predictive factors for positive cavity margins whereas characteristics of the carcinoma determined on biopsy samples and macroscopic status of the lumpectomy margins were not. Our study confirms that the systematic practice of cavity margin resection avoids surgical re-excision and reduces the likelihood of underestimating the extent of the tumor.

Effect of ankle-foot orthoses on gait, balance and gross motor function in children with cerebral palsy: a systematic review and meta-analysis.

PubMed

Lintanf, Mael; Bourseul, Jean-Sébastien; Houx, Laetitia; Lempereur, Mathieu; Brochard, Sylvain; Pons, Christelle

2018-04-01

To determine the effects of ankle-foot orthoses (AFOs) on gait, balance, gross motor function and activities of daily living in children with cerebral palsy. Five databases were searched (Pubmed, Psycinfo, Web of Science, Academic Search Premier and Cochrane Library) before January 2018. Studies of the effect of AFOs on gait, balance, gross motor function and activities of daily living in children with cerebral palsy were included. Articles with a modified PEDRO score ≥ 5/9 were selected. Data regarding population, AFO, interventions and outcomes were extracted. When possible, standardized mean differences (SMDs) were calculated from the outcomes. Thirty-two articles, corresponding to 56 studies (884 children) were included. Fifty-one studies included children with spastic cerebral palsy. AFOs increased stride length (SMD = 0.88, P < 0.001) and gait speed (SMD = 0.28, P < 0.001), and decreased cadence (SMD = -0.72, P < 0.001). Gross motor function scores improved (Gross Motor Function Measure (GMFM) D (SMD = 0.30, P = 0.004), E (SMD = 0.28, P = 0.02), Pediatric Evaluation of Disability Inventory (PEDI) (SMD = 0.57, P < 0.001)). Data relating to balance and activities of daily living were insufficient to conclude. Posterior AFOs (solid, hinged, supra-malleolar, dynamic) increased ankle dorsiflexion at initial contact (SMD = 1.65, P < 0.001) and during swing (SMD = 1.34, P < 0.001), and decreased ankle power generation in stance (SMD = -0.72, P < 0.001) in children with equinus gait. In children with spastic cerebral palsy, there is strong evidence that AFOs induce small improvements in gait speed and moderate evidence that AFOs have a small to moderate effect on gross motor function. In children with equinus gait, there is strong evidence that posterior AFOs induce large changes in distal kinematics.

How Hinge Positioning in Cross-Country Ski Bindings Affect Exercise Efficiency, Cycle Characteristics and Muscle Coordination during Submaximal Roller Skiing

PubMed Central

Bolger, Conor M.; Sandbakk, Øyvind; Ettema, Gertjan; Federolf, Peter

2016-01-01

The purposes of the current study were to 1) test if the hinge position in the binding of skating skis has an effect on gross efficiency or cycle characteristics and 2) investigate whether hinge positioning affects synergistic components of the muscle activation in six lower leg muscles. Eleven male skiers performed three 4-min sessions at moderate intensity while cross-country ski-skating and using a klapskate binding. Three different positions were tested for the binding’s hinge, ranging from the front of the first distal phalange to the metatarsal-phalangeal joint. Gross efficiency and cycle characteristics were determined, and the electromyographic (EMG) signals of six lower limb muscles were collected. EMG signals were wavelet transformed, normalized, joined into a multi-dimensional vector, and submitted to a principle component analysis (PCA). Our results did not reveal any changes to gross efficiency or cycle characteristics when altering the hinge position. However, our EMG analysis found small but significant effects of hinge positioning on muscle coordinative patterns (P < 0.05). The changed patterns in muscle activation are in alignment with previously described mechanisms that explain the effects of hinge positioning in speed-skating klapskates. Finally, the within-subject results of the EMG analysis suggested that in addition to the between-subject effects, further forms of muscle coordination patterns appear to be employed by some, but not all participants. PMID:27203597

Vertical motions of passive margins of Greenland: influence of ice sheet, glacial erosion, and sediment transport

NASA Astrophysics Data System (ADS)

Souche, A.; Medvedev, S.; Hartz, E. H.

2009-04-01

The sub-ice topography of Greenland is characterized by a central depression below the sea level and by elevated (in some places significantly) margins. Whereas the central depression may be explained by significant load of the Greenland ice sheet, the origin of the peripheral relief remains unclear. We analyze the influence of formation of the ice sheet and carving by glacial erosion on the evolution of topography along the margins of Greenland. Our analysis shows that: (1) The heavy ice loading in the central part of Greenland and consecutive peripheral bulging has a negligible effect on amplitude of the uplifted Greenland margins. (2) First order estimates of uplift due to isostatic readjustment caused by glacial erosion and unloading in the fjord systems is up to 1.1 km. (3) The increase of accuracy of topographic data (comparing several data sets of resolution with grid size from 5 km to 50 m) results in increase of the isostatic response in the model. (4) The analysis of mass redistribution during erosion-sedimentation process and data on age of offshore sediments allows us to estimate the timing of erosion along the margins of Greenland. This ongoing analysis, however, requires careful account for the link between sources (localized glacial erosion) and sinks (offshore sedimentary basins around Greenland).

Gross Motor Profile and Its Association with Socialization Skills in Children with Autism Spectrum Disorders.

PubMed

Pusponegoro, Hardiono D; Efar, Pustika; Soedjatmiko; Soebadi, Amanda; Firmansyah, Agus; Chen, Hui-Ju; Hung, Kun-Long

2016-12-01

While social impairment is considered to be the core deficit in children with autism spectrum disorder (ASD), a large proportion of these children have poor gross motor ability, and gross motor deficits may influence socialization skills in children with ASD. The objectives of this study were to compare gross motor skills in children with ASD to typically developing children, to describe gross motor problems in children with ASD, and to investigate associations between gross motor and socialization skills in children with ASD. This was a cross-sectional study including 40 ASD children aged from 18 months to 6 years and 40 age-matched typically developing controls. Gross motor and socialization skills were scored using the Vineland Adaptive Behavior Scales, 2 nd edition (Vineland-II). Below average gross motor function was found in eight of 40 (20%) ASD children. The mean gross motor v-scale score in the ASD group was 15.1 [standard deviation (SD) 3.12], significantly lower than in the control group [18.7, SD 2.09, p = 0.0001; 95% confidence intervals (CI) from -4.725 to -2.525]. The differences were most prominent in ball throwing and catching, using stairs, jumping, and bicycling. The ASD children with gross motor impairments had a mean socialization domain score of 66.6 (SD 6.50) compared to 85.7 (SD 10.90) in those without gross motor impairments (p = 0.0001, 95% CI from -25.327 to -12.736). Children with ASD had lower gross motor skills compared to typically developing children. Gross motor impairments were found in 20% of the ASD children, and these children also had lower socialization skills than those without gross motor impairments. Copyright © 2016. Published by Elsevier B.V.

Tensorial Gross-Neveu models

NASA Astrophysics Data System (ADS)

Benedetti, Dario; Carrozza, Sylvain; Gurau, Razvan; Sfondrini, Alessandro

2018-01-01

We define and study various tensorial generalizations of the Gross-Neveu model in two dimensions, that is, models with four-fermion interactions and G 3 symmetry, where we take either G = U( N) or G = O( N). Such models can also be viewed as two-dimensional generalizations of the Sachdev-Ye-Kitaev model, or more precisely of its tensorial counterpart introduced by Klebanov and Tarnopolsky, which is in part our motivation for studying them. Using the Schwinger-Dyson equations at large- N, we discuss the phenomenon of dynamical mass generation and possible combinations of couplings to avoid it. For the case G = U( N),we introduce an intermediate field representation and perform a stability analysis of the vacua. It turns out that the only apparently viable combination of couplings that avoids mass generation corresponds to an unstable vacuum. The stable vacuum breaks U( N)3 invariance, in contradiction with the Coleman-Mermin-Wagner theorem, but this is an artifact of the large- N expansion, similar to the breaking of continuous chiral symmetry in the chiral Gross-Neveu model.

The effects of therapeutic taping on gross motor function in children with cerebral palsy.

PubMed

Footer, Cheryl Burditt

2006-01-01

Therapeutic taping to address dysfunctional sitting control in children with cerebral palsy (CP) was investigated in this study. Eighteen children with quadriplegic CP, Gross Motor Function Classification System for Cerebral Palsy levels IV (n = 9) and V (n = 9) participated in the 12-week program. Subjects were assigned randomly to one of two groups: therapeutic taping + physical therapy or physical therapy only. Therapeutic taping was applied for periods of up to 72 hours over the paraspinal region. The effects were assessed with the Gross Motor Function Measure (GMFM-88) at baseline, six weeks, and 12 weeks. A factorial analysis of variance was used to examine group differences over time. No significant differences were found for the GMFM-88 scores between groups over time. Therapeutic taping does not evoke a positive functional change in the seated postural control of children with quadriplegic cerebral palsy. Subjective observation, however, suggested that one child with athetosis benefited from therapeutic taping over the paraspinal region.

Incompletely treated malignancies of the major salivary gland: Toward evidence-based care.

PubMed

Tam, Samantha; Sandulache, Vlad C; Metwalli, Kareem A; Rock, Crosby D; Eraj, Salman A; Sheu, Tommy; El-Naggar, Adel K; Fuller, Clifton D; Weber, Randal S; Lai, Stephen Y

2018-05-07

Unexpected malignancy is common in major salivary gland tumors due to variability of workup, creating challenging treatment decisions. The purpose of this study was to define treatment-related outcomes for patients with incompletely treated major salivary gland tumors. A retrospective cohort study was completed of patients with incompletely treated major salivary gland tumors. Tumor burden at presentation was established and treatment categorized. The Cox Proportional Hazards model was used to determine predictors of survival and failure. Of the 440 included patients, patients with gross residual or metastatic disease had a worse overall survival (OS; P < .001). Presentation status was an independent predictor of OS on multivariate analysis (gross residual disease adjusted hazard ratio [HR adjusted ] 2.55; 95% confidence interval [CI] 1.20-5.30; metastatic disease HR adjusted 9.53; 95% CI 3.04-27.06). Failure to achieve gross total resection during initial surgery resulted in worse OS. Adequate preoperative planning is required for initial surgical management to optimize tumor control and survival. © 2018 Wiley Periodicals, Inc.

Margin and sensitivity methods for security analysis of electric power systems

NASA Astrophysics Data System (ADS)

Greene, Scott L.

Reliable operation of large scale electric power networks requires that system voltages and currents stay within design limits. Operation beyond those limits can lead to equipment failures and blackouts. Security margins measure the amount by which system loads or power transfers can change before a security violation, such as an overloaded transmission line, is encountered. This thesis shows how to efficiently compute security margins defined by limiting events and instabilities, and the sensitivity of those margins with respect to assumptions, system parameters, operating policy, and transactions. Security margins to voltage collapse blackouts, oscillatory instability, generator limits, voltage constraints and line overloads are considered. The usefulness of computing the sensitivities of these margins with respect to interarea transfers, loading parameters, generator dispatch, transmission line parameters, and VAR support is established for networks as large as 1500 buses. The sensitivity formulas presented apply to a range of power system models. Conventional sensitivity formulas such as line distribution factors, outage distribution factors, participation factors and penalty factors are shown to be special cases of the general sensitivity formulas derived in this thesis. The sensitivity formulas readily accommodate sparse matrix techniques. Margin sensitivity methods are shown to work effectively for avoiding voltage collapse blackouts caused by either saddle node bifurcation of equilibria or immediate instability due to generator reactive power limits. Extremely fast contingency analysis for voltage collapse can be implemented with margin sensitivity based rankings. Interarea transfer can be limited by voltage limits, line limits, or voltage stability. The sensitivity formulas presented in this thesis apply to security margins defined by any limit criteria. A method to compute transfer margins by directly locating intermediate events reduces the total number of loadflow iterations required by each margin computation and provides sensitivity information at minimal additional cost. Estimates of the effect of simultaneous transfers on the transfer margins agree well with the exact computations for a network model derived from a portion of the U.S grid. The accuracy of the estimates over a useful range of conditions and the ease of obtaining the estimates suggest that the sensitivity computations will be of practical value.

29 CFR 794.120 - Meaning of “annual gross volume of sales.”

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Meaning of âannual gross volume of sales.â 794.120 Section... of Sales § 794.120 Meaning of “annual gross volume of sales.” The annual gross volume of sales of an... gross volume derived from all sales transactions is included, and will embrace among other things...

A global assessment of gross and net land change dynamics for current conditions and future scenarios

NASA Astrophysics Data System (ADS)

Fuchs, Richard; Prestele, Reinhard; Verburg, Peter H.

2018-05-01

The consideration of gross land changes, meaning all area gains and losses within a pixel or administrative unit (e.g. country), plays an essential role in the estimation of total land changes. Gross land changes affect the magnitude of total land changes, which feeds back to the attribution of biogeochemical and biophysical processes related to climate change in Earth system models. Global empirical studies on gross land changes are currently lacking. Whilst the relevance of gross changes for global change has been indicated in the literature, it is not accounted for in future land change scenarios. In this study, we extract gross and net land change dynamics from large-scale and high-resolution (30-100 m) remote sensing products to create a new global gross and net change dataset. Subsequently, we developed an approach to integrate our empirically derived gross and net changes with the results of future simulation models by accounting for the gross and net change addressed by the land use model and the gross and net change that is below the resolution of modelling. Based on our empirical data, we found that gross land change within 0.5° grid cells was substantially larger than net changes in all parts of the world. As 0.5° grid cells are a standard resolution of Earth system models, this leads to an underestimation of the amount of change. This finding contradicts earlier studies, which assumed gross land changes to appear in shifting cultivation areas only. Applied in a future scenario, the consideration of gross land changes led to approximately 50 % more land changes globally compared to a net land change representation. Gross land changes were most important in heterogeneous land systems with multiple land uses (e.g. shifting cultivation, smallholder farming, and agro-forestry systems). Moreover, the importance of gross changes decreased over time due to further polarization and intensification of land use. Our results serve as an empirical database for land change dynamics that can be applied in Earth system models and integrated assessment models.

Derivation of improved load transformation matrices for launchers-spacecraft coupled analysis, and direct computation of margins of safety

NASA Technical Reports Server (NTRS)

Klein, M.; Reynolds, J.; Ricks, E.

1989-01-01

Load and stress recovery from transient dynamic studies are improved upon using an extended acceleration vector in the modal acceleration technique applied to structural analysis. Extension of the normal LTM (load transformation matrices) stress recovery to automatically compute margins of safety is presented with an application to the Hubble space telescope.

Composite marginal quantile regression analysis for longitudinal adolescent body mass index data.

PubMed

Yang, Chi-Chuan; Chen, Yi-Hau; Chang, Hsing-Yi

2017-09-20

Childhood and adolescenthood overweight or obesity, which may be quantified through the body mass index (BMI), is strongly associated with adult obesity and other health problems. Motivated by the child and adolescent behaviors in long-term evolution (CABLE) study, we are interested in individual, family, and school factors associated with marginal quantiles of longitudinal adolescent BMI values. We propose a new method for composite marginal quantile regression analysis for longitudinal outcome data, which performs marginal quantile regressions at multiple quantile levels simultaneously. The proposed method extends the quantile regression coefficient modeling method introduced by Frumento and Bottai (Biometrics 2016; 72:74-84) to longitudinal data accounting suitably for the correlation structure in longitudinal observations. A goodness-of-fit test for the proposed modeling is also developed. Simulation results show that the proposed method can be much more efficient than the analysis without taking correlation into account and the analysis performing separate quantile regressions at different quantile levels. The application to the longitudinal adolescent BMI data from the CABLE study demonstrates the practical utility of our proposal. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Electricity prices in a competitive environment: Marginal cost pricing of generation services and financial status of electric utilities. A preliminary analysis through 2015

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

NONE

1997-08-01

The emergence of competitive markets for electricity generation services is changing the way that electricity is and will be priced in the United States. This report presents the results of an analysis that focuses on two questions: (1) How are prices for competitive generation services likely to differ from regulated prices if competitive prices are based on marginal costs rather than regulated {open_quotes}cost-of-service{close_quotes} pricing? (2) What impacts will the competitive pricing of generation services (based on marginal costs) have on electricity consumption patterns, production costs, and the financial integrity patterns, production costs, and the financial integrity of electricity suppliers? Thismore » study is not intended to be a cost-benefit analysis of wholesale or retail competition, nor does this report include an analysis of the macroeconomic impacts of competitive electricity prices.« less

Comparison of a Traditional Probabilistic Risk Assessment Approach with Advanced Safety Analysis

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

Smith, Curtis L; Mandelli, Diego; Zhegang Ma

2014-11-01

As part of the Light Water Sustainability Program (LWRS) [1], the purpose of the Risk Informed Safety Margin Characterization (RISMC) [2] Pathway research and development (R&D) is to support plant decisions for risk-informed margin management with the aim to improve economics, reliability, and sustain safety of current NPPs. In this paper, we describe the RISMC analysis process illustrating how mechanistic and probabilistic approaches are combined in order to estimate a safety margin. We use the scenario of a “station blackout” (SBO) wherein offsite power and onsite power is lost, thereby causing a challenge to plant safety systems. We describe themore » RISMC approach, illustrate the station blackout modeling, and contrast this with traditional risk analysis modeling for this type of accident scenario. We also describe our approach we are using to represent advanced flooding analysis.« less

[The physical therapy undergraduate students' responses to the gross human anatomy subjects].

PubMed

Anahara, Reiko; Kawashiro, Yukiko; Matsuno, Yoshiharu; Mori, Chisato; Kohno, Toshihiko

2008-09-01

Instruction in gross human anatomy is one of the important items in the subject for co-medical students of the physical therapist course. The physical therapy undergraduate students are required to have a solid understanding of the structure and formation of the human body. Therefore, their good-understanding of the course on the gross human anatomy and their experience of the gross human anatomy laboratory (observation practice) are acquired to improve their knowledge of the human body. To clarify the student responses to the gross human anatomy course including the gross human anatomy laboratory, several questionnaires were administered to the freshman physical therapy undergraduate student for two years. We found that more than 80% of the students, who felt a negative attitude for gross human anatomy before the course started, had a positive attitude about the gross human anatomy after going through the course. The experience of the gross human anatomy laboratory increased the students' activity of learning and they thought more about the dignity of being human after the course than before viewing. In addition, the results suggested that the multiple experiences of the gross human anatomy course are useful for the physical therapy undergraduate students to improve the quality of their understanding of the human body.

Electricity Prices in a Competitive Environment: Marginal Cost Pricing

EIA Publications

1997-01-01

Presents the results of an analysis that focuses on two questions: (1) How are prices for competitive generation services likely to differ from regulated prices if competitive prices are based on marginal costs rather than regulated cost-of-service pricing? (2) What impacts will the competitive pricing of generation services (based on marginal costs) have on electricity consumption patterns, production costs, and the financial integrity of electricity suppliers?

Comparative Evaluation of Marginal Adaptation of BiodentineTM and Other Commonly Used Root End Filling Materials-An Invitro Study

PubMed Central

P.V., Ravichandra; Vemisetty, Harikumar; K., Deepthi; Reddy S, Jayaprada; D., Ramkiran; Krishna M., Jaya Nagendra; Malathi, Gita

2014-01-01

Aim: The purpose of this investigation was to evaluate the marginal adaptation of three root-end filling materials Glass ionomer cement, Mineral trioxide aggregate and BiodentineTM. Methodology: Thirty human single-rooted teeth were resected 3 mm from the apex. Root-end cavities were then prepared using an ultrasonic tip and filled with one of the following materials Glass ionomer cement (GIC), Mineral trioxide aggregate (MTA) and a bioactive cement BiodentineTM. The apical portions of the roots were then sectioned to obtain three 1 mm thick transversal sections. Confocal laser scanning microscopy (CLSM) was used to determine area of gaps and adaptation of the root-end filling materials with the dentin. The Post hoc test, a multiple comparison test was used for statistical data analysis. Results: Statistical analysis showed lowest marginal gaps (11143.42±967.753m2) and good marginal adaptation with BiodentineTM followed by MTA (22300.97±3068.883m2) and highest marginal gaps with GIC (33388.17±12155.903m2) which were statistically significant (p<0.0001). Conclusion: A new root end filling material BiodentineTM showed better marginal adaptation than commonly used root end filling materials PMID:24783148

Marginal and Random Intercepts Models for Longitudinal Binary Data With Examples From Criminology.

PubMed

Long, Jeffrey D; Loeber, Rolf; Farrington, David P

2009-01-01

Two models for the analysis of longitudinal binary data are discussed: the marginal model and the random intercepts model. In contrast to the linear mixed model (LMM), the two models for binary data are not subsumed under a single hierarchical model. The marginal model provides group-level information whereas the random intercepts model provides individual-level information including information about heterogeneity of growth. It is shown how a type of numerical averaging can be used with the random intercepts model to obtain group-level information, thus approximating individual and marginal aspects of the LMM. The types of inferences associated with each model are illustrated with longitudinal criminal offending data based on N = 506 males followed over a 22-year period. Violent offending indexed by official records and self-report were analyzed, with the marginal model estimated using generalized estimating equations and the random intercepts model estimated using maximum likelihood. The results show that the numerical averaging based on the random intercepts can produce prediction curves almost identical to those obtained directly from the marginal model parameter estimates. The results provide a basis for contrasting the models and the estimation procedures and key features are discussed to aid in selecting a method for empirical analysis.

Gross Motor Development.

ERIC Educational Resources Information Center

Florida Learning Resources System/CROWN, Jacksonville.

The document is designed to help teachers identify and remediate gross motor development deficits in elementary school students. A definition of gross motor development and a checklist of gross motor skills are provided. Sections cover the following topics: successful teaching techniques; activities for perceptual-motor training; activities for…

Computed tomography-magnetic resonance image fusion: a clinical evaluation of an innovative approach for improved tumor localization in primary central nervous system lesions.

PubMed

Lattanzi, J P; Fein, D A; McNeeley, S W; Shaer, A H; Movsas, B; Hanks, G E

1997-01-01

We describe our initial experience with the AcQSim (Picker International, St. David, PA) computed tomography-magnetic resonance imaging (CT-MRI) fusion software in eight patients with intracranial lesions. MRI data are electronically integrated into the CT-based treatment planning system. Since MRI is superior to CT in identifying intracranial abnormalities, we evaluated the precision and feasibility of this new localization method. Patients initially underwent CT simulation from C2 to the most superior portion of the scalp. T2 and post-contrast T1-weighted MRI of this area was then performed. Patient positioning was duplicated utilizing a head cup and bridge of nose to forehead angle measurements. First, a gross tumor volume (GTV) was identified utilizing the CT (CT/GTV). The CT and MRI scans were subsequently fused utilizing a point pair matching method and a second GTV (CT-MRI/GTV) was contoured with the aid of both studies. The fusion process was uncomplicated and completed in a timely manner. Volumetric analysis revealed the CT-MRI/GTV to be larger than the CT/GTV in all eight cases. The mean CT-MRI/GTV was 28.7 cm3 compared to 16.7 cm3 by CT alone. This translated into a 72% increase in the radiographic tumor volume by CT-MRI. A simulated dose-volume histogram in two patients revealed that marginal portions of the lesion, as identified by CT and MRI, were not included in the high dose treatment volume as contoured with the use of CT alone. Our initial experience with the fusion software demonstrated an improvement in tumor localization with this technique. Based on these patients the use of CT alone for treatment planning purposes in central nervous system (CNS) lesions is inadequate and would result in an unacceptable rate of marginal misses. The importation of MRI data into three-dimensional treatment planning is therefore crucial to accurate tumor localization. The fusion process simplifies and improves precision of this task.

A model using marginal efficiency of investment to analyse carbon and nitrogen interactions in forested ecosystems

NASA Astrophysics Data System (ADS)

Thomas, R. Q.; Williams, M.

2014-12-01

Carbon (C) and nitrogen (N) cycles are coupled in terrestrial ecosystems through multiple processes including photosynthesis, tissue allocation, respiration, N fixation, N uptake, and decomposition of litter and soil organic matter. Capturing the constraint of N on terrestrial C uptake and storage has been a focus of the Earth System modelling community. Here we explore the trade-offs and sensitivities of allocating C and N to different tissues in order to optimize the productivity of plants using a new, simple model of ecosystem C-N cycling and interactions (ACONITE). ACONITE builds on theory related to plant economics in order to predict key ecosystem properties (leaf area index, leaf C:N, N fixation, and plant C use efficiency) based on the optimization of the marginal change in net C or N uptake associated with a change in allocation of C or N to plant tissues. We simulated and evaluated steady-state and transient ecosystem stocks and fluxes in three different forest ecosystems types (tropical evergreen, temperate deciduous, and temperate evergreen). Leaf C:N differed among the three ecosystem types (temperate deciduous < tropical evergreen < temperature evergreen), a result that compared well to observations from a global database describing plant traits. Gross primary productivity (GPP) and net primary productivity (NPP) estimates compared well to observed fluxes at the simulation sites. A sensitivity analysis revealed that parameterization of the relationship between leaf N and leaf respiration had the largest influence on leaf area index and leaf C:N. Also, a widely used linear leaf N-respiration relationship did not yield a realistic leaf C:N, while a more recently reported non-linear relationship simulated leaf C:N that compared better to the global trait database than the linear relationship. Overall, our ability to constrain leaf area index and allow spatially and temporally variable leaf C:N can help address challenges simulating these properties in ecosystem and Earth System models. Furthermore, the simple approach with emergent properties based on coupled C-N dynamics has potential for use in research that uses data-assimilation methods to integrate data on both the C and N cycles to improve C flux forecasts.

The effects of ecological restoration on CO2 fluxes from a climatically marginal upland blanket bog

NASA Astrophysics Data System (ADS)

Dixon, Simon; Qassim, Suzane; Rowson, James; Worrall, Fred; Evans, Martin

2013-04-01

A legacy of gully incision, deposition of industrially-derived aerial pollutants, inappropriate management and wildfire has left large expanses of the topographic Bleaklow Plateau (Peak District National Park, England, UK) bare of vegetation and susceptible to massive erosion of the peat soils. The consequence of such degradation has been to decrease the capacity of the peatland on the plateau to provide important ecosystem services including; loss of net C sink function, discolouration of surface waters, mobilisation to surface waters of stored heavy metals and infilling of upland reservoirs with peat-derived sediment. In response to on-going and worsening degradation a programme of ecological restoration has been undertaken. Restoration methods include: seeding with a lawn grass mix; liming; fertilisation; slope stabilisation; and gully blocking. This talk will present data from a five-year, observational-study of CO2 fluxes from eight sites, with four sites sampling different restoration treatments and four sampling bare and least disturbed areas. The results of the analysis reveal that sites with revegetation alongside slope stabilisation were most productive and were the largest net (daylight hours) sinks of CO2. Unrestored, bare sites, while having relatively low gross fluxes of CO2 were the largest net sources of CO2. Revegetation without slope stabilisation took longer (~18 months) to show an impact on CO2 flux in comparison to the sites with slope stabilisation. Binary logistic regression indicated that a ten centimetre increase in water table depth decreases the odds of observing a net CO2 sink, on a given site, by up to 30%. Sites with slope stabilisation were between 5-8x more likely to be net CO2 sinks than the bare sites. Sites without slope stabilisation were only 2-2.3x more likely to be net CO2 sinks compared to the bare sites. The most important conclusion of this research is that revegetation appears to be effective at increasing the likelihood of net CO2 behaviour on degraded, climatically marginal blanket peat, with revegetation alongside slope stabilisation having the greatest impact.

Radiation field size and dose determine oncologic outcome in esophageal cancer.

PubMed

Gemici, Cengiz; Yaprak, Gokhan; Batirel, Hasan Fevzi; Ilhan, Mahmut; Mayadagli, Alpaslan

2016-10-13

Locoregional recurrence is a major problem in esophageal cancer patients treated with definitive concomitant chemoradiotherapy. Approximately half of the patients fail locoregionally. We analyzed the impact of enlarged radiation field size and higher radiation dose incorporated to chemoradiotherapy on oncologic outcome. Seventy-four consecutive patients with histologically proven nonmetastatic squamous or adenocarcinoma of the esophagus were included in this retrospective analysis. All patients were locally advanced cT3-T4 and/or cN0-1. Treatment consisted of either definitive concomitant chemoradiotherapy (Def-CRT) (n = 49, 66 %) or preoperative concomitant chemoradiotherapy (Pre-CRT) followed by surgical resection (n = 25, 34 %). Patients were treated with longer radiation fields. Clinical target volume (CTV) was obtained by giving 8-10 cm margins to the craniocaudal borders of gross tumor volume (GTV) instead of 4-5 cm globally accepted margins, and some patients in Def-CRT group received radiation doses higher than 50 Gy. Isolated locoregional recurrences were observed in 9 out of 49 patients (18 %) in the Def-CRT group and in 1 out of 25 patients (3.8 %) in the Pre-CRT group (p = 0.15). The 5-year survival rate was 59 % in the Def-CRT group and 50 % in the Pre-CRT group (p = 0.72). Radiation dose was important in the Def-CRT group. Patients treated with >50 Gy (11 out of 49 patients) had better survival with respect to patients treated with 50 Gy (38 out of 49 patients). Five-year survivals were 91 and 50 %, respectively (p = 0.013). Radiation treatment planning by enlarged radiation fields in esophageal cancer decreases locoregional recurrences considerably with respect to the results reported in the literature by standard radiation fields (18 vs >50 %). Radiation dose is as important as radiation field size; patients in the Def-CRT group treated with ≥50 Gy had better survival in comparison to patients treated with 50 Gy.

Use of the Hill Interaction Matrix in Individual Counseling Research.

ERIC Educational Resources Information Center

Boyd, Robert E.

Research in counseling effectiveness is moving from the use of gross outcome measures to analysis of the counseling process. One successful approach has been the adoption of a social-psychological model of interview analysis which attempts to specify within-interview conditions which facilitate client behavior change. The criteria and procedure…

Random Sample Consensus: A Paradigm for Model Fitting with Applications to Image Analysis and Automated Cartography

DTIC Science & Technology

1980-03-01

interpreting/smoothing data containing a significant percentage of gross errors, and thus is ideally suited for applications in automated image ... analysis where interpretation is based on the data provided by error-prone feature detectors. A major portion of the paper describes the application of

Cost of improving Access to Psychological Therapies (IAPT) programme: an analysis of cost of session, treatment and recovery in selected Primary Care Trusts in the East of England region.

PubMed

Radhakrishnan, Muralikrishnan; Hammond, Geoffrey; Jones, Peter B; Watson, Alison; McMillan-Shields, Fiona; Lafortune, Louise

2013-01-01

Recent literature on Improving Access to Psychological Therapies (IAPT) has reported on improvements in clinical outcomes, changes in employment status and the concept of recovery attributable to IAPT treatment, but not on the costs of the programme. This article reports the costs associated with a single session, completed course of treatment and recovery for four treatment courses (i.e., remaining in low or high intensity treatment, stepping up or down) in IAPT services in 5 East of England region Primary Care Trusts. Costs were estimated using treatment activity data and gross financial information, along with assumptions about how these financial data could be broken down. The estimated average cost of a high intensity session was £177 and the average cost for a low intensity session was £99. The average cost of treatment was £493 (low intensity), £1416 (high intensity), £699 (stepped down), £1514 (stepped up) and £877 (All). The cost per recovered patient was £1043 (low intensity), £2895 (high intensity), £1653 (stepped down), £2914 (stepped up) and £1766 (All). Sensitivity analysis revealed that the costs are sensitive to cost ratio assumptions, indicating that inaccurate ratios are likely to influence overall estimates. Results indicate the cost per session exceeds previously reported estimates, but cost of treatment is only marginally higher. The current cost estimates are supportive of the originally proposed IAPT model on cost-benefit grounds. The study also provides a framework to estimate costs using financial data, especially when programmes have block contract arrangements. Replication and additional analyses along with evidence-based discussion regarding alternative, cost-effective methods of intervention is recommended. Copyright © 2012 Elsevier Ltd. All rights reserved.

Health expenditures spent for prevention, economic performance, and social welfare.

PubMed

Wang, Fuhmei; Wang, Jung-Der; Huang, Yu-Xiu

2016-12-01

Countries with limited resources in economic downturns often reduce government expenditures, of which spending on preventive healthcare with no apparent immediate health impact might be cut down first. This research aims to find the optimum share of preventive health expenditure to gross domestic product (GDP) and investigate the implications of preventive health services on economic performance and the population's wellbeing. We develop the economic growth model to undertake health-economic analyses and parameterize for Taiwan setting. Based on the US experiences over the period from 1975 to 2013, this research further examines the model's predictions on the relationship between preventive health expenditure and economic performance. Theoretical analysis and numerical simulations show that an inverse U-shaped relationship exists between the proportion of GDP spent on prevention and social welfare, as well as between the proportion spent on prevention and economic growth. Empirical analysis shows an under-investment in prevention in Taiwan. The spending of preventive healthcare in Taiwan government was 0.0027 GDP in 2014, while the optimization levels for economic development and social welfare would be 0 · 0119 and 0 · 0203, respectively. There is a statistically significant nonlinear relationship between health expenditure on prevention and the estimated real impact of economic performance from US experiences. The welfare-maximizing proportion of preventive expenditure is usually greater than the proportion maximizing economic growth, indicating a conflict between economic growth and welfare after a marginal share. Our findings indicate that it is worthwhile increasing investment on prevention up until an optimization level for economic development and social welfare. Such levels could also be estimated in other economies.

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

Muijs, Christina, E-mail: c.t.muijs@umcg.nl; Smit, Justin; Karrenbeld, Arend

Purpose/Objective(s): The aim of this study was to analyze the accuracy of gross tumor volume (GTV) delineation and clinical target volume (CTV) margins for neoadjuvant chemoradiation therapy (neo-CRT) in esophageal carcinoma at pathologic examination and to determine the impact on survival. Methods and Materials: The study population consisted of 63 esophageal cancer patients treated with neo-CRT. GTV and CTV borders were demarcated in situ during surgery on the esophagus, using anatomical reference points to provide accurate information regarding tumor location at pathologic evaluation. To identify prognostic factors for disease-free survival (DFS) and overall survival (OS), a Cox regression analysis wasmore » performed. Results: After resection, macroscopic residual tumor was found outside the GTV in 7 patients (11%). Microscopic residual tumor was located outside the CTV in 9 patients (14%). The median follow-up was 15.6 months. With multivariate analysis, only microscopic tumor outside the CTV (hazard ratio [HR], 4.96; 95% confidence interval [CI], 1.03-15.36), and perineural growth (HR, 5.77; 95% CI, 1.27-26.13) were identified as independent prognostic factors for OS. The 1-year OS was 20% for patients with tumor outside the CTV and 86% for those without (P<.01). For DFS, microscopic tumor outside the CTV (HR, 5.92; 95% CI, 1.89-18.54) and ypN+ (HR, 3.36; 95% CI, 1.33-8.48) were identified as independent adverse prognostic factors. The 1-year DFS was 23% versus 77% for patients with or without tumor outside the CTV (P<.01). Conclusions: Microscopic tumor outside the CTV is associated with markedly worse OS after neo-CRT. This may either stress the importance of accurate tumor delineation or reflect aggressive tumor behavior requiring new adjuvant treatment modalities.« less

Integrating economic and biophysical data in assessing cost-effectiveness of buffer strip placement.

PubMed

Balana, Bedru Babulo; Lago, Manuel; Baggaley, Nikki; Castellazzi, Marie; Sample, James; Stutter, Marc; Slee, Bill; Vinten, Andy

2012-01-01

The European Union Water Framework Directive (WFD) requires Member States to set water quality objectives and identify cost-effective mitigation measures to achieve "good status" in all waters. However, costs and effectiveness of measures vary both within and between catchments, depending on factors such as land use and topography. The aim of this study was to develop a cost-effectiveness analysis framework for integrating estimates of phosphorus (P) losses from land-based sources, potential abatement using riparian buffers, and the economic implications of buffers. Estimates of field-by-field P exports and routing were based on crop risk and field slope classes. Buffer P trapping efficiencies were based on literature metadata analysis. Costs of placing buffers were based on foregone farm gross margins. An integrated optimization model of cost minimization was developed and solved for different P reduction targets to the Rescobie Loch catchment in eastern Scotland. A target mean annual P load reduction of 376 kg to the loch to achieve good status was identified. Assuming all the riparian fields initially have the 2-m buffer strip required by the General Binding Rules (part of the WFD in Scotland), the model gave good predictions of P loads (345-481 kg P). The modeling results show that riparian buffers alone cannot achieve the required P load reduction (up to 54% P can be removed). In the medium P input scenario, average costs vary from £38 to £176 kg P at 10% and 54% P reduction, respectively. The framework demonstrates a useful tool for exploring cost-effective targeting of environmental measures. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

A unifying framework for marginalized random intercept models of correlated binary outcomes

PubMed Central

Swihart, Bruce J.; Caffo, Brian S.; Crainiceanu, Ciprian M.

2013-01-01

We demonstrate that many current approaches for marginal modeling of correlated binary outcomes produce likelihoods that are equivalent to the copula-based models herein. These general copula models of underlying latent threshold random variables yield likelihood-based models for marginal fixed effects estimation and interpretation in the analysis of correlated binary data with exchangeable correlation structures. Moreover, we propose a nomenclature and set of model relationships that substantially elucidates the complex area of marginalized random intercept models for binary data. A diverse collection of didactic mathematical and numerical examples are given to illustrate concepts. PMID:25342871

Review of optical coherence tomography in oncology

NASA Astrophysics Data System (ADS)

Wang, Jianfeng; Xu, Yang; Boppart, Stephen A.

2017-12-01

The application of optical coherence tomography (OCT) in the field of oncology has been prospering over the past decade. OCT imaging has been used to image a broad spectrum of malignancies, including those arising in the breast, brain, bladder, the gastrointestinal, respiratory, and reproductive tracts, the skin, and oral cavity, among others. OCT imaging has initially been applied for guiding biopsies, for intraoperatively evaluating tumor margins and lymph nodes, and for the early detection of small lesions that would often not be visible on gross examination, tasks that align well with the clinical emphasis on early detection and intervention. Recently, OCT imaging has been explored for imaging tumor cells and their dynamics, and for the monitoring of tumor responses to treatments. This paper reviews the evolution of OCT technologies for the clinical application of OCT in surgical and noninvasive interventional oncology procedures and concludes with a discussion of the future directions for OCT technologies, with particular emphasis on their applications in oncology.

Metastatic pancreatic carcinoma and bronchioloalveolar adenomas in an Egyptian fruit bat (Rousettus aegyptiacus).

PubMed

Cushing, Andrew C; Ossiboff, Robert; Buckles, Elizabeth; Abou-Madi, Noha

2013-09-01

An adult female, intact Egyptian fruit bat (Rousettus aegyptiacus) was presented for lethargy, anorexia, and markedly reduced flying activity. Physical and ultrasound examinations were suggestive of an abdominal mass with free fluid within the abdomen. Based on the poor and deteriorating clinical condition of the animal, euthanasia was elected. Gross necropsy revealed an irregular thickening at the root of the mesentery and a diffusely, dark-red liver with rounded hepatic margins. Histologic examination revealed extensive neoplastic effacement of the pancreas with invasion into the surrounding mesentery and mesenteric lymph nodes and metastatic spread to the liver. Based on the morphology of the neoplastic cells, the involvement of the pancreas, and immunohistochemistry, a diagnosis of metastatic pancreatic carcinoma was made. Additionally, two small neoplasms were identified in the lungs. These masses were distinct from the carcinoma, and their morphology was consistent with bronchioloalveolar adenomas. This is the first known report of either benign pulmonary lesions or pancreatic carcinomas in the order Chiroptera.

Combining forecast weights: Why and how?

NASA Astrophysics Data System (ADS)

Yin, Yip Chee; Kok-Haur, Ng; Hock-Eam, Lim

2012-09-01

This paper proposes a procedure called forecast weight averaging which is a specific combination of forecast weights obtained from different methods of constructing forecast weights for the purpose of improving the accuracy of pseudo out of sample forecasting. It is found that under certain specified conditions, forecast weight averaging can lower the mean squared forecast error obtained from model averaging. In addition, we show that in a linear and homoskedastic environment, this superior predictive ability of forecast weight averaging holds true irrespective whether the coefficients are tested by t statistic or z statistic provided the significant level is within the 10% range. By theoretical proofs and simulation study, we have shown that model averaging like, variance model averaging, simple model averaging and standard error model averaging, each produces mean squared forecast error larger than that of forecast weight averaging. Finally, this result also holds true marginally when applied to business and economic empirical data sets, Gross Domestic Product (GDP growth rate), Consumer Price Index (CPI) and Average Lending Rate (ALR) of Malaysia.

Thulium fiber laser damage to the ureter

NASA Astrophysics Data System (ADS)

Wilson, Christopher R.; Hardy, Luke A.; Irby, Pierce B.; Fried, Nathaniel M.

2015-07-01

Our laboratory is studying experimental thulium fiber laser (TFL) as a potential alternative lithotripter to the clinical gold standard Holmium:YAG laser. Safety studies characterizing undesirable Holmium laser-induced damage to ureter tissue have been previously reported. Similarly, this study characterizes TFL induced ureter and stone basket damage. A TFL beam with pulse energy of 35 mJ, pulse duration of 500 μs, and pulse rates of 150-500 Hz was delivered through a 100-μm-core, low-OH, silica optical fiber to the porcine ureter wall, in vitro. Ureter perforation times were measured and gross, histological, and optical coherence tomography images of the ablation zone were acquired. TFL operation at 150, 300, and 500 Hz produced mean ureter perforation times of 7.9, 3.8, and 1.8 s, respectively. Collateral damage averaged 510, 370, and 310 μm. TFL mean perforation time exceeded 1 s at each setting, which is a greater safety margin than previously reported during Holmium laser ureter perforation studies.

Successful subtotal orbitectomy in a cat with osteoma

PubMed Central

Corgozinho, Katia B; Cunha, Simone CS; Siqueira, Ricardo S; Souza, Heloisa JM

2015-01-01

Case summary A 14-year-old Siamese neutered male cat was evaluated for anorexia and a left periorbital mass. Skull radiographic findings showed a well-defined lesion resembling new compact bone formation without destruction. A subtotal orbitectomy was indicated. The tumor was removed intact with a normal tissue margin of at least 1 cm. There were no postsurgical complications. Histopathologic examination revealed an osteoma. The cat returned to normal appetite and activity 15 days after surgery. Six months after surgery, there were no gross signs of recurrence. Relevance and novel information Periorbital tumors are infrequently diagnosed in companion animals and most are malignant. In this case, the diagnosis was orbital osteoma. The most commonly affected bone for osteoma in cats is the mandibular bone; few cases have been identified in orbital bones. Orbital surgery has the potential to be challenging owing to complex anatomy, difficult exposure and the tendency to bleed. Surgical complications are common. In this case, although the disease was advanced, subtotal orbitectomy was successfully performed. PMID:28491397

Multimodal optical analysis discriminates freshly extracted human sample of gliomas, metastases and meningiomas from their appropriate controls

NASA Astrophysics Data System (ADS)

Zanello, Marc; Poulon, Fanny; Pallud, Johan; Varlet, Pascale; Hamzeh, H.; Abi Lahoud, Georges; Andreiuolo, Felipe; Ibrahim, Ali; Pages, Mélanie; Chretien, Fabrice; di Rocco, Federico; Dezamis, Edouard; Nataf, François; Turak, Baris; Devaux, Bertrand; Abi Haidar, Darine

2017-02-01

Delineating tumor margins as accurately as possible is of primordial importance in surgical oncology: extent of resection is associated with survival but respect of healthy surrounding tissue is necessary for preserved quality of life. The real-time analysis of the endogeneous fluorescence signal of brain tissues is a promising tool for defining margins of brain tumors. The present study aims to demonstrate the feasibility of multimodal optical analysis to discriminate fresh samples of gliomas, metastases and meningiomas from their appropriate controls. Tumor samples were studied on an optical fibered endoscope using spectral and fluorescence lifetime analysis and then on a multimodal set-up for acquiring spectral, one and two-photon fluorescence images, second harmonic generation signals and two-photon fluorescence lifetime datasets. The obtained data allowed us to differentiate healthy samples from tumor samples. These results confirmed the possible clinical relevance of this real-time multimodal optical analysis. This technique can be easily applied to neurosurgical procedures for a better delineation of surgical margins.

Money well spent: a comparison of hospital operating margin for laparoscopic and open colectomies.

PubMed

Koopmann, M C; Harms, B A; Heise, C P

2007-10-01

Cost analysis after laparoscopic colectomy has been examined, although reports evaluating the effects of laparoscopy on hospital operating margin are lacking. We compared several cost/revenue measures, including hospital operating margin, between open and laparoscopic colectomies at an academic center. Our cost-accounting database was queried for laparoscopic partial (LPC) and total colectomies (LTC), and open partial (OPC) and total colectomies (OTC) to analyze net revenue, total costs, and total hospital operating margin over a 4-year period. Laparoscopic and open colectomy cases were compared, with mean operating margin as the primary outcome. From July, 2002 through May, 2006, 842 patients were included for analysis with 138 undergoing laparoscopic colectomy. Net revenue was higher in the LTC group compared with open (US dollars 30,300 vs US dollars 26,800 [P = .02]), and lower in the LPC group (US dollars 15,300 vs US dollars 21,300 open [P < .0001]). Total costs were reduced in both the LPC and LTC groups compared with open [US dollars 11,700 vs US dollars 17,600 [P < .0001] and US dollars 18,000 vs US dollars 19,400 [P = .0019], respectively). LPC resulted in a similar HOM (US dollars 3,602) compared with OPC (US dollars 3,647; P = .35). LTC resulted in a higher HOM (US dollars 12,300) compared with OTC (US dollars 7,400; P = .02). LTC generates a significantly higher hospital operating margin than an OTC, although the margins are similar for LPC and OPC.

Matching the Statistical Model to the Research Question for Dental Caries Indices with Many Zero Counts.

PubMed

Preisser, John S; Long, D Leann; Stamm, John W

2017-01-01

Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two data sets, one consisting of fictional dmft counts in 2 groups and the other on DMFS among schoolchildren from a randomized clinical trial comparing 3 toothpaste formulations to prevent incident dental caries, are analyzed with negative binomial hurdle, zero-inflated negative binomial, and marginalized zero-inflated negative binomial models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the randomized clinical trial were similar despite their distinctive interpretations. The choice of statistical model class should match the study's purpose, while accounting for the broad decline in children's caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts. © 2017 S. Karger AG, Basel.

Matching the Statistical Model to the Research Question for Dental Caries Indices with Many Zero Counts

PubMed Central

Preisser, John S.; Long, D. Leann; Stamm, John W.

2017-01-01

Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two datasets, one consisting of fictional dmft counts in two groups and the other on DMFS among schoolchildren from a randomized clinical trial (RCT) comparing three toothpaste formulations to prevent incident dental caries, are analysed with negative binomial hurdle (NBH), zero-inflated negative binomial (ZINB), and marginalized zero-inflated negative binomial (MZINB) models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the RCT were similar despite their distinctive interpretations. Choice of statistical model class should match the study’s purpose, while accounting for the broad decline in children’s caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts. PMID:28291962

Texas curve margin of safety.

DOT National Transportation Integrated Search

2013-01-01

This software can be used to assist with the assessment of margin of safety for a horizontal curve. It is intended for use by engineers and technicians responsible for safety analysis or management of rural highway pavement or traffic control devices...

77 FR 41109 - Margin Requirements for Uncleared Swaps for Swap Dealers and Major Swap Participants

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-12

... and specifically requests quantitative data and analysis on the comparative costs and benefits of the... quantitative impact study (``QIS'') to assess the costs and benefits of margin requirements. The results of the...

SU-G-JeP3-13: Use of Volumetric Indices to Study the Viability of Respiratory Gating in Conjunction with Abdominal Compression in the Management of Non-Small Cell Lung Cancer Tumors Using Stereotactic Body Radiation Therapy Under the Conditions of Controlled Breathing

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

Malhotra, H; Gomez, J

Purpose: AAPM TG-76 report advises lung patients experiencing tumor motion >5mm to use some form of motion management with even smaller limit for complex/special procedures like SBRT. Generally, either respiratory gating or abdominal compression is used for motion management. In this retrospective study, we are using an innovative index, Volumetric Indices (VI) = (GTVnn AND GTV{sub 50+}Xmm)/(GTVnn) to quantify how much of the tumor remains within 1, 2, and 3mm margins throughout the breathing cycle using GTV{sub 50+}Xmm margin on GTV{sub 50}[nn=0,10,20,…90]. Using appropriate limits, VI can provide tumor motion information and to check if RPM gates could have beenmore » used in conjunction with abdominal compression to better manage tumor motion. Methods: 64 SBRT patients with a total of 67 lung tumors were studied. 4DCT scans were taken, fully capturing tumor motion throughout the 10 phases of the breathing cycle. For each phase, Gross Tumor Volume (GTV) was segmented and appropriates structures were defined to determine VI values. For the 2mm margin, VI values less than 0.95 for peripheral lesions and 0.97 for central lesions indicate tumor movement greater than 4mm. VI values for 1mm and 3mm margins were also analyzed signifying tumor motion of 2mm & 6mm, respectively. Results: Of the 64 patients, 35 (55%) had motion greater than 4mm & could have benefited from respiratory gating. For 5/8 (63%) middle lobe lesions, 21/27 (78%) lower lobe lesions, and 10/32 (31%) upper lobe lesions, gating could have resulted in smaller ITV. 32/55 (58%) peripheral lesions and 4/12 (33%) central lesions could have had gating. Average ITV decreased by 1.25cc (11.43%) and average VI increased by 0.11. Conclusion: Out of 64 patients, 55% exhibited motion greater than 4mm even with abdominal compression. Even with abdominalcompression, lung tumors can move >4mm as the degree of pressure which a patient can tolerate, is patient specific.« less

Effects of forest structure on hydrological processes in China

NASA Astrophysics Data System (ADS)

Sun, Jiamei; Yu, Xinxiao; Wang, Henian; Jia, Guodong; Zhao, Yang; Tu, Zhihua; Deng, Wenping; Jia, Jianbo; Chen, Jungang

2018-06-01

There are serious concerns between forest and water quantity, Chinese extensive land area makes the relationship more complicated, thus, the effects of forest structure on hydrological processes in China were not fully comprehended. In this research, forest's hydrological functions, including rainfall partitioning, litter interception, evapotranspiration (ET), were analyzed in China. The results showed that throughfall was the largest proportion of gross precipitation with fraction between 69.3 ± 8.8% and 84.4 ± 5.6%. Then was canopy interception which varied from 14.6 ± 1.4% to 29.1 ± 3.3%. Throughfall was correlated with gross precipitation, canopy thickness and canopy density. Canopy interception was correlated with gross precipitation, LAI, canopy density, biomass, mixed degree, uniform angle index, aggregation index. Stemflow accounted for only 1.2 ± 0.32% of gross precipitation, with the greatest fraction of 2.1 ± 0.2% in XBH site and the least fraction of 0.3 ± 0.1% in DB site. Gross precipitation was the main factor in determining stemflow. DB site had the greatest litter interception (7.7 ± 0.8 mm) and HB site had the least (0.9 ± 0.3 mm). Litter interception had closer correlation with undecomposed litter mass (0.66) than total litter mass (0.46). Path-coefficient analysis showed that stand density, Shannon-Wiener index, litter mass, size ratio had greater impact on litter interception than other factors. ET was mainly influenced by precipitation, and it also correlated with LAI, canopy density and biomass. In north China, ET percentage (the ratio of ET and precipitation) was 82.7-109.5%, while it decreased to 63.1-88.5% in south China, ET demand in XBS site was larger than precipitation. ET percentage increased with increasing latitude and elevation, decreased with increasing temperature.

Relationships between Isometric Muscle Strength, Gait Parameters, and Gross Motor Function Measure in Patients with Cerebral Palsy

PubMed Central

Shin, Hyung-Ik; Sung, Ki Hyuk; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Lee, In Hyeok

2016-01-01

Purpose This study investigated the correlation between isometric muscle strength, gross motor function, and gait parameters in patients with spastic cerebral palsy and to find which muscle groups play an important role for gait pattern in a flexed knee gait. Materials and Methods Twenty-four ambulatory patients (mean age, 10.0 years) with spastic cerebral palsy who were scheduled for single event multilevel surgery, including distal hamstring lengthening, were included. Preoperatively, peak isometric muscle strength was measured for the hip flexor, hip extensor, knee flexor, and knee extensor muscle groups using a handheld dynamometer, and three-dimensional (3D) gait analysis and gross motor function measure (GMFM) scoring were also performed. Correlations between peak isometric strength and GMFM, gait kinematics, and gait kinetics were analyzed. Results Peak isometric muscle strength of all muscle groups was not related to the GMFM score and the gross motor function classification system level. Peak isometric strength of the hip extensor and knee extensor was significantly correlated with the mean pelvic tilt (r=-0.588, p=0.003 and r=-0.436, p=0.033) and maximum pelvic obliquity (r=-0.450, p=0.031 and r=-0.419, p=0.041). There were significant correlations between peak isometric strength of the knee extensor and peak knee extensor moment in early stance (r=0.467, p=0.021) and in terminal stance (r=0.416, p=0.043). Conclusion There is no correlation between muscle strength and gross motor function. However, this study showed that muscle strength, especially of the extensor muscle group of the hip and knee joints, might play a critical role in gait by stabilizing pelvic motion and decreasing energy consumption in a flexed knee gait. PMID:26632404

Relationships between Isometric Muscle Strength, Gait Parameters, and Gross Motor Function Measure in Patients with Cerebral Palsy.

PubMed

Shin, Hyung Ik; Sung, Ki Hyuk; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Lee, In Hyeok; Park, Moon Seok

2016-01-01

This study investigated the correlation between isometric muscle strength, gross motor function, and gait parameters in patients with spastic cerebral palsy and to find which muscle groups play an important role for gait pattern in a flexed knee gait. Twenty-four ambulatory patients (mean age, 10.0 years) with spastic cerebral palsy who were scheduled for single event multilevel surgery, including distal hamstring lengthening, were included. Preoperatively, peak isometric muscle strength was measured for the hip flexor, hip extensor, knee flexor, and knee extensor muscle groups using a handheld dynamometer, and three-dimensional (3D) gait analysis and gross motor function measure (GMFM) scoring were also performed. Correlations between peak isometric strength and GMFM, gait kinematics, and gait kinetics were analyzed. Peak isometric muscle strength of all muscle groups was not related to the GMFM score and the gross motor function classification system level. Peak isometric strength of the hip extensor and knee extensor was significantly correlated with the mean pelvic tilt (r=-0.588, p=0.003 and r=-0.436, p=0.033) and maximum pelvic obliquity (r=-0.450, p=0.031 and r=-0.419, p=0.041). There were significant correlations between peak isometric strength of the knee extensor and peak knee extensor moment in early stance (r=0.467, p=0.021) and in terminal stance (r=0.416, p=0.043). There is no correlation between muscle strength and gross motor function. However, this study showed that muscle strength, especially of the extensor muscle group of the hip and knee joints, might play a critical role in gait by stabilizing pelvic motion and decreasing energy consumption in a flexed knee gait.

A strategy for reducing gross errors in the generalized Born models of implicit solvation

PubMed Central

Onufriev, Alexey V.; Sigalov, Grigori

2011-01-01

The “canonical” generalized Born (GB) formula [C. Still, A. Tempczyk, R. C. Hawley, and T. Hendrickson, J. Am. Chem. Soc. 112, 6127 (1990)] is known to provide accurate estimates for total electrostatic solvation energies ΔGel of biomolecules if the corresponding effective Born radii are accurate. Here we show that even if the effective Born radii are perfectly accurate, the canonical formula still exhibits significant number of gross errors (errors larger than 2kBT relative to numerical Poisson equation reference) in pairwise interactions between individual atomic charges. Analysis of exact analytical solutions of the Poisson equation (PE) for several idealized nonspherical geometries reveals two distinct spatial modes of the PE solution; these modes are also found in realistic biomolecular shapes. The canonical GB Green function misses one of two modes seen in the exact PE solution, which explains the observed gross errors. To address the problem and reduce gross errors of the GB formalism, we have used exact PE solutions for idealized nonspherical geometries to suggest an alternative analytical Green function to replace the canonical GB formula. The proposed functional form is mathematically nearly as simple as the original, but depends not only on the effective Born radii but also on their gradients, which allows for better representation of details of nonspherical molecular shapes. In particular, the proposed functional form captures both modes of the PE solution seen in nonspherical geometries. Tests on realistic biomolecular structures ranging from small peptides to medium size proteins show that the proposed functional form reduces gross pairwise errors in all cases, with the amount of reduction varying from more than an order of magnitude for small structures to a factor of 2 for the largest ones. PMID:21528947

Translocation and gross deletion breakpoints in human inherited disease and cancer II: Potential involvement of repetitive sequence elements in secondary structure formation between DNA ends.

PubMed

Chuzhanova, Nadia; Abeysinghe, Shaun S; Krawczak, Michael; Cooper, David N

2003-09-01

Translocations and gross deletions are responsible for a significant proportion of both cancer and inherited disease. Although such gene rearrangements are nonuniformly distributed in the human genome, the underlying mutational mechanisms remain unclear. We have studied the potential involvement of various types of repetitive sequence elements in the formation of secondary structure intermediates between the single-stranded DNA ends that recombine during rearrangements. Complexity analysis was used to assess the potential of these ends to form secondary structures, the maximum decrease in complexity consequent to a gross rearrangement being used as an indicator of the type of repeat and the specific DNA ends involved. A total of 175 pairs of deletion/translocation breakpoint junction sequences available from the Gross Rearrangement Breakpoint Database [GRaBD; www.uwcm.ac.uk/uwcm/mg/grabd/grabd.html] were analyzed. Potential secondary structure was noted between the 5' flanking sequence of the first breakpoint and the 3' flanking sequence of the second breakpoint in 49% of rearrangements and between the 5' flanking sequence of the second breakpoint and the 3' flanking sequence of the first breakpoint in 36% of rearrangements. Inverted repeats, inversions of inverted repeats, and symmetric elements were found in association with gross rearrangements at approximately the same frequency. However, inverted repeats and inversions of inverted repeats accounted for the vast majority (83%) of deletions plus small insertions, symmetric elements for one-half of all antigen receptor-mediated translocations, while direct repeats appear only to be involved in mediating simple deletions. These findings extend our understanding of illegitimate recombination by highlighting the importance of secondary structure formation between single-stranded DNA ends at breakpoint junctions. Copyright 2003 Wiley-Liss, Inc.

Dynamic simulation of train derailments

DOT National Transportation Integrated Search

2006-11-05

This paper describes a planar rigid-body model to examine the gross motions of rail cars in a train derailment. The model is implemented using a commercial software package called ADAMS (Automatic Dynamic Analysis of Mechanical Systems). The results ...

An empirical analysis of the effects of consanguineous marriages on economic development.

PubMed

Bildirici, Melike; Kökdener, Meltem; Ersin, Oezgür ömer

2010-01-01

In this study, development experiences toward economic development are investigated to provide an alternative analysis of economic development, human capital, and genetic inheritance in the light of consanguineous marriages. The countries analyzed in the study are discussed in accordance with consanguineous marriage practices and classified by their per capita gross domestic product (GDP) growth. A broad range of countries are analyzed in the study. Arab countries that experienced high rates of growth in their gross national income during the twentieth century but failed to fulfill adequate development measures as reflected in the growth in national income, countries undergoing transition from tight government regulation to free market democracy, and African nations that have experienced complications in the process of development show important differences in the process of economic development. It is shown that the countries that have reached high average development within the context of per capita GDP have overcome problems integral to consanguineous marriage.

Effect of a 12-Week Physical Activity Program on Gross Motor Skills in Children.

PubMed

Burns, Ryan D; Fu, You; Fang, Yi; Hannon, James C; Brusseau, Timothy A

2017-12-01

This study examined the effects of a 12-week Comprehensive School Physical Activity Program (CSPAP) on gross motor skill development in children from low-income families. Participants were 1,460 school-aged children (mean age = 8.4 ± 1.8 years; 730 girls, 730 boys) recruited from three schools receiving U.S. governmental financial assistance. Students were recruited from grades K-6. CSPAP was implemented over one semester during the 2014-2015 school year. Select gross motor skill items were assessed during each student's physical education class at baseline and at a 12-week follow-up using the Test for Gross Motor Development-2nd Edition (TGMD-2). Each student's TGMD-2 score was converted to a percentage of the total possible score. A 7 × 2 × 2 analysis of variance test with repeated measures was employed to examine the effects of age, sex, and time on TGMD-2 percent scores, adjusting for clustering within the data structure. There were greater TGMD-2 percent scores at follow-up compared with baseline (82.4% vs. 72.6%, mean difference = 9.8%, p < .001, Cohen's d = 0.67), and greater improvements were seen in younger children compared with older children (mean difference of change = 4.0%-7.5%, p < .01, Cohen's d = 0.30-0.55).

Variety of geologic silhouette shapes distinguishable by multiple rotations method of quantitative shape analysis text

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

Collins, D.G.; Parks, J.M.

1984-04-01

Silhouette shapes are two-dimensional projections of three-dimensional objects such as sand grains, gravel, and fossils. Within-the-margin markings such as chamber boundaries, sutures, or ribs are ignored. Comparisons between populations of objects from similar and differential origins (i.e., environments, species or genera, growth series, etc) is aided by quantifying the shapes. The Multiple Rotations Method (MRM) uses a variation of ''eigenshapes'', which is capable of distinguishing most of the subtle variations that the ''trained eye'' can detect. With a video-digitizer and microcomputer, MRM is fast, more accurate, and more objective than the human eye. The resulting shape descriptors comprise 5 ormore » 6 numbers per object that can be stored and retrieved to compare with similar descriptions of other objects. The original-shape outlines can be reconstituted sufficiently for gross recognition from these few numerical descriptors. Thus, a semi-automated data-retrieval system becomes feasible, with silhouette-shape descriptions as one of several recognition criteria. MRM consists of four ''rotations'': rotation about a center to a comparable orientation; a principal-components rotation to reduce the many original shape descriptors to a few; a VARIMAX orthogonal-factor rotation to achieve simple structure; and a rotation to achieve factor scores on individual objects. A variety of subtly different shapes includes sand grains from several locations, ages, and environments, and fossils of several types. This variety illustrates the feasibility of quantitative comparisons by MRM.« less

Effect of various putty-wash impression techniques on marginal fit of cast crowns.

PubMed

Nissan, Joseph; Rosner, Ofir; Bukhari, Mohammed Amin; Ghelfan, Oded; Pilo, Raphael

2013-01-01

Marginal fit is an important clinical factor that affects restoration longevity. The accuracy of three polyvinyl siloxane putty-wash impression techniques was compared by marginal fit assessment using the nondestructive method. A stainless steel master cast containing three abutments with three metal crowns matching the three preparations was used to make 45 impressions: group A = single-step technique (putty and wash impression materials used simultaneously), group B = two-step technique with a 2-mm relief (putty as a preliminary impression to create a 2-mm wash space followed by the wash stage), and group C = two-step technique with a polyethylene spacer (plastic spacer used with the putty impression followed by the wash stage). Accuracy was assessed using a toolmaker microscope to measure and compare the marginal gaps between each crown and finish line on the duplicated stone casts. Each abutment was further measured at the mesial, buccal, and distal aspects. One-way analysis of variance was used for statistical analysis. P values and Scheffe post hoc contrasts were calculated. Significance was determined at .05. One-way analysis of variance showed significant differences among the three impression techniques in all three abutments and at all three locations (P < .001). Group B yielded dies with minimal gaps compared to groups A and C. The two-step impression technique with 2-mm relief was the most accurate regarding the crucial clinical factor of marginal fit.

7 CFR 1400.501 - Determination of average adjusted gross income.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Determination of average adjusted gross income. 1400... PAYMENT ELIGIBILITY FOR 2009 AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Average Adjusted Gross Income Limitation § 1400.501 Determination of average adjusted gross income. (a) Except as otherwise provided in...

7 CFR 701.17 - Average adjusted gross income limitation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Average adjusted gross income limitation. 701.17... RELATED PROGRAMS PREVIOUSLY ADMINISTERED UNDER THIS PART § 701.17 Average adjusted gross income limitation... 9003), each applicant must meet the provisions of the Adjusted Gross Income Limitations at 7 CFR part...

75 FR 78897 - Definition of Omission From Gross Income

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... Definition of Omission From Gross Income AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations. SUMMARY: This document contains final regulations defining an omission from gross income for... overstatement of basis in a sold asset results in an omission from gross income. The regulations will affect any...

20 CFR 209.13 - Employers' gross earnings reports.

Code of Federal Regulations, 2010 CFR

2010-04-01

... RAILROAD EMPLOYERS' REPORTS AND RESPONSIBILITIES § 209.13 Employers' gross earnings reports. (a) Each employer is required to report the gross earnings of a one-percent sample group of railroad employees. The... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Employers' gross earnings reports. 209.13...

Histopathological Validation of the Surface-Intermediate-Base Margin Score for Standardized Reporting of Resection Technique during Nephron Sparing Surgery.

PubMed

Minervini, Andrea; Campi, Riccardo; Kutikov, Alexander; Montagnani, Ilaria; Sessa, Francesco; Serni, Sergio; Raspollini, Maria Rosaria; Carini, Marco

2015-10-01

The surface-intermediate-base margin score is a novel standardized reporting system of resection techniques during nephron sparing surgery. We validated the surgeon assessed surface-intermediate-base score with microscopic histopathological assessment of partial nephrectomy specimens. Between June and August 2014 data were prospectively collected from 40 consecutive patients undergoing nephron sparing surgery. The surface-intermediate-base score was assigned to all cases. The score specific areas were color coded with tissue margin ink and sectioned for histological evaluation of healthy renal margin thickness. Maximum, minimum and mean thickness of healthy renal margin for each score specific area grade (surface [S] = 0, S = 1 ; intermediate [I] or base [B] = 0, I or B = 1, I or B = 2) was reported. The Mann-Whitney U and Kruskal-Wallis tests were used to compare the thickness of healthy renal margin in S = 0 vs 1 and I or B = 0 vs 1 vs 2 grades, respectively. Maximum, minimum and mean thickness of healthy renal margin was significantly different among score specific area grades S = 0 vs 1, and I or B = 0 vs 1, 0 vs 2 and 1 vs 2 (p <0.001). The main limitations of the study are the low number of the I or B = 1 and I or B = 2 samples and the assumption that each microscopic slide reflects the entire score specific area for histological analysis. The surface-intermediate-base scoring method can be readily harnessed in real-world clinical practice and accurately mirrors histopathological analysis for quantification and reporting of healthy renal margin thickness removed during tumor excision. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Constraints Imposed by Rift Inheritance on the Compressional Reactivation of a Hyperextended Margin: Mapping Rift Domains in the North Iberian Margin and in the Cantabrian Mountains

NASA Astrophysics Data System (ADS)

Cadenas, P.; Fernández-Viejo, G.; Pulgar, J. A.; Tugend, J.; Manatschal, G.; Minshull, T. A.

2018-03-01

The Alpine Pyrenean-Cantabrian orogen developed along the plate boundary between Iberia and Europe, involving the inversion of Mesozoic hyperextended basins along the southern Biscay margin. Thus, this margin represents a natural laboratory to analyze the control of structural rift inheritance on the compressional reactivation of a continental margin. With the aim to identify former rift domains and investigate their role during the subsequent compression, we performed a structural analysis of the central and western North Iberian margin, based on the interpretation of seismic reflection profiles and local constraints from drill-hole data. Seismic interpretations and published seismic velocity models enabled the development of crustal thickness maps that helped to constrain further the offshore and onshore segmentation. Based on all these constraints, we present a rift domain map across the central and western North Iberian margin, as far as the adjacent western Cantabrian Mountains. Furthermore, we provide a first-order description of the margin segmentation resulting from its polyphase tectonic evolution. The most striking result is the presence of a hyperthinned domain (e.g., Asturian Basin) along the central continental platform that is bounded to the north by the Le Danois High, interpreted as a rift-related continental block separating two distinctive hyperextended domains. From the analysis of the rift domain map and the distribution of reactivation structures, we conclude that the landward limit of the necking domain and the hyperextended domains, respectively, guide and localize the compressional overprint. The Le Danois block acted as a local buttress, conditioning the inversion of the Asturian Basin.

Influence of Cavity Margin Design and Restorative Material on Marginal Quality and Seal of Extended Class II Resin Composite Restorations In Vitro.

PubMed

Soliman, Sebastian; Preidl, Reinhard; Karl, Sabine; Hofmann, Norbert; Krastl, Gabriel; Klaiber, Bernd

2016-01-01

To investigate the influence of three cavity designs on the marginal seal of large Class II cavities restored with low-shrinkage resin composite limited to the enamel. One hundred twenty (120) intact human molars were randomly divided into 12 groups, with three different cavity designs: 1. undermined enamel, 2. box-shaped, and 3. proximal bevel. The teeth were restored with 1. an extra-low shrinkage (ELS) composite free of diluent monomers, 2. microhybrid composite (Herculite XRV), 3. nanohybrid composite (Filtek Supreme XTE), and 4. silorane-based composite (Filtek Silorane). After artificial aging by thermocycling and storage in physiological saline, epoxy resin replicas were prepared. To determine the integrity of the restorations' approximal margins, two methods were sequentially employed: 1. replicas were made of the 120 specimens and examined using SEM, and 2. the same 120 specimens were immersed in AgNO3 solution, and the dye penetration depth was observed with a light microscope. Statistical analysis was performed using the Kruskal-Wallis and the Dunn-Bonferroni tests. After bevel preparation, SEM observations showed that restorations did not exhibit a higher percentage of continuous margin (SEM-analysis; p>0.05), but more leakage was found than with the other cavity designs (p<0.05). The lowest percentage of continuous margin was observed in ELS restorations (p<0.05). More fractured margins were observed in the undermined enamel cavity design groups (p<0.05). Bevel preparation failed to improve margin quality in large Class II composite restorations and is no longer recommended. However, undermined enamel should be removed to prevent enamel fractures.

Development and implementation of a technical and didactical training program for student tutors in the dissection course.

PubMed

Shiozawa, Thomas; Hirt, Bernhard; Celebi, Nora; Baur, Friederike; Weyrich, Peter; Lammerding-Köppel, Maria

2010-12-20

student tutors have a long tradition in gross anatomy instruction. However, the full potential of the tutors is generally not tapped, since little attention is paid to their technical and didactical training. The aim of this paper is to report a systematic approach to the development, didactic reasoning and implementation of a curriculum for training student tutors in gross anatomy. the training program was developed using the six-step approach of Kern's curriculum development model. For needs assessment, the literature research was amended by a survey among the 1st and 2nd year students of the dissection course (n=167) and two independent 90 min focus group interviews with the tutors who supervised these students (n=15). Protocols were transcribed and analyzed by margin coding. The training curriculum was setup on the basis of these data. corresponding to the literature, the students want student tutors with good teaching competence as well as adequate content knowledge and technical competence. Supporting that, the tutors request a training program enhancing their didactic skills as well as their knowledge of content and working using relevant methods. Thus, a combined didactic and professional training program has been developed. Six professional and 11 didactic learning objectives were defined. A 3 weeks training curriculum was implemented, using microteaching and group exercises for didactics and active dissection for technical training. Both parts were interlocked on a contextual and practical level. our focus group analyses revealed that a specific training program for student tutors in the dissection course is necessary. We describe a feasible task-oriented training curriculum combining didactic and professional objectives. 2010. Published by Elsevier GmbH.

Delineation of Supraclavicular Target Volumes in Breast Cancer Radiation Therapy

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

Brown, Lindsay C.; Diehn, Felix E.; Boughey, Judy C.

Purpose: To map the location of gross supraclavicular metastases in patients with breast cancer, in order to determine areas at highest risk of harboring subclinical disease. Methods and Materials: Patients with axial imaging of gross supraclavicular disease were identified from an institutional breast cancer registry. Locations of the metastatic lymph nodes were transferred onto representative axial computed tomography images of the supraclavicular region and compared with the Radiation Therapy Oncology Group (RTOG) breast cancer atlas for radiation therapy planning. Results: Sixty-two patients with 161 supraclavicular nodal metastases were eligible for study inclusion. At the time of diagnosis, 117 nodal metastasesmore » were present in 44 patients. Forty-four nodal metastases in 18 patients were detected at disease recurrence, 4 of whom had received prior radiation to the supraclavicular fossa. Of the 161 nodal metastases, 95 (59%) were within the RTOG consensus volume, 4 nodal metastases (2%) in 3 patients were marginally within the volume, and 62 nodal metastases (39%) in 30 patients were outside the volume. Supraclavicular disease outside the RTOG consensus volume was located in 3 regions: at the level of the cricoid and thyroid cartilage (superior to the RTOG volume), in the posterolateral supraclavicular fossa (posterolateral to the RTOG volume), and in the lateral low supraclavicular fossa (lateral to the RTOG volume). Only women with multiple supraclavicular metastases had nodal disease that extended superiorly to the level of the thyroid cartilage. Conclusions: For women with risk of harboring subclinical supraclavicular disease warranting the addition of supraclavicular radiation, coverage of the posterior triangle and the lateral low supraclavicular region should be considered. For women with known supraclavicular disease, extension of neck coverage superior to the cricoid cartilage may be warranted.« less

Will weight loss cause significant dosimetric changes of target volumes and organs at risk in nasopharyngeal carcinoma treated with intensity-modulated radiation therapy?

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

Chen, Chuanben; Fei, Zhaodong; Chen, Lisha

This study aimed to quantify dosimetric effects of weight loss for nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). Overall, 25 patients with NPC treated with IMRT were enrolled. We simulated weight loss during IMRT on the computer. Weight loss model was based on the planning computed tomography (CT) images. The original external contour of head and neck was labeled plan 0, and its volume was regarded as pretreatment normal weight. We shrank the external contour with different margins (2, 3, and 5 mm) and generated new external contours of head and neck. The volumes of reconstructed external contoursmore » were regarded as weight during radiotherapy. After recontouring outlines, the initial treatment plan was mapped to the redefined CT scans with the same beam configurations, yielding new plans. The computer model represented a theoretical proportional weight loss of 3.4% to 13.7% during the course of IMRT. The dose delivered to the planning target volume (PTV) of primary gross tumor volume and clinical target volume significantly increased by 1.9% to 2.9% and 1.8% to 2.9% because of weight loss, respectively. The dose to the PTV of gross tumor volume of lymph nodes fluctuated from −2.0% to 1.0%. The dose to the brain stem and the spinal cord was increased (p < 0.001), whereas the dose to the parotid gland was decreased (p < 0.001). Weight loss may lead to significant dosimetric change during IMRT. Repeated scanning and replanning for patients with NPC with an obvious weight loss may be necessary.« less

PHASE II STUDY OF HIGH DOSE PHOTON/PROTON RADIOTHERAPY IN THE MANAGEMENT OF SPINE SARCOMAS

PubMed Central

DeLaney, Thomas F.; Liebsch, Norbert J.; Pedlow, Francis X.; Adams, Judith; Dean, Susan; Yeap, Beow Y.; McManus, Patricia; Rosenberg, Andrew E.; Nielsen, G. Petur; Harmon, David C.; Spiro, Ira J.; Raskin, Kevin A.; Suit, Herman D.; Yoon, Sam S.; Hornicek, Francis J.

2009-01-01

Purpose Radiotherapy (XRT) for spine sarcomas is constrained by spinal cord, nerve, and viscera tolerance. Negative surgical margins are uncommon; hence, doses of ≥ 66 Gy are recommended. A Phase II clinical trial evaluated high dose photon/proton XRT for spine sarcomas. Materials/Methods Eligible patients had non-metastatic, thoracic, lumbar, and/or sacral spine/paraspinal sarcomas. Treatment included pre- and/or post-op photon/proton XRT +/- radical resection; patients with osteosarcoma and Ewing's sarcoma received chemotherapy. Shrinking fields delivered 50.4 cobalt Gray equivalent (GyRBE) to subclinical disease, 70.2 GyRBE to microscopic disease in the tumor bed, and 77.4 GyRBE to gross disease at 1.8 GyRBE q.d. Doses were reduced for radiosensitive histologies, concurrent chemoradiation, or when diabetes or autoimmune disease present. Spinal cord dose was limited to 63/54 GyRBE to surface/center. Intra-operative boost doses of 7.5-10 Gy could be given by dural plaque. Results 50 patients (29 chordoma, 14 chondrosarcoma, 7 other) underwent gross total (n=25) or subtotal (n=12) resection or biopsy (n=13). With 48 month median follow-up, five-year actuarial local control, recurrence-free survival, and overall survival are: 78%, 63%, and 87% respectively. Two of 36 (5.6%) patients treated for primary versus 7/14 (50%) for recurrent tumor developed local recurrence, p<0.001. Five patients developed late radiation-associated complications; no myelopathy developed but three sacral neuropathies appeared following 77.12-77.4 GyRBE. Conclusions Local control with this treatment is high in patients radiated at the time of primary presentation. Spinal cord dose constraints appear to be safe. Sacral nerves receiving 77.12-77.4 GyRBE are at risk for late toxicity. PMID:19095372

Robotic Gait Training for Individuals With Cerebral Palsy: A Systematic Review and Meta-Analysis.

PubMed

Carvalho, Igor; Pinto, Sérgio Medeiros; Chagas, Daniel das Virgens; Praxedes Dos Santos, Jomilto Luiz; de Sousa Oliveira, Tainá; Batista, Luiz Alberto

2017-11-01

To identify the effects of robotic gait training practices in individuals with cerebral palsy. The search was performed in the following electronic databases: PubMed, Embase, Medline (OvidSP), Cochrane Database of Systematic Reviews, Web of Science, Scopus, Compendex, IEEE Xplore, ScienceDirect, Academic Search Premier, and Physiotherapy Evidence Database. Studies were included if they fulfilled the following criteria: (1) they investigated the effects of robotic gait training, (2) they involved patients with cerebral palsy, and (3) they enrolled patients classified between levels I and IV using the Gross Motor Function Classification System. The information was extracted from the selected articles using the descriptive-analytical method. The Critical Review Form for Quantitative Studies was used to quantitate the presence of critical components in the articles. To perform the meta-analysis, the effects of the intervention were quantified by effect size (Cohen d). Of the 133 identified studies, 10 met the inclusion criteria. The meta-analysis showed positive effects on gait speed (.21 [-.09, .51]), endurance (.21 [-.06, .49]), and gross motor function in dimension D (.18 [-.10, .45]) and dimension E (0.12 [-.15, .40]). The results obtained suggest that this training benefits people with cerebral palsy, specifically by increasing walking speed and endurance and improving gross motor function. For future studies, we suggest investigating device configuration parameters and conducting a large number of randomized controlled trials with larger sample sizes and individuals with homogeneous impairment. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Phase 2 program on ground test of refanned JT8D turbofan engines and nacelles for the 727 airplane. Volume 4: Airplane evaluation and analysis

NASA Technical Reports Server (NTRS)

1975-01-01

The retrofit of JT8D-109 (refan) engines are evaluated on a 727-200 airplane in terms of airworthiness, performance, and noise. Design of certifiable hardware, manufacture, and ground testing of the essential nacelle components is included along with analysis of the certifiable airplane design to ensure airworthiness compliance and to predict the in-flight performance and noise characteristics of the modified airplane. The analyses confirm that the 727 refan airplane is certifiable. The refan airplane range would be 15% less that of the baseline airplane and block fuel would be increased by 1.5% to 3%. However, with this particular 727-200 model, with a brake release gross weight of 172,500 lb (78,245 kg), it is possible to operate the airplane (with minor structural modifications) at higher gross weights and increase the range up to 15% over the 727-200 (baseline) airplane. The refan airplane FAR Part 36 noise levels would be 6 to 8 EPNdB (effective perceived noise in decibels) below the baseline. Noise footprint studies showed that approach noise contour areas are small compared to takeoff areas. The 727 refan realizes a 68% to 83% reduction in annoyance-weighted area when compared to the 727-200 over a range of gross weights and operational procedures.

Marginal fit and photoelastic stress analysis of CAD-CAM and overcast 3-unit implant-supported frameworks.

PubMed

Presotto, Anna Gabriella Camacho; Bhering, Cláudia Lopes Brilhante; Mesquita, Marcelo Ferraz; Barão, Valentim Adelino Ricardo

2017-03-01

Several studies have shown the superiority of computer-assisted design and computer-assisted manufacturing (CAD-CAM) technology compared with conventional casting. However, an advanced technology exists for casting procedures (the overcasting technique), which may serve as an acceptable and affordable alternative to CAD-CAM technology for fabricating 3-unit implant-supported fixed dental prostheses (FDPs). The purpose of this in vitro study was to evaluate, using quantitative photoelastic analysis, the effect of the prosthetic framework fabrication method (CAD-CAM and overcasting) on the marginal fit and stress transmitted to implants. The correlation between marginal fit and stress was also investigated. Three-unit implant-supported FDP frameworks were made using the CAD-CAM (n=10) and overcasting (n=10) methods. The frameworks were waxed to simulate a mandibular first premolar (PM region) to first molar (M region) FDP using overcast mini-abutment cylinders. The wax patterns were overcast (overcast experimental group) or scanned to obtain the frameworks (CAD-CAM control group). All frameworks were fabricated from cobalt-chromium (CoCr) alloy. The marginal fit was analyzed according to the single-screw test protocol, obtaining an average value for each region (M and PM) and each framework. The frameworks were tightened for the photoelastic model with standardized 10-Ncm torque. Stress was measured by quantitative photoelastic analysis. The results were submitted to the Student t test, 2-way ANOVA, and Pearson correlation test (α=.05). The framework fabrication method (FM) and evaluation site (ES; M and PM regions) did not affect the marginal fit values (P=.559 for FM and P=.065 for ES) and stress (P=.685 for FM and P=.468 for ES) in the implant-supported system. Positive correlations between marginal fit and stress were observed (CAD-CAM: r=0.922; P<.001; overcast: r=0.908; P<.001). CAD-CAM and overcasting methods present similar marginal fit and stress values for 3-unit FDP frameworks. The decreased marginal fit of frameworks induces greater stress in the implant-supported system. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

46 CFR 69.117 - Spaces exempt from inclusion in gross tonnage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 2 2014-10-01 2014-10-01 false Spaces exempt from inclusion in gross tonnage. 69.117 Section 69.117 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DOCUMENTATION AND... inclusion in gross tonnage. (a) Purpose. This section lists spaces which are exempt from inclusion in gross...

46 CFR 69.117 - Spaces exempt from inclusion in gross tonnage.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 2 2012-10-01 2012-10-01 false Spaces exempt from inclusion in gross tonnage. 69.117 Section 69.117 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DOCUMENTATION AND... inclusion in gross tonnage. (a) Purpose. This section lists spaces which are exempt from inclusion in gross...

46 CFR 69.117 - Spaces exempt from inclusion in gross tonnage.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 2 2013-10-01 2013-10-01 false Spaces exempt from inclusion in gross tonnage. 69.117 Section 69.117 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DOCUMENTATION AND... inclusion in gross tonnage. (a) Purpose. This section lists spaces which are exempt from inclusion in gross...

26 CFR 1.872-1 - Gross income of nonresident alien individuals.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a...

26 CFR 1.872-1 - Gross income of nonresident alien individuals.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 9 2012-04-01 2012-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a...

26 CFR 1.872-1 - Gross income of nonresident alien individuals.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a nonresident alien...

26 CFR 1.872-1 - Gross income of nonresident alien individuals.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 9 2013-04-01 2013-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a...

26 CFR 1.872-1 - Gross income of nonresident alien individuals.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 9 2014-04-01 2014-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a...

Development of Rapid Radiochemical Method for Gross Alpha and Gross Beta Activity Concentration in Flowback and Produced Waters from Hydraulic Fracturing Operations

EPA Science Inventory

This report summarizes the development and validation of an improved method for the Determination of Gross Alpha and Gross Beta Activity in Flowback and Produced Waters from Hydraulic Fracturing Operations (FPWHFO). Flowback and produced waters are characterized by high concentra...

7 CFR 701.117 - Average adjusted gross income limitation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Average adjusted gross income limitation. 701.117... Conservation Program § 701.117 Average adjusted gross income limitation. To be eligible for payments issued... the provisions of the Adjusted Gross Income Limitations at 7 CFR part 1400 subpart G. [72 FR 45880...

7 CFR 1410.44 - Average adjusted gross income.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Average adjusted gross income. 1410.44 Section 1410... Average adjusted gross income. (a) Benefits under this part will not be available to persons or legal entities whose average adjusted gross income exceeds $1,000,000 or as further specified in part 1400...

7 CFR 1410.44 - Average adjusted gross income.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Average adjusted gross income. 1410.44 Section 1410... Average adjusted gross income. (a) Benefits under this part will not be available to persons or legal entities whose average adjusted gross income exceeds $1,000,000 or as further specified in part 1400...

5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

Code of Federal Regulations, 2010 CFR

2010-01-01

... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

Code of Federal Regulations, 2011 CFR

2011-01-01

... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

Code of Federal Regulations, 2014 CFR

2014-01-01

... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

Code of Federal Regulations, 2013 CFR

2013-01-01

... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

Code of Federal Regulations, 2012 CFR

2012-01-01

... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

26 CFR 1.809-4 - Gross amount.

Code of Federal Regulations, 2010 CFR

2010-04-01

... categories of items taken into account are: (1) Premiums. (i) The gross amount of all premiums and other... premiums and premiums and other consideration arising out of reinsurance ceded. The term gross amount of... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Gross amount. 1.809-4 Section 1.809-4 Internal...

26 CFR 1.904-6 - Allocation and apportionment of taxes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... accrued. Gross income, as determined under foreign law, in the passive category shall first be reduced by... 954(b)(5) and § 1.904-5(c)(2)(ii)(C) (adjusted gross passive income). Gross income in all separate categories (including adjusted gross passive income) is next reduced by deducting any expenses, losses, or...

26 CFR 1.904-6 - Allocation and apportionment of taxes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... accrued. Gross income, as determined under foreign law, in the passive category shall first be reduced by... 954(b)(5) and § 1.904-5(c)(2)(ii)(C) (adjusted gross passive income). Gross income in all separate categories (including adjusted gross passive income) is next reduced by deducting any expenses, losses, or...

Gross motor skill development of kindergarten children in Japan.

PubMed

Aye, Thanda; Kuramoto-Ahuja, Tsugumi; Sato, Tamae; Sadakiyo, Kaori; Watanabe, Miyoko; Maruyama, Hitoshi

2018-05-01

[Purpose] The purposes of this study were to assess and explore the gender-based differences in gross motor skill development of 5-year-old Japanese children. [Subjects and Methods] This cross-sectional study recruited 60 healthy 5-year-old (third-year kindergarten, i.e., nencho ) children (34 boys, 26 girls) from one local private kindergarten school in Otawara city, Tochigi Prefecture, Japan. Gross motor skills, including six locomotor and six object control skills, were assessed using the test of gross motor development, second edition (TGMD-2). All subjects performed two trials of each gross motor skill, and the performances were video-recorded and scored. Assessment procedures were performed according to the standardized guidelines of the TGMD-2. [Results] The majority of subjects had an average level of overall gross motor skills. Girls had significantly better locomotor skills. Boys had significantly better object control skills. [Conclusion] The gross motor skill development of 5-year-old Japanese children involves gender-based differences in locomotor and object control skills. This study provided valuable information that can be used to establish normative references for the gross motor skills of 5-year-old Japanese children.

The use of γ-rays analysis by HPGe detector to assess the gross alpha and beta activities in waters.

PubMed

Casagrande, M F S; Bonotto, D M

2018-07-01

This paper describes an alternative method for evaluating gross alpha and beta radioactivity in waters by using γ-rays analysis performed with hyper-pure germanium detector (HPGe). Several gamma emissions related to α and β - decays were used to provide the activity concentration data due to natural radionuclides commonly present in waters like 40 K and those belonging to the 238 U and 232 Th decay series. The most suitable gamma emissions related to β - decays were 214 Bi (1120.29 keV, 238 U series) and 208 Tl (583.19 keV, 232 Th series) as the equation in activity concentration yielded values compatible to those generated by the formula taking into account the detection efficiency. The absence of isolated and intense γ-rays peaks associated to α decays limited the choice to 226 Ra (186.21 keV, 238 U series) and 224 Ra (240.99 keV, 232 Th series). In these cases, it was adopted appropriate correction factors involving the absolute intensities and specific activities for avoiding the interferences of other γ-rays energies. The critical level of detection across the 186-1461 keV energy region corresponded to 0.010, 0.023, 0.038, 0.086, and 0.042 Bq/L, respectively, for 226 Ra, 224 Ra, 208 Tl, 214 Bi and 40 K. It is much lower than the WHO guideline reference value for gross alpha (0.5 Bq/L) and beta (1.0 Bq/L) in waters. The method applicability was checked by the analysis of groundwater samples from different aquifer systems occurring in the Brazilian states of São Paulo, Minas Gerais and Mato Grosso do Sul. The waters exhibit very different chemical composition and the samples with the highest radioactivity levels were those associated with lithotypes possessing enhanced uranium and thorium levels. The technique allowed directly discard the 40 K contribution to the gross beta activity as potassium is an essential element for humans. Copyright © 2018 Elsevier Ltd. All rights reserved.

Stereotactic Radiosurgery of the Postoperative Resection Cavity for Brain Metastases: Prospective Evaluation of Target Margin on Tumor Control

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

Choi, Clara Y.H.; Chang, Steven D.; Gibbs, Iris C.

2012-10-01

Purpose: Given the neurocognitive toxicity associated with whole-brain irradiation (WBRT), approaches to defer or avoid WBRT after surgical resection of brain metastases are desirable. Our initial experience with stereotactic radiosurgery (SRS) targeting the resection cavity showed promising results. We examined the outcomes of postoperative resection cavity SRS to determine the effect of adding a 2-mm margin around the resection cavity on local failure (LF) and toxicity. Patients and Methods: We retrospectively evaluated 120 cavities in 112 patients treated from 1998-2009. Factors associated with LF and distant brain failure (DF) were analyzed using competing risks analysis, with death as a competingmore » risk. The overall survival (OS) rate was calculated by the Kaplan-Meier product-limit method; variables associated with OS were evaluated using the Cox proportional hazards and log rank tests. Results: The 12-month cumulative incidence rates of LF and DF, with death as a competing risk, were 9.5% and 54%, respectively. On univariate analysis, expansion of the cavity with a 2-mm margin was associated with decreased LF; the 12-month cumulative incidence rates of LF with and without margin were 3% and 16%, respectively (P=.042). The 12-month toxicity rates with and without margin were 3% and 8%, respectively (P=.27). On multivariate analysis, melanoma histology (P=.038) and number of brain metastases (P=.0097) were associated with higher DF. The median OS time was 17 months (range, 2-114 months), with a 12-month OS rate of 62%. Overall, WBRT was avoided in 72% of the patients. Conclusion: Adjuvant SRS targeting the resection cavity of brain metastases results in excellent local control and allows WBRT to be avoided in a majority of patients. A 2-mm margin around the resection cavity improved local control without increasing toxicity compared with our prior technique with no margin.« less

An Analysis of School Funding in Eight Countries

ERIC Educational Resources Information Center

Pregot, Michael

2012-01-01

How do other countries fund their public schools? Through an analysis of common traits, such as the total percentage of funding for education in relation to the annual gross domestic product (GDP) and the annual per-pupil expenditures (correlated to the U.S. dollar), one can start to develop a clearer perspective on basic school-funding…

Developmental and physical-fitness associations with gross motor coordination problems in Peruvian children.

PubMed

de Chaves, Raquel Nichele; Bustamante Valdívia, Alcibíades; Nevill, Alan; Freitas, Duarte; Tani, Go; Katzmarzyk, Peter T; Maia, José António Ribeiro

2016-01-01

The aims of this cross-sectional study were to examine the developmental characteristics (biological maturation and body size) associated with gross motor coordination problems in 5193 Peruvian children (2787 girls) aged 6-14 years from different geographical locations, and to investigate how the probability that children suffer with gross motor coordination problems varies with physical fitness. Children with gross motor coordination problems were more likely to have lower flexibility and explosive strength levels, having adjusted for age, sex, maturation and study site. Older children were more likely to suffer from gross motor coordination problems, as were those with greater body mass index. However, more mature children were less likely to have gross motor coordination problems, although children who live at sea level or at high altitude were more likely to suffer from gross motor coordination problems than children living in the jungle. Our results provide evidence that children and adolescents with lower physical fitness are more likely to have gross motor coordination difficulties. The identification of youths with gross motor coordination problems and providing them with effective intervention programs is an important priority in order to overcome such developmental problems, and help to improve their general health status. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cervical and Incisal Marginal Discrepancy in Ceramic Laminate Veneering Materials: A SEM Analysis.

PubMed

Ranganathan, Hemalatha; Ganapathy, Dhanraj M; Jain, Ashish R

2017-01-01

Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. This was an experimental, single-blinded, in vitro trial. Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. ANOVA and post hoc Tukey honest significant difference (HSD) tests were used for statistical analysis. The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups.

Comparison of hydrothermal activity between the Adriatic and the Red Sea rift margins

NASA Astrophysics Data System (ADS)

Ball, Philip; Incerpi, Nicolò; Birkle, Peter; Lacsamana, Elizabeth; Manatschal, Gianreto; Agar, Susan; Zhang, Shuo; Borsato, Ron

2017-04-01

Detailed field studies, and access to high-quality seismic reflection and refraction data have led to an improved understanding of the architecture and evolution of magma poor and magma rich margins. Associated with the spatial-temporal evolution of the rift, it is evident that there are evolving, extensive, fluid-rock interactions due to the infiltration of fluids within the sediment, basement and lithospheric mantle. Key questions therefore arise: What are the different fluid-rock reactions that can be typed to different geodynamic stages of the rift evolution? What are their compositions and how do they interact with their environment (basement, sediments, evaporites, hydrosphere, and magmatism)? What are the implications for the evolution of the margin rheology, thermal structure, depositional environments/organic matter maturity, and reservoir quality? The Adriatic paleo-rifted margin is preserved in both SE Switzerland and northern Italy. The field exposures provide a unique opportunity to study the fluid flow history of a hyperextended magma poor extensional margin. Analysis of breccias, cement veins and replacement minerals reveal that the margin records a complex, long-lasting history of dolomitization, calcification and silicification during the Jurassic rifting. The Red Sea by contrast is a young rifted margin. It differs from the paleo-Adriatic margin by several characteristics: volcanism is more evident, and syn-tectonic sediments, including evaporites (halite and anhydrite) are thicker. Several core and fluid samples are available from both onshore and offshore wells, which reveal rift-related hydrothermal alteration. In addition, we find evidence for the presence of an extreme dynamic hydraulic system with infiltration of surface water into sub-salt units during Late Pleistocene. In this study we present results from petrographic and geochemical analysis of basement and sedimentary rocks from Adriatic field-derived samples and core/subsurface fluid samples for the Eastern Red Sea margin. The results are presented using rift domain interpretations, thereby enabling the simple comparison of the observed hydrothermal alteration within a first-order (spatial temporal) rift geodynamic framework.

Bridge Analysis and Evaluation of Effects Under Overload Vehicles

DOT National Transportation Integrated Search

2009-12-01

Movement of industrial freight infrequently requires special overload vehicles weighing 5 to 6 times the normal legal truck weight to move across highway systems. The gross vehicle weight of the overload vehicles frequently exceeds 400 kips while the...

Study of improved modeling and solution procedures for nonlinear analysis. [aircraft-like structures

NASA Technical Reports Server (NTRS)

Kamat, M. P.

1979-01-01

An evaluation of the ACTION computer code on an aircraft like structure is presented. This computer program proved adequate in predicting gross response parameters in structures which undergo severe localized cross sectional deformations.

Suspended particulate loads and transports in the nepheloid layer of the abyssal Atlantic Ocean

USGS Publications Warehouse

Biscaye, P.E.; Eittreim, S.L.

1977-01-01

Vertical profiles of light scattering from over 1000 L-DGO nephelometer stations in the Atlantic Ocean have been used to calculate mass concentrations of suspended particles based on a calibration from the western North American Basin. From these data are plotted the distributions of particulate concentrations at clear water and in the more turbid near-bottom water. Clear water is the broad minimum in concentration and light scattering that occurs at varying mid-depths in the water column. Concentrations at clear water are as much as one-to-two orders of magnitude lower than those in surface water but still reflect a similar geographic distribution: relatively higher concentrations at ocean margins, especially underneath upwelling areas, and the lowest concentrations underneath central gyre areas. These distributions within the clear water reflect surface-water biogenic productivity, lateral injection of particles from shelf areas and surface circulation patterns and require that the combination of downward vertical and horizontal transport processes of particles retain this pattern throughout the upper water column. Below clear water, the distribution of standing crops of suspended particulate concentrations in the lower water column are presented. The integration of mass of all particles per unit area (gross particulate standing crop) reflects a relative distribution similar to that at the surface and at clear water levels, superimposed on which is the strong imprint of boundary currents along the western margins of the Atlantic. Reducing the gross particulate standing crop by the integral of the concentration of clear water yields a net particulate standing crop. The distribution of this reflects primarily the interaction of circulating abyssal waters with the ocean bottom, i.e. a strong nepheloid layer which is coincident with western boundary currents and which diminishes in intensity equatorward. The resuspended particulate loads in the nepheloid layer of the basins west of the Mid-Atlantic Ridge, resulting from interaction of abyssal currents with the bottom, range from ??? 2 ?? 106 tons in the equatorial Guyana Basin to ??? 50 ?? 106 tons in the North American Basin. The total resuspended particulate load in the western basins (111 ?? 106 tons) is almost an order of magnitude greater than that in the basins east of the Mid-Atlantic Ridge (13 ?? 106 tons). The net northward flux of resuspended particles carried in the AABW drops from ??? 8 ?? 106 tons/year between the southern and northern ends of the Brazil Basin and remains ??? 1 ?? 106 tons/year across the Guyana Basin. ?? 1977.

Simultaneous determination of gross alpha, gross beta and ²²⁶Ra in natural water by liquid scintillation counting.

PubMed

Fons, J; Zapata-García, D; Tent, J; Llauradó, M

2013-11-01

The determination of gross alpha, gross beta and (226)Ra activity in natural waters is useful in a wide range of environmental studies. Furthermore, gross alpha and gross beta parameters are included in international legislation on the quality of drinking water [Council Directive 98/83/EC]. In this work, a low-background liquid scintillation counter (Wallac, Quantulus 1220) was used to simultaneously determine gross alpha, gross beta and (226)Ra activity in natural water samples. Sample preparation involved evaporation to remove (222)Rn and its short-lived decay daughters. The evaporation process concentrated the sample ten-fold. Afterwards, a sample aliquot of 8 mL was mixed with 12 mL of Ultima Gold AB scintillation cocktail in low-diffusion vials. In this study, a theoretical mathematical model based on secular equilibrium conditions between (226)Ra and its short-lived decay daughters is presented. The proposed model makes it possible to determine (226)Ra activity from two measurements. These measurements also allow determining gross alpha and gross beta simultaneously. To validate the proposed model, spiked samples with different activity levels for each parameter were analysed. Additionally, to evaluate the model's applicability in natural water, eight natural water samples from different parts of Spain were analysed. The eight natural water samples were also characterised by alpha spectrometry for the naturally occurring isotopes of uranium ((234)U, (235)U and (238)U), radium ((224)Ra and (226)Ra), (210)Po and (232)Th. The results for gross alpha and (226)Ra activity were compared with alpha spectrometry characterization, and an acceptable concordance was obtained. Copyright © 2013 Elsevier Ltd. All rights reserved.

Circumferential fit assessment of CAD/CAM single crowns--a pilot investigation on a new virtual analytical protocol.

PubMed

Matta, Ragai E; Schmitt, Johannes; Wichmann, Manfred; Holst, Stefan

2012-10-01

Techniques currently applied to determine the marginal accuracy of dental crown restorations yield inadequate information. This investigation aimed to test a new virtual approach for determining the precision of fit of single-crown copings. Zirconia single crown copings were manufactured on 10 gypsum, single-tooth master casts with two different established computer-aided design/computer-assisted manufacture (CAD/CAM) systems (groups A and B). After cementation, the circumferential fit was assessed with an industrial noncontact scanner and virtual 3D analysis, following a triple-scan protocol. Marginal fit was determined by virtual sectioning; each abutment-coping complex was digitally sliced in 360 vertical sections (1 degree per section). Standardized measurement distances for analyzing the marginal fit (z, xy, xyz) were selected, and a crosshair alignment was utilized to determine whether crowns were horizontally and/or vertically too large or small. The Mann-Whitney test was applied to test for differences between groups. Significant differences in the xy direction (P = .008) were measured between groups. Group A showed a greater number of horizontally overextended margins and a higher frequency of xy distances greater than 150 Μm, in addition to a tendency for excessive z distances (P = .095). The mean marginal gap values were clinically acceptable in the present investigation; however, a full circumferential analysis revealed significant differences in marginal coping quality.

A comparison between three different pit and fissure sealants with regard to marginal integrity.

PubMed

Fernandes, Kristlee Sabrin; Chalakkal, Paul; de Ataide, Ida de Noronha; Pavaskar, Rajdeep; Fernandes, Precylia Philo; Soni, Harleen

2012-04-01

THE AIM OF THIS STUDY IS TO COMPARE THE OCCURRENCE OF ENAMEL FRACTURES, SEALANT FRACTURES AND MARGINAL FISSURES AFTER PLACEMENT OF THREE SEALANTS: Helioseal F, Conseal F and Clinpro. Thirty individuals between 13 and 15 years of age, diagnosed with pit and fissure caries by visual and DIAGNOdent examination, were chosen for sealant placement on their mandibular molars. The sealants were placed at random, after which, impressions were made with polyvinyl siloxane and casts were fabricated. Dies were prepared, each of which were sputter coated with gold in order to be examined under a scanning electron microscope. The following morphologies were analyzed from dies from each of the sealant groups: Continuous margins, sealant fractures, marginal fissures and enamel fractures. After six months, they were recalled for impression making. Dies were prepared and microscopically analyzed as mentioned. Based on the time of evaluation, there were two groups: Initial group (soon after placement) and final group (after six months). Statistical analysis was done using the paired 't' test and One-way analysis of variance (ANOVA). Clinpro had the greatest fracture resistance, followed by Conseal F and Helioseal F. The occurrence of marginal fissure was found to be least with Clinpro.

Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients' experiences.

PubMed

Aamland, Aase; Werner, Erik L; Malterud, Kirsti

2013-06-01

Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients' positive resources can be mobilized to counteract processes of marginality. Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals. Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect.

Defining the surgical margins of adenoid cystic carcinoma and their impact on outcome: An international collaborative study.

PubMed

Amit, Moran; Na'ara, Shorook; Trejo-Leider, Leonor; Ramer, Naomi; Burstein, David; Yue, Ma; Miles, Brett; Yang, Xinjie; Lei, Delin; Bjoerndal, Kristine; Godballe, Christian; Mücke, Thomas; Wolff, Klaus-Dietrich; Eckardt, André M; Copelli, Chiara; Sesenna, Enrico; Patel, Snehal; Ganly, Ian; Gil, Ziv

2017-05-01

The mainstay of treatment in adenoid cystic carcinoma (ACC) of the head and neck is surgical resection with negative margins. The purpose of this study was to define the margin status that associates with survival outcomes of ACC of the head and neck. We conducted univariate and multivariate analyses of international data. Data of 507 patients with ACC of the head and neck were analyzed; negative margins defined as ≥5 mm were detected in 253 patients (50%). On multivariate analysis, the hazard ratios (HRs) of positive margin status were 2.68 (95% confidence interval [CI], 1.2-6.2; p = .04) and 2.63 (95% CI, 1.1-6.3; p = .03) for overall survival (OS) and disease-specific survival (DSS), respectively. Close margins had no significant impact on outcome, with HRs of 1.1 (95% CI, 0.4-3.0; p = .12) and 1.07 (95% CI, 0.3-3.4; p = .23) for OS and DSS, respectively, relative with negative margins. In head and neck ACC, positive margins are associated with the worst outcome. Negative or close margins are associated with improved outcome, regardless of the distance from the tumor. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1008-1014, 2017. © 2017 Wiley Periodicals, Inc.

Role of specimen US for predicting resection margin status in breast conserving therapy.

PubMed

Moschetta, M; Telegrafo, M; Introna, T; Coi, L; Rella, L; Ranieri, V; Cirili, A; Stabile Ianora, A A; Angelelli, G

2015-01-01

To assess the diagnostic accuracy of specimen ultrasound (US) for predicting resection margin status in women undergoing breast conserving therapy for US-detected cancer, having the histological findings as the reference standard. A total of 132 consecutive patients (age range, 34-87 years; mean, 51 years) underwent breast-conserving surgery for US-detected invasive breast cancer. All surgical specimens underwent US examination. The presence of lesion within the specimen and its distance from the specimen margins were assessed considering a threshold distance between the lesion and specimen margins of 10 mm. US findings were then compared with the pathological ones and specimen US. Sensitivity, specificity, diagnostic accuracy, positive (PPV) and negative predictive values (NPV) for predicting histological margin status were evaluated, having the histological findings as the reference standard. The histological examination detected invasive ductal carcinoma in 96/132 (73%) cases, invasive lobular carcinoma in 32/132 (24%), mucinous carcinoma in 4/132 (3%). The pathological margin analysis revealed 96/132 (73%) negative margins and 36 (27%) close/positive margins. US examination detected all 132 breast lesions within the surgical specimens. 110 (83%) negative margins and 22 (17%) positive margins were found on US. Sensitivity, specificity, diagnostic accuracy, PPV and NPV of 44%, 94%, 80%, 73% and 82%, respectively, were found for specimen US. Specimen US represents a time and cost saving imaging tool for evaluating the presence of US detected-breast lesion within surgical specimen and for predicting the histological margin status.

Gamma knife radiosurgery for vestibular schwannomas: tumor control and functional preservation in 70 patients.

PubMed

Arthurs, Benjamin J; Lamoreaux, Wayne T; Mackay, Alexander R; Demakas, John J; Giddings, Neil A; Fairbanks, Robert K; Cooke, Barton S; Elaimy, Ameer L; Peressini, Ben; Lee, Christopher M

2011-06-01

We present the previously unreported outcomes of 70 patients treated with Gamma knife radiosurgery for vestibular schwannoma (VS), including comprehensive analysis of clinical outcomes and the effects of lower marginal doses. We performed a retrospective study of patients treated for VS at Gamma knife of Spokane between 2003 and 2008. Endpoints measured include tumor control, hearing preservation, and facial nerve preservation, including the effect of tumor size and marginal dose. Statistical analysis was performed with Wilcoxon signed-rank test, paired Student t test, Mann-Whitney U test, Kendall's rank correlation, Fisher exact test, and Liddell's exact χ(2) test for matched pairs. With a mean follow-up of 26 months, 93.8% of tumors either shrank or remained static after receiving a mean marginal dose of 12.7 Gy. Tumor control was independent of marginal dose or tumor size. Hearing preservation was achieved in 64% of patients with serviceable function before the treatment. Hearing changes were independent of dose or tumor size. Preservation of good facial nerve function was achieved in 95% of patients. Post-treatment hydrocephalus occurred in 4.4% of patients, but no other significant morbidities were elucidated. In the treatment of VS, contemporary radiosurgical techniques and the use of marginal doses below 13 Gy offer excellent tumor control, at high rates relative to surgical intervention. These findings are independent of marginal dose and tumor size. Patients should be informed about the benefits and risks of radiosurgery and microsurgery before choosing an intervention. Further analysis of post-treatment outcomes should be encouraged as follow-up times increase and the treatment protocols continue to evolve.

The assessment of mucosal surgical margins in head and neck cancer surgery with narrow band imaging.

PubMed

Šifrer, Robert; Urbančič, Jure; Strojan, Primož; Aničin, Aleksandar; Žargi, Miha

2017-07-01

The diagnostic gain of narrow band imaging in the definition of surgical margins in the treatment of head and neck cancer was evaluated. A prospective study, blinded to the pathologist, with historical comparison. The study group included 45 patients subjected to the intraoperative definition of margins by narrow band imaging. The control group included 55 patients who had undergone standard definition of margins. All patients underwent resection of the tumor and frozen section analysis of superficial margins. The rate of initial R 0 resection and the ratio of histologically negative margins for both groups were statistically compared. The rate of initial R 0 resection in the study group and in the control group was 88.9% and 70.9% (P = .047), and the ratio of histologically negative margins was 95.9% and 88.4% (P = .017), respectively. Narrow band imaging reveals a microscopic extension of the tumor that could be effectively used to better define superficial margins and to achieve a higher rate of initial R 0 resections. 4 Laryngoscope, 127:1577-1582, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Effect of posterior crown margin placement on gingival health.

PubMed

Reitemeier, Bernd; Hänsel, Kristina; Walter, Michael H; Kastner, Christian; Toutenburg, Helge

2002-02-01

The clinical impact of posterior crown margin placement on gingival health has not been thoroughly quantified. This study evaluated the effect of posterior crown margin placement with multivariate analysis. Ten general dentists reviewed 240 patients with 480 metal-ceramic crowns in a prospective clinical trial. The alloy was randomly selected from 2 high gold, 1 low gold, and 1 palladium alloy. Variables were the alloy used, oral hygiene index score before treatment, location of crown margins at baseline, and plaque index and sulcus bleeding index scores recorded for restored and control teeth after 1 year. The effect of crown margin placement on sulcular bleeding and plaque accumulation was analyzed with regression models (P<.05). The probability of plaque at 1 year increased with increasing oral hygiene index score before treatment. The lingual surfaces demonstrated the highest probability of plaque. The risk of bleeding at intrasulcular posterior crown margins was approximately twice that at supragingival margins. Poor oral hygiene before treatment and plaque also were associated with sulcular bleeding. Facial sites exhibited a lower probability of sulcular bleeding than lingual surfaces. Type of alloy did not influence sulcular bleeding. In this study, placement of crown margins was one of several parameters that affected gingival health.

26 CFR 1.832-4 - Gross income.

Code of Federal Regulations, 2013 CFR

2013-04-01

... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

26 CFR 1.832-4 - Gross income.

Code of Federal Regulations, 2011 CFR

2011-04-01

... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

26 CFR 1.832-4 - Gross income.

Code of Federal Regulations, 2012 CFR

2012-04-01

... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...