Iatrogenic ureteric injuries: approaches to etiology and management

PubMed Central

Watterson, James D.; Mahoney, John E.; Futter, Norman G.; Gaffield, Johanna

1998-01-01

Injury to the ureter is a risk of any pelvic or abdominal surgery, including laparoscopy and ureteroscopy. The morbidity associated with such injury may be serious, resulting in increased hospital stay, compromise of the original surgical outcome, secondary invasive interventions, reoperation, potential loss of renal function and deterioration of the patient’s quality of life. Management of ureteric injuries, in conjunction with frank and open dialogue with the patient, can lead to an optimal outcome. For ureteral ligation, removal of the suture and assessment of ureteral viability are recommended, with surgical correction if necessary. For partial transection primary closure is suggested over stent placement. For uncomplicated upper- and middle-third ureteral injury ureteroureterostomy is the procedure of choice. For injuries above the pelvic brim several procedures are available: ureteroureterostomy, ureteroileal interposition and nephrectomy. For injuries below the pelvic brim ureteroneocystostomy is recommended with a psoas hitch or Boari bladder flap. To decrease the incidence of iatrogenic ureteral injury, a sound knowledge of abdominal and pelvic anatomy is the best prevention. If the proposed operation is likely to be close to the ureter, the ureter should be identified at the pelvic brim. If the dissection is likely to be difficult, preoperative intravenous pyelography and placement of a ureteral catheter may help in identifying and protecting the ureter. PMID:9793505

Iatrogenic Hepatitis C Virus Transmission and Safe Injection Practices.

PubMed

Defendorf, Charles M; Paul, Sindy; Scott, George J

2018-05-01

Hepatitis C virus (HCV) infection poses significant adverse health effects. Improper use of vials, needles, syringes, intravenous bags, tubing, and connectors for injections and infusions is a current preventable cause of iatrogenic HCV transmission. Numerous cases have demonstrated the need for continued vigilance and the widespread nature of this iatrogenic infection risk across a variety of medical practice settings in the United States. Failure to implement the evidence-based Centers for Disease Control and Prevention (CDC) infection prevention guidelines exposes patients to preventable harm. The guidelines establish the requirement to notify patients in cases of suspected virus transmission, as well as to screen those patients who would not otherwise have been at risk for HCV seroconversion and other bloodborne pathogens. Legal and regulatory ramifications, including state, criminal, and tort laws, hold physicians and other health care professionals accountable to use safe injection practices. This article reviews the major health risks of HCV infection, significant effects of iatrogenic infection transmission, CDC guidelines for safe injection practices, and legal regulations and ramifications designed to promote safe injection practices.

Massive thoracoabdominal aortic thrombosis in a patient with iatrogenic Cushing syndrome.

PubMed

Kim, Dong Hun; Choi, Dong-Hyun; Lee, Young-Min; Kang, Joon Tae; Chae, Seung Seok; Kim, Bo-Bae; Ki, Young-Jae; Kim, Jin Hwa; Chung, Joong-Wha; Koh, Young-Youp

2014-01-01

Massive thoracoabdominal aortic thrombosis is a rare finding in patients with iatrogenic Cushing syndrome in the absence of any coagulation abnormality. It frequently represents an urgent surgical situation. We report the case of an 82-year-old woman with massive aortic thrombosis secondary to iatrogenic Cushing syndrome. A follow-up computed tomography scan showed a decreased amount of thrombus in the aorta after anticoagulation therapy alone.

Risk of cardiovascular events in people prescribed glucocorticoids with iatrogenic Cushing’s syndrome: cohort study

PubMed Central

Petersen, Irene; Nazareth, Irwin

2012-01-01

Objective To investigate whether there is an increased risk of cardiovascular events in people who exhibit iatrogenic Cushing’s syndrome during treatment with glucocorticoids. Design Cohort study. Setting 424 UK general practices contributing to The Health Improvement Network database. Participants People prescribed systemic glucocorticoids and with a diagnosis of iatrogenic Cushing’s syndrome (n=547) and two comparison groups: those prescribed glucocorticoids and with no diagnosis of iatrogenic Cushing’s syndrome (n=3231) and those not prescribed systemic glucocorticoids (n=3282). Main outcome measures Incidence of cardiovascular events within a year after diagnosis of iatrogenic Cushing’s syndrome or after a randomly selected date, and association between iatrogenic Cushing’s syndrome and risk of cardiovascular events. Results 417 cardiovascular events occurred in 341 patients. Taking into account only the first event by patient (coronary heart disease n=177, heart failure n=101, ischaemic stroke n=63), the incidence rates of cardiovascular events per 100 person years at risk were 15.1 (95% confidence interval 11.8 to 18.4) in those prescribed glucocorticoids and with a diagnosis of iatrogenic Cushing’s syndrome, 6.4 (5.5 to 7.3) in those prescribed glucocorticoids without a diagnosis of iatrogenic Cushing’s syndrome, and 4.1 (3.4 to 4.8) in those not prescribed glucocorticoids. In multivariate analyses adjusted for sex, age, intensity of glucocorticoid use, underlying disease, smoking status, and use of aspirin, diabetes drugs, antihypertensive drugs, lipid lowering drugs, or oral anticoagulant drugs, the relation between iatrogenic Cushing’s syndrome and cardiovascular events was strong (adjusted hazard ratios 2.27 (95% confidence interval 1.48 to 3.47) for coronary heart disease, 3.77 (2.41 to 5.90) for heart failure, and 2.23 (0.96 to 5.17) for ischaemic cerebrovascular events). The adjusted hazard ratio for any cardiovascular event was 4

Iatrogenic perforation of perivaterian duodenal diverticulum: report of a case

PubMed Central

Cavanagh, James E.

1996-01-01

The author reports a case of iatrogenic perforation of a duodenal diverticulum, an extremely rare occurrence, during percutaneous radiologic extraction of a retained common-bile-duct stone. Perforation was related to the perivaterian location of the duodenal diverticulum. Because an inflammatory reaction was present, tube duodenostomy was chosen over excision, closure and drainage to prevent the complication of lateral duodenal fistula and sepsis. Whenever iatrogenic duodenal perforation is suspected, prompt radiologic documentation and early surgical consultation should be sought. PMID:8697327

Management of iatrogenic crystalline lens injury occurred during intravitreal injection.

PubMed

Erdogan, Gurkan; Gunay, Betul Onal; Unlu, Cihan; Gunay, Murat; Ergin, Ahmet

2016-08-01

To evaluate the approach to management of iatrogenic crystalline lens injury occurred during intravitreal injection (IVI). The patients who were managed operatively or followed-up without intervention after the iatrogenic lens injury due to IVI were included in the study. Capsular breaks remained either quiescent or resulted in cataract formation in the patients with inadvertent crystalline lens capsule damage. Phacoemulsification surgery was performed in patients with cataract formation with lower fluidic settings. A total of 9 cases included in the study. Seven cases underwent phacoemulsification with intraocular lens implantation. Two cases remained as quiescent lens injury during the follow-up. In 2 cases, dislocation of lens fragments occurred during phacoemulsification where pars plana vitrectomy was performed at the same session. After iatrogenic crystalline lens injury, capsular damage could remain quiescent or progress to cataract formation. Although phacoemulsification surgery can be performed with appropriate parameters, lens fragment dislocation can be observed in cases with traumatic lens damage secondary to IVI.

Iatrogenic Buschke's disease (Michelin man syndrome)

PubMed

Ahmad, N; Lawrence, J R; Macdonald, J W

1988-02-01

Scleredema [corrected] adultorum as originally described by Buschke in 1900, is cutaneous thickening of unknown aetiology. Since then several cases have been reported which have illustrated different aspects of the disease but the exact aetiology, pathogenesis and prognosis remain uncertain. Disease of possible iatrogenic origin appears not to have been described previously.

Iatrogenic nerve injuries during shoulder surgery.

PubMed

Carofino, Bradley C; Brogan, David M; Kircher, Michelle F; Elhassan, Bassem T; Spinner, Robert J; Bishop, Allen T; Shin, Alexander Y

2013-09-18

The current literature indicates that neurologic injuries during shoulder surgery occur infrequently and result in little if any morbidity. The purpose of this study was to review one institution's experience treating patients with iatrogenic nerve injuries after shoulder surgery. A retrospective review of the records of patients evaluated in a brachial plexus specialty clinic from 2000 to 2010 identified twenty-six patients with iatrogenic nerve injury secondary to shoulder surgery. The records were reviewed to determine the operative procedure, time to presentation, findings on physical examination, treatment, and outcome. The average age was forty-three years (range, seventeen to seventy-two years), and the average delay prior to referral was 5.4 months (range, one to fifteen months). Seven nerve injuries resulted from open procedures done to treat instability; nine, from arthroscopic surgery; four, from total shoulder arthroplasty; and six, from a combined open and arthroscopic operation. The injury occurred at the level of the brachial plexus in thirteen patients and at a terminal nerve branch in thirteen. Fifteen patients (58%) did not recover nerve function after observation and required surgical management. A structural nerve injury (laceration or suture entrapment) occurred in nine patients (35%), including eight of the thirteen who presented with a terminal nerve branch injury and one of the thirteen who presented with an injury at the level of the brachial plexus. Nerve injuries occurring during shoulder surgery can produce severe morbidity and may require surgical management. Injuries at the level of a peripheral nerve are more likely to be surgically treatable than injuries of the brachial plexus. A high index of suspicion and early referral and evaluation should be considered when evaluating patients with iatrogenic neurologic deficits after shoulder surgery.

The risk of iatrogenic pneumothorax after electromyography.

PubMed

Kassardjian, Charles D; O'gorman, Cullen M; Sorenson, Eric J

2016-04-01

Pneumothorax is a potentially serious complication of electromyography (EMG). Data on the frequency of pneumothorax after EMG are lacking. The purpose of this study was to determine the frequency, timing, and risk factors for iatrogenic pneumothorax after EMG. Cases of pneumothorax after EMG were reviewed for clinical, electrophysiological, and radiological data. Of 64,490 EMG studies, 7 patients had an association between the EMG and pneumothorax. All patients were symptomatic and presented within 24 hours of EMG. Sampling of serratus anterior and diaphragm was causative in 1 patient each. In 5 patients, multiple high-risk muscles were sampled. The highest frequency of pneumothorax was observed with examination of serratus anterior (0.445%) and diaphragm (0.149%). The frequency of symptomatic iatrogenic pneumothorax after EMG appears to be low, and examinations of serratus anterior and diaphragm carry the highest risk. Electromyographers should be aware of the risk of pneumothorax and should counsel patients accordingly. © 2015 Wiley Periodicals, Inc.

Iatrogenic Skin Disorders and Related Factors in Newborn Infants.

PubMed

Csoma, Zsanett Renáta; Meszes, Angéla; Ábrahám, Rita; Kemény, Lajos; Tálosi, Gyula; Doró, Péter

2016-09-01

Recent technological advances and diagnostic and therapeutic innovations have resulted in an impressive improvement in the survival of newborn infants requiring intensive care. Consequently, with the use of modern invasive diagnostic and therapeutic procedures, the incidence of iatrogenic events has also increased. The aim of this study was to assess various iatrogenic complications in neonates requiring intensive care and determine possible contributing factors to the injuries. Our prospective cross-sectional cohort survey was conducted in a central regional level III neonatal intensive care unit (NICU). Correlations between intensive therapeutic interventions, complications, factors influencing attendance and prognosis, and the prevalence of iatrogenic skin injuries (ISIs) were investigated over a 2-year study period. Between January 31, 2012, and January 31, 2014, 460 neonates were admitted to the NICU, 83 of whom exhibited some kind of ISI. The major risk factors for ISIs were low birthweight, young gestational age, long NICU stay, use of the intubation-surfactant-extubation (INSURE) technique, surfactant use, mechanical ventilation, insertion of an umbilical arterial catheter, circulatory and cardiac support with dopamine or dobutamine, pulmonary hemorrhage, intracranial hemorrhage, patent ductus arteriosus, bronchopulmonary dysplasia, and positive microbiology culture results. To prevent ISIs, careful consideration of risk factors and the creation of protocols ensuring efficient treatment of injuries are needed. © 2016 Wiley Periodicals, Inc.

Management of iatrogenic tegmen plate defects: our clinical experience and surgical technique.

PubMed

Wahba, Hassan; Ibrhaim, Samer; Youssef, Tamer Ali

2013-09-01

The objective of our study is to present our recommended approach for surgical management of iatrogenic tegmen plate defects. Patients diagnosed to have symptomatic iatrogenic tegmen plate defects were treated by one of the authors using a one-stage trans-mastoid standardized surgical procedure at Ain Shams University Hospitals. Patients' information records included history, complete examination, computed tomography (CT) and magnetic resonance imaging (MRI) of the temporal bone, and the followup data after the procedure to assess the final outcome in each case. Twelve patients with symptomatic iatrogenic tegmen plate defects were included in our study. The tegment plate defect size in the 12 patients varied from 2.2 to 15 mm (mean 5.6 ± 1.3). Postoperative followup of the patients ranged from 6 months up to 2 years (mean 1.6 ± 0.8). One patient only developed wound infection and was treated with antibiotics and regular dressings, with no other immediate postoperative complications (intracranial hematoma or meningitis). In the entire patient group, no local recurrence of middle fossa encephalocele was recorded. Our surgical trans-mastoid approach using multilayered autologous grafts is successful in closing iatrogenic tegmen plate defects more than 2.2 mm and less than 15 mm.

Sonography of iatrogenic pneumothorax in pediatric patients

PubMed Central

2013-01-01

Pneumothorax is defined as the presence of air in the pleural cavity. The incidence of iatrogenic pneumothorax in the pediatric population is 0.3–0.48 in 1000 patients. A conventional chest X-ray, in some cases supplemented with chest computed tomography, is a typical imaging examination used to confirm the diagnosis of pneumothorax. Within the last years, the relevance of transthoracic lung ultrasound in the diagnostic process of this disease entity has greatly increased. This is confirmed by the opinion of a group of experts in ultrasound lung imaging in patients in a life-threatening condition, who strongly recommend a transthoracic ultrasound examination for the diagnosis of pneumothorax in such patients. These data constituted the basis for initiating the prospective studies on the application of this method in pneumothorax diagnosis in patients of pediatric hematology and oncology wards. Aim The aim of the study was to present the possibility of using the transthoracic lung ultrasound in the diagnostic process of pneumothorax in pediatric patients, with particular attention paid to its iatrogenic form. The article discusses sonographic criteria for pneumothorax diagnosis in pediatric patients, including the sensitivity and specificity of the method, in relation to conventional chest X-ray. Material and methods The prospective studies included a group of patients treated in the Clinic of Pediatrics, Pediatric Hematology, Oncology and Endocrinology of the Academic Clinical Centre (Medical University of Gdańsk, Poland) in whom a central venous catheter was placed in the subclavian veins. The studies lasted for one year – from 1 July 2011 to 30 June 2012. The examined group comprised 63 patients – 25 girls (39.7%) and 38 boys (60.3%) aged from 1 to 17. The analysis included the results of 115 ultrasound examinations conducted in this group. Results In t he examined group with suspected or diagnosed neoplasm, iatrogenic pneumothorax was identified in 4 out

Incidence of iatrogenic pneumothorax in the United States in teaching vs. non-teaching hospitals from 2000 to 2012.

PubMed

John, Jason; Seifi, Ali

2016-08-01

Iatrogenic pneumothorax is a patient safety indicator (PSI) representing a complication of procedures such as transthoracic needle aspiration, subclavicular needle stick, thoracentesis, transbronchial biopsy, pleural biopsy, and positive pressure ventilation. This study examined whether there was a significant difference in rate of iatrogenic pneumothorax in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. We performed a retrospective cohort study on iatrogenic pneumothorax incidence from 2000 to 2012 using the Healthcare Cost and Utilization Project (HCUP) database. Pairwise t tests were performed. Odds ratios and P values were calculated, using a Bonferroni-adjusted α threshold, to examine differences in iatrogenic pneumothorax incidence in teaching vs. non-teaching hospitals. Our study revealed that after the year 2000, teaching hospitals had significantly greater iatrogenic pneumothorax incidence compared to non-teaching hospitals in every year of the study period (P<.001). Iatrogenic pneumothorax occurred with significantly greater incidence in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. This trend may have been enhanced by the residency duty-hour regulations implemented in 2003 in teaching institutions, or due to higher rates of procedures in teaching institutions due to the nature of a tertiary center. Iatrogenic pneumothorax was more prevalent in teaching hospitals compared to non-teaching hospitals after the year 2000. Further randomized control studies are warranted to evaluate the etiology of this finding. Published by Elsevier Inc.

[Reconstructive surgery in iatrogenic bile duct injuries].

PubMed

Krawczyk, M; Kania, M; Zieniewicz, K; Nyckowski, P; Patkowski, W; Karwowski, A

1997-01-01

The paper presents the results of surgical treatment performed in 54 patients with iatrogenic injury of biliary tract. All cases of injury were made during open and laparoscopic cholecystectomy. We concluded that Roux-en-Y hepatico-jejunostomy should be recommended. There were no deaths after surgery. This technic was successful therapeutic management more than 95% of cases.

Human prion diseases: surgical lessons learned from iatrogenic prion transmission.

PubMed

Bonda, David J; Manjila, Sunil; Mehndiratta, Prachi; Khan, Fahd; Miller, Benjamin R; Onwuzulike, Kaine; Puoti, Gianfranco; Cohen, Mark L; Schonberger, Lawrence B; Cali, Ignazio

2016-07-01

The human prion diseases, or transmissible spongiform encephalopathies, have captivated our imaginations since their discovery in the Fore linguistic group in Papua New Guinea in the 1950s. The mysterious and poorly understood "infectious protein" has become somewhat of a household name in many regions across the globe. From bovine spongiform encephalopathy (BSE), commonly identified as mad cow disease, to endocannibalism, media outlets have capitalized on these devastatingly fatal neurological conditions. Interestingly, since their discovery, there have been more than 492 incidents of iatrogenic transmission of prion diseases, largely resulting from prion-contaminated growth hormone and dura mater grafts. Although fewer than 9 cases of probable iatrogenic neurosurgical cases of Creutzfeldt-Jakob disease (CJD) have been reported worldwide, the likelihood of some missed cases and the potential for prion transmission by neurosurgery create considerable concern. Laboratory studies indicate that standard decontamination and sterilization procedures may be insufficient to completely remove infectivity from prion-contaminated instruments. In this unfortunate event, the instruments may transmit the prion disease to others. Much caution therefore should be taken in the absence of strong evidence against the presence of a prion disease in a neurosurgical patient. While the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have devised risk assessment and decontamination protocols for the prevention of iatrogenic transmission of the prion diseases, incidents of possible exposure to prions have unfortunately occurred in the United States. In this article, the authors outline the historical discoveries that led from kuru to the identification and isolation of the pathological prion proteins in addition to providing a brief description of human prion diseases and iatrogenic forms of CJD, a brief history of prion disease nosocomial transmission

Human prion diseases: surgical lessons learned from iatrogenic prion transmission

PubMed Central

Bonda, David J.; Manjila, Sunil; Mehndiratta, Prachi; Khan, Fahd; Miller, Benjamin R.; Onwuzulike, Kaine; Puoti, Gianfranco; Cohen, Mark L.; Schonberger, Lawrence B.; Cali, Ignazio

2016-01-01

The human prion diseases, or transmissible spongiform encephalopathies, have captivated our imaginations since their discovery in the Fore linguistic group in Papua New Guinea in the 1950s. The mysterious and poorly understood “infectious protein” has become somewhat of a household name in many regions across the globe. From bovine spongiform encephalopathy (BSE), commonly identified as mad cow disease, to endocannibalism, media outlets have capitalized on these devastatingly fatal neurological conditions. Interestingly, since their discovery, there have been more than 492 incidents of iatrogenic transmission of prion diseases, largely resulting from prion-contaminated growth hormone and dura mater grafts. Although fewer than 9 cases of probable iatrogenic neurosurgical cases of Creutzfeldt-Jakob disease (CJD) have been reported worldwide, the likelihood of some missed cases and the potential for prion transmission by neurosurgery create considerable concern. Laboratory studies indicate that standard decontamination and sterilization procedures may be insufficient to completely remove infectivity from prion-contaminated instruments. In this unfortunate event, the instruments may transmit the prion disease to others. Much caution therefore should be taken in the absence of strong evidence against the presence of a prion disease in a neurosurgical patient. While the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have devised risk assessment and decontamination protocols for the prevention of iatrogenic transmission of the prion diseases, incidents of possible exposure to prions have unfortunately occurred in the United States. In this article, the authors outline the historical discoveries that led from kuru to the identification and isolation of the pathological prion proteins in addition to providing a brief description of human prion diseases and iatrogenic forms of CJD, a brief history of prion disease nosocomial

Right main bronchial fracture resolution by digital thoracic drainage system.

PubMed

Cortés Julián, Gildardo; Mier, José M; Iñiguez, Marco A; Guzmán de Alba, Enrique

2016-03-01

Tracheobronchial stenosis is common in the thoracic surgery service, and iatrogenic injury of the airway after manipulation is not infrequent. When a digital thoracic drainage system came onto the market, many advantages were evident. A 24-year-old woman with critical right main bronchial stenosis underwent airway dilation that was complicated by a tear with a massive air leak, resulting in a total right pneumothorax. We employed a pleural drain connected to a digital thoracic drainage system. The drain was removed 2 days after successful resolution of the air leak. © The Author(s) 2015.

Iatrogenic Peripheral Nerve Injuries-Surgical Treatment and Outcome: 10 Years' Experience.

PubMed

Rasulić, Lukas; Savić, Andrija; Vitošević, Filip; Samardžić, Miroslav; Živković, Bojana; Mićović, Mirko; Baščarević, Vladimir; Puzović, Vladimir; Joksimović, Boban; Novakovic, Nenad; Lepić, Milan; Mandić-Rajčević, Stefan

2017-07-01

Iatrogenic nerve injuries are nerve injuries caused by medical interventions or inflicted accidentally by a treating physician. We describe and analyze iatrogenic nerve injuries in a total of 122 consecutive patients who received surgical treatment at our Institution during a period of 10 years, from January 1, 2003, to December 31, 2013. The final outcome evaluation was performed 2 years after surgical treatment. The most common causes of iatrogenic nerve injuries among patients in the study were the operations of bone fractures (23.9%), lymph node biopsy (19.7%), and carpal tunnel release (18%). The most affected nerves were median nerve (21.3%), accessory nerve (18%), radial nerve (15.6%), and peroneal nerve (11.5%). In 74 (60.7%) patients, surgery was performed 6 months after the injury, and in 48 (39.3%) surgery was performed within 6 months after the injury. In 80 (65.6%) patients, we found lesion in discontinuity, and in 42 (34.4%) patients lesion in continuity. The distribution of surgical procedures performed was as follows: autotransplantation (51.6%), neurolysis (23.8%), nerve transfer (13.9%), direct suture (8.2%), and resection of neuroma (2.5%). In total, we achieved satisfactory recovery in 91 (74.6%), whereas the result was dissatisfactory in 31 (25.4%) patients. Patients with iatrogenic nerve injuries should be examined as soon as possible by experts with experience in traumatic nerve injuries, so that the correct diagnosis can be reached and the appropriate therapy planned. The timing of reconstructive surgery and the technique used are the crucial factors for functional recovery. Copyright © 2017 Elsevier Inc. All rights reserved.

[Evaluation of iatrogenic accessory nerve injury in forensic medical practice].

PubMed

Somogyi, E; Irányi, J

1996-04-14

The authors give a survey of the clinical and medical-legal characteristics of the accessory nerve injury. In the past two decades the conception of the successfulness of the surgical treatment of the accessory nerve injury became prevailing. About the medical-legal aspects of the iatrogenic injury of the nerve reported in connection of the reconstructive surgery chiefly also departments of neurosurgery, orthopedics and traumatology. In the case of the authors a 70 year old patient suffered 10 years ago a iatrogenic accessory nerve injury. The mild trapezius palsy recovered spontaneously practically with cosmetic disadvantage. In connection with the development of extreme dorso-lumbal scoliosis associated with torsion the trapezius atrophy worsened. Physical therapy was partly successful. But the patient became unfit for manual work. Their observations sustain the data of authors who established that in the case of accessory nerve injury not only the surgical but also conservative treatment is usually successful. In opposite to certain data of the literature the authors establish that the iatrogenic injuries of the accessory nerve may lead to significant lifelong disability. The diagnosis is not always made in time with consequent delay in repair. This may be regarded as an unfavorable issue during medical-legal discussions. The authors recommend in interest to prevent nerve injury in the posterior triangle of the neck to perform operation in special department.

Iatrogenic surgical microscope skin burns: A systematic review of the literature and case report.

PubMed

Lopez, Joseph; Soni, Ashwin; Calva, Daniel; Susarla, Srinivas M; Jallo, George I; Redett, Richard

2016-06-01

Cutaneous burns associated with microscope-use are perceived to be uncommon adverse events in microsurgery. Currently, it is unknown what factors are associated with these iatrogenic events. In this report, we describe the case of a 1-year-old patient who suffered a full thickness skin burn from a surgical microscope after a L4-S1 laminectomy. Additionally, we present a systematic review of the literature that assessed the preoperative risk, outcome, and management of iatrogenic microscope skin burns. Lastly, a summary of the Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience (MAUDE) database of voluntary adverse events was reviewed and analyzed for clinical cases of microscope thermal injuries. The systematic literature review identified only seven articles related to microsurgery-related cutaneous burns. From these seven studies, 15 clinical cases of iatrogenic skin burns were extracted for analysis. The systematic review of the FDA MAUDE database revealed only 60 cases of cutaneous burns associated with surgical microscopes since 2004. Few cases of microscope burns have been described in the literature; this report is, to our knowledge, one of the first comprehensive reports of this iatrogenic event in the literature. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Acute iatrogenic dislocation following hip impingement arthroscopic surgery.

PubMed

Matsuda, Dean K

2009-04-01

This is the first case report of an iatrogenic anterior hip dislocation after arthroscopic surgery for femoroacetabular impingement with over 1 year of follow-up. This case report describes the clinical course of a patient with symptomatic cam-pincer femoroacetabular impingement. She underwent arthroscopic rim trimming, labral debridement after a failed attempt at labral refixation from suture cut-through, and femoral head-neck resection osteoplasty. The procedure involved supranormal hip distraction for extraction of an iatrogenic loose body (detached metallic radiofrequency probe tip). The patient had an anterior hip dislocation in the recovery room. Immediate closed reduction under general anesthesia and bracing were performed but failed despite the ability to obtain a concentric but grossly unstable reduction. After 3 failed attempts, a mini-open capsulorrhaphy was performed that successfully restored stability. Her postoperative management and outcome are presented. All of the major static stabilizers of the hip (osseous, labral, and capsuloligamentous) were surgically altered, and a multifactorial causation is proposed. Lessons learned are discussed in hopes of minimizing the occurrence of this rare but dramatic complication.

In vitro sealing of iatrogenic fetal membrane defects by a collagen plug imbued with fibrinogen and plasma.

PubMed

Engels, A C; Hoylaerts, M F; Endo, M; Loyen, S; Verbist, G; Manodoro, S; DeKoninck, P; Richter, J; Deprest, J A

2013-02-01

We aimed to demonstrate local thrombin generation by fetal membranes, as well as its ability to generate fibrin from fibrinogen concentrate. Furthermore, we aimed to investigate the efficacy of collagen plugs, soaked with plasma and fibrinogen, to seal iatrogenic fetal membrane defects. Thrombin generation by homogenized fetal membranes was measured by calibrated automated thrombography. To identify the coagulation caused by an iatrogenic membrane defect, we analyzed fibrin formation by optical densitometry, upon various concentrations of fibrinogen. The ability of a collagen plug soaked with fibrinogen and plasma was tested in an ex vivo model for its ability to seal an iatrogenic fetal membrane defect. Fetal membrane homogenates potently induced thrombin generation in amniotic fluid and diluted plasma. Upon the addition of fibrinogen concentrate, potent fibrin formation was triggered. Measured by densiometry, fibrin formation was optimal at 1250 µg/mL fibrinogen in combination with 4% plasma. A collagen plug soaked with fibrinogen and plasma sealed an iatrogenic membrane defect about 35% better than collagen plugs without these additives (P = 0.037). These in vitro experiments suggest that the addition of fibrinogen and plasma may enhance the sealing efficacy of collagen plugs in closing iatrogenic fetal membrane defects. © 2013 John Wiley & Sons, Ltd.

20-year experience with iatrogenic penile injury.

PubMed

Amukele, Samuel A; Lee, Gene W; Stock, Jeffrey A; Hanna, Moneer K

2003-10-01

We review our experience with the management of iatrogenic penile injuries. Apart from circumcision, serious damage to the penis can occur following hypospadias repair, surgery for priapism or total loss of the penis following surgical repair of bladder exstrophy. A retrospective analysis of patients with iatrogenic penile amputation referred to us between 1980 and 2000 was undertaken. Causes of injury and choice of management were reviewed. Of the 13 cases treated during the 20-year period mechanism of primary injury was circumcision in 4, hypospadias repair in 6, priapism in 1, bladder exstrophy repair in 1 and penile carcinoma in 1. A variety of techniques were used for phallic reconstruction. Penile degloving, division of suspensory ligament and rotational skin flaps achieved penile augmentation and enhancement. Reasonable cosmesis and penile length were achieved in all cases. In indicated cases microsurgical phalloplasty was technically feasible. However long-term followup showed various complications including erosions from the use of a penile stiffener. The ultimate goal of reconstructive surgery is to have a penis with normal function and appearance. The management of penile injury requires a wide variety of surgical techniques that are tailored to the individual patient. Expedient penile reconstruction is successful and therapeutic delay is associated with complications.

Iatrogenic facial palsy: the cost.

PubMed

Pulec, J L

1996-11-01

The cost of iatrogenic facial paralysis can be high. Ways to avoid facial nerve injury during surgery and, should it occur, ways to minimize the disability and cost are discussed. These include adequate preparation and training by the surgeon, the exercise of sound judgment, the presence of high morals by the surgeon, adequate preoperative diagnosis and surgical instrumentation and thorough preoperative oral and written informed consent. Should facial nerve injury occur, immediate consultation and reparative decompression, anastomosis or grafting should be performed to obtain the best ultimate result. The value of prompt, competent, sympathetic and continuing concern offered by the surgeon to the patient cannot be over emphasized.

Update on strategies limiting iatrogenic hypoglycemia

PubMed Central

Bonaventura, Aldo; Montecucco, Fabrizio; Dallegri, Franco

2015-01-01

The prevalence of type 2 diabetes mellitus (T2DM) is increasing all over the world. Targeting good glycemic control is fundamental to avoid the complications of diabetes linked to hyperglycemia. This narrative review is based on material searched for and obtained via PubMed up to April 2015. The search terms we used were: ‘hypoglycemia, diabetes, complications’ in combination with ‘iatrogenic, treatment, symptoms.’ Serious complications might occur from an inappropriate treatment of hyperglycemia. The most frequent complication is iatrogenic hypoglycemia that is often associated with autonomic and neuroglycopenic symptoms. Furthermore, hypoglycemia causes acute cardiovascular effects, which may explain some of the typical symptoms: ischemia, QT prolongation, and arrhythmia. With regards to the latter, the night represents a dangerous period because of the major increase in arrhythmias and the prolonged period of hypoglycemia; indeed, sleep has been shown to blunt the sympatho-adrenal response to hypoglycemia. Two main strategies have been implemented to reduce these effects: monitoring blood glucose values and individualized HbA1c goals. Several drugs for the treatment of T2DM are currently available and different combinations have been recommended to achieve individualized glycemic targets, considering age, comorbidities, disease duration, and life expectancy. In conclusion, according to international guidelines, hypoglycemia-avoiding therapy must reach an individualized glycemic goal, which is the lowest HbA1c not causing severe hypoglycemia and preserving awareness of hypoglycemia. PMID:26099256

[Iatrogenic hyperthyroidism secondary to weight loss medication. Predictive factors for their precocious detention].

PubMed

Goday, A; Recasens, A; Manresa, J M; Vila, J; Moix, S

1998-05-01

To establish the differential clinical characteristics between the Iatrogenic hyperthyroidism for not conventional medication for obesity treatment (weight losers) and the endogenous by Graves Basedow disease. Observational and analytical study, populational based, in the one which prospectively were compared cases with Iatrogenic hyperthyroidism (secondary to weight losers) with those with endogenous hyperthyroidism (Graves Basedow disease) as controls. Consisted of the variable clinical record of 100 correlative patients that consulted in specialized attention of endocrinology for Iatrogenic hyperthyroidism secondary to weight losers and for Graves Basedow disease. The differences observed between Iatrogenic hyperthyroidism (secondary to weight losers) (n = 43) as compared to endogenous hyperthyroidism (Graves Basedow disease) (n = 57) were: smaller age (31.8 +/- 10 as compared to 37.8 +/- 12.6 years), greater body mass index (27.6 +/- 7.2 as compared to 23.4 +/- 3.1), smaller goiter frequency (16.3% as compared to 84.2%) as well as absence of signs of ophthalmopathy (0% as compared to 57.9%). Both groups had low levels of TSH, and the difference rests in the values of free T4, low in the first group and increased in the endogenous hyperthyroidism. The odds ratio were: IMC > 27: 3.92 (0.91-16.72), age < 33 years: 5.58 (1.42-21.99), absence of goiter: 23.29 (6.39-84.85). The precedent of weight losers use was not selective of the first group, being detected in a 12.3% of cases of endogenous hyperthyroidism, though in periods of time remoter in relationship to the beginning of the clinic. In the differential diagnosis of a case of hyperthyroidism, it can be suspected Iatrogenic hyperthyroidism (secondary to weight losers) for medication for the obesity in patients of the feminine sex with overweight, without previous or familiar history of thyroid disease, and in those which in the physical exploration is not verified goiter neither ophthalmopathy.

The Effect of Botulinum Toxin on an Iatrogenic Sialo-Cutaneous Fistula

PubMed Central

Hong, Seung Eun; Kwon, Jung Woo; Kang, So Ra

2016-01-01

A sialo-cutaneous fistula is a communication between the skin and a salivary gland or duct discharging saliva. Trauma and iatrogenic complications are the most common causes of this condition. Treatments include aspiration, compression, and the administration of systemic anticholinergics; however, their effects are transient and unsatisfactory in most cases. We had a case of a patient who developed an iatrogenic sialo-cutaneous fistula after wide excision of squamous cell carcinoma in the parotid region that was not treated with conventional management, but instead completely resolved with the injection of botulinum toxin. Based on our experience, we recommend the injection of botulinum toxin into the salivary glands, especially the parotid gland, as a conservative treatment option for sialo-cutaneous fistula. PMID:28913292

Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: a systematic review and conceptual model.

PubMed

Best, Kaitlin M; Boullata, Joseph I; Curley, Martha A Q

2015-02-01

Analgesia and sedation are common therapies in pediatric critical care, and rapid titration of these medications is associated with iatrogenic withdrawal syndrome. We performed a systematic review of the literature to identify all common and salient risk factors associated with iatrogenic withdrawal syndrome and build a conceptual model of iatrogenic withdrawal syndrome risk in critically ill pediatric patients. Multiple databases, including PubMed/Medline, EMBASE, CINAHL, and the Cochrane Central Registry of Clinical Trials, were searched using relevant terms from January 1, 1980, to August 1, 2014. Articles were included if they were published in English and discussed iatrogenic withdrawal syndrome following either opioid or benzodiazepine therapy in children in acute or intensive care settings. Articles were excluded if subjects were neonates born to opioid- or benzodiazepine-dependent mothers, children diagnosed as substance abusers, or subjects with cancer-related pain; if data about opioid or benzodiazepine treatment were not specified; or if primary data were not reported. In total, 1,395 articles were evaluated, 33 of which met the inclusion criteria. To facilitate analysis, all opioid and/or benzodiazepine doses were converted to morphine or midazolam equivalents, respectively. A table of evidence was developed for qualitative analysis of common themes, providing a framework for the construction of a conceptual model. The strongest risk factors associated with iatrogenic withdrawal syndrome include duration of therapy and cumulative dose. Additionally, evidence exists linking patient, process, and system factors in the development of iatrogenic withdrawal syndrome. Most articles were prospective observational or interventional studies. Given the state of existing evidence, well-designed prospective studies are required to better characterize iatrogenic withdrawal syndrome in critically ill pediatric patients. This review provides data to support the

Iatrogenic Blood-borne Viral Infections in Refugee Children from War and Transition Zones

PubMed Central

2013-01-01

Pediatric infectious disease clinicians in industrialized countries may encounter iatrogenically transmitted HIV, hepatitis B virus, and hepatitis C virus infections in refugee children from Central Asia, Southeast Asia, and sub-Saharan Africa. The consequences of political collapse and/or civil war—work migration, prostitution, intravenous drug use, defective public health resources, and poor access to good medical care—all contribute to the spread of blood-borne viruses. Inadequate infection control practices by medical establishments can lead to iatrogenic infection of children. Summaries of 4 cases in refugee children in Australia are a salient reminder of this problem. PMID:23739597

Endovascular management of arterial injuries after blunt or iatrogenic renal trauma

PubMed Central

Chevallier, Olivier; Gehin, Sophie; Midulla, Marco; Berthod, Pierre-Emmanuel; Galland, Christophe; Briche, Pascale; Duperron, Céline; Majbri, Nabil; Mousson, Christiane; Falvo, Nicolas

2017-01-01

The kidney is the third most common abdominal organ to be injured in trauma, following the spleen and liver, respectively. The most commonly used classification scheme is the American Association for the Surgery of Trauma (AAST) classification of blunt renal injuries, which grades renal injury according to the size of laceration and its proximity to the renal hilum. Arteriovenous fistula and pseudoaneurysm are the most common iatrogenic biopsy-related or surgery-related vascular injuries in native kidneys. The approach to renal artery injuries has changed over time from more aggressive intervention to more conservative observational or endovascular management, including selective transcatheter arterial embolization (TAE) and the placement of stents/stent grafts. In this article, we describe the role and technical aspects of endovascular interventions in the management of arterial injuries after blunt or iatrogenic renal trauma. PMID:28932700

High prevalence of iatrogenic hyperthyroidism in elderly patients with atrial fibrillation in an anticoagulation clinic.

PubMed

Krishnan, Sandeep Kumar; Dohrmann, Mary L; Brietzke, Stephen A; Fleming, David A; Flaker, Greg C

2011-01-01

In elderly patients with established atrial fibrillation (AF) who are receiving thyroid replacement, regular testing for thyroid function is often not performed, placing the patient at risk for iatrogenic hyperthyroidism. Of 215 patients followed in an anticoagulation clinic, 41 were receiving thyroid replacement and 15 of these were found to have hyperthyroidism. Eight had documented AF coincident with abnormal thyroid function. In addition, only 22 patients on thyroid replacement had an annual TSH. In conclusion, iatrogenic hyperthyroidism may frequently be missed in AF patients because of inadequate monitoring of serum TSH. Thyroid replacement is common in elderly patients with AF followed in an anticoagulation clinic. Laboratory evidence of hyperthyroidism occurred in 37%, usually in patients with higher doses of thyroid replacement, and often associated with AF. The frequency of iatrogenic hyperthyroidism may be underestimated in patients with AF since many patients who receive thyroid replacement therapy are not monitored regularly with serum TSH.

Iatrogenic salivary duct injury in head and neck cancer patients: Report of four cases and review of the literature

PubMed Central

Kulyapina, Alena; Ochandiano-Caicoya, Santiago; Navarro-Cuellar, Carlos; Navarro-Vila, Carlos

2014-01-01

Introduction: The lesions of the salivary ducts may be idiopathic, post- traumatic, or iatrogenic and lead to sialocele formation with persistent painful facial swelling or cutaneous fistula formation. No consensus on treatment of this condition exists: the options of treatment include needle aspiration, pressure dressings, antisialogogue therapy, radiotherapy, botulinum toxin and surgical approaches as duct repair, diversion, ligation, different drainage systems and even parotidectomy/submaxilectomy. The management and special features of iatrogenic salivary duct injury in patients with oral cancer who underwent head and neck reconstructive surgery has not been described yet. Material and Methods: We present four cases of iatrogenic lesions of salivary ducts and its management in patients with oral cancer. Conclusions: The iatrogenic lesions of salivary ducts are to be taken into account in patients with oral cancer as the distal ends of salivary ducts could be involved in the margins of surgical resection. Different options of treatment of this complication are described. Key words:Sialocele, oral cancer, salivary duct. PMID:25136433

Iatrogenic left main coronary artery dissection due to pin-hole balloon rupture: Not to be panicked….

PubMed

Jeyakumaran, Balakumaran; Raj, Ajay; Pandit, Bhagya Narayan; Kumar, Tarun; Deora, Surender

2015-12-01

Iatrogenic left main coronary artery (LMCA) dissection is a rare complication and may have devastating consequences if not immediately intervened. The management includes urgent revascularization mostly with percutaneous coronary intervention (PCI) with bail-out stenting and rarely requires coronary artery bypass graft (CABG) surgery. In clinically and hemodynamically stable patients, a conservative approach may be preferred. Here, we present a rare case of iatrogenic retrograde LMCA dissection due to pin-hole rupture of angioplasty balloon that was managed conservatively.

[Clinical application of self-made drainage tube with balloon for iatrogenic colonic perforation].

PubMed

Liu, Bing-rong; Li, Hui; Zhao, Li-xia; Song, Ji-tao; Wang, Yan-jun; Chen, Jing; Liu, Wei

2012-07-01

To investigate the clinical efficacy of colonic bypass drainage by self-made drainage tube with balloon for iatrogenic colonic perforation. A retrospective analysis of 8 patients with iatrogenic colonic perforations from January 2009 to March 2011 was performed. Self-made drainage tubes with balloon were placed in the bowel lumen endoscopically after perforations were closed with endoclips or endoloops under endoscope. The inflatable balloon at the front-end of the tube was fixed at the mouth side of colonic perforation to achieve continuous drainage of stool and intestinal juice. Endoscopic bypass continuous drainage by using self-made drainage tube with balloon was successfully carried out in all the 8 patients. All the perforations healed and no surgical intervention required. Bypass drainage continued for 3-10 days(mean 7.6 days). One patient received colonoscopy 3 days after the procedure, and displacement of the drainage tube was noticed requiring endoscopic adjustment. All the drainage tubes were removed uneventfully, and no ulceration or perforation occurred at balloon fixed site after removal. After follow up ranging from 12 to 36 months, no chronic fistula, adhesive obstruction, or abdominal infection occurred. Colonic bypass drainage by self-made drainage tube with balloon for iatrogenic colonic perforation is simple, feasible, safe and reliable.

Iatrogenic nerve injury in a national no-fault compensation scheme: an observational cohort study.

PubMed

Moore, A E; Zhang, J; Stringer, M D

2012-04-01

Iatrogenic nerve injury causes distress and disability, and often leads to litigation. The scale and profile of these injuries has only be estimated from published case reports/series and analyses of medicolegal claims.   To determine the current spectrum of iatrogenic nerve injury in New Zealand by analysing treatment injury claims accepted by a national no-fault compensation scheme. The Accident Compensation Corporation (ACC) provides national no-fault personal accident insurance cover, which extends to patients who have sustained a treatment injury from a registered healthcare professional. Nerve injury claims identified from 5227 treatment injury claims accepted by the ACC in 2009 were analysed. From 327 claims, 292 (89.3%) documenting 313 iatrogenic nerve injuries contained sufficient information for analysis. Of these, 211 (67.4%) occurred in 11 surgical specialties, particularly orthopaedics and general surgery; the remainder involved phlebotomy services, anaesthesia and various medical specialties. The commonest causes of injury were malpositioning (n = 40), venepuncture (n = 26), intravenous cannulation (n = 21) and hip arthroplasty (n = 21). Most commonly injured were the median nerve and nerve roots (n = 32 each), brachial plexus (n = 26), and the ulnar nerve (n = 25). At least 34 (11.6%) patients were referred for surgical management of their nerve injury. Iatrogenic nerve injuries are not rare and occur in almost all branches of medicine, with malpositioning under general anaesthesia and venepuncture as leading causes. Some of these injuries are probably unavoidable, but greater awareness of which nerves are at risk and in what context should facilitate the development and/or wider implementation of preventive strategies. © 2012 Blackwell Publishing Ltd.

Percutaneous Treatment of Iatrogenic Pseudoaneurysms by Cyanoacrylate-Based Wall-Gluing

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

Del Corso, Andrea, E-mail: adelcorso2000@hotmail.com; Vergaro, Giuseppe

Purpose. Although the majority of iatrogenic pseudoaneurysms (PSAs) are amenable to ultrasound (US)-guided thrombin injection, patients with those causing neuropathy, claudication, significant venous compression, or soft tissue necrosis are considered poor candidates for this option and referred to surgery. We aimed to test the effectiveness and feasibility of a novel percutaneous cyanoacrylate glue (NBCA-MS)-based technique for treatment of symptomatic and asymptomatic iatrogenic PSA. Material and Methods. During a 3-year period, we prospectively enrolled 91 patients with iatrogenic PSA [total n = 94 (femoral n = 76; brachial n = 11; radial n = 6; axillary n = 1)]. PSA weremore » asymptomatic in 66 % of cases, and 34 % presented with symptoms due to neuropathy, venous compression, and/or soft tissue necrosis. All patients signed informed consent. All patients received NBCA-MS-based percutaneous treatment. PSA chamber emptying was first obtained by US-guided compression; superior and inferior walls of the PSA chamber were then stuck together using NBCA-MS microinjections. Successfulness of the procedure was assessed immediately and at 1-day and 1-, 3-, and 12-month US follow-up. Results. PSA occlusion rate was 99 % (93 of 94 cases). After treatment, mean PSA antero-posterior diameter decrease was 67 {+-} 22 %. Neuropathy and vein compression immediately disappeared in 91 % (29 of 32) of cases. Patients with tissue necrosis (n = 6) underwent subsequent outpatient necrosectomy. No distal embolization occurred, nor was conversion to surgery necessary. Conclusion. PSA treatment by way of NBCA-MS glue injection proved to be safe and effective in asymptomatic patients as well as those with neuropathy, venous compression, or soft-tissue necrosis (currently candidates for surgery). Larger series are needed to confirm these findings.« less

Compromises.

ERIC Educational Resources Information Center

Sizer, Theodore R.

1984-01-01

Taking as examples the issues of improving students'"high order thinking skills" and arriving at more equitable teacher salaries and school budgets, the author discusses the need for compromise solutions to widespread problems. (JBM)

A conservative management of iatrogenically damaged distal root of the mandibular second molar.

PubMed

Bansal, Rashmi; Roy, Sonali; Chandra, Praveen; Gurtu, Anuraag; Pandey, Rahul

2017-01-01

Trauma to the adjacent hard and soft tissue is the most common iatrogenic injury during extraction of the mandibular third molar. As every functional component of the dental arch is of prime importance in contemporary dental practice, the major concern must be in conserving the tooth and its structure as much as possible. The present case discusses the application of this conservative approach for management of iatrogenically damaged distal root of the mandibular second molar during extraction of impacted third molar, in which excessive guttering of alveolar bone and fractured apical third of distal root of 37 was observed radiographically. A conservative and noninvasive approach was successfully achieved to restore the damaged root by the bioactive material. Sealing of the remaining root with mineral trioxide aggregate allowed regeneration of soft and hard tissue around it.

Iatrogenic Cushing's syndrome caused by intranasal steroid use.

PubMed

Dursun, Fatma; Kirmizibekmez, Heves

2017-01-01

Cushing's syndrome (CS) is common after oral steroid use and has also been reported following topical or inhaled use, but it is extremely uncommon after intranasal administration. This is the case of a 6-year-old child who developed Cushing's syndrome after intranasal application of dexamethasone sodium phosphate for a period of 6 months. Pediatricians and other clinical practitioners should be aware that high-dose and long-term nasal steroid administration may cause iatrogenic Cushing's syndrome characterized by complications of glucocorticoid excess as well as serious and even life-threatening complications of adrenal insufficiency.

Iatrogenic spleen injury during minimally invasive left colonic flexure mobilization: the quest for evidence-based results.

PubMed

Mangano, Alberto; Gheza, Federico; Giulianotti, Pier C

2018-04-13

To assess the frequency, risk factors and outcomes of iatrogenic spleen injury during minimally invasive colo-rectal surgery with a particular focus on the routine splenic flexure mobilization tehcnique. Exclusion criteria: 1. topic not pertinent to the main topic of the review; 2. All case reports, editorials, conference highlights were excluded. After a title and abstract first selection and a final full-text analysis has been performed. The results of the selected articles are presented. The iatrogenic splenic injury rate during colorectal surgery is 0.96%. The iatrogenic injuries cause around 20% of all splenectomy. Ligaments over-traction is the most frequent mechanism of damage. The routine splenic flexure mobilization is a matter of scientific debate. open surgery, male sex, peripheral vascular disease, malignant neoplasia, diverticulitis, emergency surgery and teaching-hospital status. There is a risk difference according to the procedure: transverse colectomy has the highest risk, followed by left colectomy and total colectomy. The routine mobilization of the left colonic flexure is a debated topic. However, according to some authors (including our experience), this procedure is not a risk factor and it may be advantageous: a) it doesn't excessively prolong the total operative time; b) better surgical skills development; c) the tension-related ischemia is avoided; d) wider oncological dissection. Technical accuracy with cautious dissection/visualization can reduce the rate of iatrogenic splenic damage. Laparoscopy decreases the rate of splenic injury by almost 3,5 times. Robotic surgery may have the potential to further reduce this complication but more data are needed on the topic.

Iatrogenic popliteal artery injury in non arthroplasty knee surgery.

PubMed

Bernhoff, K; Björck, M

2015-02-01

We have investigated iatrogenic popliteal artery injuries (PAI) during non arthroplasty knee surgery regarding mechanism of injury, treatment and outcomes, and to identify successful strategies when injury occurs. In all, 21 iatrogenic popliteal artery injuries in 21 patients during knee surgery other than knee arthroplasty were identified from the Swedish Vascular Registry (Swedvasc) between 1987 and 2011. Prospective registry data were supplemented with case-records, including long-term follow-up. In total, 13 patients suffered PAI during elective surgery and eight during urgent surgery such as fracture fixation or tumour resection. Nine injuries were detected intra-operatively, five within 12 to 48 hours and seven > 48 hours post-operatively (two days to 23 years). There were 19 open vascular and two endovascular surgical repairs. Two patients died within six months of surgery. One patient required amputation. Only six patients had a complete recovery of whom had the vascular injury detected at time of injury and repaired by a vascular surgeon. Patients sustaining vascular injury during elective procedures are more likely to litigate (p = 0.029). We conclude that outcomes are poorer when there is a delay of diagnosis and treatment, and that orthopaedic surgeons should develop strategies to detect PAI early and ensure rapid access to vascular surgical support. ©2015 The British Editorial Society of Bone & Joint Surgery.

[Digital ischemia revealing multiple myeloma].

PubMed

Khammar, Z; Ouazzani, M; Bennani, B; Oubelkacem, N; Berrady, R

2018-02-01

Digital ulcers generally arise in a context of microangiopathy-related focal ischemia. In women, connective tissue diseases are the main etiology, while in men the cause is often diffuse arterial disease, e.g. Leo-Buerger disease, or emboligenic heart disease. A paraneoplastic origin of digital necrosis due to ischemia is rarely reported. A 75-year-old man presented with cyanosis of the fingertips and toes that had begun one month earlier. The physical examination found pulp ulcers on the fingers and toes of both hands and feet. Two weeks later, necrotic damage developed distally, with no other associated symptoms. Blood tests were suggestive of Kahler disease; immunodeficiency disorders tests were negative; the cyroglobulin test was positive. Multiple-drug chemotherapy was followed by clinical improvement. Distal necrotic damage is a frequent inaugural symptom in vascular disease. If the common causal mechanisms (iatrogenic, occupational, toxic, atheromatous, emboligenic heart disease, or systemic disease) have been ruled out, it is important to search for a blood disorder or cancer as the cause of distal necrotic damage. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Perioperative deaths: a further comparative review of coroner's autopsies with particular reference to the occurrence of fatal iatrogenic injury.

PubMed

Lau, G

2000-07-01

In previous triennial reviews of Coroner's perioperative autopsies conducted during the periods 1989 to 1991 and 1992 to 1994, it was observed that the necropsy incidence of such deaths rose from 2% to 2.6% (P < 0.05). Concurrently, the rate of iatrogenic deaths had nearly doubled from 15.2% to 28.8% (P < 0.02). These findings spurred a review of the subsequent triennium (1995 to 1997), in order to monitor the apparent rise in these trends and to study the frequency and occurrence of iatrogenic deaths in relation to the number of invasive procedures performed, as well as during emergency and elective procedures. A retrospective (descriptive and comparative) study, comprising a clinico-pathological review of a series of 270 perioperative deaths (defined as deaths occurring during or after invasive therapeutic or diagnostic procedures, up to a week after discharge, and excluding cases of major trauma from suicides, homicides, as well as road and industrial accidents) reported to the Coroner, for which autopsies were conducted at the Department of Forensic Medicine from 1995 to 1997. The necropsy incidence of 4.4% (270/6074) represented a significant rise over the previous triennia (P < 0.01). As in previous years, there was a predominance of males (M:F = 1.65:1) and middle-aged to elderly patients (range 0 to 92 years, mean 55.8 years, median 63 years), most of whom had died after a variable, but usually brief, postoperative interval [0 to 97, 4.2, 1 day(s)] and a more variable period of hospitalisation (< 1 to 289, 12.6, 7 days). A total of 408 invasive procedures were performed, amounting to an average of 1.5 per patient; 101 patients (37.4%) underwent multiple (> 1) interventions, which were initially classified as elective procedures in 27 cases. There were 66 (24.4%) iatrogenic deaths, of which 2 (0.7%) were due to anaesthetic mishaps; 18/64 iatrogenic deaths, unrelated to anaesthesia, occurred after the first postoperative day. The proportions of such deaths

45 CFR 30.22 - Bases for compromise.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Bases for compromise. 30.22 Section 30.22 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CLAIMS COLLECTION Debt Compromise § 30.22 Bases for compromise. (a) Compromise. The Secretary may compromise a debt if the full amount...

45 CFR 30.22 - Bases for compromise.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Bases for compromise. 30.22 Section 30.22 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CLAIMS COLLECTION Debt Compromise § 30.22 Bases for compromise. (a) Compromise. The Secretary may compromise a debt if the full amount...

45 CFR 30.22 - Bases for compromise.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Bases for compromise. 30.22 Section 30.22 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CLAIMS COLLECTION Debt Compromise § 30.22 Bases for compromise. (a) Compromise. The Secretary may compromise a debt if the full amount...

45 CFR 30.22 - Bases for compromise.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Bases for compromise. 30.22 Section 30.22 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CLAIMS COLLECTION Debt Compromise § 30.22 Bases for compromise. (a) Compromise. The Secretary may compromise a debt if the full amount...

Iatrogenic hypervitaminosis D as an unusual cause of persistent vomiting: a case report.

PubMed

Bansal, Rinkesh Kumar; Tyagi, Pankaj; Sharma, Praveen; Singla, Vikas; Arora, Veronica; Bansal, Naresh; Kumar, Ashish; Arora, Anil

2014-02-26

Vitamin D is increasingly recognized to have several beneficial effects. Vitamin D deficiency is widely prevalent. Physicians often treat patients with high doses of vitamin D for various ailments without any monitoring for adverse effects and the prescribed doses often far exceed requirements resulting in toxicity. We present here a classic case of iatrogenic hypervitaminosis D, which presented with persistent vomiting and acute renal failure. Here we present a case of a 45-year-old Asian Indian woman who presented to us with persistent vomiting the cause of which was iatrogenic hypervitaminosis D. She was treated with intravenous fluid, diuretics and calcitonin and had clinical improvement. We suggest that in any patient presenting with persistent vomiting and hypercalcemia, particularly in the presence of normal parathyroid hormone, a diagnosis of overdose of vitamin D should be suspected. Its treatment not only alleviates symptoms but also prevents ongoing acute kidney injury.

Iatrogenic Cushing's syndrome in children presenting at Children's Hospital Lahore using nappy rash ointments.

PubMed

Sattar, Hina; Manzoor, Jaida; Mirza, Liaqat; Sheikh, Abdul Malik; Butt, Taeed Ahmad

2015-05-01

To study the characteristics of infants and children presenting with iatrogenic Cushing's Syndrome due to nappy rash ointments. The descriptive study was conducted at the Children's Hospital, Lahore, from April to September 2013, and comprised patients presenting with cushingoid features and history of using nappy rash ointments. Patients having Cushing's Syndrome due to causes other than iatrogenic were excluded and so were those taking oral or parenteral steroids due to skin allergy, renal or respiratory disease. Demographic data, history and examination of all patients were recorded on a proforma and results were analysed using SPSS 16. Of the total 18 patients, 13(72%) were girls and 5(27%) were boys. Eight (44.4%) patients were younger than 6 months, 6(33.3%) were between 6 months to 1 year, while 4(22.2%) were between 12 and 18 months of age. Clobetasol alone was the most frequently used agent responsible in 13(72%) cases. Duration of use of steroid ointment was as short as 3 weeks to as much as 1 year. All the patients were using disposable diapers. Ointment was prescribed by a doctor in 5(27%) cases and self-prescribed (relative or neighbour) in 13(72%). Self-medication and prolonged use of potent steroid ointments are major contributors in development of iatrogenic Cushing's Syndrome in infants and children. Younger age, female gender and use of disposable diapers were other important predisposing factors.

48 CFR 432.616 - Compromise actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Compromise actions. 432.616 Section 432.616 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Contract Debts 432.616 Compromise actions. Compromise of a debt...

Iatrogenic hypervitaminosis D as an unusual cause of persistent vomiting: a case report

PubMed Central

2014-01-01

Introduction Vitamin D is increasingly recognized to have several beneficial effects. Vitamin D deficiency is widely prevalent. Physicians often treat patients with high doses of vitamin D for various ailments without any monitoring for adverse effects and the prescribed doses often far exceed requirements resulting in toxicity. We present here a classic case of iatrogenic hypervitaminosis D, which presented with persistent vomiting and acute renal failure. Case presentation Here we present a case of a 45-year-old Asian Indian woman who presented to us with persistent vomiting the cause of which was iatrogenic hypervitaminosis D. She was treated with intravenous fluid, diuretics and calcitonin and had clinical improvement. Conclusions We suggest that in any patient presenting with persistent vomiting and hypercalcemia, particularly in the presence of normal parathyroid hormone, a diagnosis of overdose of vitamin D should be suspected. Its treatment not only alleviates symptoms but also prevents ongoing acute kidney injury. PMID:24571630

Subclavian Artery Pseudoaneurysm in an Unusual Case of Digital Gangrene.

PubMed

Majhi, Bhuban; Pal, Nandita

2017-01-01

A young male patient presented at a tertiary care hospital with cold and bluish left upper limb accompanied with digital gangrene arousing suspicion of peripheral vascular disease. History did not reveal any high-risk behavior. Clinical examination and subsequent investigations lead to the diagnosis of acute infective endocarditis of native aortic valve along with peripheral embolism caused by methicillin-resistant Staphylococcus aureus . Fogarty's balloon embolectomy was done following which patient developed pseudoaneurysm of the left subclavian artery. These iatrogenic sequelae were managed with the resection of the pseudoaneurysm and prolonged antibiotic therapy as per the culture and sensitivity report.

38 CFR 1.931 - Bases for compromise.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Bases for compromise. 1.931 Section 1.931 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS GENERAL PROVISIONS Standards for Compromise of Claims § 1.931 Bases for compromise. (a) VA may compromise a debt if...

38 CFR 1.931 - Bases for compromise.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Bases for compromise. 1.931 Section 1.931 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS GENERAL PROVISIONS Standards for Compromise of Claims § 1.931 Bases for compromise. (a) VA may compromise a debt if...

38 CFR 1.931 - Bases for compromise.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Bases for compromise. 1.931 Section 1.931 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS GENERAL PROVISIONS Standards for Compromise of Claims § 1.931 Bases for compromise. (a) VA may compromise a debt if...

38 CFR 1.931 - Bases for compromise.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Bases for compromise. 1.931 Section 1.931 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS GENERAL PROVISIONS Standards for Compromise of Claims § 1.931 Bases for compromise. (a) VA may compromise a debt if...

10 CFR 1015.302 - Bases for compromise.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Bases for compromise. 1015.302 Section 1015.302 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) COLLECTION OF CLAIMS OWED THE UNITED STATES Standards for the Compromise of Claims § 1015.302 Bases for compromise. (a) DOE may compromise a debt if the Government cannot...

10 CFR 1015.302 - Bases for compromise.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Bases for compromise. 1015.302 Section 1015.302 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) COLLECTION OF CLAIMS OWED THE UNITED STATES Standards for the Compromise of Claims § 1015.302 Bases for compromise. (a) DOE may compromise a debt if the Government cannot...

10 CFR 1015.302 - Bases for compromise.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Bases for compromise. 1015.302 Section 1015.302 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) COLLECTION OF CLAIMS OWED THE UNITED STATES Standards for the Compromise of Claims § 1015.302 Bases for compromise. (a) DOE may compromise a debt if the Government cannot...

10 CFR 1015.302 - Bases for compromise.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Bases for compromise. 1015.302 Section 1015.302 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) COLLECTION OF CLAIMS OWED THE UNITED STATES Standards for the Compromise of Claims § 1015.302 Bases for compromise. (a) DOE may compromise a debt if the Government cannot...

Frequency and trends of contact allergy to and iatrogenic contact dermatitis caused by topical drugs over a 25-year period.

PubMed

Gilissen, Liesbeth; Goossens, An

2016-11-01

Allergic contact dermatitis is the most common adverse reaction caused by topical drugs. To study the demographic characteristics and lesion locations of patients with iatrogenic dermatitis, and to analyse contact allergy to active principles and trends in frequencies over the years. Between 1990 and 2014, 14 911 patients were patch tested with the European baseline series. Patients with a presumed iatrogenic cause were often tested with a pharmaceutical series, and, if indicated, with photo-patch tests. Most were also tested with the topical products to which they had been exposed, along with their ingredients. Eight thousand three hundred and seventy-four (56%) patients tested positively, and 2600 (17.4%, 95%CI: 16.8-18.0%) of all patients suffered from iatrogenic contact dermatitis. The most important primary sites of dermatitis were the legs, face, and hands. The most common sensitizers included topical antibiotics, antiseptics, and corticosteroids. The most frequent baseline allergens in this subgroup were budesonide, neomycin, and benzocaine, although with a decreasing trend over the years. Many other allergens from different pharmacological classes were identified. With a prevalence of 17.4% of consecutive patients, iatrogenic contact dermatitis is a frequent diagnosis in patients attending a general patch test clinic, involving one-third of the patients with at least one positive reaction. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Outcomes of Iatrogenic Genitourinary Injuries During Colorectal Surgery.

PubMed

Eswara, Jairam R; Raup, Valary T; Potretzke, Aaron M; Hunt, Steven R; Brandes, Steven B

2015-12-01

To describe, categorize, and determine the outcomes of repairs of genitourinary (GU) injuries that occur during colorectal surgery. Presently, little is known regarding these injuries or the long-term outcomes of their repair. We performed a retrospective review of patients undergoing colorectal surgery between 2003 and 2013 who experienced iatrogenic GU injuries requiring surgical repair. GU repair failures were defined as development of urine leak, urinary fistula, or anastomotic stricture requiring secondary GU intervention. Possible risk factors associated with repair failures were examined and included age, American Society of Anesthesiology score, comorbidities, type of colorectal surgery, radiation, and chemotherapy. Of 42,570 colorectal surgeries performed, 75 GU injuries were identified (0.18%). Mean age was 57.5 years (range, 22-91), and median follow-up was 19.5 months (range, 1-128). Fifty-nine (59/75, 79%) patients required a single GU repair whereas 16 of 75 (21%) patients experienced repair failure requiring additional GU intervention. The most common GU injuries were cystotomy (26/75, 35%), incomplete ureteral transection (22/75, 29%), complete proximal and distal ureteral injuries (13/75, 17%; 11/75, 15%), urethral injury (2/75, 3%), and injury to a pre-existing ileal conduit (1/75, 1). Twenty-seven patients (36%) had prior radiation and 35 patients (47%) had prior chemotherapy. Preoperative radiation and chemotherapy were both associated with failure of the GU repair (P = .003; P = .013). Delayed repair of the GU injury was also associated with repair failure (P = .001). Iatrogenic GU injuries during colorectal surgery are rare, affecting only 0.18% of colorectal procedures. Preoperative external beam radiation therapy/chemotherapy and delayed GU repair are associated with worse outcomes of repairs of these injuries. Copyright © 2015 Elsevier Inc. All rights reserved.

Oesophageal stent placement to treat a massive iatrogenic duodenal defect after laparoscopic cholecystectomy.

PubMed

Greenbaum, Alissa; Parasher, Gulshan; Demarest, Gerald; Auyang, Edward

2017-05-05

Iatrogenic duodenal injury occurring during laparoscopic cholecystectomy (LC) is managed surgically, though rarely a large, persistent fistula is refractory to surgical interventions. We present the case of a 40-year-old woman transferred to our centre following elective LC for a reported perforated duodenal ulcer. An uncontained leak was found to originate from a 1.5 cm duodenal defect, with no evidence of ulceration. A duodenostomy tube was placed. One month after abdominal closure, the patient continued to have a persistent, large duodenal fistula. A through-the-scope covered oesophageal stent was placed under endoscopic and fluoroscopic guidance. Five weeks later, it was successfully retrieved and no subsequent extravasation of contrast from the duodenum was noted. Unrecognised iatrogenic duodenal injuries sustained during LC can be catastrophic. In cases of massive duodenal defects and high-output biliary fistula uncontrolled after surgical intervention, endoscopic-guided and fluoroscopic-guided placement of a fully covered oesophageal stent may be lifesaving. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Position paper on digital communication in dentistry.

PubMed

Chambers, David W

2012-01-01

Digital communication offers advantages and challenges to dental practice. As dentistry becomes comfortable with this technology, it is essential that commercial and other values not be accepted on a par with professional ones and that the traditional dentist-patient relationship not be compromised by inserting third parties that introduce nonprofessional standards. The Officers and Regents of the American College of Dentist have prepared this background and position paper as a guide to the ethical use of digital communication in dental practice.

Association of iatrogenic hypothyroidism with azotemia and reduced survival time in cats treated for hyperthyroidism.

PubMed

Williams, T L; Elliott, J; Syme, H M

2010-01-01

Iatrogenic hypothyroidism can occur after treatment of hyperthyroidism, and is correlated with a reduced glomerular filtration rate in humans and dogs. Cats with iatrogenic hypothyroidism after treatment for hyperthyroidism will have a greater incidence of azotemia than euthyroid cats. Eighty client owned cats with hyperthyroidism. Two retrospective studies. (1) Longitudinal study of 12 hyperthyroid cats treated with radioiodine (documented as euthyroid after treatment), to assess changes in plasma thyroid stimulating hormone (TSH) concentration over a 6-month follow-up period, (2) Cross-sectional study of 75 hyperthyroid cats (documented as euthyroid) 6 months after commencement of treatment for hyperthyroidism to identify the relationship between thyroid status and the development of azotemia. Kaplan-Meier survival analysis was performed to identify relationships between thyroid and renal status and survival. Plasma TSH concentrations were not suppressed in 7 of 8 cats with hypothyroidism 3 months after radioiodine treatment. The proportion of cats with azotemia was significantly (P= .028) greater in the hypothyroid (16 of 28) than the euthyroid group (14 of 47). Twenty-eight of 41 cats (68%) with plasma TT4 concentration below the laboratory reference range had an increased plasma TSH concentration. Hypothyroid cats that developed azotemia within the follow-up period had significantly (P= .018) shorter survival times (median survival time 456 days, range 231-1589 days) than those that remained nonazotemic (median survival time 905 days, range 316-1869 days). Iatrogenic hypothyroidism appears to contribute to the development of azotemia after treatment of hyperthyroidism, and reduced survival time in azotemic cats. Copyright © 2010 by the American College of Veterinary Internal Medicine.

Diagnosis and outcome of a dog with iatrogenic hyperadrenocorticism and secondary pulmonary mineralization.

PubMed

Blois, Shauna L; Caron, Isabelle; Mitchell, Colleen

2009-04-01

A 6-year-old, spayed female dog was evaluated for a history of chronic coughing, excessive panting, and lethargy. Iatrogenic hyperadrenocorticism was diagnosed, and pulmonary mineralization was documented with a 99m Technitium-methylene diphosphonate (99mTc-MDP) scan. Blood gas analysis showed hypoxia. Clinical signs resolved and blood gas values returned to normal when corticosteroid therapy was discontinued.

Diagnosis and outcome of a dog with iatrogenic hyperadrenocorticism and secondary pulmonary mineralization

PubMed Central

Blois, Shauna L.; Caron, Isabelle; Mitchell, Colleen

2009-01-01

A 6-year-old, spayed female dog was evaluated for a history of chronic coughing, excessive panting, and lethargy. Iatrogenic hyperadrenocorticism was diagnosed, and pulmonary mineralization was documented with a 99mTechnitium-methylene diphosphonate (99mTc-MDP) scan. Blood gas analysis showed hypoxia. Clinical signs resolved and blood gas values returned to normal when corticosteroid therapy was discontinued. PMID:19436448

45 CFR 79.46 - Compromise or settlement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Compromise or settlement. 79.46 Section 79.46 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES § 79.46 Compromise or settlement. (a) Parties may make offers of compromise or settlement at any...

6 CFR 13.46 - Compromise or settlement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Compromise or settlement. 13.46 Section 13.46 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.46 Compromise or settlement. (a) Parties may Make offers of compromise or settlement at any time...

31 CFR 902.2 - Bases for compromise.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Bases for compromise. 902.2 Section 902.2 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL CLAIMS... CLAIMS § 902.2 Bases for compromise. (a) Agencies may compromise a debt if the Government cannot collect...

31 CFR 902.2 - Bases for compromise.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Bases for compromise. 902.2 Section 902.2 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL CLAIMS... CLAIMS § 902.2 Bases for compromise. (a) Agencies may compromise a debt if the Government cannot collect...

31 CFR 902.2 - Bases for compromise.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Bases for compromise. 902.2 Section 902.2 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL CLAIMS... CLAIMS § 902.2 Bases for compromise. (a) Agencies may compromise a debt if the Government cannot collect...

31 CFR 902.2 - Bases for compromise.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Bases for compromise. 902.2 Section 902.2 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL CLAIMS... CLAIMS § 902.2 Bases for compromise. (a) Agencies may compromise a debt if the Government cannot collect...

24 CFR 17.73 - Standards for compromise of claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Standards for compromise of claims... General Provisions § 17.73 Standards for compromise of claims. (a) Compromise offer. An offer to...) Documentary evidence of compromise. No compromise of a claim shall be final or binding on the Department...

Clinical Application of Six Current Classification Systems for Iatrogenic Bile Duct Injuries after Cholecystectomy.

PubMed

Velidedeoglu, Mehmet; Arikan, Akif Enes; Uludag, Sezgin Server; Olgun, Deniz Cebi; Kilic, Fahrettin; Kapan, Metin

2015-05-01

Due to being a severe complication, iatrogenic bile duct injury is still a challenging issue for surgeons in gallbladder surgery. However, a commonly accepted classification describing the type of injury has not been available yet. This study aims to evaluate ability of six current classification systems to discriminate bile duct injury patterns. Twelve patients, who were referred to our clinic because of iatrogenic bile duct injury after laparoscopic cholecystectomy were reviewed retrospectively. We described type of injury for each patient according to current six different classifications. 9 patients underwent definitive biliary reconstruction. Bismuth, Strasberg-Bismuth, Stewart-Way and Neuhaus classifications do not consider vascular involvement, Siewert system does, but only for the tangential lesions without structural loss of duct and lesion with a structural defect of hepatic or common bile duct. Siewert, Neuhaus and Stewart-Way systems do not discriminate between lesions at or above bifurcation of the hepatic duct. The Hannover classification may resolve the missing aspects of other systems by describing additional vascular involvement and location of the lesion at or above bifurcation.

Epidemic History and Iatrogenic Transmission of Blood-borne Viruses in Mid-20th Century Kinshasa.

PubMed

Hogan, Catherine A; Iles, James; Frost, Eric H; Giroux, Geneviève; Cassar, Olivier; Gessain, Antoine; Dion, Marie-Josée; Ilunga, Vicky; Rambaut, Andrew; Yengo-Ki-Ngimbi, André-Édouard; Behets, Frieda; Pybus, Oliver G; Pépin, Jacques

2016-08-01

The human immunodeficiency virus type 1 (HIV-1) pandemic was ignited in Léopoldville (now known as Kinshasa), in the former Belgian Congo. Factors that jump-started its early expansion remain unclear. Nonlethal hepatitis C virus (HCV) and human T-cell lymphotropic virus (HTLV-1) can be used to investigate past iatrogenic transmission. We undertook a cross-sectional study of elderly inhabitants of Kinshasa, with serological assays, amplification, and sequencing. Risk factors were assessed through logistic regression. Phylogenetic methods reconstructed the genetic history of HCV. A total of 217 of 839 participants (25.9%) were HCV seropositive; 26 (3.1%) were HTLV-1-seropositive. Amplification products were obtained from 118 HCV-seropositive participants; subtypes 4k (in 47 participants) and 4r (in 38) were most common. Independent risk factors for HCV subtype 4r seropositivity were intramuscular tuberculosis therapy, intravenous injections at hospital A, intravenous injections before 1960, and injections at a colonial-era venereology clinic. Intravenous injections at hospital B and antimalarials were associated with HCV subtype 4k seropositivity. Risk factors for HTLV-1 seropositivity included intravenous injections at hospitals C or D and transfusions. Evolutionary analysis of viral sequences revealed independent exponential amplification of HCV subtypes 4r and 4k from the 1950s onward. Iatrogenic transmission of HCV and HTLV-1 occurred in mid-20th century Kinshasa, at the same time and place HIV-1 emerged. Iatrogenic routes may have contributed to the early establishment of the pandemic. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Peripheral Venous Waveform Analysis for Detecting Hemorrhage and Iatrogenic Volume Overload in a Porcine Model.

PubMed

Hocking, Kyle M; Sileshi, Ban; Baudenbacher, Franz J; Boyer, Richard B; Kohorst, Kelly L; Brophy, Colleen M; Eagle, Susan S

2016-10-01

Unrecognized hemorrhage and unguided resuscitation is associated with increased perioperative morbidity and mortality. The authors investigated peripheral venous waveform analysis (PIVA) as a method for quantitating hemorrhage as well as iatrogenic fluid overload during resuscitation. The authors conducted a prospective study on Yorkshire Pigs (n = 8) undergoing hemorrhage, autologous blood return, and administration of balanced crystalloid solution beyond euvolemia. Intra-arterial blood pressure, electrocardiogram, and pulse oximetry were applied to each subject. Peripheral venous pressure was measured continuously through an upper extremity standard peripheral IV catheter and analyzed with LabChart. The primary outcome was comparison of change in the first fundamental frequency (f1) of PIVA with standard and invasive monitoring and shock index (SI). Hemorrhage, return to euvolemia, and iatrogenic fluid overload resulted in significantly non-zero slopes of f1 amplitude. There were no significant differences in heart rate or mean arterial pressure, and a late change in SI. For the detection of hypovolemia the PIVA f1 amplitude change generated an receiver operator curves (ROC) curve with an area under the curve (AUC) of 0.93; heart rate AUC = 0.61; mean arterial pressure AUC = 0.48, and SI AUC = 0.72. For hypervolemia the f1 amplitude generated an ROC curve with an AUC of 0.85, heart rate AUC = 0.62, mean arterial pressure AUC = 0.63, and SI AUC = 0.65. In this study, PIVA demonstrated a greater sensitivity for detecting acute hemorrhage, return to euvolemia, and iatrogenic fluid overload compared with standard monitoring and SI. PIVA may provide a low-cost, minimally invasive monitoring solution for monitoring and resuscitating patients with perioperative hemorrhage.

Clinical outcome of single plastic stent treatment of benign iatrogenic biliary strictures: is the outcome predetermined?

PubMed

Rajab, Murad A; Go, Jorge; Silverman, William B

2014-12-01

Endoscopic retrograde cholangiopancreatography (ERCP) is used for the management of benign iatrogenic biliary strictures after cholecystectomy and liver transplantation. Multiple stents can injure biliary circulation. If resolution of reversible ductal edema and/or ischemia is the mechanism for successful therapy then single stent placement for benign biliary stricture should work. Retrospectively reviewed ERCP records between November 1999 and 2012 provided 25 patients with repeat ERCPs performed at 10-week intervals or if symptoms of stent occlusion were present. If strictures did not improve between stent changes and if removal was not an option, hepaticojejunostomy was used. Strictures resolved in 72% of patients. Seven patients underwent hepaticojejunostomy. Three had ERCP-related complications. No stricture recurrence occurred during the follow-up period. Endoscopic single plastic stent treatment of benign biliary iatrogenic strictures has comparable success to multiple stenting. Many postsurgical strictures may have reversible ischemic/edematous component with stenting to maintain bile drainage.

Career Compromises: Framings and Their Implications.

ERIC Educational Resources Information Center

Gati, Itamar; Houminer, Daphna; Aviram, Tamar

1998-01-01

Career compromise was investigated in three framings (alternatives, aspect importance, within-aspect preference). Young adults and school counselors rated hypothetical stories. Results of four studies with different designs (Average N=106) supported the hypothesis. The alternatives framing was associated with greater compromise and decision…

Malignancy Associated Iatrogenic Iliopsoas Abscess -Venous Access Complication From Ablation Procedure.

PubMed

Iskandar, Sandia; Atoui, Moustapha; Rizwan Afzal, Muhammad; Lavu, Madhav; Reddy, Madhu; Lakkireddy, Dhanunjaya

2016-01-01

Iliopsoas abscess is a rare condition with a high rate of mortality and morbidity if left untreated. It can occur from hematogenous or lymphatic spread from distant structures or as a result of contiguous spread from adjacent structures. The disease typically occurs in patients with immunocompromised status and the symptoms can be non-specific.1,2 Generally, infectious complications from venous access during atrial fibrillation (AF) procedure are uncommon, and an iatrogenic iliopsoas abscess from percutaneous cardiac procedures has never been reported. We present the first case of iliopsoas abscess from an ablation procedure.

26 CFR 301.7122-1 - Compromises.

Code of Federal Regulations, 2013 CFR

2013-04-01

... when they provide for payment of compromised amounts in one or more equal or unequal installments. (4... achieved, collection of the full liability would cause the taxpayer economic hardship within the meaning of... policy or equity considerations identified by the taxpayer provide a sufficient basis for compromising...

26 CFR 301.7122-1 - Compromises.

Code of Federal Regulations, 2012 CFR

2012-04-01

... when they provide for payment of compromised amounts in one or more equal or unequal installments. (4... achieved, collection of the full liability would cause the taxpayer economic hardship within the meaning of... policy or equity considerations identified by the taxpayer provide a sufficient basis for compromising...

The effect of concomitant vascular disruption in patients with iatrogenic biliary injuries.

PubMed

Bilge, Orhan; Bozkiran, Süheyla; Ozden, Ilgin; Tekant, Yaman; Acarli, Koray; Alper, Aydin; Emre, Ali; Arioğul, Orhan

2003-09-01

To evaluate treatment results in iatrogenic biliary injuries with concomitant vascular injuries. Between January 1998 and May 2002 (inclusive), angiography was performed in 45 of the 105 patients treated for iatrogenic biliary tract injury. The charts of these 45 patients and 5 other patients in whom vascular injury was diagnosed at operation were evaluated retrospectively. Twenty-nine patients had concomitant vascular injury, the biliovascular injury group (BVI), and the remaining 21 patients had isolated biliary tract injury (IBTI). The most frequent initial operation was a cholecystectomy. The frequency of high-level (Bismuth III or IV) strictures was 90% in the BVI group and 62% in the IBTI group ( P<0.05). Perioperative mortality was 7% in the BVI group and 5% in the IBTI group ( P>0.05). The morbidity in the BVI group was significantly higher ( P<0.05). Two patients in each group were lost to follow up. During a median (range) follow up of 31 months (5-51 months), a successful functional outcome was achieved in 96% of the BVI group and 100% of the IBTI group with a multimodal approach ( P>0.05). The frequency of high-level biliary injury and morbidity were significantly higher in the BVI group. However, concomitant vascular injury had no significant effect on mortality and medium-term outcome of biliary reconstruction. Thus, routine preoperative angiography is not recommended.

Treatment of late identified iatrogenic injuries of the right and left hepatic duct after laparoscopic cholecystectomy without transhepatic stent and Witzel drainage: Case report.

PubMed

Rifatbegovic, Zijah; Kovacevic, Maja; Nikic, Branka

2018-05-26

Most of the case reports about high type iatrogenic hepatic duct injuries reports how to treat and make Roux-en-Y hepaticojejunostomy below the junction of the liver immediately after this condition is recognised during surgical procedure when the injury was made. Hereby we present a case where we made Roux-en-Y hepaticojejunostomy without transhepatic billiary stent and also without Witzel drainage one month after the iatrogenic injury. A 21-year-old woman suffered from iatrogenic high transectional lesion of both hepatic ducts during laparoscopic cholecystectomy in a local hospital. Iatrogenic injury was not immediately recognized. Ten days later due to patient complaints and large amount of bile in abdominal drain sac, second surgery was performed to evacuate biloma. Symptoms reappeared again, together with bile in abdominal sac, and then patient was sent to our Clinical Center. After performing additional diagnostics, high type (Class E) of iatrogenic hepatic duct injury was diagnosed. A revision surgical procedure was performed. During the exploration we found high transection lesion of right and left hepatic duct, and we decided to do Roux-en-Y hepaticojejunostomy. We created a part of anastomosis between the jejunum and liver capsule with polydioxanone suture (PDS) 4-0 because of poor quality of the remaining parts of the hepatic ducts. We made two separate hepaticojejunal anastomoses (left and right) that we partly connected to the liver capsule, where we had a defect of hepatic ducts, without Witzel enterostomy and transhepatic biliary stent. There were no significant postoperative complications. Magnetic resonance cholangiopancreatography (MRCP) was made one year after the surgical procedure, which showed the proper width of the intrahepatic bile ducts, with no signs of stenosis of anastomoses. In most cases, treatment iatrogenic BDI is based on primary repair of the duct, ductal repair with a stent or creating duct-enteric anastomosis, often used and

Iatrogenic deep musculocutaneous radiation injury following percutaneous coronary intervention.

PubMed

Monaco, JoAn L; Bowen, Kanika; Tadros, Peter N; Witt, Peter D

2003-08-01

Radiation-induced skin injury has been reported for multiple fluoroscopic procedures. Previous studies have indicated that prolonged fluoroscopic exposure during even a single percutaneous coronary intervention (PCI) may lead to cutaneous radiation injury. We document a novel case of deep muscle damage requiring wide local debridement and muscle flap reconstruction in a 59-year-old man with a large radiation-induced wound to the lower thoracic region following 1 prolonged PCI procedure. The deep muscular iatrogenic injury described in this report may be the source of significant morbidity. Recommendations to reduce radiation-induced damage include careful examination of the skin site before each procedure, minimized fluoroscopy time, utilization of pulse fluoroscopy, employment of radiation filters, and collimator s and rotation of the location of the image intensifier.

49 CFR 1503.425 - Compromise orders.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Assessment of Civil Penalties by TSA § 1503.425 Compromise orders. (a) Issuance. At any time before the... Violation, may agree to dispose of the case by the issuance of a compromise order by TSA. (b) Contents. A... that the person agrees to pay the civil penalty specified. (4) A statement that TSA makes no finding of...

Strategies for prevention of iatrogenic inferior vena cava filter entrapment and dislodgement during central venous catheter placement.

PubMed

Wu, Alex; Helo, Naseem; Moon, Eunice; Tam, Matthew; Kapoor, Baljendra; Wang, Weiping

2014-01-01

Iatrogenic migration of inferior vena cava (IVC) filters is a potentially life-threatening complication that can arise during blind insertion of central venous catheters when the guide wire becomes entangled with the filter. In this study, we reviewed the occurrence of iatrogenic migration of IVC filters in the literature and assessed methods for preventing this complication. A literature search was conducted to identify reports of filter/wire entrapment and subsequent IVC filter migration. Clinical outcomes and complications were identified. A total of 38 cases of filter/wire entrapment were identified. All of these cases involved J-tip guide wires. Filters included 23 Greenfield filters, 14 VenaTech filters, and one TrapEase filter. In 18 cases of filter/wire entrapment, there was migration of the filter to the heart and other central venous structures. Retrieval of the migrated filter was successful in only four of the 18 cases, and all of these cases were complicated by strut fracture and distant embolization of fragments. One patient required resuscitation during retrieval. Successful disengagement was possible in 20 cases without filter migration. Iatrogenic migration of an IVC filter is an uncommon complication related to wire/filter entrapment. This complication can be prevented with knowledge of the patient's history, use of proper techniques when placing a central venous catheter, identification of wire entrapment at an early stage, and use of an appropriate technique to disengage an entrapped wire. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

49 CFR 89.13 - Documentary evidence of compromise.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 1 2012-10-01 2012-10-01 false Documentary evidence of compromise. 89.13 Section 89.13 Transportation Office of the Secretary of Transportation IMPLEMENTATION OF THE FEDERAL CLAIMS COLLECTION ACT General § 89.13 Documentary evidence of compromise. A compromise of any claim is not final or binding on the United States unless it i...

49 CFR 89.13 - Documentary evidence of compromise.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 1 2013-10-01 2013-10-01 false Documentary evidence of compromise. 89.13 Section 89.13 Transportation Office of the Secretary of Transportation IMPLEMENTATION OF THE FEDERAL CLAIMS COLLECTION ACT General § 89.13 Documentary evidence of compromise. A compromise of any claim is not final or binding on the United States unless it i...

49 CFR 89.13 - Documentary evidence of compromise.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Documentary evidence of compromise. 89.13 Section 89.13 Transportation Office of the Secretary of Transportation IMPLEMENTATION OF THE FEDERAL CLAIMS COLLECTION ACT General § 89.13 Documentary evidence of compromise. A compromise of any claim is not final or binding on the United States unless it i...

49 CFR 89.13 - Documentary evidence of compromise.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Documentary evidence of compromise. 89.13 Section 89.13 Transportation Office of the Secretary of Transportation IMPLEMENTATION OF THE FEDERAL CLAIMS COLLECTION ACT General § 89.13 Documentary evidence of compromise. A compromise of any claim is not final or binding on the United States unless it i...

49 CFR 89.13 - Documentary evidence of compromise.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false Documentary evidence of compromise. 89.13 Section 89.13 Transportation Office of the Secretary of Transportation IMPLEMENTATION OF THE FEDERAL CLAIMS COLLECTION ACT General § 89.13 Documentary evidence of compromise. A compromise of any claim is not final or binding on the United States unless it i...

It's agony for us as well: Neonatal nurses reflect on iatrogenic pain.

PubMed

Green, Janet; Darbyshire, Philip; Adams, Anne; Jackson, Debra

2016-03-01

Improved techniques and life sustaining technology in the neonatal intensive care unit have resulted in an increased probability of survival for extremely premature babies. The by-product of the aggressive treatment is iatrogenic pain, and this infliction of pain can be a cause of suffering and distress for both baby and nurse. The research sought to explore the caregiving dilemmas of neonatal nurses when caring for extremely premature babies. This article aims to explore the issues arising for neonatal nurses when they inflict iatrogenic pain on the most vulnerable of human beings - babies ≤24 weeks gestation. Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical processes and procedures set out by the ethics committee have been adhered to by the researchers. A qualitative approach was used to analyse the data. The theme 'inflicting pain' comprised three sub-themes: 'when caring and torture are the same thing', 'why are we doing this!' and 'comfort for baby and nurse'. The results show that the neonatal nurses were passionate about the need for appropriate pain relief for extremely premature babies. The neonatal nurses experienced a profound sense of distress manifested as existential suffering when they inflicted pain on extremely premature babies. Inflicting pain rather than relieving it can leave the nurses questioning their role as compassionate healthcare professionals. © The Author(s) 2014.

Iatrogenic vertebral artery pseudoaneurysm due to central venous catheterization

PubMed Central

Vasquez, Jay

2011-01-01

Central venous lines have become an integral part of patient care, but they are not without complications. Vertebral artery pseudoaneurysm formation is one of the rarer complications of central line placement. Presented is a rare case of two pseudoaneurysms of the vertebral and subclavian artery after an attempted internal jugular vein catheterization. These were successfully treated with open surgical repair and bypass. Open surgical repair remains the gold standard of treatment. Endovascular repair of vertebral artery pseudoaneurysms has been described with promising outcomes, but long-term results are lacking. Ultimately, the best treatment of these iatrogenic injuries should start with prevention. Well-documented techniques to minimize mechanical complications, including inadvertent arterial puncture, should be practiced and taught in training programs to avoid the potentially devastating consequences. PMID:21566753

Nagging, Noobs and New Tricks--Students' Perceptions of School as a Context for Digital Technology Use

ERIC Educational Resources Information Center

Bulfin, Scott; Johnson, Nicola; Nemorin, Selena; Selwyn, Neil

2016-01-01

While digital technology is an integral feature of contemporary education, schools are often presumed to constrain and compromise students' uses of technology. This paper investigates students' experiences of school as a context for digital technology use. Drawing upon survey data from three Australian secondary schools (n = 1174), this paper…

Iatrogenic effects of psychosocial interventions: treatment, life context, and personal risk factors.

PubMed

Moos, Rudolf H

2012-01-01

Between 7% and 15% of individuals who participate in psychosocial interventions for substance use disorders may be worse off after treatment than before. Intervention-related predictors of iatrogenic effects include lack of bonding; lack of goal direction and monitoring; confrontation, criticism, and high emotional arousal; models and norms for substance use; and stigma and inaccurate expectations. Life context and personal predictors include lack of support, criticism, and more severe substance use and psychological problems. Ongoing monitoring and safety standards are needed to identify and counteract adverse consequences of intervention programs.

Minor head injury: pathophysiological or iatrogenic sequelae?

PubMed Central

Newcombe, F; Rabbitt, P; Briggs, M

1994-01-01

This study addresses the possibility that cognitive sequelae--albeit of a transient or minor character--can be associated with mild head injury. Twenty men (aged 16-30 years of age), whose post-traumatic amnesia did not exceed eight hours, were examined within 48 hours of their accident and again one month later. This unselected sample had no previous history of head injury. A control group of 20 men of similar socioeconomic background, was selected from medical wards (where they had been admitted for orthopaedic treatment or a minor operation). They were also retested one month after the first examination. Neuropsychological tests were selected to measure abilities often compromised after significant head injury, namely memory and attention. The experimental component consisted of the fractionation of a complex skill (paced addition) to probe for deficits at different stages of information processing: perception and input into storage; search for and retrieval of information from working memory; and paced and unpaced addition. In general, no significant difference was found between the experimental and control groups, with the possible exception of an initial decrement on two working memory tasks: probe digits and a keeping track task (where the subject has to keep in mind and update a number of variables at the same time). The keeping track paradigm, ostensibly of ecological relevance, may well be worth further exploration in memory research, and in studies of more severely head-injured patients. It is further suggested that the appropriate management and counselling of mildly head-injured patients may help to avert symptoms that are of psychological rather than pathophysiological origin. PMID:8006652

Reconstruction/Repair of Iatrogenic Biliary Injuries: Is the Robot Offering a New Option? Short Clinical Report.

PubMed

Giulianotti, Pier Cristoforo; Quadri, Pablo; Durgam, Samarth; Bianco, Francesco Maria

2018-01-01

The aim of this study is to analyze perioperative outcomes of robotic reconstruction of iatrogenic biliary injuries and describe the surgical technique in detail. Iatrogenic bile duct injuries (BDIs) continue to be a major concern in open and laparoscopic cholecystectomy. In the past decade, robotic surgery has been applied to many different procedures showing technical advantages, especially in microsurgical fields. Few cases of robotic BDI reconstructions have been described in the literature so far. This is the first clinical series of consecutive patients undergoing robotic BDI reconstructions. This study is a single-surgeon retrospective review of a prospectively maintained database including 14 patients who underwent robot-assisted biliary reconstruction due to iatrogenic BDIs. In all, 14 patients underwent robot-assisted BDI reconstructions. The mean operative time, blood loss, and length of hospitalization were 280.6 min (SD = 132.0), 135.0 mL (SD = 169.7), and 8.4 days (SD = 6.7), respectively. The conversion rate to open surgery was 0%. Long-term follow-up was available in 85.7% (12 out of 14 patients) with a mean follow-up of 36.1 months (SD = 28.1). The >30-day complication rate was 14.3% (n = 2). These 2 patients presented with recurrent episodes of cholangitis due to hepatico-jejunostomy mild stenosis, which were successfully treated with transhepatic percutaneous biliary drainage and multiple dilatations. Robot-assisted BDI reconstruction is feasible, safe, and may represent an interesting option in expert hands. It maintains all the benefits of minimally invasive surgery and seems to have technical advantages in fine dissection and microsuturing in the liver hilum (magnified microsuturing). In this series, 14 patients with major BDIs were repaired with the robotic approach, with conversion and reoperation rates of 0%. Long-term outcome evaluation requires a longer follow up and larger series, but the initial results are promising.

Protecting privacy of shared epidemiologic data without compromising analysis potential.

PubMed

Cologne, John; Grant, Eric J; Nakashima, Eiji; Chen, Yun; Funamoto, Sachiyo; Katayama, Hiroaki

2012-01-01

Ensuring privacy of research subjects when epidemiologic data are shared with outside collaborators involves masking (modifying) the data, but overmasking can compromise utility (analysis potential). Methods of statistical disclosure control for protecting privacy may be impractical for individual researchers involved in small-scale collaborations. We investigated a simple approach based on measures of disclosure risk and analytical utility that are straightforward for epidemiologic researchers to derive. The method is illustrated using data from the Japanese Atomic-bomb Survivor population. Masking by modest rounding did not adequately enhance security but rounding to remove several digits of relative accuracy effectively reduced the risk of identification without substantially reducing utility. Grouping or adding random noise led to noticeable bias. When sharing epidemiologic data, it is recommended that masking be performed using rounding. Specific treatment should be determined separately in individual situations after consideration of the disclosure risks and analysis needs.

Metachronous adrenal metastasis from operated contralateral renal cell carcinoma with adrenalectomy and iatrogenic Addison's disease.

PubMed

Ozturk, Hakan; Karaaslan, Serap

2014-09-01

Metachronous adrenal metastasis from contralateral renal cell carcinoma (RCC) surgery is an extremely rare condition. Iatrogenic Addison's disease occurring after metastasectomy (adrenalectomy) is an even rarer clinical entity. We present a case of a 68-year-old male with hematuria and left flank pain 9 years prior. The patient underwent left transperitoneal radical nephrectomy involving the ipsilateral adrenal glands due to a centrally-located, 75-mm in diameter solid mass lesion in the upper pole of the left kidney. The tumour lesion was confined within the renal capsule, and the histo-pathological examination revealed a Fuhrman nuclear grade II clear cell carcinoma. The patient underwent transperitoneal right adrenalectomy. The histopathological examination revealed metastasis of clear cell carcinoma. The patient was diagnosed with iatrogenic Addison's disease based on the measurement of serum cortisol levels and the adrenocorticotropic hormone (ACTH) stimulation test, after which glucocorticoid and mineralocorticoid replacement was initiated. The patient did not have local recurrence or new metastasis in the first year of the follow-up. The decision to perform ipsilateral adrenalectomy during radical nephrectomy constitutes a challenge, and the operating surgeon must consider all these rare factors.

20 CFR 255.18 - Compromise of overpayments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Compromise of overpayments. 255.18 Section 255.18 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT... standards which the Board applies in exercising its authority under 31 U.S.C. 3711 to compromise an...

45 CFR 30.25 - Further review of compromise offers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Further review of compromise offers. 30.25 Section 30.25 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CLAIMS COLLECTION Debt Compromise § 30.25 Further review of compromise offers. If the Secretary is uncertain whether to...

Esophageal stent placement as a therapeutic option for iatrogenic esophageal perforation in children.

PubMed

Ahmad, Alsafadi; Wong Kee Song, Louis M; Absah, Imad

2016-01-01

Iatrogenic esophageal perforation (IEP) is a potentially serious adverse event of interventional endoscopy. The approach to IEP varies from surgical repair for large perforations to conservative treatment for small contained perforations. We report a case of an 18-month-old girl with congenital esophageal stenosis suffering a large esophageal perforation after a trial of stricture dilatation, which was successfully managed by the placement of fully covered stent. Hence, in selected cases, esophageal stent placement is a feasible alternative to invasive surgery in managing IEP.

"Excess gooD can be Dangerous". A case series of iatrogenic symptomatic hypercalcemia due to hypervitaminosis D.

PubMed

Pandita, Kamal Kishore; Razdan, Sushil; Kudyar, Rattan Parkash; Beigh, Aadil; Kuchay, Shafi; Banday, Tanveer

2012-05-01

Vitamin D is increasingly recognized to have several beneficial effects. Its toxicity, causing hypercalcemia, is considered as extremely rare. We report case series of 15 patients (most of them being elderly subjects) with iatrogenic symptomatic hypercalcemia in whom toxicity occurred due to empirical excessive administration of vitamin D by oral and parenteral route.

Reducing duplex examinations in patients with iatrogenic pseudoaneurysms.

PubMed

Stone, Patrick A; Aburahma, Ali F; Flaherty, Sarah K

2006-06-01

Ultrasound-guided thrombin injection has become the initial treatment of choice for femoral access-related pseudoaneurysms. Patients typically undergo serial duplex examinations to assess for spontaneous resolution of small iatrogenic pseudoaneurysms (IPSAs) (<2.5 cm), or may require repeated diagnostic, therapeutic, and follow-up studies for larger IPSAs (>2.5 cm). We evaluated the impact of a revised treatment algorithm that includes primary treatment of both small (<2.5 cm) and larger pseudoaneurysms (>2.5 cm), rather than observation of smaller ones, and attempts to establish a single duplex examination via a point-of-care treatment strategy. We reviewed 105 consecutive patients treated with ultrasound-guided thrombin injection from July 2001 through September 2004. Patient, IPSAs, characteristics, and treatment methods were examined. The number of duplex examinations per patient was evaluated over the treatment interval. Also, published cost data were used to compare primary treatment of small ISPAs vs observation with serial duplex examinations. Successful thrombosis occurred in 103 (98.1%) of 105 treated pseudoaneurysms. No minor or major complications occurred after thrombin injection in either small or large ISPAs, and both failures requiring operation were in the large aneurysm group. The recurrence rate for the series was 1.9% (2/105), and both recurrences were successfully treated with an additional thrombin injection. A single injection was successful in treating 43 (97.7%) of 44 small (<2.5 cm) IPSAs, and one required a second injection. Patients had an average of 3.3 duplex examinations in our first year of treatment experience, which declined to 1.5 by our third year with the institution of a point-of-care service model for all pseudoaneurysms. Based on this decreased use of duplex examination and an average treatment cohort of 35 IPSA patients per year our institution, we determined this results in a reduction of 35 hours of laboratory time and

Analysis of Atlanta Compromise School Desegregation Plan.

ERIC Educational Resources Information Center

Research Atlanta, Inc., GA.

On February 22, 1973, attorneys for the National Association for the Advancement of Colored People and the Atlanta Board of Education filed a compromise desegregation plan with the U.S. District Court for the Northern District of Georgia. If the Court approves, this compromise will constitute the final desegregation plan for the Atlanta Public…

[The surgical correction of iatrogenic damage to and cicatricial stricture of the extrahepatic bile ducts].

PubMed

Vecherko, V N; Konoplia, P P; Shatalov, V F; Khatsko, V V; Shatalov, A D

1993-01-01

In treatment of 86 patients with a iatrogenic injury, or cicatricial stricture of the extrahepatic bile ducts, the Prader-Smith, Saypole-Kurian transhepatic drainage of hepatico-digestive anastomosis and that with the use of the method suggested by the authors have been used. The technique for performance of the operations is described, the special instruments are offered. After the operation, only one female patient has developed a subphrenic abscess.

Ondine's Curse - Genetic and Iatrogenic Central Hypoventilation as Diagnostic Options in Forensic Medicine.

PubMed

Susło, Robert; Trnka, Jakub; Siewiera, Jacek; Drobnik, Jarosław

2015-01-01

In the Nordic mythology a man lost his ability to breathe without remembering it after he was cursed by water nymph - referred to as 'Ondine's curse' - and then he died as soon as he fell asleep. Family medicine specialists are familiar with many sleeping disorders that their patients commonly call by the term Ondine's Curse. In medical sciences this term is historically related to the group of conditions that have as the common denominator seemingly spontaneous onset of life-threatening hypoventilation. The physiology and genetics specialists focus mainly on congenital central hypoventilation syndrome (CCHS), which was proven to be linked to several genetic mutations. Anesthesiologists tend to be more interested in similarly manifesting iatrogenic condition. Typically, patients that were previously subjected to general anesthesia, after temporarily waking up and regaining the spontaneous respiratory drive, later fall back into unconsciousness and develop hypoventilation. Anesthesiologists also call it Ondine's curse because of the sudden and unexpected sleep onset. The iatrogenic Ondine's curse is proven to be precipitated by delayed anesthetics release from patients' fat tissue - where it was deposited at the time general anesthesia was administered - back into bloodstream. Forensic medicine has to consider the latter form of Ondine's curse called scenario more often, as they investigate sudden deaths related to surgery and general anesthesia in the post-operational care period. These cases may also fall into the category of medical malpractice-related deaths.

Protecting Privacy of Shared Epidemiologic Data without Compromising Analysis Potential

DOE PAGES

Cologne, John; Grant, Eric J.; Nakashima, Eiji; ...

2012-01-01

Objective . Ensuring privacy of research subjects when epidemiologic data are shared with outside collaborators involves masking (modifying) the data, but overmasking can compromise utility (analysis potential). Methods of statistical disclosure control for protecting privacy may be impractical for individual researchers involved in small-scale collaborations. Methods . We investigated a simple approach based on measures of disclosure risk and analytical utility that are straightforward for epidemiologic researchers to derive. The method is illustrated using data from the Japanese Atomic-bomb Survivor population. Results . Masking by modest rounding did not adequately enhance security but rounding to remove several digits of relativemore » accuracy effectively reduced the risk of identification without substantially reducing utility. Grouping or adding random noise led to noticeable bias. Conclusions . When sharing epidemiologic data, it is recommended that masking be performed using rounding. Specific treatment should be determined separately in individual situations after consideration of the disclosure risks and analysis needs.« less

Protecting Privacy of Shared Epidemiologic Data without Compromising Analysis Potential

PubMed Central

Cologne, John; Grant, Eric J.; Nakashima, Eiji; Chen, Yun; Funamoto, Sachiyo; Katayama, Hiroaki

2012-01-01

Objective. Ensuring privacy of research subjects when epidemiologic data are shared with outside collaborators involves masking (modifying) the data, but overmasking can compromise utility (analysis potential). Methods of statistical disclosure control for protecting privacy may be impractical for individual researchers involved in small-scale collaborations. Methods. We investigated a simple approach based on measures of disclosure risk and analytical utility that are straightforward for epidemiologic researchers to derive. The method is illustrated using data from the Japanese Atomic-bomb Survivor population. Results. Masking by modest rounding did not adequately enhance security but rounding to remove several digits of relative accuracy effectively reduced the risk of identification without substantially reducing utility. Grouping or adding random noise led to noticeable bias. Conclusions. When sharing epidemiologic data, it is recommended that masking be performed using rounding. Specific treatment should be determined separately in individual situations after consideration of the disclosure risks and analysis needs. PMID:22505949

Gradual digital lengthening with autologous bone graft and external fixation for correction of flail toe in a patient with Raynaud's disease.

PubMed

Lamm, Bradley M; Ades, Joe K

2009-01-01

Iatrogenic flail toe is a complication of hammertoe surgery that occurs when an overaggressive resection of the proximal phalanx occurs. This can cause both functional and cosmetic concerns for the patient. We present a case report of the correction of a flail second toe in a patient with Raynaud's disease. The correction was achieved by means of gradual soft tissue lengthening with external fixation and an interposition autologous bone graft digital arthrodesis. After 5 months, this 2-stage procedure lengthened, stabilized, and restored the function of the toe. 4.

Role of over the scope clips in the management of iatrogenic gastrointestinal perforations.

PubMed

Changela, Kinesh; Virk, Muhhamad A; Patel, Niravkumar; Duddempudi, Sushil; Krishnaiah, Mahesh; Anand, Sury

2014-08-28

Advances in endoscopic and surgical techniques have increased the frequency and complexity of these procedures and associated complications such as gastrointestinal perforation. With the advancements in the field of gastroenterology, the promising use of an over the scope clips (OTSC) has fulfilled the unmet need for a reliable endoscopic devise in approximation of gastrointestinal perforation. This novel approach has raised the level of confidence in endoscopist in dealing with this serious complication during endoscopy. Here we have shared our experience with OTSC to evaluate its efficacy and safety in managing iatrogenic gastrointestinal perforations during endoscopy.

Surgical repair of the iatrogenic falsepassage in the treatment of trauma-induced posterior urethral injuries.

PubMed

Dogan, Faruk; Sahin, Ali Feyzullah; Sarıkaya, Tevfik; Dırık, Alper

2014-03-28

Pelvic fracture associated urethral injury (PFAUI) is a rare and challenging sequel of blunt pelvic trauma. Treatment of iatrogenic false urethral passage (FUP) remains as a challenge for urologists. In this case report we reviewed the iatrogenic FUP caused by wrong procedures performed in the treatment of a patient with PFAUI and the treatment of posterior urethral stricture with transperineal bulbo-prostatic anatomic urethroplasty in the management of FUP. A 37-year-old male patient with PFAUI had undergone a laparotomy procedure for pelvic bone fracture, complete urethral rupture, and bladder perforation 8 years ago. After stricture formation, patient had undergone procedures that caused FUP. Following operations, he had a low urinary flow rate, and incontinence and urgency even with small amounts of urine. FUP was diagnosed by voiding cystourethrography and retrograde urethrography. FUP was fixed with open urethroplasty with the guidance of flexible antegrade urethtoscopy. False passage should always be taken into account in the differential diagnosis of patients with persistent symptoms that underwent PFAUI therapy. In addition, we believe that in the evaluation of patients with PFAUI suspected for having a false passage, bladder neck and urethra should be assessed by combining routine voiding cystourethrography and retrograde urethrography with preoperative flexible cystoscopy via suprapubic route.

Iatrogenic bile duct strictures: a review of 22 cases.

PubMed

Ersumo, Tessema

2003-10-01

The incidence of iatrogenic bile duct strictures in Ethiopia appears to be increasing. Of 27 patients that sustained bile duct injuries at open cholecystectomy, admitted during May 1996 to December 2002, 22 cases of bile duct strictures are presented to evaluate outcome of treatment. The mean age was 40 years, 15 females. Twenty-one were referrals. The usual presenting features were biliary peritonitis and jaundice. The average time lapse between the original surgery and admission to hospital was eight months. About 73% had Bismuth grade III-IV strictures and all patients underwent Roux-en-Y hepatico-jejunostomy. Postoperatively, biliary-cutaneous fistula, recurrent ascending cholangitis and wound infection were observed frequently. The overall mortality rate was 13.6%. Bile duct injuries and strictures occur in young productive age groups. Prevention of the occurrence of bile duct injury and its progression to a devastating stricture reduces morbidity and mortality.

Iatrogenic osteomalacia: report of two cases.

PubMed

Yamamoto, Sunao; Okada, Yosuke; Mori, Hiroko; Kurozumi, Akira; Torimoto, Keiichi; Arao, Tadashi; Tanaka, Yoshiya

2013-03-01

CASE 1: An 80-year-old man presented at our hospital with pain in both knees.He had received continuous intravenous administration of saccharated ferric oxide (SFO) over a period of five years following a diagnosis of iron-deficiency anemia.Blood tests revealed hypophosphatemia (1.4 mg/dl) and high circulating levels of fibroblast growth factor 23 (FGF23) at 248.8 mg/dl.These findings led to the diagnosis of FGF23-related osteomalacia due to SFO administration.Accordingly, the treatment plan was first to discontinue SFO, which led to a decrease in pain and normalization of phosphorus and FGF23 after 1 month.CASE 2: A 63-year-old woman presented at our hospital with leg pain.She had undergone total gastrectomy for gastric cancer at 36 years of age.Blood tests revealed hypocalcemia (8.3 mg/dl) and hypophosphatemia (2.2 mg/dl), and 25(OH)D at no more than 5 pg/ml.Bone X-rays showed significantly diminished bone shadowing.These findings led to a diagnosis of vitamin D-deficient osteomalacia due to impaired absorption following total gastrectomy.For therapy, she was treated with 1 μg/day oral alfacalcidol.Two months after initiating treatment, the pain improved. When a patient is diagnosed with unexplained pain, it is important to pay attention to the possibility of an iatrogenic etiology.

A monitor for the laboratory evaluation of control integrity in digital control systems operating in harsh electromagnetic environments

NASA Technical Reports Server (NTRS)

Belcastro, Celeste M.; Fischl, Robert; Kam, Moshe

1992-01-01

This paper presents a strategy for dynamically monitoring digital controllers in the laboratory for susceptibility to electromagnetic disturbances that compromise control integrity. The integrity of digital control systems operating in harsh electromagnetic environments can be compromised by upsets caused by induced transient electrical signals. Digital system upset is a functional error mode that involves no component damage, can occur simultaneously in all channels of a redundant control computer, and is software dependent. The motivation for this work is the need to develop tools and techniques that can be used in the laboratory to validate and/or certify critical aircraft controllers operating in electromagnetically adverse environments that result from lightning, high-intensity radiated fields (HIRF), and nuclear electromagnetic pulses (NEMP). The detection strategy presented in this paper provides dynamic monitoring of a given control computer for degraded functional integrity resulting from redundancy management errors, control calculation errors, and control correctness/effectiveness errors. In particular, this paper discusses the use of Kalman filtering, data fusion, and statistical decision theory in monitoring a given digital controller for control calculation errors.

Successful embolization of iatrogenic ruptured coronary artery using Onyx: a new technique.

PubMed

Asouhidou, I; Katsaridis, V

2014-12-01

Iatrogenic perforation of coronary artery is rare during percutaneous coronary intervention (PCI); however the complications are life-threatening. Patients in this clinical setting may be treated either by stent placement, closure of the perforation with fibrin glue or coils, or with emergency bypass surgery. Onyx, a new material that has been used successfully in cerebral arteries, represents a new and safe alternative. The advantage of Onyx is that it is easily injected through a microcatheter and it allows for a longer injection time having also the ability to reach difficult anatomical locations. We present the first case of successful embolization of a right coronary artery perforation during coronary angiography using Onyx.

45 CFR 1177.12 - Compromise, suspension and termination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE HUMANITIES CLAIMS COLLECTION § 1177.12 Compromise, suspension and termination. (a) The Chairperson of the National Endowment for the Humanities or... available to the public. (b) The Chairperson of the National Endowment for the Humanities may compromise...

45 CFR 1177.12 - Compromise, suspension and termination.

Code of Federal Regulations, 2011 CFR

2011-10-01

... THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE HUMANITIES CLAIMS COLLECTION § 1177.12 Compromise, suspension and termination. (a) The Chairperson of the National Endowment for the Humanities or... available to the public. (b) The Chairperson of the National Endowment for the Humanities may compromise...

15 CFR 904.106 - Compromise of civil penalty.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Compromise of civil penalty. 904.106...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Civil Penalties § 904.106 Compromise of civil penalty. (a) NOAA, in its sole discretion, may...

Hypothyroidism and hyponatremia: data from a series of patients with iatrogenic acute hypothyroidism undergoing radioactive iodine therapy after total thyroidectomy for thyroid cancer.

PubMed

Vannucci, L; Parenti, G; Simontacchi, G; Rastrelli, G; Giuliani, C; Ognibene, A; Peri, A

2017-01-01

The aim of the present study was to evaluate the role of hypothyroidism as a cause of hyponatremia in a clinical model of iatrogenic acute hypothyroidism due to thyroid hormone withdrawal prior to ablative radioactive iodine (RAI) therapy after total thyroidectomy. The study group consisted of 101 differentiated thyroid cancer (DTC) patients (77 women and 24 men). Plasma concentration of thyroid-stimulating hormone ([TSH]) and sodium ([Na + ]) was evaluated before total thyroidectomy (pre[TSH] and pre[Na + ]) and on the day of RAI therapy (post[TSH] and post[Na + ]). The frequency of hypothyroidism-associated hyponatremia was 4 % (4/101). Pre[Na + ] was significantly higher than post[Na + ] (140.7 ± 1.6 vs 138.7 ± 2.3 mEq/L, p = 0.012). Moreover, a linear correlation was identified between pre[Na + ] and post[Na + ]. Iatrogenic acute hypothyroidism-related hyponatremia is uncommon. However, because of the significant reduction of [Na + ] in the transition from euthyroidism to iatrogenic hypothyroidism, the value of pre[Na + ] should be viewed as a parameter to be considered. Since it acts as an independent risk factor for the development of hyponatremia, patients with a pre[Na + ] close to the lower limit of normal range may deserve a closer monitoring of [Na + ].

Iatrogenic facial nerve injuries during chronic otitis media surgery: a multicentre retrospective study.

PubMed

Linder, T; Mulazimoglu, S; El Hadi, T; Darrouzet, V; Ayache, D; Somers, T; Schmerber, S; Vincent, C; Mondain, M; Lescanne, E; Bonnard, D

2017-06-01

To give an insight into why, when and where iatrogenic facial nerve (FN) injuries may occur and to explain how to deal with them in an emergency setting. Multicentre retrospective study in eight tertiary referral hospitals over 17 years. Twenty patients with partial or total FN injury during surgery for chronic otitis media (COM) were revised. Indication and type of surgery, experience of the surgeon, intra- and postoperative findings, value of CT scanning, patient management and final FN outcome were recorded. In 12 cases, the nerve was completely transected, but the surgeon was unaware in 11 cases. A minority of cases occurred in academic teaching hospitals. Tympanic segment, second genu and proximal mastoid segments were the sites involved during injury. The FN was not deliberately identified in 18 patients at the time of injury, and nerve monitoring was only applied in one patient. Before revision surgery, CT scanning correctly identified the lesion site in 11 of 12 cases and depicted additional lesions such as damage to the lateral semicircular canal. A greater auricular nerve graft was interposed in 10 cases of total transection and in one partially lesioned nerve: seven of them resulted in an HB III functional outcome. In two of the transected nerves, rerouting and direct end-to-end anastomosis was applied. A simple FN decompression was used in four cases of superficially traumatised nerves. We suggest checklists for preoperative, intraoperative and postoperative management to prevent and treat iatrogenic FN injury during COM surgery. © 2016 John Wiley & Sons Ltd.

5 CFR 1312.30 - Loss or possible compromise.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Loss or possible compromise. 1312.30 Section 1312.30 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CLASSIFICATION... Classified Information § 1312.30 Loss or possible compromise. Any person who has knowledge of the loss or...

5 CFR 1312.30 - Loss or possible compromise.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Loss or possible compromise. 1312.30 Section 1312.30 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CLASSIFICATION... Classified Information § 1312.30 Loss or possible compromise. Any person who has knowledge of the loss or...

5 CFR 1312.30 - Loss or possible compromise.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Loss or possible compromise. 1312.30 Section 1312.30 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CLASSIFICATION... Classified Information § 1312.30 Loss or possible compromise. Any person who has knowledge of the loss or...

5 CFR 1312.30 - Loss or possible compromise.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Loss or possible compromise. 1312.30 Section 1312.30 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CLASSIFICATION... Classified Information § 1312.30 Loss or possible compromise. Any person who has knowledge of the loss or...

5 CFR 1312.30 - Loss or possible compromise.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Loss or possible compromise. 1312.30 Section 1312.30 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CLASSIFICATION... Classified Information § 1312.30 Loss or possible compromise. Any person who has knowledge of the loss or...

Compromised encoding of proprioceptively determined joint angles in older adults: the role of working memory and attentional load.

PubMed

Goble, Daniel J; Mousigian, Marianne A; Brown, Susan H

2012-01-01

Perceiving the positions and movements of one's body segments (i.e., proprioception) is critical for movement control. However, this ability declines with older age as has been demonstrated by joint angle matching paradigms in the absence of vision. The aim of the present study was to explore the extent to which reduced working memory and attentional load influence older adult proprioceptive matching performance. Older adults with relatively HIGH versus LOW working memory ability as determined by backward digit span and healthy younger adults, performed memory-based elbow position matching with and without attentional load (i.e., counting by 3 s) during target position encoding. Even without attentional load, older adults with LOW digit spans (i.e., 4 digits or less) had larger matching errors than younger adults. Further, LOW older adults made significantly greater errors when attentional loads were present during proprioceptive target encoding as compared to both younger and older adults with HIGH digit span scores (i.e., 5 digits or greater). These results extend previous position matching results that suggested greater errors in older adults were due to degraded input signals from peripheral mechanoreceptors. Specifically, the present work highlights the role cognitive factors play in the assessment of older adult proprioceptive acuity using memory-based matching paradigms. Older adults with LOW working memory appear prone to compromised proprioceptive encoding, especially when secondary cognitive tasks must be concurrently executed. This may ultimately result in poorer performance on various activities of daily living.

Role of over the scope clips in the management of iatrogenic gastrointestinal perforations

PubMed Central

Changela, Kinesh; Virk, Muhhamad A; Patel, Niravkumar; Duddempudi, Sushil; Krishnaiah, Mahesh; Anand, Sury

2014-01-01

Advances in endoscopic and surgical techniques have increased the frequency and complexity of these procedures and associated complications such as gastrointestinal perforation. With the advancements in the field of gastroenterology, the promising use of an over the scope clips (OTSC) has fulfilled the unmet need for a reliable endoscopic devise in approximation of gastrointestinal perforation. This novel approach has raised the level of confidence in endoscopist in dealing with this serious complication during endoscopy. Here we have shared our experience with OTSC to evaluate its efficacy and safety in managing iatrogenic gastrointestinal perforations during endoscopy. PMID:25170237

[Iatrogenic bile duct injuries during the process of laparoscopic cholecystectomy].

PubMed

Qian, G; Wu, M; Zhang, Y

1995-11-01

Twelve patients with iatrogenic bile duct injuries occurred during laparoscopic cholecystectomy (LC) were treated from June 1992 to May 1994. All the patients underwent re-operation and were cured. The causes and characteristics of the injuries were: (1) perforation of the common hepatic or common bile duct caused by dissecting hook (3 cases); (2) necrosis and perforation of the common hepatic duct due to diathermic injury (1 case); (3) clamping of the common hepatic duct by Ti clip (1 case); (4) secondary high bile duct stricture following a failed end-to-end anastomosis or hepatico-cholangio-jejunostomy of the amputated common hepatic duct (5 cases); (5) delayed high bile duct stricture (2 cases). It is emphasized that the severity of bile duct injuries by LC be should not overlooked, and more experience in this field be accumulated to avoid this serious complication.

Quality of life, unmet needs, and iatrogenic injuries in rehabilitation of patients with Ehlers-Danlos Syndrome hypermobility type/Joint Hypermobility Syndrome.

PubMed

Bovet, Claire; Carlson, Matthew; Taylor, Matthew

2016-08-01

Ehlers-Danlos Syndrome, hypermobility type (EDS-HT) and the joint hypermobility syndrome (JHS) are connective tissue disorders that form an overlapping clinical syndrome and are associated with frequent medical visits and substantial morbidity. EDS-HT/JHS-associated pain correlates with poor quality of life. While physical therapy is the recommended treatment for EDS-HT/JHS, little is known about therapy-related patient experiences and iatrogenic injuries. We studied 38 adult EDS-HT/JHS patients, eliciting health-related quality of life (HRQoL) from 28 patients through the RAND SF-36 questionnaire. We also explored physical therapy experiences through focus groups with 13 patients. Our patients displayed poor HRQoL, with 71% reporting worse health over the past year. SF-36 scores were significantly lower than the scores of the average American population (P < 0.001 for 8 of 10 categories assessed), but were comparable to EDS-HT/JHS populations in Belgium, the Netherlands, Sweden, and Italy. Focus groups identified factors associated with: negative past physical therapy experiences, iatrogenic joint injuries, positive treatment experiences, and unmet rehabilitation needs. This group of EDS-HT/JHS patients has significant decrements in HRQoL and many unmet treatment needs, as well as a risk for iatrogenic injuries. We identify several approaches to help meet patients' needs and improve joint rehabilitation in patients with EDS-HT/JHS. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

41 CFR 105-55.020 - Bases for compromise.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false Bases for compromise. 105-55.020 Section 105-55.020 Public Contracts and Property Management Federal Property Management... Administration 55-COLLECTION OF CLAIMS OWED THE UNITED STATES § 105-55.020 Bases for compromise. (a) The General...

41 CFR 105-55.020 - Bases for compromise.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Bases for compromise. 105-55.020 Section 105-55.020 Public Contracts and Property Management Federal Property Management... Administration 55-COLLECTION OF CLAIMS OWED THE UNITED STATES § 105-55.020 Bases for compromise. (a) The General...

41 CFR 105-55.020 - Bases for compromise.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false Bases for compromise. 105-55.020 Section 105-55.020 Public Contracts and Property Management Federal Property Management... Administration 55-COLLECTION OF CLAIMS OWED THE UNITED STATES § 105-55.020 Bases for compromise. (a) The General...

41 CFR 105-55.020 - Bases for compromise.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Bases for compromise. 105-55.020 Section 105-55.020 Public Contracts and Property Management Federal Property Management... Administration 55-COLLECTION OF CLAIMS OWED THE UNITED STATES § 105-55.020 Bases for compromise. (a) The General...

19 CFR 161.5 - Compromise of Government claims.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 2 2013-04-01 2013-04-01 false Compromise of Government claims. 161.5 Section 161.5 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF.... 1617), in compromise of a Government claim arising under the Customs laws and the terms upon which it...

19 CFR 161.5 - Compromise of Government claims.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Compromise of Government claims. 161.5 Section 161.5 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF.... 1617), in compromise of a Government claim arising under the Customs laws and the terms upon which it...

19 CFR 161.5 - Compromise of Government claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Compromise of Government claims. 161.5 Section 161.5 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF.... 1617), in compromise of a Government claim arising under the Customs laws and the terms upon which it...

19 CFR 161.5 - Compromise of Government claims.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 2 2012-04-01 2012-04-01 false Compromise of Government claims. 161.5 Section 161.5 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF.... 1617), in compromise of a Government claim arising under the Customs laws and the terms upon which it...

“Excess gooD can be Dangerous”. A case series of iatrogenic symptomatic hypercalcemia due to hypervitaminosis D

PubMed Central

Pandita, Kamal Kishore; Razdan, Sushil; Kudyar, Rattan Parkash; Beigh, Aadil; Kuchay, Shafi; Banday, Tanveer

2012-01-01

Summary Vitamin D is increasingly recognized to have several beneficial effects. Its toxicity, causing hypercalcemia, is considered as extremely rare. We report case series of 15 patients (most of them being elderly subjects) with iatrogenic symptomatic hypercalcemia in whom toxicity occurred due to empirical excessive administration of vitamin D by oral and parenteral route. PMID:23087723

A digital gigapixel large-format tile-scan camera.

PubMed

Ben-Ezra, M

2011-01-01

Although the resolution of single-lens reflex (SLR) and medium-format digital cameras has increased in recent years, applications for cultural-heritage preservation and computational photography require even higher resolutions. Addressing this issue, a large-format cameras' large image planes can achieve very high resolution without compromising pixel size and thus can provide high-quality, high-resolution images.This digital large-format tile scan camera can acquire high-quality, high-resolution images of static scenes. It employs unique calibration techniques and a simple algorithm for focal-stack processing of very large images with significant magnification variations. The camera automatically collects overlapping focal stacks and processes them into a high-resolution, extended-depth-of-field image.

15 CFR 904.106 - Compromise of civil penalty.

Code of Federal Regulations, 2014 CFR

2014-01-01

... PROCEDURES Civil Penalties § 904.106 Compromise of civil penalty. (a) NOAA, in its sole discretion, may... NOAA under this section may be exercised either upon the initiative of NOAA or in response to a request... compromise authority of NOAA under this section nor NOAA's exercise thereof at any time changes the date upon...

15 CFR 904.106 - Compromise of civil penalty.

Code of Federal Regulations, 2012 CFR

2012-01-01

... PROCEDURES Civil Penalties § 904.106 Compromise of civil penalty. (a) NOAA, in its sole discretion, may... NOAA under this section may be exercised either upon the initiative of NOAA or in response to a request... compromise authority of NOAA under this section nor NOAA's exercise thereof at any time changes the date upon...

15 CFR 904.106 - Compromise of civil penalty.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROCEDURES Civil Penalties § 904.106 Compromise of civil penalty. (a) NOAA, in its sole discretion, may... NOAA under this section may be exercised either upon the initiative of NOAA or in response to a request... compromise authority of NOAA under this section nor NOAA's exercise thereof at any time changes the date upon...

15 CFR 904.106 - Compromise of civil penalty.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCEDURES Civil Penalties § 904.106 Compromise of civil penalty. (a) NOAA, in its sole discretion, may... NOAA under this section may be exercised either upon the initiative of NOAA or in response to a request... compromise authority of NOAA under this section nor NOAA's exercise thereof at any time changes the date upon...

19 CFR 161.5 - Compromise of Government claims.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 2 2014-04-01 2014-04-01 false Compromise of Government claims. 161.5 Section 161... Government claims. (a) Offer. An offer made pursuant to section 617, Tariff Act of 1930, as amended (19 U.S.C. 1617), in compromise of a Government claim arising under the Customs laws and the terms upon which it...

[Late stage stenoses of bile ducts after iatrogenic bile duct injuries following cholecystectomy].

PubMed

Bektas, H; Winny, M; Schrem, H; Becker, T; Klempnauer, J

2007-12-01

Iatrogenic bile duct injuries represent a severe complication after cholecystectomy. For the attending physician therapy and management of these injuries are a challenge. Inadequate and delayed treatment can lead to stenoses at a late stage, which can necessitate further surgical intervention. In a study data of 74 patients, who were treated in our clinic for bile duct injuries following cholecystectomy, were analysed retrospectively. A total of 8 patients with late stage bile duct strictures following iatrogenic bile duct injury including the subsequent therapy could be identified. The data of these patients were analysed in respect of cause and strategies to prevent late stage stenoses. In 62 patients the bile duct injury occurred following laparoscopic and in 12 patients following open cholecystectomy. In 16 patients the injury was combined with a vascular lesion. The interval between primary intervention and definitive therapy was 11 days in 53 patients and 1-15 years in 21 patients. In 8 patients the reason for the re-operation after a long interval (1-15 years) was a late stage stenosis. A hepatico-jejunostomy was performed subsequently and during follow-up 5 / 8 patients were symptom-free; 7 patients were re-operated due to a stenosed primary biliodigestive anastomosis and 3 patients each due to atrophy of the right liver lobe and recurrent cholangitis. One patient complained of recurrent cholangitis and a further patient of symptoms due to adhesions. If treated inadequately bile duct injuries occurring during cholecystectomy can in the long-term lead to considerable problems such as recurrent cholangitis, late stage stenoses and even to secondary biliary cirrhosis. Therefore, a complex inter-disciplinary therapeutic concept aiming at timely treatment is necessary.

Iatrogenic Aorto-Cisterna Chyli Fistula During Percutaneous Balloon Aortoplasty in a Patient with Takayasu's Arteritis: A Case Report

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

Hwang, Hye Sun; Shin, Sung Wook, E-mail: swshin@smc.samsung.co.kr; Kim, Eun Hui

2007-04-15

We present a case of iatrogenic aorto-cisterna chyli fistula that developed during percutaneous transluminal aortoplasty in a 16-year old girl with Takayasu's arteritis. The aorto-cisterna chyli fistula was angiographically confirmed and treated using a stent-graft, which successfully occluded the fistula. Her claudication then improved, although follow-up CT angiography at 10 months revealed mild recurrent aortic stenosis.

Iatrogenic occlusion of the ophthalmic artery after cosmetic facial filler injections: a national survey by the Korean Retina Society.

PubMed

Park, Kyu Hyung; Kim, Yong-Kyu; Woo, Se Joon; Kang, Se Woong; Lee, Won Ki; Choi, Kyung Seek; Kwak, Hyung Woo; Yoon, Ill Han; Huh, Kuhl; Kim, Jong Woo

2014-06-01

Iatrogenic occlusion of the ophthalmic artery and its branches is a rare but devastating complication of cosmetic facial filler injections. To investigate clinical and angiographic features of iatrogenic occlusion of the ophthalmic artery and its branches caused by cosmetic facial filler injections. Data from 44 patients with occlusion of the ophthalmic artery and its branches after cosmetic facial filler injections were obtained retrospectively from a national survey completed by members of the Korean Retina Society from 27 retinal centers. Clinical features were compared between patients grouped by angiographic findings and injected filler material. Visual prognosis and its relationship to angiographic findings and injected filler material. Ophthalmic artery occlusion was classified into 6 types according to angiographic findings. Twenty-eight patients had diffuse retinal and choroidal artery occlusions (ophthalmic artery occlusion, generalized posterior ciliary artery occlusion, and central retinal artery occlusion). Sixteen patients had localized occlusions (localized posterior ciliary artery occlusion, branch retinal artery occlusion, and posterior ischemic optic neuropathy). Patients with diffuse occlusions showed worse initial and final visual acuity and less visual gain compared with those having localized occlusions. Patients receiving autologous fat injections (n = 22) had diffuse ophthalmic artery occlusions, worse visual prognosis, and a higher incidence of combined brain infarction compared with patients having hyaluronic acid injections (n = 13). Clinical features of iatrogenic occlusion of the ophthalmic artery and its branches following cosmetic facial filler injections were diverse according to the location and extent of obstruction and the injected filler material. Autologous fat injections were associated with a worse visual prognosis and a higher incidence of combined cerebral infarction. Extreme caution and care should be taken during

Lung Hot Spot Without Corresponding Computed Tomography Abnormality on Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: Artifactual or Real, Iatrogenic or Pathologic?

PubMed

Liu, Yiyan

Focal lung uptake without corresponding lesions or abnormalities on computed tomography (CT) scan poses a dilemma in the interpretation of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). A limited number of case reports have previously suggested an artifactual or iatrogenic nature of the uptake. In the present study, 8 relevant cases were included within a retrospective search of the database. Medical records were reviewed for follow-up radiological and pathologic information. In 7 of 8 cases with focal increased FDG uptake but no corresponding lesions or abnormalities on CT scan, the lung hot spots were artifactual or iatrogenic upon follow-up diagnostic chest CT or repeated PET/CT or both the scans. Microemboli were most likely a potential cause of the pulmonary uptake, with or without partial paravenous injection. One case in the series had a real pulmonary lesion demonstrated on follow-up PET/CT scans and on surgical pathology, although the initial integrated CT and follow-up diagnostic chest CT scans revealed negative findings to demonstrate pulmonary abnormalities corresponding to the hot spot on the PET scan. In conclusion, the finding of a lung hot spot in the absence of anatomical abnormality on FDG PET/CT was most likely artifactual or iatrogenic, but it might also represent a real pulmonary lesion. Nonvisualization of anatomical abnormality could be because of its small size and position directly overlying a segmental vessel. Further image follow-up is necessary and important to clarify the nature of the uptake. Copyright © 2017 Elsevier Inc. All rights reserved.

Combating QR-Code-Based Compromised Accounts in Mobile Social Networks.

PubMed

Guo, Dong; Cao, Jian; Wang, Xiaoqi; Fu, Qiang; Li, Qiang

2016-09-20

Cyber Physical Social Sensing makes mobile social networks (MSNs) popular with users. However, such attacks are rampant as malicious URLs are spread covertly through quick response (QR) codes to control compromised accounts in MSNs to propagate malicious messages. Currently, there are generally two types of methods to identify compromised accounts in MSNs: one type is to analyze the potential threats on wireless access points and the potential threats on handheld devices' operation systems so as to stop compromised accounts from spreading malicious messages; the other type is to apply the method of detecting compromised accounts in online social networks to MSNs. The above types of methods above focus neither on the problems of MSNs themselves nor on the interaction of sensors' messages, which leads to the restrictiveness of platforms and the simplification of methods. In order to stop the spreading of compromised accounts in MSNs effectively, the attacks have to be traced to their sources first. Through sensors, users exchange information in MSNs and acquire information by scanning QR codes. Therefore, analyzing the traces of sensor-related information helps to identify the compromised accounts in MSNs. This paper analyzes the diversity of information sending modes of compromised accounts and normal accounts, analyzes the regularity of GPS (Global Positioning System)-based location information, and introduces the concepts of entropy and conditional entropy so as to construct an entropy-based model based on machine learning strategies. To achieve the goal, about 500,000 accounts of Sina Weibo and about 100 million corresponding messages are collected. Through the validation, the accuracy rate of the model is proved to be as high as 87.6%, and the false positive rate is only 3.7%. Meanwhile, the comparative experiments of the feature sets prove that sensor-based location information can be applied to detect the compromised accounts in MSNs.

Combating QR-Code-Based Compromised Accounts in Mobile Social Networks

PubMed Central

Guo, Dong; Cao, Jian; Wang, Xiaoqi; Fu, Qiang; Li, Qiang

2016-01-01

Cyber Physical Social Sensing makes mobile social networks (MSNs) popular with users. However, such attacks are rampant as malicious URLs are spread covertly through quick response (QR) codes to control compromised accounts in MSNs to propagate malicious messages. Currently, there are generally two types of methods to identify compromised accounts in MSNs: one type is to analyze the potential threats on wireless access points and the potential threats on handheld devices’ operation systems so as to stop compromised accounts from spreading malicious messages; the other type is to apply the method of detecting compromised accounts in online social networks to MSNs. The above types of methods above focus neither on the problems of MSNs themselves nor on the interaction of sensors’ messages, which leads to the restrictiveness of platforms and the simplification of methods. In order to stop the spreading of compromised accounts in MSNs effectively, the attacks have to be traced to their sources first. Through sensors, users exchange information in MSNs and acquire information by scanning QR codes. Therefore, analyzing the traces of sensor-related information helps to identify the compromised accounts in MSNs. This paper analyzes the diversity of information sending modes of compromised accounts and normal accounts, analyzes the regularity of GPS (Global Positioning System)-based location information, and introduces the concepts of entropy and conditional entropy so as to construct an entropy-based model based on machine learning strategies. To achieve the goal, about 500,000 accounts of Sina Weibo and about 100 million corresponding messages are collected. Through the validation, the accuracy rate of the model is proved to be as high as 87.6%, and the false positive rate is only 3.7%. Meanwhile, the comparative experiments of the feature sets prove that sensor-based location information can be applied to detect the compromised accounts in MSNs. PMID:27657071

Perceived Career Compromise, Affect and Work-Related Satisfaction in College Students

ERIC Educational Resources Information Center

Tsaousides, Theodore; Jome, LaRae

2008-01-01

The objective of this study was to investigate the effects of career compromise on positive affect (PA), negative affect (NA), and work-related satisfaction (WRS). Career compromise refers to the modification of occupational preferences under pressing external circumstances [Gottfredson, L. S. (1981). Circumscription and compromise: A…

Iatrogenic possibilities of orthodontic treatment and modalities of prevention

PubMed Central

Meeran, Nazeer Ahmed

2013-01-01

The benefits of orthodontic treatment are numerous and in most cases, the benefits outweigh the possible disadvantages. Orthodontic treatment can play an important role in enhancing esthetics, function, and self-esteem in patients. However, it carries with it the risks of enamel demineralization, tissue damage, root resorption, open gingival embrasures in the form of triangular spaces, allergic reactions to nickel, and treatment failure in the form of relapse. These potential complications are easily avoidable by undertaking certain precautions and timely interventions by both the orthodontist and the patient. The orthodontist must ensure that the patient is aware of the associated risks and stress the importance of the patient's role in preventing these untoward outcomes. The decision whether to proceed with the orthodontic treatment is essentially a risk-benefit analysis, where the perceived benefits of commencing treatment outweigh the potential risks. This article provides an overview of the iatrogenic possibilities of orthodontic treatment and the role of the patient as well as the orthodontist in preventing the associated risks. PMID:24987646

Framings of Career Compromises: How Career Counselors can Help.

ERIC Educational Resources Information Center

Gati, Itamar; Houminer, Daphna; Fassa, Naomi

1997-01-01

Presents a conceptual model for dealing with career compromise and discusses its implications for the career counseling process. The model identifies three possible framings that individuals may adopt when facing compromise. Suggestions are discussed for relevant intervention options aimed at decreasing the potentially harmful effects of the need…

The role of postoperative hematoma on free flap compromise.

PubMed

Ahmad, Faisal I; Gerecci, Deniz; Gonzalez, Javier D; Peck, Jessica J; Wax, Mark K

2015-08-01

Hematomas may develop in the postoperative setting after free tissue transfer. When hematomas occur, they can exert pressure on surrounding tissues. Their effect on the vascular pedicle of a free flap is unknown. We describe our incidence of hematoma in free flaps and outcomes when the flap is compromised. Retrospective chart review of 1,883 free flaps performed between July 1998 and June 2014 at a tertiary referral center. Patients with free flap compromise due to hematoma were identified. Etiology, demographic data, and outcomes were evaluated. Eighty-eight (4.7%) patients developed hematomas. Twenty (22.7%) of those had flap compromise. Twelve compromises (60%) showed evidence of pedicle thrombosis. The salvage rate was 75% versus 54% in 79 flaps with compromise from other causes (P = .12). Mean time to detection of the hematoma was 35.3 hours in salvaged flaps compared to 91.6 hours in unsalvageable flaps (P = .057). Time to operating room (OR) from detection was 2.8 hours in salvageable flaps compared to 12.4 hours in nonsalvageable flaps (P = .053). The salvage rate for flaps that returned to the OR in <5 hours was 93.3% compared to 20% (P = .0049) for those that did not. Vascular thrombosis reduced salvage rate to 58.3% from 100% (P = .002) when there was no thrombosis. In our series hematomas developed rarely. When they did, 23% went on to develop flap compromise. Prompt recognition and re-exploration allowed for a high salvage rate. Vessel thrombosis predicted inability to salvage the flap. 4 © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Surviving cancer without compromising aspirations.

PubMed

McGregor, Sandra

2011-07-01

This short paper is a reflection of how one person coped, survived and grew following numerous metastatic incidences over a 20 year period. Surviving cancer is a complex process but coping with the threat of regular recurrence has required a coping strategy that embraced the disease, set it aside and refused to compromise hopes, dreams and future life. Central to this personal journey has been the need to redefine normality, live with and set aside the fear of future metastases and death and find an answer and meaning in a changing biology, increased morbidity and possible mortality. This paper contends that not compromising the direction of travel and being able to focus on a career has ensured that survival was valuable and valued. A working environment in which students' problems have been immediate has produced different stressors. These have ultimately forced personal worries to be set aside, while living with cancer has become normal and accepted. Copyright © 2011 Elsevier Ltd. All rights reserved.

Can Digital Tools Be Used for Improving Immunization Programs?

PubMed

Tozzi, Alberto E; Gesualdo, Francesco; D'Ambrosio, Angelo; Pandolfi, Elisabetta; Agricola, Eleonora; Lopalco, Pierluigi

2016-01-01

In order to successfully control and eliminate vaccine-preventable infectious diseases, an appropriate vaccine coverage has to be achieved and maintained. This task requires a high level of effort as it may be compromised by a number of barriers. Public health agencies have issued specific recommendations to address these barriers and therefore improve immunization programs. In the present review, we characterize issues and challenges of immunization programs for which digital tools are a potential solution. In particular, we explore previously published research on the use of digital tools in the following vaccine-related areas: immunization registries, dose tracking, and decision support systems; vaccine-preventable diseases surveillance; surveillance of adverse events following immunizations; vaccine confidence monitoring; and delivery of information on vaccines to the public. Subsequently, we analyze the limits of the use of digital tools in such contexts and envision future possibilities and challenges.

Can Digital Tools Be Used for Improving Immunization Programs?

PubMed Central

Tozzi, Alberto E.; Gesualdo, Francesco; D’Ambrosio, Angelo; Pandolfi, Elisabetta; Agricola, Eleonora; Lopalco, Pierluigi

2016-01-01

In order to successfully control and eliminate vaccine-preventable infectious diseases, an appropriate vaccine coverage has to be achieved and maintained. This task requires a high level of effort as it may be compromised by a number of barriers. Public health agencies have issued specific recommendations to address these barriers and therefore improve immunization programs. In the present review, we characterize issues and challenges of immunization programs for which digital tools are a potential solution. In particular, we explore previously published research on the use of digital tools in the following vaccine-related areas: immunization registries, dose tracking, and decision support systems; vaccine-preventable diseases surveillance; surveillance of adverse events following immunizations; vaccine confidence monitoring; and delivery of information on vaccines to the public. Subsequently, we analyze the limits of the use of digital tools in such contexts and envision future possibilities and challenges. PMID:27014673

Conscientious objection and compromising the patient: Response to Hughes.

PubMed

Savulescu, Julian; Schuklenk, Udo

2018-06-19

Hughes offers a consequentialist response to our rejection of accommodation of conscientious objection in medicine. We argue here that his compromise proposition has been tried in many jurisdictions and has failed to deliver unimpeded access to care for eligible patients. The compromise position, entailing an accommodation of conscientious objection provided there is unimpeded access, fails to grasp that the objectors are both determined not to provide services they object to as well as to subvert patient access to the objected to services. Unpredictable future developments in drug R&D and resulting treatment and prevention options in medicine make the compromise position unrealistic. © 2018 John Wiley & Sons Ltd.

Iatrogenic radiation exposure to patients with early onset spine and chest wall deformities.

PubMed

Khorsand, Derek; Song, Kit M; Swanson, Jonathan; Alessio, Adam; Redding, Gregory; Waldhausen, John

2013-08-01

Retrospective cohort series. Characterize average iatrogenic radiation dose to a cohort of children with thoracic insufficiency syndrome (TIS) during assessment and treatment at a single center with vertically expandable prosthetic titanium rib. Children with TIS undergo extensive evaluations to characterize their deformity. No standardized radiographical evaluation exists, but all reports use extensive imaging. The source and level of radiation these patients receive is not currently known. We evaluated a retrospective consecutive cohort of 62 children who had surgical treatment of TIS at our center from 2001-2011. Typical care included obtaining serial radiographs, spine and chest computed tomographic (CT) scans, ventilation/perfusion scans, and magnetic resonance images. Epochs of treatment were divided into time of initial evaluation to the end of initial vertically expandable prosthetic titanium rib implantation with each subsequent epoch delineated by the next surgical intervention. The effective dose for each examination was estimated within millisieverts (mSv). Plain radiographs were calculated from references. Effective dose was directly estimated for CT scans since 2007 and an average of effective dose from 2007-2011 was used for scans before 2007. Effective dose from fluoroscopy was directly estimated. All doses were reported in mSv. A cohort of 62 children had a total of 447 procedures. There were a total of 290 CT scans, 4293 radiographs, 147 magnetic resonance images, and 134 ventilation/perfusion scans. The average accumulated effective dose was 59.6 mSv for children who had completed all treatment, 13.0 mSv up to initial surgery, and 3.2 mSv for each subsequent epoch of treatment. CT scans accounted for 74% of total radiation dose. Children managed for TIS using a consistent protocol received iatrogenic radiation doses that were on average 4 times the estimated average US background radiation exposure of 3 mSv/yr. CT scans comprised 74% of the total

Air Duster abuse causing rapid airway compromise

PubMed Central

Winston, Amanda; Kanzy, Abed; Bachuwa, Ghassan

2015-01-01

Inhalant abuse is potentially life-threatening and has resulted in many complications such as central nervous system depression, cardiac dysrhythmia and hypoxia. Inhalant abuse causing angioedema is rarely reported in the medical literature. In this report we present a case of rapidly progressive airway compromise following recreational huffing. Our patient required intubation and intensive care unit admission with complete recovery after 5 days. The aetiology of airway compromise is postulated to be due to commonly reported frost bite injury and rarely reported angioedema. To the best of our knowledge this the second case reporting angioedema secondary to huffing Air Duster. PMID:25568278

Clinical protocol with digital cad/cam chairside workflow for the rehabilitation of severely worn dentition patients

PubMed Central

GERMANO, FED.; GERMANO, FRA.; PIRO, M.; ARCURI, C.; OTTRIA, L.

2017-01-01

SUMMARY Objectives The purpose of this paper is to investigate the effectiveness and to describe a clinical protocol with digital CAD CAM chairside workflow for the rehabilitation of severely compromised and worn dentitions. Methods This article reports 4 consecutive cases, where a clinical digital chairside workflow is used for the rehabilitation of severely compromised and worn dentitions. Advantages and limitations of this method compared with the traditional prosthetic protocol are also described and discussed. Results With all four patients treated with this protocol, we obtained a good aesthetic and functional result, improvement in chewing function, loss of cold sensitivity, better preservation of most of the left hard tissue and a good level of satisfaction. In a two-year follow-up, all patients also maintained the condition obtained with prosthetic chairside rehabilitation, resulting in almost 100% cumulative survival rate. Conclusion Within the limitations of this study, we can assert that the aforementioned restorative treatment with digital CAD/CAM chairside workflow represents a valid alternative to rehabilitate this kind of patients, because it is a safe, predictable and personalized procedure but also it seems easier, faster and cheaper than traditional protocols. PMID:29285327

Iatrogenic cushing syndrome secondary to a probable interaction between voriconazole and budesonide.

PubMed

Jones, Whitney; Chastain, Cody A; Wright, Patty W

2014-07-01

Oral budesonide is commonly used for the management of Crohn's disease given its high affinity for glucocorticoid receptors and low systemic activity due to extensive first-pass metabolism through hepatic cytochrome P450 (CYP) 3A4. Voriconazole, a second-generation triazole antifungal agent, is both a substrate and potent inhibitor of CYP isoenzymes, specifically CYP2C19, CYP2C9, and CYP3A4; thus, the potential for drug-drug interactions with voriconazole is high. To our knowledge, drug-drug interactions between voriconazole and corticosteroids have not been specifically reported in the literature. We describe a 48-year-old woman who was receiving oral budesonide 9 mg/day for the management of Crohn's disease and was diagnosed with fluconazole-resistant Candida albicans esophagitis; oral voriconazole 200 mg every 12 hours for 3 weeks was prescribed for treatment. Because the patient experienced recurrent symptoms of dysphagia, a second 3-week course of voriconazole therapy was taken. Seven weeks after originally being prescribed voriconazole, she came to her primary care clinic with elevated blood pressure, lower extremity edema, and weight gain; she was prescribed a diuretic and evaluated for renal dysfunction. At a follow-up visit 6 weeks later with her specialty clinic, the patient's blood pressure was elevated, and her physical examination was notable for moon facies, posterior cervical fat pad prominence, and lower extremity pitting edema. Iatrogenic Cushing syndrome due to a drug-drug interaction between voriconazole and budesonide was suspected, and voriconazole was discontinued. Budesonide was continued as previously prescribed for her Crohn's disease. On reevaluation 2 months later, the patient's Cushingoid features had markedly regressed. To our knowledge, this is the first published case report of iatrogenic Cushing syndrome due to a probable interaction between voriconazole and oral budesonide. In patients presenting with Cushingoid features who

Tri-state delta modulation system for Space Shuttle digital TV downlink

NASA Technical Reports Server (NTRS)

Udalov, S.; Huth, G. K.; Roberts, D.; Batson, B. H.

1981-01-01

Future requirements for Shuttle Orbiter downlink communication may include transmission of digital video which, in addition to black and white, may also be either field-sequential or NTSC color format. The use of digitized video could provide for picture privacy at the expense of additional onboard hardware, together with an increased bandwidth due to the digitization process. A general objective for the Space Shuttle application is to develop a digitization technique that is compatible with data rates in the 20-30 Mbps range but still provides good quality pictures. This paper describes a tri-state delta modulation/demodulation (TSDM) technique which is a good compromise between implementation complexity and performance. The unique feature of TSDM is that it provides for efficient run-length encoding of constant-intensity segments of a TV picture. Axiomatix has developed a hardware implementation of a high-speed TSDM transmitter and receiver for black-and-white TV and field-sequential color. The hardware complexity of this TSDM implementation is summarized in the paper.

Air Duster abuse causing rapid airway compromise.

PubMed

Winston, Amanda; Kanzy, Abed; Bachuwa, Ghassan

2015-01-07

Inhalant abuse is potentially life-threatening and has resulted in many complications such as central nervous system depression, cardiac dysrhythmia and hypoxia. Inhalant abuse causing angioedema is rarely reported in the medical literature. In this report we present a case of rapidly progressive airway compromise following recreational huffing. Our patient required intubation and intensive care unit admission with complete recovery after 5 days. The aetiology of airway compromise is postulated to be due to commonly reported frost bite injury and rarely reported angioedema. To the best of our knowledge this the second case reporting angioedema secondary to huffing Air Duster. 2015 BMJ Publishing Group Ltd.

Compromise decision support problems for hierarchical design involving uncertainty

NASA Astrophysics Data System (ADS)

Vadde, S.; Allen, J. K.; Mistree, F.

1994-08-01

In this paper an extension to the traditional compromise Decision Support Problem (DSP) formulation is presented. Bayesian statistics is used in the formulation to model uncertainties associated with the information being used. In an earlier paper a compromise DSP that accounts for uncertainty using fuzzy set theory was introduced. The Bayesian Decision Support Problem is described in this paper. The method for hierarchical design is demonstrated by using this formulation to design a portal frame. The results are discussed and comparisons are made with those obtained using the fuzzy DSP. Finally, the efficacy of incorporating Bayesian statistics into the traditional compromise DSP formulation is discussed and some pending research issues are described. Our emphasis in this paper is on the method rather than the results per se.

Subthreshold and micropulse diode laser photocoagulation.

PubMed

Dorin, Giorgio

2003-09-01

Retinal laser photocoagulation is a proven, effective treatment for various retinal disorders. Common clinical protocols use intra-operatively visible endpoints that cause iatrogenic chorioretinal damage. For this reason, laser therapy is normally limited to levels of disease severity for which the benefit-to-risk ratio justifies its application. The use of 810 nm diode lasers in the MicroPulse mode offers the surgeon the possibility to minimize iatrogenic retinal damage. A less destructive laser therapy with a more favorable benefit-to-risk ratio could justify treatment earlier in the course of the disease, allowing for stabilization or improvement of less compromised visual functions.

48 CFR 232.616 - Compromise actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Compromise actions. 232.616 Section 232.616 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM... actions. Only the department/agency contract financing offices (see 232.070(c)) are authorized to...

Fighting the Whole System: Dissociative Identity Disorder, Labeling Theory, and Iatrogenic Doubting.

PubMed

Floris, Jessica; McPherson, Susan

2015-01-01

This research examines how individuals diagnosed with dissociative identity disorder construe their experiences of being labeled with a contested diagnosis. Semistructured interviews were conducted in the United Kingdom with 5 women and 2 men diagnosed with dissociative identity disorder. A framework analysis was conducted. The analysis identified 2 overarching themes: diagnosis cross-examined and navigating care systems. The diagnosis appeared to be continually assessed by participants for its fit with symptoms, and the doubt among professionals seemed to be unhelpfully reflected in participants' attempts to understand and come to terms with their experiences. The findings are considered in light of labeling theory, the iatrogenic effects of professional doubt, and current debates concerning the reliability and validity of psychiatric diagnostic systems that have been reinvigorated by the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

7 CFR 1956.68 - Compromise or adjustment without debtor's signature.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Compromise or adjustment without debtor's signature... Loan Programs and Multi-Family Housing § 1956.68 Compromise or adjustment without debtor's signature... made to obtain the debtor's signature and the date(s) of such effort. (c) The specific reasons why it...

32 CFR 842.99 - Compromise, termination, and suspension of collection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Compromise, termination, and suspension of collection. 842.99 Section 842.99 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR... States (31 U.S.C. 3701, 3711-3719) § 842.99 Compromise, termination, and suspension of collection. This...

Prediction of fetal compromise in labor.

PubMed

Prior, Tomas; Mullins, Edward; Bennett, Phillip; Kumar, Sailesh

2014-06-01

The majority of intrapartum fetal hypoxia occurs in uncomplicated pregnancies. Current intrapartum monitoring techniques have not resulted in a reduction in the incidence of cerebral palsy in term neonates. We report the development of a composite risk score to allow risk stratification of normal pregnancies before labor. Six hundred one women were recruited to this prospective observational study. All women underwent an ultrasound examination before active labor, during which fetal biometry and fetal Doppler flow resistance indices were measured. A composite risk score, amalgamating data from the umbilical artery, middle cerebral artery, and umbilical vein, was then developed and correlated with intrapartum outcomes. In cases with the highest composite risk scores, the incidence of fetal compromise (the primary outcome) was 80.0% compared with just 15.3% in cases with the lowest risk scores (relative risk 5.2, 95% confidence interval 2.7-10.1). These cases were also at increased risk of cesarean delivery (53.3% compared with 3.4%, P<.001) and of developing a fetal heart rate pattern considered pathologic by National Institute for Health and Clinical Excellence criteria (P=.003). No significant variation in Apgar scores or umbilical artery pH was observed. Intrapartum fetal compromise remains a significant global health issue. The composite risk score reported here can identify fetuses at both high risk and low risk of a subsequent diagnosis of intrapartum fetal compromise. This may enable more judicious use of current intrapartum fetal monitoring techniques, which are hampered by low specificity. II.

Iatrogenic Subclinical Hyperthyroidism Does Not Promote Weight Loss.

PubMed

Kedia, Rohit; Lowes, Alicia; Gillis, Sarah; Markert, Ronald; Koroscil, Thomas

2016-02-01

Among patients who have undergone total thyroidectomy, do those with thyroid cancer being kept iatrogenically subclinical hyperthyroid (SCH) differ from euthyroid patients in long-term weight change? In a retrospective study, medical records identified 291 patients who had undergone a thyroidectomy for differentiated thyroid cancer or benign thyroid disease. Weight, thyroid-stimulating hormone, and levothyroxine dose were measured presurgery and 1, 2, and 3 years postsurgery. Of 291 patients, 147 were in the SCH group and 144 were in the euthyroid group. At all 3 years both groups gained weight from baseline, but the two groups did not differ in weight change from baseline at any time period: year 1 (SCH mean 0.4% ± 6.2% weight gain vs euthyroid group mean 2.2% ± 6.6% weight gain; P = 0.12), year 2 (SCH mean 1.1% ± 9.1% weight gain vs euthyroid mean 2.9% ± 7.8% weight gain; P = 0.22), and year 3 (SCH mean 2.6% ± 9.2% weight gain vs euthyroid mean 3.1% ± 11.1% weight gain; P = 0.49). Among total thyroidectomy patients, weight change did not differ between SCH patients and euthyroid patients at years 1 through 3. As such, the use of levothyroxine to induce SCH did not lead to long-term weight change when compared with euthyroid patients.

Endovascular management for significant iatrogenic portal vein bleeding.

PubMed

Kim, Jong Woo; Shin, Ji Hoon; Park, Jonathan K; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu-Bo

2017-11-01

Background Despite conservative treatment, hemorrhage from an intrahepatic branch of the portal vein can cause hemodynamic instability requiring urgent intervention. Purpose To retrospectively report the outcomes of hemodynamically significant portal vein bleeding after endovascular management. Material and Methods During a period of 15 years, four patients (2 men, 2 women; median age, 70.5 years) underwent angiography and embolization for iatrogenic portal vein bleeding. Causes of hemorrhage, angiographic findings, endovascular treatment, and complications were reported. Results Portal vein bleeding occurred after percutaneous liver biopsy (n = 2), percutaneous radiofrequency ablation (n = 1), and percutaneous cholecystostomy (n = 1). The median time interval between angiography and percutaneous procedure was 5 h (range, 4-240 h). Common hepatic angiograms including indirect mesenteric portograms showed active portal vein bleeding into the peritoneal cavity with (n = 1) or without (n = 2) an arterioportal (AP) fistula, and portal vein pseudoaneurysm alone with an AP fistula (n = 1). Successful transcatheter arterial embolization (n = 2) or percutaneous transhepatic portal vein embolization (n = 2) was performed. Embolic materials were n-butyl cyanoacrylate alone (n = 2) or in combination with gelatin sponge particles and coils (n = 2). There were no major treatment-related complications or patient mortality within 30 days. Conclusion Patients with symptomatic or life-threatening portal vein bleeding following liver-penetrating procedures can successfully be managed with embolization.

[Tenotomy of carpal and digital flexor tendons for correction of congenital neuromyodysplasia in a calf].

PubMed

Sohrt, J T; Heppelmann, M; Rehage, J; Staszyk, C

2013-01-01

In a 7-day-old heifer calf, a bilateral flexural deformity of the forelimbs involving the digital flexor tendons, the suspensory ligament and the ulnar and radial carpal flexor tendons was diagnosed. After 2 weeks of conservative treatment consisting of manual stretching of the legs and the application of splints and wooden blocks, which were glued to the soles and extended beyond the tip of the claws, the right forelimb could be extended sufficiently to allow weight bearing, whereas the left forelimb could be passively extended to only approximately 120°. Therefore, tenotomy of the ulnar carpal flexor tendon, the digital flexor tendons and the suspensory ligament was carried out in the left leg. A support bandage was then applied to the leg for 8 weeks, after which the carpus and fetlock could be completely extended passively. Flexural deformity of the carpus caused by contracture of the carpal flexor tendons was treated by means of a tenotomy of the ulnar carpal flexor tendon proximal to the accessory carpal bone, which allowed preservation of the carpal tunnel and avoided the risk of iatrogenic damage to nerves and the carpal joint capsule.

Vehicle influence on permeation through intact and compromised skin.

PubMed

Gujjar, Meera; Banga, Ajay K

2014-09-10

The purpose of this study was to compare the transdermal permeation of a model compound, diclofenac diethylamine, from a hydrophilic and lipophilic vehicle across in vitro models simulating compromised skin. Mineral oil served as a lipophilic vehicle while 10mM phosphate buffered saline served as a hydrophilic vehicle. Compromised skin was simulated by tape stripping, delipidization, or microneedle application and compared with intact skin as a control. Transepidermal water loss was measured to assess barrier function. Skin compromised with tape stripping and delipidization significantly (p<0.05) increased permeation of diclofenac diethylamine compared to intact and microneedle treated skin with phosphate buffered saline vehicle. A similar trend in permeation was observed with mineral oil as the vehicle. For both vehicles, permeation across skin increased in the same order and correlated with degree of barrier impairment as indicated by transepidermal water loss values: intactcompromised skin. Copyright © 2014 Elsevier B.V. All rights reserved.

Wideband Agile Digital Microwave Radiometer

NASA Technical Reports Server (NTRS)

Gaier, Todd C.; Brown, Shannon T.; Ruf, Christopher; Gross, Steven

2012-01-01

The objectives of this work were to take the initial steps needed to develop a field programmable gate array (FPGA)- based wideband digital radiometer backend (>500 MHz bandwidth) that will enable passive microwave observations with minimal performance degradation in a radiofrequency-interference (RFI)-rich environment. As manmade RF emissions increase over time and fill more of the microwave spectrum, microwave radiometer science applications will be increasingly impacted in a negative way, and the current generation of spaceborne microwave radiometers that use broadband analog back ends will become severely compromised or unusable over an increasing fraction of time on orbit. There is a need to develop a digital radiometer back end that, for each observation period, uses digital signal processing (DSP) algorithms to identify the maximum amount of RFI-free spectrum across the radiometer band to preserve bandwidth to minimize radiometer noise (which is inversely related to the bandwidth). Ultimately, the objective is to incorporate all processing necessary in the back end to take contaminated input spectra and produce a single output value free of manmade signals to minimize data rates for spaceborne radiometer missions. But, to meet these objectives, several intermediate processing algorithms had to be developed, and their performance characterized relative to typical brightness temperature accuracy re quirements for current and future microwave radiometer missions, including those for measuring salinity, soil moisture, and snow pack.

Partially filled electrodes for digital microfluidic devices

NASA Astrophysics Data System (ADS)

Pyne, D. G.; Salman, W. M.; Abdelgawad, M.; Sun, Y.

2013-07-01

As digital microfluidics technology evolves, the need for integrating additional elements (e.g., sensing/detection and heating elements) on the electrode increases. Consequently, electrode area for droplet actuation is reduced to create space for accommodating these additional elements, which undesirably affects force generation. Electrodes cannot simply be scaled larger to compensate for this loss of force, as this would also increase droplet volume and thereby compromise the advantages thought in miniaturization. Here, we present a study evaluating, numerically with preliminary experimental verification, different partially filled electrode designs and suggesting designs that combine high actuation forces with a large reduction in electrode area.

Iatrogenic Pseudoaneurysm of Superficial Temporal Artery After Surgery for Scaphocephaly: Case Report and Review of Literature.

PubMed

Anania, Pasquale; Pacetti, Mattia; Ravegnani, Marcello; Pavanello, Marco; Piatelli, Gianluca; Consales, Alessandro

2018-03-01

Iatrogenic pseudoaneurysm of the superficial temporal artery after surgery for craniosynostosis is a complication that has never been described in the pertinent literature. Although reported for other types of surgeries, no case has been described in the pediatric population. We report on a case of pseudoaneurysm of the superficial temporal artery that occurred 9 days after corrective surgery for scaphocephaly. We also describe the management of this complication. Pseudoaneurysm is an exceptional complication in surgery for craniosynostosis, but it should be considered in case of swelling in the temporal region. Copyright © 2017 Elsevier Inc. All rights reserved.

Osteogenesis Imperfecta: Muscle-Bone Interactions when Bi-directionally Compromised.

PubMed

Phillips, Charlotte L; Jeong, Youngjae

2018-06-16

Osteogenesis imperfecta (OI) is a hereditary connective tissue disorder of skeletal fragility and more recently muscle weakness. This review highlights our current knowledge of the impact of compromised OI muscle function on muscle-bone interactions and skeletal strength in OI. The ramifications of inherent muscle weakness in OI muscle-bone interactions are just beginning to be elucidated. Studies in patients and in OI mouse models implicate altered mechanosensing, energy metabolism, mitochondrial dysfunction, and paracrine/endocrine crosstalk in the pathogenesis of OI. Compromised muscle-bone unit impacts mechanosensing and the ability of OI muscle and bone to respond to physiotherapeutic and pharmacologic treatment strategies. Muscle and bone are both compromised in OI, making it essential to understand the mechanisms responsible for both impaired muscle and bone functions and their interdependence, as this will expand and drive new physiotherapeutic and pharmacological approaches to treat OI and other musculoskeletal disorders.

14 CFR 1261.414 - Compromise of claims.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the Government's ability to enforce collection. The compromise should be for an amount which bears a... the settlement of small claims, but normally will not carry great weight in the settlement of large...

14 CFR 1261.414 - Compromise of claims.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the Government's ability to enforce collection. The compromise should be for an amount which bears a... the settlement of small claims, but normally will not carry great weight in the settlement of large...

14 CFR 1261.414 - Compromise of claims.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the Government's ability to enforce collection. The compromise should be for an amount which bears a... the settlement of small claims, but normally will not carry great weight in the settlement of large...

14 CFR 1261.414 - Compromise of claims.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the Government's ability to enforce collection. The compromise should be for an amount which bears a... the settlement of small claims, but normally will not carry great weight in the settlement of large...

Nontherapeutic Circumcision of Minors as an Ethically Problematic Form of Iatrogenic Injury.

PubMed

Svoboda, J Steven

2017-08-01

Nontherapeutic circumcision (NTC) of male infants and boys is a common but misunderstood form of iatrogenic injury that causes harm by removing functional tissue that has known erogenous, protective, and immunological properties, regardless of whether the surgery generates complications. I argue that the loss of the foreskin itself should be counted, clinically and morally, as a harm in evaluating NTC; that a comparison of benefits and risks is not ethically sufficient in an analysis of a nontherapeutic procedure performed on patients unable to provide informed consent; and that circumcision violates clinicians' imperatives to respect patients' autonomy, to do good, to do no harm, and to be just. When due consideration is given to these values, the balance of factors suggests that NTC should be deferred until the affected person can perform his own cost-benefit analysis, applying his mature, informed preferences and values. © 2017 American Medical Association. All Rights Reserved.

Indicators of safety compromise in gastrointestinal endoscopy.

PubMed

Borgaonkar, Mark Ram; Hookey, Lawrence; Hollingworth, Roger; Kuipers, Ernst J; Forster, Alan; Armstrong, David; Barkun, Alan; Bridges, Ron; Carter, Rose; de Gara, Chris; Dube, Catherine; Enns, Robert; Macintosh, Donald; Forget, Sylviane; Leontiadis, Grigorios; Meddings, Jonathan; Cotton, Peter; Valori, Roland

2012-02-01

The importance of quality indicators has become increasingly recognized in gastrointestinal endoscopy. Patient safety requires the identification and monitoring of occurrences associated with harm or the potential for harm. The identification of relevant indicators of safety compromise is, therefore, a critical element that is key to the effective implementation of endoscopy quality improvement programs. To identify key indicators of safety compromise in gastrointestinal endoscopy. The Canadian Association of Gastroenterology Safety and Quality Indicators in Endoscopy Consensus Group was formed to address issues of quality in endoscopy. A subcommittee was formed to identify key safety indicators. A systematic literature review was undertaken, and articles pertinent to safety in endoscopy were identified and reviewed. All complications and measures used to document safety were recorded. From this, a preliminary list of 16 indicators was compiled and presented to the 35-person consensus group during a three-day meeting. A revised list of 20 items was subsequently put to the consensus group for vote for inclusion on the final list of safety indicators. Items were retained only if the consensus group highly agreed on their importance. A total of 19 indicators of safety compromise were retained and grouped into the three following categories: medication-related - the need for CPR, use of reversal agents, hypoxia, hypotension, hypertension, sedation doses in patients older than 70 years of age, allergic reactions and laryngospasm⁄bronchospasm; procedure-related early - perforation, immediate postpolypectomy bleeding, need for hospital admission or transfer to emergency department from the gastroenterology unit, instrument impaction, severe persistent abdominal pain requiring evaluation proven to not be perforation; and procedure-related delayed - death within 30 days of procedure, 14-day unplanned hospitalization, 14-day unplanned contact with a health provider

Alchemy or Science? Compromising Archaeology in the Deep Sea

NASA Astrophysics Data System (ADS)

Adams, Jonathan

2007-06-01

In the torrid debate between archaeology and treasure hunting, compromise is often suggested as the pragmatic solution, especially for archaeology carried out either in deep water or beyond the constraints that commonly regulate such activities in territorial seas. Both the wisdom and the need for such compromise have even been advocated by some archaeologists, particularly in forums such as the internet and conferences. This paper argues that such a compromise is impossible, not in order to fuel confrontation but simply because of the nature of any academic discipline. We can define what archaeology is in terms of its aims, theories, methods and ethics, so combining it with an activity founded on opposing principles must transform it into something else. The way forward for archaeology in the deep sea does not lie in a contradictory realignment of archaeology’s goals but in collaborative research designed to mesh with emerging national and regional research and management plans.

Predicting intrapartum fetal compromise using the fetal cerebro-umbilical ratio.

PubMed

Sabdia, S; Greer, R M; Prior, T; Kumar, S

2015-05-01

The aim of this study was to explore the association between the cerebro-umbilical ratio measured at 35-37 weeks and intrapartum fetal compromise. This retrospective cross sectional study was conducted at the Mater Mothers' Hospital in Brisbane, Australia. Maternal demographics and fetal Doppler indices at 35-37 weeks gestation for 1381 women were correlated with intrapartum and neonatal outcomes. Babies born by caesarean section or instrumental delivery for fetal compromise had the lowest median cerebro-umbilical ratio 1.60 (IQR 1.22-2.08) compared to all other delivery groups (vaginal delivery, emergency delivery for failure to progress, emergency caesarean section for other reasons or elective caesarean section). The percentage of infants with a cerebro-umbilical ratio <10th centile that required emergency delivery (caesarean section or instrumental delivery) for fetal compromise was 22%, whereas only 7.3% of infants with a cerebro-umbilical ratio between the 10th-90th centile and 9.6% of infants with a cerebro-umbilical ratio > 90th centile required delivery for the same indication (p < 0.001). A lower cerebro-umbilical ratio was associated with an increased risk of emergency delivery for fetal compromise, OR 2.03 (95% CI 1.41-2.92), p < 0.0001. This study suggests that a low fetal cerebro-umbilical ratio measured at 35-37 weeks is associated with a greater risk of intrapartum compromise. This is a relatively simple technique which could be used to risk stratify women in diverse healthcare settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Closure Devices for Iatrogenic Thoraco-Cervical Vascular Injuries

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

Makris, Gregory C., E-mail: g.makris09@doctors.org.uk; Patel, Rafiuddin; Little, Mark

IntroductionThe unintentional arterial placement of a central venous line can have catastrophic complications. The purpose of this systematic review is to assess and analyse the available evidence regarding the use of the various vascular closure devices (VCDs) for the management of iatrogenic thoraco-cervical arterial injuries (ITCAI).MethodsA systematic review was performed according to PRISMA guidelines.ResultsThirty-two relevant case series and case reports were identified with a total of 69 patients having being studied. In the majority of the studies, plug-based VCDs were used (81%) followed by suture-based devices (19%). The majority of studies reported successful outcomes from the use of VCDs inmore » terms of achieving immediate haemostasis without any acute complications. Long-term follow-up data were only available in nine studies with only one case of carotid pseudoaneurysm being reported after 1-month post-procedure. All other cases had no reported long-term complications. Five studies performed direct or indirect comparisons between VCDs and other treatments (open surgery or stent grafting) suggesting no significant differences in safety or effectiveness.ConclusionAlthough there is limited evidence, VCDs appear to be safe and effective for the management of ITCAIs. Further research is warranted regarding the effectiveness of this approach in comparison to surgery and in order to identify those patients who are more likely to benefit from this minimally invasive approach.« less

Robotic-assisted repair of iatrogenic ureteral ligation following robotic-assisted hysterectomy.

PubMed

Kalisvaart, Jonathan F; Finley, David S; Ornstein, David K

2008-01-01

Ureteral injuries, while rare, do occur during gynecologic procedures. The expansion of laparoscopic and robotic pelvic surgical procedures increases the risk of ureteral injury from these procedures and suggests a role for minimally invasive approaches to the delayed repair of ureteral injuries. We present, to our knowledge, the first case of delayed robotic-assisted ureteral deligation and ureterolysis following iatrogenic ureteral injury occurring during a robotic abdominal hysterectomy. We present a case report and review of the literature. A 57-year-old female underwent a seemingly uncomplicated robotic-assisted laparoscopic total abdominal hysterectomy and bilateral oophorectomy for symptomatic fibroids. On postoperative day 8, she presented with persistent right flank pain. Imaging studies revealed high-grade ureteral obstruction consistent with suture ligation of the right ureter. She underwent successful robotic-assisted ureteral deligation and ureterolysis. Her postoperative course was unremarkable, and she was discharged home on postoperative day 1 from the deligation. Robotic-assisted management of complications from urologic or gynecologic surgery is technically feasible. This can potentially preserve the advantages to the patient that are being seen from the initial less-invasive surgery.

Examining potential iatrogenic effects of viewing suicide and self-injury stimuli.

PubMed

Cha, Christine B; Glenn, Jeffrey J; Deming, Charlene A; D'Angelo, Eugene J; Hooley, Jill M; Teachman, Bethany A; Nock, Matthew K

2016-11-01

The high-stakes nature of self-injurious thoughts and behaviors (SITBs) raises ethical questions and concerns. The authors examined the iatrogenic risk of recently developed behavioral measures such as the suicide or self-injury Implicit Association Tests (IATs), which include repeated and rapid presentation of SITB-related images (e.g., of cut skin) and words (e.g., death, suicide). The impact of these IATs was investigated across a series of 3 studies involving: adult web-based respondents (n = 3,304), undergraduate students (n = 100), and adolescent psychiatric inpatients (n = 89). There was minimal change in self-injurious or suicidal urges detected across all IAT studies. A slight mood decline was detected across the 3 samples, but was isolated to female research participants and 1 type of IAT that presented SITB-related images (vs. words only). Given the increasing use of novel SITB-relevant stimuli in behavioral and neurobiological studies, these findings may help researchers balance clinical sensitivity and clinical science. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Placental angiogenesis in sheep models of compromised pregnancy

PubMed Central

Reynolds, Lawrence P; Borowicz, Pawel P; Vonnahme, Kimberly A; Johnson, Mary Lynn; Grazul-Bilska, Anna T; Redmer, Dale A; Caton, Joel S

2005-01-01

Because the placenta is the organ that transports nutrients, respiratory gases and wastes between the maternal and fetal systems, development of its vascular beds is essential to normal placental function, and thus in supporting normal fetal growth. Compromised fetal growth and development have adverse health consequences during the neonatal period and throughout adult life. To establish the role of placental angiogenesis in compromised pregnancies, we first evaluated the pattern of placental angiogenesis and expression of angiogenic factors throughout normal pregnancy. In addition, we and others have established a variety of sheep models to evaluate the effects on fetal growth of various factors including maternal nutrient excess or deprivation and specific nutrients, maternal age, maternal and fetal genotype, increased numbers of fetuses, environmental thermal stress, and high altitude (hypobaric) conditions. Although placental angiogenesis is altered in each of these models in which fetal growth is adversely affected, the specific effect on placental angiogenesis depends on the type of ‘stress’ to which the pregnancy is subjected, and also differs between the fetal and maternal systems and between genotypes. We believe that the models of compromised pregnancy and the methods described in this review will enable us to develop a much better understanding of the mechanisms responsible for alterations in placental vascular development. PMID:15760944

Does low self-esteem predict health compromising behaviours among adolescents?

PubMed

Mcgee, R; Williams, S

2000-10-01

It is often believed that low self-esteem is associated with such health-compromising behaviours in adolescence as substance use, early sexual activity, eating problems and suicidal ideation. Surprisingly, there is little longitudinal research addressing this issue. This longitudinal study examines the predictive association between both global and academic self-esteem from ages 9 to 13 years, and a variety of health compromising behaviours at age 15, in a large sample of young New Zealanders. Levels of global self-esteem significantly predicted adolescent report of problem eating, suicidal ideation, and multiple health compromising behaviours. Earlier levels of self-esteem were unrelated to later substance use and early sexual activity. The findings are discussed in terms of their implications for efforts to raise self-esteem among young people. Copyright 2000 The Association for Professionals in Services for Adolescents.

[The touched masculinity: a discussion about the digital rectal exam for prostate cancer prevention].

PubMed

Gomes, Romeu; do Nascimento, Elaine Ferreira; Rebello, Lúcia Emília Figueiredo de Sousa; de Araújo, Fábio Carvalho

2008-01-01

The present study aims at analyzing the meanings attributed to the digital rectal exam, seeking to problematize questions underlying the masculine discourse on the basis of aspects of the hegemonic masculinity model. Semi-structured interviews were held with 28 men in the city of Rio de Janeiro, in 2004. Among the main results is the idea that the digital rectal exam is something that violates an interdicted space, something that compromises the current understanding of masculinity, shall say, the digital rectal exam does not only affect the prostate, it also affects the masculinity, puts it to shame. We conclude that for understanding and problematizing the questions related to the prostate cancer prevention in special, and to the question of taking care of oneself from the masculine perspective in general, we need to consider the structural and symbolic aspects that underlie these questions.

Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients.

PubMed

Morris, Timothy A; Gay, Peter C; MacIntyre, Neil R; Hess, Dean R; Hanneman, Sandra K; Lamberti, James P; Doherty, Dennis E; Chang, Lydia; Seckel, Maureen A

2017-04-01

Acute respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Identifying patients at risk for respiratory compromise coupled with monitoring of patients who have developed respiratory compromise might allow earlier interventions to prevent or mitigate further decompensation. The National Association for the Medical Direction of Respiratory Care (NAMDRC) organized a workshop meeting with representation from many national societies to address the unmet needs of respiratory compromise from a clinical practice perspective. Respiratory compromise may arise de novo or may complicate preexisting lung disease. The group identified distinct subsets of respiratory compromise that present similar opportunities for early detection and useful intervention to prevent respiratory failure. The subtypes were characterized by the pathophysiological mechanisms they had in common: impaired control of breathing, impaired airway protection, parenchymal lung disease, increased airway resistance, hydrostatic pulmonary edema, and right-ventricular failure. Classification of acutely ill respiratory patients into one or more of these categories may help in selecting the screening and monitoring strategies that are most appropriate for the patient's particular pathophysiology. Standardized screening and monitoring practices for patients with similar mechanisms of deterioration may enhance the ability to predict respiratory failure early and prevent its occurrence. Copyright © 2017 by Daedalus Enterprises.

Knowledge is power: averting safety-compromising events in the OR.

PubMed

Catalano, Kathleen

2008-12-01

Surgical procedures can be unpredictable, and safety-compromising events can jeopardize patient safety. Perioperative nurses should be watchful for factors that can contribute to safety-compromising events, as well as the errors that can follow, and know how to avert them if possible. Knowledge is power and increased awareness of patient safety issues and the resources that are available to both health care practitioners and consumers can help perioperative nurses ward off patient safety problems before they occur.

Vatican is lone opponent of world conference's compromises on abortion.

PubMed

1994-09-07

Three years in the making, the draft program of action of the 1994 International Conference on Population and Development sets nonbinding policy guidelines to contain the world's population at 7.27 billion in 2015. Although the Vatican was pleased to see Pakistan put forward a compromise formula developed to appease Catholic and Muslim objectors of abortion, the Church was unprepared to accept the compromise immediately and requested further discussion. The Vatican's rejection drew a strong chorus of vocal disapproval from other conference delegates. Even Iran accepted the draft as a "perfect text," while Sweden grudgingly accepted it as a "rock-bottom compromise." With no Catholic countries objecting to the compromise, the Vatican stood alone in its refusal to compromise with the rest of the world's leaders and peoples. Germany, speaking for the European Union, warned that enough concessions had already been made. The rationale for Vatican opposition was unclear since the section explicitly rejects abortion as a means of family planning and urges countries to minimize both the incidence of unsafe abortion and abortion overall by improving family planning. Prevention of unwanted pregnancies must be given highest priority and women should have ready access to compassionate counselling, with abortion never promoted as a means of family planning. Moreover, there is no longer a reference to sexual health education, a plea to governments to review their laws and policies on abortion, and a call to consider women's health rather than relying upon criminal codes and punitive measures. Participants said the Vatican objected to a phrase stating that abortions, where legal, should be safe, while the Church representative argued that any suggestion that abortion is safe contradicts church doctrine on the sanctity of life.

Adolescent Health-Compromising Behaviors: Motivating School Counselors.

ERIC Educational Resources Information Center

Nagel, Liza; Scherer, David G.; Lee, William

2000-01-01

Investigated middle and high school counselors' perceptions of adolescent health-compromising behaviors and motivations to intervene. Data from a survey based on protection motivation theory showed differences in counselors' perceptions of the severity of risk-taking behaviors. Perceptions were highly correlated with intentions to seek out…

The medically compromised patient: Are dental implants a feasible option?

PubMed

Vissink, A; Spijkervet, Fkl; Raghoebar, G M

2018-03-01

In healthy subjects, dental implants have evolved to be a common therapy to solve problems related to stability and retention of dentures as well as to replace failing teeth. Although dental implants are applied in medically compromised patients, it is often not well known whether this therapy is also feasible in these patients, whether the risk of implant failure and developing peri-implantitis is increased, and what specific preventive measures, if any, have to be taken when applying dental implants in these patients. Generally speaking, as was the conclusion by the leading review of Diz, Scully, and Sanz on placement of dental implants in medically compromised patients (J Dent, 41, 2013, 195), in a few disorders implant survival may be lower, and the risk of a compromised peri-implant health and its related complications be greater, but the degree of systemic disease control outweighs the nature of the disorder rather than the risk accompanying dental implant treatment. So, as dental implant treatment is accompanied by significant functional benefits and improved oral health-related quality of life, dental implant therapy is a feasible treatment in almost any medically compromised patient when the required preventive measures are taken and follow-up care is at a high level. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.

Classical Hodgkin lymphoma arising in the setting of iatrogenic immunodeficiency: a clinicopathologic study of 10 cases.

PubMed

Loo, Eric Y; Medeiros, L Jeffrey; Aladily, Tariq N; Hoehn, Daniela; Kanagal-Shamanna, Rashmi; Young, Ken H; Lin, Pei; Bueso-Ramos, Carlos E; Manning, John T; Patel, Keyur; Thomazy, Vilmos; Brynes, Russell K; Goswami, Maitrayee; Fayad, Luis E; Miranda, Roberto N

2013-08-01

Iatrogenic immunodeficiency-associated lymphoproliferative disorders are rare. A small subset of these lesions resembles classical Hodgkin lymphoma (CHL), but there are few data in the literature about these lesions. We describe 10 patients with autoimmune diseases treated with immunomodulator therapeutic agents who developed CHL. The autoimmune diseases included rheumatoid arthritis (n=5), systemic lupus erythematosus (n=2), dermatomyositis (n=1), autoimmune hepatitis (n=1), and Crohn disease (n=1), and the immunomodulatory therapies were methotrexate, azathioprine, tumor necrosis factor-α inhibitors, and thalidomide alone or in various combinations. The study group included 9 women and 1 man with a median age of 50 years (range, 25 to 77 y). The histologic features supported CHL in all cases with Reed-Sternberg (RS) and Hodgkin (H) cells in an inflammatory cell background, although the neoplasm could only be subclassified in 3 patients: 2 nodular sclerosis and 1 mixed cellularity. Immunohistochemical analysis supported the diagnosis of CHL. In all cases the RS-H cells were CD30. Nine of 10 cases were CD15, whereas CD20 was expressed variably in 4/10 cases. CD45/LCA was negative in 8 cases assessed. In situ hybridization for Epstein-Barr virus-encoded RNA was positive in the RS-H cells in 8/10 cases. The microenvironment of these lesions depicted a predominance of T-regulatory cells and M2 histiocytes. Clinical follow-up data were available for 7 patients, with a median posttreatment period of 27 months (range, 12 mo to 7 y). In all 7 patients immunomodulatory drug therapy was discontinued, and chemotherapy for CHL was administered; 2 patients also received local radiation. All 7 patients achieved complete remission and are alive. We conclude that iatrogenic immunodeficiency-associated CHL is highly associated with Epstein-Barr virus infection, and patients usually have a good outcome after discontinuation of immunomodulatory agents and chemotherapy for CHL.

14 CFR § 1261.414 - Compromise of claims.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the Government's ability to enforce collection. The compromise should be for an amount which bears a... the settlement of small claims, but normally will not carry great weight in the settlement of large...

Compromise, Well-Being, and Action Behaviors in Young Adults in Career Transition

ERIC Educational Resources Information Center

Creed, Peter A.; Blume, Kellie

2013-01-01

The authors surveyed 186 first-year university students and assessed their level of career compromise associated with making the transition to university. Compromise was operationalized as the discrepancy between the job characteristics of ideal and expected occupations. The authors also assessed career well-being (satisfaction, distress), action…

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation.

PubMed

de'Angelis, Nicola; Di Saverio, Salomone; Chiara, Osvaldo; Sartelli, Massimo; Martínez-Pérez, Aleix; Patrizi, Franca; Weber, Dieter G; Ansaloni, Luca; Biffl, Walter; Ben-Ishay, Offir; Bala, Miklosh; Brunetti, Francesco; Gaiani, Federica; Abdalla, Solafah; Amiot, Aurelien; Bahouth, Hany; Bianchi, Giorgio; Casanova, Daniel; Coccolini, Federico; Coimbra, Raul; de'Angelis, Gian Luigi; De Simone, Belinda; Fraga, Gustavo P; Genova, Pietro; Ivatury, Rao; Kashuk, Jeffry L; Kirkpatrick, Andrew W; Le Baleur, Yann; Machado, Fernando; Machain, Gustavo M; Maier, Ronald V; Chichom-Mefire, Alain; Memeo, Riccardo; Mesquita, Carlos; Salamea Molina, Juan Carlos; Mutignani, Massimiliano; Manzano-Núñez, Ramiro; Ordoñez, Carlos; Peitzman, Andrew B; Pereira, Bruno M; Picetti, Edoardo; Pisano, Michele; Puyana, Juan Carlos; Rizoli, Sandro; Siddiqui, Mohammed; Sobhani, Iradj; Ten Broek, Richard P; Zorcolo, Luigi; Carra, Maria Clotilde; Kluger, Yoram; Catena, Fausto

2018-01-01

Iatrogenic colonoscopy perforation (ICP) is a severe complication that can occur during both diagnostic and therapeutic procedures. Although 45-60% of ICPs are diagnosed by the endoscopist while performing the colonoscopy, many ICPs are not immediately recognized but are instead suspected on the basis of clinical signs and symptoms that occur after the endoscopic procedure. There are three main therapeutic options for ICPs: endoscopic repair, conservative therapy, and surgery. The therapeutic approach must vary based on the setting of the diagnosis (intra- or post-colonoscopy), the type of ICP, the characteristics and general status of the patient, the operator's level of experience, and surgical device availability. Although ICPs have been the focus of numerous publications, no guidelines have been created to standardize the management of ICPs. The aim of this article is to present the World Society of Emergency Surgery (WSES) guidelines for the management of ICP, which are intended to be used as a tool to promote global standards of care in case of ICP. These guidelines are not meant to substitute providers' clinical judgment for individual patients, and they may need to be modified based on the medical team's level of experience and the availability of local resources.

Iatrogenic Cushing syndrome in patients receiving inhaled budesonide and itraconazole or ritonavir: two cases and literature review.

PubMed

Blondin, Marie-Christine; Beauregard, Hugues; Serri, Omar

2013-01-01

To present two cases of iatrogenic Cushing syndrome caused by the interaction of budesonide, an inhaled glucocorticoid, with ritonavir and itraconazole. We present the clinical and biochemical data of two patients in whom diagnosis of Cushing syndrome was caused by this interaction. We also reviewed the pertinent literature and management options. A 71-year-old man was treated with inhaled budesonide for a chronic obstructive pulmonary disease and itraconazole for a pulmonary aspergillosis. The patient rapidly developed a typical Cushing syndrome complicated by bilateral avascular necrosis of the femoral heads. Serum 8:00 AM cortisol concentrations were suppressed at 0.76 and 0.83 μg/dL on two occasions. The patient died 4 days later of a massive myocardial infarction. The second case is a 46-year-old woman who was treated for several years with inhaled budesonide for asthma. She was put on ritonavir, a retroviral protease inhibitor, for the treatment of human immunodeficiency virus (HIV). In the following months, she developed typical signs of Cushing syndrome. Her morning serum cortisol concentration was 1.92 μg/dL. A cosyntropin stimulation test showed values of serum cortisol of <1.10, 2.65, and 5.36 μg/dL at 0, 30, and 60 minutes, respectively, confirming an adrenal insufficiency. Because the patient was unable to stop budesonide, she was advised to reduce the frequency of its administration and eventually taper the dose until cessation. Clinicians should be aware of the potential occurrence of iatrogenic Cushing syndrome and secondary adrenal insufficiency due to the association of inhaled corticosteroids with itraconazole or ritonavir.

22 CFR 213.25 - Standards for compromise.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT CLAIMS COLLECTION Compromise of Debts § 213.25... debt within a reasonable time, or the debtor refuses to pay the claim in full and the Government does... applicable exemptions available to the debtor under State and Federal law in determining the Government's...

22 CFR 213.25 - Standards for compromise.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT CLAIMS COLLECTION Compromise of Debts § 213.25... debt within a reasonable time, or the debtor refuses to pay the claim in full and the Government does... applicable exemptions available to the debtor under State and Federal law in determining the Government's...

22 CFR 213.25 - Standards for compromise.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT CLAIMS COLLECTION Compromise of Debts § 213.25... debt within a reasonable time, or the debtor refuses to pay the claim in full and the Government does... applicable exemptions available to the debtor under State and Federal law in determining the Government's...

22 CFR 213.25 - Standards for compromise.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT CLAIMS COLLECTION Compromise of Debts § 213.25... debt within a reasonable time, or the debtor refuses to pay the claim in full and the Government does... applicable exemptions available to the debtor under State and Federal law in determining the Government's...

22 CFR 213.25 - Standards for compromise.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT CLAIMS COLLECTION Compromise of Debts § 213.25... debt within a reasonable time, or the debtor refuses to pay the claim in full and the Government does... applicable exemptions available to the debtor under State and Federal law in determining the Government's...

Factors influencing treatment decision-making for maintaining or extracting compromised teeth.

PubMed

Lang-Hua, Bich Hue; McGrath, Colman P J; Lo, Edward C M; Lang, Niklaus P

2014-01-01

To evaluate treatment decision-making with respect to maintaining periodontally compromised teeth among dentists with or without postgraduate qualifications in implant dentistry. A series of patient scenarios with varying degrees of periodontal disease levels was presented to dental practitioners. Practitioners' decision-making outcome was determined, and intention to retain the compromised teeth was analyzed in bivariate and regression analyses (accounting for postgraduate implant training, gender, years in dental practice, and implant placement experience). This study involved 30 dental practitioners with postgraduate implant qualifications (GDPP), 33 dental practitioners without postgraduate implant qualifications (GDP), and 27 practitioners undergoing training for postgraduate implant qualifications (GDPT). Variations in treatment decision-making were evident between the three groups. Differences in treatment approaches to retaining compromised teeth were apparent. Furthermore, variations in rehabilitation of extracted scenarios existed in terms of use of implant and number of implants need for rehabilitation. Accounting for dentist and practice factors in regression analyses, GDPP/GDPT were three times as likely to retain periodontally compromised upper molar, with or without pain, compared to GDP (without pain OR 3.10, 95%CI 1.04, 10.62 P = 0.04; with pain OR 3.08, 95%CI 1.09, 8.14 P = 0.03). Variations in treatment decision-making with respect to retaining periodontally compromised teeth exist between dental practitioners with and those without postgraduate training in implant dentistry. Furthermore differences in management approaches in how they would retain the teeth or rehabilitate the dental arch were apparent. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

22 CFR 304.7 - Authority to adjust, determine, compromise, and settle claims.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Authority to adjust, determine, compromise, and settle claims. 304.7 Section 304.7 Foreign Relations PEACE CORPS CLAIMS AGAINST GOVERNMENT UNDER FEDERAL TORT CLAIMS ACT Procedures § 304.7 Authority to adjust, determine, compromise, and settle claims. The...

22 CFR 304.7 - Authority to adjust, determine, compromise, and settle claims.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Authority to adjust, determine, compromise, and settle claims. 304.7 Section 304.7 Foreign Relations PEACE CORPS CLAIMS AGAINST GOVERNMENT UNDER FEDERAL TORT CLAIMS ACT Procedures § 304.7 Authority to adjust, determine, compromise, and settle claims. The...

Fuzzy compromise: An effective way to solve hierarchical design problems

NASA Technical Reports Server (NTRS)

Allen, J. K.; Krishnamachari, R. S.; Masetta, J.; Pearce, D.; Rigby, D.; Mistree, F.

1990-01-01

In this paper, we present a method for modeling design problems using a compromise decision support problem (DSP) incorporating the principles embodied in fuzzy set theory. Specifically, the fuzzy compromise decision support problem is used to study hierarchical design problems. This approach has the advantage that although the system modeled has an element of uncertainty associated with it, the solution obtained is crisp and precise. The efficacy of incorporating fuzzy sets into the solution process is discussed in the context of results obtained for a portal frame.

Poor conditions of detention compromise ethical standards.

PubMed Central

Howitt, J

1995-01-01

The ethical standards of police surgeons are being compromised by conflict between obligations to their paymasters, the police authorities, and their responsibilities to their patients, when these patients are prisoners detained in unacceptable conditions and where even minimum standards of medical care and management are difficult to deliver. PMID:11644662

Children and Adolescents and Digital Media.

PubMed

Reid Chassiakos, Yolanda Linda; Radesky, Jenny; Christakis, Dimitri; Moreno, Megan A; Cross, Corinn

2016-11-01

Today's children and adolescents are immersed in both traditional and new forms of digital media. Research on traditional media, such as television, has identified health concerns and negative outcomes that correlate with the duration and content of viewing. Over the past decade, the use of digital media, including interactive and social media, has grown, and research evidence suggests that these newer media offer both benefits and risks to the health of children and teenagers. Evidence-based benefits identified from the use of digital and social media include early learning, exposure to new ideas and knowledge, increased opportunities for social contact and support, and new opportunities to access health promotion messages and information. Risks of such media include negative health effects on sleep, attention, and learning; a higher incidence of obesity and depression; exposure to inaccurate, inappropriate, or unsafe content and contacts; and compromised privacy and confidentiality. This technical report reviews the literature regarding these opportunities and risks, framed around clinical questions, for children from birth to adulthood. To promote health and wellness in children and adolescents, it is important to maintain adequate physical activity, healthy nutrition, good sleep hygiene, and a nurturing social environment. A healthy Family Media Use Plan (www.healthychildren.org/MediaUsePlan) that is individualized for a specific child, teenager, or family can identify an appropriate balance between screen time/online time and other activities, set boundaries for accessing content, guide displays of personal information, encourage age-appropriate critical thinking and digital literacy, and support open family communication and implementation of consistent rules about media use. Copyright © 2016 by the American Academy of Pediatrics.

15 CFR 19.7 - When will Commerce entities compromise a Commerce debt?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false When will Commerce entities compromise a Commerce debt? 19.7 Section 19.7 Commerce and Foreign Trade Office of the Secretary of Commerce COMMERCE DEBT COLLECTION Procedures To Collect Commerce Debts § 19.7 When will Commerce entities compromise...

15 CFR 19.7 - When will Commerce entities compromise a Commerce debt?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false When will Commerce entities compromise a Commerce debt? 19.7 Section 19.7 Commerce and Foreign Trade Office of the Secretary of Commerce COMMERCE DEBT COLLECTION Procedures To Collect Commerce Debts § 19.7 When will Commerce entities compromise...

15 CFR 19.7 - When will Commerce entities compromise a Commerce debt?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false When will Commerce entities compromise a Commerce debt? 19.7 Section 19.7 Commerce and Foreign Trade Office of the Secretary of Commerce COMMERCE DEBT COLLECTION Procedures To Collect Commerce Debts § 19.7 When will Commerce entities compromise...

15 CFR 19.7 - When will Commerce entities compromise a Commerce debt?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false When will Commerce entities compromise a Commerce debt? 19.7 Section 19.7 Commerce and Foreign Trade Office of the Secretary of Commerce COMMERCE DEBT COLLECTION Procedures To Collect Commerce Debts § 19.7 When will Commerce entities compromise...

15 CFR 19.7 - When will Commerce entities compromise a Commerce debt?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false When will Commerce entities compromise a Commerce debt? 19.7 Section 19.7 Commerce and Foreign Trade Office of the Secretary of Commerce COMMERCE DEBT COLLECTION Procedures To Collect Commerce Debts § 19.7 When will Commerce entities compromise...

In vitro models to estimate drug penetration through the compromised stratum corneum barrier.

PubMed

Engesland, André; Škalko-Basnet, Nataša; Flaten, Gøril Eide

2016-11-01

The phospholipid vesicle-based permeation assay (PVPA) is a recently established in vitro stratum corneum model to estimate the permeability of intact and healthy skin. The aim here was to further evolve this model to mimic the stratum corneum in a compromised skin barrier by reducing the barrier functions in a controlled manner. To mimic compromised skin barriers, PVPA barriers were prepared with explicitly defined reduced barrier function and compared with literature data from both human and animal skin with compromised barrier properties. Caffeine, diclofenac sodium, chloramphenicol and the hydrophilic marker calcein were tested to compare the PVPA models with established models. The established PVPA models mimicking the stratum corneum in healthy skin showed good correlation with biological barriers by ranking drugs similar to those ranked by the pig ear skin model and were comparable to literature data on permeation through healthy human skin. The PVPA models provided reproducible and consistent results with a distinction between the barriers mimicking compromised and healthy skin. The trends in increasing drug permeation with an increasing degree of compromised barriers for the model drugs were similar to the literature data from other in vivo and in vitro models. The PVPA models have the potential to provide permeation predictions when investigating drugs or cosmeceuticals intended for various compromised skin conditions and can thus possibly reduce the time and cost of testing as well as the use of animal testing in the early development of drug candidates, drugs and cosmeceuticals.

Developments in cognitive neuroscience: I. Conflict, compromise, and connectionism.

PubMed

Westen, Drew; Gabbard, Glen O

2002-01-01

The strength of psychoanalysis has always been its understanding of affect and motivation. Contemporary developments in cognitive neuroscience offer possibilities of integrating sophisticated, experimentally informed models of thought and memory with an understanding of dynamically and clinically meaningful processes. Aspects of contemporary theory and research in cognitive neuroscience are integrated with psychoanalytic theory and technique, particularly theories of conflict and compromise. After a description of evolving models of the mind in cognitive neuroscience, several issues relevant to psychoanalytic theory and practice are addressed. These include the nature of representations, the interaction of cognition and affect, and the mechanisms by which the mind unconsciously forges compromise solutions that best fit multiple cognitive and affective-motivational constraints.

Roles of Melatonin in Fetal Programming in Compromised Pregnancies

PubMed Central

Chen, Yu-Chieh; Sheen, Jiunn-Ming; Tiao, Miao-Meng; Tain, You-Lin; Huang, Li-Tung

2013-01-01

Compromised pregnancies such as those associated with gestational diabetes mellitus, intrauterine growth retardation, preeclampsia, maternal undernutrition, and maternal stress may negatively affect fetal development. Such pregnancies may induce oxidative stress to the fetus and alter fetal development through the epigenetic process that may affect development at a later stage. Melatonin is an oxidant scavenger that reverses oxidative stress during the prenatal period. Moreover, the role of melatonin in epigenetic modifications in the field of developmental programming has been studied extensively. Here, we describe the physiological function of melatonin in pregnancy and discuss the roles of melatonin in fetal programming in compromised pregnancies, focusing on its involvement in redox and epigenetic mechanisms. PMID:23466884

Compromises along the Way: Balancing Speed To Market with Sustainability while Delivering Knowledge Management Services.

ERIC Educational Resources Information Center

Heyman, Martha K.

This paper will discuss some of the compromises, and the path to those compromises, that must be made while implementing a successful knowledge management program within a for-profit enterprise. Specifically the following compromises are addressed: (1) manage knowledge where it is created, but do that within a global system; (2) no single scope…

36 CFR 1011.7 - When will the Presidio Trust compromise a debt?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false When will the Presidio Trust... Procedures To Collect Presidio Trust Debts § 1011.7 When will the Presidio Trust compromise a debt? (a... debt owed to the Presidio Trust that is not recovered as the result of a compromise will be reported to...

Leap Frog Digital Sensors and Definition, Integration & Testing FY 2003 Annual Report

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

Meitzler, Wayne D.; Ouderkirk, Steven J.; Shoemaker, Steven V.

2003-12-31

The objective of Leap Frog is to develop a comprehensive security tool that is transparent to the user community and more effective than current methods for preventing and detecting security compromises of critical physical and digital assets. Current security tools intrude on the people that interact with these critical assets by requiring them to perform additional functions or having additional visible sensors. Leap Frog takes security to the next level by being more effective and reducing the adverse impact on the people interacting with protected assets.

A Rare Cause of Death in a Woman: Iatrogenic Bladder Rupture in a Patient With an Indwelling Foley Catheter.

PubMed

Paul, Anthea B Mahesan; Simms, Lary; Paul, Abraham E; Mahesan, Andrew A; Ramzanali, Ammani

2016-05-01

The CDC estimates that 12-25% of all hospitalized patients receive a urinary catheter during their hospital stay. Foley catheter failure is uncommon and Foley catheter failure associated with iatrogenic urinary bladder rupture (IUBR) is extremely rare. Symptoms are often nonspecific and thus misdiagnosis and delayed treatment is common. In this case report, we present a case of IUBR in a woman from Foley catheter failure, which ultimately led to her demise. This case adds to the literature the importance of suspicion for IUBR in patients with indwelling Foley catheters presenting with lower abdominal pain, hematuria, and decreased urine output.

A Rare Cause of Death in a Woman: Iatrogenic Bladder Rupture in a Patient With an Indwelling Foley Catheter

PubMed Central

Paul, Anthea B. Mahesan; Simms, Lary; Paul, Abraham E.; Mahesan, Andrew A.; Ramzanali, Ammani

2016-01-01

The CDC estimates that 12–25% of all hospitalized patients receive a urinary catheter during their hospital stay. Foley catheter failure is uncommon and Foley catheter failure associated with iatrogenic urinary bladder rupture (IUBR) is extremely rare. Symptoms are often nonspecific and thus misdiagnosis and delayed treatment is common. In this case report, we present a case of IUBR in a woman from Foley catheter failure, which ultimately led to her demise. This case adds to the literature the importance of suspicion for IUBR in patients with indwelling Foley catheters presenting with lower abdominal pain, hematuria, and decreased urine output. PMID:27175339

45 CFR 30.4 - Compromise, waiver, or disposition under other statutes not precluded.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Compromise, waiver, or disposition under other statutes not precluded. 30.4 Section 30.4 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CLAIMS COLLECTION General Provisions § 30.4 Compromise, waiver, or disposition under other...

Political Compromise Makes the World Go 'Round

ERIC Educational Resources Information Center

Everett, Diana

2007-01-01

Compromise in any context is often hard to accept. It feels like a person is giving up on his or her ideals. This is especially true in dealing with politics. Legislative and congressional bills can be written with the highest of ideals in mind. By the time the bill progresses through committees and the floor debate process, it can look like a…

Iatrogenic hyperthyroidism does not promote weight loss or prevent ageing-related increases in body mass in thyroid cancer survivors.

PubMed

Polotsky, Hanah N; Brokhin, Matvey; Omry, Gal; Polotsky, Alex J; Tuttle, R Michael

2012-04-01

Thyroid cancer survivors represent a unique population in which the potential long-term effects of brief periods of intentional thyroid hormone withdrawal and/or prolonged periods of iatrogenic hyperthyroidism on body weight and body mass were evaluated. The objectives of this study were to characterize body mass changes over several years in a cohort of thyroid cancer patients with iatrogenic hyperthyroidism and to compare these changes with the expected weight gain in age-matched healthy control populations. We also evaluated the possibility that the method of preparation [thyroid hormone withdrawal (THW) vs recombinant human TSH (rhTSH)] for radioactive iodine remnant ablation may be associated with differences in body mass at the time of the final follow-up. DESIGN/SETTING/PATIENTS/INTERVENTIONS: A retrospective review identified 153 patients with thyroid cancer who underwent total thyroidectomy at one major medical centre. Of the 153 patients, 143 also had radioactive iodine remnant ablation: 70 after THW and 73 after rhTSH. Change in weight and BMI at 1-2 and 3-5 years of follow-up points were examined. Annualized weight variation within the cohort was compared with age-matched population controls expressed in kilogram/year. Significant weight gain was noted for the full cohort after 3-5 years of follow-up as compared to baseline (76 ± 21 kg at baseline vs 79 ± 23 kg at 3-5 years of follow-up, P < 0·01), which represented a 3·2% increase. Female and male patients with thyroid cancer experienced 0·46 and 0·94 kg/year gain in weight, respectively, which is similar or somewhat higher than previously published age-matched population controls (ranging from 0·23 to 0·34 kg/year). When expressed as per cent change and comparing the final weight to the pre-operative baseline, the rhTSH group experienced approximately a 1·7% increase in weight compared with the 3·9% increase seen with THW patients (P = 0·02). When expressed as kg/year change, the rh

Tragic choices and moral compromise: the ethics of allocating kidneys for transplantation.

PubMed

Hoffmaster, Barry; Hooker, Cliff

2013-09-01

For almost a decade, the Kidney Transplantation Committee of the United Network for Organ Sharing has been striving to revise its approach to allocating kidneys from deceased donors for transplantation. Two fundamental values, equality and efficiency, are central to distributing this scarce resource. The prevailing approach gives primacy to equality in the temporal form of first-come, first-served, whereas the motivation for a new approach is to redeem efficiency by increasing the length of survival of transplanted kidneys and their recipients. But decision making about a better way of allocating kidneys flounders because it is constrained by the amorphous notion of "balancing" values. This article develops a more fitting, productive approach to resolving the conflict between equality and efficiency by embedding the notion of compromise in the analysis of a tragic choice provided by Guido Calabresi and Philip Bobbitt. For Calabresi and Bobbitt, the goals of public policy with respect to tragic choices are to limit tragedy and to deal with the irreducible minimum of tragedy in the least offensive way. Satisfying the value of efficiency limits tragedy, and satisfying the value of equality deals with the irreducible minimum of tragedy in the least offensive way. But both values cannot be completely satisfied simultaneously. Compromise is occasioned when not all the several obligations that exist in a situation can be met and when neglecting some obligations entirely in order to fulfill others entirely is improper. Compromise is amalgamated with the notion of a tragic choice and then used to assess proposals for revising the allocation of kidneys considered by the Kidney Transplantation Committee. Compromise takes two forms in allocating kidneys: it occurs within particular approaches to allocating kidneys because neither equality nor efficiency can be fully satisfied, and it occurs over the course of sequential approaches to allocating kidneys that cycle between

32 CFR 2400.33 - Loss or possible compromise.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Loss or possible compromise. 2400.33 Section 2400.33 National Defense Other Regulations Relating to National Defense OFFICE OF SCIENCE AND TECHNOLOGY POLICY REGULATIONS TO IMPLEMENT E.O. 12356; OFFICE OF SCIENCE AND TECHNOLOGY POLICY INFORMATION...

32 CFR 2400.33 - Loss or possible compromise.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Loss or possible compromise. 2400.33 Section 2400.33 National Defense Other Regulations Relating to National Defense OFFICE OF SCIENCE AND TECHNOLOGY POLICY REGULATIONS TO IMPLEMENT E.O. 12356; OFFICE OF SCIENCE AND TECHNOLOGY POLICY INFORMATION...

32 CFR 2400.33 - Loss or possible compromise.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Loss or possible compromise. 2400.33 Section 2400.33 National Defense Other Regulations Relating to National Defense OFFICE OF SCIENCE AND TECHNOLOGY POLICY REGULATIONS TO IMPLEMENT E.O. 12356; OFFICE OF SCIENCE AND TECHNOLOGY POLICY INFORMATION...

32 CFR 2400.33 - Loss or possible compromise.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Loss or possible compromise. 2400.33 Section 2400.33 National Defense Other Regulations Relating to National Defense OFFICE OF SCIENCE AND TECHNOLOGY POLICY REGULATIONS TO IMPLEMENT E.O. 12356; OFFICE OF SCIENCE AND TECHNOLOGY POLICY INFORMATION...

32 CFR 2400.33 - Loss or possible compromise.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Loss or possible compromise. 2400.33 Section 2400.33 National Defense Other Regulations Relating to National Defense OFFICE OF SCIENCE AND TECHNOLOGY POLICY REGULATIONS TO IMPLEMENT E.O. 12356; OFFICE OF SCIENCE AND TECHNOLOGY POLICY INFORMATION...

40 CFR 13.26 - Payment of compromised claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Payment of compromised claims. 13.26 Section 13.26 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL CLAIMS COLLECTION... will be required to execute a confess-judgment agreement which accelerates payment of the balance due...

Acupuncture-induced haemothorax: a rare iatrogenic complication of acupuncture

PubMed Central

Karavis, Miltiades Y; Argyra, Erifili; Segredos, Venieris; Yiallouroy, Aneza; Giokas, Georgios; Theodosopoulos, Thedosios

2015-01-01

This paper reports a rare iatrogenic complication of acupuncture-induced haemothorax and comments on the importance and need for special education of physicians and physiotherapists in order to apply safe and effective acupuncture treatment. A 37-year-old healthy woman had a session of acupuncture treatments for neck and right upper thoracic non-specific musculoskeletal pain, after which she gradually developed dyspnoea and chest discomfort. After some delay while trying other treatment, she was eventually transferred to the emergency department where a chest X-ray revealed a right pneumothorax and fluid collection. She was admitted to hospital and a chest tube inserted into the right hemithorax (under ultrasound guidance) drained 800 mL of bloody fluid (haematocrit (Hct) 17.8%) in 24 h and 1200 mL over the following 3 days. Her blood Hct fell from 39.0% to 30.8% and haemoglobin from 12.7 to 10.3 g/dL. The patient recovered completely and was discharged after 9 days of hospitalisation. When dyspnoea, chest pain and discomfort occur during or after an acupuncture treatment, the possibility of secondary (traumatic) pneumo- or haemopneumothorax should be considered and the patient should remain under careful observation (watchful waiting) for at least 48 h. To maximise the safety of acupuncture, specific training should be given for the safe use of acupuncture points of the anterior and posterior thoracic wall using dry needling, trigger point acupuncture or other advanced acupuncture techniques. PMID:25791844

The "booty call": a compromise between men's and women's ideal mating strategies.

PubMed

Jonason, Peter K; Li, Norman P; Cason, Margaret J

2009-01-01

Traditionally, research on romantic and sexual relationships has focused on one-night stands and monogamous pairs. However, as the result of men and women pursuing their ideal relationship types, various compromise relationships may emerge. One such compromise is explored here: the "booty call." The results of an act-nomination and frequency study of college students provided an initial definition and exploration of this type of relationship. Booty calls tend to utilize various communication mediums to facilitate sexual contact among friends who, for men, may represent low-investment, attractive sexual partners and, for women, may represent attractive test-mates. The relationship is discussed as a compromise between men's and women's ideal mating strategies that allows men greater sexual access and women an ongoing opportunity to evaluate potential long-term mates.

Compromise Approach-Based Genetic Algorithm for Constrained Multiobjective Portfolio Selection Model

NASA Astrophysics Data System (ADS)

Li, Jun

In this paper, fuzzy set theory is incorporated into a multiobjective portfolio selection model for investors’ taking into three criteria: return, risk and liquidity. The cardinality constraint, the buy-in threshold constraint and the round-lots constraints are considered in the proposed model. To overcome the difficulty of evaluation a large set of efficient solutions and selection of the best one on non-dominated surface, a compromise approach-based genetic algorithm is presented to obtain a compromised solution for the proposed constrained multiobjective portfolio selection model.

5 CFR 1215.32 - Compromise, suspension and termination.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCEDURES DEBT MANAGEMENT Claims Collection § 1215.32 Compromise, suspension and termination. (a) The... outstanding principal is not greater than $20,000. MSPB procedures for writing off outstanding accounts are... debts where the outstanding principal is greater than $20,000 only with the approval of, or by referral...

All-inside, physeal-sparing anterior cruciate ligament reconstruction does not significantly compromise the physis in skeletally immature athletes: a postoperative physeal magnetic resonance imaging analysis.

PubMed

Nawabi, Danyal H; Jones, Kristofer J; Lurie, Brett; Potter, Hollis G; Green, Daniel W; Cordasco, Frank A

2014-12-01

Anterior cruciate ligament (ACL) reconstruction in skeletally immature patients can result in growth disturbance due to iatrogenic physeal injury. Multiple physeal-sparing ACL reconstruction techniques have been described; however, few combine the benefits of anatomic reconstruction using sockets without violation of the femoral or tibial physis. To utilize physeal-specific magnetic resonance imaging (MRI) to quantify the zone of physeal injury after all-inside ACL reconstruction in skeletally immature athletes. Case series; Level of evidence, 4. Twenty-three skeletally immature patients (mean chronologic age 12.6 years; range, 10-15 years) were prospectively evaluated after all-inside ACL reconstruction. The mean bone age was 13.2 years. There were 8 females and 15 males. Fifteen patients underwent an all-epiphyseal (AE) ACL reconstruction and 8 patients had a partial transphyseal (PTP) ACL reconstruction, which spared the femoral physis but crossed the tibial physis. At 6 and 12 months postoperatively, MRI using 3-dimensional fat-suppressed spoiled gradient recalled echo sequences and full-length standing radiographs were performed to assess graft survival, growth arrest, physeal violation, angular deformity, and leg length discrepancy. The mean follow-up for this cohort was 18.5 months (range, 12-39 months). Minimal tibial physeal violation was seen in 10 of 15 patients in the AE group and, by definition, all patients in the PTP group. The mean area of tibial physeal disturbance (±SD) was 57.8 ± 52.2 mm(2) (mean 2.1% of total physeal area) in the AE group compared with 145.1 ± 100.6 mm(2) (mean 5.4% of total physeal area) in the PTP group (P = .003). Minimal compromise of the femoral physis (1.5%) was observed in 1 case in the PTP group and no cases in the AE group. No cases of growth arrest, articular surface violation, or avascular necrosis were noted on MRI. No postoperative angular deformities or significant leg length discrepancies were observed. The

Avoidable iatrogenic complications of male urethral catheterisation and inadequate intern training: a 4-year follow-up post implementation of an intern training programme.

PubMed

Sullivan, J F; Forde, J C; Thomas, A Z; Creagh, T A

2015-02-01

To assess the impact of a structured training programme in urethral catheterisation (UC) targeted at newly qualified junior doctors on rates of iatrogenic catheter morbidity within a tertiary care referral centre. Male UC-related morbidities were retrospectively identified from our computerised inpatient urology consultation system over a 1-year period from July 2010 to June 2011. Relevant medical records were also reviewed. Results were compared with an initial study performed between July 2006 and June 2007, prior the introduction of a structured training programme in our institution. An anonymous questionnaire was used for the subjective assessment of interns about confidence in catheterising post introduction of the programme. Of 725 urological consultations, 29 (4%) were related to complications arising from male UC during the 1 year period. This reflected a statistically significant decrease when compared to our 2007 figures, 51/864 (6%) (p < 0.05). Again, the most common indication for UC was monitoring urinary output for acute medical illness (19/29, 66%). The most common complication was urethral trauma (16/29, 55%). Of the 29 cases of UC-related morbidity, 18 (62%) resulted from interns performing UC, a decrease of 12% from our original paper. A drop of 27% was seen in the rates of UC related morbidity attributable to interns during the first 6 months of internship (July-December). Overall, 70% (vs 40% original study) of interns felt that their practical training was adequate since introduction of the programme (p < 0.01) with 53% considering theoretical training adequate (vs 16% original study (p < 0.01). When asked were they confident in performing UC, 63% said they were compared to 35% before introduction of the programme (p < 0.05). UC-related iatrogenic morbidity is not uncommon even in a tertiary-care teaching hospital. Implementation of a structured training programme in UC prior to the commencement of intern year has been shown to result

Identifying genetic relatives without compromising privacy

PubMed Central

He, Dan; Furlotte, Nicholas A.; Hormozdiari, Farhad; Joo, Jong Wha J.; Wadia, Akshay; Ostrovsky, Rafail; Sahai, Amit; Eskin, Eleazar

2014-01-01

The development of high-throughput genomic technologies has impacted many areas of genetic research. While many applications of these technologies focus on the discovery of genes involved in disease from population samples, applications of genomic technologies to an individual’s genome or personal genomics have recently gained much interest. One such application is the identification of relatives from genetic data. In this application, genetic information from a set of individuals is collected in a database, and each pair of individuals is compared in order to identify genetic relatives. An inherent issue that arises in the identification of relatives is privacy. In this article, we propose a method for identifying genetic relatives without compromising privacy by taking advantage of novel cryptographic techniques customized for secure and private comparison of genetic information. We demonstrate the utility of these techniques by allowing a pair of individuals to discover whether or not they are related without compromising their genetic information or revealing it to a third party. The idea is that individuals only share enough special-purpose cryptographically protected information with each other to identify whether or not they are relatives, but not enough to expose any information about their genomes. We show in HapMap and 1000 Genomes data that our method can recover first- and second-order genetic relationships and, through simulations, show that our method can identify relationships as distant as third cousins while preserving privacy. PMID:24614977

Identifying genetic relatives without compromising privacy.

PubMed

He, Dan; Furlotte, Nicholas A; Hormozdiari, Farhad; Joo, Jong Wha J; Wadia, Akshay; Ostrovsky, Rafail; Sahai, Amit; Eskin, Eleazar

2014-04-01

The development of high-throughput genomic technologies has impacted many areas of genetic research. While many applications of these technologies focus on the discovery of genes involved in disease from population samples, applications of genomic technologies to an individual's genome or personal genomics have recently gained much interest. One such application is the identification of relatives from genetic data. In this application, genetic information from a set of individuals is collected in a database, and each pair of individuals is compared in order to identify genetic relatives. An inherent issue that arises in the identification of relatives is privacy. In this article, we propose a method for identifying genetic relatives without compromising privacy by taking advantage of novel cryptographic techniques customized for secure and private comparison of genetic information. We demonstrate the utility of these techniques by allowing a pair of individuals to discover whether or not they are related without compromising their genetic information or revealing it to a third party. The idea is that individuals only share enough special-purpose cryptographically protected information with each other to identify whether or not they are relatives, but not enough to expose any information about their genomes. We show in HapMap and 1000 Genomes data that our method can recover first- and second-order genetic relationships and, through simulations, show that our method can identify relationships as distant as third cousins while preserving privacy.

Rebamipide May Be Comparable to H2 Receptor Antagonist in Healing Iatrogenic Gastric Ulcers Created by Endoscopic Mucosal Resection: A Prospective Randomized Pilot Study

PubMed Central

Kim, Yu Jin; Lee, Sang Kil; Kim, Jie Hyun; Lee, Yong Chan

2010-01-01

Endoscopic mucosal resection (EMR) results in the formation of iatrogenic gastric ulcers and the optimal treatments for such ulcers are still unclear. We aimed to evaluate the efficacy of rebamipide in the management of EMR-induced ulcers by comparing it with an H2 receptor antagonist. After EMR, patients were randomly assigned into either rebamipide or famotidine groups. All patients received a one-week lansoprazole 30 mg q.d. therapy followed by three-week famotidine (20 mg b.i.d.) or rebamipide (100 mg t.i.d.) therapy. Four weeks after the treatments, ulcer sizes, stages, bleeding rates, and ulcer-related symptoms were compared using endoscopy and a questionnaire. A total of 63 patients were enrolled in this study. Finally, 51 patients were analyzed, 26 in rebamipide and 25 in famotidine group. Baseline characteristics were not significantly different between the two groups. Four weeks after EMR, the two groups were comparable in terms of ulcer reduction ratio (P=0.297), and ulcer stage (P=1.000). Moreover, no difference was observed with regard to ulcer-related symptoms, drug compliance, adverse drug event rates, and bleeding rates. Our data suggest that rebamipide is not inferior to famotidine in healing iatrogenic gastric ulcers, and could be a therapeutic option in the treatment of such ulcers. PMID:20358002

Cyber indicators of compromise: a domain ontology for security information and event management

DTIC Science & Technology

2017-03-01

COMPROMISE: A DOMAIN ONTOLOGY FOR SECURITY INFORMATION AND EVENT MANAGEMENT by Marsha D. Rowell March 2017 Thesis Co-Advisors: J. D...to automate this work is Security Information and Event Management (SIEM). In short, SIEM technology works by aggregating log information , and then...Distribution is unlimited. CYBER INDICATORS OF COMPROMISE: A DOMAIN ONTOLOGY FOR SECURITY INFORMATION AND EVENT MANAGEMENT Marsha D. Rowell

Acupuncture-induced haemothorax: a rare iatrogenic complication of acupuncture.

PubMed

Karavis, Miltiades Y; Argyra, Erifili; Segredos, Venieris; Yiallouroy, Aneza; Giokas, Georgios; Theodosopoulos, Thedosios

2015-06-01

This paper reports a rare iatrogenic complication of acupuncture-induced haemothorax and comments on the importance and need for special education of physicians and physiotherapists in order to apply safe and effective acupuncture treatment. A 37-year-old healthy woman had a session of acupuncture treatments for neck and right upper thoracic non-specific musculoskeletal pain, after which she gradually developed dyspnoea and chest discomfort. After some delay while trying other treatment, she was eventually transferred to the emergency department where a chest X-ray revealed a right pneumothorax and fluid collection. She was admitted to hospital and a chest tube inserted into the right hemithorax (under ultrasound guidance) drained 800 mL of bloody fluid (haematocrit (Hct) 17.8%) in 24 h and 1200 mL over the following 3 days. Her blood Hct fell from 39.0% to 30.8% and haemoglobin from 12.7 to 10.3 g/dL. The patient recovered completely and was discharged after 9 days of hospitalisation. When dyspnoea, chest pain and discomfort occur during or after an acupuncture treatment, the possibility of secondary (traumatic) pneumo- or haemopneumothorax should be considered and the patient should remain under careful observation (watchful waiting) for at least 48 h. To maximise the safety of acupuncture, specific training should be given for the safe use of acupuncture points of the anterior and posterior thoracic wall using dry needling, trigger point acupuncture or other advanced acupuncture techniques. 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.

Iatrogenic Preterm Premature Rupture of Membranes after Fetoscopic Laser Ablative Surgery.

PubMed

Maggio, Lindsay; Carr, Stephen R; Watson-Smith, Debra; O'Brien, Barbara M; Lopes, Vrishali; Muratore, Christopher S; Luks, Francois I

2015-01-01

To describe the incidence and risk factors for iatrogenic premature preterm rupture of membranes (iPPROM) after fetoscopic laser surgery for the twin-to-twin-transfusion syndrome. This is a retrospective review of all patients who have undergone fetoscopic laser surgery at a single fetal treatment center since 2000. We defined iPPROM as spontaneous rupture of membranes before the onset of labor prior to 34 weeks of gestation. The iPPROM cohort was compared to the cohort without iPPROM for several preoperative, operative, and delivery characteristics. Ninety-two consecutive patients were reviewed. The overall rate of iPPROM was 18.5% (n = 17). The rates of iPPROM within 1 and 4 weeks were 5.4 and 10.9%, respectively. The median interval from surgery to delivery was significantly shorter in the iPPROM group (21 vs. 62 days, p = 0.01). The mean gestational age at delivery (27.0 vs. 31.1 weeks, p = 0.02) was lower in the iPPROM group. No other characteristics studied differed significantly between the groups. The incidence of iPPROM was substantially lower than in recent multicenter reports; however, no risk factors of iPPROM could be identified. Whether this is related to variations in surgical or anesthetic management will require further investigation. © 2014 S. Karger AG, Basel.

Iatrogenic trigeminal post-traumatic neuropathy: a retrospective two-year cohort study.

PubMed

Klazen, Y; Van der Cruyssen, F; Vranckx, M; Van Vlierberghe, M; Politis, C; Renton, T; Jacobs, R

2018-06-01

With the growing demand for dental work, trigeminal nerve injuries are increasingly common. This retrospective cohort study examined 53 cases of iatrogenic trigeminal nerve injury seen at the Department of Oral and Maxillofacial Surgery, University Hospitals of Leuven between 2013 and 2014 (0.6% among 8845 new patient visits). Patient records were screened for post-traumatic trigeminal nerve neuropathy caused by nerve injury incurred during implant surgery, endodontic treatment, local anaesthesia, tooth extraction, or specifically third molar removal. The patients ranged in age from 15 to 80years (mean age 42.1years) and 68% were female. The referral delay ranged from 1day to 6.5years (average 10months). The inferior alveolar nerve (IAN) was most frequently injured (28 cases), followed by the lingual nerve (LN) (21 cases). Most nerve injuries were caused during third molar removal (24 cases), followed by implant placement (nine cases) and local anaesthesia injuries (nine cases). Pain symptoms were experienced by 54% of patients suffering IAN injury, compared to 10% of patients with LN injury. Persistent neurosensory disturbances were identified in 60% of patients. While prevention remains the key issue, timely referral seems to be a critical factor for the successful treatment of post-traumatic neuropathy. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Digital Collections, Digital Libraries & the Digitization of Cultural Heritage Information.

ERIC Educational Resources Information Center

Lynch, Clifford

2002-01-01

Discusses digital collections and digital libraries. Topics include broadband availability; digital rights protection; content, both non-profit and commercial; digitization of cultural content; sustainability; metadata harvesting protocol; infrastructure; authorship; linking multiple resources; data mining; digitization of reference works;…

H. Sapiens Digital: From Digital Immigrants and Digital Natives to Digital Wisdom

ERIC Educational Resources Information Center

Prensky, Marc

2009-01-01

As we move further into the 21st century, the digital native/digital immigrant paradigm created by Marc Prensky in 2001 is becoming less relevant. In this article, Prensky suggests that we should focus instead on the development of what he calls "digital wisdom." Arguing that digital technology can make us not just smarter but truly wiser, Prensky…

Endoscopic closure of an iatrogenic rupture of upper esophagus (Lannier’s triangle) with the use of endoclips – case report and review of the literature

PubMed Central

Mantzoukis, Konstantinos; Papadimitriou, Kassiani; Kouvelis, Ioannis; Theocharidou, Athina; Zebekakis, Pantelis; Vital, Victor; Nikolaidis, Pavlos; Germanidis, Georgios

2011-01-01

We present a case report regarding a 74-year-old male with iatrogenic esophageal perforation, after an attempt to remove a food bolus impaction at Lannier’s triangle (proximal esophagus). The perforation was treated endoscopically (flexible EGD) by clip application in two sessions, with excellent outcome. Esophageal perforations occur rarely, usually following a medical procedure. The clinical manifestations are often insidious with potentially catastrophic complications. Although the majority of cases have been treated conservatively and/or operatively over the years, there is a rising tendency for non-operative endoscopic interventions due to the high morbidity and mortality rates seen even in specialized units. For this reason self-expandable stents, endoclips, tissue sealants and suturing devices have been used. A high degree of clinical suspicion is essential for successful management of esophageal perforations, as is early decision to intervene and respect for basic surgical principles such as prevention and limitation of extraesophageal contamination, prevention of reflux of gastric contents and restoration of gastrointestinal tract integrity. The published reports on the use of endoclips for repairing perforations of the proximal esophagus are rare. To our knowledge, this is the first case report regarding the endoscopic application of endoclips for the successful closure of an iatrogenic perforation at Lannier’s triangle. PMID:24714287

Reliable enumeration of malaria parasites in thick blood films using digital image analysis.

PubMed

Frean, John A

2009-09-23

Quantitation of malaria parasite density is an important component of laboratory diagnosis of malaria. Microscopy of Giemsa-stained thick blood films is the conventional method for parasite enumeration. Accurate and reproducible parasite counts are difficult to achieve, because of inherent technical limitations and human inconsistency. Inaccurate parasite density estimation may have adverse clinical and therapeutic implications for patients, and for endpoints of clinical trials of anti-malarial vaccines or drugs. Digital image analysis provides an opportunity to improve performance of parasite density quantitation. Accurate manual parasite counts were done on 497 images of a range of thick blood films with varying densities of malaria parasites, to establish a uniformly reliable standard against which to assess the digital technique. By utilizing descriptive statistical parameters of parasite size frequency distributions, particle counting algorithms of the digital image analysis programme were semi-automatically adapted to variations in parasite size, shape and staining characteristics, to produce optimum signal/noise ratios. A reliable counting process was developed that requires no operator decisions that might bias the outcome. Digital counts were highly correlated with manual counts for medium to high parasite densities, and slightly less well correlated with conventional counts. At low densities (fewer than 6 parasites per analysed image) signal/noise ratios were compromised and correlation between digital and manual counts was poor. Conventional counts were consistently lower than both digital and manual counts. Using open-access software and avoiding custom programming or any special operator intervention, accurate digital counts were obtained, particularly at high parasite densities that are difficult to count conventionally. The technique is potentially useful for laboratories that routinely perform malaria parasite enumeration. The requirements of a

Digital Collections, Digital Libraries and the Digitization of Cultural Heritage Information.

ERIC Educational Resources Information Center

Lynch, Clifford

2002-01-01

Discusses the development of digital collections and digital libraries. Topics include digitization of cultural heritage information; broadband issues; lack of compelling content; training issues; types of materials being digitized; sustainability; digital preservation; infrastructure; digital images; data mining; and future possibilities for…

Applying emerging digital video interface standards to airborne avionics sensor and digital map integrations: benefits outweigh the initial costs

NASA Astrophysics Data System (ADS)

Kuehl, C. Stephen

1996-06-01

Video signal system performance can be compromised in a military aircraft cockpit management system (CMS) with the tailoring of vintage Electronics Industries Association (EIA) RS170 and RS343A video interface standards. Video analog interfaces degrade when induced system noise is present. Further signal degradation has been traditionally associated with signal data conversions between avionics sensor outputs and the cockpit display system. If the CMS engineering process is not carefully applied during the avionics video and computing architecture development, extensive and costly redesign will occur when visual sensor technology upgrades are incorporated. Close monitoring and technical involvement in video standards groups provides the knowledge-base necessary for avionic systems engineering organizations to architect adaptable and extendible cockpit management systems. With the Federal Communications Commission (FCC) in the process of adopting the Digital HDTV Grand Alliance System standard proposed by the Advanced Television Systems Committee (ATSC), the entertainment and telecommunications industries are adopting and supporting the emergence of new serial/parallel digital video interfaces and data compression standards that will drastically alter present NTSC-M video processing architectures. The re-engineering of the U.S. Broadcasting system must initially preserve the electronic equipment wiring networks within broadcast facilities to make the transition to HDTV affordable. International committee activities in technical forums like ITU-R (former CCIR), ANSI/SMPTE, IEEE, and ISO/IEC are establishing global consensus on video signal parameterizations that support a smooth transition from existing analog based broadcasting facilities to fully digital computerized systems. An opportunity exists for implementing these new video interface standards over existing video coax/triax cabling in military aircraft cockpit management systems. Reductions in signal

Imaging of iatrogenic oesophageal injuries using optimized CT oesophageal leak protocol: pearls and pitfalls.

PubMed

Madan, Rachna; Laur, Olga; Crudup, Breland; Peavy, Latia; Carter, Brett W

2018-02-01

Iatrogenic injury to the oesophagus is a serious complication which is increasingly seen in clinical practice secondary to expansion and greater acceptability of surgical and endoscopic oesophageal procedures. Morbidity and mortality following such injury is high. This is mostly due to an inflammatory response to gastric contents in the mediastinum, and the negative intrathoracic pressures that may further draw out oesophageal contents into the mediastinum leading to mediastinitis. Subsequently, pulmonary complications such as pneumonia or abscess may ensue leading to rapid clinical deterioration. Optimized and timely cross-sectional imaging evaluation is necessary for early and aggressive management of these complications. The goal of this review is to make the radiologist aware of the importance of early and accurate identification of postoperative oesophageal injury using optimized CT imaging protocols and use of oral contrast. Specifically, it is critical to differentiate benign post-operative findings, such as herniated viscus or redundant anastomosis, from clinically significant postoperative complications as this helps guide appropriate management. Advantages and drawbacks of other diagnostic methods, such as contrast oesophagogram, are also discussed.

Iatrogenic parasitic leiomyoma and leiomyomatosis peritonealis disseminata following uterine morcellation.

PubMed

Lu, Bingjian; Xu, Jing; Pan, Zimin

2016-08-01

To assess the impact of morcellation on the spread of uterine leiomyoma. Cases of parasitic leiomyoma involving prior laparoscopy were collected between 2012 and 2015 in a tertiary women's hospital in China. Their clinicopathological features and the associated reports were reviewed. All six patients with parasitic leiomyoma had laparoscopic myomectomy or hysterectomy with power morcellation 39-132 months previously. Patient 1 had widely disseminated tumors in the peritoneum and pelvis, in keeping with leiomyomatosis peritonealis disseminata (LPD). She received debulking of peritoneal tumors and lived with disease for 22 months. The implanting sites of the other parasitic tumors (patients 2-6) included the mesentery (n = 2), intestine (n = 1), pelvic parietal (n = 1), bladder (n = 1), and musculus rectus abdominis (n = 1). The diameter varied from 1 cm to 6 cm. The patients underwent abdominal subtotal hysterectomy, cervicectomy or tumor debulking and the postoperative course was unremarkable for a period of 2-32 months. Pathologically, these disseminated or parasitic leiomyomas did not show any evidence of malignancy. There were no morphological or immunohistochemical differences between the original tumor and the following seeding tumors. On literature review, 11 iatrogenic LPD have been reported after laparoscopic surgery for uterine leiomyoma. These cases may provide an alternative pathogenic mechanism for a distinct variant of LPD. Laparoscopic hysterectomy with tumor morcellation may increase the chance of tumor implantation and dissemination. Both clinicians and pathologists should be alert to this rare complication. © 2016 Japan Society of Obstetrics and Gynecology.

Segmental arterial mediolysis--an iatrogenic vascular disorder induced by ractopamine.

PubMed

Slavin, Richard E; Yaeger, Micheal J

2012-01-01

Segmental arterial mediolysis, an uncommon arterial disorder most often occurring in the splanchnic muscular arteries of the abdomen, is a cause of catastrophic hemorrhages. Its histology and initial clinical presentations suggested that it represented a localized norepinephrine-induced vasospastic response to perturbations in vascular tone and blood volume distribution caused by coexisting vasoconstrictor conditions. However, later presentations were at odds with some aspects of this hypothesis. Nine greyhound dogs were administered a single dose of ractopamine. Two dogs developing persistent conduction abnormalities with biochemical evidence of heart injury were euthanized and necropsied--one 4 days and the other 17 days after dosage This report is based on findings and comparisons of the canine abdominal and coronary arteries to segmental arterial mediolysis. Lesions having features of early-injurious-stage segmental arterial mediolysis were identified in the canine arteries 4 days postractopamine, and arteries examined after 17 days showed alterations typically occurring in reparative-stage segmental arterial mediolysis. It is suspected that ractopamine, a Beta-2 adrenergic agonist, created segmental arterial mediolysis by neuromodulating the peripheral sympathetic nervous system to release norepinephrine from varicosities of efferent nerves serving splanchnic arteries that stimulate alpha-1 receptors to induce injury at the adventitial medial junction and medial muscle apoptosis. This finding and other cited examples suggest that segmental arterial mediolysis may be a disorder principally caused by iatrogenic or accidental exposure to alpha-1 adrenergic receptor agonists or Beta-2 agonists able to release norepinephrine from the peripheral nervous system. Copyright © 2012 Elsevier Inc. All rights reserved.

Minimally invasive surgery for pedal digital deformity: an audit of complications using national benchmark indicators.

PubMed

Gilheany, Mark; Baarini, Omar; Samaras, Dean

2015-01-01

There is increasing global interest and performance of minimally invasive foot surgery (MIS) however, limited evidence is available in relation to complications associated with MIS for digital deformity correction. The aim of this prospective audit is to report the surgical and medical complications following MIS for digital deformity against standardised clinical indicators. A prospective clinical audit of 179 patients who underwent MIS to reduce simple and complex digital deformities was conducted between June 2011 and June 2013. All patients were followed up to a minimum of 12 months post operatively. Data was collected according to a modified version of the Australian Council of Healthcare standards (ACHS) clinical indicator program. The audit was conducted in accordance with the National Research Ethics Service (NRES) guidelines on clinical audit. The surgical complications included 1 superficial infection (0.53%) and 2 under-corrected digits (0.67%), which required revision surgery. Two patients who underwent isolated complex digital corrections had pain due to delayed union (0.7%), which resolved by 6 months post-op. No neurovascular compromise and no medical complications were encountered. The results compare favourably to rates reported in the literature for open reduction of digital deformity. This audit has illustrated that performing MIS to address simple and complex digital deformity results in low complication rates compared to published standards. MIS procedures were safely performed in a range of clinical settings, on varying degrees of digital deformity and on a wide range of ages and health profiles. Further studies investigating the effectiveness of these techniques are warranted and should evaluate long term patient reported outcome measures, as well as developing treatment algorithms to guide clinical decision making.

Designing privacy-friendly digital whiteboards for mediation of clinical progress.

PubMed

Gjære, Erlend Andreas; Lillebo, Børge

2014-04-04

In hospitals, digital versions of dry-erase whiteboards are increasingly becoming more common. One of the purposes with such whiteboards is to support coordination of care by augmenting visibility and availability of clinical information. However, clinical information usually concerns patients and is regarded as sensitive personal health information, meaning that it should be access controlled. The purpose of this study is to explore how digital whiteboards can be designed for supporting coordination of care, by providing clinicians with useful information in a usable way, and at the same time protect patient privacy. A demo application was designed, demonstrated and evaluated iteratively. In total, 15 professional ward nurses role-played a scenario in which the application played a central part. Afterwards, the participants were interviewed. All interviews were recorded, transcribed verbatim, and analysed qualitatively. The participants valued having updated clinical information presented on a digital whiteboard, even if the information was de-identified and abstracted. According to the participants, such information could possibly improve inter-departmental communication, reduce the number of electronic health record-logins, and make nurses more rapidly aware of new information. The participants expected that they would be able to re-identify much of the de-identified information in real situations based on their insight into their patients' recent and expected care activities. Moreover, they also valued being able to easily access more detailed information and verify patient identities. While abstraction and de-identification was regarded to sufficiently protect the patients' privacy, the nurses also pointed out the importance of having control over what can be seen by other patients and passers-by if detailed medical information was accessed on a digital whiteboard. Presenting updated information from patient care activities on a digital whiteboard in a de

32 CFR 2001.48 - Loss, possible compromise or unauthorized disclosure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... governments normally will not be advised of any security system vulnerabilities that contributed to the... INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Safeguarding § 2001.48 Loss, possible compromise or unauthorized disclosure. (a...

Ethical implications of digital images for teaching and learning purposes: an integrative review.

PubMed

Kornhaber, Rachel; Betihavas, Vasiliki; Baber, Rodney J

2015-01-01

Digital photography has simplified the process of capturing and utilizing medical images. The process of taking high-quality digital photographs has been recognized as efficient, timely, and cost-effective. In particular, the evolution of smartphone and comparable technologies has become a vital component in teaching and learning of health care professionals. However, ethical standards in relation to digital photography for teaching and learning have not always been of the highest standard. The inappropriate utilization of digital images within the health care setting has the capacity to compromise patient confidentiality and increase the risk of litigation. Therefore, the aim of this review was to investigate the literature concerning the ethical implications for health professionals utilizing digital photography for teaching and learning. A literature search was conducted utilizing five electronic databases, PubMed, Embase (Excerpta Medica Database), Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Center, and Scopus, limited to English language. Studies that endeavored to evaluate the ethical implications of digital photography for teaching and learning purposes in the health care setting were included. The search strategy identified 514 papers of which nine were retrieved for full review. Four papers were excluded based on the inclusion criteria, leaving five papers for final analysis. Three key themes were developed: knowledge deficit, consent and beyond, and standards driving scope of practice. The assimilation of evidence in this review suggests that there is value for health professionals utilizing digital photography for teaching purposes in health education. However, there is limited understanding of the process of obtaining and storage and use of such mediums for teaching purposes. Disparity was also highlighted related to policy and guideline identification and development in clinical practice. Therefore, the

Iatrogenic non-clostridial gas gangrene - a case report.

PubMed

Sh, Jayanth; Yp, Girish Chandra; J, Ramkumar

2016-03-01

Skin and soft tissue infections of the lower limbs are quite common and can at times progress rapidly to become both limb and life-threatening infections. Muscular infections usually occur in areas of the body that have been compromised or injured by a foreign body, trauma, ischaemia, injection of illicit drugs, malignancy or surgery. Gas gangrene is one such limb-threatening infection. The gas-forming infection can be clostridial or non-clostridial. Clostridia are the main causative organism of the gas gangrene. Non-clostridial gas gangrene is a rare condition and is known to be associated with high mortality. Here, we report one such rare case where a middle-aged man succumbed to non-clostridial gas gangrene after he was administered an intramuscular injection. The case was registered as a suspicious death by the police and the body was subjected to medico legal autopsy. © The Author(s) 2015.

Whatever It Takes: Health Compromising Behaviors in Female Athletes

ERIC Educational Resources Information Center

Waldron, Jennifer J.; Krane, Vikki

2005-01-01

The power and performance model of sport stresses a sport ethic of doing "whatever it takes" to win (Coakley, 2004). Uncritical acceptance of this model may lead to various health-compromising behaviors. Employing achievement goal theory, we examine why female athletes may adopt the power and performance approach. An ego motivational climate and a…

A libertarian perspective on the stem cell debate: compromising the uncompromisible.

PubMed

Block, Walter

2010-08-01

The present paper attempts to forge a compromise between those who maintain that stem cell research is out-and-out murder of young helpless human beings and those who favor this practice. The compromise is predicated upon the libertarian theory of private property rights. Starting out with the premise that not only the fetus but even the fertilized egg is a human being, with all rights thereto, it offers a competition between those who fertilize eggs for research and those who wish to adopt them. If and only if the former win this competition will they be allowed to use these very young human beings for the purposes they have constructed them. This is justified on grounds of avoiding child abuse.

On categorizing gestational, birth, and neonatal complications following late pregnancy exposure to antidepressants: the prenatal antidepressant exposure syndrome.

PubMed

Gentile, Salvatore

2010-03-01

Late in utero exposure to antidepressants has been suspected of adversely impacting pregnancy outcome and compromising neonatal adaptation. Hence, the necessity exists to analyze published information on antidepressant use during late pregnancy to individuate potential recurrent patterns of iatrogenic complications. Computerized searches on MEDLINE, PsycINFO, ENBASE, and Cochrane Library through February 10, 2010 were performed for selecting literature information and investigating the safety of antidepressants when used during late pregnancy. Antidepressant treatment during late pregnancy may increase the rates of poor pregnancy outcome and neonatal withdrawal/toxic reactions. Because both gestational complications and neonatal adverse events acknowledge the same etiology, the author suggests including such iatrogenic events under the definition of prenatal antidepressant exposure syndrome, in order to increase clinicians' awareness about the spectrum of risks which may concern the mother-infant pair when antidepressant treatment is deemed indispensable during late pregnancy.

Creating clones, kids & chimera: liberal democratic compromise at the crossroads.

PubMed

Adams, Nathan A

2004-01-01

The objective of this article is to find middle ground between the supporters and opponents of biotechnology by perpetuating the existing legal compromise pertaining to the complete range of health and welfare doctrines relevant to the biotechnological industry. The author aspires neither to add to nor detract from this liberal democratic consensus, but to preserve its constitutive balance between positivism and natural law and over-regulation and under-regulation in the hopes of stabilizing new political fault lines developing around the few biotechnological innovations already grabbing headlines. The most feasible solution is to extend the existing liberal democratic compromise with respect to equal protection, reproductive rights, the First Amendment, human subject experimentation, patent law, and parental rights. This includes banning or monopolizing certain biotechnologies and extending substantive special respect to the ex vivo living human embryo. Biotechnology must not be left to regulate itself.

CONCENTRATED AMBIENT PARTICULATE STUDIES IN HEALTHY AND COMPROMISED RODENTS

EPA Science Inventory

CONCENTRATED AMBIENT PARTICULATE STUDIES IN HEALTHY AND COMPROMISED RODENTS. WP Watkinson1, LB Wichers2, JP Nolan1, DW Winsett1, UP Kodavanti1, MCJ Schladweiler1, LC Walsh1, ER Lappi1, D Terrell1, R Slade1, AD Ledbetter1, and DL Costa1. 1USEPA, ORD/NHEERL/ETD/PTB, RTP, NC, US...

7 CFR 4290.1710 - Secretary's authority to collect or compromise claims.

Code of Federal Regulations, 2010 CFR

2010-01-01

... INVESTMENT COMPANY (âRBICâ) PROGRAM Financial Assistance for RBICs (Leverage) Miscellaneous § 4290.1710... consideration as he or she deems reasonable, collect or compromise all claims relating to obligations he or she...

The iatrogenic epidemic of prescription drug abuse: county-level determinants of opioid availability and abuse.

PubMed

Wright, Eric R; Kooreman, Harold E; Greene, Marion S; Chambers, R Andrew; Banerjee, Aniruddha; Wilson, Jeffrey

2014-05-01

Opioid use and abuse in the United States continues to expand at an alarming rate. In this study, we examine the county-level determinants of the availability and abuse of prescription opioids to better understand the socio-ecological context, and in particular the role of the healthcare delivery system, on the prescription drug abuse epidemic. We use community-level information, data from Indiana's prescription drug monitoring program in 2011, and geospatial regression methods to identify county-level correlates of the availability and abuse of prescription opioids among Indiana's 92 counties. The findings suggest that access to healthcare generally, and to dentists and pharmacists in particular, increases the availability of prescription opioids in communities, which, in turn, is associated with higher rates of opioid abuse. The results suggest that the structure of the local healthcare system is a major determinant of community-level access to opioids adding to a growing body of evidence that the problem of prescription opioid abuse is, at least in part, an "iatrogenic epidemic." Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Severe iatrogenic airway obstruction due to lingual lymphangioma].

PubMed

Segado Arenas, A; Flores González, J-C; Rubio Quiñones, F; Quintero Otero, S; Hernández González, A; Pantoja Rosso, S

2011-09-01

Lymphangioma of the tongue is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. Treatment modalities include surgery and a large number of different intralesional injections of sclerosing agents. Presently, OK-432 (Picibanil(®)) is the preferred sclerosant and when administered intralesionally will result in inflammation, sclerosis, and cicatricial contraction of the lesion. We report a case of microcystic lymphangioma of the tongue in a 5-year-old boy treated with an intralesional injection of OK-432. In the immediate postoperative period, the patient suffered severe diffuse swelling, progressive upper airway obstruction with inspiratory stridor, and respiratory distress requiring emergency fiberoptic nasotracheal intubation. Although OK-432 injections are found to be safe and effective as a first line of treatment for lymphangiomas, local swelling with potentially life-threatening airway compromise should be anticipated, especially when treating lesions near the upper airway. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Evidence for altered placental blood flow and vascularity in compromised pregnancies

PubMed Central

Reynolds, Lawrence P; Caton, Joel S; Redmer, Dale A; Grazul-Bilska, Anna T; Vonnahme, Kimberly A; Borowicz, Pawel P; Luther, Justin S; Wallace, Jacqueline M; Wu, Guoyao; Spencer, Thomas E

2006-01-01

The placenta is the organ that transports nutrients, respiratory gases, and wastes between the maternal and fetal systems. Consequently, placental blood flow and vascular development are essential components of normal placental function and are critical to fetal growth and development. Normal fetal growth and development are important to ensure optimum health of offspring throughout their subsequent life course. In numerous sheep models of compromised pregnancy, in which fetal or placental growth, or both, are impaired, utero-placental blood flows are reduced. In the models that have been evaluated, placental vascular development also is altered. Recent studies found that treatments designed to increase placental blood flow can ‘rescue’ fetal growth that was reduced due to low maternal dietary intake. Placental blood flow and vascular development are thus potential therapeutic targets in compromised pregnancies. PMID:16469783

Prostate Artery Embolization (PAE) in the Management of Refractory Hematuria of Prostatic Origin Secondary to Iatrogenic Urological Trauma: A Safe and Effective Technique.

PubMed

Kably, Isaam; Pereira, Keith; Chong, William; Bhatia, Shivank

2016-02-01

Incidence of refractory hematuria of prostatic origin (RHPO) is extremely rare, with an iatrogenic etiology even rarer. When conservative methods fail to control bleeding, more invasive surgical methods are needed. In this article we describe our experience with prostatic artery embolization (PAE) as a minimally invasive alternative treatment option in patients with RHPO secondary to iatrogenic urologic trauma. Three patients presented with RHPO. The etiologies were transurethral resection of prostate surgery, Foley catheter removal with a supratherapeutic international normalized ratio and self-traumatic Foley catheter removal respectively. Stepwise management with conservative and medical methods failed to control bleeding. Under local anesthesia and moderate sedation, bilateral PAE was performed via a right common femoral artery access and using cone beam computed tomography. An embolic mixture containing 300-500 um Embosphere® Microspheres (Biosphere Medical, Rockland, MA) was injected under fluoroscopic guidance until stasis was achieved. PAE using the described technique was a technical and clinical success in all three patients. Hematuria resolved within a period of 24 hours. There were no intra- or periprocedural complications. PAE offers a reasonable option in treatment of RHPO, regardless of the cause and may be attempted prior to surgical techniques or sometimes in conjunction. Being minimally invasive and performed under local anesthesia, PAE is especially useful when excessive bleeding prevents adequate visualization of a bleeding source during cystoscopy and in the elderly age group with several comorbidities. An added advantage is the prostatic parenchymal ischemia leading to significant prostate volume reduction and alleviation of the obstructive symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of Image Compression on Automatic Count of Immunohistochemically Stained Nuclei in Digital Images

PubMed Central

López, Carlos; Lejeune, Marylène; Escrivà, Patricia; Bosch, Ramón; Salvadó, Maria Teresa; Pons, Lluis E.; Baucells, Jordi; Cugat, Xavier; Álvaro, Tomás; Jaén, Joaquín

2008-01-01

This study investigates the effects of digital image compression on automatic quantification of immunohistochemical nuclear markers. We examined 188 images with a previously validated computer-assisted analysis system. A first group was composed of 47 images captured in TIFF format, and other three contained the same images converted from TIFF to JPEG format with 3×, 23× and 46× compression. Counts of TIFF format images were compared with the other three groups. Overall, differences in the count of the images increased with the percentage of compression. Low-complexity images (≤100 cells/field, without clusters or with small-area clusters) had small differences (<5 cells/field in 95–100% of cases) and high-complexity images showed substantial differences (<35–50 cells/field in 95–100% of cases). Compression does not compromise the accuracy of immunohistochemical nuclear marker counts obtained by computer-assisted analysis systems for digital images with low complexity and could be an efficient method for storing these images. PMID:18755997

13 CFR 107.1710 - SBA authority to collect or compromise its claims.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SMALL BUSINESS INVESTMENT COMPANIES SBA Financial Assistance for Licensees (Leverage) Miscellaneous... consideration as it deems reasonable, collect or compromise all claims relating to Preferred or Participating...

Iatrogenic Bone and Soft Tissue Trauma in Robotic-Arm Assisted Total Knee Arthroplasty Compared With Conventional Jig-Based Total Knee Arthroplasty: A Prospective Cohort Study and Validation of a New Classification System.

PubMed

Kayani, Babar; Konan, Sujith; Pietrzak, Jurek R T; Haddad, Fares S

2018-03-27

The objective of this study was to compare macroscopic bone and soft tissue injury between robotic-arm assisted total knee arthroplasty (RA-TKA) and conventional jig-based total knee arthroplasty (CJ-TKA) and create a validated classification system for reporting iatrogenic bone and periarticular soft tissue injury after TKA. This study included 30 consecutive CJ-TKAs followed by 30 consecutive RA-TKAs performed by a single surgeon. Intraoperative photographs of the femur, tibia, and periarticular soft tissues were taken before implantation of prostheses. Using these outcomes, the macroscopic soft tissue injury (MASTI) classification system was developed to grade iatrogenic bone and soft tissue injuries. Interobserver and Intraobserver validity of the proposed classification system was assessed. Patients undergoing RA-TKA had reduced medial soft tissue injury in both passively correctible (P < .05) and noncorrectible varus deformities (P < .05); more pristine femoral (P < .05) and tibial (P < .05) bone resection cuts; and improved MASTI scores compared to CJ-TKA (P < .05). There was high interobserver (intraclass correlation coefficient 0.92 [95% confidence interval: 0.88-0.96], P < .05) and intraobserver agreement (intraclass correlation coefficient 0.94 [95% confidence interval: 0.92-0.97], P < .05) of the proposed MASTI classification system. There is reduced bone and periarticular soft tissue injury in patients undergoing RA-TKA compared to CJ-TKA. The proposed MASTI classification system is a reproducible grading scheme for describing iatrogenic bone and soft tissue injury in TKA. RA-TKA is associated with reduced bone and soft tissue injury compared with conventional jig-based TKA. The proposed MASTI classification may facilitate further research correlating macroscopic soft tissue injury during TKA to long-term clinical and functional outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

[Investigation of Pneumocystis jirovecii pneumonia and colonization in iatrogenically immunosuppressed and immunocompetent patients].

PubMed

Özkoç, Soykan; Bayram Delibaş, Songül

2015-04-01

Pneumocystis pneumonia (PCP) is a potentially life-threatening infection for the immunocompromized patients. However, Pneumocystis jirovecii colonization can also be detected in healthy individuals and in patients with various underlying lung diseases. The aim of this study was to evaluate the immunocompetent and iatrogenically immunosuppressed patients in terms of PCP and P.jirovecii colonization. A total of 92 patients (66 male, 26 female; age range: 18-93 years, median: 58.5) who underwent bronchoscopy due to various pulmonary symptoms between January 2011-April 2014, were included in the study. Of these patients, 65 were under immunosuppressive therapy (38 were treated with anti-cancer drugs, 15 with anti-rejection/immunomodulatory drugs and 12 with corticosteroids), while 27 were immunocompetent. Bronchoalveolar lavage (BAL) fluids were evaluated for the presence of P.jirovecii mitochondrial gene coding ribosomal large subunit (mtLSUrRNA) with nested PCR (nPCR) method. All of the samples were also examined by Giemsa and Gomori's methenamine silver (GMG) staining methods. P.jirovecii DNA was detected in 31 (33.7%) out of 92 BAL samples by nPCR. Although six immunosuppressed patients were positive in the first round of amplification, 26 of 65 (40%) immunosuppressed and five of 27 (18.5%) immunocompetent patients were positive with nPCR. P.jirovecii cysts and trophozoites were detected in only five (16.1%) of the 31 nPCR positive samples. The probability of being immunosuppressive among nPCR positive cases was statistically higher than nPCR negative cases (χ²= 3.940; p= 0.047). This difference was more significant in organ transplant recipients and patients under anti-rejection/immunomodulatory treatment (χ²= 6.715, p= 0.01; χ²= 5.550, p= 0.018, respectively). When clinical, laboratory and radiological findings of nPCR positive patients were considered, five patients (2 kidney transplant, 1 bone marrow transplant, 1 interstitial lung disease and 1 lung

The administration of probiotics and synbiotics in immune compromised adults: is it safe?

PubMed

Van den Nieuwboer, M; Brummer, R J; Guarner, F; Morelli, L; Cabana, M; Claasen, E

2015-03-01

This study aimed to systematically evaluate safety of probiotics and synbiotics in immune compromised adults (≥18 years). Safety was analysed using the Common Terminology Clinical Adverse Events (CTCAE version 4.0) classification, thereby providing an update on previous reports using the most recent available clinical data (2008-2013). Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. Analysis of 57 clinical studies indicates that probiotic and/or synbiotic administration in immune compromised adults is safe with regard to the current evaluated probiotic strains, dosages and duration. Individuals were considered immune compromised if HIV-infected, critically ill, underwent surgery or had an organ- or an autoimmune disease. There were no major safety concerns in the study, as none of the serious adverse events (AE)s were related, or suspected to be related, to the probiotic or synbiotic product and the study products were well tolerated. Overall, AEs occurred less frequent in immune compromised subjects receiving probiotics and/or synbiotics compared to the control group. In addition, the results demonstrated a flaw in precise reporting and classification of AE in most studies. Furthermore, generalisability of conclusions are greatly limited by the inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes. We argue that standardised reporting on adverse events (CTCAE) in 'food' studies should be obligatory, thereby improving reliability of data and re-enforcing the safety profile of probiotics.

Incorporating the Last Four Digits of Social Security Numbers Substantially Improves Linking Patient Data from De-identified Hospital Claims Databases.

PubMed

Naessens, James M; Visscher, Sue L; Peterson, Stephanie M; Swanson, Kristi M; Johnson, Matthew G; Rahman, Parvez A; Schindler, Joe; Sonneborn, Mark; Fry, Donald E; Pine, Michael

2015-08-01

Assess algorithms for linking patients across de-identified databases without compromising confidentiality. Hospital discharges from 11 Mayo Clinic hospitals during January 2008-September 2012 (assessment and validation data). Minnesota death certificates and hospital discharges from 2009 to 2012 for entire state (application data). Cross-sectional assessment of sensitivity and positive predictive value (PPV) for four linking algorithms tested by identifying readmissions and posthospital mortality on the assessment data with application to statewide data. De-identified claims included patient gender, birthdate, and zip code. Assessment records were matched with institutional sources containing unique identifiers and the last four digits of Social Security number (SSNL4). Gender, birthdate, and five-digit zip code identified readmissions with a sensitivity of 98.0 percent and a PPV of 97.7 percent and identified postdischarge mortality with 84.4 percent sensitivity and 98.9 percent PPV. Inclusion of SSNL4 produced nearly perfect identification of readmissions and deaths. When applied statewide, regions bordering states with unavailable hospital discharge data had lower rates. Addition of SSNL4 to administrative data, accompanied by appropriate data use and data release policies, can enable trusted repositories to link data with nearly perfect accuracy without compromising patient confidentiality. States maintaining centralized de-identified databases should add SSNL4 to data specifications. © Health Research and Educational Trust.

Incorporating the Last Four Digits of Social Security Numbers Substantially Improves Linking Patient Data from De-identified Hospital Claims Databases

PubMed Central

Naessens, James M; Visscher, Sue L; Peterson, Stephanie M; Swanson, Kristi M; Johnson, Matthew G; Rahman, Parvez A; Schindler, Joe; Sonneborn, Mark; Fry, Donald E; Pine, Michael

2015-01-01

Objective Assess algorithms for linking patients across de-identified databases without compromising confidentiality. Data Sources/Study Setting Hospital discharges from 11 Mayo Clinic hospitals during January 2008–September 2012 (assessment and validation data). Minnesota death certificates and hospital discharges from 2009 to 2012 for entire state (application data). Study Design Cross-sectional assessment of sensitivity and positive predictive value (PPV) for four linking algorithms tested by identifying readmissions and posthospital mortality on the assessment data with application to statewide data. Data Collection/Extraction Methods De-identified claims included patient gender, birthdate, and zip code. Assessment records were matched with institutional sources containing unique identifiers and the last four digits of Social Security number (SSNL4). Principal Findings Gender, birthdate, and five-digit zip code identified readmissions with a sensitivity of 98.0 percent and a PPV of 97.7 percent and identified postdischarge mortality with 84.4 percent sensitivity and 98.9 percent PPV. Inclusion of SSNL4 produced nearly perfect identification of readmissions and deaths. When applied statewide, regions bordering states with unavailable hospital discharge data had lower rates. Conclusion Addition of SSNL4 to administrative data, accompanied by appropriate data use and data release policies, can enable trusted repositories to link data with nearly perfect accuracy without compromising patient confidentiality. States maintaining centralized de-identified databases should add SSNL4 to data specifications. PMID:26073819

Adolescent Occupational Aspirations: Test of Gottfredson's Theory of Circumscription and Compromise

ERIC Educational Resources Information Center

Cochran, Daria B.; Wang, Eugene W.; Stevenson, Sarah J.; Johnson, Leah E.; Crews, Charles

2011-01-01

The authors investigated the relationship between adolescent occupational aspirations and midlife career success. The model for adolescent occupational aspirations was derived from Gottfredson's (1981) theory of circumscription and compromise. The authors hypothesized that parental socioeconomic status (SES), ability, and gender predict adolescent…

Digital Natives or Digital Tribes?

ERIC Educational Resources Information Center

Watson, Ian Robert

2013-01-01

This research builds upon the discourse surrounding digital natives. A literature review into the digital native phenomena was undertaken and found that researchers are beginning to identify the digital native as not one cohesive group but of individuals influenced by other factors. Primary research by means of questionnaire survey of technologies…

Designing privacy-friendly digital whiteboards for mediation of clinical progress

PubMed Central

2014-01-01

activities on a digital whiteboard in a de-identified and abstracted format may support coordination of care at a hospital ward without compromising patient privacy. PMID:24708868

Acute gastrointestinal compromise in neonates with congenital diaphragmatic hernia prior to repair.

PubMed

Fox, Catherine; Stewart, Michael; King, Sebastian K; Patel, Neil

2016-12-01

Congenital diaphragmatic hernia (CDH) affects 1 in 3000 live births. Modern management strategies include delayed repair of the diaphragm to permit pre-operative optimization of cardiorespiratory status. We describe a cohort of neonates in whom early emergency operative intervention was required for potentially fatal intestinal compromise. A retrospective review was performed of all neonatal CDH patients managed at a tertiary center in an 8-year period (2005-2012). A total of 126 CDH patients were managed during the 8-year period. Five neonates (male - 1; gestation 37+4-39+7; birth weight 2.9-3.7kg; left CDH - 5) required emergency operative intervention for presumed gastrointestinal compromise. All five neonates demonstrated systemic hypotension despite inotropic support, raised serum lactate (>2mmol/L), and abnormal radiographic findings. Operative intervention occurred within 3days of birth (1-3days). Findings included gastric volvulus, jejunal volvulus, and perforated caecum. All patients underwent primary diaphragmatic repair without a patch. Temporary ileostomy was required in 1 patient. All patients remain alive. Gastrointestinal compromise is a rare, but potentially catastrophic, complication of CDH. Emergency operative intervention may be required in a select cohort of patients. Early deterioration following birth should alert clinicians to the possibility of significant intestinal pathology. Level IV case series with no comparison group. Copyright © 2016 Elsevier Inc. All rights reserved.

Sugar reduction without compromising sensory perception. An impossible dream?

PubMed

Hutchings, Scott C; Low, Julia Y Q; Keast, Russell S J

2018-03-21

Sugar reduction is a major technical challenge for the food industry to address in response to public health concerns regarding the amount of added sugars in foods. This paper reviews sweet taste perception, sensory methods to evaluate sugar reduction and the merits of different techniques available to reduce sugar content. The use of sugar substitutes (non-nutritive sweeteners, sugar alcohols, and fibres) can achieve the greatest magnitude of sugar and energy reduction, however bitter side tastes and varying temporal sweet profiles are common issues. The use of multisensory integration principles (particularly aroma) can be an effective approach to reduce sugar content, however the magnitude of sugar reduction is small. Innovation in food structure (modifying the sucrose distribution, serum release and fracture mechanics) offers a new way to reduce sugar without significant changes in food composition, however may be difficult to implement in food produced on a large scale. Gradual sugar reduction presents difficulties for food companies from a sales perspective if acceptability is compromised. Ultimately, a holistic approach where food manufacturers integrate a range of these techniques is likely to provide the best progress. However, substantial reduction of sugar in processed foods without compromising sensory properties may be an impossible dream.

Parental care compromises feeding in the pumpkinseed ( Lepomis gibbosus)

NASA Astrophysics Data System (ADS)

Zięba, G.; Dukowska, M.; Przybylski, M.; Fox, M. G.; Smith, C.

2018-04-01

Providing parental care is potentially costly. Costs can arise through elevated energy expenditure or from an increased risk of mortality. A cost of parental care can also occur because a parent is compromised in their ability to forage. We used pumpkinseed Lepomis gibbosus, a fish with an alternative male mating strategy, to test whether parental males differed in their feeding in comparison with females and cuckolder males. To address this question, we examined the stomach contents of female, cuckolder male, and parental male pumpkinseed during the breeding season over an entire diel cycle. We showed that parental males had a lower total weight of food in their stomachs in comparison with females, while cuckolder males did not. Parental males also had a lower weight and number of chironomids in their stomachs. The temporal pattern of feeding of parental males diverged from that of females, and they had a lower probability of pupal chironomids in their stomachs, which implies spatial segregation in foraging. Parental males had a greater probability of conspecific eggs in their stomachs than females, while the probability of egg cannibalism did not differ between cuckolder males and females. Overall, these finding meet predictions in accordance with an assumption that parental care and territoriality can compromise feeding.

Does initial dosing of levothyroxine in infants with congenital hypothyroidism lead to frequent dose adjustments secondary to iatrogenic hyperthyroidism on follow-up?

PubMed

Craven, Meghan; Frank, Graeme R

2018-06-27

Congenital hypothyroidism (CH) is the most common preventable cause of intellectual disability. The recommended starting dose of levothyroxine (LT4) is between 10 and 15 μg/kg, an extremely wide range. We hypothesized that a sizable proportion of newborns treated for CH at the higher end of the dosage range become biochemically hyperthyroid at a follow-up visit. This study is a retrospective chart review of infants with CH between 2002 and 2012. Of the 104 patients included in this analysis, the average age at diagnosis was 11 days and the average starting dose of LT4 was 12±2.5 μg/kg. At follow-up, 36.5% required a dose reduction because of iatrogenic hyperthyroxinemia, 51% required no dose adjustment and 12.5% required a dose increase due to an elevated thyroid stimulating hormone (TSH). The starting doses of LT4 for those requiring a dose reduction, those not requiring an adjustment and those requiring an increase in the dose were 13.2±2.4, 11.5±2.1 and 10.3±2.6 μg/kg/day, respectively (p≤0.0001). Of the 34% of infants treated with an initial dose of >12.5 μg/day, 57.1% required a dose reduction at follow-up, compared to 26.1% of those whose initial starting dose was ≤12.5 μg/kg/day (p=0.007). Following the guidelines for initiating therapy for CH, 36.5% of the infants required a dose reduction for iatrogenic hyperthyroxinemia. These infants received a higher dose of LT4 than the infants who either required no adjustment or required an increase in the dose. A narrower range for initial dosing in CH may be appropriate.

20 CFR 404.515 - Collection and compromise of claims for overpayment.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Overpayments, Underpayments, Waiver of Adjustment or Recovery of... against an individual for recovery of overpayments under title II or title XVIII (not including title... services) of the Act, not exceeding the sum of $20,000, exclusive of interest, may be compromised, or...

Digital rights language support for evolving digital cinema requirements

NASA Astrophysics Data System (ADS)

Orri, Xavier; Mas, Joan-Maria; Macq, Benoit M. M.

2003-06-01

Digital cinema can be defined as the digital electronic distribution and display of theatrical film content or live material to the theatre. However, this simple definition does not reflect the complex mesh of balanced business relationships between the different parties involved in the worldwide cinematic distribution. Its transition from an analogue to a digital business will happen progressively, starting with only content being digitally distributed and going until an all-digital business. From these facts derive strong requirements on digital rights management (DRM) systems for digital cinema and therefore on the digital rights language supporting it. This paper explores the requirements imposed by the cinematic distribution model and by its progressive transition to digital, and the impact these have on digital rights languages. We analyze the support provided by different digital rights languages, identifying weaknesses and exploring solutions in fulfilling the requirements of the digital cinema distribution model.

Forensic Analysis of Compromised Computers

NASA Technical Reports Server (NTRS)

Wolfe, Thomas

2004-01-01

Directory Tree Analysis File Generator is a Practical Extraction and Reporting Language (PERL) script that simplifies and automates the collection of information for forensic analysis of compromised computer systems. During such an analysis, it is sometimes necessary to collect and analyze information about files on a specific directory tree. Directory Tree Analysis File Generator collects information of this type (except information about directories) and writes it to a text file. In particular, the script asks the user for the root of the directory tree to be processed, the name of the output file, and the number of subtree levels to process. The script then processes the directory tree and puts out the aforementioned text file. The format of the text file is designed to enable the submission of the file as input to a spreadsheet program, wherein the forensic analysis is performed. The analysis usually consists of sorting files and examination of such characteristics of files as ownership, time of creation, and time of most recent access, all of which characteristics are among the data included in the text file.

Tail loss compromises immunity in the many-lined skink, Eutropis multifasciata

NASA Astrophysics Data System (ADS)

Kuo, Chi-Chien; Yao, Chiou-Ju; Lin, Te-En; Liu, Hsu-Che; Hsu, Yu-Cheng; Hsieh, Ming-Kun; Huang, Wen-San

2013-04-01

Tail autotomy incurs energetic costs, and thus, a trade-off in resource allocation may lead to compromised immunity in lizards. We tested the hypothesis that tailless lizards will favor constitutive innate immunity responses over an energetically costly inflammatory response. The influence of fasting and colorful ornamentation was also investigated. We experimentally induced tail autotomy in the lizard Eutropis multifasciata and found that inflammation was suppressed by tail loss, but not further affected by fasting; the suppressive effect of colorful ornamentation was manifested only in males, but not in females. Constitutive innate immunity was not affected by any of these factors. As expected, only costly inflammation was compromised, and a less expensive constitutive innate immunity might be favored as a competent first-line defense during energetically demanding periods. After considering conventional trade-offs among tail regeneration and reproduction, further extending these studies to incorporate disease risk and how this influences escape responses to predators and future reproduction would make worthwhile studies.

Method and Apparatus for Evaluating the Visual Quality of Processed Digital Video Sequences

NASA Technical Reports Server (NTRS)

Watson, Andrew B. (Inventor)

2002-01-01

A Digital Video Quality (DVQ) apparatus and method that incorporate a model of human visual sensitivity to predict the visibility of artifacts. The DVQ method and apparatus are used for the evaluation of the visual quality of processed digital video sequences and for adaptively controlling the bit rate of the processed digital video sequences without compromising the visual quality. The DVQ apparatus minimizes the required amount of memory and computation. The input to the DVQ apparatus is a pair of color image sequences: an original (R) non-compressed sequence, and a processed (T) sequence. Both sequences (R) and (T) are sampled, cropped, and subjected to color transformations. The sequences are then subjected to blocking and discrete cosine transformation, and the results are transformed to local contrast. The next step is a time filtering operation which implements the human sensitivity to different time frequencies. The results are converted to threshold units by dividing each discrete cosine transform coefficient by its respective visual threshold. At the next stage the two sequences are subtracted to produce an error sequence. The error sequence is subjected to a contrast masking operation, which also depends upon the reference sequence (R). The masked errors can be pooled in various ways to illustrate the perceptual error over various dimensions, and the pooled error can be converted to a visual quality measure.

20 CFR 410.565 - Collection and compromise of claims for overpayment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Collection and compromise of claims for overpayment. 410.565 Section 410.565 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of Benefits § 410.565...

Inadequate satellite cell replication compromises muscle regrowth following postnatal nutrient restriction

USDA-ARS?s Scientific Manuscript database

Perinatal growth impairment permanently compromises skeletal muscle mass. The present study assessed the contribution of muscle satellite cell replicative capacity to this deficit. Mouse dams were fed either a low protein (LP, n=7) or control (C, n=6) diet during lactation. Pups were weaned at 21 d ...

48 CFR 239.7102-2 - Compromising emanations-TEMPEST or other standard.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-TEMPEST or other standard. 239.7102-2 Section 239.7102-2 Federal Acquisition Regulations System DEFENSE... INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7102-2 Compromising emanations—TEMPEST or....e., an established National TEMPEST standard (e.g., NACSEM 5100, NACSIM 5100A) or a standard used by...

48 CFR 239.7102-2 - Compromising emanations-TEMPEST or other standard.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-TEMPEST or other standard. 239.7102-2 Section 239.7102-2 Federal Acquisition Regulations System DEFENSE... INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7102-2 Compromising emanations—TEMPEST or....e., an established National TEMPEST standard (e.g., NACSEM 5100, NACSIM 5100A) or a standard used by...

48 CFR 239.7102-2 - Compromising emanations-TEMPEST or other standard.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-TEMPEST or other standard. 239.7102-2 Section 239.7102-2 Federal Acquisition Regulations System DEFENSE... INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7102-2 Compromising emanations—TEMPEST or....e., an established National TEMPEST standard (e.g., NACSEM 5100, NACSIM 5100A) or a standard used by...

48 CFR 239.7102-2 - Compromising emanations-TEMPEST or other standard.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-TEMPEST or other standard. 239.7102-2 Section 239.7102-2 Federal Acquisition Regulations System DEFENSE... INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7102-2 Compromising emanations—TEMPEST or....e., an established National TEMPEST standard (e.g., NACSEM 5100, NACSIM 5100A) or a standard used by...

48 CFR 239.7102-2 - Compromising emanations-TEMPEST or other standard.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-TEMPEST or other standard. 239.7102-2 Section 239.7102-2 Federal Acquisition Regulations System DEFENSE... INFORMATION TECHNOLOGY Security and Privacy for Computer Systems 239.7102-2 Compromising emanations—TEMPEST or....e., an established National TEMPEST standard (e.g., NACSEM 5100, NACSIM 5100A) or a standard used by...

Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique

PubMed Central

Barnett, Timothy P.; O'Leary, John Mark; Dixon, Padraic M.

2016-01-01

Objective To describe a novel surgical technique for correcting postoperative ventral glottic stenosis (cicatrix or web formation) and the outcome in 2 Thoroughbred racehorses. Study Design Retrospective case report. Animals Thoroughbreds diagnosed with ventral glottic stenosis (n=2). Methods Horses presenting with iatrogenic ventral glottic stenosis and resultant exercise intolerance and abnormal exercise‐related noise were anesthetized and a midline sagittal skin incision was made over the ventral larynx and between the sternohyoideus muscles overlying the cricothyroid notch. The cricothyroid ligament, attached laryngeal cicatrix, and overlying mucosa were sagittally sectioned at the dorsal aspect of the cicatrix on the left side. The laryngeal mucosa, cicatrix, and underlying cricothyroid ligament immediately rostral and caudal to the cicatrix were sectioned in a medial (axial) direction as far as the right side of the cricothyroid notch. After resection of the majority of the attached cicatrix tissue, the residual mucosal flap (attached to the right side of the larynx) was reflected ventrally and sutured to the attachment of the cricothyroid ligament on the right side of the cricothyroid notch, creating an intact mucosal layer on the right side of the ventral larynx. Results Both horses had good intralaryngeal wound healing with minimal redevelopment of ventral glottic stenosis at 5 and 9 months postoperatively and were successfully returned to racing with complete absence of abnormal respiratory noise. Conclusion The unique laryngeal anatomy of horses, with a cartilage‐free ventral laryngeal area (cricothyroid notch), allowed the use of this novel surgical technique to successfully treat ventral glottic stenosis. PMID:27013024

Total phallic reconstruction using radial forearm free flap after iatrogenic penile amputation.

PubMed

Angulo, J C; Arance, I; Gómez-Llorens, C; Esquinas, C; Gómez-Martín, C; Fernández-Cañamaque, J L

2017-09-01

The iatrogenic loss of the penis is a rare situation. We present a challenging case of deferred total penile reconstruction in a genetic male. A 57-year-old man with the loss of the penis due to a penile abscess and necrosis secondary to penile curvature surgery. The reconstruction was performed over several operations using a radial forearm free flap (RFFF) and placement of a customised inflatable prosthesis a year later. During the first operation, the penile abscess was drained, the necrotic residues were debrided and placement of hypogastric drainage. Seven weeks later, phalloplasty was performed with RFFF and a tube-in-tube neourethra was constructed. Multiple microsurgical anastomosis was performed, and the donor site was coated with a skin graft from the thigh of partial thickness. The surgery lasted 10hours and had the complication of hair growth in the neourethra, which required mechanical endoscopic depilation on repeated occasions. The patient regained penile sensitivity. Eighteen months after the phalloplasty, a Zephyr single-body inflatable prosthesis (Geneva, Switzerland) was implanted, using the tunica albuginea of the proximal corpus cavernosum. The patient was satisfied with the aesthetics and urinary and sensory function. Four months later, the patient is gaining confidence to consider penetration. Despite the risk of postoperative complications and the need for multiple operations, phallic reconstruction with RFFF and the placement of a customised prosthetic implant can improve urinary and sexual function secondary to the loss of the penis. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

An Algorithmic Approach to the Management of Infantile Digital Fibromatosis: Review of Literature and a Case Report.

PubMed

Eypper, Elizabeth H; Lee, Johnson C; Tarasen, Ashley J; Weinberg, Maxene H; Adetayo, Oluwaseun A

2018-01-01

Objective: Infantile digital fibromatosis is a rare benign childhood tumor, infrequently cited in the literature. Hallmarks include nodular growths exclusive to fingers and toes and the presence of eosinophilic cytoplasmic inclusions on histology. This article aims to exemplify diagnoses of infantile digital fibromatosis and possible treatment options. Methods: A computerized English literature search was performed in the PubMed/MEDLINE database using MeSH headings "infantile," "juvenile," "digital," and "fibromatosis." Twenty electronic publications were selected and their clinical and histological data recorded and used to compile a treatment algorithm. Results: A 9-month-old male child was referred for a persistent, symptomatic nodule on the third left toe. A direct excision with Brunner-type incisions was performed under general anesthesia. The procedure was successful without complications. The patient has no recurrence at 2 years postsurgery and continues to be followed. Histological examination revealed a proliferation of bland, uniformly plump spindle cells with elongated nuclei and small central nucleoli without paranuclear inclusions consistent with fibromatosis. Conclusions: Asymptomatic nodules should be observed for spontaneous regression or treated with nonsurgical techniques such as chemotherapeutic or steroid injection. Surgical removal should be reserved for cases with structural or functional compromise.

Ultrafast wavelength multiplexed broad bandwidth digital diffuse optical spectroscopy for in vivo extraction of tissue optical properties

NASA Astrophysics Data System (ADS)

Torjesen, Alyssa; Istfan, Raeef; Roblyer, Darren

2017-03-01

Frequency-domain diffuse optical spectroscopy (FD-DOS) utilizes intensity-modulated light to characterize optical scattering and absorption in thick tissue. Previous FD-DOS systems have been limited by large device footprints, complex electronics, high costs, and limited acquisition speeds, all of which complicate access to patients in the clinical setting. We have developed a new digital DOS (dDOS) system, which is relatively compact and inexpensive, allowing for simplified clinical use, while providing unprecedented measurement speeds. The dDOS system utilizes hardware-integrated custom board-level direct digital synthesizers and an analog-to-digital converter to generate frequency sweeps and directly measure signals utilizing undersampling at six wavelengths modulated at discrete frequencies from 50 to 400 MHz. Wavelength multiplexing is utilized to achieve broadband frequency sweep measurements acquired at over 97 Hz. When compared to a gold-standard DOS system, the accuracy of optical properties recovered with the dDOS system was within 5.3% and 5.5% for absorption and reduced scattering coefficient extractions, respectively. When tested in vivo, the dDOS system was able to detect physiological changes throughout the cardiac cycle. The new FD-dDOS system is fast, inexpensive, and compact without compromising measurement quality.

Evaluation of instant cup noodle, irradiated for immuno-compromised patients

NASA Astrophysics Data System (ADS)

Lee, Ji-Hye; Kim, Jae-Kyung; Park, Jae-Nam; Yoon, Young-Min; Sung, Nak-Yun; Kim, Jae-Hun; Song, Beom-Seok; Yook, Hong-Sun; Kim, Byeong-Keun; Lee, Ju-Woon

2012-08-01

In the present study, initial microbial load of instant cup noodle (ICN) was investigated and gamma irradiation applied to develop immuno-compromised patients food for their safe consumption. The initial microbial population of dried vegetable and meat, and noodle was below the detection limit (1 log CFU/g); however, that of seasoning powder was just above 4 log CFU/g. Moreover, rehydrated-ICN with water at 100 °C still show above 3 log CFU/g of microbial load, which indicates the need for an additional process to control microbial safety of the seasoning powder. The total aerobic bacteria in seasoning powder and rehydrated-ICN could be controlled with 17 kGy gamma irradiation. This result referred 17 kGy gamma irradiation could reach 'practical sterility' of ICN. The overall difference in sensory properties between the non-irradiated and irradiated ICN was insignificant. Thus, gamma irradiation could improve the microbial quality of ICN, and reduce the risk of infection posed by the seasoning powder, without any adverse effects on their sensory quality. These results suggest that gamma-irradiated ICN can be used as a snack food for immuno-compromised patients.

Intergroup perception as a compromise between in-group bias and fair-mindedness.

PubMed

Singh, Ramadhar; Sharmini; Choo, Ivy

2004-08-01

Previously, perceived competence of and attraction toward targets categorized by race showed in-group bias and no bias, respectively. Consequently, previous investigators regarded intergroup perception as a compromise between the norms of in-group bias and fair-mindedness. An alternative hypothesis for such findings is that attraction is not as relevant a dimension for intergroup discrimination as is competence. To test contrasting predictions of these hypotheses, the present authors asked participants from the majority and minority groups in Singapore (ns = 320) to evaluate either competence of or attraction toward one of the five targets. Consistent with the hypothesis that intergroup perception is a compromise, both dimensions yielded a uniform but weak in-group bias. The participants' equating of the in-group with one out-group further illustrated fair-mindedness. The authors discussed implications of the findings.

Severe lactic acidosis after an iatrogenic propylene glycol overdose.

PubMed

Zosel, Amy; Egelhoff, Elizabeth; Heard, Kennon

2010-02-01

. Although the patient's outcome was death, his lactic acidosis was treated successfully with fomepizole and CVVH. Clinicians should be aware that an iatrogenic overdose of lorazepam may result in severe propylene glycol toxicity, which may be treated with fomepizole and CVVH.

40 CFR 1620.6 - Authority to adjust, determine, compromise, and settle.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Authority to adjust, determine, compromise, and settle. 1620.6 Section 1620.6 Protection of Environment CHEMICAL SAFETY AND HAZARD... Chairperson or any other lawful designee can only be made after a legal review is conducted by an attorney...

40 CFR 1620.6 - Authority to adjust, determine, compromise, and settle.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Authority to adjust, determine, compromise, and settle. 1620.6 Section 1620.6 Protection of Environment CHEMICAL SAFETY AND HAZARD... Chairperson or any other lawful designee can only be made after a legal review is conducted by an attorney...

40 CFR 1620.6 - Authority to adjust, determine, compromise, and settle.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Authority to adjust, determine, compromise, and settle. 1620.6 Section 1620.6 Protection of Environment CHEMICAL SAFETY AND HAZARD... Chairperson or any other lawful designee can only be made after a legal review is conducted by an attorney...

[Cat-scratch disease with bone compromise: atypical manifestation].

PubMed

Rodríguez C, Magdalena; Giachetto L, Gustavo; Cuneo E, Alejandro; Gutiérrez B, María del C; Shimchack R, Mario; Pírez G, M Catalina

2009-08-01

Fever, headache, myalgias and lymphadenopathy are characteristic manifestations of cat-scratch disease but other less common findings are described in 2 to 10% of cases. We report two children that presented with hepatosplenic abscesses and bone involvement. One child, had multiple areas of increased uptake in the bone scintigram with a positive serology (IgG > 1/256, IgM slightly positive). The second child had destruction of the L2 vertebral body that compromised the channel and right foramen as visualized by MRI. In both cases, bacilli were observed in the bone biopsy by Warthing-Starry stain.

A psychiatrist in a bureaucracy: the unsettling compromises.

PubMed

Weitzel, W D

1976-09-01

Psychiatrists employed by bureaucracies must make a number of compromises in order to reconcile their employing organization's formally stated aims, their superiors' day-to-day expectations, and their traditional role model of physician and patient-oriented therapist. The author studied nine psychiatrists working for the U.S. Army during a two-year period in the mid-seventies. Their adaptation to expectations and pressures of the bureaucracy can be described in one of three general ways: through alignment with the official views of the Army, compartmentalization of roles to meet both patients' expectations and the Army's expectations, or rejection of a military identity.

Computation of optimal Mars trajectories via combined chemical/electrical propulsion, Part 3: Compromise solutions

NASA Astrophysics Data System (ADS)

Miele, A.; Wang, T.; Williams, P. N.

2005-12-01

The success of the solar-electric ion engine powering the DS1 spacecraft has paved the way toward the use of low-thrust electrical engines in future planetary/interplanetary missions. Vis-à-vis a chemical engine, an electrical engine has a higher specific impulse, implying a possible decrease in propellant mass; however, the low-thrust aspect discourages the use of an electrical engine in the near-planet phases of a trip, since this might result in an increase in flight time. Therefore, a fundamental design problem is to find the best combination of chemical propulsion and electrical propulsion for a given mission, for example, a mission from Earth to Mars. With this in mind, this paper is the third of a series dealing with the optimization of Earth Mars missions via the use of hybrid engines, namely the combination of high-thrust chemical engines for planetary flight and low-thrust electrical engines for interplanetary flight. We look at the deep-space interplanetary portion of the trajectory under rather idealized conditions. The two major performance indexes, the propellant mass and the flight time, are in conflict with one another for the following reason: any attempt at reducing the former causes an increase in the latter and vice versa. Therefore, it is natural to consider a compromise performance index involving the scaled values of the propellant mass and flight time weighted respectively by the compromise factor C and its complement 1-C. We use the compromise factor as the parameter of the one-parameter family of compromise trajectories. Analyses carried out with the sequential gradient-restoration algorithm for optimal control problems lead to results which can be highlighted as follows. Thrust profile. Generally speaking, the thrust profile of the compromise trajectory includes three subarcs: the first subarc is characterized by maximum thrust in conjunction with positive (upward) thrust direction; the second subarc is characterized by zero thrust

Management of Iatrogenic Pseudoaneurysms in Patients Undergoing Coronary Artery Bypass Grafting.

PubMed

Stone, Patrick A; Thompson, Stephanie N; Hanson, Brent; Masinter, David

2016-05-01

A plethora of papers have been written regarding postcatheterization femoral pseudoaneurysms. However, literature is lacking on pseudoaneurysmal management in patients undergoing coronary artery bypass grafting (CABG). Thus, we examined if pseudoaneurysms with subsequent CABG can be managed with the same strategies as those not exposed to the intense anticoagulation accompanying CABGs. During a 14-year study period, we retrospectively examined femoral iatrogenic pseudoaneurysms (IPSAs) diagnosed postheart catheterization in patients having a subsequent CABG. Patient information was obtained from electronic medical records and included pseudoaneurysm characteristics, treatment, and resolution. Outcomes of interest included the occurrence of IPSA treatment failures and complications. In the 66 patients (mean age, 66 ± 11 years, 46% male) meeting inclusion criteria, mean dose of heparin received during the CABG procedure was 34 000 ± 23 000 units. The IPSA size distribution was the following: 17% of IPSAs measured <1 cm, 55% between 1 and 3 cm, and 21% measured >3 cm. Pseudoaneurysms were managed with compression, duplex-guided thrombin injection, and surgical repair (1%, 27%, and 26% of cases, respectively). Thrombin injection and surgical repair were 100% effective at treating pseudoaneurysms, with 1 patient experiencing a surgical site infection postsurgical repair. Observation-only management was employed in 30 (45%) patients. Nine of 30 patients with no intervention beyond observation had duplex documented resolution/thrombosis during follow-up. One patient initially managed by observation required readmission and surgical repair of an enlarging pseudoaneurysm (6 cm growth) following CABG. Management of pseudoaneurysms in patients prior to CABG should be similar to those patients not undergoing intense anticoagulation. In appropriate cases, small aneurysms can be safely observed, while thrombin injections are effective and safe as well. Thus, routine open

Immediate and late management of iatrogenic ureteric injuries: 28 years of experience.

PubMed

El Abd, Ahmed S; El-Abd, Shawky A; El-Enen, Mohamed Abo; Tawfik, Ahmed M; Soliman, Mohamed G; Abo-Farha, Mohamed; Gamasy, Abd-El Naser El; El-Sharaby, Mahmoud; El-Gamal, Samir

2015-12-01

To evaluate the long-term results after managing intraoperative and late-diagnosed cases of iatrogenic ureteric injury (IUI), treated endoscopically or by open surgery. Patients immediately diagnosed with IUI were managed under the same anaesthetic, while those referred late had a radiological assessment of the site of injury, and endoscopic management. Open surgical procedures were used only for the failed cases with previous diversion. In all, 98 patients who were followed had IUI after gynaecological, abdominopelvic and ureteroscopic procedures in 60.2%, 14.3% and 25.5%, respectively. The 27 patients diagnosed during surgery were managed immediately, while in the late-referred 71 patients ureteroscopic ureteric realignment with stenting was successful in 26 (36.6%). Complex open reconstruction with re-implantation or ureteric substitution, using bladder-tube or intestinal-loop procedures, was used in 27 (60%), 16 (35.5%) and two (4.5%) patients of the late group, respectively. A long-term radiological follow-up with a mean (range) of 46.6 (24.5-144) months showed recurrent obstruction in 16 (16.3%) patients managed endoscopically and reflux in six (8.3%) patients. Three renal units only (3%) were lost in the late-presenting patients. Patients managed immediately had better long-term results. More than a third of the late-diagnosed patients were successfully managed endoscopically with minimal morbidity. Open reconstruction by an experienced urologist who can perform a complex substitutional procedure was mandatory to preserve renal units in the long-term.

First Digit Law and Its Application to Digital Forensics

NASA Astrophysics Data System (ADS)

Shi, Yun Q.

Digital data forensics, which gathers evidence of data composition, origin, and history, is crucial in our digital world. Although this new research field is still in its infancy stage, it has started to attract increasing attention from the multimedia-security research community. This lecture addresses the first digit law and its applications to digital forensics. First, the Benford and generalized Benford laws, referred to as first digit law, are introduced. Then, the application of first digit law to detection of JPEG compression history for a given BMP image and detection of double JPEG compressions are presented. Finally, applying first digit law to detection of double MPEG video compressions is discussed. It is expected that the first digit law may play an active role in other task of digital forensics. The lesson learned is that statistical models play an important role in digital forensics and for a specific forensic task different models may provide different performance.

Laparoscopic endoloop technique - A novel approach of managing iatrogenic caecal perforation and literature review.

PubMed

Merali, N; Hussain, A

2015-01-01

An iatrogenic caecal perforation is rare, but a serious complication associated with significant morbidity and mortality. We present a 4min and 50s video on a new improvisation undertaken during laparoscopic management of post-polypectomy caecal perforation. Our patient presented with an acute abdomen following endoscopic polypectomy. At surgery, the site of caecal perforation was close to the appendicular base with devitalization tissue, secondary to diathermy usage. The hallmark of safety within this novel technique included fresh healthy tissue margins within the endoloop (detachable snare ligation) and ensuring no ischemic tissue was gathered. Complete freeing of the appendix and meso-appendicular base was required and securing three endoloops proximal to the site of perforation. The post-operative course was uneventful. The World Society of Emergency Surgery (WSES) 2013 guidelines suggested an early laparoscopic approach is a safe and effective treatment for colonoscopy-related colonic perforation. There are no national guidelines and the management is dictated by the clinical condition of the patient, co-morbidity, size and site of perforation as well as the scale of bowel preparation, and surgical experience. The endoloop technique described, undertaken during a laparoscopy is a novel approach. It is a simple and effective method, reminding clinicians to adapt techniques when necessary. Nevertheless, it is only limited to perforations around the appendicular base. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Happenstance and compromise: a gendered analysis of students' computing degree course selection

NASA Astrophysics Data System (ADS)

Lang, Catherine

2010-12-01

The number of students choosing to study computing at university continues to decline this century, with an even sharper decline in female students. This article presents the results of a series of interviews with university students studying computing courses in Australia that uncovered the influence of happenstance and compromise on course choice. This investigation provides an insight into the contributing factors into the continued downturn of student diversity in computing bachelor degree courses. Many females interviewed made decisions based on happenstance, many males interviewed had chosen computing as a compromise course, and family helped in the decision-making to a large degree in both genders. The major implication from this investigation is the finding that students of both genders appear to be socialised away from this discipline, which is perceived as a support or insurance skill, not a career in itself, in all but the most technical-oriented (usually male) student.

Is ridge preservation/augmentation at periodontally compromised extraction sockets safe? A retrospective study.

PubMed

Kim, Jung-Ju; Ben Amara, Heithem; Schwarz, Frank; Kim, Hae-Young; Lee, Jung-Won; Wikesjö, Ulf M E; Koo, Ki-Tae

2017-10-01

This study aimed to evaluate the safety of ridge preservation/augmentation procedures when performed at compromised extraction sockets. Patients subject to ridge preservation/augmentation at periodontally compromised sockets at Seoul National University Dental Hospital (SNUDH) were evaluated in a chart review. Tooth extractions due to acute infection were not included in our study as chronically formed lesions are the only lesions that can be detected from radiographic images. If inflammatory symptoms persisted following ridge preservation/augmentation and antimicrobial and anti-inflammatory therapy, the patient was categorized as a re-infection case and implanted biomaterial removed. Of 10,060 patients subject to tooth extractions at SNUDH, 2011 through 2015, 297 cases meeting inclusion criteria were reviewed. The severity and type of lesions were not specific because extracting data was only done by radiographic images and chart records. The review identified eight patients exhibiting inflammatory symptoms that required additional antimicrobial and anti-inflammatory therapy. Within this group, re-infection occurred in two patients requiring biomaterials removal. The final safety rate for the ridge preservation/augmentation was 99.3%. None of the demographic factors, systemic conditions or choice of biomaterial affected the safety of ridge preservation/augmentation. Alveolar ridge preservation/augmentation at periodontally compromised sockets appears safe following thorough removal of infectious source. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Outcomes of Soft Tissue Reconstruction for Traumatic Lower Extremity Fractures with Compromised Vascularity.

PubMed

Badash, Ido; Burtt, Karen E; Leland, Hyuma A; Gould, Daniel J; Rounds, Alexis D; Azadgoli, Beina; Patel, Ketan M; Carey, Joseph N

2017-10-01

Traumatic lower extremity fractures with compromised arterial flow are limb-threatening injuries. A retrospective review of 158 lower extremities with traumatic fractures, including 26 extremities with arterial injuries, was performed to determine the effects of vascular compromise on flap survival, successful limb salvage and complication rates. Patients with arterial injuries had a larger average flap surface area (255.1 vs 144.6 cm2, P = 0.02) and a greater number of operations (4.7 vs 3.8, P = 0.01) than patients without vascular compromise. Patients presenting with vascular injury were also more likely to require fasciotomy [odds ratio (OR): 6.5, confidence interval (CI): 2.3-18.2] and to have a nerve deficit (OR: 16.6, CI: 3.9-70.0), fracture of the distal third of the leg (OR: 2.9, CI: 1.15-7.1) and intracranial hemorrhage (OR: 3.84, CI: 1.1-12.9). After soft tissue reconstruction, patients with arterial injuries had a higher rate of amputation (OR: 8.5, CI: 1.3-53.6) and flap failure requiring a return to the operating room (OR: 4.5, CI: 1.5-13.2). Arterial injury did not correlate with infection or overall complication rate. In conclusion, arterial injuries resulted in significant complications for patients with lower extremity fractures requiring flap coverage, although limb salvage was still effective in most cases.

Digital holographic-based cancellable biometric for personal authentication

NASA Astrophysics Data System (ADS)

Verma, Gaurav; Sinha, Aloka

2016-05-01

In this paper, we propose a new digital holographic-based cancellable biometric scheme for personal authentication and verification. The realization of cancellable biometric is presented by using an optoelectronic experimental approach, in which an optically recorded hologram of the fingerprint of a person is numerically reconstructed. Each reconstructed feature has its own perspective, which is utilized to generate user-specific fingerprint features by using a feature-extraction process. New representations of the user-specific fingerprint features can be obtained from the same hologram, by changing the reconstruction distance (d) by an amount Δd between the recording plane and the reconstruction plane. This parameter is the key to make the cancellable user-specific fingerprint features using a digital holographic technique, which allows us to choose different reconstruction distances when reissuing the user-specific fingerprint features in the event of compromise. We have shown theoretically that each user-specific fingerprint feature has a unique identity with a high discrimination ability, and the chances of a match between them are minimal. In this aspect, a recognition system has also been demonstrated using the fingerprint biometric of the enrolled person at a particular reconstruction distance. For the performance evaluation of a fingerprint recognition system—the false acceptance ratio, the false rejection ratio and the equal error rate are calculated using correlation. The obtained results show good discrimination ability between the genuine and the impostor populations with the highest recognition rate of 98.23%.

Corporate corruption of the environment: sustainability as a process of compromise.

PubMed

Nyberg, Daniel; Wright, Christopher

2013-09-01

A key response to environmental degradation, climate change and declining biodiversity has been the growing adoption of market principles in an effort to better value the social good of nature. Through concepts such as 'natural capitalism' and 'corporate environmentalism', nature is increasingly viewed as a domain of capitalist endeavour. In this article, we use convention theory and a pluralist understanding of social goods to investigate how the social good of the environment is usurped by the alternate social good of the market. Through analysis of interviews with sustainability managers and corporate documentation, we highlight how organizational actors employ compromise to temporally settle disputes between competing claims about environmental activities. Our findings contribute to an understanding of the processes of empirically grounded critique and the under-theorized concept of compromise between social goods. Rather than protecting the environment, the corporate promotion of sustainability facilitates the corruption of the social good of the environment and its conversion into a market commodity. © London School of Economics and Political Science 2013.

The New Digital Divide For Digital BioMarkers.

PubMed

Torous, John; Rodriguez, Jorge; Powell, Adam

2017-09-01

As smartphone and sensors continue to become more ubiquitous across the world, digital biomarkers have emerged as a scalable and practical tool to explore disease states and advance health. But as the digital divide of access and ownership begins to fade, a new digital divide is emerging. Who are the types of people that own smartphones or smart watches, who are the types of people that download health apps or partake in digital biomarker studies, and who are the types of people that are actually active with digital biomarkers apps and sensors - the people providing the high quality and longitudinal data that this field is being founded upon? Understanding the people behind digital biomarkers, the very people this emerging field aims to help, may actually be the real challenge as well as opportunity for digital biomarkers.

Health-compromising behaviors among Vietnamese adolescents: the role of education and extracurricular activities.

PubMed

Kaplan, Celia Patricia; Zabkiewicz, Denise; McPhee, Stephen J; Nguyen, Tung; Gregorich, Steven E; Disogra, Charles; Hilton, Joan F; Jenkins, Christopher

2003-05-01

behaviors. Also, older and more acculturated adolescents were at increased risk of engaging in health-compromising behaviors. Analysis by gender revealed that the variables age, educational risk, and chance of attending college were all related to health risk behavior for both males and females. Among the boys, those who reported achieving an average grade of B or better had a decreased risk of engaging in health-compromising behaviors; however, neither extracurricular activities nor acculturation was related to health-compromising behaviors in boys. Among the girls, the reverse was true: lack of participation in extracurricular activities was related to health-compromising behaviors, whereas grades were not a significant risk factor. Among sampled Vietnamese adolescents in California, health risk behaviors are common and inversely related to some school performance indicators. Using these indicators to identify high-risk groups could allow targeted educational programs or interventions for the mitigation of health-compromising behaviors.

Integrated digital printing of flexible circuits for wireless sensing (Conference Presentation)

NASA Astrophysics Data System (ADS)

Mei, Ping; Whiting, Gregory L.; Schwartz, David E.; Ng, Tse Nga; Krusor, Brent S.; Ready, Steve E.; Daniel, George; Veres, Janos; Street, Bob

2016-09-01

Wireless sensing has broad applications in a wide variety of fields such as infrastructure monitoring, chemistry, environmental engineering and cold supply chain management. Further development of sensing systems will focus on achieving light weight, flexibility, low power consumption and low cost. Fully printed electronics provide excellent flexibility and customizability, as well as the potential for low cost and large area applications, but lack solutions for high-density, high-performance circuitry. Conventional electronics mounted on flexible printed circuit boards provide high performance but are not digitally fabricated or readily customizable. Incorporation of small silicon dies or packaged chips into a printed platform enables high performance without compromising flexibility or cost. At PARC, we combine high functionality c-Si CMOS and digitally printed components and interconnects to create an integrated platform that can read and process multiple discrete sensors. Our approach facilitates customization to a wide variety of sensors and user interfaces suitable for a broad range of applications including remote monitoring of health, structures and environment. This talk will describe several examples of printed wireless sensing systems. The technologies required for these sensor systems are a mix of novel sensors, printing processes, conventional microchips, flexible substrates and energy harvesting power solutions.

White matter compromise predicts poor intellectual outcome in survivors of pediatric low-grade glioma.

PubMed

Liu, Fang; Scantlebury, Nadia; Tabori, Uri; Bouffet, Eric; Laughlin, Suzanne; Strother, Douglas; McConnell, Dina; Hukin, Juliette; Fryer, Chris; Brière, Marie-Eve; Montour-Proulx, Isabelle; Keene, Daniel; Wang, Frank; Mabbott, Donald J

2015-04-01

While the impact of cranial radiation on white matter following treatment for pediatric brain tumor has been the focus of many recent studies, the effect of treatment in the absence of radiation has received little attention. The relations between white matter and cognitive outcome have not been explored in patients who have undergone radiation-free treatment. As most patients treated without cranial radiation survive long after their diagnosis, it is critical to identify factors that may impact structural and neurocognitive outcomes. Using diffusion tensor imaging, we examined white matter structure in 32 patients with pediatric low-grade glioma (PLGG) (19 with subtentorial location and 13 with supratentorial location) and 32 healthy participants. Indices of intellectual functioning were also evaluated. Radiation was not used to treat this cohort, aged 8-19 years. We detected evidence of deficits in IQ and compromised supra- and subtentorial white matter in patients relative to healthy children (P < .05). Compromise of supratentorial white matter mediated the impact of treatment for PLGG on IQ. Greater white matter compromise was observed in patients who presented without multiple symptoms, were treated with biopsy/no surgery, had positive neurofibromatosis 1 status, were younger age at diagnosis, and whose parents had lower levels of education (P < .05). Our findings provide evidence of increased risk of intellectual and white matter compromise in patients treated for PLGG without radiation. We identify a neural origin of cognitive deficit useful for predicting outcome and mitigating long-term adverse effects in pediatric brain tumor patients treated without cranial radiation. © The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Methamphetamine compromises gap junctional communication in astrocytes and neurons

PubMed Central

Castellano, Paul; Nwagbo, Chisom; Martinez, Luis R.; Eugenin, Eliseo A.

2016-01-01

Methamphetamine (meth) is a central nervous system (CNS) stimulant that results in psychological and physical dependency. The long-term effects of meth within the CNS include neuronal plasticity changes, blood–brain barrier compromise, inflammation, electrical dysfunction, neuronal/glial toxicity, and an increased risk to infectious diseases including HIV. Most of the reported meth effects in the CNS are related to dysregulation of chemical synapses by altering the release and uptake of neurotransmitters, especially dopamine, norepinephrine, and epinephrine. However, little is known about the effects of meth on connexin (Cx) containing channels, such as gap junctions (GJ) and hemichannels (HC). We examined the effects of meth on Cx expression, function, and its role in NeuroAIDS. We found that meth altered Cx expression and localization, decreased GJ communication between neurons and astrocytes, and induced the opening of Cx43/Cx36 HC. Furthermore, we found that these changes in GJ and HC induced by meth treatment were mediated by activation of dopamine receptors, suggesting that dysregulation of dopamine signaling induced by meth is essential for GJ and HC compromise. Meth-induced changes in GJ and HC contributed to amplified CNS toxicity by dysregulating glutamate metabolism and increasing the susceptibility of neurons and astrocytes to bystander apoptosis induced by HIV. Together, our results indicate that connexin containing channels, GJ and HC, are essential in the pathogenesis of meth and increase the sensitivity of the CNS to HIV CNS disease. PMID:26953131

76 FR 15212 - Redelegation of Authority to Compromise and Close Civil Claims

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-21

... Division directive delegates to a Principal Deputy Assistant Attorney General all of the Assistant Attorney... Review, and the Deputy Assistant Attorneys General, to compromise and close civil claims. In addition... Section 11 hereof, each of the Deputy Assistant Attorneys General is authorized to: (A) Accept offers in...

13 CFR 108.1710 - SBA authority to collect or compromise its claims.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false SBA authority to collect or compromise its claims. 108.1710 Section 108.1710 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM SBA Financial Assistance for NMVC Companies (Leverage...

Incidence of iatrogenic opioid dependence or abuse in patients with pain who were exposed to opioid analgesic therapy: a systematic review and meta-analysis.

PubMed

Higgins, C; Smith, B H; Matthews, K

2018-06-01

The prevalence and incidence of chronic conditions, such as pain and opioid dependence, have implications for policy development, resource allocation, and healthcare delivery. The primary objective of the current review was to estimate the incidence of iatrogenic opioid dependence or abuse after treatment with opioid analgesics. Systematic electronic searches utilised six research databases (Embase, Medline, PubMed, Cinahl Plus, Web of Science, OpenGrey). A 'grey' literature search and a reference search of included articles were also undertaken. The PICOS framework was used to develop search strategies and the findings are reported in accordance with the PRISMA Statement. After eligibility reviews of 6164 articles, 12 studies (involving 310 408 participants) were retained for inclusion in the meta-analyses. A random effects model (DerSimonian-Laird method) generated a pooled incidence of opioid dependence or abuse of 4.7%. There was little within-study risk of bias and no significant publication bias; however, substantial heterogeneity was found among study effects (99.78%). Sensitivity analyses indicated that the diagnostic criteria selected for identifying opioid dependence or abuse (Diagnostic Statistical Manual (DSM-IV) vs International Classification of Diseases (ICD-9)) accounted for 20% and duration of exposure to opioid analgesics accounted for 18% of variance in study effects. Longer-term opioid analgesic exposure, and prescription of strong rather than weak opioids, were associated with a significantly lower incidence of opioid dependence or abuse. The incidence of iatrogenic opioid dependence or abuse was 4.7% of those prescribed opioids for pain. Further research is required to confirm the potential for our findings to inform prevention of this serious adverse event. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Unusual Development of Iatrogenic Complex, Mixed Biliary and Duodenal Fistulas Complicating Roux-en-Y Antrectomy for Stenotic Peptic Disease of the Supraampullary Duodenum Requiring Whipple Procedure: An Uncommon Clinical Dilemma.

PubMed

Polistina, Francesco A; Costantin, Giorgio; Settin, Alessandro; Lumachi, Franco; Ambrosino, Giovanni

2010-10-23

Complex fistulas of the duodenum and biliary tree are severe complications of gastric surgery. The association of duodenal and major biliary fistulas occurs rarely and is a major challenge for treatment. They may occur during virtually any kind of operation, but they are more frequent in cases complicated by the presence of difficult duodenal ulcers or cancer, with a mortality rate of up to 35%. Options for treatment are many and range from simple drainage to extended resections and difficult reconstructions. Conservative treatment is the choice for well-drained fistulas, but some cases require reoperation. Very little is known about reoperation techniques and technical selection of the right patients. We present the case of a complex iatrogenic duodenal and biliary fistula. A 42-year-old Caucasian man with a diagnosis of postoperative peritonitis had been operated on 3 days earlier; an antrectomy with a Roux-en-Y reconstruction for stenotic peptic disease was performed. Conservative treatment was attempted with mixed results. Two more operations were required to achieve a definitive resolution of the fistula and related local complications. The decision was made to perform a pancreatoduodenectomy with subsequent reconstruction on a double jejunal loop. The patient did well and was discharged on postoperative day 17. In our experience pancreaticoduodenectomy may be an effective treatment of refractory and complex iatrogenic fistulas involving both the duodenum and the biliary tree.

Human Milk for Ill and Medically Compromised Infants: Strategies and Ongoing Innovation.

PubMed

DiLauro, Sara; Unger, Sharon; Stone, Debbie; O'Connor, Deborah L

2016-08-01

The use of human milk (mother's own milk and/or donor milk) in ill or medically compromised infants frequently requires some adaptation to address medical diagnoses and/or altered nutrition requirements. This tutorial describes the nutrition and immunological benefits of breast milk as well as provides evidence for the use of donor milk when mother's own milk is unavailable. Several strategies used to modify human milk to meet the medical and nutrition needs of an ill or medically compromised infant are reviewed. These strategies include (1) the standard fortification of human milk to support adequate growth, (2) the novel concept of target fortification in preterm infants, (3) instructions on how to alter maternal diet to address cow's milk protein intolerance and/or allergy in breast milk-fed infants, and (4) the removal and modification of the fat in breast milk used in infants diagnosed with chylothorax. © 2016 American Society for Parenteral and Enteral Nutrition.

Can We Teach Digital Natives Digital Literacy?

ERIC Educational Resources Information Center

Ng, Wan

2012-01-01

In recent years, there has been much debate about the concept of digital natives, in particular the differences between the digital natives' knowledge and adoption of digital technologies in informal versus formal educational contexts. This paper investigates the knowledge about educational technologies of a group of undergraduate students…

From Digital Divides to Digital Inequality -- The Emerging Digital Inequality in the Norwegian Unitarian School

ERIC Educational Resources Information Center

Krumsvik, Rune J.

2008-01-01

This position paper highlights existing and emerging, prospective digital divides in Norwegian schools and asks whether we are now moving from traditional digital divides to digital inequality in our digitized society and schools. Despite very good technology density in Norwegian society and schools in general, there is the reason to pay attention…

Global analysis of microscopic fluorescence lifetime images using spectral segmentation and a digital micromirror spatial illuminator.

PubMed

Bednarkiewicz, Artur; Whelan, Maurice P

2008-01-01

Fluorescence lifetime imaging (FLIM) is very demanding from a technical and computational perspective, and the output is usually a compromise between acquisition/processing time and data accuracy and precision. We present a new approach to acquisition, analysis, and reconstruction of microscopic FLIM images by employing a digital micromirror device (DMD) as a spatial illuminator. In the first step, the whole field fluorescence image is collected by a color charge-coupled device (CCD) camera. Further qualitative spectral analysis and sample segmentation are performed to spatially distinguish between spectrally different regions on the sample. Next, the fluorescence of the sample is excited segment by segment, and fluorescence lifetimes are acquired with a photon counting technique. FLIM image reconstruction is performed by either raster scanning the sample or by directly accessing specific regions of interest. The unique features of the DMD illuminator allow the rapid on-line measurement of global good initial parameters (GIP), which are supplied to the first iteration of the fitting algorithm. As a consequence, a decrease of the computation time required to obtain a satisfactory quality-of-fit is achieved without compromising the accuracy and precision of the lifetime measurements.

Substance Use Disorder and Suicide Attempt Among People Who Report Compromised Health.

PubMed

Prince, Jonathan

2018-01-02

Substance use disorder can increase the risk of suicide attempt. However, the relationship between substance use disorder and suicide attempt has yet to be explored among people who report compromised health, even though sick people are more likely to make an attempt. Among people who report fair or poor health on the National Survey of Drug Use and Health (2006-2014; N = 502,467), I examined whether people with commonly occurring substance use disorders are more likely to attempt suicide than people without substance use disorders. Logistic regression was used to predict suicide attempt from presence versus absence of substance use disorder. Among individuals reporting compromised health, those who had DSM-IV alcohol use disorders were 2.72 times (CI = 1.81-4.09, p <.001) as likely as people without SUD to attempt suicide, and people with prescription painkiller use disorders were 2.25 times (CI = 1.04-4.90, p <.05) as likely. Individuals with both alcohol and marijuana use disorders were 2.38 times (CI = 1.25-4.54, p <.01) as likely as people without substance use disorder to make an attempt, and people with both alcohol and cocaine use disorders were 3.15 times (CI = 1.16-8.60, p <.05) as likely. Conclusions/Importance: In order to help prevent suicide attempt among people who report compromised health, treatment programs that specialize in health, mental health, or substance abuse could address the drug-specific disorders that are most highly associated with the likelihood of suicide attempt. More research is needed that may underscore risk associated with other drug-specific disorders, or that substantiate the findings reported herein.

[A case of iatrogenic scrotal elephantiasis: reconstruction of the scrotal purse and the cutaneous sleeve of the penis with local skin flaps].

PubMed

Masia, D-R; Castus, P; Delia, G; Casoli, V; Martine, D

2008-02-01

Scrotal elephantiasis is a pathology of often unknown etiology. Symptomatology is characterized by an oedematius infiltration of skin and subcutaneous tissue, hard-bound aspect and purplished color. The scrotum, the penis and the perineal area are gradually affected. This pathology is very invalidating for the patient, on functional, sexual and aesthetic aspects. The authors present the case of a 58-year-old man with an enormous scrotal mass invading the penis and drowning the testicular elements, which were impossible to palpate. The aetiology was determined by exclusion and an iatrogenic origin following the cure of bilateral inguinal hernia was retained. Resection of the scrotal mass was performed. The reconstruction of the scrotal purse and the cutaneous sleeve of the penis were carried out using local flaps of the remaining healthy skin.

A compromised liver alters polychlorinated biphenyl-mediated toxicity.

PubMed

Wahlang, Banrida; Perkins, Jordan T; Petriello, Michael C; Hoffman, Jessie B; Stromberg, Arnold J; Hennig, Bernhard

2017-04-01

Exposure to environmental toxicants namely polychlorinated biphenyls (PCBs) is correlated with multiple health disorders including liver and cardiovascular diseases. The liver is important for both xenobiotic and endobiotic metabolism. However, the responses of an injured liver to subsequent environmental insults has not been investigated. The current study aims to evaluate the role of a compromised liver in PCB-induced toxicity and define the implications on overall body homeostasis. Male C57Bl/6 mice were fed either an amino acid control diet (CD) or a methionine-choline deficient diet (MCD) during the 12-week study. Mice were subsequently exposed to either PCB126 (4.9mg/kg) or the PCB mixture, Arcolor1260 (20mg/kg) and analyzed for inflammatory, calorimetry and metabolic parameters. Consistent with the literature, MCD diet-fed mice demonstrated steatosis, indicative of a compromised liver. Mice fed the MCD-diet and subsequently exposed to PCB126 showed observable wasting syndrome leading to mortality. PCB126 and Aroclor1260 exposure worsened hepatic fibrosis exhibited by the MCD groups. Interestingly, PCB126 but not Aroclor1260 induced steatosis and inflammation in CD-fed mice. Mice with liver injury and subsequently exposed to PCBs also manifested metabolic disturbances due to alterations in hepatic gene expression. Furthermore, PCB exposure in MCD-fed mice led to extra-hepatic toxicity such as upregulated circulating inflammatory biomarkers, implicating endothelial cell dysfunction. Taken together, these results indicate that environmental pollution can exacerbate toxicity caused by diet-induced liver injury which may be partially due to dysfunctional energy homeostasis. This is relevant to PCB-exposed human cohorts who suffer from alcohol or diet-induced fatty liver diseases. Copyright © 2017 Elsevier B.V. All rights reserved.

Treatment of Lung Cancer in Medically Compromised Patients.

PubMed

Crawford, Jeffrey; Wheatley-Price, Paul; Feliciano, Josephine Louella

2016-01-01

Outcomes for patients with lung cancer have been improved substantially through the integration of surgery, radiation, and systemic therapy for patients with early-stage disease. Meanwhile, advances in our understanding of molecular mechanisms have substantially advanced our treatment of patients with advanced lung cancer through the introduction of targeted therapies, immune approaches, improvements in chemotherapy, and better supportive care. However, the majority of these advances have occurred among patients with good functional status, normal organ function, and with the social and economic support systems to be able to benefit most from these treatments. The aim of this article is to bring greater attention to management of lung cancer in patients who are medically compromised, which remains a major barrier to care delivery. Impaired performance status is associated with poor outcomes and correlates with the high prevalence of cachexia among patients with advanced lung cancer. CT imaging is emerging as a research tool to quantify muscle loss in patients with cancer, and new therapeutics are on the horizon that may provide important adjunctive therapy in the future. The benefits of cancer therapy for patients with organ failure are poorly understood because of their exclusion from clinical trials. The availability of targeted therapy and immunotherapy may provide alternatives that may be easier to deliver in this population, but clinical trials of these new agents in this population are vital. Patients with lower socioeconomic status are disproportionately affected by lung cancer because of higher rates of tobacco addiction and the impact of socioeconomic status on delay in diagnosis, treatment, and outcomes. For all patients who are medically compromised with lung cancer, multidisciplinary approaches are particularly needed to evaluate these patients and to incorporate rapidly changing therapeutics to improve outcomes.

Digital disruption ?syndromes.

PubMed

Sullivan, Clair; Staib, Andrew

2017-05-18

The digital transformation of hospitals in Australia is occurring rapidly in order to facilitate innovation and improve efficiency. Rapid transformation can cause temporary disruption of hospital workflows and staff as processes are adapted to the new digital workflows. The aim of this paper is to outline various types of digital disruption and some strategies for effective management. A large tertiary university hospital recently underwent a rapid, successful roll-out of an integrated electronic medical record (EMR). We observed this transformation and propose several digital disruption "syndromes" to assist with understanding and management during digital transformation: digital deceleration, digital transparency, digital hypervigilance, data discordance, digital churn and post-digital 'depression'. These 'syndromes' are defined and discussed in detail. Successful management of this temporary digital disruption is important to ensure a successful transition to a digital platform. What is known about this topic? Digital disruption is defined as the changes facilitated by digital technologies that occur at a pace and magnitude that disrupt established ways of value creation, social interactions, doing business and more generally our thinking. Increasing numbers of Australian hospitals are implementing digital solutions to replace traditional paper-based systems for patient care in order to create opportunities for improved care and efficiencies. Such large scale change has the potential to create transient disruption to workflows and staff. Managing this temporary disruption effectively is an important factor in the successful implementation of an EMR. What does this paper add? A large tertiary university hospital recently underwent a successful rapid roll-out of an integrated electronic medical record (EMR) to become Australia's largest digital hospital over a 3-week period. We observed and assisted with the management of several cultural, behavioural and

Teaching Students to Think in the Digital Environment: Digital Literacy and Digital Inquiry

ERIC Educational Resources Information Center

Stripling, Barbara

2010-01-01

The digital world, much like any new or changing environment, demands an assessment of the situation and development of new ways of thinking or working. School librarians must, therefore, partner with other educators to identify and teach the digital literacy and inquiry skills that will enable all students to be effective digital learners.…

Digital Natives and Digital Divide: Analysing Perspective for Emerging Pedagogy

ERIC Educational Resources Information Center

Onye, Uriel U.; Du, Yunfei

2016-01-01

This paper addresses the concepts of digital natives and digital divide from the perspective of the digital outsiders (part of digital natives). It takes a critical look at the implications of available ICT in both developed and underdeveloped countries in the fight against digital divide. The major contribution to literature is by drawing…

Equilibria, prudent compromises, and the "waiting" game.

PubMed

Sim, Kwang Mong

2005-08-01

While evaluation of many e-negotiation agents are carried out through empirical studies, this work supplements and complements existing literature by analyzing the problem of designing market-driven agents (MDAs) in terms of equilibrium points and stable strategies. MDAs are negotiation agents designed to make prudent compromises taking into account factors such as time preference, outside option, and rivalry. This work shows that 1) in a given market situation, an MDA negotiates optimally because it makes minimally sufficient concession, and 2) by modeling negotiation of MDAs as a game gamma of incomplete information, it is shown that the strategies adopted by MDAs are stable. In a bilateral negotiation, it is proven that the strategy pair of two MDAs forms a sequential equilibrium for gamma. In a multilateral negotiation, it is shown that the strategy profile of MDAs forms a market equilibrium for gamma.

Uses of megavoltage digital tomosynthesis in radiotherapy

NASA Astrophysics Data System (ADS)

Sarkar, Vikren

, the software was extended to investigate if the digital tomosynthesis dataset could be used in an adaptive radiotherapy regimen through the use of the Pinnacle treatment planning software to recalculate dose delivered. The feasibility study showed that the megavoltage CBDT visually agreed with corresponding megavoltage computed tomography images. The comparative study showed that the best compromise between imaging quality and imaging dose is obtained when 11 projection images, acquired over an imaging angle of 40°, are used with the filtered back-projection algorithm. DART was successfully used to register reference and daily image sets to within 1 mm in-plane and 2.5 mm out of plane. The DART platform was also effectively used to generate updated files that the Pinnacle treatment planning system used to calculate updated dose in a rigidly shifted patient. These doses were then used to calculate a cumulative dose distribution that could be used by a physician as reference to decide when the treatment plan should be updated. In conclusion, this study showed that a software solution is possible to extend existing electronic portal imaging devices to function as cone-beam digital tomosynthesis devices and achieve daily requirement for image guided intensity modulated radiotherapy treatments. The DART platform also has the potential to be used as a part of adaptive radiotherapy solution.

Comparison of Motor-Evoked Potentials Versus Somatosensory-Evoked Potentials as Early Indicators of Neural Compromise in Rat Model of Spinal Cord Compression.

PubMed

Morris, Susan H; Howard, Jason J; El-Hawary, Ron

2017-03-15

Randomized controlled study comparing the efficacy of intraoperative somatosensory-evoked potentials (SSEPs) versus transcranial motor-evoked potentials (TcMEPs) as early indicators of neural compromise and predictors of postoperative function in a rat model of spinal cord compression. To compare the relative efficacy of SSEPs and TcMEPs to detect spinal cord compromise and predict postoperative functional deficit after spinal cord compression. There is controversy regarding the efficacy of SSEPs versus TcMEPs to detect intraoperative spinal cord compromise and predict functional outcomes. Previous trials provide some guidance as to the role of each modality in spinal cord monitoring but randomized controlled trials, which are not feasible in humans, are lacking. Twenty-four adult male Wistar rats were evenly divided into three experimental groups and one control group. The experimental groups were determined according to the length of time that 100% TcMEP signal loss was maintained: 0, 5, or 15 minutes. All animals had standardized preoperative functional testing. Spinal cord compromise was initiated utilizing a validated protocol, which involved compression via a balloon catheter introduced into the thoracic sublaminar space. Both SSEPs and TcMEPs were recorded during cord compression for each experimental group. Functional behavioral testing using two validated methods (tilt and modified Tarlov) was repeated 24 hours after termination of spinal cord compression. Post hoc, animals were redistributed into two functional subgroups, noncompromised and compromised, for statistical analysis. TcMEPs consistently detected spinal cord compromise either in advance of or at the same time as SSEPs; however, the delay in SSEP response was not significant for cases when compromised postoperative function resulted. Both SSEP and TcMEP amplitude recovery correlated well with postoperative functional scores. TcMEPs are more sensitive to spinal cord compromise than SSEPs, but the

A new method for digital video documentation in surgical procedures and minimally invasive surgery.

PubMed

Wurnig, P N; Hollaus, P H; Wurnig, C H; Wolf, R K; Ohtsuka, T; Pridun, N S

2003-02-01

Documentation of surgical procedures is limited to the accuracy of description, which depends on the vocabulary and the descriptive prowess of the surgeon. Even analog video recording could not solve the problem of documentation satisfactorily due to the abundance of recorded material. By capturing the video digitally, most problems are solved in the circumstances described in this article. We developed a cheap and useful digital video capturing system that consists of conventional computer components. Video images and clips can be captured intraoperatively and are immediately available. The system is a commercial personal computer specially configured for digital video capturing and is connected by wire to the video tower. Filming was done with a conventional endoscopic video camera. A total of 65 open and endoscopic procedures were documented in an orthopedic and a thoracic surgery unit. The median number of clips per surgical procedure was 6 (range, 1-17), and the median storage volume was 49 MB (range, 3-360 MB) in compressed form. The median duration of a video clip was 4 min 25 s (range, 45 s to 21 min). Median time for editing a video clip was 12 min for an advanced user (including cutting, title for the movie, and compression). The quality of the clips renders them suitable for presentations. This digital video documentation system allows easy capturing of intraoperative video sequences in high quality. All possibilities of documentation can be performed. With the use of an endoscopic video camera, no compromises with respect to sterility and surgical elbowroom are necessary. The cost is much lower than commercially available systems, and setting changes can be performed easily without trained specialists.

Digital Citizenship Means Character Education for the Digital Age

ERIC Educational Resources Information Center

Ohler, Jason

2011-01-01

The reality of students' cyber lives has thrust upon educators a new approach: creating character education programs tuned to digital youth that are both proactive and aggressive. Taking this approach will help integrate students' digital activities within the context of the communities in which they live, both local and digital. The digital age…

The effect of health compromising behaviors on preterm births.

PubMed

Dew, Paul C; Guillory, V James; Okah, Felix A; Cai, Jinwen; Hoff, Gerald L

2007-05-01

The objective of our study was to determine whether there were combined effects of smoking, alcohol, and illicit drug use during pregnancy on the frequency of preterm births, and if so, the magnitude of the association after adjusting for confounding factors. We conducted a retrospective cohort study of singleton live births in Kansas City, Missouri from 1990-2002. We defined health compromising behaviors as the use of cigarettes, alcohol, and illicit drugs. The effect of these behaviors on preterm births was considered for each substance individually, and in combination. The rates of preterm births for these groups were calculated. Using logistic regression, adjusted odds ratios were used to estimate the relative risk of preterm births among these groups. Over 13% of infants born to women who smoked were preterm, compared to 9.6% for non-smokers. Of infants born to women who reported alcohol use, 17.3% were preterm compared to 10.1% for non-drinkers. Smoking and alcohol use in combination was associated with 18.0% preterm births, while alcohol and drug use in combination was associated with 20.8% preterm births. The use of all three substances was associated with 31.4% preterm births. Women who engaged in health compromising behaviors during pregnancy showed an increased proportion of preterm births compared to those who did not. There is significant interaction between these behaviors leading to higher rates of preterm births than predicted by their additive effects. To decrease preterm births, we must deal with the effects of smoking, drinking, and drug use simultaneously.

Digital Citizenship Means Character Education for the Digital Age

ERIC Educational Resources Information Center

Ohler, Jason

2012-01-01

The reality of students' cyber lives has thrust upon educators a new approach: creating character education programs tuned to digital youth that are proactive and aggressive. This will help integrate students' digital activities within the context of the communities in which they live, both local and digital. The digital age beckons a new era of…

78 FR 53702 - User Fees for Processing Installment Agreements and Offers in Compromise

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... User Fees for Processing Installment Agreements and Offers in Compromise AGENCY: Internal Revenue... document contains proposed amendments to the regulations that provide user fees for installment agreements... agencies to prescribe regulations that establish charges for services provided by the agencies (user fees...

Laparoscopic endoloop technique – A novel approach of managing iatrogenic caecal perforation and literature review

PubMed Central

Merali, N.; Hussain, A.

2015-01-01

Introduction An iatrogenic caecal perforation is rare, but a serious complication associated with significant morbidity and mortality. We present a 4 min and 50 s video on a new improvisation undertaken during laparoscopic management of post-polypectomy caecal perforation. Presentation of case Our patient presented with an acute abdomen following endoscopic polypectomy. At surgery, the site of caecal perforation was close to the appendicular base with devitalization tissue, secondary to diathermy usage. The hallmark of safety within this novel technique included fresh healthy tissue margins within the endoloop (detachable snare ligation) and ensuring no ischemic tissue was gathered. Complete freeing of the appendix and meso-appendicular base was required and securing three endoloops proximal to the site of perforation. The post-operative course was uneventful. Discussion The World Society of Emergency Surgery (WSES) 2013 guidelines suggested an early laparoscopic approach is a safe and effective treatment for colonoscopy-related colonic perforation. There are no national guidelines and the management is dictated by the clinical condition of the patient, co-morbidity, size and site of perforation as well as the scale of bowel preparation, and surgical experience. Conclusion The endoloop technique described, undertaken during a laparoscopy is a novel approach. It is a simple and effective method, reminding clinicians to adapt techniques when necessary. Nevertheless, it is only limited to perforations around the appendicular base. PMID:25723744

Digital printing

NASA Astrophysics Data System (ADS)

Sobotka, Werner K.

1997-02-01

Digital printing is described as a tool to replace conventional printing machines completely. Still this goal was not reached until now with any of the digital printing technologies to be described in the paper. Productivity and costs are still the main parameters and are not really solved until now. Quality in digital printing is no problem anymore. Definition of digital printing is to transfer digital datas directly on the paper surface. This step can be carried out directly or with the use of an intermediate image carrier. Keywords in digital printing are: computer- to-press; erasable image carrier; image carrier with memory. Digital printing is also the logical development of the new digital area as it is pointed out in Nicholas Negropotes book 'Being Digital' and also the answer to networking and Internet technologies. Creating images text and color in one country and publishing the datas in another country or continent is the main advantage. Printing on demand another big advantage and last but not least personalization the last big advantage. Costs and being able to coop with this new world of prepress technology is the biggest disadvantage. Therefore the very optimistic growth rates for the next few years are really nonexistent. The development of complete new markets is too slow and the replacing of old markets is too small.

The digital darkroom, part 3: digital presentations in plastic surgery.

PubMed

Galdino, G M; Chiaramonte, M; Klatsky, S A

2001-01-01

Digital technology is becoming an increasing popular format for societal and other presentations. Part 3 of The Digital Darkroom reviews the kinds of equipment available, the advantages and disadvantages of digital projection, and the most common pitfalls encountered in preparing and presenting material in digital presentations. It closes with a series of recommendations for optimizing your digital presentation and avoiding mistakes that might decrease its effectiveness.

Placenta accreta: pathogenesis of a 20th century iatrogenic uterine disease.

PubMed

Jauniaux, E; Jurkovic, D

2012-04-01

entirely iatrogenic. Copyright © 2011 Elsevier Ltd. All rights reserved.

Results of isolated lateral retinacular reconstruction for iatrogenic medial patellar instability.

PubMed

Sanchis-Alfonso, Vicente; Montesinos-Berry, Erik; Monllau, Joan Carles; Merchant, Alan C

2015-03-01

The aim of this study was to assess the outcomes of an isolated lateral retinaculum reconstruction for iatrogenic medial patellar instability (IMPI) in patients with continued pain after failed lateral retinacular release (LRR), including associated psychometric analysis. Pain was assessed using the visual analog scale (VAS) and disability was determined with the Lysholm scale. Psychological variables such as anxiety, depression, catastrophizing, and fear-of-movement beliefs were studied by using self-administered psychometric questionnaires. All 17 patients (13 women and 4 men) in this retrospective study had undergone LRR previously for anterior knee pain or lateral patellar instability. Four patients had undergone LRR plus proximal (Insall) realignment, and one had undergone LRR plus a medial tibial tubercle transfer. After their procedures, all had disabling symptoms. All patients underwent reconstructive surgery for IMPI. At a minimum follow-up of 2 years (range, 2 to 8 years), the mean preoperative VAS score was 7.6 (range, 5 to 9) and improved to 1.9 (range, 0 to 8) at the time of final follow-up (P < .001). The mean preoperative Lysholm score was 36.4 (range, 20 to 55), and the knee was described as bad (<65 points) in all cases. Postoperatively, it improved to 86.1 (range, 70 to 94) at final follow-up (P < .001). Before surgery, 4 patients (24%) had the clinical criteria for depression, 10 (59%) had anxiety, 7 (41%) had "catastrophizing" ideas concerning pain, and all (100%) had kinesiophobia (fear of movement). After surgery, none of the patients had depression or anxiety, none had catastrophizing ideation, and only 53% had kinesiophobia. Reconstruction of the deep transverse layer of the lateral retinaculum (LR) using a central strip of the iliotibial band for IMPI in patients with continued pain after failed LRR can successfully treat these severely disabled patients. Level IV, therapeutic case series. Copyright © 2015 Arthroscopy Association of North

Digital Storytelling as an Interactive Digital Media Context

ERIC Educational Resources Information Center

Anderson, Kate T.; Chua, Puay Hoe

2010-01-01

Digital storytelling involves the creation of short, personal narratives combining images, sounds, and text in a multimedia computer-based platform. In education, digital storytelling has been used to foster learning in formal and informal spaces worldwide. The authors offer a critical discussion of claims about digital storytelling's usefulness…

A Digital Tectonic Activity Map of the Earth

NASA Technical Reports Server (NTRS)

Lowman, Paul; Masuoka, Penny; Montgomery, Brian; OLeary, Jay; Salisbury, Demetra; Yates, Jacob

1999-01-01

The subject of neotectonics, covering the structures and structural activity of the last 5 million years (i.e., post-Miocene) is a well-recognized field, including "active tectonics," focussed on the last 500,000 years in a 1986 National Research Council report of that title. However, there is a cartographic gap between tectonic maps, generally showing all features regardless of age, and maps of current seismic or volcanic activity. We have compiled a map intended to bridge this gap, using modern data bases and computer-aided cartographic techniques. The maps presented here are conceptually descended from an earlier map showing tectonic and volcanic activity of the last one million years. Drawn by hand with the National Geographic Society's 1975 "The Physical World" map as a base, the 1981 map in various revisions has been widely reproduced in textbooks and various technical publications. However, two decades of progress call for a completely new map that can take advantage of new knowledge and cartographic techniques. The digital tectonic activity map (DTM), presented in shaded relief (Fig. 1) and schematic (Fig. 2) versions, is the result. The DTM is intended to show tectonism and volcanism of the last one million years, a period long enough to be representative of global activity, but short enough that features such as fault scarps and volcanos are still geomorphically recognizable. Data Sources and Cartographic Methods The DTM is based on a wide range of sources, summarized in Table 1. The most important is the digital elevation model, used to construct a shaded relief map. The bathymetry is largely from satellite altimetry, specifically the marine gravity compilations by Smith and Sandwell (1996). The shaded relief map was designed to match the new National Geographic Society world physical map (1992), although drawn independently, from the digital elevation model. The Robinson Projection is used instead of the earlier Van der Grinten one. Although neither

Digital rights management for digital cinema

NASA Astrophysics Data System (ADS)

Kirovski, Darko; Peinado, Marcus; Petitcolas, Fabien A. P.

2001-12-01

There is a wide consensus among the feature film production studios that the Internet era brings a new paradigm for film distribution to cinemas worldwide. The benefits of digital cinema to both producers and cinemas are numerous: significantly lower distribution and maintenance costs, immediate access to film libraries, higher presentation quality, and strong potential for developing new business models. Despite these advantages, the studios are still reluctant to jump into the digital age. The main showstopper for digital cinema is the danger of widespread piracy. Piracy already costs Hollywood an estimated two billion dollars annually and digital cinema without proper copyright enforcement could increase this number. In this paper, we present a copyright management system that aims at providing the set of necessary security tools: standard cryptographic primitives and copyright protection mechanisms that enable a reliable and secure feature film delivery system.

Digital Assays Part II: Digital Protein and Cell Assays.

PubMed

Basu, Amar S

2017-08-01

A digital assay is one in which the sample is partitioned into many containers such that each partition contains a discrete number of biological entities (0, 1, 2, 3, . . .). A powerful technique in the biologist's toolkit, digital assays bring a new level of precision in quantifying nucleic acids, measuring proteins and their enzymatic activity, and probing single-cell genotype and phenotype. Where part I of this review focused on the fundamentals of partitioning and digital PCR, part II turns its attention to digital protein and cell assays. Digital enzyme assays measure the kinetics of single proteins with enzymatic activity. Digital enzyme-linked immunoassays (ELISAs) quantify antigenic proteins with 2 to 3 log lower detection limit than conventional ELISA, making them well suited for low-abundance biomarkers. Digital cell assays probe single-cell genotype and phenotype, including gene expression, intracellular and surface proteins, metabolic activity, cytotoxicity, and transcriptomes (scRNA-seq). These methods exploit partitioning to 1) isolate single cells or proteins, 2) detect their activity via enzymatic amplification, and 3) tag them individually by coencapsulating them with molecular barcodes. When scaled, digital assays reveal stochastic differences between proteins or cells within a population, a key to understanding biological heterogeneity. This review is intended to give a broad perspective to scientists interested in adopting digital assays into their workflows.

Morgellons: contested illness, diagnostic compromise and medicalisation.

PubMed

Fair, Brian

2010-05-01

The case of Morgellons illustrates how the emergence of a new medically contested illness intersected with and impacted on the diagnostic processes of an existing uncontested psychiatric condition, Delusional Parasitosis (DP). More specifically, the sociopolitical processes at play in the contested illness, Morgellons, dubiously reflect patient empowerment, as well the resilience and power of medical jurisdiction. This research offers insights into the contested illness and medicalisation literatures, and aims to bridge these two approaches towards the relationship between patient empowerment and medical authority, which I do through the notion of doctor-patient compromise. The data for this research come from a comprehensive qualitative analysis of Morgellons discourse through four key sources: the pro-Morgellons website Morgellons.org; the anti-Morgellons website Morgellonswatch.com; the popular media's portrayal of Morgellons; and the DP and Morgellons articles published in peer-reviewed medical journals, as made available on PubMed.

Leveraging Digital Mentor Texts to Write Like a Digital Writer

ERIC Educational Resources Information Center

Werderich, Donna E.; Manderino, Michael; Godinez, Gabriella

2017-01-01

This article presents an approach to reading like a digital writer to support adolescents' narrative writing in digital formats. By providing digital mentor texts for students to read like digital writers, a more comprehensive and perhaps deeper understanding of digital writing and the memoir genre can emerge.

Digital Natives and Digital Immigrants: Teaching with Technology

ERIC Educational Resources Information Center

Martin, Ellen Marie Peterson

2011-01-01

Education is witnessing an increasing demand for technology use in the classroom. At the same time, new teachers are entering the profession in high numbers, some being labeled as "Digital Natives" while others are labeled "Digital Immigrants". This qualitative case study investigated the technology practices of Digital Native and Digital…

[Constructing 3-dimensional colorized digital dental model assisted by digital photography].

PubMed

Ye, Hong-qiang; Liu, Yu-shu; Liu, Yun-song; Ning, Jing; Zhao, Yi-jiao; Zhou, Yong-sheng

2016-02-18

To explore a method of constructing universal 3-dimensional (3D) colorized digital dental model which can be displayed and edited in common 3D software (such as Geomagic series), in order to improve the visual effect of digital dental model in 3D software. The morphological data of teeth and gingivae were obtained by intra-oral scanning system (3Shape TRIOS), constructing 3D digital dental models. The 3D digital dental models were exported as STL files. Meanwhile, referring to the accredited photography guide of American Academy of Cosmetic Dentistry (AACD), five selected digital photographs of patients'teeth and gingivae were taken by digital single lens reflex camera (DSLR) with the same exposure parameters (except occlusal views) to capture the color data. In Geomagic Studio 2013, after STL file of 3D digital dental model being imported, digital photographs were projected on 3D digital dental model with corresponding position and angle. The junctions of different photos were carefully trimmed to get continuous and natural color transitions. Then the 3D colorized digital dental model was constructed, which was exported as OBJ file or WRP file which was a special file for software of Geomagic series. For the purpose of evaluating the visual effect of the 3D colorized digital model, a rating scale on color simulation effect in views of patients'evaluation was used. Sixteen patients were recruited and their scores on colored and non-colored digital dental models were recorded. The data were analyzed using McNemar-Bowker test in SPSS 20. Universal 3D colorized digital dental model with better color simulation was constructed based on intra-oral scanning and digital photography. For clinical application, the 3D colorized digital dental models, combined with 3D face images, were introduced into 3D smile design of aesthetic rehabilitation, which could improve the patients' cognition for the esthetic digital design and virtual prosthetic effect. Universal 3D colorized

Aspects on the history of transmission and favor of distribution of viruses by iatrogenic action: perhaps an example of a paradigm of the worldwide spread of HIV.

PubMed

Gürtler, Lutz G; Eberle, Josef

2017-08-01

Transmission of infectious agents might be associated with iatrogenic actions of charitable help in health care. An example is the vaccination against yellow fever in USA that transmitted hepatitis B virus. Another example is injections of praziquantel for treatment and cure of schistosomiasis in Central and Northern Africa, with a focus in Egypt that has spread hepatitis C virus. There is no indication that human T-lymphotropic virus type 1 was spread by injection treatment for African trypanosomiasis, syphilis and treponematosis, but these treatments might have contributed to the early spread of human immunodeficiency virus type 1 (HIV-1) in Central Africa. Slave trade contributed as well to the spread of viruses from Africa to the Americas; it was stopped in 1850. Until that date HIV-1 was not transported to the Americas. By analysis of nucleic acid sequence data it can be concluded that the continental spread of HCV and HIV-1 might have started around 1920 with an exponential phase from 1940 to 1970. Further iatrogenic actions that promoted the spread of HCV and HIV-1 might be vaccinations to prevent deadly diseases. The successful vaccination was followed by diminution of the infectious agent in the population such as small pox, yellow fever and measles. Measurements to reduce the spread of plague and cholera were further benefits increasing survival of diseased subjects in a population. Thus, the reduction of exposure to deadly infectious agents might have given a chance to HIV-1 infected subjects to survive and for HIV-1 to be distributed around the world starting from Central Africa in the 1950s.

Digital Preservation in Open-Source Digital Library Software

ERIC Educational Resources Information Center

Madalli, Devika P.; Barve, Sunita; Amin, Saiful

2012-01-01

Digital archives and digital library projects are being initiated all over the world for materials of different formats and domains. To organize, store, and retrieve digital content, many libraries as well as archiving centers are using either proprietary or open-source software. While it is accepted that print media can survive for centuries with…

Maternal high-fat diet and obesity compromise fetal hematopoiesis

PubMed Central

Kamimae-Lanning, Ashley N.; Krasnow, Stephanie M.; Goloviznina, Natalya A.; Zhu, Xinxia; Roth-Carter, Quinn R.; Levasseur, Peter R.; Jeng, Sophia; McWeeney, Shannon K.; Kurre, Peter; Marks, Daniel L.

2014-01-01

Objective Recent evidence indicates that the adult hematopoietic system is susceptible to diet-induced lineage skewing. It is not known whether the developing hematopoietic system is subject to metabolic programming via in utero high-fat diet (HFD) exposure, an established mechanism of adult disease in several organ systems. We previously reported substantial losses in offspring liver size with prenatal HFD. As the liver is the main hematopoietic organ in the fetus, we asked whether the developmental expansion of the hematopoietic stem and progenitor cell (HSPC) pool is compromised by prenatal HFD and/or maternal obesity. Methods We used quantitative assays, progenitor colony formation, flow cytometry, transplantation, and gene expression assays with a series of dietary manipulations to test the effects of gestational high-fat diet and maternal obesity on the day 14.5 fetal liver hematopoietic system. Results Maternal obesity, particularly when paired with gestational HFD, restricts physiological expansion of fetal HSPCs while promoting the opposing cell fate of differentiation. Importantly, these effects are only partially ameliorated by gestational dietary adjustments for obese dams. Competitive transplantation reveals compromised repopulation and myeloid-biased differentiation of HFD-programmed HSPCs to be a niche-dependent defect, apparent in HFD-conditioned male recipients. Fetal HSPC deficiencies coincide with perturbations in genes regulating metabolism, immune and inflammatory processes, and stress response, along with downregulation of genes critical for hematopoietic stem cell self-renewal and activation of pathways regulating cell migration. Conclusions Our data reveal a previously unrecognized susceptibility to nutritional and metabolic developmental programming in the fetal HSPC compartment, which is a partially reversible and microenvironment-dependent defect perturbing stem and progenitor cell expansion and hematopoietic lineage commitment. PMID

Relationship between Lower Tendency to Deceive in Aging and Inhibitory Compromise.

PubMed

El Haj, Mohamad; Antoine, Pascal

2018-01-01

Deception can be associated with a heterogeneous network of concepts such as exaggeration, misleading, white lies, and faking. This paper assesses the tendency to deceive in aging. Our main aim was to assess whether older adults would demonstrate a low tendency to deceive. A total of 42 older adults (mean age 67.64 years, SD 7.87) and 45 younger adults (mean age 21.71 years, SD 2.66) were administered a deception scale including items such as "I sometimes tell lies if I have to" or "I never take things that don't belong to me." Participants were also administered an inhibition task. The results demonstrated a low tendency to deceive and low inhibition in older adults compared with younger ones. The low tendency to deceive in the older adults was significantly correlated with their diminished inhibitory ability. The low tendency to deceive in aging seems to be related to a difficulty in inhibiting an honest response. Since inhibitory compromise has been considered mainly to trigger negative consequences for cognition, the present paper illustrates how this age-related compromise can be associated with positive social outcomes, i.e., a low tendency to deceive. © 2017 S. Karger AG, Basel.

Digital Literacy Learning in Higher Education through Digital Storytelling Approach

ERIC Educational Resources Information Center

Chan, Banny S. K.; Churchill, Daniel; Chiu, Thomas K. F.

2017-01-01

It is necessary to develop digital literacy skills with which students can communicate and express their ideas effectively using digital media. The educational sectors around the world are beginning to incorporate digital literacy into the curriculum. Digital storytelling, one of the possible classroom activities, is an approach which may help…

Digital Library and Digital Reference Service: Integration and Mutual Complementarity

ERIC Educational Resources Information Center

Liu, Jia

2008-01-01

Both the digital library and the digital reference service were invented and have been developed under the networked environment. Among their intersections, the fundamental thing is their symbiotic interest--serving the user in a more efficient way. The article starts by discussing the digital library and its service and the digital reference…

Iatrogenic Diversion of Inferior Vena Cava into Left Atrium after Surgery for a Rare Combination of Congenital Heart Diseases

PubMed Central

Sabzi, Feridoun

2016-01-01

Atrial septal defect (ASD) is a common congenital anomaly that has low surgical mortality and morbidity. We report a very rare case of a low-lying ASD, combined with the drainage of the inferior vena cava and the left superior vena cava into the left atrium. This combination was associated with an unroofed coronary sinus. We also describe an iatrogenic surgical diversion of the inferior vena cava into the left atrium with its complication. The patient presented with moderate cyanosis and was referred for elective ASD repair. He underwent surgical repair of the ASD after transthoracic echocardiography. Early postoperative right-to-left shunting with cyanosis and hypoxia was associated with abdominal complications. Surgical re-exploration revealed the diversion of the inferior vena cava into the left atrium, which was repaired with a pericardial patch. Peptic ulcer perforation was repaired after abdominal laparotomy. The patient had an uneventful recovery and was discharged home on the 17th postoperative day. One-year follow-up revealed no recurrence of cyanosis or residual ASD on echocardiography. PMID:27928261

Digital Mammography and Digital Breast Tomosynthesis.

PubMed

Moseley, Tanya W

2016-06-01

Breast imaging technology has advanced significantly from the 1930s until the present. American women have a 1 in 8 chance of developing breast cancer. Mammography has been proven in multiple clinical trials to reduce breast cancer mortality. Although a mainstay of breast imaging and improved from film-screen mammography, digital mammography is not a perfect examination. Overlapping obscuring breast tissue limits mammographic interpretation. Breast digital tomosynthesis reduces and/or eliminates overlapping obscuring breast tissue. Although there are some disadvantages with digital breast tomosynthesis, this relatively lost-cost technology may be used effectively in the screening and diagnostic settings.

Digital photography

PubMed Central

Windsor, J S; Rodway, G W; Middleton, P M; McCarthy, S

2006-01-01

Objective The emergence of a new generation of “point‐and‐shoot” digital cameras offers doctors a compact, portable and user‐friendly solution to the recording of highly detailed digital photographs and video images. This work highlights the use of such technology, and provides information for those who wish to record, store and display their own medical images. Methods Over a 3‐month period, a digital camera was carried by a doctor in a busy, adult emergency department and used to record a range of clinical images that were subsequently transferred to a computer database. Results In total, 493 digital images were recorded, of which 428 were photographs and 65 were video clips. These were successfully used for teaching purposes, publications and patient records. Conclusions This study highlights the importance of informed consent, the selection of a suitable package of digital technology and the role of basic photographic technique in developing a successful digital database in a busy clinical environment. PMID:17068281

Older people and digital disengagement: a fourth digital divide?

PubMed

Olphert, Wendy; Damodaran, Leela

2013-01-01

Digital technologies are becoming more pervasive in all areas of society. Enabling everyone to have access and capability to use the Internet and associated digital technologies, summed up in the term 'digital inclusion', is seen to have wide-ranging benefits to the individual, to the economy and to society. For older people, being digitally included can help them to maintain their independence, social connectedness and sense of worth in the face of declining health or limited capabilities, as well as also offering new opportunities to improve their quality of life. At present however, access to the technology and to the benefits is not equally distributed either between or within nations, and older people tend to be on the 'wrong' side of what is termed the 'digital divide'. Governments globally are developing strategies to promote digital inclusion and indeed Internet uptake is increasing steadily, including amongst older people. However, such strategies have focussed on getting people online, and there appears to be an assumption that once someone is online they will remain 'digitally engaged'. In fact statistics show that some users give up using the Internet, and there is emerging evidence that older people are more vulnerable to the factors which can lead to this outcome. The authors see this phenomenon as a potential but largely unrecognised 'fourth digital divide' which has serious implications for social inclusion. The objectives of this article are (a) to raise awareness of the phenomenon of digital disengagement by considering some of the emerging evidence, (b) to explore some of the potential implications of not recognising and therefore not addressing the needs of the digitally disengaged older population, and (c) to reveal the prevailing gap in knowledge which future research should address. Copyright © 2013 S. Karger AG, Basel.

Female genital alteration: a compromise solution.

PubMed

Arora, Kavita Shah; Jacobs, Allan J

2016-03-01

Despite 30 years of advocacy, the prevalence of non-therapeutic female genital alteration (FGA) in minors is stable in many countries. Educational efforts have minimally changed the prevalence of this procedure in regions where it has been widely practiced. In order to better protect female children from the serious and long-term harms of some types of non-therapeutic FGA, we must adopt a more nuanced position that acknowledges a wide spectrum of procedures that alter female genitalia. We offer a revised categorisation for non-therapeutic FGA that groups procedures by effect and not by process. Acceptance of de minimis procedures that generally do not carry long-term medical risks is culturally sensitive, does not discriminate on the basis of gender, and does not violate human rights. More morbid procedures should not be performed. However, accepting de minimis non-therapeutic f FGA procedures enhances the effort of compassionate practitioners searching for a compromise position that respects cultural differences but protects the health of their patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Voluntary and involuntary ligature of the bile duct in iatrogenic injuries: a nonadvisable approach.

PubMed

Mercado, Miguel Angel; Chan, Carlos; Jacinto, Juan Carlos; Sanchez, Norberto; Barajas, Alexandra

2008-06-01

Bile duct injuries related to laparoscopic and/or open cholecystectomy are a frequent finding and require surgical treatment. Complete obstruction is due to either intentionally or unintentionally placed ligatures or clips. The intentional application is usually performed to "facilitate identification of the duct by bile duct dilation." Considering that we are a national referral center for such injuries, we decided to analyze our cases of voluntary and involuntary duct ligation after iatrogenic bile duct injury. We reviewed the files of patients with voluntary or involuntary bile duct ligation. Results of preoperative evaluation of the ducts, operative treatment, and postoperative results were analyzed. A total of 413 patients were included. Forty-five patients presented with complete obstruction. In 15 cases, the ligature was intentional, and in 30 cases, occlusion was involuntary. Bile duct dilation (>10 mm) was demonstrated in one case of voluntary (6%) and three cases of involuntary ligations (10%). The remaining cases in both groups had no duct dilation and developed necrosis at the blinded duct and leakage proximal to the ligature, with different degrees of bilioperitoneum and/or biloma. In all cases, a Roux-en-Y hepatojejunostomy was performed. Bile duct ligature produces dilation in a very small number of patients (less than 10%) and usually produces necrosis of the blinded stump with subsequent bile leakage. Placement of a subhepatic drain and transference of the patient to a qualified center for reconstruction is the best approach if the primary surgeon is not able to do the repair.

Conflict and Compromise: Catholic and Public Hospital Partnerships

PubMed Central

Wall, Barbra Mann

2010-01-01

This article analyzes the tensions and uneasy negotiations, based on a case study, that occurred among Catholic sisters, administrators, bishops, physicians, and the Vatican for more than seven years at a hospital in Austin, Texas. Here, the largest health care system in the city, which was Catholic, joined with the local public, tax-supported hospital that provided the majority of reproductive health care services in the region. A clash resulted over whether the hospital could continue providing sterilization and contraceptive services to its primarily poor patients. This article examines the fierce debates that occurred, especially over emergency contraception and attempts to develop creative solutions after a hierarchical crackdown from the Vatican. The end result was a compromise that included the creation of a “hospital within a hospital.” PMID:20067093

Food irradiation: Special solutions for the immuno-compromised

NASA Astrophysics Data System (ADS)

Mohácsi-Farkas, Csilla

2016-12-01

Safety of food is particularly important for immuno-compromised patients, because these people are vulnerable to all sorts of infectious complications and foodborne pathogens as well, and even organisms normally considered non-pathogenic may cause problems. According to the guidelines published by the FDA, immunocompromised patients have to avoid high-risk foods, and advised to consume only pasteurized juice, milk or cheese, and well-cooked eggs, poultry, meat and fish. In the frame of an IAEA CRP the objective was to develop, in collaborations with the healthcare community, the use of irradiation to increase the variety, availability and acceptability of foods for immunocompromised, for example irradiated fresh produce (fruits, vegetables, salads) and ready-to-eat meals. Further aim was to widen the acceptance of irradiated foods by the healthcare and regulatory communities.

Digital Sensor Technology

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

Ted Quinn; Jerry Mauck; Richard Bockhorst

The nuclear industry has been slow to incorporate digital sensor technology into nuclear plant designs due to concerns with digital qualification issues. However, the benefits of digital sensor technology for nuclear plant instrumentation are substantial in terms of accuracy, reliability, availability, and maintainability. This report demonstrates these benefits in direct comparisons of digital and analog sensor applications. It also addresses the qualification issues that must be addressed in the application of digital sensor technology.

Digital Sensor Technology

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

Thomas, Ken D.; Quinn, Edward L.; Mauck, Jerry L.

The nuclear industry has been slow to incorporate digital sensor technology into nuclear plant designs due to concerns with digital qualification issues. However, the benefits of digital sensor technology for nuclear plant instrumentation are substantial in terms of accuracy and reliability. This paper, which refers to a final report issued in 2013, demonstrates these benefits in direct comparisons of digital and analog sensor applications. Improved accuracy results from the superior operating characteristics of digital sensors. These include improvements in sensor accuracy and drift and other related parameters which reduce total loop uncertainty and thereby increase safety and operating margins. Anmore » example instrument loop uncertainty calculation for a pressure sensor application is presented to illustrate these improvements. This is a side-by-side comparison of the instrument loop uncertainty for both an analog and a digital sensor in the same pressure measurement application. Similarly, improved sensor reliability is illustrated with a sample calculation for determining the probability of failure on demand, an industry standard reliability measure. This looks at equivalent analog and digital temperature sensors to draw the comparison. The results confirm substantial reliability improvement with the digital sensor, due in large part to ability to continuously monitor the health of a digital sensor such that problems can be immediately identified and corrected. This greatly reduces the likelihood of a latent failure condition of the sensor at the time of a design basis event. Notwithstanding the benefits of digital sensors, there are certain qualification issues that are inherent with digital technology and these are described in the report. One major qualification impediment for digital sensor implementation is software common cause failure (SCCF).« less

Exploring digital professionalism.

PubMed

Ellaway, Rachel H; Coral, Janet; Topps, David; Topps, Maureen

2015-01-01

The widespread use of digital media (both computing devices and the services they access) has blurred the boundaries between our personal and professional lives. Contemporary students are the last to remember a time before the widespread use of the Internet and they will be the first to practice in a largely e-health environment. This article explores concepts of digital professionalism and their place in contemporary medical education, and proposes a series of principles of digital professionalism to guide teaching, learning and practice in the healthcare professions. Despite the many risks and fears surrounding their use, digital media are not an intrinsic threat to medical professionalism. Professionals should maintain the capacity for deliberate, ethical, and accountable practice when using digital media. The authors describe a digital professionalism framework structured around concepts of proficiency, reputation, and responsibility. Digital professionalism can be integrated into medical education using strategies based on awareness, alignment, assessment, and accountability. These principles of digital professionalism provide a way for medical students and medical practitioners to embrace the positive aspects of digital media use while being mindful and deliberate in its use to avoid or minimize any negative consequences.

Mitigating Reptile Road Mortality: Fence Failures Compromise Ecopassage Effectiveness

PubMed Central

Baxter-Gilbert, James H.; Riley, Julia L.; Lesbarrères, David; Litzgus, Jacqueline D.

2015-01-01

Roadways pose serious threats to animal populations. The installation of roadway mitigation measures is becoming increasingly common, yet studies that rigorously evaluate the effectiveness of these conservation tools remain rare. A highway expansion project in Ontario, Canada included exclusion fencing and ecopassages as mitigation measures designed to offset detrimental effects to one of the most imperial groups of vertebrates, reptiles. Taking a multispecies approach, we used a Before-After-Control-Impact study design to compare reptile abundance on the highway before and after mitigation at an Impact site and a Control site from 1 May to 31 August in 2012 and 2013. During this time, radio telemetry, wildlife cameras, and an automated PIT-tag reading system were used to monitor reptile movements and use of ecopassages. Additionally, a willingness to utilize experiment was conducted to quantify turtle behavioral responses to ecopassages. We found no difference in abundance of turtles on the road between the un-mitigated and mitigated highways, and an increase in the percentage of both snakes and turtles detected dead on the road post-mitigation, suggesting that the fencing was not effective. Although ecopassages were used by reptiles, the number of crossings through ecopassages was lower than road-surface crossings. Furthermore, turtle willingness to use ecopassages was lower than that reported in previous arena studies, suggesting that effectiveness of ecopassages may be compromised when alternative crossing options are available (e.g., through holes in exclusion structures). Our rigorous evaluation of reptile roadway mitigation demonstrated that when exclusion structures fail, the effectiveness of population connectivity structures is compromised. Our project emphasizes the need to design mitigation measures with the biology and behavior of the target species in mind, to implement mitigation designs in a rigorous fashion, and quantitatively evaluate road

Mitigating reptile road mortality: fence failures compromise ecopassage effectiveness.

PubMed

Baxter-Gilbert, James H; Riley, Julia L; Lesbarrères, David; Litzgus, Jacqueline D

2015-01-01

Roadways pose serious threats to animal populations. The installation of roadway mitigation measures is becoming increasingly common, yet studies that rigorously evaluate the effectiveness of these conservation tools remain rare. A highway expansion project in Ontario, Canada included exclusion fencing and ecopassages as mitigation measures designed to offset detrimental effects to one of the most imperial groups of vertebrates, reptiles. Taking a multispecies approach, we used a Before-After-Control-Impact study design to compare reptile abundance on the highway before and after mitigation at an Impact site and a Control site from 1 May to 31 August in 2012 and 2013. During this time, radio telemetry, wildlife cameras, and an automated PIT-tag reading system were used to monitor reptile movements and use of ecopassages. Additionally, a willingness to utilize experiment was conducted to quantify turtle behavioral responses to ecopassages. We found no difference in abundance of turtles on the road between the un-mitigated and mitigated highways, and an increase in the percentage of both snakes and turtles detected dead on the road post-mitigation, suggesting that the fencing was not effective. Although ecopassages were used by reptiles, the number of crossings through ecopassages was lower than road-surface crossings. Furthermore, turtle willingness to use ecopassages was lower than that reported in previous arena studies, suggesting that effectiveness of ecopassages may be compromised when alternative crossing options are available (e.g., through holes in exclusion structures). Our rigorous evaluation of reptile roadway mitigation demonstrated that when exclusion structures fail, the effectiveness of population connectivity structures is compromised. Our project emphasizes the need to design mitigation measures with the biology and behavior of the target species in mind, to implement mitigation designs in a rigorous fashion, and quantitatively evaluate road

Digital Citizenship

ERIC Educational Resources Information Center

Isman, Aytekin; Canan Gungoren, Ozlem

2014-01-01

Era in which we live is known and referred as digital age.In this age technology is rapidly changed and developed. In light of these technological advances in 21st century, schools have the responsibility of training "digital citizen" as well as a good citizen. Digital citizens must have extensive skills, knowledge, Internet and …

Study of flood defense structural measures priorities using Compromise Programming technique

NASA Astrophysics Data System (ADS)

Lim, D.; Jeong, S.

2017-12-01

Recent climate change of global warming has led to the frequent occurrence of heavy regional rainfalls. As such, inundation vulnerability increases in urban areas with high population density due to the low runoff carrying capacity. This study selects a sample area (Janghang-eup, the Republic of Korea), which is one of the most vulnerable areas to flooding, analyzing the urban flood runoff model (XP-SWMM) and using the MCDM (Multi-Criteria Decision Making) technique to establish flood protection structural measures. To this end, we compare the alternatives and choose the optimal flood defense measure: our model is utilized with three flood prevention structural measures; (i) drainage pipe construction; (ii) water detention; and (iii) flood pumping station. Dividing the target area into three small basins, we propose flood evaluations for an inundation decrease by studying the flooded area, the maximum inundation depth, the damaged residential area, and the construction cost. In addition, Compromise Programming determines the priority of the alternatives. As a consequent, this study suggests flood pumping station for Zone 1 and drainage pipe construction for Zone 2 and Zone 3, respectively, as the optimal flood defense alternative. Keywords : MCDM; Compromise Programming; Urban Flood Prevention; This research was supported by a grant [MPSS-DP-2013-62] through the Disaster and Safety Management Institute funded by Ministry of Public Safety and Security of Korean government.

Rofecoxib does not compromise platelet aggregation during anesthesia and surgery.

PubMed

Silverman, David G; Halaszynski, Thomas; Sinatra, Raymond; Luther, Martha; Rinder, Christine S

2003-12-01

This study was undertaken because, although there is evidence that cyclooxygenase type 2 (COX)-2 inhibitors do not compromise platelets in healthy volunteers, many clinicians remain hesitant to administer them perioperatively without definitive evidence of intact platelet function during anesthesia and surgery. In 20 patients scheduled for lower abdominal and pelvic surgery, 5 mL of blood were obtained for baseline platelet aggregometry. One hour prior to surgery, patients received an oral solution of either rofecoxib (ROF) 50 mg or placebo (PLAC) by randomized, double-blinded assignment. Approximately one hour after onset of anesthesia, an intraoperative blood sample was obtained. Baseline and postdrug samples were centrifuged to generate platelet-rich plasma, which was challenged with adenosine diphosphate (ADP) and arachidonic acid (AA). Aggregometry was performed with and without incubation with aspirin. The data in each subject were normalized to baseline aggregation in response to AA alone and ADP alone. Intergroup differences were assessed using paired t test; P < 0.05 was considered significant. Consistent with known effects of anesthesia on platelet function, both groups had approximately 25% intraoperative declines in aggregation in response to ADP (P = NS for PLAC vs ROF) and even greater declines in response to AA (P = NS for PLAC vs ROF). Aspirin eliminated aggregation in response to AA in both groups (P = NS), and it caused similar declines in PLAC and ROF groups during exposure to ADP (P = NS). This study provides strong evidence that ROF does not compromise platelet aggregation during anesthesia and surgery; nor does it interfere with the platelet inhibitory effect of aspirin.

Digitized synchronous demodulator

NASA Technical Reports Server (NTRS)

Woodhouse, Christopher E. (Inventor)

1990-01-01

A digitized synchronous demodulator is constructed entirely of digital components including timing logic, an accumulator, and means to digitally filter the digital output signal. Indirectly, it accepts, at its input, periodic analog signals which are converted to digital signals by traditional analog-to-digital conversion techniques. Broadly, the input digital signals are summed to one of two registers within an accumulator, based on the phase of the input signal and medicated by timing logic. At the end of a predetermined number of cycles of the inputted periodic signals, the contents of the register that accumulated samples from the negative half cycle is subtracted from the accumulated samples from the positive half cycle. The resulting difference is an accurate measurement of the narrow band amplitude of the periodic input signal during the measurement period. This measurement will not include error sources encountered in prior art synchronous demodulators using analog techniques such as offsets, charge injection errors, temperature drift, switching transients, settling time, analog to digital converter missing code, and linearity errors.

Biomechanical studies on the effect of iatrogenic dentin removal on vertical root fractures

PubMed Central

Ossareh, A.; Rosentritt, M.; Kishen, A.

2018-01-01

Introduction: The aim of this study was to understand the mechanism by which iatrogenic root dentin removal influences radicular stress distribution and subsequently affects the resistance to vertical root fractures (VRF) in endodontically treated teeth. Materials and Methods: The experiments were conducted in two phases. Phase 1: freshly extracted premolar teeth maintained in phosphate-buffered saline were instrumented to simulate three different degrees of dentin removal, designated as low, medium, and extreme groups. Micro-Ct analyzes were performed to quantitatively determine: (a) the amount of dentin removed, (b) the remaining dentin volume, and (c) the moment of inertia of root dentin. The specimens were then subjected to thermomechanical cycling and continuous loading to determine (a) the mechanical load to fracture and (b) dentin microcracking (fractography) using scanning electron microscopy. Phase 2: Finite element analysis was used to evaluate the influence of dentin removal on the stress distribution pattern in root dentin. The data obtained were analyzed using one-way ANOVA and Tukey's post hoc test (P < 0.05). Results: Phase 1: A significantly greater volume of dentin was removed from teeth in extreme group when compared to low group (P < 0.01). The mechanical analysis showed that the load to fracture was significantly lower in teeth from extreme group (P < 0.05). A linear relationship was observed between the moment of inertia and load to fracture in all experimental groups (R2 = 0.52). Fractography showed that most microcracks were initiated from the root canal walls in extreme group. Phase 2: The numerical analysis showed that the radicular stress distribution increased apically and buccolingually with greater degree of root canal dentin removal. Conclusions: The combined experimental/numerical analyses highlighted the influence of remaining root dentin volume on the radicular bending resistance, stress distribution pattern, and subsequent

Biomechanical studies on the effect of iatrogenic dentin removal on vertical root fractures.

PubMed

Ossareh, A; Rosentritt, M; Kishen, A

2018-01-01

The aim of this study was to understand the mechanism by which iatrogenic root dentin removal influences radicular stress distribution and subsequently affects the resistance to vertical root fractures (VRF) in endodontically treated teeth. The experiments were conducted in two phases. Phase 1: freshly extracted premolar teeth maintained in phosphate-buffered saline were instrumented to simulate three different degrees of dentin removal, designated as low, medium, and extreme groups. Micro-Ct analyzes were performed to quantitatively determine: (a) the amount of dentin removed, (b) the remaining dentin volume, and (c) the moment of inertia of root dentin. The specimens were then subjected to thermomechanical cycling and continuous loading to determine (a) the mechanical load to fracture and (b) dentin microcracking (fractography) using scanning electron microscopy. Phase 2: Finite element analysis was used to evaluate the influence of dentin removal on the stress distribution pattern in root dentin. The data obtained were analyzed using one-way ANOVA and Tukey's post hoc test ( P < 0.05). Phase 1: A significantly greater volume of dentin was removed from teeth in extreme group when compared to low group ( P < 0.01). The mechanical analysis showed that the load to fracture was significantly lower in teeth from extreme group ( P < 0.05). A linear relationship was observed between the moment of inertia and load to fracture in all experimental groups ( R 2 = 0.52). Fractography showed that most microcracks were initiated from the root canal walls in extreme group. Phase 2: The numerical analysis showed that the radicular stress distribution increased apically and buccolingually with greater degree of root canal dentin removal. The combined experimental/numerical analyses highlighted the influence of remaining root dentin volume on the radicular bending resistance, stress distribution pattern, and subsequent propensity to VRF.

Folate dietary insufficiency and folic acid supplementation similarly impair metabolism and compromise hematopoiesis

PubMed Central

Henry, Curtis J.; Nemkov, Travis; Casás-Selves, Matias; Bilousova, Ganna; Zaberezhnyy, Vadym; Higa, Kelly C.; Serkova, Natalie J.; Hansen, Kirk C.; D’Alessandro, Angelo; DeGregori, James

2017-01-01

While dietary folate deficiency is associated with increased risk for birth defects and other diseases, evidence suggests that supplementation with folic acid can contribute to predisposition to some diseases, including immune dysfunction and cancer. Herein, we show that diets supplemented with folic acid both below and above the recommended levels led to significantly altered metabolism in multiple tissues in mice. Surprisingly, both low and excessive dietary folate induced similar metabolic changes, which were particularly evident for nucleotide biosynthetic pathways in B-progenitor cells. Diet-induced metabolic changes in these cells partially phenocopied those observed in mice treated with anti-folate drugs, suggesting that both deficiency and excessive levels of dietary folic acid compromise folate-dependent biosynthetic pathways. Both folate deficiency and excessive dietary folate levels compromise hematopoiesis, resulting in defective cell cycle progression, persistent DNA damage, and impaired production of lymphocytes. These defects reduce the reconstitution potential in transplantation settings and increase radiation-induced mortality. We conclude that excessive folic acid supplementation can metabolically mimic dietary folate insufficiency, leading to similar functional impairment of hematopoiesis. PMID:28883079

Understanding Youth's Health-Compromising Behaviors in Germany: An Application of the Risk-Behavior Framework.

ERIC Educational Resources Information Center

Hazard, Barbara P.; Lee, Che-Fu

1999-01-01

Analyzed the health-compromising behaviors of German youth using responses of 2,330 seventh, eighth, and ninth graders from the German Youth Study. Smoking and drinking are not seen by these students as health-threatening behaviors, but as socially appealing behaviors. Discusses implications for health education. (SLD)

Digital LAMP in a sample self-digitization (SD) chip

PubMed Central

Herrick, Alison M.; Dimov, Ivan K.; Lee, Luke P.; Chiu, Daniel T.

2012-01-01

This paper describes the realization of digital loop-mediated DNA amplification (dLAMP) in a sample self-digitization (SD) chip. Digital DNA amplification has become an attractive technique to quantify absolute concentrations of DNA in a sample. While digital polymerase chain reaction is still the most widespread implementation, its use in resource—limited settings is impeded by the need for thermal cycling and robust temperature control. In such situations, isothermal protocols that can amplify DNA or RNA without thermal cycling are of great interest. Here, we showed the successful amplification of single DNA molecules in a stationary droplet array using isothermal digital loop-mediated DNA amplification. Unlike most (if not all) existing methods for sample discretization, our design allows for automated, loss-less digitization of sample volumes on-chip. We demonstrated accurate quantification of relative and absolute DNA concentrations with sample volumes of less than 2 μl. We assessed the homogeneity of droplet size during sample self-digitization in our device, and verified that the size variation was small enough such that straightforward counting of LAMP-active droplets sufficed for data analysis. We anticipate that the simplicity and robustness of our SD chip make it attractive as an inexpensive and easy-to-operate device for DNA amplification, for example in point-of-care settings. PMID:22399016

Scanning for Digitization Projects

ERIC Educational Resources Information Center

Wentzel, Larry

2007-01-01

Librarians and archivists find themselves facing the prospect of digitization. Everyone is doing it, everyone needs it. Discussions rage nationally and internationally concerning what to digitize and the best means to present and retain digital objects. Digitization is the act of making something digital, expressing a physical object "in numerical…

Digital Longitudinal Tomosynthesis

NASA Astrophysics Data System (ADS)

Rimkus, Daniel Steven

1985-12-01

The purpose of this dissertation was to investigate the clinical utility of digital longitudinal tomosynthesis in radiology. By acquiring a finite group of digital images during a longitudinal tomographic exposure, and processing these images, tomographic planes, other than the fulcrum plane, can be reconstructed. This process is now termed "tomosynthesis". A prototype system utilizing this technique was developed. Both phantom and patient studies were done with this system. The phantom studies were evaluated by subjective, visual criterion and by quantitative analysis of edge sharpness and noise in the reconstructions. Two groups of patients and one volunteer were studied. The first patient group consisted of 8 patients undergoing intravenous urography (IVU). These patients had digital tomography and film tomography of the abdomen. The second patient group consisted of 4 patients with lung cancer admitted to the hospital for laser resection of endobronchial tumor. These patients had mediastinal digital tomograms to evaluate the trachea and mainstem bronchi. The knee of one volunteer was imaged by film tomography and digital tomography. The results of the phantom studies showed that the digital reconstructions accurately produced images of the desired planes. The edge sharpness of the reconstructions approached that of the acquired images. Adequate reconstructions were achieved with as few as 5 images acquired during the exposure, with the quality of the reconstructions improving as the number of images acquired increased. The IVU patients' digital studies had less contrast and spatial resolution than the film tomograms. The single renal lesion visible on the film tomograms was also visible in the digital images. The digital mediastinal studies were felt by several radiologists to be superior to a standard chest xray in evaluating the airways. The digital images of the volunteer's knee showed many of the same anatomic features as the film tomogram, but the digital

The Next Stage: Moving from Isolated Digital Collections to Interoperable Digital Libraries.

ERIC Educational Resources Information Center

Besser, Howard

2002-01-01

Presents a conceptual framework for digital library development and discusses how to move from isolated digital collections to interoperable digital libraries. Topics include a history of digital libraries; user-centered architecture; stages of technological development; standards, including metadata; and best practices. (Author/LRW)

Experience with protective isolation for infection prevention in the compromised host.

PubMed

Nagao, T

1986-01-01

Ten years of experience with protective isolation of compromised patients was analyzed. The total number of patients was 191 including 116 patients with leukemia. Isolation could significantly prevent exogenous infections such as pneumonia, and prophylactic antibiotic regimens consisting of vancomycin and other nonabsorbable antibiotics could reduce the onset of endogenous infections such as sepsis. Elimination of serious and fatal infections by isolation together with prophylactic antibiotics increased the chances of remission or long-term survival for cases of hematological malignancies, solid tumor and bone marrow transplantation.

Massive Iatrogenic Outbreak of Human Immunodeficiency Virus Type 1 in Rural Cambodia, 2014-2015.

PubMed

Rouet, François; Nouhin, Janin; Zheng, Du-Ping; Roche, Benjamin; Black, Allison; Prak, Sophearot; Leoz, Marie; Gaudy-Graffin, Catherine; Ferradini, Laurent; Mom, Chandara; Mam, Sovatha; Gautier, Charlotte; Lesage, Gérard; Ken, Sreymom; Phon, Kerya; Kerleguer, Alexandra; Yang, Chunfu; Killam, William; Fujita, Masami; Mean, Chhivun; Fontenille, Didier; Barin, Francis; Plantier, Jean-Christophe; Bedford, Trevor; Ramos, Artur; Saphonn, Vonthanak

2018-05-17

In 2014-2015, 242 individuals aged 2-89 years were newly diagnosed with human immunodeficiency virus type 1 (HIV-1) in Roka, a rural commune in Cambodia. A case-control study attributed the outbreak to unsafe injections. We aimed to reconstruct the likely transmission history of the outbreak. We assessed in 209 (86.4%) HIV-infected cases the presence of hepatitis C virus (HCV) and hepatitis B virus (HBV). We identified recent infections using antibody (Ab) avidity testing for HIV and HCV. We performed amplification, sequencing, and evolutionary phylogenetic analyses of viral strains. Geographical coordinates and parenteral exposure through medical services provided by an unlicensed healthcare practitioner were obtained from 193 cases and 1499 controls during interviews. Cases were coinfected with HCV (78.5%) and HBV (12.9%). We identified 79 (37.8%) recent (<130 days) HIV infections. Phylogeny of 202 HIV env C2V3 sequences showed a 198-sample CRF01_AE strains cluster, with time to most recent common ancestor (tMRCA) in September 2013 (95% highest posterior density, August 2012-July 2014), and a peak of 15 infections/day in September 2014. Three geospatial HIV hotspots were discernible in Roka and correlated with high exposure to the practitioner (P = .04). Fifty-nine of 153 (38.6%) tested cases showed recent (<180 days) HCV infections. Ninety HCV NS5B sequences formed 3 main clades, 1 containing 34 subtypes 1b with tMRCA in 2012, and 2 with 51 subtypes 6e and tMRCAs in 2002-2003. Unsafe injections in Cambodia most likely led to an explosive iatrogenic spreading of HIV, associated with a long-standing and more genetically diverse HCV propagation.

Intensity of mobile phone use and health compromising behaviours--how is information and communication technology connected to health-related lifestyle in adolescence?

PubMed

Leena, Koivusilta; Tomi, Lintonen; Arja, R Rimpelä

2005-02-01

The association of mobile phone use with health compromising behaviours (smoking, snuffing, alcohol) was studied in a survey comprising a representative sample of 14-16-year-olds (N=3485) in 2001. Mobile phone was used by 89% of respondents and by 13% for at least 1h daily. The intensity of use was positively associated with health compromising behaviours. The associations remained, although somewhat reduced, after including weekly spending money in the models. This study concludes that, at least in the present developmental level of communication technologies, intensive mobile phone use seems to be part of the same health-related lifestyle as health compromising behaviours.

Digital asset management.

PubMed

Humphrey, Clinton D; Tollefson, Travis T; Kriet, J David

2010-05-01

Facial plastic surgeons are accumulating massive digital image databases with the evolution of photodocumentation and widespread adoption of digital photography. Managing and maximizing the utility of these vast data repositories, or digital asset management (DAM), is a persistent challenge. Developing a DAM workflow that incorporates a file naming algorithm and metadata assignment will increase the utility of a surgeon's digital images. Copyright 2010 Elsevier Inc. All rights reserved.

Digital Downsides: Exploring University Students' Negative Engagements with Digital Technology

ERIC Educational Resources Information Center

Selwyn, Neil

2016-01-01

Digital technologies are now an integral feature of university study. As such, academic research has tended to concentrate on the potential of digital technologies to support, extend and even "enhance" student learning. This paper, in contrast, explores the rather more messy realities of students' engagements with digital technology. In…

Anatomical risk evaluation of iatrogenic injury to the infrapatellar branch of the saphenous nerve during medial meniscus arthroscopic surgery.

PubMed

Koch, Guillaume; Kling, Agathe; Ramamurthy, Nitin; Edalat, Faramarz; Cazzato, Roberto Luigi; Kahn, Jean-Luc; Garnon, Julien; Clavert, Philippe

2017-06-01

To determine the relationship of the medial meniscus with the infrapatellar branches of the saphenous nerve, the primary goal is to define and characterize different risk areas for these nerves during medial meniscus surgery. After dissecting 20 embalmed cadaver knees, we defined 7 readily identifiable anatomical landmarks. For each knee, we recorded 2 morphological criteria and 16 measurements. The most common anatomical course is a main trunk that is 8 mm anterior to the tuberculum adductorium and 60 mm posterior to the midpoint of the medial patellar margin. It has two main infrapatellar branches. The nerve division is 23 mm above the joint line. The path is oblique with an angle of 55.5°. The anterior meniscal landmark is 24 mm from the upper branch and 42.5 mm from the lower branch. The posterior meniscal landmark is 55 mm from the upper branch and 38 mm from the lower branch. We defined a common anatomical course for the saphenous nerve and its infrapatellar branches. Then, three different areas were defined at risk for iatrogenic nerve injuries during medial meniscus.

Digital communications: Microwave applications

NASA Astrophysics Data System (ADS)

Feher, K.

Transmission concepts and techniques of digital systems are presented; and practical state-of-the-art implementation of digital communications systems by line-of-sight microwaves is described. Particular consideration is given to statistical methods in digital transmission systems analysis, digital modulation methods, microwave amplifiers, system gain, m-ary and QAM microwave systems, correlative techniques and applications to digital radio systems, hybrid systems, digital microwave systems design, diversity and protection switching techniques, measurement techniques, and research and development trends and unsolved problems.

28 CFR 0.163 - Approval by Solicitor General of action on compromise offers in certain cases.

Code of Federal Regulations, 2010 CFR

2010-07-01

... advice from the Solicitor General that the principles of law involved do not require appellate review in... JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Authority To Compromise and Close Civil Claims and...

Digital Health Services and Digital Identity in Alberta.

PubMed

McEachern, Aiden; Cholewa, David

2017-01-01

The Government of Alberta continues to improve delivery of healthcare by allowing Albertans to access their health information online. Alberta is the only province in Canada with provincial electronic health records for all its citizens. These records are currently made available to medical practitioners, but Alberta Health believes that providing Albertans access to their health records will transform the delivery of healthcare in Alberta. It is important to have a high level of assurance that the health records are provided to the correct Albertan. Alberta Health requires a way for Albertans to obtain a digital identity with a high level of identity assurance prior to releasing health records via the Personal Health Portal. Service Alberta developed the MyAlberta Digital ID program to provide a digital identity verification service. The Ministry of Health is leveraging MyAlberta Digital ID to enable Albertans to access their personal health records through the Personal Health Portal. The Government of Alberta is advancing its vision of patient-centred healthcare by enabling Albertans to access a trusted source for health information and their electronic health records using a secure digital identity.

Iatrogenic submucosal tunnel in the ureter: a rare complication during advancement of the guide wire.

PubMed

El Darawany, Hamed; Barakat, Alaa; Madi, Maha Al; Aldamanhori, Reem; Al Otaibi, Khalid; Al-Zahrani, Ali A

2016-01-01

Inserting a guide wire is a common practice during endo-urological procedures. A rare complication in patients with ureteral stones where an iatrogenic submucosal tunnel (IST) is created during endoscopic guide wire placement. Summarize data on IST. Retrospective descriptive study of patients treated from from October 2009 until January 2015. King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. Patients with ureteral stones were divided to 2 groups. In group I (335 patients), the ureteral stones were removed by ureteroscopy in one stage. Group II (97 patients) had a 2-staged procedure starting with a double J-stent placement for kidney drainage followed within 3 weeks with ureteroscopic stone removal. Endoscopic visualization of ureteric submucosal tunneling by guide wire. IST occurred in 9/432 patients with ureteral stones (2.1%). The diagnosis in group I was made during ureteroscopy by direct visualization of a vanishing guide wire at the level of the stone (6 patients). In group II, IST was suspected when renal pain was not relieved after placement of the double J-stent or if imaging by ultrasound or intravenous urography showed persistent back pressure to the obstructed kidney (3 patients). The condition was subsequently confirmed by ureteroscopy. Forceful advancement of the guide wire in an inflamed and edematous ureteral segment impacted by a stone is probably the triggering factor for development of IST. Definitive diagnosis is possible only by direct visualization during ureteroscopy. Awareness of this potential complication is important to guard against its occurrence. Relatively small numbers of subjects and the retrospective nature of the study.

[Tuberculosis in compromised hosts].

PubMed

2003-11-01

Recent development of tuberculosis in Japan tends to converge on a specific high risk group. The proportion of tuberculosis developing particularly from the compromised hosts in the high risk group is especially high. At this symposium, therefore, we took up diabetes mellitus, gastrectomy, dialysis, AIDS and the elderly for discussion. Many new findings and useful reports for practical medical treatment are submitted; why these compromised hosts are predisposed to tuberculosis, tuberculosis diagnostic and remedial notes of those compromised hosts etc. It is an important question for the future to study how to prevent tuberculosis from these compromised hosts. 1. Tuberculosis in diabetes mellitus: aggravation and its immunological mechanism: Kazuyoshi KAWAKAMI (Department of Internal Medicine, Division of Infectious Diseases, Graduate School and Faculty of Medicine, University of the Ryukyus). It has been well documented that diabetes mellitus (DM) is a major aggravating factor in tuberculosis. The onset of this disease is more frequent in DM patients than in individuals with any underlying diseases. However, the precise mechanism of this finding remains to be fully understood. Earlier studies reported that the migration, phagocytosis and bactericidal activity of neutrophils are all impaired in DM patients, which is related to their reduced host defense to infection with extracellular bacteria, such as S. aureus and E. colli. Host defense to mycobacterial infection is largely mediated by cellular immunity, and Th1-related cytokines, such as IFN-gamma and IL-12, play a central role in this response. It is reported that serum level of these cytokines and their production by peripheral blood mononuclear cells (PBMC) are reduced in tuberculosis patients with DM, and this is supposed to be involved in the high incidence of tuberculosis in DM. Our study observed similar findings and furthermore indicated that IFN-gamma and IL-12 production by BCG-stimulated PBMC was lower

Apparatus and method for managing digital resources by passing digital resource tokens between queues

DOEpatents

Crawford, H.J.; Lindenstruth, V.

1999-06-29

A method of managing digital resources of a digital system includes the step of reserving token values for certain digital resources in the digital system. A selected token value in a free-buffer-queue is then matched to an incoming digital resource request. The selected token value is then moved to a valid-request-queue. The selected token is subsequently removed from the valid-request-queue to allow a digital agent in the digital system to process the incoming digital resource request associated with the selected token. Thereafter, the selected token is returned to the free-buffer-queue. 6 figs.

Apparatus and method for managing digital resources by passing digital resource tokens between queues

DOEpatents

Crawford, Henry J.; Lindenstruth, Volker

1999-01-01

A method of managing digital resources of a digital system includes the step of reserving token values for certain digital resources in the digital system. A selected token value in a free-buffer-queue is then matched to an incoming digital resource request. The selected token value is then moved to a valid-request-queue. The selected token is subsequently removed from the valid-request-queue to allow a digital agent in the digital system to process the incoming digital resource request associated with the selected token. Thereafter, the selected token is returned to the free-buffer-queue.

The place-value of a digit in multi-digit numbers is processed automatically.

PubMed

Kallai, Arava Y; Tzelgov, Joseph

2012-09-01

The automatic processing of the place-value of digits in a multi-digit number was investigated in 4 experiments. Experiment 1 and two control experiments employed a numerical comparison task in which the place-value of a non-zero digit was varied in a string composed of zeros. Experiment 2 employed a physical comparison task in which strings of digits varied in their physical sizes. In both types of tasks, the place-value of the non-zero digit in the string was irrelevant to the task performed. Interference of the place-value information was found in both tasks. When the non-zero digit occupied a lower place-value, it was recognized slower as a larger digit or as written in a larger font size. We concluded that place-value in a multi-digit number is processed automatically. These results support the notion of a decomposed representation of multi-digit numbers in memory. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Fuzzy topological digital space and digital fuzzy spline of electroencephalography during epileptic seizures

NASA Astrophysics Data System (ADS)

Shah, Mazlina Muzafar; Wahab, Abdul Fatah

2017-08-01

Epilepsy disease occurs because of there is a temporary electrical disturbance in a group of brain cells (nurons). The recording of electrical signals come from the human brain which can be collected from the scalp of the head is called Electroencephalography (EEG). EEG then considered in digital format and in fuzzy form makes it a fuzzy digital space data form. The purpose of research is to identify the area (curve and surface) in fuzzy digital space affected by inside epilepsy seizure in epileptic patient's brain. The main focus for this research is to generalize fuzzy topological digital space, definition and basic operation also the properties by using digital fuzzy set and the operations. By using fuzzy digital space, the theory of digital fuzzy spline can be introduced to replace grid data that has been use previously to get better result. As a result, the flat of EEG can be fuzzy topological digital space and this type of data can be use to interpolate the digital fuzzy spline.

Digital Imaging

NASA Technical Reports Server (NTRS)

1986-01-01

Digital Imaging is the computer processed numerical representation of physical images. Enhancement of images results in easier interpretation. Quantitative digital image analysis by Perceptive Scientific Instruments, locates objects within an image and measures them to extract quantitative information. Applications are CAT scanners, radiography, microscopy in medicine as well as various industrial and manufacturing uses. The PSICOM 327 performs all digital image analysis functions. It is based on Jet Propulsion Laboratory technology, is accurate and cost efficient.

Hydro-environmental management of groundwater resources: A fuzzy-based multi-objective compromise approach

NASA Astrophysics Data System (ADS)

Alizadeh, Mohammad Reza; Nikoo, Mohammad Reza; Rakhshandehroo, Gholam Reza

2017-08-01

Sustainable management of water resources necessitates close attention to social, economic and environmental aspects such as water quality and quantity concerns and potential conflicts. This study presents a new fuzzy-based multi-objective compromise methodology to determine the socio-optimal and sustainable policies for hydro-environmental management of groundwater resources, which simultaneously considers the conflicts and negotiation of involved stakeholders, uncertainties in decision makers' preferences, existing uncertainties in the groundwater parameters and groundwater quality and quantity issues. The fuzzy multi-objective simulation-optimization model is developed based on qualitative and quantitative groundwater simulation model (MODFLOW and MT3D), multi-objective optimization model (NSGA-II), Monte Carlo analysis and Fuzzy Transformation Method (FTM). Best compromise solutions (best management policies) on trade-off curves are determined using four different Fuzzy Social Choice (FSC) methods. Finally, a unanimity fallback bargaining method is utilized to suggest the most preferred FSC method. Kavar-Maharloo aquifer system in Fars, Iran, as a typical multi-stakeholder multi-objective real-world problem is considered to verify the proposed methodology. Results showed an effective performance of the framework for determining the most sustainable allocation policy in groundwater resource management.

Hybrid acousto-optic and digital equalization for microwave digital radio channels

NASA Astrophysics Data System (ADS)

Anderson, C. S.; Vanderlugt, A.

1990-11-01

Digital radio transmission systems use complex modulation schemes that require powerful signal-processing techniques to correct channel distortions and to minimize BERs. This paper proposes combining the computation power of acoustooptic processing and the accuracy of digital processing to produce a hybrid channel equalizer that exceeds the performance of digital equalization alone. Analysis shows that a hybrid equalizer for 256-level quadrature amplitude modulation (QAM) performs better than a digital equalizer for 64-level QAM.

Restoration of low-dose digital breast tomosynthesis

NASA Astrophysics Data System (ADS)

Borges, Lucas R.; Azzari, Lucio; Bakic, Predrag R.; Maidment, Andrew D. A.; Vieira, Marcelo A. C.; Foi, Alessandro

2018-06-01

In breast cancer screening, the radiation dose must be kept to the minimum necessary to achieve the desired diagnostic objective, thus minimizing risks associated with cancer induction. However, decreasing the radiation dose also degrades the image quality. In this work we restore digital breast tomosynthesis (DBT) projections acquired at low radiation doses with the goal of achieving a quality comparable to that obtained from current standard full-dose imaging protocols. A multiframe denoising algorithm was applied to low-dose projections, which are filtered jointly. Furthermore, a weighted average was used to inject a varying portion of the noisy signal back into the denoised one, in order to attain a signal-to-noise ratio comparable to that of standard full-dose projections. The entire restoration framework leverages a signal-dependent noise model with quantum gain which varies both upon the projection angle and on the pixel position. A clinical DBT system and a 3D anthropomorphic breast phantom were used to validate the proposed method, both on DBT projections and slices from the 3D reconstructed volume. The framework is shown to attain the standard full-dose image quality from data acquired at 50% lower radiation dose, whereas progressive loss of relevant details compromises the image quality if the dosage is further decreased.

Battlefield awareness computers: the engine of battlefield digitization

NASA Astrophysics Data System (ADS)

Ho, Jackson; Chamseddine, Ahmad

1997-06-01

To modernize the army for the 21st century, the U.S. Army Digitization Office (ADO) initiated in 1995 the Force XXI Battle Command Brigade-and-Below (FBCB2) Applique program which became a centerpiece in the U.S. Army's master plan to win future information wars. The Applique team led by TRW fielded a 'tactical Internet' for Brigade and below command to demonstrate the advantages of 'shared situation awareness' and battlefield digitization in advanced war-fighting experiments (AWE) to be conducted in March 1997 at the Army's National Training Center in California. Computing Devices is designated the primary hardware developer for the militarized version of the battlefield awareness computers. The first generation of militarized battlefield awareness computer, designated as the V3 computer, was an integration of off-the-shelf components developed to meet the agressive delivery requirements of the Task Force XXI AWE. The design efficiency and cost effectiveness of the computer hardware were secondary in importance to delivery deadlines imposed by the March 1997 AWE. However, declining defense budgets will impose cost constraints on the Force XXI production hardware that can only be met by rigorous value engineering to further improve design optimization for battlefield awareness without compromising the level of reliability the military has come to expect in modern military hardened vetronics. To answer the Army's needs for a more cost effective computing solution, Computing Devices developed a second generation 'combat ready' battlefield awareness computer, designated the V3+, which is designed specifically to meet the upcoming demands of Force XXI (FBCB2) and beyond. The primary design objective is to achieve a technologically superior design, value engineered to strike an optimal balance between reliability, life cycle cost, and procurement cost. Recognizing that the diverse digitization demands of Force XXI cannot be adequately met by any one computer hardware

Methamphetamine compromises gap junctional communication in astrocytes and neurons.

PubMed

Castellano, Paul; Nwagbo, Chisom; Martinez, Luis R; Eugenin, Eliseo A

2016-05-01

Methamphetamine (meth) is a central nervous system (CNS) stimulant that results in psychological and physical dependency. The long-term effects of meth within the CNS include neuronal plasticity changes, blood-brain barrier compromise, inflammation, electrical dysfunction, neuronal/glial toxicity, and an increased risk to infectious diseases including HIV. Most of the reported meth effects in the CNS are related to dysregulation of chemical synapses by altering the release and uptake of neurotransmitters, especially dopamine, norepinephrine, and epinephrine. However, little is known about the effects of meth on connexin (Cx) containing channels, such as gap junctions (GJ) and hemichannels (HC). We examined the effects of meth on Cx expression, function, and its role in NeuroAIDS. We found that meth altered Cx expression and localization, decreased GJ communication between neurons and astrocytes, and induced the opening of Cx43/Cx36 HC. Furthermore, we found that these changes in GJ and HC induced by meth treatment were mediated by activation of dopamine receptors, suggesting that dysregulation of dopamine signaling induced by meth is essential for GJ and HC compromise. Meth-induced changes in GJ and HC contributed to amplified CNS toxicity by dysregulating glutamate metabolism and increasing the susceptibility of neurons and astrocytes to bystander apoptosis induced by HIV. Together, our results indicate that connexin containing channels, GJ and HC, are essential in the pathogenesis of meth and increase the sensitivity of the CNS to HIV CNS disease. Methamphetamine (meth) is an extremely addictive central nervous system stimulant. Meth reduced gap junctional (GJ) communication by inducing internalization of connexin-43 (Cx43) in astrocytes and reducing expression of Cx36 in neurons by a mechanism involving activation of dopamine receptors (see cartoon). Meth-induced changes in Cx containing channels increased extracellular levels of glutamate and resulted in higher

Towards Trustable Digital Evidence with PKIDEV: PKI Based Digital Evidence Verification Model

NASA Astrophysics Data System (ADS)

Uzunay, Yusuf; Incebacak, Davut; Bicakci, Kemal

How to Capture and Preserve Digital Evidence Securely? For the investigation and prosecution of criminal activities that involve computers, digital evidence collected in the crime scene has a vital importance. On one side, it is a very challenging task for forensics professionals to collect them without any loss or damage. On the other, there is the second problem of providing the integrity and authenticity in order to achieve legal acceptance in a court of law. By conceiving digital evidence simply as one instance of digital data, it is evident that modern cryptography offers elegant solutions for this second problem. However, to our knowledge, there is not any previous work proposing a systematic model having a holistic view to address all the related security problems in this particular case of digital evidence verification. In this paper, we present PKIDEV (Public Key Infrastructure based Digital Evidence Verification model) as an integrated solution to provide security for the process of capturing and preserving digital evidence. PKIDEV employs, inter alia, cryptographic techniques like digital signatures and secure time-stamping as well as latest technologies such as GPS and EDGE. In our study, we also identify the problems public-key cryptography brings when it is applied to the verification of digital evidence.

The digital darkroom, part 3: digital presentation in plastic surgery.

PubMed

Galdino, G M; Chiaramonte, M; Klatsky, S A

2001-01-01

We summarize here the third and final part of our series on the Digital Darkroom. In this part, we review the use of digital technology for medical and other presentations, including the kinds of equipment available, the advantages and disadvantages of digital projection, and the most common pitfalls encountered in preparing and presenting material in digital presentations. The full text of the complete series, including expanded illustrative material and complete bibliographic documentation, is now available at our journal web site at . Please see page 39 for instructions on how to access Aesthetic Surgery Journal Online and view the entire series.

Digital Elevation Models

USGS Publications Warehouse

,

1993-01-01

The Earth Science Information Center (ESIC) distributes digital cartographic/geographic data files produced by the U.S. Geological Survey (USGS) as part of the National Mapping Program. Digital cartographic data files may be grouped into four basic types. The first of these, called a Digital Line Graph (DLG), is the line map information in digital form. These data files include information on base data categories, such as transportation, hypsography, hydrography, and boundaries. The second type, called a Digital Elevation Model (DEM), consists of a sampled array of elevations for a number of ground positions at regularly spaced intervals. The third type is Land Use and Land Cover digital data which provides information on nine major classes of land use such as urban, agricultural, or forest as well as associated map data such as political units and Federal land ownership. The fourth type, the Geographic Names Information System, provides primary information for all known places, features, and areas in the United States identified by a proper name.

Digital Therapeutics: An Integral Component of Digital Innovation in Drug Development.

PubMed

Sverdlov, Oleksandr; van Dam, Joris; Hannesdottir, Kristin; Thornton-Wells, Tricia

2018-07-01

Digital therapeutics represent a new treatment modality in which digital systems such as smartphone apps are used as regulatory-approved, prescribed therapeutic interventions to treat medical conditions. In this article we provide a critical overview of the rationale for investing in such novel modalities, including the unmet medical needs addressed by digital therapeutics and the potential for reducing current costs of medical care. We also discuss emerging pathways to regulatory approval and how innovative business models are enabling further growth in the development of digital therapeutics. We conclude by providing some recent examples of digital therapeutics that have gained regulatory approval and highlight opportunities for the near future. © 2018 American Society for Clinical Pharmacology and Therapeutics.

Sensor Compromise Detection in Multiple-Target Tracking Systems

PubMed Central

Doucette, Emily A.; Curtis, Jess W.

2018-01-01

Tracking multiple targets using a single estimator is a problem that is commonly approached within a trusted framework. There are many weaknesses that an adversary can exploit if it gains control over the sensors. Because the number of targets that the estimator has to track is not known with anticipation, an adversary could cause a loss of information or a degradation in the tracking precision. Other concerns include the introduction of false targets, which would result in a waste of computational and material resources, depending on the application. In this work, we study the problem of detecting compromised or faulty sensors in a multiple-target tracker, starting with the single-sensor case and then considering the multiple-sensor scenario. We propose an algorithm to detect a variety of attacks in the multiple-sensor case, via the application of finite set statistics (FISST), one-class classifiers and hypothesis testing using nonparametric techniques. PMID:29466314

Everglades Digital Library

Science.gov Websites

Everglades Digital Library HOME ABOUT US BROWSE ASK AN EVERGLADES LIBRARIAN EDL Collections Warmth of the Everglades Through Young Artists' Eyes Welcome to the Everglades Digital Library, an Everglades. The Everglades Digital Library is a project of the Everglades Information Network, a

Digital Broadband Content: Digital Content Strategies and policies. OECD Digital Economy Papers, No. 119

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2006

2006-01-01

The development of digital content raises new issues as rapid technological developments challenge existing business models and government policies. This OECD study identifies and discusses six groups of business and public policy issues and illustrates these with existing and potential OECD Digital Content Strategies and Policies: (1) Innovation…

Digital Terroir Mapping in the Tokaj Historical Wine Region

NASA Astrophysics Data System (ADS)

Pásztor, László; Lukácsy, György; Szabó, József; László, Péter; Burai, Péter; Bakacsi, Zsófia; Koós, Sándor; Laborczi, Annamária; Takács, Katalin; Bekő, László

2015-04-01

resolution was set to 25 meters as a compromise between the denser remotely sensed data and the resolution available by the spatial inference of the collected soil information by proper digital soil mapping techniques. Finally the plant available water content, the vigor potential and precocity (earliness) potential was calculated. Based on these three maps the optimal target of production (dessert wine, dry wine, sparkling wine) could be determined and the information could provide a basis for decisions made both prior to planting and during production. Acknowledgement: The authors are grateful to the Tokaj Kereskedőház Ltd. and to András Tombor, Head of the Supervisory Board of Tokaj Kereskedőház Ltd. who has been supporting the project for the survey of the state of vineyards. Digital soil mapping was partly supported by the Hungarian National Scientific Research Foundation (OTKA, Grant No. K105167).

Safe and effective treatment of early suprahepatic inferior vena caval outflow compromise following orthotopic liver transplantation using percutaneous transluminal angioplasty and stent placement.

PubMed

Tasse, Jordan; Borge, Marc; Pierce, Kenneth; Brems, John

2011-01-01

To describe the safety and efficacy of percutaneous transluminal angioplasty and stent placement in patients presenting with suprahepatic inferior vena cava (IVC) outflow compromise in the early postoperative period following orthotopic liver transplantation. Between October 2002 and April 2009, 3 patients presented with IVC outflow compromise in the first 2 months following orthotopic liver transplantation. All 3 underwent percutaneous transluminal angioplasty and stent placement without complication and showed significant clinical improvement at short and intermediate term follow-up. Percutaneous transluminal angioplasty and Gianturco stent placement is a safe and effective treatment for IVC outflow compromise in the early postoperative period following orthotopic liver transplantation.

Preservation in the Age of Google: Digitization, Digital Preservation, and Dilemmas

ERIC Educational Resources Information Center

Conway, Paul

2010-01-01

The cultural heritage preservation community now functions largely within the environment of digital technologies. This article begins by juxtaposing definitions of the terms "digitization for preservation" and "digital preservation" within a sociotechnical environment for which Google serves as a relevant metaphor. It then reviews two reports…

Computerized digital dermoscopy.

PubMed

Gewirtzman, A J; Braun, R P

2003-01-01

Within the past 15 years, dermoscopy has become a widely used non-invasive technique for physicians to better visualize pigmented lesions. Dermoscopy has helped trained physicians to better diagnose pigmented lesions. Now, the digital revolution is beginning to enhance standard dermoscopic procedures. Using digital dermoscopy, physicians are better able to document pigmented lesions for patient follow-up and to get second opinions, either through teledermoscopy with an expert colleague or by using computer-assisted diagnosis. As the market for digital dermoscopy products begins to grow, so do the number of decisions physicians need to make when choosing a system to fit their needs. The current market for digital dermoscopy includes two varieties of relatively simple and cheap attachments which can convert a consumer digital camera into a digital dermoscope. A coupling adapter acts as a fastener between the camera and an ordinary dermoscope, whereas a dermoscopy attachment includes the dermoscope optics and light source and can be attached directly to the camera. Other options for digital dermoscopy include complete dermoscopy systems that use a hand-held video camera linked directly to a computer. These systems differ from each other in whether or not they are calibrated as well as the quality of the camera and software interface. Another option in digital skin imaging involves spectral analysis rather than dermoscopy. This article serves as a guide to the current systems available and their capabilities.

Iatrogenic Iron Overload in Dialysis Patients at the Beginning of the 21st Century.

PubMed

Rostoker, Guy; Vaziri, Nosratola D; Fishbane, Steven

2016-05-01

Iron overload used to be considered rare in hemodialysis patients but its clinical frequency is now increasingly realized. The liver is the main site of iron storage and the liver iron concentration (LIC) is closely correlated with total iron stores in patients with secondary hemosideroses and genetic hemochromatosis. Magnetic resonance imaging is now the gold standard method for LIC estimation and monitoring in non-renal patients. Studies of LIC in hemodialysis patients by quantitative magnetic resonance imaging and magnetic susceptometry have demonstrated a strong relation between the risk of iron overload and the use of intravenous (IV) iron products prescribed at doses determined by the iron biomarker cutoffs contained in current anemia management guidelines. These findings have challenged the validity of both iron biomarker cutoffs and current clinical guidelines, especially with respect to recommended IV iron doses. Three long-term observational studies have recently suggested that excessive IV iron doses may be associated with an increased risk of cardiovascular events and death in hemodialysis patients. We postulate that iatrogenic iron overload in the era of erythropoiesis-stimulating agents may silently increase complications in dialysis patients without creating frank clinical signs and symptoms. High hepcidin-25 levels were recently linked to fatal and nonfatal cardiovascular events in dialysis patients. It is therefore tempting to postulate that the main pathophysiological pathway leading to these events may involve the pleiotropic master hormone hepcidin (synergized by fibroblast growth factor 23), which regulates iron metabolism. Oxidative stress as a result of IV iron infusions and iron overload, by releasing labile non-transferrin-bound iron, might represent a 'second hit' on the vascular bed. Finally, iron deposition in the myocardium of patients with severe iron overload might also play a role in the pathogenesis of sudden death in some patients.

Measures for curtailment of iatrogenic exposure. Guide to correct x-ray examinations (in Japanese)

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

Misonoo, K.

1973-08-01

Of the coposure dose for humans from various radiation sources, introgenic exposure amounts to 1/2 to twice the natural radiation source. Although the mechanism of induction of malignant tumor by radiation is not clanified, it is evident that it is induced after receiving a dose above 100 rads. However, the presence of a threshold, under which it does not develop, is unknown. Tabulated were ICRP's calculations on the degree of risk of injury and the estimated values of genetic injury due to 1 rad. In order to estimate the harmful effect of exposure in x-ray diagnosis, the dose in themore » critical tissue of the human body and the types and the frequency of radiation examinations are important. The judgment of genetic injury is expressed by the genetically significant dose, which is calculated from the dose in the genital gland received by individuals. The impcrtant criterion for the judgment of physical injury is the mean annual dose per person in the marrow (mean dose in the red marrow). The dose in the genital organ is important as the dose related to the evaluation of the degree of genetic risk. The characteristics of iatrogenic exposure are partial and acute exposure and a high dose rate. Tabulated individually were the frequency of x-ray examinations, the mean dose in the genital organ according urce. The radiation dose during x-ray pelvimetry to 51 patients was estimated, and the cytogenetic response of peripheral lymphocytes was determined in 25 of their newborn babies. The calculations resulted in an average midline fetal dose of 1,035 and 1,860 mrads for the patients receiving 2 projections and more than 2 projections, respectively. There was no evidence of radioinduced chromosomal darnage in the newborn infants following x-ray exposure in utero. (auth)« less

Sleep deprivation compromises resting-state emotional regulatory processes: An EEG study.

PubMed

Zhang, Jinxiao; Lau, Esther Yuet Ying; Hsiao, Janet H

2018-03-01

Resting-state spontaneous neural activities consume far more biological energy than stimulus-induced activities, suggesting their significance. However, existing studies of sleep loss and emotional functioning have focused on how sleep deprivation modulates stimulus-induced emotional neural activities. The current study aimed to investigate the impacts of sleep deprivation on the brain network of emotional functioning using electroencephalogram during a resting state. Two established resting-state electroencephalogram indexes (i.e. frontal alpha asymmetry and frontal theta/beta ratio) were used to reflect the functioning of the emotion regulatory neural network. Participants completed an 8-min resting-state electroencephalogram recording after a well-rested night or 24 hr sleep deprivation. The Sleep Deprivation group had a heightened ratio of the power density in theta band to beta band (theta/beta ratio) in the frontal area than the Sleep Control group, suggesting an effective approach with reduced frontal cortical regulation of subcortical drive after sleep deprivation. There was also marginally more left-lateralized frontal alpha power (left frontal alpha asymmetry) in the Sleep Deprivation group compared with the Sleep Control group. Besides, higher theta/beta ratio and more left alpha lateralization were correlated with higher sleepiness and lower vigilance. The results converged in suggesting compromised emotional regulatory processes during resting state after sleep deprivation. Our work provided the first resting-state neural evidence for compromised emotional functioning after sleep loss, highlighting the significance of examining resting-state neural activities within the affective brain network as a default functional mode in investigating the sleep-emotion relationship. © 2018 European Sleep Research Society.

'Compromise position' image alignment to accommodate independent motion of multiple clinical target volumes during radiotherapy: A high risk prostate cancer example.

PubMed

Rosewall, Tara; Yan, Jing; Alasti, Hamideh; Cerase, Carla; Bayley, Andrew

2017-04-01

Inclusion of multiple independently moving clinical target volumes (CTVs) in the irradiated volume causes an image guidance conundrum. The purpose of this research was to use high risk prostate cancer as a clinical example to evaluate a 'compromise' image alignment strategy. The daily pre-treatment orthogonal EPI for 14 consecutive patients were included in this analysis. Image matching was performed by aligning to the prostate only, the bony pelvis only and using the 'compromise' strategy. Residual CTV surrogate displacements were quantified for each of the alignment strategies. Analysis of the 388 daily fractions indicated surrogate displacements were well-correlated in all directions (r 2  = 0.95 (LR), 0.67 (AP) and 0.59 (SI). Differences between the surrogates displacements (95% range) were -0.4 to 1.8 mm (LR), -1.2 to 5.2 mm (SI) and -1.2 to 5.2 mm (AP). The distribution of the residual displacements was significantly smaller using the 'compromise' strategy, compared to the other strategies (p 0.005). The 'compromise' strategy ensured the CTV was encompassed by the PTV in all fractions, compared to 47 PTV violations when aligned to prostate only. This study demonstrated the feasibility of a compromise position image guidance strategy to accommodate simultaneous displacements of two independently moving CTVs. Application of this strategy was facilitated by correlation between the CTV displacements and resulted in no geometric excursions of the CTVs beyond standard sized PTVs. This simple image guidance strategy may also be applicable to other disease sites that concurrently irradiate multiple CTVs, such as head and neck, lung and cervix cancer. © 2016 The Royal Australian and New Zealand College of Radiologists.

Are "Digital Natives" Really Digitally Competent?--A Study on Chinese Teenagers

ERIC Educational Resources Information Center

Li, Yan; Ranieri, Maria

2010-01-01

Literature review has found that despite the considerable attention focused on "digital natives", few studies have carefully investigated the characteristics of this group. The purpose of this study is to contribute to the debate on digital natives by providing a "piece of evidence" on the digital competence status of a group…

How Digital Are the Digital Humanities? An Analysis of Two Scholarly Blogging Platforms

PubMed Central

Puschmann, Cornelius; Bastos, Marco

2015-01-01

In this paper we compare two academic networking platforms, HASTAC and Hypotheses, to show the distinct ways in which they serve specific communities in the Digital Humanities (DH) in different national and disciplinary contexts. After providing background information on both platforms, we apply co-word analysis and topic modeling to show thematic similarities and differences between the two sites, focusing particularly on how they frame DH as a new paradigm in humanities research. We encounter a much higher ratio of posts using humanities-related terms compared to their digital counterparts, suggesting a one-way dependency of digital humanities-related terms on the corresponding unprefixed labels. The results also show that the terms digital archive, digital literacy, and digital pedagogy are relatively independent from the respective unprefixed terms, and that digital publishing, digital libraries, and digital media show considerable cross-pollination between the specialization and the general noun. The topic modeling reproduces these findings and reveals further differences between the two platforms. Our findings also indicate local differences in how the emerging field of DH is conceptualized and show dynamic topical shifts inside these respective contexts. PMID:25675441

How digital are the Digital Humanities? An analysis of two scholarly blogging platforms.

PubMed

Puschmann, Cornelius; Bastos, Marco

2015-01-01

In this paper we compare two academic networking platforms, HASTAC and Hypotheses, to show the distinct ways in which they serve specific communities in the Digital Humanities (DH) in different national and disciplinary contexts. After providing background information on both platforms, we apply co-word analysis and topic modeling to show thematic similarities and differences between the two sites, focusing particularly on how they frame DH as a new paradigm in humanities research. We encounter a much higher ratio of posts using humanities-related terms compared to their digital counterparts, suggesting a one-way dependency of digital humanities-related terms on the corresponding unprefixed labels. The results also show that the terms digital archive, digital literacy, and digital pedagogy are relatively independent from the respective unprefixed terms, and that digital publishing, digital libraries, and digital media show considerable cross-pollination between the specialization and the general noun. The topic modeling reproduces these findings and reveals further differences between the two platforms. Our findings also indicate local differences in how the emerging field of DH is conceptualized and show dynamic topical shifts inside these respective contexts.

Digital rotation measurement unit

DOEpatents

Sanderson, S.N.

1983-09-30

A digital rotation indicator is disclosed for monitoring the position of a valve member having a movable actuator. The indicator utilizes mercury switches adapted to move in cooperation with the actuator. Each of the switches produces an output as it changes state when the actuator moves. A direction detection circuit is connected to the switches to produce a first digital signal indicative of the direction of rotation of the actuator. A count pulse generating circuit is also connected to the switches to produce a second digital pulse signal having count pulses corresponding to a change of state of any of the mercury switches. A reset pulse generating circuit is provided to generate a reset pulse each time a count pulse is generated. An up/down counter is connected to receive the first digital pulse signal and the second digital pulse signal and to count the pulses of the second digital pulse signal either up or down depending upon the instantaneous digital value of the first digital signal whereby a running count indicative of the movement of the actuator is maintained.

Compromises produced by the dialectic between self-verification and self-enhancement.

PubMed

Morling, B; Epstein, S

1997-12-01

Three studies of people's reactions to evaluative feedback demonstrated that the dialectic between self-enhancement and self-verification results in compromises between these 2 motives, as hypothesized in cognitive-experiential self-theory. The demonstration was facilitated by 2 procedural improvements: Enhancement and verification were established by calibrating evaluative feedback against self appraisals, and degree of enhancement and of verification were varied along a continuum, rather than categorically. There was also support for the hypotheses that processing in an intuitive-experiential mode favors enhancement and processing in an analytical-rational mode favors verification in the kinds of situations investigated.

Chronic Lymphocytic Leukemia as an Unusual Cause of Rapid Airway Compromise

PubMed Central

Ezzell, Erin E.; Renshaw, John S.

2017-01-01

Chronic Lymphocytic Leukemia (CLL) is the most prevalent form of non-Hodgkin's lymphoma (NHL) in Western countries predominantly affecting adults over the age of 65. CLL is commonly indolent in nature but can present locally and aggressively at extranodal sites. Although CLL may commonly present with cervical lymphadenopathy, manifestation in nonlymphoid regions of the head and neck is not well described. CLL causing upper airway obstruction is even more uncommon. We describe a case of a patient with known history of CLL and stable lymphocytosis that developed an enlarging lymphoid base of tongue (BOT) mass resulting in rapid airway compromise. PMID:28396813

Digital TMI

NASA Technical Reports Server (NTRS)

Rios, Joseph

2012-01-01

Presenting the current status of the Digital TMI project to visiting members of the FAA Command Center. Digital TMI is an effort to store national-level traffic management initiatives in a standards-compliant manner. Work is funded by the FAA.

Public Access to Digital Material; A Call to Researchers: Digital Libraries Need Collaboration across Disciplines; Greenstone: Open-Source Digital Library Software; Retrieval Issues for the Colorado Digitization Project's Heritage Database; Report on the 5th European Conference on Digital Libraries, ECDL 2001; Report on the First Joint Conference on Digital Libraries.

ERIC Educational Resources Information Center

Kahle, Brewster; Prelinger, Rick; Jackson, Mary E.; Boyack, Kevin W.; Wylie, Brian N.; Davidson, George S.; Witten, Ian H.; Bainbridge, David; Boddie, Stefan J.; Garrison, William A.; Cunningham, Sally Jo; Borgman, Christine L.; Hessel, Heather

2001-01-01

These six articles discuss various issues relating to digital libraries. Highlights include public access to digital materials; intellectual property concerns; the need for collaboration across disciplines; Greenstone software for construction and presentation of digital information collections; the Colorado Digitization Project; and conferences…

Iatrogenic Creutzfeldt-Jakob disease with Amyloid-β pathology: an international study.

PubMed

Cali, Ignazio; Cohen, Mark L; Haїk, Stéphane; Parchi, Piero; Giaccone, Giorgio; Collins, Steven J; Kofskey, Diane; Wang, Han; McLean, Catriona A; Brandel, Jean-Philippe; Privat, Nicolas; Sazdovitch, Véronique; Duyckaerts, Charles; Kitamoto, Tetsuyuki; Belay, Ermias D; Maddox, Ryan A; Tagliavini, Fabrizio; Pocchiari, Maurizio; Leschek, Ellen; Appleby, Brian S; Safar, Jiri G; Schonberger, Lawrence B; Gambetti, Pierluigi

2018-01-08

The presence of pathology related to the deposition of amyloid-β (Aβ) has been recently reported in iatrogenic Creutzfeldt-Jakob disease (iCJD) acquired from inoculation of growth hormone (GH) extracted from human cadaveric pituitary gland or use of cadaveric dura mater (DM) grafts.To investigate this phenomenon further, a cohort of 27 iCJD cases - 21 with adequate number of histopathological sections - originating from Australia, France, Italy, and the Unites States, were examined by immunohistochemistry, amyloid staining, and Western blot analysis of the scrapie prion protein (PrP Sc ), and compared with age-group matched cases of sporadic CJD (sCJD), Alzheimer disease (AD) or free of neurodegenerative diseases (non-ND).Cases of iCJD and sCJD shared similar profiles of proteinase K-resistant PrP Sc with the exception of iCJD harboring the "MMi" phenotype. Cerebral amyloid angiopathy (CAA), either associated with, or free of, Thioflavin S-positive amyloid core plaques (CP), was observed in 52% of 21 cases of iCJD, which comprised 37.5% and 61.5% of the cases of GH- and DM-iCJD, respectively. If only cases younger than 54 years were considered, Aβ pathology affected 41%, 2% and 0% of iCJD, sCJD and non-ND, respectively. Despite the patients' younger age CAA was more severe in iCJD than sCJD, while Aβ diffuse plaques, in absence of Aβ CP, populated one third of sCJD. Aβ pathology was by far most severe in AD. Tau pathology was scanty in iCJD and sCJD.In conclusion, (i) despite the divergences in the use of cadaveric GH and DM products, our cases combined with previous studies showed remarkably similar iCJD and Aβ phenotypes indicating that the occurrence of Aβ pathology in iCJD is a widespread phenomenon, (ii) CAA emerges as the hallmark of the Aβ phenotype in iCJD since it is observed in nearly 90% of all iCJD with Aβ pathology reported to date including ours, and it is shared by GH- and DM-iCJD, (iii) although the contributions to Aβ pathology of other

Digital Libraries Are Much More than Digitized Collections.

ERIC Educational Resources Information Center

Peters, Peter Evan

1995-01-01

The digital library encompasses the application of high-performance computers and networks to the production, distribution, management, and use of knowledge in research and education. A joint project by three federal agencies, which is investing in digital library initiatives at six universities, is discussed. A sidebar provides issues to consider…

Effects of Hypoglycemia on Circulating Stem and Progenitor Cells in Diabetic Patients.

PubMed

Fadini, Gian Paolo; Boscari, Federico; Cappellari, Roberta; Galasso, Silvia; Rigato, Mauro; Bonora, Benedetta Maria; D'Anna, Marianna; Bruttomesso, Daniela; Avogaro, Angelo

2018-03-01

Iatrogenic hypoglycemia is the most common acute diabetic complication, and it significantly increases morbidity. In people with diabetes, reduction in the levels of circulating stem and progenitor cells predicts adverse outcomes. To evaluate whether hypoglycemia in diabetes affects circulating stem cells and endothelial progenitor cells (EPCs). We performed an experimental hypoglycemia study (Study 1) and a case-control study (Study 2). Tertiary referral inpatient clinic. Type 1 diabetic patients (Study 1, n = 19); diabetic patients hospitalized for severe iatrogenic hypoglycemia, matched inpatient and outpatient controls (Study 2, n = 22/group). Type 1 diabetic patients underwent two in-hospital sessions of glucose monitoring during a breakfast meal with or without induction of hypoglycemia in random order. In Study 2, patients hospitalized for hypoglycemia and matched controls were compared. Circulating stem cells and EPCs were measured by flow cytometry based on the expression of CD34 and kinase insert domain receptor (KDR). In Study 1, the physiologic decline of CD34+KDR+ EPCs from 8 am to 2 pm was abolished by insulin-induced hypoglycemia in type 1 diabetic patients. In Study 2, diabetic patients hospitalized for severe iatrogenic hypoglycemia had significantly lower levels of CD34+ stem cells and CD34+KDR+ EPCs compared with diabetic inpatients or outpatient controls. In diabetic patients, a single mild hypoglycemic episode can compromise the physiologic EPC fluctuation, whereas severe hypoglycemia is associated with a marked reduction in stem cells and EPCs. These data provide a possible link between hypoglycemia and adverse outcomes of diabetes.

Could digital imaging be an alternative for digital colorimeters?

PubMed

Caglar, Alper; Yamanel, Kivanc; Gulsahi, Kamran; Bagis, Bora; Ozcan, Mutlu

2010-12-01

This study evaluated the colour parameters of composite and ceramic shade guides determined using a colorimeter and digital imaging method with illuminants at different colour temperatures. Two different resin composite shade guides, namely Charisma (Heraeus Kulzer) and Premise (Kerr Corporation), and two different ceramic shade guides, Vita Lumin Vacuum (VITA Zahnfabrik) and Noritake (Noritake Co.), were evaluated at three different colour temperatures (2,700 K, 2,700-6,500 K, and 6500 K) of illuminants. Ten shade tabs were selected (A1, A2, A3, A3,5, A4, B1, B2, B3, C2 and C3) from each shade guide. CIE Lab values were obtained using digital imaging and a colorimeter (ShadeEye NCC Dental Chroma Meter, Shofu Inc.). The data were analysed using two-way ANOVA, and Pearson's correlation. While mean L* values of both composite and ceramic shade guides were not affected from the colour temperature, L* values obtained with the colorimeter showed significantly lower values than those of the digital imaging (p < 0.01). At combined 2,700-6500 K colour temperature, the means of a* values obtained from colorimeter and digital imaging did not show significant differences (p > 0.05). For both composite and ceramic shade guides, L* and b* values obtained from colorimeter and digital imaging method presented a high level of correlation. High-level correlations were also acquired for a* values in all shade guides except for the Charisma composite shade guide. Digital imaging method could be an alternative for the colorimeters unless the proper object-camera distance, digital camera settings and suitable illumination conditions could be supplied. However, variations in shade guides, especially for composites, may affect the correlation.

Measuring digit lengths with 3D digital stereophotogrammetry: A comparison across methods.

PubMed

Gremba, Allison; Weinberg, Seth M

2018-05-09

We compared digital 3D stereophotogrammetry to more traditional measurement methods (direct anthropometry and 2D scanning) to capture digit lengths and ratios. The length of the second and fourth digits was measured by each method and the second-to-fourth ratio was calculated. For each digit measurement, intraobserver agreement was calculated for each of the three collection methods. Further, measurements from the three methods were compared directly to one another. Agreement statistics included the intraclass correlation coefficient (ICC) and technical error of measurement (TEM). Intraobserver agreement statistics for the digit length measurements were high for all three methods; ICC values exceeded 0.97 and TEM values were below 1 mm. For digit ratio, intraobserver agreement was also acceptable for all methods, with direct anthropometry exhibiting lower agreement (ICC = 0.87) compared to indirect methods. For the comparison across methods, the overall agreement was high for digit length measurements (ICC values ranging from 0.93 to 0.98; TEM values below 2 mm). For digit ratios, high agreement was observed between the two indirect methods (ICC = 0.93), whereas indirect methods showed lower agreement when compared to direct anthropometry (ICC < 0.75). Digit measurements and derived ratios from 3D stereophotogrammetry showed high intraobserver agreement (similar to more traditional methods) suggesting that landmarks could be placed reliably on 3D hand surface images. While digit length measurements were found to be comparable across all three methods, ratios derived from direct anthropometry tended to be higher than those calculated indirectly from 2D or 3D images. © 2018 Wiley Periodicals, Inc.

Radiologists' preferences for digital mammographic display. The International Digital Mammography Development Group.

PubMed

Pisano, E D; Cole, E B; Major, S; Zong, S; Hemminger, B M; Muller, K E; Johnston, R E; Walsh, R; Conant, E; Fajardo, L L; Feig, S A; Nishikawa, R M; Yaffe, M J; Williams, M B; Aylward, S R

2000-09-01

To determine the preferences of radiologists among eight different image processing algorithms applied to digital mammograms obtained for screening and diagnostic imaging tasks. Twenty-eight images representing histologically proved masses or calcifications were obtained by using three clinically available digital mammographic units. Images were processed and printed on film by using manual intensity windowing, histogram-based intensity windowing, mixture model intensity windowing, peripheral equalization, multiscale image contrast amplification (MUSICA), contrast-limited adaptive histogram equalization, Trex processing, and unsharp masking. Twelve radiologists compared the processed digital images with screen-film mammograms obtained in the same patient for breast cancer screening and breast lesion diagnosis. For the screening task, screen-film mammograms were preferred to all digital presentations, but the acceptability of images processed with Trex and MUSICA algorithms were not significantly different. All printed digital images were preferred to screen-film radiographs in the diagnosis of masses; mammograms processed with unsharp masking were significantly preferred. For the diagnosis of calcifications, no processed digital mammogram was preferred to screen-film mammograms. When digital mammograms were preferred to screen-film mammograms, radiologists selected different digital processing algorithms for each of three mammographic reading tasks and for different lesion types. Soft-copy display will eventually allow radiologists to select among these options more easily.

Digitally-bypassed transducers: interfacing digital mockups to real-time medical equipment.

PubMed

Sirowy, Scott; Givargis, Tony; Vahid, Frank

2009-01-01

Medical device software is sometimes initially developed by using a PC simulation environment that executes models of both the device and a physiological system, and then later by connecting the actual medical device to a physical mockup of the physiological system. An alternative is to connect the medical device to a digital mockup of the physiological system, such that the device believes it is interacting with a physiological system, but in fact all interaction is entirely digital. Developing medical device software by interfacing with a digital mockup enables development without costly or dangerous physical mockups, and enables execution that is faster or slower than real time. We introduce digitally-bypassed transducers, which involve a small amount of hardware and software additions, and which enable interfacing with digital mockups.

76 FR 11680 - Digital Low Power Television, Television Translator, and Television Booster Stations and Digital...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

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TEMPORAL ASSOCIATION BETWEEN PULMONARY AND SYSTEMIC EFFECTS OF PARTICULATE MATTER IN HEALTHY AND CARDIOVASCULAR COMPROMISED RATS

EPA Science Inventory

Temporal association between pulmonary and systemic effects of particulate matter in healthy and cardiovascular compromised rats

Urmila P. Kodavanti, Mette C. Schladweiler, Allen D. Ledbetter, Russ Hauser*, David C. Christiani*, John McGee, Judy R. Richards, Daniel L. Co...

2-Sulfonylpyrimidines: Mild alkylating agents with anticancer activity toward p53-compromised cells.

PubMed

Bauer, Matthias R; Joerger, Andreas C; Fersht, Alan R

2016-09-06

The tumor suppressor p53 has the most frequently mutated gene in human cancers. Many of p53's oncogenic mutants are just destabilized and rapidly aggregate, and are targets for stabilization by drugs. We found certain 2-sulfonylpyrimidines, including one named PK11007, to be mild thiol alkylators with anticancer activity in several cell lines, especially those with mutationally compromised p53. PK11007 acted by two routes: p53 dependent and p53 independent. PK11007 stabilized p53 in vitro via selective alkylation of two surface-exposed cysteines without compromising its DNA binding activity. Unstable p53 was reactivated by PK11007 in some cancer cell lines, leading to up-regulation of p53 target genes such as p21 and PUMA. More generally, there was cell death that was independent of p53 but dependent on glutathione depletion and associated with highly elevated levels of reactive oxygen species and induction of endoplasmic reticulum (ER) stress, as also found for the anticancer agent PRIMA-1(MET)(APR-246). PK11007 may be a lead for anticancer drugs that target cells with nonfunctional p53 or impaired reactive oxygen species (ROS) detoxification in a wide variety of mutant p53 cells.

Digital Language Death

PubMed Central

Kornai, András

2013-01-01

Of the approximately 7,000 languages spoken today, some 2,500 are generally considered endangered. Here we argue that this consensus figure vastly underestimates the danger of digital language death, in that less than 5% of all languages can still ascend to the digital realm. We present evidence of a massive die-off caused by the digital divide. PMID:24167559

Using Emergence Theory-Based Curriculum to Teach Compromise Skills to Students with Autistic Spectrum Disorders

ERIC Educational Resources Information Center

Fein, Lance; Jones, Don

2015-01-01

This study addresses the compromise skills that are taught to students diagnosed with autistic spectrum disorders (ASD) and related social and communication deficits. A private school in the southeastern United States implemented an emergence theory-based curriculum to address these skills, yet no formal analysis was conducted to determine its…

Fungemia and interstitial lung compromise caused by Malassezia sympodialis in a pediatric patient.

PubMed

Aguirre, Clarisa; Euliarte, Cristina; Finquelievich, Jorge; Sosa, María de los Ángeles; Giusiano, Gustavo

2015-01-01

A case of fungemia with interstitial lung compromise caused by Malassezia sympodialis is reported in an obese pediatric patient on long-term treatment with inhaled corticosteroids for asthma. The patient was hospitalized due to a post-surgical complication of appendicitis. The patient was treated with amphotericin B for 3 weeks, with good clinical evolution and subsequent negative cultures. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

Digital Earth Watch: Investigating the World with Digital Cameras

NASA Astrophysics Data System (ADS)

Gould, A. D.; Schloss, A. L.; Beaudry, J.; Pickle, J.

2015-12-01

Every digital camera including the smart phone camera can be a scientific tool. Pictures contain millions of color intensity measurements organized spatially allowing us to measure properties of objects in the images. This presentation will demonstrate how digital pictures can be used for a variety of studies with a special emphasis on using repeat digital photographs to study change-over-time in outdoor settings with a Picture Post. Demonstrations will include using inexpensive color filters to take pictures that enhance features in images such as unhealthy leaves on plants, or clouds in the sky. Software available at no cost from the Digital Earth Watch (DEW) website that lets students explore light, color and pixels, manipulate color in images and make measurements, will be demonstrated. DEW and Picture Post were developed with support from NASA. Please visit our websites: DEW: http://dew.globalsystemsscience.orgPicture Post: http://picturepost.unh.edu

Intra- and Inter-Individual Variability in Location Data for Two U.S. Health-Compromised Elderly Cohorts

EPA Science Inventory

This study provides descriptive statistical data on daily time spent in three locations of exposure assessment interest for two panel studies of health-compromised elderly individuals > 65 y old having multi-days of human activity data. The panel studies include individuals livi...

Digital Actuator Technology

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

Ken Thomas; Ted Quinn; Jerry Mauck

There are significant developments underway in new types of actuators for power plant active components. Many of these make use of digital technology to provide a wide array of benefits in performance of the actuators and in reduced burden to maintain them. These new product offerings have gained considerable acceptance in use in process plants. In addition, they have been used in conventional power generation very successfully. This technology has been proven to deliver the benefits promised and substantiate the claims of improved performance. The nuclear industry has been reluctant to incorporate digital actuator technology into nuclear plant designs duemore » to concerns due to a number of concerns. These could be summarized as cost, regulatory uncertainty, and a certain comfort factor with legacy analog technology. The replacement opportunity for these types of components represents a decision point for whether to invest in more modern technology that would provide superior operational and maintenance benefits. Yet, the application of digital technology has been problematic for the nuclear industry, due to qualification and regulatory issues. With some notable exceptions, the result has been a continuing reluctance to undertake the risks and uncertainties of implementing digital actuator technology when replacement opportunities present themselves. Rather, utilities would typically prefer to accept the performance limitations of the legacy analog actuator technologies to avoid impacts to project costs and schedules. The purpose of this report is to demonstrate that the benefits of digital actuator technology can be significant in terms of plant performance and that it is worthwhile to address the barriers currently holding back the widespread development and use of this technology. It addresses two important objectives in pursuit of the beneficial use of digital actuator technology for nuclear power plants: 1. To demonstrate the benefits of digital actuator

Is the digital divide an obstacle to e-health? An analysis of the situation in Europe and in Italy.

PubMed

Romano, Maria Francesca; Sardella, Maria Vittoria; Alboni, Fabrizio; Russo, Luana; Mariotti, Rita; Nicastro, Irene; Barletta, Valentina; Di Bello, Vitantonio

2015-01-01

The digital divide affecting elderly patients may compromise the diffusion of telemedicine systems for this age segment. It might be that the difficulties in the passage from trials to the effective distribution of telemedicine systems are also due to the awareness of a personal digital divide in the target population. The analysis aims to estimate the number of people over the age of 50 years with potential cardiovascular problems able to access the Web. It made use of data from several sources (the Survey of Health, Ageing and Retirement in Europe and the Istituto Nazionale di Statistica Multiscopo Survey). Furthermore, with regard to Italy, the estimates obtained from official data were compared with those obtained in a survey investigating heart failure patients in Tuscany. In 2011, the percentage of people suffering from cardiovascular diseases and with Web access was 24% in Europe, with significant differences by country (ranging from 53% in Switzerland to below 20% in Italy, Spain, and Portugal). In Italy, however, the proportion of people with Web access increased from 2007 to 2011, and the survey in Tuscany showed that elderly people with limited information and communications technology skills overcame challenges and learned how to connect to the Web because they started to appreciate new technologies. The opportunity to use the Internet to monitor patients with chronic disease can serve as a challenge to reduce the digital divide gap and, furthermore, to increase their social and technological inclusion.

User Impact on Selection, Digitization, and the Development of Digital Special Collections

ERIC Educational Resources Information Center

Mills, Alexandra

2015-01-01

Libraries and archives digitize their special collections in an effort to increase access to rare and unique items. To ensure that resulting digital collections meet user needs, institutions have made assessment, consultation, and user participation integral to digitization initiatives and the selection process. Institutions must also build…

Mass psychogenic illness: psychological predisposition and iatrogenic pseudo-vocal cord dysfunction and pseudo-reactive airways disease syndrome.

PubMed

Staudenmayer, Herman; Christopher, Kent L; Repsher, Lawrence; Hill, Ronald H

2011-06-01

A multidisciplinary team assessed five patients who alleged chronic medically unexplained multiorgan system symptoms described by idiopathic environmental intolerance allegedly triggered by exposure to solvents used in membrane roofing repair work on an office building. The event precipitated an incident of mass psychogenic illness (MPI). Treating physicians diagnosed irritant-associated vocal cord dysfunction (IVCD) and reactive airways disease syndrome (RADS) resulting from exposure. The authors conducted medical, psychological, and industrial hygiene evaluations. Air monitoring data for total volatile organic compounds obtained during the 2-day exposure period, measurements of emissions during membrane roofing repair at a similar site, mathematical modeling of air contaminant concentrations, and injection of tracer gas into the incident building revealed exposure levels well below those doses anticipated to cause clinical symptoms. There was no objective medical evidence validating symptoms. Review of the medical records indicated that the video laryngoscopy data, pulmonary function tests, and medical examinations relied upon by the treating physicians were inconsistent with published criteria for IVCD and RADS. Psychological evaluation identified defensiveness and self-serving misrepresentations of exaggerated health concerns associated with somatization and malingering. Each case had personality traits associated with at least one personality disorder. Social histories identified premorbid life events and stressors associated with distress. This is the first study to assess psychological predisposition, social interaction among the plaintiffs, and iatrogenic reinforcement of beliefs by diagnoses of pseudo-disorders associated with patient misrepresentation of exaggerated health concerns in an incident of MPI.

Managing Campus Energy: Compromising between Rapid Needs and Environmental Requirement

NASA Astrophysics Data System (ADS)

Ambariyanto, Ambariyanto; Utama, Yos J.; Purwanto

2018-02-01

The utilization of energy, especially electricity at Diponegoro University campus continues to increase in line with the development of the university. This increase has a direct impact on the increased costs to be paid by the university. Some of the causes of increased utilization of electrical energy is the construction of new buildings to meet the needs, increased learning activities and education, research activities in the laboratory, and various other activities. On the other hand, the increase of energy utilization is considered not good from the environment point of view, especially the utilization of electrical energy coming from non sustainable resources. Efforts to compromise on both are to develop policies in developing environmentally friendly buildings, efficiency in utilization of electrical energy, and development of sustainable energy sources.

Digital Assays Part I: Partitioning Statistics and Digital PCR.

PubMed

Basu, Amar S

2017-08-01

A digital assay is one in which the sample is partitioned into many small containers such that each partition contains a discrete number of biological entities (0, 1, 2, 3, …). A powerful technique in the biologist's toolkit, digital assays bring a new level of precision in quantifying nucleic acids, measuring proteins and their enzymatic activity, and probing single-cell genotypes and phenotypes. Part I of this review begins with the benefits and Poisson statistics of partitioning, including sources of error. The remainder focuses on digital PCR (dPCR) for quantification of nucleic acids. We discuss five commercial instruments that partition samples into physically isolated chambers (cdPCR) or droplet emulsions (ddPCR). We compare the strengths of dPCR (absolute quantitation, precision, and ability to detect rare or mutant targets) with those of its predecessor, quantitative real-time PCR (dynamic range, larger sample volumes, and throughput). Lastly, we describe several promising applications of dPCR, including copy number variation, quantitation of circulating tumor DNA and viral load, RNA/miRNA quantitation with reverse transcription dPCR, and library preparation for next-generation sequencing. This review is intended to give a broad perspective to scientists interested in adopting digital assays into their workflows. Part II focuses on digital protein and cell assays.

Digital flight control research

NASA Technical Reports Server (NTRS)

Potter, J. E.; Stern, R. G.; Smith, T. B.; Sinha, P.

1974-01-01

The results of studies which were undertaken to contribute to the design of digital flight control systems, particularly for transport aircraft are presented. In addition to the overall design considerations for a digital flight control system, the following topics are discussed in detail: (1) aircraft attitude reference system design, (2) the digital computer configuration, (3) the design of a typical digital autopilot for transport aircraft, and (4) a hybrid flight simulator.

Can Neglected Tropical Diseases Compromise Human Wellbeing in Sex-, Age-, and Trait-Specific Ways?

PubMed Central

Geary, David C.

2016-01-01

Traits that facilitate competition for reproductive resources or that influence mate choice have evolved to signal resilience to infectious disease and other stressors. As a result, the dynamics of competition and choice can, in theory, be used to generate predictions about sex-, age-, and trait-specific vulnerabilities for any sexually reproducing species, including humans. These dynamics and associated vulnerabilities are reviewed for nonhuman species, focusing on traits that are compromised by exposure to parasites. Using the same approach, sex-, age-, and trait-specific vulnerabilities to parasitic disease are illustrated for children’s and adolescent’s physical growth and fitness. Suggestions are then provided for widening the assessment of human vulnerabilities to include age-appropriate measures of behavioral (e.g., children’s play) and cognitive (e.g., language fluency) traits. These are traits that are likely to be compromised by infection in age- and sex-specific ways. Inclusion of these types of measures in studies of neglected tropic diseases has the potential to provide a more nuanced understanding of how these diseases undermine human wellbeing and may provide a useful means to study the efficacy of associated treatments. PMID:27077746

Natural Tooth Pontic: An Instant Esthetic Option for Periodontally Compromised Teeth—A Case Series

PubMed Central

Raj, Rishi; Narayan, Ipshita; Gowda, Triveni Mavinakote; Mehta, D. S.

2016-01-01

Sudden tooth loss in the esthetic zone of the maxillary or mandibular anterior region can be due to trauma, periodontal disease, or endodontic failure. The treatment options for replacing the missing tooth can vary between removable prosthesis, tooth-supported prosthesis, and implant-supported prosthesis. Irrespective of the final treatment, the first line of management would be to provisionally restore the patient's esthetic appearance at the earliest, while functionally stabilizing the compromised arch. Using the patient's own natural tooth as a pontic offers the benefits of being the right size, shape, and color and provides exact repositioning in its original intraoral three-dimensional position. Additionally, using the patient's platelet concentrate (platelet rich fibrin) facilitates early wound healing and preservation of alveolar ridge shape following tooth extraction. The abutment teeth can also be preserved with minimal or no preparation, thus keeping the technique reversible, and can be completed at the chair side thereby avoiding laboratory costs. This helps the patient better tolerate the effect of tooth loss psychologically. The article describes a successful, immediate, and viable technique for rehabilitation of three different patients requiring replacement of a single periodontally compromised tooth in an esthetic region. PMID:27994892

Prosthodontic decision-making relating to dentitions with compromised molars: the perspective of Swedish General Dental Practitioners.

PubMed

Korduner, E-K; Collin Bagewitz, I; Vult von Steyern, P; Wolf, E

2016-12-01

The aim of this investigation was to study the clinical prosthodontic decision-making process relating to dentitions with compromised molars among Swedish general dental practitioners (GDPs). Eleven Swedish GDPs were purposively selected, and all agreed to participate. Then, in-depth, semi-structured interviews were conducted and covered treatment considerations concerning two authentic patient cases, initially with complete dental arches, and later, a final treatment based on a shortened dental arch (SDA) was discussed. The cases involved patients with compromised teeth situated mainly in the molar regions. One patient suffered from extensive caries and the other from severe periodontal disease. Qualitative content analysis was used to analyse the data. In the systematic analysis, two main categories were identified: holistic and functional approach. Among the interviewed GDPs, focus was put on patients' needs, background history and motivation for treatment as well as the preservation of molar support. Within the limitations of this study, the following can be concluded: keeping a dental arch with molars seems to be important to Swedish general dental practitioners. The SDA concept does not seem to have a substantial impact on the prosthodontic decision-making relating to dentitions with compromised molars. The dentist's experiences, as well as colleagues' or consulting specialist advice together with aetiological factors and the patient's individual situation, influence the decision-making more than the SDA concept. The conflicting results in the prosthetic decision-making process concerning the relevance of age and the need for molar support need further investigation, for example based on decisions made in the dentist's own clinical practice. © 2016 John Wiley & Sons Ltd.

White matter fiber compromise contributes differentially to attention and emotion processing impairment in alcoholism, HIV-infection, and their comorbidity.

PubMed

Schulte, T; Müller-Oehring, E M; Sullivan, E V; Pfefferbaum, A

2012-10-01

Alcoholism (ALC) and HIV-1 infection (HIV) each affects emotional and attentional processes and integrity of brain white matter fibers likely contributing to functional compromise. The highly prevalent ALC+HIV comorbidity may exacerbate compromise. We used diffusion tensor imaging (DTI) and an emotional Stroop Match-to-Sample task in 19 ALC, 16 HIV, 15 ALC+HIV, and 15 control participants to investigate whether disruption of fiber system integrity accounts for compromised attentional and emotional processing. The task required matching a cue color to that of an emotional word with faces appearing between the color cue and the Stroop word in half of the trials. Nonmatched cue-word color pairs assessed selective attention, and face-word pairs assessed emotion. Relative to controls, DTI-based fiber tracking revealed lower inferior longitudinal fasciculus (ilf) integrity in HIV and ALC+HIV and lower uncinate fasciculus (uf) integrity in all three patient groups. Controls exhibited Stroop effects to positive face-word emotion, and greater interference was related to greater callosal, cingulum and ilf integrity. By contrast, HIV showed greater interference from negative Stroop words during color-nonmatch trials, correlating with greater uf compromise. For face trials, ALC and ALC+HIV showed greater Stroop-word interference, correlating with lower cingulate and callosal integrity. Thus, in HIV, conflict resolution was diminished when challenging conditions usurped resources needed to manage interference from negative emotion and to disengage attention from wrongly cued colors (nonmatch). In ALC and ALC+HIV, poorer callosal integrity was related to enhanced emotional interference suggesting curtailed interhemispheric exchange needed between preferentially right-hemispheric emotion and left-hemispheric Stroop-word functions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Accuracy of a three-dimensional dentition model digitized from an interocclusal record using a non-contact surface scanner.

PubMed

Kihara, Takuya; Yoshimi, Yuki; Taji, Tsuyoshi; Murayama, Takeshi; Tanimoto, Kotaro; Nikawa, Hiroki

2016-08-01

For orthodontic treatment, it is important to assess the dental morphology, as well as the position and inclination of teeth. The aim of this article was to develop an efficient and accurate method for the three-dimensional (3D) imaging of the maxillary and mandibular dental morphology by measuring interocclusal records using an optical scanner. The occlusal and incisal morphology of participants was registered in the intercuspal position using a hydrophilic vinyl polysiloxane and digitized into 3D models using an optical scanner. Impressions were made of the maxilla and mandible in alginate materials in order to fabricate plaster models and created into 3D models using the optical scanner based on the principal triangulation method. The occlusal and incisal areas of the interocclusal records were retained. The buccal and lingual areas were added to these regions entirely by the 3D model of the plaster model. The accuracy of this method was evaluated for each tooth, with the dental cast 3D models used as controls. The 3D model created from the interocclusal record and the plaster model of the dental morphology was analysed in 3D software. The difference between the controls and the 3D models digitized from the interocclusal records was 0.068±0.048mm, demonstrating the accuracy of this method. The presence of severe crowding may compromise the ability to separate each tooth and digitize the dental morphology. The digitization method in this study provides sufficient accuracy to visualize the dental morphology, as well as the position and inclination of these teeth. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Digital Ratiometer

NASA Technical Reports Server (NTRS)

Beer, R.

1985-01-01

Small, low-cost comparator with 24-bit-precision yields ratio signal from pair of analog or digital input signals. Arithmetic logic chips (bit-slice) sample two 24-bit analog-to-digital converters approximately once every millisecond and accumulate them in two 24-bit registers. Approach readily modified to arbitrary precision.

Digital Discrimination

ERIC Educational Resources Information Center

Blansett, Jim

2008-01-01

In recent years, the Internet has become a digital commons of commerce and education. However, accessibility standards have often been overlooked online, and the digital equivalents to curb-cuts and other physical accommodations have only rarely been implemented to serve those with print disabilities. (A print disability can be a learning…

Differentiating Digital Writing Instruction: The Intersection of Technology, Writing Instruction, and Digital Genre Knowledge

ERIC Educational Resources Information Center

Martin, Nicole M.; Lambert, Claire

2015-01-01

U.S. adolescents' prior technology experiences and exposure to digital genres vary, but they will often write digital texts as they enter college and adulthood. We explored middle school students' digital writing instructional experience in the context of a university-based summer digital writing camp. The sixth- through eighth-grade adolescents…

Enhanced susceptibility to predation in corals of compromised condition

PubMed Central

Cameron, Caitlin M.; Miller, Margaret W.

2015-01-01

The marine gastropod, Coralliophila abbreviata, is an obligate corallivore that causes substantial mortality in Caribbean Acropora spp. Considering the imperiled status of Acropora cervicornis and A. palmata, a better understanding of ecological interactions resulting in tissue loss may enable more effective conservation strategies. We examined differences in susceptibility of A. cervicornis to C. abbreviata predation based on coral tissue condition. Coral tissue condition was a strong determinant of snail prey choice, with snails preferring A. cervicornis fragments that were diseased or mechanically damaged over healthy fragments. In addition, snails always chose fragments undergoing active predation by another snail, while showing no preference for a non-feeding snail when compared with an undisturbed prey fragment. These results indicate that the condition of A. cervicornis prey influenced foraging behavior of C. abbreviata, creating a potential feedback that may exacerbate damage from predation in coral populations compromised by other types of disturbance. PMID:26734500

DESDynI Quad First Stage Processor - A Four Channel Digitizer and Digital Beam Forming Processor

NASA Technical Reports Server (NTRS)

Chuang, Chung-Lun; Shaffer, Scott; Smythe, Robert; Niamsuwan, Noppasin; Li, Samuel; Liao, Eric; Lim, Chester; Morfopolous, Arin; Veilleux, Louise

2013-01-01

The proposed Deformation, Eco-Systems, and Dynamics of Ice Radar (DESDynI-R) L-band SAR instrument employs multiple digital channels to optimize resolution while keeping a large swath on a single pass. High-speed digitization with very fine synchronization and digital beam forming are necessary in order to facilitate this new technique. The Quad First Stage Processor (qFSP) was developed to achieve both the processing performance as well as the digitizing fidelity in order to accomplish this sweeping SAR technique. The qFSP utilizes high precision and high-speed analog to digital converters (ADCs), each with a finely adjustable clock distribution network to digitize the channels at the fidelity necessary to allow for digital beam forming. The Xilinx produced FX130T Virtex 5 part handles the processing to digitally calibrate each channel as well as filter and beam form the receive signals. Demonstrating the digital processing required for digital beam forming and digital calibration is instrumental to the viability of the proposed DESDynI instrument. The qFSP development brings this implementation to Technology Readiness Level (TRL) 6. This paper will detail the design and development of the prototype qFSP as well as the preliminary results from hardware tests.

Digital In, Digital Out: Digital Editing with Firewire.

ERIC Educational Resources Information Center

Doyle, Bob; Sauer, Jeff

1997-01-01

Reviews linear and nonlinear digital video (DV) editing equipment and software, using the IEEE 1394 (FireWire) connector. Includes a chart listing specifications and rating eight DV editing systems, reviews two DV still-photo cameras, and previews beta DV products. (PEN)

Practical Applications of Digital Pathology.

PubMed

Saeed-Vafa, Daryoush; Magliocco, Anthony M

2015-04-01

Virtual microscopy and advances in machine learning have paved the way for the ever-expanding field of digital pathology. Multiple image-based computing environments capable of performing automated quantitative and morphological analyses are the foundation on which digital pathology is built. The applications for digital pathology in the clinical setting are numerous and are explored along with the digital software environments themselves, as well as the different analytical modalities specific to digital pathology. Prospective studies, case-control analyses, meta-analyses, and detailed descriptions of software environments were explored that pertained to digital pathology and its use in the clinical setting. Many different software environments have advanced platforms capable of improving digital pathology and potentially influencing clinical decisions. The potential of digital pathology is vast, particularly with the introduction of numerous software environments available for use. With all the digital pathology tools available as well as those in development, the field will continue to advance, particularly in the era of personalized medicine, providing health care professionals with more precise prognostic information as well as helping them guide treatment decisions.

Digital biology and chemistry.

PubMed

Witters, Daan; Sun, Bing; Begolo, Stefano; Rodriguez-Manzano, Jesus; Robles, Whitney; Ismagilov, Rustem F

2014-09-07

This account examines developments in "digital" biology and chemistry within the context of microfluidics, from a personal perspective. Using microfluidics as a frame of reference, we identify two areas of research within digital biology and chemistry that are of special interest: (i) the study of systems that switch between discrete states in response to changes in chemical concentration of signals, and (ii) the study of single biological entities such as molecules or cells. In particular, microfluidics accelerates analysis of switching systems (i.e., those that exhibit a sharp change in output over a narrow range of input) by enabling monitoring of multiple reactions in parallel over a range of concentrations of signals. Conversely, such switching systems can be used to create new kinds of microfluidic detection systems that provide "analog-to-digital" signal conversion and logic. Microfluidic compartmentalization technologies for studying and isolating single entities can be used to reconstruct and understand cellular processes, study interactions between single biological entities, and examine the intrinsic heterogeneity of populations of molecules, cells, or organisms. Furthermore, compartmentalization of single cells or molecules in "digital" microfluidic experiments can induce switching in a range of reaction systems to enable sensitive detection of cells or biomolecules, such as with digital ELISA or digital PCR. This "digitizing" offers advantages in terms of robustness, assay design, and simplicity because quantitative information can be obtained with qualitative measurements. While digital formats have been shown to improve the robustness of existing chemistries, we anticipate that in the future they will enable new chemistries to be used for quantitative measurements, and that digital biology and chemistry will continue to provide further opportunities for measuring biomolecules, understanding natural systems more deeply, and advancing molecular and

Conceptualizing Digital Literacies and Digital Ethics for Sustainability Education

ERIC Educational Resources Information Center

Brown, Susan A.

2014-01-01

Purpose: The purpose of this paper is to discuss the need for integrating a focus on digital literacies and digital ethics into sustainability education, proposing a conceptualization of these for sustainability education. Design/methodology/approach: The paper draws on relevant literature in the field of sustainability education and in the field…

Orientation of handle for successful prosthetic treatment in patients with an anatomic compromise after a maxillectomy.

PubMed

Sumita, Yuka I; Hattori, Mariko; Elbashti, Mahmoud E; Taniguchi, Hisashi

2017-05-01

This clinical technique provides a key procedure for successful prosthetic treatment in patients with an anatomical compromise after a maxillectomy. When making a preliminary impression, the clinician must keep the handle of the stock tray parallel to the patient's interpupillary line extraorally to maintain the correct position of the tray and to make a record of the inclination of the occlusal plane. This simple consideration during this first step of making a preliminary impression can be an important guide for both dentists and dental technicians. Information about the correct positioning of the tray and the inclination of the occlusal plane obtained by using a stock tray handle will greatly reduce the stress experienced by dentists, dental technicians, and patients during the fabrication of the prosthesis and will ultimately lead to successful prosthetic treatment in patients with anatomic compromise resulting from a maxillectomy. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Design of Digital Phase-Locked Loops For Advanced Digital Transponders

NASA Technical Reports Server (NTRS)

Nguyen, Tien M.

1994-01-01

For advanced digital space transponders, the Digital Phased-Locked Loops (DPLLs) can be designed using the available analog loops. DPLLs considered in this paper are derived from the Analog Phase-Locked Loop (APLL) using S-domain mapping techniques.

A Historical Perspective on Digital Hearing Aids: How Digital Technology Has Changed Modern Hearing Aids

PubMed Central

Levitt, Harry

2007-01-01

This article provides the author's perspective on the development of digital hearing aids and how digital signal processing approaches have led to changes in hearing aid design. Major landmarks in the evolution of digital technology are identified, and their impact on the development of digital hearing aids is discussed. Differences between analog and digital approaches to signal processing in hearing aids are identified. PMID:17301334

Digital Roundup

ERIC Educational Resources Information Center

Horn, Michael B.

2013-01-01

State policy is crucial to the spread of digital-learning opportunities at the elementary and secondary level. A review of recent legislative action reveals policies that are constantly in flux and differ quite markedly from one state to another. Some have hoped for model digital-learning legislation that could handle all the various issues…