[The managment of serious pregnant disease in the intensive care unit].

PubMed

Ali, Elhusseini; Bechir, Khemiri; Badis, Chennoufi Mohamed; Nabil, Mathlouthi; Hanene, Ellouze; Mourad, Bouchnak; Salah, Hendaoui Mohamed; Hayen, Maghrebi; Ezzeddine, Sfar; Hela, Chelli

2005-02-01

We report a retrospective study over a period of 4 years and half and bearing on 59 patients that require an intensive care. The number of childbirth during this period was 22237 with 8.97% of Caesareans. The main obstetrical diseases was: gravidic toxaemia 75.5%, uterine inertia 7%, cardiopathy 5% of the cases. The reasons for the transfer were: eclamptic state in 27% of the cases, hémostasis disorder 22% of the cases, and acute pulmonary oedema 18.6% of the cases. Average duration of hospitalization was 3.18 days. Five cases of death were noted.

Association of Parkinson's Disease and Its Subtypes with Agricultural Pesticide Exposures in Men: A Case-Control Study in France.

PubMed

Moisan, Frédéric; Spinosi, Johan; Delabre, Laurène; Gourlet, Véronique; Mazurie, Jean-Louis; Bénatru, Isabelle; Goldberg, Marcel; Weisskopf, Marc G; Imbernon, Ellen; Tzourio, Christophe; Elbaz, Alexis

2015-11-01

Pesticides have been associated with Parkinson's disease (PD), but there are few data on important exposure characteristics such as dose-effect relations. It is unknown whether associations depend on clinical PD subtypes. We examined quantitative aspects of occupational pesticide exposure associated with PD and investigated whether associations were similar across PD subtypes. As part of a French population-based case-control study including men enrolled in the health insurance plan for farmers and agricultural workers, cases with clinically confirmed PD were identified through antiparkinsonian drug claims. Two controls were matched to each case. Using a comprehensive occupational questionnaire, we computed indicators for different dimensions of exposure (duration, cumulative exposure, intensity). We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) among exposed male farmers (133 cases, 298 controls). We examined the relation between pesticides and PD subtypes (tremor dominant/non-tremor dominant) using polytomous logistic regression. There appeared to be a stronger association with intensity than duration of pesticide exposure based on separate models, as well as a synergistic interaction between duration and intensity (p-interaction = 0.04). High-intensity exposure to insecticides was positively associated with PD among those with low-intensity exposure to fungicides and vice versa, suggesting independent effects. Pesticide exposure in farms that specialized in vineyards was associated with PD (OR = 2.56; 95% CI: 1.31, 4.98). The association with intensity of pesticide use was stronger, although not significantly (p-heterogeneity = 0.60), for tremor-dominant (p-trend < 0.01) than for non-tremor-dominant PD (p-trend = 0.24). This study helps to better characterize different aspects of pesticide exposure associated with PD, and shows a significant association of pesticides with tremor-dominant PD in men, the most typical PD presentation. Moisan F, Spinosi J, Delabre L, Gourlet V, Mazurie JL, Bénatru I, Goldberg M, Weisskopf MG, Imbernon E, Tzourio C, Elbaz A. 2015. Association of Parkinson's disease and its subtypes with agricultural pesticide exposures in men: a case-control study in France. Environ Health Perspect 123:1123-1129; http://dx.doi.org/10.1289/ehp.1307970.

Study of Obstetric Admissions to the Intensive Care Unit of a Tertiary Care Hospital.

PubMed

Rathod, Ashakiran T; Malini, K V

2016-10-01

To analyze obstetric admissions to intensive care unit and to identify the risk factors responsible for intensive care admission. This is a retrospective study of all obstetric cases admitted to the intensive care unit over a period of 3 years. Data were collected from case records. The risk factors responsible for ICU admission were analyzed. There were 765 obstetric admissions to ICU accounting for 1.24 % of all deliveries. 56.20 % were in the age group of 20-25 years. 38.43 % were in their first pregnancy. 36.48 % of cases were at 37-40 weeks of gestation. Postpartum admissions were 80.91 %. Major conditions responsible were obstetric hemorrhage in 44.05 %, hypertensive disorders of pregnancy in 28.88 %, severe anemia in 14.37 %, heart disease in 12.15 %, and sepsis in 7.97 % of ICU cases. 40.39 % cases required high dependency care. Maternal mortality was seen in 15.55 % of ICU cases. Commonest cause of mortality was hemorrhagic shock (26.89 %) and multiorgan dysfunction syndrome (26.05 %). Commonest risk factors for ICU admissions are obstetric hemorrhage and hypertensive disorders of pregnancy. Other major risk factors are severe anemia, heart disease, sepsis, more than one diagnosis on admission, and the need for cesarean delivery.

Two-year outcome of team-based intensive case management for patients with schizophrenia.

PubMed

Aberg-Wistedt, A; Cressell, T; Lidberg, Y; Liljenberg, B; Osby, U

1995-12-01

Two-year outcomes of patients with schizophrenic disorders who were assigned to an intensive, team-based case management program and patients who received standard psychiatric services were assessed. The case management model featured increased staff contact time with patients, rehabilitation plans based on patients' expressed needs, and patients' attendance at team meetings where their rehabilitation plan was discussed. Forty patients were randomly assigned to either the case management group or the control group that received standard services. Patients' use of emergency and inpatient services, their quality of life, the size of their social networks, and their relatives' burden of care were assessed at assignment to the study groups and at two-year follow-up. Patients in the case management group had significantly fewer emergency visits compared with the two years before the study, and their relatives reported significantly reduced burden of care associated with relationships with psychiatric services over the two-year period. The size of patients' social networks increased for the case management group and decreased for the control group. A team-based intensive case management model is an effective intervention in the rehabilitation of patients with chronic schizophrenia.

Time-dependent effect of intensity of smoking and of occupational exposure to asbestos on the risk of lung cancer: results from the ICARE case-control study.

PubMed

Lévêque, Emilie; Lacourt, Aude; Luce, Danièle; Sylvestre, Marie-Pierre; Guénel, Pascal; Stücker, Isabelle; Leffondré, Karen

2018-05-18

To estimate the impact of intensity of both smoking and occupational exposure to asbestos on the risk of lung cancer throughout the whole exposure history. Data on 2026 male cases and 2610 male controls came from the French ICARE (Investigation of occupational and environmental causes of respiratory cancers) population-based, case-control study. Lifetime smoking history and occupational history were collected from standardised questionnaires and face-to-face interviews. Occupational exposure to asbestos was assessed using a job exposure matrix. The effects of annual average daily intensity of smoking (reported average number of cigarettes smoked per day) and asbestos exposure (estimated average daily air concentration of asbestos fibres at work) were estimated using a flexible weighted cumulative index of exposure in logistic regression models. Intensity of smoking in the 10 years preceding diagnosis had a much stronger association with the risk of lung cancer than more distant intensity. By contrast, intensity of asbestos exposure that occurred more than 40 years before diagnosis had a stronger association with the risk of lung cancer than more recent intensity, even if intensity in the 10 years preceding diagnosis also had a significant effect. Our results illustrate the dynamic of the effect of intensity of both smoking and occupational exposure to asbestos on the risk of lung cancer. They confirm that the timing of exposure plays an important role, and suggest that standard analytical methods assuming equal weights of intensity over the whole exposure history may be questionable. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

75 FR 65355 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

... Project Case Studies of Communities and States Funded under Community Activities under the Communities..., system, and environmental changes. Intensive case studies will be conducted with 24 sites: Six ARRA... Act. The case study sites will be selected to include a mix of State or community characteristics...

A study of model parameters associated with the urban climate using HCMM data. [analysis of St. Louis, Missouri infrared imagery

NASA Technical Reports Server (NTRS)

1981-01-01

Progress in the study of the intensity of the urban heat island is reported. The intensity of the heat island is commonly defined as the temperature difference between the center of the city and the surrounding suburban and rural regions. The intensity is considered as a function of changes in the season and changes in meteorological conditions in order to derive various parameters which may be used in numerical models for urban climate. Twelve case studies were selected and CCT's were ordered. In situ data was obtained from sixteen stations scattered about the city of St. Louis. Upper-air meteorological data were obtained and the water vapor and the temperature data were processed. Atmospheric transmissivities were computed for each of the case studies.

Use of Case Studies for Stimulating Thinking and Learning.

ERIC Educational Resources Information Center

Zeakes, Samuel J.

Noting that a case-study approach can stimulate student thinking and learning, this paper describes how students in a writing-intensive course on parasitology wrote brief medical case studies of parasites already studied for other students to read, evaluate, and identify the parasite. The paper presents a brief description of the course, an…

Automatic recognition of seismic intensity based on RS and GIS: a case study in Wenchuan Ms8.0 earthquake of China.

PubMed

Zhang, Qiuwen; Zhang, Yan; Yang, Xiaohong; Su, Bin

2014-01-01

In recent years, earthquakes have frequently occurred all over the world, which caused huge casualties and economic losses. It is very necessary and urgent to obtain the seismic intensity map timely so as to master the distribution of the disaster and provide supports for quick earthquake relief. Compared with traditional methods of drawing seismic intensity map, which require many investigations in the field of earthquake area or are too dependent on the empirical formulas, spatial information technologies such as Remote Sensing (RS) and Geographical Information System (GIS) can provide fast and economical way to automatically recognize the seismic intensity. With the integrated application of RS and GIS, this paper proposes a RS/GIS-based approach for automatic recognition of seismic intensity, in which RS is used to retrieve and extract the information on damages caused by earthquake, and GIS is applied to manage and display the data of seismic intensity. The case study in Wenchuan Ms8.0 earthquake in China shows that the information on seismic intensity can be automatically extracted from remotely sensed images as quickly as possible after earthquake occurrence, and the Digital Intensity Model (DIM) can be used to visually query and display the distribution of seismic intensity.

An Analysis of the Environments of Intense Convective Systems in West Africa in 2003

NASA Technical Reports Server (NTRS)

Nicholls, Stephen D.; Mohr, Karen I.

2010-01-01

We investigated the local- and regional-scale thermodynamical and dynamical environments associated with intense convective systems in West Africa during 2003. We identified convective system cases from TRMM microwave imagery, classifying each case by the system minimum 85-GHz brightness temperature and by the estimated elapsed time of propagation from high terrain. The speed of the mid-level jet, the magnitude of the low-level shear, and the surface equivalent potential temperature (theta(sub e)) were greater for the intense cases compared to the non-intense cases, although the differences between the means tended to be small, less than 3K for surface theta(sub e). Hypothesis testing of a series of commonly used intensity prediction metrics resulted in significant results only for low-level metrics such as convective available potential energy and not for any of the mid- or upper-level metrics such as 700-hPa theta(sub e). None of the environmental variables or intensity metrics by themselves or in combination appeared to be reliable direct predictors of intensity. In the regional scale analysis, the majority of intense convective systems occurred in the surface baroclinic zone where surface theta(sub e) exceeded 344 K and the 700-hPa zonal wind speeds were less than -6/ms. Fewer intense cases compared to non-intense cases were associated with African easterly wave troughs. Fewer than 25% of our cases occurred in environments with detectable Saharan dust loads, and the results for intense and non-intense cases were similar. Our results for the regional analysis were consistent with the seasonal movement of the WAM and the intertropical front, regional differences in topography, and AEW energetics.

A False-Negative Case of Primary Central Nervous System Lymphoma on 11C-Methionine PET and Intense 18F-FDG Uptake.

PubMed

García-Garzon, J R; Villasboas-Rosciolesi, Diego; Baquero, Miguel; Bassa, Pere; Soler, Marina; Riera, Eduard

2016-08-01

We report a case of a 44-year-old man with neurological symptoms and MRI findings, which were unable to differentiate between glioma and lymphoma. Metabolic characterization by means of PET imaging with F-FDG and C-methionine is proposed to determine the benign or tumor (high- and low-grade) origin of brain lesions. In this case, the MRI lesion corresponded with an inconclusive metabolic pattern of intense F-FDG uptake and no significant C-methionine uptake. Pathological study revealed a false-negative case of C-methionine due to lymphoma.

Explaining variation in hospice visit intensity for routine home care.

PubMed

Stearns, Sally C; Sheingold, Steven; Zuckerman, Rachael B

2014-01-01

Medicare pays a flat per diem rate by level of hospice service without case-mix adjustment, although previous research shows that visit intensity varies considerably over the course of hospice episodes. Concerns pertain to the inherent financial incentives for routine home care, the most frequently used level, and whether payment efficiency can be improved using case-mix adjustment. The aim of this study was to assess variation in hospice visit intensity during hospice episodes by patient, hospice, and episode characteristics to inform policy discussions regarding hospice payment methods. This observational study used Medicare claims for hospice episodes in 2010. Multiple observations were constructed per episode phase (eg, days 1-14, 15-30, etc.). Episode phase and observed characteristics were regressed on average routine home care visit intensity per day; patient and hospice fixed effects controlled for unobserved characteristics. Visit intensity was constructed using national wages to weight visits by provider type. Observed patient characteristics included age, sex, race, diagnoses, venue of care, use of other hospice levels of care, and discharge status; hospice characteristics included ownership, affiliation, size, and urban/state location. Visit intensity varied substantially by episode phase. This pattern was largely invariant to observed patient and hospice characteristics, which explained <4% of variation in visit intensity per day after adjusting for episode phase. Unobserved patient characteristics explained approximately 85% of remaining variation. These results show that case-mix adjustment based on commonly observed factors would only minimally improve hospice payment methodology.

The Interacting Axes of Environmental, Health, and Social Justice Cumulative Impacts: A Case Study of the Blueberry River First Nations

PubMed Central

Gislason, Maya K; Andersen, Holly K

2016-01-01

We consider the case of intensive resource extractive projects in the Blueberry River First Nations in Northern British Columbia, Canada, as a case study. Drawing on the parallels between concepts of cumulative environmental and cumulative health impacts, we highlight three axes along which to gauge the effects of intensive extraction projects. These are environmental, health, and social justice axes. Using an intersectional analysis highlights the way in which using individual indicators to measure impact, rather than considering cumulative effects, hides the full extent by which the affected First Nations communities are impacted by intensive extraction projects. We use the case study to contemplate several mechanisms at the intersection of these axes whereby the negative effects of each not only add but also amplify through their interactions. For example, direct impact along the environmental axis indirectly amplifies other health and social justice impacts separately from the direct impacts on those axes. We conclude there is significant work still to be done to use cumulative indicators to study the impacts of extractive industry projects—like liquefied natural gas—on peoples, environments, and health. PMID:27763548

Whooping Cough Alleviated by Homeopathic Medicines: A Case Report.

PubMed

Chung, Youngran

2017-10-02

Context • Pertussis cough (whooping cough) is distressing due to the intensity and chronicity of its cough. No specific drugs are available that can alleviate the cough's intensity or significantly shorten its duration. Homeopathic medicines are used for a wide variety of medical conditions, including cough. Objective • The study investigated the benefits of homeopathic medicines for whooping cough, to alleviate the cough's intensity and to shorten its duration. Design • The current study was a case series of patients with whooping cough. Setting • The study took place at one of the suburban hospital clinics of the Ann & Robert H. Lurie Children's Hospital of Chicago (Chicago, IL, USA). Participants • Participants were 20 patients aged 21 mo to 20 y, of whom 11 were female and 18 were male, who visited the hospital clinic for treatment of the chronic cough that is characteristic of whooping cough. The details of the cases of 3 representative participants are highlighted in the text. Intervention • The 3 representative patients all received 1 dose weekly of a 30c dilution of homeopathic pertussinum and a 6c dilution of homeopathic Drosera 3 times daily. The homeopathic medicines most often used for the other participants were the same doses of pertussinum and Drosera. Outcome Measures • Verbal feedback from patient or family were obtained at the follow-up visits. Results • The intensity and duration of participant's coughs were alleviated within days to 1 wk in most cases. Conclusions • Homeopathic medicines can alleviate the intensity or reduce the duration of whooping cough, with no adverse effects.

Immunohistochemical study of p21 and Bcl-2 in leukoplakia, oral submucous fibrosis and oral squamous cell carcinoma.

PubMed

Sutariya, Rakesh V; Manjunatha, Bhari Sharanesha

2016-11-01

Oral Squamous cell carcinoma (OSCC) results from genetic damage, leading to uncontrolled cell proliferation of damaged cells and the cell death. In the course of its progression, visible changes are taking place at the cellular level (atypical) and the resultant at the tissue level (epithelial dysplasia). The Aim of the present study was to evaluate and compare the expressions of intensity of p21 and Bcl-2 in Leukoplakia, oralsubmucous fibrosis (OSMF) and oral squamous cell carcinoma. Total 60 cases, 30 cases of oral squamous cell carcinoma, 15 cases of oral submucous fibrosis and 15 cases of Leukoplakia were evaluated immunohistochemically for p21 and Bcl-2 expression. p21 showed positive expression in 13 (86.67%) cases out of 15 cases of OSMF, 12 (80%) cases of leukoplakia out of 15 cases and 24 (80%) cases out of 30 cases of OSCC. The Bcl-2 expression was positive in 13 (86.67%) cases of OSMF, all cases of Leukoplakia and 25 (83.33%) cases of OSCC. No statistical significance was noted in the expression of p21 and Bcl-2 positive expression between OSMF, Leukoplakia and OSCC. Statistical analysis for comparison of intensity of p21 expression in different grades of OSCC showed no significance. Statistical significance difference was found between the expressions of Bcl-2 in moderately and poorly differentiated SCC. The intensity of p21 and Bcl-2 expressions in different grades of OSCC indicates a key role in progression of oral neoplasia.

Tropical cyclone intensity change. A quantitative forecasting scheme

NASA Technical Reports Server (NTRS)

Dropco, K. M.; Gray, W. M.

1981-01-01

One to two day future tropical cyclone intensity change from both a composite and an individual case point-of-view are discussed. Tropical cyclones occurring in the Gulf of Mexico during the period 1957-1977 form the primary data source. Weather charts of the NW Atlantic were initially examined, but few differences were found between intensifying and non-intensifying cyclones. A rawinsonde composite analysis detected composite differences in the 200 mb height fields, the 850 mb temperature fields, the 200 mb zonal wind and the vertical shears of the zonal wind. The individual cyclones which make up the composite study were then separately examined using this composite case knowledge. Similar parameter differences were found in a majority of individual cases. A cyclone intensity change forecast scheme was tested against independent storm cases. Correct predictions of intensification or non-intensification could be made approximately 75% of the time.

A Case Study of Teaching Marketing Research Using Client-Sponsored Projects: Method, Challenges, and Benefits

ERIC Educational Resources Information Center

Bove, Liliana L.; Davies, W. Martin

2009-01-01

This case study outlines the use of client-sponsored research projects in a quantitative postgraduate marketing research subject conducted in a 12-week semester in a research-intensive Australian university. The case study attempts to address the dearth of recent literature on client-sponsored research projects in the discipline of marketing.…

Upper gastrointestinal bleeding in severely burned patients: a case-control study to assess risk factors, causes, and outcome.

PubMed

Kim, Young Jin; Koh, Dong Hee; Park, Se Woo; Park, Sun Man; Choi, Min Ho; Jang, Hyun Joo; Kae, Sea Hyub; Lee, Jin; Byun, Hyun Woo

2014-01-01

To determine the risk factors, causes, and outcome of clinically important upper gastrointestinal bleeding that occurs in severely burned patients. The charts of all patients admitted to the burn intensive care unit were analyzed retrospectively over a 4-year period (from January 2006 to December 2009). Cases consisted of burned patients who developed upper gastrointestinal bleeding more than 24 hours after admission to the burn intensive care unit. Controls were a set of patients, in the burn intensive care unit, without upper gastrointestinal bleeding matched with cases for age and gender. Cases and controls were compared with respect to the risk factors of upper gastrointestinal bleeding and outcomes. During the study period, clinically important upper gastrointestinal bleeding occurred in 20 patients out of all 964 patients. The most common cause of upper gastrointestinal bleeding was duodenal ulcer (11 of 20 cases, 55%). In the multivariate analysis, mechanical ventilation (p = 0.044) and coagulopathy (p = 0.035) were found to be the independent predictors of upper gastrointestinal bleeding in severely burned patients. Upper gastrointestinal hemorrhage tends to occur more frequently after having prolonged mechanical ventilation and coagulopathy.

General practice cooperatives: long waiting times for home visits due to long distances?

PubMed Central

Giesen, Paul; van Lin, Nieke; Mokkink, Henk; van den Bosch, Wil; Grol, Richard

2007-01-01

Background The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting time for a home visit and the distance to the GP cooperative. Further, we investigated if other factors (traffic intensity, home visit intensity, time of day, and degree of urgency) influenced waiting times. Methods Cross-sectional study at four GP cooperatives. We used variance analysis to calculate waiting times for various categories of traffic intensity, home visit intensity, time of day, and degree of urgency. We used multiple logistic regression analysis to calculate to what degree these factors affected the ability to meet targets in urgent cases. Results The average waiting time for 5827 consultations was 30.5 min. Traffic intensity, home visit intensity, time of day and urgency of the complaint all seemed to affect waiting times significantly. A total of 88.7% of all patients were seen within 1 hour. In the case of life-threatening complaints (U1), 68.8% of the patients were seen within 15 min, and 95.6% of those with acute complaints (U2) were seen within 1 hour. For patients with life-threatening complaints (U1) the percentage of visits that met the time target of 15 minuts decreased from 86.5% (less than 2.5 km) to 16.7% (equals or more than 20 km). Discussion and conclusion Although home visits waiting times increase with increasing distance from the GP cooperative, it appears that traffic intensity, home visit intensity, and urgency also influence waiting times. For patients with life-threatening complaints waiting times increase sharply with the distance. PMID:17295925

General practice cooperatives: long waiting times for home visits due to long distances?

PubMed

Giesen, Paul; van Lin, Nieke; Mokkink, Henk; van den Bosch, Wil; Grol, Richard

2007-02-12

The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting time for a home visit and the distance to the GP cooperative. Further, we investigated if other factors (traffic intensity, home visit intensity, time of day, and degree of urgency) influenced waiting times. Cross-sectional study at four GP cooperatives. We used variance analysis to calculate waiting times for various categories of traffic intensity, home visit intensity, time of day, and degree of urgency. We used multiple logistic regression analysis to calculate to what degree these factors affected the ability to meet targets in urgent cases. The average waiting time for 5827 consultations was 30.5 min. Traffic intensity, home visit intensity, time of day and urgency of the complaint all seemed to affect waiting times significantly. A total of 88.7% of all patients were seen within 1 hour. In the case of life-threatening complaints (U1), 68.8% of the patients were seen within 15 min, and 95.6% of those with acute complaints (U2) were seen within 1 hour. For patients with life-threatening complaints (U1) the percentage of visits that met the time target of 15 minutes decreased from 86.5% (less than 2.5 km) to 16.7% (equals or more than 20 km). Although home visits waiting times increase with increasing distance from the GP cooperative, it appears that traffic intensity, home visit intensity, and urgency also influence waiting times. For patients with life-threatening complaints waiting times increase sharply with the distance.

A Comparison of the Regional Circulation in the Feet between Dialysis and Non-Dialysis Patients using Indocyanine Green Angiography.

PubMed

Nishizawa, M; Igari, K; Kudo, T; Toyofuku, T; Inoue, Y; Uetake, H

2017-09-01

Peripheral artery disease in dialysis cases is more prone to critical limb ischemia compared to non-dialysis cases, with a significantly high rate of major amputation of the lower limbs. Lesions are distributed on the more distal side in dialysis critical limb ischemia cases. The aim of this study was to investigate the usefulness of indocyanine green angiography to determine differences in the regional circulation in the foot between dialysis and non-dialysis patients. The subjects included 62 cases, among which 20 were dialysis patients and 42 were non-dialysis patients. We compared the indocyanine green angiography parameters for regions of interest in the dialysis and non-dialysis groups, which included the magnitude of intensity from indocyanine green onset to maximum intensity (Imax), the time from indocyanine green onset to maximum intensity (Tmax), the time elapsed from the fluorescence onset to half the maximum intensity (T1/2), and the time from maximum intensity to declining to 90% of the maximum intensity (Td90%). These indocyanine green angiography parameters were measured at region of interest 1 (the Chopart joint), region of interest 2 (the Lisfranc joint), and region of interest 3 (the distal region of the first metatarsal bone). In the comparison between the dialysis and non-dialysis groups, a significant difference was observed regarding Tmax, T1/2, and Td90%, especially in region of interest 3. In this study, we show that regional tissue perfusion is more deteriorated in dialysis patients compared with non-dialysis patients using indocyanine green angiography. Tmax, T1/2, and Td90% could be useful clinical parameters to compare ischemic severity of the lower limb between dialysis and non-dialysis patients.

How to Study the Influence of Intensity of Treatment on Generalized Skill and Knowledge Acquisition in Students with Disabilities

PubMed Central

Yoder, Paul J.; Woynaroski, Tiffany

2014-01-01

Seven empirical studies from this special issue and an overview chapter are reviewed to illustrate several points about studying the possible effects of treatment intensity manipulations on generalized skill or knowledge acquisition in students with disabilities. First, we make a case in favor of studying intensity as separate from complexity and expense of treatment. Second, we encourage researchers to define dependent variables in a way that allows us to determine whether treatment intensity effects on child skills and knowledge are highly generalized versus potentially context bound. Third, we acknowledge that effects of treatment intensity on generalized knowledge and skills likely vary according to student characteristics. Finally, we discuss important research design and measurement issues that are relevant to isolating the likely conditional effects of treatment intensity on generalized outcomes. PMID:25914513

Association between Pseudomonas aeruginosa positive water samples and healthcare-associated cases: nine-year study at one university hospital.

PubMed

Lefebvre, A; Bertrand, X; Quantin, C; Vanhems, P; Lucet, J-C; Nuemi, G; Astruc, K; Chavanet, P; Aho-Glélé, L S

2017-07-01

To study the association between the results of water samples and Pseudomonas aeruginosa healthcare-associated cases in a French university hospital. Generalized Estimating Equations were used on complete case and imputed datasets. The spatial unit was the building and the time unit was the quarter. For the period 2004-2013, 2932 water samples were studied; 17% were positive for P. aeruginosa. A higher incidence of P. aeruginosa cases was associated with a higher proportion of positive water samples (P=0.056 in complete case analysis and P=0.031 with the imputed dataset). The association was no longer observed when haematology and intensive care units were excluded, but was significant in analyses of data concerning intensive care units alone (P<0.001). This study suggests that water outlet contamination in hospitals can lead to an increase in healthcare-associated P. aeruginosa cases in wards dealing with susceptible patients, but does not play a significant role in other wards. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Gallium-67 scintigraphy, bronchoalveolar lavage, and pathologic changes in patients with pulmonary sarcoidosis

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

Abe, S.; Munakata, M.; Nishimura, M.

1984-05-01

The intensity of gallium-67 scintiscans, lymphocyte counts in bronchoalveolar lavage fluid, and pathologic changes were studied in 26 patients with untreated pulmonary sarcoidosis. Noncaseating granulomas were recognized with significantly greater frequency in stage 2 (80 percent; 8/10 cases) than in stage 1 (43 percent; 6/14 cases). Alveolitis showed little relation to the roentgenographic stage. There was a strong correlation between the intensity of gallium uptake in pulmonary parenchyma and the detection rate of granuloma; however, the detection rate of alveolitis was not statistically different from the intensity of gallium uptake. A highly significant correlation was revealed between the lymphocyte countsmore » in bronchoalveolar lavage fluid and the intensity of alveolitis. These observations suggest that the gallium uptake reflects mainly the presence of granuloma, and the lymphocyte count in bronchoalveolar lavage fluid reflects the intensity of alveolitis in patients with pulmonary sarcoidosis.« less

Integration of intensive care treatment and neurorehabilitation in patients with disorders of consciousness: a program description and case report.

PubMed

Eifert, Bernd; Maurer-Karattup, Petra; Schorl, Martin

2013-10-01

Severe brain injuries frequently result in disorders of consciousness, requiring intensive care unit treatment. We present a rehabilitative system that integrates neurorehabilitation into intensive care treatment. The system will be described using the case report of a young man who was in a vegetative state after a severe traumatic brain injury that resulted in major medical problems and complications. Despite these challenges, interdisciplinary therapies can be applied throughout the rehabilitative process. The patient in our case report showed significant improvements and functional gains during the course of treatment. Additional data from other patients support the feasibility of this system and show that integrating neurorehabilitation into intensive care treatment is possible and can lead to improved outcomes in this patient population. We will discuss the advantages, special features, and limitations of the system. Additional studies are needed to further demonstrate the efficacy of this approach compared with standard treatment. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Measurements of the turbulent transport of heat and momentum in convexly curved boundary layers - Effects of curvature, recovery and free-stream turbulence

NASA Technical Reports Server (NTRS)

Kim, J.; Simon, T. W.

1987-01-01

The effects of streamwise convex curvature, recovery, and freestream turbulence intensity on the turbulent transport of heat and momentum in a mature boundary layer are studied using a specially designed three-wire hot-wire probe. Increased freestream turbulence is found to increase the profiles throughout the boundary layer on the flat developing wall. Curvature effects were found to dominate turbulence intensity effects for the present cases considered. For the higher TI (turbulence intensity) case, negative values of the turbulent Prandtl number are found in the outer half of the boundary layer, indicating a breakdown in Reynolds analogy.

Treatment of children with severe cases of yersiniosis

NASA Astrophysics Data System (ADS)

Gordeets, A. V.; Beniova, S. N.; Shapovalov, E. G.; Malashenkova, V. G.; Sedulina, O. F.

2001-04-01

A study is made of a low-intensity laser radiation technique to treat severe cases of yersiniosis. This technique was tested in 43 children affected by severe cases of pseudotuberculosis and in 32 children suffering from intestinal yersiniosis. Comparing laser therapy and a conventional treatment revealed that these approaches produced significantly different therapeutic and immunological effects. It was found that low-intensity laser radiation combined with drug therapy resulted in a reduction of intoxication duration, diarrhea, hospitalization time, and drug doses. Moreover, the combined application of laser radiation and rug preparations enabled an efficient recovery of the immune state.

BestPractices Corporate Energy Management Case Study: Alcoa Teams with DOE to Reduce Energy Consumption

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

Not Available

2004-05-01

This is the first in a series of DOE Industrial Technologies Program case studies on corporate energy management. The case study highlights Alcoa Aluminum's successful results and activities through its corporate energy management approach and collaboration with DOE. Case studies in this series will be used to encourage other energy-intensive industrial plants to adopt a corporate strategy, and to promote the concept of replicating results with a company or industry.

Causes of forbush decreases and other cosmic ray variations

NASA Technical Reports Server (NTRS)

Barouch, E.; Burlaga, L. F.

1974-01-01

The relationship between neutron monitor variations and the intensity variations of the interplanetary magnetic field is studied, using Deep River data and IMP-series satellite data. In over 80% of the cases studied, identifiable depressions of the cosmic ray intensity are associated with magnetic field enhancements of several hours duration and intensity above 10 gamma. Conversely, each magnetic field enhancement has an identifiable effect (though not necessarily a marked depression) on the cosmic ray intensity. Long lasting Forbush decreases are found to be the consequence of the successive action of several such features. An explanation is presented and discussed.

Retrospective Case Study in Northeastern Pennsylvania, Study of the Potential Impacts of Hydraulic Fracturing On Drinking Water Resources

EPA Science Inventory

This report describes the retrospective case study for northeastern Pennsylvania, which was conducted in Bradford and Susquehanna Counties where some of the most intensive unconventional gas production from the Devonian-age Marcellus Shale has occurred. Gas production from the M...

Stressful life events and acute kidney injury in intensive and semi-intensive care unities.

PubMed

Diniz, Denise Para; Marques, Daniella Aparecida; Blay, Sérgio Luis; Schor, Nestor

2012-03-01

Several studies point out that pathophysiological changes related to stress may influence renal function and are associated with disease onset and evolution. However, we have not found any studies about the influence of stress on renal function and acute kidney injury. To evaluate the association between stressful life events and acute kidney injury diagnosis, specifying the most stressful classes of events for these patients in the past 12 months. Case-control study. The study was carried out at Hospital São Paulo, in Universidade Federal de São Paulo and at Hospital dos Servidores do Estado de São Paulo, in Brazil. Patients with acute kidney injury and no chronic disease, admitted to the intensive or semi-intensive care units were included. Controls included patients in the same intensive care units with other acute diseases, except for the acute kidney injury, and also with no chronic disease. Out of the 579 patients initially identified, 475 answered to the Social Readjustment Rating Scale (SRRS) questionnaire and 398 were paired by age and gender (199 cases and 199 controls). The rate of stressful life events was statistically similar between cases and controls. The logistic regression analysis to detect associated effects of the independent variables to the stressful events showed that: increasing age and economic classes A and B in one of the hospitals (Hospital São Paulo - UNIFESP) increased the chance of a stressful life event (SLE). This study did not show association between the Acute Kidney Injury Group with a higher frequency of stressful life events, but that old age, higher income, and type of clinical center were associated.

Children, Learning and Chronic Natural Disasters: How Does the Government of Dominica Address Education during Low-Intensity Hurricanes?

ERIC Educational Resources Information Center

Serrant, Ted Donaldson

2013-01-01

By the time today's Grade K students graduate high school in the Commonwealth of Dominica, they will have experienced five major and many low-intensity hurricanes (LIH). Between August and November each year, each hurricane, major or low-intensity, represents a major threat to their safety and schooling. This mixed-method case study investigated…

Relationships between Rural Inhabitants and Their Landscapes in Areas of Intensive Agricultural Use: A Case Study in Quebec (Canada)

ERIC Educational Resources Information Center

Ruiz, Julie; Domon, Gerald

2012-01-01

An understanding of the relationships between local populations and the landscape is crucial for reintroducing the multifunctional character of landscapes in areas of intensive agricultural use. This study proposes to identify and compare the relationships that local populations, both farmers and non-farmers, maintain with their landscapes in…

Two-Day, Intensive Cognitive-Behavioral Therapy for Panic Disorder: A Case Study

ERIC Educational Resources Information Center

Deacon, Brett

2007-01-01

Cognitive-behavioral therapy (CBT) is a highly effective treatment for panic disorder. However, few patients have access to this treatment, particularly those living in rural areas. In a pilot study, the author previously described the efficacy of a 2-day, intensive, exposure-based CBT intervention that was developed for the purpose of delivering…

Measurement of Insertion Loss of an Acoustic Treatment in the Presence of Additional Uncorrelated Sound Sources

NASA Technical Reports Server (NTRS)

Klos, Jacob; Palumbo, Daniel L.

2003-01-01

A method to intended for measurement of the insertion loss of an acoustic treatment applied to an aircraft fuselage in-situ is documented in this paper. Using this method, the performance of a treatment applied to a limited portion of an aircraft fuselage can be assessed even though the untreated fuselage also radiates into the cabin, corrupting the intensity measurement. This corrupting noise in the intensity measurement incoherent with the panel vibration of interest is removed by correlating the intensity to reference transducers such as accelerometers. Insertion loss of the acoustic treatments is estimated from the ratio of correlated intensity measurements with and without a treatment applied. In the case of turbulent boundary layer excitation of the fuselage, this technique can be used to assess the performance of noise control methods without requiring treatment of the entire fuselage. Several experimental studies and numerical simulations have been conducted, and results from three case studies are documented in this paper. Conclusions are drawn about the use of this method to study aircraft sidewall treatments.

Embodied Energy and GHG Emissions from Material Use in Conventional and Unconventional Oil and Gas Operations.

PubMed

Brandt, Adam R

2015-11-03

Environmental impacts embodied in oilfield capital equipment have not been thoroughly studied. In this paper, we present the first open-source model which computes the embodied energy and greenhouse gas (GHG) emissions associated with materials consumed in constructing oil and gas wells and associated infrastructure. The model includes well casing, wellbore cement, drilling mud, processing equipment, gas compression, and transport infrastructure. Default case results show that consumption of materials in constructing oilfield equipment consumes ∼0.014 MJ of primary energy per MJ of oil produced, and results in ∼1.3 gCO2-eq GHG emissions per MJ (lower heating value) of crude oil produced, an increase of 15% relative to upstream emissions assessed in earlier OPGEE model versions, and an increase of 1-1.5% of full life cycle emissions. A case study of a hydraulically fractured well in the Bakken formation of North Dakota suggests lower energy intensity (0.011 MJ/MJ) and emissions intensity (1.03 gCO2-eq/MJ) due to the high productivity of hydraulically fractured wells. Results are sensitive to per-well productivity, the complexity of wellbore casing design, and the energy and emissions intensity per kg of material consumed.

The Effects of Light Intensity, Casing Layers, and Layering Styles on Royal Sun Medicinal Mushroom, Agaricus brasiliensis (Higher Basidiomycetes) Cultivation in Turkey.

PubMed

Adanacioglu, Neşe; Boztok, Kaya; Akdeniz, Ramazan Cengiz

2015-01-01

The aim of this research is to evaluate the effects of light intensity, casing layers, and layering styles on the production of the culinary-medicinal mushroom Agaricus brasiliensis in Turkey. The experiments were designed in split-split plots and replicated twice. Three different light intensities-I1, 350 lux; I2, 450 lux; and I3, 750 lux-were used in main plots as environmental factors. A mixture of 4 different casing layers- peat (100%), peat-perlite (75%:25%), peat-clinoptilolite (75%:25%), and peat-perlite-clinoptilolite (60%:20%:20%)-were used at split plots and at split plots. S1, a flat, 3-cm casing layer; S2, a flat, 5-cm casing layer; and S3, casing soil ridges 10 cm wide × 4 cm high, 10 cm apart, were deposited on top of 1-cm overall soil casing layers. At the end of the harvest phase, the total yield was estimated per 100 kg of substrate. Biological efficiency (percentage) was determined from the fresh weight of the mushrooms and the dry weight of the compost at the end of the harvesting period. The highest total yield (7.2 kg/100 kg compost) and biological efficiency (27.63%) were achieved from I2 × peat-perlite-clinoptilolite × S2 treatment. Influence of light intensity, casing layer, layering style, and their interaction in treatments with color values (L*, a*, b*, chroma*, and hue*) also were examined. It has been shown that within color values, chroma* (saturation) values of mushroom caps were affected by light intensity, casing layer, and layering style treatments and light intensity × casing layer treatments and the brightness of mushroom caps tended to increase as light intensity increased.

Quality of life in patients with advanced lung cancer treated at home and at a palliative care unit.

PubMed

Leppert, Wojciech; Turska, Anna; Majkowicz, Mikolaj; Dziegielewska, Sylwia; Pankiewicz, Piotr; Mess, Eleonora

2012-08-01

To assess quality of life (QOL) in patients with advanced lung cancer. A prospective study of 78 patients cared at home and at a palliative care unit (PCU) with 2 QOL assessments was conducted. Fifty patients completed the study. In the EORTC QLQ-C30 role, cognitive, social functioning, global QOL, fatigue, pain, dyspnea, and appetite deteriorated; nausea/vomiting improved; dyspnea was more intense in the case of in-home patients. In the EORTC QLQ-LC13 hemoptysis improved; pain in other parts was more intense in the PCU patients. Pain (Visual Analogue scale) was more intense in the PCU patients; the level of activity (Karnofsky) decreased in the case of patients treated at home. QOL deteriorated with few differences between home and the PCU patients.

Changes in symptom intensity and emotion valence during the process of assimilation of a problematic experience: A quantitative study of a good outcome case of cognitive-behavioral therapy.

PubMed

Basto, Isabel; Pinheiro, Patrícia; Stiles, William B; Rijo, Daniel; Salgado, João

2017-07-01

The assimilation model describes the change process in psychotherapy. In this study we analyzed the relation of assimilation with changes in symptom intensity, measured session by session, and changes in emotional valence, measured for each emotional episode, in the case of a 33-year-old woman treated for depression with cognitive-behavioral therapy. Results showed the theoretically expected negative relation between assimilation of the client's main concerns and symptom intensity, and the relation between assimilation levels and emotional valence corresponded closely to the assimilation model's theoretical feelings curve. The results show how emotions work as markers of the client's current assimilation level, which could help the therapist adjust the intervention, moment by moment, to the client's needs.

JOB REDESIGN FOR OLDER WORKERS, TEN CASE STUDIES.

ERIC Educational Resources Information Center

MITNICK, EDWARD; ROTHBERG, HERMAN

AFTER IDENTIFYING FIRMS WHICH HAD USED JOB REDESIGN TO SALVAGE THE SKILL OF OLDER EMPLOYEES, RESEARCH INVESTIGATORS MADE 10 INTENSIVE CASE STUDIES IN FIRMS PRODUCING AIRCRAFT ENGINES, ALUMINUM FRAMING, BUILDING MATERIALS, CARPETS, COMPUTERS, COPPER PIPE FITTINGS, FOOTWEAR, HEAVY IRON PIPE, PRECISION INSTRUMENTS, AND PRINTED NOVELTIES. EACH STUDY…

Knowledge Transfer Partnerships and the Entrepreneurial University

ERIC Educational Resources Information Center

Wynn, Martin; Jones, Peter

2017-01-01

This article outlines one way in which less research-intensive universities can contribute to entrepreneurship by examining the achievements of several Knowledge Transfer Partnerships (KTPs) in the University of Gloucestershire. The article adopts a qualitative case study approach: four case studies of KTPs at, respectively, Beacons Business…

Bright new world

NASA Astrophysics Data System (ADS)

Kroó, Norbert; Rácz, Péter; Varró, Sándor

2016-02-01

Surface plasmons (SPOs) have been excited by intense femtosecond laser pulses on a gold film at room temperature and their near field has been analyzed by the intensity dependent response of an STM and by studying the spectra of multiplasmon emitted electrons. Around 80 GW/cm2 laser intensity, anomalies have been found in both cases, interpreted as the stepping in of electron pairing, transition to a diamagnetic state, and by anomalous Faraday rotation.

Dose-response association of physical activity with acute myocardial infarction: do amount and intensity matter?

PubMed

Elosua, Roberto; Redondo, Ana; Segura, Antonio; Fiol, Miquel; Aldasoro, Elena; Vega, Gema; Forteza, Jordi; Martí, Helena; Arteagoitia, José María; Marrugat, Jaume

2013-11-01

The aims of this study were to analyze the dose-response association between leisure time physical activity (PA) practice and myocardial infarction (MI), considering not only the total amount but also the amount of PA at different levels of intensity, and to determine whether these associations were modified by age. In a population-based age- and sex-matched case-control study, all first acute MI patients aged 25 to 74 years were prospectively registered in four Spanish hospitals between 2002 and 2004. Controls were randomly selected from population-based samples recruited during the same period of time. The Minnesota PA questionnaire was administered to assess total energy expenditure in PA and in light-, moderate-, and high-intensity PA. Finally, 1339 cases and 1339 controls were included. The association between PA and MI likelihood was non-linear, with significantly lower MI odds at low practice levels (≥ 500 MET·min/week), lowest odds around 1500 MET·min/week, and a plateau thereafter. Light- (in subjects older than 64 years), moderate-, and high-intensity PA produced similar benefits. Most of the population could reduce their likelihood of MI by engaging in PA at a moderate level of intensity or, in individuals older than 64 years, at a light level of intensity. © 2013.

Triggering Transformative Possibilities: A Case Study of Leaders' Quest in China

ERIC Educational Resources Information Center

Lau-Kwong, Kenzie

2012-01-01

This study explored the nature of transformative learning experiences among global executives who participated in Quest program, a learning journey program designed to facilitate shifting mind-sets and worldviews through 1-week intensives in countries such as China. A mixed methods, multiple case study approach was employed. First, a secondary…

Impact of aggregating exposure information from cases and controls when building a population-based job-exposure matrix from past expert evaluations.

PubMed

Kirkham, Tracy L; Siemiatycki, Jack; Labrèche, France; Lavoué, Jérôme

2016-07-01

To assess whether the inclusion of data from cases would bias a job-exposure matrix (JEM), we evaluated whether exposures were systematically different between cases and controls from a large historical case-control study. Data included 10 381 jobs assessed for occupational exposure to 294 agents within a lung cancer case-control study. For each sex, 1 JEM was developed from case jobs, and 1 from control jobs: with occupation (four-digit occupational codes), time period (1945-1959, 1960-1984, 1985-1995) and agent axes. We estimated concordance in exposure status (defined as probability of exposure threshold ≥5%) and exposure metrics of probability and intensity of exposure, between the 2 JEMs. Of all hypothetical occupation-period-agent combinations, most had no or few observations. Among males there were 8136 common cells (24-occupational codes, 3-periods, 226-agents), containing sufficient observations for comparison with 92% concordance in exposure status; discordance was equally likely to be towards cases or controls. Females had 1710 common cells (9-occupational codes, 3-periods, 114-agents) with 93% concordance in exposure status; discordant cells were more likely to reflect greater exposure among cases. Among concordantly exposed cells, probability and intensity of exposures were highly correlated between the case JEM and control JEM (Kendall τ>0.50), and absolute differences were small (median difference in probability <1.5%, median ratio in intensity=1.00) for both sexes. Agreement between the case JEM and control JEM was high, suggesting that aggregating the case and control information in our study into a single JEM is justifiable given the benefits of increased sample size. 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/

Contracting for intensive care services.

PubMed

Dorman, S

1996-01-01

Purchasers will increasingly expect clinical services in the NHS internal market to provide objective measures of their benefits and cost effectiveness in order to maintain or develop current funding levels. There is limited scientific evidence to demonstrate the clinical effectiveness of intensive care services in terms of mortality/morbidity. Intensive care is a high-cost service and studies of cost-effectiveness need to take account of case-mix variations, differences in admission and discharge policies, and other differences between units. Decisions over development or rationalisation of intensive care services should be based on proper outcome studies of well defined patient groups. The purchasing function itself requires development in order to support effective contracting.

Pedagogical Implications of Score Distribution Pattern and Learner Satisfaction in an Intensive TOEIC Course

ERIC Educational Resources Information Center

Kang, Che Chang

2014-01-01

The study aimed at investigating TOEIC score distribution patterns and learner satisfaction in an intensive TOEIC course and drew implications for pedagogical practice. A one-group pre-test post-test experiment and a survey on learner satisfaction were conducted on Taiwanese college EFL students (n = 50) in a case study. Results showed that the…

Expulsion of Fibroids to the Endometrial Cavity after Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound Surgery (MRgFUS) Treatment of Intramural Uterine Fibroids

PubMed Central

Jeong, Jae-Hyeok; Hong, Gil Pyo; Kim, Yu-Ri; Hong, Da Gyo; Ha, Jae-Eun; Yeom, Jung In; Kim, Eun-Jeong; Kim, Hyung-Il

2016-01-01

Objectives This report seeks to introduce some cases of the patients who received magnetic resonance imaging (MRI)-guided high intensity focused ultrasound (HIFU) surgery (MRgFUS)-based intramural uterine fibroids treatment where the post-MRgFUS intramural uterine fibroids decreased in its volume and protruded towards the endometrial cavity to be expelled by hysteroscopy. Methods Of the 157 patients who had received MRgFUS treatment in the Obstetrics and Gynecology of the Hospital from March, 2015 to February, 2016; this study examined 6 of the cases where, after high intensity focused ultrasound treatment, intramural uterine fibroids protruded towards the endometrial cavity to be removed by hysteroscopic myomectomy. The high intensity focused ultrasound utilized in the cases were Philips Achieva 1.5 Tesla MR (Philips Healthcare, Best, The Netherlands) and Sonalleve HIFU system. Results The volume of fibroids ranged from 26.0 cm3 to 199.5 cm3, averaging 95.6 cm3. The major axis length ranged from 4.0 cm to 8.2 cm, averaging 6.3 cm. Fibroid location in all of the patients was in intramural uterine before treatment but after the high intensity focused ultrasound treatment, the fibroids were observed to protrude towards the endometrial cavity in at least Day 5 or up to Day 73 to allow hysteroscopic myomectomy. Conclusions In some cases, after an intramural uterine fibroid is treated with MRgFUS, fibroid volume is decreased and the fibroid protrudes towards the endometrial cavity. In this case, hysteroscopic myomectomy can be a useful solution. PMID:28119893

Alcoa Teams with DOE to Reduce Energy Consumption

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

None

2004-05-01

This is the first in a series of DOE Industrial Technologies Program case studies on corporate energy management. The case study highlights Alcoa Aluminum's successful results and activities through its corporate energy management approach and collaboration with DOE. Case studies in this series will be used to encourage other energy-intensive industrial plants to adopt a corporate strategy, and to promote the concept of replicating results with a company or industry.

The mapping competences of the nurse Case/Care Manager in the context of Intensive Care.

PubMed

Alfieri, Emanuela; Ferrini, Anna Chiara; Gianfrancesco, Francesca; Lise, Gianluca; Messana, Giovanni; Tirelli, Lorenzo; Lorenzo, Ana; Sarli, Leopoldo

2017-03-15

Since the recent introduction of the Case/Care Manager's professional figure, it is quite difficult to identify properly his/her own particular features, which could be mainly be found revising mainly in American studies. Therefore, the present study intended to identify the Case/Care Manager's skills and professional profile in an Intensive Care Unit experience, taking into consideration the staff's activities, perception and expectations towards the Case/Care Manager. In particular, it has been compared the experience of an Intensive Care Units where the Case/Care Manager's profile is operational to a different Unit where a Case/Care Manager is not yet in force. a Levati's model was used to map the Case/Care Manager's skills, involving each unit whole working staff, executives and caregivers through semi-structured interviews. It has been taken into consideration the Anaesthesia Unit and Emergency Unit of Cesena's healthcare organisation (AUSL of Romagna) and a Cardiology Intensive Care Unit of Piacenza's healthcare organisation, where the Case/Care Manager's profile has not been experimented yet. Firstly, it a data collection in each healthcare organization has been organised. Subsequently, semi-structured interviews to doctors, unit nurses, caregivers, nurses' coordinators and medical staff have been used to compare each healthcare system. The interviewees' described their expectations in relation to the Case/Care Manager working in a critical area. Then, every data collected during interviews has been organised to map a Case/Care Manager's essential professional profile to work in a critical area together with medical staff. Piacenza's O.U. critical area experience reported a major demand for patients' and patient's families' assistance. On the other hand, the very same aspects seem to have been better achieved in Cesena's O.U., where a Case/Care Manager's recent introduction has actually helped to overcome the void in organising systems. a Case/Care Manager's profile has been drafted on the basis of the comparative analysis conducted. It has been noted how the Case/Care Manager's professional profile can really improve relationships and communications between medical staff and patients, promoting a major unity among the working team. According to the present research, the Case/Care Manager's profile has been proved helpful in positively influencing the team activity and to elicit major satisfaction both in patients and their family.

The dynamical link between deep Atlantic extratropical cyclones and intense Mediterranean cyclones

NASA Astrophysics Data System (ADS)

Raveh-Rubin, Shira; Flaounas, Emmanouil

2017-04-01

Breaking of atmospheric Rossby waves has been previously shown to lead to intense Mediterranean cyclones, one of the most prominent environmental risks in the region. Wave breaking may be enhanced by warm conveyor belts (WCBs) associated with extratropical cyclones developing over the Atlantic Ocean. More precisely, WCBs supply the upper troposphere with air masses of low potential vorticity that, in turn, amplify ridges and thus favor Rossby wave breaking. This study identifies and validates the relevance of the mechanism that connects Atlantic cyclones and intense mature Mediterranean cyclones through ridge amplification by WCBs. Using ECMWF ERA-Interim reanalyses and a feature-based approach, we analyze the 200 most intense Mediterranean cyclones for the years 1989-2008 and show that their majority (181 cases) is indeed associated with this mechanism upstream. Results show that multiple Atlantic cyclones are associated with each case of intense Mediterranean cyclone downstream. Moreover, the associated Atlantic cyclones are particularly deep compared to climatology.

Low input and intensified crop production systems effects on soil health and environment

USDA-ARS?s Scientific Manuscript database

The material in this chapter covers the concepts of "low-input" and "intensified" production systems in the context of input intensity and sustainability. Research-based case studies are presented that draw out the practicalities of implementing production practices on an input intensity gradient fr...

The Therapeutic Collaboration in Life Design Counselling: The Case of Ryan

ERIC Educational Resources Information Center

do Céu Taveira, Maria; Ribeiro, Eugénia; Cardoso, Paulo; Silva, Filipa

2017-01-01

This study examined the therapeutic collaboration in a case of Life Design Counseling (LDC) with narrative change and positive career outcomes. The therapeutic collaboration-change model and correspondent coding system were used to intensively study the helping relationship throughout three sessions of LDC. The collaboration coding system enables…

Enhancing Cultural Adaptation through Friendship Training: A Single-Case Study.

ERIC Educational Resources Information Center

Liu, Yi-Ching; Baker, Stanley B.

1993-01-01

Four-year-old girl from mainland China experienced culture shock when attending American university day-care center. Counseling intern from Taiwan designed friendship training program based on assumptions concerning adaptation, acculturation, and peer relationships. Evaluated as intensive single-case study, findings indicated the program may be…

Study of diatomic molecules. 2: Intensities. [optical emission spectroscopy of ScO

NASA Technical Reports Server (NTRS)

Femenias, J. L.

1978-01-01

The theory of perturbations, giving the diatomic effective Hamiltonian, is used for calculating actual molecular wave functions and intensity factors involved in transitions between states arising from Hund's coupling cases a,b, intermediate a-b, and c tendency. The Herman and Wallis corrections are derived, without any knowledge of the analytical expressions of the wave functions, and generalized to transitions between electronic states with whatever symmetry and multiplicity. A general method for studying perturbed intensities is presented using primarily modern spectroscopic numerical approaches. The method is used in the study of the ScO optical emission spectrum.

Infusing research integrity principles and practices into a regional master's degree-intensive university: a case study.

PubMed

Thompson, Carla J; Podemski, Richard; Brown, H Quincy

2012-01-01

The need for institutions of higher education to advance research and scholarly integrity across graduate degree programs involves a strong commitment from each institution to develop a comprehensive approach for promoting responsible conduct of research (RCR). In response to this need, one master's-intensive regional university implemented a three-tier model project (focusing, developing, and evaluating/sustaining) for infusing research integrity principles and practices while promoting RCR. Components of the model and implementation strategies are presented as a case study analysis. Implications of the model for promoting the RCR are projected relative to graduate programs focused on applied research.

Reliability of diagnostic coding in intensive care patients

PubMed Central

Misset, Benoît; Nakache, Didier; Vesin, Aurélien; Darmon, Mickael; Garrouste-Orgeas, Maïté; Mourvillier, Bruno; Adrie, Christophe; Pease, Sébastian; de Beauregard, Marie-Aliette Costa; Goldgran-Toledano, Dany; Métais, Elisabeth; Timsit, Jean-François

2008-01-01

Introduction Administrative coding of medical diagnoses in intensive care unit (ICU) patients is mandatory in order to create databases for use in epidemiological and economic studies. We assessed the reliability of coding between different ICU physicians. Method One hundred medical records selected randomly from 29,393 cases collected between 1998 and 2004 in the French multicenter Outcomerea ICU database were studied. Each record was sent to two senior physicians from independent ICUs who recoded the diagnoses using the International Statistical Classification of Diseases and Related Health Problems: Tenth Revision (ICD-10) after being trained according to guidelines developed by two French national intensive care medicine societies: the French Society of Intensive Care Medicine (SRLF) and the French Society of Anesthesiology and Intensive Care Medicine (SFAR). These codes were then compared with the original codes, which had been selected by the physician treating the patient. A specific comparison was done for the diagnoses of septicemia and shock (codes derived from A41 and R57, respectively). Results The ICU physicians coded an average of 4.6 ± 3.0 (range 1 to 32) diagnoses per patient, with little agreement between the three coders. The primary diagnosis was matched by both external coders in 34% (95% confidence interval (CI) 25% to 43%) of cases, by only one in 35% (95% CI 26% to 44%) of cases, and by neither in 31% (95% CI 22% to 40%) of cases. Only 18% (95% CI 16% to 20%) of all codes were selected by all three coders. Similar results were obtained for the diagnoses of septicemia and/or shock. Conclusion In a multicenter database designed primarily for epidemiological and cohort studies in ICU patients, the coding of medical diagnoses varied between different observers. This could limit the interpretation and validity of research and epidemiological programs using diagnoses as inclusion criteria. PMID:18664267

The Role of Re-Appropriation in Open Design: A Case Study on How Openness in Higher Education for Industrial Design Engineering Can Trigger Global Discussions on the Theme of Urban Gardening

ERIC Educational Resources Information Center

Ostuzzi, Francesca; Conradie, Peter; De Couvreur, Lieven; Detand, Jan; Saldien, Jelle

2016-01-01

This case study explores the opportunities for students of Industrial Design Engineering to engage with direct and indirect stakeholders by making their design process and results into open-ended designed solutions. The reported case study involved 47 students during a two-weeks intensive course on the topic of urban gardening. Observations were…

How Does Student Peer Review Influence Perceptions, Engagement and Academic Outcomes? A Case Study

ERIC Educational Resources Information Center

Mulder, Raoul; Baik, Chi; Naylor, Ryan; Pearce, Jon

2014-01-01

Involving students in peer review has many pedagogical benefits, but few studies have explicitly investigated relationships between the content of peer reviews, student perceptions and assessment outcomes. We conducted a case study of peer review within a third-year undergraduate subject at a research-intensive Australian university, in which we…

"I'm Present, 'A' Please": A Case Study Examining Grading Issues in a Recreation Curriculum

ERIC Educational Resources Information Center

Gray, H. Joey

2008-01-01

Despite extensive research, grading and the potential for grade inflation remain areas of concern within higher education. The purpose of this qualitative case study was to obtain collective understandings regarding grading and pressures to inflate grades from faculty and instructors within a research-intensive university. The study focused on a…

Connecting Reading and Writing: A Case Study

ERIC Educational Resources Information Center

Li, Zhanfang

2015-01-01

Connecting reading and writing, proposed by many scholars, is realized in this case study. The 30 participants in this study are the English majors of the third year in one School of Foreign Languages in Beijing. They are encouraged to write journals every week, based on the source text materials in their Intensive Reading class, with the final…

Code-Switching and Gender: A Longitudinal Study of Spanish/English Speaking Fraternal Boy-Girl Twins

ERIC Educational Resources Information Center

Robinson, Colin

2015-01-01

Researchers from Jean Piaget (1932) to Sehlauoi (2008) have utilized small case studies to intensively examine naturally occurring child language production in the home environment. This qualitative, 5-year longitudinal, five-year case study continues the focus of previous research on child bilingualism and code-switching; however, it aims to…

Black Male Success in STEM: A Case Study of Morehouse College

ERIC Educational Resources Information Center

Gasman, Marybeth; Nguyen, Thai-Huy; Conrad, Clifton F.; Lundberg, Todd; Commodore, Felecia

2017-01-01

The purpose of this study is to enhance our understanding of how a Historically Black College and University (HBCU) is cultivating Black male achievement in STEM. In this in-depth qualitative case study, we explore 2 resource-intensive and successful STEM pathway programs at Morehouse College, the only all-male HBCU in this country, as an…

Factors Contributing to High PhD Completion Rates: A Case Study in a Research-Intensive University in New Zealand

ERIC Educational Resources Information Center

Spronken-Smith, Rachel; Cameron, Claire; Quigg, Robin

2018-01-01

This exploratory study determined PhD completions at a research-intensive university in New Zealand and considered factors affecting PhD completions. Completion data were calculated for PhD cohorts at the University of Otago from 2000 to 2012 (n = 2770) and survival models determined whether gender, enrolment status, age at admission, citizenship,…

[Immunohistochemistry diagnosis of fungal infections].

PubMed

Rocha, D C; Duarte, M I; Pagliari, C; de Oliveira, M S

1998-01-01

Because the mycosis incidence has increased a lot with the appearing of AIDS, the Immunohistochemistry study among fungus shows the importance of fast methods for their identification that have advantage of been a durable method in comparison with immunofluorescence and the possibility of making retrospective studies in material embedded in paraffin. The Immunohistochemistry reaction with Histoplasma capsulatum, Pneumocystis carinii; and Criptococcus neoformans antibodies were sensitive, specifics, and intensely positive in all the cases previously diagnosed as Histoplasmosis, Pneumocystosis and Cryptococcosis, without cross-reaction with other fungus; while the anti-Candida albicans antibody showed weak positiveness in four Histoplasmosis cases, in one of Paracoccidioidomycosis cases and Sporotrichosis case; and the reactions with the antibody anti-P. brasiliensis were intensely positive in all the Paracoccidioidomycosis cases and weakly positive in two Histoplasmosis and two of the four Candidiasis cases. The previous identification of each fungi on tissue sample was made by Grocott method. This preliminary study showed that it is necessary to use other kinds of antibody and fungus, in order to get more details about the possible occurrence of cross-reactions. We suggest the use of new antibodies, with new standardizations in order to find the best titles for each reaction and eliminate the cross-reactions.

School-Based Cognitive-Behavioral Therapy for an Adolescent Presenting with ADHD and Explosive Anger: A Case Study

ERIC Educational Resources Information Center

Parker, Janise; Zaboski, Brian; Joyce-Beaulieu, Diana

2016-01-01

This case demonstrates the efficacy of utilizing an intensive, multi-faceted behavioral intervention paradigm. A comprehensive, integrative, school-based service model was applied to address attention deficit hyperactivity disorder symptomology, oppositional behaviors, and explosive anger at the secondary level. The case reviews a multi-modal…

Urine output on an intensive care unit: case-control study.

PubMed

Solomon, Anthony W; Kirwan, Christopher J; Alexander, Neal D E; Nimako, Kofi; Jurukov, Angela; Forth, Rebecca J; Rahman, Tony M

2010-12-14

To compare urine output between junior doctors in an intensive care unit and the patients for whom they are responsible. Case-control study. General intensive care unit in a tertiary referral hospital. 18 junior doctors responsible for clerking patients on weekday day shifts in the unit from 23 March to 23 April 2009 volunteered as "cases." Controls were the patients in the unit clerked by those doctors. Exclusion criteria (for both groups) were pregnancy, baseline estimated glomerular filtration rate <15 ml/min/1.73 m(2), and renal replacement therapy. Oliguria (defined as mean urine output <0.5 ml/kg/hour over six or more hours of measurement) and urine output (in ml/kg/hour) as a continuous variable. Doctors were classed as oliguric and "at risk" of acute kidney injury on 19 (22%) of 87 shifts in which urine output was measured, and oliguric to the point of being "in injury" on one (1%) further shift. Data were available for 208 of 209 controls matched to cases in the data collection period; 13 of these were excluded because the control was receiving renal replacement therapy. Doctors were more likely to be oliguric than their patients (odds ratio 1.99, 95% confidence interval 1.08 to 3.68, P=0.03). For each additional 1 ml/kg/hour mean urine output, the odds ratio for being a case rather than a control was 0.27 (0.12 to 0.58, P=0.001). Mortality among doctors was astonishingly low, at 0% (0% to 18%). Managing our own fluid balance is more difficult than managing it in our patients. We should drink more water. Modifications to the criteria for acute kidney injury could be needed for the assessment of junior doctors in an intensive care unit.

Lecturers' Attitudes on Electronically Supported Pre-Lecturing Material for Intensive Programs: A Case Study

ERIC Educational Resources Information Center

Kozaris, Ioannis; Varella, Evangelia A.

2010-01-01

In 2006 and 2008, two large trans-national residential summer schools on conservation science were organized as intensive programs. Learners were not only second/third cycle students in both exact sciences and humanities, but further practicing restorers; consequently their educational background, and even their way of approaching scientific…

[Risk for the development of upper gastrointestinal bleeding in children in an intensive care unit].

PubMed

Gutiérrez-Gutiérrez, Glenda Karina; Villasís-Keever, Miguel Angel; González-Ortiz, Beatriz; Troconis-Trens, Germán; Tapia-Monge, Dora María; Flores-Calderón, Judith

2014-01-01

Although gastrointestinal tract bleeding can occur at any age, most studies trying to establish causes or risk factors for its development have been conducted in adults. The aim of this study was to determine risk factors in children admitted in a pediatric intensive care unit. A retrospective case-control study was conducted. Children who developed upper gastrointestinal bleeding children during their stay at the intensive care unit were considered the cases. Variables were obtained from medical records including age, sex, nutritional status, mechanical ventilation, use of nasogastric tube, development of complications, presence of coagulopathy, use of prophylaxis for upper gastrointestinal tract bleeding, fasting and use of steroids. Using a multivariate analysis, risk factors were identified, with odds ratios (OR) and 95 % confidence intervals (95 % CI) calculations. Out of 165 patients, 58 had upper gastrointestinal bleeding (35 %). Risk factors identified were prolonged clotting times (OR = 3.35), thrombocytopenia (OR = 2.39), development of sepsis (OR = 6.74) or pneumonia (OR = 4.37). Prophylaxis for upper gastrointestinal bleeding was not a protective factor. Upper gastrointestinal bleeding frequency in children hospitalized in an intensive care unit was high. Identifying risk factors should help to reduce upper gastrointestinal bleeding frequency.

Barriers to Implementation of Case Management for Patients With Dementia: A Systematic Mixed Studies Review

PubMed Central

Khanassov, Vladimir; Vedel, Isabelle; Pluye, Pierre

2014-01-01

PURPOSE Results of case management designed for patients with dementia and their caregivers in community-based primary health care (CBPHC) were inconsistent. Our objective was to identify the relationships between key outcomes of case management and barriers to implementation. METHODS We conducted a systematic mixed studies review (including quantitative and qualitative studies). Literature search was performed in MEDLINE, PsycINFO, Embase, and Cochrane Library (1995 up to August 2012). Case management intervention studies were used to assess clinical outcomes for patients, service use, caregiver outcomes, satisfaction, and cost-effectiveness. Qualitative studies were used to examine barriers to case management implementation. Patterns in the relationships between barriers to implementation and outcomes were identified using the configurational comparative method. The quality of studies was assessed using the Mixed Methods Appraisal Tool. RESULTS Forty-three studies were selected (31 quantitative and 12 qualitative). Case management had a limited positive effect on behavioral symptoms of dementia and length of hospital stay for patients and on burden and depression for informal caregivers. Interventions that addressed a greater number of barriers to implementation resulted in increased number of positive outcomes. Results suggested that high-intensity case management was necessary and sufficient to produce positive clinical outcomes for patients and to optimize service use. Effective communication within the CBPHC team was necessary and sufficient for positive outcomes for caregivers. CONCLUSIONS Clinicians and managers who implement case management in CBPHC should take into account high-intensity case management (small caseload, regular proactive patient follow-up, regular contact between case managers and family physicians) and effective communication between case managers and other CBPHC professionals and services. PMID:25354410

Barriers to implementation of case management for patients with dementia: a systematic mixed studies review.

PubMed

Khanassov, Vladimir; Vedel, Isabelle; Pluye, Pierre

2014-01-01

Results of case management designed for patients with dementia and their caregivers in community-based primary health care (CBPHC) were inconsistent. Our objective was to identify the relationships between key outcomes of case management and barriers to implementation. We conducted a systematic mixed studies review (including quantitative and qualitative studies). Literature search was performed in MEDLINE, PsycINFO, Embase, and Cochrane Library (1995 up to August 2012). Case management intervention studies were used to assess clinical outcomes for patients, service use, caregiver outcomes, satisfaction, and cost-effectiveness. Qualitative studies were used to examine barriers to case management implementation. Patterns in the relationships between barriers to implementation and outcomes were identified using the configurational comparative method. The quality of studies was assessed using the Mixed Methods Appraisal Tool. Forty-three studies were selected (31 quantitative and 12 qualitative). Case management had a limited positive effect on behavioral symptoms of dementia and length of hospital stay for patients and on burden and depression for informal caregivers. Interventions that addressed a greater number of barriers to implementation resulted in increased number of positive outcomes. Results suggested that high-intensity case management was necessary and sufficient to produce positive clinical outcomes for patients and to optimize service use. Effective communication within the CBPHC team was necessary and sufficient for positive outcomes for caregivers. Clinicians and managers who implement case management in CBPHC should take into account high-intensity case management (small caseload, regular proactive patient follow-up, regular contact between case managers and family physicians) and effective communication between case managers and other CBPHC professionals and services. © 2014 Annals of Family Medicine, Inc.

[Economic evaluation of nosocomial infections in pediatric intensive care units in Lithuania].

PubMed

Gurskis, Vaidotas; Kėvalas, Rimantas; Kerienė, Virginija; Vaitkaitienė, Eglė; Miciulevičienė, Jolanta; Dagys, Algirdas; Ašembergienė, Jolanta; Grinkevičiūtė, Dovilė

2010-01-01

The aim of this study was to estimate direct costs related to nosocomial infection in three pediatric intensive care units in Lithuania and to overview the effectiveness of preventive programs of nosocomial infections. A prospective empirical surveillance study was launched in 3 Lithuanian pediatric intensive care units during the period of January 2005 to December 2007. Using the method of targeted selection, all children aged from 1 month and 18 years, treated in pediatric intensive care units for more than 48 hours, were enrolled into the study. Direct costs of nosocomial infections in pediatric intensive care units were calculated for each patient and each case of nosocomial infection. For calculation of average expenditures per patient-day, data from nosocomial infection registry and from analysis of hospital income for services provided at pediatric intensive care units according to price-list of health care price approved by the order of the Minister of Health of the Republic of Lithuanian (No. V-802, October 27, 2005) were used. According to length of stay, costs of intensive care services, and costs caused by nosocomial infections, all the patients were divided into two groups: those who did and did not acquire an infection. For the evaluation of economic efficiency, the patients were divided into other two groups: pre- and postintervention groups. All economic evaluation was made in national currency (litas). The data of 755 patients were used. Multiple linear regression analysis (R(2)=0.47) revealed a 6.32-day increase (95% CI, 4.32-8.33; P=0.003) in hospital stay in a pediatric intensive care unit if a patient acquired nosocomial infection. Costs related to nosocomial infections for one patient made up 5215.47 litas (95% CI, 3565.00-6874.19). Average costs caused by one nosocomial infection case were 4070.61 litas (95% CI, 2782.44-5365.22). Nosocomial infection prevention programs (interventions) gave a total economical effect of 20046.14 litas. Prevention of one patient from nosocomial infection caused a reduction of 1336.41 litas, and one avoided nosocomial infection case resulted in a 1113.67-litas reduction; cost-to-effect ratio was 1:4. Total costs related to nosocomial infections in pediatric intensive care units were high. The implementation of nosocomial infection prevention program resulted in a positive economic effect - 1 litas spent for the prevention of nosocomial infections saved 4 litas.

Assessment of Sediment Measurements in Lake Michigan as a Case Study: Implications for Monitoring and Modeling

EPA Science Inventory

Lake Michigan, the sixth largest freshwater lake in the world by surface area, was utilized as a water body for assessment within a case study. Field data collected at 116 sediment sampling sites throughout the lake in an intensive monitoring effort were utilized for assessment ...

An Active Learning Activity for an IT Ethics Course

ERIC Educational Resources Information Center

Woods, David M.; Howard, Elizabeth V.

2014-01-01

Courses in Information Technology Ethics are often designed as discussion-intensive courses where case studies are introduced and evaluated using ethical theories. Although many of the case studies directly apply to our students' online lives, the stories can sometimes seem too far removed from their own experiences. While we read the news…

Effect of intense pulsed light on immature burn scars: A clinical study

PubMed Central

Sarkar, Arindam; Dewangan, Yatindra Kumar; Bain, Jayanta; Rakshit, Pritha; Dhruw, Krishnanand; Basu, Sandip Kanti; Saha, Jayanta Kumar; Majumdar, Bijay Kumar

2014-01-01

Introduction: As intense pulsed light (IPL) is widely used to treat cutaneous vascular malformations and also used as non-ablative skin rejunuvation to remodel the skin collagen. A study has been undertaken to gauze the effect of IPL on immature burn scars with regard to vascularity, pliability and height. Materials and Methods: This study was conducted between June 2013 and May 2014, among patients with immature burn scars that healed conservatively within 2 months. Photographic evidence of appearance of scars and grading and rating was done with Vancouver Scar Scale parameters. Ratings were done for both case and control scar after the completion of four IPL treatment sessions and were compared. Results: Out of the 19 cases, vascularity, pliability and height improved significantly (P < 0.05) in 13, 14 and 11 scars respectively following IPL treatment. Conclusions: Intense pulsed light was well-tolerated by patients, caused good improvement in terms of vascularity, pliability, and height of immature burn scar. PMID:25593424

Magnetic resonance imaging and computed tomography characteristics of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion.

PubMed

Wang, Wei; Ding, Jianhui; Li, Yuan; Wang, Chaofu; Zhou, Liangping; Zhu, Hui; Peng, Weijun

2014-01-01

To characterize Xp11.2 translocation renal cell carcinoma (RCC) using magnetic resonance imaging (MRI) and computed tomography (CT). This study retrospectively collected the MRI and CT data of twelve patients with Xp11.2 translocation RCC confirmed by pathology. Nine cases underwent dynamic contrast-enhanced MRI (DCE-MRI) and 6 cases underwent CT, of which 3 cases underwent MRI and CT simultaneously. The MRI and CT findings were analyzed in regard to tumor position, size, hemorrhagic, cystic or necrotic components, calcification, tumor density, signal intensity and enhancement features. The age of the 12 patients ranged from 13 to 46 years (mean age: 23 years). T2WI revealed heterogeneous intensity, hyper-intensity, and slight hypo-intensity in 6 cases, 2 cases, and 1 case, respectively. On DCE-MR images, mild, moderate, and marked rim enhancement of the tumor in the corticomedullary phase (CMP) were observed in 1, 6, and 2 cases, respectively. The tumor parenchyma showed iso-attenuation (n = 4) or slight hyper-attenuation (n = 1) compared to the normal renal cortex on non-contrast CT images. Imaging findings were suggestive of hemorrhage (n = 4) or necrosis (n = 8) in the tumors, and there was evidence of calcification in 8 cases by CT (n = 3) and pathology (n = 8). On dynamic contrast-enhanced CT images, 3 cases and 1 case manifested moderate and strong CMP enhancement, respectively. Nine tumors by MRI and 4 tumors by CT showed prolonged enhancement. Three neoplasms presented at stage I, 2 at stage II, 3 at stage III, and 4 at stage IV according the 2010 AJCC staging criteria. XP11.2 translocation RCC should be considered when a child or young adult patient presents with a renal tumor with heterogeneous features such as hemorrhage, necrosis, cystic changes, and calcification on CT and MRI and/or is accompanied by metastatic evidence.

Magnetic Resonance Imaging and Computed Tomography Characteristics of Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE3 Gene Fusion

PubMed Central

Li, Yuan; Wang, Chaofu; Zhou, Liangping; Zhu, Hui; Peng, Weijun

2014-01-01

Purpose To characterize Xp11.2 translocation renal cell carcinoma (RCC) using magnetic resonance imaging (MRI) and computed tomography (CT). Methods This study retrospectively collected the MRI and CT data of twelve patients with Xp11.2 translocation RCC confirmed by pathology. Nine cases underwent dynamic contrast-enhanced MRI (DCE-MRI) and 6 cases underwent CT, of which 3 cases underwent MRI and CT simultaneously. The MRI and CT findings were analyzed in regard to tumor position, size, hemorrhagic, cystic or necrotic components, calcification, tumor density, signal intensity and enhancement features. Results The age of the 12 patients ranged from 13 to 46 years (mean age: 23 years). T2WI revealed heterogeneous intensity, hyper-intensity, and slight hypo-intensity in 6 cases, 2 cases, and 1 case, respectively. On DCE-MR images, mild, moderate, and marked rim enhancement of the tumor in the corticomedullary phase (CMP) were observed in 1, 6, and 2 cases, respectively. The tumor parenchyma showed iso-attenuation (n = 4) or slight hyper-attenuation (n = 1) compared to the normal renal cortex on non-contrast CT images. Imaging findings were suggestive of hemorrhage (n = 4) or necrosis (n = 8) in the tumors, and there was evidence of calcification in 8 cases by CT (n = 3) and pathology (n = 8). On dynamic contrast-enhanced CT images, 3 cases and 1 case manifested moderate and strong CMP enhancement, respectively. Nine tumors by MRI and 4 tumors by CT showed prolonged enhancement. Three neoplasms presented at stage I, 2 at stage II, 3 at stage III, and 4 at stage IV according the 2010 AJCC staging criteria. Conclusions XP11.2 translocation RCC should be considered when a child or young adult patient presents with a renal tumor with heterogeneous features such as hemorrhage, necrosis, cystic changes, and calcification on CT and MRI and/or is accompanied by metastatic evidence. PMID:24926688

Non-Infectious Ischiogluteal Bursitis: MRI Findings

PubMed Central

Lee, Sung Moon; Lee, Young Hwan; Suh, Kyung Jin; Kim, Sung Moon; Shin, Myung Jin; Jang, Han Won

2004-01-01

Objective We wished to report on the MRI findings of non-infectious ischiogluteal bursitis. Materials and Methods The MRI findings of 17 confirmed cases of non-infectious ischiogluteal bursitis were analyzed: four out of the 17 cases were confirmed with surgery, and the remaining 13 cases were confirmed with MRI plus the clinical data. Results The enlarged bursae were located deep to the gluteus muscles and postero-inferior to the ischial tuberosity. The superior ends of the bursal sacs abutted to the infero-medial aspect of the ischial tuberosity. The signal intensity within the enlarged bursa on T1-weighted image (WI) was hypo-intense in three cases (3/17, 17.6%), iso-intense in 10 cases (10/17, 58.9%), and hyper-intense in four cases (4/17, 23.5%) in comparison to that of surrounding muscles. The bursal sac appeared homogeneous in 13 patients (13/17, 76.5%) and heterogeneous in the remaining four patients (4/17, 23.5%) on T1-WI. On T2-WI, the bursa was hyper-intense in all cases (17/17, 100%); it was heterogeneous in 10 cases and homogeneous in seven cases. The heterogeneity was variable depending on the degree of the blood-fluid levels and the septae within the bursae. With contrast enhancement, the inner wall of the bursae was smooth (5/17 cases), and irregular (12/17 cases) because of the synovial proliferation and septation. Conclusion Ischiogluteal bursitis can be diagnosed with MRI by its characteristic location and cystic appearance. PMID:15637479

Heavy rain effects

NASA Technical Reports Server (NTRS)

Dunham, R. Earl, Jr.

1994-01-01

This paper summarizes the current state of knowledge of the effect of heavy rain on airplane performance. Although the effects of heavy rain on airplane systems and engines are generally known, only recently has the potential aerodynamic effect of heavy rain been recognized. In 1977 the United States Federal Aviation Administration (FAA) conducted a study of 25 aircraft accidents and incidents which occurred between 1964 and 1976 in which low-altitude wind shear could have been a contributing factor. Of the 25 cases (23 approach or landing and 2 take-off) in the study, ten cases had occurred in a rain environment, and in five cases these were classified as intense or heavy rain encounters. These results led to the reconsideration of high-intensity, short-duration rainfall as a potential weather-related aircraft safety hazard, particularly in the take-off and/or approach phases of flight.

[The German DRG system 2003-2010 from the perspective of intensive care medicine].

PubMed

Franz, Dominik; Bunzemeier, Holger; Roeder, Norbert; Reinecke, Holger

2010-01-01

Intensive care medicine is extremely heterogeneous, expensive and can only be partially planned and controlled. A correct and fair representation of intensive care medicine in the G-DRG system is an essential requirement for the use as a pricing system. From the perspective of intensive care medicine, pertinent changes of the DRG structure and differentiation of relevant parameters have been established within the G-DRG systems 2003-2010. Analysis of relevant diagnoses, medical procedures, co-payment structures and G-DRGs in the versions 2003-2010 based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Since the first G-DRG system version 2003, numerous measures improved quality of case allocation of intensive care medicine. Highly relevant to the system version 2010 are duration of mechanical ventilation, the intensive care treatment complex and complicating constellations. The number of G-DRGs relevant to intensive medical care increased from n = 3 (2003) to n = 58 (2010). For standard cases, quality of case allocation and G-DRG reimbursement are adequate in 2010. The G-DRG system gained complexity again. High demands are made on correct and complete coding of complex cases. Nevertheless, further adjustments of the G-DRG system especially for cases with extremely high costs are necessary. Where the G-DRG system is unable to cover extremely high-cost cases, reimbursement solutions beyond the G-DRG structure should be taken into account.

Magnetic resonance and computed tomographic imaging in the evaluation of acute neuropsychiatric disease in systemic lupus erythematosus.

PubMed Central

Sibbitt, W L; Sibbitt, R R; Griffey, R H; Eckel, C; Bankhurst, A D

1989-01-01

Magnetic resonance (MR) imaging and computed tomography (CT) are useful for the evaluation of central nervous system (CNS) lupus. This report describes the use of cranial MR and CT in 21 patients with systemic lupus erythematosus (SLE) with acute neuropsychiatric symptoms manifested by headache, seizures, focal neurological deficits, psychosis, or organic brain syndrome. Computed tomography was found to be insensitive and detected only diffuse atrophy (two cases), cerebral infarct (one case), and intracerebral haemorrhage (one case) in the 21 patients. Cranial MR images obtained with a General Electric 1.5 tesla Signa unit detected labile and fixed areas of increased proton intensity interpreted as focal oedema (eight cases), infarct (10 cases), haemorrhage (one), atrophy (seven), and acute sinusitis (two). Focal oedema was characterised by labile, high intensity lesions in the gray or white matter of the cerebellum, cerebrum, or brain stem, which completely resolved after aggressive corticosteroid treatment. Most high intensity reversible or fixed lesions evident on MR were not apparent on cranial CT images. In several patients sequential MR images were valuable in monitoring the efforts of treatment. Although histological confirmation of the high intensity brain lesions apparent on MR is desirable, prior necropsy studies suggest that pathological confirmation may be difficult owing to the paucity of recognisable brain lesions in patients with CNS lupus. It is concluded that for the evaluation of acute neuropsychiatric SLE MR is useful and provides more information than cranial CT. Images PMID:2619353

Candidemia in neonatal intensive care units: Barcelona, Spain.

PubMed

Rodriguez, Dolors; Almirante, Benito; Park, Benjamin J; Cuenca-Estrella, Manuel; Planes, Ana M; Sanchez, Ferran; Gene, Amadeu; Xercavins, Mariona; Fontanals, Dionisia; Rodriguez-Tudela, Juan L; Warnock, David W; Pahissa, Albert

2006-03-01

Candida spp. are increasingly important hospital-acquired pathogens in neonatal intensive care units (NICU) and cause considerable mortality in preterm infants. Most studies have been limited to a single institution. The aim of this study was to determine the epidemiology of candidemia in all Barcelona NICUs. We conducted prospective population-based surveillance for candidemia in Barcelona, Spain, during 2002-2003. This report focuses on the results from 5 participating hospitals with NICUs. We detected 24 cases, resulting in an annual incidence of 32.6 cases per 100,000 live births and 1.1 cases per 100 NICU discharges. Median gestational age was 27.5 weeks (range, 24-40.5), and there were 21 cases among very low birth weight infants. Among the 20 (83%) cases evaluated for the presence of end organ infection, endophthalmitis occurred in 2 cases, and endocarditis, meningitis and peritonitis occurred in 1 case each. Candida parapsilosis was the most frequent species isolated (67%). All isolates were fluconazole-susceptible. Crude mortality was 21%. The preponderance of C. parapsilosis candidemias observed in Barcelona NICUs is similar to reports from the literature. Morbidity and mortality associated with neonatal candidemia remain high.

Bridging the Research to Practice Gap: A Case Study Approach to Understanding EIBI Supports and Barriers in Swedish Preschools

ERIC Educational Resources Information Center

Roll-Pettersson, Lise; Olsson, Ingrid; Ala'i-Rosales, Shahla

2016-01-01

The present study examined proximal and distal barriers and supports within the Swedish service system that may affect implementation of early and intensive behavioral intervention (EIBI) for children with autism. A case study approach with roots in ethnography was chosen to explore this issue. Two preschools exemplifying "high quality…

Intensity of factor VIII treatment and the development of inhibitors in non-severe hemophilia A patients: results of the INSIGHT case-control study.

PubMed

van Velzen, A S; Eckhardt, C L; Peters, M; Leebeek, F W G; Escuriola-Ettingshausen, C; Hermans, C; Keenan, R; Astermark, J; Male, C; Peerlinck, K; le Cessie, S; van der Bom, J G; Fijnvandraat, K

2017-07-01

Essentials Research suggests that intensive treatment episodes may increase the risk to develop inhibitors. We performed an international nested case-control study with 298 non-severe hemophilia A patients. Surgery and a high dose of factor VIII concentrate were associated with increased inhibitor risk. Physicians need to review arguments for factor VIII dose and elective surgery extra critically. Background Inhibitor development is a major complication of treatment with factor VIII concentrates in hemophilia. Findings from studies among severe hemophilia A patients suggest that intensive treatment episodes increase the risk of developing inhibitors. Objectives We set out to assess whether intensive treatment is also associated with an increased risk of inhibitor development among non-severe hemophilia A patients. Patients/Methods We performed a nested case-control study. A total of 75 inhibitor patients (cases) and 223 control patients were selected from 2709 non-severe hemophilia A patients (FVIII:C, 2-40%) of the INSIGHT cohort study. Cases and controls were matched for date of birth and cumulative number of exposure days (EDs) to FVIII concentrates. Conditional logistic regression was used to calculate both unadjusted and adjusted odds ratios (aOR); the latter were adjusted for a priori specified confounders. Results Peak treatment of 5 or 10 consecutive EDs did not increase inhibitor risk (aOR, 1.0; 95% confidence interval (CI), 0.4-2.5; and aOR, 1.8; CI, 0.6-5.5, respectively). Both surgical intervention (aOR, 4.2; CI, 1.7-10.3) and a high mean dose (> 45 IU kg -1 /ED) of FVIII concentrate (aOR, 7.5; CI, 1.6-35.6) were associated with an increased inhibitor risk. Conclusions Our findings suggest that high-dose FVIII treatment and surgery increase the risk of inhibitor development in non-severe hemophilia A. Together with the notion that non-severe hemophilia A patients are at a lifelong risk of inhibitor development, we suggest that in the future physicians will review the arguments for the FVIII dose and elective surgery extra critically. © 2017 International Society on Thrombosis and Haemostasis.

Galactic Cosmic Ray Intensity Response to Interplanetary Coronal Mass Ejections/Magnetic Clouds in 1995-2009

NASA Technical Reports Server (NTRS)

Richardson, I. G.; Cane, H. V.

2011-01-01

We summarize the response of the galactic cosmic ray (CGR) intensity to the passage of the more than 300 interplanetary coronal mass ejections (ICMEs) and their associated shocks that passed the Earth during 1995-2009, a period that encompasses the whole of Solar Cycle 23. In approx.80% of cases, the GCR intensity decreased during the passage of these structures, i.e., a "Forbush decrease" occurred, while in approx.10% there was no significant change. In the remaining cases, the GCR intensity increased. Where there was an intensity decrease, minimum intensity was observed inside the ICME in approx.90% of these events. The observations confirm the role of both post-shock regions and ICMEs in the generation of these decreases, consistent with many previous studies, but contrary to the conclusion of Reames, Kahler, and Tylka (Astrophys. 1. Lett. 700, L199, 2009) who, from examining a subset of ICMEs with flux-rope-like magnetic fields (magnetic clouds) argued that these are "open structures" that allow free access of particles including GCRs to their interior. In fact, we find that magnetic clouds are more likely to participate in the deepest GCR decreases than ICMEs that are not magnetic clouds.

Prevalence of Violence Toward Community Nurses: A Questionnaire Survey.

PubMed

Gabrovec, Branko

2017-11-01

Violence toward nursing staff occurs frequently, particularly in intensive care units and closed or intensive psychiatric facilities, which have been studied previously. However, violence toward community nurses has not been investigated. The purpose of this study was to explore the frequency of violence toward community nurses in Slovenia. More than 56% of study respondents were verbally abused by their patients during the past year. More than 42% of all cases of horizontal violence were directed at community nurses.

[Evaluation of an intensive therapy program for treatment of severe behavioral disorders in mentally handicapped patients with autistic or psychotic behavior].

PubMed

Elbing, U; Rohmann, U H

1993-09-01

The development of severely disturbed and socially accepted behavior in mentally handicapped persons with autistic or psychotic symptoms is documented before, during and after an intensive therapy program conducted in a residential institution for mentally handicapped persons. Seven single case studies were made as long term observation with a duration between 18 and 33 weeks, mostly with a multiple baseline design. One or two follow ups with at least four weeks length were conducted in six out of seven cases up to four years after the end of the intensive therapy. The main results show (1) the decrease of disturbed behavior and the increase of socially accepted behavior during the therapy program, and (2) the significant reduction of the disturbed behavior patterns taking place during the baseline phase before the beginning of the therapy in all cases but one. The results are discussed under the aspects of a possible explanation for the findings and their impact on the discussion about psychotherapy research.

The Impact of Arbitration Intervention Services on Psychosocial Functioning: A Follow-Up Study

ERIC Educational Resources Information Center

Dembo, Richard; Wareham, Jennifer; Poythress, Norman G.; Cook, Brittany; Schmeidler, James

2006-01-01

We report the impact of case management services on drug use and self-reported delinquency for youths involved in a clinical trial of the Juvenile Arbitration program. The project evaluated an innovative intervention service providing 16 weeks of intensive case management services to youths and their families. The present study examines interview…

Perceptions of L1 Glossed Feedback in Automated Writing Evaluation: A Case Study

ERIC Educational Resources Information Center

Wilken, Jayme Lynn

2018-01-01

Learner perceptions toward and utilization of L1 glossed feedback in an automated writing evaluation (AWE) program were investigated in an Intensive English Program (IEP) class. This small case study focused on two Chinese students who responded to weekly surveys, semi-structured interviews, and screen capture videos of their revisions over a…

Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.

PubMed

Mohamed, Somaia

2013-03-01

There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas.

High signal intensity of intervertebral calcified disks on T1-weighted MR images resulting from fat content.

PubMed

Malghem, Jacques; Lecouvet, Frédéric E; François, Robert; Vande Berg, Bruno C; Duprez, Thierry; Cosnard, Guy; Maldague, Baudouin E

2005-02-01

To explain a cause of high signal intensity on T1-weighted MR images in calcified intervertebral disks associated with spinal fusion. Magnetic resonance and radiological examinations of 13 patients were reviewed, presenting one or several intervertebral disks showing a high signal intensity on T1-weighted MR images, associated both with the presence of calcifications in the disks and with peripheral fusion of the corresponding spinal segments. Fusion was due to ligament ossifications (n=8), ankylosing spondylitis (n=4), or posterior arthrodesis (n=1). Imaging files included X-rays and T1-weighted MR images in all cases, T2-weighted MR images in 12 cases, MR images with fat signal suppression in 7 cases, and a CT scan in 1 case. Histological study of a calcified disk from an anatomical specimen of an ankylosed lumbar spine resulting from ankylosing spondylitis was examined. The signal intensity of the disks was similar to that of the bone marrow or of perivertebral fat both on T1-weighted MR images and on all sequences, including those with fat signal suppression. In one of these disks, a strongly negative absorption coefficient was focally measured by CT scan, suggesting a fatty content. The histological examination of the ankylosed calcified disk revealed the presence of well-differentiated bone tissue and fatty marrow within the disk. The high signal intensity of some calcified intervertebral disks on T1-weighted MR images can result from the presence of fatty marrow, probably related to a disk ossification process in ankylosed spines.

Intensity-intensity correlations as a probe of interferences under conditions of noninterference in the intensity

NASA Astrophysics Data System (ADS)

Agarwal, G. S.; von Zanthier, J.; Skornia, C.; Walther, H.

2002-05-01

The different behavior of first-order interferences and second-order correlations are investigated for the case of two coherently excited atoms. For intensity measurements this problem is in many respects equivalent to Young's double-slit experiment and was investigated in an experiment by Eichmann et al. [Phys. Rev. Lett. 70, 2359 (1993)] and later analyzed in detail by Itano et al. [Phys. Rev. A 57, 4176 (1998)]. Our results show that in cases where the intensity interferences disappear the intensity-intensity correlations can display an interference pattern with a visibility of up to 100%. The contrast depends on the polarization selected for the detection and is independent of the strength of the driving field. The nonclassical nature of the calculated intensity-intensity correlations is also discussed.

The effectiveness of lavender essence on strernotomy related pain intensity after coronary artery bypass grafting

PubMed Central

Heidari Gorji, Mohammad Ali; Ashrastaghi, Om Golsum; Habibi, Valiollah; Charati, Jamshid Yazdani; Ebrahimzadeh, Mohammad Ali; Ayasi, Mitra

2015-01-01

Background: Considering the side effects of pharmacological methods, there has been a suggestion to use nonpharmacological methods such Aromatherapy following coronary artery bypass grafting (CABG). This study aims to evaluate the effectiveness of lavender 2% aromatherapy on sternotomy pain intensity after coronary artery bypass graft surgery in patients who have undergone surgery. Materials and Methods: During this clinical trial, 50 patients who were candidates for CABG, were randomly divided into two equal groups, that is, the control group (n = 25) and the case group (n = 25). Following CABG, the case group received two drops of 2% lavender oil every 15 minutes with supplemental oxygen and the control group received only supplemental oxygen through a face mask. The data collection tools comprised of the demographic check list and visual analog scale (VAS) for evaluating the pain intensity. The pain intensity were assessed pre- and five, 30, and 60 minutes post aromatherapy. The final data were analyzed by the t-test and chi-squared test. Results: The findings showed that the pain perception intensity in the case group was lower than that in the control group at the 30- and 60-minute phases after intervention (P < 0.0001). Conclusion: The result indicated that aromatherapy can be used as a complementary method in postoperative pain reduction, as it reduced pain. The patients require two sedative drugs, and moreover, it avoids expenses of treatment. PMID:26261829

Intracranial solitary fibrous tumor: imaging findings.

PubMed

Clarençon, Frédéric; Bonneville, Fabrice; Rousseau, Audrey; Galanaud, Damien; Kujas, Michèle; Naggara, Olivier; Cornu, Philippe; Chiras, Jacques

2011-11-01

To study the neuroimaging features of intracranial solitary fibrous tumors (ISFTs). Retrospective study of neuroimaging features of 9 consecutive histopathologically proven ISFT cases. Location, size, shape, density, signal intensity and gadolinium uptake were studied at CT and MRI. Data collected from diffusion-weighted imaging (DWI) (3 patients), perfusion imaging and MR spectroscopy (2 patients), and DSA (4 patients) were also analyzed. The tumors most frequently arose from the intracranial meninges (7/9), while the other lesions were intraventricular. Tumor size ranged from 2.5 to 10 cm (mean=6.6 cm). They presented multilobular shape in 6/9 patients. Most ISFTs were heterogeneous (7/9) with areas of low T2 signal intensity that strongly enhanced after gadolinium administration (6/8). Erosion of the skull was present in about half of the cases (4/9). Components with decreased apparent diffusion coefficient were seen in 2/3 ISFTs on DWI. Spectroscopy revealed elevated peaks of choline and myo-inositol. MR perfusion showed features of hyperperfusion. ISFT should be considered in cases of extra-axial, supratentorial, heterogeneous, hypervascular tumor. Areas of low T2 signal intensity that strongly enhance after gadolinium injection are suggestive of this diagnosis. Restricted diffusion and elevated peak of myo-inositol may be additional valuable features. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Excitation anisotropy in laser-induced-fluorescence spectroscopy: Broad-line excitation case

NASA Astrophysics Data System (ADS)

Hirabayashi, A.; Nambu, Y.; Fujimoto, T.

1986-01-01

Treatment of excitation anisotropy for Laser-Induced-Fluorescence Spectroscopy (LIFS) is extended to the intense excitation case. The depolarization coefficient is derived for intense excitation limit (linearly-polarized or unpolarized light excitation), and the result is presented in tables. For the region of intermediate intensity between the weak and intense excitation limits, the master equation is solved for specific example of transitions and its result is compared with experiment.

An experimental investigation on the effects of freestream turbulence intensity on film cooling effectiveness and heat transfer coefficient for an anti-vortex hole

NASA Astrophysics Data System (ADS)

Hayes, Stephen Andrew

Film cooling is used to thermally protect combustor and turbine components by creating a layer of relatively cooler air than the freestream air to insulate the components from the hot freestream gases. This relatively cooler air is taken from upstream in the high-pressure compressor section at a loss to the engine efficiency, and therefore must be used as effectively as possible. The efficiency gained from increasing the turbine inlet temperature outweighs the loss due to extracting air from the compressor section if the cooling air is used effectively. A novel anti-vortex hole (AVH) geometry has been investigated experimentally through a transient infrared thermography technique to study the film cooling effectiveness and surface convective heat transfer coefficients for varying blowing ratio and freestream turbulence intensity. A major concern with the AVH will be how the secondary jets counteract the main counter rotating vortex (CRV) pair at increased freestream turbulence levels. This is the first experimental facility to study the effects of higher freestream turbulence levels on an AVH geometry. Furthermore, this is the first experimental investigation to report centerline film cooling effectiveness and the convective heat transfer coefficient that had not been reported in prior studies. The AVH geometry is designed with two secondary holes stemming from a main cooling hole; these holes attempt to diffuse the coolant jet and mitigate the vorticity produced by conventional straight holes. This geometry shows improved results at low turbulence intensities compared to conventional straight holes. Three freestream turbulence intensities of 1, 7.5, and 11.7% were investigated at blowing ratios of 0.5, 1.0, 1.5, and 2.0 to form a test matrix of twelve different test conditions. Results showed that the higher freestream turbulence conditions were beneficial in the performance of the AVH. Increasing the blowing ratio at all turbulence levels also improved film cooling effectiveness both span-averaged and on the centerline. The highest performing case was at a turbulence intensity of 7.5% and a blowing ratio of 2.0. The 11.7% cases outperformed the 1% cases, but it appears that at 11.7% cases that the higher freestream turbulence reduces the performance of the secondary holes compared to the 7.5% cases. Increasing the blowing ratio and turbulence intensity will result in a higher heat transfer coefficient, and thus must be taken into account for future designs.

Demons deformable registration of CT and cone-beam CT using an iterative intensity matching approach.

PubMed

Nithiananthan, Sajendra; Schafer, Sebastian; Uneri, Ali; Mirota, Daniel J; Stayman, J Webster; Zbijewski, Wojciech; Brock, Kristy K; Daly, Michael J; Chan, Harley; Irish, Jonathan C; Siewerdsen, Jeffrey H

2011-04-01

A method of intensity-based deformable registration of CT and cone-beam CT (CBCT) images is described, in which intensity correction occurs simultaneously within the iterative registration process. The method preserves the speed and simplicity of the popular Demons algorithm while providing robustness and accuracy in the presence of large mismatch between CT and CBCT voxel values ("intensity"). A variant of the Demons algorithm was developed in which an estimate of the relationship between CT and CBCT intensity values for specific materials in the image is computed at each iteration based on the set of currently overlapping voxels. This tissue-specific intensity correction is then used to estimate the registration output for that iteration and the process is repeated. The robustness of the method was tested in CBCT images of a cadaveric head exhibiting a broad range of simulated intensity variations associated with x-ray scatter, object truncation, and/or errors in the reconstruction algorithm. The accuracy of CT-CBCT registration was also measured in six real cases, exhibiting deformations ranging from simple to complex during surgery or radiotherapy guided by a CBCT-capable C-arm or linear accelerator, respectively. The iterative intensity matching approach was robust against all levels of intensity variation examined, including spatially varying errors in voxel value of a factor of 2 or more, as can be encountered in cases of high x-ray scatter. Registration accuracy without intensity matching degraded severely with increasing magnitude of intensity error and introduced image distortion. A single histogram match performed prior to registration alleviated some of these effects but was also prone to image distortion and was quantifiably less robust and accurate than the iterative approach. Within the six case registration accuracy study, iterative intensity matching Demons reduced mean TRE to (2.5 +/- 2.8) mm compared to (3.5 +/- 3.0) mm with rigid registration. A method was developed to iteratively correct CT-CBCT intensity disparity during Demons registration, enabling fast, intensity-based registration in CBCT-guided procedures such as surgery and radiotherapy, in which CBCT voxel values may be inaccurate. Accurate CT-CBCT registration in turn facilitates registration of multimodality preoperative image and planning data to intraoperative CBCT by way of the preoperative CT, thereby linking the intraoperative frame of reference to a wealth of preoperative information that could improve interventional guidance.

Measuring utilization and impact of home care services: a systems model approach for cost effectiveness.

PubMed

Day, S R

1984-01-01

The relevance of home care research to policy questions is discussed as framework for study on "effects" (precursors and sequelae) of home care. This study used a large, multi-service agency's longitudinal (8-year) case records (N = 2436) to examine a system model for relationships among entry characteristics, utilization of services, and need for services upon discharge from home care. Deducing case-mix from utilization patterns, pay plan at entry was identified as best of the available predictors of both duration and intensity (using multivariate analysis). Duration and intensity, dual contributors to "total visits," were found to vary inversely and were predicted by different entering pay plans. While 1/3 of all cases were discharged to informal or self care, that was the most prevalent exit status of the clients (49%) who entered directly from hospital care. The methods used in disaggregating and analyzing these retrospectively-coded case records suggest that home services research: 1. distinguish type, intensity, and duration as components of "total visits" which combine to account for costs of care; 2. find concomitants of functional level (such as pay plan) which are accessible for designating case mix for purpose of projecting service use; 3. measure effectiveness in terms relevant to stated objectives of the long term care system, which need to acknowledge mortality and to separate service needs at entry room those at exist from the series of formal and informal providers on a continuum of care.

Studies of the Core Conditions of the Earth and Super-Earths Using Intense Ion Beams at FAIR

NASA Astrophysics Data System (ADS)

Tahir, N. A.; Lomonosov, I. V.; Borm, B.; Piriz, A. R.; Shutov, A.; Neumayer, P.; Bagnoud, V.; Piriz, S. A.

2017-09-01

Using detailed numerical simulations, we present the design of an experiment that will generate samples of iron under extreme conditions of density and pressure believed to exist in the interior of the Earth and interior of extrasolar Earth-like planets. In the proposed experiment design, an intense uranium beam is used to implode a multilayered cylindrical target that consists of a thin Fe cylinder enclosed in a thick massive W shell. Such intense uranium beams will be available at the heavy-ion synchrotron, SIS100, at the Facility for Antiprotons and Ion Research (FAIR), at Darmstadt, which is under construction and will become operational in the next few years. It is expected that the beam intensity will increase gradually over a couple of years to its maximum design value. Therefore, in our studies, we have considered a wide range of beam parameters, from the initial beam intensity (“Day One”) to the maximum specified value. It is also worth noting that two different focal spot geometries have been used. In one case, a circular focal spot with a Gaussian transverse intensity distribution is considered, whereas in the other case, an annular focal spot is used. With these two beam geometries, one can access different parts of the Fe phase diagram. For example, heating the sample with a circular focal spot generates a hot liquid state, while an annular focal spot can produce a highly compressed liquid or a highly compressed solid phase depending on the beam intensity.

Studies of the Core Conditions of the Earth and Super-Earths Using Intense Ion Beams at FAIR

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

Tahir, N. A.; Neumayer, P.; Bagnoud, V.

Using detailed numerical simulations, we present the design of an experiment that will generate samples of iron under extreme conditions of density and pressure believed to exist in the interior of the Earth and interior of extrasolar Earth-like planets. In the proposed experiment design, an intense uranium beam is used to implode a multilayered cylindrical target that consists of a thin Fe cylinder enclosed in a thick massive W shell. Such intense uranium beams will be available at the heavy-ion synchrotron, SIS100, at the Facility for Antiprotons and Ion Research (FAIR), at Darmstadt, which is under construction and will becomemore » operational in the next few years. It is expected that the beam intensity will increase gradually over a couple of years to its maximum design value. Therefore, in our studies, we have considered a wide range of beam parameters, from the initial beam intensity (“Day One”) to the maximum specified value. It is also worth noting that two different focal spot geometries have been used. In one case, a circular focal spot with a Gaussian transverse intensity distribution is considered, whereas in the other case, an annular focal spot is used. With these two beam geometries, one can access different parts of the Fe phase diagram. For example, heating the sample with a circular focal spot generates a hot liquid state, while an annular focal spot can produce a highly compressed liquid or a highly compressed solid phase depending on the beam intensity.« less

The contribution of embarrassment to phobic dental anxiety: a qualitative research study.

PubMed

Moore, Rod; Brødsgaard, Inger; Rosenberg, Nicole

2004-04-19

Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. Subjects (Ss) were consecutive specialist clinic patients, 16 men, 14 women, 20-65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9) with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment intensity ratings were positively correlated with years of avoidance and degree of mouth-hiding behaviors. Embarrassment is a complex dental anxiety manifestation with qualitative differences by complaint characteristics and perceived intensity. Some cases exhibited manifestations similar to psychiatric criteria for social anxiety disorder as chief complaint, while most manifested embarrassment as a side effect.

The contribution of embarrassment to phobic dental anxiety: a qualitative research study

PubMed Central

Moore, Rod; Brødsgaard, Inger; Rosenberg, Nicole

2004-01-01

Background Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. Methods Subjects (Ss) were consecutive specialist clinic patients, 16 men, 14 women, 20–65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. Results Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9) with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment intensity ratings were positively correlated with years of avoidance and degree of mouth-hiding behaviors. Conclusions Embarrassment is a complex dental anxiety manifestation with qualitative differences by complaint characteristics and perceived intensity. Some cases exhibited manifestations similar to psychiatric criteria for social anxiety disorder as chief complaint, while most manifested embarrassment as a side effect. PMID:15096278

Correlation between the Amount of Anti-D Antibodies and IgG Subclasses with Severity of Haemolytic Disease of Foetus and Newborn.

PubMed

Velkova, Emilija

2015-06-15

The aim of this study was to investigate the influence of subclasses to IgG anti-D on the intensity of hemolytic disease of fetus and newborn (HDFN) at 45 fetuses/newborns with symptoms of mild and severe HDFN in Republic of Macedonia. In retrospective and prospective studies, in a period of 10 years, from 2004 to 2014, there have been immunohemathology tests performed on 22 009 samples on serums of pregnant women. At 37.78% of the total number of tested patients, IgG1 and IgG3 was the reason for severe HDFN. At 17.77% of the total number of tested patients, which had only IgG1detected, was the reason for serious intensity of HDFN. The correlation of the titer to anti-D antibodies in the mother's serum and the intensity of HDFN were researched in 48 newborns. The titers between 1:8 and 1:32 resulted in 3 cases of HDFN with symptoms of severe disease and in 4 cases there were no signs of HDFN. At 12 women that had a titre between 1:32 and 1:512, five of the newborns developed severe HDFN, and seven had symptoms of mild and weak intensity form. In 3 cases the titer was higher than 512, and out of them one newborn had weak symptoms of HDFN, one developed severe HDFN and one ended with foetal death. Only in one case the titer reached a value higher than 1000, and it ended with a fetal death. The titers of the pregnant women serum those are lower than 32 and those higher than 1000 can well predict HDFN. The titers of anti-D antibodies between 64 and 512 have no exact predictive value. IgG1 and IgG3 subclasses of anti-D have no predictive value by themselves, and cannot foresee the outcome of HDFN. The research study results suggest that IgG1 and IgG3 should be included in a multi - parameter protocol for evaluation of the HDFN intensity. They can give a real assessment of the expected HDFN intensity in combination with the titer hight and the significance of the antibodies.

Cigarette smoking and cancer: intensity patterns in the alpha-tocopherol, beta-carotene cancer prevention study in Finnish men.

PubMed

Lubin, Jay H; Virtamo, Jarmo; Weinstein, Stephanie J; Albanes, Demetrius

2008-04-15

Relative risks for lung and bladder cancers by smoking intensity level off at more than 15-20 cigarettes per day. A three-parameter excess relative risk model in pack-years and intensity quantified this leveling (Lubin et al., Am J Epidemiol 2007;166:479-89). Above 15-20 cigarettes per day was an "inverse exposure rate" effect whereby, for equal pack-years, the excess relative risk/pack-year decreased with increasing intensity; that is, smoking at a lower intensity for a longer duration was more deleterious than smoking at a higher intensity for a shorter duration. After adjustment for pack-years, intensity effects were quantitatively homogeneous across multiple case-control studies of lung, bladder, oral cavity, pancreas, and esophagus cancers. The authors extended those analyses to examine intensity patterns for incident bladder, esophagus, kidney, larynx, liver, lung, oropharynx, and pancreas cancers by using data from a single prospective cohort in Finland, the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, with follow-up from enrollment, which occurred between 1985 and 1988, through April 2004. At more than 10 cigarettes per day, they found an inverse exposure rate pattern for each cancer site. After adjustment for pack-years, intensity effects were quantitatively homogeneous across the diverse cancer sites and homogeneous with intensity effects from the prior analysis of multiple studies. Consistency of intensity patterns suggested a general phenomenon and may provide clues to the molecular basis of smoking-related cancer risk.

Outcomes of exertional rhabdomyolysis following high-intensity resistance training.

PubMed

Huynh, A; Leong, K; Jones, N; Crump, N; Russell, D; Anderson, M; Steinfort, D; Johnson, D F

2016-05-01

High-intensity resistance training (HIRT) programmes are increasingly popular amongst personal trainers and those attending gymnasiums. We report the experience of exertional rhabdomyolysis (ER) at two tertiary hospitals in Melbourne, Australia. To compare the clinical outcomes of ER with other causes of rhabdomyolysis. Retrospective cross-sectional study of patients presenting with a serum creatine kinase (CK) of greater than 25 000 units/L from 1 September 2013 to 31 August 2014 at two tertiary referral hospitals in Melbourne, Australia. Records were examined to identify care measures implemented during hospital stay, clinical outcomes during admission and on subsequent follow up. Thirty four cases of rhabdomyolysis with a CK of greater than 25 000 units/L (normal range: 20-180 units/L) were identified during the 12-month study period. Twelve of the 34 cases (35%) had ER with 10 of 12 related to HIRT. No acute kidney injury, intensive care admission or death were seen among those with ER. All cases were managed conservatively, with 11 admitted and 9 receiving intravenous fluids only. In contrast, patients with rhabdomyolysis from other causes experienced significantly higher rates of intensive care admission (64%, P = 0.0002), acute kidney injury (82%, P = 0.0001) and death (27%, P = 0.069). ER resulting from HIRT appears to have a benign course compared with rhabdomyolysis of other aetiologies in patients with a serum CK greater than 25 000 units/L. Conservative management of ER appears to be adequate, although this requires confirmation in future prospective studies. © 2016 Royal Australasian College of Physicians.

Changes in case-mix and outcomes of critically ill patients in an Australian tertiary intensive care unit.

PubMed

Williams, T A; Ho, K M; Dobb, G J; Finn, J C; Knuiman, M W; Webb, S A R

2010-07-01

Critical care service is expensive and the demand for such service is increasing in many developed countries. This study aimed to assess the changes in characteristics of critically ill patients and their effect on long-term outcome. This cohort study utilised linked data between the intensive care unit database and state-wide morbidity and mortality databases. Logistic and Cox regression was used to examine hospital survival and five-year survival of 22,298 intensive care unit patients, respectively. There was a significant increase in age, severity of illness and Charlson Comorbidity Index of the patients over a 16-year study period. Although hospital mortality and median length of intensive care unit and hospital stay remained unchanged, one- and five-year survival had significantly improved with time, after adjusting for age, gender; severity of illness, organ failure, comorbidity, 'new' cancer and diagnostic group. Stratified analyses showed that the improvement in five-year survival was particularly strong among patients admitted after cardiac surgery (P = 0.001). In conclusion, although critical care service is increasingly being provided to patients with a higher severity of acute and chronic illnesses, long-term survival outcome has improved with time suggesting that critical care service may still be cost-effectiveness despite the changes in case-mix.

Hyperbaric oxygen therapy as treatment for bilateral arm compartment syndrome after CrossFit: case report and literature review.

PubMed

Mendes, Adriano Fernando; Neto, José da Mota; Heringer, Erica Maciel; de Simoni, Leandro Furtado; Pires, Diego Demolinari; Labronici, Pedro José

2018-01-01

CrossFit is a physical fitness program characterized by high-intensity workouts that can be associated with serious injury. Acute compartment syndrome in the upper limbs is a rare occurrence. It may occur after intense physical exercise, and its usual treatment is surgical. Hyperbaric oxygen therapy is a treatment described as adjunctive in cases of compartmental syndrome. We describe the case of a CrossFit practitioner who, after intense training, developed progressive symptoms of rhabdomyolysis and acute bilateral arm compartment syndrome, who was successfully treated with hyperbaric oxygen therapy and required no fasciotomy as surgical treatment. Acute compartment syndrome in the arms after intense physical exercise is a rare occurrence that should be suspected by practitioners of physical activity experiencing intense, disproportionate and progressive pain. In the case presented, hyperbaric oxygen therapy was successfully used in the treatment of the disorder, with satisfactory progress, and without the need for a surgical fasciotomy as therapy. Copyright© Undersea and Hyperbaric Medical Society.

Are Psychophysical Scales of Intensities the Same or Different when Stimuli Vary on Other Dimensions? Theory with Experiments Varying Loudness and Pitch

ERIC Educational Resources Information Center

Luce, R. Duncan; Steingrimsson, Ragnar; Narens, Louis

2010-01-01

Most studies concerning psychological measurement scales of intensive attributes have concluded that these scales are of ratio type and that the psychophysical function is closely approximated by a power function. Experiments show, for such cases, that a commutativity property must hold under either successive increases or successive decreases…

Exploring Action Learning for Academic Development in Research Intensive Settings

ERIC Educational Resources Information Center

Stocks, Claire; Trevitt, Chris; Hughes, Joseph

2018-01-01

The potential of action learning (AL) for academic development has not received a lot of attention. Building from two case studies in which AL has been used in different ways in research-intensive universities in Australia and the UK, we suggest that the approach may be of benefit to developers in the changing landscape in which they are expected…

Self-Administered Cued Naming Therapy: A Single-Participant Investigation of a Computer-Based Therapy Program Replicated in Four Cases

ERIC Educational Resources Information Center

Ramsberger, Gail; Marie, Basem

2007-01-01

Purpose: This study examined the benefits of a self-administered, clinician-guided, computer-based, cued naming therapy. Results of intense and nonintense treatment schedules were compared. Method: A single-participant design with multiple baselines across behaviors and varied treatment intensity for 2 trained lists was replicated over 4…

Advanced age, anticoagulation intensity, and risk for intracranial hemorrhage among patients taking warfarin for atrial fibrillation.

PubMed

Fang, Margaret C; Chang, Yuchiao; Hylek, Elaine M; Rosand, Jonathan; Greenberg, Steven M; Go, Alan S; Singer, Daniel E

2004-11-16

The risk for atrial fibrillation-associated stroke increases at low anticoagulation intensities. However, higher intensities increase hemorrhage risk. Optimal use of warfarin for atrial fibrillation requires precise information on the risk for intracranial hemorrhage as a function of patient age and anticoagulation intensity. To examine the relationship of age, anticoagulation intensity, and risk for intracranial hemorrhage. Case-control study. Academic medical center. 170 case-patients who developed intracranial hemorrhage during warfarin therapy and 1020 matched controls who did not; both case-patients and controls were taking warfarin for atrial fibrillation. The authors performed multivariable conditional logistic regression to determine the odds of intracranial hemorrhage with regard to age and international normalized ratio (INR), controlling for comorbid conditions and aspirin use. Case-patients were older than controls (median age, 78 years vs. 75 years; P < 0.001) and had higher median INRs (2.7 vs. 2.3; P < 0.001). The risk for intracranial hemorrhage increased at 85 years of age or older (adjusted odds ratio, 2.5 [95% CI, 1.3 to 4.7]; referent age, 70 to 74 years) and at an INR range of 3.5 to 3.9 (adjusted odds ratio, 4.6 [CI, 2.3 to 9.4]; referent INR, 2.0 to 3.0). The risk for intracranial hemorrhage at INRs less than 2.0 did not differ statistically from the risk at INRs of 2.0 to 3.0 (adjusted odds ratio, 1.3 [CI, 0.8 to 2.2]). Although duration of anticoagulation has been associated with hemorrhage in other studies, the current study could not control for this potential confounder. The risk for intracranial hemorrhage increases at age 85 years. International normalized ratios less than 2.0 were not associated with lower risk for intracranial hemorrhage compared with INRs between 2.0 and 3.0. Therefore, anticoagulation management should focus on maintaining INRs in the 2.0 to 3.0 range, even in elderly patients with atrial fibrillation, rather than targeting INRs less than 2.0. Similarly, INRs of 3.5 or greater should be avoided.

Distribution of sediment measurements in Lake Michigan as a case study: Implications for estimating sediment and water interactions in eutrophication and bioaccumulation models

EPA Science Inventory

Lake Michigan, the sixth largest freshwater lake in the world by surface area, was utilized as a water body for assessment within a case study. Field data collected at 116 sampling sites throughout the lake in an intensive monitoring effort were utilized for evaluation of the di...

Telling Our Story: A Case Study of a Collaborative Departmental Blog at Syracuse University Libraries

ERIC Educational Resources Information Center

Rauh, Anne E.; McReynolds, Stephanie J. H.

2016-01-01

This case study will take readers through the planning and publication process of a collaborative departmental library blog at Syracuse University, which is a large private, non-profit research intensive university located in central New York State. It will provide an overview of the history of the project and the mission of the blog. It will…

Comments from the Classroom: A Case Study of a Generation-1.5 Student in a University IEP and beyond

ERIC Educational Resources Information Center

Vasquez, Camilla

2007-01-01

This case study examines the patterns of participation of one US-educated refugee student in a university intensive English program (IEP). Specifically, I illustrate how the focal student used her advanced oral proficiency and prior experience with US educational norms and practices to engage in various interactional behaviours, such as shifting…

Using International Accreditation in Higher Education to Effect Changes in Organisational Culture: A Case Study from a Turkish University

ERIC Educational Resources Information Center

Collins, Ian

2015-01-01

International accreditation is now a significant yet controversial issue in global higher education. This case study looked at the experience of an intensive English language preparatory programme within a university in Turkey going through an accreditation by a foreign institution, and assessed to what extent the project managed to foster changes…

Effects of cross correlation on the relaxation time of a bistable system driven by cross-correlated noise

NASA Astrophysics Data System (ADS)

Mei, Dongcheng; Xie, Chongwei; Zhang, Li

2003-11-01

We study the effects of correlations between additive and multiplicative noise on relaxation time in a bistable system driven by cross-correlated noise. Using the projection-operator method, we derived an analytic expression for the relaxation time Tc of the system, which is the function of additive (α) and multiplicative (D) noise intensities, correlation intensity λ of noise, and correlation time τ of noise. After introducing a noise intensity ratio and a dimensionless parameter R=D/α, and then performing numerical computations, we find the following: (i) For the case of R<1, the relaxation time Tc increases as R increases. (ii) For the cases of R⩾1, there is a one-peak structure on the Tc-R plot and the effects of cross-correlated noise on the relaxation time are very notable. (iii) For the case of R<1, Tc almost does not change with both λ and τ, and for the cases of R⩾1, Tc decreases as λ increases, however Tc increases as τ increases. λ and τ play opposite roles in Tc, i.e., λ enhances the fluctuation decay of dynamical variable and τ slows down the fluctuation decay of dynamical variable.

School Websites as a Novel Internationalization Assessment Tool

ERIC Educational Resources Information Center

Yemini, Miri; Cohen, Anat

2016-01-01

This article presents a case study on internationalization assessment. The international, intercultural and global dimensions at the school level are examined, focusing on the case of one particular secondary school in Israel. A novel, practical assessment tool is presented for the measurement of internationalization intensity and scope at the…

Impact of GnRH agonist triggering and intensive luteal steroid support on live-birth rates and ovarian hyperstimulation syndrome: a retrospective cohort study

PubMed Central

2013-01-01

Background Conventional luteal support packages are inadequate to facilitate a fresh transfer after GnRH agonist (GnRHa) trigger in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS). By providing intensive luteal-phase support with oestradiol and progesterone satisfactory implantation rates can be sustained. The objective of this study was to assess the live-birth rate and incidence of OHSS after GnRHa trigger and intensive luteal steroid support compared to traditional hCG trigger and conventional luteal support in OHSS high risk Asian patients. Methods We conducted a retrospective cohort study of 363 women exposed to GnRHa triggering with intensive luteal support compared with 257 women exposed to conventional hCG triggering. Women at risk of OHSS were defined by ovarian response ≥15 follicles ≥12 mm on the day of the trigger. Results Live-birth rates were similar in both groups GnRHa vs hCG; 29.8% vs 29.2% (p = 0.69). One late onset severe OHSS case was observed in the GnRHa trigger group (0.3%) compared to 18 cases (7%) after hCG trigger. Conclusions GnRHa trigger combined with intensive luteal steroid support in this group of OHSS high risk Asian patients can facilitate fresh embryo transfer, however, in contrast to previous reports the occurrence of late onset OHSS was not completely eliminated. PMID:24369069

An investigation into possible quantum chaos in the H2 molecule under intense laser fields via Ehrenfest phase space (EPS) trajectories.

PubMed

Sadhukhan, Mainak; Deb, B M

2018-06-21

By employing the Ehrenfest "phase space" trajectory method for studying quantum chaos, developed in our laboratory, the present study reveals that the H 2 molecule under intense laser fields of three different intensities, I = 1 × 10 14  W/cm 2 , 5 × 10 14  W/cm 2 , and 1 × 10 15  W/cm 2 , does not show quantum chaos. A similar conclusion is also reached through the Loschmidt echo (also called quantum fidelity) calculations reported here for the first time for a real molecule under intense laser fields. Thus, a long-standing conjecture about the possible existence of quantum chaos in atoms and molecules under intense laser fields has finally been tested and not found to be valid in the present case.

THE PANC 3 SCORE PREDICTING SEVERITY OF ACUTE PANCREATITIS.

PubMed

Beduschi, Murilo Gamba; Mello, André Luiz Parizi; VON-Mühlen, Bruno; Franzon, Orli

2016-03-01

About 20% of cases of acute pancreatitis progress to a severe form, leading to high mortality rates. Several studies suggested methods to identify patients that will progress more severely. However, most studies present problems when used on daily practice. To assess the efficacy of the PANC 3 score to predict acute pancreatitis severity and its relation to clinical outcome. Acute pancreatitis patients were assessed as to sex, age, body mass index (BMI), etiology of pancreatitis, intensive care need, length of stay, length of stay in intensive care unit and mortality. The PANC 3 score was determined within the first 24 hours after diagnosis and compared to acute pancreatitis grade of the Revised Atlanta classification. Out of 64 patients diagnosed with acute pancreatitis, 58 met the inclusion criteria. The PANC 3 score was positive in five cases (8.6%), pancreatitis progressed to a severe form in 10 cases (17.2%) and five patients (8.6%) died. Patients with a positive score and severe pancreatitis required intensive care more often, and stayed for a longer period in intensive care units. The PANC 3 score showed sensitivity of 50%, specificity of 100%, accuracy of 91.4%, positive predictive value of 100% and negative predictive value of 90.6% in prediction of severe acute pancreatitis. The PANC 3 score is useful to assess acute pancreatitis because it is easy and quick to use, has high specificity, high accuracy and high predictive value in prediction of severe acute pancreatitis.

Modeling dental composite shrinkage by digital image correlation and finite element methods

NASA Astrophysics Data System (ADS)

Chen, Terry Yuan-Fang; Huang, Pin-Sheng; Chuang, Shu-Fen

2014-10-01

Dental composites are light-curable resin-based materials with an inherent defect of polymerization shrinkage which may cause tooth deflection and debonding of restorations. This study aimed to combine digital image correlation (DIC) and finite element analysis (FEA) to model the shrinkage behaviors under different light curing regimens. Extracted human molars were prepared with proximal cavities for composite restorations, and then divided into three groups to receive different light curing protocols: regular intensity, low intensity, and step-curing consisting of low and high intensities. For each tooth, the composite fillings were consecutively placed under both unbonded and bonded conditions. At first, the shrinkage of the unbonded restorations was analyzed by DIC and adopted as the setting of FEA. The simulated shrinkage behaviors obtained from FEA were further validated by the measurements in the bonded cases. The results showed that different light curing regimens affected the shrinkage in unbonded restorations, with regular intensity showing the greatest shrinkage strain on the top surface. The shrinkage centers in the bonded cases were located closer to the cavity floor than those in the unbonded cases, and were less affected by curing regimens. The FEA results showed that the stress was modulated by the accumulated light energy density, while step-curing may alleviate the tensile stress along the cavity walls. In this study, DIC provides a complete description of the polymerization shrinkage behaviors of dental composites, which may facilitate the stress analysis in the numerical investigation.

THE PANC 3 SCORE PREDICTING SEVERITY OF ACUTE PANCREATITIS

PubMed Central

BEDUSCHI, Murilo Gamba; MELLO, André Luiz Parizi; VON-MÜHLEN, Bruno; FRANZON, Orli

2016-01-01

Background : About 20% of cases of acute pancreatitis progress to a severe form, leading to high mortality rates. Several studies suggested methods to identify patients that will progress more severely. However, most studies present problems when used on daily practice. Objective : To assess the efficacy of the PANC 3 score to predict acute pancreatitis severity and its relation to clinical outcome. Methods : Acute pancreatitis patients were assessed as to sex, age, body mass index (BMI), etiology of pancreatitis, intensive care need, length of stay, length of stay in intensive care unit and mortality. The PANC 3 score was determined within the first 24 hours after diagnosis and compared to acute pancreatitis grade of the Revised Atlanta classification. Results : Out of 64 patients diagnosed with acute pancreatitis, 58 met the inclusion criteria. The PANC 3 score was positive in five cases (8.6%), pancreatitis progressed to a severe form in 10 cases (17.2%) and five patients (8.6%) died. Patients with a positive score and severe pancreatitis required intensive care more often, and stayed for a longer period in intensive care units. The PANC 3 score showed sensitivity of 50%, specificity of 100%, accuracy of 91.4%, positive predictive value of 100% and negative predictive value of 90.6% in prediction of severe acute pancreatitis. Conclusion : The PANC 3 score is useful to assess acute pancreatitis because it is easy and quick to use, has high specificity, high accuracy and high predictive value in prediction of severe acute pancreatitis. PMID:27120730

Internal and edge cracks in a plate of finite width under bending

NASA Technical Reports Server (NTRS)

Boduroglu, H.; Erdogan, F.

1983-01-01

Internal and edge cracks were studied by using Reissner's transverse shear theory. The effect of stress-free boundaries on the stress intensity factors in plates under bending were investigated. Among the results found, particularly interesting are those relating to the limiting cases of the crack geometries. The numerical results are given for a single internal crack, two collinear cracks, and two edge cracks. The effect of Poisson's ratio on the stress intensity factors was studied.

Complex tibial fracture outcomes following treatment with low-intensity pulsed ultrasound.

PubMed

Leung, Kwok-Sui; Lee, Wing-Sze; Tsui, Hon-For; Liu, Paul Po-Lung; Cheung, Wing-Hoi

2004-03-01

A clinical study was conducted to investigate the effect of low-intensity pulsed ultrasound (US) stimulation (LIPUS) on the healing of complex tibial fractures. Thirty complex tibial fractures were randomly assigned to the treatment with LIPUS (n = 16) or by a dummy machine (sham-exposed: n = 14). The fractures were immobilized by either internal or external fixations according to the clinical indications. LIPUS was given 20 min/day for 90 days. Fracture healing was monitored by clinical, radiological, densitometric and biochemical assessments. The LIPUS-treated group showed statistically significantly better healing, as demonstrated by all assessments. Complications were minimal in the LIPUS group. There were two cases of delayed union, with one in each group. There were two cases of infection in the control group. The delayed-union cases were subsequently treated by LIPUS and the infection cases were treated with standard protocol. Fracture healing in these patients was again treated by LIPUS.

Urine output on an intensive care unit: case-control study

PubMed Central

Kirwan, Christopher J; Alexander, Neal D E; Nimako, Kofi; Jurukov, Angela; Forth, Rebecca J; Rahman, Tony M

2010-01-01

Objective To compare urine output between junior doctors in an intensive care unit and the patients for whom they are responsible. Design Case-control study. Setting General intensive care unit in a tertiary referral hospital. Participants 18 junior doctors responsible for clerking patients on weekday day shifts in the unit from 23 March to 23 April 2009 volunteered as “cases.” Controls were the patients in the unit clerked by those doctors. Exclusion criteria (for both groups) were pregnancy, baseline estimated glomerular filtration rate <15 ml/min/1.73 m2, and renal replacement therapy. Main outcome measures Oliguria (defined as mean urine output <0.5 ml/kg/hour over six or more hours of measurement) and urine output (in ml/kg/hour) as a continuous variable. Results Doctors were classed as oliguric and “at risk” of acute kidney injury on 19 (22%) of 87 shifts in which urine output was measured, and oliguric to the point of being “in injury” on one (1%) further shift. Data were available for 208 of 209 controls matched to cases in the data collection period; 13 of these were excluded because the control was receiving renal replacement therapy. Doctors were more likely to be oliguric than their patients (odds ratio 1.99, 95% confidence interval 1.08 to 3.68, P=0.03). For each additional 1 ml/kg/hour mean urine output, the odds ratio for being a case rather than a control was 0.27 (0.12 to 0.58, P=0.001). Mortality among doctors was astonishingly low, at 0% (0% to 18%). Conclusions Managing our own fluid balance is more difficult than managing it in our patients. We should drink more water. Modifications to the criteria for acute kidney injury could be needed for the assessment of junior doctors in an intensive care unit. PMID:21156738

Intensive (Daily) Behavior Therapy for School Refusal: A Multiple Baseline Case Series

ERIC Educational Resources Information Center

Tolin, David F.; Whiting, Sara; Maltby, Nicholas; Diefenbach, Gretchen J.; Lothstein, Mary Anne; Hardcastle, Surrey; Catalano, Amy; Gray, Krista

2009-01-01

The following multiple baseline case series examines school refusal behavior in 4 male adolescents. School refusal symptom presentation was ascertained utilizing a functional analysis from the School Refusal Assessment Scale (Kearney, 2002). For the majority of cases, treatment was conducted within a 15-session intensive format over a 3-week…

Description of Exemplar Cases in the Intensive Mental Health Program: Illustrations of Application of the Therapeutic Model

ERIC Educational Resources Information Center

Nelson, Timothy D.; Mashunkashey, Joanna O.; Mitchell, Montserrat C.; Benson, Eric R.; Vernberg, Eric M.; Roberts, Michael C.

2008-01-01

We describe cases from the clinical records in the Intensive Mental Health Program to illustrate the diverse presenting problems, intervention strategies, therapeutic process, and outcomes for children receiving services in this school-based, community-oriented treatment model. Cases reflect varying degrees of treatment response and potential…

Design and Testing of a Luminance and Chrominance Stabilization System for a Computer-Controlled Color Display.

DTIC Science & Technology

1987-07-01

OVER TIME The phosphor stability over time was studied by measuring the spectrum over an extended period of time. On each day the spectrum of the...intensity, it causes the display to change in order to keep the light intensity constant. For example, in one case , the high intensity room lights were...MC1445. This device has the capability of switching! from one video source to another in a very shoi t time, 20 ns. The MC1445 is used to switch from

Single Case Evaluation of an Intensive Cognitive Behavioral Treatment for Generalized Social Anxiety Disorder

PubMed Central

Stoddard, Jill A.; Rosellini, Anthony J.; Hofmann, Stefan G.

2008-01-01

The present study investigated the efficacy of an 8-day, 6-session, intensive individual cognitive behavioral therapy protocol for social anxiety disorder using a multiple baseline across subjects design with 1, 2, and 3 months follow-up assessments. Participants were 5 outpatients with generalized social anxiety disorder. The intervention had variable effects on clinician-rated and self-report measures of anxiety and depression. The results question the efficacy of intensive psychotherapy as a general therapeutic strategy for social anxiety disorder. Directions for future research are discussed. PMID:19169365

Effect of anisotropy on defect mode peculiarities in chiral liquid crystals

NASA Astrophysics Data System (ADS)

Gevorgyan, A. H.; Oganesyan, K. B.

2018-01-01

The effect of anisotropy on defect mode peculiarities in cholesteric liquid crystals is investigated. The light transmission through the cholesteric liquid crystal layer with an anisotropic layer defect inside is solved by Ambartsumian’s layer addition modified method. Two cases are considered. In the first case, it is assumed that the defect layer is non-absorbing, and the effect of refraction anisotropy on the reflection, relative photonic density of states and the total field intensity produced in the defect layer are studied. In the second case, the defect layer is assumed to be isotropic for refraction and anisotropic for absorption, and the influence of defect layer absorption anisotropy on reflection, absorption, relative photonic density of states and the total field intensity produced in the defect layer are investigated.

Emissions reductions from expanding state-level renewable portfolio standards.

PubMed

Johnson, Jeremiah X; Novacheck, Joshua

2015-05-05

In the United States, state-level Renewable Portfolio Standards (RPS) have served as key drivers for the development of new renewable energy. This research presents a method to evaluate emissions reductions and costs attributable to new or expanded RPS programs by integrating a comprehensive economic dispatch model and a renewable project selection model. The latter model minimizes incremental RPS costs, accounting for renewable power purchase agreements (PPAs), displaced generation and capacity costs, and net changes to a state's imports and exports. We test this method on potential expansions to Michigan's RPS, evaluating target renewable penetrations of 10% (business as usual or BAU), 20%, 25%, and 40%, with varying times to completion. Relative to the BAU case, these expanded RPS policies reduce the CO2 intensity of generation by 13%, 18%, and 33% by 2035, respectively. SO2 emissions intensity decreased by 13%, 20%, and 34% for each of the three scenarios, while NOx reductions totaled 12%, 17%, and 31%, relative to the BAU case. For CO2 and NOx, absolute reductions in emissions intensity were not as large due to an increasing trend in emissions intensity in the BAU case driven by load growth. Over the study period (2015 to 2035), the absolute CO2 emissions intensity increased by 1% in the 20% RPS case and decreased by 6% and 22% for the 25% and 40% cases, respectively. Between 26% and 31% of the CO2, SO2, and NOx emissions reductions attributable to the expanded RPS occur in neighboring states, underscoring the challenges quantifying local emissions reductions from state-level energy policies with an interconnected grid. Without federal subsidies, the cost of CO2 mitigation using an RPS in Michigan is between $28 and $34/t CO2 when RPS targets are met. The optimal renewable build plan is sensitive to the capacity credit for solar but insensitive to the value for wind power.

The effects of visitor density and intensity on the behavior of two captive jaguars (Panthera onca).

PubMed

Sellinger, Rebecca L; Ha, James C

2005-01-01

Several researchers have reported significant effects of visitor density and intensity on captive animal behavior. This study determined whether this was the case for 2 captive jaguars housed at the Woodland Park Zoo, Seattle, WA. Subjects were monitored for changes in behavior as a function of visitor density and intensity. The jaguars were observed for 8 hr per week for 29 weeks--March 31 until October 11, 1998--for a total of 230 hr. Continuous frequency sampling was used, and visitor density and intensity were recorded every minute. Parametric statistics were used to test for correlations between behavior and density, intensity, or a combination of the two. Both density and intensity were significant for time spent non-visible for both cats, and intensity showed a significant effect on the female's pacing behavior. In addition, the male cat exhibited a trend for increased aggression based on both visitor density and intensity and a trend of intensity affecting his social behavior. In conclusion, both density and intensity had a significant effect on behavior, with intensity showing a larger effect.

A Case Study: A Guide to Working with a Language Impaired Child.

ERIC Educational Resources Information Center

Sapir, Selma G.; Rainho, Sergio

The document presents the case study of the interaction of a graduate student in traning, her supervisor, an 8 year old child with a language learning problem, and the child's mother. It involves a process which entails the careful matching of the child to tutor, the tutor to supervisor, and intensive work with the mother. It also is based on what…

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

PubMed

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

2013-06-01

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

Prostate Cancer and Ambient Pesticide Exposure in Agriculturally Intensive Areas in California

PubMed Central

Cockburn, Myles; Mills, Paul; Zhang, Xinbo; Zadnick, John; Goldberg, Dan; Ritz, Beate

2011-01-01

In a population-based case-control study in California's intensely agricultural Central Valley (2005–2006), the authors investigated relations between environmental pesticide/fungicide exposure and prostate cancer. Cases (n = 173) were obtained from a population-based cancer registry, and controls (n = 162) were obtained from Medicare listings and tax assessor mailings. Past ambient exposures to pesticides/fungicides were derived from residential history and independently recorded pesticide and land-use data, using a novel geographic information systems approach. In comparison with unexposed persons, increased risks of prostate cancer were observed among persons exposed to compounds which may have prostate-specific biologic effects (methyl bromide (odds ratio = 1.62, 95% confidence interval: 1.02, 2.59) and a group of organochlorines (odds ratio = 1.64, 95% confidence interval: 1.02, 2.63)) but not among those exposed to other compounds that were included as controls (simazine, maneb, and paraquat dichloride). The authors assessed the possibility of selection bias due to less-than-100% enrollment of eligible cases and controls (a critical methodological concern in studies of this kind) and determined that there was little evidence of bias affecting the estimated effect size. This study provides evidence of an association between prostate cancer and ambient pesticide exposures in and around homes in intensely agricultural areas. The associations appear specific to compounds with a plausible biologic role in prostate carcinogenesis. PMID:21447478

Time-intensive cognitive behaviour therapy for obsessive-compulsive disorder: A case series and matched comparison group.

PubMed

Oldfield, Victoria B; Salkovskis, Paul M; Taylor, Tracey

2011-03-01

A time-intensive format may be both useful and effective for the delivery of cognitive behaviour therapy (CBT) for obsessive-compulsive disorder (OCD). Intensive treatments also offer a pragmatic alternative to in-patient admission for those in a geographically remote location. Published studies of intensive treatment include pioneering exposure-response prevention (ERP) trials that emphasized the requirement for high-intensity treatment; more recently several studies have used treatment protocols with a heavy emphasis on ERP. This study compares intensive versus standard weekly treatment format following the integrated formulation-driven CBT approach widely used in UK adult mental health settings. An analysis of patients undertaking intensive CBT using a matched comparison group of those who undertook weekly CBT for OCD. Twenty-two adult patients undertook intensive format treatment (matched with a weekly group for age, gender, and initial symptoms). A range of self-report measures were examined at the end of treatment and at a 3-month follow-up. Significant treatment effects were found on a range of self-report measures; both conditions were found to be equally effective at the end of treatment and at 3-month follow-up. Uncontrolled effect sizes show that the intensive treatment was comparable to other trials of CBT for OCD. An intensive treatment format for the delivery of CBT for OCD was found to be as effective as weekly treatment. This is consistent with the recommendations from the National Institute for Clinical Excellence guidelines. This study adds to the growing literature on the effectiveness of intensive format treatment. ©2010 The British Psychological Society.

Tropical Cyclone Intensity Estimation Using Deep Convolutional Neural Networks

NASA Technical Reports Server (NTRS)

Maskey, Manil; Cecil, Dan; Ramachandran, Rahul; Miller, Jeffrey J.

2018-01-01

Estimating tropical cyclone intensity by just using satellite image is a challenging problem. With successful application of the Dvorak technique for more than 30 years along with some modifications and improvements, it is still used worldwide for tropical cyclone intensity estimation. A number of semi-automated techniques have been derived using the original Dvorak technique. However, these techniques suffer from subjective bias as evident from the most recent estimations on October 10, 2017 at 1500 UTC for Tropical Storm Ophelia: The Dvorak intensity estimates ranged from T2.3/33 kt (Tropical Cyclone Number 2.3/33 knots) from UW-CIMSS (University of Wisconsin-Madison - Cooperative Institute for Meteorological Satellite Studies) to T3.0/45 kt from TAFB (the National Hurricane Center's Tropical Analysis and Forecast Branch) to T4.0/65 kt from SAB (NOAA/NESDIS Satellite Analysis Branch). In this particular case, two human experts at TAFB and SAB differed by 20 knots in their Dvorak analyses, and the automated version at the University of Wisconsin was 12 knots lower than either of them. The National Hurricane Center (NHC) estimates about 10-20 percent uncertainty in its post analysis when only satellite based estimates are available. The success of the Dvorak technique proves that spatial patterns in infrared (IR) imagery strongly relate to tropical cyclone intensity. This study aims to utilize deep learning, the current state of the art in pattern recognition and image recognition, to address the need for an automated and objective tropical cyclone intensity estimation. Deep learning is a multi-layer neural network consisting of several layers of simple computational units. It learns discriminative features without relying on a human expert to identify which features are important. Our study mainly focuses on convolutional neural network (CNN), a deep learning algorithm, to develop an objective tropical cyclone intensity estimation. CNN is a supervised learning algorithm requiring a large number of training data. Since the archives of intensity data and tropical cyclone centric satellite images is openly available for use, the training data is easily created by combining the two. Results, case studies, prototypes, and advantages of this approach will be discussed.

Static Tensile and Transient Dynamic Response of Cracked Aluminum Plate Repaired with Composite Patch - Numerical Study

NASA Astrophysics Data System (ADS)

Khalili, S. M. R.; Shariyat, M.; Mokhtari, M.

2014-06-01

In this study, the central cracked aluminum plates repaired with two sided composite patches are investigated numerically for their response to static tensile and transient dynamic loadings. Contour integral method is used to define and evaluate the stress intensity factors at the crack tips. The reinforcement for the composite patches is carbon fibers. The effect of adhesive thickness and patch thickness and configuration in tensile loading case and pre-tension, pre-compression and crack length effect on the evolution of the mode I stress intensity factor (SIF) (KI) of the repaired structure under transient dynamic loading case are examined. The results indicated that KI of the central cracked plate is reduced by 1/10 to 1/2 as a result of the bonded composite patch repair in tensile loading case. The crack length and the pre-loads are more effective in repaired structure in transient dynamic loading case in which, the 100 N pre-compression reduces the maximum KI for about 40 %, and the 100 N pre-tension reduces the maximum KI after loading period, by about 196 %.

Glucose Transporter 1 Expression in Odontogenic Keratocyst, Dentigerous Cyst, and Ameloblastoma: An Immunohistochemical Study.

PubMed

Bandyopadhyay, Alokenath; Panda, Abikshyeet; Behura, Shyam S; Ramachandra, Sujatha; Dash, Kailash C; Mishra, Pallavi

2017-05-01

An array of odontogenic lesions manifest in the maxillofacial region with variable presentations. The biological behavior of lesions, such as odontogenic keratocyst (OKC), dentigerous cyst (DC), and ameloblastoma (AM) always invite debate. Glucose transporter 1 (GLUT-1) is proven to be an indicator of metabolic behavior of several benign and malignant neoplasms. The purpose of this study was to evaluate the expression of GLUT-1 in OKC, DC, and AM to understand their metabolic behavior. Immunohistochemical expression of GLUT-1 was evaluated in each of the 15 cases of OKC, DC, and AM. The number of labeled cells, staining intensity, and membrane or cytoplasmic expressions were the parameters assessed and analyzed using chi-square test. All cases showed positive GLUT-1 expression: 86.6% OKC showed more than 50% labeled cells followed by DC (40%) and AM (26.5%); 53.3% OKC showed strong intensity in comparison to AM, which showed weak intensity in 53.3% cases; 86.6% of OKCs showed both membrane and cytoplasmic expression followed by DC (40%) and AM (26.6%), whereas 73.3% of AM showed only membrane expression followed by DC (60%) and OKC (13.3%). Odontogenic keratocyst was found out to be more metabolically active followed by DC and AM.

Demons deformable registration of CT and cone-beam CT using an iterative intensity matching approach

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

Nithiananthan, Sajendra; Schafer, Sebastian; Uneri, Ali

2011-04-15

Purpose: A method of intensity-based deformable registration of CT and cone-beam CT (CBCT) images is described, in which intensity correction occurs simultaneously within the iterative registration process. The method preserves the speed and simplicity of the popular Demons algorithm while providing robustness and accuracy in the presence of large mismatch between CT and CBCT voxel values (''intensity''). Methods: A variant of the Demons algorithm was developed in which an estimate of the relationship between CT and CBCT intensity values for specific materials in the image is computed at each iteration based on the set of currently overlapping voxels. This tissue-specificmore » intensity correction is then used to estimate the registration output for that iteration and the process is repeated. The robustness of the method was tested in CBCT images of a cadaveric head exhibiting a broad range of simulated intensity variations associated with x-ray scatter, object truncation, and/or errors in the reconstruction algorithm. The accuracy of CT-CBCT registration was also measured in six real cases, exhibiting deformations ranging from simple to complex during surgery or radiotherapy guided by a CBCT-capable C-arm or linear accelerator, respectively. Results: The iterative intensity matching approach was robust against all levels of intensity variation examined, including spatially varying errors in voxel value of a factor of 2 or more, as can be encountered in cases of high x-ray scatter. Registration accuracy without intensity matching degraded severely with increasing magnitude of intensity error and introduced image distortion. A single histogram match performed prior to registration alleviated some of these effects but was also prone to image distortion and was quantifiably less robust and accurate than the iterative approach. Within the six case registration accuracy study, iterative intensity matching Demons reduced mean TRE to (2.5{+-}2.8) mm compared to (3.5{+-}3.0) mm with rigid registration. Conclusions: A method was developed to iteratively correct CT-CBCT intensity disparity during Demons registration, enabling fast, intensity-based registration in CBCT-guided procedures such as surgery and radiotherapy, in which CBCT voxel values may be inaccurate. Accurate CT-CBCT registration in turn facilitates registration of multimodality preoperative image and planning data to intraoperative CBCT by way of the preoperative CT, thereby linking the intraoperative frame of reference to a wealth of preoperative information that could improve interventional guidance.« less

A near miss: the importance of context in a public health informatics project in a New Zealand case study.

PubMed

Wells, Stewart; Bullen, Chris

2008-01-01

This article describes the near failure of an information technology (IT) system designed to support a government-funded, primary care-based hepatitis B screening program in New Zealand. Qualitative methods were used to collect data and construct an explanatory model. Multiple incorrect assumptions were made about participants, primary care workflows and IT capacity, software vendor user knowledge, and the health IT infrastructure. Political factors delayed system development and it was implemented untested, almost failing. An intensive rescue strategy included system modifications, relaxation of data validity rules, close engagement with software vendors, and provision of intensive on-site user support. This case study demonstrates that consideration of the social, political, technological, and health care contexts is important for successful implementation of public health informatics projects.

Homogenizing and diversifying effects of intensive agricultural land-use on plant species beta diversity in Central Europe - A call to adapt our conservation measures

Treesearch

Constanze Buhk; Martin Alt; Manuel J. Steinbauer; Carl Beierkuhnlein; Steve Warren; Anke Jentsch

2017-01-01

The prevention of biodiversity loss in agricultural landscapes to protect ecosystem stability and functions is of major importance to stabilize overall diversity. Intense agriculture leads to a loss in species richness and homogenization of species pools, but the processes behind are poorly understood due to a lack of systematic case studies: The specific...

Effect of transmission intensity on hotspots and micro-epidemiology of malaria in sub-Saharan Africa.

PubMed

Mogeni, Polycarp; Omedo, Irene; Nyundo, Christopher; Kamau, Alice; Noor, Abdisalan; Bejon, Philip

2017-06-30

Malaria transmission intensity is heterogeneous, complicating the implementation of malaria control interventions. We provide a description of the spatial micro-epidemiology of symptomatic malaria and asymptomatic parasitaemia in multiple sites. We assembled data from 19 studies conducted between 1996 and 2015 in seven countries of sub-Saharan Africa with homestead-level geospatial data. Data from each site were used to quantify spatial autocorrelation and examine the temporal stability of hotspots. Parameters from these analyses were examined to identify trends over varying transmission intensity. Significant hotspots of malaria transmission were observed in most years and sites. The risk ratios of malaria within hotspots were highest at low malaria positive fractions (MPFs) and decreased with increasing MPF (p < 0.001). However, statistical significance of hotspots was lowest at extremely low and extremely high MPFs, with a peak in statistical significance at an MPF of ~0.3. In four sites with longitudinal data we noted temporal instability and variable negative correlations between MPF and average age of symptomatic malaria across all sites, suggesting varying degrees of temporal stability. We observed geographical micro-variation in malaria transmission at sites with a variety of transmission intensities across sub-Saharan Africa. Hotspots are marked at lower transmission intensity, but it becomes difficult to show statistical significance when cases are sparse at very low transmission intensity. Given the predictability with which hotspots occur as transmission intensity falls, malaria control programmes should have a low threshold for responding to apparent clustering of cases.

Demons deformable registration of CT and cone-beam CT using an iterative intensity matching approach

PubMed Central

Nithiananthan, Sajendra; Schafer, Sebastian; Uneri, Ali; Mirota, Daniel J.; Stayman, J. Webster; Zbijewski, Wojciech; Brock, Kristy K.; Daly, Michael J.; Chan, Harley; Irish, Jonathan C.; Siewerdsen, Jeffrey H.

2011-01-01

Purpose: A method of intensity-based deformable registration of CT and cone-beam CT (CBCT) images is described, in which intensity correction occurs simultaneously within the iterative registration process. The method preserves the speed and simplicity of the popular Demons algorithm while providing robustness and accuracy in the presence of large mismatch between CT and CBCT voxel values (“intensity”). Methods: A variant of the Demons algorithm was developed in which an estimate of the relationship between CT and CBCT intensity values for specific materials in the image is computed at each iteration based on the set of currently overlapping voxels. This tissue-specific intensity correction is then used to estimate the registration output for that iteration and the process is repeated. The robustness of the method was tested in CBCT images of a cadaveric head exhibiting a broad range of simulated intensity variations associated with x-ray scatter, object truncation, and∕or errors in the reconstruction algorithm. The accuracy of CT-CBCT registration was also measured in six real cases, exhibiting deformations ranging from simple to complex during surgery or radiotherapy guided by a CBCT-capable C-arm or linear accelerator, respectively. Results: The iterative intensity matching approach was robust against all levels of intensity variation examined, including spatially varying errors in voxel value of a factor of 2 or more, as can be encountered in cases of high x-ray scatter. Registration accuracy without intensity matching degraded severely with increasing magnitude of intensity error and introduced image distortion. A single histogram match performed prior to registration alleviated some of these effects but was also prone to image distortion and was quantifiably less robust and accurate than the iterative approach. Within the six case registration accuracy study, iterative intensity matching Demons reduced mean TRE to (2.5±2.8) mm compared to (3.5±3.0) mm with rigid registration. Conclusions: A method was developed to iteratively correct CT-CBCT intensity disparity during Demons registration, enabling fast, intensity-based registration in CBCT-guided procedures such as surgery and radiotherapy, in which CBCT voxel values may be inaccurate. Accurate CT-CBCT registration in turn facilitates registration of multimodality preoperative image and planning data to intraoperative CBCT by way of the preoperative CT, thereby linking the intraoperative frame of reference to a wealth of preoperative information that could improve interventional guidance. PMID:21626913

A Scientific Approach to Improve Physiological Capacity of an Elite Cyclist.

PubMed

Rønnestad, Bent R; Hansen, Joar

2018-03-01

Previous studies in endurance athletes have indicated that block periodization (BP) can be a good alternative to the more traditional organization of training despite the fact that the total volume and intensity of the training are similar. However, these studies usually last only 4-12 wk. The aim of the present single-case study was to investigate the consequences of 58 wk with systematic BP of low-intensity training (LIT), moderate-intensity training (MIT), and high-intensity interval training (HIT) including incorporation of heavy strength training. It is important that a maintenance stimulus on the nonprioritized training modalities was added in the different training blocks. Performance-related variables were tested regularly during the intervention. The studied cyclist started with a maximal oxygen uptake (VO 2 max) of 73.8 mL · kg -1  · min -1 , peak aerobic power (W max ) of 6.14 W/kg, and a power output at 3 mmol/L blood lactate concentration (Power 3la -) of 3.6 W/kg. Total training volume during the 58-wk intervention was 678 h, of which 452 h were LIT (67%), 124 h were MIT (18%), 69 h were HIT (10%), and 34 h were heavy strength training (5%). The weekly training volume had a large range depending on the focus of the training block. After the intervention the cyclist's VO 2 max was 87 mL · kg -1  · min -1 , W max was 7.35 W/kg, and Power 3la - was 4.9 W/kg. This single case indicates that the present training program can be a good alternative to the more traditional organization of long-term training of endurance athletes. However, a general recommendation cannot be given based on this single-case study.

Effectiveness of therapy in terms of reduction of intensity and elimination of suicidal ideation in day hospital for the treatment of neurotic and behavioral disorders.

PubMed

Rodziński, Paweł; Sobański, Jerzy A; Rutkowski, Krzysztof; Cyranka, Katarzyna; Murzyn, Agnieszka; Dembińska, Edyta; Grządziel, Karolina; Mielimąka, Michał; Müldner-Nieckowski, Łukasz; Smiatek-Mazgaj, Bogna

2015-01-01

Analysis of changes in prevalence and intensity of suicidal ideation (SI) in patients who underwent an intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach in the Day Hospital for Neurotic and Behavioral Disorders. Symptom checklist KO"O" and Life Inventory completed by 461 women and 219 men who were treated in the day hospital due to neurotic, behavioral and personality disorders in 2005-2013. Patients initially reporting SI showed greater than others global intensity of the neurotic symptoms (p < 0.001 for both sexes) and greater intensity in almost all the neurotic symptoms scales. Improvement (elimination or reduction of intensity) in terms of SI was observed in 84.3% of women and 77.5% of men. The prevalence of SI-reporting patients decreased substantially from 29.1% to 10.2% in women and from 36.5% to 13.7% in men. The patients reporting SI before the commencement of psychotherapy constituted a large part of the studied population - approximately 1/3. They showed greater intensity of neurotic symptoms than those who were not reporting SI. Intensive psychotherapy in the day hospital was characterized by high effectiveness in terms of reduction and elimination of SI. Prevalence of SI in both women and men until the end of therapy decreased almost three times. Cases of improvement in terms of SI were several times more frequent than cases of deterioration in terms of SI (increase in its intensity or its occurrence at the end of therapy). Etiopathogenesis of SI and its methods of treatment require further research.

Carbaryl washoff from soybean plants.

PubMed

Willis, G H; Smith, S; McDowell, L L; Southwick, L M

1996-08-01

Both the efficacy and fate of most foliar-applied pesticides may be affected by weather variables, especially rain. A multiple-intensity rainfall simulator was used to determine the effects of rainfall intensity and amount on concentrations of carbaryl (Sevin(R) XLS Plus) washed from soybean plants. Two hours after carbaryl was applied at 1.12 kg/ha, 25 mm of rain was applied at intensities of 13.0, 27.4, 53.8, or 105.1 mm/h. About 67% of the carbaryl on the plants was washed off by 25 mm of rain. Rainfall intensity affected carbaryl concentrations in washoff; higher concentrations occurred at lower intensities. Even though the experimental conditions were designed for "worst-case" conditions, washoff patterns suggested improved carbaryl rainfastness when compared to carbaryl (formulated as a wettable powder) washoff from cotton plants in earlier studies. Rainfall amount had a greater effect on carbaryl concentrations in washoff than rainfall intensity.

Determining the Intensity of a Point-Like Source Observed on the Background of AN Extended Source

NASA Astrophysics Data System (ADS)

Kornienko, Y. V.; Skuratovskiy, S. I.

2014-12-01

The problem of determining the time dependence of intensity of a point-like source in case of atmospheric blur is formulated and solved by using the Bayesian statistical approach. A pointlike source is supposed to be observed on the background of an extended source with constant in time though unknown brightness. The equation system for optimal statistical estimation of the sequence of intensity values in observation moments is obtained. The problem is particularly relevant for studying gravitational mirages which appear while observing a quasar through the gravitational field of a far galaxy.

Character Development at the United States Air Force Academy: A Phenomenological Case Study of Graduates' Reflections

ERIC Educational Resources Information Center

Smith, J. Micheal

2010-01-01

The United States Air Force Academy develops commissionable officers of character through an intense 4-year program that includes academic, athletic, and military education and training. The literature was silent on whether the Academy effectively develops character or, if so, how the development takes place. This was a phenomenological case study…

Using Single-Case Design and Personalized Behavior Change Projects to Teach Research Methods

ERIC Educational Resources Information Center

Morgan, David L.

2009-01-01

Students in research methods courses, especially those taught in an intense format, might be hard pressed to actually conduct research studies due to logistics and time constraints. I describe the use of single-case research design and a personalized behavior project as an alternative research project for students in an undergraduate psychology…

Orienting Student Using a Case-Based Instructional Approach: A Case Study

ERIC Educational Resources Information Center

Agbor-Baiyee, W.

2009-01-01

Purpose: Orientation facilitates the transition to a new academic program to meet the need of new students to know programmatic items such as academic expectations, courses, policies and procedures. We used a problem based learning (PBL) approach to introduce our students to the expectations of our intensive 10-week Medical College Admission Test…

Parents' Perspectives: An Evaluation of Case Management Interventions in Home Visiting Programs for Young Children

ERIC Educational Resources Information Center

Allen, Susan F.

2007-01-01

In home visiting programs for children younger than age three, home visitors work with parents to enhance the child's environment. This study examined how the home visitor-parent relationship, amount of contact, and level of need affected the intensity of case management interventions received. Researchers interviewed 90 mothers to measure the…

Employment Retention after Vision Loss: Intensive Case Studies.

ERIC Educational Resources Information Center

Crudden, Adele; Fireison, Cara K.

This study examined the lives of 10 individuals with blindness or severe visual impairment who maintained competitive employment despite their vision loss. The study was designed to provide information regarding the personal characteristics and current practices related to work environment alterations which enhance competitive employment…

Case Histories of Intense Pulsed Light Phototherapy in Dermatology - the HPPL™ and IFL™ Technologies

PubMed Central

Martella, Alessandro; Raichi, Mauro

2017-01-01

The intense pulsed light (IPL) and laser technologies are widely used for skin rejuvenation and for treating several dermatological disorders such as skin dyschromia and acne, and for non-ablative dermal remodeling of rhytides and hypertrophic scars. Technological evolution is rapid. The High Power Pulsed Light™ [HPPL™] and Incoherent Fast Light™ technologies [IFL™, Novavision Group S.p.A., 20826 Misinto (MB), Italy] are recent innovations in the field of IPL technologies; IFL™ is a further evolution of the already advanced HPPL™ system. The paper presents a selection of case histories of dermatological lesions treated with the HPPL™ and IFL™ technologies. All study materials were appropriately peer-reviewed for ethical problems. PMID:28652908

Ethics and law in the intensive care unit.

PubMed

Danbury, C M; Waldmann, C S

2006-12-01

Intensive Care Medicine epitomises the difficulties inherent in modern medicine. In this chapter we examine some key medicolegal and ethical areas that are evolving. The principles of autonomy and consent are well established, but developments in UK caselaw have shown that the courts may be moving away from their traditional deference of the medical profession. We examine some recent cases and discuss the impact that these cases may have on practice in Intensive Care.

An ontological case base engineering methodology for diabetes management.

PubMed

El-Sappagh, Shaker H; El-Masri, Samir; Elmogy, Mohammed; Riad, A M; Saddik, Basema

2014-08-01

Ontology engineering covers issues related to ontology development and use. In Case Based Reasoning (CBR) system, ontology plays two main roles; the first as case base and the second as domain ontology. However, the ontology engineering literature does not provide adequate guidance on how to build, evaluate, and maintain ontologies. This paper proposes an ontology engineering methodology to generate case bases in the medical domain. It mainly focuses on the research of case representation in the form of ontology to support the case semantic retrieval and enhance all knowledge intensive CBR processes. A case study on diabetes diagnosis case base will be provided to evaluate the proposed methodology.

Kinetic energy budget studies of areas of convection

NASA Technical Reports Server (NTRS)

Fuelberg, H. E.

1979-01-01

Synoptic-scale kinetic energy budgets are being computed for three cases when large areas of intense convection occurred over the Central United States. Major energy activity occurs in the storm areas.

Incorporating deliverable monitor unit constraints into spot intensity optimization in intensity modulated proton therapy treatment planning

PubMed Central

Cao, Wenhua; Lim, Gino; Li, Xiaoqiang; Li, Yupeng; Zhu, X. Ronald; Zhang, Xiaodong

2014-01-01

The purpose of this study is to investigate the feasibility and impact of incorporating deliverable monitor unit (MU) constraints into spot intensity optimization in intensity modulated proton therapy (IMPT) treatment planning. The current treatment planning system (TPS) for IMPT disregards deliverable MU constraints in the spot intensity optimization (SIO) routine. It performs a post-processing procedure on an optimized plan to enforce deliverable MU values that are required by the spot scanning proton delivery system. This procedure can create a significant dose distribution deviation between the optimized and post-processed deliverable plans, especially when small spot spacings are used. In this study, we introduce a two-stage linear programming (LP) approach to optimize spot intensities and constrain deliverable MU values simultaneously, i.e., a deliverable spot intensity optimization (DSIO) model. Thus, the post-processing procedure is eliminated and the associated optimized plan deterioration can be avoided. Four prostate cancer cases at our institution were selected for study and two parallel opposed beam angles were planned for all cases. A quadratic programming (QP) based model without MU constraints, i.e., a conventional spot intensity optimization (CSIO) model, was also implemented to emulate the commercial TPS. Plans optimized by both the DSIO and CSIO models were evaluated for five different settings of spot spacing from 3 mm to 7 mm. For all spot spacings, the DSIO-optimized plans yielded better uniformity for the target dose coverage and critical structure sparing than did the CSIO-optimized plans. With reduced spot spacings, more significant improvements in target dose uniformity and critical structure sparing were observed in the DSIO- than in the CSIO-optimized plans. Additionally, better sparing of the rectum and bladder was achieved when reduced spacings were used for the DSIO-optimized plans. The proposed DSIO approach ensures the deliverability of optimized IMPT plans that take into account MU constraints. This eliminates the post-processing procedure required by the TPS as well as the resultant deteriorating effect on ultimate dose distributions. This approach therefore allows IMPT plans to adopt all possible spot spacings optimally. Moreover, dosimetric benefits can be achieved using smaller spot spacings. PMID:23835656

Earthquake Early Warning in Japan - Result of recent two years -

NASA Astrophysics Data System (ADS)

Shimoyama, T.; Doi, K.; Kiyomoto, M.; Hoshiba, M.

2009-12-01

Japan Meteorological Agency(JMA) started to provide Earthquake Early Warning(EEW) to the general public in October 2007. It was followed by provision of EEW to a limited number of users who understand the technical limit of EEW and can utilize it for automatic control from August 2006. Earthquake Early Warning in Japan definitely means information of estimated amplitude and arrival time of a strong ground motion after fault rupture occurred. In other words, the EEW provided by JMA is defined as a forecast of a strong ground motion before the strong motion arrival. EEW of JMA is to enable advance countermeasures to disasters caused by strong ground motions with providing a warning message of anticipating strong ground motion before the S wave arrival. However, due to its very short available time period, there should need some measures and ideas to provide rapidly EEW and utilize it properly. - EEW is issued to general public when the maximum seismic intensity 5 lower (JMA scale) or greater is expected. - EEW message contains origin time, epicentral region name, and names of areas (unit is about 1/3 to 1/4 of one prefecture) where seismic intensity 4 or greater is expected. Expected arrival time is not included because it differs substantially even in one unit area. - EEW is to be broadcast through the broadcasting media(TV, radio and City Administrative Disaster Management Radio), and is delivered to cellular phones through cell broadcast system. For those who would like to know the more precise estimation and smaller earthquake information at their point of their properties, JMA allows designated private companies to provide forecast of strong ground motion, in which the estimation of a seismic intensity as well as arrival time of S-wave are contained, at arbitrary places under the JMA’s technical assurance. From October, 2007 to August, 2009, JMA issued 11 warnings to general public expecting seismic intensity “5 lower” or greater, including M=7.2 inland earthquake at Tohoku district (Iwate-Miyagi-nairiku-earthquakes; June 14, 2008) and M=6.5 earthquake at Suruga bay (August, 11, 2009). For 7 cases out of 11 cases seismic intensity “5 lower” or greater were actually observed; for 3 cases, observed maximum seismic intensity was 4; for 1 case it was false alarm. During this period, 10 earthquakes occurred for which observed maximum seismic intensity was “5 lower” or greater. For 7 cases out of 10, JMA issued the warnings to general public; for 3 cases the warnings were not issued because expected seismic intensity was 4. The false alarm, which occurred on 25, August, 2009 by software bag, raised discussion how the false warning should be canceled. In this study, we will summarize the performance of the system ,and introduce some examples of the actual issuance .

Evaluation of a signal intensity mask in the interpretation of functional MR imaging activation maps.

PubMed

Strigel, Roberta M; Moritz, Chad H; Haughton, Victor M; Badie, Behnam; Field, Aaron; Wood, David; Hartman, Michael; Rowley, Howard A

2005-03-01

The purpose of this study was to determine the incidence of susceptibility artifacts on functional MR imaging (fMRI) studies and their effect on fMRI readings. We hypothesized that the availability of the signal intensity maps (SIMs) changes the interpretation of fMRI studies in which susceptibility artifacts affected eloquent brain regions. We reviewed 152 consecutive clinical fMRI studies performed with a SIM. The SIM consisted of the initial echo-planar images (EPI) in each section thresholded to eliminate signal intensity from outside the brain and then overlaid on anatomic images. The cause of the artifact was then determined by examining the images. Cases with a susceptibility artifact in eloquent brain were included in a blinded study read by four readers, first without and then with the SIM. For each reader, the number of times the interpretation changed on viewing the SIM was counted. Of 152 patients, 44% had signal intensity loss involving cerebral cortex and 18% involving an eloquent brain region. Causes of the artifacts were: surgical site artifact, blood products, dental devices, calcium, basal ganglia calcifications, ICP monitors, embolization materials, and air. When provided with the SIM, readers changed interpretations in 8-38% of patient cases, depending on reader experience and size and location of susceptibility artifact. Patients referred for clinical fMRI have a high incidence of susceptibility artifacts, whose presence and size can be determined by inspection of the SIM but not anatomic images. The availability of the SIM may affect interpretation of the fMRI.

Social, Organizational, and Contextual Characteristics of Clinical Decision Support Systems for Intensive Insulin Therapy: A Literature Review and Case Study

PubMed Central

Campion, Thomas R.; Waitman, Lemuel R.; May, Addison K.; Ozdas, Asli; Lorenzi, Nancy M.; Gadd, Cynthia S.

2009-01-01

Introduction: Evaluations of computerized clinical decision support systems (CDSS) typically focus on clinical performance changes and do not include social, organizational, and contextual characteristics explaining use and effectiveness. Studies of CDSS for intensive insulin therapy (IIT) are no exception, and the literature lacks an understanding of effective computer-based IIT implementation and operation. Results: This paper presents (1) a literature review of computer-based IIT evaluations through the lens of institutional theory, a discipline from sociology and organization studies, to demonstrate the inconsistent reporting of workflow and care process execution and (2) a single-site case study to illustrate how computer-based IIT requires substantial organizational change and creates additional complexity with unintended consequences including error. Discussion: Computer-based IIT requires organizational commitment and attention to site-specific technology, workflow, and care processes to achieve intensive insulin therapy goals. The complex interaction between clinicians, blood glucose testing devices, and CDSS may contribute to workflow inefficiency and error. Evaluations rarely focus on the perspective of nurses, the primary users of computer-based IIT whose knowledge can potentially lead to process and care improvements. Conclusion: This paper addresses a gap in the literature concerning the social, organizational, and contextual characteristics of CDSS in general and for intensive insulin therapy specifically. Additionally, this paper identifies areas for future research to define optimal computer-based IIT process execution: the frequency and effect of manual data entry error of blood glucose values, the frequency and effect of nurse overrides of CDSS insulin dosing recommendations, and comprehensive ethnographic study of CDSS for IIT. PMID:19815452

Gene-environment interactions between smoking and a haplotype of RAI, ASE-1 and ERCC1 polymorphisms among women in relation to risk of lung cancer in a population-based study.

PubMed

Vogel, Ulla; Sørensen, Mette; Hansen, Rikke Dalgaard; Tjønneland, Anne; Overvad, Kim; Wallin, Håkan; Nexø, Bjørn A; Raaschou-Nielsen, Ole

2007-03-08

Homozygous carriers of a haplotype consisting of ERCC1 Asn118Asn(A), ASE-1 G-21A(G), RAI IVS1 A4364G(A) are at increased risk of lung cancer especially among women. Here, we analyse for gene-environment interactions with the predefined haplotype in a case cohort study including 428 lung cancer cases and a comparison group of 800 persons, all from the prospective Diet, Cancer and Health cohort of 57,000 Danes. At high smoking intensity (>20g tobacco/day), there was only additional risk of smoking intensity among women who were homozygous carriers of the haplotype (IRR=2.03; 95% CI: 1.10-3.73 per 5 additional g tobacco/day).

Prognostic factors in pediatric sepsis study, from the Spanish Society of Pediatric Intensive Care.

PubMed

Vila Pérez, David; Jordan, Iolanda; Esteban, Elisabeth; García-Soler, Patricia; Murga, Vega; Bonil, Vanesa; Ortiz, Irene; Flores, Carlos; Bustinza, Amaya; Cambra, Francisco Jose

2014-02-01

Sepsis and septic shock represent up to 30% of admitted patients in pediatric intensive care units, with a mortality that can exceed 10%. The objective of this study is to determine the prognostic factors for mortality in sepsis. Multicenter prospective descriptive study with patients (aged 7 days to 18 years) admitted to the pediatric intensive care units for sepsis, between January 2011 and April 2012. Data from 136 patients were collected. Eighty-seven were male (63.9%). The median age was a year and a half (P25-75 0.3-5.5 years). In 41 cases (30.1%), there were underlying diseases. The most common etiology was Neisseria meningitidis (31 cases, 22.8%) followed by Streptococcus pneumoniae (16 patients, 11.8%). Seventeen cases were fatal (12.5%). In the statistical analysis, the factors associated with mortality were nosocomial infection (P = 0.004), hypotension (P <0.001) and heart and kidney failure (P < 0.001 and P = 0.004, respectively). The numbers of leukocytes, neutrophils and platelets on admission were statistically lower in the group that died (P was 0.006, 0.013 and <0.001, respectively). Multivariate analysis showed that multiple organ failure, neutropenia, purpura or coagulopathy and nosocomial infection were independent risk factors for increased mortality (odds ratio: 17, 4.9, 9 and 9.2, respectively). Patients with sepsis and multiorgan failure, especially those with nosocomial infection or the presence of neutropenia or purpura, have a worse prognosis and should be monitored and treated early.

Studies of the Coherent Half-Integer Resonance

NASA Astrophysics Data System (ADS)

Cousineau, Sarah; Holmes, Jeff; Galambos, John; Macek, Robert; Fedotov, Alexei; Wei, Jie

2002-12-01

We present studies of space-charge-induced beam profile broadening at high intensities in the Proton Storage Ring (PSR) at Los Alamos National Laboratory. Previous work has associated the observed broadening in the vertical direction with the coherent half integer resonance [1]. Here, we study the effect of the space charge environment on this resonance; specifically, we investigate the strength of the resonance versus beam intensity, longitudinal bunching factor, transverse lattice tune, and two different beam injection scenarios. For each case, detailed particle-in-cell simulations are combined with experimental results to elucidate the behavior and sensitivity of the beam resonance response.

Environmental management and labour productivity: The moderating role of capital intensity.

PubMed

Lannelongue, Gustavo; Gonzalez-Benito, Javier; Quiroz, Idaisa

2017-04-01

Recent years have seen firms improve their environmental practices, although the question still remains as to whether or not investing in such practices is or is not beneficial or simply a matter of image. This study focuses on labour productivity as a measure of performance, and we argue that the impact of greater environmental performance on that productivity is moderated by capital intensity. A sample of 2823 plants provides empirical evidence to support our approach. Specifically, the analyses, making use of estimates based on multiple regression models, reveal that environmental management has a positive impact on labour productivity in organisations with low capital intensity, although that impact becomes negative in cases of high capital intensity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Internal and edge cracks in a plate of finite width under bending

NASA Technical Reports Server (NTRS)

Boduroglu, H.; Erdogan, F.

1983-01-01

In this paper the title problem is studied by using Reissner's transverse shear theory. The main purpose of the paper is to investigate the effect of stress-free boundaries on the stress intensity factors in plates under bending. Among the results found particularly interesting are those relating to the limiting cases of the crack geometries. The numerical results are given for a single internal crack, two collinear cracks, and two edge cracks. Also studied is the effect of Poisson's ratio on the stress intensity factors.

An experimental study on the coalescence process of binary droplets in oil under ultrasonic standing waves.

PubMed

Luo, Xiaoming; Cao, Juhang; He, Limin; Wang, Hongping; Yan, Haipeng; Qin, Yahua

2017-01-01

The coalescence process of binary droplets in oil under ultrasonic standing waves was investigated with high-speed photography. Three motion models of binary droplets in coalescence process were illustrated: (1) slight translational oscillation; (2) sinusoidal translational oscillation; (3) migration along with acoustic streaming. To reveal the droplets coalescence mechanisms, the influence of main factors (such as acoustic intensity, droplet size, viscosity and interfacial tension, etc) on the motion and coalescence of binary droplets was studied under ultrasonic standing waves. Results indicate that the shortest coalescence time is achieved when binary droplets show sinusoidal translational oscillation. The corresponding acoustic intensity in this case is the optimum acoustic intensity. Under the optimum acoustic intensity, drop size decrease will bring about coalescence time decrease by enhancing the binary droplets oscillation. Moreover, there is an optimum interfacial tension to achieve the shortest coalescence time. Copyright © 2016 Elsevier B.V. All rights reserved.

Intensive behavioral therapy for agoraphobia.

PubMed

Knuts, Inge J E; Esquivel, Gabriel; Overbeek, Thea; Schruers, Koen R J

2015-03-15

We investigated the efficacy of an intensive 1-week behavioral therapy program focusing on agoraphobia for panic disorder patients with agoraphobia (PDA). The study design was a case-control study. Main outcome measure was the agoraphobia score of the Fear Questionnaire (FQ-AGO). The outcomes on the FQ-AGO of a 1-week intensive therapy (96 patients) and a twice-weekly therapy (98 patients) were compared. Agoraphobia improved significantly in both groups, 1 week and 3 months after therapy. Effect size for changes in the 1-week intensive therapy on the FQ-AGO was 0.75. Limitations are use of antidepressants, no placebo group, and no long term follow-up. Behavioral therapy for agoraphobia can be shortened significantly if intensified without affecting therapy outcome, thus allowing patients a more rapid return to work and resumption of daily activities. Copyright © 2014 Elsevier B.V. All rights reserved.

Predictors of and Trends in High-Intensity End-of-Life Care Among Children With Cancer: A Population-Based Study Using Health Services Data.

PubMed

Kassam, Alisha; Sutradhar, Rinku; Widger, Kimberley; Rapoport, Adam; Pole, Jason D; Nelson, Katherine; Wolfe, Joanne; Earle, Craig C; Gupta, Sumit

2017-01-10

Purpose Children with cancer often receive high-intensity (HI) medical care at the end-of-life (EOL). Previous studies have been limited to single centers or lacked detailed clinical data. We determined predictors of and trends in HI-EOL care by linking population-based clinical and health-services databases. Methods A retrospective decedent cohort of patients with childhood cancer who died between 2000 and 2012 in Ontario, Canada, was assembled using a provincial cancer registry and linked to population-based health-care data. Based on previous studies, the primary composite measure of HI-EOL care comprised any of the following: intravenous chemotherapy < 14 days from death; more than one emergency department visit; and more than one hospitalization or intensive care unit admission < 30 days from death. Secondary measures included those same individual measures and measures of the most invasive (MI) EOL care (eg, mechanical ventilation < 14 days from death). We determined predictors of outcomes with appropriate regression models. Sensitivity analysis was restricted to cases of cancer-related mortality, excluding treatment-related mortality (TRM) cases. Results The study included 815 patients; of these, 331 (40.6%) experienced HI-EOL care. Those with hematologic malignancies were at highest risk (odds ratio, 2.5; 95% CI, 1.8 to 3.6; P < .001). Patients with hematologic cancers and those who died after 2004 were more likely to experience the MI-EOL care (eg, intensive care unit, mechanical ventilation, odds ratios from 2.0 to 5.1). Excluding cases of TRM did not substantively change the results. Conclusion Ontario children with cancer continue to experience HI-EOL care. Patients with hematologic malignancies are at highest risk even when excluding TRM. Of concern, rates of the MI-EOL care have increased over time despite increased palliative care access. Linking health services and clinical data allows monitoring of population trends in EOL care and identifies high-risk populations for future interventions.

'Civil skepticism' and the social construction of knowledge: A case in dendroclimatology.

PubMed

Ramírez-I-Ollé, Meritxell

2018-03-01

Early Science and Technology Studies (STS) scholars recognized that the social construction of knowledge depends on skepticism's parasitic relationship to background expectations and trust. Subsequent generations have paid less empirical attention to skepticism in science and its relationship with trust. I seek to rehabilitate skepticism in STS - particularly, Merton's view of skepticism as a scientific norm sustained by trust among status peers - with a study of what I call 'civil skepticism'. The empirical grounding is a case in contemporary dendroclimatology and the development of a method ('Blue Intensity') for generating knowledge about climate change from trees. I present a sequence of four instances of civil skepticism involved in making Blue Intensity more resistant to critique, and hence credible (in laboratory experiments, workshops, conferences, and peer-review of articles). These skeptical interactions depended upon maintaining communal notions of civility among an increasingly extended network of mutually trusted peers through a variety of means: by making Blue Intensity complementary to existing methods used to study a diverse natural world (tree-ring patterns) and by contributing to a shared professional goal (the study of global climate change). I conclude with a sociological theory about the role of civil skepticism in constituting knowledge-claims of greater generality and relevance.

Agricultural land use intensity and its determinants: A case study in Taibus Banner, Inner Mongolia, China

NASA Astrophysics Data System (ADS)

Hao, Haiguang; Li, Xiubin; Tan, Minghong; Zhang, Jiping; Zhang, Huiyuan

2015-06-01

Based on rural household survey data from Taibus Banner, in the Inner Mongolia Autonomous Region, China, this study separately categorizes agricultural land use intensity into labor intensity, capital intensity, the intensity of labor-saving inputs, and the intensity of yield-increasing inputs, and then analyzes their determinants at the household level. The findings reveal that within the study area: (1) labor intensity is higher and capital intensity is lower than in the major grain-producing and economically developed areas of eastern and central China; (2) the most widely planted crops are those with the lowest labor intensity (oats) and capital intensity (benne); (3) there are marked differences in agricultural land use intensity among households; a major factor affecting land use decision-making is the reduced need for labor intensity for those households with high opportunity costs, such as those with income earned from non-farming activities which alleviates financial constraints and allows for increased capital intensity. As a result, these households invest more in labor-saving inputs; (4) households with a larger number of workers will allocate adequate time to manage their land and thus they will not necessarily invest more in labor-saving inputs. Those households with more land to manage tend to adopt an extensive cultivation strategy. Total income has a positive impact on capital intensity and a negative impact on labor intensity. Households that derive a higher proportion of their total income through farming are more reliant upon agriculture, which necessitates significant labor and yield-increasing inputs. Finally, the authors contend that policy makers should clearly recognize the impacts of non-farming employment on agricultural land use intensity. In order to ensure long-term food security and sustainable agricultural development in China, income streams from both farming and non-farming employment should be balanced.

Myonecrosis in Sickle Cell Anemia: Case Study.

PubMed

Turaga, Lalita Prabha; Boddu, Prajwal; Kipferl, Steve; Basu, Anupam; Yorath, Martin

2017-01-30

BACKGROUND Myonecrosis is one of the more poorly studied, painful manifestations of sickle cell crisis. Medical literature is sparse detailing the manifestations and management of such symptoms. In myonecrosis, red cells containing sickle hemoglobin become rigid, resulting in reduced blood flow and myonecrosis. CASE REPORT We present a case study of a patient in sickle cell crisis with an episode of acute pain and swelling to the intrinsic muscles of the foot as a prominent feature of the crises. Although muscle biopsy is considered the gold standard for the diagnosis of myositis or myonecrosis, a low intensity signal on T1 and high intensity signal on T2 at the affected muscle belly can be as conclusive as imaging studies. In an actively sickling patient any invasive intervention should be avoided as it can result in ischemic necrosis of the tissues, due to interruption of capillary flow in end-arteries. CONCLUSIONS Early recognition is critical in sickle cell disease management, allowing for prompt and aggressive fluid resuscitation which remains a cornerstone in the management of most sickle cell vaso-occlusive crises. In this instance, off loading the extremity and early fluid resuscitation resolved the pain and swelling and prevented myonecrosis.

Cancer/testis antigen SPATA19 is frequently expressed in benign prostatic hyperplasia and prostate cancer.

PubMed

Wong, Kah Keng; Hussain, Faezahtul Arbaeyah; Loo, Suet Kee; López, José I

2017-12-01

Spermatogenesis-associated 19 (SPATA19) is a cancer/testis antigen overexpressed in various cancers. However, its protein expression profile in malignant or non-malignant tissues remains unknown. Thus, in this study, we investigated SPATA19 protein expression patterns in a panel of non-malignant human samples and primary prostate cancer (PCa) with or without benign prostatic hyperplasia (BPH) tissues. SPATA19 was absent in all non-malignant tissues investigated (n=14) except testis and prostate tissues. In terms of malignancies, all PCa cases were positive for SPATA19 exhibiting frequency between 20 and 100% (median 85%) with 63 (52.5%) and 57 (47.5%) cases demonstrating weak/moderate and strong intensities, respectively. Thirty-nine PCa cases (32.5%) contained BPH, and all BPH glands were SPATA19 positive (frequency between 20 and 100%; median 90%) with 13 (33.3%) demonstrating strong SPATA19 expression. Higher SPATA19 expression (higher frequency, intensity, or H-score) was not associated with overall survival or disease-specific survival (DFS) in all PCa cases. However, biochemical recurrence (BR) was associated with worse DFS (p = 0.005) in this cohort of 120 patients, and cases with strong SPATA19 intensity were associated with BR (p = 0.020). In conclusion, we showed that SPATA19 protein was frequently expressed in both BPH and PCa glands, and this warrants future investigations on its pathogenic roles in the disease. © 2017 APMIS. Published by John Wiley & Sons Ltd.

Expanding technology in the ICU: the case for the utilization of telemedicine.

PubMed

Deslich, Stacie; Coustasse, Alberto

2014-05-01

Telemedicine has been utilized in various healthcare areas to achieve better patient outcomes, lower costs of providing services, and increase patient access to care. Tele-intensive care unit (ICU) technology has been introduced as a way to provide effective ICU services to patients with reduced access, as well as to decrease costs and improve patient care. The methodology for this qualitative study was a literature search and review of case studies. The search was limited to sources published in the last 10 years (2003-2013) in the English language. In total, 55 references were used for this research exploration inquiry. Tele-ICU was found to be an effective way to use technology to decrease costs of providing intensive care, while improving patient outcomes such as mortality and length of stay. Several case studies supported the use of telemedicine in ICUs to provide intensive care to patients who lived in rural areas and lacked access to traditional ICUs. Furthermore, it was noted that, although the initial costs for tele-ICU startup were significant, as much as $100,000 per bed, the benefits of the utilization of this technology can offset those costs by reducing costs by 24% via decreased length of stay for patients. The findings of this study have suggested that the implementation of tele-ICU may have been more beneficial than costly, and it may have provided healthcare organizations the opportunity to increase quality of care and decrease mortality, while it might have decreased costs of delivering ICU services in both rural and urban areas.

Modeling the residual effects and threshold saturation of training: a case study of Olympic swimmers.

PubMed

Hellard, Philippe; Avalos, Marta; Millet, Gregoire; Lacoste, Lucien; Barale, Frederic; Chatard, Jean-Claude

2005-02-01

The aim of this study was to model the residual effects of training on the swimming performance and to compare a model that includes threshold saturation (MM) with the Banister model (BM). Seven Olympic swimmers were studied over a period of 4 +/- 2 years. For 3 training loads (low-intensity w(LIT), high-intensity w(HIT), and strength training w(ST)), 3 residual training effects were determined: short-term (STE) during the taper phase (i.e., 3 weeks before the performance [weeks 0, 1, and 2]), intermediate-term (ITE) during the intensity phase (weeks 3, 4, and 5), and long-term (LTE) during the volume phase (weeks 6, 7, and 8). ITE and LTE were positive for w(HIT) and w(LIT), respectively (p < 0.05). Low-intensity training load during taper was related to performances by a parabolic relationship (p < 0.05). Different quality measures indicated that MM compares favorably with BM. Identifying individual training thresholds may help individualize the distribution of training loads.

Application of Elements of Numerical Methods in the Analysis of Journal Bearings in AC Induction Motors: An Industry Case Study

ERIC Educational Resources Information Center

Ahrens, Fred; Mistry, Rajendra

2005-01-01

In product engineering there often arise design analysis problems for which a commercial software package is either unavailable or cost prohibitive. Further, these calculations often require successive iterations that can be time intensive when performed by hand, thus development of a software application is indicated. This case relates to the…

Multiscale intensity homogeneity transformation method and its application to computer-aided detection of pulmonary embolism in computed tomographic pulmonary angiography (CTPA)

NASA Astrophysics Data System (ADS)

Guo, Yanhui; Zhou, Chuan; Chan, Heang-Ping; Wei, Jun; Chughtai, Aamer; Sundaram, Baskaran; Hadjiiski, Lubomir M.; Patel, Smita; Kazerooni, Ella A.

2013-04-01

A 3D multiscale intensity homogeneity transformation (MIHT) method was developed to reduce false positives (FPs) in our previously developed CAD system for pulmonary embolism (PE) detection. In MIHT, the voxel intensity of a PE candidate region was transformed to an intensity homogeneity value (IHV) with respect to the local median intensity. The IHVs were calculated in multiscales (MIHVs) to measure the intensity homogeneity, taking into account vessels of different sizes and different degrees of occlusion. Seven new features including the entropy, gradient, and moments that characterized the intensity distributions of the candidate regions were derived from the MIHVs and combined with the previously designed features that described the shape and intensity of PE candidates for the training of a linear classifier to reduce the FPs. 59 CTPA PE cases were collected from our patient files (UM set) with IRB approval and 69 cases from the PIOPED II data set with access permission. 595 and 800 PEs were identified as reference standard by experienced thoracic radiologists in the UM and PIOPED set, respectively. FROC analysis was used for performance evaluation. Compared with our previous CAD system, at a test sensitivity of 80%, the new method reduced the FP rate from 18.9 to 14.1/scan for the PIOPED set when the classifier was trained with the UM set and from 22.6 to 16.0/scan vice versa. The improvement was statistically significant (p<0.05) by JAFROC analysis. This study demonstrated that the MIHT method is effective in reducing FPs and improving the performance of the CAD system.

Racial and Ethnic Service Use Disparities Among Homeless Adults With Severe Mental Illnesses Receiving ACT

PubMed Central

Horvitz-Lennon, Marcela; Zhou, Dongli; Normand, Sharon-Lise T.; Alegría, Margarita; Thompson, Wes K.

2013-01-01

Objective Case management–based interventions aimed at improving quality of care have the potential to narrow racial and ethnic disparities among people with chronic illnesses. The aim of this study was to assess the equity effects of assertive community treatment (ACT), an evidence-based case management intervention, among homeless adults with severe mental illness. Methods This study used baseline, three-, and 12-month data for 6,829 black, Latino, and white adults who received ACT services through the ACCESS study (Access to Community Care and Effective Services and Support). Zero-inflated Poisson random regression models were used to estimate the adjusted probability of use of outpatient psychiatric services and, among service users, the intensity of use. Odds ratios and rate ratios (RRs) were computed to assess disparities at baseline and over time. Results No disparities were found in probability of use at baseline or over time. Compared with white users, baseline intensity of use was lower for black users (RR=.89; 95% confidence interval [CI]=.83–.96) and Latino users (RR=.65; CI=.52–.81]). Intensity did not change over time for whites, but it did for black and Latino users. Intensity increased for blacks between baseline and three months (RR=1.11, CI=1.06–1.17]) and baseline and 12 months (RR=1.17, CI=1.11–1.22]). Intensity of use dropped for Latinos between baseline and three months (RR=.83, CI=.70–.98). Conclusions Receipt of ACT was associated with a reduction in service use disparities for blacks but not for Latinos. Findings suggest that ACT’s equity effects differ depending on race-ethnicity. PMID:21632726

The Interactive Whiteboard: A Transitional Technology Supporting Diverse Teaching Practices

ERIC Educational Resources Information Center

Winzenried, Arthur; Dalgarno, Barney; Tinkler, Jacqueline

2010-01-01

This article describes the findings of a qualitative study investigating teacher perspectives on the impact of interactive whiteboards (IWBs) on their classroom teaching practice, using intensive case studies focusing on six primary and secondary teachers from two rural schools. The study found that all teachers were enthusiastic, had seen…

Mapping seismic intensity using twitter data; A Case study: The February 26th, 2014 M5.9 Kefallinia (Greece) earthquake

NASA Astrophysics Data System (ADS)

Arapostathis, Stathis; Parcharidis, Isaak; Kalogeras, Ioannis; Drakatos, George

2015-04-01

In this paper we present an innovative approach for the development of seismic intensity maps in minimum time frame. As case study, a recent earthquake that occurred in Western Greece (Kefallinia Island, on February 26, 2014) is used. The magnitude of the earthquake was M=5.9 (Institute of Geodynamics - National Observatory of Athens). Earthquake's effects comprising damages in property and changes of the physical environment in the area. The innovative part of this research is that we use crowdsourcing as a source to assess macroseismic intensity information, coming out from twitter content. Twitter as a social media service with micro-blogging characteristics, a semantic structure which allows the storage of spatial content, and a high volume production of user generated content is a suitable source to obtain and extract knowledge related to macroseismic intensity in different geographic areas and in short time periods. Moreover the speed in which twitter content is generated affects us to have accurate results only a few hours after the occurrence of the earthquake. The method used in order to extract, evaluate and map the intensity related information is described in brief in this paper. At first, we pick out all the tweets that have been posted within the first 48 hours, including information related to intensity and refer to a geographic location. The geo-referencing of these tweets and their association with an intensity grade according to the European Macroseismic Scale (EMS98) based on the information they contain in text followed. Finally, we apply various spatial statistics and GIS methods, and we interpolate the values to cover all the appropriate geographic areas. The final output contains macroseismic intensity maps for the Lixouri area (Kefallinia Island), produced from twitter data that have been posted in the first six, twelve, twenty four and forty eight hours after the earthquake occurrence. Results are compared with other intensity maps for same earthquake, which have been published by other institutions around the world, as well as with previous earthquake isoseismal maps for the same area.

Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre.

PubMed

Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

2016-01-01

This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users.

Human survivability of extreme impacts in free-fall.

DOT National Transportation Integrated Search

1963-08-01

Human deceleration tolerances beyond the limits imposed by voluntary experimental methods were studied by means of intensive case histories of 137 individuals who have survived extremely abrupt impacts in accidental, suicidal, and homicidal free-fall...

Challenges of rehabilitation case mix measurement in Ontario hospitals.

PubMed

Sutherland, Jason Murray; Walker, Jan

2008-03-01

Case mix classification systems have been adopted in many countries as a method to manage and finance healthcare in acute care settings; the most popular systems are based on diagnosis related groups. The most successful of those case mix systems differentiate patient types by reflecting both the intensity of resources consumed and patient acuity. Case mix systems for use with non-acute hospital activity have not been as wide-spread; other than in the United States, little attention has been directed towards case mix classification for rehabilitation activity. In a province with over 13 million inhabitants with 2496 rehabilitation beds, inpatient rehabilitation is an important component of hospital care in Ontario, Canada, and consists of the spectrum of intensive rehabilitation activities intended to restore function. Although case mix adjusted activity has been the currency in Ontario's Integrated Population Based Allocation hospital funding formula, rehabilitation activity has not been subjected to case mix measurement. A project to examine case mix classification for adult inpatient rehabilitation activity was initiated by the Ontario Ministry of Health and Long-Term Care whose outcome was a case mix system and associated cost weights that would result in rehabilitation activity being incorporated into the hospital funding formula. The process described in this study provides Ontario's provincial government with a case mix classification system for adult inpatient rehabilitation activity although there remain areas for improvement.

[A case of MM1+2 Creutzfeldt-Jakob disease with a longitudinal study of EEG and MRI].

PubMed

Katsube, Mizuho; Shiota, Yuri; Harada, Takayuki; Shibata, Hiroshi; Nagai, Atsushi

2013-11-01

We report a case of definite MM1 + 2 sporadic Creutzfeldt-Jakob disease (sCJD). A 66-year-old woman was admitted to our hospital with memory disturbance and disorientation for three months. On admission she presented a progressive cognitive insufficiency. Electroencephalography (EEG) revealed a frontal intermittent rhythmical delta activity (FIRDA) and the brain magnetic resonance imaging (MRI) showed high signal intensities in cerebral cortex on diffusion weighted images (DWI). After four months from the onset, she reached the akinetic mutism state followed by myoclonus. Follow up examination revealed that periodic synchronous discharge (PSD) was found in EEG, and DWI revealed enlargement of high signal intensity lesions in cerebral cortex. At seven months from the onset, PSD and high signal intensities of cortex became unclear with disappearance of myoclonus, and brain white matter lesions were evident on MRI. Serial studies of EEG and MRI revealed that PSD generalized from frontal lobe dominant pattern, while high signal intensity lesions of cortex diffusely increased on DWI. At ten months from the onset patient died. Pathological examination in brain showed moderate and diffuse neuronal cell loss and gliosis in cerebral cortex corresponding with DWI changes. The genotype at codon 129 of the prion protein (PrP) was homozygous methionine (MM) and the type of protease-resistant PrP (PrPres) was the mixed type of 1 and 2 in Western blot analysis. It has been rare to analyze the changes of EEG and MRI in the entire stage and to investigate pathological finding in the case of sCJD-MM1 + 2. A longitudinal examination of EEG and MRI is useful for early diagnosis of CJD. Also we could correlate these findings with clinical and histopathological phenotype.

Rural Development and Labour-Intensive Schemes. Impact Studies of Some Pilot Programmes.

ERIC Educational Resources Information Center

Gaude, J.; And Others

1987-01-01

Examines case studies of special public works programs in five countries (Burkina Faso, Burundi, Rwanda, Nepal, and United Republic of Tanzania) that included afforestation projects, anti-erosion works, and the building of reservoirs. Discusses program design, implementation, and impact. (CH)

Goal Dissensus and Educational Change

ERIC Educational Resources Information Center

Prebble, Thomas K.

1978-01-01

Current developments in organizational theory suggest that the degree of goal consensus within many organizations may be problematic. This study uses an intensive case study to explore the implications of goal dissensus in the adoption of a four-day teaching week in a Canadian high school. (Author/IRT)

Long-term variability of sleep bruxism and psychological stress in patients with jaw-muscle pain: Report of two longitudinal clinical cases.

PubMed

Muzalev, K; Visscher, C M; Koutris, M; Lobbezoo, F

2018-02-01

Sleep bruxism (SB) and psychological stress are commonly considered as contributing factors in the aetiology of temporomandibular disorder (TMD) pain. However, the lack of longitudinal studies and fluctuating nature of SB, psychological stress and TMD pain have led to contradictory results regarding the association between the possible aetiological factors and TMD pain. In the present study we investigated the contribution of SB and psychological stress to TMD pain in a longitudinal study of 2 clinical TMD pain cases during a 6-week study protocol. Two female volunteers with clinically diagnosed myalgia based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) participated in the study. Questionnaires were used to record jaw-muscle pain and psychological stress experience, and an ambulatory polysomnography technique was used to record SB intensity. Visual analysis of the data revealed that the intensity of TMD pain was not hardwired, neither with psychological stress experience nor with increased SB activity. Within the limitations of single-patient clinical cases design, our study suggested that the presence of TMD pain cannot be explained by a simple linear model which takes psychological stress or SB into account. It also seems that psychological stress was a more important predictor factor for TMD pain than SB. © 2017 John Wiley & Sons Ltd.

Piecewise exponential survival times and analysis of case-cohort data.

PubMed

Li, Yan; Gail, Mitchell H; Preston, Dale L; Graubard, Barry I; Lubin, Jay H

2012-06-15

Case-cohort designs select a random sample of a cohort to be used as control with cases arising from the follow-up of the cohort. Analyses of case-cohort studies with time-varying exposures that use Cox partial likelihood methods can be computer intensive. We propose a piecewise-exponential approach where Poisson regression model parameters are estimated from a pseudolikelihood and the corresponding variances are derived by applying Taylor linearization methods that are used in survey research. The proposed approach is evaluated using Monte Carlo simulations. An illustration is provided using data from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study of male smokers in Finland, where a case-cohort study of serum glucose level and pancreatic cancer was analyzed. Copyright © 2012 John Wiley & Sons, Ltd.

Clinical Profile of Hypertensive Emergencies in an Intensive Care Unit.

PubMed

Dhadke, Shubhangi V; Dhadke, Vithal N; Batra, Dhruv S

2017-05-01

To study the prevalence of hypertensive emergencies in an ICU set up and to study the clinical presentation of hypertensive emergencies related to cardiovascular, neurological and renovascular system. Type of Study: Cross-sectional, descriptive study. Two years from 1st December 2011 till 30th November 2013. 50 patients of hypertensive emergencies admitted to the intensive care unit of Dr. V.M. Govt. Medical College, Solapur were studied. Inclusion criteria All patients above 18 years of age. Systolic blood pressure > 180 mmHg Diastolic blood pressure > 120 mm Hg Exclusion criteria Pregnancy Patients with diabetes mellitus We classified as hypertensive emergencies all cases in which the increase in blood pressure was associated with one or more of the following types of acute or ongoing end-organ damage: hypertensive encephalopathy; stroke (cerebral infarction or intracerebral or subarachnoid hemorrhage, transient ischemic attack); acute pulmonary edema, left ventricular failure; acute myocardial infarction or unstable angina, progressive renal insufficiency features suggestive of retinopathy. All these conditions were diagnosed clinically or by approprriate diagnostic tests. most common presenting complaint in patients was breathlessness seen in 17 patients (34%), followed by neurological deficit in 14 patients (28%). Thirteen patients (26%) had complaints of headache, whereas 12 (24%) patients complained of chest pain on admission. Other symptoms included vomiting, giddiness, psychomotor agitation, and decreased urine output. Out of a total of 4076 admissions during the study period in the intensive care unit we had 50 cases of hypertensive emergencies with prevalence of 1.22% in our intensive care unit. Most common organ involvement was the retina followed by cardiovascular system, renal and then the central nervous system.

Hermite-cosine-Gaussian laser beam and its propagation characteristics in turbulent atmosphere.

PubMed

Eyyuboğlu, Halil Tanyer

2005-08-01

Hermite-cosine-Gaussian (HcosG) laser beams are studied. The source plane intensity of the HcosG beam is introduced and its dependence on the source parameters is examined. By application of the Fresnel diffraction integral, the average receiver intensity of HcosG beam is formulated for the case of propagation in turbulent atmosphere. The average receiver intensity is seen to reduce appropriately to various special cases. When traveling in turbulence, the HcosG beam initially experiences the merging of neighboring beam lobes, and then a TEM-type cosh-Gaussian beam is formed, temporarily leading to a plain cosh-Gaussian beam. Eventually a pure Gaussian beam results. The numerical evaluation of the normalized beam size along the propagation axis at selected mode indices indicates that relative spreading of higher-order HcosG beam modes is less than that of the lower-order counterparts. Consequently, it is possible at some propagation distances to capture more power by using higher-mode-indexed HcosG beams.

Intense Non-Linear Soft X-Ray Emission from a Hydride Target during Pulsed D Bombardment

NASA Astrophysics Data System (ADS)

Miley, George H.; Yang, Yang; Lipson, Andrei; Haque, Munima; Percel, Ian; Romer, Michael

Radiation emission from low-energy nuclear radiation (LENR) electrodes (both charged-particle and X-rays) represents an important feature of LENR in general. Here, calibration, measurement techniques, and soft X-ray emission results from deuterium bombardment of a Pd target (cathode) placed in a pulsed deuterium glow discharge (PGD) are described. An X-ray intensity of 13.4 mW/cm2 and a dose of 3.3 μJ/cm2 were calculated over a 0.5 ms pulse time from AXUV photodiode radiation detector measurements. A most striking feature is that X-ray energies >600 V are observed with a discharge voltage only about half of that value. To further investigate this phenomenon, emission during room temperature D-desorption from electrolytically loaded Pd:Dx cathodes was also studied. The X-ray emission energy observed was quite similar to the PGD case. However, the intensity in this case was almost 13 orders of magnitude lower due to the much lower deuterium fluxes involved.

Ab initio calculation of resonant Raman intensities of transition metal dichalcogenides

NASA Astrophysics Data System (ADS)

Miranda, Henrique; Reichardt, Sven; Molina-Sanchez, Alejandro; Wirtz, Ludger

Raman spectroscopy is used to characterize optical and vibrational properties of materials. Its computational simulation is important for the interpretation of experimental results. Two approaches are the bond polarizability model and density functional perturbation theory. However, both are known to not capture resonance effects. These resonances and quantum interference effects are important to correctly reproduce the intensities as a function of laser energy as, e.g., reported for the case of multi-layer MoTe21.We present two fully ab initio approaches that overcome this limitation. In the first, we calculate finite difference derivatives of the dielectric susceptibility with the phonon displacements2. In the second we calculate electron-light and electron-phonon matrix elements from density functional theory and use them to evaluate expressions for the Raman intensity derived from time-dependent perturbation theory. These expressions are implemented in a computer code that performs the calculations as a post-processing step. We compare both methods and study the case of triple-layer MoTe2. Luxembourg National Research Fund (FNR).

Transversely diode-pumped alkali metal vapour laser

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

Parkhomenko, A I; Shalagin, A M

2015-09-30

We have studied theoretically the operation of a transversely diode-pumped alkali metal vapour laser. For the case of high-intensity laser radiation, we have obtained an analytical solution to a complex system of differential equations describing the laser. This solution allows one to exhaustively determine all the energy characteristics of the laser and to find optimal parameters of the working medium and pump radiation (temperature, buffer gas pressure, and intensity and width of the pump spectrum). (lasers)

The Phase of Illness Paradigm: A Checklist Centric Model to Improve Patient Care in the Burn Intensive Care Unit

DTIC Science & Technology

2014-04-01

6. PUBLICATIONS, ABSTRACTS, AND PRESENTATIONS: Submitted abstracts to the 2014 Military Health Research Symposium: 1. Pamplin, J.C., Murray...Intensive Care Unit ERMS/Log Number: 12340054 W81XWH-13-2-0011 PI: LTC Jeremy Pamplin, MD Org: The Geneva Foundation/San Antonio Military Medical Center...improve clinician work related quality of life. Approach and Military Relevance This multicenter, prospective, case-matched cohort study will improve the

Cigarette Smoking and Pancreatic Cancer: A Pooled Analysis From the Pancreatic Cancer Cohort Consortium

PubMed Central

Vrieling, Alina; Lubin, Jay H.; Kraft, Peter; Mendelsohn, Julie B.; Hartge, Patricia; Canzian, Federico; Steplowski, Emily; Arslan, Alan A.; Gross, Myron; Helzlsouer, Kathy; Jacobs, Eric J.; LaCroix, Andrea; Petersen, Gloria; Zheng, Wei; Albanes, Demetrius; Amundadottir, Laufey; Bingham, Sheila A.; Boffetta, Paolo; Boutron-Ruault, Marie-Christine; Chanock, Stephen J.; Clipp, Sandra; Hoover, Robert N.; Jacobs, Kevin; Johnson, Karen C.; Kooperberg, Charles; Luo, Juhua; Messina, Catherine; Palli, Domenico; Patel, Alpa V.; Riboli, Elio; Shu, Xiao-Ou; Rodriguez Suarez, Laudina; Thomas, Gilles; Tjønneland, Anne; Tobias, Geoffrey S.; Tong, Elissa; Trichopoulos, Dimitrios; Virtamo, Jarmo; Ye, Weimin; Yu, Kai; Zeleniuch-Jacquette, Anne; Bueno-de-Mesquita, H. Bas; Stolzenberg-Solomon, Rachael Z.

2009-01-01

Smoking is an established risk factor for pancreatic cancer; however, detailed examination of the association of smoking intensity, smoking duration, and cumulative smoking dose with pancreatic cancer is limited. The authors analyzed pooled data from the international Pancreatic Cancer Cohort Consortium nested case-control study (1,481 cases, 1,539 controls). Odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression. Smoking intensity effects were examined with an excess odds ratio model that was linear in pack-years and exponential in cigarettes smoked per day and its square. When compared with never smokers, current smokers had a significantly elevated risk (odds ratio (OR) = 1.77, 95% confidence interval (CI): 1.38, 2.26). Risk increased significantly with greater intensity (≥30 cigarettes/day: OR = 1.75, 95% CI: 1.27, 2.42), duration (≥50 years: OR = 2.13, 95% CI: 1.25, 3.62), and cumulative smoking dose (≥40 pack-years: OR = 1.78, 95% CI: 1.35, 2.34). Risk more than 15 years after smoking cessation was similar to that for never smokers. Estimates of excess odds ratio per pack-year declined with increasing intensity, suggesting greater risk for total exposure delivered at lower intensity for longer duration than for higher intensity for shorter duration. This finding and the decline in risk after smoking cessation suggest that smoking has a late-stage effect on pancreatic carcinogenesis. PMID:19561064

Introducing hydrological information in rainfall intensity-duration thresholds

NASA Astrophysics Data System (ADS)

Greco, Roberto; Bogaard, Thom

2016-04-01

Regional landslide hazard assessment is mainly based on empirically derived precipitation-intensity-duration (PID) thresholds. Generally, two features of rainfall events are plotted to discriminate between observed occurrence and absence of occurrence of mass movements. Hereafter, a separation line is drawn in logarithmic space. Although successfully applied in many case studies, such PID thresholds suffer from many false positives as well as limited physical process insight. One of the main limitations is indeed that they do not include any information about the hydrological processes occurring along the slopes, so that the triggering is only related to rainfall characteristics. In order to introduce such an hydrological information in the definition of rainfall thresholds for shallow landslide triggering assessment, in this study the introduction of non-dimensional rainfall characteristics is proposed. In particular, rain storm depth, intensity and duration are divided by a characteristic infiltration depth, a characteristic infiltration rate and a characteristic duration, respectively. These latter variables depend on the hydraulic properties and on the moisture state of the soil cover at the beginning of the precipitation. The proposed variables are applied to the case of a slope covered with shallow pyroclastic deposits in Cervinara (southern Italy), for which experimental data of hourly rainfall and soil suction were available. Rainfall thresholds defined with the proposed non-dimensional variables perform significantly better than those defined with dimensional variables, either in the intensity-duration plane or in the depth-duration plane.

An improved scheme on decoy-state method for measurement-device-independent quantum key distribution.

PubMed

Wang, Dong; Li, Mo; Guo, Guang-Can; Wang, Qin

2015-10-14

Quantum key distribution involving decoy-states is a significant application of quantum information. By using three-intensity decoy-states of single-photon-added coherent sources, we propose a practically realizable scheme on quantum key distribution which approaches very closely the ideal asymptotic case of an infinite number of decoy-states. We make a comparative study between this scheme and two other existing ones, i.e., two-intensity decoy-states with single-photon-added coherent sources, and three-intensity decoy-states with weak coherent sources. Through numerical analysis, we demonstrate the advantages of our scheme in secure transmission distance and the final key generation rate.

Risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation.

PubMed

Atchison, Christie M; Amankwah, Ernest; Wilhelm, Jean; Arlikar, Shilpa; Branchford, Brian R; Stock, Arabela; Streiff, Michael; Takemoto, Clifford; Ayala, Irmel; Everett, Allen; Stapleton, Gary; Jacobs, Marshall L; Jacobs, Jeffrey P; Goldenberg, Neil A

2018-02-01

Paediatric hospital-associated venous thromboembolism is a leading quality and safety concern at children's hospitals. The aim of this study was to determine risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation. We conducted a retrospective, case-control study of children admitted to the cardiovascular intensive care unit at Johns Hopkins All Children's Hospital (St. Petersburg, Florida, United States of America) from 2006 to 2013. Hospital-associated venous thromboembolism cases were identified based on ICD-9 discharge codes and validated using radiological record review. We randomly selected two contemporaneous cardiovascular intensive care unit controls without hospital-associated venous thromboembolism for each hospital-associated venous thromboembolism case, and limited the study population to patients who had undergone cardiothoracic surgery or therapeutic cardiac catheterisation. Odds ratios and 95% confidence intervals for associations between putative risk factors and hospital-associated venous thromboembolism were determined using univariate and multivariate logistic regression. Among 2718 admissions to the cardiovascular intensive care unit during the study period, 65 met the criteria for hospital-associated venous thromboembolism (occurrence rate, 2%). Restriction to cases and controls having undergone the procedures of interest yielded a final study population of 57 hospital-associated venous thromboembolism cases and 76 controls. In a multiple logistic regression model, major infection (odds ratio=5.77, 95% confidence interval=1.06-31.4), age ⩽1 year (odds ratio=6.75, 95% confidence interval=1.13-160), and central venous catheterisation (odds ratio=7.36, 95% confidence interval=1.13-47.8) were found to be statistically significant independent risk factors for hospital-associated venous thromboembolism in these children. Patients with all three factors had a markedly increased post-test probability of having hospital-associated venous thromboembolism. Major infection, infancy, and central venous catheterisation are independent risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or cardiac catheter-based intervention, which, in combination, define a high-risk group for hospital-associated venous thromboembolism.

Across-channel interference in intensity discrimination: The role of practice and listening strategy

PubMed Central

Buss, Emily

2008-01-01

Pure tone intensity discrimination thresholds can be elevated by the introduction of remote maskers with roved level. This effect is on the order of 10 dB [10log(ΔI/I)] in some conditions and can be demonstrated under conditions of little or no energetic masking. The current study examined the effect of practice and observer strategy on this phenomenon. Experiment 1 included observers who had no formal experience with intensity discrimination and provided training over six hours on a single masked intensity discrimination task to assess learning effects. Thresholds fell with practice for most observers, with significant improvements in 6 out of 8 cases. Despite these improvements significant masking remained in all cases. The second experiment assessed trial-by-trial effects of roved masker level. Conditional probability of a ‘signal-present’ response as a function of the rove value assigned to each of the two masker tones indicates fundamental differences among observers’ processing strategies, even after six hours of practice. The variability in error patterns across practiced listeners suggests that observers approach the task differently, though this variability does not appear to be related to sensitivity. PMID:18177156

[Ulcerating Herpes simplex infections in intensive care patients].

PubMed

Fischer, M; Wohlrab, J; Radke, J; Marsch, W C; Soukup, J

2002-11-01

Herpes simplex infections are potentially a life-threatening situation for immunocompromised as well as critically ill patients. The correct diagnosis is made more difficult in comatose patients by the fact that the characteristic symptom of extreme pain cannot be registered. The clinical dermatological findings (polycyclic configuration, easily bleeding ulcers) are thus especially important in patients under intensive care conditions. As examples, the cases of 3 critically ill patients (subarachnoid bleeding or head injury) developing therapy-resistant, flat sacral or perioral skin ulcers with peripheral blisters are presented. Herpes simplex virus was confirmed immunohistologically and in the smear test. All patients subsequently died. These cases emphasize that patients in the intensive care unit are in danger of developing a chronic persistent Herpes simplex infection due to latent immunosuppression. Chronic persistent Herpes infections may be underrated in intensive therapy, and must always be ruled out in case of therapy-resistant erosions or ulcerations.

A Three-Dimensional Target Depth-Resolution Method with a Single-Vector Sensor

PubMed Central

Zhao, Anbang; Bi, Xuejie; Hui, Juan; Zeng, Caigao; Ma, Lin

2018-01-01

This paper mainly studies and verifies the target number category-resolution method in multi-target cases and the target depth-resolution method of aerial targets. Firstly, target depth resolution is performed by using the sign distribution of the reactive component of the vertical complex acoustic intensity; the target category and the number resolution in multi-target cases is realized with a combination of the bearing-time recording information; and the corresponding simulation verification is carried out. The algorithm proposed in this paper can distinguish between the single-target multi-line spectrum case and the multi-target multi-line spectrum case. This paper presents an improved azimuth-estimation method for multi-target cases, which makes the estimation results more accurate. Using the Monte Carlo simulation, the feasibility of the proposed target number and category-resolution algorithm in multi-target cases is verified. In addition, by studying the field characteristics of the aerial and surface targets, the simulation results verify that there is only amplitude difference between the aerial target field and the surface target field under the same environmental parameters, and an aerial target can be treated as a special case of a surface target; the aerial target category resolution can then be realized based on the sign distribution of the reactive component of the vertical acoustic intensity so as to realize three-dimensional target depth resolution. By processing data from a sea experiment, the feasibility of the proposed aerial target three-dimensional depth-resolution algorithm is verified. PMID:29649173

A Three-Dimensional Target Depth-Resolution Method with a Single-Vector Sensor.

PubMed

Zhao, Anbang; Bi, Xuejie; Hui, Juan; Zeng, Caigao; Ma, Lin

2018-04-12

This paper mainly studies and verifies the target number category-resolution method in multi-target cases and the target depth-resolution method of aerial targets. Firstly, target depth resolution is performed by using the sign distribution of the reactive component of the vertical complex acoustic intensity; the target category and the number resolution in multi-target cases is realized with a combination of the bearing-time recording information; and the corresponding simulation verification is carried out. The algorithm proposed in this paper can distinguish between the single-target multi-line spectrum case and the multi-target multi-line spectrum case. This paper presents an improved azimuth-estimation method for multi-target cases, which makes the estimation results more accurate. Using the Monte Carlo simulation, the feasibility of the proposed target number and category-resolution algorithm in multi-target cases is verified. In addition, by studying the field characteristics of the aerial and surface targets, the simulation results verify that there is only amplitude difference between the aerial target field and the surface target field under the same environmental parameters, and an aerial target can be treated as a special case of a surface target; the aerial target category resolution can then be realized based on the sign distribution of the reactive component of the vertical acoustic intensity so as to realize three-dimensional target depth resolution. By processing data from a sea experiment, the feasibility of the proposed aerial target three-dimensional depth-resolution algorithm is verified.

The Use of Neuromuscular Electrical Stimulation as Part of a Program of Supports To Improve Gait in a Child with Cerebral Palsy and Severe Mental Retardation--A Case Study.

ERIC Educational Resources Information Center

Kornhaber, L.; Kathirithamby, R.; Cohen, H. J.

A case study of a 10-year-old boy with cerebral palsy and severe mental retardation investigated whether he would be able to: (1) benefit from a program of supports which includes neuromuscular electrical stimulation (NMES) with intensity sufficient to achieve a tetanic muscle contraction, (2) participate in a weekly program, using NMES, in a…

CD 10 expression intensity in various grades and stages of urothelial carcinoma of urinary bladder.

PubMed

Atique, Muhammad; Abbasi, Muhammad Sajjad; Jamal, Shahid; Khadim, Muhammad Tahir; Akhtar, Farhan; Jamal, Nighat

2014-05-01

To evaluate CD10 expression in urothelial carcinoma of the urinary bladder and the association of immunohistochemical (IHC) CD10 expression intensity with grade and stage. Descriptive cross-sectional analytical study. Armed Forces Institute of Pathology, Rawalpindi, from January to December 2011. Fifty consecutive cases of urothelial bladder carcinomas, obtained through transurethral resections, were included in this study. Hematoxylin-eosin (HE) stained sections from each case were re-evaluated histopathologically according to WHO 2004 grading system. The TNM system was used for pathologic staging. On selected slides IHC CD10 marker was applied and a semiquantitative scoring for its expression based on the percentage of positive cells and intensity was performed. Data was entered and analysed on SPSS version 17. Fisher's exact test was used to compare grades, stages of urothelial carcinoma with CD 10 expression and age groups. P < 0.05 was taken as level of significance. Urothelial carcinoma was more common in males. The male to female ratio was 9:1. The older patients > 50 years had higher grade and stage as compared to the younger patients. All cases of high grade urothelial carcinoma showed higher positivity for CD 10. Twenty cases (86.95%) of high grade urothelial carcinoma were positive with +2 immunostaining while 3 cases (13.04 %) were positive with +1 staining. None of the tumors of stage pTa was positive for CD 10 expression. Of all patients with stage pT 1 tumor, 1 case (5.3%) was CD 10 negative and 17 cases (89.9%) were CD 10 positive having +1 staining with 5 - 50% staining and 1 case (5.3%) had +2 staining with more then 50% expression. Out of all patients with stage pT 2, no tumor was CD 10 negative, 3 (13.6%) patients were CD 10 positive with +1 staining and 19 (86.4%) with stage pT 2 tumor had stained positive with +2 staining. CD 10 expression was greater in high grade and invasive urothelial carcinomas; it may be associated with tumor progression in bladder cancer pathogenesis.

On the use of different measures of exposure-experiences from a case-control study on testicular cancer and PVC exposure.

PubMed

Westberg, Håkan B T; Hardell, Lennart O; Malmqvist, Nils; Ohlson, Carl-Göran; Axelson, Olav

2005-07-01

Associations between exposure to PVC plastics and testicular cancer have been reported. To improve the exposure-response analysis in a matched case-control study on testicular cancer and occupational exposures, a self-administered exposure questionnaire and expert assessment was applied and different exposure measures were developed. The questionnaires regarding work histories and employment in PVC production, manufacturing, and handling of PVC products were completed by 1582 subjects (90%). By expert assessment, 360 subjects were considered exposed, and the exposure intensity to PVC plastics for different working periods was determined. Different exposure measures to PVC plastics were then developed, such as ever/never exposed, duration, maximum intensity, median intensity, and cumulative median intensity. The correlation between the different measures of exposure was high for exposure duration and the cumulative median exposure intensity (Spearman rank coefficient r(s) = 0.94), as was the correlation between the maximum intensity and the median intensity (r(s) = 0.94). The agreement between the answers in the questionnaire and the expert assessments was moderate, Kappa value 0.56. The odds ratio for "ever" exposed based on the exposure as reported in the questionnaire was 1.1 (95%, CI 0.82-1.56), and as determined by expert assessment 1.3 (CI 1.05-1.69). The odds ratios for all four different categories of exposure measures varied between 0.86 and 2.6 but decreased by increasing exposure. An overall excess of testicular cancer for the PVC exposed vs. the unexposed was not supported by the pattern seen in a standard exposure-response analysis based on several exposure measures. The findings stress the importance of using several exposure measures as dose surrogates when the underlying toxic mechanisms are unknown and when there are indications of an overall effect.

The Impact of Lightning on Hurricane Rapid Intensification Forecasts Using the HWRF Model

NASA Astrophysics Data System (ADS)

Rosado, K.; Tallapragada, V.; Jenkins, G. S.

2016-12-01

In 2010, the National Oceanic and Atmospheric Administration (NOAA) created the Hurricane Forecast Improvement Project (HFIP) with the main goal of improving the tropical cyclone intensity and track forecasts by 50% in ten years. One of the focus areas is the improvement of the tropical cyclone rapid intensification (RI) forecasts. In order to contribute to this task, the role of lightning during the life cycle of a tropical cyclone using the NCEP operational HWRF hurricane model has been investigated. We ask two key research questions: (1) What is the functional relationship between atmospheric moisture content, lightning, and intensity in the HWRF model? and (2) How well does the HWRF model forecast the spatial distributions of lightning before, during, and after tropical cyclone intensification, especially for RI events? In order to address those questions, a lightning parameterization scheme called the Lightning Potential Index (LPI) was implemented into the HWRF model. The selected study cases to test the LPI implementation on the 2015 HWRF (operational version) are: Earl and Joaquin (North Atlantic), Haiyan (Western North Pacific), and Patricia (Eastern North Pacific). Five-day forecasts was executed on each case study with emphasis on rapid intensification periods. An extensive analysis between observed "best track" intensity, model intensity forecast, and potential for lightning forecast was performed. Preliminary results show that: (1) strong correlation between lightning and intensity changes does exists; and (2) the potential for lightning increases to its maximum peak a few hours prior to the peak intensity of the tropical cyclone. LPI peak values could potentially serve as indicator for future rapid intensification periods. Results from this investigation are giving us a better understanding of the mechanism behind lightning as a proxy for tropical cyclone steady state intensification and tropical cyclone rapid intensification processes. Improvement of lightning forecast has the potential to improve HWRF hurricane model intensity forecasts.

Potential involvement of leptin in carcinogenesis of hepatocellular carcinoma.

PubMed

Wang, Xiu-Jie; Yuan, Shu-Lan; Lu, Qing; Lu, Yan-Rong; Zhang, Jie; Liu, Yan; Wang, Wen-Dong

2004-09-01

To investigate the potential involvement of leptin in carcinogenesis of hepatocellular carcinoma (HCC) and to elucidate the etiology, carcinogenesis and progress of HCC. Expressions of Ob gene product, leptin and its receptor, Ob-R were investigated in 36 cases of HCC specimens and corresponding adjacent non-tumorous liver tissues with immunohistochemical staining. The effect of leptin on proliferation of Chang liver cell line and liver cancer cell line SMMC-7721 was studied with cell proliferation assay (MTT). Leptin expression was detected in 36 cases of adjacent non-tumorous liver tissues (36/36, 100%) with moderate (++) to strong (+++) intensity; and in 72.22%(26/36) of HCC with weaker (+) intensity (P<0.05). Thirty of 36 (83.33%) cases of adjacent non-tumorous liver tissues were positive for Ob-R, with moderate (++) to strong (+++) intensity. In HCC, 11/36 (30.56%) cases were positive, with weak (+) intensity (P<0.05). In cell proliferation assay, leptin inhibited the proliferation of Chang liver cells. The cell survival rate was 10-13% lower than that of the untreated cells (P>0.05). Leptin had little effect on the proliferation of liver cancer cells (P>0.05). High level expression and decreased or absent expression of leptin and its receptor in adjacent non-tumorous liver cells and HCC cells, inhibitory effect of leptin on the proliferation of normal Chang liver cells and no effect of leptin on proliferation of liver cancer cells, may provide new insights into the carcinogenesis and progression of human HCC. It could be assumed that leptin acting as an inhibitor and/or promoter, is involved in the process of carcinogenesis and progress of human HCC. Copyright 2004 The WJG Press ISSN

Measuring the Impact of AGN Outflows via Intensive UV and X-ray Monitoring Campaigns

NASA Astrophysics Data System (ADS)

Kriss, Gerard

2015-08-01

Observations of AGN outflows have progressed from the era of single-object surveys to intensive monitoring campaigns spanning weeks to months. The combination of multiple observations, improved temporal coverage, multi-wavelength monitoring in both the X-ray and UV bands, and the baseline of prior historical observations has enabled determinations of the locations, mass flux, and kinetic luminosities of the outflowing absorbing gas in several AGN, notably Mrk 509, NGC 5548, Mrk 335, and NGC 985. Another intensive campaign is planned for 2015-2016 on NGC 7469. In all cases, the mass flux and kinetic energy is dominated by the higher-ionization X-ray absorbing gas. But the higher-resolution UV observations give a kinematically resolved picture of the overall outflow. In most cases, the outflowing gas is located at parsec to kpc scales, with insufficient kinetic luminosity to have an evolutionary impact on the host galaxy. Typically, the kinetic luminosity is less than a percent of the Eddington luminosity. In some cases, transient, broad UV absorption troughs have appeared (e.g., Mrk 335 and NGC 5548), with variability timescales suggesting locations near the broad-line region of the AGN. Yet these higher-velocity outflows also have low-impact kinetic luminosities. In the best-studied case of NGC 5548, the strength of the broad UV absorption lines varies with the degree of soft X-ray obscuration first revealed by XMM-Newton spectra. The lower-ionization, narrow associated absorption lines in the UV spectrum of NGC 5548 that appeared concurrently with the soft X-ray obscuration vary in response to the changing UV flux on a daily basis. The intensive monitoring allows us to fit time-dependent photoionization models to the UV-absorbing gas, allowing precise determinations of the locations, mass flux, and kinetic luminosities of the absorbers.

Assessing environmental risks for high intensity agriculture using the material flow analysis method--a case study of the Dongting Lake basin in South Central China.

PubMed

Yin, Guanyi; Liu, Liming; Yuan, Chengcheng

2015-07-01

This study primarily examined the assessment of environmental risk in high intensity agricultural areas. Dongting Lake basin was taken as a case study, which is one of the major grain producing areas in China. Using data obtained from 1989 to 2012, we applied Material Flow Analysis (MFA) to show the material consumption, pollutant output and production storage in the agricultural-environmental system and assessed the environmental risk index on the basis of the MFA results. The results predicted that the status of the environmental quality of the Dongting Lake area is unsatisfactory for the foreseeable future. The direct material input (DMI) declined by 13.9%, the domestic processed output (DPO) increased by 28.21%, the intensity of material consumption (IMC) decreased by 36.7%, the intensity of material discharge (IMD) increased by 10%, the material productivity (MP) increased by 27 times, the environmental efficiency (EE) increased by 15.31 times, and the material storage (PAS) increased by 0.23%. The DMI and DPO was higher at rural places on the edge of cities, whereas the risk of urban agriculture has arisen due to the higher increasing rate of DMI and DPO in cities compared with the counties. The composite environmental risk index increased from 0.33 to 0.96, indicating that the total environmental risk changed gradually but seriously during the 24 years assessed. The driving factors that affect environmental risk in high intensity agriculture can be divided into five classes: social, economic, human, natural and disruptive incidents. This study discussed a number of effective measures for protecting the environment while ensuring food production yields. Additional research in other areas and certain improvements of this method in future studies may be necessary to develop a more effective method of managing and controlling agricultural-environmental interactions.

Treatment of localized neuropathic pain of different etiologies with the 5% lidocaine medicated plaster – a case series

PubMed Central

Likar, Rudolf; Demschar, Susanne; Kager, Ingo; Neuwersch, Stefan; Pipam, Wolfgang; Sittl, Reinhard

2015-01-01

Objective To assess the efficacy and safety of the topical 5% lidocaine medicated plaster in the treatment of localized neuropathic pain. Study design This was a case series at an Austrian pain clinic, using retrospective analysis. Patients and methods Data of 27 patients treated for localized neuropathic pain with the 5% lidocaine medicated plaster were retrospectively analyzed. Assessment included changes in overall pain intensity, in intensity of different pain qualities, and of hyperalgesia and allodynia, and changes in sleep quality. Results Patients (17 female, ten male; mean age 53.4±11.4 years) presented mainly with dorsalgia (16 patients) or postoperative/posttraumatic pain (seven patients); one patient suffered from both. The mean overall pain intensity prior to treatment with lidocaine medicated plaster was 8.4±1.2 on the 11-point Likert scale. In the majority of cases, the lidocaine plaster was applied concomitantly with preexisting pain medication (81.5% of the patients). During the 6-month observation period, overall mean pain intensity was reduced by almost 5 points (4.98) to 3.5±2.6. Substantial reductions were also observed for neuralgiform pain (5 points from 7.9±2.6 at baseline) and burning pain (3 points from 5.2±4.1). Sleep quality improved from 4.6±2.6 at baseline to 5.5±1.8. Stratification by pain diagnosis showed marked improvements in overall pain intensity for patients with dorsalgia or postoperative/posttraumatic pain. The lidocaine plaster was well tolerated. Conclusion Overall, topical treatment with the 5% lidocaine medicated plaster was associated with effective pain relief and was well tolerated. PMID:25565882

The use of land- and satellite-based precipitation radar to forecast debris flows and high water discharge: case study from June 2nd, 2016 in southern Norway.

NASA Astrophysics Data System (ADS)

Devoli, Graziella; Mengistu, Zelalem T.; Elo, Christoffer A.; Boje, Søren; Rønning, Snorre S.; Engeland, Kolbjørn; Lussana, Cristian

2017-04-01

The Norwegian flood- and landslide forecasting service at the Norwegian Water Resources and Energy Directorate (NVE) (www.varsom.no), has issued flood forecasts since 1989, and since 2013 the occurrence of many landslides events at regional level, due either to severe storms or intense snow melting, has been predicted. High intensity and short duration (less than 1 hour) rainfalls may cause sudden and abundant runoff that can entrain large quantities of loose sediments and originate debris flows. Intense convective rainstorms often develop quickly, especially during summer, and they are difficult to forecast and even to observe with a standard (synoptic) network of precipitation gauges. In those cases, the forecaster on duty can send warning messages for a very large area (encompassing many counties and many municipalities), because of the large spatial uncertainty of the prognoses and amount of rain. A standard sentence in the warning message is always included, recommending to the population to monitor the evolution of the rainstorm with weather radar products, which are available on institutional websites. In other cases, especially when the convective rainstorm is spatially confined in a small area and highly uncertain, the forecaster may choose to not issue any warning. The first situation yields false alarms for some areas, while the second situation could result in a missing event, if a landslide actually occurs. The Norwegian Meteorological Institute (MET) and NVE are working on a project to further promote the use of radar-derived products in landslides and flood forecasting. In this study, we focus on the description of a case study to present the potential of MET-NVE collaboration on the topic. As a case study, we have chosen a short-lived rainstorm occurred on June 2nd, 2016 in Motland (Rogaland county, Southern Norway), which had triggered 2 debris flows that were not forecasted. Land- and satellite-based weather radar and lighting data were used to analyse and recreate the triggering conditions for these events. The closest rain gauges in the area show very low rain intensity that cannot explain the initiation of the landslides. This is in disagreement with the eye-witness that observed intense and very local showers. The analysis of rainfall intensity estimated by both land-based and satellite-based (IMERG) radar data confirms the eye-witness observations, and it results in significantly higher values for the areas where the debris flows were triggered, if compared to precipitation interpolated from gauge observations. This was also supported by discharge responses from three small catchments in the area. Our results indicates that weather radar and lighting data are useful complements to the traditional analysis of landslide events made only by means of gauges, moreover they can be used: a) in back analyses on rainfall and landslide events in order to improve landslide thresholds; b) has a potential to assist in now-casting operations as supporting tool of a regional warning, especially in summer season, and radar prediction can be used in the proximate hour to see the storm development.

Probing the limits of the rigid-intensity-shift model in differential-phase-contrast scanning transmission electron microscopy

NASA Astrophysics Data System (ADS)

Clark, L.; Brown, H. G.; Paganin, D. M.; Morgan, M. J.; Matsumoto, T.; Shibata, N.; Petersen, T. C.; Findlay, S. D.

2018-04-01

The rigid-intensity-shift model of differential-phase-contrast imaging assumes that the phase gradient imposed on the transmitted probe by the sample causes the diffraction pattern intensity to shift rigidly by an amount proportional to that phase gradient. This behavior is seldom realized exactly in practice. Through a combination of experimental results, analytical modeling and numerical calculations, using as case studies electron microscope imaging of the built-in electric field in a p-n junction and nanoscale domains in a magnetic alloy, we explore the breakdown of rigid-intensity-shift behavior and how this depends on the magnitude of the phase gradient and the relative scale of features in the phase profile and the probe size. We present guidelines as to when the rigid-intensity-shift model can be applied for quantitative phase reconstruction using segmented detectors, and propose probe-shaping strategies to further improve the accuracy.

Management of acute overdose or withdrawal state in intrathecal baclofen therapy.

PubMed

Watve, S V; Sivan, M; Raza, W A; Jamil, F F

2012-02-01

Individuals who are treated with intrathecal Baclofen (ITB) pump delivery system for intractable spasticity can suffer from severe morbidity as a result of acute overdose or withdrawal of ITB, which can also be life threatening. Current literature has a number of single case studies with different approaches to the management in such states. The aim of this article is to consolidate available evidence and develop treatment pathways for acute ITB overdose and withdrawal states. We searched MEDLINE, EMBASE, CINAHL and the Cochrane Library databases using the keywords 'intrathecal', 'baclofen', 'withdrawal', 'overdose' to identify studies (published up to December 2010) that focused on presentation or treatment of acute overdose and withdrawal state in ITB therapy. Only original articles in English involving adult population were included. Initial search revealed 130 articles. After reading the abstract, 13 studies on ITB overdose and 23 studies on ITB withdrawal were deemed suitable for inclusion. All studies were either single-case studies or case series. Acute ITB overdose is managed with immediate cessation of baclofen delivery through the system, reducing the baclofen load by cerebrospinal fluid aspiration and by providing supportive treatment in an intensive care setting. There is no specific antidote for reversing overdose symptoms. Acute ITB withdrawal is managed by restoring the delivery of ITB, providing supportive care in an intensive care setting and using drugs like low dose propofol or benzodiazepines in selected cases. Early involvement of ITB physicians is strongly recommended.

A case series study of the neurophysiological effects of altered states of mind during intense Islamic prayer.

PubMed

Newberg, Andrew B; Wintering, Nancy A; Yaden, David B; Waldman, Mark R; Reddin, Janet; Alavi, Abass

2015-12-01

This paper presents a case series with preliminary data regarding the neurophysiological effects of specific prayer practices associated with the Islamic religion. Such practices, like other prayer practices, are likely associated with several coordinated cognitive activities and a complex pattern of brain physiology. However, there may also be changes specific to the goals of Islamic prayer which has, as its most fundamental concept, the surrendering of one's self to God. To evaluate Islamic prayer practices, we measured changes in cerebral blood flow (CBF) using single photon emission computed tomography (SPECT) in three Islamic individuals while practicing two different types of Islamic prayer. In this case series, intense Islamic prayer practices generally showed decreased CBF in the prefrontal cortex and related frontal lobe structures, and the parietal lobes. However, there were also several regions that differed between the two types of prayer practices including increased CBF in the caudate nucleus, insula, thalamus, and globus pallidus. These patterns also appear distinct from concentrative techniques in which an individual focuses on a particular idea or object. It is hypothesized that the changes in brain activity may be associated with feelings of "surrender" and "connectedness with God" described to be experienced during these intense Islamic prayer practices. Overall, these results suggest that several coordinated cognitive processes occur during intense Islamic prayer. Methodological issues and implications of the results are also discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of New York State's Children and Youth Intensive Case Management Program.

ERIC Educational Resources Information Center

Dollard, Norin; And Others

The evaluation plan for New York State's Children and Youth Intensive Case Management (CYICM) Program is described, which was introduced in July 1988. The CYICM Program is a statewide intervention focusing on keeping children with serious emotional disturbances in the least restrictive environment appropriate to their needs. It is a…

Evidence of direct cardiac damage following high-intensity exercise in chronic energy restriction: A case report and literature review.

PubMed

Baird, Marianne F; Grace, Fergal; Sculthorpe, Nicholas; Graham, Scott M; Fleming, Audrey; Baker, Julien S

2017-07-01

Following prolonged endurance events such as marathons, elevated levels of cardiospecific biomarkers are commonly reported. Although transiently raised levels are generally not considered to indicate clinical myocardial damage, comprehension of this phenomenon remains incomplete. The popularity of high-intensity interval training highlights a paucity of research measuring cardiac biomarker response to this type of exercise. This a posteriori case report discusses the elevation of cardiac troponins (cTn) associated with short interval, high-intensity exercise. In this case report, an apparently healthy 29-year-old recreationally active female presented clinically raised cardiac troponin I (cTnI) levels (>0.04 ng/mL), after performing high-intensity cycle ergometer sprints. As creatine kinase (CK) is expressed by multiple organs (e.g., skeletal muscle, brain, and myocardium), cTnI assays were performed to determine any changes in total serum CK levels not originating from skeletal muscle damage. A posteriori the individual's daily energy expenditure indicated chronically low-energy availability. Psychometric testing suggested that the individual scored positive for disordered eating, highly for fatigue levels, and low in mental health components. The current case report provides novel evidence of elevated cTnI occurring as a result of performing short duration, high intensity, cycle ergometer exercise in an individual with self-reported chronically depleted energy balance. A schematic to identify potentially "at risk" individuals is presented. Considering this as a case report, results cannot be generalized; however, the main findings suggest that individuals who habitually restrict their calorie intake below their bodies' daily energy requirements, may have elevated biomarkers of exercise induced myocardial stress from performing high-intensity exercise.

Telepractice for Pediatric Dysphagia: A Case Study

PubMed Central

Malandraki, Georgia A.; Roth, Melissa; Sheppard, Justine Joan

2014-01-01

A closed-ended intensive pediatric swallowing telepractice program was developed and piloted in one pediatric patient with Opitz BBB/G and Asperger’s Syndromes, oropharyngeal dysphagia and aerophagia. The present study is a case report. Outcome variables included behavioral, swallowing and quality of life variables, and were assessed at baseline and at the end of the four-week program. Selective variables were also assessed at a follow-up family interview four weeks post program completion. Over the four-week intervention period, the patient demonstrated substantial improvements in: oral acceptance of eating-related objects and a variety of foods (behavioral variable), timing of voluntary saliva swallows and aerophagia levels (swallowing variables) and quality of life. Follow-up interview analysis showed that most skills were retained or improved one-month post intervention. This intensive telepractice program proved to be feasible and effective for this pediatric patient with dysphagia. PMID:25945217

Case Study of High-Dose Ketamine for Treatment of Complex Regional Pain Syndrome in the Pediatric Intensive Care Unit.

PubMed

Pasek, Tracy Ann; Crowley, Kelli; Campese, Catherine; Lauer, Rachel; Yang, Charles

2017-06-01

Complex regional pain syndrome (CRPS) is a life-altering and debilitating chronic pain condition. The authors are presenting a case study of a female who received high-dose ketamine for the management of her CRPS. The innovative treatment lies not only within the pharmacologic management of her pain, but also in the fact that she was the first patient to be admitted to our pediatric intensive care unit solely for pain control. The primary component of the pharmacotherapy treatment strategy plan was escalating-dose ketamine infusion via patient-controlled-analgesia approved by the pharmacy and therapeutics committee guided therapy for this patient. The expertise of advanced practice nurses blended exquisitely to ensure patient and family-centered care and the coordination of care across the illness trajectory. The patient experienced positive outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Spectroscopic studies of ozone in cryosolutions: FT-IR spectra of 16O3 in liquid nitrogen, oxygen, argon and krypton

NASA Astrophysics Data System (ADS)

Bulanin, Kirill M.; Bulanin, Michael O.; Rudakova, Aida V.; Kolomijtsova, Tatiana D.; Shchepkin, Dmitrij N.

2018-03-01

We have measured and interpreted the IR spectra of ozone dissolved in liquid nitrogen, oxygen, argon, and krypton in the 650-4700 cm-1 spectral region at 79-117 K. Frequency shifts, band intensities and bandshapes of 22 spectral features of soluted ozone were analyzed. The bands of the A1 symmetry have a complex contour and possess an excess intensity with respect to the value of the purely vibrational transition moment. It was found that this effect is related to the manifestation of the Coriolis interaction. The bandshape distortion manifests itself as an additional intensity from the side of the B1 symmetry band being an intensity source in the case of the Coriolis interaction.

Intensity Maps Production Using Real-Time Joint Streaming Data Processing From Social and Physical Sensors

NASA Astrophysics Data System (ADS)

Kropivnitskaya, Y. Y.; Tiampo, K. F.; Qin, J.; Bauer, M.

2015-12-01

Intensity is one of the most useful measures of earthquake hazard, as it quantifies the strength of shaking produced at a given distance from the epicenter. Today, there are several data sources that could be used to determine intensity level which can be divided into two main categories. The first category is represented by social data sources, in which the intensity values are collected by interviewing people who experienced the earthquake-induced shaking. In this case, specially developed questionnaires can be used in addition to personal observations published on social networks such as Twitter. These observations are assigned to the appropriate intensity level by correlating specific details and descriptions to the Modified Mercalli Scale. The second category of data sources is represented by observations from different physical sensors installed with the specific purpose of obtaining an instrumentally-derived intensity level. These are usually based on a regression of recorded peak acceleration and/or velocity amplitudes. This approach relates the recorded ground motions to the expected felt and damage distribution through empirical relationships. The goal of this work is to implement and evaluate streaming data processing separately and jointly from both social and physical sensors in order to produce near real-time intensity maps and compare and analyze their quality and evolution through 10-minute time intervals immediately following an earthquake. Results are shown for the case study of the M6.0 2014 South Napa, CA earthquake that occurred on August 24, 2014. The using of innovative streaming and pipelining computing paradigms through IBM InfoSphere Streams platform made it possible to read input data in real-time for low-latency computing of combined intensity level and production of combined intensity maps in near-real time. The results compare three types of intensity maps created based on physical, social and combined data sources. Here we correlate the count and density of Tweets with intensity level and show the importance of processing combined data sources at the earliest time stages after earthquake happens. This method can supplement existing approaches of intensity level detection, especially in the regions with high number of Twitter users and low density of seismic networks.

Flat Plate Wake Velocity Statistics Obtained With Circular And Elliptic Trailing Edges

NASA Technical Reports Server (NTRS)

Rai, Man Mohan

2016-01-01

The near wake of a flat plate with circular and elliptic trailing edges is investigated with data from direct numerical simulations. The plate length and thickness are the same in both cases. The separating boundary layers are turbulent and statistically identical. Therefore the wake is symmetric in the two cases. The emphasis in this study is on a comparison of the wake-distributions of velocity components, normal intensity and fluctuating shear stress obtained in the two cases.

The life cycles of intense cyclonic and anticyclonic circulation systems observed over oceans

NASA Technical Reports Server (NTRS)

Smith, Phillip J.

1994-01-01

The work over the past six months has focused on the October/November 1985 blocking case study noted in the last progress report. A summary of the results of this effort is contained in the attached preprint papers for the Symposium on the Life Cycles of Extratropical Cyclones. Using this case study as a model, Ph.D. student Anthony Lupo is now initiating the multiple-case diagnosis by first examining two more fall 1985 blocking episodes. In addition, two secondary efforts have been completed, as summarized in the attached M.S. thesis abstracts. Both studies, which were primarily funded by a fellowship and a teaching assistantship, complement the objectives of this study by providing diagnoses of additional cyclone cases to serve as a comparative base for the pre-blocking cyclones to be studied in the multiple-case blocking diagnosis.

High-Intensity Strength Training Improves Function of Chronically Painful Muscles: Case-Control and RCT Studies

PubMed Central

Andersen, Christoffer H.; Skotte, Jørgen H.; Suetta, Charlotte; Søgaard, Karen; Saltin, Bengt; Sjøgaard, Gisela

2014-01-01

Aim. This study investigates consequences of chronic neck pain on muscle function and the rehabilitating effects of contrasting interventions. Methods. Women with trapezius myalgia (MYA, n = 42) and healthy controls (CON, n = 20) participated in a case-control study. Subsequently MYA were randomized to 10 weeks of specific strength training (SST, n = 18), general fitness training (GFT, n = 16), or a reference group without physical training (REF, n = 8). Participants performed tests of 100 consecutive cycles of 2 s isometric maximal voluntary contractions (MVC) of shoulder elevation followed by 2 s relaxation at baseline and 10-week follow-up. Results. In the case-control study, peak force, rate of force development, and rate of force relaxation as well as EMG amplitude were lower in MYA than CON throughout all 100 MVC. Muscle fiber capillarization was not significantly different between MYA and CON. In the intervention study, SST improved all force parameters significantly more than the two other groups, to levels comparable to that of CON. This was seen along with muscle fiber hypertrophy and increased capillarization. Conclusion. Women with trapezius myalgia have lower strength capacity during repetitive MVC of the trapezius muscle than healthy controls. High-intensity strength training effectively improves strength capacity during repetitive MVC of the painful trapezius muscle. PMID:24707475

Mapping species abundance by a spatial zero-inflated Poisson model: a case study in the Wadden Sea, the Netherlands.

PubMed

Lyashevska, Olga; Brus, Dick J; van der Meer, Jaap

2016-01-01

The objective of the study was to provide a general procedure for mapping species abundance when data are zero-inflated and spatially correlated counts. The bivalve species Macoma balthica was observed on a 500×500 m grid in the Dutch part of the Wadden Sea. In total, 66% of the 3451 counts were zeros. A zero-inflated Poisson mixture model was used to relate counts to environmental covariates. Two models were considered, one with relatively fewer covariates (model "small") than the other (model "large"). The models contained two processes: a Bernoulli (species prevalence) and a Poisson (species intensity, when the Bernoulli process predicts presence). The model was used to make predictions for sites where only environmental data are available. Predicted prevalences and intensities show that the model "small" predicts lower mean prevalence and higher mean intensity, than the model "large". Yet, the product of prevalence and intensity, which might be called the unconditional intensity, is very similar. Cross-validation showed that the model "small" performed slightly better, but the difference was small. The proposed methodology might be generally applicable, but is computer intensive.

An application of a hybrid MCDM method for the evaluation of entrepreneurial intensity among the SMEs: a case study.

PubMed

Rostamzadeh, Reza; Ismail, Kamariah; Bodaghi Khajeh Noubar, Hossein

2014-01-01

This study presents one of the first attempts to focus on critical success factors influencing the entrepreneurial intensity of Malaysian small and medium sized enterprises (SMEs) as they attempt to expand internationally. The aim of this paper is to evaluate and prioritize the entrepreneurial intensity among the SMEs using multicriteria decision (MCDM) techniques. In this research FAHP is used for finding the weights of criteria and subcriteria. Then for the final ranking of the companies, VIKOR (in Serbian: VlseKriterijumska Optimizacija I Kompromisno Resenje) method was used. Also, as an additional tool, TOPSIS technique, is used to see the differences of two methods applied over the same data. 5 main criteria and 14 subcriteria were developed and implemented in the real-world cases. As the results showed, two ranking methods provided different ranking. Furthermore, the final findings of the research based on VIKOR and TOPSIS indicated that the firms A3 and A4 received the first rank, respectively. In addition, the firm A4 was known as the most entrepreneurial company. This research has been done in the manufacturing sector, but it could be also extended to the service sector for measurement.

An Application of a Hybrid MCDM Method for the Evaluation of Entrepreneurial Intensity among the SMEs: A Case Study

PubMed Central

Ismail, Kamariah; Bodaghi Khajeh Noubar, Hossein

2014-01-01

This study presents one of the first attempts to focus on critical success factors influencing the entrepreneurial intensity of Malaysian small and medium sized enterprises (SMEs) as they attempt to expand internationally. The aim of this paper is to evaluate and prioritize the entrepreneurial intensity among the SMEs using multicriteria decision (MCDM) techniques. In this research FAHP is used for finding the weights of criteria and subcriteria. Then for the final ranking of the companies, VIKOR (in Serbian: VlseKriterijumska Optimizacija I Kompromisno Resenje) method was used. Also, as an additional tool, TOPSIS technique, is used to see the differences of two methods applied over the same data. 5 main criteria and 14 subcriteria were developed and implemented in the real-world cases. As the results showed, two ranking methods provided different ranking. Furthermore, the final findings of the research based on VIKOR and TOPSIS indicated that the firms A3 and A4 received the first rank, respectively. In addition, the firm A4 was known as the most entrepreneurial company. This research has been done in the manufacturing sector, but it could be also extended to the service sector for measurement. PMID:25197707

Risk Factors and Predictors for Candidemia in Pediatric Intensive Care Unit Patients: Implications for Prevention

PubMed Central

Zaoutis, Theoklis E.; Prasad, Priya A.; Localio, A. Russell; Coffin, Susan E.; Bell, Louis M.; Walsh, Thomas J.; Gross, Robert

2013-01-01

Summary Few data exist on risk factors for candidemia in pediatric intensive care unit (PICU) patients who are at high risk of mortality from infection. We conducted a population-based case-control study to determine risk factors and predictors for candidemia in the PICU. Background Candida species are the leading cause of invasive fungal infections in hospitalized children and are the third most common isolates recovered from pediatric healthcare-associated bloodstream infection in the US [1]. Few data exist on risk factors for candidemia in pediatric intensive care unit (PICU) patients. Methods We conducted a population-based case-control study of PICU patients at Children's Hospital of Philadelphia (CHOP) from 1997-2004. Cases were identified using laboratory records, controls were selected from PICU rosters. Controls were matched to cases by incidence density sampling, adjusting for time at risk. Following conditional multivariate analysis, we performed weighted multivariate analysis to determine predicted probabilities for candidemia given certain risk factor combinations. Results We identified 101 cases of candidemia(incidence,3.5/1,000 PICU admissions). Factors independently associated with candidemia included presence of a central venous catheter(OR 30.4;CI,7.7,119.5), malignancy(OR 4.0;CI,1.23,13.1), use of vancomycin for >3 days in the prior two weeks(OR 6.2;CI,2.4,16), and receipt of agents with activity against anaerobic organisms for >3 days in the prior two weeks(OR 3.5;CI, 1.5,8.4). Predicted probability of various combinations of the factors above ranged from 10.7%-46%. The 30-day mortality rate was 44% in cases compared to 14% in controls (OR 4.22;CI,2.35,7.60). Conclusions To our knowledge, this is the first study to evaluate independent risk factors and to determine a population of children in PICUs at high risk for developing candidemia. Future efforts should focus on validation of these risk factors identified in a different PICU population and development of interventions for prevention of candidemia in critically ill children. PMID:20636126

Body dirt or liquid gold? How the 'safety' of donated breastmilk is constructed for use in neonatal intensive care.

PubMed

Carroll, Katherine

2014-06-01

When mothers of preterm infants are unable to produce sufficient volumes of breastmilk, neonatologists in many Western countries prescribe pasteurized donor breastmilk. Breastmilk has a paradoxical presence in the neonatal intensive care unit while it has therapeutic properties, it also has the potential to transmit disease. National health authorities and local neonatal intensive care unit policies each delimit the safety of donor milk by focusing on the presence or absence of pathogens. It is in this light that breastmilk from the human milk bank is both sought and legitimated to minimize safety concerns. This research uses data arising from an ethnographic study of two human milk banks and two neonatal intensive care units in the United States, and 73 interviews with milk donors, neonatal intensive care unit parents and clinicians. The primary research question framing the study was 'What are the underlying processes and practices that have enabled donor milk to be endorsed as a safe and legitimate feeding option in neonatal intensive care units?' This study is framed using three key principles of Latour's 'new critique', namely, adding to reality rather than debunking it, getting closer to data rather than turning away from fact and creating arenas in which to assemble. As a result, conceptions of donor milk's safety are expanded. This case study of donor milk demonstrates how Latour's new critique can inform science and technology studies approaches to the study of safety in health care.

Effect of atmospheric turbulence on wind turbine wakes: An LES study

NASA Astrophysics Data System (ADS)

Wu, Y. T.; Porté-Agel, F.

2012-04-01

A comprehensive numerical study of atmospheric turbulence effect on wind-turbine wakes is presented. Large-eddy simulations of neutrally-stratified boundary layers developed over different flat surfaces (forest, farmland, grass, and snow) are performed to investigate the structure of turbine wakes in cases where the incident flows to the wind turbine have the same mean velocity at the hub height but different mean wind shears and turbulence intensity levels. The simulation results show that the different wind shears and turbulence intensity levels of the incoming flow lead to considerable influence on the spatial distribution of the mean velocity deficit, turbulence intensity, and turbulent shear stress in the wake region downstream of the turbine. In general, the recovery of the turbine-induced wake (velocity deficit) is faster and the turbulence intensity level is higher and has its maximum closer to the turbine for wakes of turbines over rougher terrain. In order to isolate the effect of turbulence intensity from that of wind shear, simulations have also been performed with synthetic inflow velocity fields that have the same mean wind shear but different turbulence intensity levels. We find that the effect of the inflow turbulence intensity on the wake recovery and turbulence levels is stronger than that of the mean shear.

Social, organizational, and contextual characteristics of clinical decision support systems for intensive insulin therapy: a literature review and case study.

PubMed

Campion, Thomas R; Waitman, Lemuel R; May, Addison K; Ozdas, Asli; Lorenzi, Nancy M; Gadd, Cynthia S

2010-01-01

Evaluations of computerized clinical decision support systems (CDSS) typically focus on clinical performance changes and do not include social, organizational, and contextual characteristics explaining use and effectiveness. Studies of CDSS for intensive insulin therapy (IIT) are no exception, and the literature lacks an understanding of effective computer-based IIT implementation and operation. This paper presents (1) a literature review of computer-based IIT evaluations through the lens of institutional theory, a discipline from sociology and organization studies, to demonstrate the inconsistent reporting of workflow and care process execution and (2) a single-site case study to illustrate how computer-based IIT requires substantial organizational change and creates additional complexity with unintended consequences including error. Computer-based IIT requires organizational commitment and attention to site-specific technology, workflow, and care processes to achieve intensive insulin therapy goals. The complex interaction between clinicians, blood glucose testing devices, and CDSS may contribute to workflow inefficiency and error. Evaluations rarely focus on the perspective of nurses, the primary users of computer-based IIT whose knowledge can potentially lead to process and care improvements. This paper addresses a gap in the literature concerning the social, organizational, and contextual characteristics of CDSS in general and for intensive insulin therapy specifically. Additionally, this paper identifies areas for future research to define optimal computer-based IIT process execution: the frequency and effect of manual data entry error of blood glucose values, the frequency and effect of nurse overrides of CDSS insulin dosing recommendations, and comprehensive ethnographic study of CDSS for IIT. Copyright (c) 2009. Published by Elsevier Ireland Ltd.

Dosimetric advantages of intensity-modulated proton therapy for oropharyngeal cancer compared with intensity-modulated radiation: A case-matched control analysis

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

Holliday, Emma B.; Kocak-Uzel, Esengul; Department of Radiation Therapy, Beykent University, Istanbul

A potential advantage of intensity-modulated proton therapy (IMPT) over intensity-modulated (photon) radiation therapy (IMRT) in the treatment of oropharyngeal carcinoma (OPC) is lower radiation dose to several critical structures involved in the development of nausea and vomiting, mucositis, and dysphagia. The purpose of this study was to quantify doses to critical structures for patients with OPC treated with IMPT and compare those with doses on IMRT plans generated for the same patients and with a matched cohort of patients actually treated with IMRT. In this study, 25 patients newly diagnosed with OPC were treated with IMPT between 2011 and 2012.more » Comparison IMRT plans were generated for these patients and for additional IMRT-treated controls extracted from a database of patients with OPC treated between 2000 and 2009. Cases were matched based on the following criteria, in order: unilateral vs bilateral therapy, tonsil vs base of tongue primary, T-category, N-category, concurrent chemotherapy, induction chemotherapy, smoking status, sex, and age. Results showed that the mean doses to the anterior and posterior oral cavity, hard palate, larynx, mandible, and esophagus were significantly lower with IMPT than with IMRT comparison plans generated for the same cohort, as were doses to several central nervous system structures involved in the nausea and vomiting response. Similar differences were found when comparing dose to organs at risks (OARs) between the IMPT cohort and the case-matched IMRT cohort. In conclusion, these findings suggest that patients with OPC treated with IMPT may experience fewer and less severe side effects during therapy. This may be the result of decreased beam path toxicities with IMPT due to lower doses to several dysphagia, odynophagia, and nausea and vomiting–associated OARs. Further study is needed to evaluate differences in long-term disease control and chronic toxicity between patients with OPC treated with IMPT in comparison to those treated with IMRT.« less

The Properties of Terrestrial Laser System Intensity for Measuring Leaf Geometries: A Case Study with Conference Pear Trees (Pyrus Communis)

PubMed Central

Balduzzi, Mathilde A.F.; Van der Zande, Dimitry; Stuckens, Jan; Verstraeten, Willem W.; Coppin, Pol

2011-01-01

Light Detection and Ranging (LiDAR) technology can be a valuable tool for describing and quantifying vegetation structure. However, because of their size, extraction of leaf geometries remains complicated. In this study, the intensity data produced by the Terrestrial Laser System (TLS) FARO LS880 is corrected for the distance effect and its relationship with the angle of incidence between the laser beam and the surface of the leaf of a Conference Pear tree (Pyrus Commmunis) is established. The results demonstrate that with only intensity, this relationship has a potential for determining the angle of incidence with the leaves surface with a precision of ±5° for an angle of incidence smaller than 60°, whereas it is more variable for an angle of incidence larger than 60°. It appears that TLS beam footprint, leaf curvatures and leaf wrinkles have an impact on the relationship between intensity and angle of incidence, though, this analysis shows that the intensity of scanned leaves has a potential to eliminate ghost points and to improve their meshing. PMID:22319374

Knowledge Construction in Online Learning Communities: A Case Study of a Doctoral Course

ERIC Educational Resources Information Center

Lai, Kwok-Wing

2015-01-01

This paper documents a study investigating co-construction of knowledge by doctoral students in an online learning community. In this study 12 students participated in the coursework and thesis proposal development stages of a doctoral program offered by a research-intensive university in New Zealand. Socio-cultural and social constructivist…

Patterns of Guidance in Inquiry Learning

ERIC Educational Resources Information Center

Veermans, Marjaana; Lallimo, Jiri; Hakkarainen, Kai

2005-01-01

The purpose of this case study was to examine a teacher's guidance of an inquiry learning project in an ordinary elementary-school classroom. The participants in the study were 21 Finnish, grade 4 students (10 years old), from which four students were selected for intensive observation. The technical infrastructure of the study was Computer…

A case-control evaluation of fungiform papillae density in burning mouth syndrome.

PubMed

Naud, Jason M; Benca, Laura; Drangsholt, Mark T; LeResche, Linda; Coldwell, Susan E

2018-04-01

It has been hypothesized that high fungiform papillae density may be a risk factor for developing the taste and pain alterations characteristic of burning mouth syndrome. Evaluate whether fungiform papillae density, taste sensitivity, and mechanical pain sensitivity differ between burning mouth syndrome cases and controls. This case-control study compared cases diagnosed with primary burning mouth syndrome with pain-free controls. Participants (17 female cases and 23 female controls) rated the intensity of sucrose, sodium chloride, citric acid, and quinine applied separately to each side of the anterior tongue and sampled whole mouth. Mechanical pain sensitivity was assessed separately for each side of the tongue using weighted pins. Digital photographs of participants' tongues were used to count fungiform papillae. Burning mouth syndrome cases had increased whole mouth taste intensity. Cases also had increased sensitivity to quinine on the anterior tongue, as well as increased mechanical pain sensitivity on the anterior tongue. Fungiform papillae density did not differ significantly between cases and controls. Fungiform papillae density on the left and right sides of the tongue were correlated in controls; however, there was no left/right side correlation in cases. Cases had increased pain and taste perception on the anterior tongue. The lack of correlation between left and right fungiform papillae density in cases may be an indication of asymmetrical lingual innervation in these patients. 3b. Laryngoscope, 128:841-846, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Aerosol Classification from High Spectral Resolution Lidar Measurements

NASA Astrophysics Data System (ADS)

Burton, S. P.; Hair, J. W.; Ferrare, R. A.; Hostetler, C. A.; Kahnert, M.; Vaughan, M. A.; Cook, A. L.; Harper, D. B.; Berkoff, T.; Seaman, S. T.; Collins, J. E., Jr.; Fenn, M. A.; Rogers, R. R.

2015-12-01

The NASA Langley airborne High Spectral Resolution Lidars, HSRL-1 and HSRL-2, have acquired large datasets of vertically resolved aerosol extinction, backscatter, and depolarization during >30 airborne field missions since 2006. The lidar measurements of aerosol intensive parameters like lidar ratio and color ratio embed information about intrinsic aerosol properties, and are combined to qualitatively classify HSRL aerosol measurements into aerosol types. Knowledge of aerosol type is important for assessing aerosol radiative forcing, and can provide useful information for source attribution studies. However, atmospheric aerosol is frequently not a single pure type, but instead is a mixture, which affects the optical and radiative properties of the aerosol. We show that aerosol intensive parameters measured by lidar can be understood using mixing rules for cases of external mixing. Beyond coarse classification and mixing between classes, variations in the lidar aerosol intensive parameters provide additional insight into aerosol processes and composition. This is illustrated by depolarization measurements at three wavelengths, 355 nm, 532 nm, and 1064 nm, made by HSRL-2. Particle depolarization ratio is an indicator of non-spherical particles. Three cases each have a significantly different spectral dependence of the depolarization ratio, related to the size of the depolarizing particles. For two dust cases, large non-spherical particles account for the depolarization of the lidar light. The spectral dependence reflects the size distribution of these particles and reveals differences in the transport histories of the two plumes. For a smoke case, the depolarization is inferred to be due to the presence of small coated soot aggregates. Interestingly, the depolarization at 355 nm is similar for this smoke case compared to the dust cases, having potential implications for the upcoming EarthCARE satellite, which will measure particle depolarization ratio only at 355 nm.

Fluorescence-guided resection with 5-aminolevulinic Acid of subependymomas of the fourth ventricle: report of 2 cases: technical case report.

PubMed

Bernal García, Luis Miguel; Cabezudo Artero, José Manuel; Marcelo Zamorano, María Bella; Gilete Tejero, Ignacio

2015-06-01

The usefulness of 5-aminolevulinic acid (5-ALA) for resection of malignant astrocytomas has been established in recent years. In addition to these tumors, it has been reported that 5-ALA fluorescence could be elicited in other tumors such as intracranial and spinal meningiomas or posterior fossa and spinal cord ependymomas, resulting in improved resections. Here, we present 2 cases of subependymomas of the fourth ventricle that showed intense fluorescence after 5-ALA administration. To the best of our knowledge, these are the first reported cases of subependymomas in this location in which 5-ALA elicited useful fluorescence. Case 1 was a 61-year-old woman with a history of headaches accompanied by vomiting in the last month. Magnetic resonance imaging (MRI) revealed a tumor occupying the fourth ventricle with slight irregular enhancement. She was operated on after administration of 5-ALA. The tumor emitted intense red fluorescence when illuminated with blue light. An MRI performed 48 hours after surgery confirmed complete resection of the tumor. The pathological diagnosis was subependymoma. Case 2 was a 35-year-old man with a history of several months of headaches and vomiting. An MRI revealed a tumor occupying the caudal part of the fourth ventricle with moderate and irregular enhancement. He was operated on after administration of 5-ALA. The tumor showed intense fluorescence. An MRI performed 48 hours after surgery confirmed a complete resection of the tumor. The pathological diagnosis was subependymoma. Fluorescence-guided resection with 5-ALA may be useful for resection of subependymomas of the fourth ventricle. However, further studies are needed.

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

Alekseev, A E; Potapov, V T; Gorshkov, B G

We report the results of studying statistical properties of the intensity of partially polarised coherent light backscattered by a single mode optical fibre. An expression is derived for the deviation of the backscattered light intensity depending on the scattering region length, the degree of the light source coherence and the degree of scattered light polarisation. It is shown that the backscattered light in a fibre scattered-light interferometer is partially polarised with the polarisation degree P = 1/3 in the case of external perturbations of the interferometer fibre. (scattering of light)

Long-term impacts of unconventional drilling operations on human and animal health.

PubMed

Bamberger, Michelle; Oswald, Robert E

2015-01-01

Public health concerns related to the expansion of unconventional oil and gas drilling have sparked intense debate. In 2012, we published case reports of animals and humans affected by nearby drilling operations. Because of the potential for long-term effects of even low doses of environmental toxicants and the cumulative impact of exposures of multiple chemicals by multiple routes of exposure, a longitudinal study of these cases is necessary. Twenty-one cases from five states were followed longitudinally; the follow-up period averaged 25 months. In addition to humans, cases involved food animals, companion animals and wildlife. More than half of all exposures were related to drilling and hydraulic fracturing operations; these decreased slightly over time. More than a third of all exposures were associated with wastewater, processing and production operations; these exposures increased slightly over time. Health impacts decreased for families and animals moving from intensively drilled areas or remaining in areas where drilling activity decreased. In cases of families remaining in the same area and for which drilling activity either remained the same or increased, no change in health impacts was observed. Over the course of the study, the distribution of symptoms was unchanged for humans and companion animals, but in food animals, reproductive problems decreased and both respiratory and growth problems increased. This longitudinal case study illustrates the importance of obtaining detailed epidemiological data on the long-term health effects of multiple chemical exposures and multiple routes of exposure that are characteristic of the environmental impacts of unconventional drilling operations.

Thermo-elastic-plastic analysis for elastic component under high temperature fatigue crack growth rate

NASA Astrophysics Data System (ADS)

Ali, Mohammed Ali Nasser

The research project presents a fundamental understanding of the fatigue crack growth mechanisms of AISI 420 martensitic stainless steel, based on the comparison analysis between the theoretical and numerical modelling, incorporating research findings under isothermal fatigue loading for solid cylindrical specimen and the theoretical modelling with the numerical simulation for tubular specimen when subjected to cyclic mechanical loading superimposed by cyclic thermal shock.The experimental part of this research programme studied the fatigue stress-life data for three types of surface conditions specimen and the isothermal stress-controlled fatigue testing at 300 °C - 600 °C temperature range. It is observed that the highest strength is obtained for the polished specimen, while the machined specimen shows lower strength, and the lowest strength is the notched specimen due to the high effect of the stress concentration. The material behaviour at room and high temperatures shows an initial hardening, followed by slow extension until fully plastic saturation then followed by crack initiation and growth eventually reaching the failure of the specimen, resulting from the dynamic strain ageing occurred from the transformation of austenitic microstructure to martensite and also, the nucleation of precipitation at grain boundaries and the incremental temperature increase the fatigue crack growth rate with stress intensity factor however, the crack growth rate at 600 °C test temperature is less than 500 °C because of the creep-fatigue taking place.The theoretical modelling presents the crack growth analysis and stress and strain intensity factor approaches analysed in two case studies based on the addition of thermo-elastic-plastic stresses to the experimental fatigue applied loading. Case study one estimates the thermal stresses superimposed sinusoidal cyclic mechanical stress results in solid cylinder under isothermal fatigue simulation. Case study two estimates the transient thermal stresses superimposed on cyclic mechanical loading results in hollow cylinder under thermal shock in heating case and down shock cooling case. The combination of stress and strain intensity factor theoretical calculations with the experimental output recorded data shows a similar behaviour with increasing temperature, and there is a fair correlation between the profiles at the beginning and then divergence with increasing the crack length. The transient influence of high temperature in case two, giving a very high thermal shock stress as a heating or cooling effects, shifting up the combined stress, when applied a cyclic mechanical load in fraction of seconds, and the reputations of these shocks, causing a fast failure under high thermal shock stress superimposed with mechanical loading.Finally, the numerical modelling analyses three cases studied were solved due to the types of loading and types of specimen geometry by using finite element models constructed through the ANSYS Workbench version 13.0. The first case is a low cyclic fatigue case for a solid cylinder specimen simulated by applying a cyclic mechanical loading. The second is an isothermal fatigue case for solid cylinder specimen simulated by supplying different constant temperatures on the outer surface with cyclic mechanical loading, where the two cases are similar to the experimental tests and the third case, is a thermo-mechanical fatigue for a hollow cylinder model by simulating a thermal up-shock generated due to transient heating on the outer surface of the model or down shock cooling on the inner surface with the cyclic mechanical loading. The results show a good agreement with the experimental data in terms of alternative stress and life in the first case. In case two results show the strain intensity factor is increases with increasing temperature similar to the theoretical solution due to the influence of the modulus of elasticity and the difference in life estimation with the experimental output record is related to the input data made of theoretical physical properties and the experimental stress-life data.

Computer program for determining rotational line intensity factors for diatomic molecules

NASA Technical Reports Server (NTRS)

Whiting, E. E.

1973-01-01

A FORTRAN IV computer program, that provides a new research tool for determining reliable rotational line intensity factors (also known as Honl-London factors), for most electric and magnetic dipole allowed diatomic transitions, is described in detail. This users manual includes instructions for preparing the input data, a program listing, detailed flow charts, and three sample cases. The program is applicable to spin-allowed dipole transitions with either or both states intermediate between Hund's case (a) and Hund's case (b) coupling and to spin-forbidden dipole transitions with either or both states intermediate between Hund's case (c) and Hund's case (b) coupling.

Intercultural Identity and Intercultural Experiences of American Students in China

ERIC Educational Resources Information Center

Tian, Mei; Lowe, John Anthony

2014-01-01

The number of international students in China is increasing rapidly, but their experiences in China remain largely unknown. This article reports an intensive longitudinal multiple case study that explores eight American students' intercultural experiences and the impacts of such experiences on individual identity during their study in a Chinese…

Integrating the transportation system with a university campus transportation master plan : a case study.

DOT National Transportation Integrated Search

2010-04-01

University campuses are considered major trip attractors. This intense level of activity generates significant : congestion levels within the campuses and in their vicinity, particularly in urban campus settings. With : university enrollment trends e...

A Case Study: Service Delivery and Parents with Disabilities.

ERIC Educational Resources Information Center

Pomerantz, Phyllis; And Others

1990-01-01

Describes a home-based intervention program that provided time-intensive, supervised, paraprofessional services to a family in which parents and infant had serious disabilities. Programmatic needs and delivery of services to disabled parents and families are discussed. (NH)

Case study of Bell's palsy applying complementary treatment within an occupational therapy model.

PubMed

Haltiwanger, Emily; Huber, Theresa; Chang, Joe C; Gonzalez-Stuart, Armando; Gonzales-Stuart, Armando

2009-01-01

For 7% of people with Bell's palsy, facial impairment is permanent. The case study patient was a 48-year-old female who had no recovery from paralysis 12 weeks after onset. Goals were to restore facial sensory-motor functions, functional abilities and reduce depression. Facial paralysis was assessed by clinical observations, the Facial Disability Index and Beck Depression Index. Complementary interventions of aromatherapy, reflexology and electro-acupuncture were used with common physical agent modalities in an intensive home activity and exercise programme. The patient had 100% return of function and resolution of depression after 10 days of intervention. The limitation of this study is that it was a retrospective case study and the investigators reconstructed the case from clinical notes. Further research using a prospective approach is recommended to replicate this study. 2009 John Wiley & Sons, Ltd

[Ischemic cholangiopathy induced by extended burns].

PubMed

Cohen, Laurence; Angot, Emilie; Goria, Odile; Koning, Edith; François, Arnaud; Sabourin, Jean-Christophe

2013-04-01

Ischemic cholangiopathy is a recently described entity occurring mainly after hepatic grafts. Very few cases after intensive care unit (ICU) for extended burn injury were reported. We report the case of a 73-year-old woman consulting in an hepatology unit, for a jaundice appearing during a hospitalisation in an intensive care unit and increasing from her leaving from ICU, where she was treated for an extended burn injury. She had no pre-existing biological features of biliary disease. Biological tests were normal. Magnetic resonance imaging acquisitions of biliary tracts pointed out severe stenosing lesions of diffuse cholangiopathy concerning intrahepatic biliary tract, mainly peri-hilar. Biopsie from the liver confirmed the diagnosis, showing a biliary cirrhosis with bile infarcts. This case is the fourth case of ischemic cholangiopathy after extended burn injury, concerning a patient without a prior history of hepatic or biliary illness and appearing after hospitalisation in intensive care unit. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

An overview of UK C130 observations from the FIRE marine stratocumulus IFO

NASA Technical Reports Server (NTRS)

Nicholls, S.; Leighton, J.; Barlow, R.

1990-01-01

An overview of the characteristics of the ten flights made by the C130 during the Intensive Field Observations (IFO) are presented. An indication of data quality is given. Comparisons of the carbon dioxide radiation thermometer and the Rosemount suggest there may be potentially serious wetting problems with the latter, especially close to cloud base. The main features of the cloud layers sampled by the C130 are summarized, including microphysical parameters. Many of the results shown are derived from a first order analysis of turbulence quantities. The gross vertical variation of heat, vapor, and liquid water fluxes from case to case, together with the observed vertical velocity variance, a good indicator of convective activity, are discussed. Preliminary results suggest that the different cases can be usefully categorized using these data. The relationship between these and the measured boundary conditions is mentioned. Similarities and differences between the various cases are highlighted, and interpreted in terms of the researchers' current understanding of stratocumulus. Attention is given to particular features of the various flights which may deserve more intensive study.

High-intensity erotic visual stimuli de-activate the primary visual cortex in women.

PubMed

Huynh, Hieu K; Beers, Caroline; Willemsen, Antoon; Lont, Erna; Laan, Ellen; Dierckx, Rudi; Jansen, Monique; Sand, Michael; Weijmar Schultz, Willibrord; Holstege, Gert

2012-06-01

The primary visual cortex, Brodmann's area (BA 17), plays a vital role in basic survival mechanisms in humans. In most neuro-imaging studies in which the volunteers have to watch pictures or movies, the primary visual cortex is similarly activated independent of the content of the pictures or movies. However, in case the volunteers perform demanding non-visual tasks, the primary visual cortex becomes de-activated, although the amount of incoming visual sensory information is the same. Do low- and high-intensity erotic movies, compared to neutral movies, produce similar de-activation of the primary visual cortex? Brain activation/de-activation was studied by Positron Emission Tomography scanning of the brains of 12 healthy heterosexual premenopausal women, aged 18-47, who watched neutral, low- and high-intensity erotic film segments. We measured differences in regional cerebral blood flow (rCBF) in the primary visual cortex during watching neutral, low-intensity erotic, and high-intensity erotic film segments. Watching high-intensity erotic, but not low-intensity erotic movies, compared to neutral movies resulted in strong de-activation of the primary (BA 17) and adjoining parts of the secondary visual cortex. The strong de-activation during watching high-intensity erotic film might represent compensation for the increased blood supply in the brain regions involved in sexual arousal, also because high-intensity erotic movies do not require precise scanning of the visual field, because the impact is clear to the observer. © 2012 International Society for Sexual Medicine.

On opportunity for emergency cesarean hysterectomy and pregnancy outcomes of patients with placenta accreta.

PubMed

Kong, Xiang; Kong, Yan; Yan, Jin; Hu, Jin-Ju; Wang, Fang-Fang; Zhang, Lei

2017-09-01

Effective diagnosis and clinical management of placenta accreta (PA) in China are not clear. The purpose of the study was to analyze the risk factors and diagnosis of PA, maternal and neonatal outcomes in patients with PA. It was a retrospective study of cases with PA, confirmed by histologically and/or clinically suspected during 3 years in 2 tertiary referral hospitals. The incidence rate of patients with PA, who had history of artificial abortion, cesarean section (CS), and placenta previa (PP) was 94%, 70%, and 72%, respectively. In 29 patients of scheduled CS group, 12 cases were performed with cesarean hysterectomy. Mean estimated blood loss (EBL) was 1.5 L, and 17 babies were admitted to neonatal intensive care unit (NICU). In the 18 cases of emergency CS group, 6 cases were performed cesarean hysterectomy. Mean EBL was 2.4 L, and 16 babies were admitted to NICU. The difference of mean EBL, cases of fetal admitted to intensive care unit in 2 groups was significant difference (P < .05).Women with history of uterine curettage, CS or PP are more likely to have PA. PA should be diagnosed early and accurately via ultrasound and magnetic resonance imaging. Maternal and neonatal outcomes in the scheduled CS are better than in emergency CS. Emergency peripartum hysterectomy is a feasible method under the circumstances of heave, fast bleeding, and the failure of conservative surgery.

Maskless Lithography Using Negative Photoresist Material: Impact of UV Laser Intensity on the Cured Line Width

NASA Astrophysics Data System (ADS)

Mohammed, Mohammed Ziauddin; Mourad, Abdel-Hamid I.; Khashan, Saud A.

2018-06-01

The application of maskless lithography technique on negative photoresist material is investigated in this study. The equipment used in this work is designed and built especially for maskless lithography applications. The UV laser of 405 nm wavelength with 0.85 Numerical Aperture is selected for direct laser writing. All the samples are prepared on a glass substrate. Samples are tested at different UV laser intensities and different stage velocities in order to study the impact on patterned line width. Three cases of spin coated layers of thickness 90 μm, 40 μm, and 28 μm on the substrate are studied. The experimental results show that line width has a generally increasing trend with intensity. However, a decreasing trend was observed for increasing velocity. The overall performance shows that the mr-DWL material is suitable for direct laser writing systems.

Maskless Lithography Using Negative Photoresist Material: Impact of UV Laser Intensity on the Cured Line Width

NASA Astrophysics Data System (ADS)

Mohammed, Mohammed Ziauddin; Mourad, Abdel-Hamid I.; Khashan, Saud A.

2018-04-01

The application of maskless lithography technique on negative photoresist material is investigated in this study. The equipment used in this work is designed and built especially for maskless lithography applications. The UV laser of 405 nm wavelength with 0.85 Numerical Aperture is selected for direct laser writing. All the samples are prepared on a glass substrate. Samples are tested at different UV laser intensities and different stage velocities in order to study the impact on patterned line width. Three cases of spin coated layers of thickness 90 μm, 40 μm, and 28 μm on the substrate are studied. The experimental results show that line width has a generally increasing trend with intensity. However, a decreasing trend was observed for increasing velocity. The overall performance shows that the mr-DWL material is suitable for direct laser writing systems.

Double-hit follicular lymphoma with MYC and BCL2 translocations: a study of 7 cases with a review of literature.

PubMed

Miao, Yuan; Hu, Shimin; Lu, Xinyan; Li, Shaoying; Wang, Wei; Medeiros, L Jeffrey; Lin, Pei

2016-12-01

Follicular lymphoma with MYC and BCL2 translocations, so-called double-hit follicular lymphoma (DH-FL), is rare. Here, we report the clinicopathological features of 7 cases of DH-FL. All neoplasms had a follicular pattern (1 partially diffuse). Five cases were predominantly low grade, 4 of which had focal (≤20%) grade 3A areas, and 2 cases were of grade 3. All cases were positive for pan-B-cell antigens, CD10, and BCL6; 6 cases were positive for BCL2. Ki-67 was less than or equal to 50% in 6 cases and 90% in 1 grade 3 case. Three patients presented with stage IV disease and 3 had a Follicular Lymphoma International Prognostic Index score of greater than 2. Six patients received immunochemotherapy, and 1 is still under induction therapy with rituximab, ibrutinib, and lenalidomide. Four achieved complete remission and two had a partial response with persistent or refractory disease. The median follow-up time was 25 months (range, 8.5-53.7 months). Two patients treated with standard regimen for follicular lymphoma had relapsed or refractory disease, and 1 died from complications of allogeneic stem cell transplant administered for relapse. In contrast, all 4 patients treated with more intensive regimen for double-hit lymphoma achieved complete remission. In summary, despite predominantly low-grade histology, cases of DH-FL in this study were aggressive and responded better to more intensive than standard treatment regimens, suggesting DH-FL is part of the spectrum of double-hit high-grade lymphoma. Copyright © 2016 Elsevier Inc. All rights reserved.

Aspects and Intensity of Pediatric Palliative Case Management Provided by a Hospital-Based Case Management Team: A Comparative Study Between Children With Malignant and Nonmalignant Disease

PubMed Central

Colenbrander, Derk A.; Bosman, Diederik K.; Grootenhuis, Martha A.; Kars, Marijke C.; Schouten-van Meeteren, Antoinette YN

2017-01-01

Objectives: Anticipating case management is considered crucial in pediatric palliative care. In 2012, our children’s university hospital initiated a specialized pediatric palliative care team (PPCT) to deliver inbound and outbound case management for children with life-shortening disease. The aim of this report is to gain insight in the first 9 months of this PPCT. Methods: Aspects of care during the first 9 months of the PPCT are presented, and comparison is made between patients with malignant disease (MD) and nonmalignant disease (NMD) in a retrospective study design. Insight in the aspects of care of all patients with a life-shortening disease was retrieved from web-based files and the hour registrations from the PPCT. Results: Forty-three children were supported by the PPCT during the first 9 months: 22 with MD with a median of 50 (1-267) days and 29 minutes (4-615) of case management per patient per day and 21 patients with NMD with a median of 79.5 (5-211) days and 16 minutes of case management per day (6-64). Our data show significantly more interprofessional contacts for patients with MD and more in-hospital contacts for patients with NMD. The median number of admission days per patient was 11 (0-22) for MD (44% for anticancer therapy) and 44 (0-303) for NMD (36% for infectious diseases). Significance of Results: This overview of aspects of pediatric palliative case management shows shorter but more intensive case management for MD in comparison with NMD. This insight in palliative case management guides the design of a PPCT. PMID:28273758

A case independent approach on the impact of climate change effects on combined sewer system performance.

PubMed

Kleidorfer, M; Möderl, M; Sitzenfrei, R; Urich, C; Rauch, W

2009-01-01

Design and construction of urban drainage systems has to be done in a predictive way, as the average lifespan of such investments is several decades. The design engineer has to predict many influencing factors and scenarios for future development of a system (e.g. change in land use, population, water consumption and infiltration measures). Furthermore, climate change can cause increased rain intensities which leads to an additional impact on drainage systems. In this paper we compare the behaviour of different performance indicators of combined sewer systems when taking into account long-term environmental change effects (change in rainfall characteristics, change in impervious area and change in dry weather flow). By using 250 virtual case studies this approach is--in principle--a Monte Carlo Simulation in which not only parameter values are varied but the entire system structure and layout is changed in each run. Hence, results are more general and case-independent. For example the consideration of an increase of rainfall intensities by 20% has the same effect as an increase of impervious area of +40%. Such an increase of rainfall intensities could be compensated by infiltration measures in current systems which lead to a reduction of impervious area by 30%.

Backward-propagating MeV electrons in ultra-intense laser interactions: Standing wave acceleration and coupling to the reflected laser pulse

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

Orban, Chris, E-mail: orban@physics.osu.edu; Feister, Scott; Innovative Scientific Solutions, Inc., Dayton, Ohio 45459

Laser-accelerated electron beams have been created at a kHz repetition rate from the reflection of intense (∼10{sup 18 }W/cm{sup 2}), ∼40 fs laser pulses focused on a continuous water-jet in an experiment at the Air Force Research Laboratory. This paper investigates Particle-in-Cell simulations of the laser-target interaction to identify the physical mechanisms of electron acceleration in this experiment. We find that the standing-wave pattern created by the overlap of the incident and reflected laser is particularly important because this standing wave can “inject” electrons into the reflected laser pulse where the electrons are further accelerated. We identify two regimes of standingmore » wave acceleration: a highly relativistic case (a{sub 0} ≥ 1), and a moderately relativistic case (a{sub 0} ∼ 0.5) which operates over a larger fraction of the laser period. In previous studies, other groups have investigated the highly relativistic case for its usefulness in launching electrons in the forward direction. We extend this by investigating electron acceleration in the specular (back reflection) direction and over a wide range of intensities (10{sup 17}–10{sup 19 }W cm{sup −2})« less

Supporting the scholar role in intensive care nursing.

PubMed

Melles, M; Freudenthal, A; de Ridder, H

2012-01-01

This study investigates how future informatics applications can support and challenge intensive care nurses (ICU nurses) to grow and learn continuously. To this end a research-and-design tool is introduced which is based on a model of the nursing process that starts from the idea that a nurse fulfills three different roles: the role of practitioner (using information immediately to base actions upon), the role of scholar (using information later on to learn from) and the role of human (coping with stress and dealing with emotions). In this paper the focus is on the scholar role. Twenty-eight intensive care staff members from six different hospitals were asked to recount an imposing experience from the perspective of each role. Regarding the scholar role, the participants mentioned 77 learning strategies they adopt for individual as well as organizational learning. Individual learning concerned reflection on former patient cases, reflection on current patient cases to anticipate a change in the patient's condition and reflection on personal behavior and decisions. Organizational learning concerned reflection on former patient cases. Examples of specific strategies were formal team evaluations focused on procedure and understanding the perspective of team members, being present at autopsies, and giving feedback on the nursing skills of colleagues. Based on these strategies design implications are defined for future nursing informatics applications, which will be presented.

Lifetime Physical Activity and Breast Cancer: a Case-Control Study in Kelantan, Malaysia.

PubMed

Yen, Siew Hwa; Knight, A; Krishna, Mbv; Muda, Wmw; Rufai, Aa

2016-01-01

Physical inactivity has been identified as the fourth leading risk factor for global mortality and is associated with increased breast cancer diagnosis and recurrence. To examine the association between adult lifetime physical activity and breast cancer risk in a case-control analysis. This study involved 122 cases of breast cancer and 121 controls in the state of Kelantan in Malaysia. A comprehensive measure of lifetime physical activity was used to assess occupational, household, and recreational/sports activity. For every type of activity, a metabolic equivalent (MET) score was assigned using the compendium of physical activities. MET-hours/week per year for all types of activities at different levels of intensities for different age groups were calculated. Logistic regression analysis was used to estimate odds ratios between various measures of physical activity and breast cancer risk. The mean MET-hours/week per year for all activities were 120.0 and 132.9 of MET-hours/week per year for cases and controls respectively. Household activities accounted for about 70% of the total lifetime physical activities. Only about 2.5% of the total lifetime physical activities were in the form of recreational/sports. This study found no association between lifetime occupational and recreational/sports physical activities with breast cancer risk among Kelantanese women. However, higher intensity lifetime household activities seemed to significantly reduce risk of breast cancer.

Neural correlates of mirth and laughter: a direct electrical cortical stimulation study.

PubMed

Yamao, Yukihiro; Matsumoto, Riki; Kunieda, Takeharu; Shibata, Sumiya; Shimotake, Akihiro; Kikuchi, Takayuki; Satow, Takeshi; Mikuni, Nobuhiro; Fukuyama, Hidenao; Ikeda, Akio; Miyamoto, Susumu

2015-05-01

Laughter consists of both motor and emotional aspects. The emotional component, known as mirth, is usually associated with the motor component, namely, bilateral facial movements. Previous electrical cortical stimulation (ES) studies revealed that mirth was associated with the basal temporal cortex, inferior frontal cortex, and medial frontal cortex. Functional neuroimaging implicated a role for the left inferior frontal and bilateral temporal cortices in humor processing. However, the neural origins and pathways linking mirth with facial movements are still unclear. We hereby report two cases with temporal lobe epilepsy undergoing subdural electrode implantation in whom ES of the left basal temporal cortex elicited both mirth and laughter-related facial muscle movements. In one case with normal hippocampus, high-frequency ES consistently caused contralateral facial movement, followed by bilateral facial movements with mirth. In contrast, in another case with hippocampal sclerosis (HS), ES elicited only mirth at low intensity and short duration, and eventually laughter at higher intensity and longer duration. In both cases, the basal temporal language area (BTLA) was located within or adjacent to the cortex where ES produced mirth. In conclusion, the present direct ES study demonstrated that 1) mirth had a close relationship with language function, 2) intact mesial temporal structures were actively engaged in the beginning of facial movements associated with mirth, and 3) these emotion-related facial movements had contralateral dominance. Copyright © 2014 Elsevier Ltd. All rights reserved.

Clinical parameters that predict the need for medium or intensive care admission in intentional drug overdose patients: A retrospective cohort study.

PubMed

van den Oever, Huub L A; van Dam, Mirja; van 't Riet, Esther; Jansman, Frank G A

2017-02-01

Many patients with intentional drug overdose (IDO) are admitted to a medium (MC) or intensive care unit (IC) without ever requiring MC/IC related interventions. The objective of this study was to develop a decision tool, using parameters readily available in the emergency room (ER) for patients with an IDO, to identify patients requiring admission to a monitoring unit. Retrospective cohort study among cases of IDO with drugs having potentially acute effects on neurological, circulatory or ventilatory function, admitted to the MC/IC unit between 2007 and 2013. A decision tool was developed, using 6 criteria, representing intubation, breathing, oxygenation, cardiac conduction, blood pressure, and consciousness. Cases were labeled as 'high acuity' if one or more criteria were present. Among 255 cases of IDO that met the inclusion criteria, 197 were identified as "high acuity". Only 70 of 255 cases underwent one or more MC/IC related interventions, of which 67 were identified as 'high acuity by the decision tool (sensitivity 95.7%). In a population of patients with intentional drug overdose with agents having potentially acute effect on vital functions, 95.7% of MC/IC interventions could be predicted by clinical assessment, supplemented with electrocardiogram and blood gas analysis, in the ER. Copyright © 2016 Elsevier Inc. All rights reserved.

Silica exposure, silicosis, and lung cancer: a necropsy study.

PubMed Central

Hessel, P A; Sluis-Cremer, G K; Hnizdo, E

1990-01-01

Recent studies of the association between lung cancer and silicosis and silica dust have been inconclusive; some showing positive association and some showing none. The present study matched 231 cases of lung cancer with 318 controls by year of birth. Subjects were selected from the necropsy records of the National Centre for Occupational Health. Data on intensity and duration of exposure to silica dust were obtained from personnel records. Presence or absence of lung cancer and the presence and severity of silicosis of the parenchyma, pleura, and hilar glands were documented from necropsy reports. Smoking data were abstracted from records of routine examinations. No case-control differences were noted for any of the exposure indicators including cumulative dust exposure, total dusty shifts, weighted average intensity of exposure, total underground shifts, and shifts in high dust. Similarly, no association was found between lung cancer and the presence or severity of silicosis and any site. Stratified analyses showed neither significant nor suggestive trends when case-control comparisons for silicosis were examined by level of dust exposure or smoking. Reasons for disparity between these results and those of some other studies may include concomitant exposures to radon daughters, asbestos, diesel emissions, and cigarette smoking; idiosyncracies of the compensation process; and the possibility of a threshold in the relation(s). PMID:2155648

Hydrodynamic cavitation for sonochemical effects.

PubMed

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

1999-03-01

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

Studying intense pulsed light method along with corticosteroid injection in treating keloid scars.

PubMed

Shamsi Meymandi, Simin; Rezazadeh, Azadeh; Ekhlasi, Ali

2014-02-01

Results of various studies suggest that the hypertrophic and keloid scars are highly prevalent in the general population and are irritating both physically and mentally. Considering the variety of existing therapies, intense pulsed light (IPL) method along with corticosteroid injection was evaluated in treating these scars. 86 subjects were included in this clinical trial. Eight sessions of therapeutic intervention were done with IPL along with corticosteroid intralesional injection using 450 to 1200 NM filter, Fluence 30-40 J/cm2, pulse duration of 2.1-10 ms and palsed delay 10-40 ms with an interval of three weeks. To specify the recovery consequences and complication rate and to determine features of the lesion, the criteria specified in the study of Eroll and Vancouver scar scale were used. The level of clinical improvement, color improvement and scar height was 89.1%, 88.8% and 89.1% respectively. The incidence of complications (1 telangiectasia case, 7 hyperpigmentation cases and 2 atrophy cases) following treatment with IPL was 11.6%. Moreover, the participants' satisfaction with IPL method was 88.8%. This study revealed that a combined therapy (intralesional corticosteroid injection + IPL) increases the recovery level of hypertrophic and keloid scars. It was also demonstrated that this method had no significant side effect and patients were highly satisfied with this method.

Examining the Effects of Intensive Supervision and Aftercare Programs for At-Risk Youth: A Systematic Review and Meta-Analysis.

PubMed

Bouchard, Jessica; Wong, Jennifer S

2018-05-01

Community correctional sentences are administered to more juvenile offenders in North America than any other judicial sentence. Particularly prominent in juvenile corrections is intensive supervision probation and aftercare/reentry, yet the effects of these supervision-oriented interventions on recidivism are mixed. The purpose of this meta-analysis is to determine the effects of intensive supervision probation and aftercare/reentry on juvenile recidivism. An extensive search of the literature and application of strict inclusion criteria resulted in the selection of 27 studies that contributed 55 individual effect sizes. Studies were pooled based on intervention type (intensive supervision probation or aftercare/reentry) and outcome measure (alleged or convicted offenses). The pooled analyses yielded contradictory results with respect to outcome measure; in both cases, supervision had a beneficial effect on alleged offenses and negatively affected convicted offenses. These patterns across intervention type and outcome measure, as well as recommendations for future research, are discussed.

Expected values and variances of Bragg peak intensities measured in a nanocrystalline powder diffraction experiment

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

Öztürk, Hande; Noyan, I. Cevdet

A rigorous study of sampling and intensity statistics applicable for a powder diffraction experiment as a function of crystallite size is presented. Our analysis yields approximate equations for the expected value, variance and standard deviations for both the number of diffracting grains and the corresponding diffracted intensity for a given Bragg peak. The classical formalism published in 1948 by Alexander, Klug & Kummer [J. Appl. Phys.(1948),19, 742–753] appears as a special case, limited to large crystallite sizes, here. It is observed that both the Lorentz probability expression and the statistics equations used in the classical formalism are inapplicable for nanocrystallinemore » powder samples.« less

An improved scheme on decoy-state method for measurement-device-independent quantum key distribution

PubMed Central

Wang, Dong; Li, Mo; Guo, Guang-Can; Wang, Qin

2015-01-01

Quantum key distribution involving decoy-states is a significant application of quantum information. By using three-intensity decoy-states of single-photon-added coherent sources, we propose a practically realizable scheme on quantum key distribution which approaches very closely the ideal asymptotic case of an infinite number of decoy-states. We make a comparative study between this scheme and two other existing ones, i.e., two-intensity decoy-states with single-photon-added coherent sources, and three-intensity decoy-states with weak coherent sources. Through numerical analysis, we demonstrate the advantages of our scheme in secure transmission distance and the final key generation rate. PMID:26463580

Expected values and variances of Bragg peak intensities measured in a nanocrystalline powder diffraction experiment

DOE PAGES

Öztürk, Hande; Noyan, I. Cevdet

2017-08-24

A rigorous study of sampling and intensity statistics applicable for a powder diffraction experiment as a function of crystallite size is presented. Our analysis yields approximate equations for the expected value, variance and standard deviations for both the number of diffracting grains and the corresponding diffracted intensity for a given Bragg peak. The classical formalism published in 1948 by Alexander, Klug & Kummer [J. Appl. Phys.(1948),19, 742–753] appears as a special case, limited to large crystallite sizes, here. It is observed that both the Lorentz probability expression and the statistics equations used in the classical formalism are inapplicable for nanocrystallinemore » powder samples.« less

EFFECTS OF LASER RADIATION ON MATTER. LASER PLASMA: Transient clearing of a water aerosol in the case of thermal blooming of an optical beam

NASA Astrophysics Data System (ADS)

Kucherov, Arkadii N.

1995-03-01

The moisture approximation is used in a study of transient clearing of a water aerosol when droplets are evaporated by an intense laser beam in the presence of a cross wind. Coordinate distributions of the beam intensity and moisture are obtained between the moment at which the beam begins to act and the attainment of a steady state. The dependences of the intensity of the beam transmitted by an aerosol medium on the scaling parameters (representing aerosol evaporation or clearing, beam attenuation, and thermal blooming) are derived. A comparison is made with experimental and theoretical results obtained by other authors.

Bonded orthotropic strips with cracks

NASA Technical Reports Server (NTRS)

Delale, F.; Erdogan, F.

1978-01-01

The elastostatic problem for a nonhomogeneous plane which consists of two sets of periodically arranged dissimilar orthotropic strips is considered. First, the problem of cracks fully imbedded into the homogeneous strips is considered. Then, the singular behavior of the stresses for two special crack geometries is studied in some detail. The first is the case of a broken laminate in which the crack tips touch the interfaces. The second is the case of cracks crossing the interfaces. A number of numerical examples are worked out in order to separate the primary material parameters influencing the stress intensity factors and the powers of stress singularity, and to determine the trends regarding the influence of the secondary parameters. Finally, some numerical results are given for the stress intensity factors in certain basic crack geometries and for typical material combinations.

Earthquake Hazard and the Environmental Seismic Intensity (ESI) Scale

NASA Astrophysics Data System (ADS)

Serva, Leonello; Vittori, Eutizio; Comerci, Valerio; Esposito, Eliana; Guerrieri, Luca; Michetti, Alessandro Maria; Mohammadioun, Bagher; Mohammadioun, Georgianna C.; Porfido, Sabina; Tatevossian, Ruben E.

2016-05-01

The main objective of this paper was to introduce the Environmental Seismic Intensity scale (ESI), a new scale developed and tested by an interdisciplinary group of scientists (geologists, geophysicists and seismologists) in the frame of the International Union for Quaternary Research (INQUA) activities, to the widest community of earth scientists and engineers dealing with seismic hazard assessment. This scale defines earthquake intensity by taking into consideration the occurrence, size and areal distribution of earthquake environmental effects (EEE), including surface faulting, tectonic uplift and subsidence, landslides, rock falls, liquefaction, ground collapse and tsunami waves. Indeed, EEEs can significantly improve the evaluation of seismic intensity, which still remains a critical parameter for a realistic seismic hazard assessment, allowing to compare historical and modern earthquakes. Moreover, as shown by recent moderate to large earthquakes, geological effects often cause severe damage"; therefore, their consideration in the earthquake risk scenario is crucial for all stakeholders, especially urban planners, geotechnical and structural engineers, hazard analysts, civil protection agencies and insurance companies. The paper describes background and construction principles of the scale and presents some case studies in different continents and tectonic settings to illustrate its relevant benefits. ESI is normally used together with traditional intensity scales, which, unfortunately, tend to saturate in the highest degrees. In this case and in unpopulated areas, ESI offers a unique way for assessing a reliable earthquake intensity. Finally, yet importantly, the ESI scale also provides a very convenient guideline for the survey of EEEs in earthquake-stricken areas, ensuring they are catalogued in a complete and homogeneous manner.

Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre

PubMed Central

Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

2016-01-01

Objectives This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. Methods We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Results Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Conclusion Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users. PMID:28002491

Changes in creatine kinase, lactate dehydrogenase and aspartate aminotransferase in saliva samples after an intense exercise: a pilot study.

PubMed

Barranco, Tomas; Tvarijonaviciute, Asta; Tecles, Fernando; Carrillo, Jose M; Sánchez-Resalt, Cristina; Jimenez-Reyes, Pedro; Rubio, Monica; García-Balletbó, Monserrat; Cerón, Jose J; Cugat, Ramon

2018-06-01

The aim of this study was to evaluate changes in the enzymes creatine kinase (CK), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) in saliva before and after an intense exercise consisting of a futsal match. CK, LDH and AST were analyzed in saliva and serum samples of eleven, injury-free, amateur young men before and 30 minutes, 12 hours and 36 hours after a futsal match. A significant increase in CK, LDH and AST was observed after the game in serum samples. In saliva, although a high interindividual variability was found with some individuals no showing increases, significant increases in CK and LDH were observed after the game. No significant changes were observed in saliva AST after the game. Our study showed for first time that CK and LDH can increase in saliva after an intensive exercise consisting on a futsal match. Results suggest that measurements of CK and LDH in saliva could be potentially used to evaluate possible muscle stress or damage in cases of intensive exercise.

Background radiation in inelastic X-ray scattering and X-ray emission spectroscopy. A study for Johann-type spectrometers

NASA Astrophysics Data System (ADS)

Paredes Mellone, O. A.; Bianco, L. M.; Ceppi, S. A.; Goncalves Honnicke, M.; Stutz, G. E.

2018-06-01

A study of the background radiation in inelastic X-ray scattering (IXS) and X-ray emission spectroscopy (XES) based on an analytical model is presented. The calculation model considers spurious radiation originated from elastic and inelastic scattering processes along the beam paths of a Johann-type spectrometer. The dependence of the background radiation intensity on the medium of the beam paths (air and helium), analysed energy and radius of the Rowland circle was studied. The present study shows that both for IXS and XES experiments the background radiation is dominated by spurious radiation owing to scattering processes along the sample-analyser beam path. For IXS experiments the spectral distribution of the main component of the background radiation shows a weak linear dependence on the energy for the most cases. In the case of XES, a strong non-linear behaviour of the background radiation intensity was predicted for energy analysis very close to the backdiffraction condition, with a rapid increase in intensity as the analyser Bragg angle approaches π / 2. The contribution of the analyser-detector beam path is significantly weaker and resembles the spectral distribution of the measured spectra. Present results show that for usual experimental conditions no appreciable structures are introduced by the background radiation into the measured spectra, both in IXS and XES experiments. The usefulness of properly calculating the background profile is demonstrated in a background subtraction procedure for a real experimental situation. The calculation model was able to simulate with high accuracy the energy dependence of the background radiation intensity measured in a particular XES experiment with air beam paths.

Endoscopic ultrasound-guided fine needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: a report of 3 cases.

PubMed

Chatzipantelis, Paschalis; Salla, Charitini; Apostolou, George; Christodoulou, Lambrini; Kakiopoulos, George; Patralexis, Charalambos

2010-01-01

Solid pseudopapillary tumor of the pancreas (SPTP) is an exceedingly rare pancreatic tumor. We present the clinical, endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) cytologic features and immunohistochemical findings performed on cell blocks of 3 SPTPs. Three females (17-32 years old) were admitted to our hospital due to unexplained episodic abdominal pain. EUS confirmed the presence of a mass in the body and tail of the pancreas (2 cases) and in the head (1 case), with distinct borders and occassional dilation of the peripheral part of the pancreatic duct. EUS-FNA cytology specimens consisted of single cells and aggregates of uniform polyhedral cells, forming branching papillary clusters with delicate fibrovascular cores and nuclear overlapping (2 cases) and glandlike structures (1 case). Variable hyaline, myxoid stromal elements and naked capillaries were also seen. The cells had bland nuclear features, small nucleoli, nuclear grooves in some of them and focally cytoplasmic projections. Mitoses and necrosis were not observed. The immunohistochemistry on cell blocks revealed: vimentin+ (3 cases), CA19.9+ (2 cases), cytokeratin 7+ (focal, intensive, 1 case), synaptophysin+ (1 case), MUC1+ (focal, intensive, 1 case), EMA+ (diffuse weak, 1 case), a1-antitrypsin and a1-antichymotrypsin+ (focal intensive, 2 cases), progesterone+ (1 case), chromogranin-A- (3 cases) and NSE- (3 cases). Cytologic and immunohistochemical findings were strongly suggestive of SPTP. Surgical resection confirmed the diagnosis in all cases. EUS-FNA cytology features and immunohistochemistry provide the diagnosis of SPTP with accuracy.

Nursing workload in public and private intensive care units

PubMed Central

Nogueira, Lilia de Souza; Koike, Karina Mitie; Sardinha, Débora Souza; Padilha, Katia Grillo; de Sousa, Regina Marcia Cardoso

2013-01-01

Objective This study sought to compare patients at public and private intensive care units according to the nursing workload and interventions provided. Methods This retrospective, comparative cohort study included 600 patients admitted to 4 intensive care units in São Paulo. The nursing workload and interventions were assessed using the Nursing Activities Score during the first and last 24 hours of the patient's stay at the intensive care unit. Pearson's chi-square test, Fisher's exact test, the Mann-Whitney test, and Student's t test were used to compare the patient groups. Results The average Nursing Activities Score upon admission to the intensive care unit was 61.9, with a score of 52.8 upon discharge. Significant differences were found among the patients at public and private intensive care units relative to the average Nursing Activities Score upon admission, as well as for 12 out of 23 nursing interventions performed during the first 24 hours of stay at the intensive care units. The patients at the public intensive care units exhibited a higher average score and overall more frequent nursing interventions, with the exception of those involved in the "care of drains", "mobilization and positioning", and "intravenous hyperalimentation". The groups also differed with regard to the evolution of the Nursing Activities Score among the total case series as well as the groups of survivors from the time of admission to discharge from the intensive care unit. Conclusion Patients admitted to public and private intensive care units exhibit differences in their nursing care demands, which may help managers with nursing manpower planning. PMID:24213086

[Electormagnetic field of the mobile phone base station: case study].

PubMed

Bieńkowski, Paweł; Zubrzak, Bartłomiej; Surma, Robert

2011-01-01

The paper presents changes in the electromagnetic field intensity in a school building and its surrounding after the mobile phone base station installation on the roof of the school. The comparison of EMF intensity measured before the base station was launched (electromagnetic background measurement) and after starting its operation (two independent control measurements) is discussed. Analyses of measurements are presented and the authors also propose the method of the electromagnetic field distribution adjustment in the area of radiation antennas side lobe to reduce the intensity of the EMF level in the base station proximity. The presented method involves the regulation of the inclination. On the basis of the measurements, it was found that the EMF intensity increased in the building and its surroundings, but the values measured with wide margins meet the requirements of the Polish law on environmental protection.

Spectroscopic studies of ozone in cryosolutions: FT-IR spectra of 16O3 in liquid nitrogen, oxygen, argon and krypton.

PubMed

Bulanin, Kirill M; Bulanin, Michael O; Rudakova, Aida V; Kolomijtsova, Tatiana D; Shchepkin, Dmitrij N

2018-03-15

We have measured and interpreted the IR spectra of ozone dissolved in liquid nitrogen, oxygen, argon, and krypton in the 650-4700cm -1 spectral region at 79-117K. Frequency shifts, band intensities and bandshapes of 22 spectral features of soluted ozone were analyzed. The bands of the А 1 symmetry have a complex contour and possess an excess intensity with respect to the value of the purely vibrational transition moment. It was found that this effect is related to the manifestation of the Coriolis interaction. The bandshape distortion manifests itself as an additional intensity from the side of the В 1 symmetry band being an intensity source in the case of the Coriolis interaction. Copyright © 2017. Published by Elsevier B.V.

Immunoexpression of EGFR and EMMPRIN in a series of cases of head and neck squamous cell carcinoma.

PubMed

de Andrade, Ana Luiza Dias Leite; Ferreira, Stefânia Jeronimo; Ferreira, Sonia Maria Soares; Ribeiro, Camila Maria Beder; Freitas, Roseana de Almeida; Galvão, Hébel Cavalcanti

2015-10-01

The epidermal growth factor receptor (EGFR) and the extracellular matrix metalloproteinase inducer (EMMPRIN) have been identified as oncologically important targets. This study aimed to evaluate the immunoexpression of EGFR and EMMPRIN in a series of cases of head and neck squamous cell carcinoma (HNSCC). Forty-five cases of HNSCC were selected for this study and evaluated with anti-EGFR and anti-EMMPRIN antibodies. The percentage of positive cells was determined assessing to the following categories: score 1 (staining in 0-50% of cells), score 2 (staining in 51-75% of cells), and score 3 (staining in >75% of cells). Immunostaining intensity was graded according to the following parameters: score 1 (absent/weak expression) and score 2 (strong expression). For EGFR, a predominance of high median scores was observed in cases of both histological grades of malignancy and in different clinical stages (p>0.05). For EMMPRIN, a statistically significant difference was observed between the histological grades of malignancy (p=0.030). Regarding the immunostaining intensity of EMMPRIN, it was observed a predominance of score 1 in cases with stages I/II, whereas most cases with stages III/IV presented score 2 (p=0.032). Considering the anatomical location, most cases of buccal floor presented higher median score of EMMPRIN in comparison with the other sites (p=0.015). These findings suggest that both proteins are potential targets for cancer therapy and EMMPRIN can be used as a prognostic marker of a more aggressive biological behavior in patients with HNSCC. Copyright © 2015 Elsevier GmbH. All rights reserved.

Intensity Mapping of Hα, Hβ, [OII], and [OIII] Lines at z < 5

NASA Astrophysics Data System (ADS)

Gong, Yan; Cooray, Asantha; Silva, Marta B.; Zemcov, Michael; Feng, Chang; Santos, Mario G.; Dore, Olivier; Chen, Xuelei

2017-02-01

Intensity mapping is becoming a useful tool to study the large-scale structure of the universe through spatial variations in the integrated emission from galaxies and the intergalactic medium. We study intensity mapping of the {{H}}α 6563 \\mathringA , [O III] 5007 Å, [O II] 3727 Å, and {{H}}β 4861 \\mathringA lines at 0.8≤slant z≤slant 5.2. The mean intensities of these four emission lines are estimated using the observed luminosity functions (LFs), cosmological simulations, and the star formation rate density (SFRD) derived from observations at z≲ 5. We calculate the intensity power spectra and consider the foreground contamination of other lines at lower redshifts. We use the proposed NASA small explorer SPHEREx (the Spectro-Photometer for the History of the universe, Epoch of Reionization, and Ices Explorer) as a case study for the detectability of the intensity power spectra of the four emission lines. We also investigate the cross-correlation with the 21 cm line probed by the Canadian Hydrogen Intensity Mapping Experiment (CHIME), Tianlai experiment and the Square Kilometer Array (SKA) at 0.8≤slant z≤slant 2.4. We find both the auto and cross power spectra can be well measured for the Hα, [O III] and [O II] lines at z≲ 3, while it is more challenging for the Hβ line. Finally, we estimate the constraint on the SFRD from intensity mapping, and find we can reach an accuracy higher than 7% at z≲ 4, which is better than with the usual method of measurements using the LFs of galaxies.

Reconsidering the Local after a Transformative Global Experience: A Comparison of Two Study Abroad Programs for Preservice Teachers

ERIC Educational Resources Information Center

Dunn, Alyssa Hadley; Dotson, Erica K.; Cross, Stephanie Behm; Kesner, John; Lundahl, Bo

2014-01-01

This comparative case study analyzes two study abroad experiences for preservice teachers--a 4-month student teaching placement in Sweden and a 3-week intensive intercultural course with school observations in France. Although they differed in duration and structure, both programs focused on developing preservice teachers' understandings of…

Them Children: A Study in Language Learning. Case Studies in Education and Culture Series.

ERIC Educational Resources Information Center

Ward, Martha Coonfield

This is a study of how children in a small community called Rosepoint, in the vicinity of New Orleans, acquire speech. The author provides essential contextualization for her problem, dealing with family composition, life space, means used to control children, and interaction between members of the household. The author made intensive observations…

The dependence of graphene Raman D-band on carrier density.

PubMed

Liu, Junku; Li, Qunqing; Zou, Yuan; Qian, Qingkai; Jin, Yuanhao; Li, Guanhong; Jiang, Kaili; Fan, Shoushan

2013-01-01

Raman spectroscopy has been an integral part of graphene research and can provide information about graphene structure, electronic characteristics, and electron-phonon interactions. In this study, the characteristics of the graphene Raman D-band, which vary with carrier density, are studied in detail, including the frequency, full width half-maximum, and intensity. We find the Raman D-band frequency increases for hole doping and decreases for electron doping. The Raman D-band intensity increases when the Fermi level approaches half of the excitation energy and is higher in the case of electron doping than that of hole doping. These variations can be explained by electron-phonon interaction theory and quantum interference between different Raman pathways in graphene. The intensity ratio of Raman D- and G-band, which is important for defects characterization in graphene, shows a strong dependence on carrier density.

Intrafocal heterogeneity of ERG protein expression and gene fusion pattern in prostate cancer.

PubMed

Suh, Ja Hee; Park, Jeong Hwan; Lee, Cheol; Moon, Kyung Chul

2017-10-01

Prostate cancer is considered to be highly heterogeneous, with various morphologic features and biologic behaviors. The TMPRSS2-ERG gene fusion is the most frequently observed genetic aberration in prostate cancer. The aim of this study was to elucidate the intrafocal heterogeneity of ERG gene fusion status. ERG immunohistochemistry (IHC) was performed in samples from 168 prostate cancer patients who had undergone radical prostatectomy, and 40 cases showing ERG-positive IHC staining were selected for tissue microarray (TMA) construction. Two to six representative cores were selected from each tumor focus. In the cases with heterogeneous ERG IHC staining intensity, the areas showing different intensities were separately selected. Using the TMA blocks, IHC and fluorescence in situ hybridization (FISH) were conducted to evaluate the heterogeneity of ERG protein expression and ERG fusion gene patterns, respectively, in a single tumor focus. Heterogeneity of ERG IHC staining was defined as the simultaneous presence of negative and positive cores in the same tumor focus. Heterogeneity of ERG FISH was defined by the presence of cores with positive and negative FISH signals or cores with break-apart and interstitial deletion FISH signals in the same tumor focus. A total of 202 TMA cores were isolated from 40 ERG-positive cases. Of the 202 total cores, 19 were negative for ERG IHC staining, and 46 showed 1+, 52 showed 2+, and 85 showed 3+ ERG staining intensity. Eleven cores were negative for ERG FISH signal, 119 cores showed ERG break-apart FISH signals, and the remaining 72 cores revealed interstitial deletion. Intrafocal heterogeneity of ERG IHC staining was found in 20% (8/40) of cases, and intrafocal heterogeneity of ERG gene fusion pattern was found in 32.5% (13/40) of cases. In summary, this study showed significantly frequent intrafocal heterogeneity of ERG protein expression, gene fusion status and fusion pattern. This heterogeneity can be caused by the development of subclones during cancer progression or the intermingling of different tumors. © 2017 Wiley Periodicals, Inc.

Scattering of electromagnetic wave by the layer with one-dimensional random inhomogeneities

NASA Astrophysics Data System (ADS)

Kogan, Lev; Zaboronkova, Tatiana; Grigoriev, Gennadii., IV.

A great deal of attention has been paid to the study of probability characteristics of electro-magnetic waves scattered by one-dimensional fluctuations of medium dielectric permittivity. However, the problem of a determination of a density of a probability and average intensity of the field inside the stochastically inhomogeneous medium with arbitrary extension of fluc-tuations has not been considered yet. It is the purpose of the present report to find and to analyze the indicated functions for the plane electromagnetic wave scattered by the layer with one-dimensional fluctuations of permittivity. We assumed that the length and the amplitude of individual fluctuations as well the interval between them are random quantities. All of indi-cated fluctuation parameters are supposed as independent random values possessing Gaussian distribution. We considered the stationary time cases both small-scale and large-scale rarefied inhomogeneities. Mathematically such problem can be reduced to the solution of integral Fred-holm equation of second kind for Hertz potential (U). Using the decomposition of the field into the series of multiply scattered waves we obtained the expression for a probability density of the field of the plane wave and determined the moments of the scattered field. We have shown that all odd moments of the centered field (U-¡U¿) are equal to zero and the even moments depend on the intensity. It was obtained that the probability density of the field possesses the Gaussian distribution. The average field is small compared with the standard fluctuation of scattered field for all considered cases of inhomogeneities. The value of average intensity of the field is an order of a standard of fluctuations of field intensity and drops with increases the inhomogeneities length in the case of small-scale inhomogeneities. The behavior of average intensity is more complicated in the case of large-scale medium inhomogeneities. The value of average intensity is the oscillating function versus the average fluctuations length if the standard of fluctuations of inhomogeneities length is greater then the wave length. When the standard of fluctuations of medium inhomogeneities extension is smaller then the wave length, the av-erage intensity value weakly depends from the average fluctuations extension. The obtained results may be used for analysis of the electromagnetic wave propagation into the media with the fluctuating parameters caused by such factors as leafs of trees, cumulus, internal gravity waves with a chaotic phase and etc. Acknowledgment: This work was supported by the Russian Foundation for Basic Research (projects 08-02-97026 and 09-05-00450).

Reimbursement for pediatric diabetes intensive case management: a model for chronic diseases?

PubMed

Beck, Joni K; Logan, Kathy J; Hamm, Robert M; Sproat, Scott M; Musser, Kathleen M; Everhart, Patricia D; McDermott, Harrold M; Copeland, Kenneth C

2004-01-01

Current reimbursement policies serve as potent disincentives for physicians who provide evaluation and management services exclusively. Such policies threaten nationwide availability of care for personnel-intensive services such as pediatric diabetes. This report describes an approach to improving reimbursement for highly specialized, comprehensive pediatric diabetes management through prospective contracting for services. The objective of this study was to determine whether pediatric diabetes intensive case management services are cost-effective to the payer, the patient, and a pediatric diabetes program. A contract with a third-party payer was created to reimburse for 3 key pediatric diabetes intensive case management components: specialty education, 24/7 telephone access to an educator (and board-certified pediatric endocrinologist as needed), and quarterly educator assessments of self-management skills. Data were collected and analyzed for 15 months after signing the contract. Within the first 15 months after the contract was signed, 22 hospital admissions for diabetic ketoacidosis (DKA) occurred in 16 different patients. After hospitalizations for DKA, all 16 patients were offered participation in the program. All were followed during the subsequent 1 to 15 months of observation. Ten patients elected to participate, and 6 refused participation. Frequency of rehospitalization, emergency department visits, and costs were compared between the 2 groups. Among the 10 participating patients, there was only 1 subsequent DKA admission, whereas among the 6 who refused participation, 5 were rehospitalized for DKA on at least 1 occasion. The 10 patients who participated in the program had greater telephone contact with the team compared with those who did not (16 crisis-management calls vs 0). Costs (education, hospitalization, and emergency department visits) per participating patient were approximately 1350 dollars less than those for nonparticipating patients. Differences between participating and nonparticipating groups included age (participants were of younger age), double-parent households (participants were more likely to be from double parent households), and number of medical visits kept (participants kept more follow-up visits). No differences in duration of diabetes, months followed in the program, sex, or ethnicity were observed. Contracting with third-party payers for pediatric diabetes intensive case management services reduces costs by reducing emergency department and inpatient hospital utilizations, likely a result of intensive education and immediate access to the diabetes health care team for crisis management. Such strategies may prove to be cost saving not only for diabetes management but also for managing other costly and personnel-intensive chronic diseases.

[Description of patients with confirmed influenza A(H1N1)pdm09 admitted to an intensive care unit and identification of severity risk factors].

PubMed

Payet, C; Lutringer-Magnin, D; Cassier, P; Lina, B; Argaud, L; Allaouchiche, B; Vanhems, P

2013-02-01

The authors had for objective to describe patients with confirmed influenza A(H1N1)pdm09 admitted to an intensive care unit (ICU) in a university hospital and to identify risk factors correlated with the severity of the disease. A prospective study was conducted in an university hospital during the A(H1N1)pdm09 influenza pandemic. Severe laboratory confirmed cases (admitted to an ICU) were described and compared with non-severe confirmed cases (not admitted to an ICU). Sixty-nine patients were included; 36 (52%) were 15 to 44 years of age. Sixteen (23%) cases were defined as severe, ten of these (63%) concerned patients 45 to 64 years of age. The independent factors associated with severity were: a history of heart disease, obesity, and tobacco abuse. This work reinforces the need to identify and protect groups at risk of severe outcomes. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

[Legionella pneumonia--a case report].

PubMed

Marques, A S; Estrada, M H

2005-01-01

Legionella, as a cause of community-acquired pneumonia, is probably under-recognized because the diagnosis relies on the use of specific tests as well the existence of an in-numerous species and serogroups not easily identify by the tests available. In studies from Europe and North America, it ranged from 2 to 15 percent of all community-acquired pneumonias that required hospitalisation, in the first four causes when culture methods were done and the second cause of those admitted in the intensive care units. We do a case report of 43 year-old man with history of cigarette smoking and corticosteroid therapy for a ocular disease, that presents with a pneumonia complicated with a Acute Respiratory Distress Syndrome (ARDS), that leaded to his admission to an intensive care unit were he was mechanical ventilated. The epidemiological investigation identified Legionella pneumophila serogroup 1. The authors present this case doing a brief review of this disease and discussing the epidemiology, clinical features, laboratory diagnosis as well as therapeutic options.

Effect modification of the association of cumulative exposure and cancer risk by intensity of exposure and time since exposure cessation: a flexible method applied to cigarette smoking and lung cancer in the SYNERGY Study.

PubMed

Vlaanderen, Jelle; Portengen, Lützen; Schüz, Joachim; Olsson, Ann; Pesch, Beate; Kendzia, Benjamin; Stücker, Isabelle; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Consonni, Dario; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Merletti, Franco; Mirabelli, Dario; Richiardi, Lorenzo; Gustavsson, Per; Plato, Nils; Jöckel, Karl-Heinz; Ahrens, Wolfgang; Pohlabeln, Hermann; Tardón, Adonina; Zaridze, David; Field, John K; 't Mannetje, Andrea; Pearce, Neil; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Stanescu Dumitru, Rodica; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Boffetta, Paolo; Forastiere, Francesco; Bueno-de-Mesquita, Bas; Peters, Susan; Brüning, Thomas; Kromhout, Hans; Straif, Kurt; Vermeulen, Roel

2014-02-01

The indiscriminate use of the cumulative exposure metric (the product of intensity and duration of exposure) might bias reported associations between exposure to hazardous agents and cancer risk. To assess the independent effects of duration and intensity of exposure on cancer risk, we explored effect modification of the association of cumulative exposure and cancer risk by intensity of exposure. We applied a flexible excess odds ratio model that is linear in cumulative exposure but potentially nonlinear in intensity of exposure to 15 case-control studies of cigarette smoking and lung cancer (1985-2009). Our model accommodated modification of the excess odds ratio per pack-year of cigarette smoking by time since smoking cessation among former smokers. We observed negative effect modification of the association of pack-years of cigarette smoking and lung cancer by intensity of cigarette smoke for persons who smoked more than 20-30 cigarettes per day. Patterns of effect modification were similar across individual studies and across major lung cancer subtypes. We observed strong negative effect modification by time since smoking cessation. Application of our method in this example of cigarette smoking and lung cancer demonstrated that reducing a complex exposure history to a metric such as cumulative exposure is too restrictive.

Effect Modification of the Association of Cumulative Exposure and Cancer Risk by Intensity of Exposure and Time Since Exposure Cessation: A Flexible Method Applied to Cigarette Smoking and Lung Cancer in the SYNERGY Study

PubMed Central

Vlaanderen, Jelle; Portengen, Lützen; Schüz, Joachim; Olsson, Ann; Pesch, Beate; Kendzia, Benjamin; Stücker, Isabelle; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Consonni, Dario; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Merletti, Franco; Mirabelli, Dario; Richiardi, Lorenzo; Gustavsson, Per; Plato, Nils; Jöckel, Karl-Heinz; Ahrens, Wolfgang; Pohlabeln, Hermann; Tardón, Adonina; Zaridze, David; Field, John K.; 't Mannetje, Andrea; Pearce, Neil; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Stanescu Dumitru, Rodica; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Boffetta, Paolo; Forastiere, Francesco; Bueno-de-Mesquita, Bas; Peters, Susan; Brüning, Thomas; Kromhout, Hans; Straif, Kurt; Vermeulen, Roel

2014-01-01

The indiscriminate use of the cumulative exposure metric (the product of intensity and duration of exposure) might bias reported associations between exposure to hazardous agents and cancer risk. To assess the independent effects of duration and intensity of exposure on cancer risk, we explored effect modification of the association of cumulative exposure and cancer risk by intensity of exposure. We applied a flexible excess odds ratio model that is linear in cumulative exposure but potentially nonlinear in intensity of exposure to 15 case-control studies of cigarette smoking and lung cancer (1985–2009). Our model accommodated modification of the excess odds ratio per pack-year of cigarette smoking by time since smoking cessation among former smokers. We observed negative effect modification of the association of pack-years of cigarette smoking and lung cancer by intensity of cigarette smoke for persons who smoked more than 20–30 cigarettes per day. Patterns of effect modification were similar across individual studies and across major lung cancer subtypes. We observed strong negative effect modification by time since smoking cessation. Application of our method in this example of cigarette smoking and lung cancer demonstrated that reducing a complex exposure history to a metric such as cumulative exposure is too restrictive. PMID:24355332

[The ultrastructure of Leydig cells under the influence of drinking mineral water and electromagnetic radiation under the stress conditions in the rats].

PubMed

Geniatulina, M S; Korolev, Yu N; Nikulina, L A

The objective of the present study was elucidate the peculiar features of low-intensity electromagnetic radiation (LI EMR) and mineral water (MW) on the ultrastructure of rat Leydig cells under conditions of immobilization stress. The experiments were carried out on outbred male rats with the use of electron microscopy. It has been demonstrated that the prophylactic consumption of drinking sulfate-containing mineral water and the application low-intensity electromagnetic radiation (with the flow power density of 1 mcW/cm2 and frequency around 1,000 Hz) or the combination of these two modalities under conditions of immobilization stress reduced the degree of ultrastructural derangement in the rat Leydig cells and stimulated the development of regenerative processes. In the cases of the single-factor impact, drinking mineral water exerted more pronounced action than low-intensity electromagnetic radiation on mitochondrial regeneration. In case of the simultaneous application of the two factors their protective action on the Leydig cells was much more conspicuous than that of either of them applied alone. It is concluded that drinking sulfate-containing mineral water in combination with the application of low-intensity electromagnetic radiation enhances resistance of the rat Leydig cells to stress.

Experimental analyses of trailing edge flows

NASA Technical Reports Server (NTRS)

Petrie, S. L.; Emmer, D. S.

1984-01-01

An experimental study of several of the trailing edge and wake turbulence properties for a NACA 64A010 airfoil section was completed. The experiment was conducted at the Ohio State University Aeronautical and Astronautical Research Laboratory in the 6 inch X 22 inch transonic wind tunnel facility. The data were obtained at a free stream Mach number of 0.80 and a flow Reynolds number (based on chord length) of 5 million. The principle diagnostic tool was a dual-component laser Doppler velocimeter. The experimental data included surface static pressures, chordwise and vertical mean velocities, RMS turbulence intensities, local flow angles, and a determination of turbulence kinetic energy in the wake. Two angles of attack (0 and 2 degrees) were investigated. At these incidence angles, four flow field surveys were obtained ranging in position from the surface of the airfoil, between the transonic shock and the trailing edge, to the far-wake. At both angles of attack, the turbulence intensities and turbulence kinetic energy were observed to decay in the streamwise direction. In the far wake, for the non-lifting case, the turbulence intensities were nearly isotropic. For the two degree case, the horizontal component of the turbulence intensity was observed to be substantially higher than the vertical component.

Cognitive Behavioral Therapy for Psychosis (CBT-p) Delivered in a Community Mental Health Setting: A Case Comparison of Clients Receiving CBT Informed Strategies by Case Managers Prior to Therapy.

PubMed

Sivec, Harry J; Montesano, Vicki L; Skubby, David; Knepp, Kristen A; Munetz, Mark R

2017-02-01

This exploratory case comparison examines the influence of case management activities on engagement and progress in psychotherapy for clients with schizophrenia. Six clients were recruited to participate in ten sessions of Cognitive Behavioral Therapy for psychosis (CBT-p). Three clients who had received Cognitive Behavioral techniques for psychosis (CBt-p, a low-intensity case management intervention) prior to receiving therapy were selected from referrals. A comparison group of three clients who had received standard case management services was selected from referrals. Cases within and across groups were compared on outcome measures and observations from case review were offered to inform future research. Delivering CBT-p services on a continuum from low- to high-intensity is discussed.

Hypnotherapy for persistent genital arousal disorder: a case study.

PubMed

Elkins, Gary R; Ramsey, Derek; Yu, Yimin

2014-01-01

Persistent genital arousal disorder (PGAD) is characterized by intrusive sexual arousal that is unresolvable via sexual activity and persists for an extended period of time. PGAD's etiology is unknown, and it has no established treatments. This case study reports on a 71-year-old female patient diagnosed with PGAD who received 9 sessions of hypnotherapy. The following measures were administered at baseline and follow-up: Hospital Anxiety and Depression Scale, Center for Epidemiologic Studies Depression Scale, Pittsburgh Sleep Quality Index, and visual analogue measurements of quality of life, intensity of symptoms, and marital interference. At follow-up, there were significant improvements in all measures. Given the currently limited alternatives for treatment, this case study suggests that hypnotherapy may be beneficial for some patients with PGAD.

Moral distress in end-of-life care in the intensive care unit.

PubMed

St Ledger, Una; Begley, Ann; Reid, Joanne; Prior, Lindsay; McAuley, Danny; Blackwood, Bronagh

2013-08-01

To explore moral distress in relatives doctors and nurses, in end-of-life care decision-making, in the adult intensive care unit. Many deaths in intensive care involve decisions about withholding and withdrawing therapy, potentially triggering moral distress. Moral distress occurs when individuals feel constrained from acting in accordance with moral choice, or act against moral judgement, generating painful, unresolved emotions, and problems that continue long after an event. Prior research has focused mainly on nurses; less is known about doctors' experiences and occurrence and impact on relatives is unknown. A narrative inquiry case study approach, funded by a Northern Ireland Health and Social Care Doctorate Fellowship Award (April 2011). In-depth digitally recorded interviews will be conducted with relatives, doctors, and nurses involved in end-of-life cases comprising: (1) withdrawal of therapy, including circulatory death organ donation; (2) non-escalation of therapy; and (3) brain stem death with a request for organ donation. Relatives will be offered the opportunity to share their experiences on 'Healthtalkonline' by copyrighting audio-visual interviews to the Health Experiences Research Group, Oxford University. Research Ethics Committee approval was obtained (April 2012). This is the first time that moral distress is explored, in a case approach, among relatives, doctors, and nurses intimately involved in end-of-life decisions in intensive care. Dissemination of findings will make a large contribution to international knowledge and understanding in this area and alert healthcare professionals and relatives to an otherwise under-recognized, but potentially detrimental, experience. Findings will inform education, practice, and policy. © 2012 Blackwell Publishing Ltd.

Impact of urbanization-related land use land cover changes and urban morphology changes on the urban heat island phenomenon.

PubMed

Zhou, Xuefan; Chen, Hong

2018-04-24

Urban growth and development caused by urbanization influence the urban heat island (UHI) phenomenon. With the rapid development of urbanization, China's major cities are facing more serious climate change problems, especially the UHI phenomenon. Proper planning and urban design of compact cities may improve the ventilation of street canyons and change the heat balance in the urban canopy and thus mitigate the UHI phenomenon. The aim of this study is to evaluate and discuss the mitigation of UHI with different types of land-use and land-cover (LUCC), as well as different development patterns for compact cities. To this end, we applied the weather research and forecasting model (WRF) with urban canopy model (WRF/UCM) in this study. To evaluate the impact of LUCC changes on the UHI, we set 2 cases based on land use and land cover statistical data from 1965 and 2008 of Wuhan. Also, to evaluate the impact of urban morphology changes on the UHI, we designed 2 hypothetical cases based on 2 different urban developing patterns, one is high rise case and another is high density case, to simulate the impact of urban morphology on the UHI. As for the results of this study, with different LUCC of 1965 and 2008, UHI intensity of Wuhan increased by 0.2 °C-0.4 °C in average. Moreover, the critical wind speed which can mitigate UHI of case 1965 is much lower than case 2008. With different urban morphology, the high-rise case may lead to lower UHI intensity at the pedestrian level due to the shading effects of high-rise buildings. However, the critical value of wind speed in the high-rise case was almost 1.5-2 times greater than that of the high-density case, which illustrates the reduced possibility of mitigating the UHI phenomenon for high-rise buildings in Wuhan City. Copyright © 2018 Elsevier B.V. All rights reserved.

Pain Catastrophizing and Its Relationship with Health Outcomes: Does Pain Intensity Matter?

PubMed Central

García-Palacios, Azucena; Botella, Cristina; Ribera-Canudas, Maria Victoria

2017-01-01

Pain catastrophizing is known to contribute to physical and mental functioning, even when controlling for the effect of pain intensity. However, research has yet to explore whether the strength of the relationship between pain catastrophizing and pain-related outcomes varies across pain intensity levels (i.e., moderation). If this was the case, it would have important implications for existing models of pain and current interventions. The present investigation explored whether pain intensity moderates the relationship between pain catastrophizing and pain-related outcomes. Participants were 254 patients (62% women) with heterogeneous chronic pain. Patients completed a measure of pain intensity, pain interference, pain catastrophizing, and physical and mental health. Pain intensity moderated the relationship between pain catastrophizing and pain interference and between pain catastrophizing and physical health status. Specifically, the strength of the correlation between pain catastrophizing and these outcomes decreased considerably as pain intensity increased. In contrast, pain intensity did not moderate the relationship between pain catastrophizing and mental health. Study findings provide a new insight into the role of pain intensity (i.e., moderator) in the relationship between pain catastrophizing and various pain-related outcomes, which might help develop existent models of pain. Clinical implications are discussed in the context of personalized therapy. PMID:28348506

Novel high-energy physics studies using intense lasers and plasmas

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

Leemans, Wim P.; Bulanov, Stepan; Esarey, Eric

2015-06-29

In the framework of the project “Novel high-energy physics studies using intense lasers and plasmas” we conducted the study of ion acceleration and “flying mirrors” with high intensity lasers in order to develop sources of ion beams and high frequency radiation for different applications. Since some schemes of laser ion acceleration are also considered a good source of “flying mirrors”, we proposed to investigate the mechanisms of “mirror” formation. As a result we were able to study the laser ion acceleration from thin foils and near critical density targets. We identified several fundamental factors limiting the acceleration in the RPAmore » regime and proposed the target design to compensate these limitations. In the case of near critical density targets, we developed a concept for the laser driven ion source for the hadron therapy. Also we studied the mechanism of “flying mirror” generation during the intense laser interaction with thin solid density targets. As for the laser-based positron creation and capture we initially proposed to study different regimes of positron beam generation and positron beam cooling. Since the for some of these schemes a good quality electron beam is required, we studied the generation of ultra-low emittance electron beams. In order to understand the fundamental physics of high energy electron beam interaction with high intensity laser pulses, which may affect the efficient generation of positron beams, we studied the radiation reaction effects.« less

The Evolution of Stress Intensity Factors and the Propagation of Cracks in Elastic Media

NASA Astrophysics Data System (ADS)

Friedman, Avner; Hu, Bei; Velazquez, Juan J. L.

When a crack Γs propagates in an elastic medium the stress intensity factors evolve with the tip x(s) of Γs. In this paper we derive formulae which describe the evolution of these stress intensity factors for a homogeneous isotropic elastic medium under plane strain conditions. Denoting by ψ=ψ(x,s) the stress potential (ψ is biharmonic and has zero traction along the crack Γs) and by κ(s) the curvature of the crack at the tip x(s), we prove that the stress intensity factors A1(s), A2(s), as functions of s, satisfy: where , are stress intensity factors of the tangential derivative of in the polar coordinate system at x(s) with θ=0 in the direction of the crack at x(s). The case of antiplane shearing is also briefly considered; in this case ψ is harmonic.

The Social Justice Leadership Retreat: A Phenomenological Case Study of Students' Construction of Race and Its Influence on Beliefs, Behavior, and Actions

ERIC Educational Resources Information Center

Bettendorf, Anthony J.

2016-01-01

This study examines students' participation in an intensive intercultural experience, the Social Justice Leadership Retreat. The study utilizes the Intercultural Maturity Model, leadership and democracy outcomes as a framework for the research. Specifically, the study investigates how this experience impacts the ways students make meaning of…

[Outlier cases in surgical disciplines. Micro-economic and macro-economic problems].

PubMed

Tecklenburg, A; Liebeneiner, J; Schaefer, O

2009-09-01

Postoperative complications will always occur and the negative impact puts strain on patients, relatives and the attending physicians. The conversion to a remuneration system based on flat rates (diagnosis-related groups) presents additional economic problems for hospitals in some resource-intensive treatments. This particularly pertains to extremely cost-intensive cases in which costs succeed revenue by the factor of 2 and are often surgical procedures. Here the economic risk increases with the number of interventions performed. Despite improvements in the remuneration system this problem persists. An improved payment for these treatments is desirable. To achieve this it is necessary to systematically analyze the extremely cost-intensive cases by experts of different medical disciplines to create a data basis for a proposal of a cost-covering payment.

Rock-magnetic properties of single zircon crystals sampled from the Tanzawa tonalitic pluton, central Japan

NASA Astrophysics Data System (ADS)

Sato, Masahiko; Yamamoto, Shinji; Yamamoto, Yuhji; Okada, Yoshihiro; Ohno, Masao; Tsunakawa, Hideo; Maruyama, Shigenori

2015-09-01

This paper reports on the rock-magnetic properties of single zircon crystals, which are essential for future work establishing the reliable paleointensity method using single zircon crystals. Zircon crystals used in this study were sampled from the Nakagawa River, which crosses the Tanzawa tonalitic pluton in central Japan. Rock-magnetic measurements were conducted on 1037 grains of zircons, but many of these measurements are below the limits of the sensitivity of the magnetometers employed. Isothermal remanent magnetizations (IRMs) of 876 zircon crystal are below the practical resolution of this study; we infer that these crystals contain no or only minute quantities of ferromagnetic minerals. The other zircon crystals contain enough magnetic minerals to be measured in the DC SQUID magnetometer. For 81 zircon crystals, IRM intensities ( M IRM) are larger than 4 × 10-12 Am2, while natural remanent magnetization (NRM) intensities ( M NRM) are below 4 × 10-12 Am2, indicating that these crystals are inappropriate for the paleomagnetic study. For the samples that had values of M NRM ≥ 4 × 10-12 Am2 and M IRM ≥ 4 × 10-12 Am2 (80 zircons), combining the rock-magnetic parameter, we proposed the sample-selection criteria for future study of paleointensity experiments using single zircon crystals. In the case that the samples had high coercivity ( B c) values (>10 mT) or high M NRM/ M IRM values (>~0.1), main remanence carriers are probably pyrrhotite and these samples are inappropriate for the paleointensity study. In the case that the samples had low B c values (<10 mT) and low M NRM/ M IRM values (<~0.1), main remanence carriers seem to be nearly pure magnetite with pseudo-single-domain grain sizes, and these samples are expected to appropriate for the paleointensity study. Total thermoremanent magnetization (TRM) acquisition experiments were also carried out for 12 samples satisfying the above criteria. The TRM intensity was comparable with that of NRM, and a rough estimation of the paleointensity using NRM/TRM ratios shows field intensities consistent with the average geomagnetic field intensity at the Tanzawa tonalitic pluton for last 5 Myr.

Spatial Variability of Mercury Wet Deposition in Eastern Ohio: Summertime Meteorological Case Study Analysis of Local Source Influences

EPA Science Inventory

Extensive exploration of event precipitation data in the Ohio River Valley indicates that coal combustion emissions play an important role in mercury (Hg) wet deposition. During July-September 2006, an intensive study was undertaken to discern the degree of local source influence...

Ethical and Moral Education: A National Case Study of Poland.

ERIC Educational Resources Information Center

Janowski, Andrzej

This study explores the Polish experience in values education. Between the years 1944 and 1989 Polish education was often state controlled with the sole purpose of subjugating education to Marxist-Leninist ideology. Over the years the communist party's dictates varied in intensity. Despite the party's efforts to prescribe ethics, certain values…

Operation of SCINDA Receiver at the University of Calcutta and Space Weather Studies

DTIC Science & Technology

2015-02-18

Terr . Phys., 2014]. (ii) The pole ward gradient of the Equatorial Ionization Anomaly (EIA) introduces more intense propagation effects on...in the Indian longitude sector: Case studies, T. Das, K.S. Paul and A. Paul, J. Atmos. Sol. Terr . Phys., http://dx.doi.org/10.1016/j.jastp

Merit Pay and Job Enlargement as Reforms: Incentives, Implementation, and Teacher Response.

ERIC Educational Resources Information Center

Firestone, William A.

1991-01-01

Based on intensive case studies of two school districts, this study compared two teacher work reforms: merit pay and job enlargement. Interviews with 64 teachers and 53 administrators, supplemented by over 1,300 survey responses, indicate the efficacy of each approach and the potential advantages of job enlargement. (SLD)

Examining the Role of Leadership in an Undergraduate Biology Institutional Reform Initiative

ERIC Educational Resources Information Center

Matz, Rebecca L.; Jardeleza, Sarah E.

2016-01-01

Undergraduate science, technology, engineering, and mathematics (STEM) education reform continues to be a national priority. We studied a reform process in undergraduate biology at a research-intensive university to explore what leadership issues arose in implementation of the initiative when characterized with a descriptive case study method. The…

Embedded Librarians: Just-in-Time or Just-in-Case? A Research Study

ERIC Educational Resources Information Center

Heathcock, Kristin

2015-01-01

Embedded librarians in online courses provide a wealth of service and information to students. Though students indicate that these services are valuable, the librarians providing embedded services frequently note that these projects are very time consuming. This study examines the provision of a less time-intensive model of embedded librarianship…

[Value of MRI in the treatment of Grave's disease orbital myopathy].

PubMed

Oğuz, V; Yolar, M; Yetik, H; Cakirer, D; Uysal, O; Pazarli, H

2001-10-01

In order to evaluate the predictability of the results in the treatment of myopathy in cases with the clinical signs of muscle involvement, 177 extraocular muscles of 27 cases whose oedematous status was detected by MRI and who were given antiinflammatory treatment according to the data of this method, were studied. The nature of involvement was detected in respect with the signal intensity and thickness of each rectus muscle prior to the treatment and at the end of the sixth month following a three months' application of combined treatment of steroids and irradiation of 2000 rads. When the initial and final results were compared, the signal intensities of four involved recti showed significant decrease at the end of the treatment, as they were evaluated separately or together. Besides the thicknesses of these groups of involved recti which were evaluated separately showed significant decrease. The evaluation of the signal intensities by MRI is a way that enables noninvasive detection of the edema and prediction of the anti-inflammatory treatment's results of dysthyroid myopathy. Therefore a systematic follow up by MRI is recommended for the treatment choice in dysthyroid myopathy.

Greenhouse Gases and Energy Intensity of Granite Rock Mining Operations in Thailand: A Case of Industrial Rock-Construction

NASA Astrophysics Data System (ADS)

Kittipongvises, Suthirat; Chavalparit, Orathai; Sutthirat, Chakkaphan

2016-12-01

This paper is aimed to systematically assess greenhouse gases (GHGs) and energy intensity of the granite rock mining operations in Thailand and also identify a range of feasible options to minimize their GHG emissions. Mining factories A, B and C, located in the Eastern region of Thailand, were selected as research case studies. The results indicated that the 3-year average of GHGs emissions from factories A to C was 3387 718 kgCO2e per year with approximately 2.92 kgCO2e per ton of granite rock produced over 2012 to 2014. Of this, the carbon intensity of grid-electricity consumption for the crushed rock production was 1.84 kgCO2/kWh. Diesel fuel combustion for transport activities in the mining factories was the greatest contributor to GHGs emissions (68 %) compared to the purchased electricity and explosion process, with 31 % and 1 %, respectively. In-Pit Crushing and Conveying (IPCC) installation, haul truck payload optimization and management, and reduction in tire rolling resistance have shown potential to reduce carbon emissions accounted for 20 % to 70 %.

Effects of intensivist coverage in a post-anaesthesia care unit on surgical patients' case mix and characteristics of the intensive care unit.

PubMed

Kastrup, Marc; Seeling, Matthes; Barthel, Stefan; Bloch, Andy; le Claire, Marie; Spies, Claudia; Scheller, Matthias; Braun, Jan

2012-07-18

There is an increasing demand for intensive care in hospitals, which can lead to capacity limitations in the intensive care unit (ICU). Due to postponement of elective surgery or delayed admission of emergency patients, outcome may be negatively influenced. To optimize the admission process to intensive care, the post-anaesthesia care unit (PACU) was staffed with intensivist coverage around the clock. The aim of this study is to demonstrate the impact of the PACU on the structure of ICU-patients and the contribution to overall hospital profit in terms of changes in the case mix index for all surgical patients. The administrative data of all surgical patients (n = 51,040) 20 months prior and 20 months after the introduction of a round-the-clock intensivist staffing of the PACU were evaluated and compared. The relative number of patients with longer length of stay (LOS) (more than seven days) in the ICU increased after the introduction of the PACU. The average monthly number of treatment days of patients staying less than 24 hours in the ICU decreased by about 50% (138.95 vs. 68.19 treatment days, P <0.005). The mean LOS in the PACU was 0.45 (± 0.41) days, compared to 0.27 (± 0.2) days prior to the implementation. The preoperative times in the hospital decreased significantly for all patients. The case mix index (CMI) per hospital day for all surgical patients was significantly higher after the introduction of a PACU: 0.286 (± 0.234) vs. 0.309 (± 0.272) P <0.001 CMI/hospital day. The introduction of a PACU and the staffing with intensive care staff might shorten the hospital LOS for surgical patients. The revenues for the hospital, as determined by the case mix index of the patients per hospital day, increased after the implementation of a PACU and more patients can be treated in the same time, due to a better use of resources.

Daily rainfall statistics of TRMM and CMORPH: A case for trans-boundary Gandak River basin

NASA Astrophysics Data System (ADS)

Kumar, Brijesh; Patra, Kanhu Charan; Lakshmi, Venkat

2016-07-01

Satellite precipitation products offer an opportunity to evaluate extreme events (flood and drought) for areas where rainfall data are not available or rain gauge stations are sparse. In this study, daily precipitation amount and frequency of TRMM 3B42V.7 and CMORPH products have been validated against daily rain gauge precipitation for the monsoon months (June-September or JJAS) from 2005-2010 in the trans-boundary Gandak River basin. The analysis shows that the both TRMM and CMORPH can detect rain and no-rain events, but they fail to capture the intensity of rainfall. The detection of precipitation amount is strongly dependent on the topography. In the plains areas, TRMM product is capable of capturing high-intensity rain events but in the hilly regions, it underestimates the amount of high-intensity rain events. On the other hand, CMORPH entirely fails to capture the high-intensity rain events but does well with low-intensity rain events in both hilly regions as well as the plain region. The continuous variable verification method shows better agreement of TRMM rainfall products with rain gauge data. TRMM fares better in the prediction of probability of occurrence of high-intensity rainfall events, but it underestimates intensity at high altitudes. This implies that TRMM precipitation estimates can be used for flood-related studies only after bias adjustment for the topography.

Data management to enhance long-term watershed research capacity: context and STWEARDS case study

USDA-ARS?s Scientific Manuscript database

Water resources are under growing pressure globally, and in the face of projected climate change, uncertainty about precipitation frequency and intensity; evapotranspiration, runoff, and snowmelt poses severe societal challenges. Interdisciplinary environmental research across natural and social sc...

Regulatory aspects of low intensity photon emission.

PubMed

Van Wijk, R; Schamhart, D H

1988-07-15

Photon emission from unicellular and multicellular organisms has been a subject of study for many decennia. In contrast to the well-known phenomenon of bioluminescence originating in luciferin-luciferase reactions, low intensity emission in the visible region of the electromagnetic spectrum has been found in almost every species studied so far. At present, the nomenclature of this phenomenon has not crystallized and it is referred to by a variety of names, such as mitogenetic radiation 29, dark luminescence 7, low-level chemiluminescence 20,36, and biophotons 57. Particular attention has been focussed on the relationship between photon emission and the regulation of various aspects of cellular metabolism, although in many cases quantitative data are still lacking. Throughout the history of this field of research the question of a functional biological role of the low intensity emission has been repeatedly raised; this is reflected, for instance, in the heterogeneity of the terms used to describe it. The discussion concerns the possible participation of photons of low intensity in intra- and intercellular communication. This paper reviews literature on the metabolic regulation of low intensity emission, as well as the regulation of photon emission initiated by external light. Furthermore, recent data are discussed with respect to a possible biocommunicative function of low intensity photon emission.

Simultaneous integrated boost with intensity modulated radiation therapy in brain oligometastases: A feasible technique for developing countries

PubMed Central

Tiwari, Vivek; Pande, Subodh C.; Verma, Kamal; Goel, Sandeep

2015-01-01

Introduction: To analyze the pattern of brain metastasis (BM), and to use intensity modulated radiation therapy (IMRT) for target dose escalation in cases with ≤3 metastatic lesions (oligometastases). Materials and Methods: Thirty-two consecutive cases of BM treated during September 2009 to August 2012 were analyzed retrospectively. Results: The study comprised 13 males (40.62%) and 19 females (59.37%). Thirteen (40%) patients presented with disseminated intracranial metastases, while 19 (60%) had ≤3 foci. In 25 cases (78%), the primary was located either in the breast (14 cases) or lung (11 cases). The 13 patients with disseminated intracranial metastases received whole brain radiation therapy to a dose of 30 Gy/10-12 daily fractions (Group A) while the 19 cases with ≤3 lesions received an additional dose of 6-10 Gy to gross lesions using a simultaneous integrated boost (SIB) with IMRT thus receiving a total dose of 36-40 Gy/12-15 fractions (Group B). Overall survival (OS) for the breast primary was 6.3 and lung primary was 5.3 months, respectively. The mean OS for breast cases in Group B was higher (9.5 months) as compared to Group A cases (1.9 months) and was statistically significant (P = 0.0056). Similarly, primary lung cancer cases in Group B showed a mean OS of 8.75 months versus 2.6 months for Group A cases (P = 0.213). Conclusions: IMRT is a safe and effective technique in cases with oligometastases for dose escalation in the form of SIB. PMID:25839012

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

Miyasaka, Y; Kadoya, N; Ito, K

Purpose: Accurate deformable image registration (DIR) between external beam radiotherapy (EBRT) and HDR brachytherapy (BT) CT images in cervical cancer is challenging. DSC has been evaluated only on the basis of the consistency of the structure, and its use does not guarantee an anatomically reasonable deformation. We evaluate the DIR accuracy for cervical cancer with DSC and anatomical landmarks using a 3D-printed pelvis phantom. Methods: A 3D-printed, deformable female pelvis phantom was created on the basis of the patient’s CT image. Urethane and silicon were used as materials for creating the uterus and bladder, respectively, in the phantom. We performedmore » DIR in two cases: case-A with a full bladder (170 ml) in both the EBRT and BT images and case-B with a full bladder in the BT image and a half bladder (100 ml) in the EBRT image. DIR was evaluated using DSCs and 70 uterus and bladder landmarks. A Hybrid intensity and structure DIR algorithm with two settings (RayStation) was used. Results: In the case-A, DSCs of the intensity-based DIR were 0.93 and 0.85 for the bladder and uterus, respectively, whereas those of hybrid-DIR were 0.98 and 0.96, respectively. The mean landmark error values of intensity-based DIR were 0.73±0.29 and 1.70±0.19 cm for the bladder and uterus, respectively, whereas those of Hybrid-DIR were 0.43±0.33 and 1.23±0.25 cm, respectively. In both cases, the Hybrid-DIR accuracy was better than the intensity-based DIR accuracy for both evaluation methods. However, for several bladder landmarks, the Hybrid-DIR landmark errors were larger than the corresponding intensity-based DIR errors (e.g., 2.26 vs 1.25 cm). Conclusion: Our results demonstrate that Hybrid-DIR can perform with a better accuracy than the intensity-based DIR for both DSC and landmark errors; however, Hybrid-DIR shows a larger landmark error for some landmarks because the technique focuses on both the structure and intensity.« less

Shade tree spatial structure and pod production explain frosty pod rot intensity in cacao agroforests, Costa Rica.

PubMed

Gidoin, Cynthia; Avelino, Jacques; Deheuvels, Olivier; Cilas, Christian; Bieng, Marie Ange Ngo

2014-03-01

Vegetation composition and plant spatial structure affect disease intensity through resource and microclimatic variation effects. The aim of this study was to evaluate the independent effect and relative importance of host composition and plant spatial structure variables in explaining disease intensity at the plot scale. For that purpose, frosty pod rot intensity, a disease caused by Moniliophthora roreri on cacao pods, was monitored in 36 cacao agroforests in Costa Rica in order to assess the vegetation composition and spatial structure variables conducive to the disease. Hierarchical partitioning was used to identify the most causal factors. Firstly, pod production, cacao tree density and shade tree spatial structure had significant independent effects on disease intensity. In our case study, the amount of susceptible tissue was the most relevant host composition variable for explaining disease intensity by resource dilution. Indeed, cacao tree density probably affected disease intensity more by the creation of self-shading rather than by host dilution. Lastly, only regularly distributed forest trees, and not aggregated or randomly distributed forest trees, reduced disease intensity in comparison to plots with a low forest tree density. A regular spatial structure is probably crucial to the creation of moderate and uniform shade as recommended for frosty pod rot management. As pod production is an important service expected from these agroforests, shade tree spatial structure may be a lever for integrated management of frosty pod rot in cacao agroforests.

Numerical study of phase conjugation in stimulated Brillouin scattering from an optical waveguide

NASA Astrophysics Data System (ADS)

Lehmberg, R. H.

1983-05-01

Stimulated Brillouin scattering (SBS) in a multimode optical waveguide is examined, and the parameters that affect the wavefront conjugation fidelity are studied. The nonlinear propagation code is briefly described and the calculated quantities are defined. The parameter study in the low reflectivity limit is described, and the effects of pump depletion are considered. The waveguide produced significantly higher fidelities than the focused configuration, in agreement with several experimental studies. The light scattered back through the phase aberrator exhibited a farfield intenstiy profile closely matching that of the incident beam; however, the nearfield intensity exhibited large and rapid spatial inhomogeneities across the entire aberrator, even for conjugation fidelities as high as 98 percent. In the absence of pump depletion, the fidelity increased with average pump intensity for amplitude gains up to around e to the 10th and then decreased slowly and monotonically with higher intensity. For all cases, pump depletion significantly enhanced the fidelity of the wavefront conjugation by inhibiting the small-scale pulling effect.

Intensive short-term vasodilation effect in the pain area of sciatica patients--case study.

PubMed

Skorupska, Elżbieta; Rychlik, Michał; Pawelec, Wiktoria; Bednarek, Agata; Samborski, Włodzimierz

2014-09-09

Varied and complicated etiology of low back pain radiating distally to the extremities is still causing disagreement and controversy around the issue of its diagnosis and treatment. Most clinicians believe that the source of that pain is generally radicular. While some of them postulate the clinical significance of the sacroiliac joint syndrome, others demonstrate that almost one in five people with back pain experience symptoms indicative of the neuropathic pain component. To date, neuropathic involvement has not been completely understood, and different mechanisms are thought to play an important role. It has been established that muscle pain (myofascial pain) e.g. active trigger points from the gluteus minimus, can mimic pain similar to sciatica, especially in the chronic stage. This paper describes patients presenting with radicular sciatica (case one and two) and sciatica-like symptoms (case three). For the first time, intensive short-term vasodilation in the pain area following needle infiltration of the gluteus minimus trigger point was recorded. Three Caucasian, European women suffering from radicular sciatica (case one and two) and sciatica-like symptoms (case three) at the age of 57, 49 and 47 respectively underwent infrared camera observation during needle infiltration of the gluteus minimus trigger point. The patients were diagnosed by a neurologist; they underwent magnetic resonance imaging, electromyography, neurography and blood test analysis. Apart from that, the patients were diagnosed by a clinician specializing in myofascial pain diagnosis. In the examined cases, trigger points-related short-term vasodilation was recorded. Confirmation of these findings in a controlled, blinded study would indicate the existence of a link between the pain of sciatica patients (radicular or sciatica-like pain) and the activity of the autonomic nervous system. Further studies on a bigger group of patients are still needed.

The expression of cytoskeleton regulatory protein Mena in colorectal lesions.

PubMed

Gurzu, Simona; Jung, I; Prantner, I; Ember, I; Pávai, Z; Mezei, T

2008-01-01

The actin regulatory proteins Ena/VASP (Enabled/Vasodilator stimulated phosphoprotein) family is involved in the control of cell motility and adhesion. They are important in the actin-dependent processes where dynamic actin reorganization it is necessary. The deregulation of actin cycle could have an important role in the cells' malignant transformation, tumor invasion or metastasis. Recently studies revealed that the human orthologue of murine Mena is modulated during the breast carcinogenesis. In our study, we tried to observe the immunohistochemical expression of mammalian Ena (Mena) in the colorectal polyps and carcinomas. We analyzed 10 adenomatous polyps (five with dysplasia) and 36 adenocarcinomas. We used the indirect immunoperoxidase staining. BD Biosciences have provided the Mena antibody. We observed that Mena was not expressed in the normal colorectal mucosa neither in polyps without dysplasia, but its expression was very high in polyps with high dysplasia. In colorectal carcinomas, Mena marked the tumoral cells in 80% of cases. In 25% of positive cases, the intensity was 3+, in 60% 2+ and in the other 15% 1+. The Mena intensity was higher in the microsatellite stable tumors (MSS) and was correlated with vascular invasion, with intensity of angiogenesis marked with CD31 and CD105 and with c-erbB-2 and p53 expression. This is the first study in the literature about Mena expression in colorectal lesions.

Technology Transfer/A Case Study: Target Strength

DTIC Science & Technology

1974-03-01

Computer, 1 972] are both correct . The first man, a former newspaper writer, credits the intense rate of change now being experienced in society to a...inasmuch as it fails to account for certain diffrac- L tion phenomena; and it will give correct results only for cases where these diffraction...mentioned above, the Luneburg -iline result of Eq. (2,2-49) should be correct as the paraboloid represents an infinite body which does not support

American football and fatal exertional heat stroke: a case study of Korey Stringer.

PubMed

Grundstein, Andrew; Knox, John A; Vanos, Jennifer; Cooper, Earl R; Casa, Douglas J

2017-08-01

On August 1, 2001, Korey Stringer, a Pro Bowl offensive tackle for the Minnesota Vikings, became the first and to date the only professional American football player to die from exertional heat stroke (EHS). The death helped raise awareness of the dangers of exertional heat illnesses in athletes and prompted the development of heat safety policies at the professional, collegiate, and interscholastic levels. Despite the public awareness of this death, no published study has examined in detail the circumstances surrounding Stringer's fatal EHS. Using the well-documented details of the case, our study shows that Stringer's fatal EHS was the result of a combination of physiological limitations, organizational and treatment failings, and extreme environmental conditions. The COMfort FormulA (COMFA) energy budget model was used to assess the relative importance of several extrinsic factors on Stringer's EHS, including weather conditions, clothing insulation, and activity levels. We found that Stringer's high-intensity training in relation to the oppressive environmental conditions was the most prominent factor in producing dangerous, uncompensable heat stress conditions and that the full football uniform played a smaller role in influencing Stringer's energy budget. The extreme energy budget levels that led to the fatal EHS would have been avoided according to our modeling through a combination of reduced intensity and lower clothing insulation. Finally, a long delay in providing medical treatment made the EHS fatal. These results highlight the importance of modern heat safety guidelines that provide controls on extrinsic factors, such as the adjustment of duration and intensity of training along with protective equipment modifications based on environmental conditions and the presence of an emergency action plan focused on rapid recognition and immediate on-site aggressive cooling of EHS cases.

American football and fatal exertional heat stroke: a case study of Korey Stringer

NASA Astrophysics Data System (ADS)

Grundstein, Andrew; Knox, John A.; Vanos, Jennifer; Cooper, Earl R.; Casa, Douglas J.

2017-08-01

On August 1, 2001, Korey Stringer, a Pro Bowl offensive tackle for the Minnesota Vikings, became the first and to date the only professional American football player to die from exertional heat stroke (EHS). The death helped raise awareness of the dangers of exertional heat illnesses in athletes and prompted the development of heat safety policies at the professional, collegiate, and interscholastic levels. Despite the public awareness of this death, no published study has examined in detail the circumstances surrounding Stringer's fatal EHS. Using the well-documented details of the case, our study shows that Stringer's fatal EHS was the result of a combination of physiological limitations, organizational and treatment failings, and extreme environmental conditions. The COMfort FormulA (COMFA) energy budget model was used to assess the relative importance of several extrinsic factors on Stringer's EHS, including weather conditions, clothing insulation, and activity levels. We found that Stringer's high-intensity training in relation to the oppressive environmental conditions was the most prominent factor in producing dangerous, uncompensable heat stress conditions and that the full football uniform played a smaller role in influencing Stringer's energy budget. The extreme energy budget levels that led to the fatal EHS would have been avoided according to our modeling through a combination of reduced intensity and lower clothing insulation. Finally, a long delay in providing medical treatment made the EHS fatal. These results highlight the importance of modern heat safety guidelines that provide controls on extrinsic factors, such as the adjustment of duration and intensity of training along with protective equipment modifications based on environmental conditions and the presence of an emergency action plan focused on rapid recognition and immediate on-site aggressive cooling of EHS cases.

Evolution and prognosis of long intensive care unit stay patients suffering a deterioration: A multicenter study.

PubMed

Hernández-Tejedor, Alberto; Cabré-Pericas, Lluís; Martín-Delgado, María Cruz; Leal-Micharet, Ana María; Algora-Weber, Alejandro

2015-06-01

The prognosis of a patient who deteriorates during a prolonged intensive care unit (ICU) stay is difficult to predict. We analyze the prognostic value of the serialized Sequential Organ Failure Assessment (SOFA) score and other variables in the early days after a complication and to build a new predictive score. EPIPUSE (Evolución y pronóstico de los pacientes con ingreso prolongado en UCI que sufren un empeoramiento, Evolution and prognosis of long intensive care unit stay patients suffering a deterioration) study is a prospective, observational study during a 3-month recruitment period in 75 Spanish ICUs. We focused on patients admitted in the ICU for 7 days or more with complications of adverse events that involve organ dysfunction impairment. Demographics, clinical variables, and serialized SOFA after a supervening clinical deterioration were recorded. Univariate and multivariate analyses were performed, and a predictive model was created with the most discriminating variables. We included 589 patients who experienced 777 cases of severe complication or adverse event. The entire sample was randomly divided into 2 subsamples, one for development purposes (528 cases) and the other for validation (249 cases). The predictive model maximizing specificity is calculated by minimum SOFA + 2 * cardiovascular risk factors + 2 * history of any oncologic disease or immunosuppressive treatment + 3 * dependence for basic activities of daily living. The area under the receiver operating characteristic curve is 0.82. A 14-point cutoff has a positive predictive value of 100% (92.7%-100%) and negative predictive value of 51% (46.4%-55.5%) for death. EPIPUSE model can predict mortality with a specificity and positive predictive value of 99% in some groups of patients. Copyright © 2015 Elsevier Inc. All rights reserved.

A case-control study to investigate the risk of leukaemia associated with exposure to benzene in petroleum marketing and distribution workers in the United Kingdom.

PubMed Central

Rushton, L; Romaniuk, H

1997-01-01

OBJECTIVES: To investigate the risk of leukaemia in workers in the petroleum distribution industry who were exposed to low levels of benzene. METHODS: From the cohort of distribution workers, 91 cases were identified as having leukaemia on either a death certificate or on cancer registration. These cases were compared with controls (four per case) randomly selected from the cohort, who were from the same company as the respective case, matched for age, and alive and under follow up at the time of case occurrence. Work histories were collected for the cases and controls, together with information about the terminals at which they had worked, fuel compositions, and occupational hygiene measurements of benzene. These data were used to derive quantitative estimates of personal exposure to benzene. Odds ratios (OR) were calculated conditional on the matching, to identify those variables in the study which were associated with risk of leukaemia. Examination of the potential effects of confounding and other variables was carried out with conditional logistic regression. Analyses were carried out for all leukaemia and separately for acute lymphoblastic, chronic lymphocytic, acute myeloid and monocytic, and chronic myeloid leukaemias. RESULTS: There was no significant increase in the overall risk of all leukaemias with higher cumulative exposure to benzene or with intensity of exposure, but risk was consistently doubled in subjects employed in the industry for > 10 years. Acute lymphoblastic leukaemia tended to occur in workers employed after 1950, who started work after the age of 30, worked for a short duration, and experienced low cumulative exposure with few peaks. The ORs did not increase with increasing cumulative exposure. The risk of chronic lymphocytic leukaemia seemed to be related most closely to duration of employment and the highest risk occurred in white collar workers with long service. These workers had only background levels of benzene exposure. There was no evidence of an association of risk with any exposure variables, and no evidence of an increasing risk with increasing cumulative exposure, mean intensity, or maximum intensity of exposure. The patterns of risk for acute myeloid and monocytic leukaemia were different from those of the lymphoid subgroups, in which duration of employment was the variable most closely related to risk. Risk was increased to an OR of 2.8 (95% confidence interval (95% CI) 0.8 to 9.4) for a cumulative exposure between 4.5 and 45 ppm-years compared with < 0.45 ppm-years. For mean intensity between 0.2 and 0.4 ppm an OR of 2.8 (95% CI 0.9 to 8.5) was found compared with < 0.02 ppm. Risk did not increase with cumulative exposure, maximum intensity, or mean intensity of exposure when treated as continuous variables. Cases of acute myeloid and monocytic leukaemia were more often classified as having peaked exposures than controls, and when variables characterising peaks, particularly daily and weekly peaks, were included in the analysis these tended to dominate the other exposure variables. However, because of the small numbers it is not possible to distinguish the relative influence of peaked and unpeaked exposures on risk of acute myeloid and monocytic leukaemia. There was no evidence of an increased risk of chronic myeloid leukaemia with increases in cumulative exposure, maximum intensity, mean intensity, and duration of employment, either as continuous or categorical variables. Analyses exploring the sensitivity of the results to the source and quality of the work histories showed similar patterns in general. However, no increases in ORs for categories of cumulative exposure were found for acute myeloid and monocytic leukaemia in the data set which included work histories obtained from personnel records still in existence, although numbers were reduced. Analyses excluding the last five and 10 years of exposure showed a tendency for ORs to reduce for chronic lymphocytic leukaemia and chronic myeloid leukaemia, and to increase for acute myeloid and monocytic leukaemia. Limitations of the study include uncertainties and gaps in the information collected, and small numbers in subcategories of exposure which can lead to wide CIs around the risk estimates and poor fit of the mathematical models. CONCLUSIONS: There is no evidence in this study of an association between exposure to benzene and lymphoid leukaemia, either acute or chronic. There is some suggestion of a relation between exposure to benzene and myeloid leukaemia, in particular for acute myeloid and monocytic leukaemia. Peaked exposures seemed to be experienced for this disease. However, in view of the limitations of the study, doubt remains as to whether the risk of acute myeloid and monocytic leukaemia is increased by cumulative exposures of < 45 ppm-years. Further work is recommended to review the work histories and redefine their quality, to explore the discrepancies between results for categorical and continuous variables, and to develop ranges around the expose estimates to enable further sensitivity analyses to be carried out. PMID:9155776

The Relationship Between Hospital Construction and High-Risk Infant Auditory Function at NICU Discharge: A Retrospective Descriptive Cohort Study.

PubMed

Willis, Valerie

2018-04-01

To describe the difference in auditory function at neonatal intensive care unit (NICU) discharge between high-risk infant cases exposed to hospital construction during NICU stay and those not exposed. Noise produced by routine NICU caregiving exceeds recommended intensity. As California hospitals undergo construction to meet seismic safety regulations, vulnerable neonates are potentially exposed to even higher levels of noise. Ramifications are unknown. Retrospective data-based descriptive cohort design was used to compare high-risk infant auditory function at NICU discharge between hospital construction exposed and unexposed groups. N = 540 infant cases (243 construction exposed and 297 unexposed controls). Infant cases born and discharged from the study site NICU in the year 2010 (unexposed) and year 2015 (exposed) and received a newborn hearing screening by automated auditory brainstem evoked response (ABER) prior to discharge with results reported. Infant cases excluded: hearing screen results by ABER unavailable, potentially confounding characteristics (congenital infection, major anomalies including cleft lip and/or palate), and transferred into or out of the study site. ABER. descriptive statistics (SPSS Version 24.0), hypothesis testing, correlation, and logistic regression. The difference in auditory function at NICU discharge between high-risk infant cases exposed to hospital construction noise and those unexposed was statistically insignificant, χ 2 = 1.666, df = 4, p = .1968, 95% confidence interval [-0.635, 2.570]. More research is needed to better understand whether hospital construction exposure during NICU admission negatively affects high-risk infant auditory function. Findings may catalyze theory development, future research, and child health policy.

Feasibility of Music and Hypnotic Suggestion to Manage Chronic Pain.

PubMed

Johnson, Alisa J; Kekecs, Zoltan; Roberts, R Lynae; Gavin, Russell; Brown, Kathleen; Elkins, Gary R

2017-01-01

The authors investigated the feasibility and possible effects of hypnotic suggestion and music for chronic pain. Ten people completed the 2-week intervention that consisted of daily listening to hypnotic suggestions combined with music. Averaged subjective pain intensity, pain bothersomeness, overall distress, anxiety, and depression decreased from baseline to endpoint. Participants rated pre- and postlistening pain intensity and pain bothersomeness decreased for each session. Information provided during end-of-study interviews indicated all participants were satisfied with treatment and felt they benefited from being in the study. Means and standard deviations are reported for outcome measures and a case study is provided. This preliminary study supports the use of a combined hypnotic suggestion and music intervention for chronic pain.

[Hematemesis in Togo: findings of a 12-month study in an intensive care unit].

PubMed

Djibril, A M; Tomta, K; Balaka, K; Bagny, A; M'ba, K B; Kaaga, L; Redah, D; Agbetra, A

2010-06-01

This prospective study was conducted over a 12-month period on patients who underwent upper digestive endoscopy for hematemesis in the medical intensive care unit (ICU) of the Tokoin University Hospital Center in Lomé, Togo. A total of 44 patients with a mean age of 44 years were included. The sex-ratio was 2.61. Risk factors included use of non-steroid anti-inflammatory (NSAI) in 16 patients (36.4%) and alcohol abuse in 13 (29.6%). At the time of admission to the ICU, 21 patients (47.7%) were in hemodynamic shock and 11 (25%) presented signs of portal hypertension. The underlying etiology was peptic ulcer in 18 cases (40.9%) including 13 cases of duodenal ulcer and 5 cases of stomach ulcer, rupture of esophageal varicosities in 8 (18.2%), gastric tumor in 6 (13.6%), Mallory Weiss syndrome in 5 (11.4%), gastritis in 4 (9,1%), and esophagitis in 3 (6.8%) due to peptic inflammation in 2 and mycotic infection in 1. The mortality rate was 45.5%. The main causes of hematemesis were peptic ulcer and rupture of esophageal varicosities. The death rate was high due to inadequate care facilities.

Optimal field-splitting algorithm in intensity-modulated radiotherapy: Evaluations using head-and-neck and female pelvic IMRT cases

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

Dou, Xin; Kim, Yusung, E-mail: yusung-kim@uiowa.edu; Bayouth, John E.

2013-04-01

To develop an optimal field-splitting algorithm of minimal complexity and verify the algorithm using head-and-neck (H and N) and female pelvic intensity-modulated radiotherapy (IMRT) cases. An optimal field-splitting algorithm was developed in which a large intensity map (IM) was split into multiple sub-IMs (≥2). The algorithm reduced the total complexity by minimizing the monitor units (MU) delivered and segment number of each sub-IM. The algorithm was verified through comparison studies with the algorithm as used in a commercial treatment planning system. Seven IMRT, H and N, and female pelvic cancer cases (54 IMs) were analyzed by MU, segment numbers, andmore » dose distributions. The optimal field-splitting algorithm was found to reduce both total MU and the total number of segments. We found on average a 7.9 ± 11.8% and 9.6 ± 18.2% reduction in MU and segment numbers for H and N IMRT cases with an 11.9 ± 17.4% and 11.1 ± 13.7% reduction for female pelvic cases. The overall percent (absolute) reduction in the numbers of MU and segments were found to be on average −9.7 ± 14.6% (−15 ± 25 MU) and −10.3 ± 16.3% (−3 ± 5), respectively. In addition, all dose distributions from the optimal field-splitting method showed improved dose distributions. The optimal field-splitting algorithm shows considerable improvements in both total MU and total segment number. The algorithm is expected to be beneficial for the radiotherapy treatment of large-field IMRT.« less

Dosimetric effect of beam arrangement for intensity-modulated radiation therapy in the treatment of upper thoracic esophageal carcinoma

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

Fu, Yuchuan; Deng, Min; Zhou, Xiaojuan

To evaluate the lung sparing in intensity-modulated radiation therapy (IMRT) for patients with upper thoracic esophageal tumors extending inferiorly to the thorax by different beam arrangement. Overall, 15 patient cases with cancer of upper thoracic esophagus were selected for a retrospective treatment-planning study. Intensity-modulated radiation therapy plans using 4, 5, and 7 beams (4B, 5B, and 7B) were developed for each patient by direct machine parameter optimization (DMPO). All plans were evaluated with respect to dose volumes to irradiated targets and normal structures, with statistical comparisons made between 4B with 5B and 7B intensity-modulated radiation therapy plans. Differences among plansmore » were evaluated using a two-tailed Friedman test at a statistical significance of p < 0.05. The maximum dose, average dose, and the conformity index (CI) of planning target volume 1 (PTV1) were similar for 3 plans for each case. No significant difference of coverage for planning target volume 1 and maximum dose for spinal cords were observed among 3 plans in present study (p > 0.05). The average V{sub 5}, V{sub 13}, V{sub 20}, mean lung dose, and generalized equivalent uniform dose (gEUD) for the total lung were significantly lower in 4B-plans than those data in 5B-plans and 7B-plans (p < 0.01). Although the average V{sub 30} for the total lung were significantly higher in 4B-plans than those in 5B-plans and 7B-plans (p < 0.05). In addition, when comparing with the 4B-plans, the conformity/heterogeneity index of the 5B- and 7B-plans were significantly superior (p < 0.05). The 4B-intensity-modulated radiation therapy plan has advantage to address the specialized problem of lung sparing to low- and intermediate-dose exposure in the thorax when dealing with relative long tumors extended inferiorly to the thoracic esophagus for upper esophageal carcinoma with the cost for less conformity. Studies are needed to compare the superiority of volumetric modulated arc therapy with intensity-modulated radiation therapy technique.« less

Economic evaluation of type 2 diabetes prevention programmes: Markov model of low- and high-intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia.

PubMed

Roberts, Samantha; Craig, Dawn; Adler, Amanda; McPherson, Klim; Greenhalgh, Trisha

2018-01-30

National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study. Low-intensity lifestyle programmes were the most cost-effective (£44/QALY, £195/QALY and £186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention (£2775/QALY, £6820/QALY and £7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention (£5224/QALY, £6842/QALY and £372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of £20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50-59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2-5.2% of the current diabetes budget for 2-9 years. This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently.

Motor Training in Degenerative Spinocerebellar Disease: Ataxia-Specific Improvements by Intensive Physiotherapy and Exergames

PubMed Central

2014-01-01

The cerebellum is essentially involved in movement control and plays a critical role in motor learning. It has remained controversial whether patients with degenerative cerebellar disease benefit from high-intensity coordinative training. Moreover, it remains unclear by which training methods and mechanisms these patients might improve their motor performance. Here, we review evidence from different high-intensity training studies in patients with degenerative spinocerebellar disease. These studies demonstrate that high-intensity coordinative training might lead to a significant benefit in patients with degenerative ataxia. This training might be based either on physiotherapy or on whole-body controlled videogames (“exergames”). The benefit shown in these studies is equal to regaining one or more years of natural disease progression. In addition, first case studies indicate that even subjects with advanced neurodegeneration might benefit from such training programs. For both types of training, the observed clinical improvements are paralleled by recoveries in ataxia-specific dysfunctions (e.g., multijoint coordination and dynamic stability). Importantly, for both types of training, the retention of the effects seems to depend on the frequency and continuity of training. Based on these studies, we here present preliminary recommendations for clinical practice, and articulate open questions that might guide future studies on neurorehabilitation in degenerative spinocerebellar disease. PMID:24877117

Very exceptional cases of VLF/LF ionospheric perturbations for deep oceanic earthquakes offshore the Japan island

NASA Astrophysics Data System (ADS)

Yamaguchi, Hiroki; Hayakawa, Masashi

2015-12-01

It is so far believed that ionospheric perturbations as detected by subionospheric VLF/LF (very low frequency/low frequency) propagation, are generated above and around the earthquake (EQ) epicenter. This paper presents very rare cases, which are in complete contrast to the above fact. We have found that in extremely rare cases when EQs happened (i) in the Pacific Ocean or (ii) offshore the Soya cape (Hokkaido) both with very large depths (300-400 km), corresponding ionospheric perturbations take place far away from the EQ epicenter and above the regions with considerable seismic intensity at the time of each EQ. Two EQs happened in the Torishima area of Izu islands (magnitude ∼7 and depth ∼400 km), and corresponding seismic intensity was observed in the Tokyo and Ibaraki districts. Our VLF data have indicated that the ionospheric perturbation takes place over such regions with high seismic intensity. Another group is two EQs (magnitude ∼5) offshore the Soya cape of Hokkaido, and the spatial distribution of seismic intensity at the time of each EQ is just around Aomori prefecture. VLF data have indicated the ionospheric perturbations taken place over the same Aomori area, which is in complete coincidence with the spatial distribution of seismic intensity. As a conclusion, these exceptional examples are, in principle, very similar to the concept of 'selectivity' (or sensitive zone) of geoelectric measurement by the Greek group, and we try to interpret these cases in the context of lithosphere-atmosphere-ionosphere coupling.

Construction and temporal behaviour study of multi RLC intense light pulses for dermatological applications.

PubMed

Hamoudi, Walid K; Ismail, Raid A; Shakir, Hussein A

2017-10-01

Driving a flash lamp in an intense pulsed light system requires a high-voltage DC power supply, capacitive energy storage and a flash lamp triggering unit. Single, double, triple and quadruple-mesh discharge and triggering circuits were constructed to provide intense light pulses of variable energy and time durations. The system was treated as [Formula: see text] circuit in some cases and [Formula: see text] circuit in others with a light pulse profile following the temporal behaviour of the exciting current pulse. Distributing the energy delivered to one lamp onto a number of LC meshes permitted longer current pulses, and consequently increased the light pulse length. Positive results were obtained when using the system to treat skin wrinkles.

De novo malignancy after pancreas transplantation in Japan.

PubMed

Tomimaru, Y; Ito, T; Marubashi, S; Kawamoto, K; Tomokuni, A; Asaoka, T; Wada, H; Eguchi, H; Mori, M; Doki, Y; Nagano, H

2015-04-01

Long-term immunosuppression is associated with an increased risk of cancer. Especially, the immunosuppression in pancreas transplantation is more intensive than that in other organ transplantation because of its strong immunogenicity. Therefore, it suggests that the risk of post-transplant de novo malignancy might increase in pancreas transplantation. However, there have been few studies of de novo malignancy after pancreas transplantation. The aim of this study was to analyze the incidence of de novo malignancy after pancreas transplantation in Japan. Post-transplant patients with de novo malignancy were surveyed and characterized in Japan. Among 107 cases receiving pancreas transplantation in Japan between 2001 and 2010, de novo malignancy developed in 9 cases (8.4%): post-transplant lymphoproliferative disorders in 6 cases, colon cancer in 1 case, renal cancer in 1 case, and brain tumor in 1 case. We clarified the incidence of de novo malignancy after pancreas transplantation in Japan. Copyright © 2015 Elsevier Inc. All rights reserved.

[Extra skeletal Ewing's sarcoma. Report of two cases. Ultrastructural study of one case (author's transl)].

PubMed

Krulik, M; Brechot, J M; de Saint-Maur, P; Lecomte, D; Mougeot-Martin, M; Audebert, A A; Zylberait, D; Debray, J

The authors report two cases of extra skeletal Ewing's sarcoma. The first case concerns a 26 years old woman presenting a tumor at the level of the sacrum area, locally recurrent, metastazing to the lungs and the lumbar column, despite of radiotherapy and chemotherapy and leading to death after a course of 18 months. The second one is that of a 30 years old man bearing a tumor of the shoulder area probably already metastazed to bones, rapidly recurrent and metastazing to the lungs and cause of death after 9 months in spite of intensive therapy. About these 2 observations a review of the literature of the cases of extra skeletal Ewing's sarcoma is done. Whatever nosologic discussion it seems that Ewing's sarcoma may present essentially as a tumor of soft tissues. An ultrastructural study has been performed in the second case. The findings are similar to those reported in Ewing's sarcoma.

Management Perception of Introducing Social Networking Sites as a Knowledge Management Tool in Higher Education: A Case Study

ERIC Educational Resources Information Center

Garcia, Elaine; Annansingh, Fenio; Elbeltagi, Ibrahim

2011-01-01

Purpose: The purpose of this paper is to present a study of the understanding and usage of social networking sites (SNS) as a knowledge management (KM) tool in knowledge-intensive enterprises. Design/methodology/approach: In terms of research approach, the study has taken an interpretitivist framework, using a higher education (HE) institution as…

Exertional sickling deaths in Army recruits with sickle cell trait.

PubMed

Ferster, Kenneth; Eichner, E Randy

2012-01-01

Exertional sickling from sickle cell trait (SCT) can pose a grave risk for some military recruits and is a troubling cause of death in college athletes. We report the cases of two U.S. Army recruits with undetected SCT who collapsed and soon died from metabolic complications of exertional sickling as they struggled to finish in time the 2-mile run of the Army Physical Fitness Test, having failed this test on prior attempts. These cases are similar to other military cases and to recent sickling deaths in college track and football. Research shows how and why, in the face of SCT, during intense exercise bouts, sickle cells can quickly form and lead to fulminant rhabdomyolysis that can be fatal. Increasing evidence suggests that, in the military and in sports, the proximate trigger for most cases of fatal sickling collapse is intensity. If this hypothesis is correct, that sickling collapse is an intensity syndrome, it raises vital questions about how best to train military recruits with SCT.

Psychosocial factors and prevalence of burnout syndrome among nursing workers in intensive care units.

PubMed

da Silva, Jorge Luiz Lima; Soares, Rafael da Silva; Costa, Felipe dos Santos; Ramos, Danusa de Souza; Lima, Fabiano Bittencourt; Teixeira, Liliane Reis

2015-01-01

To evaluate the prevalence of burnout syndrome among nursing workers in intensive care units and establish associations with psychosocial factors. This descriptive study evaluated 130 professionals, including nurses, nursing technicians, and nursing assistants, who performed their activities in intensive care and coronary care units in 2 large hospitals in the city of Rio de Janeiro, Brazil. Data were collected in 2011 using a self-reported questionnaire. The Maslach Burnout Inventory was used to evaluate the burnout syndrome dimensions, and the Self Reporting Questionnaire was used to evaluate common mental disorders. The prevalence of burnout syndrome was 55.3% (n = 72). In the quadrants of the demand-control model, low-strain workers exhibited a prevalence of 64.5% of suspected cases of burnout, whereas high-strain workers exhibited a prevalence of 72.5% of suspected cases (p = 0.006). The prevalence of suspected cases of common mental disorders was 27.7%; of these, 80.6% were associated with burnout syndrome (< 0.0001). The multivariate analysis adjusted for gender, age, educational level, weekly work duration, income, and thoughts about work during free time indicated that the categories associated with intermediate stress levels - active work (OR = 0.26; 95%CI = 0.09 - 0.69) and passive work (OR = 0.22; 95%CI = 0.07 - 0.63) - were protective factors for burnout syndrome. Psychosocial factors were associated with the development of burnout syndrome in this group. These results underscore the need for the development of further studies aimed at intervention and the prevention of the syndrome.

Psychosocial factors and prevalence of burnout syndrome among nursing workers in intensive care units

PubMed Central

da Silva, Jorge Luiz Lima; Soares, Rafael da Silva; Costa, Felipe dos Santos; Ramos, Danusa de Souza; Lima, Fabiano Bittencourt; Teixeira, Liliane Reis

2015-01-01

Objective To evaluate the prevalence of burnout syndrome among nursing workers in intensive care units and establish associations with psychosocial factors. Methods This descriptive study evaluated 130 professionals, including nurses, nursing technicians, and nursing assistants, who performed their activities in intensive care and coronary care units in 2 large hospitals in the city of Rio de Janeiro, Brazil. Data were collected in 2011 using a self-reported questionnaire. The Maslach Burnout Inventory was used to evaluate the burnout syndrome dimensions, and the Self Reporting Questionnaire was used to evaluate common mental disorders. Results The prevalence of burnout syndrome was 55.3% (n = 72). In the quadrants of the demand-control model, low-strain workers exhibited a prevalence of 64.5% of suspected cases of burnout, whereas high-strain workers exhibited a prevalence of 72.5% of suspected cases (p = 0.006). The prevalence of suspected cases of common mental disorders was 27.7%; of these, 80.6% were associated with burnout syndrome (< 0.0001). The multivariate analysis adjusted for gender, age, educational level, weekly work duration, income, and thoughts about work during free time indicated that the categories associated with intermediate stress levels - active work (OR = 0.26; 95%CI = 0.09 - 0.69) and passive work (OR = 0.22; 95%CI = 0.07 - 0.63) - were protective factors for burnout syndrome. Conclusion Psychosocial factors were associated with the development of burnout syndrome in this group. These results underscore the need for the development of further studies aimed at intervention and the prevention of the syndrome. PMID:26340152

Improvement of antibiotic therapy and ICU survival in severe non-pneumococcal community-acquired pneumonia: a matched case-control study.

PubMed

Gattarello, Simone; Lagunes, Leonel; Vidaur, Loreto; Solé-Violán, Jordi; Zaragoza, Rafael; Vallés, Jordi; Torres, Antoni; Sierra, Rafael; Sebastian, Rosa; Rello, Jordi

2015-09-10

We aimed to compare intensive care unit mortality due to non-pneumococcal severe community-acquired pneumonia between the periods 2000-2002 and 2008-2014, and the impact of the improvement in antibiotic strategies on outcomes. This was a matched case-control study enrolling 144 patients with non-pneumococcal severe pneumonia: 72 patients from the 2000-2002 database (CAPUCI I group) were paired with 72 from the 2008-2014 period (CAPUCI II group), matched by the following variables: microorganism, shock at admission, invasive mechanical ventilation, immunocompromise, chronic obstructive pulmonary disease, and age over 65 years. The most frequent microorganism was methicillin-susceptible Staphylococcus aureus (22.1%) followed by Legionella pneumophila and Haemophilus influenzae (each 20.7%); prevalence of shock was 59.7%, while 73.6% of patients needed invasive mechanical ventilation. Intensive care unit mortality was significantly lower in the CAPUCI II group (34.7% versus 16.7%; odds ratio (OR) 0.78, 95% confidence interval (CI) 0.64-0.95; p = 0.02). Appropriate therapy according to microorganism was 91.5% in CAPUCI I and 92.7% in CAPUCI II, while combined therapy and early antibiotic treatment were significantly higher in CAPUCI II (76.4 versus 90.3% and 37.5 versus 63.9%; p < 0.05). In the multivariate analysis, combined antibiotic therapy (OR 0.23, 95% CI 0.07-0.74) and early antibiotic treatment (OR 0.07, 95% CI 0.02-0.22) were independently associated with decreased intensive care unit mortality. In non-pneumococcal severe community-acquired pneumonia , early antibiotic administration and use of combined antibiotic therapy were both associated with increased intensive care unit survival during the study period.

SU-E-I-44: Some Preliminary Analysis of Angular Distribution of X-Ray Scattered On Soft Tissues

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

Ganezer, K; Krmar, M; Cvejic, Z

2015-06-15

Purpose: The angular distribution of x-radiation scattered at small angles (up to 16 degrees) from several different animal soft tissue (skin, fat, muscle, retina, etc) were measured using standard equipment devoted to study of crystal structure which provides excellent geometry conditions of measurements. showed measurable differences for different tissues. In the simplest possible case when measured samples do not differ in structure (different concentration solutions) it can be seen that intensity of scattered radiation is decreasing function of the concentration and the peak of the maximum of scattering distribution depends on the concentration as well. Methods: An x-ray scattering profilemore » usually consists of sharp diffraction peak; however some properties of the spatial profiles of scattered radiation as intensity, the peak position, height, area, FWHM, the ratio of peak heights, etc. Results: The data contained measurable differences for different tissues. In the simplest possible case when measured samples do not differ in structure (different concentration solutions) it can be seen that intensity of scattered radiation is decreasing function of the concentration and the peak of the maximum of scattering distribution depends on the concentration as well. Measurements of different samples in the very preliminary phase showed that simple biological material used in study showed slightly different scattering pattern, especially at higher angles (around 10degrees). Intensity of radiation scattered from same tissue type is very dependent on water content and several more parameters. Conclusion: This preliminary study using animal soft tissues on the angular distributions of scattered x-rays suggests that angular distributions of X-rays scattered off of soft tissues might be useful in distinguishing healthy tissue from malignant soft tissue.« less

Clinicopathological study of 81 cases of localized and systemic scleroderma.

PubMed

Succaria, F; Kurban, M; Kibbi, A-G; Abbas, O

2013-02-01

Scleroderma is a connective tissue disease that includes localized and systemic forms. Our recent encounter with a morphea case exhibiting prominent perineural inflammation microscopically prompted us to assess the features of all patients diagnosed with morphea/scleroderma at our institution. To describe the clinicopathological features of all patients diagnosed with morphea/scleroderma at American University of Beirut Medical Center (AUB-MC) between 1999 and 2010, and compare our findings with those published in the literature. A total of 81 cases (63 women and 18 men) were identified, of which 73 were localized (morphea) and eight were systemic scleroderma. Clinically, plaque type morphea was the most common variant both in adults and children, and seven (9%) cases of morphea were associated with lichen sclerosis et atrophicus (LSA). Histopathologically, perineural inflammation was observed in 49% of cases, and may serve, in addition to other features including lichen sclerosis-like changes (observed in exclusively nine cases of morphea), more diffuse dermal and less subcutaneous sclerosis, and intense inflammation, as clues favouring diagnosis of morphea over systemic sclerosis. The features of morphea/scleroderma patients in this study are generally comparable to those published in the literature, with few differences. Clinically, plaque type morphea was the most common variant both in adults and children and LSA was a frequent association. Histopathologically, perineural inflammation was commonly observed and may serve in addition to lichen sclerosis-like changes and intense inflammation as clues favouring diagnosis of morphea over systemic sclerosis. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

[Health-related quality of life in cases of attention deficit hyperactivity disorder with and without pharmacological treatment].

PubMed

López-Villalobos, José Antonio; Sacristán-Martín, Ana María; Garrido-Redondo, Mercedes; Martínez-Rivera, María Teresa; López-Sánchez, María Victoria; Rodríguez-Molinero, Luis; Camina-Gutiérrez, Ana Belén; Andrés-de Llano, Jesús

2018-06-02

The health-related quality of life (HRQoL) questionnaire is important in order to assess the effects of therapeutic intervention. The aim of this study is to analyse HRQoL, comparing cases of attention deficit hyperactivity disorder (ADHD) treated with methylphenidate (ADHD-T), untreated cases (ADHD-N), and controls. The study included a sample of 228 participants between 8 and 14 years old (114 controls, 57 ADHD-T, and 57 ADHD-N). Consecutive sampling was used in ADHD according to DSM-IV criteria (ADHD Rating Scales IV), and random sampling of controls matched by gender and age. The evaluation of HRQoL was made by using KIDSCREEN-52 parent version. The intensity of ADHD symptoms is significantly lower in ADHD-T than in ADHD-N. There is a moderate significant correlation between greater intensity of ADHD symptoms and worse HRQoL. ADHD cases have significantly worse HRQoL than controls on psychic well-being, mood, relationship with parents and friends, school environment, and social acceptance. The cases of ADHD-T have significantly better HRQoL than ADHD-N in the school dimension, but do not differ significantly in other dimensions of KIDSCREEN-52. It would be advisable that the treatment of ADHD integrates multi-dimensional therapeutic models that improve the basic symptoms of the disorder, as well as the HRQoL. Copyright © 2018. Publicado por Elsevier España, S.L.U.

A two-year follow-up study of temporomandibular disorders in a female Sami population: validation of cases and controls as predicted by questionnaire.

PubMed

Storm, Christina; Wänman, Anders

2007-11-01

The first aim of this study was to validate persistent, severe symptoms of temporomandibular disorders (TMD) among Sami females, as predicted by questionnaire. The second aim was to establish diagnoses according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis 1 among predicted cases and controls. The third aim was to compare subjects with severe TMD to controls in regard to dental occlusion, general health, and parafunctions. The subjects, Sami females living in the Arctic region of northern Sweden, all with long-standing (>or=1 year), intense (>or=5 on NS), and frequent (>or=once a week) symptoms of pain and dysfunction in the jaw-face region, were invited for clinical examination; 22 (63%) agreed to participate. Forty-six subjects with no symptoms in the jaw-face region were matched to these cases in accordance with five age groups. The examiner was blind to subject affiliation. The positive predictive value of presenting with signs and symptoms of TMD at follow-up was 0.82; the negative value was 0.87. Cases reported impaired general health and awareness of parafunctions significantly more frequently than did controls. Registered dental occlusion factors did not distinguish cases from controls. Long-standing, intense, and frequent TMD symptoms remained essentially unchanged over the 2-year follow-up of females in a Sami population. Presence of severe TMD was related to impaired general health and awareness of oral parafunctions.

Determining the anaerobic threshold in postpolio syndrome: comparison with current guidelines for training intensity prescription.

PubMed

Voorn, Eric L; Gerrits, Karin H; Koopman, Fieke S; Nollet, Frans; Beelen, Anita

2014-05-01

To determine whether the anaerobic threshold (AT) can be identified in individuals with postpolio syndrome (PPS) using submaximal incremental exercise testing, and to compare current guidelines for intensity prescription in PPS with the AT. Cohort study. Research laboratory. Individuals with PPS (N=82). Not applicable. Power output, gas exchange variables, heart rate, and rating of perceived exertion (RPE) were measured in an incremental submaximal cycle ergometry test. Two independent observers identified the AT. Comparison of current guidelines for training intensity prescription in PPS (40%-60% heart rate reserve [HRR] or RPE of 12) with the AT was based on correlations between recommended heart rate and the heart rate at the AT. In addition, we determined the proportion of individuals that would have been recommended to train at an intensity corresponding to their AT. The AT was identified in 63 (77%) of the participants. Pearson correlation coefficients between the recommended heart rate and the heart rate at the AT were lower in cases of 40% HRR (r=.56) and 60% HRR (r=.50) than in cases of prescription based on the RPE (r=.86). Based on the RPE, 55% of the individuals would have been recommended to train at an intensity corresponding to their AT. This proportion was higher compared with 40% HRR (41%) or 60% HRR (18%) as criterion. The AT can be identified in most individuals with PPS offering an individualized target for aerobic training. If the AT cannot be identified (eg, because gas analysis equipment is not available), intensity prescription can best be based on the RPE. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effects of exercise at individual anaerobic threshold and maximal fat oxidation intensities on plasma levels of nesfatin-1 and metabolic health biomarkers.

PubMed

Mohebbi, Hamid; Nourshahi, Maryam; Ghasemikaram, Mansour; Safarimosavi, Saleh

2015-03-01

Exercise is recognized as an effective method of weight management and short-term appetite regulation tool. The effect of different exercise intensities on appetite regulation hormones in healthy overweight participants has not been intensively studied. The aim of this study was to examine the influence of exercise at individual anaerobic threshold (IAT) and maximal fat oxidation (Fatmax) intensities on the nesfatin-1 response and metabolic health biomarkers in overweight men. Nine healthy overweight males (age, 23.1 ± 1.1 years) volunteered in this study in a counterbalanced order. Blood samples were obtained before, immediately after, and following the first 45 min of recovery for measuring plasma variables. There was significant decrease in plasma levels of nesfatin-1 and leptin after exercise at the IAT intensity which remained lower than baseline following 45 min of recovery. However, nesfatin-1 and leptin levels did not change significantly in any time courses of Fatmax intensity (P > 0.09). Plasma interleukin-6 (IL-6) concentration increased during exercise in both intensities (P < 0.05), whereas changes in free fatty acids (FFAs) and epinephrine concentrations were significant only at the IAT. In addition, a significant correlation was found among nesfatin-1 levels with insulin (r = 0.39, P < 0.05) and glucose (r = 0.41, P < 0.05) at basal and in response to exercise. These results indicate that IAT has a greater exercise-induced appetite regulation effect compared with Fat(max). Based on these data, the intensity of exercise may have an important role in changes of nesfatin-1, leptin, FFA, and epinephrine concentrations even though this was not the case for IL-6 and insulin resistance.

Relationships between Rainy Days, Mean Daily Intensity, and Seasonal Rainfall over the Koyna Catchment during 1961–2005

PubMed Central

Nandargi, S.; Mulye, S. S.

2012-01-01

There are limitations in using monthly rainfall totals in studies of rainfall climatology as well as in hydrological and agricultural investigations. Variations in rainfall may be considered to result from frequency changes in the daily rainfall of the respective regime. In the present study, daily rainfall data of the stations inside the Koyna catchment has been analysed for the period of 1961–2005 to understand the relationship between the rain and rainy days, mean daily intensity (MDI) and seasonal rainfall over the catchment on monthly as well as seasonal scale. Considering the topographical location of the catchment, analysis of seasonal rainfall data of 8 stations suggests that a linear relationship fits better than the logarithmic relationship in the case of seasonal rainfall versus mean daily intensity. So far as seasonal rainfall versus number of rainy days is considered, the logarithmic relationship is found to be better. PMID:22654646

Semi-occupational exposure to lead: a case study of child and adolescent street vendors in Istanbul.

PubMed

Furman, A; Laleli, M

2000-05-01

This study analyzed lead levels in scalp hair of child and adolescent street vendors in Istanbul. The mean lead in hair concentration found among children exposed to intensive motor traffic, 11.82 +/- 6.89 microg/g, was over five times higher than that in the control group, 2.70 +/- 2.30 microg/g. Vendors from a location with higher traffic density had significantly higher lead in hair levels, than vendors from a location with lower traffic density (14.18+/- 5.33 and 9.86 +/- 7.54 microg/g, respectively). The results pointed to the dose-response effect between traffic intensity and lead in hair concentration. Despite low lead content in gasoline, an intensive exposure to motor traffic may be a nonnegligible source of lead and poses a considerable health risk for individuals who work in particularly busy locations.

CFD Simulations for the Effect of Unsteady Wakes on the Boundary Layer of a Highly Loaded Low-Pressure Turbine Airfoil (L1A)

NASA Technical Reports Server (NTRS)

Vinci, Samuel, J.

2012-01-01

This report is the third part of a three-part final report of research performed under an NRA cooperative Agreement contract. The first part was published as NASA/CR-2012-217415. The second part was published as NASA/CR-2012-217416. The study of the very high lift low-pressure turbine airfoil L1A in the presence of unsteady wakes was performed computationally and compared against experimental results. The experiments were conducted in a low speed wind tunnel under high (4.9%) and then low (0.6%) freestream turbulence intensity for Reynolds number equal to 25,000 and 50,000. The experimental and computational data have shown that in cases without wakes, the boundary layer separated without reattachment. The CFD was done with LES and URANS utilizing the finite-volume code ANSYS Fluent (ANSYS, Inc.) under the same freestream turbulence and Reynolds number conditions as the experiment but only at a rod to blade spacing of 1. With wakes, separation was largely suppressed, particularly if the wake passing frequency was sufficiently high. This was validated in the 3D CFD efforts by comparing the experimental results for the pressure coefficients and velocity profiles, which were reasonable for all cases examined. The 2D CFD efforts failed to capture the three dimensionality effects of the wake and thus were less consistent with the experimental data. The effect of the freestream turbulence intensity levels also showed a little more consistency with the experimental data at higher intensities when compared with the low intensity cases. Additional cases with higher wake passing frequencies which were not run experimentally were simulated. The results showed that an initial 25% increase from the experimental wake passing greatly reduced the size of the separation bubble, nearly completely suppressing it.

Classification of Earthquake-triggered Landslide Events - Review of Classical and Particular Cases

NASA Astrophysics Data System (ADS)

Braun, A.; Havenith, H. B.; Schlögel, R.

2016-12-01

Seismically induced landslides often contribute to a significant degree to the losses related to earthquakes. The identification of possible extends of landslide affected areas can help to target emergency measures when an earthquake occurs or improve the resilience of inhabited areas and critical infrastructure in zones of high seismic hazard. Moreover, landslide event sizes are an important proxy for the estimation of the intensity and magnitude of past earthquakes in paleoseismic studies, allowing us to improve seismic hazard assessment over longer terms. Not only earthquake intensity, but also factors such as the fault characteristics, topography, climatic conditions and the geological environment have a major impact on the intensity and spatial distribution of earthquake induced landslides. Inspired by classical reviews of earthquake induced landslides, e.g. by Keefer or Jibson, we present here a review of factors contributing to earthquake triggered slope failures based on an `event-by-event' classification approach. The objective of this analysis is to enable the short-term prediction of earthquake triggered landslide event sizes in terms of numbers and size of the affected area right after an earthquake event occurred. Five main factors, `Intensity', `Fault', `Topographic energy', `Climatic conditions' and `Surface geology' were used to establish a relationship to the number and spatial extend of landslides triggered by an earthquake. Based on well-documented recent earthquakes (e.g. Haiti 2010, Wenchuan 2008) and on older events for which reliable extensive information was available (e.g. Northridge 1994, Loma Prieta 1989, Guatemala 1976, Peru 1970) the combination and relative weight of the factors was calibrated. The calibrated factor combination was then applied to more than 20 earthquake events for which landslide distribution characteristics could be crosschecked. We present cases where our prediction model performs well and discuss particular cases where it does not. These are e.g. cases of far distant, delayed or ancient earthquake induced landslides.

[Histopathological and immunohistochemical studies on mucous cysts].

PubMed

Kuroda, N

1989-01-01

The present study investigated the histopathology, histochemistry of mucopolysaccharides, and immunohistochemistry of oral mucous cysts. The materials were obtained from ninety cases that were histopathologically diagnosed as oral mucous cysts at the Department of Oral Pathology, Meikai University School of Dentistry. Mucopolysaccharide staining was done with PAS, alcian blue (AB, pH 2.5) and high iron diamine (HID). Immunohistochemical studies were focused on secretory component (SC), lactoferrin (Lf), alpha-amylase (Am), IgA, lysozyme (Ly), and keratin (Kr). The following results were obtained: 1. Histopathological findings. (1) Retention and/or retention-like type cysts occurred in was twenty-six cases and the extravasation type in sixty-four cases. (2) Cases showing epithelial lining of the cystic wall were only eight in number, and many cystic walls were contained granulation tissue (fifty cases). (3) As for inflammation of the cystic wall, the degree was slight, and infiltrated cells were mainly macrophages (so-called mucinophages) and lymphocytes. (4) Regarding adjoining salivary glands, acinar cells showed atrophic changes, and hypertrophy of mucous acinar cells was evident. Many ducts showed dilatation, and stromal connective tissue showed fibrosis and hyalinization. 2. Histochemical findings on mucopolysaccharides. (1) Mucous materials in cystic cavity, mucous acinar cells, and secretory materials in ductal lumens were intensely stained by PAS and AB. But stainability with AB was less than that with PAS staining. Serous acinar cells and ductal epithelium were negative to PAS and AB staining. (2) Stainability of the above with HID was less than at with PAS or AB. Cystic walls were not stained by HID. Mucous acinar cells reactive with HID were intensely stained, but the number of the positive cells was limited when compared with the numbers of PAS-and AB-positive cells. 3. Immunohistochemical findings. (1) As for mucous materials in the cystic cavity, reactions for Sc, Am, IgA, and Ly were all positive, whereas those for Lf and Kr were negative. (2) Staining of cystic walls was generally weak: the walls were negative for IgA, Ly and Kr showed and borderline or slightly positive for Sc, Lf, and Am. (3) Mucous acinar cells were negative for all markers examined in this study, but serous acinar cells and/or demilunes were markedly positive for Sc, Ly, and Am. (4) In ductal epithelial cells, Ly and Kr were negative, but IgA was borderline or slightly positive. Sc and Am gave intensely positive staining. (5) Secretory materials in ductal lumens, Sc were intensely positive for Lf, and Ly; slightly or moderately positive for IgA; and slightly positive or negative for Am.(ABSTRACT TRUNCATED AT 400 WORDS)

Effectiveness of sports massage for recovery of skeletal muscle from strenuous exercise.

PubMed

Best, Thomas M; Hunter, Robin; Wilcox, Aaron; Haq, Furqan

2008-09-01

Sport massage, a manual therapy for muscle and soft tissue pain and weakness, is a popular and widely used modality for recovery after intense exercise. Our objective is to determine the effectiveness of sport massage for improving recovery after strenuous exercise. We searched MEDLINE, EMBASE, and CINAHL using all current and historical names for sport massage. Reference sections of included articles were scanned to identify additional relevant articles. Study inclusion criteria required that subjects (1) were humans, (2) performed strenuous exercise, (3) received massage, and (4) were assessed for muscle recovery and performance. Ultimately, 27 studies met inclusion criteria. Eligible studies were reviewed, and data were extracted by the senior author (TMB). The main outcomes extracted were type and timing of massage and outcome measures studied. Data from 17 case series revealed inconsistent results. Most studies evaluating post-exercise function suggest that massage is not effective, whereas studies that also evaluated the symptoms of DOMS did show some benefit. Data from 10 randomized controlled trials (RCTs) do, however, provide moderate evidence for the efficacy of massage therapy. The search identified no trend between type and timing of massage and any specific outcome measures investigated. Case series provide little support for the use of massage to aid muscle recovery or performance after intense exercise. In contrast, RCTs provide moderate data supporting its use to facilitate recovery from repetitive muscular contractions. Further investigation using standardized protocols measuring similar outcome variables is necessary to more conclusively determine the efficacy of sport massage and the optimal strategy for its implementation to enhance recovery following intense exercise.

Intensive mode delivery of a neuroanatomy unit: lower final grades but higher student satisfaction.

PubMed

Whillier, Stephney; Lystad, Reidar P

2013-01-01

In 2011, Macquarie University moved to a three-session academic year which included two 13-week sessions (traditional mode) and one seven-week session (intensive mode). This study was designed to compare the intensive and traditional modes of delivery in a unit of undergraduate neuroanatomy. The new intensive mode neuroanatomy unit provided the same quantity and quality of material to the same standard, delivered by the same teachers and over the same total hours, but in a shorter timeframe. All students enrolled in session 2 (traditional mode) and session 3 (intensive mode) were invited to participate in this study. The main outcome measures were the final course grades and level of satisfaction with the course. Although there was no significant difference between the two cohorts in self-rated level of knowledge (P = 0.148), the traditional mode cohort achieved significantly higher final grades compared to the intensive mode cohort (P = 0.001). Similarly, the distribution of final grades was also different between the two cohorts. The two cohorts were equally satisfied with the unit overall, and with the lectures and tutorials. However, the intensive mode cohort was more satisfied with the laboratory practical classes compared to the traditional mode cohort (P < 0.001). Thus this study demonstrates that in the case of neuroanatomy, which is high in content, when the course is taught to the same standards as exist in the traditional mode of delivery, the students do not do as well even though they enjoy the course equally. Copyright © 2013 American Association of Anatomists.

Women, Choice and Promotion or Why Women Are Still a Minority in the Professoriate

ERIC Educational Resources Information Center

Pyke, Joanne

2013-01-01

Women remain a minority in the Australian professoriate despite decades of equal opportunity policy. This article discusses the findings of an intensive case study that investigates why women's representation declines at the most senior academic levels. Through in-depth interviews with 24 women, the study explores the extent to which women's…

Building Human Resources Management Capacity for University Research: The Case at Four Leading Vietnamese Universities

ERIC Educational Resources Information Center

Nguyen, T. L.

2016-01-01

At research-intensive universities, building human resources management (HRM) capacity has become a key approach to enhancing a university's research performance. However, despite aspiring to become a research-intensive university, many teaching-intensive universities in developing countries may not have created effective research-promoted HRM…

A major impact of the influenza seasonal epidemic on intensive care units, Réunion, April to August 2016.

PubMed

Filleul, Laurent; Ranoaritiana, Dany Bakoly; Balleydier, Elsa; Vandroux, David; Ferlay, Clémence; Jaffar-Bandjee, Marie-Christine; Jaubert, Julien; Roquebert, Bénédicte; Lina, Bruno; Valette, Martine; Hubert, Bruno; Larrieu, Sophie; Brottet, Elise

2016-11-24

The 2016 seasonal influenza in Réunion in the southern hemisphere, was dominated by influenza A(H1N1)pdm09 (possibly genogroup 6B.1). An estimated 100,500 patients with acute respiratory infection (ARI) consulted a physician (cumulative attack rate 11.9%). Sixty-six laboratory-confirmed cases (65.7/100,000 ARI consultations) were hospitalised in an intensive care unit, the highest number since 2009. Impact on intensive care units was major. Correlation between severe cases was 0.83 between Réunion and France and good for 2009 to 2015. This article is copyright of The Authors, 2016.

A major impact of the influenza seasonal epidemic on intensive care units, Réunion, April to August 2016

PubMed Central

Filleul, Laurent; Ranoaritiana, Dany Bakoly; Balleydier, Elsa; Vandroux, David; Ferlay, Clémence; Jaffar-Bandjee, Marie-Christine; Jaubert, Julien; Roquebert, Bénédicte; Lina, Bruno; Valette, Martine; Hubert, Bruno; Larrieu, Sophie; Brottet, Elise

2016-01-01

The 2016 seasonal influenza in Réunion in the southern hemisphere, was dominated by influenza A(H1N1)pdm09 (possibly genogroup 6B.1). An estimated 100,500 patients with acute respiratory infection (ARI) consulted a physician (cumulative attack rate 11.9%). Sixty-six laboratory-confirmed cases (65.7/100,000 ARI consultations) were hospitalised in an intensive care unit, the highest number since 2009. Impact on intensive care units was major. Correlation between severe cases was 0.83 between Réunion and France and good for 2009 to 2015. PMID:27918264

Studying Intense Pulsed Light Method Along With Corticosteroid Injection in Treating Keloid Scars

PubMed Central

Shamsi Meymandi, Simin; Rezazadeh, Azadeh; Ekhlasi, Ali

2014-01-01

Background: Results of various studies suggest that the hypertrophic and keloid scars are highly prevalent in the general population and are irritating both physically and mentally. Objective: Considering the variety of existing therapies, intense pulsed light (IPL) method along with corticosteroid injection was evaluated in treating these scars. Materials and Methods: 86 subjects were included in this clinical trial. Eight sessions of therapeutic intervention were done with IPL along with corticosteroid intralesional injection using 450 to 1200 NM filter, Fluence 30-40 J/cm2, pulse duration of 2.1-10 ms and palsed delay 10-40 ms with an interval of three weeks. To specify the recovery consequences and complication rate and to determine features of the lesion, the criteria specified in the study of Eroll and Vancouver scar scale were used. Results: The level of clinical improvement, color improvement and scar height was 89.1%, 88.8% and 89.1% respectively. The incidence of complications (1 telangiectasia case, 7 hyperpigmentation cases and 2 atrophy cases) following treatment with IPL was 11.6%. Moreover, the participants’ satisfaction with IPL method was 88.8%. Conclusions: This study revealed that a combined therapy (intralesional corticosteroid injection + IPL) increases the recovery level of hypertrophic and keloid scars. It was also demonstrated that this method had no significant side effect and patients were highly satisfied with this method. PMID:24719725

Management of a case with misdiagnosed spinal dural arterio-venous fistula.

PubMed

Lien, Chia-Yi; Lui, Chun-Chung; Lu, Cheng-Hsien; Chang, Wen-Neng

2014-03-01

Spinal dural arterio-venous fistula (SDAVF) is an uncommon and easily misdiagnosed vascular malformation. We aimed to report the diagnosis and management of a case with SDAVF. A 62-year-old man suffered from acute paraparesis about 15 months before this study. He underwent a neurosurgical procedure for herniated discs of the cervical spine at that time but there was no relief and the symptoms worsened despite the surgery. Neurologically, he had spastic paraparesis and decreased vibration sensation of the lower limbs. Spinal magnetic resonance imaging (MRI) revealed intra-medullary hyper-intensity lesion at T8 to T10 levels and tubular-like signal void structures in the corresponding posterior sub-arachnoid space. Further trans-arterial angiography through right T6 intercostal artery catheterization revealed engorged veins, thereby confirming the diagnosis of SDAVF. The patient was treated via endovascular embolization (18% Onyx, EV3TM MIT, Bonn, Germany) through spinal angiography and the results showed a marked decrease in engorged veins. After a 4-month follow-up, the patient was symptomatic but stable. Follow-up MRI showed a complete disappearance of the hyper-intensity change of the spinal cord. Spinal MR angiography did not reveal any recurrence of SDAVF. This case study demonstrated the easily misdiagnosed state of SDAVF. Serial neuroimage studies including spinal MRI, endovascular embolization through spinal angiography and MR angiography can be useful tools for its diagnostic confirmation, management and follow-up study.

Myonecrosis in Sickle Cell Anemia: Case Study

PubMed Central

Turaga, Lalita Prabha; Boddu, Prajwal; Kipferl, Steve; Basu, Anupam; Yorath, Martin

2017-01-01

Patient: Male, 27 Final Diagnosis: Myonecrosis of sickle cell anaemia Symptoms: Pain • redness to feet • swelling foot Medication: — Clinical Procedure: MRI Specialty: Podiatry Objective: Rare disease Background: Myonecrosis is one of the more poorly studied, painful manifestations of sickle cell crisis. Medical literature is sparse detailing the manifestations and management of such symptoms. In myonecrosis, red cells containing sickle hemoglobin become rigid, resulting in reduced blood flow and myonecrosis. Case Report: We present a case study of a patient in sickle cell crisis with an episode of acute pain and swelling to the intrinsic muscles of the foot as a prominent feature of the crises. Although muscle biopsy is considered the gold standard for the diagnosis of myositis or myonecrosis, a low intensity signal on T1 and high intensity signal on T2 at the affected muscle belly can be as conclusive as imaging studies. In an actively sickling patient any invasive intervention should be avoided as it can result in ischemic necrosis of the tissues, due to interruption of capillary flow in end-arteries. Conclusions: Early recognition is critical in sickle cell disease management, allowing for prompt and aggressive fluid resuscitation which remains a cornerstone in the management of most sickle cell vaso-occlusive crises. In this instance, off loading the extremity and early fluid resuscitation resolved the pain and swelling and prevented myonecrosis. PMID:28133359

Acoustic sounding in the planetary boundary layer

NASA Technical Reports Server (NTRS)

Kelly, E. H.

1974-01-01

Three case studies are presented involving data from an acoustic radar. The first two cases examine data collected during the passage of a mesoscale cold-air intrusion, probably thunderstorm outflow, and a synoptic-scale cold front. In these studies the radar data are compared to conventional meteorological data obtained from the WKY tower facility for the purpose of radar data interpretation. It is shown that the acoustic radar echoes reveal the boundary between warm and cold air and other areas of turbulent mixing, regions of strong vertical temperature gradients, and areas of weak or no wind shear. The third case study examines the relationship between the nocturnal radiation inversion and the low-level wind maximum or jet in the light of conclusions presented by Blackadar (1957). The low-level jet is seen forming well above the top of the inversion. Sudden rapid growth of the inversion occurs which brings the top of the inversion to a height equal that of the jet. Coincident with the rapid growth of the inversion is a sudden decrease in the intensity of the acoustic radar echoes in the inversion layer. It is suggested that the decrease in echo intensity reveals a decrease in turbulent mixing in the inversion layer as predicted by Blackadar. It is concluded that the acoustic radar can be a valuable tool for study in the lower atmosphere.

Managing cancer care through service delivery networks: The role of professional collaboration in two European cancer networks.

PubMed

Prades, Joan; Morando, Verdiana; Tozzi, Valeria D; Verhoeven, Didier; Germà, Jose R; Borras, Josep M

2017-01-01

Background The study examines two meso-strategic cancer networks, exploring to what extent collaboration can strengthen or hamper network effectiveness. Unlike macro-strategic networks, meso-strategic networks have no hierarchical governance structures nor are they institutionalised within healthcare services' delivery systems. This study aims to analyse the models of professional cooperation and the tools developed for managing clinical practice within two meso-strategic, European cancer networks. Methods Multiple case study design based on the comparative analysis of two cancer networks: Iridium, in Antwerp, Belgium and the Institut Català d'Oncologia in Catalonia, Spain. The case studies applied mixed methods, with qualitative research based on semi-structured interviews ( n = 35) together with case-site observation and material collection. Results The analysis identified four levels of collaborative intensity within medical specialties as well as in multidisciplinary settings, which became both platforms for crosscutting clinical work between hubs' experts and local care teams and the levers for network-based tools development. The organisation of clinical practice relied on professional-based cooperative processes and tiers, lacking vertical integration mechanisms. Conclusions The intensity of professional linkages largely shaped the potential of meso-strategic cancer networks to influence clinical practice organisation. Conversely, the introduction of managerial techniques or network governance structures, without introducing vertical hierarchies, was found to be critical solutions.

Monitoring of KrF excimer laser ablation for burn scars: a comparative study of transient reflection measurement and time-resolved photography of ablation plume

NASA Astrophysics Data System (ADS)

Nakajima, Akio; Arai, Tsunenori; Kikuchi, Makoto; Iwaya, Akimi; Arai, Katsuyuki; Inazaki, Satoshi; Takaoka, Takatsugu; Kato, Masayoshi

1995-05-01

A simple laser ablation monitoring during burn scar removal by KrF laser irradiation was studied to control laser fluence in real-time. Because, to obtain suitable surface for auto skin-graft, the laser fluence should be precisely controlled at each laser shot. We employed simple probe transmission method which could detect ejected material/phenomena from irradiated surface. The time-course of measured probe intensity contained a couple of attenuated peaks, which might corresponded to a shock wave front and debris plume. The delay time from laser irradiation to the debris plume peak appearance varied with the ablation fluence. The delay time of 1 J/cm2 (near ablation threshold) case prolonged 25% from 8 J/cm2 (far above threshold) case. Therefore, we think the delay time measurement by means of the simple probe transmission method may be available to attain the laser fluence control for nonuniform burn scar removal. The time-resolved photography and probe reflection method were also studied to understand the measured time-course of the transmitted probe intensity.

The Calculation of Accurate Harmonic Frequencies of Large Molecules: The Polycyclic Aromatic Hydrocarbons, a Case Study

NASA Technical Reports Server (NTRS)

Bauschlicher, Charles W., Jr.; Langhoff, Stephen R.; Arnold, James O. (Technical Monitor)

1996-01-01

The vibrational frequencies and infrared intensities of naphthalene neutral and cation are studied at the self-consistent-field (SCF), second-order Moller-Plesset (MP2), and density functional theory (DFT) levels using a variety of one-particle basis sets. Very accurate frequencies can be obtained at the DFT level in conjunction with large basis sets if they are scaled with two factors, one for the C-H stretches and a second for all other modes. We also find remarkably good agreement at the B3LYP/4-31G level using only one scale factor. Unlike the neutral PAHs where all methods do reasonably well for the intensities, only the DFT results are accurate for the PAH cations. The failure of the SCF and MP2 methods is caused by symmetry breaking and an inability to describe charge delocalization. We present several interesting cases of symmetry breaking in this study. An assessment is made as to whether an ensemble of PAH neutrals or cations could account for the unidentified infrared bands observed in many astronomical sources.

Assessing the environmental impacts of freshwater consumption in LCA.

PubMed

Pfister, Stephan; Koehler, Annette; Hellweg, Stefanie

2009-06-01

A method for assessing the environmental impacts of freshwater consumption was developed. This method considers damages to three areas of protection: human health, ecosystem quality, and resources. The method can be used within most existing life-cycle impact assessment (LCIA) methods. The relative importance of water consumption was analyzed by integrating the method into the Eco-indicator-99 LCIA method. The relative impact of water consumption in LCIA was analyzed with a case study on worldwide cotton production. The importance of regionalized characterization factors for water use was also examined in the case study. In arid regions, water consumption may dominate the aggregated life-cycle impacts of cotton-textile production. Therefore, the consideration of water consumption is crucial in life-cycle assessment (LCA) studies that include water-intensive products, such as agricultural goods. A regionalized assessment is necessary, since the impacts of water use vary greatly as a function of location. The presented method is useful for environmental decision-support in the production of water-intensive products as well as for environmentally responsible value-chain management.

The calculation of accurate harmonic frequencies of large molecules: the polycyclic aromatic hydrocarbons, a case study

NASA Astrophysics Data System (ADS)

Bauschlicher, Charles W.; Langhoff, Stephen R.

1997-07-01

The vibrational frequencies and infrared intensities of naphthalene neutral and cation are studied at the self-consistent-field (SCF), second-order Møller-Plesset (MP2), and density functional theory (DFT) levels using a variety of one-particle basis sets. Very accurate frequencies can be obtained at the DFT level in conjunction with large basis sets if they are scaled with two factors, one for the C-H stretches and a second for all other modes. We also find remarkably good agreement at the B3LYP/4-31G level using only one scale factor. Unlike the neutral polycyclic aromatic hydrocarbons (PAHs) where all methods do reasonably well for the intensities, only the DFT results are accurate for the PAH cations. The failure of the SCF and MP2 methods is caused by symmetry breaking and an inability to describe charge delocalization. We present several interesting cases of symmetry breaking in this study. An assessment is made as to whether an ensemble of PAH neutrals or cations could account for the unidentified infrared bands observed in many astronomical sources.

Using digital inpainting to estimate incident light intensity for the calculation of red blood cell oxygen saturation from microscopy images.

PubMed

Sové, Richard J; Drakos, Nicole E; Fraser, Graham M; Ellis, Christopher G

2018-05-25

Red blood cell oxygen saturation is an important indicator of oxygen supply to tissues in the body. Oxygen saturation can be measured by taking advantage of spectroscopic properties of hemoglobin. When this technique is applied to transmission microscopy, the calculation of saturation requires determination of incident light intensity at each pixel occupied by the red blood cell; this value is often approximated from a sequence of images as the maximum intensity over time. This method often fails when the red blood cells are moving too slowly, or if hematocrit is too large since there is not a large enough gap between the cells to accurately calculate the incident intensity value. A new method of approximating incident light intensity is proposed using digital inpainting. This novel approach estimates incident light intensity with an average percent error of approximately 3%, which exceeds the accuracy of the maximum intensity based method in most cases. The error in incident light intensity corresponds to a maximum error of approximately 2% saturation. Therefore, though this new method is computationally more demanding than the traditional technique, it can be used in cases where the maximum intensity-based method fails (e.g. stationary cells), or when higher accuracy is required. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Clinical Holistic Medicine: The Case Story of Anna. III. Rehabilitation of Philosophy of Life During Holistic Existential Therapy for Childhood Sexual Abuse

PubMed Central

Ventegodt, Søren; Clausen, Birgitte; Merrick, Joav

2006-01-01

When we experience life events with overwhelming emotional pain, we can escape this pain by making decisions (in our mind) that transfer responsibility from our existence to the surrounding world. By doing this, we slowly destroy the essence of our being, health, quality of life, and ability to function. The case of Anna is an excellent example of such a systematic destruction of self, done to survive the extreme pressure from childhood abuse and sexual abuse. The case study shows that the damage done to us by traumatic events is not on our body or soul, but rather our philosophy of life. The important consequence is that we can heal our existence by letting go of the negative decisions taken in the past painful and traumatic situations. By letting go of the life-denying sentences, we come back to life and take responsibility for our own life and existence. The healing of Annas existence was done by existential holistic therapy. Although the processing did not always run smoothly, as she projected very charged material on the therapists on several occasions, the process resulted in full health and a good quality of life due to her own will to recover and heal completely. The case illustrates the inner logic and complexity of intensive holistic therapy at the most difficult moment, where only a combination of intensive medical, psychiatric, and sexological treatment could set her free. In the paper, we also present a meta-perspective on intensive holistic therapy and its most characteristic phases. PMID:17370004

Clinical holistic medicine: the case story of Anna. III. Rehabilitation of philosophy of life during holistic existential therapy for childhood sexual abuse.

PubMed

Ventegodt, Søren; Clausen, Birgitte; Merrick, Joav

2006-03-07

When we experience life events with overwhelming emotional pain, we can escape this pain by making decisions (in our mind) that transfer responsibility from our existence to the surrounding world. By doing this, we slowly destroy the essence of our being, health, quality of life, and ability to function. The case of Anna is an excellent example of such a systematic destruction of self, done to survive the extreme pressure from childhood abuse and sexual abuse. The case study shows that the damage done to us by traumatic events is not on our body or soul, but rather our philosophy of life. The important consequence is that we can heal our existence by letting go of the negative decisions taken in the past painful and traumatic situations. By letting go of the life-denying sentences, we come back to life and take responsibility for our own life and existence. The healing of Anna's existence was done by existential holistic therapy. Although the processing did not always run smoothly, as she projected very charged material on the therapists on several occasions, the process resulted in full health and a good quality of life due to her own will to recover and heal completely. The case illustrates the inner logic and complexity of intensive holistic therapy at the most difficult moment, where only a combination of intensive medical, psychiatric, and sexological treatment could set her free. In the paper, we also present a meta-perspective on intensive holistic therapy and its most characteristic phases.

Optimal design of studies of influenza transmission in households. I: case-ascertained studies.

PubMed

Klick, B; Leung, G M; Cowling, B J

2012-01-01

Case-ascertained household transmission studies, in which households including an 'index case' are recruited and followed up, are invaluable to understanding the epidemiology of influenza. We used a simulation approach parameterized with data from household transmission studies to evaluate alternative study designs. We compared studies that relied on self-reported illness in household contacts vs. studies that used home visits to collect swab specimens for virological confirmation of secondary infections, allowing for the trade-off between sample size vs. intensity of follow-up given a fixed budget. For studies estimating the secondary attack proportion, 2-3 follow-up visits with specimens collected from all members regardless of illness were optimal. However, for studies comparing secondary attack proportions between two or more groups, such as controlled intervention studies, designs with reactive home visits following illness reports in contacts were most powerful, while a design with one home visit optimally timed also performed well.

Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

PubMed

Paat-Ahi, Gerli; Aaviksoo, Ain; Swiderek, Maria

2014-12-01

As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries' DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

Gallium scanning in cerebral and cranial infections. [/sup 67/Ga, /sup 99m/Tc tracer techniques

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

Waxman, A.D.; Siemsen, J.K.

1976-08-01

Eighteen patients with cranial or intracranial infections were studied with technetium and gallium brain scans. Seven of 18 lesions were noted with gallium and not with pertechnetate, while the reverse pattern was not seen. Brain abscesses were visualized with gallium but not with pertechnetate in two of five cases. Osteomyelitis of the skull and mastoiditis showed intense gallium uptake in all cases, while meningitis or cerebritis gave inconsistent results.

Using a personal digital assistant to document clinical pharmacy services in an intensive care unit.

PubMed

Lau, A; Balen, R M; Lam, R; Malyuk, D L

2001-07-01

Management Case Studies describe approaches to real-life management problems in health systems. Each installment is a brief description of a problem and how it was dealt with. The cases are intended to help readers deal with similar experiences in their own work sites. Problem solving, not hypothesis testing, is emphasized. Successful resolution of the management issue is not a criterion for publication--important lessons can be learned from failures, too.

Stress Intensity Factors for Part-Through Surface Cracks in Hollow Cylinders

NASA Technical Reports Server (NTRS)

Mettu, Sambi R.; Raju, Ivatury S.; Forman, Royce G.

1992-01-01

Flaws resulting from improper welding and forging are usually modeled as cracks in flat plates, hollow cylinders or spheres. The stress intensity factor solutions for these crack cases are of great practical interest. This report describes some recent efforts at improving the stress intensity factor solutions for cracks in such geometries with emphasis on hollow cylinders. Specifically, two crack configurations for cylinders are documented. One is that of a surface crack in an axial plane and the other is a part-through thumb-nail crack in a circumferential plane. The case of a part-through surface crack in flat plates is used as a limiting case for very thin cylinders. A combination of the two cases for cylinders is used to derive a relation for the case of a surface crack in a sphere. Solutions were sought which cover the entire range of the geometrical parameters such as cylinder thickness, crack aspect ratio and crack depth. Both the internal and external position of the cracks are considered for cylinders and spheres. The finite element method was employed to obtain the basic solutions. Power-law form of loading was applied in the case of flat plates and axial cracks in cylinders and uniform tension and bending loads were applied in the case of circumferential (thumb-nail) cracks in cylinders. In the case of axial cracks, the results for tensile and bending loads were used as reference solutions in a weight function scheme so that the stress intensity factors could be computed for arbitrary stress gradients in the thickness direction. For circumferential cracks, since the crack front is not straight, the above technique could not be used. Hence for this case, only the tension and bending solutions are available at this time. The stress intensity factors from the finite element method were tabulated so that results for various geometric parameters such as crack depth-to-thickness ratio (a/t), crack aspect ratio (a/c) and internal radius-to-thickness ratio (R/t) or the crack length-to-width ratio (2c/W) could be obtained by interpolation and extrapolation. Such complete tables were then incorporated into the NASA/FLAGRO computer program which is widely used by the aerospace community for fracture mechanics analysis.

Postmortem audit in a paediatric cardiology unit.

PubMed Central

Russell, G A; Berry, P J

1989-01-01

Postmortem examinations performed on 76 children with a clinical diagnosis of congenital heart disease were reviewed retrospectively and compared with the findings before death. Both operated and unoperated cases were studied over a three year period. Despite intensive investigation during life, there was a high rate of unsuspected abnormalities at necropsy (80%): 29 cases had undiagnosed additional cardiac anomalies or surgical flaws, which contributed to death in 13 cases. Defects in surgery were uncommon but permitted modification in surgical technique to avoid recurrence. Myocardial necrosis and pulmonary foreign body embolism were common findings, the importance of which is uncertain and requires further study for their prevention. Even in the most thoroughly investigated cases postmortem examination has a high yield of clinically important pathology which is undetected during life. Images PMID:2794078

Comprehensive Mass Analysis for Chemical Processes, a Case Study on L-Dopa Manufacture

EPA Science Inventory

To evaluate the “greenness” of chemical processes in route selection and process development, we propose a comprehensive mass analysis to inform the stakeholders from different fields. This is carried out by characterizing the mass intensity for each contributing chemical or wast...

Flying in, Flying out: Offshore Teaching in Higher Education

ERIC Educational Resources Information Center

Seah, Wee Tiong; Edwards, Julie

2006-01-01

This paper discusses the relatively new phenomenon of university education faculties offering offshore education. The analogy, "flying in, flying out" captures the intensity of such offshore experiences for visiting academics, and contrasts their professional experiences against expatriate academics. This paper reports on case studies of…

Microblogging Activities: Language Play and Tool Transformation

ERIC Educational Resources Information Center

Hattem, David

2014-01-01

The following is a qualitative case study presenting three vignettes exploring the use of language play while microblogging during an academically sanctioned task. Ten students and one teacher used "Twitter" in an intensive, English as a second language advanced grammar course to practice writing sentences with complex grammatical…

Accessing the Classroom Discourse Community through Accountable Talk: English Learners' Voices

ERIC Educational Resources Information Center

Ardasheva, Yuliya; Howell, Penny B.; Vidrio Magaña, Margarita

2016-01-01

This case study draws on Gee's (1989) "D/discourse theory" to investigate English learners' (ELs') perspectives regarding Accountable Talk (AT)--a structured, discourse-intensive instructional approach--after a yearlong implementation in three content-based (mathematics) middle school classrooms. Interviews with 21 ELs (3 Advanced…

Making Accounting Tutorials Enjoyable

ERIC Educational Resources Information Center

Bargate, Karen

2018-01-01

This paper emanates from a case study which focussed on 15 Managerial Accounting and Financial Management (MAFM) students' "enjoyment" of learning MAFM in an 18-week Writing Intensive Tutorial (WIT) programme. Interactive Qualitative Analysis (IQA) was used for the research design and as a data analysis tool. Following IQA protocols…

The Potential Benefit of Radiotherapy with Protons in Head and Neck Cancer with Respect to Normal Tissue Sparing: A Systematic Review of Literature

PubMed Central

Bijl, Hendrik P.; Schilstra, Cornelis; Pijls-Johannesma, Madelon; Langendijk, Johannes A.

2011-01-01

Purpose. Clinical studies concerning head and neck cancer patients treated with protons reporting on radiation-induced side effects are scarce. Therefore, we reviewed the literature regarding the potential benefits of protons compared with the currently used photons in terms of lower doses to normal tissue and the potential for fewer subsequent radiation-induced side effects, with the main focus on in silico planning comparative (ISPC) studies. Materials and Methods. A literature search was performed by two independent researchers on ISPC studies that included proton-based and photon-based irradiation techniques. Results. Initially, 877 papers were retrieved and 14 relevant and eligible ISPC studies were identified and included in this review. Four studies included paranasal sinus cancer cases, three included nasopharyngeal cancer cases, and seven included oropharyngeal, hypopharyngeal, and/or laryngeal cancer cases. Seven studies compared the most sophisticated photon and proton techniques: intensity-modulated photon therapy versus intensity-modulated proton therapy (IMPT). Four studies compared different proton techniques. All studies showed that protons had a lower normal tissue dose, while keeping similar or better target coverage. Two studies found that these lower doses theoretically translated into a significantly lower incidence of salivary dysfunction. Conclusion. The results of ISPC studies indicate that protons have the potential for a significantly lower normal tissue dose, while keeping similar or better target coverage. Scanned IMPT probably offers the most advantage and will allow for a substantially lower probability of radiation-induced side effects. The results of these ISPC studies should be confirmed in properly designed clinical trials. PMID:21349950

Economic aspects of severe sepsis: a review of intensive care unit costs, cost of illness and cost effectiveness of therapy.

PubMed

Burchardi, Hilmar; Schneider, Heinz

2004-01-01

Severe sepsis remains both an important clinical challenge and an economic burden in intensive care. An estimated 750,000 cases occur each year in the US alone (300 cases per 100,000 population). Lower numbers are estimated for most European countries (e.g. Germany and Austria: 54-116 cases per year per 100,000). Sepsis patients are generally treated in intensive care units (ICUs) where close supervision and intensive care treatment by a competent team with adequate equipment can be provided. Staffing costs represent from 40% to >60% of the total ICU budget. Because of the high proportion of fixed costs in ICU treatment, the total cost of ICU care is mainly dependent on the length of ICU stay (ICU-LOS). The average total cost per ICU day is estimated at approximately 1200 Euro for countries with a highly developed healthcare system (based on various studies conducted between 1989 and 2001 and converted at 2003 currency rates). Patients with infections and severe sepsis require a prolonged ICU-LOS, resulting in higher costs of treatment compared with other ICU patients. US cost-of-illness studies focusing on direct costs per sepsis patient have yielded estimates of 34,000 Euro, whereas European studies have given lower cost estimates, ranging from 23,000 Euro to 29,000 Euro. Direct costs, however, make up only about 20-30% of the cost of illness of severe sepsis. Indirect costs associated with severe sepsis account for 70-80% of costs and arise mainly from productivity losses due to mortality. Because of increasing healthcare cost pressures worldwide, economic issues have become important for the introduction of new innovations. This is evident when introducing new biotechnology products, such as drotrecogin-alpha (activated protein C), into specific therapy for severe sepsis. Data so far suggest that when drotrecogin-alpha treatment is targeted to those patients most likely to achieve the greatest benefit, the drug is cost effective by the standards of other well accepted life-saving interventions.

Improving IMRT delivery efficiency using intensity limits during inverse planning.

PubMed

Coselmon, Martha M; Moran, Jean M; Radawski, Jeffrey D; Fraass, Benedick A

2005-05-01

Inverse planned intensity modulated radiotherapy (IMRT) fields can be highly modulated due to the large number of degrees of freedom involved in the inverse planning process. Additional modulation typically results in a more optimal plan, although the clinical rewards may be small or offset by additional delivery complexity and/or increased dose from transmission and leakage. Increasing modulation decreases delivery efficiency, and may lead to plans that are more sensitive to geometrical uncertainties. The purpose of this work is to assess the use of maximum intensity limits in inverse IMRT planning as a simple way to increase delivery efficiency without significantly affecting plan quality. Nine clinical cases (three each for brain, prostate, and head/neck) were used to evaluate advantages and disadvantages of limiting maximum intensity to increase delivery efficiency. IMRT plans were generated using in-house protocol-based constraints and objectives for the brain and head/neck, and RTOG 9406 dose volume objectives in the prostate. Each case was optimized at a series of maximum intensity ratios (the product of the maximum intensity and the number of beams divided by the prescribed dose to the target volume), and evaluated in terms of clinical metrics, dose-volume histograms, monitor units (MU) required per fraction (SMLC and DMLC delivery), and intensity map variation (a measure of the beam modulation). In each site tested, it was possible to reduce total monitor units by constraining the maximum allowed intensity without compromising the clinical acceptability of the plan. Monitor unit reductions up to 38% were observed for SMLC delivery, while reductions up to 29% were achieved for DMLC delivery. In general, complicated geometries saw a smaller reduction in monitor units for both delivery types, although DMLC delivery required significantly more monitor units in all cases. Constraining the maximum intensity in an inverse IMRT plan is a simple way to improve delivery efficiency without compromising plan objectives.

[Retrospective cohort study on period of incubation and survival among former commercial plasma donors infected with HIV in Hebei province].

PubMed

Chen, Su-liang; Bai, Guang-yi; Li, Qiao-min; Li, Bao-jun; Hui, Yan-liang; Liang, Liang; Wang, Wei; Chen, Zhi-qiang; Lu, Xin-li; Wang, Xiao-feng; Zhang, Yu-qi; Zhao, Hong-ru

2012-04-01

To examine the state of incubation period and survival time of former commercial plasma donors (FCPDs) infected with HIV. All objects infected with HIV were from Hebei province and found from general investigation for FCPDs in 1995. The infector cohort by 142 cases was used to estimate incubation period. In the infector cohort, the time which infectors entered the cohort was their infection time, which was the middle value of the origin date, which was January 1, 1995. The onset of AIDS was defined as an outcome event. End point of observation was Dec 31, 2010. There were 192 months in all from beginning to end. The AIDS cohort by 57 cases was used to estimate the survival of the patients. In the patient cohort, the time of AIDS onset was defined as the time entering the cohort, and death of AIDS was defined as an outcome event. The cumulative incidence ratio, cumulative mortality, illness intensity and mortality intensity were analyzed through Kaplan-Meier. During the observation period, 123 cases of 142 infectors developed into AIDS, the cumulative incidence was 86.42% (123/142) and the intensity was 8.53/100 person-years and the median time of incubation period was 112.0 months (95%CI: 108.8 - 115.2). The death dates of 57 patients were from 1 to 24 months after onset. The cumulative mortality was 100%, and the intensity was 250.66/100 person-years and the median survival time was 3.0 months (95%CI: 1.8 - 4.2). It was estimated that the median time was 115.0 months (9.6 years) from infection to death. The median times of incubation and median survival time were 112.0 and 3.0 months, respectively.

Childbirth and Diagnosis Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

PubMed

Bellanger, Martine M; Quentin, Wilm; Tan, Siok Swan

2013-05-01

The study compares how Diagnosis-Related Group (DRG) based hospital payment systems in eleven European countries (Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) deal with women giving birth in hospitals. It aims to assist gynaecologists and national authorities in optimizing their DRG systems. National or regional databases were used to identify childbirth cases. DRG grouping algorithms and indicators of resource consumption were compared for those DRGs which account for at least 1% of all childbirth cases in the respective database. Five standardized case vignettes were defined and quasi prices (i.e. administrative prices or tariffs) of hospital deliveries according to national DRG-based hospital payment systems were ascertained. European DRG systems classify childbirth cases according to different sets of variables (between one and eight variables) into diverging numbers of DRGs (between three and eight DRGs). The most complex DRG is valued 3.5 times more resource intensive than an index case in Ireland but only 1.1 times more resource intensive than an index case in The Netherlands. Comparisons of quasi prices for the vignettes show that hypothetical payments for the most complex case amount to only € 479 in Poland but to € 5532 in Ireland. Differences in the classification of hospital childbirth cases into DRGs raise concerns whether European systems rely on the most appropriate classification variables. Physicians, hospitals and national DRG authorities should consider how other countries' DRG systems classify cases to optimize their system and to ensure fair and appropriate reimbursement. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Orbital stability and energy estimate of ground states of saturable nonlinear Schrödinger equations with intensity functions in R2

NASA Astrophysics Data System (ADS)

Lin, Tai-Chia; Wang, Xiaoming; Wang, Zhi-Qiang

2017-10-01

Conventionally, the existence and orbital stability of ground states of nonlinear Schrödinger (NLS) equations with power-law nonlinearity (subcritical case) can be proved by an argument using strict subadditivity of the ground state energy and the concentration compactness method of Cazenave and Lions [4]. However, for saturable nonlinearity, such an argument is not applicable because strict subadditivity of the ground state energy fails in this case. Here we use a convexity argument to prove the existence and orbital stability of ground states of NLS equations with saturable nonlinearity and intensity functions in R2. Besides, we derive the energy estimate of ground states of saturable NLS equations with intensity functions using the eigenvalue estimate of saturable NLS equations without intensity function.

Application of principal component analysis for improvement of X-ray fluorescence images obtained by polycapillary-based micro-XRF technique

NASA Astrophysics Data System (ADS)

Aida, S.; Matsuno, T.; Hasegawa, T.; Tsuji, K.

2017-07-01

Micro X-ray fluorescence (micro-XRF) analysis is repeated as a means of producing elemental maps. In some cases, however, the XRF images of trace elements that are obtained are not clear due to high background intensity. To solve this problem, we applied principal component analysis (PCA) to XRF spectra. We focused on improving the quality of XRF images by applying PCA. XRF images of the dried residue of standard solution on the glass substrate were taken. The XRF intensities for the dried residue were analyzed before and after PCA. Standard deviations of XRF intensities in the PCA-filtered images were improved, leading to clear contrast of the images. This improvement of the XRF images was effective in cases where the XRF intensity was weak.

End-of-life decisions in Dutch neonatal intensive care units.

PubMed

Verhagen, A A Eduard; Dorscheidt, Jozef H H M; Engels, Bernadette; Hubben, Joep H; Sauer, Pieter J

2009-10-01

To clarify the practice of end-of-life decision making in severely ill newborns. Retrospective descriptive study with face-to-face interviews. The 10 neonatal intensive care units in the Netherlands from October 2005 to September 2006. All 367 newborn infants who died in the first 2 months of life in Dutch neonatal intensive care units. Adequate documentation was available in 359 deaths. Presence of end-of-life decisions, classification of deaths in 3 groups, and physicians' considerations leading to end-of-life decisions. An end-of-life decision preceded death in 95% of cases, and in 5% treatment was continued until death. Of all of the deaths, 58% were classified as having no chance of survival and 42% were stabilized newborns with poor prognoses. Withdrawal of life-sustaining therapy was the main mode of death in both groups. One case of deliberate ending of life was found. In 92% of newborns with poor prognoses, end-of-life decisions were based on patients' future quality of life and mainly concerned future suffering. Considerations regarding the infant's present state were made in 44% of infants. Virtually all deaths in Dutch neonatal intensive care units are preceded by the decision to withdraw life-sustaining treatment and many decisions are based on future quality of life. The decision to deliberately end the life of a newborn may occur less frequently than was previously assumed.

Leisure-time physical activity and breast cancer risk by hormone receptor status: effective life periods and exercise intensity.

PubMed

Suzuki, Reiko; Iwasaki, Motoki; Kasuga, Yoshio; Yokoyama, Shiro; Onuma, Hiroshi; Nishimura, Hideki; Kusama, Ritsu; Shimazu, Taichi; Tsugane, Shoichiro

2010-11-01

Physical activity may decrease breast cancer risk. However, it is unclear what intensity of exercise and during which life periods this effect on decreasing risk is efficiently expressed, and whether the associations differ by the estrogen-/progesterone- receptor (ER/PR) status of tumors. We investigated associations between age- and intensity-specific leisure-time physical activity and ER/PR-defined breast cancer risk. We conducted a hospital-based case-control study in Nagano, Japan. Subjects were 405 cases newly diagnosed (>99% known ER/PR) from 2001 to 2005, who were age-/area-matched with 405 controls. Activity was assessed with a self-reported questionnaire which considered intensity level (moderate and/or strenuous) at different ages (at 12 and 20 years, and in the previous 5 years). Odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression. Strenuous but not moderate physical activity at age 12 was inversely associated with pre- and postmenopausal breast cancer risk across ER/PR subtypes [overall OR(≥ 5 days/week vs. none) = 0.24 (0.14-0.43)]. Moderate physical activity in the previous 5 years was significantly associated with a decrease in risk for postmenopausal ER + PR + tumors only [OR(≥ 1 day/week vs. none) = 0.35 (0.18-0.67)]. Strenuous activity in teens and moderate activity after menopause may contribute to a reduction in breast cancer risk.

Mutant p53 expression in kidney tubules adjacent to renal cell carcinoma: evidence of a precursor lesion.

PubMed

Lai, R; el Dabbagh, L; Mourad, W A

1996-06-01

Neoplastic transformation can be associated with mutations of the p53 gene. This leads to stabilization of its protein product and to its accumulation, which allows immunohistochemical detection. Mutant p53 expression has been seen in many neoplasms, including renal cell carcinoma (RCC). We recently described putative precursor lesions of RCC. The lesions were defined as intratubular epithelial dysplasia (IED) of kidney tubules adjacent to RCC. They were seen in one-third of the cases studied. The findings were based only on light microscopic analysis. We hypothesized that neoplastic transformation would be manifested by mutant p53 expression in the kidney tubules adjacent to RCC and not in nonneoplastic kidneys. Immunohistochemical staining for p53 in 24 cases of RCC with adjacent kidneys was performed. We used the DO-7 monoclonal antibody reactive for the N-terminal of the p53 protein on formalin-fixed paraffin-embedded tissue. Sections from 14 kidneys resected for nonneoplastic conditions were used as controls. Twenty-one (87%) of the 24 cases of RCC had nuclear p53 expression in the tumor cells. This included 14 cases (58%) with intense reactivity and 7 cases (29%) with weaker p53 immunoreactivity. Of the 24 cases of RCC, IED was identified in 13 cases (54%). Immunoreactivity for p53 was focally seen in tubules of all the lesions, as well as in the nonlesional areas. Six of the lesions exhibited intense nuclear staining. The kidneys adjacent to the RCC, with no evidence of IED, showed focally intense positive p53 nuclear staining in four cases. None of the control specimens showed p53 expression. Our findings provide supportive evidence that previously described IED in kidneys adjacent to RCC are most likely precursor lesions of the neoplasm. Aberrant expression of p53 in areas without evidence of IED may suggest that neoplastic transformation manifested by p53 mutation in kidney tubules may be seen before the development of the morphologic features of dysplasia and malignancy.

Nurses' knowledge and barriers regarding pain management in intensive care units.

PubMed

Wang, Hsiang-Ling; Tsai, Yun-Fang

2010-11-01

To explore nurses' knowledge and barriers regarding pain management in intensive care units. Pain is a common and treatable condition among intensive care patients. Quality care of these patients depends on the pain knowledge and pain management skills of critical care nurses. However, no single study has explored these nurses' knowledge of and perceived barriers to pain management in Taiwan. A cross-sectional study. Intensive care unit nurses (n = 370) were recruited from 16 hospitals chosen by stratified sampling across Taipei County in Taiwan. Data were collected on nurses' knowledge of pain management using the Nurses' Knowledge and Attitudes Survey-Taiwanese version, on perceived barriers to pain management using a researcher-developed scale and on background information. The overall average correct response rate for the knowledge scale was 53.4%, indicating poor knowledge of pain management. The top barrier to managing pain identified by these nurses was 'giving proper pain prescription needs doctor's approval; can't depend on me'. Knowledge of pain management was significantly and negatively related to perceived barriers to pain management. In addition, scores for knowledge and perceived barriers differed significantly by specific intensive care unit. Knowledge also differed significantly by nurses' education level, clinical competence level (nursing ladder) and hospital accreditation category. Our results indicate an urgent need to strengthen pain education by including case analysis for intensive care nurses in Taiwan. Pain education should target knowledge deficits and barriers to changing pain management approaches for Taiwanese nurses in intensive care units. © 2010 Blackwell Publishing Ltd.

A Case Report of Post-Operative Jöd-Basedow Phenomennon Following Oral and IV Iodine Contrast Administration

PubMed Central

Hull, Erroll; Lujan, Eugenio

2014-01-01

This is a case of thyrotoxicosis, due to the Jöd-Basedow phenomenon following administration of oral and IV iodinated contrast in a patient with history of gastrointestinal stromal tumor (GIST) and small bowel obstruction. The patient developed atrial fibrillation and had an extended stay in the intensive care unit. Given the aging population with possible subclinical hyperthyroidism, multinodular goiter, and the rise in contrast administration for routine diagnostic studies, this case serves to raise awareness of the risks of “routine” tests administered to our aging patient population. PMID:24716009

Hearing-loss-associated gene detection in neonatal intensive care unit.

PubMed

Yang, S M; Liu, Ying; Liu, C; Yin, A H; Wu, Y F; Zheng, X E; Yang, H M; Yang, J

2018-02-01

To investigate the frequency and mutation spectrum of hearing loss-associated gene mutation in Neonatal Intensive Care Unit (NICU). Neonates (n=2305) admitted to NICU were enrolled in this study. Nine prominent hearing loss-associated genes, GJB2 (35 del G, 176 del 16,235 del C, 299 del AT), GJB3 (538 C > T), SLC26A4 (IVS7-2A > G, 2168 A > G) and mtDNA 12S rRNA(1555 A > G, 1494 C > T), were detected. There were 73 cases hearing-loss-associated gene mutation among 2305 cases, the mutation frequency was 3.1%, with 40 cases GJB2 (235del C) mutation (54.8%), 6 cases GJB2 (299 del AT) mutation (8.2%), 21 cases SLC26A4 (IVS 7-2 A > G) mutation (28.7%), 4 cases SLC26A4 (2168 A > G) mutation (5.5%), 2 cases of GJB2 (235del C) combined SLC26A4 (IVS 7-2 A > G, 2168 A > G) mutation (2.8%). Among 73 gene mutation cases, preterm neonates presented in 18 cases, accounting for 24.7% (18/73); hyperbilirubinemia in 13 cases, accounting for 17.8% (13/73); Torch Syndrome in 15 cases, with 12 cases CMV, 2 cases rubella, 1 case toxoplasm, respectively, totally accounting for 20.54% (15/73); neonatal pneumonia in 12 cases, accounting for 16.4% (12/73); birth asphyxia in 5 cases, accounting for 6.9% (5/73); sepsis in 5 cases, accounting for 6.9% (5/73); others in 5 cases, accounting for 6.8% (5/73) . The frequency of hearing loss-associated gene mutation was higher in NICU.There were hearing loss-associated gene mutations in the NICU, suggesting this mutation may complicate with perinatal high-risk factors.

Local influence of south-east France topography and land cover on the distribution and characteristics of intense rainfall cells

NASA Astrophysics Data System (ADS)

Renard, Florent

2017-04-01

The Greater Lyon area is strongly built up, grouping 58 communes and a population of 1.3 million in approximately 500 km2. The flood risk is high as the territory is crossed by two large watercourses and by streams with torrential flow. Floods may also occur in case of runoff after heavy rain or because of a rise in the groundwater level. The whole territory can therefore be affected, and it is necessary to possess in-depth knowledge of the depths, causes and consequences of rainfall to achieve better management of precipitation in urban areas and to reduce flood risk. This study is thus focused on the effects of topography and land cover on the occurrence, intensity and area of intense rainfall cells. They are identified by local radar meteorology (C-band) combined with a processing algorithm running in a geographic information system (GIS) which identified 109,979 weighted mean centres of them in a sample composed of the five most intense rainfall events from 2001 to 2005. First, analysis of spatial distribution at an overall scale is performed, completed by study at a more detailed scale. The results show that the distribution of high-intensity rainfall cells is spread in cluster form. Subsequently, comparison of intense rainfall cells with the topography shows that cell density is closely linked with land slope but that, above all, urbanised zones feature nearly twice as many rainfall cells as farm land or forest, with more intense intensity.

Effects of soil compaction on residual stand growth in central Appalachian hardwood forest: a preliminary case study

Treesearch

Jingxin Wang; Chris LeDoux; Michael Vanderberg; Li Yaoxiang

2006-01-01

A preliminary study that quantified the impacts of soil compaction on residual tree growth associated with ground-based skidding traffic intensity and turn payload size was investigated in the central Appalachian hardwood forest. The field study was carried out on a 20-acre tract of the West Virginia University Research Forest. Skid trails were laid out in 170' -...

Multiphoton ionization of many-electron atoms and highly-charged ions in intense laser fields: a relativistic time-dependent density functional theory approach

NASA Astrophysics Data System (ADS)

Tumakov, Dmitry A.; Telnov, Dmitry A.; Maltsev, Ilia A.; Plunien, Günter; Shabaev, Vladimir M.

2017-10-01

We develop an efficient numerical implementation of the relativistic time-dependent density functional theory (RTDDFT) to study multielectron highly-charged ions subject to intense linearly-polarized laser fields. The interaction with the electromagnetic field is described within the electric dipole approximation. The resulting time-dependent relativistic Kohn-Sham (RKS) equations possess an axial symmetry and are solved accurately and efficiently with the help of the time-dependent generalized pseudospectral method. As a case study, we calculate multiphoton ionization probabilities of the neutral argon atom and argon-like xenon ion. Relativistic effects are assessed by comparison of our present results with existing non-relativistic data.

High-Resolution NU-WRF Simulations of a Deep Convective-Precipitation System During MC3E. Part 1; Comparisons Between Goddard Microphysics Schemes and Observations

NASA Technical Reports Server (NTRS)

Tao, Wei-Kuo; Wu, Di; Lang, Stephen; Chern, Jiundar; Peters-Lidard, Christa; Fridlind, Ann; Matsui, Toshihisa

2015-01-01

The Goddard microphysics scheme was recently improved by adding a 4th ice class (frozen dropshail). This new 4ICE scheme was implemented and tested in the Goddard Cumulus Ensemble model (GCE) for an intense continental squall line and a moderate,less-organized continental case. Simulated peak radar reflectivity profiles were improved both in intensity and shape for both cases as were the overall reflectivity probability distributions versus observations. In this study, the new Goddard 4ICE scheme is implemented into the regional-scale NASA Unified - Weather Research and Forecasting model (NU-WRF) and tested on an intense mesoscale convective system that occurred during the Midlatitude Continental Convective Clouds Experiment (MC3E). The NU42WRF simulated radar reflectivities, rainfall intensities, and vertical and horizontal structure using the new 4ICE scheme agree as well as or significantly better with observations than when using previous versions of the Goddard 3ICE (graupel or hail) schemes. In the 4ICE scheme, the bin microphysics-based rain evaporation correction produces more erect convective cores, while modification of the unrealistic collection of ice by dry hail produces narrow and intense cores, allowing more slow-falling snow to be transported rearward. Together with a revised snow size mapping, the 4ICE scheme produces a more horizontally stratified trailing stratiform region with a broad, more coherent light rain area. In addition, the NU-WRF 4ICE simulated radar reflectivity distributions are consistent with and generally superior to those using the GCE due to the less restrictive open lateral boundaries

Operation IVY. Joint Task Force 132, 1952

DTIC Science & Technology

1985-09-01

and auxiliary lenses (filters) must have been selected with great care. Knowledge of the light intensities to be experienced is essen- tial in making...pounds. b. !!et’od (1) The theory behind Bhangmeter operation can be described as follows. The light intensity emanated from an atomic bomb explosion...temperature distribution was made by observing the Light signals from selected spots on the outer surface of the steel case. The very early MM1K case

Study designs may influence results: the problems with questionnaire-based case-control studies on the epidemiology of glioma.

PubMed

Johansen, Christoffer; Schüz, Joachim; Andreasen, Anne-Marie Serena; Dalton, Susanne Oksbjerg

2017-03-28

Glioma is a rare brain tumour with a very poor prognosis and the search for modifiable factors is intense. We reviewed the literature concerning risk factors for glioma obtained in case-control designed epidemiological studies in order to discuss the influence of this methodology on the observed results. When reviewing the association between three exposures, medical radiation, exogenous hormone use and allergy, we critically appraised the evidence from both case-control and cohort studies. For medical radiation and hormone replacement therapy (HRT), questionnaire-based case-control studies appeared to show an inverse association, whereas nested case-control and cohort studies showed no association. For allergies, the inverse association was observed irrespective of study design. We recommend that the questionnaire-based case-control design be placed lower in the hierarchy of studies for establishing cause-and-effect for diseases such as glioma. We suggest that a state-of-the-art case-control study should, as a minimum, be accompanied by extensive validation of the exposure assessment methods and the representativeness of the study sample with regard to the exposures of interest. Otherwise, such studies cannot be regarded as 'hypothesis testing' but only 'hypothesis generating'. We consider that this holds true for all questionnaire-based case-control studies on cancer and other chronic diseases, although perhaps not to the same extent for each exposure-outcome combination.

Improving adolescent pregnancy outcomes and maternal health:a case study of comprehensive case managed services.

PubMed

Bowman, Elizabeth K; Palley, Howard A

2003-01-01

Our findings indicate how health outcomes regarding adolescent pregnancy and maternal and infant health care are intertwined with a case management process that fosters measures that are social in nature-the provision of direct services, as well as the encouragement of informal social supports systems. They also show how case managed services in a small, nongovernmental organization (NGO) with a strong commitment to its clients may provide the spontaneity and caring which results in a "match" between client needs and the delivery of services-and positive outcomes for pregnant women, early maternal health and infant health. The delivery of such case managed services in a manner which is intensive, comprehensive, flexible and integrated contributes significantly to such improved health outcomes.

Management and climate change in coastal Oregon forests: The Panther Creek Watershed as a case study

EPA Science Inventory

The highly productive forests of the Oregon Coast Range Mountains have been intensively harvested for many decades, and recent interest has emerged in the potential for removing harvest residue as a source of renewable woody biomass energy. However, the long-term consequences of ...

Change and Continuity in Experiential Education: A Case Study.

ERIC Educational Resources Information Center

James, Thomas

1989-01-01

Traces program development at the North Carolina Outward Bound school from 1967 to 1987. Describes changes in the standard three-week challenge course, evolution of short intensive courses, and introduction of tailored contract courses in response to changing market demands. Discusses implications for institutional mission, identity, and…

Using Explicit Instruction for African American Male Students in Suburban Georgia: A Qualitative Case Study

ERIC Educational Resources Information Center

Harris, Dira D.

2017-01-01

Growing gaps in reading and vocabulary achievement between minority and majority student subgroups have led to an intense focus on implementing effective classroom instructional strategies. Prior research concerning teachers' perceptions of using explicit instructional strategies to teach vocabulary to underperforming students has been…

Network Centric Operations NCO Case Study. The British Approach to Low-Intensity Operations: Part I

DTIC Science & Technology

2007-02-12

Army’s institutional memory of jungle warfare (during WW2 ) had dissipated by 1948. Nonetheless, individuals within the Army who had experienced such...with a specially stabilised TV camera mounting. It also fitted infrared surveillance systems to its Beaver spotter planes, which helped detect

Critical Curriculum Theory and Slow Ecopedagogical Activism

ERIC Educational Resources Information Center

Payne, Phillip G.

2015-01-01

Enacting a critical environmental education curriculum theory with 8- to 9-year-old children in 1978 is now "restoried" in a "history of the present/future" like "case study" for prosecuting five interrelated problems confronting progress in environmental education and its research. They are: the intense heat of the…

Integrating Participatory Elements into an Effectiveness Evaluation

ERIC Educational Resources Information Center

Wallace, Tanner LeBaron

2008-01-01

This article describes an effectiveness evaluation of an intensive case management intervention coordinated by a non-profit organization in a midsize Midwest City. As an effectiveness evaluation, the primary evaluation question was causal in nature; the key task of the evaluative study was to establish and probe connections between the…

A National Policy for Workplace Training. Lessons from State and Local Experiments.

ERIC Educational Resources Information Center

Batt, Rosemary; Osterman, Paul

Selected state and local experiments in developing/supporting workplace-centered training programs were analyzed to identify issues relevant to developing a national policy for workplace training. Intensive case studies of state economic development/training programs in California and Illinois and the employment and training programs provided by…

Foreign-Accented Speech Perception Ratings: A Multifactorial Case Study

ERIC Educational Resources Information Center

Kraut, Rachel; Wulff, Stefanie

2013-01-01

Seventy-eight native English speakers rated the foreign-accented speech (FAS) of 24 international students enrolled in an Intensive English programme at a public university in Texas on degree of accent, comprehensibility and communicative ability. Variables considered to potentially impact listeners' ratings were the sex of the speaker, the first…

Risk Mitigation and Leadership in Tactical U.S. Army Infantry Training

DTIC Science & Technology

required for this war must simulate the expected conditions, those of high-intensity conflict, as closely as possible. As U.S. strategic leaders look...doctrine, cognitive and perceptual biases, and historical case studies, this thesis suggests that U.S. Army risk management practices neither hinder nor

The structure and phase of cloud tops as observed by polarization lidar

NASA Technical Reports Server (NTRS)

Spinhirne, J. D.; Hansen, M. Z.; Simpson, J.

1983-01-01

High-resolution observations of the structure of cloud tops have been obtained with polarization lidar operated from a high altitude aircraft. Case studies of measurements acquired from cumuliform cloud systems are presented, two from September 1979 observations in the area of Florida and adjacent waters and a third during the May 1981 CCOPE experiment in southeast Montana. Accurate cloud top height structure and relative density of hydrometers are obtained from the lidar return signal intensity. Correlation between the signal return intensity and active updrafts was noted. Thin cirrus overlying developing turrets was observed in some cases. Typical values of the observed backscatter cross section were 0.1-5 (km/sr) for cumulonimbus tops. The depolarization ratio of the lidar signals was a function of the thermodynamic phase of cloud top areas. An increase of the cloud top depolarization with decreasing temperature was found for temperatures above and below -40 C.

The epidemiology of trauma in an intensive care unit in Bahrain.

PubMed

Ruehsen, M M; Abdul-Wahab, A W

1989-01-01

Injuries resulting from trauma are over-represented in Bahrain's intensive care unit beds. Using data from 1984 and 1985, this study examines the most severe etiologic agents and high-risk population groups among ICU trauma patients. Road traffic accidents were the principal cause of admission, accounting for 57% of all injury admissions. Most occurred in pedestrians suffering from severe head injury. Poisonings were the second largest category, followed by falls. In comparison with medical cases admitted to the ICU during the same 2-year period, the trauma cases included a disproportionate number of children and males in their most productive years of life, further adding to the economic burden which injuries have inflicted on this small country. The authors call for a new approach, namely passive prevention such as environmental modifications and legislation and tertiary prevention such as improvement of the country's underutilized ambulance service.

Classification of cardiac patient states using artificial neural networks

PubMed Central

Kannathal, N; Acharya, U Rajendra; Lim, Choo Min; Sadasivan, PK; Krishnan, SM

2003-01-01

Electrocardiogram (ECG) is a nonstationary signal; therefore, the disease indicators may occur at random in the time scale. This may require the patient be kept under observation for long intervals in the intensive care unit of hospitals for accurate diagnosis. The present study examined the classification of the states of patients with certain diseases in the intensive care unit using their ECG and an Artificial Neural Networks (ANN) classification system. The states were classified into normal, abnormal and life threatening. Seven significant features extracted from the ECG were fed as input parameters to the ANN for classification. Three neural network techniques, namely, back propagation, self-organizing maps and radial basis functions, were used for classification of the patient states. The ANN classifier in this case was observed to be correct in approximately 99% of the test cases. This result was further improved by taking 13 features of the ECG as input for the ANN classifier. PMID:19649222

Nonclassicality Criteria in Multiport Interferometry

NASA Astrophysics Data System (ADS)

Rigovacca, L.; Di Franco, C.; Metcalf, B. J.; Walmsley, I. A.; Kim, M. S.

2016-11-01

Interference lies at the heart of the behavior of classical and quantum light. It is thus crucial to understand the boundaries between which interference patterns can be explained by a classical electromagnetic description of light and which, on the other hand, can only be understood with a proper quantum mechanical approach. While the case of two-mode interference has received a lot of attention, the multimode case has not yet been fully explored. Here we study a general scenario of intensity interferometry: we derive a bound on the average correlations between pairs of output intensities for the classical wavelike model of light, and we show how it can be violated in a quantum framework. As a consequence, this violation acts as a nonclassicality witness, able to detect the presence of sources with sub-Poissonian photon-number statistics. We also develop a criterion that can certify the impossibility of dividing a given interferometer into two independent subblocks.

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

PubMed

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

2017-09-01

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

Traumatic anterior shoulder dislocation: a case study of nonoperative management in a mixed martial arts athlete.

PubMed

Sims, Kevin; Spina, Andreo

2009-12-01

To present an evidence-informed approach to the nonoperative management of a first-time, traumatic anterior shoulder dislocation. A 30-year-old mixed martial arts athlete, with no prior shoulder injuries, presented one day following a first-time, traumatic anterior shoulder dislocation. An eight-week, individualized, intensive, nonoperative rehabilitation program was immediately begun upon presentation. Management consisted of immobilization of the shoulder in external rotation and a progressive rehabilitation program aimed at restoring range of motion, strength of the dynamic stabilizers, and proprioception of the shoulder. Eight weeks post-dislocation the patient had regained full range of motion and strength compared to the unaffected limb and apprehension and relocation tests for instability were negative. This case illustrates successful management of a first-time, traumatic, anterior shoulder dislocation using immobilization in external rotation combined with an intensive rehabilitation program.

Traumatic anterior shoulder dislocation: a case study of nonoperative management in a mixed martial arts athlete

PubMed Central

Sims, Kevin; Spina, Andreo

2009-01-01

Objective: To present an evidence-informed approach to the nonoperative management of a first-time, traumatic anterior shoulder dislocation. Clinical Features: A 30-year-old mixed martial arts athlete, with no prior shoulder injuries, presented one day following a first-time, traumatic anterior shoulder dislocation. An eight-week, individualized, intensive, nonoperative rehabilitation program was immediately begun upon presentation. Intervention and Outcome: Management consisted of immobilization of the shoulder in external rotation and a progressive rehabilitation program aimed at restoring range of motion, strength of the dynamic stabilizers, and proprioception of the shoulder. Eight weeks post-dislocation the patient had regained full range of motion and strength compared to the unaffected limb and apprehension and relocation tests for instability were negative. Conclusion: This case illustrates successful management of a first-time, traumatic, anterior shoulder dislocation using immobilization in external rotation combined with an intensive rehabilitation program. PMID:20037691

Effects of cross-correlated noises on the relaxation time of the bistable system

NASA Astrophysics Data System (ADS)

Xie, Chong-Wei; Mei, Dong-Cheng

2003-11-01

The stationary correlation function and the associated relaxation time for a general system driven by cross-correlated white noises are derived, by virtue of a Stratonovich-like ansatz. The effects of correlated noises on the relaxation time of a bistable kinetic model coupled to an additive and a multiplicative white noises are studied. It is proved that for small fluctuations the relaxation time Tc as a function of lambda (the correlated intensity between noises) exhibits very different behaviours for alphaD (alpha and D, respectively, stand for the intensities of additive and multiplicative noises). When alpha>D, Tc increases with increasing lambda. But when alpha

Excitation Anisotropy in Laser-Induced-Fluorescence Spectroscopy —High-Intensity, Broad-Line Excitation

NASA Astrophysics Data System (ADS)

Hirabayashi, Atsumu; Nambu, Yoshihiro; Fujimoto, Takashi

1986-10-01

The problem of excitation anisotropy in laser-induced-fluorescence spectroscopy (LIFS) was investigated for the intense excitation case under the broad-line condition. The depolarization coefficient for the fluorescence light was derived in the intense-excitation limit (linearly-polarized or unpolarized light excitation) and the results are presented in tables. In the region of intermediate intensity, between the weak and intense-excitation limits, the master equation was solved for a specific example of atomic transitions and its result is compared with experimental results.

Variations in embodied energy and carbon emission intensities of construction materials

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

Wan Omar, Wan-Mohd-Sabki; School of Environmental Engineering, Universiti Malaysia Perlis, 02600 Arau, Perlis; Doh, Jeung-Hwan, E-mail: j.doh@griffith.edu.au

2014-11-15

Identification of parameter variation allows us to conduct more detailed life cycle assessment (LCA) of energy and carbon emission material over their lifecycle. Previous research studies have demonstrated that hybrid LCA (HLCA) can generally overcome the problems of incompleteness and accuracy of embodied energy (EE) and carbon (EC) emission assessment. Unfortunately, the current interpretation and quantification procedure has not been extensively and empirically studied in a qualitative manner, especially in hybridising between the process LCA and I-O LCA. To determine this weakness, this study empirically demonstrates the changes in EE and EC intensities caused by variations to key parameters inmore » material production. Using Australia and Malaysia as a case study, the results are compared with previous hybrid models to identify key parameters and issues. The parameters considered in this study are technological changes, energy tariffs, primary energy factors, disaggregation constant, emission factors, and material price fluctuation. It was found that changes in technological efficiency, energy tariffs and material prices caused significant variations in the model. Finally, the comparison of hybrid models revealed that non-energy intensive materials greatly influence the variations due to high indirect energy and carbon emission in upstream boundary of material production, and as such, any decision related to these materials should be considered carefully. - Highlights: • We investigate the EE and EC intensity variation in Australia and Malaysia. • The influences of parameter variations on hybrid LCA model were evaluated. • Key significant contribution to the EE and EC intensity variation were identified. • High indirect EE and EC content caused significant variation in hybrid LCA models. • Non-energy intensive material caused variation between hybrid LCA models.« less

Boron neutron capture therapy for recurrent high-grade meningiomas.

PubMed

Kawabata, Shinji; Hiramatsu, Ryo; Kuroiwa, Toshihiko; Ono, Koji; Miyatake, Shin-Ichi

2013-10-01

Similar to glioblastomas, high-grade meningiomas are difficult pathologies to control. In this study, the authors used boron neutron capture therapy (BNCT), a tumor-selective intensive particle radiation modality, to treat high-grade meningioma. From June 2005 to September 2011, BNCT was applied 28 times in 20 cases of recurrent high-grade meningioma. All patients had previously undergone intensive treatments such as repetitive surgeries and multiple sessions of radiation therapy. Fluorine-18-labeled boronophenylalanine ((18)F-BPA) PET was performed before BNCT in 19 of the 20 cases; BPA is itself a therapeutic compound. Compound uptake, tumor shrinkage, long-term control rate including survival time, and failure pattern of the treated patients were all evaluated. Eighteen of 19 cases studied using (18)F-BPA PET showed good BPA uptake, with ratios of tumor to normal brain greater than 2.7. These ratios indicated the likely effects of BNCT prior to neutron irradiation. The original tumor sizes were between 4.3 cm(3) and 109 cm(3). A mean tumor volume reduction of 64.5% was obtained after BNCT within just 2 months. The median follow-up duration was 13 months. Six patients are still alive; at present, the median survival times after BNCT and diagnosis are 14.1 months (95% CI 8.6-40.4 months) and 45.7 months (95% CI 32.4-70.7 months), respectively. Clinical symptoms before BNCT, such as hemiparesis and facial pain, were improved after BNCT in symptomatic cases. Systemic metastasis, intracranial distant recurrence outside the radiation field, CSF dissemination, and local tumor progression were observed in 6, 7, 3, and 3 cases, respectively, during the clinical course. Apparent pseudoprogression was observed in at least 3 cases. Symptomatic radiation injuries occurred in 6 cases, and were controllable in all but 1 case. Boron neutron capture therapy may be especially effective in cases of high-grade meningioma.

Joseph's Story: A Case Study of Late-Onset Necrotizing Enterocolitis From Early Birth to Recovery.

PubMed

Gephart, Sheila M; Martin, Laura B; Kijewski, Amy; Johnson, Scott R

2015-01-01

Although necrotizing enterocolitis (NEC) is often catastrophic among premature infants, most cases occur in the first month after birth. This case study presents Joseph's story about a 24-week surviving twin who developed severe NEC at 5 months of age just days before he was to go home. The purpose of this case study report is to place Joseph and his parents' experience in the context of what is known about NEC risk factors, clinical presentation, and treatment, and then to offer recommendations to healthcare professionals to support families from NEC diagnosis to recovery. Now 5 years old, Joseph continues to manage consequences of NEC including deafness, developmental delay, multiple food allergies, and recurrent gastrointestinal challenges from short gut syndrome. Although NEC struck late and kept Joseph in the neonatal intensive care unit for 228 days, its consequences remain with this resilient child and his family.

Recording and reproduction of microwave holograms using a scanning procedure and their subsequent optical processing

NASA Technical Reports Server (NTRS)

Hetsch, J.

1983-01-01

Intensity distributions in nonoptical wave fields can be visualized and stored on photosensitive material. In the case of microwaves, temperature effects can be utilized with the aid of liquid crystals to visualize intensity distributions. Particular advantages for the study of intensity distributions in microwave fields presents a scanning procedure in which a microcomputer is employed for the control of a probe and the storage of the measured data. The present investigation is concerned with the employment of such a scanning procedure for the recording and the reproduction of microwave holograms. The scanning procedure makes use of an approach discussed by Farhat, et al. (1973). An eight-bit microprocessor with 64 kBytes of RAM is employed together with a diskette storage system.

Graded motor imagery and the impact on pain processing in a case of CRPS.

PubMed

Walz, Andrea D; Usichenko, Taras; Moseley, G Lorimer; Lotze, Martin

2013-03-01

Graded motor imagery (GMI) shows promising results for patients with complex regional pain syndrome (CRPS). In a case with chronic unilateral CRPS type I, we applied GMI for 6 weeks and recorded clinical parameters and cerebral activation using functional magnetic resonance imaging (fMRI; pre-GMI, after each GMI block, and after 6 mo). Changes in fMRI activity were mapped during movement execution in areas associated with pain processing. A healthy participant served as a control for habituation effects. Pain intensity decreased over the course of GMI, and relief was maintained at follow-up. fMRI during movement execution revealed marked changes in S1 and S2 (areas of discriminative pain processing), which seemed to be associated with pain reduction, but none in the anterior insula and the anterior cingulate cortex (areas of affective pain processing). After mental rotation training, the activation intensity of the posterior parietal cortex was reduced to one third. Our case report develops a design capable of differentiating cerebral changes associated with behavioral therapy of CRPS type I study.

Unusual MRI findings in an immunocompetent patient with EBV encephalitis: a case report

PubMed Central

2011-01-01

Blackground It is well-known that Epstein-Barr virus (EBV) can affect the central nervous system (CNS). Case presentation Herein the authors report unusual timely Magnetic Resonance Imaging (MRI) brain scan findings in an immunocompetent patient with EBV encephalitis. Diffusion weighted MRI sequence performed during the acute phase of the disease was normal, whereas the Fast Relaxation Fast Spin Echo T2 image showed diffuse signal intensity changes in white matter. The enhancement pattern suggested an inflammatory response restricted to the brain microcirculation. Acyclovir and corticosteroid therapy was administered. After three weeks, all signal intensities returned to normal and the patient showed clinical recovery. Conclusion This report demonstrates that EBV in an immunocompetent adult can present with diffuse, reversible brain white matter involvement in the acute phase of mononucleosis. Moreover, our case suggests that a negative DWI sequence is associated with a favorable improvement in severe EBV CNS infection. More extensive studies are needed to assess what other instrumental data can help to distinguish viral lesions from other causes in the acute phase of disease. PMID:21435249

Acute venous thrombosis as complication and clue to diagnose a SAPHO syndrome case. A case report.

PubMed

Rosero, A; Ruano, R; Martin, M; Hidalgo, C; Garcia-Talavera, J

2013-01-01

This report concerns a male adult admitted for sternal and left arm pain, who was diagnosed and treated for acute deep venous thrombosis in the left subclavian and axillary veins. X-ray and a hybrid single photon emission tomography and computed tomography (SPECT-CT) scintigraphy scan revealed high intensity uptake in both sternoclavicular joints, which corresponded to hyperostosis, thereby suggesting a SAPHO syndrome. Upon reviewing the patient's medical history, we found dermatological pustulosis disease and an intermittent sternal chest pain untreated since 10 years ago. In the biochemical study we found erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) elevation, hyperglobulinemia, and mild anaemia. Initial treatment included nonsteroidal anti-inflammatory drugs (NSAIDs) with low response, which then changed to methotrexate, sulfasalazine, and prednisone. The patient's pain was controlled almost completely in 10 months. A control bone scan revealed a marked decrease in intensity of bone deposits according to clinical response. To our knowledge, there are only a few cases of SAPHO and thrombosis and none are followed up with a bone SPECT-CT scan.

Subcarrier intensity modulation for MIMO visible light communications

NASA Astrophysics Data System (ADS)

Celik, Yasin; Akan, Aydin

2018-04-01

In this paper, subcarrier intensity modulation (SIM) is investigated for multiple-input multiple-output (MIMO) visible light communication (VLC) systems. A new modulation scheme called DC-aid SIM (DCA-SIM) is proposed for the spatial modulation (SM) transmission plan. Then, DCA-SIM is extended for multiple subcarrier case which is called DC-aid Multiple Subcarrier Modulation (DCA-MSM). Bit error rate (BER) performances of the considered system are analyzed for different MIMO schemes. The power efficiencies of DCA-SIM and DCA-MSM are shown in correlated MIMO VLC channels. The upper bound BER performances of the proposed models are obtained analytically for PSK and QAM modulation types in order to validate the simulation results. Additionally, the effect of power imbalance method on the performance of SIM is studied and remarkable power gains are obtained compared to the non-power imbalanced cases. In this work, Pulse amplitude modulation (PAM) and MSM-Index are used as benchmarks for single carrier and multiple carrier cases, respectively. And the results show that the proposed schemes outperform PAM and MSM-Index for considered single carrier and multiple carrier communication scenarios.

The effect of precrash velocity reduction on occupant response using a human body finite element model.

PubMed

Guleyupoglu, B; Schap, J; Kusano, K D; Gayzik, F S

2017-07-04

The objective of this study is to use a validated finite element model of the human body and a certified model of an anthropomorphic test dummy (ATD) to evaluate the effect of simulated precrash braking on driver kinematics, restraint loads, body loads, and computed injury criteria in 4 commonly injured body regions. The Global Human Body Models Consortium (GHBMC) 50th percentile male occupant (M50-O) and the Humanetics Hybrid III 50th percentile models were gravity settled in the driver position of a generic interior equipped with an advanced 3-point belt and driver airbag. Fifteen simulations per model (30 total) were conducted, including 4 scenarios at 3 severity levels: median, severe, and the U.S. New Car Assessment Program (U.S.-NCAP) and 3 extra per model with high-intensity braking. The 4 scenarios were no precollision system (no PCS), forward collision warning (FCW), FCW with prebraking assist (FCW+PBA), and FCW and PBA with autonomous precrash braking (FCW + PBA + PB). The baseline ΔV was 17, 34, and 56.4 kph for median, severe, and U.S.-NCAP scenarios, respectively, and were based on crash reconstructions from NASS/CDS. Pulses were then developed based on the assumed precrash systems equipped. Restraint properties and the generic pulse used were based on literature. In median crash severity cases, little to no risk (<10% risk for Abbreviated injury Scale [AIS] 3+) was found for all injury measures for both models. In the severe set of cases, little to no risk for AIS 3+ injury was also found for all injury measures. In NCAP cases, highest risk was typically found with No PCS and lowest with FCW + PBA + PB. In the higher intensity braking cases (1.0-1.4 g), head injury criterion (HIC), brain injury criterion (BrIC), and chest deflection injury measures increased with increased braking intensity. All other measures for these cases tended to decrease. The ATD also predicted and trended similar to the human body models predictions for both the median, severe, and NCAP cases. Forward excursion for both models decreased across median, severe, and NCAP cases and diverged from each other in cases above 1.0 g of braking intensity. The addition of precrash systems simulated through reduced precrash speeds caused reductions in some injury criteria, whereas others (chest deflection, HIC, and BrIC) increased due to a modified occupant position. The human model and ATD models trended similarly in nearly all cases with greater risk indicated in the human model. These results suggest the need for integrated safety systems that have restraints that optimize the occupant's position during precrash braking and prior to impact.

A Case Study of Mesoscale Cyclonic Vortices Associated with the South Atlantic Convergence Zone

NASA Astrophysics Data System (ADS)

Leal de Quadro, M. F.; Faus da Silva Dias, M. A.; Herdies, D. L.; Goncalves, L.

2014-12-01

The objective of this work is to study the behavior of mesoscale cyclonic vortices (MCVs) over South America, principally those that form in association with the South Atlantic Convergence Zone (SACZ), with a view toward identifying the basic characteristics of the formation of these MCVs. Two case studies were conducted over the Continental Amazonia Zone, simulated using the BRAMS model, showing the relationship between the mesovortices formation and the convective activity near its formation region. A thermodynamic analysis of two selected MCVs, embedded in the SACZ, highlights some salient features of these intense MCVs. Both systems are associated with strong upward vertical motion throughout practically the whole troposphere, before and during formation. This motion creates a transport of moisture into the upper troposphere and the surface fluxes of sensible and latent heat are reduced when the MCVs are operating. These systems that form in more than one level in the troposphere are more intense and are associated with greater precipitation rates (over 150 mm). Another striking feature is that these systems dissipate quickly. With respect to the horizontal wind, there is no similarity in pattern between the two cases. The first case, where the base of the vortex formed at 925 hPa and extended to 875 hPa, was characterized by convergence of winds from the south - west of the vortex - with winds from the north - east of the vortex. In the second case, which extended from 800 hPa to 775 hPa, we can clearly see the motion, originating in central Brazil, transporting moisture toward the vortex and certainly serving as a local factor contributing significantly to the moisture balance in the region.

Loss of Productivity Due to Neck/Shoulder Symptoms and Hand/Arm Symptoms: Results from the PROMO-Study

PubMed Central

IJmker, Stefan; Blatter, Birgitte M.; de Korte, Elsbeth M.

2007-01-01

Introduction The objective of the present study is to describe the extent of productivity loss among computer workers with neck/shoulder symptoms and hand/arm symptoms, and to examine associations between pain intensity, various physical and psychosocial factors and productivity loss in computer workers with neck/shoulder and hand/arm symptoms. Methods A cross-sectional design was used. The study population consisted of 654 computer workers with neck/shoulder or hand/arm symptoms from five different companies. Descriptive statistics were used to describe the occurrence of self-reported productivity loss. Logistic regression analyses were used to examine the associations. Results In 26% of all the cases reporting symptoms, productivity loss was involved, the most often in cases reporting both symptoms (36%). Productivity loss involved sickness absence in 11% of the arm/hand cases, 32% of the neck/shoulder cases and 43% of the cases reporting both symptoms. The multivariate analyses showed statistically significant odds ratios for pain intensity (OR: 1.26; CI: 1.12–1.41), for high effort/no low reward (OR: 2.26; CI: 1.24–4.12), for high effort/low reward (OR: 1.95; CI: 1.09–3.50), and for low job satisfaction (OR: 3.10; CI: 1.44–6.67). Physical activity in leisure time, full-time work and overcommitment were not associated with productivity loss. Conclusion In most computer workers with neck/shoulder symptoms or hand/arm symptoms productivity loss derives from a decreased performance at work and not from sickness absence. Favorable psychosocial work characteristics might prevent productivity loss in symptomatic workers. PMID:17636455

Ultrasound and bronchoscopic controlled percutaneous tracheostomy on trauma ICU.

PubMed

Kollig, E; Heydenreich, U; Roetman, B; Hopf, F; Muhr, G

2000-11-01

Tracheostomy is a common surgical procedure performed in long-term ventilated patients in intensive care. Since the role of percutaneous dilatational tracheostomy (PDT) on Intensive Care Unit (ICU) has become steadily more important in the last few years, a prospective study was started to evaluate the economic efficiency and to show the minimization of the complication rate of this procedure. In 72 patients we performed PDT as a bedside procedure. Initially the thyroid gland and the subcutaneous vessels were studied by ultrasound in every patient. The puncture of the trachea, the dilatational procedure and the insertion of the tracheal cannula were executed under bronchoscopic monitoring. Finally, a bronchoscopic control view followed via the new cannula to detect intratracheal complications. Mechanical ventilation was maintained during the procedure and controlled by continuous pulse oximetry. According to prior ultrasound findings the place to puncture the trachea was changed in 24% of the patients, in one case tracheostomy was performed as an open conventional procedure. The following complications could be observed: one case involving perforation of a cartilaginous ring, one case with venous bleeding of a small subcutaneous vein and two cases with punctures of the bronchoscope. There were no cases of miscannulation, penetration of the posterior tracheal wall or major bleeding requiring intervention or conversion. The followup study revealed that there was no sign of further complications in any patient. In addition, cost analysis demonstrated that there was a significant economical advantage of PDT in comparison with open standard tracheostomy. Standardized ultrasonographically and bronchoscopically controlled PDT turns out to be a safe, simple and cost effective bedside procedure on ICU. Because of ultrasound examination performed before the procedure, and bronchoscopic surveillance during the procedure, safety of this procedure can be enhanced, thus minimizing the rate of complications.

The Development of Storm Surge Ensemble Prediction System and Case Study of Typhoon Meranti in 2016

NASA Astrophysics Data System (ADS)

Tsai, Y. L.; Wu, T. R.; Terng, C. T.; Chu, C. H.

2017-12-01

Taiwan is under the threat of storm surge and associated inundation, which is located at a potentially severe storm generation zone. The use of ensemble prediction can help forecasters to know the characteristic of storm surge under the uncertainty of track and intensity. In addition, it can help the deterministic forecasting. In this study, the kernel of ensemble prediction system is based on COMCOT-SURGE (COrnell Multi-grid COupled Tsunami Model - Storm Surge). COMCOT-SURGE solves nonlinear shallow water equations in Open Ocean and coastal regions with the nested-grid scheme and adopts wet-dry-cell treatment to calculate potential inundation area. In order to consider tide-surge interaction, the global TPXO 7.1 tide model provides the tidal boundary conditions. After a series of validations and case studies, COMCOT-SURGE has become an official operating system of Central Weather Bureau (CWB) in Taiwan. In this study, the strongest typhoon in 2016, Typhoon Meranti, is chosen as a case study. We adopt twenty ensemble members from CWB WRF Ensemble Prediction System (CWB WEPS), which differs from parameters of microphysics, boundary layer, cumulus, and surface. From box-and-whisker results, maximum observed storm surges were located in the interval of the first and third quartile at more than 70 % gauge locations, e.g. Toucheng, Chengkung, and Jiangjyun. In conclusion, the ensemble prediction can effectively help forecasters to predict storm surge especially under the uncertainty of storm track and intensity

The Quantum Phase-Dynamical Properties of the Squeezed Vacuum State Intensity-Couple Interacting with the Atom

NASA Technical Reports Server (NTRS)

Fan, An-Fu; Sun, Nian-Chun; Zhou, Xin

1996-01-01

The Phase-dynamical properties of the squeezed vacuum state intensity-couple interacting with the two-level atom in an ideal cavity are studied using the Hermitian phase operator formalism. Exact general expressions for the phase distribution and the associated expectation value and variance of the phase operator have been derived. we have also obtained the analytic results of the phase variance for two special cases-weakly and strongly squeezed vacuum. The results calculated numerically show that squeezing has a significant effect on the phase properties of squeezed vacuum.

Evaluation and development of satellite inferences of convective storm intensity using combined case study and thunderstorm model simulations

NASA Technical Reports Server (NTRS)

Cotton, W. R.; Tripoli, G. J.

1982-01-01

Observational requirements for predicting convective storm development and intensity as suggested by recent numerical experiments are examined. Recent 3D numerical experiments are interpreted with regard to the relationship between overshooting tops and surface wind gusts. The development of software for emulating satellite inferred cloud properties using 3D cloud model predicted data and the simulation of Heymsfield (1981) Northern Illinois storm are described as well as the development of a conceptual/semi-quantitative model of eastward propagating, mesoscale convective complexes forming to the lee of the Rocky Mountains.

An experimental study of the structure and acoustic field of a jet in a cross stream. [Ames 7-ft by 10-ft wind tunnel tests

NASA Technical Reports Server (NTRS)

Camelier, I.; Karamcheti, K.

1976-01-01

The plane of symmetry of a high speed circular jet was surveyed to measure the mean and turbulent velocity fields by using constant temperature hot wire anemometry. The intensity of the noise radiated from the jet was determined in the tunnel test section by utilizing the cross-correlation at a particular time delay between the signals of two microphones suitably located along a given direction. Experimental results indicate that the turbulent intensity inside the crossflow jet increases by a factor of (1 + 1/2) as compared to the turbulent intensity of the same jet under free conditions, with r indicating the ratio of the jet velocity by the cross stream velocity. The peak observed in the turbulence spectra obtained inside the potential core of the jet has a frequency that increases by the same factor with respect to the corresponding frequency measured in the case of the free jet. The noise radiated by the jet becomes more intense as the crossflow velocity increases. The measured acoustic intensity of the crossflow jet is higher than the value which would be expected from the increase of the turbulent intensity only.

Acute respiratory distress syndrome: an audit of incidence and outcome in Scottish intensive care units.

PubMed

Hughes, M; MacKirdy, F N; Ross, J; Norrie, J; Grant, I S

2003-09-01

This prospective audit of incidence and outcome of the acute respiratory distress syndrome was conducted as part of the national audit of intensive care practice in Scotland. All patients with acute respiratory distress syndrome in 23 adult intensive care units were identified using the diagnostic criteria defined by the American-European Consensus Conference. Daily data collection was continued until death or intensive care unit discharge. Three hundred and sixty-nine patients were diagnosed with acute respiratory distress syndrome over the 8-month study period. The frequency of acute respiratory distress syndrome in the intensive care unit population was 8.1%; the incidence in the Scottish population was estimated at 16.0 cases.100,000(-1).year(-1). Intensive care unit mortality for acute respiratory distress syndrome was 53.1%, with a hospital mortality of 60.9%. In our national unselected population of critically ill patients, the overall outcome is comparable with published series (Acute Physiology and Chronic Health Evaluation II standardised mortality ratio = 0.99). However, mortality from acute respiratory distress syndrome in Scotland is substantially higher than in recent other series suggesting an improvement in outcome in this condition.

The Diversity Project as a Joint Venture: How Higher Education and Industry Collaborate to Move the Needle of Progress

ERIC Educational Resources Information Center

Siegel, David J.

2006-01-01

This study examines the role of corporate influence in shaping an American business school's commitment to racial and ethnic diversity. Themes emerging from an intensive case study include: (a) the centrality of corporate interest and support; (b) co-investment in "pipeline development" strategies that encourage more minorities to pursue business…

Prediction of climate change impacts on agricultural watersheds and the performance of winter cover crops: Case study of the upper region of the Choptank River Watershed

USDA-ARS?s Scientific Manuscript database

Elevated CO2 concentration, temperature, and precipitation intensity driven by climate change are expected to cause significant environmental changes in the Chesapeake Bay Watershed (CBW). Although the potential effects of climate change are widely reported, few studies have been conducted to unders...

Application of a DRAINMOD-based watershed model to a lower coastal plain watershed

Treesearch

Glenn P. Fernandez; George M. Chescheir; R. Wayne Skaggs; Devendra M. Amatya

2003-01-01

This is a case study for applying DRAINMOD-GIS, a DRAINMOD based lumped parameter watershed model to Chicod Creek, a 11300 ha coastal plain watershed in North Carolina which is not intensively instrumented or documented. The study utilized the current database of land-use, topography, stream network, soil, and weather data available to the State and Federal agencies....

Gendered Universities and the Wage Gap: Case Study of a Pay Equity Audit in an Australian University

ERIC Educational Resources Information Center

Currie, Jan; Hill, Beverley

2013-01-01

Studies worldwide have found that women's pay lags behind men's in academia. This article describes pay equity policies in Australia and overseas and the use of a pay equity audit as a strategic tool to reduce gender inequities at The University of Western Australia (UWA). As a research-intensive university, UWA resembles similar universities…

A Qualitative Study of the Child, Family and Professional Factors That Influence the Use of Assistive Technology in Early Intervention.

ERIC Educational Resources Information Center

Hider, Erin D.

Factors involved in assistive technology use by young children with disabilities were explored through case studies of five families who had received intensive training at Camp Gizmo, an assistive technology camp for young children. Families, service providers, and preservice students in special education and speech language pathology engaged in a…

The Legitimacy of Curriculum Development in Post-Colonial Hong Kong: Insights from the Case of Liberal Studies

ERIC Educational Resources Information Center

Fung, Dennis; Liang, Tim

2018-01-01

Liberal Studies was initially introduced as a non-statutory subject in Hong Kong in 1992. It then confronted intense opposition and a bumpy implementation path before securing mandatory status in the new senior secondary curriculum introduced in 2009. Recently, this core subject has been under review. Whilst it is considered to promote students'…

Extreme precipitation in the Polish Carpathians in the 20th century in the context of last 500 years

NASA Astrophysics Data System (ADS)

Limanowka, Danuta; Cebulak, Elzbieta; Pyrc, Robert

2010-05-01

Extreme weather phenomena together with their exceptional course and intensity have always been dangerous for people. In the historical documents such phenomena were marked as basic disasters. First notes about weather phenomena were made in Polish lands in the 10th century. Most information concerns floods caused by intensive rains. Using the data base created within the Millennium project, extreme precipitation cases exceeding 100 mm were analysed. In each case, the intensive precipitation was followed by a summer flood in the Polish Carpathians in the Upper Vistula River basin. Data from the period of instrumental measurements in the 20th century were studied in detail by the analysis of the frequency of occurrence and the spatial and temporal distribution. The results were referred to last 500 years. The information obtained gives approximate image of extreme precipitation in the historical times in Polish lands. All available multi-proxy data were used. Newspapers' notes concerning described phenomena from 1848-1850 published in Kraków were used to complete and verify the quality of data from the early instrumental period and also to complete the data from the period of the Second World War.

Hybrid supply chain model for material requirement planning under financial constraints: A case study

NASA Astrophysics Data System (ADS)

Curci, Vita; Dassisti, Michele; Josefa, Mula Bru; Manuel, Díaz Madroñero

2014-10-01

Supply chain model (SCM) are potentially capable to integrate different aspects in supporting decision making for enterprise management tasks. The aim of the paper is to propose an hybrid mathematical programming model for optimization of production requirements resources planning. The preliminary model was conceived bottom-up from a real industrial case analysed oriented to maximize cash flow. Despite the intense computational effort required to converge to a solution, optimisation done brought good result in solving the objective function.

[Norwegian scabies in a pediatric patient with Down syndrome, a case report].

PubMed

Mantero, Natalia M; Jaime, Lorena J; Nijamin, Tamara R; Laffargue, Jorge A; De Lillo, Leonardo; Grees, Susana A

2013-12-01

Norwegian (crusted) scabies is a rare and extreme manifestation of scabies that can be observed mainly among immunosuppressed patients. Due to the high number of scabies mites present in each lesion, crusted scabies symptoms are much more intense than in usual scabies and it is thus highly contagious. A case study of a child with Down syndrome and Norwegian scabies who shows a good response to a treatment combining keratolytics, emollients, ivermectin and topical scabicides is described.

New Findings, Classification and Long-Term Follow-Up Study Based on MRI Characterization of Brainstem Encephalitis Induced by Enterovirus 71

PubMed Central

Wen, Feiqiu; Huang, Wenxian; Gan, Yungen; Zeng, Weibin; Chen, Ranran; He, Yanxia; Wang, Yonker; Liu, Zaiyi; Liang, Changhong; Wong, Kelvin K. L.

2016-01-01

Background To report the diversity of MRI features of brainstem encephalitis (BE) induced by Enterovirus 71. This is supported by implementation and testing of our new classification scheme in order to improve the diagnostic level on this specific disease. Methods Neuroimaging of 91 pediatric patients who got EV71 related BE were hospitalized between March, 2010 to October, 2012, were analyzed retrospectively. All patients underwent pre- and post-contrast MRI scan. Thereafter, 31 patients were randomly called back for follow-up MRI study during December 2013 to August 2014. The MRI signal patterns of BE primary lesion were analyzed and classified according to MR signal alteration at various disease stages. Findings in fatal and non-fatal cases were compared, and according to the MRI scan time point during the course of this disease, the patients’ conditions were classified as 1) acute stage, 2) convalescence stage, 3) post mortem stage, and 4) long term follow-up study. Results 103 patients were identified. 11 patients did not undergo MRI, as they died within 48 hours. One patient died on 14th day without MR imaging. 2 patients had postmortem MRI. Medical records and imaging were reviewed in the 91 patients, aged 4 months to 12 years, and two cadavers who have had MRI scan. At acute stage: the most frequent pattern (40 patients) was foci of prolonged T1 and T2 signal, with (15) or without (25) contrast enhancement. We observed a novel pattern in 4 patients having foci of low signal intensity on T2WI, with contrast enhancement. Another pattern in 10 patients having foci of contrast enhancement without abnormalities in T1WI or T2WI weighted images. Based on 2 cases, the entire medulla and pons had prolonged T1 and T2 signal, and 2 of our postmortem cases demonstrated the same pattern. At convalescence stage, the pattern observed in 4 patients was foci of prolonged T1 and T2 signal without contrast enhancement. Follow-up MR study of 31 cases showed normal in 26 cases, and demonstrated foci of prolonged T1 and T2 signal with hyper-intensity on FLAIR in 3 cases, or of prolonged T1 and T2 signal with hypo-intensity on FLAIR in 2 cases. Most importantly, MR findings of each case were thoroughly investigated and classified according to phases and MRI signal alteration. Conclusions This study has provided enhanced and useful information for the MRI features of BE induced by EV71, apart from common practice established by previous reports. In addition, a classification scheme that summarizes all types of features based on the MRI signal at the four different stages of the disease would be helpful to improve the diagnostic level. PMID:27798639

New Findings, Classification and Long-Term Follow-Up Study Based on MRI Characterization of Brainstem Encephalitis Induced by Enterovirus 71.

PubMed

Zeng, Hongwu; Wen, Feiqiu; Huang, Wenxian; Gan, Yungen; Zeng, Weibin; Chen, Ranran; He, Yanxia; Wang, Yonker; Liu, Zaiyi; Liang, Changhong; Wong, Kelvin K L

2016-01-01

To report the diversity of MRI features of brainstem encephalitis (BE) induced by Enterovirus 71. This is supported by implementation and testing of our new classification scheme in order to improve the diagnostic level on this specific disease. Neuroimaging of 91 pediatric patients who got EV71 related BE were hospitalized between March, 2010 to October, 2012, were analyzed retrospectively. All patients underwent pre- and post-contrast MRI scan. Thereafter, 31 patients were randomly called back for follow-up MRI study during December 2013 to August 2014. The MRI signal patterns of BE primary lesion were analyzed and classified according to MR signal alteration at various disease stages. Findings in fatal and non-fatal cases were compared, and according to the MRI scan time point during the course of this disease, the patients' conditions were classified as 1) acute stage, 2) convalescence stage, 3) post mortem stage, and 4) long term follow-up study. 103 patients were identified. 11 patients did not undergo MRI, as they died within 48 hours. One patient died on 14th day without MR imaging. 2 patients had postmortem MRI. Medical records and imaging were reviewed in the 91 patients, aged 4 months to 12 years, and two cadavers who have had MRI scan. At acute stage: the most frequent pattern (40 patients) was foci of prolonged T1 and T2 signal, with (15) or without (25) contrast enhancement. We observed a novel pattern in 4 patients having foci of low signal intensity on T2WI, with contrast enhancement. Another pattern in 10 patients having foci of contrast enhancement without abnormalities in T1WI or T2WI weighted images. Based on 2 cases, the entire medulla and pons had prolonged T1 and T2 signal, and 2 of our postmortem cases demonstrated the same pattern. At convalescence stage, the pattern observed in 4 patients was foci of prolonged T1 and T2 signal without contrast enhancement. Follow-up MR study of 31 cases showed normal in 26 cases, and demonstrated foci of prolonged T1 and T2 signal with hyper-intensity on FLAIR in 3 cases, or of prolonged T1 and T2 signal with hypo-intensity on FLAIR in 2 cases. Most importantly, MR findings of each case were thoroughly investigated and classified according to phases and MRI signal alteration. This study has provided enhanced and useful information for the MRI features of BE induced by EV71, apart from common practice established by previous reports. In addition, a classification scheme that summarizes all types of features based on the MRI signal at the four different stages of the disease would be helpful to improve the diagnostic level.

Emotional intensity influences pre-implementation and implementation of distraction and reappraisal

PubMed Central

Shafir, Roni; Schwartz, Naama; Blechert, Jens

2015-01-01

Although emotional intensity powerfully challenges regulatory strategies, its influence remains largely unexplored in affective-neuroscience. Accordingly, the present study addressed the moderating role of emotional intensity in two regulatory stages—implementation (during regulation) and pre-implementation (prior to regulation), of two major cognitive regulatory strategies—distraction and reappraisal. According to our framework, because distraction implementation involves early attentional disengagement from emotional information before it gathers force, in high-intensity it should be more effective in the short-term, relative to reappraisal, which modulates emotional processing only at a late semantic meaning phase. Supporting findings showed that in high (but not low) intensity, distraction implementation resulted in stronger modulation of negative experience, reduced neural emotional processing (centro-parietal late positive potential, LPP), with suggestive evidence for less cognitive effort (frontal-LPP), relative to reappraisal. Related pre-implementation findings confirmed that anticipating regulation of high-intensity stimuli resulted in distraction (over reappraisal) preference. In contrast, anticipating regulation of low-intensity stimuli resulted in reappraisal (over distraction) preference, which is most beneficial for long-term adaptation. Furthermore, anticipating cognitively demanding regulation, either in cases of regulating counter to these preferences or via the more effortful strategy of reappraisal, enhanced neural attentional resource allocation (Stimulus Preceding Negativity). Broad implications are discussed. PMID:25700568

Technology Solutions Case Study: Balancing Hydronic Systems in Multifamily Buildings, Chicago, Illinois

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

None

2014-09-01

In multifamily building hydronic systems, temperature imbalance may be caused by undersized piping, improperly adjusted balancing valves, inefficient water temperature and flow levels, and owner/occupant interaction with the boilers, distribution and controls. The effects of imbalance include tenant discomfort, higher energy use intensity and inefficient building operation. In this case study , Partnership for Advanced Residential Retrofit and Elevate Energy. explores cost-effective distribution upgrades and balancing measures in multifamily hydronic systems, providing a resource to contractors, auditors, and building owners on best practices to improve tenant comfort and lower operating costs.

Numerical investigation of the influence of elevated turbulence levels on the cooling effectiveness of an anti-vortex hole geometry

NASA Astrophysics Data System (ADS)

Repko, Timothy William

A novel film cooling hole geometry for use in gas turbine engines has been investigated numerically by solving the Reynolds Averaged Navier-Stokes equations in a commercial CFD code (STAR-CCM+) with varying turbulence intensity and length scale using the k-o SST turbulence model. Both steady and unsteady results were considered in order to investigate the effects of freestream turbulence intensity and length scale on this novel anti-vortex hole (AVH) concept. The AVH geometry utilizes two side holes, one on each side of the main hole, to attempt to mitigate the vorticity from the jet from the main hole. The AVH concept has been shown by past research to provide a substantial improvement over conventional film cooling hole designs. Past research has been limited to low turbulence intensity and small length scales that are not representative of the turbulent flow exiting the combustor. Three turbulence intensities (Tu = 5, 10 and 20%) and three length scales normalized by the main cooling hole diameter (Λ x/dm = 1, 3, 6) were considered in this study for a total of nine turbulence conditions. The highest intensity, largest length scale turbulence case (Tu = 20, Λx/dm = 6) is considered most representative of engine conditions and was shown to have the best cooling performance. Results show that the turbulence in the hot gases exiting the combustor can aid in the film cooling for the AVH geometry at high blowing ratios (BR = 2.0), where the blowing ratio is essentially the ratio of the jet-to-mainstream mass flux ratios. Length scale was shown to have an insignificant effect on the cooling performance at low turbulence intensity and a moderate effect at higher turbulence intensities. The adiabatic film cooling effectiveness was shown to increase as the turbulence intensity was elevated. The convective heat transfer coefficient was also shown to increase at the turbulence intensity was elevated. An increase in the heat transfer coefficient is a deleterious effect and must be weighed against the improvements in the adiabatic cooling effectiveness. The net heat flux reduction (NHFR) is the parameter used to quantify the net benefit of film cooling. As a general trend, the NHFR was shown to increase with the turbulence intensity in all cases.

Quantifying the uncertainties in life cycle greenhouse gas emissions for UK wheat ethanol

NASA Astrophysics Data System (ADS)

Yan, Xiaoyu; Boies, Adam M.

2013-03-01

Biofuels are increasingly promoted worldwide as a means for reducing greenhouse gas (GHG) emissions from transport. However, current regulatory frameworks and most academic life cycle analyses adopt a deterministic approach in determining the GHG intensities of biofuels and thus ignore the inherent risk associated with biofuel production. This study aims to develop a transparent stochastic method for evaluating UK biofuels that determines both the magnitude and uncertainty of GHG intensity on the basis of current industry practices. Using wheat ethanol as a case study, we show that the GHG intensity could span a range of 40-110 gCO2e MJ-1 when land use change (LUC) emissions and various sources of uncertainty are taken into account, as compared with a regulatory default value of 44 gCO2e MJ-1. This suggests that the current deterministic regulatory framework underestimates wheat ethanol GHG intensity and thus may not be effective in evaluating transport fuels. Uncertainties in determining the GHG intensity of UK wheat ethanol include limitations of available data at a localized scale, and significant scientific uncertainty of parameters such as soil N2O and LUC emissions. Biofuel polices should be robust enough to incorporate the currently irreducible uncertainties and flexible enough to be readily revised when better science is available.

Viral Infection in Adults with Severe Acute Respiratory Infection in Colombia

PubMed Central

Remolina, Yuly Andrea; Ulloa, María Mercedes; Vargas, Hernán; Díaz, Liliana; Gómez, Sandra Liliana; Saavedra, Alfredo; Sánchez, Edgar; Cortés, Jorge Alberto

2015-01-01

Objectives To identify the viral aetiology in adult patients with severe acute respiratory infection (SARI) admitted to sentinel surveillance institutions in Bogotá in 2012. Design A cross-sectional study was conducted in which microarray molecular techniques for viral identification were used on nasopharyngeal samples of adult patients submitted to the surveillance system, and further descriptions of clinical features and relevant clinical outcomes, such as mortality, need for critical care, use of mechanical ventilation and hospital stay, were obtained. Setting Respiratory infections requiring hospital admission in surveillance centres in Bogotá, Colombia. Participants Ninety-one adult patients with acute respiratory infection (55% were female). Measurements Viral identification, intensive care unit admission, hospital stay, and mortality. Results Viral identification was achieved for 63 patients (69.2%). Comorbidity was frequently identified and mainly involved chronic pulmonary disease or pregnancy. Influenza, Bocavirus and Adenovirus were identified in 30.8%, 28.6% and 18.7% of the cases, respectively. Admission to the intensive care unit occurred in 42.9% of the cases, while mechanical ventilation was required for 36.3%. The average hospital stay was 9.9 days, and mortality was 15.4%. Antibiotics were empirically used in 90.1% of patients. Conclusions The prevalence of viral aetiology of SARI in this study was high, with adverse clinical outcomes, intensive care requirements and high mortality. PMID:26576054

Structural and optical properties of Tb and Na-Tb co-doped Ca3V2O8 phosphors prepared by sol-gel process

NASA Astrophysics Data System (ADS)

Parab, Shambhu S.; Salker, A. V.

2018-01-01

A malic acid assisted sol-gel route was successfully employed to prepare two distinct series of green emitting Ca3V2O8 phosphors. In the first series, Tb was solely doped whereas in the second series Na and Tb were doped simultaneously in the Ca3V2O8 crystal lattice. X-ray diffraction studies proved the utility of adopted preparative method by confirming the monophasic formation of all compounds from both the series. Spectral analysis like Raman spectroscopy, UV-DRS were undertaken to analyse the local structure, crystallinity and absorptive characteristics. XPS validated the presence of desired oxidation states of all the elements present. Finally, photoluminescence studies were done to elucidate the scope of prepared compounds as green emitting phosphors and also to understand the effect of both doping schemes on the luminescence. Intense green emission was observed in both the cases. Tb concentration of 0.08 was found to be optimum in case of Tb singly doped compounds whereas Tb = 0.12 showed highest intensity among the Na-Tb co-doped samples. Moreover, a red shift in the excitation wavelength was observed after Na doping signifying a change in the local electronic environment which in turn has affected the luminescence pattern. Local crystallinity and vacancy concentrations were found to have a major say on the emission intensities.

Diagnostics of Particles emitted from a Laser generated Plasma: Experimental Data and Simulations

NASA Astrophysics Data System (ADS)

Costa, Giuseppe; Torrisi, Lorenzo

2018-01-01

The charge particle emission form laser-generated plasma was studied experimentally and theoretically using the COMSOL simulation code. The particle acceleration was investigated using two lasers at two different regimes. A Nd:YAG laser, with 3 ns pulse duration and 1010 W/cm2 intensity, when focused on solid target produces a non-equilibrium plasma with average temperature of about 30-50 eV. An Iodine laser with 300 ps pulse duration and 1016 W/cm2 intensity produces plasmas with average temperatures of the order of tens keV. In both cases charge separation occurs and ions and electrons are accelerated at energies of the order of 200 eV and 1 MeV per charge state in the two cases, respectively. The simulation program permits to plot the charge particle trajectories from plasma source in vacuum indicating how they can be deflected by magnetic and electrical fields. The simulation code can be employed to realize suitable permanent magnets and solenoids to deflect ions toward a secondary target or detectors, to focalize ions and electrons, to realize electron traps able to provide significant ion acceleration and to realize efficient spectrometers. In particular it was applied to the study two Thomson parabola spectrometers able to detect ions at low and at high laser intensities. The comparisons between measurements and simulation is presented and discussed.

New methods of MR image intensity standardization via generalized scale

NASA Astrophysics Data System (ADS)

Madabhushi, Anant; Udupa, Jayaram K.

2005-04-01

Image intensity standardization is a post-acquisition processing operation designed for correcting acquisition-to-acquisition signal intensity variations (non-standardness) inherent in Magnetic Resonance (MR) images. While existing standardization methods based on histogram landmarks have been shown to produce a significant gain in the similarity of resulting image intensities, their weakness is that, in some instances the same histogram-based landmark may represent one tissue, while in other cases it may represent different tissues. This is often true for diseased or abnormal patient studies in which significant changes in the image intensity characteristics may occur. In an attempt to overcome this problem, in this paper, we present two new intensity standardization methods based on the concept of generalized scale. In reference 1 we introduced the concept of generalized scale (g-scale) to overcome the shape, topological, and anisotropic constraints imposed by other local morphometric scale models. Roughly speaking, the g-scale of a voxel in a scene was defined as the largest set of voxels connected to the voxel that satisfy some homogeneity criterion. We subsequently formulated a variant of the generalized scale notion, referred to as generalized ball scale (gB-scale), which, in addition to having the advantages of g-scale, also has superior noise resistance properties. These scale concepts are utilized in this paper to accurately determine principal tissue regions within MR images, and landmarks derived from these regions are used to perform intensity standardization. The new methods were qualitatively and quantitatively evaluated on a total of 67 clinical 3D MR images corresponding to four different protocols and to normal, Multiple Sclerosis (MS), and brain tumor patient studies. The generalized scale-based methods were found to be better than the existing methods, with a significant improvement observed for severely diseased and abnormal patient studies.

A Likelihood-Based Framework for Association Analysis of Allele-Specific Copy Numbers.

PubMed

Hu, Y J; Lin, D Y; Sun, W; Zeng, D

2014-10-01

Copy number variants (CNVs) and single nucleotide polymorphisms (SNPs) co-exist throughout the human genome and jointly contribute to phenotypic variations. Thus, it is desirable to consider both types of variants, as characterized by allele-specific copy numbers (ASCNs), in association studies of complex human diseases. Current SNP genotyping technologies capture the CNV and SNP information simultaneously via fluorescent intensity measurements. The common practice of calling ASCNs from the intensity measurements and then using the ASCN calls in downstream association analysis has important limitations. First, the association tests are prone to false-positive findings when differential measurement errors between cases and controls arise from differences in DNA quality or handling. Second, the uncertainties in the ASCN calls are ignored. We present a general framework for the integrated analysis of CNVs and SNPs, including the analysis of total copy numbers as a special case. Our approach combines the ASCN calling and the association analysis into a single step while allowing for differential measurement errors. We construct likelihood functions that properly account for case-control sampling and measurement errors. We establish the asymptotic properties of the maximum likelihood estimators and develop EM algorithms to implement the corresponding inference procedures. The advantages of the proposed methods over the existing ones are demonstrated through realistic simulation studies and an application to a genome-wide association study of schizophrenia. Extensions to next-generation sequencing data are discussed.

[Extravasation of cytostatic agents: a serious complication of oncological treatment].

PubMed

Alfaro-Rubio, Alberto; Sanmartín, Onofre; Requena, Celia; Llombart, Beatriz; Botella-Estrada, Rafael; Nagore, Eduardo; Serra-Guillén, Carlos; Hueso, Luis; Guillén, Carlos

2006-04-01

The extravasation of cytostatic agents is a known, serious situation that can easily occur and cause chronic, irreversible damage. The incidence of extravasation ranges from 0.1 %-6.5 %, according to different studies. Many cases of extravasation can be prevented by systematizing the administration techniques for cytostatic agents. We present the clinical and histological characteristics of a series of patients with extravasation lesions. Included in the study were all patients treated with chemotherapy who developed localized lesions in the area of the cytostatic injection after extravasation was detected during administration. The patients were studied and followed up for a three-year period, from January 2000 to December 2003, inclusive. We found nine cases of extravasation among the 2,186 patients who were treated with chemotherapy, which represents an incidence of 0.41 %, and 3.4 % of all chemotherapy-induced skin lesions. The cytostatic agent most often involved was vinorelbine, and the most frequent location was the antecubital fossa. The intensity of the lesions made it necessary to delay the next cycle of treatment in 55 % of the cases. The histological findings varied depending on when the biopsy was done, showing panniculitis with low cellularity together with epidermal lesions attributable to direct cytotoxicity. The best treatment for extravasation is prevention, but when it has already occurred, measures vary depending on the cytostatic drug extravasated and the intensity of the lesions. Conservative measures are advisable before surgery.

Climate change, water security and the need for integrated policy development: the case of on-farm infrastructure investment in the Australian irrigation sector

NASA Astrophysics Data System (ADS)

Maraseni, T. N.; Mushtaq, S.; Reardon-Smith, K.

2012-09-01

The Australian Government is currently addressing the challenge of increasing water scarcity through significant on-farm infrastructure investment to facilitate the adoption of new water-efficient pressurized irrigation systems. However, it is highly likely that conversion to these systems will increase on-farm energy consumption and greenhouse gas (GHG) emissions, suggesting potential conflicts in terms of mitigation and adaptation policies. This study explored the trade-offs associated with the adoption of more water efficient but energy-intensive irrigation technologies by developing an integrated assessment framework. Integrated analysis of five case studies revealed trade-offs between water security and environmental security when conversion to pressurized irrigation systems was evaluated in terms of fuel and energy-related emissions, except in cases where older hand-shift sprinkler irrigation systems were replaced. These results suggest that priority should be given, in implementing on-farm infrastructure investment policy, to replacing inefficient and energy-intensive sprinkler irrigation systems such as hand-shift and roll-line. The results indicated that associated changes in the use of agricultural machinery and agrochemicals may also be important. The findings of this study support the use of an integrated approach to avoid possible conflicts in designing national climate change mitigation and adaptation policies, both of which are being developed in Australia.

Preoperative left ventricular internal dimension in end-diastole as earlier identification of early patent ductus arteriosus operation and postoperative intensive care in very low birth weight infants.

PubMed

Saida, Ken; Nakamura, Tomohiko; Hiroma, Takehiko; Takigiku, Kiyohiro; Yasukochi, Satoshi

2013-10-01

Patent ductus arteriosus (PDA) is common in premature infants. In very low birth weight infants (VLBWI), PDA requires surgical therapy in many cases. It is unclear to know at-risk infants showing cardio-dysfunction after PDA surgery. The purpose of this study was to identify at-risk infants showing cardio-dysfunction after surgery for patent ductus arteriosus (PDA). We examined the relationship between left ventricular (LV) performance before and after PDA ligation in a retrospective observational cohort study. We studied 64 preterm neonates with symptomatic PDA before and after surgical ligation. Echocardiographic examinations were performed pre- and postoperatively. M-mode measurements included left ventricular internal dimension in end-diastole (LVIDd) and LV fractional shortening (FS). All cases showed decreased LVFS after PDA closure. Most cases (49/64, 77%) showed postoperative FS decreased to below normal (<28%). Preoperative relative LVIDd was significantly larger in abnormal FS infants (137 ± 18%) than in normal FS infants (118 ± 11%; p<0.01). A cut-off value of preoperative relative LVIDd (absolute LVIDd/normal value) for predicting postoperative cardio-dysfunction was 127.4% (sensitivity, 0.735; specificity, 0.933; area under curve, 0.817). Determination of preoperative LVIDd might facilitate earlier identification of infants needing early PDA surgery and postoperative intensive care. © 2013 Elsevier Ireland Ltd. All rights reserved.

A Case Study of Infant Physiologic Response to Skin-to-Skin Contact After Surgery for Complex Congenital Heart Disease.

PubMed

Harrison, Tondi M; Ludington-Hoe, Susan

2015-01-01

Infants with complex congenital heart disease requiring surgical intervention within the first days or weeks of life may be the most seriously ill infants needing intensive nursing and medical care. Skin-to-skin contact (SSC) is well accepted and practiced as a positive therapeutic intervention in premature infants but is not routinely offered to infants in cardiac intensive care units. The physiologic effects of SSC in the congenital heart disease population must be examined before recommending incorporation of SSC into standard care routines. The purpose of this case study was to describe the physiologic response to a single session of SSC in an 18-day-old infant with hypoplastic left heart syndrome. Repeated measures of heart rate, respiratory rate, oxygen saturation, blood pressure, and temperature were recorded 30 minutes before SSC, during SSC (including interruptions for bottle and breast feedings), and 10 minutes after SSC was completed. All physiologic parameters were clinically acceptable throughout the 135-minute observation. This case study provides beginning evidence that SSC is safe in full-term infants after surgery for complex congenital heart disease. Further research with a larger sample is needed to examine the effects of SSC on infant physiology before surgery and earlier in the postoperative time period as well as on additional outcomes such as length of stay, maternal-infant interaction, and neurodevelopment.

The Positronium Radiative Combination Spectrum: Calculation in the Limit of Thermal Positrons and Low Densities

NASA Technical Reports Server (NTRS)

Wallyn, P.; Mahoney, W. A.; Durouchoux, Ph.; Chapuis, C.

1996-01-01

We calculate the intensities of the positronium de-excitation lines for two processes: (1) the radiative combination of free thermal electrons and positrons for transitions with principal quantum number n less than 20, and (2) charge exchange between free positrons and hydrogen and helium atoms, restricting our evaluation to the Lyman-alpha line. We consider a low-density medium modeled by the case A assumption of Baker & Menzel and use the "nL method" of Pengelly to calculate the absolute intensities. We also evaluate the positronium fine and hyperfine intensities and show that these transitions are in all cases much weaker than positronium de-excitation lines in the same wavelength range. We also extrapolate our positronium de-excitation intensities to the submillimeter, millimeter, and centimeter wavelengths. Our results favor the search of infrared transitions of positronium lines for point sources when the visual extinction A, is greater than approx. 5.

A stochastic model for stationary dynamics of prices in real estate markets. A case of random intensity for Poisson moments of prices changes

NASA Astrophysics Data System (ADS)

Rusakov, Oleg; Laskin, Michael

2017-06-01

We consider a stochastic model of changes of prices in real estate markets. We suppose that in a book of prices the changes happen in points of jumps of a Poisson process with a random intensity, i.e. moments of changes sequently follow to a random process of the Cox process type. We calculate cumulative mathematical expectations and variances for the random intensity of this point process. In the case that the process of random intensity is a martingale the cumulative variance has a linear grows. We statistically process a number of observations of real estate prices and accept hypotheses of a linear grows for estimations as well for cumulative average, as for cumulative variance both for input and output prises that are writing in the book of prises.

Analysis of myelomonocytic leukemic differentiation by a cell surface marker panel including a fucose-binding lectin from Lotus tetragonolobus.

PubMed

Elias, L; Van Epps, D E

1984-06-01

The fucose-binding lectin from Lotus tetragonolobus ( FBL -L) has been previously shown to bind specifically to normal cells of the myeloid and monocytic lineages. The purpose of this study was to explore the utility of fluoresceinated FBL -L as a leukemia differentiation marker in conjunction with a panel of other frequently used surface markers (Fc receptor, HLA-DR, OKM1, and antimonocyte antibody). FBL -L reacted with leukemic cells in 8/9 cases of clinically recognized acute myeloid leukemia, including myeloid blast crisis of chronic granulocytic leukemia, 3/3 cases of chronic phase chronic myelogenous leukemia, and in 2/7 cases of clinically undifferentiated acute leukemia. Correlations were noted between reactivity with FBL -L, and DR and Fc receptor expression. Among continuous cell lines, FBL -L bound with high intensity to a majority of HL-60 and U937 cells. The less well differentiated myeloblast cell lines, KG-1, KG1a , and HL-60 blast II, exhibited less FBL -L binding than HL-60 and U937. A moderate proportion of K562 cells exhibited low level binding of FBL -L. Several lymphoblastic cell lines exhibited a pattern of low intensity binding that was distinguishable from the high intensity binding pattern of the myeloblastic lines. FBL -L reactivity of U937 was enhanced by induction of differentiation with leukocyte conditioned medium, but not dimethylsulfoxide. Such treatments induced contrasting patterns of change of HL-60 and U937 when labeled with OKM1, alpha-Mono, and HLA-DR. These studies demonstrate the application of FBL -L to analysis and quantitation of myelomonocytic leukemic differentiation.

Adaptive use of research aircraft data sets for hurricane forecasts

NASA Astrophysics Data System (ADS)

Biswas, M. K.; Krishnamurti, T. N.

2008-02-01

This study uses an adaptive observational strategy for hurricane forecasting. It shows the impacts of Lidar Atmospheric Sensing Experiment (LASE) and dropsonde data sets from Convection and Moisture Experiment (CAMEX) field campaigns on hurricane track and intensity forecasts. The following cases are used in this study: Bonnie, Danielle and Georges of 1998 and Erin, Gabrielle and Humberto of 2001. A single model run for each storm is carried out using the Florida State University Global Spectral Model (FSUGSM) with the European Center for Medium Range Weather Forecasts (ECMWF) analysis as initial conditions, in addition to 50 other model runs where the analysis is randomly perturbed for each storm. The centers of maximum variance of the DLM heights are located from the forecast error variance fields at the 84-hr forecast. Back correlations are then performed using the centers of these maximum variances and the fields at the 36-hr forecast. The regions having the highest correlations in the vicinity of the hurricanes are indicative of regions from where the error growth emanates and suggests the need for additional observations. Data sets are next assimilated in those areas that contain high correlations. Forecasts are computed using the new initial conditions for the storm cases, and track and intensity skills are then examined with respect to the control forecast. The adaptive strategy is capable of identifying sensitive areas where additional observations can help in reducing the hurricane track forecast errors. A reduction of position error by approximately 52% for day 3 of forecast (averaged over 7 storm cases) over the control runs is observed. The intensity forecast shows only a slight positive impact due to the model’s coarse resolution.

Appearance of bony lesions on 3-D CT reconstructions: a case study in variable renderings

NASA Astrophysics Data System (ADS)

Mankovich, Nicholas J.; White, Stuart C.

1992-05-01

This paper discusses conventional 3-D reconstruction for bone visualization and presents a case study to demonstrate the dangers of performing 3-D reconstructions without careful selection of the bone threshold. The visualization of midface bone lesions directly from axial CT images is difficult because of the complex anatomic relationships. Three-dimensional reconstructions made from the CT to provide graphic images showing lesions in relation to adjacent facial bones. Most commercially available 3-D image reconstruction requires that the radiologist or technologist identify a threshold image intensity value that can be used to distinguish bone from other tissues. Much has been made of the many disadvantages of this technique, but it continues as the predominant method in producing 3-D pictures for clinical use. This paper is intended to provide a clear demonstration for the physician of the caveats that should accompany 3-D reconstructions. We present a case of recurrent odontogenic keratocyst in the anterior maxilla where the 3-D reconstructions, made with different bone thresholds (windows), are compared to the resected specimen. A DMI 3200 computer was used to convert the scan data from a GE 9800 CT into a 3-D shaded surface image. Threshold values were assigned to (1) generate the most clinically pleasing image, (2) produce maximum theoretical fidelity (using the midpoint image intensity between average cortical bone and average soft tissue), and (3) cover stepped threshold intensities between these two methods. We compared the computer lesions with the resected specimen and noted measurement errors of up to 44 percent introduced by inappropriate bone threshold levels. We suggest clinically applicable standardization techniques in the 3-D reconstruction as well as cautionary language that should accompany the 3-D images.

Effects of reflection on clinical decision-making of intensive care unit nurses.

PubMed

Razieh, Shahrokhi; Somayeh, Ghafari; Fariba, Haghani

2018-07-01

Nurses are one of the most influential factors in overcoming the main challenges faced by health systems throughout the world. Every health system should, hence, empower nurses in clinical judgment and decision-making skills. This study evaluated the effects of implementing Tanner's reflection method on clinical decision-making of nurses working in an intensive care unit (ICU). This study used an experimental, pretest, posttest design. The setting was the intensive care unit of Amin Hospital Isfahan, Iran. The convenience sample included 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). This clinical trial was performed on 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). The nurses were selected by census sampling and randomly allocated to either the case or the control group. Data were collected using a questionnaire containing demographic characteristics and the clinical decision-making scale developed by Laurie and Salantera (NDMI-14). The questionnaire was completed before and one week after the intervention. The data were analyzed using SPSS 21.0. The two groups were not significantly different in terms of the level and mean scores of clinical decision-making before the intervention (P = 0.786). Based on the results of independent t-test, the mean score of clinical decision-making one week after the intervention was significantly higher in the case group than in the control group (P = 0.009; t = -2.69). The results of Mann Whitney test showed that one week after the intervention, the nurses' level of clinical decision-making in the case group rose to the next level (P = 0.001). Reflection could improve the clinical decision-making of ICU nurses. It is, thus, recommended to incorporate this method into the nursing curriculum and care practices. Copyright © 2018. Published by Elsevier Ltd.

Emergency management for congenital tracheal stenosis with endoluminal stenting in pediatric intensive care units

PubMed Central

Xu, Xuan; Ding, Hui; Liu, Xicheng; Zhu, Bin; Feng, Zhichun

2016-01-01

Objective: The objective of this study was to share our experience in the management of congenital tracheal stenosis (CTS) using self-expanding intraluminal stents in infants. Methods: From January 2010 to August 2012, 31 infants with CTS treated using stents by bronchoscope in pediatric intensive care units (PICUs) were recruited for this study. Results: Among the 31 patients, 17 were male and 14 were female with their ages ranging from 55 days to 22 months. CTS was associated with congenital heart disease (CHD) in 22 patients. There were no immediate stent-related airway complications. A significant and immediate improvement of respiratory obstruction following stent placement in all 31 patients led to successful weaning from the breathing machine and extubation. Granulation tissue formation as a complication was observed in three (9.7%) patients, but all were successfully managed using cryotherapy. During follow up (up to 24 months), stents in 29 infants remained functional. In seven cases, stents were retrieved under bronchoscope (the same day to 10 months), and three cases required stent replacement (each of the three cases had the stent replaced three times). Nine infants died after stenting due to other causes and two infants abandoned treatment. Conclusion: Airway stenting may provide an important therapeutic option in infants with CTS. PMID:27126522

SU-E-T-617: Plan Quality Estimation of Intensity-Modulated Radiotherapy Cases for Lung Cancer

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

Koo, J; Yoon, M; Chung, W

Purpose: To estimate the planning quality of intensity-modulated radiotherapy in lung cancer cases and to provide preliminary data for the development of a planning quality assurance algorithm. Methods: 42 IMRT plans previously used in cases of solitary lung cancers were collected. Organs in or near the thoracic cavity, such as lung (ipsilateral, contralateral), heart, liver, esophagus, cord and bronchus were considered as organs at risk (OARs) in this study. The coverage index (CVI), conformity index (CI), homogeneity index (HI), volume, irregularity (standard deviation of center-surface distance) were used to compare PTV dose characteristics. The effective uniform dose (EUD), V10Gy, andmore » V20Gy of the OARs were used to compare OAR dose characteristics. Results: Average CVI, CI, HI values were 0.9, 0.8, 0.1, respectively. CVI and CI had narrow Gaussian distribution curves without a singular value, but one case had a relatively high (0.25) HI because of location and irregular shape (Irregularity of 18.5 when average was 12.5) of PTV. EUDs tended to decrease as OAR-PTV distance increased and OAR-PTV overlap volume decreased. Conclusion: This work indicates the potential for significant plan quality deviation of similar lung cancer cases. Considering that this study were from a single department, differences in the treatment results for a given patient would be much more pronounced if multiple departments (and therefore more planners) were involved. Therefore, further examination of QA protocols is needed to reduce deviations in radiation treatment planning.« less

The change in management of bronchiolitis in the intensive care unit between 2000 and 2015.

PubMed

Mecklin, Minna; Heikkilä, Paula; Korppi, Matti

2018-05-15

This case-control study evaluated interventions for bronchiolitis in relation to time in the pediatric intensive care unit (PICU) during a 16-year surveillance period. Together, 105 infants aged < 12 months were treated for bronchiolitis in the PICU, and for them, we selected 210 controls admitted for bronchiolitis closest to cases. We collected data on treatments in the PICU, at the ward and in the emergency department for three periods: years 2000-2005, 2006-2010, and 2011-2015. Median hospital length of stay for PICU patients were 7 days (interquartile range 5-12), 5 days (4-8) and 8 days (4-12.5, p = 0.127), respectively. By time, the use of inhaled beta-agonist (68 vs. 44 vs. 38%, p = 0.019) and systemic corticosteroids (29 vs. 15 vs. 5%, p = 0.019) decreased, but that of racemic adrenaline (59 vs. 78 vs. 84%, p = 0.035) and hypertonic saline (0 vs. 0 vs. 54%, p < 0.001) inhalations increased in the PICU. Similar changes were seen at the ward. In the PICU, non-invasive ventilation therapies increased significantly, but intubation rates did not decline. Beta-agonists and systemic corticosteroids were used less by time in intensive care for infant bronchiolitis, but the use of hypertonic saline and racemic adrenaline increased, though their effectiveness has been questioned. What is Known: • Until now, studies have shown which treatments do not work in bronchiolitis, and so, there is no consensus how infants with bronchiolitis should be treated. In particular, there is no consensus on different interventions in intensive care for bronchiolitis. What is New: • During 2000-2015, treatments with inhaled beta-agonists and systemic corticosteroids decreased but treatments with racemic adrenaline and hypertonic saline inhalations increased in intensive care for bronchiolitis. Similar changes were seen at the ward. Though non-invasive ventilation therapies increased, the intubation rate did not decline.

China's Pathways to Achieving 40% ~ 45% Reduction in CO{sub 2} Emissions per Unit of GDP in 2020: Sectoral Outlook and Assessment of Savings Potential

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

Zheng, Nina; Fridley, David; Zhou, Nan

2011-09-30

Achieving China’s goal of reducing its carbon intensity (CO{sub 2} per unit of GDP) by 40% to 45% percent below 2005 levels by 2020 will require the strengthening and expansion of energy efficiency policies across the buildings, industries and transport sectors. This study uses a bottom-up, end-use model and two scenarios -- an enhanced energy efficiency (E3) scenario and an alternative maximum technically feasible energy efficiency improvement (Max Tech) scenario – to evaluate what policies and technical improvements are needed to achieve the 2020 carbon intensity reduction target. The findings from this study show that a determined approach by Chinamore » can lead to the achievement of its 2020 goal. In particular, with full success in deepening its energy efficiency policies and programs but following the same general approach used during the 11th Five Year Plan, it is possible to achieve 49% reduction in CO{sub 2} emissions per unit of GDP (CO{sub 2} emissions intensity) in 2020 from 2005 levels (E3 case). Under the more optimistic but feasible assumptions of development and penetration of advanced energy efficiency technology (Max Tech case), China could achieve a 56% reduction in CO{sub 2} emissions intensity in 2020 relative to 2005 with cumulative reduction of energy use by 2700 Mtce and of CO{sub 2} emissions of 8107 Mt CO{sub 2} between 2010 and 2020. Energy savings and CO{sub 2} mitigation potential varies by sector but most of the energy savings potential is found in energy-intensive industry. At the same time, electricity savings and the associated emissions reduction are magnified by increasing renewable generation and improving coal generation efficiency, underscoring the dual importance of end-use efficiency improvements and power sector decarbonization.« less

Neonatal bacterial meningitis: Results from a cross-sectional hospital based study.

PubMed

Softić, Izeta; Tahirović, Husref; Hasanhodžić, Mensuda

2015-01-01

The aim of the study was to determine the epidemiological characteristics of bacterial meningitis observed in neonates born in the Department of Gynaecology and Obstetrics, University Clinical Centre Tuzla, Bosnia and Herzegovina, admitted to Intensive care unit (NICU) or readmitted, because of suspected infection, after discharge from the nursery. This study was carried out from July 1, 2012 to June 30, 2013. During this period 4136 neonates were born. All neonates admitted to the Intensive care unit with signs and symptoms of systemic infections, and neonates readmitted to the Intensive care unit, after discharge from the nursery for sepsis work up were included in the study. Eighteen of 200 neonates (9%) admitted or readmitted to the NICU developed meningitis. 61% cases were late onset meningitis. The overall incidence was 4.4/1000 live births. The mortality rate was 11.1%. The mean age of symptom presentation was 8.7 days. The most common clinical features were: fever, respiratory distress and jaundice. Significant risk factors for acquiring meningitis were: male gender, Caesarean delivery, stained amniotic fluid. Positive CSF finding were detected in 6/18 (33.3%) of cases. Gram-positive bacteria were more frequently responsible for confirmed meningitis. In all neonates with meningitis blood culture was examined and 5 (50%) yielded Gram-negative bacteria. The high rates of neonatal meningitis with predominant late onset may suggest nosocomial origin. Measures to improve antenatal, intrapartum and delivery care and measures during NICU hospitalisation are necessary to lower the risk of nosocomial infections. Copyright © 2015 by Academy of Sciences and Arts of Bosnia and Herzegovina.

The impact of surgery on global climate: a carbon footprinting study of operating theatres in three health systems.

PubMed

MacNeill, Andrea J; Lillywhite, Robert; Brown, Carl J

2017-12-01

Climate change is a major global public health priority. The delivery of health-care services generates considerable greenhouse gas emissions. Operating theatres are a resource-intensive subsector of health care, with high energy demands, consumable throughput, and waste volumes. The environmental impacts of these activities are generally accepted as necessary for the provision of quality care, but have not been examined in detail. In this study, we estimate the carbon footprint of operating theatres in hospitals in three health systems. Surgical suites at three academic quaternary-care hospitals were studied over a 1-year period in Canada (Vancouver General Hospital, VGH), the USA (University of Minnesota Medical Center, UMMC), and the UK (John Radcliffe Hospital, JRH). Greenhouse gas emissions were estimated using primary activity data and applicable emissions factors, and reported according to the Greenhouse Gas Protocol. Site greenhouse gas evaluations were done between Jan 1 and Dec 31, 2011. The surgical suites studied were found to have annual carbon footprints of 5 187 936 kg of CO 2 equivalents (CO 2 e) at JRH, 4 181 864 kg of CO 2 e at UMMC, and 3 218 907 kg of CO 2 e at VGH. On a per unit area basis, JRH had the lowest carbon intensity at 1702 kg CO 2 e/m 2 , compared with 1951 kg CO 2 e/m 2 at VGH and 2284 kg CO 2 e/m 2 at UMMC. Based on case volumes at all three sites, VGH had the lowest carbon intensity per operation at 146 kg CO 2 e per case compared with 173 kg CO 2 e per case at JRH and 232 kg CO 2 e per case at UMMC. Anaesthetic gases and energy consumption were the largest sources of greenhouse gas emissions. Preferential use of desflurane resulted in a ten-fold difference in anaesthetic gas emissions between hospitals. Theatres were found to be three to six times more energy-intense than the hospital as a whole, primarily due to heating, ventilation, and air conditioning requirements. Overall, the carbon footprint of surgery in the three countries studied is estimated to be 9·7 million tonnes of CO 2 e per year. Operating theatres are an appreciable source of greenhouse gas emissions. Emissions reduction strategies including avoidance of desflurane and occupancy-based ventilation have the potential to lessen the climate impact of surgical services without compromising patient safety. None. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Unconventional Use of Intense Pulsed Light

PubMed Central

Piccolo, D.; Di Marcantonio, D.; Crisman, G.; Cannarozzo, G.; Sannino, M.; Chiricozzi, A.; Chimenti, S.

2014-01-01

According to the literature, intense pulsed light (IPL) represents a versatile tool in the treatment of some dermatological conditions (i.e., pigmentation disorders, hair removal, and acne), due to its wide range of wavelengths. The authors herein report on 58 unconventional but effective uses of IPL in several cutaneous diseases, such as rosacea (10 cases), port-wine stain (PWS) (10 cases), disseminated porokeratosis (10 cases), pilonidal cyst (3 cases), seborrheic keratosis (10 cases), hypertrophic scar (5 cases) and keloid scar (5 cases), Becker's nevus (2 cases), hidradenitis suppurativa (2 cases), and sarcoidosis (1 case). Our results should suggest that IPL could represent a valid therapeutic support and option by providing excellent outcomes and low side effects, even though it should be underlined that the use and the effectiveness of IPL are strongly related to the operator's experience (acquired by attempting at least one specific course on the use of IPL and one-year experience in a specialized centre). Moreover, the daily use of these devices will surely increase clinical experience and provide new information, thus enhancing long-term results and improving IPL effectiveness. PMID:25276803

Unconventional use of intense pulsed light.

PubMed

Piccolo, D; Di Marcantonio, D; Crisman, G; Cannarozzo, G; Sannino, M; Chiricozzi, A; Chimenti, S

2014-01-01

According to the literature, intense pulsed light (IPL) represents a versatile tool in the treatment of some dermatological conditions (i.e., pigmentation disorders, hair removal, and acne), due to its wide range of wavelengths. The authors herein report on 58 unconventional but effective uses of IPL in several cutaneous diseases, such as rosacea (10 cases), port-wine stain (PWS) (10 cases), disseminated porokeratosis (10 cases), pilonidal cyst (3 cases), seborrheic keratosis (10 cases), hypertrophic scar (5 cases) and keloid scar (5 cases), Becker's nevus (2 cases), hidradenitis suppurativa (2 cases), and sarcoidosis (1 case). Our results should suggest that IPL could represent a valid therapeutic support and option by providing excellent outcomes and low side effects, even though it should be underlined that the use and the effectiveness of IPL are strongly related to the operator's experience (acquired by attempting at least one specific course on the use of IPL and one-year experience in a specialized centre). Moreover, the daily use of these devices will surely increase clinical experience and provide new information, thus enhancing long-term results and improving IPL effectiveness.

Intensive Care in India: The Indian Intensive Care Case Mix and Practice Patterns Study.

PubMed

Divatia, Jigeeshu V; Amin, Pravin R; Ramakrishnan, Nagarajan; Kapadia, Farhad N; Todi, Subhash; Sahu, Samir; Govil, Deepak; Chawla, Rajesh; Kulkarni, Atul P; Samavedam, Srinivas; Jani, Charu K; Rungta, Narendra; Samaddar, Devi Prasad; Mehta, Sujata; Venkataraman, Ramesh; Hegde, Ashit; Bande, B D; Dhanuka, Sanjay; Singh, Virendra; Tewari, Reshma; Zirpe, Kapil; Sathe, Prachee

2016-04-01

To obtain information on organizational aspects, case mix and practices in Indian Intensive Care Units (ICUs). An observational, 4-day point prevalence study was performed between 2010 and 2011 in 4209 patients from 124 ICUs. ICU and patient characteristics, and interventions were recorded for 24 h of the study day, and outcomes till 30 days after the study day. Data were analyzed for 4038 adult patients from 120 ICUs. On the study day, mean age, Acute Physiology and Chronic Health Evaluation (APACHE II) and sequential organ failure assessment (SOFA) scores were 54.1 ± 17.1 years, 17.4 ± 9.2 and 3.8 ± 3.6, respectively. About 46.4% patients had ≥1 organ failure. Nearly, 37% and 22.2% patients received mechanical ventilation (MV) and vasopressors or inotropes, respectively. Nearly, 12.2% patients developed an infection in the ICU. About 28.3% patients had severe sepsis or septic shock (SvSpSS) during their ICU stay. About 60.7% patients without infection received antibiotics. There were 546 deaths and 183 terminal discharges (TDs) from ICU (including left against medical advice or discharged on request), with ICU mortality 729/4038 (18.1%). In 1627 patients admitted within 24 h of the study day, the standardized mortality ratio was 0.67. The APACHE II and SOFA scores, public hospital ICUs, medical ICUs, inadequately equipped ICUs, medical admission, self-paying patient, presence of SvSpSS, acute respiratory failure or cancer, need for a fluid bolus, and MV were independent predictors of mortality. The high proportion of TDs and the association of public hospitals, self-paying patients, and inadequately equipped hospitals with mortality has important implications for critical care in India.

Modulational instability in a PT-symmetric vector nonlinear Schrödinger system

NASA Astrophysics Data System (ADS)

Cole, J. T.; Makris, K. G.; Musslimani, Z. H.; Christodoulides, D. N.; Rotter, S.

2016-12-01

A class of exact multi-component constant intensity solutions to a vector nonlinear Schrödinger (NLS) system in the presence of an external PT-symmetric complex potential is constructed. This type of uniform wave pattern displays a non-trivial phase whose spatial dependence is induced by the lattice structure. In this regard, light can propagate without scattering while retaining its original form despite the presence of inhomogeneous gain and loss. These constant-intensity continuous waves are then used to perform a modulational instability analysis in the presence of both non-hermitian media and cubic nonlinearity. A linear stability eigenvalue problem is formulated that governs the dynamical evolution of the periodic perturbation and its spectrum is numerically determined using Fourier-Floquet-Bloch theory. In the self-focusing case, we identify an intensity threshold above which the constant-intensity modes are modulationally unstable for any Floquet-Bloch momentum belonging to the first Brillouin zone. The picture in the self-defocusing case is different. Contrary to the bulk vector case, where instability develops only when the waves are strongly coupled, here an instability occurs in the strong and weak coupling regimes. The linear stability results are supplemented with direct (nonlinear) numerical simulations.

Antifreeze on a freezing morning: ethylene glycol poisoning in a 2-year-old

PubMed Central

Hann, Gayle; Duncan, Dana; Sudhir, Gopakumar; West, Peter; Sohi, Dalbir

2012-01-01

This case report describes the presentation and management of a 2-year-old child who ingested a potentially fatal amount of ethylene glycol (EG). There are few published cases worldwide of EG poisoning in children managed with fomepizole. All cases described in the literature were managed in a paediatric intensive care unit. In this case, the child presented irritable, pale and confused with high anion gap metabolic acidosis. As there were no paediatric intensive care beds available in the region, the child was successfully managed in a high dependency area in our district general hospital. The child fully recovered and was discharged home in 7 days. The authors believe that multi-disciplinary team management and the use of fomepizole contributed to the positive outcome and this case raised many useful learning points. PMID:22605809

The Development of Case Studies to Evaluate the Usefulness of Teaching Interactions in One-to-One Teaching of Early Number

ERIC Educational Resources Information Center

Ewing, Bronwyn

2016-01-01

This research paper reports on phase two of an Australian study that examined video-recorded intensive one-to-one teaching interactions with 6-7-year-old students who were in their second year of schooling and identified by the their class teacher as low attaining in early number. The two-phased study from which this paper emerges was originally…

The rationale for intensity-modulated proton therapy in geometrically challenging cases

NASA Astrophysics Data System (ADS)

Safai, S.; Trofimov, A.; Adams, J. A.; Engelsman, M.; Bortfeld, T.

2013-09-01

Intensity-modulated proton therapy (IMPT) delivered with beam scanning is currently available at a limited number of proton centers. However, a simplified form of IMPT, the technique of field ‘patching’, has long been a standard practice in proton therapy centers. In field patching, different parts of the target volume are treated from different directions, i.e., a part of the tumor gets either full dose from a radiation field, or almost no dose. Thus, patching represents a form of binary intensity modulation. This study explores the limitations of the standard binary field patching technique, and evaluates possible dosimetric advantages of continuous dose modulations in IMPT. Specifics of the beam delivery technology, i.e., pencil beam scanning versus passive scattering and modulation, are not investigated. We have identified two geometries of target volumes and organs at risk (OAR) in which the use of field patching is severely challenged. We focused our investigations on two patient cases that exhibit these geometries: a paraspinal tumor case and a skull-base case. For those cases we performed treatment planning comparisons of three-dimensional conformal proton therapy (3DCPT) with field patching versus IMPT, using commercial and in-house software, respectively. We also analyzed the robustness of the resulting plans with respect to systematic setup errors of ±1 mm and range errors of ±2.5 mm. IMPT is able to better spare OAR while providing superior dose coverage for the challenging cases identified above. Both 3DCPT and IMPT are sensitive to setup errors and range uncertainties, with IMPT showing the largest effect. Nevertheless, when delivery uncertainties are taken into account IMPT plans remain superior regarding target coverage and OAR sparing. On the other hand, some clinical goals, such as the maximum dose to OAR, are more likely to be unmet with IMPT under large range errors. IMPT can potentially improve target coverage and OAR sparing in challenging cases, even when compared with the relatively complicated and time consuming field patching technique. While IMPT plans tend to be more sensitive to delivery uncertainties, their dosimetric advantage generally holds. Robust treatment planning techniques may further reduce the sensitivity of IMPT plans.

[System-immanent incentives in the remuneration for psychiatry and psychosomatics : Analysis exemplified by treatment of alcohol-related disorders].

PubMed

Horter, H; Zapp, W; Driessen, M

2016-07-01

The German fixed rate remuneration system in psychiatry and psychosomatics (PEPP) has been criticized by many specialty associations because negative effects on mental healthcare are expected through economic incentives. Through analysis of performance data in the treatment of alcohol dependency at the Evangelical Hospital Bielefeld (Evangelisches Krankenhaus Bielefeld, EvKB) from 2014 and various simulations, the incentives of the PEPP (version 2015) were analyzed and its potential impact on patient care was evaluated. Groups of cases were created based on the clinical data. Various parameters were evaluated, such as duration of treatment, PEPP coding, loss of income by merging cases and case remuneration. Additionally, changes in the duration of treatment, the intensity of treatment and the intensity of care were simulated. In the simulations a reduction in the duration of treatment by 16.1 % led to additional revenues of 1.9 % per treatment day. The calculated additional costs of 1:1 care and intensive nursing care were not completely covered by the additional revenues, whereas psychotherapeutic inpatient treatment programs showed positive profit contributions. Complicated cases with increased merging of cases showed lower revenues but with above average expenditure of efforts. The current version of the PEPP leads to misdirected incentives in patient care. This is caused, for example, by the fact that higher profit contributions can be realized in some patient groups and intensive nursing care of patients is insufficiently represented. It is not clear whether these incentives will persist or can be compensated in subsequent versions of the system.

MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine.

PubMed

Xiao, Lianxiang; Lin, Xiangtao; Cao, Jinfeng; Wang, Xueyu; Wu, Lebin

2011-09-01

Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5mg and atropine 0.025 mg. These patients were referred to our hospital within 24h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment. Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.

Clinical efficacy of Trigonella foenum graecum (Fenugreek) and dry cupping therapy on intensity of pain in patients with primary dysmenorrhea.

PubMed

Inanmdar, Wajida; Sultana, Arshiya; Mubeen, Umraz; Rahman, Khaleequr

2016-05-25

To determine the effificacy and safety of fenugreek seed and dry cupping on intensity of pain in primary dysmenorrhea. Sixty patients with primary dysmenorrhea were enrolled in this prospective, open-labeled, randomized, standard-controlled study, conducted in the National Institute of Unani Medicine Hospital between February 2010 and April 2011. In group A (20 cases), 3 g powder of fenugreek seed (3 capsules, 1 g each) was given orally twice daily from day 1 to 3 of menstrual cycle. Group B (20 cases) received the same dose of fenugreek seed as group A along with dry cupping therapy [two 4.2-cm and one 2.5-cm cups (internal diameter)], which was applied below the umbilicus for 15 min on day 1 and day 3 of menstrual cycle for 3 consecutive months. The control group C (20 cases) was given mefenamic acid, 500 mg twice daily, on the same protocol. The reduction in menstrual pain intensity was measured with well validated Visual Analogue Scale and safety of fenugreek seed was evaluated by clinical examination and laboratory investigations. Baseline characteristics and biochemical parameters were comparable and homogenous among all groups (P>0.05). The percentage reduction in lower abdominal pain was 66.89%, 66.49%, and 62.88% in A, B and C groups respectively at the end of the treatment. No adverse drug effects were noticed. The fenugreek seed and dry cupping are effificacious, safe, cost effective, and well tolerated.