Feasibility study for remote assessment of cognitive function in multiple sclerosis.

PubMed

George, Michaela F; Holingue, Calliope B; Briggs, Farren B S; Shao, Xiaorong; Bellesis, Kalliope H; Whitmer, Rachel A; Schaefer, Catherine; Benedict, Ralph Hb; Barcellos, Lisa F

2016-01-01

Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published. To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals. The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized. 11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007). Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures.

Feasibility study for remote assessment of cognitive function in multiple sclerosis

PubMed Central

George, Michaela F.; Holingue, Calliope B.; Briggs, Farren B.S.; Shao, Xiaorong; Bellesis, Kalliope H.; Whitmer, Rachel A.; Schaefer, Catherine; Benedict, Ralph HB; Barcellos, Lisa F.

2017-01-01

Background Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published. Objective To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals. Methods The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized. Results 11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007). Conclusions Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures. PMID:28255581

Intermountain Cyclogenesis: a Climatology and Multiscale Case Studies

NASA Astrophysics Data System (ADS)

Lee, Tiros Peijiun

1995-11-01

A detailed study of Intermountain cyclones over the western United States is conducted through climatological and case studies. An eleven-year (1976-1986) statistical survey shows that the Nevada cyclogenesis is mainly a springtime (March, April) event while a secondary maximum of cyclogenesis frequency is found in November. Nearly 75% of the Nevada cyclogenesis events (177 out of 237 cases) take place under large-scale westerly to southerly flow aloft across the Sierra Nevada Mountains, while 24% of the events (57 out of 237 cases) occur under northwesterly flow aloft. A composite study of these two types of the flow is shown to demonstrate how differences in large-scale topography affect Intermountain cyclogenesis processes. The result from a case study of 9-11 February 1984 reveals that an antecedent Nevada lee trough formed as a result of large-scale southwesterly flow aloft interacting with the underlying terrain well before the surface and upper-level troughs moved onshore. Subsequent cyclogenesis took place in situ with the axis of the trough as the center of large-scale quasi-geostrophic ascent/positive potential vorticity advection began to spread across the Sierra Nevada Mountains. As the cyclone moved downstream, it was observed to weaken well before reaching the Continental Divide while a new cyclonic development occurred east of the Rocky Mountains. It is shown that the weakening of the Intermountain cyclone was associated with the ongoing interaction between the Intermountain cyclone and large-scale topography and the progressive outrunning of the large-scale dynamical forcing aloft away from the surface cyclone center. An investigation of the large-scale evolution for the 26-29 January 1980 case, which developed beneath the northwesterly flow aloft, further reveals that the underlying topography plays two major roles in contributing to the initial cyclogenesis: (1) to block and to retard cold, stable air east of the Continental Divide from rushing into the Great Basin region, and (2) to produce differential pressure falls across the Sierra Nevada Mountains (more along the eastern slopes) in response to increasing cross -mountain flow. Numerous transient shortwaves in the midtroposphere rapidly move across the GB and the Rocky Mountains into the Plains States, while the Intermountain cyclone moves slower than to the disturbances aloft. There is no downstream lee trough/cyclogenesis to the east of the Rockies during the investigation period since the leeside is characterized by cold, stable air. The third case study is made of an 11-14 December 1987 Intermountain cyclogenesis case which took place in an area of relatively warm and less stable environment near the Arizona-New Mexico border beneath northwesterly flow aloft. The ensuing interaction between the large -scale flow and underlying terrain allowed the surface cyclone to remain quasi-stationary for its entire 36 h life span. We also document a cold-season small-scale Catalina eddy development in the coastal southern California waters in this case. The eddy formed as the equatorward and northeasterly flow upstream of the coastal (San Rafael and Saint Ynez) mountains increased in the lower troposphere. Weak large-scale ascent in the mid- and upper-troposphere over the incipient eddy environment provided evidence of the orographic nature of the small -scale cyclone. The eddy was eventually displaced seaward and weakened with the arrival of powerful large-scale subsidence and increasing northeasterly downslope flow at the lower levels that reached the coastal waters.

Effect of using an audience response system on learning environment, motivation and long-term retention, during case-discussions in a large group of undergraduate veterinary clinical pharmacology students.

PubMed

Doucet, Michèle; Vrins, André; Harvey, Denis

2009-12-01

Teaching methods that provide an opportunity for individual engagement and focussed feedback are required to create an active learning environment for case-based teaching in large groups. A prospective observational controlled study was conducted to evaluate whether the use of an audience response system (ARS) would promote an active learning environment during case-based discussions in large groups, have an impact on student motivation and improve long-term retention. Group A (N = 83) participated in large group case discussions where student participation was voluntary, while for group B (N = 86) an ARS was used. Data collection methods included student and teacher surveys, student focus group interviews, independent observations and 1-year post-course testing. Results indicated that the use of an ARS provided an active learning environment during case-based discussions in large groups by favouring engagement, observation and critical reflection and by increasing student and teacher motivation. Although final exam results were significantly improved in group B, long-term retention was not significantly different between groups. It was concluded that ARS use significantly improved the learning experience associated with case-based discussions in a large group of undergraduate students.

Campus Leadership's Influence in Implementing a Community College's Sustainability Goals: A Case Study

ERIC Educational Resources Information Center

Larson, Barbara A.

2012-01-01

The case study documented one large, multicampus community college's progress in implementing sustainability goals outlined in the American College and University Presidents' Climate Commitment (ACUPCC). The case study examined the role of branch-campus presidents and the college president in institutionalizing sustainability. Responses…

Incorporating Case Studies into a World Food and Population Course

ERIC Educational Resources Information Center

Econopouly, Bethany F.; Byrne, Patrick F.; Johnson, Marc A.

2010-01-01

The use of case studies in college courses can increase student engagement with the subject matter and improve analytical, problem-solving, and communication skills. Case studies were introduced in a relatively large (54 students) undergraduate world food and population course at Colorado State University in the spring semester of 2008 and…

Retrospective Case Study in Northeastern Pennsylvania

EPA Pesticide Factsheets

The EPA chose Bradford County, and parts of neighboring Susquehanna County, as a retrospective case study location because of the extensive hydraulic fracturing activities occurring there, coincident with the large number of homeowner complaints.

Using Case Study Multi-Methods to Investigate Close(r) Collaboration: Course-Based Tutoring and the Directive/Nondirective Instructional Continuum

ERIC Educational Resources Information Center

Corbett, Steven J.

2011-01-01

This essay presents case studies of "course-based tutoring" (CBT) and one-to-one tutorials in two sections of developmental first-year composition (FYC) at a large West Coast research university. The author's study uses a combination of rhetorical and discourse analyses and ethnographic and case study multi-methods to investigate both…

Anaplastic large cell lymphoma and breast implants: five Australian cases.

PubMed

Taylor, Kim O; Webster, Howard R; Prince, H Miles

2012-04-01

There has never been a convincing association between breast implants and breast malignancy. A total of 42 cases of non-Hodgkin's lymphoma of the breast associated with implant capsules have been reported. The majority of the patients have anaplastic large cell lymphoma of T-cell origin. These lymphoma types have less frequently been observed in women without implants. The senior author (H.R.W.) diagnosed and treated two women with anaplastic large cell lymphoma in a short period of time. After this, the authors were contacted by other surgeons in Australia who had treated similar cases. The authors report five new cases of anaplastic large cell lymphoma associated with breast implants. There is an apparent spectrum of disease, with some cases pursuing an aggressive clinical course, although most have experienced a good prognosis. Both saline and silicone implants are implicated. All implant shells were textured. Textured surface implants only became widely used in the 1990s and therefore were not significantly represented in the large cohort studies of breast implant safety undertaken in the early 1990s. The diagnosis of anaplastic large cell lymphoma in the breast needs to be considered in patients, particularly those presenting with a periprosthetic seroma 6 months or more after breast implant insertion. Risk, V.

Identifiability of large-scale non-linear dynamic network models applied to the ADM1-case study.

PubMed

Nimmegeers, Philippe; Lauwers, Joost; Telen, Dries; Logist, Filip; Impe, Jan Van

2017-06-01

In this work, both the structural and practical identifiability of the Anaerobic Digestion Model no. 1 (ADM1) is investigated, which serves as a relevant case study of large non-linear dynamic network models. The structural identifiability is investigated using the probabilistic algorithm, adapted to deal with the specifics of the case study (i.e., a large-scale non-linear dynamic system of differential and algebraic equations). The practical identifiability is analyzed using a Monte Carlo parameter estimation procedure for a 'non-informative' and 'informative' experiment, which are heuristically designed. The model structure of ADM1 has been modified by replacing parameters by parameter combinations, to provide a generally locally structurally identifiable version of ADM1. This means that in an idealized theoretical situation, the parameters can be estimated accurately. Furthermore, the generally positive structural identifiability results can be explained from the large number of interconnections between the states in the network structure. This interconnectivity, however, is also observed in the parameter estimates, making uncorrelated parameter estimations in practice difficult. Copyright © 2017. Published by Elsevier Inc.

Supraventricular tachycardia induced by chocolate: is chocolate too sweet for the heart?

PubMed

Parasramka, Saurabh; Dufresne, Alix

2012-09-01

Conflicting studies have been published concerning the association between chocolate and cardiovascular diseases. Fewer articles have described the potential arrhythmogenic risk related to chocolate intake. We present a case of paroxysmal supraventricular tachycardia in a woman after consumption of large quantity of chocolate. A 53-year-old woman with no significant medical history presented to us with complaints of palpitations and shortness of breath after consuming large amounts of chocolate. Electrocardiogram showed supraventricular tachycardia at 165 beats per minute, which was restored to sinus rhythm after adenosine bolus injection. Electrophysiology studies showed atrioventricular nodal reentry tachycardia, which was treated with radiofrequency ablation. Chocolate contains caffeine and theobromine, which are methylxanthines and are competitive antagonists of adenosine and can have arrhythmogenic potential. Our case very well describes an episode of tachycardia precipitated by large amount of chocolate consumption in a patient with underlying substrate. There are occasional case reports describing association between chocolate, caffeine, and arrhythmias. A large Danish study, however, did not find any association between amount of daily caffeine consumption and risk of arrhythmia.

Implementation and value of using a split-plot reader design in a study of digital breast tomosynthesis in a breast cancer assessment clinic

NASA Astrophysics Data System (ADS)

Mall, Suneeta; Brennan, Patrick C.; Mello-Thoms, Claudia

2015-03-01

The rapid evolution in medical imaging has led to an increased number of recurrent trials, primarily to ensure that the efficacy of new imaging techniques is known. The cost associated with time and resources in conducting such trials is usually high. The recruitment of participants, in a medium to large reader study, is often very challenging as the demanding number of cases discourages involvement with the trial. We aim to evaluate the efficacy of Digital Breast Tomosynthesis (DBT) in a recall assessment clinic in Australia in a prospective multi-reader-multi-case (MRMC) trial. Conducting such a study with the more commonly used fully crossed MRMC study design would require more cases and more cases read per reader, which was not viable in our setting. With an aim to perform a cost effective yet statistically efficient clinical trial, we evaluated alternative study designs, particularly the alternative split-plot MRMC study design and compared and contrasted it with more commonly used fully crossed MRMC study design. Our results suggest that `split-plot', an alternative MRMC study design, could be very beneficial for medium to large clinical trials and the cost associated with conducting such trials can be greatly reduced without adversely effecting the variance of the study. We have also noted an inverse dependency between number of required readers and cases to achieve a target variance. This suggests that split-plot could also be very beneficial for studies that focus on cases that are hard to procure or readers that are hard to recruit. We believe that our results may be relevant to other researchers seeking to design a medium to large clinical trials.

Feasibility of using a large Clinical Data Warehouse to automate the selection of diagnostic cohorts.

PubMed

Stephen, Reejis; Boxwala, Aziz; Gertman, Paul

2003-01-01

Data from Clinical Data Warehouses (CDWs) can be used for retrospective studies and for benchmarking. However, automated identification of cases from large datasets containing data items in free text fields is challenging. We developed an algorithm for categorizing pediatric patients presenting with respiratory distress into Bronchiolitis, Bacterial pneumonia and Asthma using clinical variables from a CDW. A feasibility study of this approach indicates that case selection may be automated.

Birth outcomes of male and female patients with infantile hypertrophic pyloric stenosis--a population-based case-control study.

PubMed

Vermes, Gabor; Mátrai, Ákos; Czeizel, Andrew E; Ács, Nándor

2016-01-01

Most of the patients are affected by isolated infantile hypertrophic pyloric stenosis (IHPS) beyond the polygenic predisposition, the other factors in the multifactorial etiology are largely unknown. The main characteristic of IHPS is the robust male predominance, thus the aim of this study was to analyze birth outcomes in males and females whether they are different or not. The study samples included 241 cases with IHPS, 357 matched, and 38,151 population controls without any defect in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. The findings of this case-control study confirmed the well-known strong male excess (85.5%). The mean gestational age was somewhat longer and it is associated with a lower rate of preterm births. Mean birth weight did not show significant differences among the study groups, but the rate of low birthweight was higher in cases with IHPS. However, these differences were found only in males. Thus, intrauterine fetal growth restriction is characteristic only for male cases with IHPS. Our study confirmed the well-known obvious male excess of cases with IHPS, but our findings suggest some differences in birth outcomes of male and female cases. Male cases with IHPS had intrauterine fetal growth restriction while females did not. These data may indicate some differences in the pathogenesis of IHPS in males and females.

Teaching Large Sections of a Business Communication Course: A Multicase Study

ERIC Educational Resources Information Center

Wright, Carol

2017-01-01

The purpose of this research is to examine specific examples of how business communication courses are delivered in large, face-to-face university classes to discover implications of these large courses. This case study reviewed four classes from two different midsized universities whose classes range from 48 to 300 students. Findings suggest…

Context Matters: Increasing Understanding with Interactive Clicker Case Studies

ERIC Educational Resources Information Center

Lundeberg, Mary A.; Kang, Hosun; Wolter, Bjorn; delMas, Robert; Armstrong, Norris; Borsari, Bruno; Boury, Nancy; Brickman, Peggy; Hannam, Kristi; Heinz, Cheryl; Horvath, Thomas; Knabb, Maureen; Platt, Terry; Rice, Nancy; Rogers, Bill; Sharp, Joan; Ribbens, Eric; Maier, Kimberly S.; Deschryver, Mike; Hagley, Rodney; Goulet, Tamar; Herreid, Clyde F.

2011-01-01

Although interactive technology is presumed to increase student understanding in large classes, no previous research studies have empirically explored the effects of Clicker Cases on students' performance. A Clicker Case is a story (e.g., a problem someone is facing) that uses clickers (student response systems) to engage students in understanding…

Using full-cohort data in nested case-control and case-cohort studies by multiple imputation.

PubMed

Keogh, Ruth H; White, Ian R

2013-10-15

In many large prospective cohorts, expensive exposure measurements cannot be obtained for all individuals. Exposure-disease association studies are therefore often based on nested case-control or case-cohort studies in which complete information is obtained only for sampled individuals. However, in the full cohort, there may be a large amount of information on cheaply available covariates and possibly a surrogate of the main exposure(s), which typically goes unused. We view the nested case-control or case-cohort study plus the remainder of the cohort as a full-cohort study with missing data. Hence, we propose using multiple imputation (MI) to utilise information in the full cohort when data from the sub-studies are analysed. We use the fully observed data to fit the imputation models. We consider using approximate imputation models and also using rejection sampling to draw imputed values from the true distribution of the missing values given the observed data. Simulation studies show that using MI to utilise full-cohort information in the analysis of nested case-control and case-cohort studies can result in important gains in efficiency, particularly when a surrogate of the main exposure is available in the full cohort. In simulations, this method outperforms counter-matching in nested case-control studies and a weighted analysis for case-cohort studies, both of which use some full-cohort information. Approximate imputation models perform well except when there are interactions or non-linear terms in the outcome model, where imputation using rejection sampling works well. Copyright © 2013 John Wiley & Sons, Ltd.

A Successful Replication of the River Visitor Inventory and Monitoring Process for Capacity Management

Treesearch

Kenneth Chilman; James Vogel; Greg Brown; John H. Burde

2004-01-01

This paper has 3 purposes: to discuss 1. case study research and its utility for recreation management decisionmaking, 2. the recreation visitor inventory and monitoring process developed from case study research, and 3. a successful replication of the process in a large-scale, multi-year application. Although case study research is discussed in research textbooks as...

Large plunging schwannoma of the floor of the mouth involving the mylohyoid nerve: a case report and review of the literature.

PubMed

Nilesh, Kumar; Naniwadekar, Ramchandra G; Malik, Neelima A

2016-01-01

Extracranial schwannomas are rare in the oral cavity, accounting for only 1% of all tumors of this type. This article presents a case study of a schwannoma arising from the mylohyoid nerve that presented as a large nodular swelling in the floor of the mouth extending into the submandibular space.

Trends in prevalence of patient case-mix adjusters used in the Medicare dialysis payment system.

PubMed

Hollenbeak, Christopher S; Rubin, Robert J; Tzivelekis, Spiros; Stephens, J Mark

2015-06-01

The Medicare End-Stage Renal Disease Prospective Payment System (PPS) used data from 2006-08 to set weights for each case-mix adjuster that is part of the bundled payment formula. The details of the population case-mix were not made public, and little is known about consistency of case-mix over time. This study estimated the prevalence of case-mix adjusters during 2006-2008 and analyzed changes in case-mix prevalence from 2000-2008. Cross-sectional cohort study using United States Renal Data System data for Medicare dialysis patients. Three 3-year cohorts (2000-02, 2003-05, 2006-08) were analyzed for changes over time in case-mix prevalence. Double-digit trends were observed in many case-mix categories between 2000-02 and 2006-08. Large declines were observed in prevalence of patients with low BMI, pericarditis, new to dialysis, and ages 18-44. Large increases were observed in chronic co-morbidities, pneumonia and age cohort 80+. Substantial changes in case-mix adjuster prevalence suggest the PPS payment formula should be regularly updated.

FLAME: A platform for high performance computing of complex systems, applied for three case studies

DOE PAGES

Kiran, Mariam; Bicak, Mesude; Maleki-Dizaji, Saeedeh; ...

2011-01-01

FLAME allows complex models to be automatically parallelised on High Performance Computing (HPC) grids enabling large number of agents to be simulated over short periods of time. Modellers are hindered by complexities of porting models on parallel platforms and time taken to run large simulations on a single machine, which FLAME overcomes. Three case studies from different disciplines were modelled using FLAME, and are presented along with their performance results on a grid.

Determinants of Successful Training Practices in Large Australian Firms.

ERIC Educational Resources Information Center

Dawe, Susan

The determinants of successful training practices in large Australian firms were examined. The study's three phases were as follows: (1) a review of existing literature; (2) a meta-analysis of previously conducted case studies of 49 large Australian firms in 14 industrial sectors; and (3) a comparative analysis of the findings of the past studies…

Contemporary Instructor-Librarian Collaboration: A Case Study of an Online Embedded Librarian Implementation

ERIC Educational Resources Information Center

Edwards, Mary E.; Black, Erik W.

2012-01-01

This paper reports the results of a case study evaluation of an embedded librarian project at a large, land-grant, research institution. The case is comprised of learners who are full-time academic health care professionals enrolled in an online graduate educational technology program. The mixed methods methodology focused on assessing the…

A Case for Competencies: Assessing the Value of Trait-Based Performance Appraisal for Non-Faculty University Employees

ERIC Educational Resources Information Center

Messa, Emily A.; Horn, Catherine L.; Longacre, Teri Elkins; Olenchak, F. Richard; Penney, Lisa M.

2016-01-01

A case study analyzed how supervisors at one university selected competencies, or trait-based skills, for non-faculty employees. This case study provides a valuable contribution by focusing on employees at one institution type--a large, public research university. While it has been documented that non-faculty employees provide important…

Open and Distance Learning: Case Studies from Industry and Education. Open and Distance Learning Series.

ERIC Educational Resources Information Center

Brown, Stephen C., Ed.

This book contains 14 case studies, written by those involved in the teaching and training initiatives, that illustrate the use of open and distance learning strategies. The case studies, drawn from many parts of the world (but mostly British based), feature efforts in large and small companies in a variety of industries. The first part of the…

A Case Study of Engineering Ethics

NASA Astrophysics Data System (ADS)

Shimizu, Kazuo

In Engineering Ethics Class at Shizuoka University, the Code of Ethics and Cases for Electrical Engineers by IEEJ Ethics committee is used to promote for high education effect to correspond large number of students (140students). In this paper, a case study in the class, and survey results for ethics value of students are presented. In addition, some comments for role playing act on the case of virtual experiences by students are described.

Initial Technology Assessment for the Large-Aperture UV-Optical-Infrared (LUVOIR) Mission Concept Study

NASA Technical Reports Server (NTRS)

Bolcar, Matthew R.; Feinberg, Lee; France, Kevin; Rauscher, Bernard J.; Redding, David; Schiminovich, David

2016-01-01

The NASA Astrophysics Division's 30-Year Roadmap prioritized a future large-aperture space telescope operating in the ultra-violet/optical/infrared wavelength regime. The Association of Universities for Research in Astronomy envisioned a similar observatory, the High Definition Space Telescope. And a multi-institution group also studied the Advanced Technology Large Aperture Space Telescope. In all three cases, a broad science case is outlined, combining general astrophysics with the search for biosignatures via direct-imaging and spectroscopic characterization of habitable exoplanets. We present an initial technology assessment that enables such an observatory that is currently being studied for the 2020 Decadal Survey by the Large UV/Optical/Infrared (LUVOIR) surveyor Science and Technology Definition Team. We present here the technology prioritization for the 2016 technology cycle and define the required technology capabilities and current state-of-the-art performance. Current, planned, and recommended technology development efforts are also reported.

Initial Technology Assessment for the Large UV-Optical-Infrared (LUVOIR) Mission Concept Study

NASA Technical Reports Server (NTRS)

Bolcar, Matthew R.; Feinberg, Lee D.; France, Kevin; Rauscher, Bernard J.; Redding, David; Schiminovich, David

2016-01-01

The NASA Astrophysics Divisions 30-Year Roadmap prioritized a future large-aperture space telescope operating in the ultra-violet-optical-infrared wavelength regime. The Association of Universities for Research in Astronomy envisioned a similar observatory, the High Definition Space Telescope. And a multi-institution group also studied the Advanced Technology Large Aperture Space Telescope. In all three cases, a broad science case is outlined, combining general astrophysics with the search for bio-signatures via direct-imaging and spectroscopic characterization of habitable exo-planets. We present an initial technology assessment that enables such an observatory that is currently being studied for the 2020 Decadal Survey by the Large UV-Optical Infrared (LUVOIR) surveyor Science and Technology Definition Team. We present here the technology prioritization for the 2016 technology cycle and define the required technology capabilities and current state-of-the-art performance. Current, planned, and recommended technology development efforts are also reported.

The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study Protocol

PubMed Central

Woo, Daniel; Rosand, Jonathan; Kidwell, Chelsea; McCauley, Jacob L.; Osborne, Jennifer; Brown, Mark W.; West, Sandra E.; Rademacher, Eric W.; Waddy, Salina; Roberts, Jamie N.; Koch, Sebastian; Gonzales, Nicole R.; Sung, Gene; Kittner, Steven J.; Birnbaum, Lee; Frankel, Michael; Daniel Testai, Fernando; Hall, Christiana E.; Elkind, Mitchell S. V.; Flaherty, Matthew; Coull, Bruce; Chong, Ji Y.; Warwick, Tanya; Malkoff, Marc; James, Michael L.; Ali, Latisha K.; Worrall, Bradford B.; Jones, Floyd; Watson, Tiffany; Leonard, Anne; Martinez, Rebecca; Sacco, Ralph I; Langefeld, Carl D.

2013-01-01

Background and Purpose Epidemiologic studies of intracerebral hemorrhage (ICH) have consistently demonstrated variation in incidence, location, age at presentation, and outcomes among non-Hispanic white, black, and Hispanic populations. We report here the design and methods for this large, prospective, multi-center case-control study of ICH. Methods The ERICH study is a multi-center, prospective case-control study of ICH. Cases are identified by hot-pursuit and enrolled using standard phenotype and risk factor information and include neuroimaging and blood sample collection. Controls are centrally identified by random digit dialing to match cases by age (+/−5 years), race, ethnicity, gender and metropolitan region. Results As of March 22, 2013, 1,655 cases of ICH had been recruited into the study which is 101.5% of the target for that date and 851 controls had been recruited which is 67.2% of the target for that date (1,267 controls) for a total of 2,506 subjects which is 86.5% of the target for that date (2,897 subjects). Of the 1,655 cases enrolled, 1,640 cases had the case interview entered into the database of which 628 (38%) were non-Hispanic black, 458 (28%) were non-Hispanic white and 554 (34%) were Hispanic. Of the 1,197 cases with imaging submitted, 876 (73.2%) had a 24 hour follow-up CT available In addition to CT imaging, 607 cases have had MRI evaluation. Conclusion The ERICH study is a large, case-control study of ICH with particular emphasis on recruitment of minority populations for the identification of genetic and epidemiologic risk factors for ICH and outcomes after ICH. PMID:24021679

Geothermal Case Studies

DOE Data Explorer

Young, Katherine

2014-09-30

database.) In fiscal year 2015, NREL is working with universities to populate additional case studies on OpenEI. The goal is to provide a large enough dataset to start conducting analyses of exploration programs to identify correlations between successful exploration plans for areas with similar geologic occurrence models.

WMOST v2 Case Study: Monponsett Ponds

EPA Science Inventory

This webinar presents an overview of the preliminary results of a case study application of EPA's Watershed Management Optimization Support Tool v2 (WMOST) for stakeholders in the Monponsett Ponds Watershed Workgroup. Monponsett Ponds is a large water system consisting of two ba...

Large deviations in the presence of cooperativity and slow dynamics

NASA Astrophysics Data System (ADS)

Whitelam, Stephen

2018-06-01

We study simple models of intermittency, involving switching between two states, within the dynamical large-deviation formalism. Singularities appear in the formalism when switching is cooperative or when its basic time scale diverges. In the first case the unbiased trajectory distribution undergoes a symmetry breaking, leading to a change in shape of the large-deviation rate function for a particular dynamical observable. In the second case the symmetry of the unbiased trajectory distribution remains unbroken. Comparison of these models suggests that singularities of the dynamical large-deviation formalism can signal the dynamical equivalent of an equilibrium phase transition but do not necessarily do so.

Cannibalism, Kuru, and Mad Cows: Prion Disease As a "Choose-Your-Own-Experiment" Case Study to Simulate Scientific Inquiry in Large Lectures.

PubMed

Serrano, Antonio; Liebner, Jeffrey; Hines, Justin K

2016-01-01

Despite significant efforts to reform undergraduate science education, students often perform worse on assessments of perceptions of science after introductory courses, demonstrating a need for new educational interventions to reverse this trend. To address this need, we created An Inexplicable Disease, an engaging, active-learning case study that is unusual because it aims to simulate scientific inquiry by allowing students to iteratively investigate the Kuru epidemic of 1957 in a choose-your-own-experiment format in large lectures. The case emphasizes the importance of specialization and communication in science and is broadly applicable to courses of any size and sub-discipline of the life sciences.

Desktop Techniques for Analyzing Surface-Ground Water Interactions. The Reelfoot Lake Case Study

DTIC Science & Technology

1988-05-01

Reelfoot Lake Case Study DTlCSELECTE JUN 13 M Research Document No. 28 May 1988 Approved for Public Release. Distribution Unlimited. 86 , l~ g DESKTOP...TECHNIQUES FOR ANALYZING SURFACE-GROUND WATER INTERACTIONS The Reelfoot Lake Case Study Prepared by Dennis B. McLaughlin ’ Ia Prepared for The...Engineers became involved in a study of Reelfoot Lake , a large natural lake in northwestern Tennessee. Although modeling studies of the lake and its

Twelve Case Studies of Terminations and Divestitures by Business Firms.

DTIC Science & Technology

1986-04-01

Harvard, Stanford, and Dartmouth business schools and from textbooks. The cases indicated that large organizations have difficulty terminating or...Dartmouth business schools and from textbooks.2 Of approximately 70 termination cases that fit our general criteria, only the dozen listed in Table 1

Brief Report: Maternal Smoking during Pregnancy and Autism Spectrum Disorders

ERIC Educational Resources Information Center

Lee, Brian K.; Gardner, Renee M.; Dal, Henrik; Svensson, Anna; Galanti, Maria Rosaria; Rai, Dheeraj; Dalman, Christina; Magnusson, Cecilia

2012-01-01

Prenatal exposure to tobacco smoke is suggested as a potential risk factor for autism spectrum disorders (ASD). Previous epidemiological studies of this topic have yielded mixed findings. We performed a case-control study of 3,958 ASD cases and 38,983 controls nested in a large register-based cohort in Sweden. ASD case status was measured using a…

Drugs & the Brain: Case-based Instruction for an Undergraduate Neuropharmacology Course.

PubMed

Nagel, Anastasia; Nicholas, Andrea

2017-01-01

In order to transform a traditional large non-majors general education (GE) neurobiology lecture (Drugs & the Brain) into an active learning course, we developed a series of directed mini-cases targeting major drug classes. Humorous and captivating case-based situations were used to better engage and motivate students to solve problems related to neuropharmacology and physiology. Here we provide directed cases, questions and learning outcomes for our opiates mini-cases. In addition, we describe how case studies were incorporated into our course and assessed using peer review and online quizzing. An in-depth analysis of the overall course transformation on student exam performance, opinions and instructor evaluations can be found in the JUNE article Don't Believe the Gripe! Increasing Course Structure in a Large Non-majors Neuroscience Course.

Navigating Access and Maintaining Established Practice: Social Studies Teachers' Technology Integration at Three Florida Middle Schools

ERIC Educational Resources Information Center

Sheffield, Caroline

2011-01-01

This mixed methods multiple case study explored middle school social studies teachers' instructional use of digital technology at three suburban middle schools This mixed methods, multiple-case study explored middle school social studies teachers' instructional use of digital technology at three suburban middle schools in a large Florida school…

In vivo verification of proton beam path by using post-treatment PET/CT imaging.

PubMed

Hsi, Wen C; Indelicato, Daniel J; Vargas, Carlos; Duvvuri, Srividya; Li, Zuofeng; Palta, Jatinder

2009-09-01

The purpose of this study is to establish the in vivo verification of proton beam path by using proton-activated positron emission distributions. A total of 50 PET/CT imaging studies were performed on ten prostate cancer patients immediately after daily proton therapy treatment through a single lateral portal. The PET/CT and planning CT were registered by matching the pelvic bones, and the beam path of delivered protons was defined in vivo by the positron emission distribution seen only within the pelvic bones, referred to as the PET-defined beam path. Because of the patient position correction at each fraction, the marker-defined beam path, determined by the centroid of implanted markers seen in the posttreatment (post-Tx) CT, is used for the planned beam path. The angular variation and discordance between the PET- and marker-defined paths were derived to investigate the intrafraction prostate motion. For studies with large discordance, the relative location between the centroid and pelvic bones seen in the post-Tx CT was examined. The PET/CT studies are categorized for distinguishing the prostate motion that occurred before or after beam delivery. The post-PET CT was acquired after PET imaging to investigate prostate motion due to physiological changes during the extended PET acquisition. The less than 2 degrees of angular variation indicates that the patient roll was minimal within the immobilization device. Thirty of the 50 studies with small discordance, referred as good cases, show a consistent alignment between the field edges and the positron emission distributions from the entrance to the distal edge. For those good cases, average displacements are 0.6 and 1.3 mm along the anterior-posterior (D(AP)) and superior-inferior (D(SI)) directions, respectively, with 1.6 mm standard deviations in both directions. For the remaining 20 studies demonstrating a large discordance (more than 6 mm in either D(AP) or D(SI)), 13 studies, referred as motion-after-Tx cases, also show large misalignment between the field edge and the positron emission distribution in lipomatous tissues around the prostate. These motion-after-Tx cases correspond to patients with large changes in volume of rectal gas between the post-Tx and the post-PET CTs. The standard deviations for D(AP) and D(SI) are 5.0 and 3.0 mm, respectively, for these motion-after-Tx cases. The final seven studies, referred to as position-error cases, which had a large discordance but no misalignment, were found to have deviations of 4.6 and 3.6 mm in D(AP) and D(SI), respectively. The position-error cases correspond to a large discrepancy on the relative location between the centroid and pelvic bones seen in post-Tx CT and recorded x-ray radiographs. Systematic analyses of proton-activated positron emission distributions provide patient-specific information on prostate motion (sigmaM) and patient position variability (sigmap) during daily proton beam delivery. The less than 2 mm of displacement variations in the good cases indicates that population-based values of sigmap and sigmaM, used in margin algorithms for treatment planning at the authors' institution are valid for the majority of cases. However, a small fraction of PET/CT studies (approximately 14%) with -4 mm displacement variations may require different margins. Such data are useful in establishing patient-specific planning target volume margins.

Next-Generation Sequencing of a Cohort of Pulmonary Large Cell Carcinomas Reclassified by World Health Organization 2015 Criteria.

PubMed

Driver, Brandon R; Portier, Bryce P; Mody, Dina R; Deavers, Michael; Bernicker, Eric H; Kim, Min P; Teh, Bin S; Santacruz, Jose F; Kopas, Lisa; Munden, Reginald F; Cagle, Philip T

2016-04-01

The classification of pulmonary large cell carcinoma has undergone a major revision with the recent World Health Organization (WHO) 2015 Classification. Many large cell carcinomas are now reassigned to either adenocarcinoma with solid pattern or nonkeratinizing squamous cell carcinoma based on immunopositivity for adenocarcinoma markers or squamous cell carcinoma markers, respectively. Large cell carcinomas that are negative for adenocarcinoma and squamous cell carcinoma immunomarkers are now classified as large cell carcinoma with null immunohistochemical features (LCC-N). Although a few studies investigated the mutation profile of large cell carcinomas grouped by immunostain profile before the publication of the new WHO classification, investigation of tumors previously diagnosed as large cell carcinoma and reclassified according to the 2015 WHO classification has not, to our knowledge, been reported. To determine the mutation profiles of pulmonary large cell carcinomas reclassified by WHO 2015 criteria. Archival cases of non-small cell lung carcinoma with large cell carcinoma morphology (n = 17) were reclassified according to 2015 WHO criteria. To determine mutation profile, we employed Ion Torrent (Life Technologies, Carlsbad, California)-based next-generation sequencing (50 genes; more than 2800 mutations) in addition to real-time quantitative reverse transcription polymerase chain reaction for ALK translocation detection. Two of 17 cases (12%) were reclassified as LCC-N, and both had mutations-BRAF D594N in one case and KRAS G12C in the other case. Seven of 17 cases (41%) were reclassified in the adenocarcinoma with solid pattern group, which showed one KRAS G12C and one EGFR E709K + G719C double mutation in addition to mutations in TP53. Eight of 17 cases (47%) were reclassified in the nonkeratinizing squamous cell carcinoma group, which showed mutations in PIK3CA, CDKN2A, and TP53. No ALK translocations or amplifications were detected. The adenocarcinoma with solid pattern group showed mutations typical of adenocarcinoma, whereas the nonkeratinizing squamous cell carcinoma group showed mutations typical of squamous cell carcinoma. Both LCC-N cases had mutations associated with adenocarcinoma, supporting the hypothesis that LCC-N is related to adenocarcinoma.

Russian Policy on Methane Emissions in the Oil and Gas Sector: A Case Study in Opportunities and Challenges in Reducing Short-Lived Forcers

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

Evans, Meredydd; Roshchanka, Volha

2014-08-04

This paper uses Russian policy in the oil and gas sector as a case study in assessing options and challenges for scaling-up emission reductions. We examine the challenges to achieving large-scale emission reductions, successes that companies have achieved to date, how Russia has sought to influence methane emissions through its environmental fine system, and options for helping companies achieve large-scale emission reductions in the future through simpler and clearer incentives.

Operative factors associated with short-term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013

PubMed Central

Gonzalez, L. M.; Fogle, C. A.; Baker, W. T.; Hughes, F. E.; Law, J. M.; Motsinger-Reif, A. A.; Blikslager, A. T.

2014-01-01

Summary Reasons for performing the study There is an important need for objective parameters that accurately predict the outcome of horses with large colon volvulus. Objectives To evaluate the predictive value of a series of histomorphometric parameters on short-term outcome, as well as the impact of colonic resection on horses with large colon volvulus. Study Design Retrospective cohort study Methods Adult horses admitted to the Equine and Farm Animal Veterinary Center at North Carolina State University, Peterson & Smith and Chino Valley Equine Hospitals between 2006–2013 undergoing an exploratory celiotomy, diagnosed with large colon volvulus of ≥360 degrees, where a pelvic flexure biopsy was obtained, and that recovered from general anaesthesia, were selected for inclusion in the study. Logistic regression was used to determine associations between signalment, histomorphometric measurements of interstitial: crypt ratio, degree of haemorrhage, percentage loss of luminal and glandular epithelium, as well as colonic resection with short-term outcome (discharge from the hospital). Results Pelvic flexure biopsies from 47 horses with large colon volvulus were evaluated. Factors that were significantly associated with short-term outcome on univariate logistic regression were Thoroughbred breed (P = 0.04), interstitial: crypt ratio >1 (P = 0.02) and haemorrhage score ≥3 (P = 0.005). Resection (P = 0.92) was not found to be significantly associated with short-term outcome. No combined factors increased the likelihood of death in forward stepwise logistic regression modelling. A digitally quantified haemorrhage area measurement strengthened the association of haemorrhage with non-survival in cases of large colon volvulus. Conclusions Histomorphometric measurements of interstitial: crypt ratio and degree of haemorrhage predict short-term outcome in cases of large colon volvulus. Resection was not associated with short-term outcome in horses selected for this study. Accurate quantification of mucosal haemorrhage at the time of surgery may improve veterinary surgeons’ prognostic capabilities in horses with large colon volvulus. PMID:24735170

Genome-Wide Association Study Reveals Greater Polygenic Loading for Schizophrenia in Cases With a Family History of Illness

PubMed Central

Bigdeli, Tim B.; Ripke, Stephan; Bacanu, Silviu-Alin; Lee, Sang Hong; Wray, Naomi R.; Gejman, Pablo V.; Rietschel, Marcella; Cichon, Sven; St Clair, David; Corvin, Aiden; Kirov, George; McQuillin, Andrew; Gurling, Hugh; Rujescu, Dan; Andreassen, Ole A.; Werge, Thomas; Blackwood, Douglas H.R.; Pato, Carlos N.; Pato, Michele T.; Malhotra, Anil K.; O’Donovan, Michael C.; Kendler, Kenneth S.; Fanous, Ayman H.

2018-01-01

Genome-wide association studies (GWAS) of schizophrenia have yielded more than 100 common susceptibility variants, and strongly support a substantial polygenic contribution of a large number of small allelic effects. It has been hypothesized that familial schizophrenia is largely a consequence of inherited rather than environmental factors. We investigated the extent to which familiality of schizophrenia is associated with enrichment for common risk variants detectable in a large GWAS. We analyzed single nucleotide polymorphism (SNP) data for cases reporting a family history of psychotic illness (N = 978), cases reporting no such family history (N = 4,503), and unscreened controls (N = 8,285) from the Psychiatric Genomics Consortium (PGC1) study of schizophrenia. We used a multinomial logistic regression approach with model-fitting to detect allelic effects specific to either family history subgroup. We also considered a polygenic model, in which we tested whether family history positive subjects carried more schizophrenia risk alleles than family history negative subjects, on average. Several individual SNPs attained suggestive but not genome-wide significant association with either family history subgroup. Comparison of genome-wide polygenic risk scores based on GWAS summary statistics indicated a significant enrichment for SNP effects among family history positive compared to family history negative cases (Nagelkerke’s R2 = 0.0021; P = 0.00331; P-value threshold <0.4). Estimates of variability in disease liability attributable to the aggregate effect of genome-wide SNPs were significantly greater for family history positive compared to family history negative cases (0.32 and 0.22, respectively; P = 0.031).We found suggestive evidence of allelic effects detectable in large GWAS of schizophrenia that might be specific to particular family history subgroups. However, consideration of a polygenic risk score indicated a significant enrichment among family history positive cases for common allelic effects. Familial illness might, therefore, represent a more heritable form of schizophrenia, as suggested by previous epidemiological studies. PMID:26663532

[Anatomicopathological relation between facial nerve and large vestibular Schwannoma].

PubMed

Jiang, T; Yu, C; Guo, E; Guan, S; Yan, C

2001-05-10

To study the anatomicopathological relation between facial nerve and large vestibular schwannoma. Operation by suboccipital retrosigmoid sinus approach was performed on 40 cases with large vestibular schwannoma, During the operation, the anatomicopathological relation between the facial nerve and the vestibular schwannoma was observed directly. The facial nerve was found to be located ventrally (deep under the tumor), dorsally (over the tumor), at the upper pole of the tumor (near the tentorium cerebelli), at the lower pole of the tumor (near the rear group cranial nerves), or aberrant (unable to be identified because of infiltration of tumor). In 31 cases, mainly with parenchymatous tumor, the facial nerve was flat in shape. In 9 cases, mainly with cystic tumor, the facial nerve was bandlike. The facial nerve varies greatly in neuroanatomy among patients with large vestibular schwannoma. Strengthening of operative monitoring can increase the safety of operation.

A Study of Large Droplet Ice Accretions in the NASA-Lewis IRT at Near-Freezing Conditions

NASA Technical Reports Server (NTRS)

Miller, Dean R.; Addy, Harold E. , Jr.; Ide, Robert F.

1996-01-01

This report documents the results of an experimental study on large droplet ice accretions which was conducted in the NASA-Lewis Icing Research Tunnel (IRT) with a full-scale 77.25 inch chord Twin-Otter wing section. This study was intended to: (1) document the existing capability of the IRT to produce a large droplet icing cloud, and (2) study the effect of various parameters on large droplet ice accretions. Results are presented from a study of the IRT's capability to produce large droplets with MVD of 99 and 160 microns. The effect of the initial water droplet temperature on the resultant ice accretion was studied for different initial spray bar air and water temperatures. The initial spray bar water temperature was found to have no discernible effect upon the large droplet ice accretions. Also, analytical and experimental results suggest that the water droplet temperature is very nearly the same as the tunnel ambient temperature, thus providing a realistic simulation of the large droplet natural icing condition. The effect of temperature, droplet size, airspeed, angle-of attack, flap setting and de-icer boot cycling time on ice accretion was studied, and will be discussed in this report. It was found that, in almost all of the cases studied, an ice ridge formed immediately aft of the active portion of the de-icer boot. This ridge was irregular in shape, varied in location, and was in some cases discontinuous due to aerodynamic shedding.

Revisiting Approaches to Learning in Science and Engineering: A Case Study

ERIC Educational Resources Information Center

Gynnild, V.; Myrhaug, D.

2012-01-01

Several studies have applied the dichotomy of deep and surface approaches to learning in a range of disciplinary contexts. Existing questionnaires have largely assumed the existence of these constructs; however, in a recent study Case and Marshall (2004) described two additional context-specific approaches to learning in engineering. The current…

Gender Differences in Student Performance in Large Lecture Classrooms Using Personal Response Systems ("Clickers") with Narrative Case Studies

ERIC Educational Resources Information Center

Kang, Hosun; Lundeberg, Mary; Wolter, Bjorn; delMas, Robert; Herreid, Clyde F.

2012-01-01

This study investigated gender differences in science learning between two pedagogical approaches: traditional lecture and narrative case studies using personal response systems ("clickers"). Thirteen instructors of introductory biology classes at 12 different institutions across the USA and Canada used two types of pedagogy (Clicker…

Students' Perceptions of Meaningfulness in First Year Experience Courses: A Case Study

ERIC Educational Resources Information Center

Evans, Nancy J.

2012-01-01

This qualitative case study, framed by a constructivist perspective, addresses a deficit in the literature and the knowledge base of a first year experience (FYE) academic program at a large, urban university regarding freshmen perceptions of meaningfulness in their courses. Existing studies identify concepts related to meaningfulness, but do not…

Wicked Problems in Large Organizations: Why Pilot Retention Continues to Challenge the Air Force

DTIC Science & Technology

2017-05-25

ABSTRACT This monograph in military studies investigates the makeup of and approach to complex problems, with a case study on the Air Force’s...priorities, as well as a short, recent history of the pilot retention problem. Following that is a case study on the work done by the Air Staff in...Lonsberry, USAF, 38 pages. This monograph in military studies investigates the makeup of and approach to complex problems, with a case study on the

Effect of individual parameter changes on the outcome of the estimated short-term dietary exposure to pesticides.

PubMed

van der Velde-Koerts, Trijntje; Breysse, Nicolas; Pattingre, Lauriane; Hamey, Paul Y; Lutze, Jason; Mahieu, Karin; Margerison, Sam; Ossendorp, Bernadette C; Reich, Hermine; Rietveld, Anton; Sarda, Xavier; Vial, Gaelle; Sieke, Christian

2018-06-03

In 2015 a scientific workshop was held in Geneva, where updating the International Estimate of Short-Term Intake (IESTI) equations was suggested. This paper studies the effects of the proposed changes in residue inputs, large portions, variability factors and unit weights on the overall short-term dietary exposure estimate. Depending on the IESTI case equation, a median increase in estimated overall exposure by a factor of 1.0-6.8 was observed when the current IESTI equations are replaced by the proposed IESTI equations. The highest increase in the estimated exposure arises from the replacement of the median residue (STMR) by the maximum residue limit (MRL) for bulked and blended commodities (case 3 equations). The change in large portion parameter does not have a significant impact on the estimated exposure. The use of large portions derived from the general population covering all age groups and bodyweights should be avoided when large portions are not expressed on an individual bodyweight basis. Replacement of the highest residue (HR) by the MRL and removal of the unit weight each increase the estimated exposure for small-, medium- and large-sized commodities (case 1, case 2a or case 2b equations). However, within the EU framework lowering of the variability factor from 7 or 5 to 3 counterbalances the effect of changes in other parameters, resulting in an estimated overall exposure change for the EU situation of a factor of 0.87-1.7 and 0.6-1.4 for IESTI case 2a and case 2b equations, respectively.

Acoustical case studies of three green buildings

NASA Astrophysics Data System (ADS)

Siebein, Gary; Lilkendey, Robert; Skorski, Stephen

2005-04-01

Case studies of 3 green buildings with LEED certifications that required extensive acoustical retrofit work to become satisfactory work environments for their intended user groups will be used to define areas where green building design concepts and acoustical design concepts require reconciliation. Case study 1 is an office and conference center for a city environmental education agency. Large open spaces intended to collect daylight through clerestory windows provided large, reverberant volumes with few acoustic finishes that rendered them unsuitable as open office space and a conference room/auditorium. Case Study 2 describes one of the first gold LEED buildings in the southeast whose primary design concepts were so narrowly focused on thermal and lighting issues that they often worked directly against basic acoustical requirements resulting in sound levels of NC 50-55 in classrooms and faculty offices, crosstalk between classrooms and poor room acoustics. Case study 3 is an environmental education and conference center with open public areas, very high ceilings, and all reflective surfaces made from wood and other environmentally friendly materials that result in excessive loudness when the building is used by the numbers of people which it was intended to serve.

Impact of rainfall on the moisture content of large woody fuels

Treesearch

Helen H. Mohr; Thomas A. Waldrop

2013-01-01

This unreplicated case study evaluates the impact of rainfall on large woody fuels over time. We know that one rainfall event may decrease the Keetch-Byram Drought Index, but this study shows no real increase in fuel moisture in 1,000- hour fuels after just one rainfall. Several rain events over time are required for the moisture content of large woody fuels to...

Qualitative case study data analysis: an example from practice.

PubMed

Houghton, Catherine; Murphy, Kathy; Shaw, David; Casey, Dympna

2015-05-01

To illustrate an approach to data analysis in qualitative case study methodology. There is often little detail in case study research about how data were analysed. However, it is important that comprehensive analysis procedures are used because there are often large sets of data from multiple sources of evidence. Furthermore, the ability to describe in detail how the analysis was conducted ensures rigour in reporting qualitative research. The research example used is a multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Data analysis was conducted using a framework guided by the four stages of analysis outlined by Morse ( 1994 ): comprehending, synthesising, theorising and recontextualising. The specific strategies for analysis in these stages centred on the work of Miles and Huberman ( 1994 ), which has been successfully used in case study research. The data were managed using NVivo software. Literature examining qualitative data analysis was reviewed and strategies illustrated by the case study example provided. Discussion Each stage of the analysis framework is described with illustration from the research example for the purpose of highlighting the benefits of a systematic approach to handling large data sets from multiple sources. By providing an example of how each stage of the analysis was conducted, it is hoped that researchers will be able to consider the benefits of such an approach to their own case study analysis. This paper illustrates specific strategies that can be employed when conducting data analysis in case study research and other qualitative research designs.

Improving Child Maltreatment Detection Systems: A Large-Scale Case Study Involving Health, Social Services, and School Professionals

ERIC Educational Resources Information Center

Cerezo, M.A.; Pons-Salvador, G.

2004-01-01

Objectives:: The purpose of this 5-year study was to improve detection in two consecutive phases: (a) To close the gap between the number of identified cases and the actual number of cases of child abuse by increasing detection; and (b) To increase the possibility of a broader spectrum of detection. Method:: The Balearic Islands (one of the…

Assessing Higher Level Learning: Developing Rubrics for Case Analysis

ERIC Educational Resources Information Center

Rochford, Linda; Borchert, Patricia S.

2011-01-01

Case study analyses allow students to demonstrate proficiency in executing authentic tasks in marketing and management, facilitating faculty evaluation of higher order learning outcomes. Effective and consistent assessment of case analyses depends in large part on the development of sound rubrics. The authors explored the process of rubric…

The Atacama Large Aperture Submm/mm Telescope (AtLAST) Project

NASA Astrophysics Data System (ADS)

Bertoldi, Frank

2018-01-01

In the past decade a strong case has been made for the construction of a next generation, 25 to 40-meter large submillimeter telescope, most notably through the CCAT and the Japanese LST projects. Although much effort had been spent on detailed science cases and technological studies, none of these projects have yet secured funding to advance to construction. We invite the interested community to join a study of the scientific merit, technical implementation, and financial path toward what we coin the "Atacama Large Submillimeter Telescope" (AtLAST). Through this community workshop, working groups, and a final report to be released in early 2019, we hope to motivate the global astronomy community to value and support the realization of such a facility.

A review of public desert land lease policies for concentrated solar power plants and the impact on their economic performance

NASA Astrophysics Data System (ADS)

Smyrnakis, Christos; Phocas-Cosmetatos, Alex; Kynigalakis, Kostantinos

2016-05-01

Large scale Concentrated Solar Power (CSP) plants need large plots of land with very high solar resource and thus are often deployed in desert areas which are usually owned by the state or a municipal authority. This study discusses the implication and practices of land lease policies with regards to CSP development. The strategy followed on a land lease is examined by definition on a case-specific basis and this text is by no means exhaustive with regards to its content. The study also discusses the pricing of land in various cases, presents the governing types of land lease and their effect on the economic performance of hypothetical CSP projects under various cases.

Case management: a case study.

PubMed

Stanton, M P; Walizer, E M; Graham, J I; Keppel, L

2000-01-01

This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

Pulmonary artery closure in combination with patch technique for treating congenital heart disease combined with large patent ductus arteriosus: A clinical study of 9 cases

PubMed Central

Wen, Bing; Yang, Junya; Liu, Huiruo; Jiao, Zhouyang; Zhao, Wenzeng

2016-01-01

Objective: To document clinical experience of treating congenital heart disease combined with large patent ductus arteriosus with pulmonary artery closure in combination with patch technique. Methods: Thirty-six patients (8 males and 28 females) who suffered from congenital heart disease and underwent hybrid surgery in the First Affiliated Hospital of Zhengzhou University from October 2010 to February 2014 were selected for this study. They aged 14 to 39 years and weighed 32.20 to 61.50 kg. Diameter of arterial duct was between 10 mm and 13 mm; 28 cases were tube type, 4 cases were funnel type and four cases were window type. All patients had moderate or severe pulmonary arterial hypertension; besides, there were 28 cases of ventricular septal defect, 16 cases of atrial septal defect, eight cases of aortic insufficiency, four cases of mitral stenosis and insufficiency and four cases of infectious endocarditis. Cardz Pulmonary Bypass (CPB) was established after chest was opened along the middle line. With the help of Transesophageal echocardiography, large patent ductus arteriosus was blocked off through pulmonary artery. Pulmonary artery was cut apart after blocking of heart. Large patent ductus arteriosus on the side of pulmonary artery was strengthened with autologous pericardial patch. Results: Of 36 patients, 32 patients had patent ductus arteriosus closure device and four patients had atrial septal defect closure device. Pulmonary arteries of 36 cases were all successfully closed. Systolic pressure declined after closure ((54.86±19.23) mmHg vs (96.05±23.07) mmHg, p<0.05); average pulmonary arterial pressure also declined after closure ((39.15±14.83) mmHg vs (72.88±15.76) mmHg, p<0.05). The patients were followed up for one to fifty one months (average 11.5 months). Compared to before surgery, left atrial diameter, left ventricular diameter and pulmonary artery diameter all narrowed after surgery. Besides, clinical symptoms were relieved and cardiac function of the patients also improved. Conclusion: Hybrid surgery is feasible and safe in treating patients with large patent ductus arteriosus and congenital heart disease, which decreases surgical problems, shortens surgical time and lowers the incidence of complications. PMID:27375685

Pulmonary artery closure in combination with patch technique for treating congenital heart disease combined with large patent ductus arteriosus: A clinical study of 9 cases.

PubMed

Wen, Bing; Yang, Junya; Liu, Huiruo; Jiao, Zhouyang; Zhao, Wenzeng

2016-01-01

To document clinical experience of treating congenital heart disease combined with large patent ductus arteriosus with pulmonary artery closure in combination with patch technique. Thirty-six patients (8 males and 28 females) who suffered from congenital heart disease and underwent hybrid surgery in the First Affiliated Hospital of Zhengzhou University from October 2010 to February 2014 were selected for this study. They aged 14 to 39 years and weighed 32.20 to 61.50 kg. Diameter of arterial duct was between 10 mm and 13 mm; 28 cases were tube type, 4 cases were funnel type and four cases were window type. All patients had moderate or severe pulmonary arterial hypertension; besides, there were 28 cases of ventricular septal defect, 16 cases of atrial septal defect, eight cases of aortic insufficiency, four cases of mitral stenosis and insufficiency and four cases of infectious endocarditis. Cardz Pulmonary Bypass (CPB) was established after chest was opened along the middle line. With the help of Transesophageal echocardiography, large patent ductus arteriosus was blocked off through pulmonary artery. Pulmonary artery was cut apart after blocking of heart. Large patent ductus arteriosus on the side of pulmonary artery was strengthened with autologous pericardial patch. Of 36 patients, 32 patients had patent ductus arteriosus closure device and four patients had atrial septal defect closure device. Pulmonary arteries of 36 cases were all successfully closed. Systolic pressure declined after closure ((54.86±19.23) mmHg vs (96.05±23.07) mmHg, p<0.05); average pulmonary arterial pressure also declined after closure ((39.15±14.83) mmHg vs (72.88±15.76) mmHg, p<0.05). The patients were followed up for one to fifty one months (average 11.5 months). Compared to before surgery, left atrial diameter, left ventricular diameter and pulmonary artery diameter all narrowed after surgery. Besides, clinical symptoms were relieved and cardiac function of the patients also improved. Hybrid surgery is feasible and safe in treating patients with large patent ductus arteriosus and congenital heart disease, which decreases surgical problems, shortens surgical time and lowers the incidence of complications.

Childhood Giftedness, Adolescent Agency: A Systemic Multiple-Case Study

ERIC Educational Resources Information Center

Mudrak, Jiri; Zabrodska, Katerina

2015-01-01

Although considerable research has addressed development from childhood giftedness to adult excellence, subjective perceptions of this development by gifted individuals themselves have remained largely unexplored. This multiple case study examined the ways in which young adults, who in the past had been identified as gifted, made sense of their…

Examination of Student Outcomes in Play Therapy: A Qualitative Case Study Design

ERIC Educational Resources Information Center

Dillman Taylor, Dalena L.; Blount, Ashley J.; Bloom, Zachary

2017-01-01

Outcome research examining the effectiveness of teaching methods in counselor education is sparse. The researchers conducted a qualitative investigation utilizing an instrumental case study to examine the influence of a constructivist-developmental format on a play therapy counseling course in a large CACREP accredited university in the…

What Matters to Career K-12 Educators

ERIC Educational Resources Information Center

Harris, Mary M.

2014-01-01

Case studies about issues arising from education policy were written between 2003 and 2011 by doctoral candidates in Curriculum and Instruction who were career K-12 educators. Literary analysis was employed in grouping 57 case studies, which described primarily situations that occurred in school districts in one large metropolitan area, by topic…

Bias correction of risk estimates in vaccine safety studies with rare adverse events using a self-controlled case series design.

PubMed

Zeng, Chan; Newcomer, Sophia R; Glanz, Jason M; Shoup, Jo Ann; Daley, Matthew F; Hambidge, Simon J; Xu, Stanley

2013-12-15

The self-controlled case series (SCCS) method is often used to examine the temporal association between vaccination and adverse events using only data from patients who experienced such events. Conditional Poisson regression models are used to estimate incidence rate ratios, and these models perform well with large or medium-sized case samples. However, in some vaccine safety studies, the adverse events studied are rare and the maximum likelihood estimates may be biased. Several bias correction methods have been examined in case-control studies using conditional logistic regression, but none of these methods have been evaluated in studies using the SCCS design. In this study, we used simulations to evaluate 2 bias correction approaches-the Firth penalized maximum likelihood method and Cordeiro and McCullagh's bias reduction after maximum likelihood estimation-with small sample sizes in studies using the SCCS design. The simulations showed that the bias under the SCCS design with a small number of cases can be large and is also sensitive to a short risk period. The Firth correction method provides finite and less biased estimates than the maximum likelihood method and Cordeiro and McCullagh's method. However, limitations still exist when the risk period in the SCCS design is short relative to the entire observation period.

Electron microscopy study of Ni induced crystallization in amorphous Si thin films

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

Radnóczi, G. Z.; Battistig, G.; Pécz, B., E-mail: pecz.bela@ttk.mta.hu

2015-02-17

The crystallization of amorphous silicon is studied by transmission electron microscopy. The effect of Ni on the crystallization is studied in a wide temperature range heating thinned samples in-situ inside the microscope. Two cases of limited Ni source and unlimited Ni source are studied and compared. NiSi{sub 2} phase started to form at a temperature as low as 250°C in the limited Ni source case. In-situ observation gives a clear view on the crystallization of silicon through small NiSi{sub 2} grain formation. The same phase is observed at the crystallization front in the unlimited Ni source case, where a secondmore » region is also observed with large grains of Ni{sub 3}Si{sub 2}. Low temperature experiments show, that long annealing of amorphous silicon at 410 °C already results in large crystallized Si regions due to the Ni induced crystallization.« less

Research and Teaching: Eight Is Not Enough--The Level of Questioning and Its Impact on Learning in Clicker Cases

ERIC Educational Resources Information Center

Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric; Herreid, Clyde Freeman

2016-01-01

Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

Association of CLU and PICALM variants with Alzheimer's disease

PubMed Central

Kamboh, M.I.; Minster, R. L.; Demirci, F.Y.; Ganguli, M.; DeKosky, S.T.; Lopez, O.L.; Barmada, M.M.

2010-01-01

Two recent large genome-wide association studies have reported significant associations in the CLU (APOJ), CR1 and PICALM genes. In order to replicate these findings, we examined 7 single nucleotide polymorphisms (SNPs) most significantly implicated by these studies in a large case-control sample comprising of 2,707 individuals. Principle components analysis revealed no population substructure in our sample. While no association was observed with CR1 SNPs (P=0.30–0.457), a trend of association was seen with the PICALM (P=0.071–0.086) and CLU (P=0.148–0.258) SNPs. A meta-analysis of three studies revealed significant associations with all three genes. Our data from an independent and large case-control sample suggest that these gene regions should be followed up by comprehensive resequencing to find functional variants. PMID:20570404

Accuracy of frozen section in the diagnosis of ovarian tumours.

PubMed

Toneva, F; Wright, H; Razvi, K

2012-07-01

The purpose of our retrospective study was to assess the accuracy of intraoperative frozen section diagnosis compared to final paraffin diagnosis in ovarian tumours at a gynaecological oncology centre in the UK. We analysed 66 cases and observed that frozen section consultation agreed with final paraffin diagnosis in 59 cases, which provided an accuracy of 89.4%. The overall sensitivity and specificity for all tumours were 85.4% and 100%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 100% and 89.4%, respectively. Of the seven cases with discordant results, the majority were large, mucinous tumours, which is in line with previous studies. Our study demonstrated that despite its limitations, intraoperative frozen section has a high accuracy and sensitivity for assessing ovarian tumours; however, care needs to be taken with large, mucinous tumours.

Implementation at the School Building Level: The Development and Analysis of Nine Mini-Case Studies.

ERIC Educational Resources Information Center

Hall, Gene; And Others

As part of a district-wide longitudinal study of the implementation of a science curriculum innovation, researchers developed case studies of a sample of nine elementary schools in the Jefferson County School District, a large suburban system in Colorado. The study applied the Concerns-Based Adoption Model, which assumes that change is carried out…

Extrinsic Motivation for Large-Scale Assessments: A Case Study of a Student Achievement Program at One Urban High School

ERIC Educational Resources Information Center

Emmett, Joshua; McGee, Dean

2013-01-01

The purpose of this case study was to discover the critical attributes of a student achievement program, known as "Think Gold," implemented at one urban comprehensive high school as part of the improvement process. Student achievement on state assessments improved during the period under study. The study draws upon perspectives on…

The Enterprise Training System and Training Content Analysis of Selected Manufacturing Companies in Taiwan, R.O.C.: A Case Study.

ERIC Educational Resources Information Center

Kuo, Mike Chu-Hsun

A study investigated the current enterprise training system in Taiwan and proposed suitable training suggestions for manufacturing industry through a carefully designed case study. Literature review and field study were used to gather research data. Interviews were conducted at four large manufacturing companies during the period October 1990 to…

A regularized variable selection procedure in additive hazards model with stratified case-cohort design.

PubMed

Ni, Ai; Cai, Jianwen

2018-07-01

Case-cohort designs are commonly used in large epidemiological studies to reduce the cost associated with covariate measurement. In many such studies the number of covariates is very large. An efficient variable selection method is needed for case-cohort studies where the covariates are only observed in a subset of the sample. Current literature on this topic has been focused on the proportional hazards model. However, in many studies the additive hazards model is preferred over the proportional hazards model either because the proportional hazards assumption is violated or the additive hazards model provides more relevent information to the research question. Motivated by one such study, the Atherosclerosis Risk in Communities (ARIC) study, we investigate the properties of a regularized variable selection procedure in stratified case-cohort design under an additive hazards model with a diverging number of parameters. We establish the consistency and asymptotic normality of the penalized estimator and prove its oracle property. Simulation studies are conducted to assess the finite sample performance of the proposed method with a modified cross-validation tuning parameter selection methods. We apply the variable selection procedure to the ARIC study to demonstrate its practical use.

A Collective Case Study of the Idiosyncratic Language of Formal Thought Disorder in Cases of Disorganized Psychosis

ERIC Educational Resources Information Center

Lowe, Amanda R.

2012-01-01

This study focuses on a meaningful understanding of idiosyncratic language in psychosis. The psychotic neologisms examined in this dissertation challenge the listener's accurate understanding. Idiosyncratic aspects of speech in psychosis are largely researched from a diagnostic perspective in the literature. This study asks how individuals…

Relationships between Food Manufacturers and Retailers and Possible Implications for Training.

ERIC Educational Resources Information Center

King, Richard; Kruse, Wilfried

A pilot study examined the relationship between the retail sector and food and beverages industries and their implications for training. A range of case studies were undertaken in food manufacturing and retailing enterprises in the United Kingdom (UK) and Germany. The UK case studies examined the problems of manufacturers, both small and large,…

Positivism, Postmodernism, or Critical Theory? A Case Study of Communications Students' Understandings of Criticism

ERIC Educational Resources Information Center

Fuchs, Christian; Sandoval, Marisol

2008-01-01

Neoliberalism has resulted in a large-scale economization and capitalization of society that has also permeated the academic system. The paper at hand provides the result of a case study that analyzed how students, who are today frequently confronted by the combination of studying and precarious labour and insecure job perspectives, assess the…

A Framework for Violence: Clarifying the Role of Motivation in Lone-Actor Terrorism

DTIC Science & Technology

2017-03-01

Within the timeframe included in this study , there was, on average, just over one case of lone-actor terrorism per year.60 Spaaij expanded his...informants and sting operations.63 Within the Becker study , twelve out of eighty-four attacks, relied on confidential informants.64 In certain cases , the...indicators of personal or ideological grievances. The data used for this research are publicly available and largely based on two case studies compiled

Automated and Autonomous Systems for Combat Service Support: Scoping Study and Technology Prioritisation

DTIC Science & Technology

2016-10-01

workshop, and use case development for automated and autonomous systems for CSS. The scoping study covers key concepts and trends, a technology scan, and...requirements and delimiters for the selected technologies. The report goes on to present detailed use cases for two technologies of interest: semi...selected use cases . As a result of the workshop, the large list of technologies and applications from the scoping study was narrowed down to the top

Primary sternum diffuse large B-cell lymphoma: A case report and review of the literature

PubMed Central

TONG, MENG-YING; ZHANG, XIAN; YU, ZHE; SUN, XIU-HUA; LI, SHUANG; ZHANG, YANG

2015-01-01

Primary bone lymphoma (PBL) is a rare disease, accounting for >1% of all cases of malignant lymphoma. Diffuse large B-cell lymphoma (DLBCL) is the most common histological type of PBL. The present study reported the case of a 68-year-old male with primary bone DLBCL, originally occurred in the sternum, which is a rare form of presentation. Computed tomography (CT), magnetic resonance imaging and bone emission CT were performed, followed by immunohistochemical analysis of a biopsy specimen, and the results were used to establish the diagnosis. At the time of diagnosis, no osseous involvement was observed. The clinical, radiological and histological features of PBL can mimic other medical conditions, thereby making the diagnosis difficult, and frequently leading to delays in treatment. The present study investigated the clinical features, management and prognosis of PBL, and reviewed previous relevant cases. PMID:26137117

Vacuum extraction failure is associated with a large head circumference.

PubMed

Kabiri, Doron; Lipschuetz, Michal; Cohen, Sarah M; Yagel, Oren; Levitt, Lorinne; Herzberg, Shmuel; Ezra, Yossef; Yagel, Simcha; Amsalem, Hagai

2018-04-24

To determine whether large head circumference increases the risk of vacuum extraction failure. This EMR-based study included all attempted vacuum extractions performed in a tertiary center between January 2010 and June 2015. All term singleton live births were eligible. Cases were divided into four groups: head circumference ≥90th percentile both with birth weight ≥90th percentile and <90th percentile and fetal head circumference <90th percentile with birth weight ≥90th and <90th percentile. Risk of failed vacuum extraction was compared among these groups. Other neonatal and maternal parameters were also evaluated as potential risk factors. Multinomial multivariable regression provided adjusted odds ratio for vacuum extraction failure while controlling for potential confounders. During the study period, 48,007 deliveries met inclusion criteria, of which 3835 had an attempt at vacuum extraction. We identified 215 (5.6%) cases of vacuum extraction failure. The adjusted odds ratios (aOR) for vacuum extraction failure in cases of large fetal head circumference was 2.31 (95%CI, 1.7-3.15, p < .001). Primiparity, prolonged second stage and occipito-posterior presentation were also found to be significant risk factors for failed vacuum extraction. In this study, we found that large head circumference was associated with vacuum extraction failure rather than high birth weight.

Risk of Gambling Disorder and Impulse Control Disorder With Aripiprazole, Pramipexole, and Ropinirole: A Pharmacoepidemiologic Study.

PubMed

Etminan, Mahyar; Sodhi, Mohit; Samii, Ali; Procyshyn, Ric M; Guo, Michael; Carleton, Bruce C

2017-02-01

Recently, the US Food and Drug Administration issued a warning regarding the potential risk of gambling disorder, but large epidemiologic studies are lacking. We used a large health claims database from the United States and conducted a nested case-control study. Cases were defined as subjects newly diagnosed with gambling disorder or impulse control disorder. For each case, 10 controls were selected and matched to cases by age and follow-up time and calendar time. Adjusted rate ratios were computed with conditional logistic regression. There are 355 cases of gambling disorder and 3550 controls along with 4341 cases of impulse control disorder and 43,410 corresponding controls. After adjusting for confounders, users of aripiprazole demonstrated an increased risk of pathologic gambling (rate ratio [RR], 5.23; 95% confidence interval [CI], 1.78-15.38) and impulse control disorder (RR, 7.71; 95% CI, 5.81-10.34). The risk was also elevated for pramipexole or ropinirole for both gambling disorder and impulse control disorder (RR, 7.61; 95% CI, 2.75-21.07; RR, 3.28; 95% CI, 2.31-4.66, respectively). Our study confirms an association between aripiprazole, pramipexole, or ropinirole and impulse control disorder and gambling disorder.

XPAT: a toolkit to conduct cross-platform association studies with heterogeneous sequencing datasets.

PubMed

Yu, Yao; Hu, Hao; Bohlender, Ryan J; Hu, Fulan; Chen, Jiun-Sheng; Holt, Carson; Fowler, Jerry; Guthery, Stephen L; Scheet, Paul; Hildebrandt, Michelle A T; Yandell, Mark; Huff, Chad D

2018-04-06

High-throughput sequencing data are increasingly being made available to the research community for secondary analyses, providing new opportunities for large-scale association studies. However, heterogeneity in target capture and sequencing technologies often introduce strong technological stratification biases that overwhelm subtle signals of association in studies of complex traits. Here, we introduce the Cross-Platform Association Toolkit, XPAT, which provides a suite of tools designed to support and conduct large-scale association studies with heterogeneous sequencing datasets. XPAT includes tools to support cross-platform aware variant calling, quality control filtering, gene-based association testing and rare variant effect size estimation. To evaluate the performance of XPAT, we conducted case-control association studies for three diseases, including 783 breast cancer cases, 272 ovarian cancer cases, 205 Crohn disease cases and 3507 shared controls (including 1722 females) using sequencing data from multiple sources. XPAT greatly reduced Type I error inflation in the case-control analyses, while replicating many previously identified disease-gene associations. We also show that association tests conducted with XPAT using cross-platform data have comparable performance to tests using matched platform data. XPAT enables new association studies that combine existing sequencing datasets to identify genetic loci associated with common diseases and other complex traits.

Implementing Summative Assessment with a Formative Flavour: A Case Study in a Large Class

ERIC Educational Resources Information Center

Broadbent, Jaclyn; Panadero, Ernesto; Boud, David

2018-01-01

Teaching a large class can present real challenges in design, management and standardisation of assessment practices. One of the main dilemmas for university teachers is how to implement effective formative assessment practices with accompanying high-quality feedback consistently over time with large classroom groups. This article reports on how…

Case Study: Commercialization of sweet sorghum juice clarification for large-scale syrup manufacture

USDA-ARS?s Scientific Manuscript database

The precipitation and burning of insoluble granules of starch from sweet sorghum juice on heating coils prevented the large scale manufacture of syrup at a new industrial plant in Missouri, USA. To remove insoluble starch granules, a series of small and large-scale experiments were conducted at the...

Large-Scale High School Reform through School Improvement Networks: Exploring Possibilities for "Developmental Evaluation"

ERIC Educational Resources Information Center

Peurach, Donald J.; Lenhoff, Sarah Winchell; Glazer, Joshua L.

2016-01-01

Recognizing school improvement networks as a leading strategy for large-scale high school reform, this analysis examines developmental evaluation as an approach to examining school improvement networks as "learning systems" able to produce, use, and refine practical knowledge in large numbers of schools. Through a case study of one…

SCALE(ing)-UP Teaching: A Case Study of Student Motivation in an Undergraduate Course

ERIC Educational Resources Information Center

Chittum, Jessica R.; McConnell, Kathryne Drezek; Sible, Jill

2017-01-01

Teaching large classes is increasingly common; thus, demand for effective large-class pedagogy is rising. One method, titled "SCALE-UP" (Student-Centered Active Learning Environment for Undergraduate Programs), is intended for large classes and involves collaborative, active learning in a technology-rich and student-centered environment.…

[Tonsillectomy for PANDAS?].

PubMed

Windfuhr, J P

2016-04-01

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a disease attributed to children with obsessive compulsive or tic disorders associated with streptococcal infections. Because otolaryngologists evaluate a large number of pediatric patients with recurrent streptococcal infections, tonsillectomy (TE) is a common option of therapy. This study was undertaken to evaluate the efficacy of tonsillectomy in patients presenting with a verified PANDAS. A PubMed research was performed using search terms "tonsillectomy" and "PANDAS", "OCD", "compulsive", "pediatric autoimmune", "Chorea" and "Tic" limited by publication date January 1, 1995 to July 31, 2015. Reviews without patients were not included in the review. Nine papers matched our search terms, including 6 case reports with 8 patients and 3 case series. Most case reports were in favor for TE, but this was by far not supported by the findings in the case series. The follow-up ranged form 2-36 months (case reports) and 24-36 months (case series). establishing the diagnosis of PANDAS is complicated by underlying co-morbidities in the field of neurology-psychiatry and the lack of a reliable biomarker. The positive outcome after TE as reported in case studies may be influenced by the postoperative medication and is not supported by the results of large-scale studies. In the light of the considerable postoperative morbidity and unavoidable mortality rate it appears wise to indicate TE only in clinical studies with standardized inclusion criteria. © Georg Thieme Verlag KG Stuttgart · New York.

Phenotypic Association Analyses With Copy Number Variation in Recurrent Depressive Disorder.

PubMed

Rucker, James J H; Tansey, Katherine E; Rivera, Margarita; Pinto, Dalila; Cohen-Woods, Sarah; Uher, Rudolf; Aitchison, Katherine J; Craddock, Nick; Owen, Michael J; Jones, Lisa; Jones, Ian; Korszun, Ania; Barnes, Michael R; Preisig, Martin; Mors, Ole; Maier, Wolfgang; Rice, John; Rietschel, Marcella; Holsboer, Florian; Farmer, Anne E; Craig, Ian W; Scherer, Stephen W; McGuffin, Peter; Breen, Gerome

2016-02-15

Defining the molecular genomic basis of the likelihood of developing depressive disorder is a considerable challenge. We previously associated rare, exonic deletion copy number variants (CNV) with recurrent depressive disorder (RDD). Sex chromosome abnormalities also have been observed to co-occur with RDD. In this reanalysis of our RDD dataset (N = 3106 cases; 459 screened control samples and 2699 population control samples), we further investigated the role of larger CNVs and chromosomal abnormalities in RDD and performed association analyses with clinical data derived from this dataset. We found an enrichment of Turner's syndrome among cases of depression compared with the frequency observed in a large population sample (N = 34,910) of live-born infants collected in Denmark (two-sided p = .023, odds ratio = 7.76 [95% confidence interval = 1.79-33.6]), a case of diploid/triploid mosaicism, and several cases of uniparental isodisomy. In contrast to our previous analysis, large deletion CNVs were no more frequent in cases than control samples, although deletion CNVs in cases contained more genes than control samples (two-sided p = .0002). After statistical correction for multiple comparisons, our data do not support a substantial role for CNVs in RDD, although (as has been observed in similar samples) occasional cases may harbor large variants with etiological significance. Genetic pleiotropy and sample heterogeneity suggest that very large sample sizes are required to study conclusively the role of genetic variation in mood disorders. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Analysis of Clinical Cohort Data Using Nested Case-control and Case-cohort Sampling Designs. A Powerful and Economical Tool.

PubMed

Ohneberg, K; Wolkewitz, M; Beyersmann, J; Palomar-Martinez, M; Olaechea-Astigarraga, P; Alvarez-Lerma, F; Schumacher, M

2015-01-01

Sampling from a large cohort in order to derive a subsample that would be sufficient for statistical analysis is a frequently used method for handling large data sets in epidemiological studies with limited resources for exposure measurement. For clinical studies however, when interest is in the influence of a potential risk factor, cohort studies are often the first choice with all individuals entering the analysis. Our aim is to close the gap between epidemiological and clinical studies with respect to design and power considerations. Schoenfeld's formula for the number of events required for a Cox' proportional hazards model is fundamental. Our objective is to compare the power of analyzing the full cohort and the power of a nested case-control and a case-cohort design. We compare formulas for power for sampling designs and cohort studies. In our data example we simultaneously apply a nested case-control design with a varying number of controls matched to each case, a case cohort design with varying subcohort size, a random subsample and a full cohort analysis. For each design we calculate the standard error for estimated regression coefficients and the mean number of distinct persons, for whom covariate information is required. The formula for the power of a nested case-control design and the power of a case-cohort design is directly connected to the power of a cohort study using the well known Schoenfeld formula. The loss in precision of parameter estimates is relatively small compared to the saving in resources. Nested case-control and case-cohort studies, but not random subsamples yield an attractive alternative for analyzing clinical studies in the situation of a low event rate. Power calculations can be conducted straightforwardly to quantify the loss of power compared to the savings in the num-ber of patients using a sampling design instead of analyzing the full cohort.

Primary central nervous system diffuse large B-cell lymphoma shows an activated B-cell-like phenotype with co-expression of C-MYC, BCL-2, and BCL-6.

PubMed

Li, Xiaomei; Huang, Ying; Bi, Chengfeng; Yuan, Ji; He, Hong; Zhang, Hong; Yu, QiuBo; Fu, Kai; Li, Dan

2017-06-01

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, whose main prognostic factor is closely related to germinal center B-cell-like subtype (GCB- DLBCL) or activated B-cell-like type (non-GCB-DLBCL). The most common type of primary central nervous system lymphoma is diffuse large B-cell type with poor prognosis and the reason is unclear. This study aims to stratify primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) according to the cell-of-origin (COO) and to investigate the multiple proteins expression of C-MYC, BCL-6, BCL-2, TP53, further to elucidate the reason why primary central nervous system diffuse large B-cell lymphoma possesses a poor clinical outcome as well. Nineteen cases of primary central nervous system DLBCL were stratified according to immunostaining algorithms of Hans, Choi and Meyer (Tally) and we investigated the multiple proteins expression of C-MYC, BCL-6, BCL-2, TP53. The Epstein-Barr virus and Borna disease virus infection were also detected. Among nineteen cases, most (15-17 cases) were assigned to the activated B-cell-like subtype, highly expression of C-MYC (15 cases, 78.9%), BCL-2 (10 cases, 52.6%), BCL-6 (15 cases, 78.9%). Unfortunately, two cases were positive for PD-L1 while PD-L2 was not expressed in any case. Two cases infected with BDV but no one infected with EBV. In conclusion, most primary central nervous system DLBCLs show an activated B-cell-like subtype characteristic and have multiple expressions of C-MYC, BCL-2, BCL-6 protein, these features might be significant factor to predict the outcome and guide treatment of PCNS-DLBCLs. Copyright © 2017 Elsevier GmbH. All rights reserved.

Large-Cell Transformed Mycosis Fungoides Coexisting with Mycosis Fungoides Bullosa: A Case Report and Review of the Literature

PubMed Central

Porntharukcharoen, Saneerat; Rutnin, Suthinee; Rajatanavin, Natta

2017-01-01

Mycosis fungoides is the most common form of cutaneous T-cell lymphoma. Both large-cell transformed mycosis fungoides and mycosis fungoides bullosa are rare presentations and predict unfavorable prognosis. We report the case of a 61-year-old woman who presented with generalized erythematous scaly annular plaques, and histopathology confirmed the diagnosis of mycosis fungoides. She was treated with various conventional therapies but only achieved partial response and always relapsed after discontinuation of treatment. Her last treatment was combined chemotherapy (CHOP regimen) followed by romidepsin. However, 1 month after the last cycle of romidepsin, she developed multiple ulcerative masses and nodules. Skin biopsy was compatible with CD30+ large cell transformation, and she was treated with a new combination of chemotherapy (ifosfamide, carboplatin, etoposide). One day after receiving chemotherapy, multiple tense bullae on normal-appearing skin and mycosis fungoid plaques erupted. A histological study demonstrated subepidermal blistering with epidermotropism of atypical lymphocytes. Direct immunofluorescence study was negative. The results confirmed the diagnosis of mycosis fungoides bullosa. We present the first reported case of large-cell transformed mycosis fungoides coexisting with mycosis fungoides bullosa. PMID:29515392

Sustainable Imaginaries: A Case Study of a Large Suburban Canadian University

ERIC Educational Resources Information Center

Vaughter, Philip; Alsop, Steve

2017-01-01

Purpose: This paper aims to explore the concept of sustainability imaginaries--unifying core assumptions on what sustainability entails held by stakeholders--set within a large suburban Canadian university. The study aims to expand the field of research into imaginaries by focusing on imaginaries within an institution as opposed to a societal or…

Framing Innovation: The Role of Distributed Leadership in Gaining Acceptance of Large-Scale Technology Initiatives

ERIC Educational Resources Information Center

Turner, Henry J.

2014-01-01

This dissertation of practice utilized a multiple case-study approach to examine distributed leadership within five school districts that were attempting to gain acceptance of a large-scale 1:1 technology initiative. Using frame theory and distributed leadership theory as theoretical frameworks, this study interviewed each district's…

Undertaking an Ecological Approach to Advance Game-Based Learning: A Case Study

ERIC Educational Resources Information Center

Shah, Mamta; Foster, Aroutis

2014-01-01

Systematic incorporation of digital games in schools is largely unexplored. This case study explored the ecological conditions necessary for implementing a game-based learning course by examining the interaction between three domains (the innovator, the innovation, and the context). From January-April 2012, one in-service teacher learned and…

Practice and Policy to Enhance Student Induction and Transition: A Case Study of Institution-Wide Change

ERIC Educational Resources Information Center

Alsford, Sally; Rose, Christine

2014-01-01

This case study gives an analytical account of institutional development in induction provision. Driven by student experience concerns, a London post-1992 University set up an "enhanced induction project" to provide a more integrated, personalised approach through more coordinated processes. In a large, diverse context, university-wide…

Practices of Management Development: A Malaysian Case Study

ERIC Educational Resources Information Center

Law, Kian Aun

2008-01-01

This paper deals with a case study of Management Development (MD) practices at Malaysian Assurance Alliance (MAA). The aim of this research is to investigate how a large Malaysian insurance corporation developed and integrated MD initiatives with current organizational needs and tasks. Attempts were made to map and categorize the MD initiatives…

Contested Values in Further Education: Findings from a Case Study of the Management of Change.

ERIC Educational Resources Information Center

Elliott, Geoffrey; Crossley, Michael

1997-01-01

The recent trend toward development of a radical, market-oriented educational policy with seemingly contradictory pressures for centralization and decentralization has been well-documented. Based on a case study of a large urban (British) college, this paper considers implications, suggesting that contemporary policy thrusts have spawned…

Mind the Gap: A Case Study of Values-Based Decision Making in a Nonprofit Organization

ERIC Educational Resources Information Center

Craft, Jana L.

2013-01-01

Using an exploratory case study approach, this research examined the consistency between espoused and enacted values within a large nonprofit organization known as an ethical leader in the human services industry. This research explored ethical business culture, ethical decision making, deontological and utilitarian moral paradigms and learning…

Primary Datasets for Case Studies of River-Water Quality

ERIC Educational Resources Information Center

Goulder, Raymond

2008-01-01

Level 6 (final-year BSc) students undertook case studies on between-site and temporal variation in river-water quality. They used professionally-collected datasets supplied by the Environment Agency. The exercise gave students the experience of working with large, real-world datasets and led to their understanding how the quality of river water is…

Implementing an Early Intervention Program for Residential Students Who Present with Suicide Risk: A Case Study

ERIC Educational Resources Information Center

Rivero, Estela M.; Cimini, M. Dolores; Bernier, Joseph E.; Stanley, Judith A.; Murray, Andrea D.; Anderson, Drew A.; Wright, Heidi R.

2014-01-01

Objective: This case study examined the effects of an early intervention program designed to respond to residential college students demonstrating risk for suicide. Participants: Participants were 108 undergraduates at a large northeastern public university referred to an early intervention program subsequent to presenting with risk factors for…

Interpersonal Consulting Skills for Instructional Technology Consultants: A Multiple Case Study

ERIC Educational Resources Information Center

van Leusen, Peter; Ottenbreit-Lefwich, Anne T.; Brush, Thomas

2016-01-01

Building a trust-based relationship with faculty is one of the most important attributes of effective Instructional Technology Consultants (ITC) in order to integrate emerging technologies into higher education. Utilizing a multiple case study research design, four experienced ITCs at a large urban research university located in the Midwest showed…

A Tale of Three Classes: Case Studies in Course Complexity

ERIC Educational Resources Information Center

Gill, T. Grandon; Jones, Joni

2010-01-01

This paper examines the question of decomposability versus complexity of teaching situations by presenting three case studies of MIS courses. Because all three courses were highly successful in their observed outcomes, the paper hypothesizes that if the attributes of effective course design are decomposable, one would expect to see a large number…

C++ and operating systems performance - A case study

NASA Technical Reports Server (NTRS)

Russo, Vincent F.; Madany, Peter W.; Campbell, Roy H.

1990-01-01

Object-oriented design and programming has many software engineering advantages. Its application to large systems, however, has previously been constrained by performance concerns. The Choices operating system, which has over 75,000 lines of code, is object-oriented and programmed in C++. This paper is a case study of the performance of Choices.

Primary Prevention: Reducing Institutional Racism/Sexism Through Consultation. Case Study.

ERIC Educational Resources Information Center

O'Neil, James M.; Conyne, Robert

This paper presents a two-year primary prevention intervention aimed at reducing institutional racism and sexism at a large midwestern university. A case study format is used to describe the history, process, and outcomes of the consultation that resulted in proactive change in the institution. Definitions of primary prevention are given and the…

Globalisation, Transnational Academic Mobility and the Chinese Knowledge Diaspora: An Australian Case Study

ERIC Educational Resources Information Center

Yang, Rui; Welch, Anthony R.

2010-01-01

The master discourses of economic globalisation and the knowledge economy each cite knowledge diasporas as vital "trans-national human capital". Based on a case study of a major Australian university, this article examines the potential to deploy China's large and highly-skilled diaspora in the service of Chinese and Australian…

Purification and characterization of black walnut (Juglans nigra) Allergen, Jug n 4

USDA-ARS?s Scientific Manuscript database

Tree nuts as a group have caused a significant number of cases of fatal anaphylactic reactions. In a large scale study of US peanut and tree nut allergy cases with 5149 patients, walnuts were the leading cause of allergic reactions. The purpose of this study was to purify and characterize potential ...

Implementing RTI in a High School: A Case Study

ERIC Educational Resources Information Center

Fisher, Douglas; Frey, Nancy

2013-01-01

This case study chronicles the efforts of a small high school over a 2-year period as it designed and implemented a response to intervention (RTI) program for students at the school. Their efforts were largely successful, with improved achievement, attendance, and grade point averages and a decrease in special education referrals. Major themes…

Managers and Information Technology: A Case Study of Organizational Change in County Government.

ERIC Educational Resources Information Center

Rosenbaum, Howard

1992-01-01

Discussion of the interrelationship of information technology, managers, and users, and the structure of public sector organizations focuses on a case study that examined the organizational changes in the information services department of a large, urban county government as a result of the use of sophisticated information technologies. (11…

Workshop Organization and Management in Adult Education. Case Study of the MOBRAL System.

ERIC Educational Resources Information Center

da Costa, Lamartine Pereira

This case study of the organizational structure of the Brazilian Literacy Movement (MOBRAL) describes the various organizational changes made as the mediating agency attempted to develop a large-scale national program within the existing social structure. Steps in the organization's development are traced from: (1) Beginnings in 1970 under the…

Under-reporting of sputum smear-positive tuberculosis cases in Kenya.

PubMed

Tollefson, D; Ngari, F; Mwakala, M; Gethi, D; Kipruto, H; Cain, K; Bloss, E

2016-10-01

Although an estimated three million tuberculosis (TB) cases worldwide are missed by national TB programs annually, the level of under-reporting of diagnosed cases in high TB burden settings is largely unknown. To quantify and describe under-reporting of sputum smear-positive TB cases in Kenya. A national-level retrospective TB inventory study was conducted. All sputum smear-positive TB cases diagnosed by public or private laboratories during 1 April-30 June 2013 were extracted from laboratory registers in 73 randomly sampled subcounties and matched to TB cases in the national TB surveillance system (TIBU). Bivariate and multivariate analyses were conducted. In the subcounties sampled, 715 of 3409 smear-positive TB cases in laboratory registers were not found in TIBU. The estimated level of under-reporting of smear-positive TB cases in Kenya was 20.7% (95%CI 18.4-23.0). Under-reporting was greatest in subcounties with a high TB burden. Unreported cases were more likely to be patients aged ⩾55 years, have scanty smear results, and be diagnosed at large facilities, private facilities, and facilities in high TB burden regions. In Kenya, one fifth of smear-positive TB cases diagnosed during the study period went unreported, suggesting that the true TB burden is higher than reported. TB surveillance in Kenya should be strengthened to ensure all diagnosed TB cases are reported.

Promoting Student Achievement: A Case Study of Change Actions Employed by an Urban School Superintendent

ERIC Educational Resources Information Center

Bealer, David E.

2010-01-01

The purpose of this study was to examine the change strategies and actions taken by an urban district superintendent to improve student achievement. In a qualitative case study of a large urban school district, one research question and three subquestions focused on: 10 specific reform strategies to improve student achievement, how the quality and…

The Views of International Students Regarding University Support Services in Australia: A Case Study

ERIC Educational Resources Information Center

Roberts, Pam; Boldy, Duncan; Dunworth, Katie

2015-01-01

This paper reports on a study aimed at developing an improved understanding of the support needs of international students. Using a case study approach at one Australian university, a three stage data collection process was adopted: interviews with key support service providers in the university, student focus groups, and a large-scale survey.…

Educating Citizens for Participatory Democracy: A Case Study of Local Government Education Policy in Pelotas, Brazil

ERIC Educational Resources Information Center

McCowan, Tristan

2006-01-01

A case study was undertaken of Pelotas, a large town in southern Brazil, where a recent government of the Workers' Party (PT) implemented a range of social policy reforms. The study draws on interviews with key members of the Municipal Secretariat of Education and policy documents, analyzing them in relation to theoretical literature on…

Personal Development Planning in Initial Teacher Training: A Case Study from Post-Compulsory Education

ERIC Educational Resources Information Center

Thompson, Ron; Hallwood, Linda; Clements, Christine; Rivron, Helen

2009-01-01

This paper provides a case study of personal development planning (PDP) within an initial teacher training course for the post-compulsory sector, delivered through a large consortium in the north of England. The paper reviews conceptual and empirical studies of PDP in higher education and reports on the practice and perceptions of students and…

[Large benign prostatic hiperplasia].

PubMed

Soria-Fernández, Guillermo René; Jungfermann-Guzman, José René; Lomelín-Ramos, José Pedro; Jaspersen-Gastelum, Jorge; Rosas-Nava, Jesús Emmanuel

2012-01-01

the term prostatic hyperplasia is most frequently used to describe the benign prostatic growth, this being a widely prevalent disorder associated with age that affects most men as they age. The association between prostate growth and urinary obstruction in older adults is well documented. large benign prostatic hyperplasia is rare and few cases have been published and should be taken into account during the study of tumors of the pelvic cavity. we report the case of an 81-year-old who had significant symptoms relating to storage and bladder emptying, with no significant elevation of prostate specific antigen. this is a rare condition but it is still important to diagnose and treat as it may be related to severe obstructive uropathy and chronic renal failure. In our institution, cases of large prostatic hyperplasia that are solved by suprapubic adenomectomy are less than 3%.

Ischemic stroke subtypes: a population-based study of incidence rates among blacks and whites.

PubMed

Schneider, Alexander T; Kissela, Brett; Woo, Daniel; Kleindorfer, Dawn; Alwell, Kathleen; Miller, Rosemary; Szaflarski, Jerzy; Gebel, James; Khoury, Jane; Shukla, Rakesh; Moomaw, Charles; Pancioli, Arthur; Jauch, Edward; Broderick, Joseph

2004-07-01

Blacks have an excess burden of stroke compared with whites; however, data comparing ischemic stroke subtypes among the 2 groups are limited and typically involve relative frequencies. The objective of this study is to compare the incidence rates of ischemic stroke subtypes between blacks and whites within a large, representative, biracial population. The Greater Cincinnati/Northern Kentucky Stroke Study is designed to measure incidence rates and trends of all strokes within a well-defined, large, biracial population. Hospitalized cases were ascertained by International Classification of Disease (9th revision; ICD-9) discharge codes. Out-of-hospital events were ascertained by prospective screening of emergency department admission logs, review of coroners' cases, and monitoring all public health and hospital-based primary care clinics. A sampling scheme was used to ascertain events from nursing homes and all other primary care physician offices. All potential cases underwent detailed chart abstraction and confirmed by physician review. Based on all available clinical, laboratory, and radiographic information, ischemic stroke cases were subtyped into the following categories: cardioembolic, large-vessel, small-vessel, other, and stroke of undetermined cause. Race-specific incidence rates were calculated and compared after adjusting for age and gender, and standardizing to the 1990 US population. Between July 1, 1993, and June 30, 1994, 1956 first-ever ischemic strokes occurred among blacks and whites in the study population. Small-vessel strokes and strokes of undetermined cause were nearly twice as common among blacks. Large-vessel strokes were 40% more common among blacks than whites, and there was a trend toward cardioembolic strokes being more common among blacks. The excess burden of ischemic strokes among blacks compared with whites is not uniformly spread across the different subtypes. Large-vessel strokes are more common and cardioembolic stroke are as common among blacks, traditionally thought to be more common among whites.

Computational Modeling And Analysis Of Synthetic Jets

NASA Technical Reports Server (NTRS)

Mittal, Rajat; Cattafesta, Lou

2005-01-01

In the last report we focused on the study of 3D synthetic jets of moderate jet aspect-ratio. Jets in quiescent and cross-flow cases were investigated. Since most of the synthetic jets in practical applications are found to be of large aspect ratio, the focus was shifted to studying synthetic jets of large aspect ratio. In the current year, further progress has been made by studying jets of aspect ratio 8 and infinity. Some other aspects of the jet, like the vorticity flux is looked into apart from analyzing the vortex dynamics, velocity profiles and the other dynamical characteristics of the jet which allows us to extract some insight into the effect of these modifications on the jet performance. Also, efforts were made to qualitatively validate the simulated results with the NASA Langley test cases at higher jet Reynolds number for the quiescent jet case.

Tisettanta case study: the interoperation of furniture production companies

NASA Astrophysics Data System (ADS)

Amarilli, Fabrizio; Spreafico, Alberto

This chapter presents the Tisettanta case study, focusing on the definition of the possible innovations that ICT technologies can bring to the Italian wood-furniture industry. This sector is characterized by industrial clusters composed mainly of a few large companies with international brand reputations and a large base of SMEs that manufacture finished products or are specialized in the production of single components/processes (such as the Brianza cluster, where Tisettanta operates). In this particular business ecosystem, ICT technologies can bring relevant support and improvements to the supply chain process, where collaborations between enterprises are put into action through the exchange of business documents such as orders, order confirmation, bills of lading, invoices, etc. The analysis methodology adopted in the Tisettanta case study refers to the TEKNE Methodology of Change (see Chapter 2), which defines a framework for supporting firms in the adoption of the Internetworked Enterprise organizational paradigm.

Grant Development for Large Scale Research Proposals: An Overview and Case Study

ERIC Educational Resources Information Center

Goodman, Ira S.

2011-01-01

With some NIH pay lines running at or below the 10th percentile, and funding becoming scarce for large science grants, new approaches are necessary to secure large interdisciplinary grant awards. The UCSD Moores Cancer Center has developed a team approach, starting with the identification of a competitive opportunity and progressing to the…

Framing Innovation: The Impact of the Superintendent's Technology Infrastructure Decisions on the Acceptance of Large-Scale Technology Initiatives

ERIC Educational Resources Information Center

Arnold, Erik P.

2014-01-01

A multiple-case qualitative study of five school districts that had implemented various large-scale technology initiatives was conducted to describe what superintendents do to gain acceptance of those initiatives. The large-scale technology initiatives in the five participating districts included 1:1 District-Provided Device laptop and tablet…

Large cell neuroendocrine cervical tumor treated by radical surgery and adjuvant chemotherapy: A case report and literature review.

PubMed

BacalbaȘa, Nicolae; Stoica, Claudia; Marcu, Madalina; Mihalache, Daniela; Vasilescu, Florina; Popa, Ileana; Mirea, Gratiela; Bălescu, Irina

2016-01-01

Neuroendocrine carcinomas of the uterine cervix are rare, but extremely aggressive, gynecological malignancies that are associated with an overall poor prognosis. The present study reports the case of a 41-year-old patient diagnosed with large cell neuroendocrine cervical tumor. A radical total hysterectomy with bilateral adnexectomy, pelvic and lymph node dissection was performed. The post-operative course was uneventful, and the patient was discharged on post-operative day 8.

Language and Content: The Case of Law.

ERIC Educational Resources Information Center

Beasley, Colin J.

A discussion of the teaching and learning of English for special purposes focuses on the interrelationship of content and language, particularly in the case of education for the legal professions. It is noted that law students must both study a large corpus of case and statute law and legal principles and learn the language of the law, with its…

A complementary graphical method for reducing and analyzing large data sets. Case studies demonstrating thresholds setting and selection.

PubMed

Jing, X; Cimino, J J

2014-01-01

Graphical displays can make data more understandable; however, large graphs can challenge human comprehension. We have previously described a filtering method to provide high-level summary views of large data sets. In this paper we demonstrate our method for setting and selecting thresholds to limit graph size while retaining important information by applying it to large single and paired data sets, taken from patient and bibliographic databases. Four case studies are used to illustrate our method. The data are either patient discharge diagnoses (coded using the International Classification of Diseases, Clinical Modifications [ICD9-CM]) or Medline citations (coded using the Medical Subject Headings [MeSH]). We use combinations of different thresholds to obtain filtered graphs for detailed analysis. The thresholds setting and selection, such as thresholds for node counts, class counts, ratio values, p values (for diff data sets), and percentiles of selected class count thresholds, are demonstrated with details in case studies. The main steps include: data preparation, data manipulation, computation, and threshold selection and visualization. We also describe the data models for different types of thresholds and the considerations for thresholds selection. The filtered graphs are 1%-3% of the size of the original graphs. For our case studies, the graphs provide 1) the most heavily used ICD9-CM codes, 2) the codes with most patients in a research hospital in 2011, 3) a profile of publications on "heavily represented topics" in MEDLINE in 2011, and 4) validated knowledge about adverse effects of the medication of rosiglitazone and new interesting areas in the ICD9-CM hierarchy associated with patients taking the medication of pioglitazone. Our filtering method reduces large graphs to a manageable size by removing relatively unimportant nodes. The graphical method provides summary views based on computation of usage frequency and semantic context of hierarchical terminology. The method is applicable to large data sets (such as a hundred thousand records or more) and can be used to generate new hypotheses from data sets coded with hierarchical terminologies.

A parallel metaheuristic for large mixed-integer dynamic optimization problems, with applications in computational biology

PubMed Central

Henriques, David; González, Patricia; Doallo, Ramón; Saez-Rodriguez, Julio; Banga, Julio R.

2017-01-01

Background We consider a general class of global optimization problems dealing with nonlinear dynamic models. Although this class is relevant to many areas of science and engineering, here we are interested in applying this framework to the reverse engineering problem in computational systems biology, which yields very large mixed-integer dynamic optimization (MIDO) problems. In particular, we consider the framework of logic-based ordinary differential equations (ODEs). Methods We present saCeSS2, a parallel method for the solution of this class of problems. This method is based on an parallel cooperative scatter search metaheuristic, with new mechanisms of self-adaptation and specific extensions to handle large mixed-integer problems. We have paid special attention to the avoidance of convergence stagnation using adaptive cooperation strategies tailored to this class of problems. Results We illustrate its performance with a set of three very challenging case studies from the domain of dynamic modelling of cell signaling. The simpler case study considers a synthetic signaling pathway and has 84 continuous and 34 binary decision variables. A second case study considers the dynamic modeling of signaling in liver cancer using high-throughput data, and has 135 continuous and 109 binaries decision variables. The third case study is an extremely difficult problem related with breast cancer, involving 690 continuous and 138 binary decision variables. We report computational results obtained in different infrastructures, including a local cluster, a large supercomputer and a public cloud platform. Interestingly, the results show how the cooperation of individual parallel searches modifies the systemic properties of the sequential algorithm, achieving superlinear speedups compared to an individual search (e.g. speedups of 15 with 10 cores), and significantly improving (above a 60%) the performance with respect to a non-cooperative parallel scheme. The scalability of the method is also good (tests were performed using up to 300 cores). Conclusions These results demonstrate that saCeSS2 can be used to successfully reverse engineer large dynamic models of complex biological pathways. Further, these results open up new possibilities for other MIDO-based large-scale applications in the life sciences such as metabolic engineering, synthetic biology, drug scheduling. PMID:28813442

A parallel metaheuristic for large mixed-integer dynamic optimization problems, with applications in computational biology.

PubMed

Penas, David R; Henriques, David; González, Patricia; Doallo, Ramón; Saez-Rodriguez, Julio; Banga, Julio R

2017-01-01

We consider a general class of global optimization problems dealing with nonlinear dynamic models. Although this class is relevant to many areas of science and engineering, here we are interested in applying this framework to the reverse engineering problem in computational systems biology, which yields very large mixed-integer dynamic optimization (MIDO) problems. In particular, we consider the framework of logic-based ordinary differential equations (ODEs). We present saCeSS2, a parallel method for the solution of this class of problems. This method is based on an parallel cooperative scatter search metaheuristic, with new mechanisms of self-adaptation and specific extensions to handle large mixed-integer problems. We have paid special attention to the avoidance of convergence stagnation using adaptive cooperation strategies tailored to this class of problems. We illustrate its performance with a set of three very challenging case studies from the domain of dynamic modelling of cell signaling. The simpler case study considers a synthetic signaling pathway and has 84 continuous and 34 binary decision variables. A second case study considers the dynamic modeling of signaling in liver cancer using high-throughput data, and has 135 continuous and 109 binaries decision variables. The third case study is an extremely difficult problem related with breast cancer, involving 690 continuous and 138 binary decision variables. We report computational results obtained in different infrastructures, including a local cluster, a large supercomputer and a public cloud platform. Interestingly, the results show how the cooperation of individual parallel searches modifies the systemic properties of the sequential algorithm, achieving superlinear speedups compared to an individual search (e.g. speedups of 15 with 10 cores), and significantly improving (above a 60%) the performance with respect to a non-cooperative parallel scheme. The scalability of the method is also good (tests were performed using up to 300 cores). These results demonstrate that saCeSS2 can be used to successfully reverse engineer large dynamic models of complex biological pathways. Further, these results open up new possibilities for other MIDO-based large-scale applications in the life sciences such as metabolic engineering, synthetic biology, drug scheduling.

Laryngopyocele: report of a rare case and systematic review.

PubMed

Al-Yahya, Syarifah N; Baki, Marina Mat; Saad, Sakina Mohd; Azman, Mawaddah; Mohamad, Abdullah Sani

2016-01-01

A systematic review on laryngopyoceles across Ovid, PubMed, and Google Scholar database was conducted. A total of 61 papers published between 1952 and 2015 were found. Of these, 23 cases written in English, which described the number of cases, surgical approaches, resort to tracheostomy, complications, and outcomes, were shortlisted. Four cases of laryngopyoceles were managed endoscopically using a cold instrument, microdebrider, or laser. Eighteen cases were operated via an external approach, and 1 case applied both approaches. One of 4 endoscopic and 10 of 18 external approaches involved tracheostomy. The present study aimed to report a case of large mixed laryngopyocele that was successfully drained and marsupialized endoscopically using suction diathermy without requiring tracheostomy. Management using suction diathermy for excision and marsupialization of a laryngopyocele has never been reported and can be recommended as a feasible method due to its widespread availability. In the presence of a large laryngopyocele impeding the airway, tracheostomy may be averted in a controlled setting. None specified.

Outbreak of Neisseria meningitidis C in workers at a large food-processing plant in Brazil: challenges of controlling disease spread to the larger community.

PubMed

Iser, B P M; Lima, H C A V; de Moraes, C; de Almeida, R P A; Watanabe, L T; Alves, S L A; Lemos, A P S; Gorla, M C O; Gonçalves, M G; Dos Santos, D A; Sobel, J

2012-05-01

SUMMARYAn outbreak of meningococcal disease (MD) with severe morbidity and mortality was investigated in midwestern Brazil in order to identify control measures. A MD case was defined as isolation of Neisseria meningitidis, or detection of polysaccharide antigen in a sterile site, or presence of clinical purpura fulminans, or an epidemiological link with a laboratory-confirmed case-patient, between June and August 2008. In 8 out of 16 MD cases studied, serogroup C ST103 complex was identified. Five (31%) cases had neurological findings and five (31%) died. The attack rate was 12 cases/100 000 town residents and 60 cases/100 000 employees in a large local food-processing plant. We conducted a matched case-control study of eight primary laboratory-confirmed cases (1:4). Factors associated with illness in single variable analysis were work at the processing plant [matched odds ratio (mOR) 22, 95% confidence interval (CI) 2·3-207·7, P<0·01], and residing <1 year in Rio Verde (mOR 7, 95% CI 1·11-43·9, P<0·02). Mass vaccination (>10 000 plant employees) stopped propagation in the plant, but not in the larger community.

Should Child Protection Services Respond Differently to Maltreatment, Risk of Maltreatment, and Risk of Harm?

ERIC Educational Resources Information Center

Fallon, Barbara; Trocme, Nico; MacLaurin, Bruce

2011-01-01

Objective: To examine evidence available in large-scale North American datasets on child abuse and neglect that can assist in understanding the complexities of child protection case classifications. Methods: A review of child abuse and neglect data from large North American epidemiological studies including the Canadian Incidence Study of Reported…

Estimating migratory fish distribution from altitude and basin area: a case study in a large Neotropical river

Treesearch

Jose Ricardo Barradas; Lucas G. Silva; Bret C. Harvey; Nelson F. Fontoura

2012-01-01

1. The objective of this study was to identify longitudinal distribution patterns of large migratory fish species in the Uruguay River basin, southern Brazil, and construct statistical distribution models for Salminus brasiliensis, Prochilodus lineatus, Leporinus obtusidens and Pseudoplatystoma corruscans. 2. The sampling programme resulted in 202 interviews with old...

Standard Errors for National Trends in International Large-Scale Assessments in the Case of Cross-National Differential Item Functioning

ERIC Educational Resources Information Center

Sachse, Karoline A.; Haag, Nicole

2017-01-01

Standard errors computed according to the operational practices of international large-scale assessment studies such as the Programme for International Student Assessment's (PISA) or the Trends in International Mathematics and Science Study (TIMSS) may be biased when cross-national differential item functioning (DIF) and item parameter drift are…

Predictive value of autoantibody testing for validating self-reported diagnoses of rheumatoid arthritis in the Women's Health Initiative.

PubMed

Walitt, Brian; Mackey, Rachel; Kuller, Lewis; Deane, Kevin D; Robinson, William; Holers, V Michael; Chang, Yue-Fang; Moreland, Larry

2013-05-01

Rheumatoid arthritis (RA) research using large databases is limited by insufficient case validity. Of 161,808 postmenopausal women in the Women's Health Initiative, 15,691 (10.2%) reported having RA, far higher than the expected 1% population prevalence. Since chart review for confirmation of an RA diagnosis is impractical in large cohort studies, the current study (2009-2011) tested the ability of baseline serum measurements of rheumatoid factor and anti-cyclic citrullinated peptide antibodies, second-generation assay (anti-CCP2), to identify physician-validated RA among the chart-review study participants with self-reported RA (n = 286). Anti-CCP2 positivity had the highest positive predictive value (PPV) (80.0%), and rheumatoid factor positivity the lowest (44.6%). Together, use of disease-modifying antirheumatic drugs and anti-CCP2 positivity increased PPV to 100% but excluded all seronegative cases (approximately 15% of all RA cases). Case definitions inclusive of seronegative cases had PPVs between 59.6% and 63.6%. False-negative results were minimized in these test definitions, as evidenced by negative predictive values of approximately 90%. Serological measurements, particularly measurement of anti-CCP2, improved the test characteristics of RA case definitions in the Women's Health Initiative.

Ways with Data: Understanding Coding as Writing

ERIC Educational Resources Information Center

Lindgren, Chris

2017-01-01

In this dissertation, I report findings from an exploratory case-study about Ray, a web developer, who works on a data-driven news team that finds and tells compelling stories with large sets of data. I implicate this case of Ray's coding on a data team in a writing studies epistemology, which is guided by the following question: "What might…

Pedagogy and Process: A Case Study of Writing in a Hybrid Learning Model

ERIC Educational Resources Information Center

Keiner, Jason F.

2017-01-01

This qualitative case study explored the perceived experiences and outcomes of writing in a hybrid model of instruction in a large suburban high school. In particular, the impact of a hybrid model on the writing process and on future writing performance were examined. In addition, teacher expectation and teacher attitude and their impact upon…

Advisory Groups to Encourage Collaboration: A Case Study

ERIC Educational Resources Information Center

Stephens, Lisa A.; Glynn, Graham; Lavallee, David; Moreau, Joseph; Orzech, Mary Jo; Pence, Harry E.

2011-01-01

This article is a case study of how the provost and senior executive leadership of one large university system capitalized on a long-standing advisory group as a tool to support communication and collaboration across a broad constituency. These advisory efforts help guide both future directions and investment. It is the story of how this group has…

When It Rains It Pours: Crises at Oakmont University SACSA Case Study

ERIC Educational Resources Information Center

Akers, C. Ryan; Heiselt, April K.

2009-01-01

This article presents a case study at Oakmont University where a presidential debate will be held on campus. Oakmont University is a large public research institution located in the Southeastern United States. This Carnegie Doctoral/Research I institution enrolls more than 35,000, 75% undergraduate and 25% graduate students. Located in somewhat of…

Implementing an Audience-Specific Small-Group Gatekeeper Training Program to Respond to Suicide Risk among College Students: A Case Study

ERIC Educational Resources Information Center

Cimini, M. Dolores; Rivero, Estela M.; Bernier, Joseph E.; Stanley, Judith A.; Murray, Andrea D.; Anderson, Drew A.; Wright, Heidi R.; Bapat, Mona

2014-01-01

Objective: This case study evaluated the effectiveness of an audience-specific, single-session, small-group interactive gatekeeper training program conducted at a large northeastern public university. Participants: Participants were 335 faculty, staff, and students completing gatekeeper training programs tailored to their group needs. Methods:…

Lifelong Education and Community Learning: Three Case Studies in India. UIE Monographs, 7.

ERIC Educational Resources Information Center

Patel, V; Shukla, N. N.

Three case studies of educational practices in India illustrate that lifelong learning (1) is not confined to childhood; (2) encompasses a large number of sources outside formal education; and (3) can lead to improvement of everday life. These three educational activities, all at semi-rural institutions, and directed toward improving aborigines'…

Pearls and Pitfalls in Evaluating a Student Assistance Program: A Five-Year Case Study

ERIC Educational Resources Information Center

Wilburn, Sharon T.; Wilburn, Kenneth T.; Weaver, Dax M.; Bowles, Kathy

2007-01-01

This article presents data from a five-year evaluation-research case study of a large urban schools district's internal Student Assistance Program (SAP). The district employed specially trained and licensed school-based counselors to implement an internal SAP expanded to include tertiary prevention, and modeled after an employee assistance program…

System Learning in an Urban School District: A Case Study of Intra-District Learning

ERIC Educational Resources Information Center

Redding, Christopher; Cannata, Marisa; Miller, Jason

2017-01-01

This paper presents evidence from a unique reform model that allowed teachers and other educators in a large urban district to collaborate with one another in the development of an innovation meant to improve student ownership and responsibility. In this longitudinal case study, we describe school stakeholders' learning about the design, the…

A Case Study of Enabling Factors in the Technology Integration Change Process

ERIC Educational Resources Information Center

Hsu, Pi-Sui; Sharma, Priya

2008-01-01

The purpose of this qualitative case study was to analyze enabling factors in the technology integration change process in a multi-section science methods course, SCIED 408 (pseudonym), from 1997 to 2003 at a large northeastern university in the United States. We used two major data collection methods, in-depth interviewing and document reviews.…

Evolution of a Campus Sustainability Network: A Case Study in Organizational Change

ERIC Educational Resources Information Center

Kurland, Nancy B.

2011-01-01

Purpose: The purpose of this paper is to examine the evolution of a sustainability network at a large California public university, as an example of organizational change. Design/methodology/approach: The paper combines participant observation and case study techniques over a three-year period. From 2007 to 2010, the author helped found the…

Knowledge Co-production at the Research-Practice Interface: Embedded Case Studies from Urban Forestry

Treesearch

Lindsay K. Campbell; Erika S. Svendsen; Lara A. Roman

2016-01-01

Cities are increasingly engaging in sustainability efforts and investment in green infrastructure, including large-scale urban tree planting campaigns. In this context, researchers and practitioners are working jointly to develop applicable knowledge for planning and managing the urban forest. This paper presents three case studies of knowledge co-production in the...

Best Practices Case Study: Tom Walsh and Co. - New Columbus, Portland, OR

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

none,

2010-09-01

Case study of Tom Walsh, who achieved 50% in heating and cooling energy savings over the 2004 IECC with advanced framing, superior air sealing, extra insulation, and ducts in conditioned space. Surface water runoff in the large urban rebuild development was handled with pervious pavers, swales, retention of existing trees, and green spaces.

System Learning in an Urban School District: A Case Study of Intra-District Learning

ERIC Educational Resources Information Center

Redding, Christopher; Cannata, Marisa; Miller, Jason M.

2018-01-01

This paper presents evidence from a unique reform model that allowed teachers and other educators in a large urban district to collaborate with one another in the development of an innovation meant to improve student ownership and responsibility. In this longitudinal case study, we describe school stakeholders' learning about the design, the…

Operative factors associated with short-term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013.

PubMed

Gonzalez, L M; Fogle, C A; Baker, W T; Hughes, F E; Law, J M; Motsinger-Reif, A A; Blikslager, A T

2015-05-01

There is an important need for objective parameters that accurately predict the outcome of horses with large colon volvulus. To evaluate the predictive value of a series of histomorphometric parameters on short-term outcome, as well as the impact of colonic resection on horses with large colon volvulus. Retrospective cohort study. Adult horses admitted to the Equine and Farm Animal Veterinary Center at North Carolina State University, Peterson and Smith and Chino Valley Equine Hospitals between 2006 and 2013 that underwent an exploratory coeliotomy, diagnosed with large colon volvulus of ≥360 degrees, where a pelvic flexure biopsy was obtained, and that recovered from general anaesthesia, were selected for inclusion in the study. Logistic regression was used to determine associations between signalment, histomorphometric measurements of interstitium-to-crypt ratio, degree of haemorrhage, percentage loss of luminal and glandular epithelium, as well as colonic resection with short-term outcome (discharge from the hospital). Pelvic flexure biopsies from 47 horses with large colon volvulus were evaluated. Factors that were significantly associated with short-term outcome on univariate logistic regression were Thoroughbred breed (P = 0.04), interstitium-to-crypt ratio >1 (P = 0.02) and haemorrhage score ≥3 (P = 0.005). Resection (P = 0.92) was not found to be associated significantly with short-term outcome. No combined factors increased the likelihood of death in forward stepwise logistic regression modelling. A digitally quantified measurement of haemorrhage area strengthened the association of haemorrhage with nonsurvival in cases of large colon volvulus. Histomorphometric measurements of interstitium-to-crypt ratio and degree of haemorrhage predict short-term outcome in cases of large colon volvulus. Resection was not associated with short-term outcome in horses selected for this study. Accurate quantification of mucosal haemorrhage at the time of surgery may improve veterinary surgeons' prognostic capabilities in horses with large colon volvulus. © 2014 EVJ Ltd.

The politics of large infrastructure investment decision-making : the case of the second avenue subway case study.

DOT National Transportation Integrated Search

2013-11-01

Over the past few decades, urbanization and economic growth have intensified the need for more efficient urban and : regional transportation, including the expansion and reorganization of existing transportation networks. Given such : huge investment...

Case file coding of child maltreatment: Methods, challenges, and innovations in a longitudinal project of youth in foster care.

PubMed

Huffhines, Lindsay; Tunno, Angela M; Cho, Bridget; Hambrick, Erin P; Campos, Ilse; Lichty, Brittany; Jackson, Yo

2016-08-01

State social service agency case files are a common mechanism for obtaining information about a child's maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requirements of social science research designs. Specifically, accessing and navigating case files is an extensive undertaking, and a task that many researchers have had to maneuver with little guidance. Even after the files are in hand and the research questions and relevant variables have been clarified, case file information about a child's maltreatment exposure can be idiosyncratic, vague, inconsistent, and incomplete, making coding such information into useful variables for statistical analyses difficult. The Modified Maltreatment Classification System (MMCS) is a popular tool used to guide the process, and though comprehensive, this coding system cannot cover all idiosyncrasies found in case files. It is not clear from the literature how researchers implement this system while accounting for issues outside of the purview of the MMCS or that arise during MMCS use. Finally, a large yet reliable file coding team is essential to the process, however, the literature lacks training guidelines and methods for establishing reliability between coders. In an effort to move the field toward a common approach, the purpose of the present discussion is to detail the process used by one large-scale study of child maltreatment, the Studying Pathways to Adjustment and Resilience in Kids (SPARK) project, a longitudinal study of resilience in youth in foster care. The article addresses each phase of case file coding, from accessing case files, to identifying how to measure constructs of interest, to dealing with exceptions to the coding system, to coding variables reliably, to training large teams of coders and monitoring for fidelity. Implications for a comprehensive and efficient approach to case file coding are discussed.

Case file coding of child maltreatment: Methods, challenges, and innovations in a longitudinal project of youth in foster care☆

PubMed Central

Huffhines, Lindsay; Tunno, Angela M.; Cho, Bridget; Hambrick, Erin P.; Campos, Ilse; Lichty, Brittany; Jackson, Yo

2016-01-01

State social service agency case files are a common mechanism for obtaining information about a child’s maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requirements of social science research designs. Specifically, accessing and navigating case files is an extensive undertaking, and a task that many researchers have had to maneuver with little guidance. Even after the files are in hand and the research questions and relevant variables have been clarified, case file information about a child’s maltreatment exposure can be idiosyncratic, vague, inconsistent, and incomplete, making coding such information into useful variables for statistical analyses difficult. The Modified Maltreatment Classification System (MMCS) is a popular tool used to guide the process, and though comprehensive, this coding system cannot cover all idiosyncrasies found in case files. It is not clear from the literature how researchers implement this system while accounting for issues outside of the purview of the MMCS or that arise during MMCS use. Finally, a large yet reliable file coding team is essential to the process, however, the literature lacks training guidelines and methods for establishing reliability between coders. In an effort to move the field toward a common approach, the purpose of the present discussion is to detail the process used by one large-scale study of child maltreatment, the Studying Pathways to Adjustment and Resilience in Kids (SPARK) project, a longitudinal study of resilience in youth in foster care. The article addresses each phase of case file coding, from accessing case files, to identifying how to measure constructs of interest, to dealing with exceptions to the coding system, to coding variables reliably, to training large teams of coders and monitoring for fidelity. Implications for a comprehensive and efficient approach to case file coding are discussed. PMID:28138207

Urban School Systems and Education Reform: Key Lessons From a Case Study of Large Urban School Systems

ERIC Educational Resources Information Center

Snipes, Jason C.; Casserly, Michael D.

2004-01-01

Foundations for Success, a study conducted by MDRC for the Council of the Great City Schools, examined the reform efforts of 3 large urban school districts and a portion of a 4th that had been successful in improving student achievement and reducing racial achievement gaps. This article summarizes the key findings of the study and discusses the…

Rapid Operational Access and Maneuver Support (ROAMS) Platform for Improved Military Logistics Lines of Communication and Operational Vessel Routing

DTIC Science & Technology

2017-06-01

case study in a northeastern American metropolitan area. METHODOLOGY : The ROAMS platform provides expanded analysis, model automation, and enhanced...shoals. An initial route for such operations is selected much like the military logistics case . Subsequent adjustments to routes may be done on an ad...IX-45 June 2017 8 CASE STUDY: The ROAMS platform was applied to a large, northeast American metropolitan region to demonstrate the capability of

Stream computing for biomedical signal processing: A QRS complex detection case-study.

PubMed

Murphy, B M; O'Driscoll, C; Boylan, G B; Lightbody, G; Marnane, W P

2015-01-01

Recent developments in "Big Data" have brought significant gains in the ability to process large amounts of data on commodity server hardware. Stream computing is a relatively new paradigm in this area, addressing the need to process data in real time with very low latency. While this approach has been developed for dealing with large scale data from the world of business, security and finance, there is a natural overlap with clinical needs for physiological signal processing. In this work we present a case study of streams processing applied to a typical physiological signal processing problem: QRS detection from ECG data.

Implementing large-scale programmes to optimise the health workforce in low- and middle-income settings: a multicountry case study synthesis.

PubMed

Gopinathan, Unni; Lewin, Simon; Glenton, Claire

2014-12-01

To identify factors affecting the implementation of large-scale programmes to optimise the health workforce in low- and middle-income countries. We conducted a multicountry case study synthesis. Eligible programmes were identified through consultation with experts and using Internet searches. Programmes were selected purposively to match the inclusion criteria. Programme documents were gathered via Google Scholar and PubMed and from key informants. The SURE Framework - a comprehensive list of factors that may influence the implementation of health system interventions - was used to organise the data. Thematic analysis was used to identify the key issues that emerged from the case studies. Programmes from Brazil, Ethiopia, India, Iran, Malawi, Venezuela and Zimbabwe were selected. Key system-level factors affecting the implementation of the programmes were related to health worker training and continuing education, management and programme support structures, the organisation and delivery of services, community participation, and the sociopolitical environment. Existing weaknesses in health systems may undermine the implementation of large-scale programmes to optimise the health workforce. Changes in the roles and responsibilities of cadres may also, in turn, impact the health system throughout. © 2014 John Wiley & Sons Ltd.

Computer Simulation in Mass Emergency and Disaster Response: An Evaluation of Its Effectiveness as a Tool for Demonstrating Strategic Competency in Emergency Department Medical Responders

ERIC Educational Resources Information Center

O'Reilly, Daniel J.

2011-01-01

This study examined the capability of computer simulation as a tool for assessing the strategic competency of emergency department nurses as they responded to authentically computer simulated biohazard-exposed patient case studies. Thirty registered nurses from a large, urban hospital completed a series of computer-simulated case studies of…

Ethical implications of excessive cluster sizes in cluster randomised trials.

PubMed

Hemming, Karla; Taljaard, Monica; Forbes, Gordon; Eldridge, Sandra M; Weijer, Charles

2018-02-20

The cluster randomised trial (CRT) is commonly used in healthcare research. It is the gold-standard study design for evaluating healthcare policy interventions. A key characteristic of this design is that as more participants are included, in a fixed number of clusters, the increase in achievable power will level off. CRTs with cluster sizes that exceed the point of levelling-off will have excessive numbers of participants, even if they do not achieve nominal levels of power. Excessively large cluster sizes may have ethical implications due to exposing trial participants unnecessarily to the burdens of both participating in the trial and the potential risks of harm associated with the intervention. We explore these issues through the use of two case studies. Where data are routinely collected, available at minimum cost and the intervention poses low risk, the ethical implications of excessively large cluster sizes are likely to be low (case study 1). However, to maximise the social benefit of the study, identification of excessive cluster sizes can allow for prespecified and fully powered secondary analyses. In the second case study, while there is no burden through trial participation (because the outcome data are routinely collected and non-identifiable), the intervention might be considered to pose some indirect risk to patients and risks to the healthcare workers. In this case study it is therefore important that the inclusion of excessively large cluster sizes is justifiable on other grounds (perhaps to show sustainability). In any randomised controlled trial, including evaluations of health policy interventions, it is important to minimise the burdens and risks to participants. Funders, researchers and research ethics committees should be aware of the ethical issues of excessively large cluster sizes in cluster trials. © 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.

Tonsillectomy remains a questionable option for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).

PubMed

Windfuhr, Jochen P

2016-01-01

Background: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a disease attributed to children with obsessive compulsive disorders (OCD) or tic disorders associated with streptococcal infections. Because otolaryngologists examine a large number of pediatric patients with recurrent streptococcal infections, tonsillectomy (TE) is a common option of therapy. This study was conducted to evaluate the efficacy of TE in patients presenting with verified PANDAS. Material and methods: A PubMed review was performed using search terms "tonsillectomy" and "PANDAS", "OCD", "compulsive" "pediatric autoimmune", "chorea" and "tic" limited by publication date of January 1, 1995, to July 31, 2015. Reviews without patients were not included in the review. Results: Nine papers matched our search criteria, including 6 case reports with 8 patients and 3 case series. Most case reports were in favor of TE, but this was by far not supported by the findings in the case series. The follow-up ranged from 2 to 36 months in case reports and from 24 to 36 in case series. Conclusion: Establishing the diagnosis of PANDAS is complicated because of underlying comorbidities in the field of neurology-psychiatry and the lack of a reliable biomarker. The positive outcome after TE as reported in case studies may be influenced by the postoperative medication and is not supported by the results of large-scale studies. In the light of the considerable postoperative morbidity rate, it appears wise to indicate TE for PANDAS only in supervised clinical studies.

Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

PubMed

Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

2017-06-01

Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

Summer 2012 Colorado Wildfire Non-Profit Sector Case Study

DTIC Science & Technology

2012-11-01

all- populations shelter accommodating individuals with Access and Functional Needs (AFN) and sheltering for companion animals. Penrose Equestrian...Center was established as the large animal shelter and was managed by the El Paso County CART. Both companion and large animals were accepted for...themselves as safe- www.redcross.org/safeandwell. Information on sheltering companion animals at multiple locations is distributed. Large Animal

Ultrasound-assisted lysis using recombinant tissue plasminogen activator and the EKOS EkoSonic endovascular system for treating right atrial thrombus and massive pulmonary embolism: A case study.

PubMed

Shammas, N W; Padaria, R; Ahuja, G

2015-12-01

Right atrial thrombus in the setting of a large pulmonary embolus is rare and is associated with serious adverse events. This case report presents the role played by EKOS EkoSonic ultrasound system in successfully treating right atrial thrombus and massive pulmonary embolism. A 69-year-old female presented with a massive pulmonary embolus and a large mobile right atrial thrombus. She was treated with catheter-directed lysis using the EKOS EkoSonic ultrasound system and tissue plasminogen activator, with complete resolution of her right atrial thrombus and a marked improvement in her pulmonary embolus and hemodynamics. This case report provides a new and an effective option to treat right atrial thrombus associated with a large pulmonary embolus leading to a good outcome. © The Author(s) 2014.

Subharmonic edge waves on a large, shallow island

NASA Astrophysics Data System (ADS)

Foda, Mostafa A.

1988-08-01

Subharmonic resonance of edge waves by incident and reflected waves has been studied thus far for the case of a plane infinite beach. The analysis will be extended here to the case of a curved coastline, with a large radius of curvature and slowly varying beach slope in the longshore direction. It will be shown that the effects of such slow beach slope changes on a propagating edge wave are similar to the familiar shoaling effects on incident waves. The case of subharmonic edge wave generation on large shallow islands will be discussed in detail. The nonlinear analysis will show that within a certain range of island sizes, the generation mechanism can produce a stable standing edge wave around the island. For larger islands the solution disintegrates into two out-of-phase envelopes of opposite-going edge waves. For still larger islands, the generated progressive edge waves become unstable to sideband modulations.

A qualitative analysis of bus simulator training on transit incidents : a case study in Florida. [Summary].

DOT National Transportation Integrated Search

2013-01-01

The simulator was once a very expensive, large-scale mechanical device for training military pilots or astronauts. Modern computers, linking sophisticated software and large-screen displays, have yielded simulators for the desktop or configured as sm...

Hyporheic flow patterns in relation to large river floodplain attributes

EPA Science Inventory

Field-calibrated models of hyporheic flow have emphasized low-order headwater systems. In many cases, however, hyporheic flow in large lowland river floodplains may be an important contributor to ecosystem services such as maintenance of water quality and habitat. In this study, ...

Treatment of old-growth stands and its effects on birds, ants, and large woody debris: a case study.

Treesearch

Evelyn L. Bull; Torolf R. Torgersen; Arlene K. Blumton; Carol M. McKenzie; Dave S. Wyland

1995-01-01

An old-strucutre stand with large amounts of tree mortality was treated to accelerate regeneration and reduce fuel loads but still maintain its function as old growth for selected bird species. The small-diameter (

Hyporheic flow patterns in relation to large river floodplain attributes Journal

EPA Science Inventory

Field-calibrated models of hyporheic flow have emphasized low-order headwater systems. In many cases, however, hyporheic flow in large lowland river floodplains may be an important contributor to ecosystem services such as maintenance of water quality and habitat. In this study, ...

Exploration of large, rare copy number variants associated with psychiatric and neurodevelopmental disorders in individuals with anorexia nervosa.

PubMed

Yilmaz, Zeynep; Szatkiewicz, Jin P; Crowley, James J; Ancalade, NaEshia; Brandys, Marek K; van Elburg, Annemarie; de Kovel, Carolien G F; Adan, Roger A H; Hinney, Anke; Hebebrand, Johannes; Gratacos, Monica; Fernandez-Aranda, Fernando; Escaramis, Georgia; Gonzalez, Juan R; Estivill, Xavier; Zeggini, Eleftheria; Sullivan, Patrick F; Bulik, Cynthia M

2017-08-01

Anorexia nervosa (AN) is a serious and heritable psychiatric disorder. To date, studies of copy number variants (CNVs) have been limited and inconclusive because of small sample sizes. We conducted a case-only genome-wide CNV survey in 1983 female AN cases included in the Genetic Consortium for Anorexia Nervosa. Following stringent quality control procedures, we investigated whether pathogenic CNVs in regions previously implicated in psychiatric and neurodevelopmental disorders were present in AN cases. We observed two instances of the well-established pathogenic CNVs in AN cases. In addition, one case had a deletion in the 13q12 region, overlapping with a deletion reported previously in two AN cases. As a secondary aim, we also examined our sample for CNVs over 1 Mbp in size. Out of the 40 instances of such large CNVs that were not implicated previously for AN or neuropsychiatric phenotypes, two of them contained genes with previous neuropsychiatric associations, and only five of them had no associated reports in public CNV databases. Although ours is the largest study of its kind in AN, larger datasets are needed to comprehensively assess the role of CNVs in the etiology of AN.

The Use of CASES-97 Observations to Assess and Parameterize the Impact of Land-Surface Heterogeneity on Area-Average Surface Heat Fluxes for Large-Scale Coupled Atmosphere-Hydrology Models

NASA Technical Reports Server (NTRS)

Chen, Fei; Yates, David; LeMone, Margaret

2001-01-01

To understand the effects of land-surface heterogeneity and the interactions between the land-surface and the planetary boundary layer at different scales, we develop a multiscale data set. This data set, based on the Cooperative Atmosphere-Surface Exchange Study (CASES97) observations, includes atmospheric, surface, and sub-surface observations obtained from a dense observation network covering a large region on the order of 100 km. We use this data set to drive three land-surface models (LSMs) to generate multi-scale (with three resolutions of 1, 5, and 10 kilometers) gridded surface heat flux maps for the CASES area. Upon validating these flux maps with measurements from surface station and aircraft, we utilize them to investigate several approaches for estimating the area-integrated surface heat flux for the CASES97 domain of 71x74 square kilometers, which is crucial for land surface model development/validation and area water and energy budget studies. This research is aimed at understanding the relative contribution of random turbulence versus organized mesoscale circulations to the area-integrated surface flux at the scale of 100 kilometers, and identifying the most important effective parameters for characterizing the subgrid-scale variability for large-scale atmosphere-hydrology models.

Large cell neuroendocrine carcinoma of the parotid gland: case report and literature review.

PubMed

Casas, Pablo; Bernáldez, Ricardo; Patrón, Mercedes; López-Ferrer, Pilar; García-Cabezas, Miguel A

2005-03-01

A 74-year-old male presented with a large polinodular mass in the neck. Fine needle aspiration cytology (FNAC) showed an undifferentiated large cell carcinoma. Computed tomography (CT) showed a large parotid mass with multiple satelite nodules. The remaining radiological studies were normal. Radical parotidectomy was performed. The tumor was a large cell carcinoma with neuroendocrine features and positive immunostain for neuroendocrine markers. The patient received postoperative radiotherapy and was free of tumor eight months later. Only four cases of large cell neuroendocrine carcinoma (LCNEC) of the salivary gland have been communicated. All of them have involved the parotid gland. This tumor presents in elderly patients as a large infiltrating parotid mass. Fine needle aspiration cytology serves to recognize the carcinoma, but it fails in recognizing the neuroendocrine features of the tumor. The histopathological features of this tumor are the same as in other organs. Chromogranin and synaptophysin are useful immunohistochemical markers. A primary location of the tumor in another organ, specially the lung, should be ruled out. Surgery is the main treatment modality and can be complemented with postoperative radiotherapy. The prognosis seems to be poor. More studies are needed to better define the therapeutical alternatives and prognostic factors of these rare tumors.

Lack of association between migraine headache and patent foramen ovale: results of a case-control study.

PubMed

Garg, Pallav; Servoss, Stephen J; Wu, Justina C; Bajwa, Zahid H; Selim, Magdy H; Dineen, Alexis; Kuntz, Richard E; Cook, E Francis; Mauri, Laura

2010-03-30

Clinical observations of migraine headache symptoms in patients with a patent foramen ovale (PFO), both of which conditions are highly prevalent, have raised the question of a possible pathophysiological relationship. We sought to evaluate the assumption of an association between migraine headaches and the presence of PFO by use of a large case-control study. We conducted a case-control study to assess the prevalence of PFO in subjects with and without migraine. Case subjects were those with a history of migraine (diagnosed by neurologists at a specialty academic headache clinic). Control subjects were healthy volunteers without migraine 1:1 matched on the basis of age and sex with case subjects. Presence of PFO was determined by transthoracic echocardiogram with second harmonic imaging and transcranial Doppler ultrasonography during a standardized procedure of infused agitated saline contrast with or without Valsalva maneuver and a review of the results by experts blinded to case-control status. PFO was considered present if both studies were positive. Odds ratios were calculated with conditional logistic regression in the matched cohort (n=288). In the matched analysis, the prevalence of PFO was similar in case and control subjects (26.4% versus 25.7%; odds ratio 1.04, 95% confidence interval 0.62 to 1.74, P=0.90). There was no difference in PFO prevalence in those with migraine with aura and those without (26.8% versus 26.1%; odds ratio 1.03, 95% confidence interval 0.48 to 2.21, P=0.93). We found no association between migraine headaches and the presence of PFO in this large case-control study.

A Case Study Examining the Career Academy Model at a Large Urban Public High School

ERIC Educational Resources Information Center

Ho, Howard

2013-01-01

This study focused on how career academies were implemented at a large, urban, public high school. Research shows that the career academy model should consist of 3 core components: (a) a small learning community (SLC), (b) a theme-based curriculum, and (c) business partnerships (Stern, Dayton, & Raby, 2010). The purpose of this qualitative…

An Investigation Examining the Perceived Implications of Principal Leadership Changing a Large Comprehensive High School into Smaller Learning Communities

ERIC Educational Resources Information Center

Miller, Raymond J.

2012-01-01

The purpose of this qualitative case study was to examine the perceived implications that principal leadership has on transforming a large comprehensive high school into smaller learning communities (SLCs); and to speculate on possible factors that contribute to the change process after the implementation of SLCs. The study explores the roles,…

The South: Birmingham Case Study, and The South as a Region. Grade Five (Unit IV). Resource Unit. Project Social Studies.

ERIC Educational Resources Information Center

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

A case study on Birmingham is presented in the first part of this resource unit on regional studies designed for fifth graders. The objective of the sequent occupance unit is to illustrate the impact which the discovery and utilization of a large natural resource, namely, iron ore, can have on the development of a city, in the hope that students…

The Effects of a Midbrain Glioma on Memory and Other Functions: A Longitudinal Single Case Study

ERIC Educational Resources Information Center

Weddell, Rodger A.

2008-01-01

Our understanding of the effects of midbrain damage on cognition is largely based on animal studies, though there have been occasional investigations of the effects of human midbrain lesions on cognition. This investigation of a rare case of a glioma initially confined to the dorsal midbrain explores the effects of disease progression on IQ,…

Implications of Information Technology for Employment, Skills, and Wages: Findings from Sectoral and Case Study Research. Final Report

ERIC Educational Resources Information Center

Handel, Michael J.

2004-01-01

This paper reviews evidence from industry-specific and case studies that shed light on the extent to which computers and automation eliminate jobs, raise job skill requirements, and, consequently, contribute to increased wage inequality between less- and more skilled workers. This paper complements a previous review of large-scale econometric…

Effects of an Incentive Based Budgeting System on Institutional Performance Indicators: An Exploratory Longitudinal Case Study of a Public University

ERIC Educational Resources Information Center

Willett, Michael S.

2013-01-01

The purpose of this exploratory longitudinal case study was to examine how the implementation of an Incentive Based Budgeting (IBB) system (i.e., Responsibility-Centered Management [RCM]) affected selected institutional performance indicators at the campus level and two comparable schools at a large Mid-Western public University. The value of…

Culturally Responsive Peace Education: A Case Study at One Urban Latino K-8 Catholic School

ERIC Educational Resources Information Center

Buck, Brandon

2016-01-01

This paper presents a case study of a yearlong research-based peace education program at one urban K-8 private Catholic school situated in a community plagued by structural violence in an enclave of a large Midwestern city. To frame the analysis, the author employs concepts central to culturally responsive pedagogy (including cultural competence,…

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…

Online and Paper Evaluations of Courses: A Literature Review and Case Study

ERIC Educational Resources Information Center

Morrison, Keith

2013-01-01

This paper reviews the literature on comparing online and paper course evaluations in higher education and provides a case study of a very large randomised trial on the topic. It presents a mixed but generally optimistic picture of online course evaluations with respect to response rates, what they indicate, and how to increase them. The paper…

Scaffolded Writing and Early Literacy Development with Children Who Are Deaf: A Case Study

ERIC Educational Resources Information Center

Scott-Weich, Bridget; Yaden, David B., Jr.

2017-01-01

This case study examined the effects that the processes of private speech and materialization (using line underscores as word placeholders) had on the emergent writing behaviours of one, six-year-old student who was enrolled in an auditory--oral deaf or hard of hearing (DHH) first-grade classroom situated on a large urban public school campus.…

Transitioning from Marketing-Oriented Design to User-Oriented Design: A Case Study

ERIC Educational Resources Information Center

Laster, Shari; Stitz, Tammy; Bove, Frank J.; Wise, Casey

2011-01-01

The transition to a new architecture and design for an academic library Web site does not always proceed smoothly. In this case study, a library at a large research university hired an outside Web development contractor to create a new architecture and design for the university's Web site using dotCMS, an open-source content management system. The…

Long-term effects of peatland cultivation on soil physical and hydraulic properties: Case study in Canada

Treesearch

Dennis W. Hallema; Jonathan A. Lafond; Yann Périard; Silvio J. Gumiere; Ge Sun; Jean Caron

2015-01-01

Organic soils are an excellent substrate for commercial lettuce (Lactuca sativa L.) farming; however, drainage accelerates oxidation of the surface layer and reduces the water holding capacity, which is often lethal for crops that are sensitive to water stress. In this case study, we analyzed 942 peat samples from a large cultivated peatland complex...

Progressive multifocal leukoencephalopathy in patients with systemic lupus erythematosus: a systematic literature review.

PubMed

Henegar, C E; Eudy, A M; Kharat, V; Hill, D D; Bennett, D; Haight, B

2016-05-01

To determine risk factors for progressive multifocal leukoencephalopathy (PML) in systemic lupus erythematosus (SLE) patients, and understand how underlying disease or treatment for SLE may be associated with PML in this population. Studies published in English between January 1, 1984 and October 31, 2014 that reported PML in adult SLE patients were included. Immunosuppression was defined as exposure to ≥1 immunosuppressant drug of interest at PML diagnosis: belimumab, rituximab, mycophenolate mofetil, azathioprine, cyclophosphamide, methotrexate and high-dose corticosteroids (>15 mg/day). Minimal immunosuppression was defined as low-dose corticosteroids (≤15 mg/day) and/or anti-malarials. Thirty-five publications met our inclusion criteria: four observational studies, two large case series, and 29 case reports that described 35 cases. Reported PML incidence rates among SLE patients based on observational studies ranged from 1.0 to 2.4 cases/100,000 person-years. Of the 35 case reports, three cases were exposed to no immunosuppressant drugs at PML diagnosis, five cases had minimal immunosuppression, 23 cases had immunosuppression, and four cases were indeterminate. The evidence from this literature review suggests that, while PML is a very rare disease in SLE patients, there does appear to be an increased risk of PML associated with SLE compared to the general population, potentially due to immunosuppression, other contributing factors in their underlying disease, treatments prescribed to manage disease, or some combination of these factors. Additional large observational studies, designed to assess exposure to drugs of interest and complicated treatment histories, are needed to provide further evidence about potential mechanisms contributing to the onset of PML in SLE patients. © The Author(s) 2016.

Meeting the Knowledge Needs of the Academy and Industry: A Case Study of a Partnership between a University and a Large Energy Company in South Africa

ERIC Educational Resources Information Center

Cele, Mlungisi Gabriel

2005-01-01

This case study examines the evolution of the 21-year research partnership between the University of Cape Town (UCT) and the South African Coal Oil and Gas Corporation (SASOL). The study finds that an individual academic has played a significant role in steering transformation research activities and culture in the university?s Chemical…

Hemi-wedge osteotomy in the management of large angular deformities around the knee joint.

PubMed

El-Alfy, Barakat Sayed

2016-08-01

Angular deformity around the knee joint is a common orthopedic problem. Many options are available for the management of such problem with varying degrees of success and failure. The aim of the present study was to assess the results of hemi-wedge osteotomy in the management of big angular deformities about the knee joint. Twenty-eight limbs in 21 patients with large angular deformities around the knee joint were treated by the hemi-wedge osteotomy technique. The ages ranged from 12 to 43 years with an average of 19.8 years. The deformity ranged from 20° to 40° with a mean of 30.39° ± 5.99°. The deformities were genu varum in 12 cases and genu valgum in 9 cases. Seven cases had bilateral deformities. Small wedge was removed from the convex side of the bone and put in the gap created in the other side after correction of the deformity. At the final follow-up, the deformity was corrected in all cases except two. Full range of knee movement was regained in all cases. The complications included superficial wound infection in two cases, overcorrection in one case, pain along the lateral aspect of the knee in one case and recurrence of the deformity in one case. No cases were complicated by nerve injury or vascular injury. Hemi-wedge osteotomy is a good method for treatment of deformities around the knee joint. It can correct large angular deformities without major complications.

[Epidemiological methods used in studies in the prevalence of Tourette syndrome].

PubMed

Stefanoff, Paweł; Mazurek, Jacek

2003-01-01

Tourette syndrome (TS) prevalence was studied since the early 80-ies. Its clinical course is characterised by co-occurrence of motor and vocal tics. Results of previous epidemiological studies were surprisingly divergent: the prevalence varied from 0.5 to 115 cases per 10,000 population. The disease previously recognised as extremely rare and severe is now considered as quite common, with often moderate course. Selected methods used in studies of TS prevalence and analysis of their possible impact on study results are presented. The studies were divided into 3 groups: studies of the hospitalised population, large-scale screenings and studies involving school population, basing on characteristic and size of population, methods of selection of subjects, diagnostic and screening methods used. Studies of the hospitalised population involved patients with most severe symptoms, in different age groups, different methods of final diagnosis confirmation were used. TS prevalence varied from 0.5 up to 15 cases per 10,000 population. Procedures used in large-scale screening studies made possible the elimination of potential selection bias. Large populations were studied using transparent and repetitive confirmation of diagnoses. Their validity was additionally checked in parallel validity studies. TS prevalence was in the range 4.3 to 10 cases per 10,000 population. The highest TS prevalence was obtained in studies involving schoolchildren. Data were gathered from multiple sources: from parents, teachers and children, as well as from classroom observation. Diagnoses were made by experienced clinicians. TS prevalence obtained in school population studies was between 36.2 up to 115 per 10,000 population.

The Value of Large-Scale Randomised Control Trials in System-Wide Improvement: The Case of the Reading Catch-Up Programme

ERIC Educational Resources Information Center

Fleisch, Brahm; Taylor, Stephen; Schöer, Volker; Mabogoane, Thabo

2017-01-01

This article illustrates the value of large-scale impact evaluations with counterfactual components. It begins by exploring the limitations of small-scale impact studies, which do not allow reliable inference to a wider population or which do not use valid comparison groups. The paper then describes the design features of a recent large-scale…

Effects of Particle Size on the Shear Behavior of Coarse Grained Soils Reinforced with Geogrid.

PubMed

Kim, Daehyeon; Ha, Sungwoo

2014-02-07

In order to design civil structures that are supported by soils, the shear strength parameters of soils are required. Due to the large particle size of coarse-grained soils, large direct shear tests should be performed. In this study, large direct shear tests on three types of coarse grained soils (4.5 mm, 7.9 mm, and 15.9 mm) were performed to evaluate the effects of particle size on the shear behavior of coarse grained soils with/without geogrid reinforcements. Based on the direct shear test results, it was found that, in the case of no-reinforcement, the larger the maximum particle size became, the larger the friction angle was. Compared with the no-reinforcement case, the cases reinforced with either soft geogrid or stiff geogrid have smaller friction angles. The cohesion of the soil reinforced with stiff geogrid was larger than that of the soil reinforced with soft geogrid. The difference in the shear strength occurs because the case with a stiff geogrid has more soil to geogrid contact area, leading to the reduction in interlocking between soil particles.

A successful healthy live birth from a female patient with hypogonadotropic hypogonadism and oocytes with unusually large cytoplasmic inclusions.

PubMed

Duvan, Candan İltemir; Pekel, Aslıhan; Ercan, Ummu Gulsum; Arıkan, Yuksel Onaran

2016-03-01

This study aimed to report the case of a successful live birth from a woman having oocytes with abnormally large cytoplasmic inclusions. The patient described in this case is a 28 year-old woman with hypogonadotropic hypogonadism (HH) with a history of two previous unsuccessful in vitro fertilization (IVF) attempts offered an antagonist protocol. Stimulation was performed with human menopausal gonadotropin 300 IU/day. The intracytoplasmic sperm injection (ICSI) procedure was performed 4-6 hours after oocyte aspiration for all mature oocytes. Six oocytes were retrieved, five of which mature (MII). All oocytes had abnormal cytoplasmic structures. Two were fertilized after ICSI and two top quality embryos were transferred on Day 2. Our case report suggests that HH patients with refractile bodies/lipofuscin in their oocytes may not have their pregnancies negatively affected. While there have been several reports of successful births from dysmorphic oocytes, no cases of successful pregnancies followed by live births from young women with HH and oocytes with large cytoplasmic inclusions had been reported to date.

Investigating potential transferability of place-based research in land system science

NASA Astrophysics Data System (ADS)

Václavík, Tomáš; Langerwisch, Fanny; Cotter, Marc; Fick, Johanna; Häuser, Inga; Hotes, Stefan; Kamp, Johannes; Settele, Josef; Spangenberg, Joachim H.; Seppelt, Ralf

2016-09-01

Much of our knowledge about land use and ecosystem services in interrelated social-ecological systems is derived from place-based research. While local and regional case studies provide valuable insights, it is often unclear how relevant this research is beyond the study areas. Drawing generalized conclusions about practical solutions to land management from local observations and formulating hypotheses applicable to other places in the world requires that we identify patterns of land systems that are similar to those represented by the case study. Here, we utilize the previously developed concept of land system archetypes to investigate potential transferability of research from twelve regional projects implemented in a large joint research framework that focus on issues of sustainable land management across four continents. For each project, we characterize its project archetype, i.e. the unique land system based on a synthesis of more than 30 datasets of land-use intensity, environmental conditions and socioeconomic indicators. We estimate the transferability potential of project research by calculating the statistical similarity of locations across the world to the project archetype, assuming higher transferability potentials in locations with similar land system characteristics. Results show that areas with high transferability potentials are typically clustered around project sites but for some case studies can be found in regions that are geographically distant, especially when values of considered variables are close to the global mean or where the project archetype is driven by large-scale environmental or socioeconomic conditions. Using specific examples from the local case studies, we highlight the merit of our approach and discuss the differences between local realities and information captured in global datasets. The proposed method provides a blueprint for large research programs to assess potential transferability of place-based studies to other geographical areas and to indicate possible gaps in research efforts.

Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort

PubMed Central

Budhathoki, Sanjeev; Hidaka, Akihisa; Sawada, Norie; Tanaka-Mizuno, Sachiko; Kuchiba, Aya; Charvat, Hadrien; Goto, Atsushi; Kojima, Satoshi; Sudo, Natsuki; Shimazu, Taichi; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro; Iwasaki, Motoki

2018-01-01

Abstract Objective To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study. Design Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort. Setting Nine public health centre areas across Japan. Participants 3301 incident cases of cancer and 4044 randomly selected subcohort participants. Exposure Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference. Main outcome measure Incidence of overall or site specific cancer. Results Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios. Conclusions In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites. PMID:29514781

Large filter feeding marine organisms as indicators of microplastic in the pelagic environment: the case studies of the Mediterranean basking shark (Cetorhinus maximus) and fin whale (Balaenoptera physalus).

PubMed

Fossi, Maria Cristina; Coppola, Daniele; Baini, Matteo; Giannetti, Matteo; Guerranti, Cristiana; Marsili, Letizia; Panti, Cristina; de Sabata, Eleonora; Clò, Simona

2014-09-01

The impact of microplastics (plastic fragments smaller than 5 mm) on large filter feeding marine organisms such as baleen whales and sharks are largely unknown. These species potentially are ingesting micro-litter by filter feeding activity. Here we present the case studies of the Mediterranean fin whale (Balaenoptera physalus) and basking shark (Cetorhinus maximus) exploring the toxicological effects of microplastics in these species measuring the levels of phthalates in both species. The results show higher concentration of MEHP in the muscle of basking shark in comparison to fin whale blubber. These species can be proposed as indicators of microplastics in the pelagic environment in the implementation of Descriptor 8 and 10 of the EU Marine Strategy Framework Directive (MSFD). Copyright © 2014 Elsevier Ltd. All rights reserved.

Large-Scale Networked Virtual Environments: Architecture and Applications

ERIC Educational Resources Information Center

Lamotte, Wim; Quax, Peter; Flerackers, Eddy

2008-01-01

Purpose: Scalability is an important research topic in the context of networked virtual environments (NVEs). This paper aims to describe the ALVIC (Architecture for Large-scale Virtual Interactive Communities) approach to NVE scalability. Design/methodology/approach: The setup and results from two case studies are shown: a 3-D learning environment…

Saving Energy in Industrial Companies: Case Studies of Energy Efficiency Programs in Large U.S. Industrial Corporations and the Role of Ratepayer-Funded Support

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

None, None

This paper is designed for companies looking to cut costs through energy savings, ratepayer-funded program administrators interested in increasing large industrial company participation in energy efficiency program offerings, and state utility commissions.

Social tension as precursor of large damaging earthquake: legend or reality?

NASA Astrophysics Data System (ADS)

Molchanov, O.

2008-11-01

Using case study of earthquake (EQ) activity and war conflicts in Caucasus during 1975 2002 time interval and correlation analysis of global distribution of damaging EQs and war-related social tension during 1901 2005 period we conclude:

• There is a statistically reliable increase of social tension several years (or several months in case study) before damaging EQs,
• There is evident decrease of social tension several years after damaging EQs, probably due to society consolidation,
• Preseismic effect is absent for the large EQs in unpopulated areas,
• There is some factual background for legendary belief in Almighty retribution for social abnormal behavior.

Brief Communication: On the rapid and efficient monitoring results dissemination in landslide emergency scenarios: the Mont de La Saxe case study

NASA Astrophysics Data System (ADS)

Giordan, D.; Manconi, A.; Allasia, P.; Bertolo, D.

2015-04-01

Straightforward communication of monitoring results is of major importance in emergency scenarios relevant to large slope instabilities. Here we describe the communication strategy developed for the Mont de La Saxe case study, a large rockslide threatening La Palud and Entrèves hamlets in the Courmayeur municipality (Aosta Valley, Italy). Starting from the definition of actions and needs of the Landslide Management Team, including scientists, technicians, civil protection operators, decision makers, and politicians, we show that sharing and disseminating ad hoc information simplifies the understanding of the landslide evolution, as well as the correct communication of the level of criticality.

Dependability analysis of parallel systems using a simulation-based approach. M.S. Thesis

NASA Technical Reports Server (NTRS)

Sawyer, Darren Charles

1994-01-01

The analysis of dependability in large, complex, parallel systems executing real applications or workloads is examined in this thesis. To effectively demonstrate the wide range of dependability problems that can be analyzed through simulation, the analysis of three case studies is presented. For each case, the organization of the simulation model used is outlined, and the results from simulated fault injection experiments are explained, showing the usefulness of this method in dependability modeling of large parallel systems. The simulation models are constructed using DEPEND and C++. Where possible, methods to increase dependability are derived from the experimental results. Another interesting facet of all three cases is the presence of some kind of workload of application executing in the simulation while faults are injected. This provides a completely new dimension to this type of study, not possible to model accurately with analytical approaches.

Transient severe left ventricular dysfunction following percutaneous patent ductus arteriosus closure in an adult with bicuspid aortic valve: A case report

PubMed Central

HWANG, HUI-JEONG; YOON, KYUNG LIM; SOHN, IL SUK

2016-01-01

The present study reported the case of a 60-year-old female with patent ductus arteriosus (PDA) and a bicuspid aortic valve, who presented with transient severe left ventricular (LV) dysfunction following percutaneous closure of PDA, as identified by speckle tracking analysis. Transient LV dysfunction following PDA closure has previously been reported; however, severe LV dysfunction is rare. In the present case, the combination of a large PDA size, large amount of shunting, LV remodeling and bicuspid aortic valve may have induced serious deterioration of LV function following PDA closure. Furthermore, speckle-tracking echocardiography may be useful in the estimation of functional alterations in the myocardium of the LV following PDA closure. The observations detailed in the present study may improve the understanding of the pathophysiology and myocardial patterns of transient left ventricular dysfunction following PDA closure in adult humans. PMID:26998021

Transient severe left ventricular dysfunction following percutaneous patent ductus arteriosus closure in an adult with bicuspid aortic valve: A case report.

PubMed

Hwang, Hui-Jeong; Yoon, Kyung Lim; Sohn, Il Suk

2016-03-01

The present study reported the case of a 60-year-old female with patent ductus arteriosus (PDA) and a bicuspid aortic valve, who presented with transient severe left ventricular (LV) dysfunction following percutaneous closure of PDA, as identified by speckle tracking analysis. Transient LV dysfunction following PDA closure has previously been reported; however, severe LV dysfunction is rare. In the present case, the combination of a large PDA size, large amount of shunting, LV remodeling and bicuspid aortic valve may have induced serious deterioration of LV function following PDA closure. Furthermore, speckle-tracking echocardiography may be useful in the estimation of functional alterations in the myocardium of the LV following PDA closure. The observations detailed in the present study may improve the understanding of the pathophysiology and myocardial patterns of transient left ventricular dysfunction following PDA closure in adult humans.

Pre-surgical road map for thyroid cancer and large goiters: Practical benefits of detailed radiological evaluation by surgeon.

PubMed

Panchangam, Ramakanth Bhargav; Guntupalli, Satyam; Seetharamaiah, Thotakura; Kumbhar, Uday Shamrao

2015-01-01

Pre-surgical radiological evaluation of neck is often mandatory for surgical planning in high risk thyroid cancer and large goiters. Frequently, surgeons are overdependent on radiologist's report. In this context, we analysed the practical benefits of surgeon's independent radiological evaluation in our institutional experience. This prospective study was conducted in Endocrine Surgery department of a teaching hospital in South India. Cases operated between January 2011 and June 2012 (18 months) were included. Films of cross-sectional imaging were read in detail by primary and assistant surgeons in correlation with stepwise operative planning and documented. Cases with additional radiological signs on surgeon's evaluation, which were missing in radiologist's report are discussed in detail. F: M ratio is 67:24. Mean age was 45.3 ± 9.8 years (37 - 76). Forty-seven cases of thyroid cancer and 44 cases of large goiters were analysed. Surgeon read additional signs such as obliterated fat plane between goiter and subcutaneous plane; level I lymph nodes; bilateral cervical lymphadenopathy, internal jugular vein thrombus, and pharyngeal invasion helped in pre-operatively planned modification of operative steps for optimal R0 resection and total thyroidectomy. A mean of 1.42 ± 0.83 (1 - 6), additional signs were detected on surgeon's radiological evaluation compared to radiologist's report in 41.7% of cases. These findings modified the pre-operative plan, facilitating better surgical outcome in 28.6% of cases. In high-risk thyroid cancer and large goiters, detailed radiological evaluation by surgeon facilitates optimal surgical resection and superior outcome compared to radiologist report-guided surgery.

Two-tier Haddon matrix approach to fault analysis of accidents and cybernetic search for relationship to effect operational control: a case study at a large construction site.

PubMed

Mazumdar, Atmadeep; Sen, Krishna Nirmalya; Lahiri, Balendra Nath

2007-01-01

The Haddon matrix is a potential tool for recognizing hazards in any operating engineering system. This paper presents a case study of operational hazards at a large construction site. The fish bone structure helps to visualize and relate the chain of events, which led to the failure of the system. The two-tier Haddon matrix approach helps to analyze the problem and subsequently prescribes preventive steps. The cybernetic approach has been undertaken to establish the relationship among event variables and to identify the ones with most potential. Those event variables in this case study, based on the cybernetic concepts like control responsiveness and controllability salience, are (a) uncontrolled swing of sheet contributing to energy, (b) slippage of sheet from anchor, (c) restricted longitudinal and transverse swing or rotation about the suspension, (d) guilt or uncertainty of the crane driver, (e) safe working practices and environment.

A comparison of single- and multi-site calibration and validation: a case study of SWAT in the Miyun Reservoir watershed, China

NASA Astrophysics Data System (ADS)

Bai, Jianwen; Shen, Zhenyao; Yan, Tiezhu

2017-09-01

An essential task in evaluating global water resource and pollution problems is to obtain the optimum set of parameters in hydrological models through calibration and validation. For a large-scale watershed, single-site calibration and validation may ignore spatial heterogeneity and may not meet the needs of the entire watershed. The goal of this study is to apply a multi-site calibration and validation of the Soil andWater Assessment Tool (SWAT), using the observed flow data at three monitoring sites within the Baihe watershed of the Miyun Reservoir watershed, China. Our results indicate that the multi-site calibration parameter values are more reasonable than those obtained from single-site calibrations. These results are mainly due to significant differences in the topographic factors over the large-scale area, human activities and climate variability. The multi-site method involves the division of the large watershed into smaller watersheds, and applying the calibrated parameters of the multi-site calibration to the entire watershed. It was anticipated that this case study could provide experience of multi-site calibration in a large-scale basin, and provide a good foundation for the simulation of other pollutants in followup work in the Miyun Reservoir watershed and other similar large areas.

Global strength assessment in oblique waves of a large gas carrier ship, based on a non-linear iterative method

NASA Astrophysics Data System (ADS)

Domnisoru, L.; Modiga, A.; Gasparotti, C.

2016-08-01

At the ship's design, the first step of the hull structural assessment is based on the longitudinal strength analysis, with head wave equivalent loads by the ships' classification societies’ rules. This paper presents an enhancement of the longitudinal strength analysis, considering the general case of the oblique quasi-static equivalent waves, based on the own non-linear iterative procedure and in-house program. The numerical approach is developed for the mono-hull ships, without restrictions on 3D-hull offset lines non-linearities, and involves three interlinked iterative cycles on floating, pitch and roll trim equilibrium conditions. Besides the ship-wave equilibrium parameters, the ship's girder wave induced loads are obtained. As numerical study case we have considered a large LPG liquefied petroleum gas carrier. The numerical results of the large LPG are compared with the statistical design values from several ships' classification societies’ rules. This study makes possible to obtain the oblique wave conditions that are inducing the maximum loads into the large LPG ship's girder. The numerical results of this study are pointing out that the non-linear iterative approach is necessary for the computation of the extreme loads induced by the oblique waves, ensuring better accuracy of the large LPG ship's longitudinal strength assessment.

Tonsillectomy remains a questionable option for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)

PubMed Central

Windfuhr, Jochen P.

2016-01-01

Background: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a disease attributed to children with obsessive compulsive disorders (OCD) or tic disorders associated with streptococcal infections. Because otolaryngologists examine a large number of pediatric patients with recurrent streptococcal infections, tonsillectomy (TE) is a common option of therapy. This study was conducted to evaluate the efficacy of TE in patients presenting with verified PANDAS. Material and methods: A PubMed review was performed using search terms “tonsillectomy” and “PANDAS”, “OCD”, “compulsive” “pediatric autoimmune”, “chorea” and “tic” limited by publication date of January 1, 1995, to July 31, 2015. Reviews without patients were not included in the review. Results: Nine papers matched our search criteria, including 6 case reports with 8 patients and 3 case series. Most case reports were in favor of TE, but this was by far not supported by the findings in the case series. The follow-up ranged from 2 to 36 months in case reports and from 24 to 36 in case series. Conclusion: Establishing the diagnosis of PANDAS is complicated because of underlying comorbidities in the field of neurology-psychiatry and the lack of a reliable biomarker. The positive outcome after TE as reported in case studies may be influenced by the postoperative medication and is not supported by the results of large-scale studies. In the light of the considerable postoperative morbidity rate, it appears wise to indicate TE for PANDAS only in supervised clinical studies. PMID:28025607

Effectiveness and safety of bedaquiline-containing regimens in the treatment of MDR- and XDR-TB: a multicentre study.

PubMed

Borisov, Sergey E; Dheda, Keertan; Enwerem, Martin; Romero Leyet, Rodolfo; D'Ambrosio, Lia; Centis, Rosella; Sotgiu, Giovanni; Tiberi, Simon; Alffenaar, Jan-Willem; Maryandyshev, Andrey; Belilovski, Evgeny; Ganatra, Shashank; Skrahina, Alena; Akkerman, Onno; Aleksa, Alena; Amale, Rohit; Artsukevich, Janina; Bruchfeld, Judith; Caminero, Jose A; Carpena Martinez, Isabel; Codecasa, Luigi; Dalcolmo, Margareth; Denholm, Justin; Douglas, Paul; Duarte, Raquel; Esmail, Aliasgar; Fadul, Mohammed; Filippov, Alexey; Davies Forsman, Lina; Gaga, Mina; Garcia-Fuertes, Julia-Amaranta; García-García, José-María; Gualano, Gina; Jonsson, Jerker; Kunst, Heinke; Lau, Jillian S; Lazaro Mastrapa, Barbara; Teran Troya, Jorge Lazaro; Manga, Selene; Manika, Katerina; González Montaner, Pablo; Mullerpattan, Jai; Oelofse, Suzette; Ortelli, Martina; Palmero, Domingo Juan; Palmieri, Fabrizio; Papalia, Antonella; Papavasileiou, Apostolos; Payen, Marie-Christine; Pontali, Emanuele; Robalo Cordeiro, Carlos; Saderi, Laura; Sadutshang, Tsetan Dorji; Sanukevich, Tatsiana; Solodovnikova, Varvara; Spanevello, Antonio; Topgyal, Sonam; Toscanini, Federica; Tramontana, Adrian R; Udwadia, Zarir Farokh; Viggiani, Pietro; White, Veronica; Zumla, Alimuddin; Migliori, Giovanni Battista

2017-05-01

Large studies on bedaquiline used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) are lacking. This study aimed to evaluate the safety and effectiveness of bedaquiline-containing regimens in a large, retrospective, observational study conducted in 25 centres and 15 countries in five continents.428 culture-confirmed MDR-TB cases were analysed (61.5% male; 22.1% HIV-positive, 45.6% XDR-TB). MDR-TB cases were admitted to hospital for a median (interquartile range (IQR)) 179 (92-280) days and exposed to bedaquiline for 168 (86-180) days. Treatment regimens included, among others, linezolid, moxifloxacin, clofazimine and carbapenems (82.0%, 58.4%, 52.6% and 15.3% of cases, respectively).Sputum smear and culture conversion rates in MDR-TB cases were 63.6% and 30.1%, respectively at 30 days, 81.1% and 56.7%, respectively at 60 days; 85.5% and 80.5%, respectively at 90 days and 88.7% and 91.2%, respectively at the end of treatment. The median (IQR) time to smear and culture conversion was 34 (30-60) days and 60 (33-90) days. Out of 247 culture-confirmed MDR-TB cases completing treatment, 71.3% achieved success (62.4% cured; 8.9% completed treatment), 13.4% died, 7.3% defaulted and 7.7% failed. Bedaquiline was interrupted due to adverse events in 5.8% of cases. A single case died, having electrocardiographic abnormalities that were probably non-bedaquiline related.Bedaquiline-containing regimens achieved high conversion and success rates under different nonexperimental conditions. Copyright ©ERS 2017.

An Exploration of the Effects of a Literature-Based Socialemotional Learning Curriculum on the Kindergarten Classes in a Large K-5 Elementary School

ERIC Educational Resources Information Center

Werkheiser, Susan N. Gravle

2014-01-01

The purpose of this case study was to explore the effects of a literature-based social-emotional learning curriculum on kindergarten students' social-emotional behaviors, awareness, and early reading skills in a large elementary school. The study examined beliefs/perceptions of kindergarten teachers in regards to what reading skills students…

Issues in Estimating Program Effects and Studying Implementation in Large-Scale Educational Experiments: The Case of a Connected Classroom Technology Program

ERIC Educational Resources Information Center

Shin, Hye Sook

2009-01-01

Using data from a nationwide, large-scale experimental study of the effects of a connected classroom technology on student learning in algebra (Owens et al., 2004), this dissertation focuses on challenges that can arise in estimating treatment effects in educational field experiments when samples are highly heterogeneous in terms of various…

Examining the relationship between fire history and sudden oak death patterns: a case study in Sonoma County

Treesearch

Max A. Moritz; Dennis C. Odion

2006-01-01

Fire is often integral to forest ecology and can affect forest disease dynamics. Sudden oak death has spread across a large, fire-prone portion of California, killing large numbers of oaks and tanoaks and infecting most associated woody plants. Building on our earlier study of fire-disease dynamics, we examined spatial patterns of confirmed infections in relation to...

Survey on the Policy of Continuing Training in Large Firms. Case Studies in Belgium, Spain, France, the Netherlands, and the United Kingdom.

ERIC Educational Resources Information Center

Dupont, Georges; Reis, Fernanda

A study examined employee training policies and their implementation in four or five large companies in five countries (Belgium, Spain, France, the Netherlands, and the United Kingdom). Data were gathered through interviews by an expert in each of the countries using an interviewer's guide developed for the project (resulting in approximately 30…

Virtual Schooling through the Eyes of an At-Risk Student: A Case Study

ERIC Educational Resources Information Center

Barbour, Michael K.; Siko, Jason P.

2012-01-01

While much of the growth in the popularity of virtual schooling has involved at-risk students, little research exists on the experiences of these students in this largely independent setting. This paper describes a case study of an at-risk student in a rural school in the province of Newfoundland and Labrador who was enrolled in an online course…

The Use of Electronic Voting Systems in Lectures within Business and Marketing: A Case Study of Their Impact on Student Learning

ERIC Educational Resources Information Center

Masikunas, George; Panayiotidis, Andreas; Burke, Linda

2007-01-01

This article presents a case study of the impact on student learning of introducing an electronic voting system (EVS) into large-group lectures for first-year undergraduate students undertaking degrees in marketing and business systems. We discuss the potential for using EVS-style interactive lectures in marketing and business programmes. We then…

Undergraduate Social Work Students: Learning Interviewing Skills in a Hybrid Practice Class

ERIC Educational Resources Information Center

Barclay, Barbara

2012-01-01

This action research case study explored undergraduate social work students' perceived learning of interviewing skills in a hybrid environment course delivery. The single case study consisted of 19 students enrolled in a practice course blending web-based and face-to-face (f2f) meetings (4 of 15 f2f) within a large urban college. As part of…

The Literacy Factor: Adding Value to Training. Investigation of the Inclusion of Literacy in Training Packages in the Food Processing Industry.

ERIC Educational Resources Information Center

Sanguinetti, Jill

The effects of the inclusion of literacy and numeracy competencies within Australia's food processing industry training package were examined in two case studies of training at two food processing facilities in Victoria. The first case study involved a large pasta factory that had approximately 270 employees and a contract with a registered…

English Teachers in the Digital Age--A Case Study of Policy and Expert Practice from England

ERIC Educational Resources Information Center

Goodwyn, Andy

2011-01-01

This article is a case study of how English teachers in England have coped with the paradigm shift from print to digital literacy. It reviews a large scale national initiative that was intended to upskill all teachers, considers its weak impact and explores the author's involvement in the evaluation of the project's direct value to English…

What Account of Science Shall We Give? a Case Study of Scientists Teaching First-Year University Subjects

ERIC Educational Resources Information Center

Smith, Dorothy V.; Mulhall, Pamela J.; Gunstone, Richard F.; Hart, Christina E.

2015-01-01

This article presents a case study of four academic scientists. These academics teach in the first year of a Bachelor of Science degree at a large research-focused Australian university that has demanded and supported a greater focus on undergraduate learning. Taken as a whole, the accounts of science that the first-year academics in this case…

Exploring the Roles and Nature of Science: A Case Study of Severe Acute Respiratory Syndrome

ERIC Educational Resources Information Center

Lee, Yeung Chung

2008-01-01

The roles of science in society and the nature of science are the focus of many science curricula. Current views about these two aspects of science have largely been informed by the history of scientific development. This article uses the outbreak of severe acute respiratory syndrome--a recent health scare--as a case study to explore the roles of…

Risk of lymphoma in women with breast implants: analysis of clinical studies.

PubMed

Largent, Joan; Oefelein, Michael; Kaplan, Hilton M; Okerson, Ted; Boyle, Peter

2012-05-01

Large studies suggest that the overall rate of lymphoma in women with breast implants is no greater than in the general population; clinical reports suggest an association between breast implants and the rare non-Hodgkin lymphoma, anaplastic large cell lymphoma (ALCL). Observed cases of lymphoma reported in Allergan-sponsored breast implant clinical studies were compared with expected cases on the basis of the incidence of lymphoma among women in the National Cancer Institute's Surveillance Epidemiology and End Results program, using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). In clinical studies, there were 28 observed cases of lymphoma among 89 382 patients and 204 682 person-years of follow-up compared with 43 expected cases [SIR: 28/43=0.65 (95% CI: 0.43-0.94), P=0.02]. SIRs were calculated stratifying by baseline cancer history: women without prior cancer [SIR: 17/24=0.70 (95% CI: 0.41-1.13), P=0.17] and women with prior cancer [SIR: 11/14=0.79 (95% CI: 0.39-1.41), P=0.52]. SIRs were calculated by implant shell type: textured shell implants [SIR: 16/23=0.70 (95% CI: 0.40-1.13), P=0.16] and smooth shell implants [SIR: 12/19=0.63 (95% CI: 0.33-1.10), P=0.12]. Surveillance Epidemiology and End Results reported 12 cases of primary breast ALCL in women between 1996 and 2007 without a history of cancer, for an average annual incidence of 4.28 (95% CI: 3.51-5.05)/100 million women in the US - these women may or may not have breast implants. In clinical studies, three ALCL cases were reported in women with breast implants and a history of breast cancer, yielding a crude incidence rate of 1.46 (95% CI: 0.30-4.3)/100 000 person-years. Large clinical studies, based on over 200 000 person-years of follow-up, suggest no evidence of an increased risk of lymphoma among women who have received breast implants.

Examining the Impact of a Video Case-Based Mathematics Methods Course on Secondary Pre-Service Teachers' Skills at Analysing Students' Strategies

ERIC Educational Resources Information Center

Martinez, Mara Vanina; Superfine, Alison Castro; Carlton, Theresa; Dasgupta, Chandan

2015-01-01

This paper focuses on results from a study conducted with two cohorts of pre-service teachers (PSTs) in a video case-based mathematics methods course at a large Midwestern university in the US. The motivation for this study was to look beyond whether or not PSTs pay attention to mathematical thinking of students, as shown by previous studies when…

Case Studies in Science Ethics

NASA Astrophysics Data System (ADS)

Williams, Karen

2010-03-01

Everyone in science should have ethics education training. I have seen graduate students taken advantage of by their mentors. Many of us have seen misconduct...but what should we do about it? Young scientists are often unaware of the rules in science and make mistakes because of their ignorance of the rules in that particular field of study. Then there are an increasing number of cases in the news of overt cases of misrepresentation in science. All are welcome to attend this discussion of case studies. A case study on topics such as: how to treat data properly, how our values in science affect our work, who gets authorship on scientific papers, who is first author on a paper, what you should do if you uncover misconduct or plagiarism in your university, and we will discuss the scientist's role in society. This will be a painless, non-confrontational small group, then large group discussion of each case

The Pericles Space Case: Preserving Earth Observation Data for the Future

NASA Astrophysics Data System (ADS)

Muller, C.; Pandey, P.; Pericles Consortium

2016-08-01

PERICLES (Promoting and Enhancing the Reuse of Information throughout the Content Lifecycle exploiting Evolving Semantics) is an FP7 project started on February 2013. It aims at preserving by design large and complex data sets. PERICLES is coordinated by King's College London, UK and its partners are University of Borås (Sweden), CERT (Greece), DotSoft(Greece), GeorgAugustUniversität, Göttingen (Germany), University of Liverpool (UK), Space Application Services (Belgium), XEROX France and University of Edinburgh (UK). Two additional partners provide the case studies: Tate Gallery (UK) brings the digital art and media case study and B.USOC (Belgian Users Support and Operations Centre) brings the space science case study.

Global Lakes Sentinel Services: Monitoring Water Quality Trends in Deep, Clear Lakes to Detect Causes and Effects of Changes in Trophic Status

NASA Astrophysics Data System (ADS)

Poser, Kathrin; Peters, Steef; Hommersom, Annelies; Giardino, Claudia; Bresciani, Mariano; Cazzaniga, Ilaria; Schenk, Karin; Heege, Thomas; Philipson, Petra; Ruescas, Ana; Bottcher, Martin; Stelzer, Kerstin

2015-12-01

The GLaSS project develops a prototype infrastructure to ingest and process large amounts of Sentinel-2 and Sentinel-3 data for lakes and reservoirs. To demonstrate the value of satellite observations for the management of aquatic ecosystems, global case studies are performed addressing different types of lakes with their respective problems and management questions. One of these case studies is concentrating on deep clear lakes worldwide. The aim of this case study is to evaluate trends of chlorophyll-a concentrations (Chl-a) as a proxy of the trophic status based on the MERIS full resolution data archive. Some preliminary results of this case study are presented here.

A Study of Fan Stage/Casing Interaction Models

NASA Technical Reports Server (NTRS)

Lawrence, Charles; Carney, Kelly; Gallardo, Vicente

2003-01-01

The purpose of the present study is to investigate the performance of several existing and new, blade-case interactions modeling capabilities that are compatible with the large system simulations used to capture structural response during blade-out events. Three contact models are examined for simulating the interactions between a rotor bladed disk and a case: a radial and linear gap element and a new element based on a hydrodynamic formulation. The first two models are currently available in commercial finite element codes such as NASTRAN and have been showed to perform adequately for simulating rotor-case interactions. The hydrodynamic model, although not readily available in commercial codes, may prove to be better able to characterize rotor-case interactions.

Validation of self-reported start year of mobile phone use in a Swedish case-control study on radiofrequency fields and acoustic neuroma risk.

PubMed

Pettersson, David; Bottai, Matteo; Mathiesen, Tiit; Prochazka, Michaela; Feychting, Maria

2015-01-01

The possible effect of radiofrequency exposure from mobile phones on tumor risk has been studied since the late 1990s. Yet, empirical information about recall of the start of mobile phone use among adult cases and controls has never been reported. Limited knowledge about recall errors hampers interpretations of the epidemiological evidence. We used network operator data to validate the self-reported start year of mobile phone use in a case-control study of mobile phone use and acoustic neuroma risk. The answers of 96 (29%) cases and 111 (22%) controls could be included in the validation. The larger proportion of cases reflects a more complete and detailed reporting of subscription history. Misclassification was substantial, with large random errors, small systematic errors, and no significant differences between cases and controls. The average difference between self-reported and operator start year was -0.62 (95% confidence interval: -1.42, 0.17) years for cases and -0.71 (-1.50, 0.07) years for controls, standard deviations were 3.92 and 4.17 years, respectively. Agreement between self-reported and operator-recorded data categorized into short, intermediate and long-term use was moderate (kappa statistic: 0.42). Should an association exist, dilution of risk estimates and distortion of exposure-response patterns for time since first mobile phone use could result from the large random errors in self-reported start year. Retrospective collection of operator data likely leads to a selection of "good reporters", with a higher proportion of cases. Thus, differential recall cannot be entirely excluded.

Large outbreak of salmonella phage type 1 infection with high infection rate and severe illness associated with fast food premises.

PubMed

Giraudon, I; Cathcart, S; Blomqvist, S; Littleton, A; Surman-Lee, S; Mifsud, A; Anaraki, S; Fraser, G

2009-06-01

To describe the epidemiology of an outbreak of Salmonella enteritidis phage type 1 (PT1) infection associated with a fast food premises, and to identify the causative factors leading to an acute outbreak with high attack rate and severe illness including hospital admission. Integrated descriptive study of epidemiology, food and environmental microbiology, and professional environmental health assessment, supplemented by a case-case analytical study. Cases were identified through multiple sources and were interviewed to identify food items consumed. Descriptive epidemiology of all cases and a case-case analytical study of risk factors for severe illness were undertaken. Microbiological investigation included analysis and typing of pathogens from stools, blood and environmental surfaces. Professional environmental heath assessment of the premises was undertaken. S. enteritidis PT1 was recovered from two-thirds of faecal samples. Three cases had dual infection with enterotoxin-producing Clostridium perfringens. S. enteritidis PT1 was isolated from 14 of 40 food samples examined and C. perfringens was isolated from eight food samples. Environmental health inspection of the premises revealed multiple deficiencies, including deficits in food preparation and hygiene consistent with multiple cross-contamination, and time-temperature abuse of sauces widely used across menu items. Severe cases were associated with consumption of chips and salad. Outbreaks from fast food premises have been infrequently described. This outbreak demonstrates the potential for fast food premises, with multiple deficiencies in food preparation and hygiene, to produce large, intense community outbreaks with high attack rates and severe illness, highly confined in space and time.

Cognitive, Linguistic, and Motor Abilities in a Multigenerational Family with Childhood Apraxia of Speech.

PubMed

Carrigg, Bronwyn; Parry, Louise; Baker, Elise; Shriberg, Lawrence D; Ballard, Kirrie J

2016-10-05

This study describes the phenotype in a large family with a strong, multigenerational history of severe speech sound disorder (SSD) persisting into adolescence and adulthood in approximately half the cases. Aims were to determine whether a core phenotype, broader than speech, separated persistent from resolved SSD cases; and to ascertain the uniqueness of the phenotype relative to published cases. Eleven members of the PM family (9-55 years) were assessed across cognitive, language, literacy, speech, phonological processing, numeracy, and motor domains. Between group comparisons were made using the Mann-Whitney U-test (p < 0.01). Participant performances were compared to normative data using standardized tests and to the limited published data on persistent SSD phenotypes. Significant group differences were evident on multiple speech, language, literacy, phonological processing, and verbal intellect measures without any overlapping scores. Persistent cases performed within the impaired range on multiple measures. Phonological memory impairment and subtle literacy weakness were present in resolved SSD cases. A core phenotype distinguished persistent from resolved SSD cases that was characterized by a multiple verbal trait disorder, including Childhood Apraxia of Speech. Several phenotypic differences differentiated the persistent SSD phenotype in the PM family from the few previously reported studies of large families with SSD, including the absence of comorbid dysarthria and marked orofacial apraxia. This study highlights how comprehensive phenotyping can advance the behavioral study of disorders, in addition to forming a solid basis for future genetic and neural studies. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Using Multiple Big Datasets and Machine Learning to Produce a New Global Particulate Dataset: A Technology Challenge Case Study

NASA Astrophysics Data System (ADS)

Lary, D. J.

2013-12-01

A BigData case study is described where multiple datasets from several satellites, high-resolution global meteorological data, social media and in-situ observations are combined using machine learning on a distributed cluster using an automated workflow. The global particulate dataset is relevant to global public health studies and would not be possible to produce without the use of the multiple big datasets, in-situ data and machine learning.To greatly reduce the development time and enhance the functionality a high level language capable of parallel processing has been used (Matlab). A key consideration for the system is high speed access due to the large data volume, persistence of the large data volumes and a precise process time scheduling capability.

Semi-analytical study of the tokamak pedestal density profile in a single-null diverted plasma with puffing-recycling gas sources

NASA Astrophysics Data System (ADS)

Shi, Bingren

2010-10-01

The tokamak pedestal density structure is generally studied using a diffusion-dominant model. Recent investigations (Stacey and Groebner 2009 Phys. Plasmas 16 102504) from first principle based physics have shown a plausible existence of large inward convection in the pedestal region. The diffusion-convection equation with rapidly varying convection and diffusion coefficients in the near edge region and model puffing-recycling neutral particles is studied in this paper. A peculiar property of its solution for the existence of the large convection case is that the pedestal width of the density profile, qualitatively different from the diffusion-dominant case, depends mainly on the width of the inward convection and only weakly on the neutral penetration length and its injection position.

Using genetic prediction from known complex disease Loci to guide the design of next-generation sequencing experiments.

PubMed

Jostins, Luke; Levine, Adam P; Barrett, Jeffrey C

2013-01-01

A central focus of complex disease genetics after genome-wide association studies (GWAS) is to identify low frequency and rare risk variants, which may account for an important fraction of disease heritability unexplained by GWAS. A profusion of studies using next-generation sequencing are seeking such risk alleles. We describe how already-known complex trait loci (largely from GWAS) can be used to guide the design of these new studies by selecting cases, controls, or families who are most likely to harbor undiscovered risk alleles. We show that genetic risk prediction can select unrelated cases from large cohorts who are enriched for unknown risk factors, or multiply-affected families that are more likely to harbor high-penetrance risk alleles. We derive the frequency of an undiscovered risk allele in selected cases and controls, and show how this relates to the variance explained by the risk score, the disease prevalence and the population frequency of the risk allele. We also describe a new method for informing the design of sequencing studies using genetic risk prediction in large partially-genotyped families using an extension of the Inside-Outside algorithm for inference on trees. We explore several study design scenarios using both simulated and real data, and show that in many cases genetic risk prediction can provide significant increases in power to detect low-frequency and rare risk alleles. The same approach can also be used to aid discovery of non-genetic risk factors, suggesting possible future utility of genetic risk prediction in conventional epidemiology. Software implementing the methods in this paper is available in the R package Mangrove.

Fetal Growth and Childhood Cancer: A Population-Based Study

PubMed Central

Sørensen, Henrik Toft; Grotmol, Tom; Engeland, Anders; Stephansson, Olof; Gissler, Mika; Tretli, Steinar; Troisi, Rebecca

2013-01-01

OBJECTIVE: The etiology of childhood cancers is largely unknown. Studies have suggested that birth characteristics may be associated with risk. Our goal was to evaluate the risk of childhood cancers in relation to fetal growth. METHODS: We conducted a case-control study nested within Nordic birth registries. The study included cancer cases diagnosed in Denmark, Finland, Norway, and Sweden among children born from 1967 to 2010 and up to 10 matched controls per case, totaling 17 698 cases and 172 422 controls. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were derived from conditional logistic regression. RESULTS: Risks of all childhood cancers increased with increasing birth weight (Ptrend ≤ .001). Risks of acute lymphoid leukemia and Wilms tumor were elevated when birth weight was >4000 g and of central nervous system tumors when birth weight was >4500 g. Newborns large for gestational age were at increased risk of Wilms tumor (OR: 2.1 [95% CI: 1.2–3.6]) and connective/soft tissue tumors (OR: 2.1 [95% CI: 1.1–4.4]). In contrast, the risk of acute myeloid leukemia was increased among children born small for gestational age (OR: 1.8 [95% CI: 1.1–3.1]). Children diagnosed with central nervous system tumors at <1 year of age had elevated risk with increasing head circumference (Ptrend < .001). Those with head circumference >39 cm had the highest risk (OR: 4.7 [95% CI: 2.5–8.7]). CONCLUSIONS: In this large, Nordic population-based study, increased risks for several childhood tumors were associated with measures of fetal growth, supporting the hypothesis that tumorigenesis manifesting in childhood is initiated in utero. PMID:24167169

Evaluation of US rear underride guard regulation for large trucks using real-world crashes.

PubMed

Brumbelow, Matthew L; Blanar, Laura

2010-11-01

Current requirements for rear underride guards on large trucks are set by the National Highway Traffic Safety Administration in Federal Motor Vehicle Safety Standards (FMVSS) 223 and 224. The standards have been in place since 1998, but their adequacy has not been evaluated apart from two series of controlled crash tests. The current study used detailed reviews of real-world crashes from the Large Truck Crash Causation Study to assess the ability of guards that comply with certain aspects of the regulation to mitigate passenger vehicle underride. It also evaluated the dangers posed by underride of large trucks that are exempt from guard requirements. For the 115 cases meeting the inclusion criteria, coded data, case narratives, photographs, and measurements were used to examine the interaction between study vehicles. The presence and type of underride guard was determined, and its performance in mitigating underride was categorized. Overall, almost one-half of the passenger vehicles had underride damage classified as severe or catastrophic. These vehicles accounted for 23 of the 28 in which occupants were killed. For the cases involving trailers with underride guards compliant with one or both FMVSS, guard deformation or complete failure was frequent and most commonly due to weak attachments, buckling of the trailer chassis, or bending of the lateral end of the guard under narrow overlap loading. Most of the truck units studied qualified for at least one of the FMVSS exemptions. The two largest groups were trailers with small wheel setbacks and single-unit straight trucks. Dump trucks represented a particularly hazardous category of straight truck. The current study suggests several weaknesses in the rear underride guard regulation. The standard allows too much ground clearance, the quasi-static test conditions allow guard designs that fail in narrow overlap crashes, and certifying guards independent of trailers leads to systems with inadequate attachment and chassis strength. Additionally, the regulation should be expanded to cover a higher percentage of the large truck fleet.

Diagnostic Accuracy of Virtual Pathology vs Traditional Microscopy in a Large Dermatopathology Study.

PubMed

Kent, Michael N; Olsen, Thomas G; Feeser, Theresa A; Tesno, Katherine C; Moad, John C; Conroy, Michael P; Kendrick, Mary Jo; Stephenson, Sean R; Murchland, Michael R; Khan, Ayesha U; Peacock, Elizabeth A; Brumfiel, Alexa; Bottomley, Michael A

2017-12-01

Digital pathology represents a transformative technology that impacts dermatologists and dermatopathologists from residency to academic and private practice. Two concerns are accuracy of interpretation from whole-slide images (WSI) and effect on workflow. Studies of considerably large series involving single-organ systems are lacking. To evaluate whether diagnosis from WSI on a digital microscope is inferior to diagnosis of glass slides from traditional microscopy (TM) in a large cohort of dermatopathology cases with attention on image resolution, specifically eosinophils in inflammatory cases and mitotic figures in melanomas, and to measure the workflow efficiency of WSI compared with TM. Three dermatopathologists established interobserver ground truth consensus (GTC) diagnosis for 499 previously diagnosed cases proportionally representing the spectrum of diagnoses seen in the laboratory. Cases were distributed to 3 different dermatopathologists who diagnosed by WSI and TM with a minimum 30-day washout between methodologies. Intraobserver WSI/TM diagnoses were compared, followed by interobserver comparison with GTC. Concordance, major discrepancies, and minor discrepancies were calculated and analyzed by paired noninferiority testing. We also measured pathologists' read rates to evaluate workflow efficiency between WSI and TM. This retrospective study was caried out in an independent, national, university-affiliated dermatopathology laboratory. Intraobserver concordance of diagnoses between WSI and TM methods and interobserver variance from GTC, following College of American Pathology guidelines. Mean intraobserver concordance between WSI and TM was 94%. Mean interobserver concordance was 94% for WSI and GTC and 94% for TM and GTC. Mean interobserver concordance between WSI, TM, and GTC was 91%. Diagnoses from WSI were noninferior to those from TM. Whole-slide image read rates were commensurate with WSI experience, achieving parity with TM by the most experienced user. Diagnosis from WSI was found equivalent to diagnosis from glass slides using TM in this statistically powerful study of 499 dermatopathology cases. This study supports the viability of WSI for primary diagnosis in the clinical setting.

Cytologic and immunocytochemical features of EBV negative primary effusion lymphoma: report on seven Japanese cases.

PubMed

Kishimoto, Koji; Kitamura, Takashi; Hirayama, Yoshiko; Tate, Genshu; Mitsuya, Toshiyuki

2009-04-01

Primary effusion lymphoma (PEL) is very rare type of non-Hodgkin's lymphoma (NHL) usually confined to the body cavities such as the pleural space, pericardium, and peritoneum. PEL is a human herpes virus-8 (HHV-8)-associated lymphoma and commonly observed in human immunodeficiency virus (HIV)-infected patients. However, HIV-infected patients are extremely fewer in Japan in comparison with those in Western countries; PEL is usually not associated with HIV infection in Japan. This report presents seven Japanese cases of PEL. In situ hybridization revealed that the PEL cells were negative for EBV in all cases. An immunocytological analysis showed that only one case was positive for HHV-8, and PEL cells were positive for CD20 in all cases. MUM1 was positive, but CD10 and CD138 were negative in six cases. One case each was positive for CD30 and BCL-6. The phenotypic patterns of HIV-related is BCL6-/MUM1+/CD138+, thus, the phenotypic findings observed by immunocytochemistry in this study were somehow different from those reported in Western countries. However, the cytomorphological features of PEL cells showed large cell size, abundant basophilic cytoplasm, coarse chromatin, and occasional binucleated or multinucleated cells, similar to a large cell immunoblastic and anaplastic large cell lymphoma, indicating that the cytomorphological characteristics of PE cells in Giemsa and Papanicolaou stain were consistent with those reported abroad. The prognosis for PEL in these cases was poor, but the survival time was variable ranging from 1 month to 54 months, and was different from that of Western cases. No p16/CDKN2A expression was observed, and one case showed PEL cells with a BLIMP1 mutation.

Epidemiology of infective endocarditis in a large Belgian non-referral hospital.

PubMed

Poesen, K; Pottel, H; Colaert, J; De Niel, C

2014-06-01

Guidelines for diagnosis of infective endocarditis are largely based upon epidemiological studies in referral hospitals. Referral bias, however, might impair the validity of guidelines in non-referral hospitals. Recent studies in non-referral care centres on infective endocarditis are sparse. We conducted a retrospective epidemiological study on infective endocarditis in a large non-referral hospital in a Belgian city (Kortrijk). The medical record system was searched for all cases tagged with a putative diagnosis of infective endocarditis in the period 2003-2010. The cases that fulfilled the modified Duke criteria for probable or definite infective endocarditis were included. Compared to referral centres, an older population with infective endocarditis, and fewer predisposing cardiac factors and catheter-related infective endocarditis is seen in our population. Our patients have fewer prosthetic valve endocarditis as well as fewer staphylococcal endocarditis. Our patients undergo less surgery, although mortality rate seems to be highly comparable with referral centres, with nosocomial infective endocarditis as an independent predictor of mortality. The present study suggests that characteristics of infective endocarditis as well as associative factors might differ among non-referral hospitals and referral hospitals.

Flow cytometry in the bone marrow evaluation of follicular and diffuse large B-cell lymphomas.

PubMed

Palacio, C; Acebedo, G; Navarrete, M; Ruiz-Marcellán, C; Sanchez, C; Blanco, A; López, A

2001-09-01

Bone marrow biopsies are routinely performed in the staging of patients with lymphoma. Despite the lack of evidence for its usefulness, many institutions include flow cytometry (FC) of bone-marrow aspirates in an attempt to increase sensitivity and specificity. The aim of this study is to evaluate the usefulness of FC for the assessment of bone-marrow involvement by lymphoma in follicular (FL) and diffuse large B-cell lymphomas (DLBCL). Seventy-nine bone marrow biopsies from 65 patients diagnosed with FL or DLBCL were examined to compare histology and FC for the assessment of bone-marrow involvement by lymphoma. Bone marrow histology showed involvement (BM+) in 16 cases (20.3%), lack of infiltration (BM(-)) in 52 cases (65.8%) and undetermined or undiagnosed for involvement (BMu) in 11 cases (13.9%). FC was positive for involvement in 28 cases (35.4%) and negative in 51 cases (64.6%). 65 cases (95%) showed concordance between the results of morphology and FC (BM(+)/FC(+) or BM(-)/FC(-)). No BM(+)/FC(-) cases were observed. 3 cases showed discrepant results (BM(-)/FC(+)). In these 3 cases the molecular studies (PCR) demonstrated clonal rearrangement of the heavy immunoglobulin chain (IgH) and/or bcl2-IgH in agreement with the flow results. Among the 11 cases with BMu, all but 2 were FC(+) and concordance with the PCR results was seen in 9 cases (81.9%). We conclude that FC is just as sensitive or perhaps slightly more sensitive than histology in the detection of bone marrow involvement in FL and DLBCL. FC studies may be warranted in those cases in which the morphology is not diagnosed. The clinical relevance of the small clonal B-cell population in patients without histologic bone marrow involvement (BM(-)/FC(+) cases) remains an open question.

Examining the interrater reliability of the Hare Psychopathy Checklist-Revised across a large sample of trained raters.

PubMed

Blais, Julie; Forth, Adelle E; Hare, Robert D

2017-06-01

The goal of the current study was to assess the interrater reliability of the Psychopathy Checklist-Revised (PCL-R) among a large sample of trained raters (N = 280). All raters completed PCL-R training at some point between 1989 and 2012 and subsequently provided complete coding for the same 6 practice cases. Overall, 3 major conclusions can be drawn from the results: (a) reliability of individual PCL-R items largely fell below any appropriate standards while the estimates for Total PCL-R scores and factor scores were good (but not excellent); (b) the cases representing individuals with high psychopathy scores showed better reliability than did the cases of individuals in the moderate to low PCL-R score range; and (c) there was a high degree of variability among raters; however, rater specific differences had no consistent effect on scoring the PCL-R. Therefore, despite low reliability estimates for individual items, Total scores and factor scores can be reliably scored among trained raters. We temper these conclusions by noting that scoring standardized videotaped case studies does not allow the rater to interact directly with the offender. Real-world PCL-R assessments typically involve a face-to-face interview and much more extensive collateral information. We offer recommendations for new web-based training procedures. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

SU-C-210-02: Impact of Intrafractional Motion On TomoTherapy Stereotactic Body Radiotherapy (SBRT) 4D Dosimetry

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

Lian, J; Matney, J; Chao, E

2015-06-15

Purpose: TomoTherapy treatment has unique challenges in handling intrafractional motion compared to conventional LINAC. This study is aimed to gain a realistic and quantitative understanding of motion impact on TomoTherapy SBRT treatment of lung and prostate cancer patients. Methods: A 4D dose engine utilizing GPUs and including motion during treatment was developed for the efficient simulation of TomoTherapy delivered dosimetry. Two clinical CyberKnife lung cases with respiratory motion tracking and two prostate cases with a slower non-periodical organ motion treated by LINAC plus Calypso tracking were used in the study. For each disease site, one selected case has an averagemore » motion (6mm); the other has a large motion (10mm for lung and 15mm for prostate). SBRT of lung and prostate cases were re-planned on TomoTherapy with 12 Gyx4 fractions and 7Gyx5 fractions, respectively, all with 95% PTV coverage. Each case was planned with 4 jaw settings: 1) conventional 1cm static, 2) 2.5cm static, 3) 2.5cm dynamic, and 4) 5cm dynamic. The intrafractional rigid motion of the target was applied in the dose calculation of individual fractions of each plan and total dose was accumulated from multiple fractions. Results: For 1cm static jaw plans with motions applied, PTV coverage is related to motion type and amplitude. For SBRT patients with average motion (6mm), the PTV coverage remains > 95% for lung case and 74% for prostate case. For cases with large motion, PTV coverage drops to 61% for lung SBRT and 49% for prostate SBRT. Plans with other jaws improve uniformity of moving target, but still suffer from poor PTV coverage (< 70%). Conclusion: TomoTherapy lung SBRT is less motion-impacted when average amplitude of respiratory-induced intrafractional motion is present (6mm). When motion is large and/or non-periodic (prostate), all studied plans lead to significantly decreased target coverage in actual delivered dosimetry.« less

Balancing the Phosphorus Budget of a Swine Farm: A Case Study

ERIC Educational Resources Information Center

Nelson, Nathan O.; Mikkelsen, Robert L.

2005-01-01

Trends in animal production have moved the industry toward large confined animal feeding operations (CAFOs). These CAFOs concentrate large amounts of manure-based nutrients in relatively small areas, which increases the risk of nutrient loss to the surrounding environment. In response to water quality concerns, P-based manure application…

Faculty Viewpoints on Teaching Large-Enrollment Science Courses with Clickers

ERIC Educational Resources Information Center

MacArthur, James; Jones, Loretta; Suits, Jerry

2011-01-01

In this interpretivist case study, four professors who have effectively used clickers to teach chemistry at a large university in a western state were observed and interviewed. Seventeen 50-minute class periods were observed and four 40-50 minute interviews were conducted. Having an institutional culture that promotes the use of clickers and…

The Timing of Teacher Hires and Teacher Qualifications: Is There an Association?

ERIC Educational Resources Information Center

Engel, Mimi

2012-01-01

Background: Case studies suggest that late hiring timelines are common in large urban school districts and result in the loss of qualified teachers to surrounding suburbs. To date, however, there has been no large-scale quantitative investigation of the relationship between the timing of teacher hires and teacher qualifications. Purpose: This…

Impact of RFID on Retail Value Chain: A Mixed Method Study

ERIC Educational Resources Information Center

Bhattacharya, Mithu

2011-01-01

Radio Frequency Identification (RFID) mandates by large retailers and various government agencies have driven a large number of organizations to roll out the technology. Despite these commitments the business case for RFID is far from reality and is still at its infancy. This dissertation work aims at providing realistic perspective on the…

Channeling Consumers to Preferred Providers and the Impact of Status Quo Bias: Does Type of Provider Matter?

PubMed Central

Boonen, Lieke H H M; Donkers, Bas; Schut, Frederik T

2011-01-01

Context To effectively bargain about the price and quality of health services, health insurers need to successfully channel their enrollees. Little is known about consumer sensitivity to different channeling incentives. In particular, the impact of status quo bias, which is expected to differ between different provider types, can play a large role in insurers' channeling ability. Objective To examine consumer sensitivity to channeling strategies and to analyze the impact of status quo bias for different provider types. Data Sources/Study Design With a large-scale discrete choice experiment, we investigate the impact of channeling incentives on choices for pharmacies and general practitioners (GPs). Survey data were obtained among a representative Dutch household panel (n=2,500). Principal Findings Negative financial incentives have a two to three times larger impact on provider choice than positive ones. Positive financial incentives have a relatively small impact on GP choice, while the impact of qualitative incentives is relatively large. Status quo bias has a large impact on provider choice, which is more prominent in the case of GPs than in the case of pharmacies. Conclusion The large impact of the status quo bias makes channeling consumers away from their current providers a daunting task, particularly in the case of GPs. PMID:21029092

Navigating political minefields: partnerships in organizational case study research.

PubMed

Moll, Sandra

2012-01-01

The purpose of this paper is to examine key challenges associated with conducting politically sensitive research within a workplace setting, and to highlight strategic partnerships that can be developed to address these challenges. The author's research on employee mental health issues within a large healthcare facility serves as the foundation for identification and description of "political minefields" that investigators may encounter when conducting organizational case study research. Key methodological principles from the literature on qualitative case study research will frame discussion of how to understand and address political sensitivities in the research process. The benefits of conducting organizational case study research will be outlined, followed by discussion of methodological challenges that can emerge in negotiating entry, collecting data (gatekeepers, researcher reflexivity, participant authenticity and non-maleficence), and communicating research findings. Courage, collaboration and clear communication with stakeholders at all levels of the organization are critical to the success of workplace based case study research.

Utilization of Large Scale Surface Models for Detailed Visibility Analyses

NASA Astrophysics Data System (ADS)

Caha, J.; Kačmařík, M.

2017-11-01

This article demonstrates utilization of large scale surface models with small spatial resolution and high accuracy, acquired from Unmanned Aerial Vehicle scanning, for visibility analyses. The importance of large scale data for visibility analyses on the local scale, where the detail of the surface model is the most defining factor, is described. The focus is not only the classic Boolean visibility, that is usually determined within GIS, but also on so called extended viewsheds that aims to provide more information about visibility. The case study with examples of visibility analyses was performed on river Opava, near the Ostrava city (Czech Republic). The multiple Boolean viewshed analysis and global horizon viewshed were calculated to determine most prominent features and visibility barriers of the surface. Besides that, the extended viewshed showing angle difference above the local horizon, which describes angular height of the target area above the barrier, is shown. The case study proved that large scale models are appropriate data source for visibility analyses on local level. The discussion summarizes possible future applications and further development directions of visibility analyses.

Unusually large complex odontoma in maxillary sinus associated with unerupted tooth. Report of case and review of literature.

PubMed

Singer, Steven R; Mupparapu, Muralidhar; Milles, Maano; Rinaggio, Joseph; Pisano, Dominic; Quaranta, Patrick

2007-01-01

An unusual case of a large complex odontoma with an associated impacted tooth is presented. Odontomas are hamartomatous growths of enamel, dentin, cementum and pulp tissue. Although they are usually tooth-sized or smaller, occasionally, the complex variant can exhibit considerable growth, as was seen in the case presented here. It occupied most of the maxillary sinus and displaced the floor of the orbit and the medial and posterior walls of the left maxillary sinus. Panoramic radiographs, as well as axial and coronal CT studies, showed the extent of the lesion in various dimensions. A differential diagnosis of various calcifying tumors was formulated on the basis of these findings. The lesion was surgically excised, and histologic analysis confirmed the radiographic impression. Although odontomas of this magnitude are rare, this case demonstrates the value of imaging, radiographic histopathologic diagnosis and surgical treatment planning prior to any definitive treatment.

[Reduced number of fatal and life-threatening reactions to food. Reporting by the medical profession has resulted in effective measures].

PubMed

Foucard, Tony; Yman, Ingrid Malmheden; Nordvall, Lennart

The results from the Swedish system for reporting severe and fatal reactions caused by food for the period 1993-96 were published in Lakartidningen in 1997. We now report the results for the period 1997-2003. The number of fatal cases has decreased from 1.75 to 0.86 per year and the number of life-threatening cases from 3 to I per year. The most gratifying result was the large decrease in severe reactions caused by soy, from 3 deaths and 6 life-threatening cases during the first 4-year period to just one life-threatening case during the following 7-year period. This reduction is probably largely due to an increased awareness of identified risk persons, but also to a reduced use of soy protein. The ongoing study illustrates the usefulness of a national system for reporting severe and fatal reactions caused by food.

The US Army in Transition: Implications of the IDF Experience in the Second Lebanon War

DTIC Science & Technology

Israel Hezbollah War as a historical case in which a contemporary army had to transition from sustained irregular operations to large-scale...conventional war . The case study shows that the Israeli Defense Force did not make this transition effectively, and it examines factors that contributed to

Economic Development and the University: A Case Study of a Failed Program.

ERIC Educational Resources Information Center

Senter, Richard, Jr.

1996-01-01

The role of the university in programs to stimulate economic development is examined, and the case of one such program that failed is described. Problems within the program included financial losses in large projects, corruption, widespread public criticism, and criminal convictions of two top program officers. Possible solutions, including…

Utilizing the Peer Group Method with Case Studies to Teach Pharmacokinetics.

ERIC Educational Resources Information Center

Sims, Pamela J.

1994-01-01

A pharmacy school large-group (110 students) course in pharmacokinetics was designed to incorporate small-group team-based problem solving. The method allows students to learn material through traditional lecture, research the topic further, discuss the information gained, and apply the learning to specific cases in a manner that promotes…

Instructional Leadership of High School Assistant Principals in Northern California

ERIC Educational Resources Information Center

Garrard, John Christian Timothy

2013-01-01

To identify how high school assistant principals in large suburban schools serve as instructional leaders and how they develop these skills, this research utilized a multiple-case study design, followed by a cross-case analysis of the data. This research explores the instructional leadership of three female comprehensive high school assistant…

"Good Morning, I'm a Heterosexual": A Case in the Closet in Rural Australia.

ERIC Educational Resources Information Center

Downey, Belinda

2001-01-01

A case study of an Australian gay teacher in a rural community explores issues related to being in "the closet," which is seen as a patriarchal construction designed to maintain itself. Despite legal protection to equal rights, gay, lesbian, bisexual, and transgendered teachers experience significant discrimination, fueled largely by…

Medullary Carcinoma of the Penis: A Distinctive HPV-related Neoplasm: A Report of 12 Cases.

PubMed

Cañete-Portillo, Sofía; Clavero, Omar; Sanchez, Diego F; Silvero, Arturo; Abed, Francisco; Rodriguez, Ingrid M; Ayala, Gustavo; Alemany, Laia; Munoz, Nubia; de Sanjose, Silvia; Quint, Wim; Bosch, Francesc X; Cubilla, Antonio L

2017-04-01

A third to half of penile invasive squamous cell carcinomas are human papillomavirus (HPV) related. Warty (condylomatous), warty-basaloid, and basaloid carcinomas are the most common subtypes associated with HPV. Less frequent are clear cell and lymphoepithelioma-like carcinomas. Here we report a novel penile tumor associated with HPV. Twelve cases were selected from 1010 penile carcinomas, part of an international HPV detection study conducted at the Institut Català d'Oncologia, Barcelona, Spain. Immunostaining with p16 was performed on all cases, and HPV-mRNA detection was also performed. En bloc full tumor staining was the utilized criteria for positivity of p16. For HPV-DNA detection, whole-tissue section polymerase chain reaction analysis was performed by SPF10-DEIA-LiPA25 (version 1). The patients' ages ranged from 42 to 92 years (average, 71 y). The tumor was most commonly located in the glans. A characteristic microscopic finding was the presence of a moderate to dense tumor-associated inflammatory cell infiltrate composed of neutrophils, lymphocytes, plasma cells, or eosinophils. Tumors grew in large solid sheets, nests, or had a trabecular pattern. Cells were large and poorly differentiated or anaplastic. Keratinization was minimal or absent. Nuclei were large with prominent nucleoli. Mitoses were numerous. Tumor necrosis was common. Deep invasion of the corpora cavernosa was frequent. p16 and HPV-DNA were positive in all cases, whereas mRNA detection was positive in 9 cases only. The prevalent genotype was HPV16 (9 cases, 75%). Other genotypes were HPVs 58, 33, and 66. Medullary carcinomas of the penis are morphologically distinctive HPV-related high-grade neoplasms affecting older individuals. More studies are necessary to delineate the epidemiological, clinical, and molecular features of this unusual penile neoplasm.

[The Efficiency and Complications of ESD and ESTD in the Treatment of Large Esophageal Mucosal Lesions].

PubMed

Wang, Jin; Qin, Jin-yu; Guo, Tian-jiao; Gan, Tao; Wang, Yi-ping; Wu, Jun-chao

2015-11-01

To study the efficiency and complications of endoscopic submucosal dissection (ESD) and endoscopic submucosal tunnel dissection (ESTD) in the treatment of large esophageal mucosal lesions. The clinical data were collected from the patients who received ESD or ESTD for the treatment of early esophageal lesions in our hospital during January 1, 2014 to July 15, 2015, including the en bloc resection rate, curative resection rate, postoperative complication rate, the risk factors of complications were explored by univariate and multivariate analysis. A total of 50 patients were involved in the study, ESD or ESTD were performed successfully in 53 times, including 6 cases of ESD,47 cases of ESTD, The average age was (61.9 +/- 6.8) yr., the average operating time was (83.57 +/- 32.33) min, the average dissected lesion was (14.82 +/- 3.18) cm2, En bloc resection rate was 94.34%, the curative rate was 84.90%. There were 1 case of bleeding, 1 case of perforation, 45 (84.90%) cases of fever, 13 cases (24.53%) of esophageal stricture. The severity of stricture was associated with the operation time Codds ratio (OR) = 1.040, 95% confidence interal (CI): 1.007-1.075) and esophageal circumference (OR=9.972, 95% CI: 1.221-81.416). The residual resection margin appeared in 8 patients, and the lesion area (OR=1.145, 95% CI: 1.013-1.294) was the only risk factor. ESD and ESTD are safe and effective in the treatment of early esophageal lesions, but seems have relatively high incidence of esopgageal stricture and residual resection margin in the treatment of large esophageal lesions.

What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips.

PubMed

Fessy, M H; Putman, S; Viste, A; Isida, R; Ramdane, N; Ferreira, A; Leglise, A; Rubens-Duval, B; Bonin, N; Bonnomet, F; Combes, A; Boisgard, S; Mainard, D; Leclercq, S; Migaud, H

2017-09-01

Dislocation after total hip arthroplasty (THA) is a leading reason for surgical revision. The risk factors for dislocation are controversial, particularly those related to the patient and to the surgical procedure itself. The differences in opinion on the impact of these factors stem from the fact they are often evaluated using retrospective studies or in limited patient populations. This led us to carry out a prospective case-control study on a large population to determine: 1) the risk factors for dislocation after THA, 2) the features of these dislocations, and 3) the contribution of patient-related factors and surgery-related factors. Risk factors for dislocation related to the patient and procedure can be identified using a large case-control study. A multicenter, prospective case-control study was performed between January 1 and December 31, 2013. Four patients with stable THAs were matched to each patient with a dislocated THA. This led to 566 primary THA cases being included: 128 unstable, 438 stable. The primary matching factors were sex, age, initial diagnosis, surgical approach, implantation date and type of implants (bearing size, standard or dual-mobility cup). The patients with unstable THAs were 67±12 [37-73]years old on average; there were 61 women (48%) and 67 men (52%). Hip osteoarthritis (OA) was the main reason for the THA procedure in 71% (91/128) of the unstable group. The dislocation was posterior in 84 cases and anterior in 44 cases. The dislocation occurred within 3 months of the primary surgery in 48 cases (38%), 3 to 12 months after in 23 cases (18%), 1 to 5years after in 20 cases (16%), 5 to 10years after in 17 cases (13%) and more than 10years later in 20 cases. The dislocation recurred within 6 months of the initial dislocation in 23 of the 128 cases (18%). The risk factors for instability were a high ASA score with an odds ratio (OR) of 1.93 (95% CI: 1.4-2.6), neurological disability (cognitive, motor or psychiatric disorders) with an OR of 3.9 (95% CI: 2.15-7.1), history of spinal disease (lumbar stenosis, spinal fusion, discectomy, scoliosis and injury sequelae) with an OR of 1.89 (95% CI: 1.0-3.6), unrepaired joint capsule (all approaches) with an OR of 4.1 (95% CI: 2.3-7.37), unrepaired joint capsule (posterior approach) with an OR of 6.0 (95% CI: 2.2-15.9), and cup inclination outside Lewinnek's safe zone (30°-50°) with OR of 2.4 (95% CI: 1.4-4.0). This large comparative study isolated important patient-related factors for dislocation that surgeons must be aware of. We also found evidence that implanting the cup in 30° to 50° inclination has a major impact on preventing dislocation. Level III; case-control study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Designing Adult Education Activities: A Case of Civic Education Programmes by National Commission for Civic Education in the Ashaiman Municipality in Ghana

ERIC Educational Resources Information Center

Afriyie, Sally Adwoa

2015-01-01

This article discusses the efficiency of the design of educational activities of the National Commission for Civic Education (NCCE) in Ashaiman municipality in Ghana. Using a descriptive case study design, data was collected from seven (7) Community Based Groups in Ashaiman. The results of the study indicated that to a large extent, there was…

Adult Graduates' Perceptions of the Value of a Bachelor's Degree Earned Online from a Private Research University: A Qualitative Case Study

ERIC Educational Resources Information Center

Hagan, Eric J.

2013-01-01

This qualitative case study examined the life impact of earning an online Bachelor's degree as an adult from a large private East Coast research university. As the number of adult students and the popularity of online learning continue to increase, there is a need for improved understanding of the value of online degree programs for adult…

Building a Better Applicant Pool--A Case Study of the Use of Predictive Modeling and Market Segmentation to Build and Enroll Better Pools of Students

ERIC Educational Resources Information Center

Herridge, Bart; Heil, Robert

2003-01-01

Predictive modeling has been a popular topic in higher education for the last few years. This case study shows an example of an effective use of modeling combined with market segmentation to strategically divide large, unmanageable prospect and inquiry pools and convert them into applicants, and eventually, enrolled students. (Contains 6 tables.)

The Influence of Tier One of RtI[superscript 2] and Instructional Coaching on Teacher Instruction and Student/ELL Learning: A Multiple Case Study

ERIC Educational Resources Information Center

Valadez, Frances E.

2012-01-01

The purpose of this case study was to demonstrate the influence of Tier 1 of Response to Intervention and Instruction (RtI[superscript 2]) and instructional coaching on teachers' instruction and on students' and English Language Learners' (ELL) learning. Research was conducted in one large urban elementary school. The unit of study…

Optimization under variability and uncertainty: a case study for NOx emissions control for a gasification system.

PubMed

Chen, Jianjun; Frey, H Christopher

2004-12-15

Methods for optimization of process technologies considering the distinction between variability and uncertainty are developed and applied to case studies of NOx control for Integrated Gasification Combined Cycle systems. Existing methods of stochastic optimization (SO) and stochastic programming (SP) are demonstrated. A comparison of SO and SP results provides the value of collecting additional information to reduce uncertainty. For example, an expected annual benefit of 240,000 dollars is estimated if uncertainty can be reduced before a final design is chosen. SO and SP are typically applied to uncertainty. However, when applied to variability, the benefit of dynamic process control is obtained. For example, an annual savings of 1 million dollars could be achieved if the system is adjusted to changes in process conditions. When variability and uncertainty are treated distinctively, a coupled stochastic optimization and programming method and a two-dimensional stochastic programming method are demonstrated via a case study. For the case study, the mean annual benefit of dynamic process control is estimated to be 700,000 dollars, with a 95% confidence range of 500,000 dollars to 940,000 dollars. These methods are expected to be of greatest utility for problems involving a large commitment of resources, for which small differences in designs can produce large cost savings.

Development of a Response Surface Thermal Model for Orion Mated to the International Space Station

NASA Technical Reports Server (NTRS)

Miller, Stephen W.; Meier, Eric J.

2010-01-01

A study was performed to determine if a Design of Experiments (DOE)/Response Surface Methodology could be applied to on-orbit thermal analysis and produce a set of Response Surface Equations (RSE) that accurately predict vehicle temperatures. The study used an integrated thermal model of the International Space Station and the Orion Outer mold line model. Five separate factors were identified for study: yaw, pitch, roll, beta angle, and the environmental parameters. Twenty external Orion temperatures were selected as the responses. A DOE case matrix of 110 runs was developed. The data from these cases were analyzed to produce an RSE for each of the temperature responses. The initial agreement between the engineering data and the RSE predictions was encouraging, although many RSEs had large uncertainties on their predictions. Fourteen verification cases were developed to test the predictive powers of the RSEs. The verification showed mixed results with some RSE predicting temperatures matching the engineering data within the uncertainty bands, while others had very large errors. While this study to not irrefutably prove that the DOE/RSM approach can be applied to on-orbit thermal analysis, it does demonstrate that technique has the potential to predict temperatures. Additional work is needed to better identify the cases needed to produce the RSEs

Establish susceptibility and risk assessment models for rainfall-induced landslide: A case in Central Taiwan

NASA Astrophysics Data System (ADS)

Wu, Chunhung; Huang, Jyuntai

2017-04-01

Most of the landslide cases in Taiwan were triggered by rainfall or earthquake events. The heavy rainfall in the typhoon seasons, from June to October, causes the landslide hazard more serious. Renai Towhship is of the most large landslide cases after 2009 Typhoon Morakot (from Aug. 5 to Aug. 10, 2009) in Taiwan. Around 2,744 landslides cases with the total landslide area of 21.5 km2 (landslide ratio =1.8%), including 26 large landslide cases, induced after 2009 Typhoon Morakot in Renai Towhship. The area of each large landslides case is more than 0.1 km2, and the area of the largest case is around 0.96 km2. 58% of large landslide cases locate in the area with metamorphosed sandstone. The mean slope of 26 large landslide cases ranges from 15 degree to 56 degree, and the accumulated rainfall during 2009 Typhoon Morakot ranges from 530 mm to 937 mm. Three methods, including frequency ratio method (abbreviated as FR), weights of evidence method (abbreviated as WOE), and logistic regression method (abbreviated as LR), are used in this study to establish the landslides susceptibility in the Renai Township, Nantou County, Taiwan. Eight landslide related-factors, including elevation, slope, aspect, geology, land use, distance to drainage, distance to fault, accumulation rainfall during 2009 Typhoon Morakot, are used to establish the landslide susceptibility models in this study. The landslide inventory after 2009 Typhoon Morakot is also used to test the model performance in this study. The mean accumulated rainfall in Renai Township during 2009 typhoon Morakot was around 735 mm with the maximum 1-hr, 3-hrs, and 6-hrs rainfall intensity of 44 mm/1-hr, 106 mm/3-hrs and 204 mm/6-hrs, respectively. The range of original susceptibility values established by three methods are 4.0 to 20.9 for FR, -33.8 to -16.1 for WOE, and -41.7 to 5.7 for LR, and the mean landslide susceptibility value are 8.0, -24.6 and 0.38, respectively. The AUC values are 0.815 for FR, 0.816 for WOE, and 0.823 for LR. The study normalized the susceptibility value range of three landslide susceptibility models to 0 to 1 to deeply compare the model performance. The normalized landslide susceptibility value > 0.5 and ≦0.5 are regarded as predicted-landslide area and predicted-not-landslide area. The ratio of the area in the predicted-landslide area to the total area is 3.0% for FR, 71.4% for WOE, and 26.5% for LR. And the correct ratio is 65.5% for FR, 61.9% for WOE, 74.5% for LR. The study adopted 14 rainfall stations with more than 20 years daily rainfall data in Renai Township to estimate the 24 hrs accumulated rainfall with different RPYs. Landslide susceptibility map under 24 hrs accumulated rainfall distribution with different RPYs is used to estimate the landslide disaster location and scale. The landslide risk under different RPYs in Renai Township is calculated as 2.62 billion for 5 RPYs, 3.06 billion for 10 RPYs, 4.69 billion for 25 RPYs, 5.97 billion for 50 RPYs, 6.98 billion for 100 RPYs, and 8.23 billion for 200 RPYs, respectively.

Outcome of strict implementation of infection prevention control measures during an outbreak of Middle East respiratory syndrome.

PubMed

El Bushra, Hassan E; Al Arbash, Hussain A; Mohammed, Mutaz; Abdalla, Osman; Abdallah, Mohamed N; Al-Mayahi, Zayid K; Assiri, Abdallah M; BinSaeed, Abdulaziz A

2017-05-01

The objective of this retrospective cohort study was to assess the impact of implementation of different levels of infection prevention and control (IPC) measures during an outbreak of Middle East respiratory syndrome (MERS) in a large tertiary hospital in Saudi Arabia. The setting was an emergency room (ER) in a large tertiary hospital and included primary and secondary MERS patients. Rapid response teams conducted repeated assessments of IPC and monitored implementation of corrective measures using a detailed structured checklist. We ascertained the epidemiologic link between patients and calculated the secondary attack rate per 10,000 patients visiting the ER (SAR/10,000) in 3 phases of the outbreak. In phase I, 6 primary cases gave rise to 48 secondary cases over 4 generations, including a case that resulted in 9 cases in the first generation of secondary cases and 21 cases over a chain of 4 generations. During the second and third phases, the number of secondary cases sharply dropped to 18 cases and 1 case, respectively, from a comparable number of primary cases. The SAR/10,000 dropped from 75 (95% confidence interval [CI], 55-99) in phase I to 29 (95% CI, 17-46) and 3 (95% CI, 0-17) in phases II and III, respectively. The study demonstrated salient evidence that proper institution of IPC measures during management of an outbreak of MERS could remarkably change the course of the outbreak. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

A retrospective cohort study of suspected child maltreatment cases resulting in hospitalization.

PubMed

Friedman, Lee S; Sheppard, Shirley; Friedman, Daniel

2012-11-01

Although the incidence and risk factors of child abuse have been well researched, there continues to be a need for large studies that provide information regarding the process of recognizing children whose health and lives are most seriously threatened by abuse and neglect, in particular children requiring hospitalization as a result of child abuse. The purpose of this study was to (1) describe differences in the type of injuries and illnesses of children hospitalized for abuse and neglect and (2) assess the relationship between in-hospital mortality and child maltreatment. For this retrospective cohort study, child maltreatment cases were identified using medical record databases of patients treated in all hospitals and trauma units in Illinois. A comparison group of children not suffering from suspected maltreatment were randomly selected and matched by age and data source to the suspected maltreatment cases. 2656 children under the age of 13 years suspected of suffering maltreatment who were admitted to any hospital in Illinois between 2000 and 2009. The analysis showed distinct patterns in injury, physical illness and psychological disorders for each subgroup of maltreatment cases. Among the cases of maltreatment 75.6% were discharged home, 2.9% into child protective services and 15.8% to an intermediate care facility. In the final multivariable conditional logistic regression model, children suffering maltreatment continued to have a higher odds of dying during hospitalization (adjusted OR=2.99; CI95%: 1.63, 5.45; p<0.001). There were distinct diagnostic patterns and outcomes among suspected cases of child maltreatment admitted to Illinois hospitals over a 10-year period. This large retrospective cohort study confirms findings reported in many smaller studies and larger national cross-sectional surveys. Copyright © 2012 Elsevier Ltd. All rights reserved.

Partition function of free conformal fields in 3-plet representation

NASA Astrophysics Data System (ADS)

Beccaria, Matteo; Tseytlin, Arkady A.

2017-05-01

Simplest examples of AdS/CFT duality correspond to free CFTs in d dimensions with fields in vector or adjoint representation of an internal symmetry group dual in the large N limit to a theory of massless or massless plus massive higher spins in AdS d+1. One may also study generalizations when conformal fields belong to higher dimensional representations, i.e. carry more than two internal symmetry indices. Here we consider the case of the 3-fundamental ("3-plet") representation. One motivation is a conjectured connection to multiple M5-brane theory: heuristic arguments suggest that it may be related to an (interacting) CFT of 6d (2,0) tensor multiplets in 3-plet representation of large N symmetry group that has an AdS7 dual. We compute the singlet partition function Z on S 1 × S d-1 for a free field in 3-plet representation of U( N) and analyse its novel large N behaviour. The large N limit of the low temperature expansion of Z which is convergent in the vector and adjoint cases here is only asymptotic, reflecting the much faster growth of the number of singlet operators with dimension, indicating a phase transition at very low temperature. Indeed, while the critical temperatures in the vector ( T c ˜ N γ , γ > 0) and adjoint ( T c ˜ 1) cases are finite, we find that in the 3-plet case T c ˜ (log N)-1, i.e. it approaches zero at large N. We discuss some details of large N solution for the eigenvalue distribution. Similar conclusions apply to higher p-plet representations of U( N) or O( N) and also to the free p-tensor theories invariant under [U( N)] p or [ O( N)] p with p ≥ 3.

The course of the buccal nerve: relationships with the temporalis muscle during the prenatal period

PubMed Central

MÉRIDA-VELASCO, J. R.; RODRÍGUEZ-VÁZQUEZ, J. F.; CUADRA, C.; MÉRIDA-VELASCO, J. A.; JIMÉNEZ-COLLADO, J.

2001-01-01

The aim of this study was to describe the course of the buccal nerve and its relationships with the temporalis muscle during the prenatal period. Serial sections of 90 human fetal specimens ranging from 9 to 17 wk development were studied by light microscopy. Each fetal specimen was studied on both right and left sides, making a total of 180 cases for study. A 3-D reconstruction of the region analysed in one of the specimens was made. In 89 cases the buccal nerve was located medial to the temporalis muscle; in 73 cases it penetrated the muscle; in 15 cases it lay in a canal formed by the muscle fibres and was covered by fascia, and finally, in 3 cases it was a branch of the inferior alveolar nerve. The study has revealed that in a large number of cases the buccal nerve maintains an intimate association with the temporalis muscle. PMID:11327204

Enhancing TB case detection: experience in offering upfront Xpert MTB/RIF testing to pediatric presumptive TB and DR TB cases for early rapid diagnosis of drug sensitive and drug resistant TB.

PubMed

Raizada, Neeraj; Sachdeva, Kuldeep Singh; Nair, Sreenivas Achuthan; Kulsange, Shubhangi; Gupta, Radhey Shayam; Thakur, Rahul; Parmar, Malik; Gray, Christen; Ramachandran, Ranjani; Vadera, Bhavin; Ekka, Shobha; Dhawan, Shikha; Babre, Ameet; Ghedia, Mayank; Alavadi, Umesh; Dewan, Puneet; Khetrapal, Mini; Khanna, Ashwini; Boehme, Catharina; Paramsivan, Chinnambedu Nainarappan

2014-01-01

Diagnosis of pulmonary tuberculosis (PTB) in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB) cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India. The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB)) accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm. 4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8) pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2) of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4) who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high (98%, CI 90.1-99.9), with no statistically significant variation with respect to past history of treatment. Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising solution to present-day challenges in the diagnosis of PTB in pediatric patients.

Effect of Non-Alignment/Alignment of Attenuation Map Without/With Emission Motion Correction in Cardiac SPECT/CT

NASA Astrophysics Data System (ADS)

Dey, Joyoni; Segars, W. Paul; Pretorius, P. Hendrik; King, Michael A.

2015-08-01

Purpose: We investigate the differences without/with respiratory motion correction in apparent imaging agent localization induced in reconstructed emission images when the attenuation maps used for attenuation correction (from CT) are misaligned with the patient anatomy during emission imaging due to differences in respiratory state. Methods: We investigated use of attenuation maps acquired at different states of a 2 cm amplitude respiratory cycle (at end-expiration, at end-inspiration, the center map, the average transmission map, and a large breath-hold beyond range of respiration during emission imaging) to correct for attenuation in MLEM reconstruction for several anatomical variants of the NCAT phantom which included both with and without non-rigid motion between heart and sub-diaphragmatic regions (such as liver, kidneys etc). We tested these cases with and without emission motion correction and attenuation map alignment/non-alignment. Results: For the NCAT default male anatomy the false count-reduction due to breathing was largely removed upon emission motion correction for the large majority of the cases. Exceptions (for the default male) were for the cases when using the large-breathhold end-inspiration map (TI_EXT), when we used the end-expiration (TE) map, and to a smaller extent, the end-inspiration map (TI). However moving the attenuation maps rigidly to align the heart region, reduced the remaining count-reduction artifacts. For the female patient count-reduction remained post motion correction using rigid map-alignment due to the breast soft-tissue misalignment. Quantitatively, after the transmission (rigid) alignment correction, the polar-map 17-segment RMS error with respect to the reference (motion-less case) reduced by 46.5% on average for the extreme breathhold case. The reductions were 40.8% for end-expiration map and 31.9% for end-inspiration cases on the average, comparable to the semi-ideal case where each state uses its own attenuation map for correction. Conclusions: Two main conclusions are that even rigid emission motion correction to rigidly align the heart region to the attenuation map helps in average cases to reduce the count-reduction artifacts and secondly, within the limits of the study (ex. rigid correction) when there is lung tissue inferior to the heart as with the NCAT phantom employed in this study end-expiration maps (TE) might best be avoided as they may create more artifacts than the end-inspiration (TI) maps.

Australian Schizophrenia Research Bank: a database of comprehensive clinical, endophenotypic and genetic data for aetiological studies of schizophrenia.

PubMed

Loughland, Carmel; Draganic, Daren; McCabe, Kathryn; Richards, Jacqueline; Nasir, Aslam; Allen, Joanne; Catts, Stanley; Jablensky, Assen; Henskens, Frans; Michie, Patricia; Mowry, Bryan; Pantelis, Christos; Schall, Ulrich; Scott, Rodney; Tooney, Paul; Carr, Vaughan

2010-11-01

This article describes the establishment of the Australian Schizophrenia Research Bank (ASRB), which operates to collect, store and distribute linked clinical, cognitive, neuroimaging and genetic data from a large sample of people with schizophrenia and healthy controls. Recruitment sources for the schizophrenia sample include a multi-media national advertising campaign, inpatient and community treatment services and non-government support agencies. Healthy controls have been recruited primarily through multi-media advertisements. All participants undergo an extensive diagnostic and family history assessment, neuropsychological evaluation, and blood sample donation for genetic studies. Selected individuals also complete structural MRI scans. Preliminary analyses of 493 schizophrenia cases and 293 healthy controls are reported. Mean age was 39.54 years (SD = 11.1) for the schizophrenia participants and 37.38 years (SD = 13.12) for healthy controls. Compared to the controls, features of the schizophrenia sample included a higher proportion of males (cases 65.9%; controls 46.8%), fewer living in married or de facto relationships (cases 16.1%; controls 53.6%) and fewer years of education (cases 13.05, SD = 2.84; controls 15.14, SD = 3.13), as well as lower current IQ (cases 102.68, SD = 15.51; controls 118.28, SD = 10.18). These and other sample characteristics are compared to those reported in another large Australian sample (i.e. the Low Prevalence Disorders Study), revealing some differences that reflect the different sampling methods of these two studies. The ASRB is a valuable and accessible schizophrenia research facility for use by approved scientific investigators. As recruitment continues, the approach to sampling for both cases and controls will need to be modified to ensure that the ASRB samples are as broadly representative as possible of all cases of schizophrenia and healthy controls.

Genetic Basis of Autoantibody Positive and Negative Rheumatoid Arthritis Risk in a Multi-ethnic Cohort Derived from Electronic Health Records

PubMed Central

Kurreeman, Fina; Liao, Katherine; Chibnik, Lori; Hickey, Brendan; Stahl, Eli; Gainer, Vivian; Li, Gang; Bry, Lynn; Mahan, Scott; Ardlie, Kristin; Thomson, Brian; Szolovits, Peter; Churchill, Susanne; Murphy, Shawn N.; Cai, Tianxi; Raychaudhuri, Soumya; Kohane, Isaac; Karlson, Elizabeth; Plenge, Robert M.

2011-01-01

Discovering and following up on genetic associations with complex phenotypes require large patient cohorts. This is particularly true for patient cohorts of diverse ancestry and clinically relevant subsets of disease. The ability to mine the electronic health records (EHRs) of patients followed as part of routine clinical care provides a potential opportunity to efficiently identify affected cases and unaffected controls for appropriate-sized genetic studies. Here, we demonstrate proof-of-concept that it is possible to use EHR data linked with biospecimens to establish a multi-ethnic case-control cohort for genetic research of a complex disease, rheumatoid arthritis (RA). In 1,515 EHR-derived RA cases and 1,480 controls matched for both genetic ancestry and disease-specific autoantibodies (anti-citrullinated protein antibodies [ACPA]), we demonstrate that the odds ratios and aggregate genetic risk score (GRS) of known RA risk alleles measured in individuals of European ancestry within our EHR cohort are nearly identical to those derived from a genome-wide association study (GWAS) of 5,539 autoantibody-positive RA cases and 20,169 controls. We extend this approach to other ethnic groups and identify a large overlap in the GRS among individuals of European, African, East Asian, and Hispanic ancestry. We also demonstrate that the distribution of a GRS based on 28 non-HLA risk alleles in ACPA+ cases partially overlaps with ACPA- subgroup of RA cases. Our study demonstrates that the genetic basis of rheumatoid arthritis risk is similar among cases of diverse ancestry divided into subsets based on ACPA status and emphasizes the utility of linking EHR clinical data with biospecimens for genetic studies. PMID:21211616

Moving into a new era of periodontal genetic studies: relevance of large case-control samples using severe phenotypes for genome-wide association studies.

PubMed

Vaithilingam, R D; Safii, S H; Baharuddin, N A; Ng, C C; Cheong, S C; Bartold, P M; Schaefer, A S; Loos, B G

2014-12-01

Studies to elucidate the role of genetics as a risk factor for periodontal disease have gone through various phases. In the majority of cases, the initial 'hypothesis-dependent' candidate-gene polymorphism studies did not report valid genetic risk loci. Following a large-scale replication study, these initially positive results are believed to be caused by type 1 errors. However, susceptibility genes, such as CDKN2BAS (Cyclin Dependend KiNase 2B AntiSense RNA; alias ANRIL [ANtisense Rna In the Ink locus]), glycosyltransferase 6 domain containing 1 (GLT6D1) and cyclooxygenase 2 (COX2), have been reported as conclusive risk loci of periodontitis. The search for genetic risk factors accelerated with the advent of 'hypothesis-free' genome-wide association studies (GWAS). However, despite many different GWAS being performed for almost all human diseases, only three GWAS on periodontitis have been published - one reported genome-wide association of GLT6D1 with aggressive periodontitis (a severe phenotype of periodontitis), whereas the remaining two, which were performed on patients with chronic periodontitis, were not able to find significant associations. This review discusses the problems faced and the lessons learned from the search for genetic risk variants of periodontitis. Current and future strategies for identifying genetic variance in periodontitis, and the importance of planning a well-designed genetic study with large and sufficiently powered case-control samples of severe phenotypes, are also discussed. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

IT Governance in SMEs: Trust or Control?

NASA Astrophysics Data System (ADS)

Devos, Jan; van Landeghem, Hendrik; Deschoolmeester, Dirk

It is believed by many scholars that a small and medium-sized enterprise (SME) cannot be seen through the lens of a large firm. Theories which explain IT governance in large organizations and methodologies used by practitioners can therefore not be extrapolated to SMEs, which have a completely different economic, cultural and managerial environment. SMEs suffer from resource poverty, have less IS experience and need more external support. SMEs largely contribute to the failure of many IS projects. We define an outsourced information system failure (OISF) as a failure of IT governance in an SME environment and propose a structure for stating propositions derived from both agency theory and theory of trust. The theoretical question addressed in this paper is: how and why do OISFs occur in SMEs? We have chosen a qualitative and positivistic IS case study research strategy based on multiple cases. Eight cases of IS projects were selected. We found that trust is more important than control issues like output-based contracts and structured controls for eliminating opportunistic behaviour in SMEs. We conclude that the world of SMEs is significantly different from that of large companies. This necessitates extra care to be taken on the part of researchers and practitioners when designing artefacts for SMEs.

The National Birth Defects Prevention Study: a review of the methods

PubMed Central

Reefhuis, Jennita; Gilboa, Suzanne M.; Anderka, Marlene; Browne, Marilyn L.; Feldkamp, Marcia L.; Hobbs, Charlotte A.; Jenkins, Mary M.; Langlois, Peter H.; Newsome, Kimberly B.; Olshan, Andrew F.; Romitti, Paul A.; Shapira, Stuart K.; Shaw, Gary M.; Tinker, Sarah C.; Honein, Margaret A.

2015-01-01

Background The National Birth Defects Prevention Study (NBDPS) is a large population-based multi-center case-control study of major birth defects in the United States. Methods Data collection took place from 1998 through 2013 on pregnancies ending between October 1997 and December 2011. Cases could be live born, stillborn or induced terminations, and were identified from birth defects surveillance programs in Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas and Utah. Controls were live born infants without major birth defects identified from the same geographical regions and time periods as cases via either vital records or birth hospitals. Computer-assisted telephone interviews were completed with women between 6 weeks and 24 months after the estimated date of delivery. After completion of interviews, families received buccal cell collection kits for the mother, father and infant (if living). Results There were 47,832 eligible cases and 18,272 eligible controls. Among these, 32,187 (67%) and 11,814 (65%) respectively, provided interview information about their pregnancies. Buccal cell collection kits with a cytobrush for at least one family member were returned by 19,065 case and 6,211 control families (65% and 59% of those who were sent a kit). More than 500 projects have been proposed by the collaborators and over 200 manuscripts published using data from the NBDPS through December 2014. Conclusion The NBDPS has made substantial contributions to the field of birth defects epidemiology through its rigorous design, including case classification, detailed questionnaire and specimen collection, large study population, and collaborative activities across Centers. PMID:26033852

The National Birth Defects Prevention Study: A review of the methods.

PubMed

Reefhuis, Jennita; Gilboa, Suzanne M; Anderka, Marlene; Browne, Marilyn L; Feldkamp, Marcia L; Hobbs, Charlotte A; Jenkins, Mary M; Langlois, Peter H; Newsome, Kimberly B; Olshan, Andrew F; Romitti, Paul A; Shapira, Stuart K; Shaw, Gary M; Tinker, Sarah C; Honein, Margaret A

2015-08-01

The National Birth Defects Prevention Study (NBDPS) is a large population-based multicenter case-control study of major birth defects in the United States. Data collection took place from 1998 through 2013 on pregnancies ending between October 1997 and December 2011. Cases could be live born, stillborn, or induced terminations, and were identified from birth defects surveillance programs in Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas, and Utah. Controls were live born infants without major birth defects identified from the same geographical regions and time periods as cases by means of either vital records or birth hospitals. Computer-assisted telephone interviews were completed with women between 6 weeks and 24 months after the estimated date of delivery. After completion of interviews, families received buccal cell collection kits for the mother, father, and infant (if living). There were 47,832 eligible cases and 18,272 eligible controls. Among these, 32,187 (67%) and 11,814 (65%), respectively, provided interview information about their pregnancies. Buccal cell collection kits with a cytobrush for at least one family member were returned by 19,065 case and 6,211 control families (65% and 59% of those who were sent a kit). More than 500 projects have been proposed by the collaborators and over 200 manuscripts published using data from the NBDPS through December 2014. The NBDPS has made substantial contributions to the field of birth defects epidemiology through its rigorous design, including case classification, detailed questionnaire and specimen collection, large study population, and collaborative activities across Centers. © 2015 Wiley Periodicals, Inc.

Geometric metastability, quivers and holography

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

Aganagic, Mina; Aganagic, Mina; Beem, Christopher

2007-09-06

We use large N duality to study brane/anti-brane configurations on a class of Calabi-Yau manifolds. With only branes present, the Calabi-Yau manifolds in question give rise to N=2 ADE quiver theories deformed by superpotential terms. We show that the large N duality conjecture of hep-th/0610249 reproduces correctly the known qualitative features of the brane/anti-brane physics. In the supersymmetric case, the gauge theories have Seiberg dualities which are represented as flops in the geometry. Moreover, the holographic dual geometry encodes the whole RG flow of the gauge theory. In the non-supersymmetric case, the large N duality predicts that the brane/anti-brane theoriesmore » also enjoy such dualities, and allows one to pick out the good description at a given energy scale.« less

A Computational Approach to Qualitative Analysis in Large Textual Datasets

PubMed Central

Evans, Michael S.

2014-01-01

In this paper I introduce computational techniques to extend qualitative analysis into the study of large textual datasets. I demonstrate these techniques by using probabilistic topic modeling to analyze a broad sample of 14,952 documents published in major American newspapers from 1980 through 2012. I show how computational data mining techniques can identify and evaluate the significance of qualitatively distinct subjects of discussion across a wide range of public discourse. I also show how examining large textual datasets with computational methods can overcome methodological limitations of conventional qualitative methods, such as how to measure the impact of particular cases on broader discourse, how to validate substantive inferences from small samples of textual data, and how to determine if identified cases are part of a consistent temporal pattern. PMID:24498398

Continued investigation of solid propulsion economics. Task 1B: Large solid rocket motor case fabrication methods - Supplement process complexity factor cost technique

NASA Technical Reports Server (NTRS)

Baird, J.

1967-01-01

This supplement to Task lB-Large Solid Rocket Motor Case Fabrication Methods supplies additional supporting cost data and discusses in detail the methodology that was applied to the task. For the case elements studied, the cost was found to be directly proportional to the Process Complexity Factor (PCF). The PCF was obtained for each element by identifying unit processes that are common to the elements and their alternative manufacturing routes, by assigning a weight to each unit process, and by summing the weighted counts. In three instances of actual manufacture, the actual cost per pound equaled the cost estimate based on PCF per pound, but this supplement, recognizes that the methodology is of limited, rather than general, application.

Physician gender and patient centered communication: the moderating effect of psychosocial and biomedical case characteristics.

PubMed

Shin, Dong Wook; Roter, Debra L; Roh, Yong Kyun; Hahm, Sang Keun; Cho, BeLong; Park, Hoon-Ki

2015-01-01

Female physicians have a more patient-centered communication style than their male counterparts; however, few studies have investigated how the biomedical or psychosocial nature of a patient diagnosis might moderate this relationship. Seventy six 3rd year residents (50 male and 26 females) seeking board certification from the Korean Academy of Family Medicine participated in the 2013 Clinical Practice Examination by conducting two simulated patient (SP) interviews, one presenting a largely psychosocial case and the other largely biomedical. The interview recordings were coded with the Roter Interaction Analysis System (RIAS). Female physicians and their SPs engaged in more dialog than male physicians in both cases. Female physicians were more patient-centered than males for the psychosocial case (t = -3.24, P < 0.05), however, their scores did not differ for the biomedical case. In multivariate analysis, a significant interaction between physician gender and case (z = -3.90, P < 0.001) similarly demonstrated greater female patient-centeredness only for the predominantly psychosocial case. Case characteristics moderated the association between physician gender and patient-centeredness. Case characteristics need to be considered in future research on the association of physician gender and the patient-centered communication, as well as in the tailoring of physician communication training. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Potential benefits of underride guards in large truck side crashes.

PubMed

Brumbelow, Matthew L

2012-01-01

To evaluate the maximum potential for side underride guards (SUGs) to reduce passenger vehicle occupant fatalities and injuries in crashes with large trucks in the United States. Examination of the Large Truck Crash Causation Study (LTCCS) identified 206 crash events involving a passenger vehicle impact with the side of a large truck. Each case was evaluated to determine whether the most severe injury sustained by a passenger vehicle occupant was a result of the impact with the side of the truck and whether an SUG could have reduced the injury severity. Data from the 2006-2008 Fatality Analysis Reporting System (FARS) and Trucks Involved in Fatal Accidents (TIFA) survey were used to compare the types of trucks involved in all fatal side impacts with passenger vehicles with the truck types in the LTCCS cases that were studied. FARS and TIFA data also were used to estimate the total annual number of passenger vehicle occupants killed in truck side impacts. In 143 of the 206 cases, the truck side impact produced the most severe injury sustained by a passenger vehicle occupant. In the other cases, no passenger vehicle occupant was injured or the most severe injury was due to an event preceding or following the truck side impact. Forty-nine of these occupants sustained injuries coded as level 3 or higher on the abbreviated injury scale (AIS) or were killed. SUGs could have reduced injury severity in 76 of the 143 cases, including 38 of the 49 cases with an AIS ≥ 3 coded injury or fatality. Semi-trailers were the most common type of impacted truck unit, both overall and when considering only cases where an SUG could have mitigated injury severity. Crashes where the front of the passenger vehicle struck the side of the semi-trailer perpendicularly or obliquely from the oncoming direction were less common overall than side-to-side and oblique/same direction crashes but more often produced an AIS ≥ 3 injury or fatality. The distribution of truck types in the LTCCS sample was similar to that in the FARS and TIFA data. Overall, around 1600 passenger vehicle occupants were killed in 2-vehicle truck side impact crashes during 2006-2008, or 22 percent of all passenger vehicle occupants who died in 2-vehicle crashes with large trucks. Structural incompatibility was a common factor in LTCCS crashes between passenger vehicles and the sides of large trucks. SUGs could have reduced injury risk in around three fourths of the crashes that produced an AIS ≥ 3 injury or fatality. Most of these crashes involved semi-trailers. However, the necessary strength and location of these SUGs present technical challenges that need to be addressed.

A new resource for developing and strengthening large-scale community health worker programs.

PubMed

Perry, Henry; Crigler, Lauren; Lewin, Simon; Glenton, Claire; LeBan, Karen; Hodgins, Steve

2017-01-12

Large-scale community health worker programs are now growing in importance around the world in response to the resurgence of interest and growing evidence of the importance of community-based primary health care for improving the health of populations in resource-constrained, high-mortality settings. These programs, because of their scale and operational challenges, merit special consideration by the global health community, national policy-makers, and program implementers. A new online resource is now available to assist in that effort: Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers ( http://www.mchip.net/CHWReferenceGuide ). This CHW Reference Guide is the product of 27 different collaborators who, collectively, have a formidable breadth and depth of experience and knowledge about CHW programming around the world. It provides a thoughtful discussion about the many operational issues that large-scale CHW programs need to address as they undergo the process of development, expansion or strengthening. Detailed case studies of 12 national CHW programs are included in the Appendix-the most current and complete cases studies as a group that are currently available. Future articles in this journal will highlight many of the themes in the CHW Reference Guide and provide an update of recent advances and experiences. These articles will serve, we hope, to (1) increase awareness about the CHW Reference Guide and its usefulness and (2) connect a broader audience to the critical importance of strengthening large-scale CHW programs for the health benefits that they can bring to underserved populations around the world.

Calcium and vitamin D and risk of colorectal cancer: results from a large population-based case-control study in Newfoundland and Labrador and Ontario.

PubMed

Sun, Zhuoyu; Wang, Peizhong Peter; Roebothan, Barbara; Cotterchio, Michelle; Green, Roger; Buehler, Sharon; Zhao, Jinhui; Squires, Josh; Zhao, Jing; Zhu, Yun; Dicks, Elizabeth; Campbell, Peter T; Mclaughlin, John R; Parfrey, Patrick S

2011-01-01

Previous epidemiological studies have been suggestive but inconclusive in demonstrating inverse associations of calcium, vitamin D, dairy product intakes with risk of colorectal cancer (CRC). We conducted a large population-based comparison of such associations in Newfoundland and Labrador (NL) and Ontario (ON). A case control study design was used. Colorectal cancer cases were new CRC patients aged 20-74 years. Controls were a sex and age-group matched random sample of the population in each province. 1760 cases and 2481 controls from NL and ON were analyzed. Information on dietary intake and lifestyle was collected using self-administered food frequency and personal history questionnaires. Controls reported higher mean daily intakes of total calcium and total vitamin D than cases in both provinces. In ON, significant reduced CRC risk was associated with intakes of total calcium (OR of highest vs. lowest quintiles was 0.57, 95% CI 0.42-0.77, p(trend) = 0.03), total vitamin D (OR = 0.73, 95% CI 0.54-1.00), dietary calcium (OR = 0.76, 95% CI 0.60-0.97), dietary vitamin D (OR = 0.77, 95% CI 0.61-0.99), total dairy products and milk (OR = 0.78, 95% CI 0.60-1.00), calcium-containing supplements use (OR = 0.76). In NL, the inverse associations of calcium, vitamin D with CRC risk were most pronounced among calcium- or vitamin D-containing supplement users (OR = 0.67, 0.68, respectively). Results of this study add to the evidence that total calcium, dietary calcium, total vitamin D, dietary vitamin D, calcium- or vitamin D-containing supplement use may reduce the risk of CRC. The inverse associations of CRC risk with intakes of total dairy products and milk may be largely due to calcium and vitamin D.

Child sexual abuse: an Italian perspective.

PubMed

Cattaneo, Cristina; Ruspa, Marina; Motta, Tiziano; Gentilomo, Andrea; Scagnelli, Chiara

2007-06-01

The problem of child sexual abuse is a growing reality in Italy. The experience of over 200 children seen by the SVS (Soccorso Violenza Sessuale) Centre in Milan (the first Italian large-scale study) may give more information on the European situation. This study is a retrospective study based on information contained in the files of children beneath the age of 14 seen at the SVS Centre between May 1996 and May 2003, who arrived with a suspicion of child sexual abuse. Over 80% of all cases fell within the normal-aspecific category according to Adams' 2001 classification. This first Italian survey, though not based on substantiated cases but only on cases of suspected sexual abuse, supplies a perspective on a large northern European city such as Milan. Data seem similar to those published in other non-European studies, particularly as regards clinical signs observed. Thus, the results of this study, with all their limitations, start to give a perspective on the frequency and type of child population reaching this Italian center, what the scenarios are, what signs the children present and how infrequent it is to find clinical anogenital signs concerning for sexual abuse.

Rare coding variants in the phospholipase D3 gene confer risk for Alzheimer's disease

NASA Astrophysics Data System (ADS)

2014-01-01

Genome-wide association studies (GWAS) have identified several risk variants for late-onset Alzheimer's disease (LOAD). These common variants have replicable but small effects on LOAD risk and generally do not have obvious functional effects. Low-frequency coding variants, not detected by GWAS, are predicted to include functional variants with larger effects on risk. To identify low-frequency coding variants with large effects on LOAD risk, we carried out whole-exome sequencing (WES) in 14 large LOAD families and follow-up analyses of the candidate variants in several large LOAD case-control data sets. A rare variant in PLD3 (phospholipase D3; Val232Met) segregated with disease status in two independent families and doubled risk for Alzheimer's disease in seven independent case-control series with a total of more than 11,000 cases and controls of European descent. Gene-based burden analyses in 4,387 cases and controls of European descent and 302 African American cases and controls, with complete sequence data for PLD3, reveal that several variants in this gene increase risk for Alzheimer's disease in both populations. PLD3 is highly expressed in brain regions that are vulnerable to Alzheimer's disease pathology, including hippocampus and cortex, and is expressed at significantly lower levels in neurons from Alzheimer's disease brains compared to control brains. Overexpression of PLD3 leads to a significant decrease in intracellular amyloid-β precursor protein (APP) and extracellular Aβ42 and Aβ40 (the 42- and 40-residue isoforms of the amyloid-β peptide), and knockdown of PLD3 leads to a significant increase in extracellular Aβ42 and Aβ40. Together, our genetic and functional data indicate that carriers of PLD3 coding variants have a twofold increased risk for LOAD and that PLD3 influences APP processing. This study provides an example of how densely affected families may help to identify rare variants with large effects on risk for disease or other complex traits.

Rare coding variants in the phospholipase D3 gene confer risk for Alzheimer's disease.

PubMed

Cruchaga, Carlos; Karch, Celeste M; Jin, Sheng Chih; Benitez, Bruno A; Cai, Yefei; Guerreiro, Rita; Harari, Oscar; Norton, Joanne; Budde, John; Bertelsen, Sarah; Jeng, Amanda T; Cooper, Breanna; Skorupa, Tara; Carrell, David; Levitch, Denise; Hsu, Simon; Choi, Jiyoon; Ryten, Mina; Sassi, Celeste; Bras, Jose; Gibbs, Raphael J; Hernandez, Dena G; Lupton, Michelle K; Powell, John; Forabosco, Paola; Ridge, Perry G; Corcoran, Christopher D; Tschanz, JoAnn T; Norton, Maria C; Munger, Ronald G; Schmutz, Cameron; Leary, Maegan; Demirci, F Yesim; Bamne, Mikhil N; Wang, Xingbin; Lopez, Oscar L; Ganguli, Mary; Medway, Christopher; Turton, James; Lord, Jenny; Braae, Anne; Barber, Imelda; Brown, Kristelle; Pastor, Pau; Lorenzo-Betancor, Oswaldo; Brkanac, Zoran; Scott, Erick; Topol, Eric; Morgan, Kevin; Rogaeva, Ekaterina; Singleton, Andy; Hardy, John; Kamboh, M Ilyas; George-Hyslop, Peter St; Cairns, Nigel; Morris, John C; Kauwe, John S K; Goate, Alison M

2014-01-23

Genome-wide association studies (GWAS) have identified several risk variants for late-onset Alzheimer's disease (LOAD). These common variants have replicable but small effects on LOAD risk and generally do not have obvious functional effects. Low-frequency coding variants, not detected by GWAS, are predicted to include functional variants with larger effects on risk. To identify low-frequency coding variants with large effects on LOAD risk, we carried out whole-exome sequencing (WES) in 14 large LOAD families and follow-up analyses of the candidate variants in several large LOAD case-control data sets. A rare variant in PLD3 (phospholipase D3; Val232Met) segregated with disease status in two independent families and doubled risk for Alzheimer's disease in seven independent case-control series with a total of more than 11,000 cases and controls of European descent. Gene-based burden analyses in 4,387 cases and controls of European descent and 302 African American cases and controls, with complete sequence data for PLD3, reveal that several variants in this gene increase risk for Alzheimer's disease in both populations. PLD3 is highly expressed in brain regions that are vulnerable to Alzheimer's disease pathology, including hippocampus and cortex, and is expressed at significantly lower levels in neurons from Alzheimer's disease brains compared to control brains. Overexpression of PLD3 leads to a significant decrease in intracellular amyloid-β precursor protein (APP) and extracellular Aβ42 and Aβ40 (the 42- and 40-residue isoforms of the amyloid-β peptide), and knockdown of PLD3 leads to a significant increase in extracellular Aβ42 and Aβ40. Together, our genetic and functional data indicate that carriers of PLD3 coding variants have a twofold increased risk for LOAD and that PLD3 influences APP processing. This study provides an example of how densely affected families may help to identify rare variants with large effects on risk for disease or other complex traits.

Risk factors for mumps at a university with a large mumps outbreak.

PubMed

Huang, Angela S; Cortese, Margaret M; Curns, Aaron T; Bitsko, Rebecca H; Jordan, Hannah T; Soud, Fatma; Villalon-Gomez, Jose; Denning, Patricia M; Ens, Kim A; Hanson, Gail R; Dayan, Gustavo H

2009-01-01

Routine measles-mumps-rubella (MMR) vaccine use has greatly decreased the incidence of mumps in the U.S. However, a resurgence of mumps occurred in 2006. We investigated the large outbreak at a university and assessed risk factors for disease. We described the outbreak and conducted a case-control study. We interviewed case students (identified from student health service and health department records) and control students (selected from a randomly ordered administrative list) and assessed their vaccination status. We compared case students with > or = 2 MMR doses and control students with > or = 2 MMR doses in univariate and multivariate analyses. The mean age of the 174 case students was 20.9 years; 65% were women. Ninety-seven case students and 147 control students were enrolled in the study. Two-dose MMR coverage was 99% among case and control students with complete records. Only 33% of case students reported exposure to someone with mumps. Case students were more likely than control students to be aged 18 to 19 years (vs. aged 22 years, adjusted odds ratio [AOR] = 5.55; 95% confidence interval [CI] 2.09, 14.74), to report exposure to mumps (AOR=2.31, 95% CI 1.13, 4.73), and to have worked/volunteered on campus (AOR=2.91, 95% CI 1.33, 6.33). Also, women in dormitories had increased odds of mumps compared with men in dormitories. High two-dose MMR coverage was not sufficient to prevent the outbreak. Further study is needed to better understand the effects of dormitory residency and gender on mumps transmission. Clinicians should be vigilant for mumps in young adults presenting with parotitis regardless of immunization history.

Using Facebook Groups to Encourage Science Discussions in a Large-Enrollment Biology Class

ERIC Educational Resources Information Center

Pai, Aditi; McGinnis, Gene; Bryant, Dana; Cole, Megan; Kovacs, Jennifer; Stovall, Kyndra; Lee, Mark

2017-01-01

This case study reports the instructional development, impact, and lessons learned regarding the use of Facebook as an educational tool within a large enrollment Biology class at Spelman College (Atlanta, GA). We describe the use of this social networking site to (a) engage students in active scientific discussions, (b) build community within the…

High Schools on a Human Scale: How Small Schools Can Transform American Education.

ERIC Educational Resources Information Center

Toch, Thomas

This book argues that large American high schools have become obsolete and uses case studies of four new or restructured schools to show why smallness and distinctiveness are prerequisites for school reform. The large comprehensive high school developed as an economical means of providing a range of "tracks," from practical subjects for future…

Dispersal of forest insects

NASA Technical Reports Server (NTRS)

Mcmanus, M. L.

1979-01-01

Dispersal flights of selected species of forest insects which are associated with periodic outbreaks of pests that occur over large contiguous forested areas are discussed. Gypsy moths, spruce budworms, and forest tent caterpillars were studied for their massive migrations in forested areas. Results indicate that large dispersals into forested areas are due to the females, except in the case of the gypsy moth.

Long range transport of air pollutants in Europe and acid precipitation in Norway

Treesearch

Jack Nordo

1976-01-01

Observations show that pollutants from large emission sources may cause significant air concentrations 500 to 1000 miles away. Very acid precipitation occurs in such periods. The scavenging is often intensified by the topography. Case studies will be presented, with special emphasis on acid precipitation in Scandinavia. Large scale dispersion models have been developed...

The Impact of Globalisation on SME-Subcontractors' Supply Chain Strategies: A Danish Case Study

ERIC Educational Resources Information Center

Gammelgaard, Britta; Mathiasen, John Bang

2007-01-01

Globalisation and competition have impacted on not only large firms but also Small and Medium sizes Enterprises (SME) and these enterprises often act as subcontractors to larger firms operating in international markets. The impact of globalisation is severe on the SME-subcontractors due to supply chain linkages between large and SMEs through…

Sewage sludge pasteurization by gamma radiation: Financial viability case studies

NASA Astrophysics Data System (ADS)

Swinwood, Jean F.; Kotler, Jiri

This paper examines the financial viability of sewage sludge pasteurization by gamma radiation, by examining the following three North American scenarios: 1) Small volume sewage treatment plant experiencing high sludge disposal costs. 2) Large volume sewage treatment plant experiencing low sludge disposal costs. 3) Large volume sewage treatment plant experiencing high sludge disposal costs.

Evolution of the Instructional Design in a Series of Online Workshops

ERIC Educational Resources Information Center

Patry, Anne; Brown, Elizabeth Campbell; Rousseau, Rémi; Caron, Jeanette

2015-01-01

This case recounts the story of the design and production of a series of online workshops for French-speaking healthcare professionals in Canada. The project spans a couple of years and, despite encountering some challenges, succeeds in large part because of its strong foundation: the instructional design. This case study features an instructional…

Connecting Schools to Neighborhood Revitalization: The Case of the Maple Heights Neighborhood Association

ERIC Educational Resources Information Center

Pesch, Lawrence P.

2014-01-01

This case study focuses on the way a neighborhood association connects schools to broad change in an urban neighborhood of a large Midwestern city. The first section provides a review of the literature on community involvement in school and neighborhood reform. It reviews the historical origins of the current school-community relationship, the…

Dyslexia and Dyscalculia: Two Learning Disorders with Different Cognitive Profiles

ERIC Educational Resources Information Center

Landerl, Karin; Fussenegger, Barbara; Moll, Kristina; Willburger, Edith

2009-01-01

This study tests the hypothesis that dyslexia and dyscalculia are associated with two largely independent cognitive deficits, namely a phonological deficit in the case of dyslexia and a deficit in the number module in the case of dyscalculia. In four groups of 8- to 10-year-olds (42 control, 21 dyslexic, 20 dyscalculic, and 26…

A Chinaman's Chance in Civil Rights Demonstration: A Case Study.

ERIC Educational Resources Information Center

Sim, Yawsoon

A traffic incident in April of 1975 developed into an unprecedented civil rights demonstration by Chinese residents in New York City's Chinatown in May of that year. This paper attempts to trace the factors which led to this large scale demonstration and analyze the development of decision making in this case. The demonstration was the result of…

Rural Education and Out-Migration: The Case of a Coastal Community

ERIC Educational Resources Information Center

Corbett, Michael

2005-01-01

In this article, I report on findings from a case study examining the relationship between formal education and out-migration in a Canadian coastal community from the early 1960s to the late 1990s. Although high rates of village-level out-migration were chronic, most migration trajectories were short-range. Contrary to large-scale quantitative…

The Effect of Self-Explanation of Pathophysiological Mechanisms of Diseases on Medical Students' Diagnostic Performance

ERIC Educational Resources Information Center

Peixoto, José Maria; Mamede, Sílvia; de Faria, Rosa Malena Delbone; Moura, Alexandre Sampaio; Santos, Silvana Maria Elói; Schmidt, Henk G.

2017-01-01

Self-explanation while diagnosing clinical cases fosters medical students' diagnostic performance. In previous studies on self-explanation, students were free to self-explain any aspect of the case, and mostly clinical knowledge was used. Elaboration on knowledge of pathophysiological mechanisms of diseases has been largely unexplored in studies…

Multispecies reaction-diffusion systems

NASA Astrophysics Data System (ADS)

Aghamohammadi, A.; Fatollahi, A. H.; Khorrami, M.; Shariati, A.

2000-10-01

Multispecies reaction-diffusion systems, for which the time evolution equations of correlation functions become a closed set, are considered. A formal solution for the average densities is found. Some special interactions and the exact time dependence of the average densities in these cases are also studied. For the general case, the large-time behavior of the average densities has also been obtained.

False-positive liver scan in a patient with hepatic amyloidosis: case report

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

Suzuki, K.; Okuda, K.; Yoshida, T.

1976-01-01

A case of secondary hepatic amyloidosis exhibiting a large liver and multiple defects on the $sup 198$Au-radiocolloid scintigraph is presented. Biopsy and angiographic studies indicated that the areas of reduced colloid uptake represented heavy amyloid deposition, and the area of the left lobe with contrasting high activity most probably represented compensatory hypertrophy. (auth)

Examining What We Mean by "Collaboration" in Collaborative Action Research: A Cross-Case Analysis

ERIC Educational Resources Information Center

Bruce, Catherine D.; Flynn, Tara; Stagg-Peterson, Shelley

2011-01-01

The purpose of this paper is to report on the nature of collaboration in a multi-year, large-scale collaborative action research project in which a teachers' federation (in Ontario, Canada), university researchers and teachers partnered to investigate teacher-selected topics for inquiry. Over two years, 14 case studies were generated involving six…

Personality as a risk factor in large bowel cancer: data from the Melbourne Colorectal Cancer Study.

PubMed

Kune, G A; Kune, S; Watson, L F; Bahnson, C B

1991-02-01

In a case control study which formed one arm of a large, population-based investigation of colorectal cancer incidence, aetiology and survival. 'The Melbourne Colorectal Cancer Study', among others, 22 psychosocially orientated questions were asked by personal interview of 637 histologically confirmed new cases of colorectal cancer and 714 age/sex frequency matched community controls, from Melbourne (population 2.81 million). Self-reported childhood or adult life 'unhappiness' was statistically significantly more common among the cancer cases, while 'unhappiness with retirement' was similarly distributed among cases and controls. Questions which were formulated to test a particular personality profile as a cancer risk, and which included the elements of denial and repression of anger and of other negative emotions, a commitment to prevailing social norms resulting in the external appearance of a 'nice' or 'good' person, a suppression of reactions which may offend others and the avoidance of conflict, showed a statistically significant discrimination between cases and controls. The risk of colorectal cancer with respect to this model was independent of the previously found risk factors of diet, beer intake, and family history of colorectal cancer, and was also independent of other potential confounding factors of socioeconomic level, marital status, religion and country of birth. Although the results must be interpreted with caution, the data are consistent with the hypothesis that this personality type may play a role in the clinical expression of colorectal cancer and merits further study.

Assessing accuracy of a probabilistic model for very large fire in the Rocky Mountains: A High Park Fire case study

NASA Astrophysics Data System (ADS)

Stavros, E.; Abatzoglou, J. T.; Larkin, N.; McKenzie, D.; Steel, A.

2012-12-01

Across the western United States, the largest wildfires account for a major proportion of the area burned and substantially affect mountain forests and their associated ecosystem services, among which is pristine air quality. These fires commandeer national attention and significant fire suppression resources. Despite efforts to understand the influence of fuel loading, climate, and weather on annual area burned, few studies have focused on understanding what abiotic factors enable and drive the very largest wildfires. We investigated the correlation between both antecedent climate and in-situ biophysical variables and very large (>20,000 ha) fires in the western United States from 1984 to 2009. We built logistic regression models, at the spatial scale of the national Geographic Area Coordination Centers (GACCs), to estimate the probability that a given day is conducive to a very large wildfire. Models vary in accuracy and in which variables are the best predictors. In a case study of the conditions of the High Park Fire, neighboring Fort Collins, Colorado, occurring in early summer 2012, we evaluate the predictive accuracy of the Rocky Mountain model.

Trauma-related pathological dissociation in a case with cerebral palsy.

PubMed

Fung, Hong Wang

2016-01-01

This article provides a case report of a Chinese-Cantonese female with both cerebral palsy and dissociative identity disorder. To my knowledge, this is the first report of a case with dissociative identity disorder from Hong Kong, as well as the first report of a case with both dissociative identity disorder and cerebral palsy in the literature. Large-sample studies should be undertaken in the future to investigate the prevalence of dissociative disorders in a variety of populations in Hong Kong, including individuals with diagnosed brain diseases.

Priority-setting and hospital strategic planning: a qualitative case study.

PubMed

Martin, Douglas; Shulman, Ken; Santiago-Sorrell, Patricia; Singer, Peter

2003-10-01

To describe and evaluate the priority-setting element of a hospital's strategic planning process. Qualitative case study and evaluation against the conditions of 'accountability for reasonableness' of a strategic planning process at a large urban university-affiliated hospital. The hospital's strategic planning process met the conditions of 'accountability for reasonableness' in large part. Specifically: the hospital based its decisions on reasons (both information and criteria) that the participants felt were relevant to the hospital; the number and type of participants were very extensive; the process, decisions and reasons were well communicated throughout the organization, using multiple communication vehicles; and the process included an ethical framework linked to an effort to evaluate and improve the process. However, there were opportunities to improve the process, particularly by giving participants more time to absorb the information relevant to priority-setting decisions, more time to take difficult decisions and some means to appeal or revise decisions. A case study linked to an evaluation using 'accountability for reasonableness' can serve to improve priority-setting in the context of hospital strategic planning.

Fat-forming Solitary Fibrous Tumor of the Kidney - A Case Report and Literature Review.

PubMed

Bacalbasa, Nicolae; Balescu, Irina; Jinescu, George; Marcu, Madalina; Contolenco, Andreea; Pop, Doina; Dobritoiu, Dragos; Ionescu, Olivia; Ionescu, Paris; Stoica, Claudia

2018-01-01

Fat-forming solitary fibrous tumors arising from the kidney are extremely rare, with only few cases reported so far. We report the case of a 49-year-old patient investigated for lumbar pain and diagnosed preoperatively with a large retroperitoneal tumor destroying the right kidney. The patient was submitted to surgery, the tumor being resected en bloc with right nephrectomy. The histopathological studies demonstrated the presence of a hemangiopericytoma-like tumor with adipocytary component; the immunohistochemical studies demonstrated the presence of cluster of differentiation 34 (CD34), while human melanoma black (HMB45) staining was negative. Therefore, the diagnostic of fat-forming solitary fibrous tumor of the kidney was established. The postoperative outcome was uneventful, the patient being discharged on the sixth postoperative day. In conclusion, although fat-forming solitary fibrous tumor of the kidney is a very rare entity, this diagnosis should be taken into consideration whenever a large retroperitoneal mass with high adipose content and renal invasion is described at the preoperative studies. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

High penetrance of pheochromocytoma associated with the novel C634Y/Y791F double germline mutation in the RET protooncogene.

PubMed

Toledo, Rodrigo A; Wagner, Simona M; Coutinho, Flavia L; Lourenço, Delmar M; Azevedo, Juliana A; Longuini, Viviane C; Reis, Mariana T A; Siqueira, Sheila A C; Lucon, Antonio M; Tavares, Marcos R; Fragoso, Maria C B V; Pereira, Adelaide A; Dahia, Patricia L M; Mulligan, Lois M; Toledo, Sergio P A

2010-03-01

Previous studies have shown that double RET mutations may be associated with unusual multiple endocrine neoplasia type 2 (MEN 2) phenotypes. Our objective was to report the clinical features of patients harboring a previously unreported double mutation of the RET gene and to characterize this mutation in vitro. Sixteen patients from four unrelated families and harboring the C634Y/Y791F double RET germline mutation were included in the study. Large pheochromocytomas measuring 6.0-14 cm and weighing up to 640 g were identified in the four index cases. Three of the four tumors were bilateral. High penetrance of pheochromocytoma was also seen in the C634Y/Y791F-mutation-positive relatives (seven of nine, 77.7%). Of these, two cases had bilateral tumors, one presented with multifocal tumors, two cases had large tumors (>5 cm), and one case, which was diagnosed with a large (5.5 x 4.5 x 4.0 cm) pheochromocytoma, reported early onset of symptoms of the disease (14 yr old). The overall penetrance of pheochromocytoma was 84.6% (11 of 13). Development of medullary thyroid carcinoma in our patients seemed similar to that observed in patients with codon 634 mutations. Haplotype analysis demonstrated that the mutation did not arise from a common ancestor. In vitro studies showed the double C634Y/Y791F RET receptor was significantly more phosphorylated than either activated wild-type receptor or single C634Y and Y791F RET mutants. Our data suggest that the natural history of the novel C634Y/Y791F double mutation carries a codon 634-like pattern of medullary thyroid carcinoma development, is associated with increased susceptibility to unusually large bilateral pheochromocytomas, and is likely more biologically active than each individual mutation.

The Use of Central Pathology Review With Digital Slide Scanning in Advanced-stage Mycosis Fungoides and Sézary Syndrome: A Multi-institutional and International Pathology Study.

PubMed

Gru, Alejandro A; Kim, Jinah; Pulitzer, Melissa; Guitart, Joan; Battistella, Maxime; Wood, Gary S; Cerroni, Lorenzo; Kempf, Werner; Willemze, Rein; Pawade, Joya; Querfeld, Christiane; Schaffer, Andras; Pincus, Laura; Tetzlaff, Michael; Duvic, Madeleine; Scarisbrick, Julia; Porcu, Pierluigi; Mangold, Aaron R; DiCaudo, David J; Shinohara, Michi; Hong, Eric K; Horton, Bethany; Kim, Youn H

2018-06-01

This pathology PILOT study aims to define the role and feasibility of centralized pathology review in a cohort of 75 patients from different centers in the United States and Europe using digital slide scanning. The pathologic material from 75 patients who had been diagnosed with mycosis fungoides/Sézary syndrome and were clinically staged as IIb or above was retrieved from 11 participating centers. Each pathology reviewer was provided with the pathologic diagnosis (by the referring pathologist), and the following list of histopathologic criteria (presence or absence) from the initial report: epidermotropism, folliculotropism (FT), large cell transformation, syringotropism, and granulomas. Patients with advance stage were selected for this study as this is a population where there is significant variability in the diagnosis of pathologic prognostic and predictive biomarkers. The slides were digitally scanned with an Aperio scanner and consensus review of cases occurred when major or minor discrepancies between the referral diagnosis and central pathology review occurred. Among the 75 cases, 70 (93.3%) had a final consensus diagnosis between the 3 central review pathologists. The overall agreement between the consensus review and the referring pathologist was 60%. The overall agreement was also higher between the reviewers and consensus review, compared with the referring pathologist and consensus. 65.3% of cases had some type of discrepancy (major or minor) between the outside and consensus review. Major discrepancies were seen in 34 of 73 cases (46.6%; 73 cases indicated a yes or no response). Minor discrepancies were seen in 32 of 75 (42.7%) of cases. Most of the major discrepancies were accounted by a difference in interpretation in the presence or absence of large cell transformation or FT. Most minor discrepancies were explained by a different interpretation in the expression of CD30. We found digital slide scanning to be a beneficial, reliable, and practical for a methodical approach to perform central pathology review in the context of a large clinical prospective study.

MO-FG-BRA-07: Intrafractional Motion Effect Can Be Minimized in Tomotherapy Stereotactic Body Radiotherapy (SBRT)

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

Price, A; Chang, S; Matney, J

2016-06-15

Purpose: Tomotherapy has unique challenges in handling intrafractional motion compared to conventional LINAC. In this study, we analyzed the impact of intrafractional motion on cumulative dosimetry using actual patient motion data and investigated real time jaw/MLC compensation approaches to minimize the motion-induced dose discrepancy in Tomotherapy SBRT treatment. Methods: Intrafractional motion data recorded in two CyberKnife lung treatment cases through fiducial tracking and two LINAC prostate cases through Calypso tracking were used in this study. For each treatment site, one representative case has an average motion (6mm) and one has a large motion (10mm for lung and 15mm for prostate).more » The cases were re-planned on Tomotherapy for SBRT. Each case was planned with 3 different jaw settings: 1cm static, 2.5cm dynamic, and 5cm dynamic. 4D dose accumulation software was developed to compute dose with the recorded motions and theoretically compensate motions by modifying original jaw and MLC to track the trajectory of the tumor. Results: PTV coverage in Tomotherapy SBRT for patients with intrafractional motion depends on motion type, amplitude and plan settings. For the prostate patient with large motion, PTV coverage changed from 97.2% (motion-free) to 47.1% (target motion-included), 96.6% to 58.5% and 96.3% to 97.8% for the 1cm static jaw, 2.5cm dynamic jaw and 5cm dynamic jaw setting, respectively. For the lung patient with large motion, PTV coverage discrepancies showed a similar trend of change. When the jaw and MLC compensation program was engaged, the motion compromised PTV coverage was recovered back to >95% for all cases and plans. All organs at risk (OAR) were spared with < 5% increase from original motion-free plans. Conclusion: Tomotherapy SBRT is less motion-impacted when 5cm dynamic jaw is used. Once the motion pattern is known, the jaw and MLC compensation program can largely minimize the compromised target coverage and OAR sparing.« less

Acquired immunodeficiency syndrome in a patient with no known risk factors: a pathological study.

PubMed

Burt, A D; Scott, G; Shiach, C R; Isles, C G

1984-04-01

We present the pathological findings in a case of acquired immunodeficiency syndrome (AIDS) in a patient with no known risk factor. Postmortem examination showed klebsiella lung abscess, generalised cytomegalovirus infection, cerebral toxoplasmosis, and a primary cerebral lymphoma. An additional feature was the presence of dilatation of the intrahepatic large bile ducts in association with an atypical distribution of cytomegalovirus. The relation between this case and previously reported cases of AIDS is discussed.

Acoustic emission studies of large advanced composite rocket motor cases.

NASA Technical Reports Server (NTRS)

Robinson, E. Y.

1973-01-01

Acoustic emission (AE) patterns were measured during pressure testing of advanced composite rocket motor cases made of boron/epoxy and graphite/epoxy. Both accelerometers and high frequency AE transducers were used, and both frequency spectrum and amplitude distribution were studied. The AE patterns suggest that precursor emission might be used in certain cases to anticipate failure. The technique of hold-cycle AE monitoring was also evaluated and could become a valuable decision gate for test continuation/termination. Data presented show similarity of accelerometers and AE transducer responses despite the different frequency response, and suggest that structural AE phenomena are broadband.

A case report of evaluating a large-scale health systems improvement project in an uncontrolled setting: a quality improvement initiative in KwaZulu-Natal, South Africa.

PubMed

Mate, Kedar S; Ngidi, Wilbroda Hlolisile; Reddy, Jennifer; Mphatswe, Wendy; Rollins, Nigel; Barker, Pierre

2013-11-01

New approaches are needed to evaluate quality improvement (QI) within large-scale public health efforts. This case report details challenges to large-scale QI evaluation, and proposes solutions relying on adaptive study design. We used two sequential evaluative methods to study a QI effort to improve delivery of HIV preventive care in public health facilities in three districts in KwaZulu-Natal, South Africa, over a 3-year period. We initially used a cluster randomised controlled trial (RCT) design. During the RCT study period, tensions arose between intervention implementation and evaluation design due to loss of integrity of the randomisation unit over time, pressure to implement changes across the randomisation unit boundaries, and use of administrative rather than functional structures for the randomisation. In response to this loss of design integrity, we switched to a more flexible intervention design and a mixed-methods quasiexperimental evaluation relying on both a qualitative analysis and an interrupted time series quantitative analysis. Cluster RCT designs may not be optimal for evaluating complex interventions to improve implementation in uncontrolled 'real world' settings. More flexible, context-sensitive evaluation designs offer a better balance of the need to adjust the intervention during the evaluation to meet implementation challenges while providing the data required to evaluate effectiveness. Our case study involved HIV care in a resource-limited setting, but these issues likely apply to complex improvement interventions in other settings.

Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort.

PubMed

Budhathoki, Sanjeev; Hidaka, Akihisa; Yamaji, Taiki; Sawada, Norie; Tanaka-Mizuno, Sachiko; Kuchiba, Aya; Charvat, Hadrien; Goto, Atsushi; Kojima, Satoshi; Sudo, Natsuki; Shimazu, Taichi; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro; Iwasaki, Motoki

2018-03-07

To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study. Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort. Nine public health centre areas across Japan. 3301 incident cases of cancer and 4044 randomly selected subcohort participants. Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference. Incidence of overall or site specific cancer. Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios. In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Rapid Geometry Creation for Computer-Aided Engineering Parametric Analyses: A Case Study Using ComGeom2 for Launch Abort System Design

NASA Technical Reports Server (NTRS)

Hawke, Veronica; Gage, Peter; Manning, Ted

2007-01-01

ComGeom2, a tool developed to generate Common Geometry representation for multidisciplinary analysis, has been used to create a large set of geometries for use in a design study requiring analysis by two computational codes. This paper describes the process used to generate the large number of configurations and suggests ways to further automate the process and make it more efficient for future studies. The design geometry for this study is the launch abort system of the NASA Crew Launch Vehicle.

Power suppression at large scales in string inflation

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

Cicoli, Michele; Downes, Sean; Dutta, Bhaskar, E-mail: mcicoli@ictp.it, E-mail: sddownes@physics.tamu.edu, E-mail: dutta@physics.tamu.edu

2013-12-01

We study a possible origin of the anomalous suppression of the power spectrum at large angular scales in the cosmic microwave background within the framework of explicit string inflationary models where inflation is driven by a closed string modulus parameterizing the size of the extra dimensions. In this class of models the apparent power loss at large scales is caused by the background dynamics which involves a sharp transition from a fast-roll power law phase to a period of Starobinsky-like slow-roll inflation. An interesting feature of this class of string inflationary models is that the number of e-foldings of inflationmore » is inversely proportional to the string coupling to a positive power. Therefore once the string coupling is tuned to small values in order to trust string perturbation theory, enough e-foldings of inflation are automatically obtained without the need of extra tuning. Moreover, in the less tuned cases the sharp transition responsible for the power loss takes place just before the last 50-60 e-foldings of inflation. We illustrate these general claims in the case of Fibre Inflation where we study the strength of this transition in terms of the attractor dynamics, finding that it induces a pivot from a blue to a redshifted power spectrum which can explain the apparent large scale power loss. We compute the effects of this pivot for example cases and demonstrate how magnitude and duration of this effect depend on model parameters.« less

Power suppression at large scales in string inflation

NASA Astrophysics Data System (ADS)

Cicoli, Michele; Downes, Sean; Dutta, Bhaskar

2013-12-01

We study a possible origin of the anomalous suppression of the power spectrum at large angular scales in the cosmic microwave background within the framework of explicit string inflationary models where inflation is driven by a closed string modulus parameterizing the size of the extra dimensions. In this class of models the apparent power loss at large scales is caused by the background dynamics which involves a sharp transition from a fast-roll power law phase to a period of Starobinsky-like slow-roll inflation. An interesting feature of this class of string inflationary models is that the number of e-foldings of inflation is inversely proportional to the string coupling to a positive power. Therefore once the string coupling is tuned to small values in order to trust string perturbation theory, enough e-foldings of inflation are automatically obtained without the need of extra tuning. Moreover, in the less tuned cases the sharp transition responsible for the power loss takes place just before the last 50-60 e-foldings of inflation. We illustrate these general claims in the case of Fibre Inflation where we study the strength of this transition in terms of the attractor dynamics, finding that it induces a pivot from a blue to a redshifted power spectrum which can explain the apparent large scale power loss. We compute the effects of this pivot for example cases and demonstrate how magnitude and duration of this effect depend on model parameters.

An efficient approach for surveillance of childhood diabetes by type derived from electronic health record data: the SEARCH for Diabetes in Youth Study

PubMed Central

Zhong, Victor W; Obeid, Jihad S; Craig, Jean B; Pfaff, Emily R; Thomas, Joan; Jaacks, Lindsay M; Beavers, Daniel P; Carey, Timothy S; Lawrence, Jean M; Dabelea, Dana; Hamman, Richard F; Bowlby, Deborah A; Pihoker, Catherine; Saydah, Sharon H

2016-01-01

Objective To develop an efficient surveillance approach for childhood diabetes by type across 2 large US health care systems, using phenotyping algorithms derived from electronic health record (EHR) data. Materials and Methods Presumptive diabetes cases <20 years of age from 2 large independent health care systems were identified as those having ≥1 of the 5 indicators in the past 3.5 years, including elevated HbA1c, elevated blood glucose, diabetes-related billing codes, patient problem list, and outpatient anti-diabetic medications. EHRs of all the presumptive cases were manually reviewed, and true diabetes status and diabetes type were determined. Algorithms for identifying diabetes cases overall and classifying diabetes type were either prespecified or derived from classification and regression tree analysis. Surveillance approach was developed based on the best algorithms identified. Results We developed a stepwise surveillance approach using billing code–based prespecified algorithms and targeted manual EHR review, which efficiently and accurately ascertained and classified diabetes cases by type, in both health care systems. The sensitivity and positive predictive values in both systems were approximately ≥90% for ascertaining diabetes cases overall and classifying cases with type 1 or type 2 diabetes. About 80% of the cases with “other” type were also correctly classified. This stepwise surveillance approach resulted in a >70% reduction in the number of cases requiring manual validation compared to traditional surveillance methods. Conclusion EHR data may be used to establish an efficient approach for large-scale surveillance for childhood diabetes by type, although some manual effort is still needed. PMID:27107449

A Study on Wheel Sinkage and Rolling Resistance with variations in wheel geometry for Plain and Lugged wheels on TRI -1 Soil Simulant

NASA Astrophysics Data System (ADS)

Gireesh Kumar, Pala; Jayalekshmi, S.

2018-03-01

Wheel-soil Interaction studies are gaining momentum in the field of Terramechanics, but the basis is Terzaghi’s bearing capacity equation. For the current study, on a lunar soil simulant TRI – 1, two plain rigid wheels are considered, i.e., small wheel (dia. of 210 mm and width of 50 mm) and large wheel (dia. 160 mm and width 32 mm). Also, different number of lugs (N = 8, 12, 16) with various lug heights (h = 5 mm, 10 mm, 15 mm) are used. In this paper, the variation of wheel sinkages from experiments obtained for various wheel weights are examined and presented. The parameter, Coefficient of rolling resistance (CRR) is determined for various cases. Hence, rolling resistance was determined and examined from the obtained CRR for all cases. Among the cases examined, the large wheel with weight 67.44 N for plain wheels and weight 67.85 N for lugged wheel (no. of lugs = 16, and height of lugs = 5 mm) registered better mobility. Similarly, for small wheel with weight 52.189 N for plain wheel and weight 52.481 N for lugged wheel (no. of lugs = 16, and height of lugs = 5 mm) registered better mobility, a lesser rolling resistance for these cases.

Distribution of causes of maternal mortality during delivery and post-partum: results of an African multicentre hospital-based study.

PubMed

Thonneau, Patrick F; Matsudai, Tomohiro; Alihonou, Eusèbe; De Souza, Jose; Faye, Ousseynou; Moreau, Jean-Charles; Djanhan, Yao; Welffens-Ekra, Christiane; Goyaux, Nathalie

2004-06-15

To assess the maternal mortality ratio in maternity units of reference hospitals in large west African cities, and to describe the distribution of complications and causes of maternal deaths. Prospective descriptive study in twelve reference maternities located in three African countries (Benin, Ivory Coast, Senegal). Data (clinical findings at hospital entry, medical history, complications, type of surgery, vital status of the women at discharge) were collected from obstetrical and surgical files and from admission hospital registers. All cases of maternal deaths were systematically reviewed by African and European staff. Of a total of 10,515 women, 1495 presented a major obstetric complication with dystocia or inappropriate management of the labour phase as the leading cause. Eighty-five maternal deaths were reported, giving a global hospital-based maternal mortality ratio of 800/100,000. Hypertensive disorders were involved in 25/85 cases (29%) and post-partum haemorrhage in 13/85 cases (15%). Relatively few cases (14) of major sepsis were reported, leading to three maternal deaths. The results of this multicentre study confirm the high rates of maternal mortality in maternity units of reference hospitals in large African cities, and in addition to dystocia the contribution of hypertensive disorders and post-partum haemorrhage to maternal deaths.

North-East monsoon rainfall extremes over the southern peninsular India and their association with El Niño

NASA Astrophysics Data System (ADS)

Singh, Prem; Gnanaseelan, C.; Chowdary, J. S.

2017-12-01

The present study investigates the relationship between extreme north-east (NE) monsoon rainfall (NEMR) over the Indian peninsula region and El Niño forcing. This turns out to be a critical science issue especially after the 2015 Chennai flood. The puzzle being while most El Niños favour good NE monsoon, some don't. In fact some El Niño years witnessed deficit NE monsoon. Therefore two different cases (or classes) of El Niños are considered for analysis based on standardized NEMR index and Niño 3.4 index with case-1 being both Niño-3.4 and NEMR indices greater than +1 and case-2 being Niño-3.4 index greater than +1 and NEMR index less than -1. Composite analysis suggests that SST anomalies in the central and eastern Pacific are strong in both cases but large differences are noted in the spatial distribution of SST over the Indo-western Pacific region. This questions our understanding of NEMR as mirror image of El Niño conditions in the Pacific. It is noted that the favourable excess NEMR in case-1 is due to anomalous moisture transport from Bay of Bengal and equatorial Indian Ocean to southern peninsular India. Strong SST gradient between warm western Indian Ocean (and Bay of Bengal) and cool western Pacific induced strong easterly wind anomalies during NE monsoon season favour moisture transport towards the core NE monsoon region. Further anomalous moisture convergence and convection over the core NE monsoon region supported positive rainfall anomalies in case-1. While in case-2, weak SST gradients over the Indo-western Pacific and absence of local low level convergence over NE monsoon region are mainly responsible for deficit rainfall. The ocean dynamics in the Indian Ocean displayed large differences during case-1 and case-2, suggesting the key role of Rossby wave dynamics in the Indian Ocean on NE monsoon extremes. Apart from the large scale circulation differences the number of cyclonic systems land fall for case-1 and case-2 have also contributed for variations in NE monsoon rainfall extremes during El Niño years. This study indicates that despite having strong warming in the central and eastern Pacific, NE monsoon rainfall variations over the southern peninsular India is mostly determined by SST gradient over the Indo-western Pacific region and number of systems formation in the Bay of Bengal and their land fall. The paper concludes that though the favourable large scale circulation induced by Pacific is important in modulating the NE monsoon rainfall the local air sea interaction plays a key role in modulating or driving rainfall extremes associated with El Niño.

Assessment of TREM2 rs75932628 association with Alzheimer's disease in a population-based sample: the Cache County Study.

PubMed

Gonzalez Murcia, Josue D; Schmutz, Cameron; Munger, Caitlin; Perkes, Ammon; Gustin, Aaron; Peterson, Michael; Ebbert, Mark T W; Norton, Maria C; Tschanz, Joann T; Munger, Ronald G; Corcoran, Christopher D; Kauwe, John S K

2013-12-01

Recent studies have identified the rs75932628 (R47H) variant in TREM2 as an Alzheimer's disease risk factor with estimated odds ratio ranging from 2.9 to 5.1. The Cache County Memory Study is a large, population-based sample designed for the study of memory and aging. We genotyped R47H in 2974 samples (427 cases and 2540 control subjects) from the Cache County study using a custom TaqMan assay. We observed 7 heterozygous cases and 12 heterozygous control subjects with an odds ratio of 3.5 (95% confidence interval, 1.3-8.8; p = 0.0076). The minor allele frequency and population attributable fraction for R47H were 0.0029 and 0.004, respectively. This study replicates the association between R47H and Alzheimer's disease risk in a large, population-based sample, and estimates the population frequency and attributable risk of this rare variant. Copyright © 2013 Elsevier Inc. All rights reserved.

Surgery for juvenile nasopharyngeal angiofibroma with lateral extension to the infratemporal fossa.

PubMed

Yamada, Masato; Tsunoda, Atsunobu; Tokumaru, Takao; Aoyagi, Masaru; Kawano, Yoshihisa; Yano, Tomoyuki; Kishimoto, Seiji

2014-08-01

The study aimed to assess the usefulness of skull base surgery for large juvenile nasopharyngeal angiofibroma (JNA) with lateral extension to the infratemporal fossa. Eleven cases were enrolled for this study, and the mean age was 17.7 years old (range: 8-32). Six out of 11 cases underwent surgery as an initial treatment, and the other five underwent secondary surgery after initial surgery or radiotherapy in other institutions. The range of extension of tumor, feeding arteries, surgical approach, and treatment outcome were estimated. All tumors originated from the sphenopalatine foramen. Based on the imaging study, there was extension to the cavernous sinus observed in eight cases, as well as to the middle cranial fossa (8), orbit (4), and anterior cranial fossa (1). These tumors were diagnosed as Andrews' Stage IVa (3) and IVb (8). However, infiltration into the cavernous sinus was observed in one case only during surgery. Ten tumors were separated carefully from the cavernous sinus or dura and were accurately diagnosed as Stage IIIb. In all cases, the main arterial feeders of the JNAs were branches of the external carotid artery, which were embolized prior to surgery. However, 10 cases were also fed by branches of the internal carotid artery (branches of the ophthalmic artery), in which these arteries could not be embolized. Coronal skin incision (1) and a facial dismasking flap (9) were used, and in one case, wide lateral skin incision with temporary incision of the facial nerve was applied. The orbito-zygomatic approach and its modification was applied to all the cases. Fronto-lateral craniotomy was applied in four cases and lateral craniotomy in seven cases. Total resection was achieved in 10 cases and subtotal resection in one case. No mortality was noted in this series. Temporal trismus was observed in all cases which subsided gradually. Cheek numbness and facial palsy were observed in three and two cases, respectively. Coupled with craniotomy, tumor removal was successfully carried out in 11 patients with JNAs, which showed large lateral extension. Our surgical strategy is a safe and effective approach for the removal of JNAs with infratemporal fossa extension. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Morphofunctional characteristics of immunocompetent cells in dysplasia of the breast].

PubMed

Dikshteĭn, E A; Burlak, Iu P; Shevchenko, N I

1985-01-01

Immunocompetent cells were studied in the stroma and epithelium of 34 cases of mammary gland dysplasia. The following stainings were used for light microscopy: hematoxylin and eosin, methods of Brachet, van Gieson, Romanovsky-Giemsa, hallocyanine alums, Gomori, PAS-reaction as well as the determination of acid and alkaline phosphatases, glucose-6-phosphate and succinate dehydrogenase were used. 14 cases were studied ultrastructurally. Two types of small B lymphocytes and one type of large lymphocytes, stromal macrophages are described. Their morphofunctional characteristics is given and their properties in proliferating and non-proliferating fibroadenomatosis are shown. Interaction of intraepithelial large granular lymphocytes (normal killers) with immature epithelial cells resulting in the death of these epitheliocytes is described. The results obtained are regarded as a morphological manifestation of the immune surveillance.

Transmission characteristics of MERS and SARS in the healthcare setting: a comparative study.

PubMed

Chowell, Gerardo; Abdirizak, Fatima; Lee, Sunmi; Lee, Jonggul; Jung, Eunok; Nishiura, Hiroshi; Viboud, Cécile

2015-09-03

The Middle East respiratory syndrome (MERS) coronavirus has caused recurrent outbreaks in the Arabian Peninsula since 2012. Although MERS has low overall human-to-human transmission potential, there is occasional amplification in the healthcare setting, a pattern reminiscent of the dynamics of the severe acute respiratory syndrome (SARS) outbreaks in 2003. Here we provide a head-to-head comparison of exposure patterns and transmission dynamics of large hospital clusters of MERS and SARS, including the most recent South Korean outbreak of MERS in 2015. To assess the unexpected nature of the recent South Korean nosocomial outbreak of MERS and estimate the probability of future large hospital clusters, we compared exposure and transmission patterns for previously reported hospital clusters of MERS and SARS, based on individual-level data and transmission tree information. We carried out simulations of nosocomial outbreaks of MERS and SARS using branching process models rooted in transmission tree data, and inferred the probability and characteristics of large outbreaks. A significant fraction of MERS cases were linked to the healthcare setting, ranging from 43.5 % for the nosocomial outbreak in Jeddah, Saudi Arabia, in 2014 to 100 % for both the outbreak in Al-Hasa, Saudi Arabia, in 2013 and the outbreak in South Korea in 2015. Both MERS and SARS nosocomial outbreaks are characterized by early nosocomial super-spreading events, with the reproduction number dropping below 1 within three to five disease generations. There was a systematic difference in the exposure patterns of MERS and SARS: a majority of MERS cases occurred among patients who sought care in the same facilities as the index case, whereas there was a greater concentration of SARS cases among healthcare workers throughout the outbreak. Exposure patterns differed slightly by disease generation, however, especially for SARS. Moreover, the distributions of secondary cases per single primary case varied highly across individual hospital outbreaks (Kruskal-Wallis test; P < 0.0001), with significantly higher transmission heterogeneity in the distribution of secondary cases for MERS than SARS. Simulations indicate a 2-fold higher probability of occurrence of large outbreaks (>100 cases) for SARS than MERS (2 % versus 1 %); however, owing to higher transmission heterogeneity, the largest outbreaks of MERS are characterized by sharper incidence peaks. The probability of occurrence of MERS outbreaks larger than the South Korean cluster (n = 186) is of the order of 1 %. Our study suggests that the South Korean outbreak followed a similar progression to previously described hospital clusters involving coronaviruses, with early super-spreading events generating a disproportionately large number of secondary infections, and the transmission potential diminishing greatly in subsequent generations. Differences in relative exposure patterns and transmission heterogeneity of MERS and SARS could point to changes in hospital practices since 2003 or differences in transmission mechanisms of these coronaviruses.

Identification of Cytological Features Distinguishing Mucosa-Associated Lymphoid Tissue Lymphoma from Reactive Lymphoid Proliferation Using Thyroid Liquid-Based Cytology

PubMed Central

Suzuki, Ayana; Hirokawa, Mitsuyoshi; Ito, Aki; Takada, Nami; Higuchi, Miyoko; Hayashi, Toshitetsu; Kuma, Seiji; Miyauchi, Akira

2018-01-01

Objective To identify cytological differences between mucosa-associated lymphoid tissue lymphoma (MALT-L) and nonneoplastic lymphocytes using thyroid liquid-based cytology (LBC). Study Design We observed LBC and conventional specimens from 35 MALT-L cases, 3 diffuse large B-cell cell lymphoma (DLBCL) cases, and 44 prominent nonneoplastic lymphocytic infiltration cases. Results In MALT-L cases, the incidence of lymphoglandular bodies in the LBC specimens was lower than that in the conventional specimens (p < 0.001). Moreover, the nuclear sizes in LBC specimens were larger than those in conventional specimens. In 62.9% of the MALT-L and all DLBCL specimens, large nuclei were present in > 10% of the lymphoid cells in LBC specimens. Two cases with prominent nonneoplastic lymphocytic infiltration also exhibited these findings. In LBC specimens, swollen naked nuclei with less punctate chromatin patterns and thin nuclear margins were observed in 92.1% of lymphoma and 20.5% of prominent nonneoplastic lymphocytic infiltration. Elongated nuclei were significantly more apparent in thyroid lymphoma than in prominent nonneoplastic lymphocytic infiltration (p < 0.001), with a significantly higher incidence in LBC specimens than in conventional specimens (p < 0.001). Conclusions Lymphoglandular bodies are not reliable markers for lymphoma diagnosis using LBC specimens. Large, swollen naked, and elongated nuclei are useful in distinguishing thyroid lymphoma from nonneoplastic lymphocytes in LBC specimens. PMID:29597203

Surgical resection of large encephalocele: a report of two cases and consideration of resectability based on developmental morphology.

PubMed

Ohba, Hideo; Yamaguchi, Satoshi; Sadatomo, Takashi; Takeda, Masaaki; Kolakshyapati, Manish; Kurisu, Kaoru

2017-03-01

The first-line treatment of encephalocele is reduction of herniated structures. Large irreducible encephalocele entails resection of the lesion. In such case, it is essential to ascertain preoperatively if the herniated structure encloses critical venous drainage. Two cases of encephalocele presenting with large occipital mass underwent magnetic resonance (MR) imaging. In first case, the skin mass enclosed the broad space containing cerebrospinal fluid and a part of occipital lobe and cerebellum. The second case had occipital mass harboring a large portion of cerebrum enclosing dilated ventricular space. Both cases had common venous anomalies such as split superior sagittal sinus and high-positioned torcular herophili. They underwent resection of encephalocele without subsequent venous congestion. We could explain the pattern of venous anomalies in encephalocele based on normal developmental theory. Developmental theory connotes that major dural sinuses cannot herniate into the sac of encephalocele. Irrespective to its size, encephalocele can be resected safely at the neck without subsequent venous congestion.

Expert Systems In Medical Studies - A New Twist

NASA Astrophysics Data System (ADS)

Slagle, James R.; Long, John M.; Wick, Michael R.; Matts, John P.; Leon, Arthur S.

1986-03-01

The use of experts to evaluate large amounts of trial data results in increasingly expensive and time consuming research. We are investigating the role expert systems can play in reducing the time and expense of research projects. Current methods in large clinical studies for evaluating data are often crude and superficial. We have developed, for a large clinical trial, an expert system for analysis of treadmill exercise ECG test results. In the cases we are studying, a patient is given a treadmill exercise ECG test once a year for five years. Pairs of these exercise tests are then evaluated by cardiologists to determine the condition of the patient's heart. The results of our system show great promise for the use of expert systems in reducing the time and expense of large clinical trials.

Investigation of occupational and environmental causes of respiratory cancers (ICARE): a multicenter, population-based case-control study in France.

PubMed

Luce, Danièle; Stücker, Isabelle

2011-12-14

Occupational causes of respiratory cancers need to be further investigated: the role of occupational exposures in the aetiology of head and neck cancers remains largely unknown, and there are still substantial uncertainties for a number of suspected lung carcinogens. The main objective of the study is to examine occupational risk factors for lung and head and neck cancers. ICARE is a multi-center, population-based case-control study, which included a group of 2926 lung cancer cases, a group of 2415 head and neck cancer cases, and a common control group of 3555 subjects. Incident cases were identified in collaboration with cancer registries, in 10 geographical areas. The control group was a random sample of the population of these areas, with a distribution by sex and age comparable to that of the cases, and a distribution by socioeconomic status comparable to that of the population. Subjects were interviewed face to face, using a standardized questionnaire collecting particularly information on tobacco and alcohol consumption, residential history and a detailed description of occupational history. Biological samples were also collected from study subjects. The main occupational exposures of interest are asbestos, man-made mineral fibers, formaldehyde, polycyclic aromatic hydrocarbons, chromium and nickel compounds, arsenic, wood dust, textile dust, solvents, strong acids, cutting fluids, silica, diesel fumes, welding fumes. The complete list of exposures of interest includes more than 60 substances. Occupational exposure assessment will use several complementary methods: case-by-case evaluation of exposure by experts; development and use of algorithms to assess exposure from the questionnaires; application of job-exposure matrices. The large number of subjects should allow to uncover exposures associated with moderate increase in risks, and to evaluate risks associated with infrequent or widely dispersed exposures. It will be possible to study joint effects of exposure to different occupational risk factors, to examine the interactions between occupational exposures, tobacco smoking, alcohol drinking, and genetic risk factors, and to estimate the proportion of respiratory cancers attributable to occupational exposures in France. In addition, information on many non-occupational risk factors is available, and the study will provide an excellent framework for numerous studies in various fields.

Using unmanned aerial vehicle (UAV) surveys and image analysis in the study of large surface-associated marine species: a case study on reef sharks Carcharhinus melanopterus shoaling behaviour.

PubMed

Rieucau, G; Kiszka, J J; Castillo, J C; Mourier, J; Boswell, K M; Heithaus, M R

2018-06-01

A novel image analysis-based technique applied to unmanned aerial vehicle (UAV) survey data is described to detect and locate individual free-ranging sharks within aggregations. The method allows rapid collection of data and quantification of fine-scale swimming and collective patterns of sharks. We demonstrate the usefulness of this technique in a small-scale case study exploring the shoaling tendencies of blacktip reef sharks Carcharhinus melanopterus in a large lagoon within Moorea, French Polynesia. Using our approach, we found that C. melanopterus displayed increased alignment with shoal companions when distributed over a sandflat where they are regularly fed for ecotourism purposes as compared with when they shoaled in a deeper adjacent channel. Our case study highlights the potential of a relatively low-cost method that combines UAV survey data and image analysis to detect differences in shoaling patterns of free-ranging sharks in shallow habitats. This approach offers an alternative to current techniques commonly used in controlled settings that require time-consuming post-processing effort. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A large community outbreak of blastomycosis in Wisconsin with geographic and ethnic clustering.

PubMed

Roy, Monika; Benedict, Kaitlin; Deak, Eszter; Kirby, Miles A; McNiel, Jena T; Sickler, Carrie J; Eckardt, Eileen; Marx, Ruth K; Heffernan, Richard T; Meece, Jennifer K; Klein, Bruce S; Archer, John R; Theurer, Joan; Davis, Jeffrey P; Park, Benjamin J

2013-09-01

Blastomycosis is a potentially life-threatening infection caused by the soil-based dimorphic fungus Blastomyces dermatitidis, which is endemic throughout much of the Midwestern United States. We investigated an increase in reported cases of blastomycosis that occurred during 2009-2010 in Marathon County, Wisconsin. Case detection was conducted using the Wisconsin Electronic Disease Surveillance System (WEDSS). WEDSS data were used to compare demographic, clinical, and exposure characteristics between outbreak-related and historical case patients, and to calculate blastomycosis incidence rates. Because initial mapping of outbreak case patients' homes and recreational sites demonstrated unusual neighborhood and household case clustering, we conducted a 1:3 matched case-control study to identify factors associated with being in a geographic cluster. Among the 55 patients with outbreak-related cases, 33 (70%) were hospitalized, 2 (5%) died, 30 (55%) had cluster-related cases, and 20 (45%) were Hmong. The overall incidence increased significantly since 2005 (average 11% increase per year, P < .001), and incidence during 2005-2010 was significantly higher among Asians than non-Asians (2010 incidence: 168 vs 13 per 100 000 population). Thirty of the outbreak cases grouped into 5 residential clusters. Outdoor activities were not risk factors for blastomycosis among cluster case patients or when comparing outbreak cases to historical cases. This outbreak of blastomycosis, the largest ever reported, was characterized by unique household and neighborhood clustering likely related to multifocal environmental sources. The reasons for the large number of Hmong affected are unclear, but may involve genetic predisposition.

Ensuring the availability of the nursing workforce through philanthropy: a case study.

PubMed

Bolton, Linda Burnes; Swanson, Jane; Zamora, Elizabeth

2014-01-01

The Institute of Medicine report on the Future of Nursing identified the need to increase the preparation of nurses, create pathways for nurses to lead as partners to improve health by promoting interprofessional education and practice, and to remove barriers to full practice of nurses across the continuum. This case study shares the experience of large systems and their creativity using philanthropy in their quest to ensure the availability of a qualified nursing workforce.

Further studies of stall flutter and nonlinear divergence of two-dimensional wings

NASA Technical Reports Server (NTRS)

Dugundji, J.; Chopra, I.

1975-01-01

An experimental investigation is made of the purely torsional stall flutter of a two-dimensional wing pivoted about the midchord, and also of the bending-torsion stall flutter of a two-dimensional wing pivoted about the quarterchord. For the purely torsional flutter case, large amplitude limit cycles ranging from + or - 11 to + or - 160 degrees were observed. Nondimensional harmonic coefficients were extracted from the free transient vibration tests for amplitudes up to 80 degrees. Reasonable nondimensional correlation was obtained for several wing configurations. For the bending-torsion flutter case, large amplitude coupled limit cycles were observed with torsional amplitudes as large as + or - 40 degrees. The torsion amplitudes first increased, then decreased with increasing velocity. Additionally, a small amplitude, predominantly torsional flutter was observed when the static equilibrium angle was near the stall angle.

Evaluation of paradoxical TB–associated IRIS with the use of standardized case definitions for resource limited settings

PubMed Central

Eshun-Wilson, Ingrid; Havers, Fiona; Nachega, Jean B; Prozesky, Hans W; Taljaard, Jantjie J; Zeier, Michele D; Cotton, Mark; Simon, Gary; Soentjens, Patrick

2011-01-01

Objective Standardized case definitions have recently been proposed by the International Network for the Study of HIV-associated IRIS (INSHI) for use in resource-limited settings. We evaluated paradoxical TB-associated IRIS in a large cohort from a TB endemic setting with the use of these case definitions. Design A retrospective cohort analysis. Methods We reviewed records from 1250 South African patients who initiated anti-retroviral therapy (ART) over a five-year period. Results 333 (27%) of the patients in the cohort had prevalent TB at the initiation of ART. Of 54 possible paradoxical TB-associated IRIS cases, 35 fulfilled the INSHI case definitions (11% of TB cases). Conclusions INSHI standardised case definitions were used successfully in identifying paradoxical TB-associated IRIS in this cohort and resulted in a similar proportion of TB IRIS cases (11%) as that reported in previous studies from resource-limited settings (8-13%). This case definition should be evaluated prospectively. PMID:20160249

Schramm-Loewner (SLE) analysis of quasi two-dimensional turbulent flows

NASA Astrophysics Data System (ADS)

Thalabard, Simon

2012-02-01

Quasi two-dimensional turbulence can be observed in several cases: for example, in the laboratory using liquid soap films, or as the result of a strong imposed rotation as obtained in three-dimensional large direct numerical simulations. We study and contrast SLE properties of such flows, in the former case in the inverse cascade of energy to large scale, and in the latter in the direct cascade of energy to small scales in the presence of a fully-helical forcing. We thus examine the geometric properties of these quasi 2D regimes in the context of stochastic geometry, as was done for the 2D inverse cascade by Bernard et al. (2006). We show that in both cases the data is compatible with self-similarity and with SLE behaviors, whose different diffusivities can be heuristically determined.

Motivators that Do Not Motivate: The Case of Chinese EFL Learners and the Influence of Culture on Motivation

ERIC Educational Resources Information Center

Chen, Judy F.; Warden, Clyde A.; Chang, Huo-Tsan

2005-01-01

Language learning motivation plays an important role in both research and teaching, yet language learners are still largely understood in terms of North American and European cultural values. This research explored language learning motivation constructs in a Chinese cultural setting, where large numbers of students are required to study English.…

Co-adapting societal and ecological interactions following large disturbances in urban park woodlands

Treesearch

Margaret Carreiro; Wayne Zipperer

2011-01-01

The responses of urban park woodlands to large disturbances provide the opportunity to identify and examine linkages in social-ecological systems in urban landscapes.We propose that the Panarchy model consisting of hierarchically nested adaptive cycles provides a useful framework to evaluate those linkages.We use two case studies as examples – Cherokee Park in...

"Playing It Like a Professional": Approaches to Ensemble Direction in Tertiary Institutions

ERIC Educational Resources Information Center

Harrison, Scott; O'Bryan, Jessica; Lebler, Don

2013-01-01

This article reports on a case study of three directors of large ensembles within a large conservatoire and the ways in which they attempted to scaffold their students into professional music careers. The core aim in this article is to respond to the question "What is the role and function of the ensemble experience on the training of the…

Empty Promises: A Case Study of Restructuring and the Exclusion of English Language Learners in Two Brooklyn High Schools

ERIC Educational Resources Information Center

Asian American Legal Defense and Education Fund, 2009

2009-01-01

Since 2002, the New York City Department of Education (DOE) has attempted to reverse the city's severe drop-out crisis through a large scale restructuring of high schools, focused mainly on closing large, comprehensive high schools and replacing them with small high schools that offer a more personalized learning environment. Unfortunately, this…

A Judicial Presentation of Evidence of a Student Culture of "Dealing"

ERIC Educational Resources Information Center

Wood, Nathan B.; Lawrenz, Frances; Haroldson, Rachelle

2009-01-01

This study uses a new-to-educational-research methodology, based on the legal process, to build a case that U.S. students have been largely ignored in discussion and planning for their own, presumed futures. A variety of evidence, from two large and distinct data bases, is drawn together to show: (1) students perceive their classrooms in ways…

Perspectives on the age and distribution of large wood in riparian carbon pools

Treesearch

Richard P. Guyette; William G. Cole; Daniel C. Dey; Rose-Marie Muzkia

2002-01-01

Most knowledge of carbon budgets is derived from the productivity and sequestration of carbon in terrestrial and marine ecosystems. Less is known of carbon stored in riparian areas associated with lakes and rivers. Case studies of the age distribution of carbon in aquatic large wood (C1w) from two different landscapes with different drainage...

Use of Item Models in a Large-Scale Admissions Test: A Case Study

ERIC Educational Resources Information Center

Sinharay, Sandip; Johnson, Matthew S.

2008-01-01

"Item models" (LaDuca, Staples, Templeton, & Holzman, 1986) are classes from which it is possible to generate items that are equivalent/isomorphic to other items from the same model (e.g., Bejar, 1996, 2002). They have the potential to produce large numbers of high-quality items at reduced cost. This article introduces data from an…

Excellence in Workplace Literacy, Large Business Winner, 2001: The North West Company. Case Study.

ERIC Educational Resources Information Center

Campbell, Alison

The North West Company (NWC), which is the leading retailer of food and everyday products and services to remote communities across northern Canada and Alaska, was the large business winner of the Excellence in Workplace Literacy award in 2001. NWC's workplace literacy program was selected for an award because of the improvements it brought, not…

A Case Study of the Uses Supported by Higher Education Computer Networks and an Analysis of Application Traffic

ERIC Educational Resources Information Center

Pisano, Mark

2017-01-01

Universities and Higher Education Institutions spend large sums of money to maintain and build network infrastructures. Current research and discussions in this area revolve around providing large amounts of bandwidth to students who live in a residence hall. However, there is a lack of information showing what is being used to support research…

Systems Thinking Tools for Improving Evidence-Based Practice: A Cross-Case Analysis of Two High School Leadership Teams

ERIC Educational Resources Information Center

Kensler, Lisa A. W.; Reames, Ellen; Murray, John; Patrick, Lynne

2012-01-01

Teachers and administrators have access to large volumes of data but research suggests that they lack the skills to use data effectively for continuous school improvement. This study involved a cross-case analysis of two high school leadership teams' early stages of evidence-based practice development; differing forms of external support were…

The Psychosocial Factors Contributing to the Underrepresentation of African American Males in Advanced High School Mathematics Courses

ERIC Educational Resources Information Center

Rowlett, Joel Everett

2013-01-01

This case study examined the beliefs of African American males on the psychosocial and pedagogical factors contributing to the underrepresentation of African American males in advanced high school math courses. Six 11th grade African American male juniors from a large, comprehensive, Southeastern high school served as individual cases. Within- and…

Novel deletions involving the USH2A gene in patients with Usher syndrome and retinitis pigmentosa.

PubMed

García-García, Gema; Aller, Elena; Jaijo, Teresa; Aparisi, Maria J; Larrieu, Lise; Faugère, Valérie; Blanco-Kelly, Fiona; Ayuso, Carmen; Roux, Anne-Francoise; Millán, José M

2014-01-01

The aim of the present work was to identify and characterize large rearrangements involving the USH2A gene in patients with Usher syndrome and nonsyndromic retinitis pigmentosa. The multiplex ligation-dependent probe amplification (MLPA) technique combined with a customized array-based comparative genomic hybridization (aCGH) analysis was applied to 40 unrelated patients previously screened for point mutations in the USH2A gene in which none or only one pathologic mutation was identified. We detected six large deletions involving USH2A in six out of the 40 cases studied. Three of the patients were homozygous for the deletion, and the remaining three were compound heterozygous with a previously identified USH2A point mutation. In five of these cases, the patients displayed Usher type 2, and the remaining case displayed nonsyndromic retinitis pigmentosa. The exact breakpoint junctions of the deletions found in USH2A in four of these cases were characterized. Our study highlights the need to develop improved efficient strategies of mutation screening based upon next generation sequencing (NGS) that reduce cost, time, and complexity and allow simultaneous identification of all types of disease-causing mutations in diagnostic procedures.

Prenatal Therapy of Large Placental Chorioangiomas: Case Report and Review of the Literature

PubMed Central

Hosseinzadeh, Pardis; Shamshirsaz, Alireza A.; Javadian, Pouya; Espinoza, Jimmy; Gandhi, Manisha; Ruano, Rodrigo; Cass, Darrell L.; Olutoye, Oluyinka A.; Belfort, Michael A.

2015-01-01

Objective To review techniques and outcomes of different prenatal treatments for large placental chorioangiomas. Study Design Presentation of a case of laparoscopic-assisted laser coagulation and a systematic review of the literature for articles related to intervention for placental chorioangioma. Results A total of 37 cases of definitive (n = 23) and supportive therapy (n = 14) were evaluated, including one case treated in our center. Approximately 35% of the patients had a spontaneous preterm delivery in definitive treatment group versus 36% in the supportive group. The infant survival rates were 65 and 71% in the two groups, respectively. We further compared the two types of laser ablation (fetoscopic [n = 10] and interstitial [n = 4]). Approximately 30% of the patients in the fetoscopic and 25% in interstitial group, had a spontaneous preterm delivery. Survival rates were 60 and 100% in fetoscopic and interstitial groups, respectively. Conclusion Laser ablation and embolization of chorioangiomas via minimally invasive approach may prevent or reverse fetal hydrops due to high cardiac states. However, further studies are needed to refine the appropriate selection criteria that will justify the risk of this invasive in utero therapy for chorioangiomas. PMID:26495184

Salmonella enterica serovar Enteritidis phage type 4 outbreak associated with eggs in a large prison, London 2009: an investigation using cohort and case/non-case study methodology.

PubMed

Davies, A R; Ruggles, R; Young, Y; Clark, H; Reddell, P; Verlander, N Q; Arnold, A; Maguire, H

2013-05-01

In September 2009, an outbreak of Salmonella enterica serovar Enteritidis affected 327 of 1419 inmates at a London prison. We applied a cohort design using aggregated data from the kitchen about portions of food distributed, aligned this with individual food histories from 124 cases (18 confirmed, 106 probable) and deduced the exposures of those remaining well. Results showed that prisoners eating egg cress rolls were 26 times more likely to be ill [risk ratio 25.7, 95% confidence interval (CI) 15.5-42.8, P<0.001]. In a case/non-case multivariable analysis the adjusted odds ratio for egg cress rolls was 41.1 (95% CI 10.3-249.7, P<0.001). The epidemiological investigation was strengthened by environmental and microbiological investigations. This paper outlines an approach to investigations in large complex settings where aggregate data for exposures may be available, and led to the development of guidelines for the management of future gastrointestinal outbreaks in prison settings.

An entropy-based statistic for genomewide association studies.

PubMed

Zhao, Jinying; Boerwinkle, Eric; Xiong, Momiao

2005-07-01

Efficient genotyping methods and the availability of a large collection of single-nucleotide polymorphisms provide valuable tools for genetic studies of human disease. The standard chi2 statistic for case-control studies, which uses a linear function of allele frequencies, has limited power when the number of marker loci is large. We introduce a novel test statistic for genetic association studies that uses Shannon entropy and a nonlinear function of allele frequencies to amplify the differences in allele and haplotype frequencies to maintain statistical power with large numbers of marker loci. We investigate the relationship between the entropy-based test statistic and the standard chi2 statistic and show that, in most cases, the power of the entropy-based statistic is greater than that of the standard chi2 statistic. The distribution of the entropy-based statistic and the type I error rates are validated using simulation studies. Finally, we apply the new entropy-based test statistic to two real data sets, one for the COMT gene and schizophrenia and one for the MMP-2 gene and esophageal carcinoma, to evaluate the performance of the new method for genetic association studies. The results show that the entropy-based statistic obtained smaller P values than did the standard chi2 statistic.

Percutaneous fetoscopic closure of large open spina bifida using a bilaminar skin substitute.

PubMed

Lapa Pedreira, Denise A; Acacio, Gregório L; Gonçalves, Rodrigo T; Sá, Renato Augusto M; Brandt, Reynaldo A; Chmait, Ramen; Kontopoulos, Eftichia; Quintero, Ruben A

2018-01-04

We have previously described our percutaneous fetoscopic technique for the treatment of open spina bifida (OSB). However, approximately 20-30% of OSB defects are too large to allow primary skin closure. We hereby describe a modification of our standard technique using a bilaminar skin substitute to allow closure of such large spinal defects. The aim of this study was to report our clinical experience with the use of a bilaminar skin substitute and a percutaneous fetoscopic technique for the prenatal closure of large spina bifida defects. Surgeries were performed between 24.0 and 28.9 gestational weeks under general anesthesia, using an entirely percutaneous fetoscopic approach with partial CO2 insufflation of the uterine cavity, as previously described. If there was enough skin to be sutured in the midline, only a biocellulose patch was placed over the placode. In cases where skin approximation was not possible, a bilaminar skin substitute (two layers: one silicone and one dermal matrix) was placed over the biocellulose. The surgical site was assessed at birth, and long-term follow-up was performed. Forty-seven consecutive fetuses underwent percutaneous fetoscopic OSB repair. Premature preterm rupture of membranes (PPROM) occurred in 38 (84%), and the mean gestational age at delivery was 32,8 + 2.5 weeks. A bilaminar skin substitute was required in 13 (29%), of which 5 was associated with myeloschisis. In all cases the skin substitute was found at the surgical site, at birth. In 3 (15%) of these cases, postnatal additional repair was needed. In the other 10 cases, the silicone layer detached spontaneously from the dermal matrix (average 25 days after birth), and the lesion healed by secondary-intention. Operating time was significantly longer in cases requiring the bilaminar skin substitute (additional 42 minutes). The subgroup with bilaminar skin substitute had similar PPROM rate and delivery gestational age compared to the one patch group. Complete reversal of hindbrain herniation occurred in 68% of the one patch and in 33% (p < 0.05) of the two patches group. In 4 cases there was no reversal and 3 of them were myeloschisis cases. Large OSB defects may be successfully treated in utero using a bilaminar skin substitute over a biocellulose patch through an entirely percutaneous approach. Although the operating time is longer, surgical outcomes are similar to cases closed primarily. Myeloschisis seems to have a worse prognosis then myelomeningocele cases. PPROM and preterm birth continue to be a challenge. Further experience is needed to assess the risks and benefits of this technique for management of large OSB defects. This article is protected by copyright. All rights reserved.

[External biliary fistulas selectively managed by endoscopic retrograde cholangiography with sphincterotomy and/or stent placement].

PubMed

Săftoiu, A; Gheonea, D I; Surlin, V; Ciurea, M E; Georgescu, A; Andrei, E; Blendea, A; Georgescu, C C; Georgescu, I; Ciurea, T

2006-01-01

External bile duct fistulas are inherent postoperative complications that usually appear after biliary tract surgery, traumatic bile duct injuries and liver surgery for hepatic hydatid disease or liver transplant. The management is highly individualized, while the success and long-term results of endoscopic and surgical techniques are conflicting. The study included 32 cases with external bile duct fistulas managed by endoscopic retrograde cholangiography (ERC) with sphincterotomy and/or stent placement, including "rendez-vous" procedures in 2 cases. The causes of the external fistula were represented by cholecystectomy with/without retained common bile duct stones or strictures (22 cases), cholecystectomy and drainage of a subphrenic abscess caused by severe acute pancreatitis (1 case) and surgical interventions for hepatic hydatid disease (9 cases). Due to the prospective protocol of the study we were able to apply an individualized endoscopic treatment: sphincterotomy with proper relief of the bile duct obstruction (stone extraction) or sphincterotomy with large-size (10 Fr) stent placement for large-sized bile duct defects. The results consisted in closure of the fistula in 3.5 +/- 1.7 days for the subgroup of patients with sphincterotomy alone. Among the patients with stent insertion, fistulas healed slower in 14 +/- 3.5 days. There were no complications after endoscopic treatment; however the stent could not be passed in one patient that required subsequent surgery. In conclusion, endoscopic intervention is the treatment of choice for small external biliary fistulas complicating biliary tract surgery or liver surgery for hepatic hydatid disease. When the fistula is large, the placement of a 10 Fr endoprosthesis becomes necessary, while failure of endoscopic treatment leads to surgery with hepatico-jejunal anastomosis.

Molecular Study of Three Lebanese and Syrian Patients with Waardenburg Syndrome and Report of Novel Mutations in the EDNRB and MITF Genes.

PubMed

Haddad, N M; Ente, D; Chouery, E; Jalkh, N; Mehawej, C; Khoueir, Z; Pingault, V; Mégarbané, A

2011-01-01

Waardenburg syndrome (WS) is a genetic disorder characterized primarily by depigmentation of the skin and hair, heterochromia of the irides, sensorineural deafness, and sometimes by dystopia canthorum, and Hirschsprung disease. WS presents a large clinical and genetic heterogeneity. Four different types have been individualized and linked to 5 different genes. We report 2 cases of WS type II and 1 case of WS type IV from Lebanon and Syria. The genetic studies revealed 2 novel mutations in the MITF gene of the WS type II cases and 1 novel homozygous mutation in the EDNRB gene of the WS type IV case. This is the first molecular study of patients from the Arab world. Additional cases will enable a more detailed description of the clinical spectrum of Waardenburg syndrome in this region.

Molecular Study of Three Lebanese and Syrian Patients with Waardenburg Syndrome and Report of Novel Mutations in the EDNRB and MITF Genes

PubMed Central

Haddad, N.M.; Ente, D.; Chouery, E.; Jalkh, N.; Mehawej, C.; Khoueir, Z.; Pingault, V.; Mégarbané, A.

2011-01-01

Waardenburg syndrome (WS) is a genetic disorder characterized primarily by depigmentation of the skin and hair, heterochromia of the irides, sensorineural deafness, and sometimes by dystopia canthorum, and Hirschsprung disease. WS presents a large clinical and genetic heterogeneity. Four different types have been individualized and linked to 5 different genes. We report 2 cases of WS type II and 1 case of WS type IV from Lebanon and Syria. The genetic studies revealed 2 novel mutations in the MITF gene of the WS type II cases and 1 novel homozygous mutation in the EDNRB gene of the WS type IV case. This is the first molecular study of patients from the Arab world. Additional cases will enable a more detailed description of the clinical spectrum of Waardenburg syndrome in this region. PMID:21373256

Large N[sub c], constituent quarks, and N, [Delta] charge radii

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

Alfons J. Buchmann; Richard F. Lebed.

2000-03-01

The authors show how one may define baryon constituent quarks in a rigorous manner, given physical assumptions that hold in the large-N[sub c] limit of QCD. This constituent picture gives rise to an operator expansion that has been used to study large-N[sub c] baryon observables; here they apply it to the case of charge radii of the N and [Delta] states. For example, one finds the relation r[sub p][sup 2] [minus] r[sub [Delta][sup +

Large Colloids in Cholesteric Liquid Crystals

NASA Astrophysics Data System (ADS)

Stratford, K.; Gray, A.; Lintuvuori, J. S.

2015-12-01

We describe a coarse-grained Landau-de Gennes model of liquid crystals (LCs) including hydrodynamics based on the Beris-Edwards equations. The model is employed to study the impact of large colloids on the long range LC defect structure in the cholesteric LC blue phases. `Large' here means that the particle size is comparable to the cholesteric pitch, the length scale on which the LC order undergoes a helical twist. We investigate the case of a single particle, with either normal or degenerate planar anchoring, placed initially in an equilibrium blue phase LC. It is found that in some cases, well defined steady disclination structure emerges at the particle surface, while in other cases no clear steady state is reached in the simulations, and disclination reorganisation appears to proliferate through the bulk LC. These systems are of potential interest in the context of using LCs to template self-assembly of colloid structure, e.g., for opto-electronic devices. Computationally, we demonstrate a parallel approach using mixed message-passing and threaded model on graphical processing units allows effective and efficient progress for this problem.

Diurnal variation of eye movement and heart rate variability in the human fetus at term.

PubMed

Morokuma, S; Horimoto, N; Satoh, S; Nakano, H

2001-07-01

To elucidate diurnal variations in eye movement and fetal heart rate (FHR) variability in the term fetus, we observed these two parameters continuously for 24 h, using real-time ultrasound and Doppler cardiotocograph, respectively. Studied were five uncomplicated fetuses at term. The time series data of the presence and absence of eye movement and mean FHR value for each 1 min were analyzed using the maximum entropy method (MEM) and subsequent nonlinear least squares fitting. According to the power value of eye movement, all five cases were classified into two groups: three cases in the large power group and two cases in the small power group. The acrophases of eye movement and FHR variability in the large power group were close, thereby implying the existence of a diurnal rhythm in both these parameters and also that they are synchronized. In the small power group, the acrophases were separated. The synchronization of eye movement and FHR variability in the large power group suggests that these phenomena are governed by a common central mechanism related to diurnal rhythm generation.

Online Continuing Professional Education: An Evaluative Case Study

ERIC Educational Resources Information Center

Pullen, Darren L.

2005-01-01

An evaluation study, assessing the pedagogical and instructional design (e-pedagogy) effectiveness of online continuing professional education (CPE) courses offered by a large Australasian CPE provider to health care professionals (HCPs). The study used a naturalistic theory approach in conjunction with a multilevel evaluation to examine the…

MicroRNA expression in benign breast tissue and risk of subsequent invasive breast cancer.

PubMed

Rohan, Thomas; Ye, Kenny; Wang, Yihong; Glass, Andrew G; Ginsberg, Mindy; Loudig, Olivier

2018-01-01

MicroRNAs are endogenous, small non-coding RNAs that control gene expression by directing their target mRNAs for degradation and/or posttranscriptional repression. Abnormal expression of microRNAs is thought to contribute to the development and progression of cancer. A history of benign breast disease (BBD) is associated with increased risk of subsequent breast cancer. However, no large-scale study has examined the association between microRNA expression in BBD tissue and risk of subsequent invasive breast cancer (IBC). We conducted discovery and validation case-control studies nested in a cohort of 15,395 women diagnosed with BBD in a large health plan between 1971 and 2006 and followed to mid-2015. Cases were women with BBD who developed subsequent IBC; controls were matched 1:1 to cases on age, age at diagnosis of BBD, and duration of plan membership. The discovery stage (316 case-control pairs) entailed use of the Illumina MicroRNA Expression Profiling Assay (in duplicate) to identify breast cancer-associated microRNAs. MicroRNAs identified at this stage were ranked by the strength of the correlation between Illumina array and quantitative PCR results for 15 case-control pairs. The top ranked 14 microRNAs entered the validation stage (165 case-control pairs) which was conducted using quantitative PCR (in triplicate). In both stages, linear regression was used to evaluate the association between the mean expression level of each microRNA (response variable) and case-control status (independent variable); paired t-tests were also used in the validation stage. None of the 14 validation stage microRNAs was associated with breast cancer risk. The results of this study suggest that microRNA expression in benign breast tissue does not influence the risk of subsequent IBC.

MicroRNA expression in benign breast tissue and risk of subsequent invasive breast cancer

PubMed Central

Ye, Kenny; Wang, Yihong; Ginsberg, Mindy; Loudig, Olivier

2018-01-01

MicroRNAs are endogenous, small non-coding RNAs that control gene expression by directing their target mRNAs for degradation and/or posttranscriptional repression. Abnormal expression of microRNAs is thought to contribute to the development and progression of cancer. A history of benign breast disease (BBD) is associated with increased risk of subsequent breast cancer. However, no large-scale study has examined the association between microRNA expression in BBD tissue and risk of subsequent invasive breast cancer (IBC). We conducted discovery and validation case-control studies nested in a cohort of 15,395 women diagnosed with BBD in a large health plan between 1971 and 2006 and followed to mid-2015. Cases were women with BBD who developed subsequent IBC; controls were matched 1:1 to cases on age, age at diagnosis of BBD, and duration of plan membership. The discovery stage (316 case-control pairs) entailed use of the Illumina MicroRNA Expression Profiling Assay (in duplicate) to identify breast cancer-associated microRNAs. MicroRNAs identified at this stage were ranked by the strength of the correlation between Illumina array and quantitative PCR results for 15 case-control pairs. The top ranked 14 microRNAs entered the validation stage (165 case-control pairs) which was conducted using quantitative PCR (in triplicate). In both stages, linear regression was used to evaluate the association between the mean expression level of each microRNA (response variable) and case-control status (independent variable); paired t-tests were also used in the validation stage. None of the 14 validation stage microRNAs was associated with breast cancer risk. The results of this study suggest that microRNA expression in benign breast tissue does not influence the risk of subsequent IBC. PMID:29432432

Type 1 neurofibromatosis and pulmonary hypertension: a report of two cases and a review

PubMed Central

Malviya, Amit; Mishra, Sundeep; Kothari, Shyam S

2012-01-01

Pulmonary hypertension in type 1 neurofibromatosis is not well known and was previously attributed to diffuse fibrosing alveolitis and parenchymal tumours. More recently, cases of severe pulmonary hypertension due to pulmonary vasculopathy have been described. Involvement of vascular beds, both large and medium calibre vessels, but not pulmonary vasculature, in type 1 neurofibromatosis is well known. The authors describe two such cases and briefly review the literature. Pulmonary arterial hypertension in neurofibromatosis warrants further studies. PMID:27326022

A large common-source outbreak of norovirus gastroenteritis in a hotel in Singapore, 2012.

PubMed

Raj, P; Tay, J; Ang, L W; Tien, W S; Thu, M; Lee, P; Pang, Q Y; Tang, Y L; Lee, K Y; Maurer-Stroh, S; Gunalan, V; Cutter, J; Goh, K T

2017-02-01

An outbreak of gastroenteritis affected 453 attendees (attack rate 28·5%) of six separate events held at a hotel in Singapore. Active case detection, case-control studies, hygiene inspections and microbial analysis of food, environmental and stool samples were conducted to determine the aetiology of the outbreak and the modes of transmission. The only commonality was the food, crockery and cutlery provided and/or handled by the hotel's Chinese banquet kitchen. Stool specimens from 34 cases and 15 food handlers were positive for norovirus genogroup II. The putative index case was one of eight norovirus-positive food handlers who had worked while they were symptomatic. Several food samples and remnants tested positive for Escherichia coli or high faecal coliforms, aerobic plate counts and/or total coliforms, indicating poor food hygiene. This large common-source outbreak of norovirus gastroenteritis was caused by the consumption of contaminated food and/or contact with contaminated crockery or cutlery provided or handled by the hotel's Chinese banquet kitchen.

Case-based Reasoning for Automotive Engine Performance Tune-up

NASA Astrophysics Data System (ADS)

Vong, C. M.; Huang, H.; Wong, P. K.

2010-05-01

The automotive engine performance tune-up is greatly affected by the calibration of its electronic control unit (ECU). The ECU calibration is traditionally done by trial-and-error method. This traditional method consumes a large amount of time and money because of a large number of dynamometer tests. To resolve this problem, case based reasoning (CBR) is employed, so that an existing and effective ECU setup can be adapted to fit another similar class of engines. The adaptation procedure is done through a more sophisticated step called case-based adaptation (CBA) [1, 2]. CBA is an effective knowledge management tool, which can interactively learn the expert adaptation knowledge. The paper briefly reviews the methodologies of CBR and CBA. Then the application to ECU calibration is described via a case study. With CBR and CBA, the efficiency of calibrating an ECU can be enhanced. A prototype system has also been developed to verify the usefulness of CBR in ECU calibration.

Evaluation of integration methods for hybrid simulation of complex structural systems through collapse

NASA Astrophysics Data System (ADS)

Del Carpio R., Maikol; Hashemi, M. Javad; Mosqueda, Gilberto

2017-10-01

This study examines the performance of integration methods for hybrid simulation of large and complex structural systems in the context of structural collapse due to seismic excitations. The target application is not necessarily for real-time testing, but rather for models that involve large-scale physical sub-structures and highly nonlinear numerical models. Four case studies are presented and discussed. In the first case study, the accuracy of integration schemes including two widely used methods, namely, modified version of the implicit Newmark with fixed-number of iteration (iterative) and the operator-splitting (non-iterative) is examined through pure numerical simulations. The second case study presents the results of 10 hybrid simulations repeated with the two aforementioned integration methods considering various time steps and fixed-number of iterations for the iterative integration method. The physical sub-structure in these tests consists of a single-degree-of-freedom (SDOF) cantilever column with replaceable steel coupons that provides repeatable highlynonlinear behavior including fracture-type strength and stiffness degradations. In case study three, the implicit Newmark with fixed-number of iterations is applied for hybrid simulations of a 1:2 scale steel moment frame that includes a relatively complex nonlinear numerical substructure. Lastly, a more complex numerical substructure is considered by constructing a nonlinear computational model of a moment frame coupled to a hybrid model of a 1:2 scale steel gravity frame. The last two case studies are conducted on the same porotype structure and the selection of time steps and fixed number of iterations are closely examined in pre-test simulations. The generated unbalance forces is used as an index to track the equilibrium error and predict the accuracy and stability of the simulations.

Investigation of established genetic risk variants for glioma in prediagnostic samples from a population-based nested case-control study.

PubMed

Wibom, Carl; Späth, Florentin; Dahlin, Anna M; Langseth, Hilde; Hovig, Eivind; Rajaraman, Preetha; Johannesen, Tom Børge; Andersson, Ulrika; Melin, Beatrice

2015-05-01

Although glioma etiology is poorly understood in general, growing evidence indicates a genetic component. Four large genome-wide association studies (GWAS) have linked common genetic variants with an increased glioma risk. However, to date, these studies are based largely on a case-control design, where cases have been recruited at the time of or after diagnosis. They may therefore suffer from a degree of survival bias, introduced when rapidly fatal cases are not included. To confirm glioma risk variants in a prospective setting, we have analyzed 11 previously identified risk variants in a set of prediagnostic serum samples with 598 cases and 595 matched controls. Serum samples were acquired from The Janus Serum Bank, a Norwegian population-based biobank reserved for cancer research. We confirmed the association with glioma risk for variants within five genomic regions: 8q24.21 (CCDC26), 9p21.3 (CDKN2B-AS1), 11q23.3 (PHLDB1), 17p13.1 (TP53), and 20q13.33 (RTEL1). However, previously identified risk variants within the 7p11.2 (EGFR) region were not confirmed by this study. Our results indicate that the risk variants that were confirmed by this study are truly associated with glioma risk and may, consequently, affect gliomagenesis. Though the lack of positive confirmation of EGFR risk variants may be attributable to relatively limited statistical power, it nevertheless raises the question whether they truly are risk variants or markers for glioma prognosis. Our findings indicate the need for further studies to clarify the role of glioma risk loci with respect to prolonged survival versus etiology. ©2015 American Association for Cancer Research.

Case studies continue to illuminate the cognitive neuroscience of memory.

PubMed

Rosenbaum, R Shayna; Gilboa, Asaf; Moscovitch, Morris

2014-05-01

The current ubiquity of functional neuroimaging studies, and the importance they have had in elucidating brain function, obscures the fact that much of what we know about brain-behavior relationships derives largely from the study of single- and multiple-patient cases. A major goal of the present review is to describe how single cases continue to uniquely and critically contribute to cognitive neuroscience theory. With several recent examples from the literature, we demonstrate that single cases can both challenge accepted dogma and generate hypotheses and theories that steer the field in new directions. We discuss recent findings from case studies that specify critical functions of the hippocampus in episodic memory and recollection, and clarify its role in nonmnemonic abilities. Although we focus on the hippocampus, we discuss other regions and the occurrence of new associative learning, as well as the involvement of the ventromedial prefrontal and parietal cortices in memory encoding and retrieval. We also describe ways of dealing with the shortcomings of case studies, and emphasize the partnership of patient and neuroimaging methods in constraining neurocognitive models of memory. © 2014 New York Academy of Sciences.

Social marketing's unique contribution to mental health stigma reduction and HIV testing: two case studies.

PubMed

Thackeray, Rosemary; Keller, Heidi; Heilbronner, Jennifer Messenger; Dellinger, Laura K Lee

2011-03-01

Since its inception in 2005, articles in Health Promotion Practice's social marketing department have focused on describing social marketing's unique contributions and the application of each to the practice of health promotion. This article provides a brief review of six unique features (marketing mix, consumer orientation, segmentation, exchange, competition, and continuous monitoring) and then presents two case studies-one on reducing stigma related to mental health and the other a large-scale campaign focused on increasing HIV testing among African American youth. The two successful case studies show that social marketing principles can be applied to a wide variety of topics among various population groups.

Analytical considerations for study design

Treesearch

Barry R. Noon; William M. Block

1990-01-01

Studies of the foraging behaviors of birds have been largely descriptive and comparative. One might then expect studies with similar objectives to have similar study designs but that is not the case. Papers in this symposium that focused specifically on study design contain a diversity of biological perspectives. Similarly, there is no accord among statisticians on...

Syphilis in the economic center of South China: results from a real-time, web-based surveillance program.

PubMed

Zhang, Wangjian; Du, Zhicheng; Tang, Shaokai; Guo, Pi; Ye, Xingdong; Hao, Yuantao

2015-08-08

Guangzhou is the economic center of South China, which is currently suffering an insidious re-emergence of syphilis. Syphilis epidemic in this area is a matter of serious concern, because of the special economic position of Guangzhou and its large migrant population. Therefore, a comprehensive analysis of surveillance data is needed to provide further information for developing targeted control programs. Case-based surveillance data obtained from a real-time, web-based system were analyzed. A hierarchical clustering method was applied to classify the 12 districts of Guangzhou into several epidemiological regions. The district-level annual incidence and clustering results were displayed on the same map to show the spatial patterns of syphilis in Guangzhou. A total of 60,178 syphilis cases were reported during the period from 2005 to 2013, among which primary/secondary syphilis accounted for 15,864 cases (26.36 %), latent syphilis for 41,078 cases (68.26 %) and congenital syphilis for 2,090 cases (3.47 %). Moreover, primary/secondary syphilis burden slightly decreased from 17.5-18.0 cases per 100,000 people in the first years to 10.6 cases per 100,000 in 2013, with latent syphilis largely increasing from 18.5 cases per 100,000 to 43.4 cases per 100,000. Districts of Guangzhou could be classified into 3 epidemiological regions according to the syphilis burden over the last 3 years of the study period. The burden of primary/secondary syphilis appears to be decreasing in recent years, whereas that of latent syphilis is increasing. Given the epidemiological features and the annual changes found in this study, it is suggested that future control programs should be more population-specific and spatially targeted.

Pigmented Creatine Deposits in Amyotrophic Lateral Sclerosis Central Nervous System Tissues Identified by Synchrotron Fourier Transform Infrared Microspectroscopy and X-ray Fluorescence Spectromicroscopy

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

Kastyak, M.; Szczerbowska-Boruchowska, M; Adamek, D

2010-01-01

Amyotrophic Lateral Sclerosis (ALS) is an untreatable, neurodegenerative disease of motor neurons characterized by progressive muscle atrophy, limb paralysis, dysarthria, dysphagia, dyspnae and finally death. Large motor neurons in ventral horns of spinal cord and motor nuclei in brainstem, large pyramidal neurons of motor cortex and/or large myelinated axons of corticospinal tracts are affected. In recent synchrotron Fourier Transform Infrared microspectroscopy (sFTIR) studies of ALS CNS autopsy tissue, we discovered a small deposit of crystalline creatine, which has a crucial role in energy metabolism. We have now examined unfixed, snap frozen, post-autopsy tissue sections of motor cortex, brain stem, spinalmore » cord, hippocampus and substantia nigra from six ALS and three non-degenerated cases with FTIR and micro-X-ray fluorescence (XRF). Heterogeneous pigmented deposits were discovered in spinal cord, brain stem and motor neuron cortex of two ALS cases. The FTIR signature of creatine has been identified in these deposits and in numerous large, non-pigmented deposits in four of the ALS cases. Comparable pigmentation and creatine deposits were not found in controls or in ALS hippocampus and substantia nigra. Ca, K, Fe, Cu and Zn, as determined by XRF, were not correlated with the pigmented deposits; however, there was a higher incidence of hot spots (Ca, Zn, Fe and Cu) in the ALS cases. The identity of the pigmented deposits remains unknown, although the absence of Fe argues against both erythrocytes and neuromelanin. We conclude that elevated creatine deposits may be indicators of dysfunctional oxidative processes in some ALS cases.« less

Benefits and applications of interdisciplinary digital tools for environmental meta-reviews and analyses

NASA Astrophysics Data System (ADS)

Grubert, Emily; Siders, Anne

2016-09-01

Digitally-aided reviews of large bodies of text-based information, such as academic literature, are growing in capability but are not yet common in environmental fields. Environmental sciences and studies can benefit from application of digital tools to create comprehensive, replicable, interdisciplinary reviews that provide rapid, up-to-date, and policy-relevant reports of existing work. This work reviews the potential for applications of computational text mining and analysis tools originating in the humanities to environmental science and policy questions. Two process-oriented case studies of digitally-aided environmental literature reviews and meta-analyses illustrate potential benefits and limitations. A medium-sized, medium-resolution review (∼8000 journal abstracts and titles) focuses on topic modeling as a rapid way to identify thematic changes over time. A small, high-resolution review (∼300 full text journal articles) combines collocation and network analysis with manual coding to synthesize and question empirical field work. We note that even small digitally-aided analyses are close to the upper limit of what can be done manually. Established computational methods developed in humanities disciplines and refined by humanities and social science scholars to interrogate large bodies of textual data are applicable and useful in environmental sciences but have not yet been widely applied. Two case studies provide evidence that digital tools can enhance insight. Two major conclusions emerge. First, digital tools enable scholars to engage large literatures rapidly and, in some cases, more comprehensively than is possible manually. Digital tools can confirm manually identified patterns or identify additional patterns visible only at a large scale. Second, digital tools allow for more replicable and transparent conclusions to be drawn from literature reviews and meta-analyses. The methodological subfields of digital humanities and computational social sciences will likely continue to create innovative tools for analyzing large bodies of text, providing opportunities for interdisciplinary collaboration with the environmental fields.

High-Dimensional Multivariate Repeated Measures Analysis with Unequal Covariance Matrices.

PubMed

Harrar, Solomon W; Kong, Xiaoli

2015-03-01

In this paper, test statistics for repeated measures design are introduced when the dimension is large. By large dimension is meant the number of repeated measures and the total sample size grow together but either one could be larger than the other. Asymptotic distribution of the statistics are derived for the equal as well as unequal covariance cases in the balanced as well as unbalanced cases. The asymptotic framework considered requires proportional growth of the sample sizes and the dimension of the repeated measures in the unequal covariance case. In the equal covariance case, one can grow at much faster rate than the other. The derivations of the asymptotic distributions mimic that of Central Limit Theorem with some important peculiarities addressed with sufficient rigor. Consistent and unbiased estimators of the asymptotic variances, which make efficient use of all the observations, are also derived. Simulation study provides favorable evidence for the accuracy of the asymptotic approximation under the null hypothesis. Power simulations have shown that the new methods have comparable power with a popular method known to work well in low-dimensional situation but the new methods have shown enormous advantage when the dimension is large. Data from Electroencephalograph (EEG) experiment is analyzed to illustrate the application of the results.

High-Dimensional Multivariate Repeated Measures Analysis with Unequal Covariance Matrices

PubMed Central

Harrar, Solomon W.; Kong, Xiaoli

2015-01-01

In this paper, test statistics for repeated measures design are introduced when the dimension is large. By large dimension is meant the number of repeated measures and the total sample size grow together but either one could be larger than the other. Asymptotic distribution of the statistics are derived for the equal as well as unequal covariance cases in the balanced as well as unbalanced cases. The asymptotic framework considered requires proportional growth of the sample sizes and the dimension of the repeated measures in the unequal covariance case. In the equal covariance case, one can grow at much faster rate than the other. The derivations of the asymptotic distributions mimic that of Central Limit Theorem with some important peculiarities addressed with sufficient rigor. Consistent and unbiased estimators of the asymptotic variances, which make efficient use of all the observations, are also derived. Simulation study provides favorable evidence for the accuracy of the asymptotic approximation under the null hypothesis. Power simulations have shown that the new methods have comparable power with a popular method known to work well in low-dimensional situation but the new methods have shown enormous advantage when the dimension is large. Data from Electroencephalograph (EEG) experiment is analyzed to illustrate the application of the results. PMID:26778861

Hodgkin's disease and CD30-positive anaplastic large cell lymphomas--a continuous spectrum of malignant disorders. A quantitative morphometric and immunohistologic study.

PubMed Central

Leoncini, L.; Del Vecchio, M. T.; Kraft, R.; Megha, T.; Barbini, P.; Cevenini, G.; Poggi, S.; Pileri, S.; Tosi, P.; Cottier, H.

1990-01-01

The authors have examined cellular areas of lymphoma tissue in 28 cases of Hodgkin's disease (HD) or anaplastic large cell lymphoma (ALCL, 'Ki-1 cell lymphoma') to evaluate the boundaries between the two entities. Methods applied included conventional histology; test point analysis; semiautomated morphometry of nuclear profile features of Reed-Sternberg and other atypical large cells (RSALCs); and immunohistochemistry of these elements on all paraffin sections and, in 15 cases, on frozen sections. Mean nuclear profile morphotypes of RSALCs per case varied independently of immunophenotype and histologic diagnosis. Conversely, immunohistochemistry demonstrated significant, although not consistent, preferential positivities of these CD30+ elements for CD15 in HD, and for epithelial membrane antigen (EMA) and CD43 in ALCLs. In the latter, RSALCs also exhibited a tendency for CD45 and CD45RO positivity and for the expression of T-cell-associated antigens. However, there were considerable overlaps. This continuous spectrum of RSALC nuclear profile morphotypes and immunophenotypes, ranging from HD over questionable cases, intermediate between HD and ALCL, to ALCLs, was paralleled by differences in the reactive component of lymphomas. Lymphocytes and granulocytes were significantly deficient in ALCLs. Images Figure 1 PMID:2173409

Progressing the state of knowledge on the human influence on hydrological droughts through case studies

NASA Astrophysics Data System (ADS)

Rangecroft, Sally; Van Loon, Anne; Bosman, Marianne; Wanders, Niko; Di Baldassarre, Giuliano; AghaKouchak, Amir

2017-04-01

Human activities can have a large influence on changes in the hydrological system and hydrological extremes, more than climate variability and climate change in some cases. However, there are currently only a limited number of studies which aim to quantify the human impact on hydrological droughts. Here we present a synthesis study of existing and new results that aims to summarize and quantify the anthropogenic impact on hydrological drought from case studies and observations. By combining a large number of case studies, we allow conclusions to be drawn about the effects of different human activities. This work suggests ways forward to increase our understanding on how human activities are influencing drought characteristics; invaluable information for water resource management and adaptation. During this project, the impact of different human activities (e.g. water abstraction, reservoir building, urbanisation, etc) on drought frequency, duration and deficit has been calculated in a consistent manner, allowing for an improved understanding to how they have impacted droughts. This consistent methodology is a necessary element for this comparative hydrology exercise, yet we use one which is flexible and applicable to different case study set ups and data availability. The methodology used here depends on available observation data, with three possible approaches: i) paired catchment approach; ii) upstream-downstream comparison; iii) observation modelling framework. The synthesised results of the existing and new case studies cover a number of human activities, hydro-climatic and socio-economic contexts. In particular, we remove the climate dependency in the results by using case studies from multiple climatic regions, including UK, Italy, US, Australia, Mexico and Chile. For groundwater abstraction, it is clear across all the relevant case studies that abstraction activities worsen drought events. This is especially prominent in the deficit volumes, with nearly all results showing at least a 50% increase in deficit compared to the natural situation due to the human activity. However, for the reservoir case studies we find mixed results with some catchments showing drought alleviation and others demonstrating an aggravation of drought. These results show us that the impact of reservoirs on droughts downstream is dependent on reservoir management and purpose. From the urbanised case studies we find urbanisation to be a more difficult human activity to quantify and analyse. Mixed results indicate possible conflicting processes occurring due to urbanisation, and the need for further case studies and discussions. This is the first step towards quantifying the human influence on drought on the global scale using catchment scale observation-based studies, which will provide important information for global scale modellers, water managers and drought policy makers.

Case Study Investigations of Large-Amplitude Inertia-Gravity Wave Environments and Mesoscale Structures

NASA Technical Reports Server (NTRS)

Bosart, Lance F.

2001-01-01

The research effort supported by NASA Grant NAG5-7469, awarded to the University at Albany, State University of New York (UA/SUNY), comprises the following two projects: (1) the observational study of large-amplitude inertia-gravity wave environments over the continental United States; and (2) the definition of opportunities and issues in extratropical cyclone dynamics and related phenomenological studies that may be addressed using high-resolution global datasets produced by the Data Assimilation Office (DAO) at the NASA/Goddard Space Flight Center.

Combining matched and unmatched control groups in case-control studies.

PubMed

le Cessie, Saskia; Nagelkerke, Nico; Rosendaal, Frits R; van Stralen, Karlijn J; Pomp, Elisabeth R; van Houwelingen, Hans C

2008-11-15

Multiple control groups in case-control studies are used to control for different sources of confounding. For example, cases can be contrasted with matched controls to adjust for multiple genetic or unknown lifestyle factors and simultaneously contrasted with an unmatched population-based control group. Inclusion of different control groups for a single exposure analysis yields several estimates of the odds ratio, all using only part of the data. Here the authors introduce an easy way to combine odds ratios from several case-control analyses with the same cases. The approach is based upon methods used for meta-analysis but takes into account the fact that the same cases are used and that the estimated odds ratios are therefore correlated. Two ways of estimating this correlation are discussed: sandwich methodology and the bootstrap. Confidence intervals for the pooled estimates and a test for checking whether the odds ratios in the separate case-control studies differ significantly are derived. The performance of the method is studied by simulation and by applying the methods to a large study on risk factors for thrombosis, the MEGA Study (1999-2004), wherein cases with first venous thrombosis were included with a matched control group of partners and an unmatched population-based control group.

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.

Characteristics of Hospitalized Cases of Pertussis in Catalonia and Navarra, Two Regions in the North of Spain.

PubMed

Crespo, Inma; Toledo, Diana; Soldevila, Núria; Jordán, Iolanda; Solano, Rubén; Castilla, Jesús; Caylà, Joan A; Godoy, Pere; Muñoz-Almagro, Carmen; Domínguez, Ángela

2015-01-01

Pertussis causes a large number of cases and hospitalizations in Catalonia and Navarra. We made a study of household cases of pertussis during 2012 and 2013 in order to identify risk factors for hospitalization in pertussis cases. Each primary case reported triggered the study of their contacts. Close contacts at home and people who were in contact for >2 hours during the transmission period of cases were included. The adjusted OR and 95% confidence intervals (CI) was calculated using logistic regression. A total of 1124 pertussis cases were detected, of which 14.9% were hospitalized. Inspiratory whoop (aOR: 1.64; CI: 1.02-2.65), apnoea (aOR: 2.47; CI: 1.51-4.03) and cyanosis (aOR: 15.51; CI: 1.87-128.09) were more common in hospitalized than in outpatient cases. Hospitalization occurred in 8.7% of correctly-vaccinated cases, 41.1% of non-vaccinated cases and 9.4% of partially-vaccinated cases. In conclusion, inspiratory whoop, apnoea and cyanosis were associated factors to hospitalization while vaccination reduced hospitalizations due to pertussis.

Characteristics of Hospitalized Cases of Pertussis in Catalonia and Navarra, Two Regions in the North of Spain

PubMed Central

Crespo, Inma; Toledo, Diana; Soldevila, Núria; Castilla, Jesús; Godoy, Pere; Muñoz-Almagro, Carmen; Domínguez, Ángela

2015-01-01

Pertussis causes a large number of cases and hospitalizations in Catalonia and Navarra. We made a study of household cases of pertussis during 2012 and 2013 in order to identify risk factors for hospitalization in pertussis cases. Each primary case reported triggered the study of their contacts. Close contacts at home and people who were in contact for >2 hours during the transmission period of cases were included. The adjusted OR and 95% confidence intervals (CI) was calculated using logistic regression. A total of 1124 pertussis cases were detected, of which 14.9% were hospitalized. Inspiratory whoop (aOR: 1.64; CI: 1.02–2.65), apnoea (aOR: 2.47; CI: 1.51–4.03) and cyanosis (aOR: 15.51; CI: 1.87–128.09) were more common in hospitalized than in outpatient cases. Hospitalization occurred in 8.7% of correctly-vaccinated cases, 41.1% of non-vaccinated cases and 9.4% of partially-vaccinated cases. In conclusion, inspiratory whoop, apnoea and cyanosis were associated factors to hospitalization while vaccination reduced hospitalizations due to pertussis. PMID:26440655

Students' Test Motivation in PISA: The Case of Norway

ERIC Educational Resources Information Center

Hopfenbeck, Therese N.; Kjaernsli, Marit

2016-01-01

Do students make their best effort in large-scale assessment studies such as the "Programme for International Student Assessment" (PISA)? Despite six cycles of PISA surveys from 2000 to 2015, empirical studies regarding students' test motivation and experience of the tests are sparse. The present study examines students' test motivation…

Social Identity Theories and Educational Engagement

ERIC Educational Resources Information Center

Kelly, Sean

2009-01-01

There is a large body of research in studies of schooling, particularly ethnographic case studies, which posits that collective action among students undermines engagement in school and contributes to educational inequality. In this paper I review studies of engagement from a social identity theory perspective. To what extent can collective action…

Meta-Analysis of Single-Case Research Design Studies on Instructional Pacing.

PubMed

Tincani, Matt; De Mers, Marilyn

2016-11-01

More than four decades of research on instructional pacing has yielded varying and, in some cases, conflicting findings. The purpose of this meta-analysis was to synthesize single-case research design (SCRD) studies on instructional pacing to determine the relative benefits of brisker or slower pacing. Participants were children and youth with and without disabilities in educational settings, excluding higher education. Tau-U, a non-parametric statistic for analyzing data in SCRD studies, was used to determine effect size estimates. The article extraction yielded 13 instructional pacing studies meeting contemporary standards for high quality SCRD research. Eleven of the 13 studies reported small to large magnitude effects when two or more pacing parameters were compared, suggesting that instructional pacing is a robust instructional variable. Brisker instructional pacing with brief inter-trial interval (ITI) produced small increases in correct responding and medium to large reductions in challenging behavior compared with extended ITI. Slower instructional pacing with extended wait-time produced small increases in correct responding, but also produced small increases in challenging behavior compared with brief wait-time. Neither brief ITI nor extended wait-time meets recently established thresholds for evidence-based practice, highlighting the need for further instructional pacing research. © The Author(s) 2016.

Comments on: blood product transfusion in emergency department patients: a case control study of practice patterns and impact on outcome.

PubMed

Karami, Manoochehr; Khazaei, Salman

2017-12-06

Clinical decision makings according studies result require the valid and correct data collection, andanalysis. However, there are some common methodological and statistical issues which may ignore by authors. In individual matched case- control design bias arising from the unconditional analysis instead of conditional analysis. Using an unconditional logistic for matched data causes the imposition of a large number of nuisance parameters which may result in seriously biased estimates.

Design method of large-diameter rock-socketed pile with steel casing

NASA Astrophysics Data System (ADS)

Liu, Ming-wei; Fang, Fang; Liang, Yue

2018-02-01

There is a lack of the design and calculation method of large-diameter rock-socketed pile with steel casing. Combined with the “twelfth five-year plan” of the National Science & Technology Pillar Program of China about “Key technologies on the ports and wharfs constructions of the mountain canalization channels”, this paper put forward the structured design requirements of concrete, steel bar distribution and steel casing, and a checking calculation method of the bearing capacity of the normal section of the pile and the maximum crack width at the bottom of the steel casing. The design method will have some degree of guiding significance for the design of large-diameter rock-socketed pile with steel casing.

Size does matter - span of control in hospitals.

PubMed

Holm-Petersen, Christina; Østergaard, Sussanne; Andersen, Per Bo Noergaard

2017-04-10

Purpose Centralization, mergers and cost reductions have generally led to increasing levels of span of control (SOC), and thus potentially to lower leadership capacity. The purpose of this paper is to explore how a large SOC impacts hospital staff and their leaders. Design/methodology/approach The study is based on a qualitative explorative case study of three large inpatient wards. Findings The study finds that the nursing staff and their frontline leaders experience challenges in regard to visibility and role of the leader, e.g., in creating overview, coordination, setting-up clear goals, following up and being in touch. However, large wards also provide flexibility and development possibilities. Practical implications The authors discuss the implications of these findings for decision makers in deciding future SOC and for future SOC research. Originality/value Only few studies have qualitatively explored the consequences of large SOC in hospitals.

Use of pneumatic lithotripsy for managing difficult CBD calculi.

PubMed

Farooq Qadri, Syed Javid; Khan, Muneer; Khan, Naveed

2011-01-01

About 7-12% of patients who harbor gallbladder calculi concomitant common bile duct (CBD) calculi are present. The treatment of gallbladder calculi has standardized in the form of laparoscopic cholecystectomy but management of CBD calculi is still evolving. Endoscopic removal of CBD calculi <2 cm in diameter is successful in 90-100% of cases but patients harboring stones >2 cm in diameter high failure rates can be seen. Traditionally, laparoscopically one can achieve success rate comparable to endoscopic surgery but large and impacted calculi may cause failures. If one uses pneumatic lithotripsy during laparoscopic management of CBD calculi one can achieve 100% stone clearance irrespective of size, degree of hardness and impaction. This study evaluates the feasibility of using pneumatic lithotripsy for CBD calculi. To our knowledge this is the 1st reported series of using pneumatic lithotripsy for CBD calculi. From June 2002 to June 2010 96 laparoscopic CBD explorations (LCBDE) were done for CBD calculi. Patients having choledocholithiasis with CBD diameter of >10 mm were taken for LCBDE while in patients with CBD diameter of <10 mm were referred for endoscopic clearance. Additionally ERCP failure cases were also subjected to LCBDE. Rigid nephroscope was used for LCBDE and usually calculi were removed by forceps only. In patients having large, hard &/or impacted calculi pneumatic lithotripsy were used for fragmentation. Out of the 96 patients in 12 (12.5%) cases pneumatic lithotripsy was used for stone fragmentation. Out of these 12 cases 5 (41.6%) were ERCP failure cases. At a mean hospital stay of 2.5 days 100% stone clearance was achieved in all cases with no perioperative complication. The present study shows how successfully pneumatic lithotripsy can be used to fragment large, hard &/or impacted CBD calculi. Pneumatic lithotripsy being user friendly easily available can reliably fragment CBD calculi in one session. Copyright © 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Reported Influence of Evaluation Data on Decision Makers' Actions: An Empirical Examination

ERIC Educational Resources Information Center

Christie, Christina A.

2007-01-01

Using a set of scenarios derived from actual evaluation studies, this simulation study examines the reported influence of evaluation information on decision makers' potential actions. Each scenario described a context where one of three types of evaluation information (large-scale study data, case study data, or anecdotal accounts) is presented…

Study Abroad Programs: A Golden Opportunity for Academic Library Engagement

ERIC Educational Resources Information Center

Denda, Kayo

2013-01-01

Study abroad programs in higher education increasingly play a major role in training students for global citizenship. This case study, conducted in a large research university in the United States, identifies the information needs of students and faculty in study abroad programs. Of particular interest is how awareness of library resources and…

Precocious puberty and large multicystic ovaries in young girls with primary hypothyroidism.

PubMed

Sanjeevaiah, Aravind Raj; Sanjay, Subbarayappa; Deepak, Tejesweni; Sharada, Ardanareshwaran; Srikanta, Sri S

2007-10-01

To describe 2 cases of primary hypothyroidism, precocious puberty, large multicystic ovaries, possible diagnostic dilemma, unilateral oophorectomies, and subsequent response to levothyroxine replacement therapy. We present the clinical, biochemical, radiologic, and histopathologic findings in 2 patients with rare cases of Van Wyk-Grumbach syndrome and megaovaries, who underwent unilateral oophorectomy. Two patients, an 8-year-old girl and a 3-year-old girl (cases 1 and 2, respectively), were referred to our center. Both patients presented with precocious puberty and vaginal bleeding and had undergone unilateral oophorectomy before referral. In the first patient (case 1), the surgical intervention was a consequence of torsion of the left megaovary, necessitating emergency oophorectomy. Oophorectomy in the second patient (case 2) was a result of initial diagnostic confusion, inasmuch as a sexcord stromal tumor was suspected. A detailed history, physical examination, and laboratory results pointed toward primary hypothyroidism due to Hashimoto's thyroiditis and thyroid dysgenesis, respectively. Serial ultrasound studies of the abdomen and pelvis revealed large multicystic ovaries, with progressive enlargement (including regrowth from an apparent ovarian "postsurgical remnant"). Both patients responded dramatically after initiation of levothyroxine replacement therapy, with no further vaginal bleeding and reversal of megaovary to normal size (in case 1). In a highly selected minority of children with untreated primary hypothyroidism, there is development of precocious puberty and progressively enlarging multicystic ovaries. The precise endocrine, neuroanatomic, and neurophysiologic bases for this phenomenon are unclear. Nevertheless, the entire clinicopathologic picture, including giant ovaries, dramatically reverts to normal status with the restoration of a euthyroid state by means of simple levothyroxine replacement therapy.

A Large Drawing of a Nephron for Teaching Medical Students Renal Physiology, Histology, and Pharmacology

ERIC Educational Resources Information Center

Robinson, Philip G.; Newman, David; Reitz, Cara L.; Vaynberg, Lena Z.; Bahga, Dalbir K.; Levitt, Morton H.

2018-01-01

The purpose of this study is to see whether a large drawing of a nephron helped medical students in self-directed learning groups learn renal physiology, histology, and pharmacology before discussing clinical cases. The end points were the grades on the renal examination and a student survey. The classes in the fall of 2014 and 2015 used the…

The Effects of the Great Recession on Educational Attainment: Evidence from a Large Urban High School District

ERIC Educational Resources Information Center

Mordechay, Kfir

2017-01-01

Economic crises are a recurrent phenomenon in American society, yet there is little knowledge of the impacts on educational opportunity. Using data from a large high school district as a case study, this research explores the impact of the Great Recession (2007-2009) on high school senior graduation rates in an area at the epicenter of the…

Linking Errors in Trend Estimation in Large-Scale Surveys: A Case Study. Research Report. ETS RR-10-10

ERIC Educational Resources Information Center

Xu, Xueli; von Davier, Matthias

2010-01-01

One of the major objectives of large-scale educational surveys is reporting trends in academic achievement. For this purpose, a substantial number of items are carried from one assessment cycle to the next. The linking process that places academic abilities measured in different assessments on a common scale is usually based on a concurrent…

How the Leaders of One High-Achieving, Large, Urban High School Communicate with Latino Families about Math

ERIC Educational Resources Information Center

Kittelson, Andrea

2016-01-01

The purpose of this instrumental case study was to understand the ways in which the leaders of one high-achieving, large, urban high school communicate with Latino families about math with the intent to shine a light on the issue of communication with families as it relates to student achievement and the persistent math achievement gap among…

Developing a "Semi-Systematic" Approach to Using Large-Scale Data-Sets for Small-Scale Interventions: The "Baby Matterz" Initiative as a Case Study

ERIC Educational Resources Information Center

O'Brien, Mark

2011-01-01

The appropriateness of using statistical data to inform the design of any given service development or initiative often depends upon judgements regarding scale. Large-scale data sets, perhaps national in scope, whilst potentially important in informing the design, implementation and roll-out of experimental initiatives, will often remain unused…

Newly invented biobased materials from low-carbon, diverted waste fibers: research methods, testing, and full-scale application in a case study structure

Treesearch

Julee A Herdt; John Hunt; Kellen Schauermann

2016-01-01

This project demonstrates newly invented, biobased construction materials developed by applying lowcarbon, biomass waste sources through the Authors’ engineered fiber processes and technology. If manufactured and applied large-scale the project inventions can divert large volumes of cellulose waste into high-performance, low embodied energy, environmental construction...

A Case Study Examining Undergraduate Public Health Student Experiences at a Large, Private, Urban Research University

ERIC Educational Resources Information Center

Baillie, Colleen P.

2017-01-01

Undergraduate students represent a new but growing population at a school of public (SPH) health at a large, private, urban research university on the East Coast. This SPH has offered a minor in public health since 2010, and a major was initiated in 2014. The school also plans to offer an accelerated bachelor's-to-master's in public health…

Bifurcation study of phase oscillator systems with attractive and repulsive interaction.

PubMed

Burylko, Oleksandr; Kazanovich, Yakov; Borisyuk, Roman

2014-08-01

We study a model of globally coupled phase oscillators that contains two groups of oscillators with positive (synchronizing) and negative (desynchronizing) incoming connections for the first and second groups, respectively. This model was previously studied by Hong and Strogatz (the Hong-Strogatz model) in the case of a large number of oscillators. We consider a generalized Hong-Strogatz model with a constant phase shift in coupling. Our approach is based on the study of invariant manifolds and bifurcation analysis of the system. In the case of zero phase shift, various invariant manifolds are analytically described and a new dynamical mode is found. In the case of a nonzero phase shift we obtained a set of bifurcation diagrams for various systems with three or four oscillators. It is shown that in these cases system dynamics can be complex enough and include multistability and chaotic oscillations.

Bifurcation study of phase oscillator systems with attractive and repulsive interaction

NASA Astrophysics Data System (ADS)

Burylko, Oleksandr; Kazanovich, Yakov; Borisyuk, Roman

2014-08-01

We study a model of globally coupled phase oscillators that contains two groups of oscillators with positive (synchronizing) and negative (desynchronizing) incoming connections for the first and second groups, respectively. This model was previously studied by Hong and Strogatz (the Hong-Strogatz model) in the case of a large number of oscillators. We consider a generalized Hong-Strogatz model with a constant phase shift in coupling. Our approach is based on the study of invariant manifolds and bifurcation analysis of the system. In the case of zero phase shift, various invariant manifolds are analytically described and a new dynamical mode is found. In the case of a nonzero phase shift we obtained a set of bifurcation diagrams for various systems with three or four oscillators. It is shown that in these cases system dynamics can be complex enough and include multistability and chaotic oscillations.

Assessing Leading ERP-SAP Implementation in Leading Firms in Indonesia

NASA Astrophysics Data System (ADS)

Syaiful, B.; Gunawan, W.

2017-01-01

Enterprise resource planning (ERP) enables to bring critical capabilities to an organisation, however, the implementation of such capabilities is often surrounded with problems. The implementing ERP-SAP in Indonesian enterprises are still facing tremendous challenges with the failure rate can reach more than 80% of the cases. The article examines the common problems faced by the consultants whenever they deal with their clients, from the practical perspectives. The article takes the multiple case studies of the leading enterprises in Indonesia, such as: KS (largest steel producer), GEM (large mining producer), and HS (large retailer), with the aim to identify the root of problems of SAP implementation. The outcome of the study is expected to provide the consultants with the guideline to understand the ERP implementation process in their clients and effective solutions to cope with it.

Probabilistic failure assessment with application to solid rocket motors

NASA Technical Reports Server (NTRS)

Jan, Darrell L.; Davidson, Barry D.; Moore, Nicholas R.

1990-01-01

A quantitative methodology is being developed for assessment of risk of failure of solid rocket motors. This probabilistic methodology employs best available engineering models and available information in a stochastic framework. The framework accounts for incomplete knowledge of governing parameters, intrinsic variability, and failure model specification error. Earlier case studies have been conducted on several failure modes of the Space Shuttle Main Engine. Work in progress on application of this probabilistic approach to large solid rocket boosters such as the Advanced Solid Rocket Motor for the Space Shuttle is described. Failure due to debonding has been selected as the first case study for large solid rocket motors (SRMs) since it accounts for a significant number of historical SRM failures. Impact of incomplete knowledge of governing parameters and failure model specification errors is expected to be important.

It's a Knuckleball: A Critical Case Study of a Collaborative between a University and the "Real World" of School Leadership

ERIC Educational Resources Information Center

Cyprès, Autumn Tooms

2014-01-01

This is a look at the political games within games that are enmeshed in a high-profile, heavily funded, politically charged collaborative focused on preparing new school leaders between a large prestigious university and a circle of school leaders and policymakers. This case specifically considers how power and money corrupt the original vision…

"I Don't Write, I Print": A Case Study in Literacy.

ERIC Educational Resources Information Center

Price-Miller, Carol

A copy of a letter to a cable company, printed in large block letters and not following standard rules of spelling and syntax, serves as a catalyst for thoughts about the person who wrote the letter and a discussion about what constitutes literacy. Despite the appearances of the letter, a case can be made for the author as a writer. A close look…

Primary renal diffuse large B-cell lymphoma with central nervous system involvement: a rare case report and literature review.

PubMed

Wang, Ying; Guo, Shuangshuang

2015-01-01

Primary renal lymphoma is a rare entity. Of these, diffuse large B-cell lymphoma is the most common pathological type and, R-CHOP regimen was the preferred chemotherapy for it. Here we present an adult case of primary renal diffuse large B-cell lymphoma.

Uncovering Capgras delusion using a large-scale medical records database

PubMed Central

Marshall, Caryl; Kanji, Zara; Wilkinson, Sam; Halligan, Peter; Deeley, Quinton

2017-01-01

Background Capgras delusion is scientifically important but most commonly reported as single case studies. Studies analysing large clinical records databases focus on common disorders but none have investigated rare syndromes. Aims Identify cases of Capgras delusion and associated psychopathology, demographics, cognitive function and neuropathology in light of existing models. Method Combined computational data extraction and qualitative classification using 250 000 case records from South London and Maudsley Clinical Record Interactive Search (CRIS) database. Results We identified 84 individuals and extracted diagnosis-matched comparison groups. Capgras was not ‘monothematic’ in the majority of cases. Most cases involved misidentified family members or close partners but others were misidentified in 25% of cases, contrary to dual-route face recognition models. Neuroimaging provided no evidence for predominantly right hemisphere damage. Individuals were ethnically diverse with a range of psychosis spectrum diagnoses. Conclusions Capgras is more diverse than current models assume. Identification of rare syndromes complements existing ‘big data’ approaches in psychiatry. Declaration of interests V.B. is supported by a Wellcome Trust Seed Award in Science (200589/Z/16/Z) and the UCLH NIHR Biomedical Research Centre. S.W. is supported by a Wellcome Trust Strategic Award (WT098455MA). Q.D. has received a grant from King’s Health Partners. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:28794897

Association of atrial fibrillation and cancer: Analysis from two large population-based case-control studies.

PubMed

Saliba, Walid; Rennert, Hedy S; Gronich, Naomi; Gruber, Stephen B; Rennert, Gad

2018-01-01

An association between atrial fibrillation (AF) and risk of cancer has been suggested in several studies, including prospective cohort studies. However, the magnitude and the temporal nature of this association remain unclear. Data from two large prospective population-based case-control studies, the Molecular Epidemiology of Colorectal Cancer (MECC, n = 8,383) and the Breast Cancer in Northern Israel Study (BCINIS, n = 11,608), were used to better understand the nature and temporality of a possible association between cancer diagnosis and AF events before and after cancer diagnosis. A case-control study approach was employed to study prior AF as a risk factor for cancer, and a cohort study approach was employed to study incident cancer as a risk factor for AF. AF was associated with a significant reduced odds of cancer as reflected in the case-control approach, with an adjusted OR = 0.77 (95% CI, 0.65-0.91), while cancer was not found to be significantly associated with elevated risk of AF in the cohort approach, with an adjusted HR = 1.10 (0.98-1.23). The immediate period (90 days) after an AF event was associated with a 1.85 times increased risk of cancer, and the immediate period after the diagnosis of cancer was associated with a 3.4 fold increased risk of AF. These findings probably reflect both the effect of acute transient conditions associated with new cancer diagnosis and detection bias. Similar results were identified with colorectal and breast cancer cases. Atrial fibrillation of longer than 90 days duration is associated with reduced odds of new cancer diagnosis. The results of this study suggest that an association observed in prior research may be due to instances related to cancer diagnosis and detection bias rather than a causal relationship. However, there may be bias in the sampling and residual confounding that distort the associations.

The effects of recall errors and of selection bias in epidemiologic studies of mobile phone use and cancer risk.

PubMed

Vrijheid, Martine; Deltour, Isabelle; Krewski, Daniel; Sanchez, Marie; Cardis, Elisabeth

2006-07-01

This paper examines the effects of systematic and random errors in recall and of selection bias in case-control studies of mobile phone use and cancer. These sensitivity analyses are based on Monte-Carlo computer simulations and were carried out within the INTERPHONE Study, an international collaborative case-control study in 13 countries. Recall error scenarios simulated plausible values of random and systematic, non-differential and differential recall errors in amount of mobile phone use reported by study subjects. Plausible values for the recall error were obtained from validation studies. Selection bias scenarios assumed varying selection probabilities for cases and controls, mobile phone users, and non-users. Where possible these selection probabilities were based on existing information from non-respondents in INTERPHONE. Simulations used exposure distributions based on existing INTERPHONE data and assumed varying levels of the true risk of brain cancer related to mobile phone use. Results suggest that random recall errors of plausible levels can lead to a large underestimation in the risk of brain cancer associated with mobile phone use. Random errors were found to have larger impact than plausible systematic errors. Differential errors in recall had very little additional impact in the presence of large random errors. Selection bias resulting from underselection of unexposed controls led to J-shaped exposure-response patterns, with risk apparently decreasing at low to moderate exposure levels. The present results, in conjunction with those of the validation studies conducted within the INTERPHONE study, will play an important role in the interpretation of existing and future case-control studies of mobile phone use and cancer risk, including the INTERPHONE study.

Inclusion of Biological Foundations of Human Behavior in Counselor Education.

ERIC Educational Resources Information Center

Panther, Edward E.

1987-01-01

Reports that textbooks and counseling approaches studied by prospective counselors largely omit information on biological foundations of human behavior, although biological factors often affect human behavior profoundly. Uses case study examples to show importance of biological factors. Recommends that counselor educators understand biological…

Ongoing data reduction, theoretical studies, and supporting research in magnetospheric physics

NASA Technical Reports Server (NTRS)

Scarf, F. L.; Greenstadt, E. W.

1982-01-01

The investigators published a very large number of space science research papers, and in almost all cases these papers involved correlative multi-spacecraft studies. A tabulation of these research papers is provided. Quarterly progress reports for the second contractual period are included.

Gender, Class and Rurality: Australian Case Studies

ERIC Educational Resources Information Center

Bryant, Lia; Pini, Barbara

2009-01-01

The interrelationship between gender and class in rural spaces has received little attention. While rural scholars have focused on the implications for class from processes of gentrification and agricultural and rural restructuring, these analyses have remained largely ungendered. Similarly, feminist rural studies have rarely explored subjectivity…

Gradient flow of O(N) nonlinear sigma model at large N

DOE PAGES

Aoki, Sinya; Kikuchi, Kengo; Onogi, Tetsuya

2015-04-28

Here, we study the gradient flow equation for the O(N) nonlinear sigma model in two dimensions at large N. We parameterize solution of the field at flow time t in powers of bare fields by introducing the coefficient function X n for the n-th power term (n = 1, 3, ··· ). Reducing the flow equation by keeping only the contributions at leading order in large N, we obtain a set of equations for X n ’s, which can be solved iteratively starting from n = 1. For n = 1 case, we find an explicit form of the exactmore » solution. Using this solution, we show that the two point function at finite flow time t is finite. As an application, we obtain the non-perturbative running coupling defined from the energy density. We also discuss the solution for n = 3 case.« less

Vibrations of beams and rods carrying a moving mass

NASA Astrophysics Data System (ADS)

Zhao, X. W.; van der Heijden, G. H. M.; Hu, Z. D.

2016-05-01

We study the vibration of slender one-dimensional elastic structures (beams, cables, wires, rods) under the effect of a moving mass or load. We first consider the classical small- deflection (Euler-Bernoulli) beam case, where we look at tip vibrations of a cantilever as a model for a barreled launch system. Then we develop a theory for large deformations based on Cosserat rod theory. We illustrate the effect of moving loads on large-deformation structures with a few cable and arch problems. Large deformations are found to have a resonance detuning effect on the cable. For the arch we find different failure modes depending on its depth: a shallow arch fails by in-plane collapse, while a deep arch fails by sideways flopping. In both cases the speed of the traversing load is found to have a stabilising effect on the structure, with failure suppressed entirely at sufficiently high speed.

Sub-Selective Quantization for Learning Binary Codes in Large-Scale Image Search.

PubMed

Li, Yeqing; Liu, Wei; Huang, Junzhou

2018-06-01

Recently with the explosive growth of visual content on the Internet, large-scale image search has attracted intensive attention. It has been shown that mapping high-dimensional image descriptors to compact binary codes can lead to considerable efficiency gains in both storage and performing similarity computation of images. However, most existing methods still suffer from expensive training devoted to large-scale binary code learning. To address this issue, we propose a sub-selection based matrix manipulation algorithm, which can significantly reduce the computational cost of code learning. As case studies, we apply the sub-selection algorithm to several popular quantization techniques including cases using linear and nonlinear mappings. Crucially, we can justify the resulting sub-selective quantization by proving its theoretic properties. Extensive experiments are carried out on three image benchmarks with up to one million samples, corroborating the efficacy of the sub-selective quantization method in terms of image retrieval.

Massive cortico-subcortical ischemic stroke with a consecutive hemorrhagic event: a case report.

PubMed

Pirici, D; Ion, Daniela Adriana; Mogoantă, L; Mărgăritescu, Otilia; Pirici, Ionica; Foarfă, Camelia; Tudorică, Valerica; Panduru, N M; Coconu, Marieta; Checheriţă, I A

2011-01-01

We report a case of a 78-year-old woman with a large cerebral infarction probably due to athermanous embolism following atrial fibrillation. The patient, known with atrial fibrillation, high blood pressure and heart failure, complained of headache and motor impairment on the left side of the body. CT imaging revealed a subacute ischemic lesion in the right fronto-occipital lobes, and an old ischemic lesion in the right fronto-parietal lobes. Anticoagulant treatment was conducted with careful monitoring of the coagulability status. After almost three weeks, suddenly the patient became comatose and died shortly after. Macroscopic and microscopic examination confirmed the cortico-subcortical ischemic lesions, but also identified a fresh hemorrhagic site in pons, distant from the initial lesion sites. An immunohistochemical study identified blood vessels in the ischemic sites completely isolated from any glial support. This is a rare case of a large cerebral infarction with a pontine hemorrhagic event.

Lung carcinoma mimicking malignant lymphoma: report of three cases.

PubMed

Matsui, K; Kitagawa, M; Wakaki, K; Masuda, S

1993-10-01

Three cases of lung carcinomas with unusual histologic appearances that have received little or no comment in the literature are presented. They were initially confused with malignant lymphoma because of a diffuse proliferation of relatively monotonous cells simulating large-cell immunoblastic lymphoma. In each case, the possibility of malignant lymphoma was excluded with confidence after the immunohistochemical study (leucocyte common antigen negative and cytokeratins positive), although with conventional microscopy several foci of cohesive groups of tumor cells were observed. The tumors were ranked at the clinical stage II or III when they were initially discovered, but all patients died of disease within 1 year. The present three tumors show an aggressive behavior and could be classified into a peculiar variant of 'large cell' carcinoma. It is necessary for surgical pathologists to have an idea of these variants of lung carcinoma in order to avoid erroneous diagnosis.

Gibbs sampling on large lattice with GMRF

NASA Astrophysics Data System (ADS)

Marcotte, Denis; Allard, Denis

2018-02-01

Gibbs sampling is routinely used to sample truncated Gaussian distributions. These distributions naturally occur when associating latent Gaussian fields to category fields obtained by discrete simulation methods like multipoint, sequential indicator simulation and object-based simulation. The latent Gaussians are often used in data assimilation and history matching algorithms. When the Gibbs sampling is applied on a large lattice, the computing cost can become prohibitive. The usual practice of using local neighborhoods is unsatisfying as it can diverge and it does not reproduce exactly the desired covariance. A better approach is to use Gaussian Markov Random Fields (GMRF) which enables to compute the conditional distributions at any point without having to compute and invert the full covariance matrix. As the GMRF is locally defined, it allows simultaneous updating of all points that do not share neighbors (coding sets). We propose a new simultaneous Gibbs updating strategy on coding sets that can be efficiently computed by convolution and applied with an acceptance/rejection method in the truncated case. We study empirically the speed of convergence, the effect of choice of boundary conditions, of the correlation range and of GMRF smoothness. We show that the convergence is slower in the Gaussian case on the torus than for the finite case studied in the literature. However, in the truncated Gaussian case, we show that short scale correlation is quickly restored and the conditioning categories at each lattice point imprint the long scale correlation. Hence our approach enables to realistically apply Gibbs sampling on large 2D or 3D lattice with the desired GMRF covariance.

Systemic arterial embolization in patients with hemoptysis: initial experience with ethylene vinyl alcohol copolymer in 15 cases.

PubMed

Khalil, Antoine; Fartoukh, Muriel; Bazot, Marc; Parrot, Antoine; Marsault, Claude; Carette, Marie-France

2010-01-01

The purpose of this study was a preliminary evaluation of the use of ethylene vinyl alcohol copolymer to treat patients with hemoptysis of systemic arterial origin. We reviewed the cases of 15 consecutively registered patients (10 men, five women; mean age, 53.7 years) who underwent endovascular administration of ethylene vinyl alcohol copolymer in the management of hemoptysis. The indications, immediate control of hemoptysis, and clinical tolerability were analyzed. The indications for embolization were mainly early recurrence of hemoptysis with reperfusion of systemic arteries in seven cases; unstable microcatheter in two cases; large ectopic bronchial artery in two cases; and, in one case each, bronchial arterial bleeding through a small anastomotic network, aneurysm of the left internal thoracic artery in a patient with invasive aspergillosis, a potentially risky connection between the bronchial and right coronary arteries, and occlusion of a systemic artery due to Pryce type 1 intralobar lung sequestration. Hemoptysis was controlled in all but one case and did not recur in the other 14 cases. The injection procedure was well tolerated. Ethylene vinyl alcohol copolymer embolization for hemoptysis of systemic arterial origin is feasible. The agent seems beneficial in the care of patients with recurrent hemoptysis after previous bronchial arterial embolization, patients who would be at high risk during embolization with microparticles, and patients who need embolization of large systemic arteries through small-caliber anastomoses.

Literature Review: Herbal Medicine Treatment after Large-Scale Disasters.

PubMed

Takayama, Shin; Kaneko, Soichiro; Numata, Takehiro; Kamiya, Tetsuharu; Arita, Ryutaro; Saito, Natsumi; Kikuchi, Akiko; Ohsawa, Minoru; Kohayagawa, Yoshitaka; Ishii, Tadashi

2017-01-01

Large-scale natural disasters, such as earthquakes, tsunamis, volcanic eruptions, and typhoons, occur worldwide. After the Great East Japan earthquake and tsunami, our medical support operation's experiences suggested that traditional medicine might be useful for treating the various symptoms of the survivors. However, little information is available regarding herbal medicine treatment in such situations. Considering that further disasters will occur, we performed a literature review and summarized the traditional medicine approaches for treatment after large-scale disasters. We searched PubMed and Cochrane Library for articles written in English, and Ichushi for those written in Japanese. Articles published before 31 March 2016 were included. Keywords "disaster" and "herbal medicine" were used in our search. Among studies involving herbal medicine after a disaster, we found two randomized controlled trials investigating post-traumatic stress disorder (PTSD), three retrospective investigations of trauma or common diseases, and seven case series or case reports of dizziness, pain, and psychosomatic symptoms. In conclusion, herbal medicine has been used to treat trauma, PTSD, and other symptoms after disasters. However, few articles have been published, likely due to the difficulty in designing high quality studies in such situations. Further study will be needed to clarify the usefulness of herbal medicine after disasters.

Architectural Optimization of Digital Libraries

NASA Technical Reports Server (NTRS)

Biser, Aileen O.

1998-01-01

This work investigates performance and scaling issues relevant to large scale distributed digital libraries. Presently, performance and scaling studies focus on specific implementations of production or prototype digital libraries. Although useful information is gained to aid these designers and other researchers with insights to performance and scaling issues, the broader issues relevant to very large scale distributed libraries are not addressed. Specifically, no current studies look at the extreme or worst case possibilities in digital library implementations. A survey of digital library research issues is presented. Scaling and performance issues are mentioned frequently in the digital library literature but are generally not the focus of much of the current research. In this thesis a model for a Generic Distributed Digital Library (GDDL) and nine cases of typical user activities are defined. This model is used to facilitate some basic analysis of scaling issues. Specifically, the calculation of Internet traffic generated for different configurations of the study parameters and an estimate of the future bandwidth needed for a large scale distributed digital library implementation. This analysis demonstrates the potential impact a future distributed digital library implementation would have on the Internet traffic load and raises questions concerning the architecture decisions being made for future distributed digital library designs.

Large multistate outbreak of norovirus gastroenteritis associated with frozen strawberries, Germany, 2012.

PubMed

Bernard, H; Faber, M; Wilking, H; Haller, S; Höhle, M; Schielke, A; Ducomble, T; Siffczyk, C; Merbecks, S S; Fricke, G; Hamouda, O; Stark, K; Werber, D

2014-02-27

From 20 September through 5 October 2012, the largest recorded food-borne outbreak in Germany occurred. Norovirus was identified as the causative agent. We conducted four analytical epidemiological studies, two case–control studies and two surveys (in total 150 cases) in secondary schools in three different federal states. Overall, 390 institutions in five federal states reported nearly 11,000 cases of gastroenteritis. They were predominantly schools and childcare facilities and were supplied almost exclusively by one large catering company. The analytical epidemiological studies consistently identified dishes containing strawberries as the most likely vehicle, with estimated odds ratios ranging from 2.6 to 45.4. The dishes had been prepared in different regional kitchens of the catering company and were served in the schools two days before the peaks of the respective outbreaks. All affected institutions had received strawberries of one lot, imported frozen from China. The outbreak vehicle was identified within a week, which led to a timely recall and prevented more than half of the lot from reaching the consumer. This outbreak exemplifies the risk of large outbreaks in the era of global food trade. It underlines the importance of timely surveillance and epidemiological outbreak investigations for food safety.

The consequences of metric production for small manufacturers. Volume 2: Case studies of large business-small business interactions

NASA Astrophysics Data System (ADS)

Hitchcock, H. H.; Coates, J. F.; Canavan, M. M.; Prillaman, G. H.; Nettles, M. S.

1982-02-01

Over the last decade, controversy, concern, and conjecture have surrounded the effects of metric conversion on small business. Enthusiasts for metric argue that conversion would benefit small businesses in two ways. It would expand their markets, especially export markets. It would also improve business by making production processes more rational. Dissenters argue that conversion is unnecessary and possibly harmful to the majority of the nation's small businesses. Against this backdrop, the U.S. Metric Board is fulfilling its statutory mission to find out what happens to small businesses that convert to metric. The first phase of the project was a search for small businesses that had made substantial investments in converting to metric. That search showed that small businesses were most likely to invest in metric production in response to large corporations' needs for metric parts and products. The second phase of the research consisted of three case studies of the effects of large companies' conversion on small business suppliers. The team studied how the conversion of a General Electric Company department, two Ford Motor Company product lines, and three divisions of Ingersoll-Rand affected their small business suppliers.

B-cell posttransplant lymphoproliferative disorder isolated to the central nervous system is Epstein-Barr virus positive and lacks p53 and Myc expression by immunohistochemistry.

PubMed

Sundin, Andrew; Grzywacz, Bartosz J; Yohe, Sophia; Linden, Michael A; Courville, Elizabeth L

2017-03-01

In this retrospective study from one institution, we performed a clinicopathological study of a cohort of patients with posttransplant lymphoproliferative disorder (PTLD) confined to the central nervous system. We also identified a comparison cohort of patients with de novo primary diffuse large B-cell lymphoma of the central nervous system. We performed a detailed morphologic review, evaluated Epstein-Barr virus (EBV) by in situ hybridization, and interpreted a panel of immunohistochemical stains in a subset of cases including Hans classification markers (CD10, BCL6, MUM1), p53, CD30, Myc, and BCL2. All 17 of the posttransplant and none of 11 de novo cases were EBV positive (P < .005). Morphologic patterns identified in the PTLD cases were monomorphic diffuse large B-cell lymphoma pattern (10 patients) and "T-cell-rich" pattern (7 patients). The monomorphic posttransplant cases were more likely to be Myc negative (P = .015) and CD30 positive (P < .005) than the de novo cases, and showed a similarly low rate of p53 positivity by immunohistochemistry. No prognostic factors for overall survival were identified. Central nervous system PTLD is EBV positive, typically lacks p53 and Myc expression by immunohistochemistry, and can present with numerous background T lymphocytes. Copyright © 2016 Elsevier Inc. All rights reserved.

Reemergence of Measles in the Americas: The Genotype B3 2011-2012 Outbreak in Ecuador.

PubMed

Le, Nicole K; Mhaskar, Rahul; Hoare, Ismael; Espinel, Mauricio; Fernanda Rivadeneira, María; Malavade, Sharad; Izurieta, Ricardo

2017-06-02

This study characterizes a measles outbreak which occurred in Ecuador in 2011-2012, analyzing data from 3700 suspected cases of measles reported to Ecuador's Ministry of Public Health. The study population had a large age range and included 333 confirmed cases of measles. The greatest number of cases were found in the <1 year (32.43%, n = 108) and 1-4 year (30.03%, n = 100) age-groups. Compared to Mestizos, indigenous people had the highest number of cases (68.2%, n = 227), as well as a higher risk of infection (OR 7.278 (CI 5.251-10.087)). The greatest protection from measles was observed in individuals who received two doses of the measles vaccine. Residents of Pastaza (OR 6.645 CI (3.183-13.873)) and Tungurahua (OR 8.346 CI (5.570-12.507)) had a higher risk of infection than the other provinces. Of the 17 laboratory confirmed cases, all were identified as genotype B3. Age-group, ethnicity, measles vaccinations, and residence in Tungurahua and Pastaza were correlated with rates of measles infection in the outbreak. Tungurahua and Pastaza, where the outbreak originated, have large indigenous populations. Indigenous children <1 year of age showed the highest incidence. It is likely that indigenous women do not have immunity to the virus, and so are unable to confer measles resistance to their newborns.

A GIS-based methodology for selecting stormwater disconnection opportunities.

PubMed

Moore, S L; Stovin, V R; Wall, M; Ashley, R M

2012-01-01

The purpose of this paper is to introduce a geographic information system (GIS)-based decision support tool that assists the user to select not only areas where (retrofit) sustainable drainage systems (SuDS) could be implemented within a large catchment (>100 ha), but also to allow discrimination between suitable SuDS techniques based on their likely feasibility and effectiveness. The tool is applied to a case study catchment within London, UK, with the aim of increasing receiving water quality by reducing combined sewer overflow (CSO) spill frequency and volume. The key benefit of the tool presented is to allow rapid assessment of the retrofit SuDS potential of large catchments. It is not intended to replace detailed site investigations, but may help to direct attention to sites that have the greatest potential for retrofit SuDS implementation. Preliminary InfoWorks CS modelling of 'global disconnections' within the case study catchment, e.g. the removal of 50% of the total impervious area, showed that CSO spill volume could be reduced by 55 to 78% during a typical year. Using the disconnection hierarchy developed by the authors, the feasibility of retrofit SuDS deployment within the case study catchment is assessed, and the implications discussed.

[Primary breast lymphoma: a clinical, pathological and immunophenotypic study of eight cases].

PubMed

Ying, Jianming; Feng, Xiaoli; Liu, Xiuyun; Xie, Yongqiang; Sun, Yuntian

2002-12-01

To study the clinical, pathological and immunophenotypic characteristics of the primary breast lymphoma (PBL). Analyses of clinical history, preoperative findings, histological and immunohistochemical features of eight patients with PBL were performed. Malignant lymphoma was difficult to diagnose preoperatively. All patients were women. The age range was from 34 approximately 65 years (mean 46.4 years). The right breast was involved initially in three patients, the left in four. One patient presented bilateral involvement. Seven patients were assessed at stage IE, one with ipsolateral axillary lymph nodes involvement at stage IIE. According to the WHO classification, five patients were diagnosed as diffuse large B-cell lymphoma (4/5 centroblast, 1/5 immunoblast); the other three patients as MALT lymphoma, all with lymphoepithelial lesions. The paraffin-embedded tissues of all cases showed immunoreactivity for B-cell markers CD20, CD45RA. CD5 and CD10 were negative in all cases. Follow-up data were obtained in six patients, none recurred or died within 8 to 108 months after diagnosis. This study indicates that most PBL are diffuse large B-cell lymphoma and MALT lymphoma and have a better prognosis after comprehensive therapy.

The Queensland study of Melanoma: Environmental and Genetic Associations (Q-MEGA). Study design, baseline characteristics, and repeatability of phenotype and sun exposure measures

PubMed Central

Baxter, Amanda J.; Hughes, Maria Celia; Kvaskoff, Marina; Siskind, Victor; Shekar, Sri; Aitken, Joanne F.; Green, Adele C.; Duffy, David L.; Hayward, Nicholas K.; Martin, Nicholas G.; Whiteman, David C.

2013-01-01

Cutaneous malignant melanoma (CMM) is a major health issue in Queensland, Australia which has the world’s highest incidence. Recent molecular and epidemiologic studies suggest that CMM arises through multiple etiological pathways involving gene-environment interactions. Understanding the potential mechanisms leading to CMM requires larger studies than those previously conducted. This article describes the design and baseline characteristics of Q-MEGA, the Queensland study of Melanoma: Environmental and Genetic Associations, which followed-up four population-based samples of CMM patients in Queensland, including children, adolescents, men aged over 50, and a large sample of adult cases and their families, including twins. Q-MEGA aims to investigate the roles of genetic and environmental factors, and their interaction, in the etiology of melanoma. 3,471 participants took part in the follow-up study and were administered a computer-assisted telephone interview in 2002–2005. Updated data on environmental and phenotypic risk factors, and 2,777 blood samples were collected from interviewed participants as well as a subset of relatives. This study provides a large and well-described population-based sample of CMM cases with follow-up data. Characteristics of the cases and repeatability of sun exposure and phenotype measures between the baseline and the follow-up surveys, from six to 17 years later, are also described. PMID:18361720

International Comparative Studies in Education: Descriptions of Selected Large-Scale Assessments and Case Studies.

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC. Commission on Behavioral and Social Sciences and Education.

Since its inception in 1988, the Board on International Comparative Studies in Education (BICSE) has monitored U.S. participation in those cross national comparative studies in education that are funded by its sponsors, the National Science Foundation and the National Center for Education Statistics. This set of international study descriptions…

Analyzing self-controlled case series data when case confirmation rates are estimated from an internal validation sample.

PubMed

Xu, Stanley; Clarke, Christina L; Newcomer, Sophia R; Daley, Matthew F; Glanz, Jason M

2018-05-16

Vaccine safety studies are often electronic health record (EHR)-based observational studies. These studies often face significant methodological challenges, including confounding and misclassification of adverse event. Vaccine safety researchers use self-controlled case series (SCCS) study design to handle confounding effect and employ medical chart review to ascertain cases that are identified using EHR data. However, for common adverse events, limited resources often make it impossible to adjudicate all adverse events observed in electronic data. In this paper, we considered four approaches for analyzing SCCS data with confirmation rates estimated from an internal validation sample: (1) observed cases, (2) confirmed cases only, (3) known confirmation rate, and (4) multiple imputation (MI). We conducted a simulation study to evaluate these four approaches using type I error rates, percent bias, and empirical power. Our simulation results suggest that when misclassification of adverse events is present, approaches such as observed cases, confirmed case only, and known confirmation rate may inflate the type I error, yield biased point estimates, and affect statistical power. The multiple imputation approach considers the uncertainty of estimated confirmation rates from an internal validation sample, yields a proper type I error rate, largely unbiased point estimate, proper variance estimate, and statistical power. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A study of the transferability of influenza case detection systems between two large healthcare systems

PubMed Central

Wagner, Michael M.; Cooper, Gregory F.; Ferraro, Jeffrey P.; Su, Howard; Gesteland, Per H.; Haug, Peter J.; Millett, Nicholas E.; Aronis, John M.; Nowalk, Andrew J.; Ruiz, Victor M.; López Pineda, Arturo; Shi, Lingyun; Van Bree, Rudy; Ginter, Thomas; Tsui, Fuchiang

2017-01-01

Objectives This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD) that use clinical notes from emergency department (ED) to detect influenza cases. Methods A BCD uses natural language processing (NLP) to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN) to infer patients’ diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC) and Intermountain Healthcare in Utah (BCDIH). At each site, we manually built a rule-based NLP and trained a Bayesain network classifier from over 40,000 ED encounters between Jan. 2008 and May. 2010 using feature selection, machine learning, and expert debiasing approach. Transferability of a BCD in this study may be impacted by seven factors: development (source) institution, development parser, application (target) institution, application parser, NLP transfer, BN transfer, and classification task. We employed an ANOVA analysis to study their impacts on BCD performance. Results Both BCDs discriminated well between influenza and non-influenza on local test cases (AUCs > 0.92). When tested for transferability using the other institution’s cases, BCDUPMC discriminations declined minimally (AUC decreased from 0.95 to 0.94, p<0.01), and BCDIH discriminations declined more (from 0.93 to 0.87, p<0.0001). We attributed the BCDIH decline to the lower recall of the IH parser on UPMC notes. The ANOVA analysis showed five significant factors: development parser, application institution, application parser, BN transfer, and classification task. Conclusion We demonstrated high influenza case detection performance in two large healthcare systems in two geographically separated regions, providing evidentiary support for the use of automated case detection from routinely collected electronic clinical notes in national influenza surveillance. The transferability could be improved by training Bayesian network classifier locally and increasing the accuracy of the NLP parser. PMID:28380048

A study of the transferability of influenza case detection systems between two large healthcare systems.

PubMed

Ye, Ye; Wagner, Michael M; Cooper, Gregory F; Ferraro, Jeffrey P; Su, Howard; Gesteland, Per H; Haug, Peter J; Millett, Nicholas E; Aronis, John M; Nowalk, Andrew J; Ruiz, Victor M; López Pineda, Arturo; Shi, Lingyun; Van Bree, Rudy; Ginter, Thomas; Tsui, Fuchiang

2017-01-01

This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD) that use clinical notes from emergency department (ED) to detect influenza cases. A BCD uses natural language processing (NLP) to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN) to infer patients' diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC) and Intermountain Healthcare in Utah (BCDIH). At each site, we manually built a rule-based NLP and trained a Bayesain network classifier from over 40,000 ED encounters between Jan. 2008 and May. 2010 using feature selection, machine learning, and expert debiasing approach. Transferability of a BCD in this study may be impacted by seven factors: development (source) institution, development parser, application (target) institution, application parser, NLP transfer, BN transfer, and classification task. We employed an ANOVA analysis to study their impacts on BCD performance. Both BCDs discriminated well between influenza and non-influenza on local test cases (AUCs > 0.92). When tested for transferability using the other institution's cases, BCDUPMC discriminations declined minimally (AUC decreased from 0.95 to 0.94, p<0.01), and BCDIH discriminations declined more (from 0.93 to 0.87, p<0.0001). We attributed the BCDIH decline to the lower recall of the IH parser on UPMC notes. The ANOVA analysis showed five significant factors: development parser, application institution, application parser, BN transfer, and classification task. We demonstrated high influenza case detection performance in two large healthcare systems in two geographically separated regions, providing evidentiary support for the use of automated case detection from routinely collected electronic clinical notes in national influenza surveillance. The transferability could be improved by training Bayesian network classifier locally and increasing the accuracy of the NLP parser.

Relative intensity noise transfer of large-bandwidth pump lasers in Raman fiber amplifiers

NASA Astrophysics Data System (ADS)

Keita, Kafing; Delaye, Philippe; Frey, Robert; Roosen, Gérald

2006-12-01

A theoretical analysis of the Raman amplification in optical fibers and the pump-to-signal relative intensity noise (RIN) transfer has been performed in the spectral domain. An efficient Raman amplification of a monochromatic signal beam by a large-bandwidth pump beam has been demonstrated for a pump bandwidth much smaller than the Raman linewidth. Under the same approximation the pump-to-signal RIN transfer has been calculated in both cases of copropagating and counterpropagating beams in the two limiting cases of modulated monochromatic and smooth-profile large-bandwidth pump beams. At low frequencies the excess of noise evidenced in the case of a modulated monochromatic pump beam did not exist in the case of large-bandwidth pseudoincoherent sources. As this noise reduction can be as large as 13 dB for a 40 dB net gain of the amplifier, such incoherent pumping sources must be considered for the purpose of low-noise Raman amplifiers.

Use of buccal mucosa patch graft for recurrent large urethrocutaneous fistula after hypospadias repair.

PubMed

Kiss, András; Pirót, László; Karsza, Levente; Merksz, Miklós

2004-01-01

To assess the effectiveness of buccal mucosa patch graft in the treatment of recurrent large urethrocutaneous fistula after hypospadias repair. A free graft of buccal mucosa was used for closure in 7 boys (mean age 4.8 years) with large (>4 mm) urethocutaneous fistula. Four fistulas were in the midshaft, 2 of them penoscrotal and 1 coronal type. All patients had undergone at least two previous unsuccessful fistula repairs, and 3 of them had undergone three attempts for closure. Fistula repairs were similar in all cases. The repair was successful in 6 out of 7 cases, and in these cases the urinary stream was good after the removal of the catheter. The unsuccessful case was the coronal one. Based on our experience it seems that in cases with recurrent large fistula after hypospadias reconstruction, the use of buccal mucosa patch graft for closure is a good treatment choice. Copyright 2004 S. Karger AG, Basel

Missing data treatments matter: an analysis of multiple imputation for anterior cervical discectomy and fusion procedures.

PubMed

Ondeck, Nathaniel T; Fu, Michael C; Skrip, Laura A; McLynn, Ryan P; Cui, Jonathan J; Basques, Bryce A; Albert, Todd J; Grauer, Jonathan N

2018-04-09

The presence of missing data is a limitation of large datasets, including the National Surgical Quality Improvement Program (NSQIP). In addressing this issue, most studies use complete case analysis, which excludes cases with missing data, thus potentially introducing selection bias. Multiple imputation, a statistically rigorous approach that approximates missing data and preserves sample size, may be an improvement over complete case analysis. The present study aims to evaluate the impact of using multiple imputation in comparison with complete case analysis for assessing the associations between preoperative laboratory values and adverse outcomes following anterior cervical discectomy and fusion (ACDF) procedures. This is a retrospective review of prospectively collected data. Patients undergoing one-level ACDF were identified in NSQIP 2012-2015. Perioperative adverse outcome variables assessed included the occurrence of any adverse event, severe adverse events, and hospital readmission. Missing preoperative albumin and hematocrit values were handled using complete case analysis and multiple imputation. These preoperative laboratory levels were then tested for associations with 30-day postoperative outcomes using logistic regression. A total of 11,999 patients were included. Of this cohort, 63.5% of patients had missing preoperative albumin and 9.9% had missing preoperative hematocrit. When using complete case analysis, only 4,311 patients were studied. The removed patients were significantly younger, healthier, of a common body mass index, and male. Logistic regression analysis failed to identify either preoperative hypoalbuminemia or preoperative anemia as significantly associated with adverse outcomes. When employing multiple imputation, all 11,999 patients were included. Preoperative hypoalbuminemia was significantly associated with the occurrence of any adverse event and severe adverse events. Preoperative anemia was significantly associated with the occurrence of any adverse event, severe adverse events, and hospital readmission. Multiple imputation is a rigorous statistical procedure that is being increasingly used to address missing values in large datasets. Using this technique for ACDF avoided the loss of cases that may have affected the representativeness and power of the study and led to different results than complete case analysis. Multiple imputation should be considered for future spine studies. Copyright © 2018 Elsevier Inc. All rights reserved.

Operating room waste: disposable supply utilization in neurosurgical procedures.

PubMed

Zygourakis, Corinna C; Yoon, Seungwon; Valencia, Victoria; Boscardin, Christy; Moriates, Christopher; Gonzales, Ralph; Lawton, Michael T

2017-02-01

OBJECTIVE Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization of disposable supplies and the costs associated with opened but unused items (i.e., "waste") in neurosurgical procedures. METHODS Every disposable supply that was unused at the end of surgery was quantified through direct observation of 58 neurosurgical cases at the University of California, San Francisco, in August 2015. Item costs (in US dollars) were determined from the authors' supply catalog, and statistical analyses were performed. RESULTS Across 58 procedures (36 cranial, 22 spinal), the average cost of unused supplies was $653 (range $89-$3640, median $448, interquartile range $230-$810), or 13.1% of total surgical supply cost. Univariate analyses revealed that case type (cranial versus spinal), case category (vascular, tumor, functional, instrumented, and noninstrumented spine), and surgeon were important predictors of the percentage of unused surgical supply cost. Case length and years of surgical training did not affect the percentage of unused supply cost. Accounting for the different case distribution in the 58 selected cases, the authors estimate approximately $968 of OR waste per case, $242,968 per month, and $2.9 million per year, for their neurosurgical department. CONCLUSIONS This study shows a large variation and significant magnitude of OR waste in neurosurgical procedures. At the authors' institution, they recommend price transparency, education about OR waste to surgeons and nurses, preference card reviews, and clarification of supplies that should be opened versus available as needed to reduce waste.

Tubal factor infertility in Benin City, Nigeria - sociodemographics of patients and aetiopathogenic factors.

PubMed

Umeora, O U J; Mbazor, J O; Okpere, E E

2007-04-01

In Africa, infertility constitutes a major gynaecological complaint and causes enormous socio-psychological stress to the patients. This study examined retrospective data at the University of Benin Teaching Hospital, Benin City, Nigeria, over a 5-year period to determine the factors associated with tubal infertility. Tubal infertility was confirmed in 13.5% of the 1181 new cases of infertility over the study period. The mean age of the patients was 33.2+/-9.5 years. Over 65% were nulliparous and all socioeconomic classes were affected. Major associated factors included infections such as post-abortal sepsis, puerperal sepsis and pelvic inflammatory disease (PID). Infertility is largely preventable. Attention should be focused on reducing the incidence of unsafe abortion and its consequences, providing clean and safe delivery as well as reducing the incidence of and ensuring proper treatment of any cases of PID. Infertility is largely preventable. Attention should be focused on reducing the incidence of unsafe abortion and its consequences, providing clean and safe delivery as well as reducing the incidence of and ensuring proper treatment of any cases of PID.

Interventional cardiology live case presentations: regulatory considerations.

PubMed

Farb, Andrew; Brown, Sheila A; Wolf, Deborah A; Zuckerman, Bram

2010-10-01

Live case presentations are increasingly common at interventional cardiology conferences. Taking advantage of significant advances in communication technology, broadcasts of procedures can be viewed as an extension of traditional medical education targeted to large groups of practitioners. However, there are important ethical, commercial, and patient safety issues associated with live cases that deserve attention. Use of investigational devices in live case demonstrations is subject to review and approval by FDA's Center for Devices and Radiological Health (CDRH), and the outcomes of patients participating in live cases are considered in the overall clinical study results. This article discusses CDRH's regulatory view of live case presentations with a focus on patient safety, clinical trial integrity, and concerns regarding improper medical device promotion. © 2010 Wiley-Liss, Inc.

Interventional cardiology live case presentations regulatory considerations.

PubMed

Farb, Andrew; Brown, Sheila A; Wolf, Deborah A; Zuckerman, Bram

2010-10-01

Live case presentations are increasingly common at interventional cardiology conferences. Taking advantage of significant advances in communication technology, broadcasts of procedures can be viewed as an extension of traditional medical education targeted to large groups of practitioners. However, there are important ethical, commercial, and patient safety issues associated with live cases that deserve attention. Use of investigational devices in live case demonstrations is subject to review and approval by FDA's Center for Devices and Radiological Health (CDRH), and the outcomes of patients participating in live cases are considered in the overall clinical study results. This article discusses CDRH's regulatory view of live case presentations with a focus on patient safety, clinical trial integrity, and concerns regarding improper medical device promotion. Copyright © 2010. Published by Elsevier Inc.

The Safety of Soft Contact Lenses in Children

PubMed Central

Bullimore, Mark A.

2017-01-01

ABSTRACT Purpose There is increasing interest in fitting children with soft contact lenses. This review collates data from a range of studies to estimate the incidence of complications, specifically corneal infiltrative events and microbial keratitis, in patients under the age of 18 years. Methods Peer-review papers were identified using PubMed and the Web of Science. A broad range of studies are summarized including large-scale epidemiological studies of contact lens–related complications, hospital-based case series, long- and short-term prospective studies, and multicenter retrospective studies. Results Nine prospective studies representing 1800 patient years of wear in 7- to 19-year-olds include safety outcomes. In three large prospective studies representing between 159 and 723 patient years of soft contact lens wear in patients 8 to 14 years, the incidence of corneal infiltrative events is up to 136 per 10,000 years. Data from a large retrospective study show similar rates of corneal infiltrative events: 97 per 10,000 years in 8- to 12-year-olds (based on 411 patient years of wear) and 335 per 10,000 years in 13- to 17-year-olds (based on 1372 patient years of wear). None of the prospective studies report any cases of microbial keratitis. Five clinical studies where safety data are not reported constitute a further 493 patient years. One retrospective study found no cases of microbial keratitis occurred in 8- to 12-year-olds (411 patient years) and an incidence of 15 per 10,000 patient years in 13- to 17-year-olds (1372 patient years)—no higher than the incidence of microbial keratitis in adults wearing soft contact lenses on an overnight basis. Conclusions The overall picture is that the incidence of corneal infiltrative events in children is no higher than in adults, and in the youngest age range of 8 to 11 years, it may be markedly lower. PMID:28514244

Large Eddy Simulation of Cirrus Clouds

NASA Technical Reports Server (NTRS)

Wu, Ting; Cotton, William R.

1999-01-01

The Regional Atmospheric Modeling System (RAMS) with mesoscale interactive nested-grids and a Large-Eddy Simulation (LES) version of RAMS, coupled to two-moment microphysics and a new two-stream radiative code were used to investigate the dynamic, microphysical, and radiative aspects of the November 26, 1991 cirrus event. Wu (1998) describes the results of that research in full detail and is enclosed as Appendix 1. The mesoscale nested grid simulation successfully reproduced the large scale circulation as compared to the Mesoscale Analysis and Prediction System's (MAPS) analyses and other observations. Three cloud bands which match nicely to the three cloud lines identified in an observational study (Mace et al., 1995) are predicted on Grid #2 of the nested grids, even though the mesoscale simulation predicts a larger west-east cloud width than what was observed. Large-eddy simulations (LES) were performed to study the dynamical, microphysical, and radiative processes in the 26 November 1991 FIRE 11 cirrus event. The LES model is based on the RAMS version 3b developed at Colorado State University. It includes a new radiation scheme developed by Harrington (1997) and a new subgrid scale model developed by Kosovic (1996). The LES model simulated a single cloud layer for Case 1 and a two-layer cloud structure for Case 2. The simulations demonstrated that latent heat release can play a significant role in the formation and development of cirrus clouds. For the thin cirrus in Case 1, the latent heat release was insufficient for the cirrus clouds to become positively buoyant. However, in some special cases such as Case 2, positively buoyant cells can be embedded within the cirrus layers. These cells were so active that the rising updraft induced its own pressure perturbations that affected the cloud evolution. Vertical profiles of the total radiative and latent heating rates indicated that for well developed, deep, and active cirrus clouds, radiative cooling and latent heating could be comparable in magnitude in the cloudy layer. This implies that latent heating cannot be neglected in the construction of a cirrus cloud model. The probability density function (PDF) of w was analyzed to assist in the parameterization of cloud-scale velocities in large-scale models. For the more radiatively-driven, thin cirrus case, the PDFs are approximately Gaussian. However, in the interior of the deep, convectively unstable case, the PDFs of w are multi-modal and very broad, indicating that parameterizing cloud-scale motions for such clouds can be very challenging. The results of this research are described in detail in a paper submitted to the Journal of Atmospheric Science (Wu and Cotton, 1999), which is enclosed as Appendix 2. Using soundings extracted from a mesoscale simulation of the November 26, 1991 cirrus event, the radiative effects on vapor deposition/sublimation of ice crystals was studied using a two-dimensional cloud-resolving model (CRM) version of RAMS, coupled to an explicit bin-resolving microphysics. The CRM simulations of the November 26, 1991 cirrus event demonstrate that the radiative impact on the diffusional growth (or sublimation) of ice crystals is significant. In this case, the ice particles experienced radiative warming. Model results show that radiative feedbacks in the diffusional growth of ice particles can be very complex. Radiative warming of an ice particle will restrict the particle's diffusional growth. In the case of radiative warming, ice particles larger than a certain size will experience so much radiative warming that surface ice saturation vapor pressures become large enough to cause sublimation of the larger crystals, while smaller crystals are growing by vapor deposition. However, ice mass production can be enhanced in the case of radiative cooling of an ice particle. For the November 26, 1991 cirrus event, radiative feedback results in significant reduction in the total ice mass, especially in the production of large ice crystals, and consequently, both radiative and dynamic properties of the cirrus cloud are significantly affected. A complete description of this research has been submitted as a paper to the Journal of Atmospheric Science (Wu et al., 1999), and included as Appendix 3.

Rare coding variants in Phospholipase D3 (PLD3) confer risk for Alzheimer's disease

PubMed Central

Cruchaga, Carlos; Benitez, Bruno A.; Cai, Yefei; Guerreiro, Rita; Harari, Oscar; Norton, Joanne; Budde, John; Bertelsen, Sarah; Jeng, Amanda T.; Cooper, Breanna; Skorupa, Tara; Carrell, David; Levitch, Denise; Hsu, Simon; Choi, Jiyoon; Ryten, Mina; Sassi, Celeste; Bras, Jose; Gibbs, Raphael J.; Hernandez, Dena G.; Lupton, Michelle K.; Powell, John; Forabosco, Paola; Ridge, Perry G.; Corcoran, Christopher D.; Tschanz, JoAnn T.; Norton, Maria C.; Munger, Ronald G.; Schmutz, Cameron; Leary, Maegan; Demirci, F. Yesim; Bamne, Mikhil N.; Wang, Xingbin; Lopez, Oscar L.; Ganguli, Mary; Medway, Christopher; Turton, James; Lord, Jenny; Braae, Anne; Barber, Imelda; Brown, Kristelle; Pastor, Pau; Lorenzo-Betancor, Oswaldo; Brkanac, Zoran; Scott, Erick; Topol, Eric; Morgan, Kevin; Rogaeva, Ekaterina; Singleton, Andy; Hardy, John; Kamboh, M. Ilyas; George-Hyslop, Peter St; Cairns, Nigel; Morris, John C.; Kauwe, John S.K.; Goate, Alison M.

2014-01-01

Genome-wide association studies (GWAS) have identified several risk variants for late-onset Alzheimer's disease (LOAD)1,2. These common variants have replicable but small effects on LOAD risk and generally do not have obvious functional effects. Low-frequency coding variants, not detected by GWAS, are predicted to include functional variants with larger effects on risk. To identify low frequency coding variants with large effects on LOAD risk, we performed whole exome-sequencing (WES) in 14 large LOAD families and follow-up analyses of the candidate variants in several large case-control datasets. A rare variant in PLD3 (phospholipase-D family, member 3, rs145999145; V232M) segregated with disease status in two independent families and doubled risk for AD in seven independent case-control series (V232M meta-analysis; OR= 2.10, CI=1.47-2.99; p= 2.93×10-5, 11,354 cases and controls of European-descent). Gene-based burden analyses in 4,387 cases and controls of European-descent and 302 African American cases and controls, with complete sequence data for PLD3, indicate that several variants in this gene increase risk for AD in both populations (EA: OR= 2.75, CI=2.05-3.68; p=1.44×10-11, AA: OR= 5.48, CI=1.77-16.92; p=1.40×10-3). PLD3 is highly expressed in brain regions vulnerable to AD pathology, including hippocampus and cortex, and is expressed at lower levels in neurons from AD brains compared to control brains (p=8.10×10-10). Over-expression of PLD3 leads to a significant decrease in intracellular APP and extracellular Aβ42 and Aβ40, while knock-down of PLD3 leads to a significant increase in extracellular Aβ42 and Aβ40. Together, our genetic and functional data indicate that carriers of PLD3 coding variants have a two-fold increased risk for LOAD and that PLD3 influences APP processing. This study provides an example of how densely affected families may be used to identify rare variants with large effects on risk for disease or other complex traits. PMID:24336208

Arthroscopic modified Mason-Allen technique for large U- or L-shaped rotator cuff tears.

PubMed

Jung, Sung-Weon; Kim, Dong-Hee; Kang, Seung-Hoon; Lee, Ji-Heon

2017-07-01

While a conventional single- or double-row repair technique could be applied for repair of C-shaped tears, a different surgical strategy should be considered for repair of U- or L-shaped tears because they typically have complex patterns with anterior, posterior, or both mobile leaves. This study was performed to examine the outcomes of the modified Mason-Allen technique for footprint restoration in the treatment of large U- or L-shaped rotator cuff tears. Thirty-two patients who underwent an arthroscopic modified Mason-Allen technique for large U- or L-shaped rotator cuff tears between January 2012 and December 2013 were included in this study. Margin convergence was first performed to reduce the tear gap and tension, and then, an arthroscopic Mason-Allen technique was performed to restore the rotator cuff footprint in a side-to-end repair fashion. All patients were evaluated preoperatively and for a minimum of 2 years of follow-up with a visual analog scale (VAS) for pain, Constant score, and ultrasonography. There was significant improvement in all VAS and Constant scores compared with the preoperative values (P < 0.001). Functional results by Constant scores included 9 cases that were classified as excellent, 11 cases as good, 8 cases as fair, and 2 cases as poor. Binary logistic regression analysis revealed that heavy work, pseudoparalysis, joint space narrowing, fatty degeneration of the SST and IST, and a positive tangent sign were found to significantly correlate with functional outcomes. Multivariable logistic regression analysis revealed that only fatty degeneration of the SST was a risk factor for fair/poor clinical outcomes. Complications occurred in 5 of the 32 patients (15.6 %), and the reoperation rate due to complications was 6.3 % (2 of 32 patients). An arthroscopic modified Mason-Allen technique was sufficient to restore the footprint of the rotator cuff in our data. Overall satisfactory results were achieved in most patients, with the exception of those with severe fatty degeneration. An arthroscopic modified Mason-Allen technique could be an effective and reliable alternative for patients with large U- or L-shaped rotator cuff tears. Case Series, Therapeutic Level IV.

Combined use of coils and Onyx for transcatheter closure of coronary artery fistulae.

PubMed

Li, Pan; Xu, Xudong; Zhang, Zheng; Wang, Feiyu; Wang, Zhongkai; Chen, Feng; Zhang, Bili; Qin, Yongwen; Chen, Shaoping; Zhao, Xianxian

2018-04-06

The aim of this study was to evaluate the safety and efficacy of combined endovascular coiling and Onyx embolisation in patients with a coronary artery fistula (CAF). Between September 2014 and September 2016, 26 patients with CAFs were enrolled in our study for attempted combined therapy using coils and Onyx. The mean age of patients was 64.0±9.5 years (range, 44-78 years). CAFs were large in 10 and medium in 16 patients. The mean number of coils used was 3.1±1.2 (range, two to six), and the average volume of Onyx was 0.4±0.1 ml (range, 0.2-0.6 ml). Immediate post-embolisation angiography demonstrated that complete occlusion was achieved in 23 patients (88.5%) and a small residual fistula was achieved in three patients (11.5%). Follow-up imaging (median, 11.5 months; range, nine to 20) revealed stable occlusion of CAF in 21 cases (80.8%), trivial recanalisation in four cases (15.4%), and large recanalisation in only one case (3.8%). Re-closure was performed in the patient with large recanalisation. During the follow-up period, no deaths, severe procedure-related complications, or new symptoms occurred. In selected patients with CAF, transcatheter embolisation in combined therapy using coils and Onyx appears to be a valid option, providing a high success rate and low rate of recanalisation.

The impact of ordinate scaling on the visual analysis of single-case data.

PubMed

Dart, Evan H; Radley, Keith C

2017-08-01

Visual analysis is the primary method for detecting the presence of treatment effects in graphically displayed single-case data and it is often referred to as the "gold standard." Although researchers have developed standards for the application of visual analysis (e.g., Horner et al., 2005), over- and underestimation of effect size magnitude is not uncommon among analysts. Several characteristics have been identified as potential contributors to these errors; however, researchers have largely focused on characteristics of the data itself (e.g., autocorrelation), paying less attention to characteristics of the graphic display which are largely in control of the analyst (e.g., ordinate scaling). The current study investigated the impact that differences in ordinate scaling, a graphic display characteristic, had on experts' accuracy in judgments regarding the magnitude of effect present in single-case percentage data. 32 participants were asked to evaluate eight ABAB data sets (2 each presenting null, small, moderate, and large effects) along with three iterations of each (32 graphs in total) in which only the ordinate scale was manipulated. Results suggest that raters are less accurate in their detection of treatment effects as the ordinate scale is constricted. Additionally, raters were more likely to overestimate the size of a treatment effect when the ordinate scale was constricted. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Association between aircraft, road and railway traffic noise and depression in a large case-control study based on secondary data.

PubMed

Seidler, Andreas; Hegewald, Janice; Seidler, Anna Lene; Schubert, Melanie; Wagner, Mandy; Dröge, Patrik; Haufe, Eva; Schmitt, Jochen; Swart, Enno; Zeeb, Hajo

2017-01-01

Few studies have examined the relationship between traffic noise and depression providing inconclusive results. This large case-control study is the first to assess and directly compare depression risks by aircraft, road traffic and railway noise. The study population included individuals aged ≥40 years that were insured by three large statutory health insurance funds and were living in the region of Frankfurt international airport. Address-specific exposure to aircraft, road and railway traffic noise in 2005 was estimated. Based on insurance claims and prescription data, 77,295 cases with a new clinical depression diagnosis between 2006 and 2010 were compared with 578,246 control subjects. For road traffic noise, a linear exposure-risk relationship was found with an odds ratio (OR) of 1.17 (95% CI=1.10-1.25) for 24-h continuous sound levels ≥70dB. For aircraft noise, the risk estimates reached a maximum OR of 1.23 (95% CI=1.19-1.28) at 50-55dB and decreased at higher exposure categories. For railway noise, risk estimates peaked at 60-65dB (OR=1.15, 95% CI=1.08-1.22). The highest OR of 1.42 (95% CI=1.33-1.52) was found for a combined exposure to noise above 50dB from all three sources. This study indicates that traffic noise exposure might lead to depression. As a potential explanation for the decreasing risks at high traffic noise levels, vulnerable people might actively cope with noise (e.g. insulate or move away). Copyright © 2016 Elsevier Inc. All rights reserved.

Direct traumatic carotid cavernous fistula: angiographic classification and treatment strategies. Study of 172 cases.

PubMed

Chi, Cuong Tran; Nguyen, Dang; Duc, Vo Tan; Chau, Huynh Hong; Son, Vo Tan

2014-01-01

We report our experience in treatment of traumatic direct carotid cavernous fistula (CCF) via endovascular intervention. We hereof recommend an additional classification system for type A CCF and suggest respective treatment strategies. Only type A CCF patients (Barrow's classification) would be recruited for the study. Based on the angiographic characteristics of the CCF, we classified type A CCF into three subtypes including small size, medium size and large size fistula depending on whether there was presence of the anterior carotid artery (ACA) and/or middle carotid artery (MCA). Angiograms with opacification of both ACA and MCA were categorized as small size fistula. Angiograms with opacification of either ACA or MCA were categorized as medium size fistula and those without opacification of neither ACA nor MCA were classified as large size fiatula. After the confirm angiogram, endovascular embolization would be performed impromptu using detachable balloon, coils or both. All cases were followed up for complication and effect after the embolization. A total of 172 direct traumatic CCF patients were enrolled. The small size fistula was accountant for 12.8% (22 cases), medium size 35.5% (61 cases) and large size fistula accountant for 51.7% (89 cases). The successful rate of fistula occlusion under endovascular embolization was 94% with preservation of the carotid artery in 70%. For the treatment of each subtype, a total of 21/22 cases of the small size fistulas were successfully treated using coils alone. The other single case of small fistula was defaulted. Most of the medium and large size fistulas were cured using detachable balloons. When the fistula sealing could not be obtained using detachable balloon, coils were added to affirm the embolization of the cavernous sinus via venous access. There were about 2.9% of patient experienced direct carotid artery puncture and 0.6% puncture after carotid artery cut-down exposure. About 30% of cases experienced sacrifice of the parent vessels and it was associated with sizes of the fistula. Total severe complication was about 2.4% which included 1 death (0.6%) due to vagal shock; 1 transient hemiparesis post-sacrifice occlusion of the carotid artery but the patient had recovered after 3 months; 1 acute thrombus embolism and the patient was completely saved with recombinant tissue plaminogen activator (rTPA); 1 balloon dislodgement then got stuck at the anterior communicating artery but the patient was asymptomatic. Endovascular intervention as the treatment of direct traumatic CCF had high cure rate and low complication with its ability to preserve the carotid artery. It also can supply flexible accesses to the fistulous site with various alternative embolic materials. The new classification of type A CCF based on angiographic features was helpful for planning for the embolization. Coil should be considered as the first embolic material for small size fistula meanwhile detachable balloons was suggested as the first-choice embolic agent for the medium and large size fistula.

Prospective Multicenter Study on the Challenges Inherent to Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction.

PubMed

Yang, Min Jae; Kim, Jin Hong; Hwang, Jae Chul; Yoo, Byung Moo; Lee, Sang Hyub; Ryu, Ji Kon; Kim, Yong-Tae; Woo, Sang Myung; Lee, Woo Jin; Jeong, Seok; Lee, Don Haeng

2018-06-22

Although endoscopic bilateral stent-in-stent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic reintervention. This study aimed to evaluate the technical feasibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases with technical success. Stent occlusion occurred in 63.2% of patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Large cell-type stents for endoscopic bilateral stent-in-stent placement showed acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

Diagnostic pitfalls associated with a large true posterior communicating artery aneurysm: a case report.

PubMed

Nagatani, Kimihiro; Otani, Naoki; Seno, Soichiro; Takeuchi, Satoru; Wada, Kojiro; Mori, Kentaro

2013-10-01

True posterior communicating artery (PCoA) aneurysm is an aneurysm that originates from the PCoA, and large or giant true PCoA aneurysms are rare. We report a case of a large true PCoA aneurysm successfully clipped after anterior clinoidectomy and discuss the diagnostic pitfalls associated with this rare clinical entity.

Paranuclear blue inclusions in metastatic undifferentiated small cell carcinoma in the bone marrow.

PubMed

Wittchow, R; Laszewski, M; Walker, W; Dick, F

1992-09-01

Paranuclear blue inclusions (PBIs) are frequently identified within metastatic undifferentiated small cell carcinoma (SCC) cells on air-dried bone marrow aspirates stained with Wright's stain. To determine the sensitivity and specificity of this finding, 116 bone marrow aspirates containing metastatic neoplasms were evaluated for the presence and frequency of PBIs. Bone marrow specimens included 47 cases of metastatic SCC of the lung, 13 cases of large cell lymphoma, 19 cases of neuroblastoma, five cases of small, noncleaved cell lymphoma, seven cases of rhabdomyosarcoma, three cases of Ewing's sarcoma, three cases of other sarcomas, and 19 cases of non-small cell carcinoma (adenocarcinoma). PBIs were identified in 40 of 47 (85%) cases of SCC and their frequency varied from 0 to 24% of tumor cells among different cases. In approximately half the cases of SCC, PBIs were identified in 1 to 4% tumor cells; and in eight cases, PBIs were present in 5% or more of tumor cells. PBIs were also identified in two of seven (29%) cases of rhabdomyosarcoma and one case of malignant peripheral nerve sheath tumor, but they were not seen in Ewing's sarcoma, small non-cleaved cell lymphoma, large cell lymphoma, neuroblastoma, or non-small cell carcinoma. In addition, PBIs were not seen in alcohol-fixed, Papanicolaou-stained cytology specimens containing SCC. Ultrastructurally, PBIs may represent phagocytized nuclear/cellular material. PBIs are a feature of small cell carcinoma on air-dried, cytologic material stained with Romanowsky type stains. Their presence may provide diagnostic information with regard to the differential diagnosis of metastatic SCC in the bone marrow. Future studies evaluating non-bone marrow Wright's stained fine-needle aspiration specimens are needed to determine if PBIs are useful in distinguishing SCC from other poorly differentiated tumors in the cytology laboratory.

[Primary central nervous system diffuse large B cell lymphoma: a clinicopathologic and molecular study].

PubMed

Ma, Z P; Ainiwaer, Babayi; Liu, Z Y; Shi, X L; Cui, W L; Zhang, W; Li, X X

2016-11-08

Objective: To investigate clinicopathologic characteristics, immunophenotype and EB virus-related molecular genetic alterations in primary central nervous system diffuse large B cell lymphoma (DLBCL) along with correlation with clinical prognosis. Methods: A total of 30 cases of primary central nervous system DLBCL were retrospectively studied by retrieving clinical data, histological evaluation and immunophenotyping by EnVision two steps methods. The expression of EBER mRNA was detected by in situ hybridization and bcl-2, bcl-6 and C-MYC gene abnormalities were analyzed by interphase fluorescence in situ hybridization. Results: The cases included 18 males and 12 females (sex ratio of 1.5∶1.0) with an age ranging from 24 to 78 years (average age of 52 years, the median age of 53 years). The single primary clinical presentation was focal neurologic deficits. Tumor locations were supratentorial (21 cases), subtentorial (7 cases), involving both locations in 2 cases. Diffuse growth pattern was observed with large lymphoid cells mostly resembling centroblasts with abundant basophilic cytoplasm with oval to round, vesicular nuclei containing fine chromatin. An angiocentric and angiodestructive growth pattern was also present. Other features included perivascular space invasion. Immunohistochemical staining using a panel of CD10, bcl-6 and MUM1, six cases were germinal center-like (GCB) and 24 cases were non-germinal central-like (non-GCB). The positive rates of bcl-2, bcl-6 and C-MYC were 53.3% (16/30), 80.0% (24/30) and 20.0% (6/30), respectively. Genetic alterations were detected by FISH and the gene arrangement rates of bcl-2, bcl-6 and C-MYC were 3.3% (1/30), 16.7% (5/30) and 3.3% (1/30), respectively. There were 19 cases in stage 0-1 disease and 11 cases had stage 2-3 disease. Postoperative follow-up for average 13.6 months showed the median survival of 10 months, one-year survival of 46.7% and 16 patients died within a year. Conclusions: The clinical prognosis of primary central nerve system DLBCL depends on age, clinical performence status score, IPI score, immune classification and treatment. Patients typically progress rapidly with the high mortality within one year of diagnosis. Surgical resection combined with high-dose methotrexate or cytarabine chemotherapy offer the best treatment option.

A case-control study of Nocardia mastitis in Nova Scotia dairy herds

PubMed Central

Ferns, Lyn; Dohoo, Ian; Donald, Alan

1991-01-01

A case-control study was conducted to identify herd production, housing, and hygienic and therapeutic factors associated with a diagnosis of Nocardia mastitis in dairy herds in Nova Scotia. The data were collected by on-farm interviews with owners of 54 case and 54 control herds. Logistic regression was used to study risk factors. The use of dry cow products containing neomycin, including two specific dry cow products, was strongly associated with a diagnosis of Nocardia mastitis in a herd. Other factors which increased the risk of Nocardia mastitis were higher levels of production, larger herd size, and a large percentage of cows treated with dry cow products. These results are compared to results from a similar study carried out in Ontario. PMID:17423896

Noun and verb differences in picture naming: past studies and new evidence.

PubMed

Mätzig, Simone; Druks, Judit; Masterson, Jackie; Vigliocco, Gabriella

2009-06-01

We re-examine the double dissociation view of noun-verb differences by critically reviewing past lesion studies reporting selective noun or verb deficits in picture naming, and reporting the results of a new picture naming study carried out with aphasic patients and comparison participants. Since there are theoretical arguments and empirical evidence that verb processing is more demanding than noun processing, in the review we distinguished between cases that presented with large and small differences between nouns and verbs. We argued that the latter cases may be accounted for in terms of greater difficulty in processing verbs than nouns. For the cases reporting large differences between nouns and verbs we assessed consistency in lesion localization and consistency in diagnostic classification. More variability both in terms of diagnostic category and lesion sites was found among the verb impaired than the noun impaired patients. In the experimental study, nine aphasic patients and nine age matched neurologically unimpaired individuals carried out a picture naming study that used a large set of materials matched for age of acquisition and in addition to accuracy measures, latencies were also recorded. Despite the patients' variable language deficits, diagnostic category and the matched materials, all patients performed faster and more accurately in naming the object than the action pictures. The comparison participants performed similarly. We also carried out a qualitative analysis of the errors patients made and showed that different types of errors were made in response to object and action pictures. We concluded that action naming places more and different demands on the language processor than object naming. The conclusions of the literature review and the results of the experimental study are discussed in relation to claims previous studies have made on the basis of the double dissociation found between nouns and verbs. We argue that these claims are only justified when it can be shown that the impairments to the two categories occur for the same underlying reason and that the differences between the two categories are large.

Treatments of Missing Values in Large National Data Affect Conclusions: The Impact of Multiple Imputation on Arthroplasty Research.

PubMed

Ondeck, Nathaniel T; Fu, Michael C; Skrip, Laura A; McLynn, Ryan P; Su, Edwin P; Grauer, Jonathan N

2018-03-01

Despite the advantages of large, national datasets, one continuing concern is missing data values. Complete case analysis, where only cases with complete data are analyzed, is commonly used rather than more statistically rigorous approaches such as multiple imputation. This study characterizes the potential selection bias introduced using complete case analysis and compares the results of common regressions using both techniques following unicompartmental knee arthroplasty. Patients undergoing unicompartmental knee arthroplasty were extracted from the 2005 to 2015 National Surgical Quality Improvement Program. As examples, the demographics of patients with and without missing preoperative albumin and hematocrit values were compared. Missing data were then treated with both complete case analysis and multiple imputation (an approach that reproduces the variation and associations that would have been present in a full dataset) and the conclusions of common regressions for adverse outcomes were compared. A total of 6117 patients were included, of which 56.7% were missing at least one value. Younger, female, and healthier patients were more likely to have missing preoperative albumin and hematocrit values. The use of complete case analysis removed 3467 patients from the study in comparison with multiple imputation which included all 6117 patients. The 2 methods of handling missing values led to differing associations of low preoperative laboratory values with commonly studied adverse outcomes. The use of complete case analysis can introduce selection bias and may lead to different conclusions in comparison with the statistically rigorous multiple imputation approach. Joint surgeons should consider the methods of handling missing values when interpreting arthroplasty research. Copyright © 2017 Elsevier Inc. All rights reserved.

Investigation of Maternal Genotype Effects in Autism by Genome-Wide Association

PubMed Central

Yuan, Han; Dougherty, Joseph D.

2014-01-01

Lay Abstract Autism spectrum disorders (ASDs) are pervasive developmental disorders which have both a genetic and environmental component. One source of the environmental component is the in utero (prenatal) environment. The maternal genome can potentially contribute to the risk of autism in children by altering this prenatal environment. In this study, the possibility of maternal genotype effects was explored by looking for common variants (single nucleotide polymorphisms, or SNPs) in the maternal genome associated with increased risk of autism in children. We performed a case/control genome-wide association study (GWAS) using mothers of probands as cases and either fathers of probands or normal females as controls, using two collections of families with autism. We did not identify any SNP that reached significance and thus a common variant of large effect is unlikely. However, there was evidence for the possibility of a large number of alleles each carrying a small effect. This suggested that if there is a contribution to autism risk through common-variant maternal genetic effects, it may be the result of multiple loci of small effects. We did not investigate rare variants in this study. Scientific Abstract Like most psychiatric disorders, autism spectrum disorders have both a genetic and an environmental component. While previous studies have clearly demonstrated the contribution of in utero (prenatal) environment on autism risk, most of them focused on transient environmental factors. Based on a recent sibling study, we hypothesized that environmental factors could also come from the maternal genome, which would result in persistent effects across siblings. In this study, the possibility of maternal genotype effects was examined by looking for common variants (single nucleotide polymorphisms, or SNPs) in the maternal genome associated with increased risk of autism in children. A case/control genome-wide association study (GWAS) was performed using mothers of probands as cases and either fathers of probands or normal females as controls. Autism Genetic Resource Exchange (AGRE) and Illumina Genotype Control Database (iCon) were used as our discovery cohort (n=1616). The same analysis was then replicated on Simon Simplex Collection (SSC) and Study of Addiction: Genetics and Environment (SAGE) datasets (n=2732). We did not identify any SNP that reached genome-wide significance (p<10−8) and thus a common variant of large effect is unlikely. However, there was evidence for the possibility of a large number of alleles of effective size marginally below our power to detect. PMID:24574247

Should child protection services respond differently to maltreatment, risk of maltreatment, and risk of harm?

PubMed

Fallon, Barbara; Trocmé, Nico; MacLaurin, Bruce

2011-04-01

To examine evidence available in large-scale North American datasets on child abuse and neglect that can assist in understanding the complexities of child protection case classifications. A review of child abuse and neglect data from large North American epidemiological studies including the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS), the National Child Abuse and Neglect Data System (NCANDS), and the National Incidence Studies of Reported Child Abuse and Neglect (NIS). The authors of this paper argue that recent evidence from large North American epidemiological studies examining the incidence of child abuse and neglect demonstrate that children and families identified as being at risk of maltreatment present with as many household and caregiver concerns as investigations that are substantiated. In order to continue to develop appropriate services and policies for vulnerable children the authors urge continue definitional clarity for research in child maltreatment that considers the exemplars or indicators of categories, in tandem with parental and child characteristics which can provide one source of evidence-basis to meaningful child protection case classifications. Continued monitoring, refined by the dilemmas faced in practice, are critical for a continued public health investment in children's well-being, predicated upon upholding children's rights. Copyright © 2011 Elsevier Ltd. All rights reserved.

Large-Eddy Simulation of the Impact of Great Garuda Project on Wind and Thermal Environment over Built-Up Area in Jakarta

NASA Astrophysics Data System (ADS)

Yucel, M.; Sueishi, T.; Inagaki, A.; Kanda, M.

2017-12-01

`Great Garuda' project is an eagle-shaped offshore structure with 17 artificial islands. This project has been designed for the coastal protection and land reclamation of Jakarta due to catastrophic flooding in the city. It offers an urban generation for 300.000 inhabitants and 600.000 workers in addition to its water safety goal. A broad coalition of Indonesian scientists has criticized the project for being negative impacts on the surrounding environment. Despite the vast research by Indonesian scientist on maritime environment, studies on wind and thermal environment over built-up area are still lacking. However, the construction of the various islands off the coast may result changes in wind patterns and thermal environment due to the alteration of the coastline and urbanization in the Jakarta Bay. Therefore, it is important to understand the airflow within the urban canopy in case of unpredictable gust events. These gust events may occur through the closely-packed high-rise buildings and pedestrians may be harmed from such gusts. Accordingly, we used numerical simulations to investigate the impact of the sea wall and the artificial islands over built-up area and, the intensity of wind gusts at the pedestrian level. Considering the fact that the size of turbulence organized structure sufficiently large computational domain is required. Therefore, a 19.2km×4.8km×1.0 km simulation domain with 2-m resolution in all directions was created to explicitly resolve the detailed shapes of buildings and the flow at the pedestrian level. This complex computation was accomplished by implementing a large-eddy simulation (LES) model. Two case studies were conducted considering the effect of realistic surface roughness and upward heat flux. Case_1 was conducted based on the current built environment and Case_2 for investigating the effect of the project on the chosen coastal region of the city. Fig.1 illustrates the schematic of the large-eddy simulation domains of two cases with and without Great Garuda Sea Wall and 17 artificial islands. 3D model of Great Garuda is shown in Fig.2. In addition to the cases mentioned above, the simulation will be generated assigning more realistic heat flux outputs from energy balance model and, inflow boundary conditions coupling with mesoscale model (Weather Research and Forecast model).

Laterality defects in the national birth defects prevention study 1998-2007 birth prevalence and descriptive epidemiology

USDA-ARS?s Scientific Manuscript database

Little is known epidemiologically about laterality defects. Using data from the National Birth Defects Prevention Study (NBDPS), a large multi-site case-control study of birth defects, we analyzed prevalence and selected characteristics in children born with laterality defects born from 1998 to 2007...

Brokering Boundaries: Literacy Change Agents at Work

ERIC Educational Resources Information Center

VanDeusen-MacLeod, Elizabeth A.

2009-01-01

The purpose of this mixed-method descriptive case study is to investigate the role technical assistance providers within the context of one state's large-scale literacy grant program. This study provides an in-depth examination of one state's technical assistance providers known as Reading First Facilitators (RFF) through the study of a group of…

Girl-Child Education Outcomes: A Case Study from Ghana

ERIC Educational Resources Information Center

Arku, Frank S.; Angmor, Emmanuel N.; Tetteh, Isaac K.

2014-01-01

The importance of girl-child education is largely documented and initiatives to promote girl-child education are widespread. However, studies on service delivery methods, processes and the impacts are limited in the literature. This study assessed the Plan Ghana's girl-child educational project. According to the findings, the project has helped to…

Academic Choices and Motivation: Diverse Groups in Israel

ERIC Educational Resources Information Center

Arar, Khalid; Abramovitz, Ruth; Bar-Yishay, Hanna; Notzer, Neta

2017-01-01

Israel is a multi-cultural society with a Jewish majority and a large Arab minority. This study aims to examine whether Israeli Arab and Jewish students have different motivations and consider different factors when choosing a college for postgraduate studies. A case study, during the academic year 2010-11 administered questionnaires to 290 Jewish…

A survey of major east coast snowstorms, 1960-1983. Part 2: Case studies of eighteen storms

NASA Technical Reports Server (NTRS)

Kocin, P. J.; Uccellini, L. W.

1985-01-01

Snowfall, surface and upper air charts, and available satellite images are presented for eighteen major East Coast snowstorms that occurred between 1960 and 1983. The charts and descriptions of key fields are provided so that students, weather forecasters, and researchers alike can visualize how a large sample of major winter cyclones form and intensify. Although there are noted similarities in certain aspects of the surface and upper tropospheric development of the storms, significant case-to-case variability precludes the ability to effectively composite these weather systems.

Late onset MELAS with m.3243A > G mutation and its association with aneurysm formation.

PubMed

Zhu, Kun; Li, Shuang; Chen, Huan; Wang, Yao; Yu, Miao; Wang, Hongyan; Zhao, Weijie; Cao, Yunpeng

2017-08-01

We reported a 53-year-old with late-onset mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) accompanied by aneurysm and large vessel dilations. Most studies have focused on microangiopathy causing stroke-like episodes. We report a case to describe large vessel involvement in clinical considerations, and possible mechanisms of aneurysm formation. We recommended regular angiographic examination for patients with MELAS.

Contribution of stable isotopes (C,N,S) in collagen of late Pleistocene large mammal trophic ecology and landscape use: a case study in Goyet and Scladina cave (30-40,000 years BP)

NASA Astrophysics Data System (ADS)

Bocherens, Hervé; Germonpré, Mietje

2010-05-01

Two Belgian caves yielded very rich large mammal associations dating around 30 to 40,000 years ago: Goyet and Scladina cave (layer 1A). These sites are only 5 km apart but the cave entrances open on different valleys, in a quite diverse landscape ranging between open, unprotected uplands, steep cliffs and sheltered sun-exposed gorges, with the larger Meuse valley nearby. This mosaic scenery permitted during the Last Glacial a rich diversity of fossil flora and fauna. The faunal association includes a large diversity of taxa including Aurochs Bos primigenius, steppe bison Bison priscus, reindeer Rangifer tarandus, giant deer Megaloceros giganteus, horse Equus ferus, woolly rhinoceros Coelodonta antiquitatis, woolly mammoth Mammuthus primigenius, cave bear Ursus spelaeus, brown bear Ursus arctos, wolf Canis lupus, cave lion Panthera leo spelaea, and cave hyaena Crocuta crocuta spelaea. All the 90 studied bones and teeth yielded collagen with excellent collagen preservation, allowing reliable investigations of carbon, nitrogen and sulfur isotopic biogeochemistry. The combination of three different isotopic tracers allows to deciphering the effects of food selection and landscape use by different herbivorous and carnivorous taxa. This is the first study to include sulfur isotopic signatures in the study of late Quaternary large mammal palaeobiology. This new tracer yields evidence on mobility and differences in pasture areas, as different geological bedrock may exhibit various sulfur isotopic signatures that will pass on the herbivores and further on their predators. Using this feature in addition to the trophic information provided by carbon and nitrogen isotopic signatures, it appears that for some species present in both sites, such as horse and woolly rhinoceros, the individuals found in each site probably did not use the same pasture areas. This seems to also the case for the overwhelmingly vegetarian cave bears. In addition, individuals from the same species found in one site sometimes exhibit clear isotopic differences in the three isotopic tracers that suggest different pasture grounds as well, and therefore the possibility of different herds in the vicinity of the cave site. In the case of cave hyeanas, the isotopic signatures of individuals from both caves are not significantly different and suggest that these predators obtained their prey from a large territory including the pasture grounds of herbivores from both caves. In addition, direct radiocarbon dating of some of the studied collagen allows to investigating possible chronological trends. This study shows how new isotopic tracers can provide invaluable information on late Quaternary large mammal palaeobiology.

Interactive large-group teaching in a dermatology course.

PubMed

Ochsendorf, F R; Boehncke, W-H; Sommerlad, M; Kaufmann, R

2006-12-01

This is a prospective study to find out whether an interactive large-group case-based teaching approach combined with small-group bedside teaching improves student satisfaction and learning outcome in a practical dermatology course. During two consecutive terms a rotating system of large-group interactive case-study-method teaching with two tutors (one content expert, one process facilitator) and bedside teaching with randomly appointed tutors was evaluated with a nine-item questionnaire and multiple-choice test performed at the beginning and the end of the course (n = 204/231 students evaluable). The results of three different didactic approaches utilized over the prior year served as a control. The interactive course was rated significantly better (p < 0.0001) than the standard course with regard to all items. The aggregate mark given by the students for the whole course was 1.58-0.61 (mean +/- SD, range 1 (good)-5 (poor)). This was significantly better than the standard course (p < 0.0001) and not different from small-group teaching approaches. The mean test results in the final examination improved significantly (p < 0.01). The combination of large-group interactive teaching and small-group bedside teaching was well accepted, improved the learning outcome, was rated as good as a small-group didactic approach and needed fewer resources in terms of personnel.

Redesign of a large lecture course into a small-group learning course.

PubMed

Ferreri, Stefanie P; O'Connor, Shanna K

2013-02-12

Objective. To describe the redesign of a large self-care course previously delivered in a traditional lecture format to a small-group case-based course.Design. Prereadings and study guides were used to facilitate students' independent learning prior to class. Large lecture classes were replaced with smaller group-based learning classes. This change in delivery format allowed students to spend the majority of class time conducting small-group learning activities, such as case studies to promote communication, problem solving, and interpersonal skills.Assessment. Changes in course delivery were assessed over a 2-year period by comparing students' grades and satisfaction ratings on course evaluations. A comparison of course evaluations between the class formats revealed that students were provided more opportunities to develop verbal communication skills and tackle and resolve unfamiliar problems in the revised course. The activities resulted in better overall course grades.Conclusions. Redesigning to a small-group discussion format for a self-care course can be accomplished by increasing student accountability for acquiring factual content outside the classroom. Compared with student experiences in the previous large lecture-based class, students in the smaller-class format reported a preference for working in teams and achieved significantly better academic grades with the new course format.

Fluid-structure interaction involving large deformations: 3D simulations and applications to biological systems

NASA Astrophysics Data System (ADS)

Tian, Fang-Bao; Dai, Hu; Luo, Haoxiang; Doyle, James F.; Rousseau, Bernard

2014-02-01

Three-dimensional fluid-structure interaction (FSI) involving large deformations of flexible bodies is common in biological systems, but accurate and efficient numerical approaches for modeling such systems are still scarce. In this work, we report a successful case of combining an existing immersed-boundary flow solver with a nonlinear finite-element solid-mechanics solver specifically for three-dimensional FSI simulations. This method represents a significant enhancement from the similar methods that are previously available. Based on the Cartesian grid, the viscous incompressible flow solver can handle boundaries of large displacements with simple mesh generation. The solid-mechanics solver has separate subroutines for analyzing general three-dimensional bodies and thin-walled structures composed of frames, membranes, and plates. Both geometric nonlinearity associated with large displacements and material nonlinearity associated with large strains are incorporated in the solver. The FSI is achieved through a strong coupling and partitioned approach. We perform several validation cases, and the results may be used to expand the currently limited database of FSI benchmark study. Finally, we demonstrate the versatility of the present method by applying it to the aerodynamics of elastic wings of insects and the flow-induced vocal fold vibration.

Fluid–structure interaction involving large deformations: 3D simulations and applications to biological systems

PubMed Central

Tian, Fang-Bao; Dai, Hu; Luo, Haoxiang; Doyle, James F.; Rousseau, Bernard

2013-01-01

Three-dimensional fluid–structure interaction (FSI) involving large deformations of flexible bodies is common in biological systems, but accurate and efficient numerical approaches for modeling such systems are still scarce. In this work, we report a successful case of combining an existing immersed-boundary flow solver with a nonlinear finite-element solid-mechanics solver specifically for three-dimensional FSI simulations. This method represents a significant enhancement from the similar methods that are previously available. Based on the Cartesian grid, the viscous incompressible flow solver can handle boundaries of large displacements with simple mesh generation. The solid-mechanics solver has separate subroutines for analyzing general three-dimensional bodies and thin-walled structures composed of frames, membranes, and plates. Both geometric nonlinearity associated with large displacements and material nonlinearity associated with large strains are incorporated in the solver. The FSI is achieved through a strong coupling and partitioned approach. We perform several validation cases, and the results may be used to expand the currently limited database of FSI benchmark study. Finally, we demonstrate the versatility of the present method by applying it to the aerodynamics of elastic wings of insects and the flow-induced vocal fold vibration. PMID:24415796

The Higgs boson can delay reheating after inflation

NASA Astrophysics Data System (ADS)

Freese, Katherine; Sfakianakis, Evangelos I.; Stengel, Patrick; Visinelli, Luca

2018-05-01

The Standard Model Higgs boson, which has previously been shown to develop an effective vacuum expectation value during inflation, can give rise to large particle masses during inflation and reheating, leading to temporary blocking of the reheating process and a lower reheat temperature after inflation. We study the effects on the multiple stages of reheating: resonant particle production (preheating) as well as perturbative decays from coherent oscillations of the inflaton field. Specifically, we study both the cases of the inflaton coupling to Standard Model fermions through Yukawa interactions as well as to Abelian gauge fields through a Chern-Simons term. We find that, in the case of perturbative inflaton decay to SM fermions, reheating can be delayed due to Higgs blocking and the reheat temperature can decrease by up to an order of magnitude. In the case of gauge-reheating, Higgs-generated masses of the gauge fields can suppress preheating even for large inflaton-gauge couplings. In extreme cases, preheating can be shut down completely and must be substituted by perturbative decay as the dominant reheating channel. Finally, we discuss the distribution of reheat temperatures in different Hubble patches, arising from the stochastic nature of the Higgs VEV during inflation and its implications for the generation of both adiabatic and isocurvature fluctuations.

Novel deletions involving the USH2A gene in patients with Usher syndrome and retinitis pigmentosa

PubMed Central

García-García, Gema; Jaijo, Teresa; Aparisi, Maria J.; Larrieu, Lise; Faugère, Valérie; Blanco-Kelly, Fiona; Ayuso, Carmen; Roux, Anne-Francoise; Millán, José M.

2014-01-01

Purpose The aim of the present work was to identify and characterize large rearrangements involving the USH2A gene in patients with Usher syndrome and nonsyndromic retinitis pigmentosa. Methods The multiplex ligation-dependent probe amplification (MLPA) technique combined with a customized array-based comparative genomic hybridization (aCGH) analysis was applied to 40 unrelated patients previously screened for point mutations in the USH2A gene in which none or only one pathologic mutation was identified. Results We detected six large deletions involving USH2A in six out of the 40 cases studied. Three of the patients were homozygous for the deletion, and the remaining three were compound heterozygous with a previously identified USH2A point mutation. In five of these cases, the patients displayed Usher type 2, and the remaining case displayed nonsyndromic retinitis pigmentosa. The exact breakpoint junctions of the deletions found in USH2A in four of these cases were characterized. Conclusions Our study highlights the need to develop improved efficient strategies of mutation screening based upon next generation sequencing (NGS) that reduce cost, time, and complexity and allow simultaneous identification of all types of disease-causing mutations in diagnostic procedures. PMID:25352746

Going Large or Going Small in Plant Design: Comparison between a P.P. with three small Kaplan turbines and a P.P. with just one Large Kaplan turbine

NASA Astrophysics Data System (ADS)

Castro-Otero, C.

2017-04-01

Very often small turbine manufacturers are requested to produce sizeable turbines, too large in terms of physical dimensions, power or designing capacity. In these cases clever alternative solutions should be found to meet customers’ needs. For instance: in the old times twin runner Francis turbines were an option instead of one large machine, or if a too large Pelton turbine cannot be manufactured or designed, a good option is to install a medium size Francis and a small Pelton. Likewise, a similar approach needs to be taken should the manufacturer be asked for a too large Kaplan. Facing this situation a good option is to install three or more small Kaplan turbines. This particular case was studied in depth and after all the considerations had been made, the following question arouse: Is this a way out for the manufacturer or is it really the best option for the customer? The choice made as a way out for the manufacturer became the best option for the customer and a success for both parties. This paper aims to encourage developers and engineering firms to search for more options than the traditional one to find the best option in plant design.

Convex hulls of random walks in higher dimensions: A large-deviation study

NASA Astrophysics Data System (ADS)

Schawe, Hendrik; Hartmann, Alexander K.; Majumdar, Satya N.

2017-12-01

The distribution of the hypervolume V and surface ∂ V of convex hulls of (multiple) random walks in higher dimensions are determined numerically, especially containing probabilities far smaller than P =10-1000 to estimate large deviation properties. For arbitrary dimensions and large walk lengths T , we suggest a scaling behavior of the distribution with the length of the walk T similar to the two-dimensional case and behavior of the distributions in the tails. We underpin both with numerical data in d =3 and d =4 dimensions. Further, we confirm the analytically known means of those distributions and calculate their variances for large T .

Laparoscopic Removal of a Large Ovarian Mass Utilizing Planned Trocar Puncture

PubMed Central

2012-01-01

Background: Large cystic ovarian masses pose technical challenges to the laparoscopic surgeon. Removing large, potentially malignant specimens must be done with care to avoid the leakage of cyst fluid into the abdominal cavity. Case: We present the case of a large ovarian cystic mass treated laparoscopically with intentional trocar puncture of the mass to drain and remove the mass. Discussion: Large cystic ovarian masses can be removed laparoscopically with intentional trocar puncture of the mass to facilitate removal without leakage of cyst fluid. PMID:22906344

Mining free-text medical records for companion animal enteric syndrome surveillance.

PubMed

Anholt, R M; Berezowski, J; Jamal, I; Ribble, C; Stephen, C

2014-03-01

Large amounts of animal health care data are present in veterinary electronic medical records (EMR) and they present an opportunity for companion animal disease surveillance. Veterinary patient records are largely in free-text without clinical coding or fixed vocabulary. Text-mining, a computer and information technology application, is needed to identify cases of interest and to add structure to the otherwise unstructured data. In this study EMR's were extracted from veterinary management programs of 12 participating veterinary practices and stored in a data warehouse. Using commercially available text-mining software (WordStat™), we developed a categorization dictionary that could be used to automatically classify and extract enteric syndrome cases from the warehoused electronic medical records. The diagnostic accuracy of the text-miner for retrieving cases of enteric syndrome was measured against human reviewers who independently categorized a random sample of 2500 cases as enteric syndrome positive or negative. Compared to the reviewers, the text-miner retrieved cases with enteric signs with a sensitivity of 87.6% (95%CI, 80.4-92.9%) and a specificity of 99.3% (95%CI, 98.9-99.6%). Automatic and accurate detection of enteric syndrome cases provides an opportunity for community surveillance of enteric pathogens in companion animals. Copyright © 2014 Elsevier B.V. All rights reserved.

Mining the Galaxy Zoo Database: Machine Learning Applications

NASA Astrophysics Data System (ADS)

Borne, Kirk D.; Wallin, J.; Vedachalam, A.; Baehr, S.; Lintott, C.; Darg, D.; Smith, A.; Fortson, L.

2010-01-01

The new Zooniverse initiative is addressing the data flood in the sciences through a transformative partnership between professional scientists, volunteer citizen scientists, and machines. As part of this project, we are exploring the application of machine learning techniques to data mining problems associated with the large and growing database of volunteer science results gathered by the Galaxy Zoo citizen science project. We will describe the basic challenge, some machine learning approaches, and early results. One of the motivators for this study is the acquisition (through the Galaxy Zoo results database) of approximately 100 million classification labels for roughly one million galaxies, yielding a tremendously large and rich set of training examples for improving automated galaxy morphological classification algorithms. In our first case study, the goal is to learn which morphological and photometric features in the Sloan Digital Sky Survey (SDSS) database correlate most strongly with user-selected galaxy morphological class. As a corollary to this study, we are also aiming to identify which galaxy parameters in the SDSS database correspond to galaxies that have been the most difficult to classify (based upon large dispersion in their volunter-provided classifications). Our second case study will focus on similar data mining analyses and machine leaning algorithms applied to the Galaxy Zoo catalog of merging and interacting galaxies. The outcomes of this project will have applications in future large sky surveys, such as the LSST (Large Synoptic Survey Telescope) project, which will generate a catalog of 20 billion galaxies and will produce an additional astronomical alert database of approximately 100 thousand events each night for 10 years -- the capabilities and algorithms that we are exploring will assist in the rapid characterization and classification of such massive data streams. This research has been supported in part through NSF award #0941610.

Melanocytic nevi, nevus genes and melanoma risk in a large case-control study in the United Kingdom

PubMed Central

Newton-Bishop, Julia A; Chang, Yu-Mei; Iles, Mark M; Taylor, John C; Bakker, Bert; Chan, May; Leake, Susan; Karpavicius, Birute; Haynes, Sue; Fitzgibbon, Elaine; Elliott, Faye; Kanetsky, Peter A.; Harland, Mark; Barrett, Jennifer H; Bishop, D Timothy

2010-01-01

Background Increased number of melanocytic nevi is a potent melanoma risk factor. We have carried out a large population-based case-control study to explore the environmental and genetic determinants of nevi and the relationship with melanoma risk. Methods We report nevus phenotype in relation to differing patterns of sun exposure, inherited variation at loci shown in recent genome-wide association studies to be nevus genes, and risk. Results Increased numbers of nevi were associated with holiday sun exposure, particularly on intermittently sun-exposed body sites (test for trend p<0.0001). Large nevi were also associated with holiday sun exposure (p=0.002). Single nucleotide polymorphisms (SNPs) on chromosomes 9 and 22 were associated with increased numbers of nevi (p=0.04 and p=0.002 respectively) and larger nevi (p=0.03 and p=0.002), whereas that on chromosome 6 was associated only with large nevi (p=0.01). Melanoma risk was associated with increased nevus count, large nevi and atypical nevi for tumors in all body sites (including rare sites) irrespective of age. The risk persisted when adjusted for inheritance of nevus SNPs. Conclusions The at-risk nevus phenotype is associated with behaviors known to increase melanoma risk (holiday sun exposure). Although SNPs on chromosomes 6, 9 and 22 were shown to be nevus genes they explained only a small proportion of melanoma risk and nevus phenotype; therefore a number of nevus genes likely remain to be identified. Impact This paper confirms the importance of nevi in melanoma pathogenesis and increases understanding of their genetic determinants. PMID:20647408

Visual analysis of large heterogeneous social networks by semantic and structural abstraction.

PubMed

Shen, Zeqian; Ma, Kwan-Liu; Eliassi-Rad, Tina

2006-01-01

Social network analysis is an active area of study beyond sociology. It uncovers the invisible relationships between actors in a network and provides understanding of social processes and behaviors. It has become an important technique in a variety of application areas such as the Web, organizational studies, and homeland security. This paper presents a visual analytics tool, OntoVis, for understanding large, heterogeneous social networks, in which nodes and links could represent different concepts and relations, respectively. These concepts and relations are related through an ontology (also known as a schema). OntoVis is named such because it uses information in the ontology associated with a social network to semantically prune a large, heterogeneous network. In addition to semantic abstraction, OntoVis also allows users to do structural abstraction and importance filtering to make large networks manageable and to facilitate analytic reasoning. All these unique capabilities of OntoVis are illustrated with several case studies.

3T MRI evaluation of large nerve perineural spread of head and neck cancers.

PubMed

Baulch, Justin; Gandhi, Mitesh; Sommerville, Jennifer; Panizza, Ben

2015-10-01

Accurate definition of the presence and extent of large nerve perineural spread (PNS) is a vital component in planning appropriate surgery and radiotherapy for head and neck cancers. Our research aimed to define the sensitivity and specificity of 3T MRI in detecting the presence and extent of large nerve PNS, compared with histologic evaluation. Retrospective review of surgically proven cases of large nerve PNS in patients with preoperative 3T MRI performed as high resolution neurogram. 3T MRI had a sensitivity of 95% and a specificity of 84%, detecting PNS in 36 of 38 nerves and correctly identifying uninvolved nerves in 16 of 19 cases. It correctly identified the zonal extent of spread in 32 of 36 cases (89%), underestimating the extent in three cases and overestimating the extent in one case. Targeted 3T MRI is highly accurate in defining the presence and extent of large nerve PNS in head and neck cancers. However, there is still a tendency to undercall the zonal extent due to microscopic, radiologically occult involvement. Superficial large nerve involvement also remains a difficult area of detection for radiologists and should be included as a 'check area' for review. Further research is required to define the role radiation-induced neuritis plays in the presence of false-positive PNS on MRI. © 2015 The Royal Australian and New Zealand College of Radiologists.

Primary Diffuse Large B-Cell Lymphoma in a Patient with Rubinstein-Taybi Syndrome: Case Report and Review of the Literature.

PubMed

Sy, Christopher; Henry, James; Kura, Bhavani; Brenner, Andrew; Grandhi, Ramesh

2018-01-01

Rubinstein-Taybi syndrome (RSTS) is a rare, congenital syndrome that is known to be associated with neoplasms of various organ systems. Evaluation and treatment of such patients is challenging, given the cognitive delay and heterogeneity of pathologic presentations that define this syndrome. Presented here is a case of a patient with RSTS, diagnosed at birth, who presented with subtle symptoms of lethargy and a change in behavior. He was found to have a large (7.0-cm × 4.7-cm), right-sided brain mass that was eventually diagnosed as a primary central nervous system lymphoma. To the best of our knowledge, this is the first reported case of a primary central nervous system lymphoma presenting in a patient with RSTS. This was confirmed through microscopic and histologic studies. The large size attained by this mass in our patient highlights the increased scrutiny and surveillance needed to provide the best care for these patients. A multidisciplinary team approach is ideal as successful treatment of our patient using surgical debulking, appropriate chemotherapy, and close postoperative follow-up has resulted in an excellent clinical outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Additional studies of forest classification accuracy as influenced by multispectral scanner spatial resolution

NASA Technical Reports Server (NTRS)

Sadowski, F. E.; Sarno, J. E.

1976-01-01

First, an analysis of forest feature signatures was used to help explain the large variation in classification accuracy that can occur among individual forest features for any one case of spatial resolution and the inconsistent changes in classification accuracy that were demonstrated among features as spatial resolution was degraded. Second, the classification rejection threshold was varied in an effort to reduce the large proportion of unclassified resolution elements that previously appeared in the processing of coarse resolution data when a constant rejection threshold was used for all cases of spatial resolution. For the signature analysis, two-channel ellipse plots showing the feature signature distributions for several cases of spatial resolution indicated that the capability of signatures to correctly identify their respective features is dependent on the amount of statistical overlap among signatures. Reductions in signature variance that occur in data of degraded spatial resolution may not necessarily decrease the amount of statistical overlap among signatures having large variance and small mean separations. Features classified by such signatures may thus continue to have similar amounts of misclassified elements in coarser resolution data, and thus, not necessarily improve in classification accuracy.

Tracking Parkinson's: Study Design and Baseline Patient Data.

PubMed

Malek, Naveed; Swallow, Diane M A; Grosset, Katherine A; Lawton, Michael A; Marrinan, Sarah L; Lehn, Alexander C; Bresner, Catherine; Bajaj, Nin; Barker, Roger A; Ben-Shlomo, Yoav; Burn, David J; Foltynie, Thomas; Hardy, John; Morris, Huw R; Williams, Nigel M; Wood, Nicholas; Grosset, Donald G

2015-01-01

There is wide variation in the phenotypic expression of Parkinson's disease (PD), which is driven by both genetic and epidemiological influences. To define and explain variation in the clinical phenotype of PD, in relation to genotypic variation. Tracking Parkinson's is a multicentre prospective longitudinal epidemiologic and biomarker study of PD. Patients attending specialist clinics in the United Kingdom with recent onset (<3.5 years) and young onset (diagnosed <50 years of age) PD were enrolled. Motor, non-motor and quality of life assessments were performed using validated scales. Cases are followed up 6 monthly up to 4.5 years for recent onset PD, and up to 1 year for young onset PD. We present here baseline clinical data from this large and demographically representative cohort. 2247 PD cases were recruited (1987 recent onset, 260 young onset). Recent onset cases had a mean (standard deviation, SD) age of 67.6 years (9.3) at study entry, 65.7% males, with disease duration 1.3 years (0.9), MDS-UPDRS 3 scores 22.9 (12.3), LEDD 295 mg/day (211) and PDQ-8 score 5.9 (4.8). Young onset cases were 53.5 years old (7.8) at study entry, 66.9% male, with disease duration 10.2 years (6.7), MDS-UPDRS 3 scores 27.4 (15.3), LEDD 926 mg/day (567) and PDQ-8 score 11.6 (6.1). We have established a large clinical PD cohort, consisting of young onset and recent onset cases, which is designed to evaluate variation in clinical expression, in relation to genetic influences, and which offers a platform for future imaging and biomarker research.

Achieving Actionable Results from Available Inputs: Metamodels Take Building Energy Simulations One Step Further

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

Horsey, Henry; Fleming, Katherine; Ball, Brian

Modeling commercial building energy usage can be a difficult and time-consuming task. The increasing prevalence of optimization algorithms provides one path for reducing the time and difficulty. Many use cases remain, however, where information regarding whole-building energy usage is valuable, but the time and expertise required to run and post-process a large number of building energy simulations is intractable. A relatively underutilized option to accurately estimate building energy consumption in real time is to pre-compute large datasets of potential building energy models, and use the set of results to quickly and efficiently provide highly accurate data. This process is calledmore » metamodeling. In this paper, two case studies are presented demonstrating the successful applications of metamodeling using the open-source OpenStudio Analysis Framework. The first case study involves the U.S. Department of Energy's Asset Score Tool, specifically the Preview Asset Score Tool, which is designed to give nontechnical users a near-instantaneous estimated range of expected results based on building system-level inputs. The second case study involves estimating the potential demand response capabilities of retail buildings in Colorado. The metamodel developed in this second application not only allows for estimation of a single building's expected performance, but also can be combined with public data to estimate the aggregate DR potential across various geographic (county and state) scales. In both case studies, the unique advantages of pre-computation allow building energy models to take the place of topdown actuarial evaluations. This paper ends by exploring the benefits of using metamodels and then examines the cost-effectiveness of this approach.« less

Extreme interplanetary rotational discontinuities at 1 AU

NASA Astrophysics Data System (ADS)

Lepping, R. P.; Wu, C.-C.

2005-11-01

This study is concerned with the identification and description of a special subset of four Wind interplanetary rotational discontinuities (from an earlier study of 134 directional discontinuities by Lepping et al. (2003)) with some "extreme" characteristics, in the sense that every case has (1) an almost planar current sheet surface, (2) a very large discontinuity angle (ω), (3) at least moderately strong normal field components (>0.8 nT), and (4) the overall set has a very broad range of transition layer thicknesses, with one being as thick as 50 RE and another at the other extreme being 1.6 RE, most being much thicker than are usually studied. Each example has a well-determined surface normal (n) according to minimum variance analysis and corroborated via time delay checking of the discontinuity with observations at IMP 8 by employing the local surface planarity. From the variance analyses, most of these cases had unusually large ratios of intermediate-to-minimum eigenvalues (λI/λmin), being on average 32 for three cases (with a fourth being much larger), indicating compact current sheet transition zones, another (the fifth) extreme property. For many years there has been a controversy as to the relative distribution of rotational (RDs) to tangential discontinuities (TDs) in the solar wind at 1 AU (and elsewhere, such as between the Sun and Earth), even to the point where some authors have suggested that RDs with large ∣Bn∣s are probably not generated or, if generated, are unstable and therefore very rare. Some of this disagreement apparently has been due to the different selection criteria used, e.g., some allowed eigenvalue ratios (λI/λmin) to be almost an order of magnitude lower than 32 in estimating n, usually introducing unacceptable error in n and therefore also in ∣Bn∣. However, we suggest that RDs may not be so rare at 1 AU, but good quality cases (where ∣Bn∣ confidently exceeds the error in ∣Bn∣) appear to be uncommon, and further, cases of large ∣Bn∣ may indeed be rare. Finally, the issue of estimating the number of RDs-to-TDs was revisited using the full 134 events of the original Lepping et al. (2003) study (which utilized the RDs' propagation speeds for this estimation, an unconventional approach) but now by considering only normal field components, the more conventional approach. This resulted in slightly different conclusions, depending on specific assumptions used, making the unconventional approach suspect.

Social media campaigns that make a difference: what can public health learn from the corporate sector and other social change marketers?

PubMed

Freeman, Becky; Potente, Sofia; Rock, Vanessa; McIver, Jacqueline

2015-03-30

A great deal of enthusiasm and interest exists in using social media for public health communications, but few research studies have examined its success in promoting and adopting protective health behaviours. To begin to understand how best to develop effective online social marketing campaigns, this paper provides a summary of success factors and key lessons learnt from selected social media campaign case studies. Case study review Methods: A selection of case studies was reviewed for lessons in campaign development, delivery and evaluation from both the corporate and public health sectors. Information about the objective of the campaign, the tactics used and the lessons learnt was extracted from each case study. Lessons learnt from across the case studies were then sorted according to themes. Lessons from the nine case studies selected were categorised into eight themes: planning, use of social media tools, community, content, personal benefits, promotion, costs and challenges. Outcome evaluation data were lacking in the case studies. Overall, the nine case studies show that social media hold promise in changing user behaviours and that social media are highly effective in recruiting participants and motivating them to take small, concrete actions. The case studies also demonstrate that there is room in social media for targeted, inexpensive, small-scale projects, as well as large, well-funded, mass-reach marketing blitzes. Social media campaign process and impact evaluation measures are readily available. Outcome evaluation models and measures are needed to better assess the effectiveness of social media campaigns in changing health behaviours.

Duration of Dengue Viremia in Blood Donors and Relationships Between Donor Viremia, Infection Incidence and Clinical Case Reports During a Large Epidemic

PubMed Central

Busch, Michael P.; Sabino, Ester C.; Brambilla, Donald; Lopes, Maria Esther; Capuani, Ligia; Chowdhury, Dhuly; McClure, Christopher; Linnen, Jeffrey M.; Prince, Harry; Simmons, Graham; Lee, Tzong-Hae; Kleinman, Steven; Custer, Brian

2016-01-01

Background. Dengue viruses (DENV-1–4) pose a transfusion-transmission risk. This study estimated the dengue RNA detection period in asymptomatic blood donors and relationships between donor viremia and dengue incidence during a large epidemic. Methods. Donor samples from the 2012 dengue transmission season in Rio de Janeiro, Brazil, were tested for DENV RNA by a transcription-mediated amplification (TMA) assay, with DENV types and viral loads determined by polymerase chain reaction. Samples collected during the first and last weeks of enrollment were tested for DENV immunoglobulin (Ig) G and IgM to estimate incidence during the study period, which was analyzed relative to nucleic acid amplification technology (NAT) yield to estimate the duration of NAT-detectable viremia and compared with reported clinical dengue cases in Rio. Results. Samples from 16 241 donations were tested; 87 (0.54%) were confirmed as DENV-4 RNA positive. Dengue IgM-positive/IgG-positive reactivity increased from 2.8% to 8.8%, indicating a 6.2% incidence (95% confidence interval [CI], 3.2%–9.1%) during the study period. Based on these data, we estimated a 9.1-day period (95% CI, 4.4–13.9 days) of RNA detectable with TMA. With 100 475 reported cases of clinical dengue, 1 RNA-positive donation was identified per 800 DENV cases. Conclusions. These parameters allow projections of dengue incidence from donor NAT yield data and vice versa, and suggest that viremic donations will be rare relative to clinical disease cases. PMID:27302934

Detection of Traveling Ionospheric Disturbances (TIDs) from various man-made sources using Global Navigation Satellite System (GNSS)

NASA Astrophysics Data System (ADS)

Helmboldt, J.; Park, J.; von Frese, R. R. B.; Grejner-Brzezinska, D. A.

2016-12-01

Traveling ionospheric disturbance (TID) is generated by various sources and detectable by observing the spatial and temporal change of electron contents in the ionosphere. This study focused on detecting and analyzing TIDs generated by acoustic-gravity waves from man-made events including underground nuclear explosions (UNEs), mine collapses, mine blasts, and large chemical explosions (LCEs) using Global Navigation Satellite System (GNSS). In this study we selected different types of events for case study which covers two US and three North Korean UNEs, two large US mine collapses, three large US mine blasts, and a LCE in northern China and a second LCE at the Nevada Test Site. In most cases, we successfully detected the TIDs as array signatures from the multiple nearby GNSS stations. The array-based TID signatures from these studies were found to yield event-appropriate TID propagation speeds ranging from about a few hundred m/s to roughly a km/s. In addition, the event TID waveforms, and propagation angles and directions were established. The TID waveforms and the maximum angle between each event and the IPP of its TID with the longest travel distance from the source may help differentiate UNEs and LCEs, but the uneven distributions of the observing GNSS stations complicates these results. Thus, further analysis is required of the utility of the apertures of event signatures in the ionosphere for discriminating these events. In general, the results of this study show the potential utility of GNSS observations for detecting and mapping the ionospheric signatures of large-energy anthropological explosions and subsurface collapses.

A case study of enterprise historic resources information management in large transportation agencies.

DOT National Transportation Integrated Search

2010-01-01

Historic resources are in some way managed by every transportation agency in the nation. Transportation agencies manage historic and prehistoric archaeological sites, buildings, structures, objects, routes, landscapes, and districts to prevent damage...

IgV(H) and bcl6 somatic mutation analysis reveals the heterogeneity of cutaneous B-cell lymphoma, and indicates the presence of undisclosed local antigens.

PubMed

Franco, Renato; Camacho, Francisca I; Fernández-Vázquez, Amalia; Algara, Patrocinio; Rodríguez-Peralto, José L; De Rosa, Gaetano; Piris, Miguel A

2004-06-01

Our understanding of the ontology of B-cell lymphomas (BCL) has been improved by the study of mutational status of IgV(H) and bcl6 genes, but only a few cases of cutaneous BCL have been examined for this status. We analyzed IgV(H) and bcl6 somatic mutations in 10 cutaneous BCL, classified as follicular (three primary and one secondary), primary marginal zone (two cases), and diffuse large BCL (three primary and one secondary). We observed a lower rate (<2%) of IgV(H) mutation in all marginal zone lymphomas, and a preferential usage of V(H)2-70 (one primary follicular and two primary diffuse large BCL). Fewer than expected replacement mutations in framework regions (FR) were observed in three primary follicular lymphomas (FLs) and in all diffuse large BCL, indicating a negative antigen selection pressure. Ongoing mutations were observed in eight of 10 cases. Only two primary FLs and two diffuse large BCL showed bcl6 somatic mutation. These data support the heterogeneous nature of the different cutaneous BCL, and specifically the distinction between cutaneous follicular and marginal zone lymphomas. The biased usage of V(H)2-70, the low rate of replacement mutation in the FR, and the presence of ongoing mutation imply that local antigens could modulate the growth of primary cutaneous BCL.

Imprint cytologic features in renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion in an adult: a case report.

PubMed

Yamaguchi, Tadanori; Kuroda, Naoto; Imamura, Yoshiaki; Hes, Ondrej; Kawada, Takako; Nakayama, Keizou

2009-01-01

Adult-onset renal cell carcinoma (RCC) associated with Xp11.2 translocation/TFE3 gene fusion is a very rare tumor. To date, there are no reports on immunocytochemical study of the primary tumor. We describe such a case that we diagnosed by immunocytochemistry of imprint cytology material. A 46-year-old man was found to have a mass in the lower pole of the right kidney. Magnetic resonance imaging (MRI) T2-weighted images showed a hypointense area in the tumor, and papillary RCC was suspected. Imprint cytology showed tumor cells that were isolated or arranged in large or small papillary clusters. Irregularly shaped large oval nuclei, finely granular chromatin and a single large nucleolus were noted. Cytoplasm was abundant and admixed with clear and granular eosinophilic patterns and scattered large vacuolated cells. Almost all tumor cells diffusely expressed immunocytochemical reactivity to TFE3 protein. Hyaline nodules were observed in the stroma. Ultrastructurally, neoplastic cells contained rhomboid crystals identical to those of alveolar soft part sarcoma. The immunocytochemistry of TFE3 protein may be a powerful tool for accurate diagnosis when RCC associated with Xp11.2 translocation/TFE3 gene fusion is suspected by imprint cytology even in adult-onset cases, and cytotechnologists should accurately recognize cytologic findings of this tumor.

New-onset asthma after exposure to the steam system additive 2-diethylaminoethanol. A descriptive study.

PubMed

Gadon, M E; Melius, J M; McDonald, G J; Orgel, D

1994-06-01

Through a leak in the steam heating system, the anticorrosive agent 2-diethylaminoethanol was released into the air of a large office building. Irritative symptoms were experienced by most of the 2500 employees, and 14 workers developed asthma within 3 months of exposure. This study was undertaken to review clinical characteristics of these asthmatics. Environmental exposure monitoring data and medical records were reviewed. Seven of 14 cases were defined as "confirmed" and 7 of 14 as "suspect," using the National Institute for Occupational Safety and Health surveillance case definition of occupational asthma. Spirometry was positive in 4 of 14 of the cases and peak flow testing in 10 of 14. Three cases were diagnosed on the basis of work-related symptoms and physical examination alone. The study suggests that acute exposure to the irritating steam additive 2-diethylaminoethanol was a contributing factor in the development of clinical asthma in this population.