On the use of Different Methodologies in Cognitive Neuropsychology: Drink Deep and from Several Sources

PubMed Central

Nickels, Lyndsey; Howard, David; Best, Wendy

2012-01-01

Cognitive neuropsychology has championed the use of single-case research design. Recently, however, case series designs that employ multiple single cases have been increasingly utilized to address theoretical issues using data from neuropsychological populations. In this paper, we examine these methodologies, focusing on a number of points in particular. First we discuss the use of dissociations and associations, often thought of as a defining feature of cognitive neuropsychology, and argue that they are better viewed as part of a spectrum of methods that aim to explain and predict behaviour. We also raise issues regarding case series design in particular, arguing that selection of an appropriate sample, including controlling degree of homogeneity, is critical and constrains the theoretical claims that can be made on the basis of the data. We discuss the possible interpretation of “outliers” in a case series, suggesting that while they may reflect “noise” caused by variability in performance due to factors that are not of relevance to the theoretical claims, they may also reflect the presence of patterns that are critical to test, refine, and potentially falsify our theories. The role of case series in treatment research is also raised, in light of the fact that, despite their status as gold standard, randomized controlled trials cannot provide answers to many crucial theoretical and clinical questions. Finally, we stress the importance of converging evidence: We propose that it is conclusions informed by multiple sources of evidence that are likely to best inform theory and stand the test of time. PMID:22746689

Alcoa North American Extrusions Implements Energy Use Assessments at Multiple Facilities: Office of Industrial Technologies (OIT) BestPractices Aluminum Assessment Case Study

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

U.S. Department of Energy

2001-08-05

This case study is the latest in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. The case studies document the activities, savings, and lessons learned on these projects.

Fatal overdoses involving hydromorphone and morphine among inpatients: a case series

PubMed Central

Lowe, Amanda; Hamilton, Michael; Greenall BScPhm MHSc, Julie; Ma, Jessica; Dhalla, Irfan; Persaud, Nav

2017-01-01

Background: Opioids have narrow therapeutic windows, and errors in ordering or administration can be fatal. The purpose of this study was to describe deaths involving hydromorphone and morphine, which have similar-sounding names, but different potencies. Methods: In this case series, we describe deaths of patients admitted to hospital or residents of long-term care facilities that involved hydromorphone and morphine. We searched for deaths referred to the Patient Safety Review Committee of the Office of the Chief Coroner for Ontario between 2007 and 2012, and subsequently reviewed by 2014. We reviewed each case to identify intervention points where errors could have been prevented. Results: We identified 8 cases involving decedents aged 19 to 91 years. The cases involved errors in prescribing, order processing and transcription, dispensing, administration and monitoring. For 7 of the 8 cases, there were multiple (2 or more) possible intervention points. Six cases may have been prevented by additional patient monitoring, and 5 cases involved dispensing errors. Interpretation: Opioid toxicity deaths in patients living in institutions can be prevented at multiple points in the prescribing and dispensing processes. Interventions aimed at preventing errors in hydromorphone and morphine prescribing, administration and patient monitoring should be implemented and rigorously evaluated. PMID:28401133

Fatal overdoses involving hydromorphone and morphine among inpatients: a case series.

PubMed

Lowe, Amanda; Hamilton, Michael; Greenall BScPhm MHSc, Julie; Ma, Jessica; Dhalla, Irfan; Persaud, Nav

2017-01-01

Opioids have narrow therapeutic windows, and errors in ordering or administration can be fatal. The purpose of this study was to describe deaths involving hydromorphone and morphine, which have similar-sounding names, but different potencies. In this case series, we describe deaths of patients admitted to hospital or residents of long-term care facilities that involved hydromorphone and morphine. We searched for deaths referred to the Patient Safety Review Committee of the Office of the Chief Coroner for Ontario between 2007 and 2012, and subsequently reviewed by 2014. We reviewed each case to identify intervention points where errors could have been prevented. We identified 8 cases involving decedents aged 19 to 91 years. The cases involved errors in prescribing, order processing and transcription, dispensing, administration and monitoring. For 7 of the 8 cases, there were multiple (2 or more) possible intervention points. Six cases may have been prevented by additional patient monitoring, and 5 cases involved dispensing errors. Opioid toxicity deaths in patients living in institutions can be prevented at multiple points in the prescribing and dispensing processes. Interventions aimed at preventing errors in hydromorphone and morphine prescribing, administration and patient monitoring should be implemented and rigorously evaluated.

Power Mobility Training for Young Children with Multiple, Severe Impairments: A Case Series.

PubMed

Kenyon, Lisa K; Farris, John P; Gallagher, Cailee; Hammond, Lyndsay; Webster, Lauren M; Aldrich, Naomi J

2017-02-01

Young children with neurodevelopmental conditions are often limited in their ability to explore and learn from their environment. The purposes of this case series were to (1) describe the outcomes of using an alternative power mobility device with young children who had multiple, severe impairments; (2) develop power mobility training methods for use with these children; and (3) determine the feasibility of using various outcome measures. Three children with cerebral palsy (Gross Motor Function Classification System Levels IV, V, and V) ages 17 months to 3.5 years participated in the case series. Examination included the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) and the Dimensions of Mastery Questionnaire (DMQ). An individualized, engaging power mobility training environment was created for each participant. Intervention was provided for 60 minutes per week over 12 weeks. All participants exhibited improvements in power mobility skills. Post-intervention PEDI-CAT scores increased in various domains for all participants. Post-intervention DMQ scores improved in Participants 1 and 2. The participants appeared to make improvements in their beginning power mobility skills. Additional research is planned to further explore the impact of power mobility training in this unique population.

Dengue virus infection in renal allograft recipients: a case series during 2010 outbreak.

PubMed

Prasad, N; Bhadauria, D; Sharma, R K; Gupta, A; Kaul, A; Srivastava, A

2012-04-01

Dengue virus infection is an emerging global threat caused by Arbovirus, a virus from Flaviridiae family, which is transmitted by mosquitoes, Aedes aegypti and Aedes albopictus. Renal transplant recipients who live in the endemic zones of dengue infection or who travel to an endemic zone could be at risk of this infection. Despite multiple epidemics and a high case fatality rate in the Southeast Asian region, only a few cases of dengue infection in renal transplant recipients have been reported. Here, we report a case series of 8 dengue viral infection in renal transplant recipients. Of the 8 patients, 3 developed dengue hemorrhagic shock syndrome and died. © 2011 John Wiley & Sons A/S.

Investigation of Severe Craniomaxillofacial Battle Injuries Sustained by U.S. Service Members: A Case Series

PubMed Central

Brown Baer, Pamela R.; Wenke, Joseph C.; Thomas, Steven J.; Hale, Colonel Robert G.

2012-01-01

This case series describes craniomaxillofacial battle injuries, currently available surgical techniques, and the compromised outcomes of four service members who sustained severe craniomaxillofacial battle injuries in Iraq or Afghanistan. Demographic information, diagnostic evaluation, surgical procedures, and outcomes were collected and detailed with a follow-up of over 2 years. Reconstructive efforts with advanced, multidisciplinary, and multiple revision procedures were indicated; the full scope of conventional surgical options and resources were utilized. Patients experienced surgical complications, including postoperative wound dehiscence, infection, flap failure, inadequate mandibular healing, and failure of fixation. These complications required multiple revisions and salvage interventions. In addition, facial burns complicated reconstructive efforts by delaying treatment, decreasing surgical options, and increasing procedural numbers. All patients, despite multiple surgeries, continue to have functional and aesthetic deficits as a result of their injuries. Currently, no conventional treatments are available to satisfactorily reconstruct the face severely ravaged by explosive devices to an acceptable level, much less to natural form and function. PMID:24294409

Kernel canonical-correlation Granger causality for multiple time series

NASA Astrophysics Data System (ADS)

Wu, Guorong; Duan, Xujun; Liao, Wei; Gao, Qing; Chen, Huafu

2011-04-01

Canonical-correlation analysis as a multivariate statistical technique has been applied to multivariate Granger causality analysis to infer information flow in complex systems. It shows unique appeal and great superiority over the traditional vector autoregressive method, due to the simplified procedure that detects causal interaction between multiple time series, and the avoidance of potential model estimation problems. However, it is limited to the linear case. Here, we extend the framework of canonical correlation to include the estimation of multivariate nonlinear Granger causality for drawing inference about directed interaction. Its feasibility and effectiveness are verified on simulated data.

Clinical experience with Leptospermum honey use for treatment of hard to heal neonatal wounds: case series.

PubMed

Boyar, V; Handa, D; Clemens, K; Shimborske, D

2014-02-01

Preterm, critically ill neonates represent a challenge in wound healing. Many factors predispose infants to skin injuries, including decreased epidermal-dermal cohesion, deficient stratum corneum, relatively alkaline pH of skin surface, impaired nutrition and presence of multiple devices on the skin. We present a case series describing the use of medical-grade honey-Leptospermum honey (Medihoney), for successful treatment of slowly healing neonatal wounds, specifically stage 3 pressure ulcer, dehiscent and infected sternal wound, and full-thickness wound from an extravasation injury.

Evolving Curricular Models in Culinary Arts: An Instrumental Case Study of a Technical Field

ERIC Educational Resources Information Center

Cossio, Allison

2016-01-01

The purpose of this research study was to examine how chefs and other individuals in the food industry understood the field of culinary arts. This study used an instrumental case study with purposeful sampling of multiple cases. Through a series of open-ended interviews using snowball-sampling strategy that concluded with 45 participants sharing…

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.

Equine acquired multiple acyl-CoA dehydrogenase deficiency (MADD) in 14 horses associated with ingestion of Maple leaves (Acer pseudoplatanus) covered with European tar spot (Rhytisma acerinum).

PubMed

van der Kolk, J H; Wijnberg, I D; Westermann, C M; Dorland, L; de Sain-van der Velden, M G M; Kranenburg, L C; Duran, M; Dijkstra, J A; van der Lugt, J J; Wanders, R J A; Gruys, E

2010-01-01

This case-series describes fourteen horses suspected of equine acquired multiple acyl-CoA dehydrogenase deficiency (MADD) also known as atypical myopathy of which seven cases were confirmed biochemically with all horses having had access to leaves of the Maple tree (Acer pseudoplatanus) covered with European tar spot (Rhytisma acerinum). Assessment of organic acids, glycine conjugates, and acylcarnitines in urine was regarded as gold standard in the biochemical diagnosis of equine acquired multiple acyl-CoA dehydrogenase deficiency. Copyright © 2010 Elsevier Inc. All rights reserved.

Psychogenic Dyspnea and Therapeutic Chest Radiograph

ERIC Educational Resources Information Center

Kaufman, Kenneth R.; Endres, Jennifer K.; Kaufman, Nathaniel D.

2007-01-01

Conversion disorders, the physical expression of unresolved psychological pain, can be associated with mourning. This case report is third in a series of articles by the authors on childhood mourning reflecting the effects of multiple losses (K. R. Kaufman & N. D. Kaufman, 2005; K. R. Kaufman & N. D. Kaufman, 2006). In this case report, perception…

Case, Teacher and School Characteristics Influencing Teachers' Detection and Reporting of Child Physical Abuse and Neglect: Results from an Australian Survey

ERIC Educational Resources Information Center

Walsh, Kerryann; Bridgstock, Ruth; Farrell, Ann; Rassafiani, Mehdi; Schweitzer, Robert

2008-01-01

Objective: To identify the influence of multiple case, teacher and school characteristics on Australian primary school teachers' propensity to detect and report child physical abuse and neglect using vignettes as short hypothetical cases. Methods: A sample of 254 teachers completed a self-report questionnaire. They responded to a series of 32…

Occurrence of Multiple Sclerosis After Drug Exposure: Insights From Evidence Mapping.

PubMed

Antonazzo, Ippazio Cosimo; Raschi, Emanuel; Vignatelli, Luca; Baldin, Elisa; Riise, Trond; D'Alessandro, Roberto; De Ponti, Fabrizio; Poluzzi, Elisabetta

2017-09-01

The role of drugs in the occurrence of multiple sclerosis (MS) is perceived to be insufficiently investigated. The aim of this study was to map and assess the evidence on MS occurrence after drug exposure, in order to identify possible signals of causal association. A search strategy was performed in MEDLINE and Embase as of July 2016; references consistent with the aim of the study were analysed to extract relevant measures of causal association between drugs and MS. The Newcastle-Ottawa Scale and appropriate guidelines from the International Society for Pharmacoepidemiology (ISPE) and the International Society of Pharmacovigilance (ISoP) were used to assess the quality of included studies. After screening 832 articles, 58 were selected (of which 14 were found by checking the reference lists of reviews): 30 case reports and case series, 24 longitudinal studies and four randomized controlled trials. Seven longitudinal studies had good (at least 7 out of 9) quality scores, whereas case reports/case series presented several limitations. Half of included articles focused on immunomodulatory drugs (etanercept, infliximab and adalimumab), especially in case reports/series, suggesting an association with MS occurrence. Contraceptives and antibacterials were investigated in some population-based studies, without definite results. A heterogeneous pharmacological profile of identified classes emerged. Low strength of evidence and conflicting results highlighted the difficulties in addressing the possible contribution of drugs in MS occurrence. Methodological advances are needed, especially to control the confounding role of underlying disease for specific drug classes.

Chondrodysplasia with multiple dislocations: comprehensive study of a series of 30 cases.

PubMed

Ranza, E; Huber, C; Levin, N; Baujat, G; Bole-Feysot, C; Nitschke, P; Masson, C; Alanay, Y; Al-Gazali, L; Bitoun, P; Boute, O; Campeau, P; Coubes, C; McEntagart, M; Elcioglu, N; Faivre, L; Gezdirici, A; Johnson, D; Mihci, E; Nur, B G; Perrin, L; Quelin, C; Terhal, P; Tuysuz, B; Cormier-Daire, V

2017-06-01

The group of chondrodysplasia with multiple dislocations includes several entities, characterized by short stature, dislocation of large joints, hand and/or vertebral anomalies. Other features, such as epiphyseal or metaphyseal changes, cleft palate, intellectual disability are also often part of the phenotype. In addition, several conditions with overlapping features are related to this group and broaden the spectrum. The majority of these disorders have been linked to pathogenic variants in genes encoding proteins implicated in the synthesis or sulfation of proteoglycans (PG). In a series of 30 patients with multiple dislocations, we have performed exome sequencing and subsequent targeted analysis of 15 genes, implicated in chondrodysplasia with multiple dislocations, and related conditions. We have identified causative pathogenic variants in 60% of patients (18/30); when a clinical diagnosis was suspected, this was molecularly confirmed in 53% of cases. Forty percent of patients remain without molecular etiology. Pathogenic variants in genes implicated in PG synthesis are of major importance in chondrodysplasia with multiple dislocations and related conditions. The combination of hand features, growth failure severity, radiological aspects of long bones and of vertebrae allowed discrimination among the different conditions. We propose key diagnostic clues to the clinician. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Non-Hodgkin's malignant lymphoma with cervicofacial expression. Modulation of the radiotherapy-chemotherapy combination according to the cytological class].

PubMed

Bolla, M; Sotto, J J; Sotto, M F; Junien Lavillauroy, C; Bryon, J P; Vrousos, C; Holland, D

1984-01-01

An analysis was conducted in March 1983, after a mean follow up of 40 months, of cases of cervicofacial stages I and II non-Hodgkins malignant lymphoma in 3 children and 41 adults (mean age: 51 years, range: 6-90 years) treated between 1969 and March 1981. According to the Working Formulation malignancy was low in 4 cases, intermediate in 24 and high in 13; 3 cases could not ne classified retrospectively. Cytologic classification showed 13 of class 1 of low malignancy, 7 of class 2 of high malignancy with leukemic potential, and 16 of class 3 of high malignancy with a course leading to tumor formation. The cavum was involved in 10 cases, the tonsils in 9, the parotids in 1, the uvula in 1, isolated cervical adenopathies in 14, multiple unilateral adenopathies in 3 and bilateral cervical adenopathies in 5 cases. Therapy varied according to the series: in the first series (1969-1975) the 23 cases were treated by radiotherapy alone (40-55 Gy). In the second series (1976-1981) of 21 cases, chemotherapy was given as a function of the cytologic class: prophylactic chemotherapy for 6 months after radiation for classes 1 and 2, initial chemotherapy for 6 weeks, cerebral radiation and methotrexate intrathecally, and maintenance chemotherapy for 3 months in class 3. The failure rate for radiated zones was identical in the 2 series (less than 10%). Adjusted 5-year survival rate was 60% for series 1 against 70% for series 2 (p = 0.9), and adjusted remission rate was 43% against 64% (p = 0.8).

Accelerated Implantable Defibrillator Battery Depletion Secondary to Lithium Cluster Formation: A Case Series.

PubMed

Aggarwal, Ashim; Sarmiento, Joseph J; Charles, David R; Parr, Alan R; Baman, Timir S

2016-04-01

Device failure from unanticipated and precipitous battery depletion is uncommon but can be life-threatening. Multiple mechanisms of battery failure have been previously described in the medical literature. However, in this current case series, we describe the largest cohort of patients (n = 4) with St. Jude (St. Paul, MN, USA) early implantable defibrillator battery depletion attributable to lithium cluster formation causing short circuit and high current drain. Clinicians must be aware of this occult cause of device failure and more studies are needed to determine its true prevalence. © 2015 Wiley Periodicals, Inc.

Viruses in case series of tumors: Consistent presence in different cancers in the same subject

PubMed Central

Arroyo Mühr, Laila Sara; Hortlund, Maria; Bzhalava, Zurab; Nordqvist Kleppe, Sara; Bzhalava, Davit; Dillner, Joakim

2017-01-01

Studies investigating presence of viruses in cancer often analyze case series of cancers, resulting in detection of many viruses that are not etiologically linked to the tumors where they are found. The incidence of virus-associated cancers is greatly increased in immunocompromised individuals. Non-melanoma skin cancer (NMSC) is also greatly increased and a variety of viruses have been detected in NMSC. As immunosuppressed patients often develop multiple independent NMSCs, we reasoned that viruses consistently present in independent tumors might be more likely to be involved in tumorigenesis. We sequenced 8 different NMSCs from 1 patient in comparison to 8 different NMSCs from 8 different patients. Among the latter, 12 different virus sequences were detected, but none in more than 1 tumor each. In contrast, the patient with multiple NMSCs had human papillomavirus type 15 and type 38 present in 6 out of 8 NMSCs. PMID:28257474

Method and Excel VBA Algorithm for Modeling Master Recession Curve Using Trigonometry Approach.

PubMed

Posavec, Kristijan; Giacopetti, Marco; Materazzi, Marco; Birk, Steffen

2017-11-01

A new method was developed and implemented into an Excel Visual Basic for Applications (VBAs) algorithm utilizing trigonometry laws in an innovative way to overlap recession segments of time series and create master recession curves (MRCs). Based on a trigonometry approach, the algorithm horizontally translates succeeding recession segments of time series, placing their vertex, that is, the highest recorded value of each recession segment, directly onto the appropriate connection line defined by measurement points of a preceding recession segment. The new method and algorithm continues the development of methods and algorithms for the generation of MRC, where the first published method was based on a multiple linear/nonlinear regression model approach (Posavec et al. 2006). The newly developed trigonometry-based method was tested on real case study examples and compared with the previously published multiple linear/nonlinear regression model-based method. The results show that in some cases, that is, for some time series, the trigonometry-based method creates narrower overlaps of the recession segments, resulting in higher coefficients of determination R 2 , while in other cases the multiple linear/nonlinear regression model-based method remains superior. The Excel VBA algorithm for modeling MRC using the trigonometry approach is implemented into a spreadsheet tool (MRCTools v3.0 written by and available from Kristijan Posavec, Zagreb, Croatia) containing the previously published VBA algorithms for MRC generation and separation. All algorithms within the MRCTools v3.0 are open access and available free of charge, supporting the idea of running science on available, open, and free of charge software. © 2017, National Ground Water Association.

Brilliant Blue G double staining enhances successful internal limiting membrane peeling with minimal adverse effect by low cellular permeability into live cells.

PubMed

Hisatomi, Toshio; Notomi, Shoji; Tachibana, Takashi; Oishi, Seiichiro; Asato, Ryo; Yamashita, Takehiro; Murakami, Yusuke; Ikeda, Yasuhiro; Enaida, Hiroshi; Sakamoto, Taiji; Ishibashi, Tatsuro

2015-02-01

Brilliant Blue G is used as a surgical adjuvant for retinal surgery. Although BBG double or multiple staining was reported, the effectiveness and safety of repeated staining is still elusive. To further examine the effectiveness and safety, we examined BBG in clinical cases in vivo, primary cell culture in vitro, and surgically resected specimen ex vivo. A retrospective interventional case series with in vitro and ex vivo studies were performed. Vitrectomy was performed in 28 cases of epiretinal membrane with BBG single to multiple staining. The surgically resected membranes were stained by BBG with or without cellular fixation. Primary cell cultures were examined with BBG and live/death cell markers, such as Calcein AM and TUNEL. Single staining provided satisfactory staining in seven cases. Double or multiple staining substantially visualized internal limiting membrane (21 cases), especially the edges of remaining internal limiting membrane (11 cases). Adverse retinal staining was not noted and the final visual acuity showed no difference with multiple staining. The live cells barely stained with BBG, while some dead cells were stained. Brilliant Blue G multiple staining substantially enhanced the visualization of internal limiting membrane. The absence of abnormal staining supports the safety of repeated BBG staining.

Case Studies of Successful Schoolwide Enrichment Model-Reading (SEM-R) Classroom Implementations. Research Monograph Series. RM10204

ERIC Educational Resources Information Center

Reis, Sally M.; Little, Catherine A.; Fogarty, Elizabeth; Housand, Angela M.; Housand, Brian C.; Sweeny, Sheelah M.; Eckert, Rebecca D.; Muller, Lisa M.

2010-01-01

The purpose of this qualitative study was to examine the scaling up of the Schoolwide Enrichment Model in Reading (SEM-R) in 11 elementary and middle schools in geographically diverse sites across the country. Qualitative comparative analysis was used in this study, with multiple data sources compiled into 11 in-depth school case studies…

Variables affecting the financial viability of your practice: a case study.

PubMed

Binderman, J

2001-01-01

Utilizing the discussion of variables affecting practice financial viability, a case study is considered. The case study reveals the relative impact multiple variables have upon the bottom line, including: practice capacity, percentage of capitation, and fee-for-service in the practice, as well as patient visit rates and patient churning. This article presents basic financial information through a case study model, utilizing a series of worksheets that can be adapted to any practice situation to encourage improved financial viability.

Generalized multiplicative error models: Asymptotic inference and empirical analysis

NASA Astrophysics Data System (ADS)

Li, Qian

This dissertation consists of two parts. The first part focuses on extended Multiplicative Error Models (MEM) that include two extreme cases for nonnegative series. These extreme cases are common phenomena in high-frequency financial time series. The Location MEM(p,q) model incorporates a location parameter so that the series are required to have positive lower bounds. The estimator for the location parameter turns out to be the minimum of all the observations and is shown to be consistent. The second case captures the nontrivial fraction of zero outcomes feature in a series and combines a so-called Zero-Augmented general F distribution with linear MEM(p,q). Under certain strict stationary and moment conditions, we establish a consistency and asymptotic normality of the semiparametric estimation for these two new models. The second part of this dissertation examines the differences and similarities between trades in the home market and trades in the foreign market of cross-listed stocks. We exploit the multiplicative framework to model trading duration, volume per trade and price volatility for Canadian shares that are cross-listed in the New York Stock Exchange (NYSE) and the Toronto Stock Exchange (TSX). We explore the clustering effect, interaction between trading variables, and the time needed for price equilibrium after a perturbation for each market. The clustering effect is studied through the use of univariate MEM(1,1) on each variable, while the interactions among duration, volume and price volatility are captured by a multivariate system of MEM(p,q). After estimating these models by a standard QMLE procedure, we exploit the Impulse Response function to compute the calendar time for a perturbation in these variables to be absorbed into price variance, and use common statistical tests to identify the difference between the two markets in each aspect. These differences are of considerable interest to traders, stock exchanges and policy makers.

Kabuki syndrome: a Chinese case series and systematic review of the spectrum of mutations.

PubMed

Liu, Shuang; Hong, Xiafei; Shen, Cheng; Shi, Quan; Wang, Jian; Xiong, Feng; Qiu, Zhengqing

2015-04-21

Kabuki syndrome is a rare hereditary disease affecting multiple organs. The causative genes identified to date are KMT2D and KDMA6. The aim of this study is to evaluate the clinical manifestations and the spectrum of mutations of KMT2D. We retrospectively retrieved a series of eight patients from two hospitals in China and conducted Sanger sequencing for all of the patients and their parents if available. We also reviewed the literature and plotted the mutation spectrum of KMT2D. The patients generally presented with typical clinical manifestations as previously reported in other countries. Uncommon symptoms included spinal bifida and Dandy-Walker malformation. With respect to the mutations, five mutations were found in five patients, including two frameshift indels, one nonsense mutation and two missense mutations. This is the first case series on Kabuki syndrome in Mainland China. Unusual symptoms, such as spinal bifida and Dandy-Walker syndrome, suggested that neurological developmental defects may accompany Kabuki syndrome. This case series helps broaden the mutation spectrum of Kabuki syndrome and adds information regarding the manifestations of Kabuki syndrome.

The effect of nabilone on neuropsychological functions related to driving ability: an extended case series.

PubMed

Kurzthaler, Ilsemarie; Bodner, Thomas; Kemmler, Georg; Entner, Tanja; Wissel, Joerg; Berger, Thomas; Fleischhacker, W Wolfgang

2005-06-01

The primary goal of this prospective extended case series was to obtain the first data about the potential influence of nabilone intake on driving ability related neuropsychological functions. Six patients were investigated within a placebo controlled, double-blind crossover study of this synthetic cannabinoid (2 mg/day) in patients with multiple sclerosis and spasticity associated pain. Five neuropsychological functions (reaction time, working memory, divided attention, psychomotor speed and mental flexibility) were assessed. No indication was found of a deterioration of any of the five investigated neuropsychological functions during the 4-week treatment period with nabilone. Copyright 2005 John Wiley & Sons, Ltd.

The relative effects on math performance of single- versus multiple-ratio schedules: a case study1

PubMed Central

Lovitt, Tom C.; Esveldt, Karen A.

1970-01-01

This series of four experiments sought to assess the comparative effects of multiple- versus single-ratio schedules on a pupil's responding to mathematics materials. Experiment I, which alternated between single- and multiple-ratio contingencies, revealed that during the latter phase the subject responded at a higher rate. Similar findings were revealed by Exp. II. The third experiment, which manipulated frequency of reinforcement rather than multiple ratios, revealed that the alteration had a minimal effect on the subject's response rate. A final experiment, conducted to assess further the effects of multiple ratios, provided data similar to those of Exp. I and II. PMID:16795267

Contraction Options and Optimal Multiple-Stopping in Spectrally Negative Lévy Models

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

Yamazaki, Kazutoshi, E-mail: kyamazak@kansai-u.ac.jp

This paper studies the optimal multiple-stopping problem arising in the context of the timing option to withdraw from a project in stages. The profits are driven by a general spectrally negative Lévy process. This allows the model to incorporate sudden declines of the project values, generalizing greatly the classical geometric Brownian motion model. We solve the one-stage case as well as the extension to the multiple-stage case. The optimal stopping times are of threshold-type and the value function admits an expression in terms of the scale function. A series of numerical experiments are conducted to verify the optimality and tomore » evaluate the efficiency of the algorithm.« less

Corneoscleral Laceration and Ocular Burns Caused by Electronic Cigarette Explosions

PubMed Central

Paley, Grace L.; Echalier, Elizabeth; Eck, Thomas W.; Hong, Augustine R.; Gregory, Darren G.; Lubniewski, Anthony J.

2016-01-01

Purpose: To report cases of acute globe rupture and bilateral corneal burns from electronic cigarette (EC) explosions. Methods: Case series. Results: We describe a series of patients with corneal injury caused by EC explosions. Both patients suffered bilateral corneal burns and decreased visual acuity, and one patient sustained a unilateral corneoscleral laceration with prolapsed iris tissue and hyphema. A review of the scientific literature revealed no prior reported cases of ocular injury secondary to EC explosions; however, multiple media and government agency articles describe fires and explosions involving ECs, including at least 4 with ocular injuries. Conclusions: Given these cases and the number of recent media reports, ECs pose a significant public health risk. Users should be warned regarding the possibility of severe injury, including sight-threatening ocular injuries ranging from corneal burns to full-thickness corneoscleral laceration. PMID:27191672

A case series of pregnancy- and lactation-associated osteoporosis and a review of the literature

PubMed Central

Nakamura, Yukio; Kamimura, Mikio; Ikegami, Shota; Mukaiyama, Keijiro; Komatsu, Masatoshi; Uchiyama, Shigeharu; Kato, Hiroyuki

2015-01-01

The syndrome of pregnancy- and lactation-associated osteoporosis is a rare disorder whose precise etiology and treatment are largely unknown. We herein report two such cases occurring in the early postpartum period that led to multiple fragility compression fractures. Combination therapy of vitamin D and vitamin K enabled a marked gradual increase in bone mineral density. PMID:26379439

Therapeutic assessment for preadolescent boys with oppositional defiant disorder: a replicated single-case time-series design.

PubMed

Smith, Justin D; Handler, Leonard; Nash, Michael R

2010-09-01

The Therapeutic Assessment (TA) model is a relatively new treatment approach that fuses assessment and psychotherapy. The study examines the efficacy of this model with preadolescent boys with oppositional defiant disorder and their families. A replicated single-case time-series design with daily measures is used to assess the effects of TA and to track the process of change as it unfolds. All 3 families benefitted from participation in TA across multiple domains of functioning, but the way in which change unfolded was unique for each family. These findings are substantiated by the Behavior Assessment System for Children (Reynolds & Kamphaus, 2004). The TA model is shown to be an effective treatment for preadolescent boys with oppositional defiant disorder and their families. Further, the time-series design of this study illustrated how this empirically grounded case-based methodology reveals when and how change unfolds during treatment in a way that is usually not possible with other research designs.

75 FR 48349 - Agency Forms Undergoing Paperwork Reduction Act review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-10

... monitor syndrome-based (e.g., case information collected in emergency departments (EDs) and diagnostic... syndromic surveillance systems. EARS has been designed and used to monitor syndromic data from emergency... events such as the Beijing Summer Olympics; multiple Superbowls (football) and World Series (baseball...

Diverticular disease of the right colon.

PubMed

Radhi, Jasim M; Ramsay, Jennifer A; Boutross-Tadross, Odette

2011-10-06

The incidence of colonic diverticular disease varies with national origin, cultural background and diet. The frequency of this disease increases with advancing age. Right-sided diverticular disease is uncommon and reported to occur in 1-2% of surgical specimens in European and American series. In contrast the disease is more prevalent and reported in 43-50% of specimens in Asian series. Various lines of evidence suggest this variation may represent hereditary differences. The aim of the study is to report all cases of right sided diverticular disease underwent surgical resection or identified during pathological examination of right hemicoloectomy specimens A retrospective review of all surgical specimens with right sided colonic diverticular disease selected from a larger database of all colonic diverticulosis and diverticulitis surgical specimen reported between January 1993 and December 2010 at the Pathology Department McMaster University Medical Centre Canada. The clinical and pathological features of these cases were reviewed The review identified 15 cases of right colon diverticulosis. The clinical diagnoses of these cases were appendicitis, diverticulitis or adenocarcinoma. Eight cases of single congenital perforated diverticuli were identified and seven cases were incidental multiple acquired diverticuli found in specimen resected for right side colonic carcinomas/large adenomas. Laparotomy or laparoscopic assisted haemicolectomies were done for all cases. Pathological examination showed caecal wall thickening with inflammation associated with perforated diverticuli. Histology confirmed true solitary diverticuli that exhibited in two cases thick walled vessels in the submucosa and muscular layer indicating vascular malformation/angiodysplasia. Acquired diverticuli tend to be multiple and are mostly seen in specimens resected for neoplastic right colon diseases. Single true diverticular disease of the right colon is usually of congenital type and affects younger age group and may be associated with angiodysplasia in some cases. Multiple false diverticuli are more seen in association with caecal carcinoma or large adenomas. These are usually asymptomatic and are more seen in older patients. However this study dose not reflects the true incidence of the disease in the general population.

Time series smoother for effect detection.

PubMed

You, Cheng; Lin, Dennis K J; Young, S Stanley

2018-01-01

In environmental epidemiology, it is often encountered that multiple time series data with a long-term trend, including seasonality, cannot be fully adjusted by the observed covariates. The long-term trend is difficult to separate from abnormal short-term signals of interest. This paper addresses how to estimate the long-term trend in order to recover short-term signals. Our case study demonstrates that the current spline smoothing methods can result in significant positive and negative cross-correlations from the same dataset, depending on how the smoothing parameters are chosen. To circumvent this dilemma, three classes of time series smoothers are proposed to detrend time series data. These smoothers do not require fine tuning of parameters and can be applied to recover short-term signals. The properties of these smoothers are shown with both a case study using a factorial design and a simulation study using datasets generated from the original dataset. General guidelines are provided on how to discover short-term signals from time series with a long-term trend. The benefit of this research is that a problem is identified and characteristics of possible solutions are determined.

Time series smoother for effect detection

PubMed Central

Lin, Dennis K. J.; Young, S. Stanley

2018-01-01

In environmental epidemiology, it is often encountered that multiple time series data with a long-term trend, including seasonality, cannot be fully adjusted by the observed covariates. The long-term trend is difficult to separate from abnormal short-term signals of interest. This paper addresses how to estimate the long-term trend in order to recover short-term signals. Our case study demonstrates that the current spline smoothing methods can result in significant positive and negative cross-correlations from the same dataset, depending on how the smoothing parameters are chosen. To circumvent this dilemma, three classes of time series smoothers are proposed to detrend time series data. These smoothers do not require fine tuning of parameters and can be applied to recover short-term signals. The properties of these smoothers are shown with both a case study using a factorial design and a simulation study using datasets generated from the original dataset. General guidelines are provided on how to discover short-term signals from time series with a long-term trend. The benefit of this research is that a problem is identified and characteristics of possible solutions are determined. PMID:29684033

An approach to natalizumab hypersensitivity: a case series of induction of tolerance.

PubMed

Camacho-Halili, Marie; George, Roxanne; Gottesman, Malcolm; Davis-Lorton, Mark

2011-02-01

Induction of tolerance protocols have been applied successfully to manage allergic reactions to many medications. Hypersensitivity reactions to natalizumab (TYSABRI®) have been recognized as a growing problem. In circumstances where a hypersensitivity reaction to a medication has occurred, but no suitable alternative exists, drug induction of tolerance protocols may be considered. Drug induction of tolerance protocols were performed in three patients with prior hypersensitivity reactions to natalizumab. All three patients tolerated the protocol without adverse reactions, allowing for the safe reintroduction of natalizumab. To conclude, this case series demonstrates success with an induction of tolerance procedure to a highly effective biological agent for multiple sclerosis, in patients with allergic reactions to natalizumab.

Responding To Infectious Disease: Multiple Cases of Staph Infections in a Rural School District. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 3, 2008

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an incident involving several cases of Methicillin-resistant Staphylococcus aureus (MRSA) at a rural high school. MRSA is a specific strain of Staphylococcus aureus bacteria (often called staph)…

The impact of days off between cases on perioperative outcomes for robotic-assisted laparoscopic prostatectomy.

PubMed

Pearce, Shane M; Pariser, Joseph J; Patel, Sanjay G; Anderson, Blake B; Eggener, Scott E; Zagaja, Gregory P

2016-02-01

To examine the effect of days off between cases on perioperative outcomes for robotic-assisted laparoscopic prostatectomy (RALP). We analyzed a single-surgeon series of 2036 RALP cases between 2003 and 2014. Days between cases (DBC) was calculated as the number of days elapsed since the surgeon's previous RALP with the second start cases assigned 0 DBC. Surgeon experience was assessed by dividing sequential case experience into cases 0-99, cases 100-249, cases 250-999, and cases 1000+ based on previously reported learning curve data for RALP. Outcomes included estimated blood loss (EBL), operative time (OT), and positive surgical margins (PSMs). Multiple linear regression was used to assess the impact of the DBC and surgeon experience on EBL, OT, and PSM, while controlling for patient characteristics, surgical technique, and pathologic variables. Overall median DBC was 1 day (0-3) and declined with increasing surgeon case experience. Multiple linear regression demonstrated that each additional DBC was independently associated with increased EBL [β = 3.7, 95% CI (1.3-6.2), p < 0.01] and OT [β = 2.3 (1.4-3.2), p < 0.01], but was not associated with rate of PSM [β = 0.004 (-0.003-0.010), p = 0.2]. Increased experience was also associated with reductions in EBL and OT (p < 0.01). Surgeon experience of 1000+ cases was associated with a 10% reduction in PSM rate (p = 0.03) compared to cases 0-99. In a large single-surgeon RALP series, DBC was associated with increased blood loss and operative time, but not associated with positive surgical margins, when controlling for surgeon experience.

Principals' Perceptions of Successful Leadership

ERIC Educational Resources Information Center

Childers, Gary L.

2013-01-01

The purposes of this qualitative multiple case study were to determine the catalysts and pathways that caused principals to move from managers to effective leaders. Data were collected through a series of interviews with 4 principals who were selected through a purposeful sampling procedure. The interviews were audio recorded, transcribed, and…

Education and Gender Egalitarianism: The Case of China

ERIC Educational Resources Information Center

Shu, Xiaoling

2004-01-01

This study examined Chinese attitudes toward women's careers, marriage rights, sexual freedom, and the importance of having sons using a 1991 national sample of individuals and community-level data and through a series of nested multilevel models. Education influences gender attitudes in multiple ways at both the micro- and macrolevels.…

Multiple Indicator Stationary Time Series Models.

ERIC Educational Resources Information Center

Sivo, Stephen A.

2001-01-01

Discusses the propriety and practical advantages of specifying multivariate time series models in the context of structural equation modeling for time series and longitudinal panel data. For time series data, the multiple indicator model specification improves on classical time series analysis. For panel data, the multiple indicator model…

Some contributions of the Department of Veterans Affairs to the epidemiology of multiple sclerosis.

PubMed

Kurtzke, J F

2008-09-01

The first class 1 treatment trial ever conducted in multiple sclerosis (MS) was a Veterans Administration Cooperative Study. This led us to explore MS in the military-veteran populations of the United States in three main series: Army men hospitalized with final diagnoses of MS in World War II, all veterans of World War II and the Korean Conflict, and veterans of later service up to 1994. In each series, all cases had been matched with pre-illness military peers. These series provide major information on its clinical features, course and prognosis, including survival, by sex and race (white men and women; black men), as well as risk factors for occurrence, course, and survival. They comprise the only available nationwide morbidity distributions of MS in the United States. Veterans who are service-connected for MS by the Department of Veterans Affairs and matched with their military peers remain a unique and currently available resource for further clinical and epidemiological study of this disease.

[Special cases of multiple sclerosis].

PubMed

Mendibe Bilbao, Mar

2014-12-01

Multiple sclerosis is a chronic disease that usually occurs in young people and affects them for the rest of their lives. Patients and their families usually have a series of doubts and questions on everyday matters and all types of situations that occur during the distinct stages of life and which can influence the course of the disease. The aim of this review is to provide specific answers to these questions. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Music therapy in the treatment of multiple sclerosis: a comprehensive literature review.

PubMed

Ostermann, Thomas; Schmid, Wolfgang

2006-04-01

Coping with multiple sclerosis symptoms still remains a challenge for each patient suffering from this chronic inflammatory disease. Therefore, patients often turn to using complementary and alternative medicine (CAM). In this review, the authors aimed to investigate the current state of literature of music therapy in the treatment of multiple sclerosis (MS). Medline, PubMed, Embase, AMED, CAMbase and the Music Therapy World Journal Index were searched for the terms MS and 'music therapy'. In addition, an internet search using Google Scholar was performed. The authors found seven case-reports/series and seven studies on music therapy for MS-patients. Both the case reports and studies presented here are pioneer work. Most of the studies are naturally predominated by the use of qualitative and uncontrolled research designs. Nevertheless, the results of the studies as well as the case reports demonstrate patients' improvement in the domains of self-acceptance, anxiety and depression. The results of the studies as well as the case reports define a sufficient basis for further music therapeutical work as they show a variety of psychosocial and emotional benefits for MS patients.

Variables affecting the financial viability of your practice.

PubMed

Binderman, J

2001-01-01

Financial viability of physician practices depends upon multiple variables: capacity of the practice, the mix of managed care contracts, cost of care, make-up of patient population, patient visit rates, and utilization of alternate methods of patient interaction. This article presents an introduction to these ideas; the second in this series will expand on the groundwork with a case scenario for a typical family practice. The articles present basic financial information in a practical manner, utilizing a series of worksheets to determine how these various items affect the bottom line.

Using Formative Assessment to Support Complex Learning in Conditions of Social Adversity

ERIC Educational Resources Information Center

Crossouard, Barbara

2011-01-01

This article reports on research into formative assessment within a task design that produces multiple opportunities for teacher and pupil dialogue. It draws upon in-depth case studies conducted in schools in socially deprived areas of Scotland, using policy and documentary analysis, video-observation, and an iterative series of interviews with…

Precision of Curriculum-Based Measurement Reading Data: Considerations for Multiple-Baseline Designs

ERIC Educational Resources Information Center

Klingbeil, David A.; Van Norman, Ethan R.; Nelson, Peter M.

2017-01-01

Single-case designs provide an established technology for evaluating the effects of academic interventions. Researchers interested in studying the long-term effects of reading interventions often use curriculum-based measures of reading (CBM-R) as they possess many of the desirable characteristics for use in a time-series design. The reliability…

High Altitude Cerebral Edema

DTIC Science & Technology

1986-03-01

described neuropathological findings of cerebral edema and wi4espread petechial hemorrhages in two HAPE fatalities and later reported (52...lethargy, thirst, indigestion, hysterical outburst o: other behavior disturbances, decreased concentration, fever , couhh and peripheral edema (52...autopsy results from the two fatalities in their series. In both cases multiple, widespread petechial hemorrhages were noted throughout the brain. One

A Pilot Study of Integrated Listening Systems for Children with Sensory Processing Problems

ERIC Educational Resources Information Center

Schoen, Sarah A.; Miller, Lucy J.; Sullivan, Jillian

2015-01-01

This pilot study explored the effects of Integrated Listening Systems (iLs) Focus Series on individualized parent goals for children with sensory processing impairments. A nonconcurrent multiple baseline, repeated measure across participants, single-case study design was employed (n = 7). The 40-session intervention was delivered at home and in…

MetaRNA-Seq: An Interactive Tool to Browse and Annotate Metadata from RNA-Seq Studies.

PubMed

Kumar, Pankaj; Halama, Anna; Hayat, Shahina; Billing, Anja M; Gupta, Manish; Yousri, Noha A; Smith, Gregory M; Suhre, Karsten

2015-01-01

The number of RNA-Seq studies has grown in recent years. The design of RNA-Seq studies varies from very simple (e.g., two-condition case-control) to very complicated (e.g., time series involving multiple samples at each time point with separate drug treatments). Most of these publically available RNA-Seq studies are deposited in NCBI databases, but their metadata are scattered throughout four different databases: Sequence Read Archive (SRA), Biosample, Bioprojects, and Gene Expression Omnibus (GEO). Although the NCBI web interface is able to provide all of the metadata information, it often requires significant effort to retrieve study- or project-level information by traversing through multiple hyperlinks and going to another page. Moreover, project- and study-level metadata lack manual or automatic curation by categories, such as disease type, time series, case-control, or replicate type, which are vital to comprehending any RNA-Seq study. Here we describe "MetaRNA-Seq," a new tool for interactively browsing, searching, and annotating RNA-Seq metadata with the capability of semiautomatic curation at the study level.

Comparison of Statistical Algorithms for the Detection of Infectious Disease Outbreaks in Large Multiple Surveillance Systems

PubMed Central

Farrington, C. Paddy; Noufaily, Angela; Andrews, Nick J.; Charlett, Andre

2016-01-01

A large-scale multiple surveillance system for infectious disease outbreaks has been in operation in England and Wales since the early 1990s. Changes to the statistical algorithm at the heart of the system were proposed and the purpose of this paper is to compare two new algorithms with the original algorithm. Test data to evaluate performance are created from weekly counts of the number of cases of each of more than 2000 diseases over a twenty-year period. The time series of each disease is separated into one series giving the baseline (background) disease incidence and a second series giving disease outbreaks. One series is shifted forward by twelve months and the two are then recombined, giving a realistic series in which it is known where outbreaks have been added. The metrics used to evaluate performance include a scoring rule that appropriately balances sensitivity against specificity and is sensitive to variation in probabilities near 1. In the context of disease surveillance, a scoring rule can be adapted to reflect the size of outbreaks and this was done. Results indicate that the two new algorithms are comparable to each other and better than the algorithm they were designed to replace. PMID:27513749

Subacute motor neuron hyperexcitability with mercury poisoning: a case series and literature review.

PubMed

Zhou, Zhibin; Zhang, Xingwen; Cui, Fang; Liu, Ruozhuo; Dong, Zhao; Wang, Xiaolin; Yu, Shengyuan

2014-01-01

Motor neuron hyperexcitability (MNH) indicates a disorder characterized by an ectopic motor nerve discharge on electromyogram (EMG). Here, we present a series of three cases of subacute MNH with mercury poisoning. The first case showed hyperhidrosis, insomnia, generalied myokymia, cramps, tremor, weight loss, and myokymic and neuromyotonic discharges, followed by encephalopathy with confusion, hallucinations, and memory decrease. The second case was similar to the former but without encephalopathic features. The third case showed widespread fasciculation, fatigue, insomnia, weight loss, and autonomic dysfunction, including constipation, micturition difficulty, and impotence, with multiple fibrillation, unstable fasciculation, widened motor neuron potential, and an incremental response at high-rate stimulation in repetitive nerve stimulation. Based on the symptoms, the three cases were diagnosed as Morvan's syndrome, Isaacs' syndrome, and Lambert-Eaton myasthenic syndrome with ALS-like syndrome, respectively. Mercury poisoning in the three cases was confirmed by analysis of blood and urine samples. All cases recovered several months after chelation therapy and were in good condition at follow-up. Very few cases of MNH linked with mercury exposure have been reported in the literature. The mechanism of mercury-induced MNH may be associated with ion channel dysfunction. © 2014 S. Karger AG, Basel.

Hypothalamic-pituitary sarcoidosis with vision loss and hypopituitarism: case series and literature review.

PubMed

Anthony, Jeremy; Esper, Gregory J; Ioachimescu, Adriana

2016-02-01

Hypothalamic-pituitary (HP) neurosarcoidosis (NS) accounts for 0.5 % cases of sarcoidosis and 1 % of HP masses. Correlative data on endocrine and neurological outcomes is lacking. Retrospective case series and literature review of presentation, treatment and outcome of HP NS. Our series includes 4 men, ages 34-59, followed for a median of 7.3 years (range 1.5-17). All had optic neuropathy, multiple pituitary hormone abnormalities (PHAs) and other organ involvement by sarcoidosis (lung, sino-nasal, brain/spine and facial nerve). Two patients had central diabetes insipidus and one impaired thirst with polydipsia. After treatment with high-dose glucocorticoids, optic neuropathy improved in one case and stabilized in the others. After treatment, HP lesions improved radiologically, but PHAs persisted in all cases. Review of four published series on HP NS in addition to ours yielded 46 patients, age 37 ± 11.8 years, 65 % male. PHAs consisted of anterior hypopituitarism (LH/FSH 88.8 %, TSH 67.4 %, GH 50.0 %, ACTH 48.8 %), hyperprolactinemia (48.8 %) and diabetes insipidus (65.2 %). PHAs were the first sign of disease in 54.3 % patients. Vision problems occurred in 28.3 % patients, but optic neuropathy was not well documented in previous series. Most patients (93.5 %) received high-dose glucocorticoids followed by taper; 50 % also received other immunomodulators, including methotrexate, mycophenolate mofetil, cyclosporine, azathioprine, infliximab and hydrochloroquine. Only 13 % patients showed improvement in PHAs. All-cause mortality was 8.7 %. HP NS is a serious disease requiring multidisciplinary treatment and lifelong follow-up. Prospective multicentric studies are needed to determine a more standardized approach to HP NS and outline predictors of disease outcome.

Subcutaneous intralesional Ksharodaka injection: A novel treatment for the management of Warts: A case series.

PubMed

Gundeti, Manohar S; Reddy, R Govind; Muralidhar, Jangle Vidya

2014-01-01

Warts are generally managed using cryosurgery, keratolytic ointments, curettage and electrodessication. Warts, vis-a-vis Charmakila, in Ayurvedic classical texts are classified into different types depending on the dominance of dosha. Ayurveda prescribes oral medications, topical use of Kshara (alkaline ash of herbs), Agni (thermal cautery) and Shastrakarma (surgery) for removal of Charmakila. Use of topical Kshara in the form of powder, aqueous solution i.e. Ksharodaka and Ksharasutra (thread smeared with Kshara) for warts has been reported. However, these methods necessitate multiple sittings and takea longer duration for removal of the warts. Herewith, we report a case series of different types of warts treated with intralesional infiltration of Apamarga Ksharodaka (AK), i.e. aqueous solution of Apamarga (Achyranthes aspera) Kshara. We observed that all these warts took a minimum of 2-6 days to shed off, leaving minor scars. There were no adverse reactions reported in any of these cases.

Falcon: Visual analysis of large, irregularly sampled, and multivariate time series data in additive manufacturing

DOE PAGES

Steed, Chad A.; Halsey, William; Dehoff, Ryan; ...

2017-02-16

Flexible visual analysis of long, high-resolution, and irregularly sampled time series data from multiple sensor streams is a challenge in several domains. In the field of additive manufacturing, this capability is critical for realizing the full potential of large-scale 3D printers. Here, we propose a visual analytics approach that helps additive manufacturing researchers acquire a deep understanding of patterns in log and imagery data collected by 3D printers. Our specific goals include discovering patterns related to defects and system performance issues, optimizing build configurations to avoid defects, and increasing production efficiency. We introduce Falcon, a new visual analytics system thatmore » allows users to interactively explore large, time-oriented data sets from multiple linked perspectives. Falcon provides overviews, detailed views, and unique segmented time series visualizations, all with adjustable scale options. To illustrate the effectiveness of Falcon at providing thorough and efficient knowledge discovery, we present a practical case study involving experts in additive manufacturing and data from a large-scale 3D printer. The techniques described are applicable to the analysis of any quantitative time series, though the focus of this paper is on additive manufacturing.« less

Falcon: Visual analysis of large, irregularly sampled, and multivariate time series data in additive manufacturing

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

Steed, Chad A.; Halsey, William; Dehoff, Ryan

Flexible visual analysis of long, high-resolution, and irregularly sampled time series data from multiple sensor streams is a challenge in several domains. In the field of additive manufacturing, this capability is critical for realizing the full potential of large-scale 3D printers. Here, we propose a visual analytics approach that helps additive manufacturing researchers acquire a deep understanding of patterns in log and imagery data collected by 3D printers. Our specific goals include discovering patterns related to defects and system performance issues, optimizing build configurations to avoid defects, and increasing production efficiency. We introduce Falcon, a new visual analytics system thatmore » allows users to interactively explore large, time-oriented data sets from multiple linked perspectives. Falcon provides overviews, detailed views, and unique segmented time series visualizations, all with adjustable scale options. To illustrate the effectiveness of Falcon at providing thorough and efficient knowledge discovery, we present a practical case study involving experts in additive manufacturing and data from a large-scale 3D printer. The techniques described are applicable to the analysis of any quantitative time series, though the focus of this paper is on additive manufacturing.« less

Multiple left anterior descending coronary artery to left ventricular fistula - A case series and literature review.

PubMed

Iyer, Praneet; Yelisetti, Rishitha

2017-10-01

Coronary artery fistulas (CAFs) are found in 0.3-0.8% of patients who undergo coronary angiography. CAFs are defined as single or multiple, small or large direct communications that arise from one or more coronary arteries and enter into one of the four cardiac chambers or major vessels. We present two cases of multiple coronary artery fistulas arising from diagonal and left anterior descending (LAD) branches of left coronary artery draining into the left ventricle. In both the cases, No intervention was performed. Of the congenital fistulas, two major groups are identified: solitary CAFs or coronary artery-left ventricular multiple micro-fistulas (CALVMMFs). Noninvasive techniques such as transthoracic echocardiography, transesophageal echocardiography and magnetic resonance imaging are becoming increasingly popular for diagnosis and follow-up of CAFs. Despite the advent of these newer non-invasive modalities, coronary angiography remains the gold standard for diagnosis. Treatment of CAFs is indicated when the patients are symptomatic with left ventricular volume overload, myocardial ischemia, left ventricular dysfunction or in the presence of a large or increasing left-to-right shunt. If the fistula is small and hemodynamically insignificant, it can be managed with conservative management. Multiple left anterior descending to left ventricle (LV) fistulas are extremely rare and, as per our literature review, we noted only a few case reports of coronary artery fistulas between branches of LAD and left ventricle.

Numerical investigation on the effects of acceleration reversal times in Rayleigh-Taylor Instability with multiple reversals

NASA Astrophysics Data System (ADS)

Farley, Zachary; Aslangil, Denis; Banerjee, Arindam; Lawrie, Andrew G. W.

2017-11-01

An implicit large eddy simulation (ILES) code, MOBILE, is used to explore the growth rate of the mixing layer width of the acceleration-driven Rayleigh-Taylor instability (RTI) under variable acceleration histories. The sets of computations performed consist of a series of accel-decel-accel (ADA) cases in addition to baseline constant acceleration and accel-decel (AD) cases. The ADA cases are a series of varied times for the second acceleration reversal (t2) and show drastic differences in the growth rates. Upon the deceleration phase, the kinetic energy of the flow is shifted into internal wavelike patterns. These waves are evidenced by the examined differences in growth rate in the second acceleration phase for the set of ADA cases. Here, we investigate global parameters that include mixing width, growth rates and the anisotropy tensor for the kinetic energy to better understand the behavior of the growth during the re-acceleration period. Authors acknowledge financial support from DOE-SSAA (DE-NA0003195) and NSF CAREER (#1453056) awards.

Simplification of multiple Fourier series - An example of algorithmic approach

NASA Technical Reports Server (NTRS)

Ng, E. W.

1981-01-01

This paper describes one example of multiple Fourier series which originate from a problem of spectral analysis of time series data. The example is exercised here with an algorithmic approach which can be generalized for other series manipulation on a computer. The generalized approach is presently pursued towards applications to a variety of multiple series and towards a general purpose algorithm for computer algebra implementation.

Study of placenta of children born with congenital malformations.

PubMed

Stoll, Claude; Alembik, Yves; Dott, Béatrice; Roth, Marie-Paule

2003-01-01

The malformations in this study were observed in a series of 279,642 consecutive births of known outcome registered in our Registry of congenital anomalies. For each case, more than 50 factors included in the registration forms were studied. One of the factors studied was the placenta. For each malformed child, a control was chosen. Cases with maternal known factors impairing placenta function, i.e. vasculopathy and diabetes, were excluded. In each category of malformations studied, the malformed children were divided into isolated and non-isolated (multiple malformed) cases. The weight of placenta of isolated cases was not lower than the weight of placenta of the controls. In contrast, the weight of placenta of the cases with non-isolated malformations was lower than the weight of placenta of the controls and of the isolated cases, for all categories of malformations but gastroschisis and omphalocele. The mean weights at birth of the cases with multiple malformations were also lower than those of the controls. The human placenta discounts a principal functional part, the maternal blood in the intervillous space. Congenital malformations may interact with this function.

Treatment Failure after Multiple Courses of Triclabendazole among Patients with Fascioliasis in Cusco, Peru: A Case Series

PubMed Central

Cabada, Miguel M.; Lopez, Martha; Cruz, Maria; Delgado, Jennifer R.; Hill, Virginia; White, A. Clinton

2016-01-01

Triclabendazole is reported to be highly effective in treatment of human fascioliasis. We present 7 of 19 selected cases of human fascioliasis referred to our center in the Cusco region of Peru that failed to respond to triclabendazole. These were mostly symptomatic adults of both sexes that continued passing Fasciola eggs in the stool despite multiple treatments with 2 doses of triclabendazole at 10 mg/kg per dose. We documented the presence of eggs by rapid sedimentation and Kato Katz tests after each treatment course. We found that repeated triclabendazole courses were not effective against fascioliasis in this group of people. These findings suggest that resistance to triclabendazole may be an emerging problem in the Andes. PMID:26808543

Treatment Failure after Multiple Courses of Triclabendazole among Patients with Fascioliasis in Cusco, Peru: A Case Series.

PubMed

Cabada, Miguel M; Lopez, Martha; Cruz, Maria; Delgado, Jennifer R; Hill, Virginia; White, A Clinton

2016-01-01

Triclabendazole is reported to be highly effective in treatment of human fascioliasis. We present 7 of 19 selected cases of human fascioliasis referred to our center in the Cusco region of Peru that failed to respond to triclabendazole. These were mostly symptomatic adults of both sexes that continued passing Fasciola eggs in the stool despite multiple treatments with 2 doses of triclabendazole at 10 mg/kg per dose. We documented the presence of eggs by rapid sedimentation and Kato Katz tests after each treatment course. We found that repeated triclabendazole courses were not effective against fascioliasis in this group of people. These findings suggest that resistance to triclabendazole may be an emerging problem in the Andes.

Treatment of Obsessive Compulsive Disorder in Young Children: An Intervention Model and Case Series

ERIC Educational Resources Information Center

Ginsburg, Golda S.; Burstein, Marcy; Becker, Kimberly D.; Drake, Kelly L.

2011-01-01

This article presents an intervention model for young children with obsessive-compulsive disorder (OCD). The intervention, designed to reduce compulsive behavior and improve parenting practices, was tested using a multiple baseline design with 7 children (M = 6 years old; 57% female) in which participants were randomly assigned to 1, 2, or 3 weeks…

Findings of multiple HPV genotypes in cervical carcinoma are associated with poor cancer-specific survival in a Swedish cohort of cervical cancer primarily treated with radiotherapy.

PubMed

Kaliff, Malin; Sorbe, Bengt; Mordhorst, Louise Bohr; Helenius, Gisela; Karlsson, Mats G; Lillsunde-Larsson, Gabriella

2018-04-10

Cervical cancer (CC) is one of the most common cancers in women and virtually all cases of CC are a result of a persistent infection of human papillomavirus (HPV). For disease detected in early stages there is curing treatment but when diagnosed late with recurring disease and metastasis there are limited possibilities. Here we evaluate HPV impact on treatment resistance and metastatic disease progression. Prevalence and distribution of HPV genotypes and HPV16 variants in a Swedish CC patient cohort (n=209) was evaluated, as well as HPV influence on patient prognosis. Tumor samples suitable for analysis (n=204) were genotyped using two different real-time PCR methods. HPV16 variant analysis was made using pyrosequencing. Results showed that HPV prevalence in the total series was 93%. Of the HPV-positive samples, 13% contained multiple infections, typically with two high-risk HPV together. Primary cure rate for the complete series was 95%. Recurrence rate of the complete series was 28% and distant recurrences were most frequent (20%). Patients with tumors containing multiple HPV-strains and particularly HPV genotypes belonging to the alpha 7 and 9 species together had a significantly higher rate of distant tumor recurrences and worse cancer-specific survival rate.

Genome-wide association study in discordant sibships identifies multiple inherited susceptibility alleles linked to lung cancer.

PubMed

Galvan, Antonella; Falvella, Felicia S; Frullanti, Elisa; Spinola, Monica; Incarbone, Matteo; Nosotti, Mario; Santambrogio, Luigi; Conti, Barbara; Pastorino, Ugo; Gonzalez-Neira, Anna; Dragani, Tommaso A

2010-03-01

We analyzed a series of young (median age = 52 years) non-smoker lung cancer patients and their unaffected siblings as controls, using a genome-wide 620 901 single-nucleotide polymorphism (SNP) array analysis and a case-control DNA pooling approach. We identified 82 putatively associated SNPs that were retested by individual genotyping followed by use of the sib transmission disequilibrium test, pointing to 36 SNPs associated with lung cancer risk in the discordant sibs series. Analysis of these 36 SNPs in a polygenic model characterized by additive and interchangeable effects of rare alleles revealed a highly statistically significant dosage-dependent association between risk allele carrier status and proportion of cancer cases. Replication of the same 36 SNPs in a population-based series confirmed the association with lung cancer for three SNPs, suggesting that phenocopies and genetic heterogeneity can play a major role in the complex genetics of lung cancer risk in the general population.

Refeeding syndrome or refeeding hypophosphatemia: a systematic review of cases.

PubMed

Skipper, Annalynn

2012-02-01

Nutrition support clinicians refer to the abnormalities in laboratory data and changes in clinical signs and symptoms that follow refeeding of starved or malnourished patients as refeeding syndrome. Theoretical descriptions of refeeding syndrome include a complex and extensive list of changes, such as hypophosphatemia, hypomagnesemia, hypokalemia, hyponatremia, hypocalcemia, hyperglycemia, and vitamin deficiency--all of which are accompanied by clinical signs and symptoms. In practice, clinicians see asymptomatic refeeding hypophosphatemia more often than a full-blown syndrome with multiple laboratory and clinical abnormalities. Confusion results because there is no widely accepted or uniformly applied set of defining characteristics for diagnosing refeeding syndrome. To gain insight into the clinical characteristics of refeeding syndrome described in the literature, a systematic review of reported cases and case series was conducted. Since 2000, 20 authors described 27 cases that contained sufficient data for review. Hypophosphatemia occurred in 26 patients (96%). While 19 patients (71%) experienced at least 1 other laboratory abnormality, only 14 (51%) exhibited a consistent pattern of abnormally low phosphorus and magnesium levels. Seven patients had hypocalcemia (26%), and hyponatremia was reported in 3 patients (11%). There were no reports of hyperglycemia. Mean data reported in case series containing data from 63 patients showed that hypophosphatemia was a consistent finding but that other abnormalities were not consistently identified. Findings suggest that refeeding hypophosphatemia is not accompanied by a consistent pattern of biochemical or clinical abnormalities among case reports or case series of patients reported to have refeeding syndrome.

Cyclosporine treatment of severe Hidradenitis suppurativa--A case series.

PubMed

Anderson, Marianne D; Zauli, Stefania; Bettoli, Vincenzo; Boer, Jurr; Jemec, Gregor B E

2016-01-01

Hidradenitis suppurativa (HS) is an overlooked but common disease severely affecting both genders. HS is generally perceived as difficult to treat and although a number of treatments are available, the need for more effective treatment is apparent. Cyclosporine A (CsA) has been suggested as an effective treatment in four smaller case series. It was therefore decided to review a larger series of cases, reporting all outcomes in order to provide a less biased base for evaluating the potential of CsA for use in HS. An exploratory retrospective review of case notes was performed at three departments of dermatology with a special interest in HS, where HS had been treated with CsA in the period 2009-2012. In total, 18 HS patients treated with CsA were identified and analysed and 50% reported some benefit. All patients had previously been treated with multiple various other modalities. This is an exploratory retrospective review with a limited number of patients. This retrospective review found some effect of CsA in the recalcitrant cases studied, mainly reported as "slight improvement". This may be due to a number of factors which may have overestimated (e.g., concommitant therapy) or underestimated (e.g., case selection of recalcitrant cases) the effect, and indicates the need for prospective evaluation of the claims. The present data provide a basis for power calculations in future studies investigating the potential for treating HS with CsA in a randomised controlled trial.

Esophageal Perforation Following Anterior Cervical Spine Surgery: Case Report and Review of the Literature

PubMed Central

Hershman, Stuart H.; Kunkle, William A.; Kelly, Michael P.; Buchowski, Jacob M.; Ray, Wilson Z.; Bumpass, David B.; Gum, Jeffrey L.; Peters, Colleen M.; Singhatanadgige, Weerasak; Kim, Jin Young; Smith, Zachary A.; Hsu, Wellington K.; Nassr, Ahmad; Currier, Bradford L.; Rahman, Ra’Kerry K.; Isaacs, Robert E.; Smith, Justin S.; Shaffrey, Christopher; Thompson, Sara E.; Wang, Jeffrey C.; Lord, Elizabeth L.; Buser, Zorica; Arnold, Paul M.; Fehlings, Michael G.; Mroz, Thomas E.

2017-01-01

Study Design: Multicenter retrospective case series and review of the literature. Objective: To determine the rate of esophageal perforations following anterior cervical spine surgery. Methods: As part of an AOSpine series on rare complications, a retrospective cohort study was conducted among 21 high-volume surgical centers to identify esophageal perforations following anterior cervical spine surgery. Staff at each center abstracted data from patients’ charts and created case report forms for each event identified. Case report forms were then sent to the AOSpine North America Clinical Research Network Methodological Core for data processing and analysis. Results: The records of 9591 patients who underwent anterior cervical spine surgery were reviewed. Two (0.02%) were found to have esophageal perforations following anterior cervical spine surgery. Both cases were detected and treated in the acute postoperative period. One patient was successfully treated with primary repair and debridement. One patient underwent multiple debridement attempts and expired. Conclusions: Esophageal perforation following anterior cervical spine surgery is a relatively rare occurrence. Prompt recognition and treatment of these injuries is critical to minimizing morbidity and mortality. PMID:28451488

Esophageal Perforation Following Anterior Cervical Spine Surgery: Case Report and Review of the Literature.

PubMed

Hershman, Stuart H; Kunkle, William A; Kelly, Michael P; Buchowski, Jacob M; Ray, Wilson Z; Bumpass, David B; Gum, Jeffrey L; Peters, Colleen M; Singhatanadgige, Weerasak; Kim, Jin Young; Smith, Zachary A; Hsu, Wellington K; Nassr, Ahmad; Currier, Bradford L; Rahman, Ra'Kerry K; Isaacs, Robert E; Smith, Justin S; Shaffrey, Christopher; Thompson, Sara E; Wang, Jeffrey C; Lord, Elizabeth L; Buser, Zorica; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

2017-04-01

Multicenter retrospective case series and review of the literature. To determine the rate of esophageal perforations following anterior cervical spine surgery. As part of an AOSpine series on rare complications, a retrospective cohort study was conducted among 21 high-volume surgical centers to identify esophageal perforations following anterior cervical spine surgery. Staff at each center abstracted data from patients' charts and created case report forms for each event identified. Case report forms were then sent to the AOSpine North America Clinical Research Network Methodological Core for data processing and analysis. The records of 9591 patients who underwent anterior cervical spine surgery were reviewed. Two (0.02%) were found to have esophageal perforations following anterior cervical spine surgery. Both cases were detected and treated in the acute postoperative period. One patient was successfully treated with primary repair and debridement. One patient underwent multiple debridement attempts and expired. Esophageal perforation following anterior cervical spine surgery is a relatively rare occurrence. Prompt recognition and treatment of these injuries is critical to minimizing morbidity and mortality.

Evaluation of Epidermal Skin Grafts for the Treatment of Complex Wounds in a Wound Care Center: A 94-Patient Case Series.

PubMed

Lincoln, Katherine; Hyde, Jessica

2016-10-01

In recent years, a new technology for autologous epidermal harvesting has been developed to produce epidermal skin grafts (ESGs) for use over wounds. This technology employs negative pressure and heat to raise the epidermal skin layer, allowing for consistent and reproducible epidermal harvesting. The aim of this case series is to present the authors' experience using an automated, epidermal harvesting system to produce ESGs to treat wounds of patients with multiple comorbidities. This case series was conducted between January 1, 2013 and December 31, 2014. Patients with wounds (≤ 25 cm2) that failed to heal were treated with ESGs by a group of 3 wound care physicians in 2 outpatient wound care centers in a community health center setting. A total of 94 patients with 102 wounds were identified. Of the 94 patients, 3 were noncompliant and 9 were lost to follow-up. Therefore, 82 patients with 90 wounds were included in the analysis. The majority of wounds demonstrated epithelialization (83/90, 92.2%). Of the 90 wounds, 75 (83.3%) healed following epidermal grafting, 4 (4.4%) wounds displayed improvement, and 11 (12.2%) did not heal. Minimal or no pain at the donor site was reported by the patients, and all donor sites healed without complications. This case series provides additional evidence for the use of ESGs for the treatment of wounds that fail to heal.

Crude oil price forecasting based on hybridizing wavelet multiple linear regression model, particle swarm optimization techniques, and principal component analysis.

PubMed

Shabri, Ani; Samsudin, Ruhaidah

2014-01-01

Crude oil prices do play significant role in the global economy and are a key input into option pricing formulas, portfolio allocation, and risk measurement. In this paper, a hybrid model integrating wavelet and multiple linear regressions (MLR) is proposed for crude oil price forecasting. In this model, Mallat wavelet transform is first selected to decompose an original time series into several subseries with different scale. Then, the principal component analysis (PCA) is used in processing subseries data in MLR for crude oil price forecasting. The particle swarm optimization (PSO) is used to adopt the optimal parameters of the MLR model. To assess the effectiveness of this model, daily crude oil market, West Texas Intermediate (WTI), has been used as the case study. Time series prediction capability performance of the WMLR model is compared with the MLR, ARIMA, and GARCH models using various statistics measures. The experimental results show that the proposed model outperforms the individual models in forecasting of the crude oil prices series.

Crude Oil Price Forecasting Based on Hybridizing Wavelet Multiple Linear Regression Model, Particle Swarm Optimization Techniques, and Principal Component Analysis

PubMed Central

Shabri, Ani; Samsudin, Ruhaidah

2014-01-01

Crude oil prices do play significant role in the global economy and are a key input into option pricing formulas, portfolio allocation, and risk measurement. In this paper, a hybrid model integrating wavelet and multiple linear regressions (MLR) is proposed for crude oil price forecasting. In this model, Mallat wavelet transform is first selected to decompose an original time series into several subseries with different scale. Then, the principal component analysis (PCA) is used in processing subseries data in MLR for crude oil price forecasting. The particle swarm optimization (PSO) is used to adopt the optimal parameters of the MLR model. To assess the effectiveness of this model, daily crude oil market, West Texas Intermediate (WTI), has been used as the case study. Time series prediction capability performance of the WMLR model is compared with the MLR, ARIMA, and GARCH models using various statistics measures. The experimental results show that the proposed model outperforms the individual models in forecasting of the crude oil prices series. PMID:24895666

Angiolymphoid hyperplasia with eosinophilia: a clinicopathologic study of 9 cases.

PubMed

Guinovart, R M; Bassas-Vila, J; Morell, L; Ferrándiz, C

2014-03-01

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare disease characterized by single or multiple angiomatous lesions typically located on the scalp and the face. We present a retrospective analysis of 9 cases of ALHE. The lesions appeared largely as multiple grouped papules or, in some cases, subcutaneous nodules, located mainly on the scalp, particularly around the ear. We also observed lesions in atypical locations, such as areas of the head other than the scalp, and the shoulder, neck, and forearm. At these sites the lesions had an atypical clinical appearance that made diagnosis difficult; this should be borne in mind in patients with single, well-delimited lesions with a vascular appearance and superficial ulceration or crusting. Surgery was the most common treatment in our series, and even though ALHE is considered a benign condition, recurrence was common. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis.

PubMed

Broggi, G; Ferroli, P; Franzini, A; Servello, D; Dones, I

2000-01-01

To examine surgical findings and results of microvascular decompression (MVD) for trigeminal neuralgia (TN), including patients with multiple sclerosis, to bring new insight about the role of microvascular compression in the pathogenesis of the disorder and the role of MVD in its treatment. Between 1990 and 1998, 250 patients affected by trigeminal neuralgia underwent MVD in the Department of Neurosurgery of the "Istituto Nazionale Neurologico C Besta" in Milan. Limiting the review to the period 1991-6, to exclude the "learning period" (the first 50 cases) and patients with less than 1 year follow up, surgical findings and results were critically analysed in 148 consecutive cases, including 10 patients with multiple sclerosis. Vascular compression of the trigeminal nerve was found in all cases. The recurrence rate was 15.3% (follow up 1-7 years, mean 38 months). In five of 10 patients with multiple sclerosis an excellent result was achieved (follow up 12-39 months, mean 24 months). Patients with TN for more than 84 months did significantly worse than those with a shorter history (p<0.05). There was no mortality and most complications occurred in the learning period. Surgical complications were not related to age of the patients. Aetiopathogenesis of trigeminal neuralgia remains a mystery. These findings suggest a common neuromodulatory role of microvascular compression in both patients with or without multiple sclerosis rather than a direct causal role. MVD was found to be a safe and effective procedure to relieve typical TN in patients of all ages. It should be proposed as first choice surgery to all patients affected by TN, even in selected cases with multiple sclerosis, to give them the opportunity of pain relief without sensory deficits.

Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis

PubMed Central

Broggi, G.; Ferroli, P.; Franzini, A.; Servello, D.; Dones, I.

2000-01-01

OBJECTIVE—To examine surgical findings and results of microvascular decompression (MVD) for trigeminal neuralgia (TN), including patients with multiple sclerosis, to bring new insight about the role of microvascular compression in the pathogenesis of the disorder and the role of MVD in its treatment.
METHODS—Between 1990 and 1998, 250 patients affected by trigeminal neuralgia underwent MVD in the Department of Neurosurgery of the "Istituto Nazionale Neurologico C Besta" in Milan. Limiting the review to the period 1991-6, to exclude the "learning period" (the first 50 cases) and patients with less than 1 year follow up, surgical findings and results were critically analysed in 148 consecutive cases, including 10 patients with multiple sclerosis.
RESULTS—Vascular compression of the trigeminal nerve was found in all cases. The recurrence rate was 15.3% (follow up 1-7 years, mean 38 months). In five of 10 patients with multiple sclerosis an excellent result was achieved (follow up 12-39 months, mean 24months). Patients with TN for more than 84 months did significantly worse than those with a shorter history (p<0.05). There was no mortality and most complications occurred in the learning period. Surgical complications were not related to age of the patients.
CONCLUSIONS—Aetiopathogenesis of trigeminal neuralgia remains a mystery. These findings suggest a common neuromodulatory role of microvascular compression in both patients with or without multiple sclerosis rather than a direct causal role. MVD was found to be a safe and effective procedure to relieve typical TN in patients of all ages. It should be proposed as first choice surgery to all patients affected by TN, even in selected cases with multiple sclerosis, to give them the opportunity of pain relief without sensory deficits. 

 PMID:10601403

Plasma exchange therapy in steroid-unresponsive relapses in patients with multiple sclerosis.

PubMed

Trebst, Corinna; Reising, Ansgar; Kielstein, Jan T; Hafer, Carsten; Stangel, Martin

2009-01-01

Plasma exchange (PE) is well established for conditions such as rapid progressive vasculitis associated with autoantibodies against neutrophil cytoplasmic antigens (ANCA), anti-glomerular basement membrane (GBM) antibody disease, or thrombotic thrombocytopenic purpura (TTP). Also, several neurological disorders, such as acute worsening in myasthenia gravis, Guillan-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP), can successfully be treated with PE. Only small case series have previously shown that PE is also effective in relapses in patients with multiple sclerosis (MS). We report our experiences of PE therapy in a series of 20 patients with 21 steroid unresponsive MS relapses. A marked-to-moderate clinical response with clear gain of function in 76% of patients with uni- or bilateral optic neuritis and in 87.5% of patients with relapses other than optic neuritis was observed. PE is an effective and well tolerated therapeutic option for steroid-unresponsive MS relapses.

A generalized Grubbs-Beck test statistic for detecting multiple potentially influential low outliers in flood series

USGS Publications Warehouse

Cohn, T.A.; England, J.F.; Berenbrock, C.E.; Mason, R.R.; Stedinger, J.R.; Lamontagne, J.R.

2013-01-01

he Grubbs-Beck test is recommended by the federal guidelines for detection of low outliers in flood flow frequency computation in the United States. This paper presents a generalization of the Grubbs-Beck test for normal data (similar to the Rosner (1983) test; see also Spencer and McCuen (1996)) that can provide a consistent standard for identifying multiple potentially influential low flows. In cases where low outliers have been identified, they can be represented as “less-than” values, and a frequency distribution can be developed using censored-data statistical techniques, such as the Expected Moments Algorithm. This approach can improve the fit of the right-hand tail of a frequency distribution and provide protection from lack-of-fit due to unimportant but potentially influential low flows (PILFs) in a flood series, thus making the flood frequency analysis procedure more robust.

SORL1 variants and risk of late-onset Alzheimer's disease.

PubMed

Li, Yonghong; Rowland, Charles; Catanese, Joseph; Morris, John; Lovestone, Simon; O'Donovan, Michael C; Goate, Alison; Owen, Michael; Williams, Julie; Grupe, Andrew

2008-02-01

A recent study reported significant association of late-onset Alzheimer's disease (LOAD) with multiple single nucleotide polymorphisms (SNPs) and haplotypes in SORL1, a neuronal sortilin-related receptor protein known to be involved in the trafficking and processing of amyloid precursor protein. Here we attempted to validate this finding in three large, well characterized case-control series. Approximately 2000 samples from the three series were individually genotyped for 12 SNPs, including the 10 reported significant SNPs and 2 that constitute the reported significant haplotypes. A total of 25 allelic and haplotypic association tests were performed. One SNP rs2070045 was marginally replicated in the three sample sets combined (nominal P=0.035); however, this result does not remain significant when accounting for multiple comparisons. Further validation in other sample sets will be required to assess the true effects of SORL1 variants in LOAD.

A generalized Grubbs-Beck test statistic for detecting multiple potentially influential low outliers in flood series

NASA Astrophysics Data System (ADS)

Cohn, T. A.; England, J. F.; Berenbrock, C. E.; Mason, R. R.; Stedinger, J. R.; Lamontagne, J. R.

2013-08-01

The Grubbs-Beck test is recommended by the federal guidelines for detection of low outliers in flood flow frequency computation in the United States. This paper presents a generalization of the Grubbs-Beck test for normal data (similar to the Rosner (1983) test; see also Spencer and McCuen (1996)) that can provide a consistent standard for identifying multiple potentially influential low flows. In cases where low outliers have been identified, they can be represented as "less-than" values, and a frequency distribution can be developed using censored-data statistical techniques, such as the Expected Moments Algorithm. This approach can improve the fit of the right-hand tail of a frequency distribution and provide protection from lack-of-fit due to unimportant but potentially influential low flows (PILFs) in a flood series, thus making the flood frequency analysis procedure more robust.

Early-Onset Multiple Sclerosis in Isfahan, Iran: Report of the Demographic and Clinical Features of 221 Patients.

PubMed

Etemadifar, Masoud; Nourian, Sayed-Mohammadamin; Nourian, Niloofaralsadat; Abtahi, Seyed-Hossein; Sayahi, Farnaz; Saraf, Zahra; Fereidan-Esfahani, Mahboobeh

2016-06-01

It is estimated that early-onset multiple sclerosis multiple sclerosis (early-onset multiple sclerosis) approximately incorporates 3-5% of the multiple sclerosis population. In this report on early-onset multiple sclerosis, the authors aimed to define demographic, clinical and imaging features in a case-series of true-childhood multiple sclerosis and to compare its characteristics with juvenile multiple sclerosis. The authors inspected the records of multiple sclerosis patients who were registered by Isfahan MS Society. Clinical and demographic data of children with less than 16 years of age were reviewed retrospectively. Out of 4536 multiple sclerosis patients referred to the authors' center, 221 patients (4.8%) had multiple sclerosis starting at the age of 16 or less (11 true-childhood multiple sclerosis vs 210 juvenile-onset multiple sclerosis); the female to male ratio was 4.81:1. In the mean follow-up period of 6.2 years, 22 patients (10.5%) had positive family history of multiple sclerosis, 196 (88.6%) patients were classified as relapsing-remitting multiple sclerosis, the mean (± SD Expanded Disability Status Scale) was 1.5 ± 1.1 at the last evaluation. The most common initial presentation was optic nerve involvement (36.1%) and cerebellar sign and symptoms (14.6%). In all, 13 patients (5.8%) had experienced seizure in the course of multiple sclerosis. This study indicated that early-onset multiple sclerosis is not rare condition and overwhelmingly affects girls even at prepubertal onset. Physicians should consider multiple sclerosis in suspicious pediatric cases. © The Author(s) 2016.

The Identity Construction Experiences of Early Career English Language Teachers in Hong Kong. Great Expectations and Practical Realities

ERIC Educational Resources Information Center

Trent, John

2016-01-01

This article reports the results of a multiple qualitative case study which investigated the challenges that seven early career English language teachers in Hong Kong confronted as they constructed their professional and personal identities. A series of in-depth interviews with participants during the entire first year of their full-time teaching…

Utilizing an Early Childhood Science Curriculum: Factors Influencing Implementation and How Variations Affect Students' Skills and Attitudes

ERIC Educational Resources Information Center

Shamas-Brandt, Ellen

2012-01-01

Early childhood is a ripe time for students to begin learning science, but due to certain constraints, this instruction is not happening as frequently as it should. This mixed-methods, multiple case study examined how two teachers implemented an early childhood science curriculum, the "Young Scientist Series." The teacher participants…

When Does Repeated Search in Scenes Involve Memory? Looking at versus Looking for Objects in Scenes

ERIC Educational Resources Information Center

Vo, Melissa L. -H.; Wolfe, Jeremy M.

2012-01-01

One might assume that familiarity with a scene or previous encounters with objects embedded in a scene would benefit subsequent search for those items. However, in a series of experiments we show that this is not the case: When participants were asked to subsequently search for multiple objects in the same scene, search performance remained…

Implementing Education Reforms in New Zealand, 1987-97: A Case Study. The Education Reform and Management Series, Vol. 1, No. 1.

ERIC Educational Resources Information Center

Perris, Lyall

In 1987 New Zealand faced multiple economic problems and high unemployment. A flexible and responsive education system was needed to produce the skills, attitudes, and learning required for New Zealand's future. The primary objective was decentralizing authority to school level. This book emphasizes the process of successful reform, rather than…

Pattern of Injuries from Road Traffic Accidents Presented at a Rural Teaching Institution of Karachi.

PubMed

Shamim, Muhammad

2017-08-01

The aim of the study is to study the pattern of injuries from road traffic accidents presented at the emergency department of a rural teaching institution in Karachi. This descriptive case series was conducted prospectively in the Emergency Department of Fatima Hospital and Baqai Medical University from 1 January 2012 to 21 March 2013. There were 385 patients in the series. All of the patients with recent injuries from road traffic accidents were included. Cases with injuries more than 72 h old were excluded. The majority of patients had lower limb injuries 172 (44.7%), followed by head and neck injuries 107 (27.8%), multiple injuries 62 (16.1%), upper limb injuries 22 (5.7%), abdominoperineal injuries 19 (5%), and chest injuries 3 (0.8%). Majority (229, 59.5%) of patients were given first aid treatment and discharged, while 151 (39.3%) patients were either admitted or referred to better equipped hospitals. Three patients were brought dead, and two patients left against medical advice. The lower limb injuries were the commonest road traffic accidental injuries, followed by head and neck injuries, multiple injuries, upper limb injuries, abdominoperineal injuries, and chest injuries.

Vocal fold paralysis following surgical ductal closure in extremely low birth weight infants: A case series of feeding and respiratory complications

PubMed Central

Malcolm, William F.; Hornik, Christoph; Smith, P. Brian; Evans, Adele; Cotten, C. Michael

2010-01-01

Surgical closure of a Patent Ductus Arteriosus (PDA) continues to be frequent among Extremely Low Birth Weight (ELBW) infants, despite improvements in the medical management of PDA’s and rising questions about its pathophysiologic role. Among other possible complications of this surgical intervention, left vocal fold paralysis (LVFP) has been reported. Only more recently, however, neonatologists are realizing the frequency and impact of this complication on chronic respiratory and feeding difficulties in the ELBW population. In this case series, we describe the clinical course of three sets of multiple births, for which at least one infant underwent surgical closure of his PDA and subsequently developed feeding and/or respiratory difficulties due to LVFP, and compare them to their respective siblings who did not sustain this complication. PMID:18974752

Pediatric recurrent respiratory tract infections: when and how to explore the immune system? (About 53 cases).

PubMed

El-Azami-El-Idrissi, Mohammed; Lakhdar-Idrissi, Mounia; Chaouki, Sanae; Atmani, Samir; Bouharrou, Abdelhak; Hida, Moustapha

2016-01-01

Recurrent respiratory tract infections are one of the most frequent reasons for pediatric visits and hospitalization. Causes of this pathology are multiple ranging from congenital to acquired and local to general. Immune deficiencies are considered as underlying conditions predisposing to this pathology. Our work is about to determine when and how to explore the immune system when facing recurrent respiratory infections. This was based on the records of 53 children hospitalized at the pediatrics unit of Hassan II University Hospital, Fez Morocco. Thirty boys and 23 girls with age ranging from 5 months to 12 years with an average age of 2 years were involved in this study. Bronchial foreign body was the main etiology in children of 3 to 6 year old. Gastro-esophageal reflux, which in some cases is a consequence of chronic cough, as well as asthma were most frequent in infants (17 and 15% respectively). Immune deficiency was described in 7.5% of patients and the only death we deplored in our series belongs to this group. Recurrent respiratory tract infections have multiple causes. In our series they are dominated by foreign body inhalation and gastroesophageal reflux, which in some cases is a consequence of a chronic cough. Immune deficiency is not frequent but could influence the prognosis. Therefore immune explorations should be well codified.

Multiple sclerosis in US veterans of the Vietnam era and later military service: race, sex, and geography.

PubMed

Wallin, Mitchell T; Page, William F; Kurtzke, John F

2004-01-01

We identified 5345 cases of multiple sclerosis (MS) among US veterans who first entered military service between 1960 and 1994, and who were "service-connected" for MS by the Department of Veterans Affairs (VA). Two controls per case were matched on age, date of service entry, and branch of service. Available for service and VA files were demographic and military data for 4951 cases and 9378 controls. Versus white men, relative risk of MS was significantly higher for all women, at 2.99 for whites, 2.86 for blacks, and 3.51 for those of other races. This was a significant increase from our prior series of veterans of World War II and the Korean Conflict, where white women had a relative risk of 1.79. Risk for black men was higher now (0.67 vs 0.44), while other men remained low (0.30 vs 0.22). Residence at service entry in the northern tier of states had a relative risk of 2.02 versus the southern tier, which was significantly less than the 2.64 for the earlier series. Residence by individual state at birth and service entry for white men further supported this decreasing geographic differential. Such marked changes in geography, sex, and race in such a short interval strongly imply a primary environmental factor in the cause or precipitation of this disease.

Subcutaneous intralesional Ksharodaka injection: A novel treatment for the management of Warts: A case series

PubMed Central

Gundeti, Manohar S.; Reddy, R. Govind; Muralidhar, Jangle Vidya

2014-01-01

Warts are generally managed using cryosurgery, keratolytic ointments, curettage and electrodessication. Warts, vis-a-vis Charmakila, in Ayurvedic classical texts are classified into different types depending on the dominance of dosha. Ayurveda prescribes oral medications, topical use of Kshara (alkaline ash of herbs), Agni (thermal cautery) and Shastrakarma (surgery) for removal of Charmakila. Use of topical Kshara in the form of powder, aqueous solution i.e. Ksharodaka and Ksharasutra (thread smeared with Kshara) for warts has been reported. However, these methods necessitate multiple sittings and takea longer duration for removal of the warts. Herewith, we report a case series of different types of warts treated with intralesional infiltration of Apamarga Ksharodaka (AK), i.e. aqueous solution of Apamarga (Achyranthes aspera) Kshara. We observed that all these warts took a minimum of 2-6 days to shed off, leaving minor scars. There were no adverse reactions reported in any of these cases. PMID:25624698

Incomplete ileus and hemafecia as the presenting features of multi-organ involved primary systemic AL amyloidosis: a rare case report.

PubMed

Tian, Li; Tang, Anliu; Zhang, Xian; Mei, Zhen; Liu, Fen; Li, Jingbo; Li, Xiayu; Ai, Feiyan; Wang, Xiaoyan; Shen, Shourong

2017-06-05

AL Amyloidosis is known to be a systemic disease affecting multiple organs and tissue while it's rare that patients present with gastrointestinal symptoms at first and later develop multiple-organ dysfuction. Clinical signs are not specific and the diagnosis is rarely given before performing immunofixation and endoscopy with multiple biopsies. We would like to emphasize the value of precise diagnostic process of AL amyloidosis. In this case report, we describe a 56-year-old man who presented with recurrent periumbilical pain for 4 months and gradually worsened over a month. After a series of tests, he was finally diagnosed with primary systemic AL amyloidosis. He was treated with a chemotherapy regimen (Melphalan, dexamethasone and thalidomide) achieving a good clinical response. On account of the high misdiagnosis rate, establishing the most precise diagnosis in first time with typing amyloidogenic protein becomes increasingly vital. Although the presenting feature is usually nonspecific, AL amyloidosis ought to be considered when multiple organs are involved in a short period.

A structured framework for assessing sensitivity to missing data assumptions in longitudinal clinical trials.

PubMed

Mallinckrodt, C H; Lin, Q; Molenberghs, M

2013-01-01

The objective of this research was to demonstrate a framework for drawing inference from sensitivity analyses of incomplete longitudinal clinical trial data via a re-analysis of data from a confirmatory clinical trial in depression. A likelihood-based approach that assumed missing at random (MAR) was the primary analysis. Robustness to departure from MAR was assessed by comparing the primary result to those from a series of analyses that employed varying missing not at random (MNAR) assumptions (selection models, pattern mixture models and shared parameter models) and to MAR methods that used inclusive models. The key sensitivity analysis used multiple imputation assuming that after dropout the trajectory of drug-treated patients was that of placebo treated patients with a similar outcome history (placebo multiple imputation). This result was used as the worst reasonable case to define the lower limit of plausible values for the treatment contrast. The endpoint contrast from the primary analysis was - 2.79 (p = .013). In placebo multiple imputation, the result was - 2.17. Results from the other sensitivity analyses ranged from - 2.21 to - 3.87 and were symmetrically distributed around the primary result. Hence, no clear evidence of bias from missing not at random data was found. In the worst reasonable case scenario, the treatment effect was 80% of the magnitude of the primary result. Therefore, it was concluded that a treatment effect existed. The structured sensitivity framework of using a worst reasonable case result based on a controlled imputation approach with transparent and debatable assumptions supplemented a series of plausible alternative models under varying assumptions was useful in this specific situation and holds promise as a generally useful framework. Copyright © 2012 John Wiley & Sons, Ltd.

Modelling fourier regression for time series data- a case study: modelling inflation in foods sector in Indonesia

NASA Astrophysics Data System (ADS)

Prahutama, Alan; Suparti; Wahyu Utami, Tiani

2018-03-01

Regression analysis is an analysis to model the relationship between response variables and predictor variables. The parametric approach to the regression model is very strict with the assumption, but nonparametric regression model isn’t need assumption of model. Time series data is the data of a variable that is observed based on a certain time, so if the time series data wanted to be modeled by regression, then we should determined the response and predictor variables first. Determination of the response variable in time series is variable in t-th (yt), while the predictor variable is a significant lag. In nonparametric regression modeling, one developing approach is to use the Fourier series approach. One of the advantages of nonparametric regression approach using Fourier series is able to overcome data having trigonometric distribution. In modeling using Fourier series needs parameter of K. To determine the number of K can be used Generalized Cross Validation method. In inflation modeling for the transportation sector, communication and financial services using Fourier series yields an optimal K of 120 parameters with R-square 99%. Whereas if it was modeled by multiple linear regression yield R-square 90%.

Clinical and Radiologic Predictive Factors of Rib Fractures in Outpatients With Chest Pain.

PubMed

Zhang, Liang; McMahon, Colm J; Shah, Samir; Wu, Jim S; Eisenberg, Ronald L; Kung, Justin W

To identify the clinical and radiologic predictive factors of rib fractures in stable adult outpatients presenting with chest pain and to determine the utility of dedicated rib radiographs in this population of patients. Following Institutional Review Board approval, we performed a retrospective review of 339 consecutive cases in which a frontal chest radiograph and dedicated rib series had been obtained for chest pain in the outpatient setting. The frontal chest radiograph and dedicated rib series were sequentially reviewed in consensus by two fellowship-trained musculoskeletal radiologists blinded to the initial report. The consensus interpretation of the dedicated rib series was used as the gold standard. Multiple variable logistic regression analysis assessed clinical and radiological factors associated with rib fractures. Fisher exact test was used to assess differences in medical treatment between the 2 groups. Of the 339 patients, 53 (15.6%) had at least 1 rib fracture. Only 20 of the 53 (37.7%) patients' fractures could be identified on the frontal chest radiograph. The frontal chest radiograph had a sensitivity of 38% and specificity of 100% when using the rib series as the reference standard. No pneumothorax, new mediastinal widening or pulmonary contusion was identified. Multiple variable logistic regression analysis of clinical factors associated with the presence of rib fractures revealed a significant association of trauma history (odds ratio 5.7 [p < 0.05]) and age ≥40 (odds radio 3.1 [p < 0.05]). Multiple variable logistic regression analysis of radiographic factors associated with rib fractures in this population demonstrated a significant association of pleural effusion with rib fractures (odds ratio 18.9 [p < 0.05]). Patients with rib fractures received narcotic analgesia in 47.2% of the cases, significantly more than those without rib fractures (21.3%, p < 0.05). None of the patients required hospitalization. In the stable outpatient setting, rib fractures have a higher association with a history of minor trauma and age ≥40 in the adult population. Radiographic findings associated with rib fractures include pleural effusion. The frontal chest radiograph alone has low sensitivity in detecting rib fractures. The dedicated rib series detected a greater number of rib fractures. Although no patients required hospitalization, those with rib fractures were more likely to receive narcotic analgesia. Copyright © 2018 Elsevier Inc. All rights reserved.

Classroom Interaction Studies as a Source for Teacher Competencies: The Use of Case Studies with Multiple Instruments for Studying Teacher Competencies in Multicultural Classes

ERIC Educational Resources Information Center

den Brok, Perry; van Eerde, Dolly; Hajer, Maaike

2010-01-01

Dealing with ethnic and linguistic diversity is one of the major challenges in today's education. Therefore, the formulation of competencies for teachers and teacher training should take into account the specific requirements of teaching in multicultural schools. In 2002, a series of small-scale studies were conducted to identify and formulate…

Systematic review of general thoracic surgery articles to identify predictors of operating room case durations.

PubMed

Dexter, Franklin; Dexter, Elisabeth U; Masursky, Danielle; Nussmeier, Nancy A

2008-04-01

Previous studies of operating room (OR) information systems data over the past two decades have shown how to predict case durations using the combination of scheduled procedure(s), individual surgeon and assistant(s), and type of anesthetic(s). We hypothesized that the accuracy of case duration prediction could be improved by the use of other electronic medical record data (e.g., patient weight or surgeon notes using standardized vocabularies). General thoracic surgery was used as a model specialty because much of its workload is elective (scheduled) and many of its cases are long. PubMed was searched for thoracic surgery papers reporting operative time, surgical time, etc. The systematic literature review identified 48 papers reporting statistically significant differences in perioperative times. There were multiple reports of differences in OR times based on the procedure(s), perioperative team including primary surgeon, and type of anesthetic, in that sequence of importance. All such detail may not be known when the case is originally scheduled and thus may require an updated duration the day before surgery. Although the use of these categorical data from OR systems can result in few historical data for estimating each case's duration, bias and imprecision of case duration estimates are unlikely to be affected. There was a report of a difference in case duration based on additional information. However, the incidence of the procedure for the diagnosis was so uncommon as to be unlikely to affect OR management. Matching findings of prior studies using OR information system data, multiple case series show that it is important to rely on the precise procedure(s), surgical team, and type of anesthetic when estimating case durations. OR information systems need to incorporate the statistical methods designed for small numbers of prior surgical cases. Future research should focus on the most effective methods to update the prediction of each case's duration as these data become available. The case series did not reveal additional data which could be cost-effectively integrated with OR information systems data to improve the accuracy of predicted durations for general thoracic surgery cases.

Klebsiella Pneumoniae Liver Abscess: A Case Series of Six Asian Patients

PubMed Central

Oikonomou, Katerina G.; Aye, Myint

2017-01-01

Case series Patient: Female, 60 • Male, 45 • Male, 56 • Male, 65 • Female, 57 • Male, 35 Final Diagnosis: Klebsiella pneumoniae liver abscess Symptoms: Fever Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Rare co-existance of disease or pathology Background: Liver abscesses represent a serious infection of hepatic parenchyma and are associated with significant morbidity and mortality. The emergence of a new hypervirulent variant of Klebsiella pneumoniae, which can cause serious infections in the Asian population, is under investigation. We report a case series of six Asian patients hospitalized at our institution from January 2013 to November 2015 for liver abscess due to Klebsiella pneumoniae. Case Report: Charts of six Asian patients were retrospectively reviewed. Four patients were male and two were female. The mean age was 53 years (range: 35–64 years). All patients had no known past medical history of immunodeficiency. Three patients had multiple liver abscesses at the time of initial presentation. In five patients, the source of entry of the pathogenic microorganism was unknown and in one patient the suspected source of entry was the gastrointestinal tract. In three patients there was also concomitant Klebsiella pneumoniae bacteremia. The mean duration of antibiotic treatment was seven weeks and the mean duration of hospital stay was 13.5 days. Conclusions: Liver abscess should always be included in the differential diagnosis in cases of sepsis without obvious source and/or in the clinical scenarios of fever, abdominal pain, and liver lesions. PMID:28947732

Osteomalacia: a case series of patients with atypical clinical orthopaedic presentations.

PubMed

Fok, A W M; Ng, T P

2010-12-01

Osteomalacia is uncommon in an affluent subtropical city like Hong Kong, where sunlight exposure is adequate and nutritional support is good. We present three patients who had osteomalacia with different presentations. A 74-year-old male with oncogenic osteomalacia presented with multiple bone pain. His biochemical markers returned to normal 4 days postoperatively after resection of a second toe giant cell tumour of tendon sheath. A 62-year-old woman with a history of liver problem and proximal muscle weakness was admitted with atraumatic fracture of the left distal humerus due to osteomalacia. An 81-year-old vegetarian woman with inadequate sun exposure complained of multiple bone pains. Subsequent investigation revealed dietary- and sunlight-deficient osteomalacia with multiple bony abnormalities including marked femur bowing.

Too attractive: the growing problem of magnet ingestions in children.

PubMed

Brown, Julie C; Otjen, Jeffrey P; Drugas, George T

2013-11-01

Small, powerful magnets are increasingly available in toys and other products and pose a health risk. Small spherical neodymium magnets marketed since 2008 are of particular concern. The objective of this study was to determine the incidence, characteristics, and management of single and multiple-magnet ingestions over time. Magnet ingestion cases at a tertiary children's hospital were identified using radiology reports from June 2002 to December 2012. Cases were verified by chart and imaging review. Relative risk regressions were used to determine changes in the incidence of ingestions and interventions over time. Of 56 cases of magnet ingestion, 98% occurred in 2006 or later, and 57% involved multiple magnets. Median age was 8 years (range, 0-18 years). Overall, 21% of single and 88% of multiple ingestions had 2 or more imaging series obtained, whereas no single and 56.3% of multiple ingestions required intervention (25.0% endoscopy, 18.8% surgery, 12.5% both). Magnet ingestions increased in 2010 to 2012 compared with 2007 to 2009 (relative risk, 1.9; 95% confidence interval, 1.2-3.0). Small, spherical magnets likely from magnet sets comprised 27% of ingestions, all ingested 2010 or later: 86% involved multiple magnets, 50% of which required intervention. Excluding these cases, ingestions of other magnets did not increase in 2010 to 2012 compared with 2007 to 2009 (relative risk, 0.94; 95% confidence interval, 0.6-1.4). The incidence of pediatric magnet ingestions and subsequent interventions has increased over time. Multiple-magnet ingestions result in high utilization of radiological imaging and surgical interventions. Recent increases parallel the increased availability of small, spherical magnet sets. Young and at-risk children should not have access to these and other small magnets. Improved regulation and magnet safety standards are needed.

A simulation study to compare three self-controlled case series approaches: correction for violation of assumption and evaluation of bias.

PubMed

Hua, Wei; Sun, Guoying; Dodd, Caitlin N; Romio, Silvana A; Whitaker, Heather J; Izurieta, Hector S; Black, Steven; Sturkenboom, Miriam C J M; Davis, Robert L; Deceuninck, Genevieve; Andrews, N J

2013-08-01

The assumption that the occurrence of outcome event must not alter subsequent exposure probability is critical for preserving the validity of the self-controlled case series (SCCS) method. This assumption is violated in scenarios in which the event constitutes a contraindication for exposure. In this simulation study, we compared the performance of the standard SCCS approach and two alternative approaches when the event-independent exposure assumption was violated. Using the 2009 H1N1 and seasonal influenza vaccines and Guillain-Barré syndrome as a model, we simulated a scenario in which an individual may encounter multiple unordered exposures and each exposure may be contraindicated by the occurrence of outcome event. The degree of contraindication was varied at 0%, 50%, and 100%. The first alternative approach used only cases occurring after exposure with follow-up time starting from exposure. The second used a pseudo-likelihood method. When the event-independent exposure assumption was satisfied, the standard SCCS approach produced nearly unbiased relative incidence estimates. When this assumption was partially or completely violated, two alternative SCCS approaches could be used. While the post-exposure cases only approach could handle only one exposure, the pseudo-likelihood approach was able to correct bias for both exposures. Violation of the event-independent exposure assumption leads to an overestimation of relative incidence which could be corrected by alternative SCCS approaches. In multiple exposure situations, the pseudo-likelihood approach is optimal; the post-exposure cases only approach is limited in handling a second exposure and may introduce additional bias, thus should be used with caution. Copyright © 2013 John Wiley & Sons, Ltd.

Rigid Calabi-Yau threefolds, Picard Eisenstein series and instantons

NASA Astrophysics Data System (ADS)

Bao, L.; Kleinschmidt, A.; Nilsson, B. E. W.; Persson, D.; Pioline, B.

2013-12-01

Type IIA string theory compactified on a rigid Calabi-Yau threefold gives rise to a classical moduli space that carries an isometric action of U(2, 1). Various quantum corrections break this continuous isometry to a discrete subgroup. Focussing on the case where the intermediate Jacobian of the Calabi-Yau admits complex multiplication by the ring of quadratic imaginary integers d, we argue that the remaining quantum duality group is an arithmetic Picard modular group PU(2, 1; d). Based on this proposal we construct an Eisenstein series invariant under this duality group and study its non-Abelian Fourier expansion. This allows the prediction of non-perturbative effects, notably the contribution of D2- and NS5-brane instantons. The present work extends our previous analysis in 0909.4299 which was restricted to the special case of the Gaussian integers 1 = Bbb Z[i].

[Obstructive sleep apnea syndrome in patients attending a psychiatry outpatient service: a case series].

PubMed

Tamayo Martínez, Nathalie; Rosselli Cock, Diego

Obstructive sleep apnea syndrome (OSAS) is a condition associated with multiple negative outcomes. People with mental illness might be at increased risk of having it, given that medication given has adverse effects on weight and there are alterations in sleep associated with them; however, there are few studies in this population. Describe the patients and the results of polysomnography ordered based on clinical symptoms in a psychiatric outpatient clinic between 2012 and 2014. A case series in which medical records were evaluated. 58 patients who underwent polysomnography, 89% of them had OSAS, 16% were obese and 19% were been treated with benzodiazepines. This is a condition that must be considered during the clinical evaluation of patients with mental illness, since its presence should make clinicians think about drug treatment and follow up. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Single-incision laparoscopic surgery through an ostomy site: a natural approach by an unnatural orifice.

PubMed

Lopez, Nicole E; Peterson, Carrie Y; Ramamoorthy, Sonia L; McLemore, Elisabeth C; Sedrak, Michael F; Lowy, Andrew M; Horgan, Santiago; Talamini, Mark A; Sicklick, Jason K

2015-02-01

Single-incision laparoscopic surgery (SILS) is gaining popularity for a wide variety of surgical operations and capitalizes on the benefits of traditional laparoscopic surgery without incurring multiple incision sites. Traditionally, SILS is performed by a midline periumbilical approach. However, such a minimally invasive approach may be utilized in patients who already have an abdominal incision. Our series retrospectively reviews 7 cases in which we utilized the fascial defect at the time of after ostomy reversal as our SILS incision site. In turn, we performed a variety of concurrent intra-abdominal procedures with excellent technical success and outcomes. Our study is the largest single-institution case series of this novel approach and suggests that utilizing an existing ostomy-site abdominal incision is a safe and effective location for SILS port placement and should be considered in patients undergoing concurrent procedures.

Distinguishing epidemiological features of the 2013–2016 West Africa Ebola virus disease outbreak

PubMed Central

Shultz, James M.; Espinel, Zelde; Espinola, Maria; Rechkemmer, Andreas

2016-01-01

ABSTRACT The 2013–2016 West Africa Ebola virus disease epidemic was notable for its scope, scale, and complexity. This briefing presents a series of distinguishing epidemiological features that set this outbreak apart. Compared to one concurrent and 23 previous outbreaks of the disease over 40 years, this was the only occurrence of Ebola virus disease involving multiple nations and qualifying as a pandemic. Across multiple measures of magnitude, the 2013–2016 outbreak was accurately described using superlatives: largest and deadliest in terms of numbers of cases and fatalities; longest in duration; and most widely dispersed geographically, with outbreak-associated cases occurring in 10 nations. In contrast, the case-fatality rate was much lower for the 2013–2016 outbreak compared to the other 24 outbreaks. A population of particular interest for ongoing monitoring and public health surveillance is comprised of more than 17,000 “survivors,” Ebola patients who successfully recovered from their illness. The daunting challenges posed by this outbreak were met by an intensive international public health response. The near-exponential rate of increase of incident Ebola cases during mid-2014 was successfully slowed, reversed, and finally halted through the application of multiple disease containment and intervention strategies. PMID:28229017

Local search heuristic for the discrete leader-follower problem with multiple follower objectives

NASA Astrophysics Data System (ADS)

Kochetov, Yury; Alekseeva, Ekaterina; Mezmaz, Mohand

2016-10-01

We study a discrete bilevel problem, called as well as leader-follower problem, with multiple objectives at the lower level. It is assumed that constraints at the upper level can include variables of both levels. For such ill-posed problem we define feasible and optimal solutions for pessimistic case. A central point of this work is a two stage method to get a feasible solution under the pessimistic case, given a leader decision. The target of the first stage is a follower solution that violates the leader constraints. The target of the second stage is a pessimistic feasible solution. Each stage calls a heuristic and a solver for a series of particular mixed integer programs. The method is integrated inside a local search based heuristic that is designed to find near-optimal leader solutions.

A series of 240 odontogenic keratocysts: Should we continue to use the terminology of 'keratocystic odontogenic tumour' for the solid variant of odontogenic keratocyst?

PubMed

Kahraman, Devrim; Gunhan, Omer; Celasun, Bulent

2018-04-11

Most of the odontogenic keratocysts show an indolent behaviour like non-neoplastic lesions. For this reason, the odontogenic keratocyst was reclassified within the odontogenic cysts category in the WHO 2017 classification. Some odontogenic keratocysts may contain satellite cysts or solid squamoid islands within their wall. Recently, a solid form of odontogenic keratocyst has also been described which is composed entirely of multiple epithelial islands and small cysts in a collagenous stroma. The true nature of this variant is unclear yet. In this article, we present a series of 204 odontogenic keratocyst cases. Clinical and histologic findings of the cases in this series were described. These were also categorised according to the presence of satellite lesions. Additionally, the features of two cases of the solid form of odontogenic keratocysts were compared with those of the previous reports and other histologically similar odontogenic lesions. Current evidence suggests that this variant may be neoplastic and it differs from other odontogenic keratocysts, at least histologically. We believe diagnosing a solid lesion as a cyst is counterintuitive and the term "keratocystic odontogenic tumour" better describes this particular variant. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The Value of Interrupted Time-Series Experiments for Community Intervention Research

PubMed Central

Biglan, Anthony; Ary, Dennis; Wagenaar, Alexander C.

2015-01-01

Greater use of interrupted time-series experiments is advocated for community intervention research. Time-series designs enable the development of knowledge about the effects of community interventions and policies in circumstances in which randomized controlled trials are too expensive, premature, or simply impractical. The multiple baseline time-series design typically involves two or more communities that are repeatedly assessed, with the intervention introduced into one community at a time. It is particularly well suited to initial evaluations of community interventions and the refinement of those interventions. This paper describes the main features of multiple baseline designs and related repeated-measures time-series experiments, discusses the threats to internal validity in multiple baseline designs, and outlines techniques for statistical analyses of time-series data. Examples are given of the use of multiple baseline designs in evaluating community interventions and policy changes. PMID:11507793

Primary Multiple Simultaneous Intracerebral Hemorrhages between 1950 and 2013: Analysis of Data on Age, Sex and Outcome.

PubMed

Laiwattana, Denchai; Sangsawang, Bussara; Sangsawang, Nucharee

2014-01-01

Primary multiple simultaneous intracerebral hemorrhages (MSICHs) are quite rare. Although occasional reports have been found, there have been no systematic reviews. The published case reports and case series contain overlapping data, leading to erroneous information about MSICHs. This is the first extensive review of accessible studies published in English on MSICHs. Our primary objective was to analyze the demographic data on age, sex, outcome and prognosis with regard to primary MSICHs. A PubMed search without language restriction for articles with results from human studies and registered between January 1950 and September 2013 yielded 677 articles. The following inclusion criteria were applied: (1) reported case(s) or case series on primary MSICHs; (2) text partly or fully in English, and (3) text contains identifiable data on age, sex and outcome of patients. A total of 24 articles met all the inclusion criteria. The reference lists of these 24 articles were inspected for additional relevant articles, which yielded another 20 articles. In all, 248 cases were identified; 143 cases were excluded for various reasons: 52 duplicate cases, 18 cases of multiple nonsimultaneous intracerebral hemorrhages, 25 cases of secondary MSICHs, and 48 cases with incomplete data on age, sex and outcome. The remaining 105 cases were analyzed. MSICHs were found to be more common in bilateral cases (53.33%): there were bilateral basal ganglia hemorrhages (33.33%), bilateral thalamic hemorrhages (18.10%), bilateral lobar hemorrhages (0.95%) and bilateral cerebellar hemorrhages (0.95%). Nonbilateral MSICHs were found in 46.67% of the cases. The hematomas were commonly distributed in the basal ganglia (45.83%), thalamus (30.56%) and cerebellum (10.19%). MSICHs were more frequently encountered in males (60.95%; average age: 59.13 ± 12.49 years). The average age of the female patients was higher (63.89 ± 13.11 years). Patients with primary MSICHs had a survival rate of 56.20%. There was a favorable outcome of primary MSICHs in 18.10% of all the cases, the highest proportion of which was in the nonbilateral MSICH group. The remaining 38.10% had unfavorable outcomes. Death occurred in 43.80% of all cases, the highest proportion being found in the bilateral basal ganglia hemorrhage group. Primary MSICHs share features with solitary intracerebral hemorrhage regarding age, sex, and the location and distribution of hematomas, but they have a poorer outcome (p < 0.05). Primary MSICHs are rare and share features with solitary intracerebral hemorrhage regarding age and the location and distribution of hematomas. Patients have a poorer prognosis but higher favorable outcome rates in case of survival. This information adds to the awareness of clinicians that higher rates of favorable outcomes can be achieved for MSICHs.

Multivariate exploration of non-intrusive load monitoring via spatiotemporal pattern network

DOE PAGES

Liu, Chao; Akintayo, Adedotun; Jiang, Zhanhong; ...

2017-12-18

Non-intrusive load monitoring (NILM) of electrical demand for the purpose of identifying load components has thus far mostly been studied using univariate data, e.g., using only whole building electricity consumption time series to identify a certain type of end-use such as lighting load. However, using additional variables in the form of multivariate time series data may provide more information in terms of extracting distinguishable features in the context of energy disaggregation. In this work, a novel probabilistic graphical modeling approach, namely the spatiotemporal pattern network (STPN) is proposed for energy disaggregation using multivariate time-series data. The STPN framework is shownmore » to be capable of handling diverse types of multivariate time-series to improve the energy disaggregation performance. The technique outperforms the state of the art factorial hidden Markov models (FHMM) and combinatorial optimization (CO) techniques in multiple real-life test cases. Furthermore, based on two homes' aggregate electric consumption data, a similarity metric is defined for the energy disaggregation of one home using a trained model based on the other home (i.e., out-of-sample case). The proposed similarity metric allows us to enhance scalability via learning supervised models for a few homes and deploying such models to many other similar but unmodeled homes with significantly high disaggregation accuracy.« less

Multivariate exploration of non-intrusive load monitoring via spatiotemporal pattern network

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

Liu, Chao; Akintayo, Adedotun; Jiang, Zhanhong

Non-intrusive load monitoring (NILM) of electrical demand for the purpose of identifying load components has thus far mostly been studied using univariate data, e.g., using only whole building electricity consumption time series to identify a certain type of end-use such as lighting load. However, using additional variables in the form of multivariate time series data may provide more information in terms of extracting distinguishable features in the context of energy disaggregation. In this work, a novel probabilistic graphical modeling approach, namely the spatiotemporal pattern network (STPN) is proposed for energy disaggregation using multivariate time-series data. The STPN framework is shownmore » to be capable of handling diverse types of multivariate time-series to improve the energy disaggregation performance. The technique outperforms the state of the art factorial hidden Markov models (FHMM) and combinatorial optimization (CO) techniques in multiple real-life test cases. Furthermore, based on two homes' aggregate electric consumption data, a similarity metric is defined for the energy disaggregation of one home using a trained model based on the other home (i.e., out-of-sample case). The proposed similarity metric allows us to enhance scalability via learning supervised models for a few homes and deploying such models to many other similar but unmodeled homes with significantly high disaggregation accuracy.« less

A Practical Guide for the Formulation of Propositions in the Bayesian Approach to DNA Evidence Interpretation in an Adversarial Environment.

PubMed

Gittelson, Simone; Kalafut, Tim; Myers, Steven; Taylor, Duncan; Hicks, Tacha; Taroni, Franco; Evett, Ian W; Bright, Jo-Anne; Buckleton, John

2016-01-01

The interpretation of complex DNA profiles is facilitated by a Bayesian approach. This approach requires the development of a pair of propositions: one aligned to the prosecution case and one to the defense case. This note explores the issue of proposition setting in an adversarial environment by a series of examples. A set of guidelines generalize how to formulate propositions when there is a single person of interest and when there are multiple individuals of interest. Additional explanations cover how to handle multiple defense propositions, relatives, and the transition from subsource level to activity level propositions. The propositions depend on case information and the allegations of each of the parties. The prosecution proposition is usually known. The authors suggest that a sensible proposition is selected for the defense that is consistent with their stance, if available, and consistent with a realistic defense if their position is not known. © 2015 American Academy of Forensic Sciences.

Prostatic Artery Embolization After Failed Urological Interventions for Benign Prostatic Obstruction: A Case Series of Three Patients

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

Bhatia, Shivank S., E-mail: sbhatia1@med.miami.edu; Dalal, Ravi, E-mail: rdalal@med.miami.edu; Gomez, Christopher, E-mail: Cgomez7@med.miami.edu

Benign prostate obstruction with associated lower urinary tract symptoms is a common diagnosis with multiple minimally invasive treatment options available. Herein, the authors describe three patients who failed prior different urological interventions who underwent prostate artery embolization with a subsequent improvement in symptoms. The positive response suggests that embolization may be an effective treatment alternative in this subset of patients.

The Impact of Rural Non-Farm Residential Development on the Provision of Local Public Services. Iowa Land Use Research Report Series.

ERIC Educational Resources Information Center

Fisher, Peter S.

Using multiple regression analysis for each county and a case study of selected services in Johnson County, Iowa, the study estimated the impacts of rural non-farm development in Iowa on the demand for local public services, on the cost of providing these services, and on the distribution of service benefits and tax burdens among population…

Apparatus for gas sorption measurement with integrated gas composition measurement device and gas mixing

DOEpatents

Micklash. II, Kenneth James; Dutton, Justin James; Kaye, Steven

2014-06-03

An apparatus for testing of multiple material samples includes a gas delivery control system operatively connectable to the multiple material samples and configured to provide gas to the multiple material samples. Both a gas composition measurement device and pressure measurement devices are included in the apparatus. The apparatus includes multiple selectively openable and closable valves and a series of conduits configured to selectively connect the multiple material samples individually to the gas composition device and the pressure measurement devices by operation of the valves. A mixing system is selectively connectable to the series of conduits and is operable to cause forced mixing of the gas within the series of conduits to achieve a predetermined uniformity of gas composition within the series of conduits and passages.

Pelvic fracture in multiple trauma: A 67-case series.

PubMed

Caillot, M; Hammad, E; Le Baron, M; Villes, V; Leone, M; Flecher, X

2016-12-01

Severe pelvic trauma remains associated with elevated mortality, largely due to hemorrhagic shock. The main study objective was to test for correlation between fracture type and mortality. The secondary objective was to assess the efficacy in terms of mortality of multidisciplinary management following a decision-tree in multiple trauma victims admitted to a level 1 trauma center. Between July 2011 and July 2013, 534 severe trauma patients were included in a single-center continuous prospective observational study. All patients with hemorrhagic shock received early treatment by pelvic binder. Patients with active bleeding on full-body CT or persisting hemorrhagic shock underwent arteriography with or without embolization. Pelvic trauma was graded on the Tile classification. The principle end-point was mortality. Median age was 40 years (range, 26-48 years), with a 79% male/female sex ratio. Thirty-two of the 67 patients with pelvic trauma (48%) were in hemorrhagic shock at admission. Median injury severity score (ISS) was 36 (range, 24-43). On the Tile classification, 22 patients (33%) were grade A, 33 (49%) grade B and 12 (18%) grade C. Overall mortality was 19%, and 42% in case of hemorrhagic shock. Mortality was significantly higher with Tile C than A or B (58% vs. 9.1% and 12.1%, respectively; P=0.001). Vertical shear fracture (Tile C) was associated with greater mortality from hemorrhagic shock. IV, case series. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Cytomegalovirus (CMV) in cervical cancer screening tests: A series of 8 cases and review of the literature.

PubMed

Elgert, Paul A; Yee-Chang, Melissa; Simsir, Aylin

2018-04-26

Cytomegalovirus (CMV) is a ubiquitous infection typically affecting over 50% of the US population by age 40. We report 8 cases of CMV infections detected in cervical cancer screening tests, the largest series of cases thus far reported in gynecologic cytology specimens. A retrospective review of our pathology archival computer database was performed from January 1, 1994 through December 31, 2016 for CMV infections reported in cervical cytology specimens. The slides were retrieved for review if available. The eight patients ranged in age from 21-46 years, with a median age of 27 years and average age of 29.5 years. Two patients were significantly immunocompromised with one patient having AIDS and one patient diagnosed with autoimmune disease. The remaining six patients are considered immunocompetent. Cases were identified most often in the fall and winter months (6 of 8 cases). Seven cases were found using Surepath Pap (SP) liquid-based processing and one case was reported in a classic Papanicolaou smear (CPS). There was no correlation of cytologic presentation of CMV with a distinct cytohormonal pattern or inflammatory constituents. Rare diagnostic cells with changes of CMV infection were seen in 75% of the cases. The presence of CMV did not usually result in adverse patient outcome, except where CMV was one of the multiple opportunistic infections detected in the patient with AIDS. © 2018 Wiley Periodicals, Inc.

On the estimate of deviations of partial sums of a multiple Fourier-Walsh series of the form S2j,⋯,2jf (x ) of a function in the metric L1(Qk)

NASA Astrophysics Data System (ADS)

Igenberlina, Alua; Matin, Dauren; Turgumbayev, Mendybay

2017-09-01

In this paper, deviations of the partial sums of a multiple Fourier-Walsh series of a function in the metric L1(Qk) on a dyadic group are investigated. This estimate plays an important role in the study of equivalent normalizations in this space by means of a difference, oscillation, and best approximation by polynomials in the Walsh system. The classical classical Besov space and its equivalent normalizations are set forth in the well-known monographs of Nikolsky S.M., Besov O.V., Ilyin V.P., Triebel H.; in the works of Kazakh scientists such as Amanov T.I., Mynbaev K.T., Otelbaev M.O., Smailov E.S.. The Besov spaces on the dyadic group and the Vilenkin groups in the one-dimensional case are considered in works by Ombe H., Bloom Walter R, Fournier J., Onneweer C.W., Weyi S., Jun Tateoka.

Extramedullary plasmacytomas in the context of multiple myeloma.

PubMed

Aguado, Beatriz; Iñigo, Belen; Sastre, Jose L; Oriol, Albert

2011-11-01

Plasmacytoma is a frequent complication of multiple myeloma, either at diagnosis or within disease progression. The extramedullary disease confers a poorer prognosis and is biologically distinct with high-risk molecular and histological features, being resistant to conventional treatments. Radiation therapy remains the most effective treatment for extramedullary lesions to achieve local control. There are very limited data from randomized trials regarding the most appropriate systemic treatment. Case reports such as those presented here, as well as retrospective analysis of series, suggest that lenalidomide is an effective agent, in combination with dexamethasone, in this setting. Additional studies are needed to define the proper management of this condition.

Single-specialty management and reconstruction of necrotizing fasciitis of the upper extremities: clinical and economic benefits from a case series.

PubMed

Mattison, Gennaya; Leis, Amber R; Gupta, Subhas C

2014-05-01

Patients with necrotizing fasciitis are managed with multiple prompt, radical surgical debridements and critical care support. Debridement and reconstruction are often provided by different surgical teams. Anecdotally, single-specialty management seemed to be a more efficient management strategy. This study aimed to investigate and compare the outcomes of management by plastic surgery versus multiple disciplines through a retrospective economic and clinical analysis of patients with necrotizing fasciitis treated over 8 years. We also present 3 index cases for which our service functioned as the primary management team. Necrotizing fasciitis cases evaluated and treated by our department, covering both Level I and Level II Trauma Centers, were reviewed for total charges, length of hospital stay, length of intensive care unit (ICU) stay, and number of procedures. The admission Acute Physiology and Chronic Health Evaluation II score was calculated for each patient. Three comparative index cases of upper extremity necrotizing fasciitis managed primarily by the plastic surgery team are presented in greater detail. Patients managed primarily by the plastic surgery service had equivalent Acute Physiology and Chronic Health Evaluation II scores to patients managed by multiple services for their necrotizing fasciitis, with the average score higher for patients managed by plastic surgery alone. In a case-matched series of upper extremity necrotizing fasciitis, the patients admitted directly to plastic surgery had shorter average lengths of hospital and ICU stays as well as decreased total number of procedures, resulting in decreased average total hospital charges. There were no amputations among the cases treated primarily by the plastic surgery. The patients also required smaller areas of reconstruction with skin grafting despite large initial areas of debridement compared to those whose reconstructive teams differed from the team performing the debridement. Improved economic and clinical outcomes-as indicated by the reduced lengths of overall and ICU stay, the reduced number of procedures, none of the cases requiring amputation, and the reduced need for skin grafting-may be attainable when the surgeon eventually performing the reconstruction is involved early in management. We propose that, in the interest of improving patient care, a closer collaboration should be established between the reconstructive and primary managing teams.

Pediatric emotional dysregulation and behavioral disruptiveness treated with hypnosis: a time-series design.

PubMed

Iglesias, Alex; Iglesias, Adam

2014-01-01

A case of pediatric oppositional defiant disorder (ODD) with concomitant emotional dysregulation and secondary behavioral disruptiveness was treated with hypnosis by means of the hypnotic hold, a method adapted by the authors. An A-B-A-B time-series design with multiple replications was employed to measure the relationship of the hypnotic treatment to the dependent measure: episodes of emotional dysregulation with accompanying behavioral disruptiveness. The findings indicated a statistically significant relationship between the degree of change from phase to phase and the treatment. Follow-up at 6 months indicated a significant reduction of the frequency of targeted episodes of emotional dysregulation and behavioral disruptiveness at home.

Discovering time-lagged rules from microarray data using gene profile classifiers

PubMed Central

2011-01-01

Background Gene regulatory networks have an essential role in every process of life. In this regard, the amount of genome-wide time series data is becoming increasingly available, providing the opportunity to discover the time-delayed gene regulatory networks that govern the majority of these molecular processes. Results This paper aims at reconstructing gene regulatory networks from multiple genome-wide microarray time series datasets. In this sense, a new model-free algorithm called GRNCOP2 (Gene Regulatory Network inference by Combinatorial OPtimization 2), which is a significant evolution of the GRNCOP algorithm, was developed using combinatorial optimization of gene profile classifiers. The method is capable of inferring potential time-delay relationships with any span of time between genes from various time series datasets given as input. The proposed algorithm was applied to time series data composed of twenty yeast genes that are highly relevant for the cell-cycle study, and the results were compared against several related approaches. The outcomes have shown that GRNCOP2 outperforms the contrasted methods in terms of the proposed metrics, and that the results are consistent with previous biological knowledge. Additionally, a genome-wide study on multiple publicly available time series data was performed. In this case, the experimentation has exhibited the soundness and scalability of the new method which inferred highly-related statistically-significant gene associations. Conclusions A novel method for inferring time-delayed gene regulatory networks from genome-wide time series datasets is proposed in this paper. The method was carefully validated with several publicly available data sets. The results have demonstrated that the algorithm constitutes a usable model-free approach capable of predicting meaningful relationships between genes, revealing the time-trends of gene regulation. PMID:21524308

de la Vallée-Poussin means of Fourier series for the quadratic spectrum and for spectra with power-like density

NASA Astrophysics Data System (ADS)

Bochkarev, S. V.

2014-02-01

A new method is proposed and elaborated for investigating complex or real trigonometric series with various spectra. It is based on new multiplicative inequalities which give a lower bound for the integral norm of the de la Vallée-Poussin means and are themselves based on results establishing corresponding analogues of the Littlewood-Paley theorem in the BMO, Hardy, and Lorentz spaces. For spectra with power-like density a description of the class of absolute values of coefficients such that the corresponding complex or real trigonometric series are Fourier series is found which depends on the arithmetic characteristics of the spectrum and is sharp in limiting cases. Furthermore, for the quadratic spectrum some results of Hardy and Littlewood on elliptic theta functions are generalized and refined. For the quadratic spectrum and power-like spectra with non-integer exponents new lower bounds are found for the integral norms of exponential sums. Bibliography: 41 titles.

Junior Seau: An Illustrative Case of Chronic Traumatic Encephalopathy and Update on Chronic Sports-Related Head Injury.

PubMed

Azad, Tej D; Li, Amy; Pendharkar, Arjun V; Veeravagu, Anand; Grant, Gerald A

2016-02-01

Few neurologic diseases have captured the nation's attention more completely than chronic traumatic encephalopathy (CTE), which has been discovered in the autopsies of professional athletes, most notably professional football players. The tragic case of Junior Seau, a Hall of Fame, National Football League linebacker, has been the most high-profile confirmed case of CTE. Here we describe Seau's case, which concludes an autopsy conducted at the National Institutes of Health that confirmed the diagnosis. Since 1990, Junior Seau had a highly distinguished 20-year career playing for the National Football League as a linebacker, from which he sustained multiple concussions. He committed suicide on May 2, 2012, at age 43, after which an autopsy confirmed a diagnosis of CTE. His clinical history was significant for a series of behavioral disturbances. Seau's history and neuropathologic findings were used to better understand the pathophysiology, diagnosis, and possible risk factors for CTE. This high-profile case reflects an increasing awareness of CTE as a long-term consequence of multiple traumatic brain injuries. The previously unforeseen neurologic risks of American football have begun to cast doubt on the safety of the sport. Copyright © 2016 Elsevier Inc. All rights reserved.

Prostatic cancer. Treated at a categorical center, 1980-1983.

PubMed

Slack, N H; Lane, W W; Priore, R L; Murphy, G P

1986-03-01

This report covers the experience from 537 patients with prostatic cancer seen at Roswell Park Memorial Institute (RPMI) from 1980 through 1983. This is a look at experiences in the early 1980s and is a continuation of the series covering the decades of the 1950s, 1960s, and 1970s. Referrals continue to dominate the series (85% of cases) but are now only slightly younger (65 years) than in-house diagnoses (66 years), of which one third were diagnosed at autopsy. Survival rates in this series, although limited in follow-up, were similar at two years to those in the 1970s and in the extensive series collected by the survey of the American College of Surgeons. Multiple primary tumors were observed in 22 per cent of this series, most frequently involving the bladder in addition to the prostate. Treatments continue to involve chemotherapy earlier in the course of disease as part of a succession of therapeutic modalities that include transurethral resection of prostate (TURP) or prostatectomy, lymph node dissection, external irradiation, castration, and hormones.

Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE for Metastatic Neuroendocrine Tumor Occurring in Association with Multiple Endocrine Neoplasia Type 1 and Cushing's Syndrome.

PubMed

Naik, Chinna; Basu, Sandip

2017-01-01

Neuroendocrine tumor (NET) occurring in association with other endocrine syndromes forms a distinct entity. The aim was to assess the therapy response profile of the routine peptide receptor radionuclide therapy (PRRT) in this relatively uncommon but clinically challenging subgroup of patients. A retrospective analysis was undertaken from the case records from those who were treated with 177 Lu-DOTATATE for metastatic NET. In addition to assessing the therapeutic efficacy, emphasis was also given to study lesional sites and scan pattern. A total of 5 cases were found: In this series of five cases, four belonged to multiple endocrine neoplasia type 1 (MEN1) syndrome; in these four MEN1 syndrome patients, the primary site of NET was thymic region ( n = 1), duodenum ( n = 1), and pancreas ( n = 2). The fifth case was of Cushing's syndrome with the primary site of NET in the thymus. A good symptomatic response was observed in all MEN1 syndrome cases (100%) and progression of symptoms in the patient with Cushing's syndrome. The biochemical response (assessed by measurement of tumor marker serum chromogranin A) demonstrated very good partial response (defined by more than 75% reduction of tumor marker) in 2 MEN1 cases and Cushing's syndrome, good partial response (25-75% reduction of tumor marker) in the remaining 2 MEN1 cases. Scan wise (assessed by technetium [ 99m Tc]-hydrazinonicotinamide [HYNIC]-tektrotyd [TOC]/ 68 Ga-DOTA-NOC/TATE positron emission tomography-computed tomography [PET-CT] and fluorodeoxyglucose [FDG] PET-CT) partial response was observed in 3 MEN1 cases, stable disease was noted in one MEN1 case and disease progression was noted in the patient with Cushing's syndrome. The change in FDG uptake was found to be an important sensitive scan parameter in the treatment evaluation of NETs compared to somatostatin receptor-based imaging in the cases with low MiB1 index. In our series, good palliative response to 177 Lu-DOTA-octreotate (DOTATATE) PRRT was observed in most NET patients associated with MEN1 syndrome without any major hematological or renal toxicity.

Statistical strategies for averaging EC50 from multiple dose-response experiments.

PubMed

Jiang, Xiaoqi; Kopp-Schneider, Annette

2015-11-01

In most dose-response studies, repeated experiments are conducted to determine the EC50 value for a chemical, requiring averaging EC50 estimates from a series of experiments. Two statistical strategies, the mixed-effect modeling and the meta-analysis approach, can be applied to estimate average behavior of EC50 values over all experiments by considering the variabilities within and among experiments. We investigated these two strategies in two common cases of multiple dose-response experiments in (a) complete and explicit dose-response relationships are observed in all experiments and in (b) only in a subset of experiments. In case (a), the meta-analysis strategy is a simple and robust method to average EC50 estimates. In case (b), all experimental data sets can be first screened using the dose-response screening plot, which allows visualization and comparison of multiple dose-response experimental results. As long as more than three experiments provide information about complete dose-response relationships, the experiments that cover incomplete relationships can be excluded from the meta-analysis strategy of averaging EC50 estimates. If there are only two experiments containing complete dose-response information, the mixed-effects model approach is suggested. We subsequently provided a web application for non-statisticians to implement the proposed meta-analysis strategy of averaging EC50 estimates from multiple dose-response experiments.

Klebsiella Pneumoniae Liver Abscess: A Case Series of Six Asian Patients.

PubMed

Oikonomou, Katerina G; Aye, Myint

2017-09-26

BACKGROUND Liver abscesses represent a serious infection of hepatic parenchyma and are associated with significant morbidity and mortality. The emergence of a new hypervirulent variant of Klebsiella pneumoniae, which can cause serious infections in the Asian population, is under investigation. We report a case series of six Asian patients hospitalized at our institution from January 2013 to November 2015 for liver abscess due to Klebsiella pneumoniae. CASE REPORT Charts of six Asian patients were retrospectively reviewed. Four patients were male and two were female. The mean age was 53 years (range: 35-64 years). All patients had no known past medical history of immunodeficiency. Three patients had multiple liver abscesses at the time of initial presentation. In five patients, the source of entry of the pathogenic microorganism was unknown and in one patient the suspected source of entry was the gastrointestinal tract. In three patients there was also concomitant Klebsiella pneumoniae bacteremia. The mean duration of antibiotic treatment was seven weeks and the mean duration of hospital stay was 13.5 days. CONCLUSIONS Liver abscess should always be included in the differential diagnosis in cases of sepsis without obvious source and/or in the clinical scenarios of fever, abdominal pain, and liver lesions.

Oral Findings in 58 Adults with Tuberous Sclerosis Complex

PubMed Central

Sparling, MAJ Joshua D.; Hong, Chien-Hui; Brahim, Jaime S.; Moss, Joel; Darling, Thomas N.

2010-01-01

Background Gingival fibromas and dental pitting are among the diagnostic criteria for tuberous sclerosis complex (TSC). Objective Our goal was to document the oral findings in 58 adult patients with TSC. Results Forty patients (69%) had oral fibromas, appearing mostly on the attached or interdental gingiva. Other oral sites included buccal and labial mucosa, the superior labial frenulum, palate, and tongue. Fifty-six patients (97 %) had multiple dental enamel pits. Limitations This case series comprised predominantly adult females with TSC and lymphangioleiomyomatosis. Conclusions Oral fibromas in TSC are mostly, but not exclusively, gingival. Dental pits are present in nearly all patients. The multiple oral papules in TSC may appear similar to those observed in Cowden syndrome, Birt-Hogg-Dube syndrome, and rarely in multiple endocrine neoplasia type 1. PMID:17239986

Enhancement of Cognitive Processing by Multiple Sclerosis Patients Using Liquid Cooling Technology: A Case Study

NASA Technical Reports Server (NTRS)

Montgomery, Leslie D.; Montgomery, Richard W.; Ku, Yu-Tsuan; Luna, Bernadette (Technical Monitor)

1997-01-01

Cognitive dysfunction is a common symptom in patients with multiple sclerosis (MS). This can have a significant impact on the quality of life of both the patient and of their primary care giver. This case study explores the possibility that liquid cooling therapy may be used to enhance the cognitive processing of MS patients in the same way that it provides temporary relief of some physical impairment. Two MS patients were presented a series of pattern discrimination tasks before and after being cooled with a liquid cooling garment for a one hour period. The subject whose ear temperature was reduced during cooling showed greater electroencephalographic (EEG) activity and scored much better on the task after cooling. The patient whose ear temperature was unaffected by cooling showed less EEG activity and degraded performance after the one hour cooling period.

Mesoscopic Community Structure of Financial Markets Revealed by Price and Sign Fluctuations.

PubMed

Almog, Assaf; Besamusca, Ferry; MacMahon, Mel; Garlaschelli, Diego

2015-01-01

The mesoscopic organization of complex systems, from financial markets to the brain, is an intermediate between the microscopic dynamics of individual units (stocks or neurons, in the mentioned cases), and the macroscopic dynamics of the system as a whole. The organization is determined by "communities" of units whose dynamics, represented by time series of activity, is more strongly correlated internally than with the rest of the system. Recent studies have shown that the binary projections of various financial and neural time series exhibit nontrivial dynamical features that resemble those of the original data. This implies that a significant piece of information is encoded into the binary projection (i.e. the sign) of such increments. Here, we explore whether the binary signatures of multiple time series can replicate the same complex community organization of the financial market, as the original weighted time series. We adopt a method that has been specifically designed to detect communities from cross-correlation matrices of time series data. Our analysis shows that the simpler binary representation leads to a community structure that is almost identical with that obtained using the full weighted representation. These results confirm that binary projections of financial time series contain significant structural information.

Characteristics, location and origin of flare activity in a complex active region

NASA Technical Reports Server (NTRS)

Machado, M. E.; Gary, G. A.; Hagyard, M. J.; Hernandez, A. M.; Rovira, M. G.

1986-01-01

The observational characteristics of series of multiple-loop flares from a complex active region are summarized. The location of the highest observed photospheric magnetic shear is found to be the commonly observed site of flare onset, but not, in many cases, the magnetic region where the largest time-integrated energy release is observed. The observations thus reveal a consistent pattern of energy-release processes related to the magnetic-field topology.

A Multilevel Multiset Time-Series Model for Describing Complex Developmental Processes

PubMed Central

Ma, Xin; Shen, Jianping

2017-01-01

The authors sought to develop an analytical platform where multiple sets of time series can be examined simultaneously. This multivariate platform capable of testing interaction effects among multiple sets of time series can be very useful in empirical research. The authors demonstrated that the multilevel framework can readily accommodate this analytical capacity. Given their intention to use the multilevel multiset time-series model to pursue complicated research purposes, their resulting model is relatively simple to specify, to run, and to interpret. These advantages make the adoption of their model relatively effortless as long as researchers have the basic knowledge and skills in working with multilevel growth modeling. With multiple potential extensions of their model, the establishment of this analytical platform for analysis of multiple sets of time series can inspire researchers to pursue far more advanced research designs to address complex developmental processes in reality. PMID:29881094

Optimal Subset Selection of Time-Series MODIS Images and Sample Data Transfer with Random Forests for Supervised Classification Modelling

PubMed Central

Zhou, Fuqun; Zhang, Aining

2016-01-01

Nowadays, various time-series Earth Observation data with multiple bands are freely available, such as Moderate Resolution Imaging Spectroradiometer (MODIS) datasets including 8-day composites from NASA, and 10-day composites from the Canada Centre for Remote Sensing (CCRS). It is challenging to efficiently use these time-series MODIS datasets for long-term environmental monitoring due to their vast volume and information redundancy. This challenge will be greater when Sentinel 2–3 data become available. Another challenge that researchers face is the lack of in-situ data for supervised modelling, especially for time-series data analysis. In this study, we attempt to tackle the two important issues with a case study of land cover mapping using CCRS 10-day MODIS composites with the help of Random Forests’ features: variable importance, outlier identification. The variable importance feature is used to analyze and select optimal subsets of time-series MODIS imagery for efficient land cover mapping, and the outlier identification feature is utilized for transferring sample data available from one year to an adjacent year for supervised classification modelling. The results of the case study of agricultural land cover classification at a regional scale show that using only about a half of the variables we can achieve land cover classification accuracy close to that generated using the full dataset. The proposed simple but effective solution of sample transferring could make supervised modelling possible for applications lacking sample data. PMID:27792152

Optimal Subset Selection of Time-Series MODIS Images and Sample Data Transfer with Random Forests for Supervised Classification Modelling.

PubMed

Zhou, Fuqun; Zhang, Aining

2016-10-25

Nowadays, various time-series Earth Observation data with multiple bands are freely available, such as Moderate Resolution Imaging Spectroradiometer (MODIS) datasets including 8-day composites from NASA, and 10-day composites from the Canada Centre for Remote Sensing (CCRS). It is challenging to efficiently use these time-series MODIS datasets for long-term environmental monitoring due to their vast volume and information redundancy. This challenge will be greater when Sentinel 2-3 data become available. Another challenge that researchers face is the lack of in-situ data for supervised modelling, especially for time-series data analysis. In this study, we attempt to tackle the two important issues with a case study of land cover mapping using CCRS 10-day MODIS composites with the help of Random Forests' features: variable importance, outlier identification. The variable importance feature is used to analyze and select optimal subsets of time-series MODIS imagery for efficient land cover mapping, and the outlier identification feature is utilized for transferring sample data available from one year to an adjacent year for supervised classification modelling. The results of the case study of agricultural land cover classification at a regional scale show that using only about a half of the variables we can achieve land cover classification accuracy close to that generated using the full dataset. The proposed simple but effective solution of sample transferring could make supervised modelling possible for applications lacking sample data.

McCune-Albright syndrome, natural history and multidisciplinary management in a series of 14 pediatric cases.

PubMed

Agopiantz, Mikael; Journeau, Pierre; Lebon-Labich, Béatrice; Sorlin, Arthur; Cuny, Thomas; Weryha, Georges; Leheup, Bruno

2016-02-01

McCune-Albright syndrome is a rare disorder characterized by endocrine disorders, café-au-lait spots and fibrous dysplasia of bone that occurs early in life. A series of 14 pediatric cases were followed between 1994 and 2013 by the competence center for rare endocrine diseases and constitutional bone diseases at CHU de Nancy (France). The diagnosis is based on the presence of at least two symptoms. The mean follow-up was 6 years (1-17 years). The sex ratio was six girls per boy. The incidence was 0.28 cases/million population/year. Mean age at diagnosis was 6 years. A mutation in the GNAS gene was found in 33% of patients tested. Gonadal involvement (13/14 cases), including early peripheral puberty and ovarian cysts in girls (82%) occurred on average at 4 years of age. Bone involvement (10/14 cases) appeared on average at 5 years of age and was most often multiple (80%) with fracture risk, and the skull, with a neurosensory risk. Clinical definition and methods of screening and monitoring can be improved to allow for an earlier intervention. It must be multidisciplinary and take into account the disability and quality of life of the patient. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Versatile utilization of real-time intraoperative contrast-enhanced ultrasound in cranial neurosurgery: technical note and retrospective case series.

PubMed

Lekht, Ilya; Brauner, Noah; Bakhsheshian, Joshua; Chang, Ki-Eun; Gulati, Mittul; Shiroishi, Mark S; Grant, Edward G; Christian, Eisha; Zada, Gabriel

2016-03-01

Intraoperative contrast-enhanced ultrasound (iCEUS) offers dynamic imaging and provides functional data in real time. However, no standardized protocols or validated quantitative data exist to guide its routine use in neurosurgery. The authors aimed to provide further clinical data on the versatile application of iCEUS through a technical note and illustrative case series. Five patients undergoing craniotomies for suspected tumors were included. iCEUS was performed using a contrast agent composed of lipid shell microspheres enclosing perflutren (octafluoropropane) gas. Perfusion data were acquired through a time-intensity curve analysis protocol obtained using iCEUS prior to biopsy and/or resection of all lesions. Three primary tumors (gemistocytic astrocytoma, glioblastoma multiforme, and meningioma), 1 metastatic lesion (melanoma), and 1 tumefactive demyelinating lesion (multiple sclerosis) were assessed using real-time iCEUS. No intraoperative complications occurred following multiple administrations of contrast agent in all cases. In all neoplastic cases, iCEUS replicated enhancement patterns observed on preoperative Gd-enhanced MRI, facilitated safe tumor debulking by differentiating neoplastic tissue from normal brain parenchyma, and helped identify arterial feeders and draining veins in and around the surgical cavity. Intraoperative CEUS was also useful in guiding a successful intraoperative needle biopsy of a cerebellar tumefactive demyelinating lesion obtained during real-time perfusion analysis. Intraoperative CEUS has potential for safe, real-time, dynamic contrast-based imaging for routine use in neurooncological surgery and image-guided biopsy. Intraoperative CEUS eliminates the effect of anatomical distortions associated with standard neuronavigation and provides quantitative perfusion data in real time, which may hold major implications for intraoperative diagnosis, tissue differentiation, and quantification of extent of resection. Further prospective studies will help standardize the role of iCEUS in neurosurgery.

Time Series Model Identification by Estimating Information.

DTIC Science & Technology

1982-11-01

principle, Applications of Statistics, P. R. Krishnaiah , ed., North-Holland: Amsterdam, 27-41. Anderson, T. W. (1971). The Statistical Analysis of Time Series...E. (1969). Multiple Time Series Modeling, Multivariate Analysis II, edited by P. Krishnaiah , Academic Press: New York, 389-409. Parzen, E. (1981...Newton, H. J. (1980). Multiple Time Series Modeling, II Multivariate Analysis - V, edited by P. Krishnaiah , North Holland: Amsterdam, 181-197. Shibata, R

Outcomes of reintervention after failed urethroplasty.

PubMed

Ekerhult, Teresa Olsen; Lindqvist, Klas; Peeker, Ralph; Grenabo, Lars

2017-02-01

Urethroplasty is a procedure that has a high success rate. However, there exists a small subgroup of patients who require multiple procedures to achieve an acceptable result. This study analyses the outcomes of a series of patients with failed urethroplasty. This is a retrospective review of 82 failures out of 407 patients who underwent urethroplasty due to urethral stricture during the period 1999-2013. Failure was defined as the need for an additional surgical procedure. Of the failures, 26 patients had penile strictures and 56 had bulbar strictures. Meatal strictures were not included. The redo procedures included one or multiple direct vision internal urethrotomies, dilatations or new urethroplasties, all with a long follow-up time. The patients underwent one to seven redo surgeries (mean 2.4 procedures per patient). In the present series of patients, endourological procedures cured 34% (28/82) of the patients. Ten patients underwent multiple redo urethroplasties until a satisfactory outcome was achieved; the penile strictures were the most difficult to cure. In patients with bulbar strictures, excision with anastomosis and substitution urethroplasty were equally successful. Nevertheless, 18 patients were defined as treatment failures. Of these patients, nine ended up with clean intermittent self-dilatation as a final solution, five had perineal urethrostomy and four are awaiting a new reintervention. Complicated cases need centralized professional care. Despite the possibility of needing multiple reinterventions, the majority of patients undergoing urethroplasty have a good chance of successful treatment.

A Python-based interface to examine motions in time series of solar images

NASA Astrophysics Data System (ADS)

Campos-Rozo, J. I.; Vargas Domínguez, S.

2017-10-01

Python is considered to be a mature programming language, besides of being widely accepted as an engaging option for scientific analysis in multiple areas, as will be presented in this work for the particular case of solar physics research. SunPy is an open-source library based on Python that has been recently developed to furnish software tools to solar data analysis and visualization. In this work we present a graphical user interface (GUI) based on Python and Qt to effectively compute proper motions for the analysis of time series of solar data. This user-friendly computing interface, that is intended to be incorporated to the Sunpy library, uses a local correlation tracking technique and some extra tools that allows the selection of different parameters to calculate, vizualize and analyze vector velocity fields of solar data, i.e. time series of solar filtergrams and magnetograms.

Velocity landscape correlation resolves multiple flowing protein populations from fluorescence image time series.

PubMed

Pandžić, Elvis; Abu-Arish, Asmahan; Whan, Renee M; Hanrahan, John W; Wiseman, Paul W

2018-02-16

Molecular, vesicular and organellar flows are of fundamental importance for the delivery of nutrients and essential components used in cellular functions such as motility and division. With recent advances in fluorescence/super-resolution microscopy modalities we can resolve the movements of these objects at higher spatio-temporal resolutions and with better sensitivity. Previously, spatio-temporal image correlation spectroscopy has been applied to map molecular flows by correlation analysis of fluorescence fluctuations in image series. However, an underlying assumption of this approach is that the sampled time windows contain one dominant flowing component. Although this was true for most of the cases analyzed earlier, in some situations two or more different flowing populations can be present in the same spatio-temporal window. We introduce an approach, termed velocity landscape correlation (VLC), which detects and extracts multiple flow components present in a sampled image region via an extension of the correlation analysis of fluorescence intensity fluctuations. First we demonstrate theoretically how this approach works, test the performance of the method with a range of computer simulated image series with varying flow dynamics. Finally we apply VLC to study variable fluxing of STIM1 proteins on microtubules connected to the plasma membrane of Cystic Fibrosis Bronchial Epithelial (CFBE) cells. Copyright © 2018 Elsevier Inc. All rights reserved.

Quasi-measures on the group G{sup m}, Dirichlet sets, and uniqueness problems for multiple Walsh series

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

Plotnikov, Mikhail G

2011-02-11

Multiple Walsh series (S) on the group G{sup m} are studied. It is proved that every at most countable set is a uniqueness set for series (S) under convergence over cubes. The recovery problem is solved for the coefficients of series (S) that converge outside countable sets or outside sets of Dirichlet type. A number of analogues of the de la Vallee Poussin theorem are established for series (S). Bibliography: 28 titles.

Extracutaneous atypical syphilis in HIV-infected patients.

PubMed

Prieto, Paula; Imaz, Arkaitz; Calatayud, Laura; García, Olga; Saumoy, María; Podzamczer, Daniel

2017-12-07

We describe a series of cases of syphilis with atypical extracutaneous clinical presentation diagnosed in HIV-infected patients. Retrospective observational study. All cases of syphilis diagnosed in HIV-infected patients during the period between June 2013 and June 2016 in a tertiary hospital of the Barcelona metropolitan area were analysed. A total of 71 cases of syphilis were diagnosed, 32 of them presenting with clinical signs or symptoms. Seven of these cases (9.8% of the total and 21.8% of the symptomatic cases) had atypical presentations with extracutaneous involvement: ocular (4), gastric (1), multiple hepatic abscesses (1) and generalised adenopathies (1). Patients were treated with intramuscular or intravenous penicillin and the clinical and serological evolution was good in all of them. Extracutaneous atypical clinical presentations were observed in 21.8% of symptomatic cases of syphilis in HIV+ patients with ocular involvement being the most freqent. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Absence of chronic traumatic encephalopathy in retired football players with multiple concussions and neurological symptomatology.

PubMed

Hazrati, Lili-Naz; Tartaglia, Maria C; Diamandis, Phedias; Davis, Karen D; Green, Robin E; Wennberg, Richard; Wong, Janice C; Ezerins, Leo; Tator, Charles H

2013-01-01

Chronic traumatic encephalopathy (CTE) is the term coined for the neurodegenerative disease often suspected in athletes with histories of repeated concussion and progressive dementia. Histologically, CTE is defined as a tauopathy with a distribution of tau-positive neurofibrillary tangles (NFTs) that is distinct from other tauopathies, and usually shows an absence of beta-amyloid deposits, in contrast to Alzheimer's disease (AD). Although the connection between repeated concussions and CTE-type neurodegeneration has been recently proposed, this causal relationship has not yet been firmly established. Also, the prevalence of CTE among athletes with multiple concussions is unknown. We performed a consecutive case series brain autopsy study on six retired professional football players from the Canadian Football League (CFL) with histories of multiple concussions and significant neurological decline. All participants had progressive neurocognitive decline prior to death; however, only 3 cases had post-mortem neuropathological findings consistent with CTE. The other 3 participants had pathological diagnoses of AD, amyotrophic lateral sclerosis (ALS), and Parkinson's disease (PD). Moreover, the CTE cases showed co-morbid pathology of cancer, vascular disease, and AD. Our case studies highlight that not all athletes with history of repeated concussions and neurological symptomology present neuropathological changes of CTE. These preliminary findings support the need for further research into the link between concussion and CTE as well as the need to expand the research to other possible causes of taupathy in athletes. They point to a critical need for prospective studies with good sampling methods to allow us to understand the relationship between multiple concussions and the development of CTE.

Endoscopic Repair of CSF Fistulae: A Ten Year Experience

PubMed Central

Alexander, Arun; Mathew, John; Varghese, Ajoy Mathew

2016-01-01

Introduction Cerebrospinal Fluid (CFF) fistulae are repaired endoscopically with varying degrees of success around the world. Large series are still uncommon, and the results varied primarily because of the different techniques by different surgeons and also because of a variation in the patient profile in each series, for example, many series deal primarily with traumatic CSF leaks where the defects are larger and outcomes poorer. Aim To analyse the surgical outcomes of Endoscopic CSF rhinorrhea closure. Materials and Methods This is a series of 34 cases operated upon primarily by one surgeon in two different centres over a period of 10 years. Results Of the 34 cases, 76% of the patients were women. Among the patients only 20.6% patients had a history of trauma preceding the CSF leak. The most common site of leak was in the fovea ethmoidalis in 19 (55.8%) followed by 10 (29.4%) in the cribriform plate. An overlay technique of placing the multiple layers of fascia and mucosa was used in 26 (76.5%) patients and underlay technique in the remaining. Postoperative lumbar drain was used in all patients. Conclusion Based on the treatment outcome of the 34 patients, it can be concluded that the success rate of a single endoscopic procedure in our experience is 97% and 100% following the second. Endoscopic approach for closure of CSF leak is safe with minimal complications and little morbidity. PMID:27656471

Deep brain stimulation in uncommon tremor disorders: indications, targets, and programming.

PubMed

Artusi, Carlo Alberto; Farooqi, Ashar; Romagnolo, Alberto; Marsili, Luca; Balestrino, Roberta; Sokol, Leonard L; Wang, Lily L; Zibetti, Maurizio; Duker, Andrew P; Mandybur, George T; Lopiano, Leonardo; Merola, Aristide

2018-03-06

In uncommon tremor disorders, clinical efficacy and optimal anatomical targets for deep brain stimulation (DBS) remain inadequately studied and insufficiently quantified. We performed a systematic review of PubMed.gov and ClinicalTrials.gov. Relevant articles were identified using the following keywords: "tremor", "Holmes tremor", "orthostatic tremor", "multiple sclerosis", "multiple sclerosis tremor", "neuropathy", "neuropathic tremor", "fragile X-associated tremor/ataxia syndrome", and "fragile X." We identified a total of 263 cases treated with DBS for uncommon tremor disorders. Of these, 44 had Holmes tremor (HT), 18 orthostatic tremor (OT), 177 multiple sclerosis (MS)-associated tremor, 14 neuropathy-associated tremor, and 10 fragile X-associated tremor/ataxia syndrome (FXTAS). DBS resulted in favorable, albeit partial, clinical improvements in HT cases receiving Vim-DBS alone or in combination with additional targets. A sustained improvement was reported in OT cases treated with bilateral Vim-DBS, while the two cases treated with unilateral Vim-DBS demonstrated only a transient effect. MS-associated tremor responded to dual-target Vim-/VO-DBS, but the inability to account for the progression of MS-associated disability impeded the assessment of its long-term clinical efficacy. Neuropathy-associated tremor substantially improved with Vim-DBS. In FXTAS patients, while Vim-DBS was effective in improving tremor, equivocal results were observed in those with ataxia. DBS of select targets may represent an effective therapeutic strategy for uncommon tremor disorders, although the level of evidence is currently in its incipient form and based on single cases or limited case series. An international registry is, therefore, warranted to clarify selection criteria, long-term results, and optimal surgical targets.

Mutational profiles of breast cancer metastases from a rapid autopsy series reveal multiple evolutionary trajectories.

PubMed

Avigdor, Bracha Erlanger; Cimino-Mathews, Ashley; DeMarzo, Angelo M; Hicks, Jessica L; Shin, James; Sukumar, Saraswati; Fetting, John; Argani, Pedram; Park, Ben H; Wheelan, Sarah J

2017-12-21

Heterogeneity within and among tumors in a metastatic cancer patient is a well-established phenomenon that may confound treatment and accurate prognosis. Here, we used whole-exome sequencing to survey metastatic breast cancer tumors from 5 patients in a rapid autopsy program to construct the origin and genetic development of metastases. Metastases were obtained from 5 breast cancer patients using a rapid autopsy protocol and subjected to whole-exome sequencing. Metastases were evaluated for sharing of somatic mutations, correlation of copy number variation and loss of heterozygosity, and genetic similarity scores. Pathological features of the patients' disease were assessed by immunohistochemical analyses. Our data support a monoclonal origin of metastasis in 3 cases, but in 2 cases, metastases arose from at least 2 distinct subclones in the primary tumor. In the latter 2 cases, the primary tumor presented with mixed histologic and pathologic features, suggesting early divergent evolution within the primary tumor with maintenance of metastatic capability in multiple lineages. We used genetic and histopathological evidence to demonstrate that metastases can be derived from a single or multiple independent clones within a primary tumor. This underscores the complexity of breast cancer clonal evolution and has implications for how best to determine and implement therapies for early- and late-stage disease.

Mutational profiles of breast cancer metastases from a rapid autopsy series reveal multiple evolutionary trajectories

PubMed Central

Avigdor, Bracha Erlanger; Cimino-Mathews, Ashley; DeMarzo, Angelo M.; Hicks, Jessica L.; Shin, James; Sukumar, Saraswati; Fetting, John; Argani, Pedram; Park, Ben H.; Wheelan, Sarah J.

2017-01-01

Heterogeneity within and among tumors in a metastatic cancer patient is a well-established phenomenon that may confound treatment and accurate prognosis. Here, we used whole-exome sequencing to survey metastatic breast cancer tumors from 5 patients in a rapid autopsy program to construct the origin and genetic development of metastases. Metastases were obtained from 5 breast cancer patients using a rapid autopsy protocol and subjected to whole-exome sequencing. Metastases were evaluated for sharing of somatic mutations, correlation of copy number variation and loss of heterozygosity, and genetic similarity scores. Pathological features of the patients’ disease were assessed by immunohistochemical analyses. Our data support a monoclonal origin of metastasis in 3 cases, but in 2 cases, metastases arose from at least 2 distinct subclones in the primary tumor. In the latter 2 cases, the primary tumor presented with mixed histologic and pathologic features, suggesting early divergent evolution within the primary tumor with maintenance of metastatic capability in multiple lineages. We used genetic and histopathological evidence to demonstrate that metastases can be derived from a single or multiple independent clones within a primary tumor. This underscores the complexity of breast cancer clonal evolution and has implications for how best to determine and implement therapies for early- and late-stage disease. PMID:29263308

Nonsyndromic Bilateral Multiple Impacted Supernumerary Mandibular Third Molars: A Rare and Unusual Case Report

PubMed Central

Reddy, G. Siva Prasad; Reddy, G. V.; Krishna, I. Venkata; Regonda, Shravan Kumar

2013-01-01

A supernumerary tooth is that which is present additionally to the normal series and can be found in any region of the dental arch. An impacted tooth is defined as the one which is embedded in the alveolus, so that its eruption is prevented, or the tooth is locked in position by bone or the adjacent teeth. The occurrence of multiple supernumerary teeth in only one patient in the absence of an associated systemic condition or syndrome is considered as a rare phenomenon. The occurrence of supernumerary teeth in the lower molar region is rare. A prevalence of less than 2% of cases occurring in this region has been estimated. Their occurrence presents a clinical problem for orthodontists and oral surgeons. The cause, frequency, complications, and surgical operation of impacted teeth are always interesting subjects for study and research. An impacted tooth can result in caries, pulp disease, periapical and periodontal disease, temporomandibular joint disorder, infection of the fascial space, root resorption of the adjacent tooth, and even oral and maxillofacial tumours. The management of impacted wisdom teeth has changed over the past 20 years from removal of nonsymptomatic third molars to simple observation. The aim of this paper is to present a rare case of bilateral multiple impacted supernumerary mandibular third molars. PMID:23476818

Cystic lung disease in birt-hogg-dubé syndrome: a case series of three patients.

PubMed

Kilincer, Abidin; Ariyurek, Orhan Macit; Karabulut, Nevzat

2014-06-01

Birt-Hogg-Dubé syndrome is characterized by clinical manifestations such as hamartomas of the skin, renal tumors and lung cysts with spontaneous pneumothoraces. Patients with Birt-Hogg-Dubé syndrome may present with only multiple lung cysts. We report the chest computerized tomography (CT) features of three patients with Birt-Hogg-Dubé syndrome. Each patient had multiple lung cysts of various sizes according to chest CT evaluation, most of which were located in lower lobes and related to pleura. The identification of unique characteristics in the chest CT of patients with Birt-Hogg-Dubé syndrome may provide an efficient mechanism for diagnosis.

Products of multiple Fourier series with application to the multiblade transformation

NASA Technical Reports Server (NTRS)

Kunz, D. L.

1981-01-01

A relatively simple and systematic method for forming the products of multiple Fourier series using tensor like operations is demonstrated. This symbolic multiplication can be performed for any arbitrary number of series, and the coefficients of a set of linear differential equations with periodic coefficients from a rotating coordinate system to a nonrotating system is also demonstrated. It is shown that using Fourier operations to perform this transformation make it easily understood, simple to apply, and generally applicable.

Falcon: A Temporal Visual Analysis System

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

Steed, Chad A.

2016-09-05

Flexible visible exploration of long, high-resolution time series from multiple sensor streams is a challenge in several domains. Falcon is a visual analytics approach that helps researchers acquire a deep understanding of patterns in log and imagery data. Falcon allows users to interactively explore large, time-oriented data sets from multiple linked perspectives. Falcon provides overviews, detailed views, and unique segmented time series visualizations with multiple levels of detail. These capabilities are applicable to the analysis of any quantitative time series.

Is electroconvulsive therapy during pregnancy safe?

PubMed

Jiménez-Cornejo, Magdalena; Zamorano-Levi, Natalia; Jeria, Álvaro

2016-12-07

Therapeutic options for psychiatric conditions are limited during pregnancy because many drugs are restricted or contraindicated. Electroconvulsive therapy constitutes an alternative, however there is controversy over its safety. Using the Epistemonikos database, which is maintained by searching multiple databases, we found five systematic reviews, including 81 studies overall describing case series or individual cases. Data were extracted from the identified reviews and summary tables of the results were prepared using the GRADE method. We concluded it is not clear what are the risks associated with electroconvulsive therapy during pregnancy because the certainty of the existing evidence is very low. Likewise, existing systematic reviews and international clinical guidelines differ in their conclusions and recommendations.

[Scimitar syndrome: a case series].

PubMed

Jaramillo González, Carlos; Karam Bechara, José; Sáenz Gómez, Jessica; Siegert Olivares, Augusto; Jamaica Balderas, Lourdes

Scimitar syndrome is a rare and complex congenital anomaly of the lung with multiple variables and is named for its resemblance to the classical radiological crooked sword. Its defining feature is the anomalous pulmonary drainage. It is associated with various cardiothoracic malformations and a wide spectrum of clinical manifestations. Nine patients diagnosed with scimitar syndrome found in the database of Hospital Infantil de México between 2009 and 2013 were reviewed. Demographic records, clinical status and hemodynamic parameters reported were collected. This case series called attention to certain differences between our group of patients and those reported in the international literature. Patients were predominantly female and were diagnosed between 1 and 20 months of life. All were asymptomatic at the time of the study. Half of the patients had a history of respiratory disease and all patients had with pulmonary hypertension. Surgical management was required in on-third of the patient group. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Improvement of nonsuicidal self-injury following treatment with antipsychotics possessing strong D1 antagonistic activity: evidence from a report of three cases.

PubMed

Wollweber, Bastian; Keck, Martin E; Schmidt, Ulrike

2015-08-01

There is no drug treatment for nonsuicidal self-injury (NSSI), a highly prevalent and burdensome symptom of several psychiatric diseases like posttraumatic stress disorder (PTSD), personality disorders, and major depression (MD). Here, we present a retrospective series of three patients demonstrating a persistent remission in MD-associated NSSI in response to treatment with antipsychotics possessing marked D1 receptor antagonistic activity. To the best of the authors' knowledge, the case series presented is only the second clinical paper suggesting a role for D1 antagonists in NSSI drug therapy. Together with previously published data from rodent models, the findings suggest a role for D1 antagonists in NSSI drug therapy and hence for the D1 receptor in NSSI pathogenesis. This conclusion is limited by the facts that the patients presented here received polypharmacy and that the D1 receptor antagonistic antipsychotics suggested here as effective 'anti-auto-aggressants' do not address D1 receptors only but multiple neurotransmitter receptors/systems.

Multiple plate hydrostatic viscous damper

NASA Technical Reports Server (NTRS)

Ludwig, L. P. (Inventor)

1981-01-01

A device for damping radial motion of a rotating shaft is described. The damper comprises a series of spaced plates extending in a radial direction. A hydraulic piston is utilized to place a load in these plates. Each annular plate is provided with a suitable hydrostatic bearing geometry on at least one of its faces. This structure provides a high degree of dampening in a rotor case system of turbomachinery in general. The damper is particularly useful in gas turbine engines.

[Laparoscopic aspect and clinical relevance of cholangiofibromas].

PubMed

Henning, H; Friedrich, K; Lüders, C J

1982-12-01

In a current series of 1160 laparoscopies in 38 cases (3.2%) we found cholangiofibromas. The picture of single, sporadic and multiple cholangiofibromas as well as cholangiofibromatosis is both described and documented by laparoscopic photography. Clinically it seems remarkable that only patients with alcohol- or drug-induced liver injury showed such alterations. The prevalence of cholangiofibromas in toxic liver damage suggests that we are here not dealing with embryonal aberrations (hamartomas) but apparently with cellular inductive phenomena.

Schema therapy for chronic depression: Results of a multiple single case series.

PubMed

Renner, Fritz; Arntz, Arnoud; Peeters, Frenk P M L; Lobbestael, Jill; Huibers, Marcus J H

2016-06-01

The aim of this study was to test the effects of individual schema therapy (ST) for patients with chronic depression. Using a multiple-baseline single case series design, patients with chronic major depressive disorder (N = 25) first entered a 6-24 weeks baseline phase; this phase functioned as a no-treatment control condition. Then, patients started a 12 week exploration phase during which symptoms and underlying schemas were explored; this phase functioned as an attention control condition. Next, patients received up to 65 sessions of individual ST. The Beck Depression Inventory II (BDI-II) and the Quick Inventory of Depressive Symptomatology (QIDS) were the primary outcome measures. The BDI-II was assessed once a week during all phases of the study resulting in 100 repeated assessments per participant on average. Mixed regression analysis was used to contrast change in symptoms during the intervention with change in symptoms during the baseline and exploration control phases. When compared to the no-treatment control period, the intervention had a significant, large effect on depressive symptoms (Cohen's d BDI-II = 1.30; Cohen's d QIDS = 1.22). Effects on secondary continuous outcomes were moderate to large. The small sample size and lack of a control group. These findings provide evidence that ST might be an effective treatment for patients with chronic depression. Copyright © 2015 Elsevier Ltd. All rights reserved.

Management of Patients With Hepatitis C Virus, Monoclonal Gammopathy of Undetermined Significance, and Multiple Myeloma

PubMed Central

Hannaford, Alisse; Del Bello, David; Leng, Siyang; Chari, Ajai; Perumalswami, Ponni; Dieterich, Douglas; Branch, Andrea

2017-01-01

Background and Aim: The vast majority of the 2.7 million individuals in the United States who are currently infected with hepatitis C virus (HCV) were born between 1945 and 1965. The median age of these patients in this particular generation at the time of this writing was 55 years. In the general population, older age is a risk factor for multiple myeloma (MM) and other monogammopathies. As the baby boomer population ages, HCV providers are increasingly likely to encounter HCV-infected patients with a monoclonal gammopathy. Guidelines for managing these patients are needed. Methods: We conducted a detailed case series investigation of 4 HCV-positive patients with MM or a monoclonal gammopathy disorder. Patients were followed at the Mount Sinai Faculty Practice liver clinic. We also performed a detailed review of the literature exploring if there is any known association between HCV, MM, and monoclonal gammopathy. Results and Conclusions: There is no convincing evidence of a causal association between HCV and MM. HCV is linked to type II and type III cryoglobulinemia, specific kinds of monoclonal gammopathies of determinable significance. Whether a link exists between HCV and MM or monoclonal gammopathy of undetermined significance is unclear. Our case series provides the first evidence that modern HCV treatments with direct-acting antivirals can be safely and effectively co-administered with MM chemotherapy. PMID:28748190

Management of Patients With Hepatitis C Virus, Monoclonal Gammopathy of Undetermined Significance, and Multiple Myeloma.

PubMed

Hannaford, Alisse; Del Bello, David; Leng, Siyang; Chari, Ajai; Perumalswami, Ponni; Dieterich, Douglas; Branch, Andrea

2017-01-01

Background and Aim: The vast majority of the 2.7 million individuals in the United States who are currently infected with hepatitis C virus (HCV) were born between 1945 and 1965. The median age of these patients in this particular generation at the time of this writing was 55 years. In the general population, older age is a risk factor for multiple myeloma (MM) and other monogammopathies. As the baby boomer population ages, HCV providers are increasingly likely to encounter HCV-infected patients with a monoclonal gammopathy. Guidelines for managing these patients are needed. Methods: We conducted a detailed case series investigation of 4 HCV-positive patients with MM or a monoclonal gammopathy disorder. Patients were followed at the Mount Sinai Faculty Practice liver clinic. We also performed a detailed review of the literature exploring if there is any known association between HCV, MM, and monoclonal gammopathy. Results and Conclusions: There is no convincing evidence of a causal association between HCV and MM. HCV is linked to type II and type III cryoglobulinemia, specific kinds of monoclonal gammopathies of determinable significance. Whether a link exists between HCV and MM or monoclonal gammopathy of undetermined significance is unclear. Our case series provides the first evidence that modern HCV treatments with direct-acting antivirals can be safely and effectively co-administered with MM chemotherapy.

A study of pilot modeling in multi-controller tasks

NASA Technical Reports Server (NTRS)

Whitbeck, R. F.; Knight, J. R.

1972-01-01

A modeling approach, which utilizes a matrix of transfer functions to describe the human pilot in multiple input, multiple output control situations, is studied. The approach used was to extend a well established scalar Wiener-Hopf minimization technique to the matrix case and then study, via a series of experiments, the data requirements when only finite record lengths are available. One of these experiments was a two-controller roll tracking experiment designed to force the pilot to use rudder in order to coordinate and reduce the effects of aileron yaw. One model was computed for the case where the signals used to generate the spectral matrix are error and bank angle while another model was computed for the case where error and yaw angle are the inputs. Several anomalies were observed to be present in the experimental data. These are defined by the descriptive terms roll up, break up, and roll down. Due to these algorithm induced anomalies, the frequency band over which reliable estimates of power spectra can be achieved is considerably less than predicted by the sampling theorem.

Case Series in Cognitive Neuropsychology: Promise, Perils and Proper Perspective

PubMed Central

Rapp, Brenda

2012-01-01

Schwartz & Dell (2010) advocated for a major role for case series investigations in cognitive neuropsychology. They defined the key features of this approach and presented a number of arguments and examples illustrating the benefits of case series studies and their contribution to computational cognitive neuropsychology. In the Special Issue on “Case Series in Cognitive Neuropsychology” there are six commentaries on Schwartz and Dell (2010) as well as a response to the six commentaries by Dell and Schwartz. In this paper, I provide a brief summary of the key points made in Schwartz and Dell (2010) and I review the promise and perils of case series design as revealed by the six commentaries. I conclude by placing the set of papers within a broader perspective, providing some clarification of the historical record on case series and single case approaches, raising some cautionary notes for case series studies and situating both case series and single case approaches within the larger context of theory development in the cognitive sciences. PMID:22746685

Learning curve in robotic rectal cancer surgery: current state of affairs.

PubMed

Jiménez-Rodríguez, Rosa M; Rubio-Dorado-Manzanares, Mercedes; Díaz-Pavón, José Manuel; Reyes-Díaz, M Luisa; Vazquez-Monchul, Jorge Manuel; Garcia-Cabrera, Ana M; Padillo, Javier; De la Portilla, Fernando

2016-12-01

Robotic-assisted rectal cancer surgery offers multiple advantages for surgeons, and it seems to yield the same clinical outcomes as regards the short-time follow-up of patients compared to conventional laparoscopy. This surgical approach emerges as a technique aiming at overcoming the limitations posed by rectal cancer and other surgical fields of difficult access, in order to obtain better outcomes and a shorter learning curve. A systematic review of the literature of robot-assisted rectal surgery was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The search was conducted in October 2015 in PubMed, MEDLINE and the Cochrane Central Register of Controlled Trials, for articles published in the last 10 years and pertaining the learning curve of robotic surgery for colorectal cancer. It consisted of the following key words: "rectal cancer/learning curve/robotic-assisted laparoscopic surgery". A total of 34 references were identified, but only 9 full texts specifically addressed the analysis of the learning curve in robot-assisted rectal cancer surgery, 7 were case series and 2 were non-randomised case-comparison series. Eight papers used the cumulative sum (CUSUM) method, and only one author divided the series into two groups to compare both. The mean number of cases for phase I of the learning curve was calculated to be 29.7 patients; phase II corresponds to a mean number 37.4 patients. The mean number of cases required for the surgeon to be classed as an expert in robotic surgery was calculated to be 39 patients. Robotic advantages could have an impact on learning curve for rectal cancer and lower the number of cases that are necessary for rectal resections.

Development of temporal modelling for forecasting and prediction of malaria infections using time-series and ARIMAX analyses: a case study in endemic districts of Bhutan.

PubMed

Wangdi, Kinley; Singhasivanon, Pratap; Silawan, Tassanee; Lawpoolsri, Saranath; White, Nicholas J; Kaewkungwal, Jaranit

2010-09-03

Malaria still remains a public health problem in some districts of Bhutan despite marked reduction of cases in last few years. To strengthen the country's prevention and control measures, this study was carried out to develop forecasting and prediction models of malaria incidence in the endemic districts of Bhutan using time series and ARIMAX. This study was carried out retrospectively using the monthly reported malaria cases from the health centres to Vector-borne Disease Control Programme (VDCP) and the meteorological data from Meteorological Unit, Department of Energy, Ministry of Economic Affairs. Time series analysis was performed on monthly malaria cases, from 1994 to 2008, in seven malaria endemic districts. The time series models derived from a multiplicative seasonal autoregressive integrated moving average (ARIMA) was deployed to identify the best model using data from 1994 to 2006. The best-fit model was selected for each individual district and for the overall endemic area was developed and the monthly cases from January to December 2009 and 2010 were forecasted. In developing the prediction model, the monthly reported malaria cases and the meteorological factors from 1996 to 2008 of the seven districts were analysed. The method of ARIMAX modelling was employed to determine predictors of malaria of the subsequent month. It was found that the ARIMA (p, d, q) (P, D, Q)s model (p and P representing the auto regressive and seasonal autoregressive; d and D representing the non-seasonal differences and seasonal differencing; and q and Q the moving average parameters and seasonal moving average parameters, respectively and s representing the length of the seasonal period) for the overall endemic districts was (2,1,1)(0,1,1)12; the modelling data from each district revealed two most common ARIMA models including (2,1,1)(0,1,1)12 and (1,1,1)(0,1,1)12. The forecasted monthly malaria cases from January to December 2009 and 2010 varied from 15 to 82 cases in 2009 and 67 to 149 cases in 2010, where population in 2009 was 285,375 and the expected population of 2010 to be 289,085. The ARIMAX model of monthly cases and climatic factors showed considerable variations among the different districts. In general, the mean maximum temperature lagged at one month was a strong positive predictor of an increased malaria cases for four districts. The monthly number of cases of the previous month was also a significant predictor in one district, whereas no variable could predict malaria cases for two districts. The ARIMA models of time-series analysis were useful in forecasting the number of cases in the endemic areas of Bhutan. There was no consistency in the predictors of malaria cases when using ARIMAX model with selected lag times and climatic predictors. The ARIMA forecasting models could be employed for planning and managing malaria prevention and control programme in Bhutan.

Primary Sjogren's syndrome with central nervous system involvement.

PubMed

Alhomoud, Iftetah A; Bohlega, Saeed A; Alkawi, Mohammed Z; Alsemari, Abdulaziz M; Omer, Saleh M; Alsenani, Fahmi M

2009-08-01

To describe the clinical, laboratory, and radiological features of Primary Sjogren's syndrome (PSS) with central nervous system (CNS) involvement. A retrospective case series of 12 female patients with PSS and CNS involvement at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia from 1991-2009. The diagnosis of PSS is defined by the American-European Diagnostic Criteria. We analyzed the clinical, radiological, and immunological features. The mean age was 40 years (range 16-58 years); all patient were females and presented with active neurological symptoms. The neurological involvement preceded the classic sicca symptoms (33%). Eight patients (66%) presented with myelopathy, 9 patients (75%) had optic neuritis, and the rest had variable neurological signs. Immunological tests (anti-Sjogren's syndrome A and anti-Sjogren's syndrome B) were high in 7 patients (58%). Minor salivary gland biopsy revealed inflammatory cell infiltrate in 11 patients (92%). Brain MRI showed scattered white matter changes in 7 patients (58%). Spine MRI showed multiple foci of hyperintensity in T2-weighted image in 6 patients (50%), and long segment of hyperintensity at the cervical spinal cord in 2 patients (16%). Our findings demonstrate that CNS involvements in PSS have great clinical variability and could precede the classic sicca symptoms by years. Primary Sjogren's syndrome can mimic multiple sclerosis (primary progressive multiple sclerosis or relapsing remitting multiple sclerosis), therefore a screening test for PSS should be considered in suspected cases. A well-defined management protocol awaits studies with larger case numbers.

Optimization of Multiple and Multipurpose Reservoir System Operations by Using Matrix Structure (Case Study: Karun and Dez Reservoir Dams)

PubMed Central

Othman, Faridah; Taghieh, Mahmood

2016-01-01

Optimal operation of water resources in multiple and multipurpose reservoirs is very complicated. This is because of the number of dams, each dam’s location (Series and parallel), conflict in objectives and the stochastic nature of the inflow of water in the system. In this paper, performance optimization of the system of Karun and Dez reservoir dams have been studied and investigated with the purposes of hydroelectric energy generation and providing water demand in 6 dams. On the Karun River, 5 dams have been built in the series arrangements, and the Dez dam has been built parallel to those 5 dams. One of the main achievements in this research is the implementation of the structure of production of hydroelectric energy as a function of matrix in MATLAB software. The results show that the role of objective function structure for generating hydroelectric energy in weighting method algorithm is more important than water supply. Nonetheless by implementing ε- constraint method algorithm, we can both increase hydroelectric power generation and supply around 85% of agricultural and industrial demands. PMID:27248152

Sacral neuromodulation for the treatment of neurogenic lower urinary tract dysfunction caused by multiple sclerosis: a single-centre prospective series.

PubMed

Engeler, Daniel S; Meyer, Daniel; Abt, Dominik; Müller, Stefanie; Schmid, Hans-Peter

2015-10-23

Sacral neuromodulation is well established in the treatment of refractory, non-neurogenic lower urinary tract dysfunction, but its efficacy and safety in patients with lower urinary tract dysfunction of neurological origin is unclear. Only few case series have been reported for multiple sclerosis. We prospectively evaluated the efficacy and safety of sacral neuromodulation in patients with multiple sclerosis. Seventeen patients (13 women, 4 men) treated with sacral neuromodulation for refractory neurogenic lower urinary tract dysfunction caused by multiple sclerosis were prospectively enrolled (2007-2011). Patients had to have stable disease and confirmed neurogenic lower urinary tract dysfunction. Voiding variables, adverse events, and subjective satisfaction were assessed. Sixteen (94 %) patients had a positive test phase with a >70 % improvement. After implantation of the pulse generator (InterStim II), the improvement in voiding variables persisted. At 3 years, the median voided volume had improved significantly from 125 (range 0 to 350) to 265 ml (range 200 to 350) (p < 0.001), the post void residual from 170 (range 0 to 730) to 25 ml (range 0 to 300) (p = 0.01), micturition frequency from 12 (range 6 to 20) to 7 (range 4 to 12) (p = 0.003), and number of incontinence episodes from 3 (range 0 to 10) to 0 (range 0 to 1) (p = 0.006). The median subjective degree of satisfaction was 80 %. Only two patients developed lack of benefit. No major complications occurred. Chronic sacral neuromodulation promises to be an effective and safe treatment of refractory neurogenic lower urinary tract dysfunction in selected patients with multiple sclerosis.

Tuberculous otitis media: clinical aspects of 12 cases.

PubMed

Nishiike, Suetaka; Irifune, Morihiro; Doi, Katsumi; Osaki, Yasuhiro; Kiuchi, Nobuo

2003-11-01

The clinical features of tuberculous otitis media (TOM) have changed. This study was performed to evaluate changing trends in the clinical manifestations of TOM. We reviewed a series of 12 cases of TOM (13 ears) recently treated at Osaka Prefectural Habikino Hospital. The results showed a mean age of 41 years and a male predominance of 1.4 to 1. Central or total perforations of the tympanic membrane were observed in most cases, but none of the patients had multiple perforations. Nine patients (75%) had active pulmonary tuberculosis. Normal lung status or inactive pulmonary tuberculosis was significantly more frequent in the older age group. Diagnosis of primary TOM required more time than that of secondary TOM. Most cases of primary TOM had high infectiousness of the primary lesion. We summarize the clinical features of patients who should be evaluated for TOM.

Normalization methods in time series of platelet function assays

PubMed Central

Van Poucke, Sven; Zhang, Zhongheng; Roest, Mark; Vukicevic, Milan; Beran, Maud; Lauwereins, Bart; Zheng, Ming-Hua; Henskens, Yvonne; Lancé, Marcus; Marcus, Abraham

2016-01-01

Abstract Platelet function can be quantitatively assessed by specific assays such as light-transmission aggregometry, multiple-electrode aggregometry measuring the response to adenosine diphosphate (ADP), arachidonic acid, collagen, and thrombin-receptor activating peptide and viscoelastic tests such as rotational thromboelastometry (ROTEM). The task of extracting meaningful statistical and clinical information from high-dimensional data spaces in temporal multivariate clinical data represented in multivariate time series is complex. Building insightful visualizations for multivariate time series demands adequate usage of normalization techniques. In this article, various methods for data normalization (z-transformation, range transformation, proportion transformation, and interquartile range) are presented and visualized discussing the most suited approach for platelet function data series. Normalization was calculated per assay (test) for all time points and per time point for all tests. Interquartile range, range transformation, and z-transformation demonstrated the correlation as calculated by the Spearman correlation test, when normalized per assay (test) for all time points. When normalizing per time point for all tests, no correlation could be abstracted from the charts as was the case when using all data as 1 dataset for normalization. PMID:27428217

Mesoscopic Community Structure of Financial Markets Revealed by Price and Sign Fluctuations

PubMed Central

Almog, Assaf; Besamusca, Ferry; MacMahon, Mel; Garlaschelli, Diego

2015-01-01

The mesoscopic organization of complex systems, from financial markets to the brain, is an intermediate between the microscopic dynamics of individual units (stocks or neurons, in the mentioned cases), and the macroscopic dynamics of the system as a whole. The organization is determined by “communities” of units whose dynamics, represented by time series of activity, is more strongly correlated internally than with the rest of the system. Recent studies have shown that the binary projections of various financial and neural time series exhibit nontrivial dynamical features that resemble those of the original data. This implies that a significant piece of information is encoded into the binary projection (i.e. the sign) of such increments. Here, we explore whether the binary signatures of multiple time series can replicate the same complex community organization of the financial market, as the original weighted time series. We adopt a method that has been specifically designed to detect communities from cross-correlation matrices of time series data. Our analysis shows that the simpler binary representation leads to a community structure that is almost identical with that obtained using the full weighted representation. These results confirm that binary projections of financial time series contain significant structural information. PMID:26226226

Clinical, diagnostic and pathologic features of presumptive cases of Chlamydia pecorum-associated arthritis in Australian sheep flocks.

PubMed

Walker, Evelyn; Moore, Cecily; Shearer, Patrick; Jelocnik, Martina; Bommana, Sankhya; Timms, Peter; Polkinghorne, Adam

2016-09-08

Arthritis is an economically significant disease in lambs and is usually the result of a bacterial infection. One of the known agents of this disease is Chlamydia pecorum, a globally recognised livestock pathogen associated with several diseases in sheep, cattle and other hosts. Relatively little published information is available on the clinical, diagnostic and pathologic features of C. pecorum arthritis in sheep, hindering efforts to enhance our understanding of this economically significant disease. In this case series, a combination of standard diagnostic testing used routinely by veterinarians, such as the Chlamydia complement fixation text (CFT), veterinary clinical examinations, and additional screening via C. pecorum specific qPCR was used to describe putative chlamydial infections in five sheep flocks with suspected ovine arthritis. Five separate cases involving multiple lambs (aged six to ten months) of different breeds with suspected C. pecorum arthritis are presented. In two of the five cases, arthritic lambs exhibited marked depression and lethargy. Arthritis with concurrent conjunctivitis was present in four out of five lamb flocks examined. Chlamydia CFT demonstrated medium to high positive antibody titres in all flocks examined. C. pecorum shedding was evident at multiple sites including the conjunctiva, rectum and vagina, as determined via qPCR. Two of the five flocks received antimicrobials and all flocks recovered uneventfully regardless of treatment. This case series highlights the features a field veterinarian may encounter in cases of suspected ovine chlamydial arthritis. Our analysis suggests a presumptive diagnosis of chlamydial arthritis in lambs can be made when there is evidence of joint stiffness with or without synovial effusion and elevated chlamydia antibody titres. C. pecorum-specific qPCR was found to be a useful ancillary diagnostic tool, detecting Chlamydia positivity in low or negative CFT titre animals. Variables such as symptom duration relative to sampling, sheep breed and farm management practices were all factors recorded that paint a complex epidemiological and diagnostic picture for this disease. These case studies serve to provide a platform for further research to improve diagnostic testing and new treatment and control strategies for C. pecorum infections in sheep.

Ultrasonographic and clinicopathologic features of segmental dilatations of the common bile duct in four cats

PubMed Central

Spain, Heather N; Penninck, Dominique G; Webster, Cynthia RL; Daure, Evence; Jennings, Samuel H

2017-01-01

Case series summary This case series documents ultrasonographic and clinicopathologic features of four cats with marked segmental dilatations of the common bile duct (CBD). All cats had additional ultrasonographic changes to the hepatobiliary system, including hepatomegaly, tubular to saccular intra/extrahepatic biliary duct dilatation and biliary debris accumulation. Based on all available data the presence of extrahepatic biliary duct obstruction (EHBDO) was ruled out in 3/4 cases and was equivocal in one case. One cat underwent re-routing surgery to address the CBD dilatation after multiple recurrent infections, one cat was euthanized and had a post-mortem examination and two cats were medically managed with antibiotics, liver protectants, gastroprotectants and cholerectics. Relevance and novel information The ultrasonographic features of the CBD in this population of cats were supportive of choledochal cysts (CCs). The maximal diameter of the CBD dilatations exceeded 5 mm in all cases, a sign that has been previously reported to be consistent with EHBDO. In our study, dilatations were segmental rather than diffuse. Given the high morbidity and mortality associated with hepatobiliary surgery in cats, segmental dilatation of the CBD should not prompt emergency surgery. Some cats may respond to medical management. Careful planning for cyst resection was beneficial in one cat. Evaluation of CC morphology (eg, size, location, concurrent intrahepatic anomalies) may assist in selecting cats that could benefit from surgical intervention. PMID:28680700

Multicentric myelolipoma in a dog.

PubMed

Kamiie, Junichi; Fueki, Keisuke; Amagai, Harumi; Ichikawa, Youichiro; Shirota, Kinji

2009-03-01

We report herein a case of multicentric myelolipoma in an 11-year-old beagle dog that presented with vomiting. Laparotomy demonstrated the presence of a large mass adherent to the greater omentum and multiple small white maculae in the spleen. Cytological and histological examinations revealed that the mass and maculae comprised mature adipocytes and hematopoietic elements including granulocytic, erythrocytic and megakaryocytic series in several phases of maturation and macrophages containing hemosiderin deposits, resembling bone marrow. Multicentric myelolipoma was diagnosed. This is first report of multicentric myelolipoma in a dog.

Delayed diagnosis of a pseudoaneurysm with recurrent hemarthrosis of the knee joint.

PubMed

Becher, Christoph; Burger, Ulrike L; Allenberg, Jens R; Kaufmann, Guenter W; Thermann, Hajo

2008-06-01

This is a case report of recurrent hemarthrosis of the knee joint over 3 months. The patient, a 47-year-old male had three arthroscopic procedures with multiple joint punctures over a 3-month-period prior to our initial consultation. The first procedure (arthroscopic synovectomy) was done for suspected infection following a series of hyaluronic acid injections. Recurrent hemarthrosis developed subsequent to this. Upon further evaluation, a pseudoaneurysm of the superior middle genicular artery was detected and successfully treated with selective angiographic embolization.

Nandrolone decanoate for the treatment of erythropoietin refractory anemia: a case series.

PubMed

Chawla, Bobby; Iqbal, Fahad M; Chawla, Manjeet S

2009-01-01

Erythropoietin refractory anemias represent a continuing and increasing burden on the healthcare system. The current practice of providing these patients with rHuEPO does not seem to be working. Fewer than 50% of patients respond in some studies. We demonstrate that androgens have multiple benefits in this population. They control anemia and stop transfusion dependence and improve nutritional parameters. In some patients, they also have a salutary effect on both white blood cell and platelet counts.

A case of recurrent psychosis during sickle cell disease crisis treated successfully with ziprasidone.

PubMed

Spiegel, David R; Messerschmidt, Cory; Morewitz, Jerry; Akintola, Morakinyo

2013-01-01

We present and follow a series of three consecutive hospitalizations of a 36-year-old, African-American male with sickle cell anemia disease who presented with sickle cell crises and a new onset psychotic episode. After multiple hospitalizations for prior episodes of sickle cell crisis-induced pain, treated with rehydration, blood transfusions, and opiate medication, this hospitalization was the first time he developed psychosis. As such, we discuss the differential diagnosis of the latter, and effective adjunctive treatment with ziprasidone.

Absence of chronic traumatic encephalopathy in retired football players with multiple concussions and neurological symptomatology

PubMed Central

Hazrati, Lili-Naz; Tartaglia, Maria C.; Diamandis, Phedias; Davis, Karen D.; Green, Robin E.; Wennberg, Richard; Wong, Janice C.; Ezerins, Leo; Tator, Charles H.

2013-01-01

Background: Chronic traumatic encephalopathy (CTE) is the term coined for the neurodegenerative disease often suspected in athletes with histories of repeated concussion and progressive dementia. Histologically, CTE is defined as a tauopathy with a distribution of tau-positive neurofibrillary tangles (NFTs) that is distinct from other tauopathies, and usually shows an absence of beta-amyloid deposits, in contrast to Alzheimer's disease (AD). Although the connection between repeated concussions and CTE-type neurodegeneration has been recently proposed, this causal relationship has not yet been firmly established. Also, the prevalence of CTE among athletes with multiple concussions is unknown. Methods: We performed a consecutive case series brain autopsy study on six retired professional football players from the Canadian Football League (CFL) with histories of multiple concussions and significant neurological decline. Results: All participants had progressive neurocognitive decline prior to death; however, only 3 cases had post-mortem neuropathological findings consistent with CTE. The other 3 participants had pathological diagnoses of AD, amyotrophic lateral sclerosis (ALS), and Parkinson's disease (PD). Moreover, the CTE cases showed co-morbid pathology of cancer, vascular disease, and AD. Discussion: Our case studies highlight that not all athletes with history of repeated concussions and neurological symptomology present neuropathological changes of CTE. These preliminary findings support the need for further research into the link between concussion and CTE as well as the need to expand the research to other possible causes of taupathy in athletes. They point to a critical need for prospective studies with good sampling methods to allow us to understand the relationship between multiple concussions and the development of CTE. PMID:23745112

Rickets: case series and diagnostic review of hypovitaminosis D in swine.

PubMed

Madson, Darin M; Ensley, Steve M; Gauger, Phil C; Schwartz, Kent J; Stevenson, Greg W; Cooper, Vickie L; Janke, Bruce H; Burrough, Eric R; Goff, Jesse P; Horst, Ronald L

2012-11-01

Rickets can be attributed to nutritional, genetic, hormonal, or toxic disturbances and is classified as a metabolic bone disease. Rickets is most often associated with inappropriate dietary levels of calcium, phosphorus, and/or vitamin D. During a 27-month period (January 2010 through March 2012), the Iowa State University Veterinary Diagnostic Laboratory investigated causes of sudden, unexpected death and lameness in growing pigs throughout the Midwestern United States. Clinical observations from 17 growing pig cases included weakness, lameness, reluctance to move, muscle fasciculations and/or tremors, tetany, and death. Ribs were weak, soft, and bent prior to breaking; rachitic lesions were apparent at costochondral junctions in multiple cases. Acute and/or chronic bone fractures were also noted in multiple bones. Failure of endochondral ossification, expanded physes, infractions, thin trabeculae, and increased osteoclasts were noted microscopically. Decreased bone ash and serum 25(OH)D(3), combined with clinical and microscopic evaluation, confirmed a diagnosis of vitamin D-dependent rickets in all cases. In 3 cases, disease was linked to a specific nutrient supplier that ultimately resulted in a voluntary feed recall; however, most cases in the current investigation were not associated with a particular feed company. The present report describes vitamin D-associated rickets and its importance as a potential cause of weakness, lameness, muscle fasciculations, recumbency or sudden unexpected death in swine, and describes appropriate samples and tests for disease diagnosis.

Renal manifestations of human brucellosis: First report of minimal change disease.

PubMed

Sabanis, Nikolaos; Gavriilaki, Eleni; Paschou, Eleni; Tsotsiou, Eleni; Kalaitzoglou, Asterios; Kavlakoudis, Christos; Vasileiou, Sotirios

2016-05-01

Human brucellosis is considered a great example of the complexity of clinical manifestations possibly affecting multiple organs or systems. Renal manifestations of human brucellosis have been documented in few case reports and one case series. Herein, we present a case of Nephrotic syndrome (NS) due to minimal change disease in the course of acute brucellosis. A 53-year-old male farmer was admitted to our department with acute brucellosis and NS. Renal biopsy revealed minimal change disease. Combined treatment with prednisone (1 mg/kg), rifampicin (600 mg/day), and doxycycline (200 mg/day) was initiated. Complete remission of NS was achieved at the end of the fourth week. One year later, the patient remained in complete remission of NS without any sign of relapse of brucellosis.

Design considerations for case series models with exposure onset measurement error.

PubMed

Mohammed, Sandra M; Dalrymple, Lorien S; Sentürk, Damla; Nguyen, Danh V

2013-02-28

The case series model allows for estimation of the relative incidence of events, such as cardiovascular events, within a pre-specified time window after an exposure, such as an infection. The method requires only cases (individuals with events) and controls for all fixed/time-invariant confounders. The measurement error case series model extends the original case series model to handle imperfect data, where the timing of an infection (exposure) is not known precisely. In this work, we propose a method for power/sample size determination for the measurement error case series model. Extensive simulation studies are used to assess the accuracy of the proposed sample size formulas. We also examine the magnitude of the relative loss of power due to exposure onset measurement error, compared with the ideal situation where the time of exposure is measured precisely. To facilitate the design of case series studies, we provide publicly available web-based tools for determining power/sample size for both the measurement error case series model as well as the standard case series model. Copyright © 2012 John Wiley & Sons, Ltd.

Implementation of collisions on GPU architecture in the Vorpal code

NASA Astrophysics Data System (ADS)

Leddy, Jarrod; Averkin, Sergey; Cowan, Ben; Sides, Scott; Werner, Greg; Cary, John

2017-10-01

The Vorpal code contains a variety of collision operators allowing for the simulation of plasmas containing multiple charge species interacting with neutrals, background gas, and EM fields. These existing algorithms have been improved and reimplemented to take advantage of the massive parallelization allowed by GPU architecture. The use of GPUs is most effective when algorithms are single-instruction multiple-data, so particle collisions are an ideal candidate for this parallelization technique due to their nature as a series of independent processes with the same underlying operation. This refactoring required data memory reorganization and careful consideration of device/host data allocation to minimize memory access and data communication per operation. Successful implementation has resulted in an order of magnitude increase in simulation speed for a test-case involving multiple binary collisions using the null collision method. Work supported by DARPA under contract W31P4Q-16-C-0009.

Human-Robot Teaming for Hydrologic Data Gathering at Multiple Scales

NASA Astrophysics Data System (ADS)

Peschel, J.; Young, S. N.

2017-12-01

The use of personal robot-assistive technology by researchers and practitioners for hydrologic data gathering has grown in recent years as barriers to platform capability, cost, and human-robot interaction have been overcome. One consequence to this growth is a broad availability of unmanned platforms that might or might not be suitable for a specific hydrologic investigation. Through multiple field studies, a set of recommendations has been developed to help guide novice through experienced users in choosing the appropriate unmanned platforms for a given application. This talk will present a series of hydrologic data sets gathered using a human-robot teaming approach that has leveraged unmanned aerial, ground, and surface vehicles over multiple scales. The field case studies discussed will be connected to the best practices, also provided in the presentation. This talk will be of interest to geoscience researchers and practitioners, in general, as well as those working in fields related to emerging technologies.

Achondroplasia with multiple-suture craniosynostosis: a report of a new case of this rare association.

PubMed

Bessenyei, Beáta; Nagy, Andrea; Balogh, Erzsébet; Novák, László; Bognár, László; Knegt, Alida C; Oláh, Eva

2013-10-01

We report on a female patient with an exceedingly rare combination of achondroplasia and multiple-suture craniosynostosis. Besides the specific features of achondroplasia, synostosis of the metopic, coronal, lambdoid, and squamosal sutures was found. Series of neurosurgical interventions were carried out, principally for acrocephaly and posterior plagiocephaly. The most common achondroplasia mutation, a p.Gly380Arg in the fibroblast growth factor receptor 3 (FGFR3) gene, was detected. Cytogenetic and array CGH analyses, as well as molecular genetic testing of FGFR1, 2, 3 and TWIST1 genes failed to identify any additional genetic alteration. It is suggested that this unusual phenotype is a result of variable expressivity of the common achondroplasia mutation. Copyright © 2013 Wiley Periodicals, Inc.

Acute monocytic leukemia and multiple abnormalities in a child with duplication of 1q detected by GTG-banding and SKY.

PubMed

Scrideli, Carlos A; Baruffi, Marcelo R; Squire, Jeremy A; Ramos, Ester S; Karaskova, Jana; Heck, Benjamin; Tone, Luiz G

2005-12-01

Patients with 1q duplication have demonstrated a wide range of multiple congenital abnormalities. Alterations involving this chromosomal region have being described in hematopoietic malignancies and a series of candidate genes that may be associated with neoplasias have been mapped in this region. We describe a case of partial trisomy 1q "syndrome" and acute monocytic leukemia. Cytogenetic study of the bone marrow cells by GTG-banding and spectral karyotyping (SKY) showed dup(1)(q23q44) in all cells analyzed. The dismorphological features with the dup(1q) suggest a constitutional chromosome alteration and the first, in our knowledge, association of a trisomy 1q "syndrome" with AML.

Maintenance electroconvulsive therapy for depression with catatonia in a young woman with Down syndrome.

PubMed

Torr, Jennifer; D'Abrera, Juan Carlos

2014-12-01

To describe and discuss the use of maintenance electroconvulsive therapy (ECT) in a young woman with Down syndrome and depression with catatonia. Clinical case report. A 23-year-old woman with Down syndrome (mosaic type) and a 4-year history of depressed mood triggered by adverse life events presented with mutism, psychomotor retardation, and compromised oral intake. Multiple trials of antidepressant medications were either ineffective or complicated by adverse reactions. She improved rapidly with a course of bilateral ECT but required maintenance ECT to sustain recovery. A series of premorbid, morbid, and post-treatment drawings by the young woman highlight the efficacy of treatment. Electroconvulsive therapy was found to be a safe and effective treatment for life-threatening mental illness in a young woman with Down syndrome who had failed multiple trials of antidepressant medications. This case highlights the importance of considering catatonia as a diagnosis in persons with Down syndrome and the effectiveness of electroconvulsive treatment.

Seat belt syndrome with unstable Chance fracture dislocation of the second lumbar vertebra without neurological deficits.

PubMed

Onu, David O; Hunn, Andrew W; Bohmer, Robert D

2014-01-08

The seat belt syndrome is a recognised complication of seat belt use in vehicles. Unstable Chance fractures of the spine without neurological deficits have been reported infrequently. We describe a young woman with completely disrupted Chance fracture of the second lumbar vertebra in association with left hemidiaphragmatic rupture/hernia, multiple bowel perforations, splenic capsular tear, left humeral shaft and multiple rib fractures. These injuries which resulted from high-speed vehicle collision and led to death of one of the occupants were readily detected by trauma series imaging. The patient was successfully treated by a dedicated multidisciplinary team which adopted a staged surgical approach and prioritisation of care. There were no manifested neurological or other deficits after 1 year of follow-up. To the authors' knowledge, this is the first report of such a case in Australasia. We discuss the challenging surgical management, highlighting the role of radiological imaging in such cases and provide a literature review.

Epidemiologic programs for computers and calculators. A microcomputer program for multiple logistic regression by unconditional and conditional maximum likelihood methods.

PubMed

Campos-Filho, N; Franco, E L

1989-02-01

A frequent procedure in matched case-control studies is to report results from the multivariate unmatched analyses if they do not differ substantially from the ones obtained after conditioning on the matching variables. Although conceptually simple, this rule requires that an extensive series of logistic regression models be evaluated by both the conditional and unconditional maximum likelihood methods. Most computer programs for logistic regression employ only one maximum likelihood method, which requires that the analyses be performed in separate steps. This paper describes a Pascal microcomputer (IBM PC) program that performs multiple logistic regression by both maximum likelihood estimation methods, which obviates the need for switching between programs to obtain relative risk estimates from both matched and unmatched analyses. The program calculates most standard statistics and allows factoring of categorical or continuous variables by two distinct methods of contrast. A built-in, descriptive statistics option allows the user to inspect the distribution of cases and controls across categories of any given variable.

Fitting Multimeric Protein Complexes into Electron Microscopy Maps Using 3D Zernike Descriptors

PubMed Central

Esquivel-Rodríguez, Juan; Kihara, Daisuke

2012-01-01

A novel computational method for fitting high-resolution structures of multiple proteins into a cryoelectron microscopy map is presented. The method named EMLZerD generates a pool of candidate multiple protein docking conformations of component proteins, which are later compared with a provided electron microscopy (EM) density map to select the ones that fit well into the EM map. The comparison of docking conformations and the EM map is performed using the 3D Zernike descriptor (3DZD), a mathematical series expansion of three-dimensional functions. The 3DZD provides a unified representation of the surface shape of multimeric protein complex models and EM maps, which allows a convenient, fast quantitative comparison of the three dimensional structural data. Out of 19 multimeric complexes tested, near native complex structures with a root mean square deviation of less than 2.5 Å were obtained for 14 cases while medium range resolution structures with correct topology were computed for the additional 5 cases. PMID:22417139

Fitting multimeric protein complexes into electron microscopy maps using 3D Zernike descriptors.

PubMed

Esquivel-Rodríguez, Juan; Kihara, Daisuke

2012-06-14

A novel computational method for fitting high-resolution structures of multiple proteins into a cryoelectron microscopy map is presented. The method named EMLZerD generates a pool of candidate multiple protein docking conformations of component proteins, which are later compared with a provided electron microscopy (EM) density map to select the ones that fit well into the EM map. The comparison of docking conformations and the EM map is performed using the 3D Zernike descriptor (3DZD), a mathematical series expansion of three-dimensional functions. The 3DZD provides a unified representation of the surface shape of multimeric protein complex models and EM maps, which allows a convenient, fast quantitative comparison of the three-dimensional structural data. Out of 19 multimeric complexes tested, near native complex structures with a root-mean-square deviation of less than 2.5 Å were obtained for 14 cases while medium range resolution structures with correct topology were computed for the additional 5 cases.

Boolean network identification from perturbation time series data combining dynamics abstraction and logic programming.

PubMed

Ostrowski, M; Paulevé, L; Schaub, T; Siegel, A; Guziolowski, C

2016-11-01

Boolean networks (and more general logic models) are useful frameworks to study signal transduction across multiple pathways. Logic models can be learned from a prior knowledge network structure and multiplex phosphoproteomics data. However, most efficient and scalable training methods focus on the comparison of two time-points and assume that the system has reached an early steady state. In this paper, we generalize such a learning procedure to take into account the time series traces of phosphoproteomics data in order to discriminate Boolean networks according to their transient dynamics. To that end, we identify a necessary condition that must be satisfied by the dynamics of a Boolean network to be consistent with a discretized time series trace. Based on this condition, we use Answer Set Programming to compute an over-approximation of the set of Boolean networks which fit best with experimental data and provide the corresponding encodings. Combined with model-checking approaches, we end up with a global learning algorithm. Our approach is able to learn logic models with a true positive rate higher than 78% in two case studies of mammalian signaling networks; for a larger case study, our method provides optimal answers after 7min of computation. We quantified the gain in our method predictions precision compared to learning approaches based on static data. Finally, as an application, our method proposes erroneous time-points in the time series data with respect to the optimal learned logic models. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Drug-induced Fanconi syndrome associated with fumaric acid esters treatment for psoriasis: a case series.

PubMed

Balak, Deepak M W; Bouwes Bavinck, Jan Nico; de Vries, Aiko P J; Hartman, Jenny; Neumann, Hendrik A Martino; Zietse, Robert; Thio, Hok Bing

2016-02-01

Fumaric acid esters (FAEs), an oral immunomodulating treatment for psoriasis and multiple sclerosis, have been anecdotally associated with proximal renal tubular dysfunction due to a drug-induced Fanconi syndrome. Few data are available on clinical outcomes of FAE-induced Fanconi syndrome. Descriptive case series with two cases of Fanconi syndrome associated with FAE treatment diagnosed at two Dutch university nephrology departments, three cases reported at the Dutch and German national pharmacovigilance databases and six previously reported cases. All 11 cases involved female patients with psoriasis. The median age at the time of onset was 38 years [interquartile range (IQR) 37-46]. Patients received long-term FAEs treatment with a median treatment duration of 60 months (IQR 28-111). Laboratory tests were typically significant for low serum levels of phosphate and uric acid, while urinalysis showed glycosuria and proteinuria. Eight (73%) patients had developed a hypophosphataemic osteomalacia and three (27%) had pathological bone fractures. All patients discontinued FAEs, while four (36%) patients were treated with supplementation of phosphate and/or vitamin D. Five (45%) patients had persisting symptoms despite FAEs discontinuation. FAEs treatment can cause drug-induced Fanconi syndrome, but the association has been reported infrequently. Female patients with psoriasis treated long term with FAEs seem to be particularly at risk. Physicians treating patients with FAEs should be vigilant and monitor for the potential occurrence of Fanconi syndrome. Measurement of the urinary albumin:total protein ratio is a suggested screening tool for tubular proteinuria in Fanconi syndrome.

Compression based entropy estimation of heart rate variability on multiple time scales.

PubMed

Baumert, Mathias; Voss, Andreas; Javorka, Michal

2013-01-01

Heart rate fluctuates beat by beat in a complex manner. The aim of this study was to develop a framework for entropy assessment of heart rate fluctuations on multiple time scales. We employed the Lempel-Ziv algorithm for lossless data compression to investigate the compressibility of RR interval time series on different time scales, using a coarse-graining procedure. We estimated the entropy of RR interval time series of 20 young and 20 old subjects and also investigated the compressibility of randomly shuffled surrogate RR time series. The original RR time series displayed significantly smaller compression entropy values than randomized RR interval data. The RR interval time series of older subjects showed significantly different entropy characteristics over multiple time scales than those of younger subjects. In conclusion, data compression may be useful approach for multiscale entropy assessment of heart rate variability.

Multiple Gingival Recession Coverage Treated with Vestibular Incision Subperiosteal Tunnel Access Approach with or without Platelet-Rich Fibrin - A Case Series

PubMed Central

Garg, Surbhi; Arora, Sachit Anand; Chhina, Shivjot; Singh, Padam

2017-01-01

Background: Gingival recession involves both soft tissue and hard tissue loss. In this evolutionary era of dentistry, newer techniques have evolved for complete coverage of isolated recession defects. Since 2012, vestibular incision subperiosteal tunnel access (VISTA) technique was used with various regenerative membranes to treat multiple recession defects (MRDs). Platelet-rich fibrin (PRF) membrane, a pool of growth factors but have any added advantage to recession coverage techniques is controversial. Thus, in this case series, we compare the effect of VISTA with or without PRF-membrane for the treatment of Classes I and III MRDs. Subjects and Methods: Four patients between of age 30 and 40 years (two patients having bilateral Class I and another two having bilateral Class III MRDs) were selected from the Department of Periodontics, ITS Dental College, Greater Noida and designated as Case I–IV simultaneously. Recession defects at antagonist sites in each patient were corrected by VISTA approach with or without PRF-membrane. Recorded clinical parameters included recession depth, recession width, pocket probing depth, and clinical attachment level (CAL) at baseline and 6 months postoperatively. Results: Patients having Class I recession defects showed almost complete root coverage with VISTA technique alone and reflected no added advantage of PRF-membrane. However, patients with Class III recession defects treated with VISTA + PRF-membrane showed more reduction in recession depth and gain in CAL as compared to sites treated with VISTA only. Conclusion: VISTA alone is a convenient technique for treatment of Class I MRDs. Addition of PRF-membrane for Class III recession defects give better outcome in term of reduction of recession depth and gain in CAL 6 month postoperatively. PMID:29042736

Testing and analysis of flat and curved panels with multiple cracks

DOT National Transportation Integrated Search

1994-08-01

An experimental and analytical investigation of multiple cracking in various types of test specimens is described in this paper. The testing phase is comprised of a flat unstiffened panel series and curved stiffened and unstiffened panel series. The ...

A multi-tiered time-series modelling approach to forecasting respiratory syncytial virus incidence at the local level.

PubMed

Spaeder, M C; Fackler, J C

2012-04-01

Respiratory syncytial virus (RSV) is the most common cause of documented viral respiratory infections, and the leading cause of hospitalization, in young children. We performed a retrospective time-series analysis of all patients aged <18 years with laboratory-confirmed RSV within a network of multiple affiliated academic medical institutions. Forecasting models of weekly RSV incidence for the local community, inpatient paediatric hospital and paediatric intensive-care unit (PICU) were created. Ninety-five percent confidence intervals calculated around our models' 2-week forecasts were accurate to ±9·3, ±7·5 and ±1·5 cases/week for the local community, inpatient hospital and PICU, respectively. Our results suggest that time-series models may be useful tools in forecasting the burden of RSV infection at the local and institutional levels, helping communities and institutions to optimize distribution of resources based on the changing burden and severity of illness in their respective communities.

Phocomelia: a worldwide descriptive epidemiologic study in a large series of cases from the International Clearinghouse for Birth Defects Surveillance and Research, and overview of the literature.

PubMed

Bermejo-Sánchez, Eva; Cuevas, Lourdes; Amar, Emmanuelle; Bianca, Sebastiano; Bianchi, Fabrizio; Botto, Lorenzo D; Canfield, Mark A; Castilla, Eduardo E; Clementi, Maurizio; Cocchi, Guido; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R Brian; Mastroiacovo, Pierpaolo; Mutchinick, Osvaldo M; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Siffel, Csaba; Szabova, Elena; Martínez-Frías, María-Luisa

2011-11-15

Epidemiologic data on phocomelia are scarce. This study presents an epidemiologic analysis of the largest series of phocomelia cases known to date. Data were provided by 19 birth defect surveillance programs, all members of the International Clearinghouse for Birth Defects Surveillance and Research. Depending on the program, data corresponded to a period from 1968 through 2006. A total of 22,740,933 live births, stillbirths and, for some programs, elective terminations of pregnancy for fetal anomaly (ETOPFA) were monitored. After a detailed review of clinical data, only true phocomelia cases were included. Descriptive data are presented and additional analyses compared isolated cases with those with multiple congenital anomalies (MCA), excluding syndromes. We also briefly compared congenital anomalies associated with nonsyndromic phocomelia with those presented with amelia, another rare severe congenital limb defect. A total of 141 phocomelia cases registered gave an overall total prevalence of 0.62 per 100,000 births (95% confidence interval: 0.52-0.73). Three programs (Australia Victoria, South America ECLAMC, Italy North East) had significantly different prevalence estimates. Most cases (53.2%) had isolated phocomelia, while 9.9% had syndromes. Most nonsyndromic cases were monomelic (55.9%), with an excess of left (64.9%) and upper limb (64.9%) involvement. Most nonsyndromic cases (66.9%) were live births; most isolated cases (57.9%) weighed more than 2,499 g; most MCA (60.7%) weighed less than 2,500 g, and were more likely stillbirths (30.8%) or ETOPFA (15.4%) than isolated cases. The most common associated defects were musculoskeletal, cardiac, and intestinal. Epidemiological differences between phocomelia and amelia highlighted possible differences in their causes. Copyright © 2011 Wiley Periodicals, Inc.

Phocomelia: A Worldwide Descriptive Epidemiologic Study in a Large Series of Cases From the International Clearinghouse for Birth Defects Surveillance and Research, and Overview of the Literature

PubMed Central

Bermejo-Sánchez, Eva; Cuevas, Lourdes; Amar, Emmanuelle; Bianca, Sebastiano; Bianchi, Fabrizio; Botto, Lorenzo D.; Canfield, Mark A.; Castilla, Eduardo E.; Clementi, Maurizio; Cocchi, Guido; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R. Brian; Mastroiacovo, Pierpaolo; Mutchinick, Osvaldo M.; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Siffel, Csaba; Szabova, Elena; Martínez-Frías, María-Luisa

2015-01-01

Epidemiologic data on phocomelia are scarce. This study presents an epidemiologic analysis of the largest series of phocomelia cases known to date. Data were provided by 19 birth defect surveillance programs, all members of the International Clearinghouse for Birth Defects Surveillance and Research. Depending on the program, data corresponded to a period from 1968 through 2006. A total of 22,740,933 live births, stillbirths and, for some programs, elective terminations of pregnancy for fetal anomaly (ETOPFA) were monitored. After a detailed review of clinical data, only true phocomelia cases were included. Descriptive data are presented and additional analyses compared isolated cases with those with multiple congenital anomalies (MCA), excluding syndromes. We also briefly compared congenital anomalies associated with nonsyndromic phocomelia with those presented with amelia, another rare severe congenital limb defect. A total of 141 phocomelia cases registered gave an overall total prevalence of 0.62 per 100,000 births (95% confidence interval: 0.52–0.73). Three programs (Australia Victoria, South America ECLAMC, Italy North East) had significantly different prevalence estimates. Most cases (53.2%) had isolated phocomelia, while 9.9% had syndromes. Most nonsyndromic cases were monomelic (55.9%), with an excess of left (64.9%) and upper limb (64.9%) involvement. Most nonsyndromic cases (66.9%) were live births; most isolated cases (57.9%) weighed more than 2,499 g; most MCA (60.7%) weighed less than 2,500 g, and were more likely stillbirths (30.8%) or ETOPFA (15.4%) than isolated cases. The most common associated defects were musculoskeletal, cardiac, and intestinal. Epidemiological differences between phocomelia and amelia highlighted possible differences in their causes. PMID:22002800

Power Laws, Scale Invariance and the Generalized Frobenius Series:

NASA Astrophysics Data System (ADS)

Visser, Matt; Yunes, Nicolas

We present a self-contained formalism for calculating the background solution, the linearized solutions and a class of generalized Frobenius-like solutions to a system of scale-invariant differential equations. We first cast the scale-invariant model into its equidimensional and autonomous forms, find its fixed points, and then obtain power-law background solutions. After linearizing about these fixed points, we find a second linearized solution, which provides a distinct collection of power laws characterizing the deviations from the fixed point. We prove that generically there will be a region surrounding the fixed point in which the complete general solution can be represented as a generalized Frobenius-like power series with exponents that are integer multiples of the exponents arising in the linearized problem. While discussions of the linearized system are common, and one can often find a discussion of power-series with integer exponents, power series with irrational (indeed complex) exponents are much rarer in the extant literature. The Frobenius-like series we encounter can be viewed as a variant of the rarely-discussed Liapunov expansion theorem (not to be confused with the more commonly encountered Liapunov functions and Liapunov exponents). As specific examples we apply these ideas to Newtonian and relativistic isothermal stars and construct two separate power series with the overlapping radius of convergence. The second of these power series solutions represents an expansion around "spatial infinity," and in realistic models it is this second power series that gives information about the stellar core, and the damped oscillations in core mass and core radius as the central pressure goes to infinity. The power-series solutions we obtain extend classical results; as exemplified for instance by the work of Lane, Emden, and Chandrasekhar in the Newtonian case, and that of Harrison, Thorne, Wakano, and Wheeler in the relativistic case. We also indicate how to extend these ideas to situations where fixed points may not exist — either due to "monotone" flow or due to the presence of limit cycles. Monotone flow generically leads to logarithmic deviations from scaling, while limit cycles generally lead to discrete self-similar solutions.

An experimental investigation of the flow physics of high-lift systems

NASA Technical Reports Server (NTRS)

Thomas, Flint O.; Nelson, R. C.

1995-01-01

This progress report is a series of overviews outlining experiments on the flow physics of confluent boundary layers for high-lift systems. The research objectives include establishing the role of confluent boundary layer flow physics in high-lift production; contrasting confluent boundary layer structures for optimum and non-optimum C(sub L) cases; forming a high quality, detailed archival data base for CFD/modelling; and examining the role of relaminarization and streamline curvature. Goals of this research include completing LDV study of an optimum C(sub L) case; performing detailed LDV confluent boundary layer surveys for multiple non-optimum C(sub L) cases; obtaining skin friction distributions for both optimum and non-optimum C(sub L) cases for scaling purposes; data analysis and inner and outer variable scaling; setting-up and performing relaminarization experiments; and a final report establishing the role of leading edge confluent boundary layer flow physics on high-lift performance.

Modular, multi-level groundwater sampler

DOEpatents

Nichols, Ralph L.; Widdowson, Mark A.; Mullinex, Harry; Orne, William H.; Looney, Brian B.

1994-01-01

Apparatus for taking a multiple of samples of groundwater or pressure measurements from a well simultaneously. The apparatus comprises a series of chambers arranged in an axial array, each of which is dimensioned to fit into a perforated well casing and leave a small gap between the well casing and the exterior of the chamber. Seals at each end of the container define the limits to the axial portion of the well to be sampled. A submersible pump in each chamber pumps the groundwater that passes through the well casing perforations into the gap from the gap to the surface for analysis. The power lines and hoses for the chambers farther down the array pass through each chamber above them in the array. The seals are solid, water-proof, non-reactive, resilient disks supported to engage the inside surface of the well casing. Because of the modular design, the apparatus provides flexibility for use in a variety of well configurations.

Narcolepsy in pediatric age – Experience of a tertiary pediatric hospital

PubMed Central

Dias Costa, Filipa; Barreto, Maria Inês; Clemente, Vanda; Vasconcelos, Mónica; Estêvão, Maria Helena; Madureira, Núria

2014-01-01

Narcolepsy, a chronic disorder of the sleep–wake cycle of multifactorial etiology, is characterized by excessive daytime sleepiness, often associated with cataplexy, hypnagogic/hypnopompic hallucinations and sleep paralysis. Both early clinical suspicion and therapeutic approach are essential for promotion of cognitive development and social integration of these children. The authors present a descriptive retrospective study of a series of eight children in whom symptoms first started between 6.8 and 10.5 years of age. Diagnostic delay ranged from 4 months to 2 years. One child had H1N1 flu vaccination eight months before the clinical onset. The first multiple sleep latency test was positive in 6 of 8 cases. All cases were treated with methylphenidate, and venlafaxine was associated in 4 of them. In one case the initial therapy was exclusively behavioral. In all cases, symptomatic improvement, better school performance and social integration were achieved after therapeutic adjustment. PMID:26483902

Usefulness of Novel Immunotherapeutic Strategies for Idiopathic Recurrent Pericarditis.

PubMed

Lotan, Dor; Wasserstrum, Yishay; Fardman, Alexander; Kogan, Michael; Adler, Yehuda

2016-03-01

Idiopathic recurrent pericarditis (IRP) is a debilitating illness which leads to great suffering and multiple hospitalizations. Management of acute pericarditis and subsequent recurrences has evolved significantly as the use of colchicine-based strategies become more prevalent, yet there still remains a subset of patients who remain refractory to colchicine therapy, and these patients require prolonged corticosteroid (CS) therapy for the control of symptoms. Since the 1960s, there have been reports of successful management of these cases with immunosuppressive therapy. Current guidelines support the use of anakinra, intravenous immunoglobulins, and azathioprine for management of IRP, with the goals of both control of symptoms and withdrawal of CS. Recent reports supply evidence for both auto-inflammatory and autoimmune activity in these patients. We herein review the current available reports regarding the evidence regarding the pathophysiology and reported cases and case series of IRP cases managed with immunomodulation therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

Stellate ganglion block used to treat symptoms associated with combat-related post-traumatic stress disorder: a case series of 166 patients.

PubMed

Mulvaney, Sean W; Lynch, James H; Hickey, Matthew J; Rahman-Rawlins, Tabassum; Schroeder, Matthew; Kane, Shawn; Lipov, Eugene

2014-10-01

Report the successful use of stellate ganglion blocks (SGBs) in 166 active duty service members with multiple combat deployments experiencing anxiety symptoms associated with post-traumatic stress disorder (PTSD). Successful treatment of PTSD symptoms with SGB has been reported previously. This is the largest published case series evaluating SGB with a minimum of 3 months follow-up. Following clinical interview including administration of the PTSD Checklist (PCL), 166 service members with symptoms of PTSD elected to receive a SGB. All patients received a SGB on the right side at the level of the sixth cervical vertebrae (C6). The PCL was administered the day before treatment to establish a baseline, repeated 1 week later, and then monthly out to 3 months. A positive response was considered to be an improvement in the PCL score by 10 or greater points. Follow-up PCL scores from 3 to 6 months were obtained and analyzed for 166 patients. In a military population with multiple combat deployments, over 70% of the patients treated had a clinically significant improvement in their PCL score which persisted beyond 3 to 6 months postprocedure. Selective blockade of the right cervical sympathetic chain at the C6 level is a safe and minimally invasive procedure that may provide durable relief from anxiety symptoms associated with PTSD. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Internal Snapping Hip Syndrome: Incidence of Multiple-Tendon Existence and Outcome After Endoscopic Transcapsular Release.

PubMed

Ilizaliturri, Victor M; Suarez-Ahedo, Carlos; Acuña, Marco

2015-10-01

To report the frequency of presentation of bifid or multiple iliopsoas tendons in patients who underwent endoscopic release for internal snapping hip syndrome (ISHS) and to compare both groups. A consecutive series of patients with ISHS were treated with endoscopic transcapsular release of the iliopsoas tendon at the central compartment and prospectively followed up. The inclusion criteria were patients with a diagnosis of ISHS with failure of conservative treatment. During the procedure, the presence of a bifid tendon was intentionally looked for. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated preoperatively and at last follow-up. Four patients presented with a bifid tendon and one patient had 3 tendons. At a minimum of 12 months' follow-up, the presence of snapping recurrence was evaluated and the WOMAC scores were compared between both groups. Among 279 hip arthroscopies, 28 patients underwent central transcapsular iliopsoas tendon release. The mean age was 29.25 years (range, 16 to 65 years; 6 left and 22 right hips). Group 1 included 5 patients with multiple tendons; the remaining patients formed group 2 (n = 23). None of the patients presented with ISHS recurrence. The mean WOMAC score in group 1 was 39 points (95% confidence interval [CI], 26.2 to 55.4 points) preoperatively and 73.6 points (95% CI, 68.4 to 79.6 points) at last follow-up. In group 2 the mean WOMAC score was 47.21 points (95% CI, 44.4 to 58.2 points) preoperatively and 77.91 points (95% CI, 67.8 to 83.4 points) at last follow-up. We identified a bifid tendon retrospectively on magnetic resonance arthrograms in 3 of the 5 cases that were found to have multiple tendons during surgery. None of these were recognized before the procedures. In this series the surgeon intentionally looked for multiple tendons, which were found in 17.85% of the cases. Clinical results in patients with single- and multiple-tendon snapping seem to be similarly adequate. However, the possibility of a type II error should be considered given the small number of patients. Level IV. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Development of temporal modelling for forecasting and prediction of malaria infections using time-series and ARIMAX analyses: A case study in endemic districts of Bhutan

PubMed Central

2010-01-01

Background Malaria still remains a public health problem in some districts of Bhutan despite marked reduction of cases in last few years. To strengthen the country's prevention and control measures, this study was carried out to develop forecasting and prediction models of malaria incidence in the endemic districts of Bhutan using time series and ARIMAX. Methods This study was carried out retrospectively using the monthly reported malaria cases from the health centres to Vector-borne Disease Control Programme (VDCP) and the meteorological data from Meteorological Unit, Department of Energy, Ministry of Economic Affairs. Time series analysis was performed on monthly malaria cases, from 1994 to 2008, in seven malaria endemic districts. The time series models derived from a multiplicative seasonal autoregressive integrated moving average (ARIMA) was deployed to identify the best model using data from 1994 to 2006. The best-fit model was selected for each individual district and for the overall endemic area was developed and the monthly cases from January to December 2009 and 2010 were forecasted. In developing the prediction model, the monthly reported malaria cases and the meteorological factors from 1996 to 2008 of the seven districts were analysed. The method of ARIMAX modelling was employed to determine predictors of malaria of the subsequent month. Results It was found that the ARIMA (p, d, q) (P, D, Q)s model (p and P representing the auto regressive and seasonal autoregressive; d and D representing the non-seasonal differences and seasonal differencing; and q and Q the moving average parameters and seasonal moving average parameters, respectively and s representing the length of the seasonal period) for the overall endemic districts was (2,1,1)(0,1,1)12; the modelling data from each district revealed two most common ARIMA models including (2,1,1)(0,1,1)12 and (1,1,1)(0,1,1)12. The forecasted monthly malaria cases from January to December 2009 and 2010 varied from 15 to 82 cases in 2009 and 67 to 149 cases in 2010, where population in 2009 was 285,375 and the expected population of 2010 to be 289,085. The ARIMAX model of monthly cases and climatic factors showed considerable variations among the different districts. In general, the mean maximum temperature lagged at one month was a strong positive predictor of an increased malaria cases for four districts. The monthly number of cases of the previous month was also a significant predictor in one district, whereas no variable could predict malaria cases for two districts. Conclusions The ARIMA models of time-series analysis were useful in forecasting the number of cases in the endemic areas of Bhutan. There was no consistency in the predictors of malaria cases when using ARIMAX model with selected lag times and climatic predictors. The ARIMA forecasting models could be employed for planning and managing malaria prevention and control programme in Bhutan. PMID:20813066

Geochemistry of lavas from Taal volcano, southwestern Luzon, Philippines: evidence for multiple magma supply systems and mantle source heterogeneity

USGS Publications Warehouse

Miklius, Asta; Flower, M.F.J.; Huijsmans, J.P.P.; Mukasa, S.B.; Castillo, P.

1991-01-01

Taal lava series can be distinguished from each other by differences in major and trace element trends and trace element ratios, indicating multiple magmatic systems associated with discrete centers in time and space. On Volcano Island, contemporaneous lava series range from typically calc-alkaline to iron-enriched. Major and trace element variation in these series can be modelled by fractionation of similar assemblages, with early fractionation of titano-magnetite in less iron-enriched series. However, phase compositional and petrographic evidence of mineral-liquid disequilibrium suggests that magma mixing played an important role in the evolution of these series. -from Authors

Bleeding and infection with external ventricular drainage: a systematic review in comparison with adjudicated adverse events in the ongoing Clot Lysis Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III (CLEAR-III IHV) trial.

PubMed

Dey, Mahua; Stadnik, Agnieszka; Riad, Fady; Zhang, Lingjiao; McBee, Nichol; Kase, Carlos; Carhuapoma, J Ricardo; Ram, Malathi; Lane, Karen; Ostapkovich, Noeleen; Aldrich, Francois; Aldrich, Charlene; Jallo, Jack; Butcher, Ken; Snider, Ryan; Hanley, Daniel; Ziai, Wendy; Awad, Issam A

2015-03-01

Retrospective series report varied rates of bleeding and infection with external ventricular drainage (EVD). There have been no prospective studies of these risks with systematic surveillance, threshold definitions, or independent adjudication. To analyze the rate of complications in the ongoing Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III (CLEAR III) trial, providing a comparison with a systematic review of complications of EVD in the literature. Patients were prospectively enrolled in the CLEAR III trial after placement of an EVD for obstructive intraventricular hemorrhage and randomized to receive recombinant tissue-type plasminogen activator or placebo. We counted any detected new hemorrhage (catheter tract hemorrhage or any other distant hemorrhage) on computed tomography scan within 30 days from the randomization. Meta-analysis of published series of EVD placement was compiled with STATA software. Growing or unstable hemorrhage was reported as a cause of exclusion from the trial in 74 of 5707 cases (1.3%) screened for CLEAR III. The first 250 patients enrolled have completed adjudication of adverse events. Forty-two subjects (16.8%) experienced ≥1 new bleeds or expansions, and 6 of 250 subjects (2.4%) suffered symptomatic hemorrhages. Eleven cases (4.4%) had culture-proven bacterial meningitis or ventriculitis. Risks of bleeding and infection in the ongoing CLEAR III trial are comparable to those previously reported in EVD case series. In the present study, rates of new bleeds and bacterial meningitis/ventriculitis are very low despite multiple daily injections, blood in the ventricles, the use of thrombolysis in half the cases, and generalization to >60 trial sites.

Unraveling multiple changes in complex climate time series using Bayesian inference

NASA Astrophysics Data System (ADS)

Berner, Nadine; Trauth, Martin H.; Holschneider, Matthias

2016-04-01

Change points in time series are perceived as heterogeneities in the statistical or dynamical characteristics of observations. Unraveling such transitions yields essential information for the understanding of the observed system. The precise detection and basic characterization of underlying changes is therefore of particular importance in environmental sciences. We present a kernel-based Bayesian inference approach to investigate direct as well as indirect climate observations for multiple generic transition events. In order to develop a diagnostic approach designed to capture a variety of natural processes, the basic statistical features of central tendency and dispersion are used to locally approximate a complex time series by a generic transition model. A Bayesian inversion approach is developed to robustly infer on the location and the generic patterns of such a transition. To systematically investigate time series for multiple changes occurring at different temporal scales, the Bayesian inversion is extended to a kernel-based inference approach. By introducing basic kernel measures, the kernel inference results are composed into a proxy probability to a posterior distribution of multiple transitions. Thus, based on a generic transition model a probability expression is derived that is capable to indicate multiple changes within a complex time series. We discuss the method's performance by investigating direct and indirect climate observations. The approach is applied to environmental time series (about 100 a), from the weather station in Tuscaloosa, Alabama, and confirms documented instrumentation changes. Moreover, the approach is used to investigate a set of complex terrigenous dust records from the ODP sites 659, 721/722 and 967 interpreted as climate indicators of the African region of the Plio-Pleistocene period (about 5 Ma). The detailed inference unravels multiple transitions underlying the indirect climate observations coinciding with established global climate events.

Long-lasting behavioral effects in neonatal mice with multiple exposures to ketamine-xylazine anesthesia

PubMed Central

Huang, Lianyan; Hayes, Scott; Yang, Guang

2016-01-01

Anesthetic agents are often administered in the neonatal period, a time of rapid brain development and synaptogenesis. Mounting evidence suggests that anesthetics can disrupt neurocognitive development, particularly in cases of multiple or prolonged anesthetic exposure. Previous studies have shown that administering multiple doses of ketamine-xylazine (KX) anesthesia to neonatal mice can induce long-term changes to synaptic plasticity in the cortex, but the effect on neurocognitive function remains unclear. In this study, we exposed neonatal mice to single dose and multiple doses of KX anesthesia in the neonatal period (postnatal days 7, 9, 11), and conducted a series of behavioral tests in young adulthood (1 month of age). Mice receiving multiple doses of KX anesthesia showed deficits in novel object recognition, sociability, preference for social novelty and contextual fear response, but no effect on auditory-cued fear response. Single dose of KX anesthesia had no effect on these behaviors except for contextual fear response. We also observed that multiple exposures to KX anesthesia were associated with decreased CaMKII phosphorylation, which is known to play a role in synapse development and long-term potentiation, likely contributing to learning impairment. PMID:27622724

Generalizing DTW to the multi-dimensional case requires an adaptive approach

PubMed Central

Hu, Bing; Jin, Hongxia; Wang, Jun; Keogh, Eamonn

2017-01-01

In recent years Dynamic Time Warping (DTW) has emerged as the distance measure of choice for virtually all time series data mining applications. For example, virtually all applications that process data from wearable devices use DTW as a core sub-routine. This is the result of significant progress in improving DTW’s efficiency, together with multiple empirical studies showing that DTW-based classifiers at least equal (and generally surpass) the accuracy of all their rivals across dozens of datasets. Thus far, most of the research has considered only the one-dimensional case, with practitioners generalizing to the multi-dimensional case in one of two ways, dependent or independent warping. In general, it appears the community believes either that the two ways are equivalent, or that the choice is irrelevant. In this work, we show that this is not the case. The two most commonly used multi-dimensional DTW methods can produce different classifications, and neither one dominates over the other. This seems to suggest that one should learn the best method for a particular application. However, we will show that this is not necessary; a simple, principled rule can be used on a case-by-case basis to predict which of the two methods we should trust at the time of classification. Our method allows us to ensure that classification results are at least as accurate as the better of the two rival methods, and, in many cases, our method is significantly more accurate. We demonstrate our ideas with the most extensive set of multi-dimensional time series classification experiments ever attempted. PMID:29104448

Applications of time-series analysis to mood fluctuations in bipolar disorder to promote treatment innovation: a case series.

PubMed

Holmes, E A; Bonsall, M B; Hales, S A; Mitchell, H; Renner, F; Blackwell, S E; Watson, P; Goodwin, G M; Di Simplicio, M

2016-01-26

Treatment innovation for bipolar disorder has been hampered by a lack of techniques to capture a hallmark symptom: ongoing mood instability. Mood swings persist during remission from acute mood episodes and impair daily functioning. The last significant treatment advance remains Lithium (in the 1970s), which aids only the minority of patients. There is no accepted way to establish proof of concept for a new mood-stabilizing treatment. We suggest that combining insights from mood measurement with applied mathematics may provide a step change: repeated daily mood measurement (depression) over a short time frame (1 month) can create individual bipolar mood instability profiles. A time-series approach allows comparison of mood instability pre- and post-treatment. We test a new imagery-focused cognitive therapy treatment approach (MAPP; Mood Action Psychology Programme) targeting a driver of mood instability, and apply these measurement methods in a non-concurrent multiple baseline design case series of 14 patients with bipolar disorder. Weekly mood monitoring and treatment target data improved for the whole sample combined. Time-series analyses of daily mood data, sampled remotely (mobile phone/Internet) for 28 days pre- and post-treatment, demonstrated improvements in individuals' mood stability for 11 of 14 patients. Thus the findings offer preliminary support for a new imagery-focused treatment approach. They also indicate a step in treatment innovation without the requirement for trials in illness episodes or relapse prevention. Importantly, daily measurement offers a description of mood instability at the individual patient level in a clinically meaningful time frame. This costly, chronic and disabling mental illness demands innovation in both treatment approaches (whether pharmacological or psychological) and measurement tool: this work indicates that daily measurements can be used to detect improvement in individual mood stability for treatment innovation (MAPP).

Resident Perspectives of an Interactive Case Review Following Independent Didactic Study as a Method of Teaching a Pediatric Imaging Curriculum.

PubMed

Rozenberg, Aleksandr; Dheer, Sachin; Nazarian, Levon N; Long, Suzanne S

The ABR has recently changed the format of the board examination, in which the oral examination was replaced by a computer based multiple-choice test. The purpose of this study was to determine resident's perceptions of a new conference resembling the new ABR format. Residents were requested to review a series of didactic pediatric imaging presentations prior to attending case conference. During conference, unknown cases reflecting the subject matter from the didactic presentations were presented along with multiple-choice questions. We then surveyed resident perspectives after each case conference. Between 14 and 18 residents were surveyed at the end of each subspecialty case review presentation. About 94% of resident respondents felt that the independent didactic study followed by an interactive case review session would better prepare them for the ABR certification exams, compared to didactic lectures alone. Furthermore, 95% of the respondents indicated that they preferred the independent didactic review followed by interactive case review versus didactic lecture alone. Most the respondents (85%) felt that combining independent didactic review with interactive unknown case sessions made the material more interesting and provided greater understanding of the material. There was no statistically significant difference in the distribution of answers across the subspecialty sessions (p > .05). Radiology residents favorably reviewed the combination of independent review of didactic material prior to interactive case review. Material presented in this fashion is felt to be more interesting and is thought to result in enhanced understanding of pediatric radiology material. Copyright © 2017 Elsevier Inc. All rights reserved.

The Validity of the Comparative Interrupted Time Series Design for Evaluating the Effect of School-Level Interventions.

PubMed

Jacob, Robin; Somers, Marie-Andree; Zhu, Pei; Bloom, Howard

2016-06-01

In this article, we examine whether a well-executed comparative interrupted time series (CITS) design can produce valid inferences about the effectiveness of a school-level intervention. This article also explores the trade-off between bias reduction and precision loss across different methods of selecting comparison groups for the CITS design and assesses whether choosing matched comparison schools based only on preintervention test scores is sufficient to produce internally valid impact estimates. We conduct a validation study of the CITS design based on the federal Reading First program as implemented in one state using results from a regression discontinuity design as a causal benchmark. Our results contribute to the growing base of evidence regarding the validity of nonexperimental designs. We demonstrate that the CITS design can, in our example, produce internally valid estimates of program impacts when multiple years of preintervention outcome data (test scores in the present case) are available and when a set of reasonable criteria are used to select comparison organizations (schools in the present case). © The Author(s) 2016.

Optical Variability Signatures from Massive Black Hole Binaries

NASA Astrophysics Data System (ADS)

Kasliwal, Vishal P.; Frank, Koby Alexander; Lidz, Adam

2017-01-01

The hierarchical merging of dark matter halos and their associated galaxies should lead to a population of supermassive black hole binaries (MBHBs). We consider plausible optical variability signatures from MBHBs at sub-parsec separations and search for these using data from the Catalina Real-Time Transient Survey (CRTS). Specifically, we model the impact of relativistic Doppler beaming on the accretion disk emission from the less massive, secondary black hole. We explore whether this Doppler modulation may be separated from other sources of stochastic variability in the accretion flow around the MBHBs, which we describe as a damped random walk (DRW). In the simple case of a circular orbit, relativistic beaming leads to a series of broad peaks — located at multiples of the orbital frequency — in the fluctuation power spectrum. We extend our analysis to the case of elliptical orbits and discuss the effect of beaming on the flux power spectrum and auto-correlation function using simulations. We present a code to model an observed light curve as a stochastic DRW-type time series modulated by relativistic beaming and apply the code to CRTS data.

Symptomatic thoracic spinal cord herniation: case series and technical report.

PubMed

Hawasli, Ammar H; Ray, Wilson Z; Wright, Neill M

2014-09-01

Idiopathic spinal cord herniation (ISCH) is an uncommon condition located predominantly in the thoracic spine and often associated with a remote history of a major traumatic injury. ISCH has an incompletely described presentation and unknown etiology. There is no consensus on the treatment algorithm and surgical technique, and there are few data on clinical outcomes. In this case series and technical report, we describe the atypical myelopathy presentation, remote history of traumatic injury, radiographic progression, treatment, and outcomes of 5 patients treated at Washington University for symptomatic ISCH. A video showing surgical repair is presented. In contrast to classic compressive myelopathy symptomatology, ISCH patients presented with an atypical myelopathy, characterized by asymmetric motor and sensory deficits and early-onset urinary incontinence. Clinical deterioration correlated with progressive spinal cord displacement and herniation observed on yearly spinal imaging in a patient imaged serially because of multiple sclerosis. Finally, compared with compressive myelopathy in the thoracic spine, surgical treatment of ISCH led to rapid improvement despite a long duration of symptoms. Symptomatic ISCH presents with atypical myelopathy and slow temporal progression and can be successfully managed with surgical repair.

The treatment of chronic post-traumatic nightmares using psychodynamic-interpersonal psychotherapy: a single-case study.

PubMed

Kellett, S; Beail, N

1997-03-01

This article presents a single-case experimental study of a woman suffering a traumatized reaction to a road traffic accident (RTA). In addition to meeting the DSM-IV (APA, 1994) criteria for the diagnosis of PTSD, the client suffered recurrent bizarre nightmares. The client reported at assessment, that each night her dreams were dominated by a terrifying hooded cloaked faceless figure. The central aim of the study therefore was to assess the efficacy of a psychodynamic-interpersonal (PI) style psychotherapy in the context of an unusual PTSD reaction. The methodology employed an A/B multiple baseline time series design, with six month follow-up. A and B represent a series of dream diary observations under two conditions: assessment/baseline (A) and treatment/intervention (B). Treatment consisted of a manualized psychodynamic-interpersonal (PI) psychotherapy to facilitate insight into the content and meaning of the nightmares. The intervention reduced the frequency and associated distress of the nightmares to zero. Follow-up at six months noted the long-term efficacy of the psychotherapy. The study is discussed with reference to the assimilation model of psychotherapeutic change.

Out-of-hospital and emergency department management of epidemic scombroid poisoning.

PubMed

Eckstein, M; Serna, M; DelaCruz, P; Mallon, W K

1999-09-01

To report two epidemic outbreaks of scombroid food poisoning and their emergency medical services (EMS) response and emergency department (ED) treatment, analyzing the impact of early physician involvement and on-line medical control. Retrospective case series of two multiple-casualty incidents (MCIs) involving scombroid food poisoning. A total 57 patients were treated from two separate incidents, with 30 patients transported to area hospitals. One patient required treatment with a cardiac medication in the field and another patient eventually required hospital admission. On-scene medical control (incident 1) and early identification of the index case (incident 2) were instrumental to out-of-hospital care interventions and conservation of resources. Patient triage, field treatment, and hospital transport were expedited, with some patients treated and released from the scene. Immediate diagnosis of a food-borne illness in the out-of-hospital setting allows rapid treatment at the scene and allows for the efficient transport of multiple patients to a single receiving facility. EMS medical directors should be able to immediately respond to such incidents to make presumptive diagnoses and accurately direct patient care. When this is not possible, early identification of the index case facilitates early diagnosis and treatment.

The Convergence Problems of Eigenfunction Expansions of Elliptic Differential Operators

NASA Astrophysics Data System (ADS)

Ahmedov, Anvarjon

2018-03-01

In the present research we investigate the problems concerning the almost everywhere convergence of multiple Fourier series summed over the elliptic levels in the classes of Liouville. The sufficient conditions for the almost everywhere convergence problems, which are most difficult problems in Harmonic analysis, are obtained. The methods of approximation by multiple Fourier series summed over elliptic curves are applied to obtain suitable estimations for the maximal operator of the spectral decompositions. Obtaining of such estimations involves very complicated calculations which depends on the functional structure of the classes of functions. The main idea on the proving the almost everywhere convergence of the eigenfunction expansions in the interpolation spaces is estimation of the maximal operator of the partial sums in the boundary classes and application of the interpolation Theorem of the family of linear operators. In the present work the maximal operator of the elliptic partial sums are estimated in the interpolation classes of Liouville and the almost everywhere convergence of the multiple Fourier series by elliptic summation methods are established. The considering multiple Fourier series as an eigenfunction expansions of the differential operators helps to translate the functional properties (for example smoothness) of the Liouville classes into Fourier coefficients of the functions which being expanded into such expansions. The sufficient conditions for convergence of the multiple Fourier series of functions from Liouville classes are obtained in terms of the smoothness and dimensions. Such results are highly effective in solving the boundary problems with periodic boundary conditions occurring in the spectral theory of differential operators. The investigations of multiple Fourier series in modern methods of harmonic analysis incorporates the wide use of methods from functional analysis, mathematical physics, modern operator theory and spectral decomposition. New method for the best approximation of the square-integrable function by multiple Fourier series summed over the elliptic levels are established. Using the best approximation, the Lebesgue constant corresponding to the elliptic partial sums is estimated. The latter is applied to obtain an estimation for the maximal operator in the classes of Liouville.

On the equivalence of case-crossover and time series methods in environmental epidemiology.

PubMed

Lu, Yun; Zeger, Scott L

2007-04-01

The case-crossover design was introduced in epidemiology 15 years ago as a method for studying the effects of a risk factor on a health event using only cases. The idea is to compare a case's exposure immediately prior to or during the case-defining event with that same person's exposure at otherwise similar "reference" times. An alternative approach to the analysis of daily exposure and case-only data is time series analysis. Here, log-linear regression models express the expected total number of events on each day as a function of the exposure level and potential confounding variables. In time series analyses of air pollution, smooth functions of time and weather are the main confounders. Time series and case-crossover methods are often viewed as competing methods. In this paper, we show that case-crossover using conditional logistic regression is a special case of time series analysis when there is a common exposure such as in air pollution studies. This equivalence provides computational convenience for case-crossover analyses and a better understanding of time series models. Time series log-linear regression accounts for overdispersion of the Poisson variance, while case-crossover analyses typically do not. This equivalence also permits model checking for case-crossover data using standard log-linear model diagnostics.

Imaging characteristics of hemophagocytic lymphohistiocytosis.

PubMed

Fitzgerald, Nancy E; MacClain, Kenneth L

2003-06-01

Hemophagocytic lymphohistiocytosis (HLH) is a nonmalignant disorder of immune regulation, with overproduction of cytokines and diminished immune surveillance. Symptoms are nonspecific and may affect multiple organs, including the central nervous system. Neuroimaging findings have been described in case reports and small series; body imaging findings have not been described extensively. OBJECTIVE. To summarize findings of the most frequently performed imaging studies of the brain, chest and abdomen in patients with HLH. Retrospective review of chest radiographs and CT, abdominal ultrasound and CT, brain CT and MRI, skeletal surveys, and autopsy data. Twenty-five patients were diagnosed and treated for HLH at our institution over an 11-year period; 15 patients (60%) died. Common chest radiograph findings included alveolar-interstitial opacities with pleural effusions, often with rapid evolution and resolution. Hepatosplenomegaly, gallbladder wall thickening, hyperechoic kidneys and ascites were common abdominal findings, which resolved after therapy in some cases. Brain-imaging studies revealed nonspecific periventricular white-matter abnormalities, brain-volume loss and enlargement of extra-axial fluid spaces. Three infant cases, one with intracranial hemorrhage, one with multiple pathologic rib fractures and one with diaphyseal periosteal reaction involving multiple long bones on skeletal survey, raised suspicion of child abuse at presentation. Abuse was not substantiated in any case. Clinicians and radiologists should be aware of the radiographic manifestations of HLH, which are nonspecific and overlap with infectious, inflammatory and neoplastic disorders. Findings in the chest (similar to acute respiratory distress syndrome) and abdomen may progress rapidly and then regress with institution of appropriate anti-HLH therapy. CNS findings may be progressive. In some infants, initial imaging findings may mimic nonaccidental trauma.

Impacts of a mass vaccination campaign against pandemic H1N1 2009 influenza in Taiwan: a time-series regression analysis.

PubMed

Wu, Un-In; Wang, Jann-Tay; Chang, Shan-Chwen; Chuang, Yu-Chung; Lin, Wei-Ru; Lu, Min-Chi; Lu, Po-Liang; Hu, Fu-Chang; Chuang, Jen-Hsiang; Chen, Yee-Chun

2014-06-01

A multicenter, hospital-wide, clinical and epidemiological study was conducted to assess the effectiveness of the mass influenza vaccination program during the 2009 H1N1 influenza pandemic, and the impact of the prioritization strategy among people at different levels of risk. Among the 34 359 medically attended patients who displayed an influenza-like illness and had a rapid influenza diagnostic test (RIDT) at one of the three participating hospitals, 21.0% tested positive for influenza A. The highest daily number of RIDT-positive cases in each hospital ranged from 33 to 56. A well-fitted multiple linear regression time-series model (R(2)=0.89) showed that the establishment of special community flu clinics averted an average of nine cases daily (p=0.005), and an increment of 10% in daily mean level of population immunity against pH1N1 through vaccination prevented five cases daily (p<0.001). Moreover, the regression model predicted five-fold or more RIDT-positive cases if the mass influenza vaccination program had not been implemented, and 39.1% more RIDT-positive cases if older adults had been prioritized for vaccination above school-aged children. Mass influenza vaccination was an effective control measure, and school-aged children should be assigned a higher priority for vaccination than older adults during an influenza pandemic. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Systematic review of physiotherapy interventions to improve gross motor capacity and performance in children and adolescents with an acquired brain injury.

PubMed

Baque, Emmah; Sakzewski, Leanne; Barber, Lee; Boyd, Roslyn N

2016-01-01

To systematically review the efficacy of physiotherapy interventions to improve gross motor capacity, performance and societal participation in children aged 5-17 years with an acquired brain injury (ABI). Randomized and non-randomized controlled trials, cohort, case series, case-control and case studies were included and classified according to grades of evidence. Methodological quality of studies was assessed using the Downs and Black (D&B) scale and quantitative data was analysed using effect sizes. Two home-based studies investigated functional strength training (one randomized controlled trial, n = 20, level 2b, D&B = 16/32 and one non-randomized self-control study, n = 19, level 4, D&B = 15/32). Four studies evaluated virtual reality including: one pilot study, n = 50, level 4, D&B = 22/32; one single-subject, non-concurrent, randomized multiple baseline study, n = 3, level 4, D&B = 15/32; one case series study, n = 2, level 4, D&B = 15/32; one case study, n = 1, level 4, D&B = 15/32. Effect sizes for the randomized controlled trial ranged between 0.30-1.29 for the Functional Reach and Timed Up and Go outcome measures. There is preliminary evidence to support the efficacy of physiotherapy interventions to improve gross motor outcomes in children with an ABI. Both functional strength training and virtual-reality based therapy are potential treatment options for clinicians to prescribe in either home or clinical settings.

Efficacy of spinal cord stimulators in treating peripheral neuropathy: a case series.

PubMed

Abd-Elsayed, Alaa; Schiavoni, Nick; Sachdeva, Harsh

2016-02-01

Peripheral neuropathy is a common cause of pain, and it is increasing in prevalence. Peripheral neuropathic pain is very hard to treat and can be resistant to multiple pain management modalities. Our series aimed at testing the efficacy of spinal cord stimulators (SCSs) in treating resistant painful peripheral neuropathy. Case 1: A 79-year-old man presented to our clinic with long-standing history of painful peripheral diabetic neuropathy resistant to conservative management. After failure of all possible modalities, we offered the patient an SCS trial that was very successful, and we proceeded with the permanent implant that continued to help with his pain and allowed the patient to wean down his medications. Case 2: A 60-year-old man presented with chronic peripheral neuropathy secondary to HIV, patient failed all conservative and procedural management. Patient then had an SCS trial that relieved his pain significantly. Unfortunately, we did not proceed with the implant due to deterioration of the patient general health. Case 3: A 39-year-old woman presented with painful peripheral neuropathy secondary to chemotherapy for breast cancer. After failure of medication management and procedures, patient had a SCS trial that improved her pain and we then proceeded with performing the permanent implant that controlled her pain. We presented 3 cases with chronic painful peripheral neuropathy secondary to HIV, diabetes mellitus, and chemotherapy that was resistant to conservative pain management and procedures that was successfully treated with neurostimulation. Copyright © 2016 Elsevier Inc. All rights reserved.

Statistical Engineering in Air Traffic Management Research

NASA Technical Reports Server (NTRS)

Wilson, Sara R.

2015-01-01

NASA is working to develop an integrated set of advanced technologies to enable efficient arrival operations in high-density terminal airspace for the Next Generation Air Transportation System. This integrated arrival solution is being validated and verified in laboratories and transitioned to a field prototype for an operational demonstration at a major U.S. airport. Within NASA, this is a collaborative effort between Ames and Langley Research Centers involving a multi-year iterative experimentation process. Designing and analyzing a series of sequential batch computer simulations and human-in-the-loop experiments across multiple facilities and simulation environments involves a number of statistical challenges. Experiments conducted in separate laboratories typically have different limitations and constraints, and can take different approaches with respect to the fundamental principles of statistical design of experiments. This often makes it difficult to compare results from multiple experiments and incorporate findings into the next experiment in the series. A statistical engineering approach is being employed within this project to support risk-informed decision making and maximize the knowledge gained within the available resources. This presentation describes a statistical engineering case study from NASA, highlights statistical challenges, and discusses areas where existing statistical methodology is adapted and extended.

Gain-scheduling multivariable LPV control of an irrigation canal system.

PubMed

Bolea, Yolanda; Puig, Vicenç

2016-07-01

The purpose of this paper is to present a multivariable linear parameter varying (LPV) controller with a gain scheduling Smith Predictor (SP) scheme applicable to open-flow canal systems. This LPV controller based on SP is designed taking into account the uncertainty in the estimation of delay and the variation of plant parameters according to the operating point. This new methodology can be applied to a class of delay systems that can be represented by a set of models that can be factorized into a rational multivariable model in series with left/right diagonal (multiple) delays, such as, the case of irrigation canals. A multiple pool canal system is used to test and validate the proposed control approach. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

The great debate series: surgical treatment of aortic valve abnormalities in children.

PubMed

d'Udekem, Yves; Tweddell, James S; Karl, Tom R

2018-05-01

This article is the latest in an EJCTS series entitled 'The Great Debates'. We have chosen the topic of aortic valve (AoV) surgery in children, with a focus on infants and neonates. The topic was selected due to the significant challenges that AoV problems in the young may present to the surgical team. There are many areas of active controversy, despite the vast accumulated world experience. We have tried to incorporate many of these issues in the questions posed, not claiming to be all-inclusive. The individuals invited to this debate are experts in paediatric valve surgery, with broad and successful clinical experiences on multiple continents. We hope that the facts and opinions presented in this debate will generate interest and discussion and perhaps prove useful in decision-making for future complex valve cases.

Universal RCFT correlators from the holomorphic bootstrap

NASA Astrophysics Data System (ADS)

Mukhi, Sunil; Muralidhara, Girish

2018-02-01

We elaborate and extend the method of Wronskian differential equations for conformal blocks to compute four-point correlation functions on the plane for classes of primary fields in rational (and possibly more general) conformal field theories. This approach leads to universal differential equations for families of CFT's and provides a very simple re-derivation of the BPZ results for the degenerate fields ϕ 1,2 and ϕ 2,1 in the c < 1 minimal models. We apply this technique to compute correlators for the WZW models corresponding to the Deligne-Cvitanović exceptional series of Lie algebras. The application turns out to be subtle in certain cases where there are multiple decoupled primaries. The power of this approach is demonstrated by applying it to compute four-point functions for the Baby Monster CFT, which does not belong to any minimal series.

The Gaussian Graphical Model in Cross-Sectional and Time-Series Data.

PubMed

Epskamp, Sacha; Waldorp, Lourens J; Mõttus, René; Borsboom, Denny

2018-04-16

We discuss the Gaussian graphical model (GGM; an undirected network of partial correlation coefficients) and detail its utility as an exploratory data analysis tool. The GGM shows which variables predict one-another, allows for sparse modeling of covariance structures, and may highlight potential causal relationships between observed variables. We describe the utility in three kinds of psychological data sets: data sets in which consecutive cases are assumed independent (e.g., cross-sectional data), temporally ordered data sets (e.g., n = 1 time series), and a mixture of the 2 (e.g., n > 1 time series). In time-series analysis, the GGM can be used to model the residual structure of a vector-autoregression analysis (VAR), also termed graphical VAR. Two network models can then be obtained: a temporal network and a contemporaneous network. When analyzing data from multiple subjects, a GGM can also be formed on the covariance structure of stationary means-the between-subjects network. We discuss the interpretation of these models and propose estimation methods to obtain these networks, which we implement in the R packages graphicalVAR and mlVAR. The methods are showcased in two empirical examples, and simulation studies on these methods are included in the supplementary materials.

Nerve lesioning with direct current

NASA Astrophysics Data System (ADS)

Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

2011-02-01

Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

Acute cellular insulin resistance and hyperglycemia associated with hypophosphatemia after cardiac surgery.

PubMed

Garazi, Esther; Bridge, Suzanne; Caffarelli, Anthony; Ruoss, Stephen; Van der Starre, Pieter

2015-01-15

Successful glycemic control reduces morbidity and mortality in cardiac surgery patients. Protocols that include insulin infusions are commonly followed to achieve target blood glucose levels. Insulin resistance has been reported and linked to low serum phosphate levels in animal models and studies in diabetic outpatients, but not in postoperative patients. The following case series is a retrospective observational review of 8 cardiac surgery patients who developed insulin resistance early after surgery; this resistance was reversed by correcting serum hypophosphatemia. We discuss the multiple underlying mechanisms causing hypophosphatemia.

Hypopigmentation Induced by Frequent Low-Fluence, Large-Spot-Size QS Nd:YAG Laser Treatments.

PubMed

Wong, Yisheng; Lee, Siong See Joyce; Goh, Chee Leok

2015-12-01

The Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (QS 1064-nm Nd:YAG) laser is increasingly used for nonablative skin rejuvenation or "laser toning" for melasma. Multiple and frequent low-fluence, large-spot-size treatments are used to achieve laser toning, and these treatments are associated with the development of macular hypopigmentation as a complication. We present a case series of three patients who developed guttate hypomelanotic macules on the face after receiving laser toning treatment with QS 1064-nm Nd:YAG.

Methylprednisolone liver toxicity: A new case and a French regional pharmacovigilance survey.

PubMed

Dumortier, Jérôme; Cottin, Judith; Lavie, Caroline; Guillaud, Olivier; Hervieu, Valérie; Chambon-Augoyard, Christine; Scoazec, Jean-Yves; Vukusic, Sandra; Vial, Thierry

2017-09-01

Reported hepatotoxicity induced by corticosteroids is very rare, and the diagnosis is highly challenging in the context of auto-immune disease. We report here a case of high-dose methylprednisolone (MP)-induced acute hepatitis confirmed by liver histology in a patient with multiple sclerosis (MS) and a case series (n=4) notified to the French Pharmacovigilance center of Lyon. In all 5 cases, other common causes of hepatitis were excluded. The causal relationship with MP pulse therapy was supported by the fact that MP was the only culprit drug. In addition, 3 of these 5 patients underwent unintended single or multiple positive MP rechallenge. Our 5 patients scored a RUCAM score from 6 (probable) to 10 (highly probable). MP-induced liver injury is probably very rare, since only less than 30 cases have been reported in the literature. Nevertheless, our cases strongly illustrates that many cases could have been unrecognized; final diagnosis in 3 of 5 of our patients was made after the second or third episode of acute hepatitis. In conclusion, these cases we report here strongly illustrates that high-dose MP-induced liver injury can occur in patients treated for MS or auto-immune disorder. Unintended re-challenge can confirm the diagnosis and can help to distinguish it from autoimmune hepatitis. Performing liver function tests routinely both before and after MP administration would be beneficial, as the timely recognition of this complication and early drug withdrawal may prevent progression of severe necrosis hepatic injury. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Rainfall disaggregation for urban hydrology: Effects of spatial consistence

NASA Astrophysics Data System (ADS)

Müller, Hannes; Haberlandt, Uwe

2015-04-01

For urban hydrology rainfall time series with a high temporal resolution are crucial. Observed time series of this kind are very short in most cases, so they cannot be used. On the contrary, time series with lower temporal resolution (daily measurements) exist for much longer periods. The objective is to derive time series with a long duration and a high resolution by disaggregating time series of the non-recording stations with information of time series of the recording stations. The multiplicative random cascade model is a well-known disaggregation model for daily time series. For urban hydrology it is often assumed, that a day consists of only 1280 minutes in total as starting point for the disaggregation process. We introduce a new variant for the cascade model, which is functional without this assumption and also outperforms the existing approach regarding time series characteristics like wet and dry spell duration, average intensity, fraction of dry intervals and extreme value representation. However, in both approaches rainfall time series of different stations are disaggregated without consideration of surrounding stations. This yields in unrealistic spatial patterns of rainfall. We apply a simulated annealing algorithm that has been used successfully for hourly values before. Relative diurnal cycles of the disaggregated time series are resampled to reproduce the spatial dependence of rainfall. To describe spatial dependence we use bivariate characteristics like probability of occurrence, continuity ratio and coefficient of correlation. Investigation area is a sewage system in Northern Germany. We show that the algorithm has the capability to improve spatial dependence. The influence of the chosen disaggregation routine and the spatial dependence on overflow occurrences and volumes of the sewage system will be analyzed.

The β Pictoris association low-mass members: Membership assessment, rotation period distribution, and dependence on multiplicity

NASA Astrophysics Data System (ADS)

Messina, S.; Lanzafame, A. C.; Malo, L.; Desidera, S.; Buccino, A.; Zhang, L.; Artemenko, S.; Millward, M.; Hambsch, F.-J.

2017-10-01

Context. Low-mass members of young loose stellar associations and open clusters exhibit a wide spread of rotation periods. Such a spread originates from the distributions of masses and initial rotation periods. However, multiplicity can also play a significant role. Aims: We aim to investigate the role played by physical companions in multiple systems in shortening the primordial disk lifetime, anticipating the rotation spin up with respect to single stars. Methods: We have compiled the most extensive list to date of low-mass bona fide and candidate members of the young 25-Myr β Pictoris association. We have measured from our own photometric time series or from archival time series the rotation periods of almost all members. In a few cases the rotation periods were retrieved from the literature. We used updated UVWXYZ components to assess the membership of the whole stellar sample. Thanks to the known basic properties of most members we built the rotation period distribution distinguishing between bona fide members and candidate members and according to their multiplicity status. Results: We find that single stars and components of multiple systems in wide orbits (>80 AU) have rotation periods that exhibit a well defined sequence arising from mass distribution with some level of spread likely arising from initial rotation period distribution. All components of multiple systems in close orbits (<80 AU) have rotation periods that are significantly shorter than their equal-mass single counterparts. For these close components of multiple systems a linear dependence of rotation rate on separation is only barely detected. A comparison with the younger 13 Myr h Per cluster and with the older 40-Myr open clusters and stellar associations NGC 2547, IC 2391, Argus, and IC 2602 and the 130-Myr Pleiades shows that whereas the evolution of F-G stars is well reproduced by angular momentum evolution models, this is not the case for the slow K and early-M stars. Finally, we find that the amplitude of their light curves is correlated neither with rotation nor with mass. Conclusions: Once single stars and wide components of multiple systems are separated from close components of multiple systems, the rotation period distributions exhibit a well defined dependence on mass that allows us to make a meaningful comparison with similar distributions of either younger or older associations and clusters. Such cleaned distributions allow us to use the stellar rotation period meaningfully as an age indicator for F and G type stars. Tables 2 and 3 are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/607/A3

Informatics in radiology (infoRAD): Vendor-neutral case input into a server-based digital teaching file system.

PubMed

Kamauu, Aaron W C; DuVall, Scott L; Robison, Reid J; Liimatta, Andrew P; Wiggins, Richard H; Avrin, David E

2006-01-01

Although digital teaching files are important to radiology education, there are no current satisfactory solutions for export of Digital Imaging and Communications in Medicine (DICOM) images from picture archiving and communication systems (PACS) in desktop publishing format. A vendor-neutral digital teaching file, the Radiology Interesting Case Server (RadICS), offers an efficient tool for harvesting interesting cases from PACS without requiring modifications of the PACS configurations. Radiologists push imaging studies from PACS to RadICS via the standard DICOM Send process, and the RadICS server automatically converts the DICOM images into the Joint Photographic Experts Group format, a common desktop publishing format. They can then select key images and create an interesting case series at the PACS workstation. RadICS was tested successfully against multiple unmodified commercial PACS. Using RadICS, radiologists are able to harvest and author interesting cases at the point of clinical interpretation with minimal disruption in clinical work flow. RSNA, 2006

ON THE GEOMETRY OF MEASURABLE SETS IN N-DIMENSIONAL SPACE ON WHICH GENERALIZED LOCALIZATION HOLDS FOR MULTIPLE FOURIER SERIES OF FUNCTIONS IN L_p, p>1

NASA Astrophysics Data System (ADS)

Bloshanskiĭ, I. L.

1984-02-01

The precise geometry is found of measurable sets in N-dimensional Euclidean space on which generalized localization almost everywhere holds for multiple Fourier series which are rectangularly summable.Bibliography: 14 titles.

Variation in the levels of pregnancy-specific beta-1-glycoprotein in maternal serum from chromosomally abnormal pregnancies.

PubMed

Graham, G W; Crossley, J A; Aitken, D A; Connor, J M

1992-06-01

Human pregnancy-specific beta-1-glycoprotein (SP1) was assayed retrospectively in stored maternal serum (MS) samples from 82 chromosomally abnormal pregnancies and 377 matched controls. The median MSSP1 concentration in 48 Down's syndrome pregnancies was significantly elevated at 1.17 multiples of the control median (MOM), and significantly reduced (0.5 MOM) in a group of eight cases of unbalanced translocations. There was no significant difference in median SP1 concentrations in cases of trisomy 18, trisomy 13, balanced translocations, or sex chromosome abnormalities. A comparison with human chorionic gonadotrophin results in the same series of samples indicates that SP1 is a less sensitive predictor of Down's syndrome pregnancies.

Cerebral magnetic resonance imaging of compressed air divers in diving accidents.

PubMed

Gao, G K; Wu, D; Yang, Y; Yu, T; Xue, J; Wang, X; Jiang, Y P

2009-01-01

To investigate the characteristics of the cerebral magnetic resonance imaging (MRI) of compressed air divers in diving accidents, we conducted an observational case series study. MRI of brain were examined and analysed on seven cases compressed air divers complicated with cerebral arterial gas embolism CAGE. There were some characteristics of cerebral injury: (1) Multiple lesions; (2) larger size; (3) Susceptible to parietal and frontal lobe; (4) Both cortical grey matter and subcortical white matter can be affected; (5) Cerebellum is also the target of air embolism. The MRI of brain is an sensitive method for detecting cerebral lesions in compressed air divers in diving accidents. The MRI should be finished on divers in diving accidents within 5 days.

Early Tibiotalocalcaneal Arthrodesis Intramedullary Nail for Treatment of a Complex Tibial Pilon Fracture (AO/OTA 43-C).

PubMed

Hsu, Andrew R; Szatkowski, Jan P

2015-06-01

Management of severely comminuted, complete articular tibial pilon fractures (AO/OTA 43-C) remains a challenge, with few treatment options providing good clinical outcomes. Open reduction and internal fixation of the tibial plafond, tibiotalar arthrodesis, and salvage hindfoot reconstruction procedures are all associated with surgical complications and functional limitations. In this report, we present a case of a complex pilon fracture in a patient with multiple medical comorbidities and socioeconomic disadvantages that was successfully and acutely treated with a retrograde tibiotalocalcaneal hindfoot arthrodesis nail. At final follow-up examination, the patient had decreased pain, a stable plantigrade foot, and could ambulate with normal shoes without any assistive devices. Therapeutic, Level IV: Case series. © 2014 The Author(s).

Drug-induced Fanconi syndrome associated with fumaric acid esters treatment for psoriasis: a case series

PubMed Central

Balak, Deepak M.W.; Bouwes Bavinck, Jan Nico; de Vries, Aiko P.J.; Hartman, Jenny; Neumann, Hendrik A. Martino; Zietse, Robert; Thio, Hok Bing

2016-01-01

Background Fumaric acid esters (FAEs), an oral immunomodulating treatment for psoriasis and multiple sclerosis, have been anecdotally associated with proximal renal tubular dysfunction due to a drug-induced Fanconi syndrome. Few data are available on clinical outcomes of FAE-induced Fanconi syndrome. Methods Descriptive case series with two cases of Fanconi syndrome associated with FAE treatment diagnosed at two Dutch university nephrology departments, three cases reported at the Dutch and German national pharmacovigilance databases and six previously reported cases. Results All 11 cases involved female patients with psoriasis. The median age at the time of onset was 38 years [interquartile range (IQR) 37–46]. Patients received long-term FAEs treatment with a median treatment duration of 60 months (IQR 28–111). Laboratory tests were typically significant for low serum levels of phosphate and uric acid, while urinalysis showed glycosuria and proteinuria. Eight (73%) patients had developed a hypophosphataemic osteomalacia and three (27%) had pathological bone fractures. All patients discontinued FAEs, while four (36%) patients were treated with supplementation of phosphate and/or vitamin D. Five (45%) patients had persisting symptoms despite FAEs discontinuation. Conclusions FAEs treatment can cause drug-induced Fanconi syndrome, but the association has been reported infrequently. Female patients with psoriasis treated long term with FAEs seem to be particularly at risk. Physicians treating patients with FAEs should be vigilant and monitor for the potential occurrence of Fanconi syndrome. Measurement of the urinary albumin:total protein ratio is a suggested screening tool for tubular proteinuria in Fanconi syndrome. PMID:26798466

A COMBINED TREATMENT APPROACH EMPHASIZING IMPAIRMENT-BASED MANUAL THERAPY AND EXERCISE FOR HIP-RELATED COMPENSATORY INJURY IN ELITE ATHLETES: A CASE SERIES

PubMed Central

Short, Gretchen; Strack, Donald; Anloague, Philip; Brewster, Brian

2017-01-01

Background/Purpose: Athletes experiencing hip, groin, and low back pain often exhibit similar clinical characteristics. Individuals with hip, groin and low back pain may have the presence of multiple concurrent pathoanatomical diagnoses. Regardless, similar regional characteristics and dysfunction may contribute to the patient's chief complaint, potentially creating a sub-group of individuals that may be defined by lumbopelvic and hip mobility limitations, motor control impairments, and other shared clinical findings. The purpose of this case series is to describe the conservative management of elite athletes, within the identified aforementioned sub-group, that emphasized regional manual therapy interventions, and therapeutic exercise designed to improve lumbopelvic and hip mobility, stability and motor control. Case Descriptions: Five elite athletes were clinically diagnosed by a physical therapist with primary pathologies including adductor-related groin pain (ARGP), femoral acetabular impingement (FAI) with acetabular labral lesion and acute, mechanical low back pain (LBP). Similar subjective, objective findings and overall clinical profiles were identified among all subjects. Common findings aside from the chief complaint included, but were not limited to, decreased hip range of motion (ROM), impaired lumbopelvic motor control and strength, lumbar hypomobility in at least one segment, and a positive hip flexion-adduction-internal rotation (FADIR) special test. A three-phase impairment-based physical therapy program was implemented to resolve the primary complaints and return the subjects to their desired level of function. Acute phase rehabilitation consisted of manual therapy and fundamental motor control exercises. Progression to the sub-acute and terminal phases was based on improved subjective pain reports and progress with functional impairments. As the subjects progress through the rehabilitation phases, the delivery of physical therapy interventions were defined by decreased manual therapies and an increased emphasis and priority on graded exercise. Outcomes: Significant reductions in reported pain (>2 points Numeric Pain Rating Scale), improved reported function via functional outcome measures (Hip and Groin Outcome Score), and continued participation in sport occurred in all five cases without the need for surgical intervention. Discussion: The athletes described in this case series make up a common clinical sub-group defined by hip and lumbopelvic mobility restrictions, lumbopelvic and lower extremity motor control impairments and potentially other shared clinical findings. Despite differences in pathoanatomic findings, similar objective findings were identified and similar treatment plans were applied, potentially affecting the movement system as a whole. Subjects were conservatively managed allowing continued participation in sport within their competitive seasons. Conclusion: Comprehensive conservative treatment of the athletes with shared impairments, as described in this case series, may be of clinical importance when managing athletes with hip, groin, and low back pain. Level of Evidence: Therapy, Level 4, Case Series PMID:29158960

Fovea sparing internal limiting membrane peeling using multiple parafoveal curvilinear peels for myopic foveoschisis: technique and outcome.

PubMed

Jin, Haiying; Zhang, Qi; Zhao, Peiquan

2016-10-18

To introduce a modified surgical technique, the "parafoveal multiple curvelinear internal limiting membrane (ILM) peeling", to preserve epi-foveal ILM in myopic foveoschisis surgery. Consecutive patients with myopic foveoschisis were enrolled in the present prospective interventional case series. The surgeries were performed using transconjunctival 23-gauge system. The macular area was divided into quadrants. ILM was peeled off in a curvilinear manner centered around the site that was away from the central fovea in each quadrant. Shearing forces were used to control the direction to keep the peeling away from central fovea. ILM at central fovea of about 500 to 1000 μm was preserved by this technique. This technique was performed in 20 eyes of 20 consecutive patients. Epi-foveal ILM was successfully preserved in all cases using the technique. Patients were followed up for more than 12 months. The mean postoperative logMAR visual acuity improved from 1.67 ± 0.65 preoperatively to 1.15 ± 0.49 (P = 0.015; paired t-test). Postoperative OCT examinations showed that full-thickness macular holes (MHs) did not developed in any case. Central fovea thickness decreased from 910 ± 261 μm preoperatively to 125 ± 85 postoperatively (P = 0.001; paired t-test). Fovea sparing ILM peeling using multiple parafoveal curvilinear peels prevents the development of postoperative full-thickness MHs in eyes with myopic foveoschisis.

A procedure of multiple period searching in unequally spaced time-series with the Lomb-Scargle method

NASA Technical Reports Server (NTRS)

Van Dongen, H. P.; Olofsen, E.; VanHartevelt, J. H.; Kruyt, E. W.; Dinges, D. F. (Principal Investigator)

1999-01-01

Periodogram analysis of unequally spaced time-series, as part of many biological rhythm investigations, is complicated. The mathematical framework is scattered over the literature, and the interpretation of results is often debatable. In this paper, we show that the Lomb-Scargle method is the appropriate tool for periodogram analysis of unequally spaced data. A unique procedure of multiple period searching is derived, facilitating the assessment of the various rhythms that may be present in a time-series. All relevant mathematical and statistical aspects are considered in detail, and much attention is given to the correct interpretation of results. The use of the procedure is illustrated by examples, and problems that may be encountered are discussed. It is argued that, when following the procedure of multiple period searching, we can even benefit from the unequal spacing of a time-series in biological rhythm research.

Time-Series Analysis: Assessing the Effects of Multiple Educational Interventions in a Small-Enrollment Course

NASA Astrophysics Data System (ADS)

Warren, Aaron R.

2009-11-01

Time-series designs are an alternative to pretest-posttest methods that are able to identify and measure the impacts of multiple educational interventions, even for small student populations. Here, we use an instrument employing standard multiple-choice conceptual questions to collect data from students at regular intervals. The questions are modified by asking students to distribute 100 Confidence Points among the options in order to indicate the perceived likelihood of each answer option being the correct one. Tracking the class-averaged ratings for each option produces a set of time-series. ARIMA (autoregressive integrated moving average) analysis is then used to test for, and measure, changes in each series. In particular, it is possible to discern which educational interventions produce significant changes in class performance. Cluster analysis can also identify groups of students whose ratings evolve in similar ways. A brief overview of our methods and an example are presented.

deltaGseg: macrostate estimation via molecular dynamics simulations and multiscale time series analysis.

PubMed

Low, Diana H P; Motakis, Efthymios

2013-10-01

Binding free energy calculations obtained through molecular dynamics simulations reflect intermolecular interaction states through a series of independent snapshots. Typically, the free energies of multiple simulated series (each with slightly different starting conditions) need to be estimated. Previous approaches carry out this task by moving averages at certain decorrelation times, assuming that the system comes from a single conformation description of binding events. Here, we discuss a more general approach that uses statistical modeling, wavelets denoising and hierarchical clustering to estimate the significance of multiple statistically distinct subpopulations, reflecting potential macrostates of the system. We present the deltaGseg R package that performs macrostate estimation from multiple replicated series and allows molecular biologists/chemists to gain physical insight into the molecular details that are not easily accessible by experimental techniques. deltaGseg is a Bioconductor R package available at http://bioconductor.org/packages/release/bioc/html/deltaGseg.html.

Cluster bomb ocular injuries.

PubMed

Mansour, Ahmad M; Hamade, Haya; Ghaddar, Ayman; Mokadem, Ahmad Samih; El Hajj Ali, Mohamad; Awwad, Shady

2012-01-01

To present the visual outcomes and ocular sequelae of victims of cluster bombs. This retrospective, multicenter case series of ocular injury due to cluster bombs was conducted for 3 years after the war in South Lebanon (July 2006). Data were gathered from the reports to the Information Management System for Mine Action. There were 308 victims of clusters bombs; 36 individuals were killed, of which 2 received ocular lacerations and; 272 individuals were injured with 18 receiving ocular injury. These 18 surviving individuals were assessed by the authors. Ocular injury occurred in 6.5% (20/308) of cluster bomb victims. Trauma to multiple organs occurred in 12 of 18 cases (67%) with ocular injury. Ocular findings included corneal or scleral lacerations (16 eyes), corneal foreign bodies (9 eyes), corneal decompensation (2 eyes), ruptured cataract (6 eyes), and intravitreal foreign bodies (10 eyes). The corneas of one patient had extreme attenuation of the endothelium. Ocular injury occurred in 6.5% of cluster bomb victims and 67% of the patients with ocular injury sustained trauma to multiple organs. Visual morbidity in civilians is an additional reason for a global ban on the use of cluster bombs.

Management of penetrating colon and rectal injuries in the pediatric patient.

PubMed

Haut, Elliott R; Nance, Michael L; Keller, Martin S; Groner, Jonathan I; Ford, Henri R; Kuhn, Ann; Tuchfarber, Barbara; Garcia, Victor; Schwab, C William; Stafford, Perry W

2004-09-01

Management of civilian penetrating colon injuries in the adult has evolved from the universal use of fecal diversion to the highly selective use of colostomy. We hypothesized that a similar management approach was appropriate for the pediatric population. A retrospective review of pediatric patients (age <17 years) with a penetrating colorectal injury was performed at six Level I trauma centers for the period January 1990 through June 2001. For the period of review, 53 children with a penetrating colorectal injury were identified. Firearms caused 89 percent of the injuries. The colon was injured in 83 percent (n = 44) of patients and the rectum in 17 percent (n = 9) of patients. The colorectal injury was managed without colostomy in 62 percent (n = 33) and with colostomy in 38 percent (colon = 11, rectum = 9). All rectal injuries were treated with colostomy. The hospital length of stay was longer in the colostomy group (17.6 days vs. 11.4 days). The complication rate was higher in the colostomy group (55 percent vs. 27 percent), which included two patients with stoma-related complications. There was no mortality in this series. Primary repair was used safely in most cases of civilian penetrating colon injuries in the pediatric population. All rectal injuries were treated with colostomy in this series. Fecal diversion was used selectively. Colostomy was performed for selected cases of colon wounds associated with shock, multiple blood transfusions, multiple other injuries, extensive contamination, and high-velocity weapons. In the absence of these associated factors, primary repair appears justified.

Unscaled Bayes factors for multiple hypothesis testing in microarray experiments.

PubMed

Bertolino, Francesco; Cabras, Stefano; Castellanos, Maria Eugenia; Racugno, Walter

2015-12-01

Multiple hypothesis testing collects a series of techniques usually based on p-values as a summary of the available evidence from many statistical tests. In hypothesis testing, under a Bayesian perspective, the evidence for a specified hypothesis against an alternative, conditionally on data, is given by the Bayes factor. In this study, we approach multiple hypothesis testing based on both Bayes factors and p-values, regarding multiple hypothesis testing as a multiple model selection problem. To obtain the Bayes factors we assume default priors that are typically improper. In this case, the Bayes factor is usually undetermined due to the ratio of prior pseudo-constants. We show that ignoring prior pseudo-constants leads to unscaled Bayes factor which do not invalidate the inferential procedure in multiple hypothesis testing, because they are used within a comparative scheme. In fact, using partial information from the p-values, we are able to approximate the sampling null distribution of the unscaled Bayes factor and use it within Efron's multiple testing procedure. The simulation study suggests that under normal sampling model and even with small sample sizes, our approach provides false positive and false negative proportions that are less than other common multiple hypothesis testing approaches based only on p-values. The proposed procedure is illustrated in two simulation studies, and the advantages of its use are showed in the analysis of two microarray experiments. © The Author(s) 2011.

ePRISM: A case study in multiple proxy and mixed temporal resolution integration

USGS Publications Warehouse

Robinson, Marci M.; Dowsett, Harry J.

2010-01-01

As part of the Pliocene Research, Interpretation and Synoptic Mapping (PRISM) Project, we present the ePRISM experiment designed I) to provide climate modelers with a reconstruction of an early Pliocene warm period that was warmer than the PRISM interval (similar to 3.3 to 3.0 Ma), yet still similar in many ways to modern conditions and 2) to provide an example of how best to integrate multiple-proxy sea surface temperature (SST) data from time series with varying degrees of temporal resolution and age control as we begin to build the next generation of PRISM, the PRISM4 reconstruction, spanning a constricted time interval. While it is possible to tie individual SST estimates to a single light (warm) oxygen isotope event, we find that the warm peak average of SST estimates over a narrowed time interval is preferential for paleoclimate reconstruction as it allows for the inclusion of more records of multiple paleotemperature proxies.

Refractory Cushing's disease caused by multinodular ACTH-cell hyperplasia.

PubMed

McKeever, P E; Koppelman, M C; Metcalf, D; Quindlen, E; Kornblith, P L; Strott, C A; Howard, R; Smith, B H

1982-09-01

A patient with pituitary-dependent hypercortisolism, unresponsive to resection of nodules in the anterior lobe, is described. Histochemical stains of the nodules showed multiple, focal, cellular expansions of the fibrovascular stroma. Transitions between normal and expanded adenohypophysial acini were present. Immunoperoxidase stains for ACTH and other pituitary hormones revealed that these multiple foci contained an excess of ACTH-positive cells. Less than 10% of the cells in these foci were negative for ACTH and positive for other hormones. Serial sections showed that these foci of predominantly ACTH-producing acini were not connected. Clinical, morphological, and immunohistochemical data indicated that ACTH-cell hyperplasia caused Crushing's disease in this patient. Pathologic study of individual cases should concentrate on determining whether hyperplasia or adenoma exist at the time of surgical exploration of the pituitary gland, since this determination is important to proper treatment. Tentative criteria to recognize ACTH-cell hyperplasia are: 1. Multiple foci of ACTH laden cells. 2. A minor subpopulation of cells of alternate hormone series. 3. Expansion without destruction of acini in the adenohypophysis.

Effect of Contralateral Strength Training on Muscle Weakness in People With Multiple Sclerosis: Proof-of-Concept Case Series.

PubMed

Manca, Andrea; Cabboi, Maria Paola; Ortu, Enzo; Ginatempo, Francesca; Dragone, Daniele; Zarbo, Ignazio Roberto; de Natale, Edoardo Rosario; Mureddu, Giovanni; Bua, Guido; Deriu, Franca

2016-06-01

The contralateral strength training (CST) effect is a transfer of muscle performance to the untrained limb following training of the contralateral side. The aim of this study was to explore, in individuals with multiple sclerosis (MS) presenting marked lower limb strength asymmetry, the effectiveness of CST on management of muscle weakness of the more-affected limb following training of the less-affected limb. A single-subject research design was used. Eight individuals with MS underwent 16 to 18 high-intensity training sessions of the less-affected ankle dorsiflexor muscles. The primary outcome measure of this single-system case series was maximal strength expressed as peak moment and maximal work. Secondary outcome measures were: Six-Minute-Walk Test, Timed "Up & Go" Test, 10-Meter Timed Walk Test, and Multiple Sclerosis Quality of Life-54 questionnaire. After the 6-week intervention, the contralateral more affected (untrained) limb showed a 22% to 24% increase in maximal strength. From pretest-posttest measurements, participants also performed significantly better on the clinical and functional secondary outcome measures. At the 12-week follow-up, the strength levels of the weaker untrained limb remained significantly superior to baseline levels in the majority (5 out of 8) of the outcome parameters. Considering the design used, the absence of a control group, and the sample size, these findings should be cautiously generalized and will need confirmation in a properly planned randomized controlled trial. The present proof-of-concept study shows, for the first time, the occurrence of the CST effect on muscle performance of ankle dorsiflexor muscles in people with MS. These preliminary findings reveal new potential implications for CST as a promising rehabilitation approach to those conditions where unilateral muscle weakness does not allow or makes difficult performing conventional strength training of the weaker limb. © 2016 American Physical Therapy Association.

Gallbladder perforation: case series and systematic review.

PubMed

Date, Ravindra S; Thrumurthy, Sri G; Whiteside, Sigrid; Umer, Mohammed A; Pursnani, Kishore G; Ward, Jeremy B; Mughal, M Muntzer

2012-01-01

Gallbladder perforation is a serious complication of acute cholecystitis. Its management has evolved considerably since its classification by Niemeier in 1934. This review summarises the evidence surrounding the natural progression of this condition and potential problems with Niemeier's classification, and proposes a management algorithm for the more complex type II perforation. Data from a retrospective case series and a systematic review were combined. The case series included all patients with gallbladder perforations from 2004 to 2008 at a British teaching hospital. The systematic review searched for gallbladder perforation using the MEDLINE, Embase, Web of Science and Cochrane Library (2011 Issue 4) databases, as well as recent conference abstracts. The outcome data were analysed using SPSS version 15. No adjustments were made for multiple testing. 198 patients (including 19 patients from the present series) with a mean age of 62.1+/-9.7 years and male gender proportion of 55.4% (range 33.3-76.7%) were included. The most common gallbladder perforations were type II (median 46.2%, range 7.4-83.3%), followed by type I (median 40.6%, range 16.7-70.0%) and type III (median 10.1%, range 0-48.1%). Perforation was associated with cholelithiasis in 86.6% (range 78.9-90.6%) of patients, and the overall median mortality rate was 10.8% (range 0-12.5%). Male gender was weakly associated with mortality (p = 0.089) but age (p = 0.877) and cholelithiasis (p = 0.425) were not. Mortality did not vary significantly with perforation type. Gallbladder perforation should be reported according to the original Neimeier's classification to avoid heterogeneity in data (e.g. varying rates of perforation types). The algorithm proposed in this study aims to guide the management of complex type II gallbladder perforations to minimise subsequent morbidity and mortality. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Endoscopic Endonasal Approach in Skull Base Chondrosarcoma Associated with Maffucci Syndrome: Case Series and Literature Review.

PubMed

Beer-Furlan, André; Balsalobre, Leonardo; Vellutini, Eduardo A S; Stamm, Aldo C

2016-01-01

Maffucci syndrome is a nonhereditary disorder in which patients develop multiple enchondromas and cutaneous, visceral, or soft tissue hemangiomas. The potential malignant progression of enchondroma into a secondary chondrosarcoma is a well-known fact. Nevertheless, chondrosarcoma located at the skull base in patients with Maffuci syndrome is a very rare condition, with only 18 cases reported in the literature. We report 2 other cases successfully treated through an expanded endoscopic endonasal approach and discuss the condition based on the literature review. Skull base chondrosarcoma associated with Maffucci syndrome is a rare condition. The disease cannot be cured, therefore surgical treatment should be performed in symptomatic patients aiming for maximal tumor resection with function preservation. The endoscopic endonasal approach is a safe and reliable alternative for the management of these tumors. Copyright © 2016 Elsevier Inc. All rights reserved.

[Palliative care in Primary Care: presentation of a case].

PubMed

Álvarez-Cordovés, M M; Mirpuri-Mirpuri, P G; Gonzalez-Losada, J; Chávez-Díaz, B

2013-10-01

We present a case of a patient diagnosed with glioblastoma multiforme refractory to treatment. Glioblastoma multiforme is the most common primary brain tumour and unfortunately the most aggressive, with an estimated mortality of about 90% in the first year after diagnosis. In our case the patient had reached a stage of life where quality of life was importsnt, with palliative care being the only recourse. The family is the mainstay in the provision of care of terminally ill patients, and without their active participation it would be difficult to achieve the objectives in patient care. We must also consider the family of the terminally ill in our care aim, as its members will experience a series of changes that will affect multiple areas where we should take action. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Life-threatening heat stroke presenting with ST elevations: a report of consecutive cases during the heat wave in Austria in July 2013.

PubMed

Lassnig, Elisabeth; Dinkhauser, Patrick; Maurer, Edwin; Eber, Bernd

2014-08-01

Heat stroke is a life-threatening condition due to an acute thermoregulatory failure during exposure to high environmental temperatures. We report a series of four cases (three exertional, one classic heat stroke) during the heat wave of July 2013 in Austria. All of them presented with a core temperature > 41 °C, central nervous dysfunction, acute respiratory and renal failure, disseminated intravascular coagulation, rhabdomyolysis, and severe electrocardiographic changes, two cases even mimicking ST-elevation myocardial infarction. The patients were cooled to normal temperature with the "Arctic sun" external cooling system within hours. Electrocardiographic changes resolved quickly. All patients primarily recovered from multiple organ dysfunction and could be discharged from intensive care unit. Unfortunately, the two elder patients died 1 week and 5 weeks later because of late complications.

Paroxetine Treatment of Problematic Pornography Use: A Case Series

PubMed Central

Gola, Mateusz; Potenza, Marc N.

2016-01-01

Background How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive–compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU). Case presentation Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment. Discussion Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months. Conclusions Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use. PMID:27440474

Paroxetine Treatment of Problematic Pornography Use: A Case Series.

PubMed

Gola, Mateusz; Potenza, Marc N

2016-09-01

Background How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive-compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU). Case presentation Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment. Discussion Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months. Conclusions Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use.

Detection of Undocumented Changepoints Using Multiple Test Statistics and Composite Reference Series.

NASA Astrophysics Data System (ADS)

Menne, Matthew J.; Williams, Claude N., Jr.

2005-10-01

An evaluation of three hypothesis test statistics that are commonly used in the detection of undocumented changepoints is described. The goal of the evaluation was to determine whether the use of multiple tests could improve undocumented, artificial changepoint detection skill in climate series. The use of successive hypothesis testing is compared to optimal approaches, both of which are designed for situations in which multiple undocumented changepoints may be present. In addition, the importance of the form of the composite climate reference series is evaluated, particularly with regard to the impact of undocumented changepoints in the various component series that are used to calculate the composite.In a comparison of single test changepoint detection skill, the composite reference series formulation is shown to be less important than the choice of the hypothesis test statistic, provided that the composite is calculated from the serially complete and homogeneous component series. However, each of the evaluated composite series is not equally susceptible to the presence of changepoints in its components, which may be erroneously attributed to the target series. Moreover, a reference formulation that is based on the averaging of the first-difference component series is susceptible to random walks when the composition of the component series changes through time (e.g., values are missing), and its use is, therefore, not recommended. When more than one test is required to reject the null hypothesis of no changepoint, the number of detected changepoints is reduced proportionately less than the number of false alarms in a wide variety of Monte Carlo simulations. Consequently, a consensus of hypothesis tests appears to improve undocumented changepoint detection skill, especially when reference series homogeneity is violated. A consensus of successive hypothesis tests using a semihierarchic splitting algorithm also compares favorably to optimal solutions, even when changepoints are not hierarchic.

Temporal abstraction for the analysis of intensive care information

NASA Astrophysics Data System (ADS)

Hadad, Alejandro J.; Evin, Diego A.; Drozdowicz, Bartolomé; Chiotti, Omar

2007-11-01

This paper proposes a scheme for the analysis of time-stamped series data from multiple monitoring devices of intensive care units, using Temporal Abstraction concepts. This scheme is oriented to obtain a description of the patient state evolution in an unsupervised way. The case of study is based on a dataset clinically classified with Pulmonary Edema. For this dataset a trends based Temporal Abstraction mechanism is proposed, by means of a Behaviours Base of time-stamped series and then used in a classification step. Combining this approach with the introduction of expert knowledge, using Fuzzy Logic, and multivariate analysis by means of Self-Organizing Maps, a states characterization model is obtained. This model is feasible of being extended to different patients groups and states. The proposed scheme allows to obtain intermediate states descriptions through which it is passing the patient and that could be used to anticipate alert situations.

Cutaneous involvement in multiple myeloma (MM): A case series with clinicopathologic correlation.

PubMed

Malysz, Jozef; Talamo, Giampaolo; Zhu, Junjia; Clarke, Loren E; Bayerl, Michael G; Ali, Liaqat; Helm, Klaus F; Chung, Catherine G

2016-05-01

Disease-specific skin lesions are rare in patients with multiple myeloma (MM). We sought to further characterize the clinical and pathologic features of patients with cutaneous involvement with MM. We identified 13 patients with cutaneous lesions of MM. Cutaneous lesions consisted of pink, red, and violaceous papules, nodules, and/or plaques that varied in size. Histopathology revealed atypical plasma cells with occasional plasmablastic features. MM had aggressive biologic features and was at an advanced stage in the majority of patients. Despite aggressive management, including chemotherapy and stem-cell transplantation, most patients died of progressive disease within a few months after the development of cutaneous lesions. The study group was relatively small. Cutaneous involvement with MM is associated with aggressive biologic behavior and short survival. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Comparison of missing value imputation methods in time series: the case of Turkish meteorological data

NASA Astrophysics Data System (ADS)

Yozgatligil, Ceylan; Aslan, Sipan; Iyigun, Cem; Batmaz, Inci

2013-04-01

This study aims to compare several imputation methods to complete the missing values of spatio-temporal meteorological time series. To this end, six imputation methods are assessed with respect to various criteria including accuracy, robustness, precision, and efficiency for artificially created missing data in monthly total precipitation and mean temperature series obtained from the Turkish State Meteorological Service. Of these methods, simple arithmetic average, normal ratio (NR), and NR weighted with correlations comprise the simple ones, whereas multilayer perceptron type neural network and multiple imputation strategy adopted by Monte Carlo Markov Chain based on expectation-maximization (EM-MCMC) are computationally intensive ones. In addition, we propose a modification on the EM-MCMC method. Besides using a conventional accuracy measure based on squared errors, we also suggest the correlation dimension (CD) technique of nonlinear dynamic time series analysis which takes spatio-temporal dependencies into account for evaluating imputation performances. Depending on the detailed graphical and quantitative analysis, it can be said that although computational methods, particularly EM-MCMC method, are computationally inefficient, they seem favorable for imputation of meteorological time series with respect to different missingness periods considering both measures and both series studied. To conclude, using the EM-MCMC algorithm for imputing missing values before conducting any statistical analyses of meteorological data will definitely decrease the amount of uncertainty and give more robust results. Moreover, the CD measure can be suggested for the performance evaluation of missing data imputation particularly with computational methods since it gives more precise results in meteorological time series.

Rectosigmoidian Involvement in Advanced-stage Ovarian Cancer – Intraoperative Decisions

PubMed Central

BACALBASA, NICOLAE; BALESCU, IRINA; DIMA, SIMONA

2017-01-01

Background/Aim: Ovarian cancer remains one of the most commonly encountered malignancies affecting women worldwide, that is unfortunately commonly diagnosed in advanced stages of the disease. In these stages, the tumoral process usually involves the surrounding viscera throughout contiguity or induces the apparition of distant metastases via peritoneal, lymphatic or hematogenous spread, multiple resections being needed in order to achieve a good control of the disease. Patients and Methods: In the present study, we present a case series of 12 patients in whom various surgical procedures on the rectosigmoidian loop were performed in order to achieve debulking surgery to no residual disease. Results: Digestive tract resections consisted of rectosigmoidian resection with left colostomy in three cases, low rectosigmoidian resections with anastomosis in eight cases and a stripping procedure of the peritoneal layer in one case. Conclusion: Due to the close proximity of the digestive and gynecological tract, advanced-stage ovarian tumors frequently involve the rectosigmoidian loop, imposing association of digestive tract surgical procedures. PMID:28882968

Rectosigmoidian Involvement in Advanced-stage Ovarian Cancer - Intraoperative Decisions.

PubMed

Bacalbasa, Nicolae; Balescu, Irina; Dima, Simona

2017-01-01

Ovarian cancer remains one of the most commonly encountered malignancies affecting women worldwide, that is unfortunately commonly diagnosed in advanced stages of the disease. In these stages, the tumoral process usually involves the surrounding viscera throughout contiguity or induces the apparition of distant metastases via peritoneal, lymphatic or hematogenous spread, multiple resections being needed in order to achieve a good control of the disease. In the present study, we present a case series of 12 patients in whom various surgical procedures on the rectosigmoidian loop were performed in order to achieve debulking surgery to no residual disease. Digestive tract resections consisted of rectosigmoidian resection with left colostomy in three cases, low rectosigmoidian resections with anastomosis in eight cases and a stripping procedure of the peritoneal layer in one case. Due to the close proximity of the digestive and gynecological tract, advanced-stage ovarian tumors frequently involve the rectosigmoidian loop, imposing association of digestive tract surgical procedures. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

PARACOCCIDIOIDOMYCOSIS TREATMENT

PubMed Central

SHIKANAI-YASUDA, Maria Aparecida

2015-01-01

SUMMARY Considered to be an emerging endemic mycosis in Latin America, paracoccidioidomycosis is characterized by a chronic course and involvement of multiple organs in immunocompromised hosts. Infection sequelae are mainly related to pulmonary and adrenal insufficiency. The host-parasite interaction results in different expressions of the immune response depending on parasite pathogenicity, fungal load and genetic characteristics of the host. A few controlled and case series reports have shown that azoles and fast-acting sulfa derivatives are useful treatment alternatives in milder forms of the disease. For moderate/severe cases, more prolonged treatments or even parenteral routes are required especially when there is involvement of the digestive tract mucosa, resulting in poor drug absorption. Although comparative studies have reported that shorter treatment regimens with itraconazole are able to induce cure in chronically-infected patients, there are still treatment challenges such as the need for more controlled studies involving acute cases, the search for new drugs and combinations, and the search for compounds capable of modulating the immune response in severe cases as well as the paradoxical reactions. PMID:26465367

A generalized least squares regression approach for computing effect sizes in single-case research: application examples.

PubMed

Maggin, Daniel M; Swaminathan, Hariharan; Rogers, Helen J; O'Keeffe, Breda V; Sugai, George; Horner, Robert H

2011-06-01

A new method for deriving effect sizes from single-case designs is proposed. The strategy is applicable to small-sample time-series data with autoregressive errors. The method uses Generalized Least Squares (GLS) to model the autocorrelation of the data and estimate regression parameters to produce an effect size that represents the magnitude of treatment effect from baseline to treatment phases in standard deviation units. In this paper, the method is applied to two published examples using common single case designs (i.e., withdrawal and multiple-baseline). The results from these studies are described, and the method is compared to ten desirable criteria for single-case effect sizes. Based on the results of this application, we conclude with observations about the use of GLS as a support to visual analysis, provide recommendations for future research, and describe implications for practice. Copyright © 2011 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Use of bortezomib in heavy-chain deposition disease: a report of 3 cases.

PubMed

Patel, Kinjal; Dillon, John J; Leung, Nelson; Bomback, Andrew S; Appel, Gerald B; D'Agati, Vivette; Canetta, Pietro A

2014-07-01

Heavy-chain deposition disease (HCDD) is a rare complication of plasma cell dyscrasia in which monoclonal heavy chains deposit in glomerular and tubular basement membranes of the kidney. Clinical and pathologic features of HCDD have been well described in case reports and series, but evidence supporting specific therapies is sparse. Historically, the disease has had a poor prognosis, intensifying the need to clarify optimal treatments. We describe 3 cases of HCDD with biopsy-proven glomerular involvement, severe nephrotic syndrome, and decline in kidney function that were treated successfully with bortezomib, a proteasome inhibitor. None of these patients had multiple myeloma. In all cases, bortezomib-based therapy resulted in sustained resolution of nephrotic syndrome and improvement in kidney function. All 3 patients developed peripheral neuropathy; otherwise, treatment was well tolerated. To our knowledge, this is the first description of the clinical effectiveness of bortezomib against HCDD. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Improving air quality in megacities: Mexico City case study.

PubMed

Molina, Luisa T; Molina, Mario J

2004-06-01

The development and effective implementation of solutions to the air pollution problems in the Mexico City Metropolitan Area is essential to guarantee the health and welfare of its inhabitants. To achieve this, it is essential to have the active and informed participation of the civil society, the academic community, the private sector, and the government, because dealing with pollution requires the use of different strategies in multiple fields of action. The Mexico City case study brings together health, transportation, administration, and many other interdisciplinary approaches to understanding and defeating air pollution. Although focused on the Mexico City area, the work conducted under this case study has significance for developing nations generally. Although policies to reduce air pollution should be based on the best available scientific knowledge, political will and capacity must transform this knowledge into action. This case study has developed a series of recommendations emphasizing the interaction between different disciplines that have provided the foundation for the 10-year air quality management program prepared by the Mexican Metropolitan Environmental Commission.

Modular, multi-level groundwater sampler

DOEpatents

Nichols, R.L.; Widdowson, M.A.; Mullinex, H.; Orne, W.H.; Looney, B.B.

1994-03-15

An apparatus is described for taking a multiple of samples of groundwater or pressure measurements from a well simultaneously. The apparatus comprises a series of chambers arranged in an axial array, each of which is dimensioned to fit into a perforated well casing and leave a small gap between the well casing and the exterior of the chamber. Seals at each end of the container define the limits to the axial portion of the well to be sampled. A submersible pump in each chamber pumps the groundwater that passes through the well casing perforations into the gap from the gap to the surface for analysis. The power lines and hoses for the chambers farther down the array pass through each chamber above them in the array. The seals are solid, water-proof, non-reactive, resilient disks supported to engage the inside surface of the well casing. Because of the modular design, the apparatus provides flexibility for use in a variety of well configurations. 3 figures.

Bayesian correlated clustering to integrate multiple datasets

PubMed Central

Kirk, Paul; Griffin, Jim E.; Savage, Richard S.; Ghahramani, Zoubin; Wild, David L.

2012-01-01

Motivation: The integration of multiple datasets remains a key challenge in systems biology and genomic medicine. Modern high-throughput technologies generate a broad array of different data types, providing distinct—but often complementary—information. We present a Bayesian method for the unsupervised integrative modelling of multiple datasets, which we refer to as MDI (Multiple Dataset Integration). MDI can integrate information from a wide range of different datasets and data types simultaneously (including the ability to model time series data explicitly using Gaussian processes). Each dataset is modelled using a Dirichlet-multinomial allocation (DMA) mixture model, with dependencies between these models captured through parameters that describe the agreement among the datasets. Results: Using a set of six artificially constructed time series datasets, we show that MDI is able to integrate a significant number of datasets simultaneously, and that it successfully captures the underlying structural similarity between the datasets. We also analyse a variety of real Saccharomyces cerevisiae datasets. In the two-dataset case, we show that MDI’s performance is comparable with the present state-of-the-art. We then move beyond the capabilities of current approaches and integrate gene expression, chromatin immunoprecipitation–chip and protein–protein interaction data, to identify a set of protein complexes for which genes are co-regulated during the cell cycle. Comparisons to other unsupervised data integration techniques—as well as to non-integrative approaches—demonstrate that MDI is competitive, while also providing information that would be difficult or impossible to extract using other methods. Availability: A Matlab implementation of MDI is available from http://www2.warwick.ac.uk/fac/sci/systemsbiology/research/software/. Contact: D.L.Wild@warwick.ac.uk Supplementary information: Supplementary data are available at Bioinformatics online. PMID:23047558

A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

PubMed

O'Neill, Kevin R; Fehlings, Michael G; Mroz, Thomas E; Smith, Zachary A; Hsu, Wellington K; Kanter, Adam S; Steinmetz, Michael P; Arnold, Paul M; Mummaneni, Praveen V; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Smith, Justin S; Shaffrey, Christopher; Tannoury, Chadi A; Tannoury, Tony; Gokaslan, Ziya L; Gum, Jeffrey L; Hart, Robert A; Isaacs, Robert E; Sasso, Rick C; Bumpass, David B; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce C; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M; Pace, Jonathan R; Smith, Gabriel A; Than, Khoi D; Riew, K Daniel

2017-04-01

Retrospective multicenter case series study. Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

Laser treatment of cutaneous angiokeratomas: A systematic review.

PubMed

Nguyen, Jannett; Chapman, Lance W; Korta, Dorota Z; Zachary, Christopher B

2017-11-01

Angiokeratomas can present therapeutic challenges, especially in cases of extensive lesions, where traditional surgical methods carry high risks of scarring and hemorrhage. Argon, pulsed dye (PDL), neodymium-doped yttrium aluminum garnet (Nd:YAG), copper vapor, potassium titanyl phosphate, carbon dioxide, and erbium-doped yttrium aluminum garnet (Er:YAG) lasers have emerged as alternative options. To review the use and efficacy of lasers in treating angiokeratomas. A PubMed search identified randomized clinical trials, cohort studies, case series, and case reports involving laser treatment of cutaneous angiokeratomas. Twenty-five studies were included. Quality ratings were assigned using the Oxford Centre for Evidence-Based Medicine scheme. Several laser modalities are effective in treating multiple variants of angiokeratomas. Vascular lasers like PDL, Nd:YAG, and argon are the most studied and of these, PDL offers the safest side effect profile. Nd:YAG may be more effective for hyperkeratotic angiokeratomas. Combination treatment with multiple laser modalities has also demonstrated some success. Lasers are a promising treatment option for angiokeratomas, but current use is limited by the lack of treatment guidelines. There are limited high quality studies comparing laser treatments to each other and to non-laser options. Additional studies are needed to establish guidelines and to optimize laser parameters. © 2017 Wiley Periodicals, Inc.

Case reports and case series in prehospital emergency care research.

PubMed

Patterson, P Daniel; Weaver, Matthew; Clark, Sunday; Yealy, Donald M

2010-11-01

Research begins with a clearly stated question, problem or hypothesis. The selection of a study design appropriate to the task is the next key step. This paper provides guidance for the use of case report and case series designs by describing the 'what', 'when' and 'how' of both designs. Also described is the use of case reports and case series study designs in prehospital emergency research and the quality of published literature from 2000 to mid-2008.

A COMBINED TREATMENT APPROACH EMPHASIZING IMPAIRMENT-BASED MANUAL THERAPY AND EXERCISE FOR HIP-RELATED COMPENSATORY INJURY IN ELITE ATHLETES: A CASE SERIES.

PubMed

Short, Steve; Short, Gretchen; Strack, Donald; Anloague, Philip; Brewster, Brian

2017-11-01

Athletes experiencing hip, groin, and low back pain often exhibit similar clinical characteristics. Individuals with hip, groin and low back pain may have the presence of multiple concurrent pathoanatomical diagnoses. Regardless, similar regional characteristics and dysfunction may contribute to the patient's chief complaint, potentially creating a sub-group of individuals that may be defined by lumbopelvic and hip mobility limitations, motor control impairments, and other shared clinical findings. The purpose of this case series is to describe the conservative management of elite athletes, within the identified aforementioned sub-group, that emphasized regional manual therapy interventions, and therapeutic exercise designed to improve lumbopelvic and hip mobility, stability and motor control. Five elite athletes were clinically diagnosed by a physical therapist with primary pathologies including adductor-related groin pain (ARGP), femoral acetabular impingement (FAI) with acetabular labral lesion and acute, mechanical low back pain (LBP). Similar subjective, objective findings and overall clinical profiles were identified among all subjects. Common findings aside from the chief complaint included, but were not limited to, decreased hip range of motion (ROM), impaired lumbopelvic motor control and strength, lumbar hypomobility in at least one segment, and a positive hip flexion-adduction-internal rotation (FADIR) special test. A three-phase impairment-based physical therapy program was implemented to resolve the primary complaints and return the subjects to their desired level of function. Acute phase rehabilitation consisted of manual therapy and fundamental motor control exercises. Progression to the sub-acute and terminal phases was based on improved subjective pain reports and progress with functional impairments. As the subjects progress through the rehabilitation phases, the delivery of physical therapy interventions were defined by decreased manual therapies and an increased emphasis and priority on graded exercise. Significant reductions in reported pain (>2 points Numeric Pain Rating Scale), improved reported function via functional outcome measures (Hip and Groin Outcome Score), and continued participation in sport occurred in all five cases without the need for surgical intervention. The athletes described in this case series make up a common clinical sub-group defined by hip and lumbopelvic mobility restrictions, lumbopelvic and lower extremity motor control impairments and potentially other shared clinical findings. Despite differences in pathoanatomic findings, similar objective findings were identified and similar treatment plans were applied, potentially affecting the movement system as a whole. Subjects were conservatively managed allowing continued participation in sport within their competitive seasons. Comprehensive conservative treatment of the athletes with shared impairments, as described in this case series, may be of clinical importance when managing athletes with hip, groin, and low back pain. Therapy, Level 4, Case Series.

Integrating Hypnosis with Other Therapies for Treating Specific Phobias: A Case Series.

PubMed

Hirsch, Joseph A

2018-04-01

There is a high prevalence of anxiety disorders including specific phobias and panic disorder in the United States and Europe. A variety of therapeutic modalities including pharmacotherapy, cognitive behavioral therapy, systematic desensitization, hypnosis, in vivo exposure, and virtual reality exposure therapy have been applied. No one modality has been entirely successful. There has been only a limited attempt to combine psychological therapies in the treatment of specific phobias and panic disorder and what has been done has been primarily with systematic desensitization or cognitive behavioral therapy along with hypnotherapy. I present two cases of multiple specific phobias that were successfully treated with hypnotherapy combined with virtual reality exposure therapy or in vivo exposure therapy. The rationale for this integrative therapy and the neurobiological constructs are considered.

Accelerating Large Data Analysis By Exploiting Regularities

NASA Technical Reports Server (NTRS)

Moran, Patrick J.; Ellsworth, David

2003-01-01

We present techniques for discovering and exploiting regularity in large curvilinear data sets. The data can be based on a single mesh or a mesh composed of multiple submeshes (also known as zones). Multi-zone data are typical to Computational Fluid Dynamics (CFD) simulations. Regularities include axis-aligned rectilinear and cylindrical meshes as well as cases where one zone is equivalent to a rigid-body transformation of another. Our algorithms can also discover rigid-body motion of meshes in time-series data. Next, we describe a data model where we can utilize the results from the discovery process in order to accelerate large data visualizations. Where possible, we replace general curvilinear zones with rectilinear or cylindrical zones. In rigid-body motion cases we replace a time-series of meshes with a transformed mesh object where a reference mesh is dynamically transformed based on a given time value in order to satisfy geometry requests, on demand. The data model enables us to make these substitutions and dynamic transformations transparently with respect to the visualization algorithms. We present results with large data sets where we combine our mesh replacement and transformation techniques with out-of-core paging in order to achieve significant speed-ups in analysis.

Video Game Rehabilitation of Velopharyngeal Dysfunction: A Case Series.

PubMed

Cler, Gabriel J; Mittelman, Talia; Braden, Maia N; Woodnorth, Geralyn Harvey; Stepp, Cara E

2017-06-22

Video games provide a promising platform for rehabilitation of speech disorders. Although video games have been used to train speech perception in foreign language learners and have been proposed for aural rehabilitation, their use in speech therapy has been limited thus far. We present feasibility results from at-home use in a case series of children with velopharyngeal dysfunction (VPD) using an interactive video game that provided real-time biofeedback to facilitate appropriate nasalization. Five participants were recruited across a range of ages, VPD severities, and VPD etiologies. Participants completed multiple weeks of individual game play with a video game that provides feedback on nasalization measured via nasal accelerometry. Nasalization was assessed before and after training by using nasometry, aerodynamic measures, and expert perceptual judgments. Four participants used the game at home or school, with the remaining participant unwilling to have the nasal accelerometer secured to his nasal skin, perhaps due to his young age. The remaining participants showed a tendency toward decreased nasalization after training, particularly for the words explicitly trained in the video game. Results suggest that video game-based systems may provide a useful rehabilitation platform for providing real-time feedback of speech nasalization in VPD. https://doi.org/10.23641/asha.5116828.

Symptomatic Thoracic Spinal Cord Herniation: Case Series and Technical Report

PubMed Central

Hawasli, Ammar H.; Ray, Wilson Z.; Wright, Neill M.

2014-01-01

Background and Importance Idiopathic spinal cord herniation (ISCH) is an uncommon condition located predominantly in the thoracic spine and often associated with a remote history of a major traumatic injury. ISCH has an incompletely described presentation and unknown etiology. There is no consensus on treatment algorithm and surgical technique, and there is little data on clinical outcomes. Clinical Presentation In this case series and technical report, we describe the atypical myelopathy presentation, remote history of traumatic injury, radiographic progression, treatment, and outcomes of 5 patients treated at Washington University for symptomatic ISCH. A video showing surgical repair is presented. In contrast to classic compressive myelopathy symptomology, ISCH patients presented with an atypical myelopathy, characterized by asymmetric motor and sensory deficits and early-onset urinary incontinence. Clinical deterioration correlated with progressive spinal cord displacement and herniation observed on yearly spinal imaging in a patient imaged serially due to multiple sclerosis. Finally compared to compressive myelopathy in the thoracic spine, surgical treatment of ISH led to rapid improvement despite long duration of symptoms. Conclusion Symptomatic ISCH presents with atypical myelopathy and slow temporal progression and can be successfully managed with surgical repair. PMID:24871148

Multiple Acquisition InSAR Analysis: Persistent Scatterer and Small Baseline Approaches

NASA Astrophysics Data System (ADS)

Hooper, A.

2006-12-01

InSAR techniques that process data from multiple acquisitions enable us to form time series of deformation and also allow us to reduce error terms present in single interferograms. There are currently two broad categories of methods that deal with multiple images: persistent scatterer methods and small baseline methods. The persistent scatterer approach relies on identifying pixels whose scattering properties vary little with time and look angle. Pixels that are dominated by a singular scatterer best meet these criteria; therefore, images are processed at full resolution to both increase the chance of there being only one dominant scatterer present, and to reduce the contribution from other scatterers within each pixel. In images where most pixels contain multiple scatterers of similar strength, even at the highest possible resolution, the persistent scatterer approach is less optimal, as the scattering characteristics of these pixels vary substantially with look angle. In this case, an approach that interferes only pairs of images for which the difference in look angle is small makes better sense, and resolution can be sacrificed to reduce the effects of the look angle difference by band-pass filtering. This is the small baseline approach. Existing small baseline methods depend on forming a series of multilooked interferograms and unwrapping each one individually. This approach fails to take advantage of two of the benefits of processing multiple acquisitions, however, which are usually embodied in persistent scatterer methods: the ability to find and extract the phase for single-look pixels with good signal-to-noise ratio that are surrounded by noisy pixels, and the ability to unwrap more robustly in three dimensions, the third dimension being that of time. We have developed, therefore, a new small baseline method to select individual single-look pixels that behave coherently in time, so that isolated stable pixels may be found. After correction for various error terms, the phase values of the selected pixels are unwrapped using a new three-dimensional algorithm. We apply our small baseline method to an area in southern Iceland that includes Katla and Eyjafjallajökull volcanoes, and retrieve a time series of deformation that shows transient deformation due to intrusion of magma beneath Eyjafjallajökull. We also process the data using the Stanford method for persistent scatterers (StaMPS) for comparison.

A pragmatic regional interdependence approach to primary frozen shoulder: a retrospective case series.

PubMed

Wong, Christopher Kevin; Strang, Bryanna L; Schram, Galen A; Mercer, Elizabeth A; Kesting, Rebecca S; Deo, Kabi S

2018-05-01

Although the shoulder is known to move together with the scapula and other upper quarter joints, the current frozen shoulder clinical practice guidelines describe only physical therapy study treatments directed to the shoulder. None received a strong recommendation, highlighting the need for alternate interventions. This retrospective case series describes a pragmatic regional interdependence approach to frozen shoulder with impairment and functional outcomes, noting whether final ROM approached normal. Five consecutive patients referred with frozen shoulder diagnoses attended 11-21 sessions over 5-10 weeks with one physical therapist. Treatment addressed inter-related regions (shoulder, shoulder girdle, scapulothoracic/humerothoracic, and spine) following a pragmatic approach using impairment-based interventions (joint/soft tissue mobilization, muscle stretching/strengthening) as well as patient education, modalities and warm up that addressed individual presentations. All patients improved on all outcomes. Mean shoulder ROM at discharge, the impairment outcome, demonstrated large effect size increases: flexion (117 ± 10-179 ± 12, d  = 5.9), abduction (74 ± 8-175 ± 9, d  = 9.3), external rotation (23 ± 7-89 ± 2, d  = 12.0). The Disability of Arm Shoulder Hand functional outcome score upon follow up demonstrated a large effect size improvement ( d  = 1.5) from 40.0 ± 19.4-6.2 ± 3.7. Final ROM approached normal. This case series utilized a regional interdependence approach to frozen shoulder that included manual therapy interventions directed to consistent upper quarter body segments. Shoulder ROM was returned to near normal with functional improvements evident months after discharge. A pragmatic regional interdependence approach addressing multiple joints related to shoulder function may benefit other people with frozen shoulder. 4.

BRONJ in patients with rheumatoid arthritis: a multicenter case series.

PubMed

Di Fede, O; Bedogni, A; Giancola, F; Saia, G; Bettini, G; Toia, F; D'Alessandro, N; Firenze, A; Matranga, D; Fedele, S; Campisi, G

2016-09-01

Osteonecrosis of the jaw (ONJ) is a potentially severe adverse effect of various medications (bisphosphonates, anti-resorptive, and anti-angiogenic drugs). ONJ pathogenesis is still unclear although some risk factors have been recognized. Of these, rheumatoid arthritis (RA) has been hypothesized as a potential risk factor for developing ONJ. This observational study will describe a multicenter case series of patients affected with RA and ONJ, and it will attempt to evaluate the association between features of ONJ and pharmacological, systemic, and site variables. Demographic, pharmacological, and clinical data from 18 RA patients with ONJ were collected and registered from three Italian centers (i.e., Palermo, Verona, and Padua) from 2004 to 2013. Sixteen (88.9%) patients were in therapy for RA: 9 of 18 (50.0%) with systemic steroids, 3 of 18 (16.7%) with methotrexate, and 4 of 18 (22.2%) with both medications. Two patients were not receiving treatment for RA. All patients took NBPs for secondary osteoporosis (average NBP duration of 69 months, range: 20-130): Fifteen (83.3%) patients were treated with single NBPs, while three (16.7%) with different molecules; one patient was also treated with denosumab. Mandible was affected more frequently (66.7%) than maxilla (33.3%); one patient presented multiple ONJ events. This is the first multicenter case series in the international literature regarding our topic. Focusing on our data, it could be hypothesized that patients with RA may be more susceptible to ONJ than the majority of osteometabolic patients. In our opinion, it could be important to monitor also denosumab or other biological drug side effects. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Characterizing rainfall of hot arid region by using time-series modeling and sustainability approaches: a case study from Gujarat, India

NASA Astrophysics Data System (ADS)

Machiwal, Deepesh; Kumar, Sanjay; Dayal, Devi

2016-05-01

This study aimed at characterization of rainfall dynamics in a hot arid region of Gujarat, India by employing time-series modeling techniques and sustainability approach. Five characteristics, i.e., normality, stationarity, homogeneity, presence/absence of trend, and persistence of 34-year (1980-2013) period annual rainfall time series of ten stations were identified/detected by applying multiple parametric and non-parametric statistical tests. Furthermore, the study involves novelty of proposing sustainability concept for evaluating rainfall time series and demonstrated the concept, for the first time, by identifying the most sustainable rainfall series following reliability ( R y), resilience ( R e), and vulnerability ( V y) approach. Box-whisker plots, normal probability plots, and histograms indicated that the annual rainfall of Mandvi and Dayapar stations is relatively more positively skewed and non-normal compared with that of other stations, which is due to the presence of severe outlier and extreme. Results of Shapiro-Wilk test and Lilliefors test revealed that annual rainfall series of all stations significantly deviated from normal distribution. Two parametric t tests and the non-parametric Mann-Whitney test indicated significant non-stationarity in annual rainfall of Rapar station, where the rainfall was also found to be non-homogeneous based on the results of four parametric homogeneity tests. Four trend tests indicated significantly increasing rainfall trends at Rapar and Gandhidham stations. The autocorrelation analysis suggested the presence of persistence of statistically significant nature in rainfall series of Bhachau (3-year time lag), Mundra (1- and 9-year time lag), Nakhatrana (9-year time lag), and Rapar (3- and 4-year time lag). Results of sustainability approach indicated that annual rainfall of Mundra and Naliya stations ( R y = 0.50 and 0.44; R e = 0.47 and 0.47; V y = 0.49 and 0.46, respectively) are the most sustainable and dependable compared with that of other stations. The highest values of sustainability index at Mundra (0.120) and Naliya (0.112) stations confirmed the earlier findings of R y- R e- V y approach. In general, annual rainfall of the study area is less reliable, less resilient, and moderately vulnerable, which emphasizes the need of developing suitable strategies for managing water resources of the area on sustainable basis. Finally, it is recommended that multiple statistical tests (at least two) should be used in time-series modeling for making reliable decisions. Moreover, methodology and findings of the sustainability concept in rainfall time series can easily be adopted in other arid regions of the world.

Whole-exome sequencing and targeted gene sequencing provide insights into the role of PALB2 as a male breast cancer susceptibility gene.

PubMed

Silvestri, Valentina; Zelli, Veronica; Valentini, Virginia; Rizzolo, Piera; Navazio, Anna Sara; Coppa, Anna; Agata, Simona; Oliani, Cristina; Barana, Daniela; Castrignanò, Tiziana; Viel, Alessandra; Russo, Antonio; Tibiletti, Maria Grazia; Zanna, Ines; Masala, Giovanna; Cortesi, Laura; Manoukian, Siranoush; Azzollini, Jacopo; Peissel, Bernard; Bonanni, Bernardo; Peterlongo, Paolo; Radice, Paolo; Palli, Domenico; Giannini, Giuseppe; Chillemi, Giovanni; Montagna, Marco; Ottini, Laura

2017-01-01

Male breast cancer (MBC) is a rare disease whose etiology appears to be largely associated with genetic factors. BRCA1 and BRCA2 mutations account for about 10% of all MBC cases. Thus, a fraction of MBC cases are expected to be due to genetic factors not yet identified. To further explain the genetic susceptibility for MBC, whole-exome sequencing (WES) and targeted gene sequencing were applied to high-risk, BRCA1/2 mutation-negative MBC cases. Germ-line DNA of 1 male and 2 female BRCA1/2 mutation-negative breast cancer (BC) cases from a pedigree showing a first-degree family history of MBC was analyzed with WES. Targeted gene sequencing for the validation of WES results was performed for 48 high-risk, BRCA1/2 mutation-negative MBC cases from an Italian multicenter study of MBC. A case-control series of 433 BRCA1/2 mutation-negative MBC and female breast cancer (FBC) cases and 849 male and female controls was included in the study. WES in the family identified the partner and localizer of BRCA2 (PALB2) c.419delA truncating mutation carried by the proband, her father, and her paternal uncle (all affected with BC) and the N-acetyltransferase 1 (NAT1) c.97C>T nonsense mutation carried by the proband's maternal aunt. Targeted PALB2 sequencing detected the c.1984A>T nonsense mutation in 1 of the 48 BRCA1/2 mutation-negative MBC cases. NAT1 c.97C>T was not found in the case-control series. These results add strength to the evidence showing that PALB2 is involved in BC risk for both sexes and indicate that consideration should be given to clinical testing of PALB2 for BRCA1/2 mutation-negative families with multiple MBC and FBC cases. Cancer 2017;123:210-218. © 2016 American Cancer Society. © 2016 American Cancer Society.

Exploring total cardiac variability in healthy and pathophysiological subjects using improved refined multiscale entropy.

PubMed

Marwaha, Puneeta; Sunkaria, Ramesh Kumar

2017-02-01

Multiscale entropy (MSE) and refined multiscale entropy (RMSE) techniques are being widely used to evaluate the complexity of a time series across multiple time scales 't'. Both these techniques, at certain time scales (sometimes for the entire time scales, in the case of RMSE), assign higher entropy to the HRV time series of certain pathologies than that of healthy subjects, and to their corresponding randomized surrogate time series. This incorrect assessment of signal complexity may be due to the fact that these techniques suffer from the following limitations: (1) threshold value 'r' is updated as a function of long-term standard deviation and hence unable to explore the short-term variability as well as substantial variability inherited in beat-to-beat fluctuations of long-term HRV time series. (2) In RMSE, entropy values assigned to different filtered scaled time series are the result of changes in variance, but do not completely reflect the real structural organization inherited in original time series. In the present work, we propose an improved RMSE (I-RMSE) technique by introducing a new procedure to set the threshold value by taking into account the period-to-period variability inherited in a signal and evaluated it on simulated and real HRV database. The proposed I-RMSE assigns higher entropy to the age-matched healthy subjects than that of patients suffering from atrial fibrillation, congestive heart failure, sudden cardiac death and diabetes mellitus, for the entire time scales. The results strongly support the reduction in complexity of HRV time series in female group, old-aged, patients suffering from severe cardiovascular and non-cardiovascular diseases, and in their corresponding surrogate time series.

Scale-dependent intrinsic entropies of complex time series.

PubMed

Yeh, Jia-Rong; Peng, Chung-Kang; Huang, Norden E

2016-04-13

Multi-scale entropy (MSE) was developed as a measure of complexity for complex time series, and it has been applied widely in recent years. The MSE algorithm is based on the assumption that biological systems possess the ability to adapt and function in an ever-changing environment, and these systems need to operate across multiple temporal and spatial scales, such that their complexity is also multi-scale and hierarchical. Here, we present a systematic approach to apply the empirical mode decomposition algorithm, which can detrend time series on various time scales, prior to analysing a signal's complexity by measuring the irregularity of its dynamics on multiple time scales. Simulated time series of fractal Gaussian noise and human heartbeat time series were used to study the performance of this new approach. We show that our method can successfully quantify the fractal properties of the simulated time series and can accurately distinguish modulations in human heartbeat time series in health and disease. © 2016 The Author(s).

Employment as a welder and Parkinson disease among heavy equipment manufacturing workers.

PubMed

Marsh, Gary M; Gula, Mary Jean

2006-10-01

We investigated whether employment as a welder with potential exposure to manganese and other substances is associated with Parkinson disease (PD), parkinsonism or related neurological disorders, or accelerates the age of onset of PD. We selected cases and controls from 12,595 persons ever employed at three Caterpillar Inc. (CAT) plants between 1976 and 2004 with potential to make a medical insurance claim between 1998 and 2004. Cases had filed a claim for 1) PD, 2) "secondary parkinsonism", 3) "other degenerative diseases of the basal ganglia" or 4) "essential and other specific forms of tremor". Cases were grouped by claims: Group 1-claims 1 and 2 and Group 2-claims 1 to 4, and as study period incident (SPI) or prevalent. Each case was matched to two series of 10 controls each on date of case's first claim, year of birth, race and sex. Series I was also matched on plant. Odds ratios (OR) and 95% confidence intervals (CI) for the variable, "ever welder in any CAT plant" were: Group 1-SPI Cases: Series I (OR = .76, CI = .26-2.19), Series II (OR = .81, CI = .29-2.25); Group 1- Prevalent Cases: Series I (OR = .82, CI = .36-1.86), Series II (OR = .97, CI = .42-2.23); Group 2- SPI Cases: Series I (OR = 1.03, CI = .57-1.87), Series II (OR = 1.21, CI = .67-2.20) Group 2-Prevalent Cases: Series I (OR = 1.02, CI = .62-1.71), Series II (OR = .86, CI = .51-1.43). Our finding of no statistically significant associations for welding employment was maintained following adjustment for potential confounding and evaluation of possible effect modification. Employment as a welder did not accelerate the age of onset of PD. Our study supported the conclusion that employment as a welder is not associated with Parkinson disease, parkinsonism or a related neurological disorder.

A Framework and Algorithms for Multivariate Time Series Analytics (MTSA): Learning, Monitoring, and Recommendation

ERIC Educational Resources Information Center

Ngan, Chun-Kit

2013-01-01

Making decisions over multivariate time series is an important topic which has gained significant interest in the past decade. A time series is a sequence of data points which are measured and ordered over uniform time intervals. A multivariate time series is a set of multiple, related time series in a particular domain in which domain experts…

Electric properties and carrier multiplication in breakdown sites in multi-crystalline silicon solar cells

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

Schneemann, Matthias; Carius, Reinhard; Rau, Uwe

2015-05-28

This paper studies the effective electrical size and carrier multiplication of breakdown sites in multi-crystalline silicon solar cells. The local series resistance limits the current of each breakdown site and is thereby linearizing the current-voltage characteristic. This fact allows the estimation of the effective electrical diameters to be as low as 100 nm. Using a laser beam induced current (LBIC) measurement with a high spatial resolution, we find carrier multiplication factors on the order of 30 (Zener-type breakdown) and 100 (avalanche breakdown) as new lower limits. Hence, we prove that also the so-called Zener-type breakdown is followed by avalanche multiplication. Wemore » explain that previous measurements of the carrier multiplication using thermography yield results higher than unity, only if the spatial defect density is high enough, and the illumination intensity is lower than what was used for the LBIC method. The individual series resistances of the breakdown sites limit the current through these breakdown sites. Therefore, the measured multiplication factors depend on the applied voltage as well as on the injected photocurrent. Both dependencies are successfully simulated using a series-resistance-limited diode model.« less

Clinical time series prediction: Toward a hierarchical dynamical system framework.

PubMed

Liu, Zitao; Hauskrecht, Milos

2015-09-01

Developing machine learning and data mining algorithms for building temporal models of clinical time series is important for understanding of the patient condition, the dynamics of a disease, effect of various patient management interventions and clinical decision making. In this work, we propose and develop a novel hierarchical framework for modeling clinical time series data of varied length and with irregularly sampled observations. Our hierarchical dynamical system framework for modeling clinical time series combines advantages of the two temporal modeling approaches: the linear dynamical system and the Gaussian process. We model the irregularly sampled clinical time series by using multiple Gaussian process sequences in the lower level of our hierarchical framework and capture the transitions between Gaussian processes by utilizing the linear dynamical system. The experiments are conducted on the complete blood count (CBC) panel data of 1000 post-surgical cardiac patients during their hospitalization. Our framework is evaluated and compared to multiple baseline approaches in terms of the mean absolute prediction error and the absolute percentage error. We tested our framework by first learning the time series model from data for the patients in the training set, and then using it to predict future time series values for the patients in the test set. We show that our model outperforms multiple existing models in terms of its predictive accuracy. Our method achieved a 3.13% average prediction accuracy improvement on ten CBC lab time series when it was compared against the best performing baseline. A 5.25% average accuracy improvement was observed when only short-term predictions were considered. A new hierarchical dynamical system framework that lets us model irregularly sampled time series data is a promising new direction for modeling clinical time series and for improving their predictive performance. Copyright © 2014 Elsevier B.V. All rights reserved.

Wrong Answers on Multiple-Choice Achievement Tests: Blind Guesses or Systematic Choices?.

ERIC Educational Resources Information Center

Powell, J. C.

A multi-faceted model for the selection of answers for multiple-choice tests was developed from the findings of a series of exploratory studies. This model implies that answer selection should be curvilinear. A series of models were tested for fit using the chi square procedure. Data were collected from 359 elementary school students ages 9-12.…

The Representation of Multiple Intelligences Types in the Top-Notch Series: A Textbook Evaluation

ERIC Educational Resources Information Center

Razmjoo, Seyyed Ayatollah; Jozaghi, Zahra

2010-01-01

This study aims at evaluating Top-Notch series through a checklist devised by the researchers based on the elements of the Multiple Intelligences (MI) theory proposed by Gardner (1998). With the shift from teacher-centered classrooms to learner-centered one, more and more research is needed to be done in the realm of students' need analysis. One…

Taphonomic problems in reconstructing sea-level history from the late Quaternary marine terraces of Barbados

USGS Publications Warehouse

Muhs, Daniel; Simmons, Kathleen R.

2017-01-01

Although uranium series (U-series) ages of growth-position fossil corals are important to Quaternary sea-level history, coral clast reworking from storms can yield ages on a terrace dating to more than one high-sea stand, confounding interpretations of sea-level history. On northern Barbados, U-series ages corals from a thick storm deposit are not always younger with successively higher stratigraphic positions, but all date to the last interglacial period (~127 ka to ~112 ka), Marine Isotope Substage (MIS) 5.5. The storm deposit ages are consistent with the ages of growth-position corals found at the base of the section and at landward localities on this terrace. Thus, in this case, analysis of only a few corals would not have led to an error in interpreting sea-level history. In contrast, a notch cut into older Pleistocene limestone below the MIS 5.5 terrace contains corals that date to both MIS 5.5 (~125 ka) and MIS 5.3 (~108 ka). We infer that the notch formed during MIS 5.3 and the MIS 5.5 corals are reworked. Similar multiple ages of corals on terraces have been reported elsewhere on Barbados. Thus, care must be taken in interpreting U-series ages of corals that are reported without consideration of taphonomy.

Persistent threats to validity in single-group interrupted time series analysis with a cross over design.

PubMed

Linden, Ariel

2017-04-01

The basic single-group interrupted time series analysis (ITSA) design has been shown to be susceptible to the most common threat to validity-history-the possibility that some other event caused the observed effect in the time series. A single-group ITSA with a crossover design (in which the intervention is introduced and withdrawn 1 or more times) should be more robust. In this paper, we describe and empirically assess the susceptibility of this design to bias from history. Time series data from 2 natural experiments (the effect of multiple repeals and reinstatements of Louisiana's motorcycle helmet law on motorcycle fatalities and the association between the implementation and withdrawal of Gorbachev's antialcohol campaign with Russia's mortality crisis) are used to illustrate that history remains a threat to ITSA validity, even in a crossover design. Both empirical examples reveal that the single-group ITSA with a crossover design may be biased because of history. In the case of motorcycle fatalities, helmet laws appeared effective in reducing mortality (while repealing the law increased mortality), but when a control group was added, it was shown that this trend was similar in both groups. In the case of Gorbachev's antialcohol campaign, only when contrasting the results against those of a control group was the withdrawal of the campaign found to be the more likely culprit in explaining the Russian mortality crisis than the collapse of the Soviet Union. Even with a robust crossover design, single-group ITSA models remain susceptible to bias from history. Therefore, a comparable control group design should be included, whenever possible. © 2016 John Wiley & Sons, Ltd.

Case Series Investigations in Cognitive Neuropsychology

PubMed Central

Schwartz, Myrna F.; Dell, Gary S.

2011-01-01

Case series methodology involves the systematic assessment of a sample of related patients, with the goal of understanding how and why they differ from one another. This method has become increasingly important in cognitive neuropsychology, which has long been identified with single-subject research. We review case series studies dealing with impaired semantic memory, reading, and language production, and draw attention to the affinity of this methodology for testing theories that are expressed as computational models and for addressing questions about neuroanatomy. It is concluded that case series methods usefully complement single-subject techniques. PMID:21714756

Two-dimensional nuclear magnetic resonance of quadrupolar systems

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

Wang, Shuanhu

1997-09-01

This dissertation describes two-dimensional nuclear magnetic resonance theory and experiments which have been developed to study quadruples in the solid state. The technique of multiple-quantum magic-angle spinning (MQMAS) is extensively reviewed and expanded upon in this thesis. Specifically, MQMAS is first compared with another technique, dynamic-angle spinning (DAS). The similarity between the two techniques allows us to extend much of the DAS work to the MQMAS case. Application of MQMAS to a series of aluminum containing materials is then presented. The superior resolution enhancement through MQMAS is exploited to detect the five- and six-coordinated aluminum in many aluminosilicate glasses. Combiningmore » the MQMAS method with other experiments, such as HETCOR, greatly expands the possibility of the use of MQMAS to study a large range of problems and is demonstrated in Chapter 5. Finally, the technique switching-angle spinning (SAS) is applied to quadrupolar nuclei to fully characterize a quadrupolar spin system in which all of the 8 NMR parameters are accurately determined. This dissertation is meant to demonstrate that with the combination of two-dimensional NMR concepts and new advanced spinning technologies, a series of multiple-dimensional NMR techniques can be designed to allow a detailed study of quadrupolar nuclei in the solid state.« less

Automatic Multi-sensor Data Quality Checking and Event Detection for Environmental Sensing

NASA Astrophysics Data System (ADS)

LIU, Q.; Zhang, Y.; Zhao, Y.; Gao, D.; Gallaher, D. W.; Lv, Q.; Shang, L.

2017-12-01

With the advances in sensing technologies, large-scale environmental sensing infrastructures are pervasively deployed to continuously collect data for various research and application fields, such as air quality study and weather condition monitoring. In such infrastructures, many sensor nodes are distributed in a specific area and each individual sensor node is capable of measuring several parameters (e.g., humidity, temperature, and pressure), providing massive data for natural event detection and analysis. However, due to the dynamics of the ambient environment, sensor data can be contaminated by errors or noise. Thus, data quality is still a primary concern for scientists before drawing any reliable scientific conclusions. To help researchers identify potential data quality issues and detect meaningful natural events, this work proposes a novel algorithm to automatically identify and rank anomalous time windows from multiple sensor data streams. More specifically, (1) the algorithm adaptively learns the characteristics of normal evolving time series and (2) models the spatial-temporal relationship among multiple sensor nodes to infer the anomaly likelihood of a time series window for a particular parameter in a sensor node. Case studies using different data sets are presented and the experimental results demonstrate that the proposed algorithm can effectively identify anomalous time windows, which may resulted from data quality issues and natural events.

TWO CRITERIA FOR WEAK GENERALIZED LOCALIZATION FOR MULTIPLE TRIGONOMETRIC FOURIER SERIES OF FUNCTIONS IN L_p, p \\ge 1

NASA Astrophysics Data System (ADS)

Bloshanskiĭ, I. L.

1986-04-01

The concept of weak generalized localization almost everywhere is introduced. For the multiple Fourier series of a function f, weak generalized localization almost everywhere holds on the set E (E is an arbitrary set of positive measure E \\subset T^N = \\lbrack- \\pi, \\pi\\rbrack^N) if the condition f(x) \\in L_p(T^N), p \\ge 1, f = 0 on E implies that the indicated series converges almost everywhere on some subset E_1 \\subset E of positive measure. For a large class of sets \\{ E \\}, E \\subset T^N, a number of propositions are proved showing that weak localization of rectangular sums holds on the set E in the classes L_p, p \\ge 1, if and only if the set E has certain specific properties. In the course of the proof the precise geometry and structure of the subset E_1 of E on which the multiple Fourier series converges almost everywhere to zero are determined. Bibliography: 13 titles.

Local contrast-enhanced MR images via high dynamic range processing.

PubMed

Chandra, Shekhar S; Engstrom, Craig; Fripp, Jurgen; Neubert, Ales; Jin, Jin; Walker, Duncan; Salvado, Olivier; Ho, Charles; Crozier, Stuart

2018-09-01

To develop a local contrast-enhancing and feature-preserving high dynamic range (HDR) image processing algorithm for multichannel and multisequence MR images of multiple body regions and tissues, and to evaluate its performance for structure visualization, bias field (correction) mitigation, and automated tissue segmentation. A multiscale-shape and detail-enhancement HDR-MRI algorithm is applied to data sets of multichannel and multisequence MR images of the brain, knee, breast, and hip. In multisequence 3T hip images, agreement between automatic cartilage segmentations and corresponding synthesized HDR-MRI series were computed for mean voxel overlap established from manual segmentations for a series of cases. Qualitative comparisons between the developed HDR-MRI and standard synthesis methods were performed on multichannel 7T brain and knee data, and multisequence 3T breast and knee data. The synthesized HDR-MRI series provided excellent enhancement of fine-scale structure from multiple scales and contrasts, while substantially reducing bias field effects in 7T brain gradient echo, T 1 and T 2 breast images and 7T knee multichannel images. Evaluation of the HDR-MRI approach on 3T hip multisequence images showed superior outcomes for automatic cartilage segmentations with respect to manual segmentation, particularly around regions with hyperintense synovial fluid, across a set of 3D sequences. The successful combination of multichannel/sequence MR images into a single-fused HDR-MR image format provided consolidated visualization of tissues within 1 omnibus image, enhanced definition of thin, complex anatomical structures in the presence of variable or hyperintense signals, and improved tissue (cartilage) segmentation outcomes. © 2018 International Society for Magnetic Resonance in Medicine.

A stochastical event-based continuous time step rainfall generator based on Poisson rectangular pulse and microcanonical random cascade models

NASA Astrophysics Data System (ADS)

Pohle, Ina; Niebisch, Michael; Zha, Tingting; Schümberg, Sabine; Müller, Hannes; Maurer, Thomas; Hinz, Christoph

2017-04-01

Rainfall variability within a storm is of major importance for fast hydrological processes, e.g. surface runoff, erosion and solute dissipation from surface soils. To investigate and simulate the impacts of within-storm variabilities on these processes, long time series of rainfall with high resolution are required. Yet, observed precipitation records of hourly or higher resolution are in most cases available only for a small number of stations and only for a few years. To obtain long time series of alternating rainfall events and interstorm periods while conserving the statistics of observed rainfall events, the Poisson model can be used. Multiplicative microcanonical random cascades have been widely applied to disaggregate rainfall time series from coarse to fine temporal resolution. We present a new coupling approach of the Poisson rectangular pulse model and the multiplicative microcanonical random cascade model that preserves the characteristics of rainfall events as well as inter-storm periods. In the first step, a Poisson rectangular pulse model is applied to generate discrete rainfall events (duration and mean intensity) and inter-storm periods (duration). The rainfall events are subsequently disaggregated to high-resolution time series (user-specified, e.g. 10 min resolution) by a multiplicative microcanonical random cascade model. One of the challenges of coupling these models is to parameterize the cascade model for the event durations generated by the Poisson model. In fact, the cascade model is best suited to downscale rainfall data with constant time step such as daily precipitation data. Without starting from a fixed time step duration (e.g. daily), the disaggregation of events requires some modifications of the multiplicative microcanonical random cascade model proposed by Olsson (1998): Firstly, the parameterization of the cascade model for events of different durations requires continuous functions for the probabilities of the multiplicative weights, which we implemented through sigmoid functions. Secondly, the branching of the first and last box is constrained to preserve the rainfall event durations generated by the Poisson rectangular pulse model. The event-based continuous time step rainfall generator has been developed and tested using 10 min and hourly rainfall data of four stations in North-Eastern Germany. The model performs well in comparison to observed rainfall in terms of event durations and mean event intensities as well as wet spell and dry spell durations. It is currently being tested using data from other stations across Germany and in different climate zones. Furthermore, the rainfall event generator is being applied in modelling approaches aimed at understanding the impact of rainfall variability on hydrological processes. Reference Olsson, J.: Evaluation of a scaling cascade model for temporal rainfall disaggregation, Hydrology and Earth System Sciences, 2, 19.30

An unusual case of isolated, serial metastases of gallbladder carcinoma involving the chest wall, axilla, breast and lung parenchyma

PubMed Central

Jeyaraj, Pamela; Sio, Terence T.; Iott, Matthew J.

2013-01-01

In the English literature, only 9 cases of adenocarcinoma of the gallbladder with cutaneous metastasis have been reported so far. One case of multiple cutaneous metastases along with deposits in the breast tissue has been reported. We present a case of incidental metastatic gallbladder carcinoma with no intra-abdominal disease presenting as a series of four isolated cutaneous right chest wall, axillary nodal, breast, and pulmonary metastases following resection and adjuvant chemoradiation for her primary tumor. In spite of the metastatic disease coupled with the aggressive nature of the cancer, this patient reported that her energy level had returned to baseline with a good appetite and a stable weight indicating a good performance status and now is alive at 25 months since diagnosis. Her serially-presented, oligometastatic diseases were well-controlled by concurrent chemoradiotherapy and stereotactic radiation therapy. We report this case study because of its rarity and for the purpose of complementing current literature with an additional example of cutaneous metastasis from adenocarcinoma of the gallbladder. PMID:23772306

Facial dog bite injuries in children: treatment and outcome assessment.

PubMed

Eppley, Barry L; Schleich, Arno Rene

2013-03-01

Dog bite injuries to a child's face are not an infrequent occurrence. They may require primary and revisional surgery. All result in permanent facial scars. This report describes the treatment and outcomes of dog bites of the face, scalp, and neck based on a case series of 107 children over a 10-year period.The average children's age was 5.9 years. In cases where the dog was identified (95%), it was known to the victim and their family. The events leading to the dog bite were categorized as provoked (77%) in the majority of the cases.The majority of wounds could be closed primarily without a significant risk of wound infection. Complex reconstructions were required in more severe cases. The majority of families (77%) opted for scar revision between 9 and 18 months after initial treatment to improve the aesthetic outcome.Lawsuit actions resulted in 39 of the cases making good documentation an essential part of treatment. Dogbite injuries to the face in children frequently require multiple scar revisions to obtain the best possible aesthetic outcome, and the family should be so counseled at the onset of treatment.

Applications of time-series analysis to mood fluctuations in bipolar disorder to promote treatment innovation: a case series

PubMed Central

Holmes, E A; Bonsall, M B; Hales, S A; Mitchell, H; Renner, F; Blackwell, S E; Watson, P; Goodwin, G M; Di Simplicio, M

2016-01-01

Treatment innovation for bipolar disorder has been hampered by a lack of techniques to capture a hallmark symptom: ongoing mood instability. Mood swings persist during remission from acute mood episodes and impair daily functioning. The last significant treatment advance remains Lithium (in the 1970s), which aids only the minority of patients. There is no accepted way to establish proof of concept for a new mood-stabilizing treatment. We suggest that combining insights from mood measurement with applied mathematics may provide a step change: repeated daily mood measurement (depression) over a short time frame (1 month) can create individual bipolar mood instability profiles. A time-series approach allows comparison of mood instability pre- and post-treatment. We test a new imagery-focused cognitive therapy treatment approach (MAPP; Mood Action Psychology Programme) targeting a driver of mood instability, and apply these measurement methods in a non-concurrent multiple baseline design case series of 14 patients with bipolar disorder. Weekly mood monitoring and treatment target data improved for the whole sample combined. Time-series analyses of daily mood data, sampled remotely (mobile phone/Internet) for 28 days pre- and post-treatment, demonstrated improvements in individuals' mood stability for 11 of 14 patients. Thus the findings offer preliminary support for a new imagery-focused treatment approach. They also indicate a step in treatment innovation without the requirement for trials in illness episodes or relapse prevention. Importantly, daily measurement offers a description of mood instability at the individual patient level in a clinically meaningful time frame. This costly, chronic and disabling mental illness demands innovation in both treatment approaches (whether pharmacological or psychological) and measurement tool: this work indicates that daily measurements can be used to detect improvement in individual mood stability for treatment innovation (MAPP). PMID:26812041

Prevalence and predictors of germline CDKN2A mutations for melanoma cases from Australia, Spain and the United Kingdom.

PubMed

Harland, Mark; Cust, Anne E; Badenas, Celia; Chang, Yu-Mei; Holland, Elizabeth A; Aguilera, Paula; Aitken, Joanne F; Armstrong, Bruce K; Barrett, Jennifer H; Carrera, Cristina; Chan, May; Gascoyne, Joanne; Giles, Graham G; Agha-Hamilton, Chantelle; Hopper, John L; Jenkins, Mark A; Kanetsky, Peter A; Kefford, Richard F; Kolm, Isabel; Lowery, Johanna; Malvehy, Josep; Ogbah, Zighereda; Puig-Butille, Joan-Anton; Orihuela-Segalés, Jordi; Randerson-Moor, Juliette A; Schmid, Helen; Taylor, Claire F; Whitaker, Linda; Bishop, D Timothy; Mann, Graham J; Newton-Bishop, Julia A; Puig, Susana

2014-01-01

Mutations in the CDKN2A and CDK4 genes predispose to melanoma. From three case-control studies of cutaneous melanoma, we estimated the prevalence and predictors of these mutations for people from regions with widely differing latitudes and melanoma incidence. Population-based cases and controls from the United Kingdom (1586 cases, 499 controls) and Australia (596 early-onset cases, 476 controls), and a hospital-based series from Spain (747 cases, 109 controls), were screened for variants in all exons of CDKN2A and the p16INK4A binding domain of CDK4. The prevalence of mutations for people with melanoma was similar across regions: 2.3%, 2.5% and 2.0% for Australia, Spain and the United Kingdom respectively. The strongest predictors of carrying a mutation were having multiple primaries (odds ratio (OR) = 5.4, 95% confidence interval (CI: 2.5, 11.6) for 2 primaries and OR = 32.4 (95% CI: 14.7, 71.2) for 3 or more compared with 1 primary only); and family history (OR = 3.8; 95% CI:1.89, 7.5) for 1 affected first- or second-degree relative and OR = 23.2 (95% CI: 11.3, 47.6) for 2 or more compared with no affected relatives). Only 1.1% of melanoma cases with neither a family history nor multiple primaries had mutations. There is a low probability (<2%) of detecting a germline CDKN2A mutation in people with melanoma except for those with a strong family history of melanoma (≥2 affected relatives, 25%), three or more primary melanomas (29%), or more than one primary melanoma who also have other affected relatives (27%).

Stacked Transformer for Driver Gain and Receive Signal Splitting

NASA Technical Reports Server (NTRS)

Driscoll, Kevin R.

2013-01-01

In a high-speed signal transmission system that uses transformer coupling, there is a need to provide increased transmitted signal strength without adding active components. This invention uses additional transformers to achieve the needed gain. The prior art uses stronger drivers (which require an IC redesign and a higher power supply voltage), or the addition of another active component (which can decrease reliability, increase power consumption, reduce the beneficial effect of serializer/deserializer preemphasis or deemphasis, and/or interfere with fault containment mechanisms), or uses a different transformer winding ratio (which requires redesign of the transformer and may not be feasible with high-speed signals that require a 1:1 winding ratio). This invention achieves the required gain by connecting the secondaries of multiple transformers in series. The primaries of these transformers are currently either connected in parallel or are connected to multiple drivers. There is also a need to split a receive signal to multiple destinations with minimal signal loss. Additional transformers can achieve the split. The prior art uses impedance-matching series resistors that cause a loss of signal. Instead of causing a loss, most instantiations of this invention would actually provide gain. Multiple transformers are used instead of multiple windings on a single transformer because multiple windings on the same transformer would require a redesign of the transformer, and may not be feasible with high-speed transformers that usually require a bifilar winding with a 1:1 ratio. This invention creates the split by connecting the primaries of multiple transformers in series. The secondary of each transformer is connected to one of the intended destinations without the use of impedance-matching series resistors.

The multiple imputation method: a case study involving secondary data analysis.

PubMed

Walani, Salimah R; Cleland, Charles M

2015-05-01

To illustrate with the example of a secondary data analysis study the use of the multiple imputation method to replace missing data. Most large public datasets have missing data, which need to be handled by researchers conducting secondary data analysis studies. Multiple imputation is a technique widely used to replace missing values while preserving the sample size and sampling variability of the data. The 2004 National Sample Survey of Registered Nurses. The authors created a model to impute missing values using the chained equation method. They used imputation diagnostics procedures and conducted regression analysis of imputed data to determine the differences between the log hourly wages of internationally educated and US-educated registered nurses. The authors used multiple imputation procedures to replace missing values in a large dataset with 29,059 observations. Five multiple imputed datasets were created. Imputation diagnostics using time series and density plots showed that imputation was successful. The authors also present an example of the use of multiple imputed datasets to conduct regression analysis to answer a substantive research question. Multiple imputation is a powerful technique for imputing missing values in large datasets while preserving the sample size and variance of the data. Even though the chained equation method involves complex statistical computations, recent innovations in software and computation have made it possible for researchers to conduct this technique on large datasets. The authors recommend nurse researchers use multiple imputation methods for handling missing data to improve the statistical power and external validity of their studies.

The detection of local irreversibility in time series based on segmentation

NASA Astrophysics Data System (ADS)

Teng, Yue; Shang, Pengjian

2018-06-01

We propose a strategy for the detection of local irreversibility in stationary time series based on multiple scale. The detection is beneficial to evaluate the displacement of irreversibility toward local skewness. By means of this method, we can availably discuss the local irreversible fluctuations of time series as the scale changes. The method was applied to simulated nonlinear signals generated by the ARFIMA process and logistic map to show how the irreversibility functions react to the increasing of the multiple scale. The method was applied also to series of financial markets i.e., American, Chinese and European markets. The local irreversibility for different markets demonstrate distinct characteristics. Simulations and real data support the need of exploring local irreversibility.

Multiple fractures in infants who have Ehlers-Danlos/hypermobility syndrome and or vitamin D deficiency: A case series of 72 infants whose parents were accused of child abuse and neglect

PubMed Central

Hossein-Nezhad, A.; Tabatabaei, F.

2017-01-01

ABSTRACT Objective: To increase the level of awareness that Ehlers-Danlos/hypermobility syndrome (EDS) and vitamin D deficiency are associated with infantile fragility fractures and radiologic features that may be mistakenly reported to be caused by non-accidental trauma due to Child Abuse and Neglect (CAN). Patients and Methods: We constructed a case series, the largest to date, of infants with EDS who were vitamin D sufficient, insufficient and deficient and infants without EDS but with documented vitamin D deficiency and radiologic evidence of rickets who presented with multiple fractures originally diagnosed as being non-accidental and caused by child abuse. These infants were referred to the outpatient Bone Health Care Clinic at Boston University Medical Campus over a 6-year (2010–2015) period. We also present 6 index cases in which the court concluded that there was no convincing evidence of child abuse and the infants were returned to their parents. Institutional Review Board (IRB) approval was obtained. Results: We present 72 cases of infants with multiple fractures diagnosed to be caused by non-accidental trauma. All infants were younger than one year of age. Among them, 93%(67) had clinical evidence of EDS and/or a family history with a confirmed clinical diagnosis of at least one parent having EDS and the other 7%(5) without evidence of EDS had vitamin D deficiency/infantile rickets. Three of the EDS infants were diagnosed as osteogenesis imperfecta (OI)/EDS overlap syndrome. The most common fractures noted at diagnosis were ribs and extremity fractures (including classic metaphyseal lesions). Serum levels of 25-hydroxyvitamin D [25(OH)D] were reported in 48 infants (18.0 ± 8.5 ng/ml) and in 30 mothers (21.3 ± 11.7 ng/ml). Sixty-three percent (27) of the EDS infants who had their serum 25(OH)D measured were vitamin D deficient 25(OH)D<20 ng/ml and 5 were vitamin D sufficient 25(OH)D>30 ng/ml. The mean serum level for infants with vitamin D deficiency/rickets was (10.2 ± 3.0 ng/ml) Conclusion: EDS, OI/EDS and vitamin D deficiency/infantile rickets are associated with fragility fractures in infants that can be misinterpreted as caused by non-accidental trauma due to child abuse. PMID:29511428

Ketamine Therapy for Treatment-resistant Depression in a Patient with Multiple Sclerosis: A Case Report.

PubMed

Messer, Michael M; Haller, Irina V

2017-01-01

Objective: Depression is a common condition among patients with multiple sclerosis and often becomes resistant to oral antidepressants. We report a patient with multiple sclerosis who developed severe treatment-resistant depression and who was successfully treated with intravenous ketamine over the period of two years. Methods: Ketamine treatment protocol included an initial series of six treatments administered every other day, followed by a maintenance schedule. Ketamine was administered intravenously at 0.5mg/kg of ideal body weight over 40 minutes. Depression symptoms were measured using Beck Depression Index. Results: The patient's Beck Depression Index score prior to initiating ketamine treatment was 38, corresponding to severe depression. Response to treatment, defined as 50-percent reduction in Beck Depression Index score, was observed after five treatments. For this patient, the maintenance schedule ranged from a weekly treatment to one treatment every three weeks. During the two-year observation period, this patient was able to maintain a stable non-depressed mood and had no worsening of her MS symptoms. Conclusion: Ketamine may be an alternative treatment for resistant depression and may have a special use in patients with multiple sclerosis.

Multifocal fibrosing thyroiditis: report of 55 cases of a poorly recognized entity.

PubMed

Fellegara, Giovanni; Rosai, Juan

2015-03-01

During the course of our consultation activity, we have recognized a peculiar form of thyroiditis in which multiple foci of fibrosis, most of which were associated with reactive atypia of the surrounding follicles, are present. We have referred to this condition, both in our consultation reports and in the third series of A.F.I.P. Fascicle on Tumors of the Thyroid Gland, as "multifocal fibrosing thyroiditis" or (less frequently) "multifocal sclerosing thyroiditis," which are descriptive terms that highlight the benign/inflammatory nature of the process, its multiplicity, and its unknown pathogenesis. The aim of this study is to better define the morphologic features of this process and correlate it with some clinical data. With this purpose, the consultation files of one of the authors (J.R.) were searched for cases coded as multifocal fibrosing thyroiditis or multifocal sclerosing thyroiditis in a 20-year period ranging from January 1989 to December 2009. A total of 55 cases were identified that displayed the above-listed features. There were 51 (93%) female and 4 (7%) male patients (F/M=12.75), with ages ranging between 15 and 71 years (mean age, 47.03 y; median age, 44.5 y). Microscopically, multiple foci of fibrosis were identified in all cases, their number ranging from 2 to 51 per case (mean number, 16), with a mean diameter of 3 mm (range: 0.36 to 15.1 mm). Although heterogenous in shape and size, the individual foci were rather similar to each other in composition, being characterized by a fibrotic poorly cellular center that merged with a cellular peripheral zone. Some of the follicular structures present at the periphery of the scar and-to a lesser extent-those entrapped inside it underwent complex reactive and regenerative (atypical) changes that simulated malignancy. We discuss the differential diagnosis with other benign and malignant thyroid conditions and speculate about its pathogenesis and possible relationship with papillary thyroid microcarcinoma.

Multiple Myeloma and Its Precursor Disease Among Firefighters Exposed to the World Trade Center Disaster.

PubMed

Landgren, Ola; Zeig-Owens, Rachel; Giricz, Orsolya; Goldfarb, David; Murata, Kaznouri; Thoren, Katie; Ramanathan, Lakshmi; Hultcrantz, Malin; Dogan, Ahmet; Nwankwo, George; Steidl, Ulrich; Pradhan, Kith; Hall, Charles B; Cohen, Hillel W; Jaber, Nadia; Schwartz, Theresa; Crowley, Laura; Crane, Michael; Irby, Shani; Webber, Mayris P; Verma, Amit; Prezant, David J

2018-06-01

The World Trade Center (WTC) attacks on September 11, 2001, created an unprecedented environmental exposure to known and suspected carcinogens suggested to increase the risk of multiple myeloma. Multiple myeloma is consistently preceded by the precursor states of monoclonal gammopathy of undetermined significance (MGUS) and light-chain MGUS, detectable in peripheral blood. To characterize WTC-exposed firefighters with a diagnosis of multiple myeloma and to conduct a screening study for MGUS and light-chain MGUS. Case series of multiple myeloma in firefighters diagnosed between September 11, 2001, and July 1, 2017, together with a seroprevalence study of MGUS in serum samples collected from Fire Department of the City of New York (FDNY) firefighters between December 2013 and October 2015. Participants included all WTC-exposed FDNY white, male firefighters with a confirmed physician diagnosis of multiple myeloma (n = 16) and WTC-exposed FDNY white male firefighters older than 50 years with available serum samples (n = 781). WTC exposure defined as rescue and/or recovery work at the WTC site between September 11, 2001, and July 25, 2002. Multiple myeloma case information, and age-adjusted and age-specific prevalence rates for overall MGUS (ie, MGUS and light-chain MGUS), MGUS, and light-chain MGUS. Sixteen WTC-exposed white male firefighters received a diagnosis of multiple myeloma after September 11, 2001; median age at diagnosis was 57 years (interquartile range, 50-68 years). Serum/urine monoclonal protein isotype/free light-chain data were available for 14 cases; 7 (50%) had light-chain multiple myeloma. In a subset of 7 patients, myeloma cells were assessed for CD20 expression; 5 (71%) were CD20 positive. In the screening study, we assayed peripheral blood from 781 WTC-exposed firefighters. The age-standardized prevalence rate of MGUS and light-chain MGUS combined was 7.63 per 100 persons (95% CI, 5.45-9.81), 1.8-fold higher than rates from the Olmsted County, Minnesota, white male reference population (relative rate, 1.76; 95% CI, 1.34-2.29). The age-standardized prevalence rate of light-chain MGUS was more than 3-fold higher than in the same reference population (relative rate, 3.13; 95% CI, 1.99-4.93). Environmental exposure to the WTC disaster site is associated with myeloma precursor disease (MGUS and light-chain MGUS) and may be a risk factor for the development of multiple myeloma at an earlier age, particularly the light-chain subtype.

The role of ICP monitoring in patients with persistent cerebrospinal fluid leak following spinal surgery: a case series.

PubMed

Craven, Claudia; Toma, Ahmed K; Khan, Akbar A; Watkins, Laurence D

2016-09-01

Cerebrospinal fluid (CSF) leak following spinal surgery is a relatively common surgical complication. A disturbance in the underlying CSF dynamics could be the causative factor in a small group of patients with refractory CSF leaks that require multiple surgical repairs and prolonged hospital admission. A retrospective case series of patients with persistent post spinal surgery CSF leak referred to the hydrocephalus service for continuous intracranial pressure (ICP) monitoring. Patients' notes were reviewed for medical history, ICP data, radiological data, and subsequent management and outcome. Five patients (two males/three females, mean age, 35.4 years) were referred for ICP monitoring over a 12-month period. These patients had prolonged CSF leak despite multiple repair attempts 252 ± 454 days (mean ± SD). On ICP monitoring, all five patients had abnormal results, with the mean ICP 8.95 ± 4.41 mmHg. Four had abnormal pulse amplitudes, mean 6.15 mmHg ± 1.22 mmHg. All five patients underwent an intervention. Three patients underwent insertion of ventriculoperitoneal (VP) shunts. One patient had venous sinus stent insertion and one patient underwent medical management with acetazolamide. All five of the patients' CSF leak resolved post intervention. The mean time to resolution of CSF leak post intervention was 10.8  ± 12.9 days. Abnormal cerebrospinal fluid dynamics could be the underlying factor in patients with a persistent and treatment-refractory CSF leak post spinal surgery. Treatments aimed at lowering ICP may be beneficial in this group of patients. Whether abnormal pressure and dynamics represent a pre-existing abnormality or is induced by spinal surgery should be a subject of further study.

Inter-individual cognitive variability in children with Asperger's syndrome

PubMed Central

Gonzalez-Gadea, Maria Luz; Tripicchio, Paula; Rattazzi, Alexia; Baez, Sandra; Marino, Julian; Roca, Maria; Manes, Facundo; Ibanez, Agustin

2014-01-01

Multiple studies have tried to establish the distinctive profile of individuals with Asperger's syndrome (AS). However, recent reports suggest that adults with AS feature heterogeneous cognitive profiles. The present study explores inter-individual variability in children with AS through group comparison and multiple case series analysis. All participants completed an extended battery including measures of fluid and crystallized intelligence, executive functions, theory of mind, and classical neuropsychological tests. Significant group differences were found in theory of mind and other domains related to global information processing. However, the AS group showed high inter-individual variability (both sub- and supra-normal performance) on most cognitive tasks. Furthermore, high fluid intelligence correlated with less general cognitive impairment, high cognitive flexibility, and speed of motor processing. In light of these findings, we propose that children with AS are characterized by a distinct, uneven pattern of cognitive strengths and weaknesses. PMID:25132817

Disease activity return after natalizumab cessation in multiple sclerosis.

PubMed

Rasenack, Maria; Derfuss, Tobias

2016-05-01

Natalizumab (NAT) was the first monoclonal antibody to be approved for the treatment of relapsing-remitting multiple sclerosis. Its considerable and sustained efficacy has been demonstrated in two phase III studies. However, there are several reasons why its use is limited in clinical practice. The main argument for stopping use of the drug is the risk of the rare but serious progressive multifocal leukencephalopathy. Other reasons are neutralizing antibodies and pregnancy. There is compelling evidence from some clinical trials and many case series that disease activity returns upon suspension or cessation of NAT. Several therapeutic strategies that have been tested to prevent or reduce the recurrence of disease activity will be reviewed in this article. Considering these data, it is evident that the decision to stop NAT treatment has different implications and consequences. A subsequent therapy after cessation of NAT is needed to reduce the risk of disease recurrence.

Reconstruction of Nasal Cleft Deformities Using Expanded Forehead Flaps: A Case Series.

PubMed

Ramanathan, Manikandhan; Sneha, Pendem; Parameswaran, Ananthnarayanan; Jayakumar, Naveen; Sailer, Hermann F

2014-12-01

Reconstruction of the nasal clefts is a challenging task considering the nasal anatomic complexity and their possible association with craniofacial defects. The reconstruction of these defects needs extensive amounts of soft tissue that warrant the use of forehead flaps. Often presence of cranial defects and low hairline compromise the amount of tissue available for reconstruction warrenting tissue expansion. To evaluate the efficacy of tissue expansion in reconstruction of congenital nasal clefts. 9 patients with congenital nasal clefts involving multiple sub units were taken up for nasal reconstruction with expanded forehead flaps. The average amount of expansion needed was 200 ml. The reconstruction was performed in 3 stages. Expanded forehead flaps proved to be best modality for reconstruction providing the skin cover needed for ala, columella and dorsum with minimal scarring at the donor site. Expansion of the forehead flap is a viable option for multiple sub unit reconstruction in congenital nasal cleft deformities.

Broadband piezoelectric energy harvesting devices using multiple bimorphs with different operating frequencies.

PubMed

Xue, Huan; Hu, Yuantai; Wang, Qing-Ming

2008-09-01

This paper presents a novel approach for designing broadband piezoelectric harvesters by integrating multiple piezoelectric bimorphs (PBs) with different aspect ratios into a system. The effect of 2 connecting patterns among PBs, in series and in parallel, on improving energy harvesting performance is discussed. It is found for multifrequency spectra ambient vibrations: 1) the operating frequency band (OFB) of a harvesting structure can be widened by connecting multiple PBs with different aspect ratios in series; 2) the OFB of a harvesting structure can be shifted to the dominant frequency domain of the ambient vibrations by increasing or decreasing the number of PBs in parallel. Numerical results show that the OFB of the piezoelectric energy harvesting devices can be tailored by the connection patterns (i.e., in series and in parallel) among PBs.

Evaluating the reliability of Late Quaternary landform ages: Integrating 10Be cosmogenic surface exposure dating with U-series dating of pedogenic carbonate on alluvial and fluvial deposits, Sonoran desert, California

NASA Astrophysics Data System (ADS)

Blisniuk, K.; Sharp, W. D.

2015-12-01

To assess the reliability of Quaternary age determinations of alluvial and fluvial deposits across the Sonoran Desert (Coachella Valley and Anza Borrego) in southern California, we applied both 10Be exposure age dating of surface clasts and U-series dating of pedogenic carbonate from subsurface clast-coatings to the same deposits. We consider agreement between dates from the two techniques to indicate reliable age estimates because each technique is subject to distinct assumptions and therefore their systematic uncertainties are largely independent. 10Be exposure dates should yield maximum ages when no correction is made for inheritance and post-depositional erosion is negligible. U-series dating, in contrast, provides minimum dates because pedogenic carbonate forms after deposition. Our results show that: (1) For deposits ca. 70 ka or younger, 10Be and U-series dates were generally concordant. We note, however, that in most cases U-series soil dates exceed 10Be exposure dates that are corrected for inheritance when using 10Be in modern alluvium. This suggests that 10Be concentrations of modern alluvium may exceed the 10Be acquired by late Pleistocene deposits during fluvial transport and hillslope residence (i.e., Pleistocene inherited 10Be). (2) For deposits older than ~70 ka, U-series dates are significantly younger than the 10Be dates. This implies that U-series dates in this region may significantly underestimate the depositional age of older alluvium, probably because of delayed onset of deposition, slow accumulation, or poor preservation of secondary carbonate in response to climatic controls. Thus, whenever possible, multiple dating methods should be applied to obtain reliable ages for late Quaternary deposits.

Conditional Spectral Analysis of Replicated Multiple Time Series with Application to Nocturnal Physiology.

PubMed

Krafty, Robert T; Rosen, Ori; Stoffer, David S; Buysse, Daniel J; Hall, Martica H

2017-01-01

This article considers the problem of analyzing associations between power spectra of multiple time series and cross-sectional outcomes when data are observed from multiple subjects. The motivating application comes from sleep medicine, where researchers are able to non-invasively record physiological time series signals during sleep. The frequency patterns of these signals, which can be quantified through the power spectrum, contain interpretable information about biological processes. An important problem in sleep research is drawing connections between power spectra of time series signals and clinical characteristics; these connections are key to understanding biological pathways through which sleep affects, and can be treated to improve, health. Such analyses are challenging as they must overcome the complicated structure of a power spectrum from multiple time series as a complex positive-definite matrix-valued function. This article proposes a new approach to such analyses based on a tensor-product spline model of Cholesky components of outcome-dependent power spectra. The approach exibly models power spectra as nonparametric functions of frequency and outcome while preserving geometric constraints. Formulated in a fully Bayesian framework, a Whittle likelihood based Markov chain Monte Carlo (MCMC) algorithm is developed for automated model fitting and for conducting inference on associations between outcomes and spectral measures. The method is used to analyze data from a study of sleep in older adults and uncovers new insights into how stress and arousal are connected to the amount of time one spends in bed.

Joint Seasonal ARMA Approach for Modeling of Load Forecast Errors in Planning Studies

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

Hafen, Ryan P.; Samaan, Nader A.; Makarov, Yuri V.

2014-04-14

To make informed and robust decisions in the probabilistic power system operation and planning process, it is critical to conduct multiple simulations of the generated combinations of wind and load parameters and their forecast errors to handle the variability and uncertainty of these time series. In order for the simulation results to be trustworthy, the simulated series must preserve the salient statistical characteristics of the real series. In this paper, we analyze day-ahead load forecast error data from multiple balancing authority locations and characterize statistical properties such as mean, standard deviation, autocorrelation, correlation between series, time-of-day bias, and time-of-day autocorrelation.more » We then construct and validate a seasonal autoregressive moving average (ARMA) model to model these characteristics, and use the model to jointly simulate day-ahead load forecast error series for all BAs.« less

Modeling influenza-like illnesses through composite compartmental models

NASA Astrophysics Data System (ADS)

Levy, Nir; , Michael, Iv; Yom-Tov, Elad

2018-03-01

Epidemiological models for the spread of pathogens in a population are usually only able to describe a single pathogen. This makes their application unrealistic in cases where multiple pathogens with similar symptoms are spreading concurrently within the same population. Here we describe a method which makes possible the application of multiple single-strain models under minimal conditions. As such, our method provides a bridge between theoretical models of epidemiology and data-driven approaches for modeling of influenza and other similar viruses. Our model extends the Susceptible-Infected-Recovered model to higher dimensions, allowing the modeling of a population infected by multiple viruses. We further provide a method, based on an overcomplete dictionary of feasible realizations of SIR solutions, to blindly partition the time series representing the number of infected people in a population into individual components, each representing the effect of a single pathogen. We demonstrate the applicability of our proposed method on five years of seasonal influenza-like illness (ILI) rates, estimated from Twitter data. We demonstrate that our method describes, on average, 44% of the variance in the ILI time series. The individual infectious components derived from our model are matched to known viral profiles in the populations, which we demonstrate matches that of independently collected epidemiological data. We further show that the basic reproductive numbers (R 0) of the matched components are in range known for these pathogens. Our results suggest that the proposed method can be applied to other pathogens and geographies, providing a simple method for estimating the parameters of epidemics in a population.

Multiple Coaxial Catheter System for Reliable Access in Interventional Stroke Therapy

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

Kulcsar, Zsolt, E-mail: kulcsarzsolt22@gmail.com; Yilmaz, Hasan; Bonvin, Christophe

2010-12-15

In some patients with acute cerebral vessel occlusion, navigating mechanical thrombectomy systems is difficult due to tortuous anatomy of the aortic arch, carotid arteries, or vertebral arteries. Our purpose was to describe a multiple coaxial catheter system used for mechanical revascularization that helps navigation and manipulations in tortuous vessels. A triple or quadruple coaxial catheter system was built in 28 consecutive cases presenting with acute ischemic stroke. All cases were treated by mechanical thrombectomy with the Penumbra System. In cases of unsuccessful thrombo-aspiration, additional thrombolysis or angioplasty with stent placement was used for improving recanalization. The catheter system consisted ofmore » an outermost 8-Fr and an intermediate 6-Fr guiding catheter, containing the inner Penumbra reperfusion catheters. The largest, 4.1-Fr, reperfusion catheter was navigated over a Prowler Select Plus microcatheter. The catheter system provided access to reach the cerebral lesions and provided stability for the mechanically demanding manipulations of thromboaspiration and stent navigation in all cases. Apart from their mechanical role, the specific parts of the system could also provide access to different types of interventions, like carotid stenting through the 8-Fr guiding catheter and intracranial stenting and thrombolysis through the Prowler Select Plus microcatheter. In this series, there were no complications related to the catheter system. In conclusion, building up a triple or quadruple coaxial system proved to be safe and efficient in our experience for the mechanical thrombectomy treatment of acute ischemic stroke.« less

[Bacterial brain abscess--experiences with 67 patients].

PubMed

Berlit, P; Fedel, C; Tornow, K; Schmiedek, P

1996-08-01

Sixty-seven patients with brain abscess were managed over 19 years (1975-1993). Our series had a 2.5 to 1 male predominance; the age distribution was from 3 days to 81 years. The underlying conditions of hematogenic brain abscesses (n = 33; 49%) included lung infections (n = 16), heart disease (n = 4), sepsis (n = 10), and other foci (n = 3). Otolaryngologic infections led to the abscess in 10 cases; there were 9 traumatic abscesses. The causes remained unknown in 15 cases. There were 47 solitary abscesses (70%) and 20 multiple abscesses. The most frequent presenting signs and symptoms were neurologic deficits (n = 17), disturbances of consciousness (n = 14), seizures (n = 6), and headaches, meningism and vomiting (n = 13). Causative organisms were isolated in 39 cases (58%) and included staphylococci (n = 6), streptococci (n = 6), enterobacteriae (n = 2), and anaerobic pathogens (n = 9). The most reliable laboratory sign of inflammation was an elevated ESR (52/59 patients). With the advent of computed tomography, burr hole aspiration of the abscess with or without drainage was possible in 30 cases; the mortality in this subgroup was 9%. All 4 patients with surgical excision in the pre CT-era died. The mortality of patients treated with antibiotics only was 62% (18/29). Overall mortality was 37% (25/67), including 5 cases with post mortem-diagnosis of brain abscess. Good recovery was achieved in 29/42 survivors. Predictors of a poor outcome were the patient's age, the level of consciousness, multiple abscesses, polybacterial cultures, and a hematogenic etiology, but not the size of the abscess.

Radiosurgery to the Postoperative Surgical Cavity: Who Needs Evidence?

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

Roberge, David, E-mail: david.roberge@mcgill.ca; Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal, Montreal, QC; Parney, Ian

2012-06-01

There is a growing interest in adjuvant radiosurgery after resection of hematogenous brain metastases. This is exemplified by the approximately 1000 cases reported in mainly retrospective series. These cases fall into four paradigms: adjuvant radiosurgery as an alternative to whole-brain radiotherapy (WBRT), radiosurgery neoadjuvant to the surgical resection, radiosurgery as an intensification of adjuvant WBRT, and adjuvant radiosurgery for patients having failed prior WBRT. These procedures seem well tolerated, with an approximate 5% risk of radiation necrosis. Although crude local control rates for each strategy seem improved over surgery alone, multiple biases make comparisons with standard WBRT difficult without prospectivemore » data. Because evidence lags behind clinical practice, an upcoming intergroup trial will aim to clarify the value of the most common tumor bed radiosurgery strategy by randomizing oligometastatic patients between adjuvant WBRT and adjuvant radiosurgery.« less

Forecasting the Relative and Cumulative Effects of Multiple Stressors on At-risk Populations

DTIC Science & Technology

2011-08-01

Vitals (observed vital rates), Movement, Ranges, Barriers (barrier interactions), Stochasticity (a time series of stochasticity indices...Simulation Viewer are themselves stochastic . They can change each time it is run. B. 196 Analysis If multiple Census events are present in the life...30-year period. A monthly time series was generated for the 20th-century using monthly anomalies for temperature, precipitation, and percent

Methodology Series Module 2: Case-control Studies.

PubMed

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

Cluster Bomb Ocular Injuries

PubMed Central

Mansour, Ahmad M.; Hamade, Haya; Ghaddar, Ayman; Mokadem, Ahmad Samih; El Hajj Ali, Mohamad; Awwad, Shady

2012-01-01

Purpose: To present the visual outcomes and ocular sequelae of victims of cluster bombs. Materials and Methods: This retrospective, multicenter case series of ocular injury due to cluster bombs was conducted for 3 years after the war in South Lebanon (July 2006). Data were gathered from the reports to the Information Management System for Mine Action. Results: There were 308 victims of clusters bombs; 36 individuals were killed, of which 2 received ocular lacerations and; 272 individuals were injured with 18 receiving ocular injury. These 18 surviving individuals were assessed by the authors. Ocular injury occurred in 6.5% (20/308) of cluster bomb victims. Trauma to multiple organs occurred in 12 of 18 cases (67%) with ocular injury. Ocular findings included corneal or scleral lacerations (16 eyes), corneal foreign bodies (9 eyes), corneal decompensation (2 eyes), ruptured cataract (6 eyes), and intravitreal foreign bodies (10 eyes). The corneas of one patient had extreme attenuation of the endothelium. Conclusions: Ocular injury occurred in 6.5% of cluster bomb victims and 67% of the patients with ocular injury sustained trauma to multiple organs. Visual morbidity in civilians is an additional reason for a global ban on the use of cluster bombs. PMID:22346132

An Optimization of Inventory Demand Forecasting in University Healthcare Centre

NASA Astrophysics Data System (ADS)

Bon, A. T.; Ng, T. K.

2017-01-01

Healthcare industry becomes an important field for human beings nowadays as it concerns about one’s health. With that, forecasting demand for health services is an important step in managerial decision making for all healthcare organizations. Hence, a case study was conducted in University Health Centre to collect historical demand data of Panadol 650mg for 68 months from January 2009 until August 2014. The aim of the research is to optimize the overall inventory demand through forecasting techniques. Quantitative forecasting or time series forecasting model was used in the case study to forecast future data as a function of past data. Furthermore, the data pattern needs to be identified first before applying the forecasting techniques. Trend is the data pattern and then ten forecasting techniques are applied using Risk Simulator Software. Lastly, the best forecasting techniques will be find out with the least forecasting error. Among the ten forecasting techniques include single moving average, single exponential smoothing, double moving average, double exponential smoothing, regression, Holt-Winter’s additive, Seasonal additive, Holt-Winter’s multiplicative, seasonal multiplicative and Autoregressive Integrated Moving Average (ARIMA). According to the forecasting accuracy measurement, the best forecasting technique is regression analysis.

Clinical Profile of Levamisole-Adulterated Cocaine-Induced Vasculitis/Vasculopathy: A 30-Case Series.

PubMed

Muñoz-Vahos, Carlos Horacio; Herrera-Uribe, Sebastián; Arbeláez-Cortés, Álvaro; Jaramillo-Arroyave, Daniel; González-Naranjo, Luis Alonso; Vásquez-Duque, Gloria; Restrepo-Escobar, Mauricio; Correa-Londoño, Luis Alfonso; Arias-Restrepo, Luis Fernando; Vanegas-García, Adriana Lucía

2018-05-19

The aims of this study were to describe clinical and laboratory manifestations of patients with levamisole-adulterated cocaine-induced vasculitis/vasculopathy and to propose a skin classification according to the distribution and severity of lesions. We report the characteristics of 30 patients admitted with levamisole-adulterated cocaine-induced vasculitis/vasculopathy in 4 high-complexity institutions in Colombia, from December 2010 to May 2017. We compare our findings with the principal published series. Median age was 31 years (interquartile range, 27-38 years) with a male-to-female ratio of 5:1. Eighty-three percent of the patients had retiform purpura affecting the limbs, buttocks, face, or abdomen; 73% had ear necrosis, 50% cutaneous ulcers, 17% genital necrosis, 13% oral ulcers, and 10% digital necrosis. Cutaneous involvement was classified according to the frequency of the compromised corporal area, and purpuric lesions were stratified in 4 grades of severity. Anti-neutrophil cytoplasmic autoantibodies were positive in 85% of the cases, lupus anticoagulant in 73%, and antinuclear autoantibodies in 57%, and rheumatoid factor was negative in all cases. We found nephritis in 17 cases (57%). Prednisolone was used in most of the patients (70%), with other immunosuppressive agents being used in a lower percentage. Improvement was observed in 93% of the patients, but symptoms recurred in 40%, attributed to relapses in consumption. End-stage chronic renal disease developed in 10% of the cases, and 1 patient died. Because of rising cocaine consumption and levamisole adulteration frequency, levamisole-adulterated cocaine-induced vasculitis/vasculopathy is becoming more common. Detailed characterization of skin involvement coupled with multiple antibody positivity is essential for a diagnosis. Renal involvement is frequent, clinically and histologically heterogeneous, and potentially serious.

Models for short term malaria prediction in Sri Lanka

PubMed Central

Briët, Olivier JT; Vounatsou, Penelope; Gunawardena, Dissanayake M; Galappaththy, Gawrie NL; Amerasinghe, Priyanie H

2008-01-01

Background Malaria in Sri Lanka is unstable and fluctuates in intensity both spatially and temporally. Although the case counts are dwindling at present, given the past history of resurgence of outbreaks despite effective control measures, the control programmes have to stay prepared. The availability of long time series of monitored/diagnosed malaria cases allows for the study of forecasting models, with an aim to developing a forecasting system which could assist in the efficient allocation of resources for malaria control. Methods Exponentially weighted moving average models, autoregressive integrated moving average (ARIMA) models with seasonal components, and seasonal multiplicative autoregressive integrated moving average (SARIMA) models were compared on monthly time series of district malaria cases for their ability to predict the number of malaria cases one to four months ahead. The addition of covariates such as the number of malaria cases in neighbouring districts or rainfall were assessed for their ability to improve prediction of selected (seasonal) ARIMA models. Results The best model for forecasting and the forecasting error varied strongly among the districts. The addition of rainfall as a covariate improved prediction of selected (seasonal) ARIMA models modestly in some districts but worsened prediction in other districts. Improvement by adding rainfall was more frequent at larger forecasting horizons. Conclusion Heterogeneity of patterns of malaria in Sri Lanka requires regionally specific prediction models. Prediction error was large at a minimum of 22% (for one of the districts) for one month ahead predictions. The modest improvement made in short term prediction by adding rainfall as a covariate to these prediction models may not be sufficient to merit investing in a forecasting system for which rainfall data are routinely processed. PMID:18460204

Development of a new British Geologcial Survey(BGS) Map Series: Seabed Geomorphology

NASA Astrophysics Data System (ADS)

Dove, Dayton

2015-04-01

BGS scientists are developing a new offshore map series, Seabed Geomorphology (1:50k), to join the existing 1:250k 'Sea Bed Sediments', 'Quaternary Geology', and 'Solid Geology' map series. The increasing availability of extensive high-resolution swath bathymetry data (e.g. MCA's Civil Hydrography Programme) provides an unprecedented opportunity to characterize the processes which formed, and actively govern the physical seabed environment. Mapping seabed geomorphology is an effective means to describe individual, or groups of features whose form and other physical attributes (e.g. symmetry) may be used to distinguish feature origin. Swath bathymetry also provides added and renewed value to other data types (e.g. grab samples, legacy seismic data). In such cases the geomorphic evidence may be expanded to make inferences on the evolution of seabed features as well as their association with the underlying geology and other environmental variables/events over multiple timescales. Classifying seabed geomorphology is not particularly innovative or groundbreaking. Terrestrial geomorphology is of course a well established field of science, and within the marine environment for example, mapping submarine glacial landforms has probably become the most reliable method to reconstruct the extent and dynamics of past ice-sheets. What is novel here, and we believe useful/necessary for a survey organization, is to standardise the geomorphological classification scheme such that it is applicable to multiple and diverse environments. The classification scheme should be sufficiently detailed and interpretive to be informative, but not so detailed that we over-interpret or become mired in disputed feature designations or definitions. We plan to present the maps at 1:50k scale with the intention that these maps will be 'enabling' resources for research, educational, commercial, and policy purposes, much like the existing 1:250k map series. We welcome feedback on the structure and content of the proposed classification scheme, as well as the anticipated value to respective user communities.

Intrinsic vs. spurious long-range memory in high-frequency records of environmental radioactivity - Critical re-assessment and application to indoor 222Rn concentrations from Coimbra, Portugal

NASA Astrophysics Data System (ADS)

Donner, Reik V.; Potirakis, Stelios M.; Barbosa, Susana M.; Matos, Jose A. O.

2015-04-01

The presence or absence of long-range correlations in environmental radioactivity fluctuations has recently attracted considerable interest. Among a multiplicity of practically relevant applications, identifying and disentangling the environmental factors controlling the variable concentrations of the radioactive noble gas Radon is important for estimating its effect on human health and the efficiency of possible measures for reducing the corresponding exposition. In this work, we present a critical re-assessment of a multiplicity of complementary methods that have been previously applied for evaluating the presence of long-range correlations and fractal scaling in environmental Radon variations with a particular focus on the specific properties of the underlying time series. As an illustrative case study, we subsequently re-analyze two high-frequency records of indoor Radon concentrations from Coimbra, Portugal, each of which spans several months of continuous measurements at a high temporal resolution of five minutes. Our results reveal that at the study site, Radon concentrations exhibit complex multi-scale dynamics with qualitatively different properties at different time-scales: (i) essentially white noise in the high-frequency part (up to time-scales of about one hour), (ii) spurious indications of a non-stationary, apparently long-range correlated process (at time scales between hours and one day) arising from marked periodic components probably related to tidal frequencies, and (iii) low-frequency variability indicating a true long-range dependent process, which might be dominated by a response to meteorological drivers. In the presence of such multi-scale variability, common estimators of long-range memory in time series are necessarily prone to fail if applied to the raw data without previous separation of time-scales with qualitatively different dynamics. We emphasize that similar properties can be found in other types of geophysical time series (for example, tide gauge records), calling for a careful application of time series analysis tools when studying such data.

SPICODYN: A Toolbox for the Analysis of Neuronal Network Dynamics and Connectivity from Multi-Site Spike Signal Recordings.

PubMed

Pastore, Vito Paolo; Godjoski, Aleksandar; Martinoia, Sergio; Massobrio, Paolo

2018-01-01

We implemented an automated and efficient open-source software for the analysis of multi-site neuronal spike signals. The software package, named SPICODYN, has been developed as a standalone windows GUI application, using C# programming language with Microsoft Visual Studio based on .NET framework 4.5 development environment. Accepted input data formats are HDF5, level 5 MAT and text files, containing recorded or generated time series spike signals data. SPICODYN processes such electrophysiological signals focusing on: spiking and bursting dynamics and functional-effective connectivity analysis. In particular, for inferring network connectivity, a new implementation of the transfer entropy method is presented dealing with multiple time delays (temporal extension) and with multiple binary patterns (high order extension). SPICODYN is specifically tailored to process data coming from different Multi-Electrode Arrays setups, guarantying, in those specific cases, automated processing. The optimized implementation of the Delayed Transfer Entropy and the High-Order Transfer Entropy algorithms, allows performing accurate and rapid analysis on multiple spike trains from thousands of electrodes.

Increasing the quality, comparability and accessibility of phytoplankton species composition time-series data

NASA Astrophysics Data System (ADS)

Zingone, Adriana; Harrison, Paul J.; Kraberg, Alexandra; Lehtinen, Sirpa; McQuatters-Gollop, Abigail; O'Brien, Todd; Sun, Jun; Jakobsen, Hans H.

2015-09-01

Phytoplankton diversity and its variation over an extended time scale can provide answers to a wide range of questions relevant to societal needs. These include human health, the safe and sustained use of marine resources and the ecological status of the marine environment, including long-term changes under the impact of multiple stressors. The analysis of phytoplankton data collected at the same place over time, as well as the comparison among different sampling sites, provide key information for assessing environmental change, and evaluating new actions that must be made to reduce human induced pressures on the environment. To achieve these aims, phytoplankton data may be used several decades later by users that have not participated in their production, including automatic data retrieval and analysis. The methods used in phytoplankton species analysis vary widely among research and monitoring groups, while quality control procedures have not been implemented in most cases. Here we highlight some of the main differences in the sampling and analytical procedures applied to phytoplankton analysis and identify critical steps that are required to improve the quality and inter-comparability of data obtained at different sites and/or times. Harmonization of methods may not be a realistic goal, considering the wide range of purposes of phytoplankton time-series data collection. However, we propose that more consistent and detailed metadata and complementary information be recorded and made available along with phytoplankton time-series datasets, including description of the procedures and elements allowing for a quality control of the data. To keep up with the progress in taxonomic research, there is a need for continued training of taxonomists, and for supporting and complementing existing web resources, in order to allow a constant upgrade of knowledge in phytoplankton classification and identification. Efforts towards the improvement of metadata recording, data annotation and quality control procedures will ensure the internal consistency of phytoplankton time series and facilitate their comparability and accessibility, thus strongly increasing the value of the precious information they provide. Ultimately, the sharing of quality controlled data will allow one to recoup the high cost of obtaining the data through the multiple use of the time-series data in various projects over many decades.

An approach to checking case-crossover analyses based on equivalence with time-series methods.

PubMed

Lu, Yun; Symons, James Morel; Geyh, Alison S; Zeger, Scott L

2008-03-01

The case-crossover design has been increasingly applied to epidemiologic investigations of acute adverse health effects associated with ambient air pollution. The correspondence of the design to that of matched case-control studies makes it inferentially appealing for epidemiologic studies. Case-crossover analyses generally use conditional logistic regression modeling. This technique is equivalent to time-series log-linear regression models when there is a common exposure across individuals, as in air pollution studies. Previous methods for obtaining unbiased estimates for case-crossover analyses have assumed that time-varying risk factors are constant within reference windows. In this paper, we rely on the connection between case-crossover and time-series methods to illustrate model-checking procedures from log-linear model diagnostics for time-stratified case-crossover analyses. Additionally, we compare the relative performance of the time-stratified case-crossover approach to time-series methods under 3 simulated scenarios representing different temporal patterns of daily mortality associated with air pollution in Chicago, Illinois, during 1995 and 1996. Whenever a model-be it time-series or case-crossover-fails to account appropriately for fluctuations in time that confound the exposure, the effect estimate will be biased. It is therefore important to perform model-checking in time-stratified case-crossover analyses rather than assume the estimator is unbiased.

Covered metal stent or multiple plastic stents for refractory pancreatic ductal strictures in chronic pancreatitis: a systematic review.

PubMed

Shen, Yonghua; Liu, Mingdong; Chen, Min; Li, Yunhong; Lu, Ying; Zou, Xiaoping

2014-01-01

Refractory chronic pancreatitis has been proposed as a challenge for endoscopists following routine single plastic stenting. However, data on the efficacy and safety of further endoscopic stenting are still controversial. The current systematic review aimed to assess the efficacy and safety of placement of fully covered self-expandable metal stent (FCSEMS) and multiple plastic stents. Databases including MEDLINE, EMBASE, the Cochrane Library, CBM, CNKI, VIP, and WANFANG Database were used to search relevant trials. Published studies were assessed by using well-defined inclusion and exclusion criteria. The process was independently performed by two investigators. A total of 5 studies provided data of 80 patients. Forest plots and publication bias were not carried out because few studies were relevant and screened studies were all case series. The technical success rate was 100% both in placement of FCSEMS and multiple plastic stents. The functional success rate after placement of FCSEMS was 100%, followed by multiple plastic stents (94.7%). Complications occurred 26.2% after FCSEMS placement, which was not described in detail in multiple plastic stents. The stent migration rate was 8.2% for FCSEMS and 10.5% for multiple plastic stents. Reintervention rate was 9.8% for FCSEMS and 15.8% for multiple plastic stents. Pain improvement rate was 85.2% for FCSEMS and 84.2% for multiple plastic stents. FCSEMS appeared to be no significant difference with multiple plastic stents in treatment of refractory chronic pancreatitis. We need to develop more investigations. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Perturbation Theory/Machine Learning Model of ChEMBL Data for Dopamine Targets: Docking, Synthesis, and Assay of New l-Prolyl-l-leucyl-glycinamide Peptidomimetics.

PubMed

Ferreira da Costa, Joana; Silva, David; Caamaño, Olga; Brea, José M; Loza, Maria Isabel; Munteanu, Cristian R; Pazos, Alejandro; García-Mera, Xerardo; González-Díaz, Humbert

2018-06-25

Predicting drug-protein interactions (DPIs) for target proteins involved in dopamine pathways is a very important goal in medicinal chemistry. We can tackle this problem using Molecular Docking or Machine Learning (ML) models for one specific protein. Unfortunately, these models fail to account for large and complex big data sets of preclinical assays reported in public databases. This includes multiple conditions of assays, such as different experimental parameters, biological assays, target proteins, cell lines, organism of the target, or organism of assay. On the other hand, perturbation theory (PT) models allow us to predict the properties of a query compound or molecular system in experimental assays with multiple boundary conditions based on a previously known case of reference. In this work, we report the first PTML (PT + ML) study of a large ChEMBL data set of preclinical assays of compounds targeting dopamine pathway proteins. The best PTML model found predicts 50000 cases with accuracy of 70-91% in training and external validation series. We also compared the linear PTML model with alternative PTML models trained with multiple nonlinear methods (artificial neural network (ANN), Random Forest, Deep Learning, etc.). Some of the nonlinear methods outperform the linear model but at the cost of a notable increment of the complexity of the model. We illustrated the practical use of the new model with a proof-of-concept theoretical-experimental study. We reported for the first time the organic synthesis, chemical characterization, and pharmacological assay of a new series of l-prolyl-l-leucyl-glycinamide (PLG) peptidomimetic compounds. In addition, we performed a molecular docking study for some of these compounds with the software Vina AutoDock. The work ends with a PTML model predictive study of the outcomes of the new compounds in a large number of assays. Therefore, this study offers a new computational methodology for predicting the outcome for any compound in new assays. This PTML method focuses on the prediction with a simple linear model of multiple pharmacological parameters (IC 50 , EC 50 , K i , etc.) for compounds in assays involving different cell lines used, organisms of the protein target, or organism of assay for proteins in the dopamine pathway.

A note on an attempt at more efficient Poisson series evaluation. [for lunar libration

NASA Technical Reports Server (NTRS)

Shelus, P. J.; Jefferys, W. H., III

1975-01-01

A substantial reduction has been achieved in the time necessary to compute lunar libration series. The method involves eliminating many of the trigonometric function calls by a suitable transformation and applying a short SNOBOL processor to the FORTRAN coding of the transformed series, which obviates many of the multiplication operations during the course of series evaluation. It is possible to accomplish similar results quite easily with other Poisson series.

Systematic review of the methodological and reporting quality of case series in surgery.

PubMed

Agha, R A; Fowler, A J; Lee, S-Y; Gundogan, B; Whitehurst, K; Sagoo, H K; Jeong, K J L; Altman, D G; Orgill, D P

2016-09-01

Case series are an important and common study type. No guideline exists for reporting case series and there is evidence of key data being missed from such reports. The first step in the process of developing a methodologically sound reporting guideline is a systematic review of literature relevant to the reporting deficiencies of case series. A systematic review of methodological and reporting quality in surgical case series was performed. The electronic search strategy was developed by an information specialist and included MEDLINE, Embase, Cochrane Methods Register, Science Citation Index and Conference Proceedings Citation index, from the start of indexing to 5 November 2014. Independent screening, eligibility assessments and data extraction were performed. Included articles were then analysed for five areas of deficiency: failure to use standardized definitions, missing or selective data (including the omission of whole cases or important variables), transparency or incomplete reporting, whether alternative study designs were considered, and other issues. Database searching identified 2205 records. Through the process of screening and eligibility assessments, 92 articles met inclusion criteria. Frequencies of methodological and reporting issues identified were: failure to use standardized definitions (57 per cent), missing or selective data (66 per cent), transparency or incomplete reporting (70 per cent), whether alternative study designs were considered (11 per cent) and other issues (52 per cent). The methodological and reporting quality of surgical case series needs improvement. The data indicate that evidence-based guidelines for the conduct and reporting of case series may be useful. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Teratoma of the nervous system: A case series.

PubMed

Algahtani, Hussein; Shirah, Bader; Abdullah, Ahad; Bazaid, Abdulrahman

Teratoma is a common form of germ cell tumors composed of multiple tissues foreign to the site in which arise with a histological representation of all three germ cell layers. Intracranial teratomas are very rare. In this study, we report three cases of intracranial teratomas with an interesting clinical course, neuroradiology, and outcome. In addition, we review the literature and convey important messages to the neuroscience community regarding issues related to the management of these rare tumors. The present cases are interesting examples of intracranial teratoma in terms of location of the tumor and neuroimaging findings. Delay in surgical intervention may complicate the course of the disease with progressive enlargement of tumors and development of complication including hydrocephalus. Using endoscopic surgical techniques may emerge as the preferred intervention option as compared to other traditional methods. We recommend the establishment of a national and international registry for intracranial tumors. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

Glaucoma filtration surgery following sustained elevation of intraocular pressure secondary to intravitreal anti-VEGF injections.

PubMed

Skalicky, Simon E; Ho, Ivan; Agar, Ashish; Bank, Allan

2012-07-01

To document cases of sustained elevation of intraocular pressure (IOP) while receiving intravitreal anti-vascular endothelial growth factor (VEGF) agents and subsequent management. A retrospective series of all cases managed by the authors and colleagues was performed. Six patients developed sustained elevated IOP; five received ranibizumab and one bevacizumab. Four received unilateral and two received bilateral injections. Two had preexisting primary open-angle glaucoma and one had pseudoexfoliative glaucoma, all with stable IOP prior to anti-VEGF treatment. Angles were open in all cases. Peak IOP averaged 43 mm Hg (range: 34 to 60 mm Hg). The mean number of injections preceding the IOP increase was 10 (range: 1 to 20). Four patients required trabeculectomy, one selective laser trabeculoplasty, and one multiple topical medications. A sustained increase in IOP requiring glaucoma filtering surgery is a rare but important treatment complication for patients receiving intravitreal anti-VEGF therapy, especially those with preexisting glaucoma or glaucoma risk factors. Copyright 2012, SLACK Incorporated.

Annular lichenoid dermatitis of youth ... and beyond: a series of 6 cases.

PubMed

Cesinaro, Anna Maria; Sighinolfi, Pamela; Greco, Antonietta; Garagnani, Lorella; Conti, Andrea; Fantini, Fabrizio

2009-05-01

Annular lichenoid dermatitis of youth (ALDY) is a clinico-pathologic entity described in children and young patients, clinically reminiscent of morphea, annular erythema, vitiligo or mycosis fungoides. We report on six patients presenting single or multiple lesions, distributed particularly on the flanks and abdomen, with clinical and histologic features consistent with ALDY. Two patients were young girls and four were adults males. Three patients received topical therapy and four showed complete resolution of the lesions after a 24-65 months follow-up. Analogously to the cases reported so far, immunohistochemistry showed a T cell infiltrate with a predominance of CD8+ lymphocytes, while T cell receptor rearrangement was absent in all cases. It seems appropriate to include annular lichenoid dermatitis of youth among the dermatoses with a lichenoid pattern. For the first time, we found that it can affect also adult patients, therefore we propose to rename the disease annular lichenoid dermatitis. The differential diagnosis with mycosis fungoides, especially in adult patients, is particularly crucial for their proper management and treatment.

Clinical time series prediction: towards a hierarchical dynamical system framework

PubMed Central

Liu, Zitao; Hauskrecht, Milos

2014-01-01

Objective Developing machine learning and data mining algorithms for building temporal models of clinical time series is important for understanding of the patient condition, the dynamics of a disease, effect of various patient management interventions and clinical decision making. In this work, we propose and develop a novel hierarchical framework for modeling clinical time series data of varied length and with irregularly sampled observations. Materials and methods Our hierarchical dynamical system framework for modeling clinical time series combines advantages of the two temporal modeling approaches: the linear dynamical system and the Gaussian process. We model the irregularly sampled clinical time series by using multiple Gaussian process sequences in the lower level of our hierarchical framework and capture the transitions between Gaussian processes by utilizing the linear dynamical system. The experiments are conducted on the complete blood count (CBC) panel data of 1000 post-surgical cardiac patients during their hospitalization. Our framework is evaluated and compared to multiple baseline approaches in terms of the mean absolute prediction error and the absolute percentage error. Results We tested our framework by first learning the time series model from data for the patient in the training set, and then applying the model in order to predict future time series values on the patients in the test set. We show that our model outperforms multiple existing models in terms of its predictive accuracy. Our method achieved a 3.13% average prediction accuracy improvement on ten CBC lab time series when it was compared against the best performing baseline. A 5.25% average accuracy improvement was observed when only short-term predictions were considered. Conclusion A new hierarchical dynamical system framework that lets us model irregularly sampled time series data is a promising new direction for modeling clinical time series and for improving their predictive performance. PMID:25534671

Binary versus non-binary information in real time series: empirical results and maximum-entropy matrix models

NASA Astrophysics Data System (ADS)

Almog, Assaf; Garlaschelli, Diego

2014-09-01

The dynamics of complex systems, from financial markets to the brain, can be monitored in terms of multiple time series of activity of the constituent units, such as stocks or neurons, respectively. While the main focus of time series analysis is on the magnitude of temporal increments, a significant piece of information is encoded into the binary projection (i.e. the sign) of such increments. In this paper we provide further evidence of this by showing strong nonlinear relations between binary and non-binary properties of financial time series. These relations are a novel quantification of the fact that extreme price increments occur more often when most stocks move in the same direction. We then introduce an information-theoretic approach to the analysis of the binary signature of single and multiple time series. Through the definition of maximum-entropy ensembles of binary matrices and their mapping to spin models in statistical physics, we quantify the information encoded into the simplest binary properties of real time series and identify the most informative property given a set of measurements. Our formalism is able to accurately replicate, and mathematically characterize, the observed binary/non-binary relations. We also obtain a phase diagram allowing us to identify, based only on the instantaneous aggregate return of a set of multiple time series, a regime where the so-called ‘market mode’ has an optimal interpretation in terms of collective (endogenous) effects, a regime where it is parsimoniously explained by pure noise, and a regime where it can be regarded as a combination of endogenous and exogenous factors. Our approach allows us to connect spin models, simple stochastic processes, and ensembles of time series inferred from partial information.

Intermediate energy proton-deuteron elastic scattering

NASA Technical Reports Server (NTRS)

Wilson, J. W.

1973-01-01

A fully symmetrized multiple scattering series is considered for the description of proton-deuteron elastic scattering. An off-shell continuation of the experimentally known twobody amplitudes that retains the exchange symmeteries required for the calculation is presented. The one boson exchange terms of the two body amplitudes are evaluated exactly in this off-shell prescription. The first two terms of the multiple scattering series are calculated explicitly whereas multiple scattering effects are obtained as minimum variance estimates from the 146-MeV data of Postma and Wilson. The multiple scattering corrections indeed consist of low order partial waves as suggested by Sloan based on model studies with separable interactions. The Hamada-Johnston wave function is shown consistent with the data for internucleon distances greater than about 0.84 fm.

Wavelet regression model in forecasting crude oil price

NASA Astrophysics Data System (ADS)

Hamid, Mohd Helmie; Shabri, Ani

2017-05-01

This study presents the performance of wavelet multiple linear regression (WMLR) technique in daily crude oil forecasting. WMLR model was developed by integrating the discrete wavelet transform (DWT) and multiple linear regression (MLR) model. The original time series was decomposed to sub-time series with different scales by wavelet theory. Correlation analysis was conducted to assist in the selection of optimal decomposed components as inputs for the WMLR model. The daily WTI crude oil price series has been used in this study to test the prediction capability of the proposed model. The forecasting performance of WMLR model were also compared with regular multiple linear regression (MLR), Autoregressive Moving Average (ARIMA) and Generalized Autoregressive Conditional Heteroscedasticity (GARCH) using root mean square errors (RMSE) and mean absolute errors (MAE). Based on the experimental results, it appears that the WMLR model performs better than the other forecasting technique tested in this study.

A new series of yeast shuttle vectors for the recovery and identification of multiple plasmids from Saccharomyces cerevisiae.

PubMed

Frazer, LilyAnn Novak; O'Keefe, Raymond T

2007-09-01

The availability of Saccharomyces cerevisiae yeast strains with multiple auxotrophic markers allows the stable introduction and selection of more than one yeast shuttle vector containing marker genes that complement the auxotrophic markers. In certain experimental situations there is a need to recover more than one shuttle vector from yeast. To facilitate the recovery and identification of multiple plasmids from S. cerevisiae, we have constructed a series of plasmids based on the pRS series of yeast shuttle vectors. Bacterial antibiotic resistance genes to chloramphenicol, kanamycin and zeocin have been combined with the yeast centromere sequence (CEN6), the autonomously replicating sequence (ARSH4) and one of the four yeast selectable marker genes (HIS3, TRP1, LEU2 or URA3) from the pRS series of vectors. The 12 plasmids produced differ in antibiotic resistance and yeast marker gene within the backbone of the multipurpose plasmid pBluescript II. The newly constructed vectors show similar mitotic stability to the original pRS vectors. In combination with the ampicillin-resistant pRS series of yeast shuttle vectors, these plasmids now allow the recovery and identification in bacteria of up to four different vectors from S. cerevisiae. Copyright (c) 2007 John Wiley & Sons, Ltd.

Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

PubMed Central

Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

2014-01-01

AIM To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation. METHODS Non-comparative retrospective observational case series. Participants: 30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi'an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs) were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. Main outcome measures: visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations. RESULTS The follow-up time was 11-36mo (21.4±7.13). Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL dislocation, and endophthalmitis. CONCLUSION To take early treatment of traumatic lens subluxation/dislocation in patients with secondary glaucoma by individual surgical plan based on the different eye conditions would be safe and effective, which can effectively control the intraocular pressure and restore some vision. PMID:24790868

A Study of the Impact of Thirteen Celebrity Suicides on Subsequent Suicide Rates in South Korea from 2005 to 2009

PubMed Central

Fu, King-wa; Chan, C. H.

2013-01-01

A number of ecological studies have found a pattern of increasing suicide rates after suicides of several Asian entertainment celebrities. However, the finding may be subject to positive outcome bias where cases with no perceived impact may be routinely excluded. In this study, we deploy interrupted time-series analysis using ARIMA transfer function models to investigate systematically the impact of thirteen celebrity suicides on subsequent suicide rates in South Korea. We find that three out of eleven cases were found to be followed by a significant increase in suicide rate, while controlling for seasonality, secular trends, and unemployment rates. Such significant increases could last for nine weeks. Non-significance cases may be attributable to the small amount of media coverage, the “displacement” effect of preceding case, and the negative connotation of celebrity deaths. We therefore conclude that whether or not the impacts were detected may be largely conditioned by various contextual factors. Current evidence based on ecological studies is insufficient to draw a firm conclusion. Further studies using multiple approaches should be developed. PMID:23342026

Model-Based Design of Long-Distance Tracer Transport Experiments in Plants.

PubMed

Bühler, Jonas; von Lieres, Eric; Huber, Gregor J

2018-01-01

Studies of long-distance transport of tracer isotopes in plants offer a high potential for functional phenotyping, but so far measurement time is a bottleneck because continuous time series of at least 1 h are required to obtain reliable estimates of transport properties. Hence, usual throughput values are between 0.5 and 1 samples h -1 . Here, we propose to increase sample throughput by introducing temporal gaps in the data acquisition of each plant sample and measuring multiple plants one after each other in a rotating scheme. In contrast to common time series analysis methods, mechanistic tracer transport models allow the analysis of interrupted time series. The uncertainties of the model parameter estimates are used as a measure of how much information was lost compared to complete time series. A case study was set up to systematically investigate different experimental schedules for different throughput scenarios ranging from 1 to 12 samples h -1 . Selected designs with only a small amount of data points were found to be sufficient for an adequate parameter estimation, implying that the presented approach enables a substantial increase of sample throughput. The presented general framework for automated generation and evaluation of experimental schedules allows the determination of a maximal sample throughput and the respective optimal measurement schedule depending on the required statistical reliability of data acquired by future experiments.

Identifying Changes of Complex Flood Dynamics with Recurrence Analysis

NASA Astrophysics Data System (ADS)

Wendi, D.; Merz, B.; Marwan, N.

2016-12-01

Temporal changes in flood hazard system are known to be difficult to detect and attribute due to multiple drivers that include complex processes that are non-stationary and highly variable. These drivers, such as human-induced climate change, natural climate variability, implementation of flood defense, river training, or land use change, could impact variably on space-time scales and influence or mask each other. Flood time series may show complex behavior that vary at a range of time scales and may cluster in time. Moreover hydrological time series (i.e. discharge) are often subject to measurement errors, such as rating curve error especially in the case of extremes where observation are actually derived through extrapolation. This study focuses on the application of recurrence based data analysis techniques (recurrence plot) for understanding and quantifying spatio-temporal changes in flood hazard in Germany. The recurrence plot is known as an effective tool to visualize the dynamics of phase space trajectories i.e. constructed from a time series by using an embedding dimension and a time delay, and it is known to be effective in analyzing non-stationary and non-linear time series. Sensitivity of the common measurement errors and noise on recurrence analysis will also be analyzed and evaluated against conventional methods. The emphasis will be on the identification of characteristic recurrence properties that could associate typical dynamic to certain flood events.

Long-term Outcome of Multiple Small-diameter Drilling Decompression Combined with Hip Arthroscopy versus Drilling Alone for Early Avascular Necrosis of the Femoral Head.

PubMed

Li, Ji; Li, Zhong-Li; Zhang, Hao; Su, Xiang-Zheng; Wang, Ke-Tao; Yang, Yi-Meng

2017-06-20

Avascular necrosis of femoral head (AVNFH) typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone. This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients (98 hips) with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips (Group A) or drilling decompression alone in 34 cases/55 hips (Group B). Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test. All patients were followed up for an average of 57.6 months (range: 17-108 months). Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris' scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 (t = -7.21, P = 0.001) than Group B with mean Harris' scores improved from 69.46 ± 9.71 to 75.79 ± 4.13 (t = -9.47, P = 0.037) (significantly different: t = -2.54, P = 0.017). The total surgery effective rate was also significantly different between Groups A and B (86.0% vs. 74.5%; χ2 = 3.69, P = 0.02). For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone.

Dravet syndrome as epileptic encephalopathy: evidence from long-term course and neuropathology

PubMed Central

Catarino, Claudia B.; Liu, Joan Y.W.; Liagkouras, Ioannis; Gibbons, Vaneesha S.; Labrum, Robyn W.; Ellis, Rachael; Woodward, Cathy; Davis, Mary B.; Smith, Shelagh J.; Cross, J. Helen; Appleton, Richard E.; Yendle, Simone C.; McMahon, Jacinta M.; Bellows, Susannah T.; Jacques, Thomas S.; Zuberi, Sameer M.; Koepp, Matthias J.; Martinian, Lillian; Scheffer, Ingrid E.; Thom, Maria

2011-01-01

Dravet syndrome is an epilepsy syndrome of infantile onset, frequently caused by SCN1A mutations or deletions. Its prevalence, long-term evolution in adults and neuropathology are not well known. We identified a series of 22 adult patients, including three adult post-mortem cases with Dravet syndrome. For all patients, we reviewed the clinical history, seizure types and frequency, antiepileptic drugs, cognitive, social and functional outcome and results of investigations. A systematic neuropathology study was performed, with post-mortem material from three adult cases with Dravet syndrome, in comparison with controls and a range of relevant paediatric tissue. Twenty-two adults with Dravet syndrome, 10 female, were included, median age 39 years (range 20–66). SCN1A structural variation was found in 60% of the adult Dravet patients tested, including one post-mortem case with DNA extracted from brain tissue. Novel mutations were described for 11 adult patients; one patient had three SCN1A mutations. Features of Dravet syndrome in adulthood include multiple seizure types despite polytherapy, and age-dependent evolution in seizure semiology and electroencephalographic pattern. Fever sensitivity persisted through adulthood in 11 cases. Neurological decline occurred in adulthood with cognitive and motor deterioration. Dysphagia may develop in or after the fourth decade of life, leading to significant morbidity, or death. The correct diagnosis at an older age made an impact at several levels. Treatment changes improved seizure control even after years of drug resistance in all three cases with sufficient follow-up after drug changes were instituted; better control led to significant improvement in cognitive performance and quality of life in adulthood in two cases. There was no histopathological hallmark feature of Dravet syndrome in this series. Strikingly, there was remarkable preservation of neurons and interneurons in the neocortex and hippocampi of Dravet adult post-mortem cases. Our study provides evidence that Dravet syndrome is at least in part an epileptic encephalopathy. PMID:21719429

Basal Cell Carcinoma With Matrical Differentiation: Clinicopathologic, Immunohistochemical, and Molecular Biological Study of 22 Cases.

PubMed

Kyrpychova, Liubov; Carr, Richard A; Martinek, Petr; Vanecek, Tomas; Perret, Raul; Chottová-Dvořáková, Magdalena; Zamecnik, Michal; Hadravsky, Ladislav; Michal, Michal; Kazakov, Dmitry V

2017-06-01

Basal cell carcinoma (BCC) with matrical differentiation is a fairly rare neoplasm, with about 30 cases documented mainly as isolated case reports. We studied a series of this neoplasm, including cases with an atypical matrical component, a hitherto unreported feature. Lesions coded as BCC with matrical differentiation were reviewed; 22 cases were included. Immunohistochemical studies were performed using antibodies against BerEp4, β-catenin, and epithelial membrane antigen (EMA). Molecular genetic studies using Ion AmpliSeq Cancer Hotspot Panel v2 by massively parallel sequencing on Ion Torrent PGM were performed in 2 cases with an atypical matrical component (1 was previously subjected to microdissection to sample the matrical and BCC areas separately). There were 13 male and 9 female patients, ranging in age from 41 to 89 years. Microscopically, all lesions manifested at least 2 components, a BCC area (follicular germinative differentiation) and areas with matrical differentiation. A BCC component dominated in 14 cases, whereas a matrical component dominated in 4 cases. Matrical differentiation was recognized as matrical/supramatrical cells (n=21), shadow cells (n=21), bright red trichohyaline granules (n=18), and blue-gray corneocytes (n=18). In 2 cases, matrical areas manifested cytologic atypia, and a third case exhibited an infiltrative growth pattern, with the tumor metastasizing to a lymph node. BerEP4 labeled the follicular germinative cells, whereas it was markedly reduced or negative in matrical areas. The reverse pattern was seen with β-catenin. EMA was negative in BCC areas but stained a proportion of matrical/supramatrical cells. Genetic studies revealed mutations of the following genes: CTNNB1, KIT, CDKN2A, TP53, SMAD4, ERBB4, and PTCH1, with some differences between the matrical and BCC components. It is concluded that matrical differentiation in BCC in most cases occurs as multiple foci. Rare neoplasms manifest atypia in the matrical areas. Immunohistochemical analysis for BerEP4, EMA, and β-catenin can be helpful in limited biopsy specimens. From a molecular biological prospective, BCC and matrical components appear to share some of the gene mutations but have differences in others, but this observation must be validated in a large series.

Low-dose exposure to Veratrum album in children causes mild effects--a case series.

PubMed

Rauber-Lüthy, Christine; Halbsguth, Ulrike; Kupferschmidt, Hugo; König, Naoko; Mégevand, Chloé; Zihlmann, Karin; Ceschi, Alessandro

2010-03-01

White or false hellebore (Veratrum album) has a toxicological relevance because of the potential for misidentification of this plant as yellow gentian (Gentiana lutea). We report a retrospective case series of 11 children (8-12 years) with accidental intake of V. album at a youth camp where they had collected herbs for preparing fresh herb tea. Two children (18%) remained asymptomatic. Nine (82%) developed mild gastrointestinal symptoms, six (55%) presented neurological symptoms, and three (27%) showed bradycardia. All children recovered completely within 10 h of ingestion. The plant was identified at the emergency department; however, detection of veratridine and cevadine by means of high-performance liquid chromatography-Mass spectrometry from the blood of the child with the most severe symptoms was negative (limit 0.01 ng/mL). Veratrum species contain more than 200 different alkaloids, which are the principal toxins and are responsible for most clinical symptoms. There are likely multiple mechanisms of toxicity and some of them are only partially understood. The opening of voltage-gated sodium channels is probably one of the most relevant pathophysiological mechanisms. Veratrum album intoxication in children demonstrated the same clinical course as observed in adults. Accidental ingestion of a low dose of the plant had a favorable outcome with supportive care.

Endoscopic partial medial maxillectomy with mucosal flap for maxillary sinus mucoceles.

PubMed

Durr, Megan L; Goldberg, Andrew N

2014-01-01

To describe a technique of endoscopic medial maxillectomy with mucosal flap for postoperative maxillary sinus mucoceles and to present a case series of subjects who underwent this procedure. This case series includes four subjects with postoperative maxillary sinus mucoceles who underwent resection via endoscopic partial medial maxillectomy with a mucosal flap. We will discuss the clinical presentation, imaging characteristics, operative details, and outcomes. Four subjects are included in this study. The average age at the time of medial maxillectomy was 52 years (range 35-65 years). Three subjects (75%) were female. One subject (25%) had bilateral postoperative maxillary sinus mucoceles. Two subjects (50%) had unilateral right sided mucoceles, and the remaining subject had a unilateral left sided mucocele. All subjects had a history of multiple sinus procedures for chronic sinusitis including Caldwell-Luc procedures ipsilateral to the postoperative mucocele. All subjects underwent endoscopic medial maxillectomy without complication and were symptom free at the last follow up appointment, average 24 months (range 3-71 months) after medial maxillectomy. For postoperative maxillary sinus mucoceles in locations that are difficult to access via the middle meatus antrostomy, we recommend endoscopic medial maxillectomy with mucosal flap. Our preliminary experience with four subjects demonstrates complete resolution of symptoms after this procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

Detection of skeletal muscle metastases on initial staging of lung cancer: a retrospective case series.

PubMed

Bocchino, Marialuisa; Valente, Tullio; Somma, Francesco; de Rosa, Ilaria; Bifulco, Marco; Rea, Gaetano

2014-03-01

Estimation of skeletal muscle metastases (SMMs) at the time of diagnosis and/or initial staging of lung cancer. Retrospective evaluation of clinical charts and imaging data suggestive of SMMs of patients with histology-proved lung cancer over a 5-year period. SMMs were identified in 46 out of 1,754 patients. Single and multiple (62.9% of cases) SMMs were detected by total body multi-detector computed tomography (MDCT). They were associated with poorly differentiated (43%) and advanced adenocarcinomas (52%) without clinically relevant symptoms and/or signs. Psoas and buttock muscles were most frequently involved (33.3%). MDCT findings consisted of well-defined homogeneously hyperdense oval masses (31%), lesions with ring-like enhancement and central hypoattenuation (68%), or large abscess-like necrotic lesions (24%). Sonography revealed well-defined hypoechoic masses (41.6%), ill-defined hypoechoic lesions (33.3%), or anechoic areas with a necrotic centre (25%). Positron emission tomography revealed that all SMMs were metabolically active. SMMs are uncommon but not negligible in lung cancer, with an estimated prevalence of 2.62% in our series. Although histology remains the recommended method, use of high-performance imaging techniques and increased clinical suspicion may improve their early detection. Efforts addressing their effect on the natural history of lung cancer are needed.

Video Game Rehabilitation of Velopharyngeal Dysfunction: A Case Series

PubMed Central

Mittelman, Talia; Braden, Maia N.; Woodnorth, Geralyn Harvey; Stepp, Cara E.

2017-01-01

Purpose Video games provide a promising platform for rehabilitation of speech disorders. Although video games have been used to train speech perception in foreign language learners and have been proposed for aural rehabilitation, their use in speech therapy has been limited thus far. We present feasibility results from at-home use in a case series of children with velopharyngeal dysfunction (VPD) using an interactive video game that provided real-time biofeedback to facilitate appropriate nasalization. Method Five participants were recruited across a range of ages, VPD severities, and VPD etiologies. Participants completed multiple weeks of individual game play with a video game that provides feedback on nasalization measured via nasal accelerometry. Nasalization was assessed before and after training by using nasometry, aerodynamic measures, and expert perceptual judgments. Results Four participants used the game at home or school, with the remaining participant unwilling to have the nasal accelerometer secured to his nasal skin, perhaps due to his young age. The remaining participants showed a tendency toward decreased nasalization after training, particularly for the words explicitly trained in the video game. Conclusion Results suggest that video game–based systems may provide a useful rehabilitation platform for providing real-time feedback of speech nasalization in VPD. Supplemental Material https://doi.org/10.23641/asha.5116828 PMID:28655049

Genetic variants in the immunoglobulin heavy chain locus are associated with the IgG index in multiple sclerosis.

PubMed

Buck, Dorothea; Albrecht, Eva; Aslam, Muhammad; Goris, An; Hauenstein, Natalie; Jochim, Angela; Cepok, Sabine; Grummel, Verena; Dubois, Bénédicte; Berthele, Achim; Lichtner, Peter; Gieger, Christian; Winkelmann, Juliane; Hemmer, Bernhard

2013-01-01

Intrathecal synthesis of immunoglobulin gamma (IgG) synthesis is frequently observed in patients with multiple sclerosis (MS). Whereas the extent of intrathecal IgG synthesis varies largely between patients, it remains rather constant in the individual patient over time. The aim of this study was to identify common genetic variants associated with the IgG index as a marker of intrathecal IgG synthesis in MS. We performed a genome-wide association study of the IgG index in a discovery series of 229 patients. For confirmation we performed a replication in 2 independent series comprising 256 and 153 patients, respectively. The impact of associated single nucleotide polymorphisms (SNPs) on MS susceptibility was analyzed in an additional 1,854 cases and 5,175 controls. Significant association between the IgG index and 5 SNPs was detected in the discovery and confirmed in both replication series reaching combined p values of p = 6.5 × 10(-11) to p = 7.5 × 10(-16) . All identified SNPs are clustered around the immunoglobulin heavy chain (IGHC) locus on chromosome 14q32.33 and are in linkage disequilibrium (r(2) range, 0.71-0.95). The best associated SNP is located in an intronic region of the immunoglobulin gamma3 heavy chain gene. Additional sequencing identified the GM21* haplotype to be associated with a high IgG index. Further evaluation of the IGHC SNPs revealed no association with susceptibility to MS in our data set. The extent of intrathecal IgG in MS is influenced by the IGHC locus. No association with susceptibility to MS was found. Therefore GM haplotypes might affect intrathecal IgG synthesis independently of the underlying disease. Copyright © 2012 American Neurological Association.

Reducing child mortality in Nigeria: a case study of immunization and systemic factors.

PubMed

Nwogu, Rufus; Ngowu, Rufus; Larson, James S; Kim, Min Su

2008-07-01

The purpose of the study is to assess the outcome of the Expanded Program on Immunization (EPI) in Nigeria, as well as to examine systemic factors influencing its high under-five mortality rate (UFMR). The principal objective of the EPI program when it was implemented in 1978 was to reduce mortality, morbidity and disability associated with six vaccine preventable diseases namely tuberculosis, tetanus, diphtheria, measles, pertussis and poliomyelitis. The methodological approach to this study is quantitative, using secondary time series data from 1970 to 2003. The study tested three hypotheses using time series multiple regression analysis with autocorrelation adjustment as a statistical model. The results showed that the EPI program had little effect on UFMR in Nigeria. Only the literacy rate and domestic spending on healthcare had statistically significant effects on the UFMR. The military government was not a significant factor in reducing or increasing the UFMR. It appears that Nigeria needs a unified approach to healthcare delivery, rather than fragmented programs, to overcome cultural and political divisions in society.

Detecting daily routines of older adults using sensor time series clustering.

PubMed

Hajihashemi, Zahra; Yefimova, Maria; Popescu, Mihail

2014-01-01

The aim of this paper is to develop an algorithm to identify deviations in patterns of day-to-day activities of older adults to generate alerts to the healthcare providers for timely interventions. Daily routines, such as bathroom visits, can be monitored by automated in-home sensor systems. We present a novel approach that finds periodicity in sensor time series data using clustering approach. For this study, we used data set from TigerPlace, a retirement community in Columbia, MO, where apartments are equipped with a network of motion, pressure and depth sensors. A retrospective multiple case study (N=3) design was used to quantify bathroom visits as parts of the older adult's daily routine, over a 10-day period. The distribution of duration, number, and average time between sensor hits was used to define the confidence level for routine visit extraction. Then, a hierarchical clustering was applied to extract periodic patterns. The performance of the proposed method was evaluated through experimental results.

Comment on "Astronomical constraints on the duration of the Early Jurassic Pliensbachian Stage and global climatic fluctuations" [Earth Planet. Sci. Lett. 455 (2016) 149-165

NASA Astrophysics Data System (ADS)

Smith, David G.; Bailey, Robin J.

2018-01-01

Astrochronology employs spectral analysis of stratigraphic data series to substantiate and quantify depositional cyclicity, and thus to establish a probable causal link between cases of rhythmic bedding and periodic orbitally-forced climate change. Vaughan et al. (2011 - not cited by Ruhl et al.) showed that the spectral methods conventionally used in cyclostratigraphy will generate false positive results - they will identify multiple cycles that are not present in the data. Tests with synthetic random datasets are both a simple and an essential way to prove this. Ruhl et al. (2016) used the methods to which these criticisms apply in their analysis of XRF-compositional data series from the Early Jurassic of the Mochras borehole, Wales. We use properly corrected methods to re-examine some of their data, showing that their spectral results are not valid, thus casting doubt on their proposed calibration of Pliensbachian time.

Preoperative Onyx embolization of hypervascular head, neck, and spinal tumors: experience with 100 consecutive cases from a single tertiary center.

PubMed

Rangel-Castilla, Leonardo; Shah, Ankit H; Klucznik, Richard Paul; Diaz, Orlando M

2014-01-01

Preoperative embolization of head, neck, and spinal tumors is frequently used to control tumor bleeding, reduce operative time, and achieve better resection. Numerous embolic materials have been used. The use of the liquid embolic agent Onyx is rapidly increasing but current experience is limited to small case series. Our purpose was to evaluate the indications, techniques, angiographic devascularization, blood loss, outcome, and general efficacy of preoperative tumor embolization with Onyx in a large series. Retrospective analysis of 100 consecutive cases of head, neck, and spinal tumors embolized with Onyx and prospective follow-up. 100 patients (63 women, 37 men) were included. Tumors included 39 meningiomas, 23 metastases, 16 parangliomas, five juvenile nasal angiofibromas, five giant cell bone tumors, three Ewing's sarcomas, three hemangiomas, three hemangioblastomas, two multiple myelomas, and one osteoblastoma. In all patients, angiographic analysis of the feeding arteries and branches was performed and all embolizations were completed in a single session. Additional materials were used in 28 patients. No mortality or major complications were observed. Minor complications were seen in 11 patients. 85 patients underwent surgery; 79 within the next 48 h and six of them 4-188 days after embolization. Embolization of intracranial, head, neck, and spinal tumors with Onyx is effective and safe by a transarterial route or by direct puncture. Onyx penetrates well into the tumor capillary with less arterial catheterization. Studies are necessary to establish long term utility in adjunct or palliative tumor embolization.

Calculating three loop ladder and V-topologies for massive operator matrix elements by computer algebra

NASA Astrophysics Data System (ADS)

Ablinger, J.; Behring, A.; Blümlein, J.; De Freitas, A.; von Manteuffel, A.; Schneider, C.

2016-05-01

Three loop ladder and V-topology diagrams contributing to the massive operator matrix element AQg are calculated. The corresponding objects can all be expressed in terms of nested sums and recurrences depending on the Mellin variable N and the dimensional parameter ε. Given these representations, the desired Laurent series expansions in ε can be obtained with the help of our computer algebra toolbox. Here we rely on generalized hypergeometric functions and Mellin-Barnes representations, on difference ring algorithms for symbolic summation, on an optimized version of the multivariate Almkvist-Zeilberger algorithm for symbolic integration, and on new methods to calculate Laurent series solutions of coupled systems of differential equations. The solutions can be computed for general coefficient matrices directly for any basis also performing the expansion in the dimensional parameter in case it is expressible in terms of indefinite nested product-sum expressions. This structural result is based on new results of our difference ring theory. In the cases discussed we deal with iterative sum- and integral-solutions over general alphabets. The final results are expressed in terms of special sums, forming quasi-shuffle algebras, such as nested harmonic sums, generalized harmonic sums, and nested binomially weighted (cyclotomic) sums. Analytic continuations to complex values of N are possible through the recursion relations obeyed by these quantities and their analytic asymptotic expansions. The latter lead to a host of new constants beyond the multiple zeta values, the infinite generalized harmonic and cyclotomic sums in the case of V-topologies.

An update on the causes, assessment and management of third division sensory trigeminal neuropathies.

PubMed

Carter, E; Yilmaz, Z; Devine, M; Renton, T

2016-06-24

Introduction Sensory neuropathies of the mandibular division of the trigeminal (V3) nerve can be debilitating, causing difficulty with daily function. It has a variety of causes, including iatrogenic injury, usually caused by third molar removal, local anaesthetic administration, implant placement or endodontic treatment. Non-iatrogenic causes include infection, primary or secondary neoplasia and various medical conditions.Objective To review the aetiology, evaluation and management of V3 neuropathy in a retrospective case-series of patients referred to a specialist nerve injury clinic over an eight-year period, particularly focusing on the non-iatrogenic causes of this presentation.Methods A retrospective analysis of the case notes of 372 patients referred to the specialist nerve injury clinic between 2006 and 2014 was carried out to establish the cause of the neuropathy and subsequent management or referral. The assessment protocol of trigeminal neuropathy used in the clinic is also outlined.Results Most patients (89.5%) presented with neuropathy due to iatrogenic injury. Of the non-iatrogenic causes (10.5%), malignancy accounted for a fifth of presentations, and infection almost two-fifths, demonstrating the importance of prompt identification of a cause and management by the clinician, or referral to the appropriate specialty. Other, more rare causes are also presented, including multiple sclerosis, sickle-cell anaemia and Paget's disease, highlighting the importance to the clinician of considering differential diagnoses.Conclusions This case series demonstrates the less frequent, but nevertheless important, non-iatrogenic causes which clinicians should consider when assessing patients with trigeminal neuropathy.

Magnet-related injury rates in children: a single hospital experience.

PubMed

Agbo, Chioma; Lee, Lois; Chiang, Vincent; Landscahft, Assaf; Kimia, Tomer; Monuteaux, Michael C; Kimia, Amir A

2013-07-01

The ingestion of multiple magnets simultaneously or the placement of magnets in both nares can lead to serious injury resulting from the attraction of the magnets across the tissues. The impact of mandatory standards for toys containing magnets has not been thoroughly investigated. The aim of the present study was to describe the emergency department (ED) visit rate for magnet-related injuries. We performed a retrospective study of children evaluated for magnet-related injuries from 1995 to 2012 in an urban tertiary care pediatric ED. We identified cases using a computerized text-search methodology followed by manual chart review. We included children evaluated for magnet ingestion or impaction in the ears, nose, vagina, or rectum. We assessed the type and number of magnets as well as management and required interventions. A Poisson regression model was used to analyze rates of injury over time. We identified 112 cases of magnet injuries. The median patient age was 6 years (IQR 3.5, 10), and 54% were male. Compared to before 2006, the rate for all magnet-related injuries in 2007-2012 (incidence rate ratio 3.44; 95% confidence interval 2.3-5.11) as well as multiple magnet-related injuries (incidence rate ratio 7.54; 95% confidence interval 3.51-16.19) increased. Swallowed magnets accounted for 86% of the injuries. Thirteen patients had endoscopy performed for magnet removal (12%), and 4 (4%) had a surgical intervention. Magnets from toys account for the majority of the injuries. The number of ED visits for magnet-related injuries in children may be rising and are underreported, with an increase in the proportion of multiple magnets involvement. In our case series, mandatory standard for toys had no mitigating effect.

Coupling detrended fluctuation analysis for analyzing coupled nonstationary signals.

PubMed

Hedayatifar, L; Vahabi, M; Jafari, G R

2011-08-01

When many variables are coupled to each other, a single case study could not give us thorough and precise information. When these time series are stationary, different methods of random matrix analysis and complex networks can be used. But, in nonstationary cases, the multifractal-detrended-cross-correlation-analysis (MF-DXA) method was introduced for just two coupled time series. In this article, we have extended the MF-DXA to the method of coupling detrended fluctuation analysis (CDFA) for the case when more than two series are correlated to each other. Here, we have calculated the multifractal properties of the coupled time series, and by comparing CDFA results of the original series with those of the shuffled and surrogate series, we can estimate the source of multifractality and the extent to which our series are coupled to each other. We illustrate the method by selected examples from air pollution and foreign exchange rates.

Coupling detrended fluctuation analysis for analyzing coupled nonstationary signals

NASA Astrophysics Data System (ADS)

Hedayatifar, L.; Vahabi, M.; Jafari, G. R.

2011-08-01

When many variables are coupled to each other, a single case study could not give us thorough and precise information. When these time series are stationary, different methods of random matrix analysis and complex networks can be used. But, in nonstationary cases, the multifractal-detrended-cross-correlation-analysis (MF-DXA) method was introduced for just two coupled time series. In this article, we have extended the MF-DXA to the method of coupling detrended fluctuation analysis (CDFA) for the case when more than two series are correlated to each other. Here, we have calculated the multifractal properties of the coupled time series, and by comparing CDFA results of the original series with those of the shuffled and surrogate series, we can estimate the source of multifractality and the extent to which our series are coupled to each other. We illustrate the method by selected examples from air pollution and foreign exchange rates.

Homogenised daily lake surface water temperature data generated from multiple satellite sensors: A long-term case study of a large sub-Alpine lake

PubMed Central

Pareeth, Sajid; Salmaso, Nico; Adrian, Rita; Neteler, Markus

2016-01-01

Availability of remotely sensed multi-spectral images since the 1980’s, which cover three decades of voluminous data could help researchers to study the changing dynamics of bio-physical characteristics of land and water. In this study, we introduce a new methodology to develop homogenised Lake Surface Water Temperature (LSWT) from multiple polar orbiting satellites. Precisely, we developed homogenised 1 km daily LSWT maps covering the last 30 years (1986 to 2015) combining data from 13 satellites. We used a split-window technique to derive LSWT from brightness temperatures and a modified diurnal temperature cycle model to homogenise data which were acquired between 8:00 to 17:00 UTC. Gaps in the temporal LSWT data due to the presence of clouds were filled by applying Harmonic ANalysis of Time Series (HANTS). The satellite derived LSWT maps were validated based on long-term monthly in-situ bulk temperature measurements in Lake Garda, the largest lake in Italy. We found the satellite derived homogenised LSWT being significantly correlated to in-situ data. The new LSWT time series showed a significant annual rate of increase of 0.020 °C yr−1 (*P < 0.05), and of 0.036 °C yr−1 (***P < 0.001) during summer. PMID:27502177

Oral lichen planus in childhood: a case series.

PubMed

Cascone, Marco; Celentano, Antonio; Adamo, Daniela; Leuci, Stefania; Ruoppo, Elvira; Mignogna, Michele D

2017-06-01

Although the exact incidence of pediatric oral lichen planus (OLP) is unknown, the oral mucosa seems to be less commonly involved, and the clinical presentation is often atypical. The aim of the study is to present a case series of OLP in childhood. From our database, we retrospectively selected and analyzed the clinical data of OLP patients under the age of 18 where the diagnosis had been confirmed by histopathological analysis. The case series from our database shows eight patients, four males and four females. The mean (±SD) age at the time of diagnosis of the disease was 13.5 (±2.73) years, ranging in age from 9 to 17. Clinically, a reticular pattern was present in six patients (75%), and the tongue was the most commonly involved oral site (six cases, 75%). We also report the first case of OLP in a 9-year-old girl affected by autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. We report the largest case series of pediatric OLP published in literature thus far. Differences in the disease between adults and pediatric patients have been detected, but further investigation and a larger case series are needed to establish any detailed differences in clinical outcomes. © 2017 The International Society of Dermatology.

17 CFR 20.5 - Series S filings.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Series S filings. 20.5 Section... FOR PHYSICAL COMMODITY SWAPS § 20.5 Series S filings. (a) 102S filing. (1) When a counterparty... 102S filing only once for each counterparty, even if such persons at various times have multiple...

Introduction and application of the multiscale coefficient of variation analysis.

PubMed

Abney, Drew H; Kello, Christopher T; Balasubramaniam, Ramesh

2017-10-01

Quantifying how patterns of behavior relate across multiple levels of measurement typically requires long time series for reliable parameter estimation. We describe a novel analysis that estimates patterns of variability across multiple scales of analysis suitable for time series of short duration. The multiscale coefficient of variation (MSCV) measures the distance between local coefficient of variation estimates within particular time windows and the overall coefficient of variation across all time samples. We first describe the MSCV analysis and provide an example analytical protocol with corresponding MATLAB implementation and code. Next, we present a simulation study testing the new analysis using time series generated by ARFIMA models that span white noise, short-term and long-term correlations. The MSCV analysis was observed to be sensitive to specific parameters of ARFIMA models varying in the type of temporal structure and time series length. We then apply the MSCV analysis to short time series of speech phrases and musical themes to show commonalities in multiscale structure. The simulation and application studies provide evidence that the MSCV analysis can discriminate between time series varying in multiscale structure and length.

On the Stationarity of Multiple Autoregressive Approximants: Theory and Algorithms

DTIC Science & Technology

1976-08-01

a I (3.4) Hannan and Terrell (1972) consider problems of a similar nature. Efficient estimates A(1),... , A(p) , and i of A(1)... ,A(p) and...34Autoregressive model fitting for control, Ann . Inst. Statist. Math., 23, 163-180. Hannan, E. J. (1970), Multiple Time Series, New York, John Wiley...Hannan, E. J. and Terrell , R. D. (1972), "Time series regression with linear constraints, " International Economic Review, 13, 189-200. Masani, P

A PC-based telemetry system for acquiring and reducing data from multiple PCM streams

NASA Astrophysics Data System (ADS)

Simms, D. A.; Butterfield, C. P.

1991-07-01

The Solar Energy Research Institute's (SERI) Wind Research Program is using Pulse Code Modulation (PCM) Telemetry Data-Acquisition Systems to study horizontal-axis wind turbines. Many PCM systems are combined for use in test installations that require accurate measurements from a variety of different locations. SERI has found them ideal for data-acquisition from multiple wind turbines and meteorological towers in wind parks. A major problem has been in providing the capability to quickly combine and examine incoming data from multiple PCM sources in the field. To solve this problem, SERI has developed a low-cost PC-based PCM Telemetry Data-Reduction System (PC-PCM System) to facilitate quick, in-the-field multiple-channel data analysis. The PC-PCM System consists of two basic components. First, PC-compatible hardware boards are used to decode and combine multiple PCM data streams. Up to four hardware boards can be installed in a single PC, which provides the capability to combine data from four PCM streams directly to PC disk or memory. Each stream can have up to 62 data channels. Second, a software package written for use under DOS was developed to simplify data-acquisition control and management. The software, called the Quick-Look Data Management Program, provides a quick, easy-to-use interface between the PC and multiple PCM data streams. The Quick-Look Data Management Program is a comprehensive menu-driven package used to organize, acquire, process, and display information from incoming PCM data streams. The paper describes both hardware and software aspects of the SERI PC-PCM system, concentrating on features that make it useful in an experiment test environment to quickly examine and verify incoming data from multiple PCM streams. Also discussed are problems and techniques associated with PC-based telemetry data-acquisition, processing, and real-time display.

A scalable database model for multiparametric time series: a volcano observatory case study

NASA Astrophysics Data System (ADS)

Montalto, Placido; Aliotta, Marco; Cassisi, Carmelo; Prestifilippo, Michele; Cannata, Andrea

2014-05-01

The variables collected by a sensor network constitute a heterogeneous data source that needs to be properly organized in order to be used in research and geophysical monitoring. With the time series term we refer to a set of observations of a given phenomenon acquired sequentially in time. When the time intervals are equally spaced one speaks of period or sampling frequency. Our work describes in detail a possible methodology for storage and management of time series using a specific data structure. We designed a framework, hereinafter called TSDSystem (Time Series Database System), in order to acquire time series from different data sources and standardize them within a relational database. The operation of standardization provides the ability to perform operations, such as query and visualization, of many measures synchronizing them using a common time scale. The proposed architecture follows a multiple layer paradigm (Loaders layer, Database layer and Business Logic layer). Each layer is specialized in performing particular operations for the reorganization and archiving of data from different sources such as ASCII, Excel, ODBC (Open DataBase Connectivity), file accessible from the Internet (web pages, XML). In particular, the loader layer performs a security check of the working status of each running software through an heartbeat system, in order to automate the discovery of acquisition issues and other warning conditions. Although our system has to manage huge amounts of data, performance is guaranteed by using a smart partitioning table strategy, that keeps balanced the percentage of data stored in each database table. TSDSystem also contains modules for the visualization of acquired data, that provide the possibility to query different time series on a specified time range, or follow the realtime signal acquisition, according to a data access policy from the users.

Monitoring gradual ecosystem change using Landsat time series analyses: case studies in selected forest and rangeland ecosystems

USGS Publications Warehouse

Vogelmann, James E.; Xian, George; Homer, Collin G.; Tolk, Brian

2012-01-01

The focus of the study was to assess gradual changes occurring throughout a range of natural ecosystems using decadal Landsat Thematic Mapper (TM) and Enhanced Thematic Mapper Plus (ETM +) time series data. Time series data stacks were generated for four study areas: (1) a four scene area dominated by forest and rangeland ecosystems in the southwestern United States, (2) a sagebrush-dominated rangeland in Wyoming, (3) woodland adjacent to prairie in northwestern Nebraska, and (4) a forested area in the White Mountains of New Hampshire. Through analyses of time series data, we found evidence of gradual systematic change in many of the natural vegetation communities in all four areas. Many of the conifer forests in the southwestern US are showing declines related to insects and drought, but very few are showing evidence of improving conditions or increased greenness. Sagebrush communities are showing decreases in greenness related to fire, mining, and probably drought, but very few of these communities are showing evidence of increased greenness or improving conditions. In Nebraska, forest communities are showing local expansion and increased canopy densification in the prairie–woodland interface, and in the White Mountains high elevation understory conifers are showing range increases towards lower elevations. The trends detected are not obvious through casual inspection of the Landsat images. Analyses of time series data using many scenes and covering multiple years are required in order to develop better impressions and representations of the changing ecosystem patterns and trends that are occurring. The approach described in this paper demonstrates that Landsat time series data can be used operationally for assessing gradual ecosystem change across large areas. Local knowledge and available ancillary data are required in order to fully understand the nature of these trends.

[Seven cases of tuberculous otitis media].

PubMed

Nishiike, S; Irifune, M; Kubo, T

2000-12-01

Tuberculous otitis media (TOM) is a variable and puzzling infectious disease that is sometimes confused with other chronic middle ear diseases. A series of 7 cases (9 ears) of TOM recently treated at Osaka Prefectural Habikino Hospital is reviewed to assess the recent features of the disease. In most cases, the pathogenetic mechanism was probably aspiration of tubercle bacilli through the eustachian tube. In most cases, abundant granulations were observed in the middle and external ears, but multiple perforations of the tympanic membrane were not seen. The manifestations were variable, such as otorrhea from the perforation and otitis media with effusion. In their early stage, most cases of TOMs due to transmission via the eustachian tube are tend to resemble otitis media with effusion. Smear tests, culture, PCR, and histopathological examinations, each of which has advantages and disadvantages, must be repeated to achieve a definitive diagnosis. Tuberculin tests can be unreliable, but a chest x-ray is indispensable whenever TOM is suspected. Antitubercular chemotherapy and 2% kanamycin earwash yielded good results. Since the classical criteria for the diagnosis of TOM are no longer valid, we propose a new criterion for diagnosis in the early stage of the disease.

Towards a sustainable modular robot system for planetary exploration

NASA Astrophysics Data System (ADS)

Hossain, S. G. M.

This thesis investigates multiple perspectives of developing an unmanned robotic system suited for planetary terrains. In this case, the unmanned system consists of unit-modular robots. This type of robot has potential to be developed and maintained as a sustainable multi-robot system while located far from direct human intervention. Some characteristics that make this possible are: the cooperation, communication and connectivity among the robot modules, flexibility of individual robot modules, capability of self-healing in the case of a failed module and the ability to generate multiple gaits by means of reconfiguration. To demonstrate the effects of high flexibility of an individual robot module, multiple modules of a four-degree-of-freedom unit-modular robot were developed. The robot was equipped with a novel connector mechanism that made self-healing possible. Also, design strategies included the use of series elastic actuators for better robot-terrain interaction. In addition, various locomotion gaits were generated and explored using the robot modules, which is essential for a modular robot system to achieve robustness and thus successfully navigate and function in a planetary environment. To investigate multi-robot task completion, a biomimetic cooperative load transportation algorithm was developed and simulated. Also, a liquid motion-inspired theory was developed consisting of a large number of robot modules. This can be used to traverse obstacles that inevitably occur in maneuvering over rough terrains such as in a planetary exploration. Keywords: Modular robot, cooperative robots, biomimetics, planetary exploration, sustainability.

Ultrasound and Perforated Viscus; Dirty Fluid, Dirty Shadows, and Peritoneal Enhancement.

PubMed

Shokoohi, Hamid; S Boniface, Keith; M Abell, Bruce; Pourmand, Ali; Salimian, Mohammad

2016-01-01

Early detection of free air in the peritoneal cavity is vital in diagnosis of life-threatening emergencies, and can play a significant role in expediting treatment. We present a series of cases in which bedside ultrasound (US) in the emergency department accurately identified evidence of free intra-peritoneal air and echogenic (dirty) free fluid consistent with a surgical final diagnosis of a perforated hollow viscus. In all patients with suspected perforated viscus, clinicians were able to accurately identify the signs of pneumoperitoneum including enhanced peritoneal stripe sign (EPSS), peritoneal stripe reverberations, and focal air collections associated with dirty shadowing or distal multiple reflections as ring down artifacts. In all cases, hollow viscus perforation was confirmed surgically. It seems that, performing US in patients with suspected perforated viscus can accurately identify presence of intra-peritoneal echogenic or "dirty" free fluid as well as evidence of free air, and may expedite patient management.

Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ.

PubMed

Albright, Len; Derickson, Elizabeth S; Massey, Douglas S

2013-06-01

This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ - the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities.

Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ

PubMed Central

Albright, Len; Derickson, Elizabeth S.; Massey, Douglas S.

2016-01-01

This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ – the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities. PMID:27390552

[Which technique should be used in the phenotyping of lymphocytic alveolitis: Immunocytochemistry or flow cytometry].

PubMed

Mlika, Mona; Kasmi, Rihem; Safra, Ines; Braham, Emna; Chebbi, Chokri; Mezni, Faouzi El

2017-10-01

Diffuse interstitial pneumonias are considered as a group of multiple affections characterized by challenging diagnoses because of the lack of specific clinical signs. Radiologic investigations highlight the diagnoses in most of the cases but bronchoalveolar lavage plays a key role in the diagnostic diagram. We aim to compare the immunocytochemical technique and the flow cytometry in the phenotyping of lymphocytic alveolitis. We described a series of 32 lymphocytic alveolitis, which were analyzed using immunocytochemistry and flow cytometry. We found a good reproducibility between the immunocytochemistry performed on smears and cytoblocks (kappa=0.7) and a poor reproducibility between immunocytochemistry and flow cytometry (kappa=0.35). Our study emphasized on the poor reproducibility between immunocytochemistry and flow cytometry. Further studies about the reliability of both techniques are needed especially in discordant cases. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Psychogenic dyspnea and therapeutic chest radiograph.

PubMed

Kaufman, Kenneth R; Endres, Jennifer K; Kaufman, Nathaniel D

2007-04-01

Conversion disorders, the physical expression of unresolved psychological pain, can be associated with mourning. This case report is third in a series of articles by the authors on childhood mourning reflecting the effects of multiple losses (K. R. Kaufman & N. D. Kaufman, 2005; K. R. Kaufman & N. D. Kaufman, 2006). In this case report, perception of potential death (self or parent) after a motor vehicle accident precipitated psychogenic dyspnea. A "therapeutic" chest radiograph was an effective initial treatment. Rapid intervention with explanation of the functional nature of the conversion symptom, why this symptom developed, and how to address the underlying stresses in the future led to an excellent outcome. Psychosocial intervention should be included in the multidisciplinary approach toward the child with conversion disorder, be it in an ambulatory, ER, or inpatient setting. The clinician must remember that medically unexplained symptoms in childhood may represent a child's expression of mourning.

Explaining rapid reinfections in multiple-wave influenza outbreaks: Tristan da Cunha 1971 epidemic as a case study

PubMed Central

Camacho, Anton; Ballesteros, Sébastien; Graham, Andrea L.; Carrat, Fabrice; Ratmann, Oliver; Cazelles, Bernard

2011-01-01

Influenza usually spreads through the human population in multiple-wave outbreaks. Successive reinfection of individuals over a short time interval has been explicitly reported during past pandemics. However, the causes of rapid reinfection and the role of reinfection in driving multiple-wave outbreaks remain poorly understood. To investigate these issues, we focus on a two-wave influenza A/H3N2 epidemic that occurred on the remote island of Tristan da Cunha in 1971. Over 59 days, 273 (96%) of 284 islanders experienced at least one attack and 92 (32%) experienced two attacks. We formulate six mathematical models invoking a variety of antigenic and immunological reinfection mechanisms. Using a maximum-likelihood analysis to confront model predictions with the reported incidence time series, we demonstrate that only two mechanisms can be retained: some hosts with either a delayed or deficient humoral immune response to the primary influenza infection were reinfected by the same strain, thus initiating the second epidemic wave. Both mechanisms are supported by previous empirical studies and may arise from a combination of genetic and ecological causes. We advocate that a better understanding and account of heterogeneity in the human immune response are essential to analysis of multiple-wave influenza outbreaks and pandemic planning. PMID:21525058

Incidence of metachronous gastric cancer in the remnant stomach after synchronous multiple cancer surgery.

PubMed

Nozaki, Isao; Hato, Shinji; Kobatake, Takaya; Ohta, Koji; Kubo, Yoshirou; Nishimura, Rieko; Kurita, Akira

2014-01-01

In the preoperative evaluation for gastric cancer, high-resolution endoscopic technologies allow us to detect small accessory lesions. However, it is not known if the gastric remnant after partial gastrectomy for synchronous multiple gastric cancers has a greater risk for metachronous cancer. The purpose of this study was to determine the incidence of metachronous cancer in this patient subset compared with that after solitary cancer surgery. Data on a consecutive series of 1,281 patients gastrectomized for early gastric cancer from 1991 to 2007 were analyzed retrospectively. The 715 gastric remnants after distal gastrectomy were periodically surveyed by endoscopic examination in Shikoku Cancer Center. Among those surveyed cases, 642 patients were pathologically diagnosed with solitary lesion (SO group) and 73 patients with synchronous multiple lesions (MU group) at the time of the initial surgery. In the follow-up period, 15 patients in the SO group and 3 patients in the MU group were diagnosed as having metachronous cancer in the gastric remnant. The cumulative 4-year incidence rate was 1.9 % in the SO group and 5.5 % in the MU group. The difference did not reach the significant level by the log-rank test. The incidence of metachronous cancer is higher after multiple cancer surgery; however, the difference is not statistically significant.

Successful use of right unilateral ECT for catatonia: a case series.

PubMed

Cristancho, Pilar; Jewkes, Delaina; Mon, Thetsu; Conway, Charles

2014-03-01

Catatonia is a neuropsychiatric syndrome involving motor signs in association with disorders of mood, behavior, or thought. Bitemporal electrode placement electroconvulsive therapy (ECT) is a proven effective treatment for catatonia, and this mode of ECT delivery is the preferred method of treatment in this condition. Studies in major depressive disorder have demonstrated that suprathreshold, nondominant (right) hemisphere, unilateral electrode placement ECT has fewer adverse effects, especially cognitive adverse effects, than bitemporal ECT. This case series describes the use of right unilateral (RUL) ECT in 5 patients with catatonia. Before ECT, all 5 patients in this series initially failed therapy with benzodiazepines and psychotropic medications. Each catatonic patient received a series of 8 to 12 RUL ECT in an every-other-day series. After ECT, 4 of the 5 patients had a full recovery from catatonia. One patient achieved only partial response to RUL ECT, and no additional benefit was obtained with bitemporal ECT. All patients in this case series tolerated RUL ECT without major adverse effects. This case series illustrates successful use of RUL ECT in patients with catatonia and adds to the early literature demonstrating its effective use in treating this complex condition.

Hemoadsorption by CytoSorb in septic patients: a case series.

PubMed

Kogelmann, Klaus; Jarczak, Dominik; Scheller, Morten; Drüner, Matthias

2017-03-27

Septic shock, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, is a highly lethal condition that causes substantial morbidity and mortality among critically ill patients. One of the hallmarks of sepsis is the excessive release of cytokines and other inflammatory mediators causing refractory hypotension, tissue damage, metabolic acidosis and ultimately multiple organ failure. In this context, cytokine reduction by hemoadsorption represents a new concept for blood purification, developed to attenuate the overwhelming systemic levels of pro-inflammatory and anti-inflammatory mediators released in the early phase of sepsis. In the present case series, we evaluated the impact of a new hemoadsorption device (CytoSorb) used as adjunctive therapy, on hemodynamics and clinically relevant outcome parameters in 26 critically ill patients with septic shock and in need of renal replacement therapy. We found that treatment of these patients with septic shock was associated with hemodynamic stabilization and a reduction in blood lactate levels. Actual mortality in the overall patient population was lower than mortality predicted by acute physiology and chronic health evaluation II (APACHE II). These effects seem to be more pronounced in patients in whom therapy started within 24 h of sepsis diagnosis, whereas a delay in the start of therapy was associated with a poor response to therapy in terms of reduction of catecholamine demand and survival. Moreover, from our patient population, medical patients seemed to benefit more than post-surgical patients in terms of survival. Treatment using the CytoSorb device was safe and well-tolerated with no device-related adverse events during or after the treatment sessions. Hemoadsorption using CytoSorb resulted in rapid hemodynamic stabilization and increased survival, particularly in patients in whom therapy was started early. Given the positive clinical experience of this case series, randomized controlled trials are urgently needed to define the potential benefits of this new treatment option.

Graft Utilization in the Bridging Reconstruction of Irreparable Rotator Cuff Tears: A Systematic Review.

PubMed

Lewington, Matthew R; Ferguson, Devin P; Smith, T Duncan; Burks, Robert; Coady, Catherine; Wong, Ivan Ho-Bun

2017-11-01

Rotator cuff tears are one of the most common conditions affecting the shoulder. Because of the difficulty in managing massive rotator cuff tears and the inability of standard techniques to prevent arthropathy, surgeons have developed several novel techniques to improve outcomes and ideally alter the natural history. To systematically review the existing literature and analyze reported outcomes to evaluate the effectiveness of using a bridging graft reconstruction technique to treat large to massive irreparable rotator cuff tears. Systematic review. A systematic search of PubMed, EMBASE, CINAHL, and CENTRAL was employed with the key terms "tear," "allograft," and "rotator cuff." Eligibility was determined by a 3-phase screening process according to the outlined inclusion/exclusion criteria. Data in relation to the primary and secondary outcomes were summarized. The results were synthesized according to the origin of the graft and the level of evidence. Fifteen studies in total were included in this review: 2 comparative studies and 13 observational case series. Both the biceps tendon and the fascia lata autograft groups had significantly superior structural integrity rates on magnetic resonance imaging at 12-month minimum follow-up when compared with their partial primary repair counterparts (58% vs 26%, P = .036; 79% vs 58%, P < .05), respectively. Multiple noncomparative case series investigating allografts, xenografts, and synthetic materials for bridging reconstruction of large to massive rotator cuff tears demonstrated high structural healing rates (74%-90%, 73%-100%, and 60%-90%, respectively). Additionally, both comparative studies and case series demonstrated a general improvement of patients' functional outcome scores. Using a graft for an anatomic bridging rotator cuff repair results in improved function on objective testing and may be functionally better than nonanatomic or partial repair of large to massive rotator cuff tears. Allograft or xenograft techniques appear to be favorable options, given demonstrated functional improvement, imaging-supported graft survival, and lack of harvest complication risk. More high-quality randomized controlled studies are needed to further assess this technique.

The antibiotic management of gonorrhoea in Ontario, Canada following multiple changes in guidelines: an interrupted time-series analysis.

PubMed

Dickson, Catherine; Taljaard, Monica; Friedman, Dara Spatz; Metz, Gila; Wong, Tom; Grimshaw, Jeremy M

2017-12-01

This study assessed adherence with first-line gonorrhoea treatment recommendations in Ontario, Canada, following recent guideline changes due to antibiotic resistance. We used interrupted times-series analyses to analyse treatment data for cases of uncomplicated gonorrhoea reported in Ontario, Canada, between January 2006 and May 2014. We assessed adherence with first-line treatment according to the guidelines in place at the time and the use of specific antibiotics over time. We used the introduction of new recommendations in the Canadian Guidelines for Sexually Transmitted Infections in 2008 and 2011 and the release of the province of Ontario's Guidelines for the Treatment and Management of Gonococcal Infections in Ontario in 2013 as interruptions in the time-series analysis. Overall, 34 287 gonorrhoea cases were reported between 1 January 2006 and 31 May 2014. Treatment data were available for 32 312 (94.2%). Our analysis included 32 272 (94.1%) cases without either a conjunctival or disseminated infection. Following the release of the 2011 recommendations, adherence with first-line recommendations immediately decreased to below 30%. Adherence slowly increased but did not reach baseline levels before the 2013 guidelines were released. Following release of the 2013 guidelines, adherence again decreased; adherence is slowly recovering but by May 2014, was only approximately 60%. Due to concerns about antibiotic resistance, gonorrhoea treatment guidelines need to be updated regularly and rapidly adopted in practice. Our study showed poor adherence following dissemination of updated guidelines. Over a year after the latest Ontario guidelines were released, 40% of patients did not receive first-line treatment, putting them at risk of treatment failure and potentially promoting further drug resistance. Greater attention should be devoted to dissemination and implementation of new guidelines. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Quantifying and Reducing Uncertainty in Correlated Multi-Area Short-Term Load Forecasting

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

Sun, Yannan; Hou, Zhangshuan; Meng, Da

2016-07-17

In this study, we represent and reduce the uncertainties in short-term electric load forecasting by integrating time series analysis tools including ARIMA modeling, sequential Gaussian simulation, and principal component analysis. The approaches are mainly focusing on maintaining the inter-dependency between multiple geographically related areas. These approaches are applied onto cross-correlated load time series as well as their forecast errors. Multiple short-term prediction realizations are then generated from the reduced uncertainty ranges, which are useful for power system risk analyses.

Prospective detection of open spina bifida at 11-13 weeks by assessing intracranial translucency and posterior brain.

PubMed

Chaoui, R; Benoit, B; Heling, K S; Kagan, K O; Pietzsch, V; Sarut Lopez, A; Tekesin, I; Karl, K

2011-12-01

We describe a case series of six fetuses with open spina bifida (OSB) from four different prenatal units, where the anomaly was detected at the routine 11-13-week ultrasound examination. Crown-rump length ranged from 49 to 78 mm. All cases were first suspected during nuchal translucency thickness measurement in the mid-sagittal plane of the face. OSB was lumbosacral in five fetuses and cervical in one. The intracranial translucency (IT) was obliterated in two cases, but some fluid was found in the other four cases. However, in all cases the typical landmarks of a normal posterior brain and normal IT were absent. In all six cases the ratio of brainstem diameter to brainstem-occipital bone distance was increased (≥ 1). This detection of an abnormal posterior brain led to a targeted examination and detection of the spinal lesion during the same examination in five cases, whereas in one suspicious case the patient was recalled at 17 weeks, when the abnormality was detected. Two fetuses had both multiple anomalies and trisomy 18. These prospective cases demonstrate the feasibility of using the standard mid-sagittal plane commonly used for NT measurement to assess the IT and the posterior brain and to determine the presence of OSB during NT screening. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

Methodology Series Module 2: Case-control Studies

PubMed Central

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same ‘study base’ as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias. PMID:27057012

Multiple Victims of Carbon Monoxide Poisoning in the Aftermath of a Wildfire: A Case Series.

PubMed

Santos, Luís Ramos; Alves-Correia, Magna; Câmara, Margarida; Lélis, Manuela; Caldeira, Carmo; Brazão, Maria Luz; Nóbrega, José Júlio

2018-03-29

Carbon monoxide poisoning may occur in several contexts. Retrospective of 37 carbon monoxide poisoning cases that underwent hyperbaric oxygen during wildfires in Funchal in August 2016. The studied sample included 37 patients, mean age of 38 years, 78% males. Ten were firefighters, four children and two pregnant victims. Neurological symptoms were the most reported. Median carboxyhemoglobin level was 3.7% (IQR 2.7). All received high-flow oxygen from admission to delivery of hyperbaric oxygen. Persistence of symptoms was the main indication for hyperbaric oxygen. Median time to hyperbaric oxygen was 4.8 hours (IQR 9.5), at 2.5 ATA for 90 minutes, without major complications. Discharge in less than 24 hours occurred in 92% of the cases. Thirty days follow-up: five patients presented clinical symptoms of late neurological syndrome; twelve patients were lost to follow-up. Carboxyhemoglobin levels on admission and mean time to hyperbaric oxygen were no different between those who did and did not develop the syndrome at 30 days (p = 0.44 and p = 0.58, respectively). Late neurological syndrome at 30 days occurred in 20% and no new cases were reported at 12 months. Use of hyperbaric oxygen appears to have reduced the incidence of the syndrome. This seems to be the first Portuguese series reporting use of hyperbaric oxygen in carbon monoxide poisoning due to wildfires. The authors intend to alert to the importance of referral of these patients because the indications and benefits of this treatment are well documented. This is especially important given the ever-growing issue of wildfires in Portugal.

What's in a Name? The Incorrect Use of Case Series as a Study Design Label in Studies Involving Dogs and Cats.

PubMed

Sargeant, J M; O'Connor, A M; Cullen, J N; Makielski, K M; Jones-Bitton, A

2017-07-01

Study design labels are used to identify relevant literature to address specific clinical and research questions and to aid in evaluating the evidentiary value of research. Evidence from the human healthcare literature indicates that the label "case series" may be used inconsistently and inappropriately. Our primary objective was to determine the proportion of studies in the canine and feline veterinary literature labeled as case series that actually corresponded to descriptive cohort studies, population-based cohort studies, or other study designs. Our secondary objective was to identify the proportion of case series in which potentially inappropriate inferential statements were made. Descriptive evaluation of published literature. One-hundred published studies (from 19 journals) labeled as case series. Studies were identified by a structured literature search, with random selection of 100 studies from the relevant citations. Two reviewers independently characterized each study, with disagreements resolved by consensus. Of the 100 studies, 16 were case series. The remaining studies were descriptive cohort studies (35), population-based cohort studies (36), or other observational or experimental study designs (13). Almost half (48.8%) of the case series or descriptive cohort studies, with no control group and no formal statistical analysis, included inferential statements about the efficacy of treatment or statistical significance of potential risk factors. Authors, peer-reviewers, and editors should carefully consider the design elements of a study to accurately identify and label the study design. Doing so will facilitate an understanding of the evidentiary value of the results. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Cross-contact chain

NASA Technical Reports Server (NTRS)

Lieneweg, Udo (Inventor)

1988-01-01

A system is provided for use with wafers that include multiple integrated circuits that include two conductive layers in contact at multiple interfaces. Contact chains are formed beside the integrated circuits, each contact chain formed of the same two layers as the circuits, in the form of conductive segments alternating between the upper and lower layers and with the ends of the segments connected in series through interfaces. A current source passes a current through the series-connected segments, by way of a pair of current tabs connected to opposite ends of the series of segments. While the current flows, voltage measurements are taken between each of a plurality of pairs of voltage tabs, the two tabs of each pair connected to opposite ends of an interface that lies along the series-connected segments. A plot of interface conductances on a normal probability chart, enables prediction of the yield of good integrated circuits from the wafer.

Cross-contact chain

NASA Technical Reports Server (NTRS)

Lieneweg, U. (Inventor)

1986-01-01

A system is provided for use with wafers that include multiple integrated circuits that include two conductive layers in contact at multiple interfaces. Contact chains are formed beside the integrated circuits, each contact chain formed of the same two layers as the circuits, in the form of conductive segments alternating between the upper and lower layers and with the ends of the segments connected in series through interfaces. A current source passes a current through the series-connected segments, by way of a pair of current tabs connected to opposite ends of the series of segments. While the current flows, voltage measurements are taken between each of a plurality of pairs of voltage tabs, the two tabs of each pair connected to opposite ends of an interface that lies along the series-connected segments. A plot of interface conductances on normal probability chart enables prediction of the yield of good integrated circuits from the wafer.

Improvement of downscaled rainfall and temperature across generations over the Western Himalayan region of India

NASA Astrophysics Data System (ADS)

Das, L.; Dutta, M.; Akhter, J.; Meher, J. K.

2016-12-01

It is a challenging task to create station level (local scale) climate change information over the mountainous locations of Western Himalayan Region (WHR) in India because of limited data availability and poor data quality. In the present study, missing values of station data were handled through Multiple Imputation Chained Equation (MICE) technique. Finally 22 numbers of rain gauge and 16 number of temperature station data having continuous record during 1901­2005 and 1969­2009 period respectively were considered as reference stations for developing downscaled rainfall and temperature time series from five commonly available GCMs in the IPCC's different generation assessment reports namely 2nd, 3rd, 4th and 5th hereafter known as SAR, TAR, AR4 and AR5 respectively. Downscaled models were developed using the combined data from the ERA-interim reanalysis and GCMs historical runs (in spite of forcing were not identical in different generation) as predictor and station level rainfall and temperature as predictands. Station level downscaled rainfall and temperature time series were constructed for five GCMs available in each generation. Regional averaged downscaled time series comprising of all stations was prepared for each model and generation and the downscaled results were compared with observed time series. Finally an Overall Model Improvement Index (OMII) was developed using the downscaling results, which was used to investigate the model improvement across generations as well as the improvement of downscaling results obtained from the Empirical Statistical Downscaling (ESD) methods. In case of temperature, models have improved from SAR to AR5 over the study area. In all most all the GCMs TAR is showing worst performance over the WHR by considering the different statistical indices used in this study. In case of precipitation, no model has shown gradual improvement from SAR to AR5 both for interpolated and downscaled values.

Intramolecular cation-π interactions in protonated phenylalanine derivatives.

PubMed

Fu, Weiqiang; Carr, Patrick J J; Lecours, Michael J; Burt, Michael; Marta, Rick A; Steinmetz, Vincent; Fillion, Eric; McMahon, Terrance B; Hopkins, W Scott

2016-12-21

The structures and properties of a series of phenylalanine (Phe) derivatives have been investigated in a joint computational and experimental infrared multiple photon dissociation (IRMPD) study. IRMPD spectra in the 1000-2000 cm -1 region show that protonation is localized on the amine group in all cases. Intramolecular cation-π interactions between the ammonium group and the phenyl ring heavily influence molecular geometries and properties such as gas phase basicity and proton affinity. By varying substituents on the phenyl ring, one can sensitively tune the cation-π interaction and, therefore, the molecular structure and properties. Variations in molecular structures and properties as a function of phenyl ring substitution are shown to correlate with substituent Hammett parameters.

Big enough for an aromatase inhibitor? How adiposity affects male fertility.

PubMed

Stephens, Sahar M; Polotsky, Alex J

2013-07-01

Obesity is a pandemic and is associated with multiple medical problems including subfertility. Male obesity has been associated with altered semen parameters and reproductive hormonal levels, including a reduced testosterone:estradiol (T:E₂) ratio. Treatment methods employed for obesity-related male subfertility include gonadotropin administration, weight loss, and aromatase inhibitors. Letrozole is a highly effective nonsteroidal aromatase inhibitor that has been used to treat male subfertility in several case series with promising results. Adequately designed randomized controlled studies are needed to produce evidence-based data on the role of aromatase inhibitors in male subfertility management and evaluate the side-effect profile. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The multiple meanings of ataques de nervios in the Latino community.

PubMed

Guarnaccia, P J; DeLaCancela, V; Carrillo, E

1989-05-01

Ataques de nervios ("attacks of nerves") have been discussed in the psychiatric and anthropological literature for over thirty years. The early psychiatric articles focused on the pathology expressed by the ataque. More recent articles by anthropologists and Latino mental health professionals have reconceptualized the ataque through understanding its cultural meaning and the social factors which provoke an ataque de nervios. This article is a contribution to this reinterpretation of the ataque de nervios among Latinos. Through a series of case studies, we argue that the ataque is an expression of anger and grief resulting from the disruption of family systems, the process of migration, and concerns about family members in peoples' countries of origin.

Resurgence of catatonia following tapering or stoppage of lorazepam - A case series and implications.

PubMed

Ali, Syed Farooq; Gowda, Guru S; Jaisoorya, T S; Math, Suresh Bada

2017-08-01

The resurgence of catatonia following tapering of lorazepam is a common clinical phenomenon. However, there is limited evidence on the relationship between tapering method of lorazepam and resurgence of catatonic state. We report seven (0.6%) such patients who were found to have resurgence of catatonia. The mean age is 35.7 years; five of them had schizophrenia and other psychotic spectrum disorders. Five of them had resurgence within one week of stoppage, and three of them had multiple resurgences and required maintenance treatment with lorazepam. So gradual tapering and maintenance treatment with lorazepam might be effective in preventing resurgence of catatonia. Copyright © 2017 Elsevier B.V. All rights reserved.

Loss of Fumarate Hydratase and Aberrant Protein Succination Detected With S-(2-Succino)-Cysteine Staining to Identify Patients With Multiple Cutaneous and Uterine Leiomyomatosis and Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome.

PubMed

Llamas-Velasco, Mar; Requena, Luis; Adam, Julie; Frizzell, Norma; Hartmann, Arndt; Mentzel, Thomas

2016-12-01

Hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome is an autosomal dominant disorder caused by heterozygotic germline mutations in fumarate hydratase (FH) with incomplete penetrance, and clinically challenging to diagnose. Immunohistochemical stainings may favor an earlier diagnosis. The authors have tested 31 smooth muscle neoplasms. Ten of the 13 lesions from patients with HLRCC syndrome showed negative FH staining. Most sporadic piloleiomyomas presented strongly positive FH staining although 5 cases were negative. Sensitivity of FH staining in our series is 83.3% but specificity is 75%. Anti-S-(2-succino)-cysteine (2SC) showed the opposite intensity staining pattern and showed great correlation with anti-FH (rho spearman = -0.797). Anti-2SC staining increased the diagnostic accuracy in 19% of the cases. The main limitation of this study is the lack additional clinical data to further classify the cases as the case inclusion was histopathological. Negative FH staining could indicate a high risk of HLRCC but it could also suggest the presence of a syndrome in up to 25% of sporadic cases. Thus, when there is a doubtful case, anti-2SC may be added to exclude the syndrome if a negative staining is found.

Association between bullous pemphigoid and neurologic diseases: a case-control study.

PubMed

Casas-de-la-Asunción, E; Ruano-Ruiz, J; Rodríguez-Martín, A M; Vélez García-Nieto, A; Moreno-Giménez, J C

2014-11-01

In the past 10 years, bullous pemphigoid has been associated with other comorbidities and neurologic and psychiatric conditions in particular. Case series, small case-control studies, and large population-based studies in different Asian populations, mainland Europe, and the United Kingdom have confirmed this association. However, no data are available for the Spanish population. This was an observational, retrospective, case-control study with 1:2 matching. Fifty-four patients with bullous pemphigoid were selected. We compared the percentage of patients in each group with concurrent neurologic conditions, ischemic heart disease, diabetes, chronic obstructive pulmonary disease, and solid tumors using univariate logistic regression. An association model was constructed with conditional multiple logistic regression. The case group had a significantly higher percentage of patients with cerebrovascular accident and/or transient ischemic attack (odds ratio [OR], 3.06; 95% CI, 1.19-7.87], dementia (OR, 5.52; 95% CI, 2.19-13.93), and Parkinson disease (OR, 5; 95% CI, 1.57-15.94). A significantly higher percentage of cases had neurologic conditions (OR, 6.34; 95% CI, 2.89-13.91). Dementia and Parkinson disease were independently associated with bullous pemphigoid in the multivariate analysis. Patients with bullous pemphigoid have a higher frequency of neurologic conditions. Copyright © 2013 Elsevier España, S.L.U. and AEDV. All rights reserved.

76 FR 71341 - BASINS and WEPP Climate Assessment Tools: Case Study Guide to Potential Applications

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

... report presents a series of short case studies designed to illustrate the capabilities of these tools for... change impacts on water. This report presents a series of short case studies using the BASINS and WEPP climate assessment tools. The case studies are designed to illustrate the capabilities of these tools for...

Deconstructing Calculation Methods, Part 3: Multiplication

ERIC Educational Resources Information Center

Thompson, Ian

2008-01-01

In this third of a series of four articles, the author deconstructs the primary national strategy's approach to written multiplication. The approach to multiplication, as set out on pages 12 to 15 of the primary national strategy's "Guidance paper" "Calculation" (DfES, 2007), is divided into six stages: (1) mental…

Fatal dog attacks in Canada, 1990–2007

PubMed Central

Raghavan, Malathi

2008-01-01

In Canada, public debates on dog attacks are dominated by studies from the United States. An electronic search of media reports in the Canadian Newsstand database, for the years 1990 to 2007, identified 28 fatalities from dog-bite injuries. Predominant factors in this case series were owned, known dogs; residential location; children’s unsupervised access to area with dogs; and rural/remote areas, including aboriginal reserves in the prairies. A higher proportion of sled dogs and, possibly, mixed-breed dogs in Canada than in the United States caused fatalities, as did multiple dogs rather than single dogs. Free-roaming dog packs, reported only from rural communities, caused most on-reserve fatalities. Future studies are needed to assess if this rural/urban divide is observed in nonfatal attacks and if the breeds that bite in Canada are different from the breeds that killed. Breed representation in this paper and, perhaps, multiple-dog overrepresentation should be understood in the context of the overall Canadian dog population. PMID:18624067

Aggressive posterior retinopathy of prematurity in infants ≥ 1500 g birth weight.

PubMed

Sanghi, Gaurav; Dogra, Mangat R; Katoch, Deeksha; Gupta, Amod

2014-02-01

In this retrospective case series, we report the spectrum and outcomes of aggressive posterior retinopathy of prematurity (APROP) in infants ≥ 1500 g birth weight. Twenty-nine eyes of 15 infants are included. All infants were referred from level I or II nurseries, received supplemental unmonitored oxygen for prolonged duration (>1 week) and had multiple systemic co-morbidities. Of the 29 eyes, 10 (34.5%) had zone 1 and 19 (65.5%) had posterior zone 2 disease. Twenty-five (86.2%) eyes had flat neovascularization and 4 (13.8%) eyes had brush like proliferation. We noticed large vascular loops in 10 (34.5%) eyes. After confluent laser photocoagulation, 22 (75.9%) eyes had a favorable outcome. The study concludes that APROP in heavier (≥ 1500 g birth weight) premature infants occurs mostly in posterior zone 2 with flat neovascularization and atypical features like large vascular loops. Supplemental unmonitored oxygen for prolonged duration and multiple systemic co-morbidities could be a contributing factor.

Data fusion of multi-scale representations for structural damage detection

NASA Astrophysics Data System (ADS)

Guo, Tian; Xu, Zili

2018-01-01

Despite extensive researches into structural health monitoring (SHM) in the past decades, there are few methods that can detect multiple slight damage in noisy environments. Here, we introduce a new hybrid method that utilizes multi-scale space theory and data fusion approach for multiple damage detection in beams and plates. A cascade filtering approach provides multi-scale space for noisy mode shapes and filters the fluctuations caused by measurement noise. In multi-scale space, a series of amplification and data fusion algorithms are utilized to search the damage features across all possible scales. We verify the effectiveness of the method by numerical simulation using damaged beams and plates with various types of boundary conditions. Monte Carlo simulations are conducted to illustrate the effectiveness and noise immunity of the proposed method. The applicability is further validated via laboratory cases studies focusing on different damage scenarios. Both results demonstrate that the proposed method has a superior noise tolerant ability, as well as damage sensitivity, without knowing material properties or boundary conditions.

Combining Machine Learning Systems and Multiple Docking Simulation Packages to Improve Docking Prediction Reliability for Network Pharmacology

PubMed Central

Hsin, Kun-Yi; Ghosh, Samik; Kitano, Hiroaki

2013-01-01

Increased availability of bioinformatics resources is creating opportunities for the application of network pharmacology to predict drug effects and toxicity resulting from multi-target interactions. Here we present a high-precision computational prediction approach that combines two elaborately built machine learning systems and multiple molecular docking tools to assess binding potentials of a test compound against proteins involved in a complex molecular network. One of the two machine learning systems is a re-scoring function to evaluate binding modes generated by docking tools. The second is a binding mode selection function to identify the most predictive binding mode. Results from a series of benchmark validations and a case study show that this approach surpasses the prediction reliability of other techniques and that it also identifies either primary or off-targets of kinase inhibitors. Integrating this approach with molecular network maps makes it possible to address drug safety issues by comprehensively investigating network-dependent effects of a drug or drug candidate. PMID:24391846

Effects of load proportioning on the capacity of multiple-hole composite joints

NASA Technical Reports Server (NTRS)

Hyer, M. W.; Chastain, P. A.

1985-01-01

This study addresses the issue of adjusting the proportion of load transmitted by each hole in a multiple-hole joint so that the joint capacity is a maximum. Specifically two-hole-in-series joints are examined. The results indicate that when each hole reacts 50% of the total load, the joint capacity is not a maximum. One hole generally is understressed at joint failure. The algorithm developed to determine the load proportion at each hole which results in maximum capacity is discussed. The algorithm includes two-dimensional finite-element stress analysis and failure criteria. The algorithm is used to study the effects of joint width, hole spacing, and hole to joint-end distance on load proportioning and capacity. To study hole size effects, two hole diameters are considered. Three laminates are considered: a quasi-isotropic laminate; a cross-ply laminate; and a 45 degree angle-ply laminate. By proportioning the load, capacity can be increased generally from 5 to 10%. In some cases a greater increase is possible.

Development of a High-Throughput Ion-Exchange Resin Characterization Workflow.

PubMed

Liu, Chun; Dermody, Daniel; Harris, Keith; Boomgaard, Thomas; Sweeney, Jeff; Gisch, Daryl; Goltz, Bob

2017-06-12

A novel high-throughout (HTR) ion-exchange (IEX) resin workflow has been developed for characterizing ion exchange equilibrium of commercial and experimental IEX resins against a range of different applications where water environment differs from site to site. Because of its much higher throughput, design of experiment (DOE) methodology can be easily applied for studying the effects of multiple factors on resin performance. Two case studies will be presented to illustrate the efficacy of the combined HTR workflow and DOE method. In case study one, a series of anion exchange resins have been screened for selective removal of NO 3 - and NO 2 - in water environments consisting of multiple other anions, varied pH, and ionic strength. The response surface model (RSM) is developed to statistically correlate the resin performance with the water composition and predict the best resin candidate. In case study two, the same HTR workflow and DOE method have been applied for screening different cation exchange resins in terms of the selective removal of Mg 2+ , Ca 2+ , and Ba 2+ from high total dissolved salt (TDS) water. A master DOE model including all of the cation exchange resins is created to predict divalent cation removal by different IEX resins under specific conditions, from which the best resin candidates can be identified. The successful adoption of HTR workflow and DOE method for studying the ion exchange of IEX resins can significantly reduce the resources and time to address industry and application needs.

Seeing is believing: video classification for computed tomographic colonography using multiple-instance learning.

PubMed

Wang, Shijun; McKenna, Matthew T; Nguyen, Tan B; Burns, Joseph E; Petrick, Nicholas; Sahiner, Berkman; Summers, Ronald M

2012-05-01

In this paper, we present development and testing results for a novel colonic polyp classification method for use as part of a computed tomographic colonography (CTC) computer-aided detection (CAD) system. Inspired by the interpretative methodology of radiologists using 3-D fly-through mode in CTC reading, we have developed an algorithm which utilizes sequences of images (referred to here as videos) for classification of CAD marks. For each CAD mark, we created a video composed of a series of intraluminal, volume-rendered images visualizing the detection from multiple viewpoints. We then framed the video classification question as a multiple-instance learning (MIL) problem. Since a positive (negative) bag may contain negative (positive) instances, which in our case depends on the viewing angles and camera distance to the target, we developed a novel MIL paradigm to accommodate this class of problems. We solved the new MIL problem by maximizing a L2-norm soft margin using semidefinite programming, which can optimize relevant parameters automatically. We tested our method by analyzing a CTC data set obtained from 50 patients from three medical centers. Our proposed method showed significantly better performance compared with several traditional MIL methods.

Multiple disturbances classifier for electric signals using adaptive structuring neural networks

NASA Astrophysics Data System (ADS)

Lu, Yen-Ling; Chuang, Cheng-Long; Fahn, Chin-Shyurng; Jiang, Joe-Air

2008-07-01

This work proposes a novel classifier to recognize multiple disturbances for electric signals of power systems. The proposed classifier consists of a series of pipeline-based processing components, including amplitude estimator, transient disturbance detector, transient impulsive detector, wavelet transform and a brand-new neural network for recognizing multiple disturbances in a power quality (PQ) event. Most of the previously proposed methods usually treated a PQ event as a single disturbance at a time. In practice, however, a PQ event often consists of various types of disturbances at the same time. Therefore, the performances of those methods might be limited in real power systems. This work considers the PQ event as a combination of several disturbances, including steady-state and transient disturbances, which is more analogous to the real status of a power system. Six types of commonly encountered power quality disturbances are considered for training and testing the proposed classifier. The proposed classifier has been tested on electric signals that contain single disturbance or several disturbances at a time. Experimental results indicate that the proposed PQ disturbance classification algorithm can achieve a high accuracy of more than 97% in various complex testing cases.

Seeing is Believing: Video Classification for Computed Tomographic Colonography Using Multiple-Instance Learning

PubMed Central

Wang, Shijun; McKenna, Matthew T.; Nguyen, Tan B.; Burns, Joseph E.; Petrick, Nicholas; Sahiner, Berkman

2012-01-01

In this paper we present development and testing results for a novel colonic polyp classification method for use as part of a computed tomographic colonography (CTC) computer-aided detection (CAD) system. Inspired by the interpretative methodology of radiologists using 3D fly-through mode in CTC reading, we have developed an algorithm which utilizes sequences of images (referred to here as videos) for classification of CAD marks. For each CAD mark, we created a video composed of a series of intraluminal, volume-rendered images visualizing the detection from multiple viewpoints. We then framed the video classification question as a multiple-instance learning (MIL) problem. Since a positive (negative) bag may contain negative (positive) instances, which in our case depends on the viewing angles and camera distance to the target, we developed a novel MIL paradigm to accommodate this class of problems. We solved the new MIL problem by maximizing a L2-norm soft margin using semidefinite programming, which can optimize relevant parameters automatically. We tested our method by analyzing a CTC data set obtained from 50 patients from three medical centers. Our proposed method showed significantly better performance compared with several traditional MIL methods. PMID:22552333

The possible effects of the solar and geomagnetic activity on multiple sclerosis.

PubMed

Papathanasopoulos, Panagiotis; Preka-Papadema, Panagiota; Gkotsinas, Anastasios; Dimisianos, Nikolaos; Hillaris, Alexandros; Katsavrias, Christos; Antonakopoulos, Gregorios; Moussas, Xenophon; Andreadou, Elisabeth; Georgiou, Vasileios; Papachristou, Pinelopi; Kargiotis, Odysseas

2016-07-01

Increasing observational evidence on the biological effects of Space Weather suggests that geomagnetic disturbances may be an environmental risk factor for multiple sclerosis (MS) relapses. In the present study, we aim to investigate the possible effect of geomagnetic disturbances on MS activity. MS patient admittance rates were correlated with the solar and geophysical data covering an eleven-year period (1996-2006, 23rd solar cycle). We also examined the relationship of patterns of the solar flares, the coronal mass ejections (CMEs) and the solar wind with the recorded MS admission numbers. The rate of MS patient admittance due to acute relapses was found to be associated with the solar and geomagnetic events. There was a "primary" peak in MS admittance rates shortly after intense geomagnetic storms followed by a "secondary" peak 7-8 months later. We conclude that the geomagnetic and solar activity may represent an environmental health risk factor for multiple sclerosis and we discuss the possible mechanisms underlying this association. More data from larger case series are needed to confirm these preliminary results and to explore the possible influence of Space Weather on the biological and radiological markers of the disease. Copyright © 2016 Elsevier B.V. All rights reserved.

[Changes in the diagnosis and therapeutic management of hepatic trauma. A retrospective study comparing 2 series of cases in different (1997-1984 vs. 2001-2008)].

PubMed

Sánchez-Bueno, Francisco; Fernández-Carrión, Jezabel; Torres Salmerón, Gloria; García Pérez, Rocío; Ramírez Romero, Pablo; Fuster Quiñonero, Matilde; Parrilla, Pascual

2011-01-01

We present a series of 146 cases of hepatic trauma (HT) treated in our hospital over a period of 8 yearsm (2001-2008), and comparing it with a previous series of 92 cases (1977-1984). The mean age in the current series was 28.6 years and the majority were male. The closed traumas were mainly penetrating, with the most frequent cause being road traffic accidents. The American Association for the Surgery of Trauma (AAST) classification was used to evaluate the grade of the hepatic injury. Associated abdominal and /or extra-abdominal injuries were seen in 79.5% of the patients, with the most frequent being chest trauma, compared to bone fractures in the previous series. The most common associated intra-abdominal injury was the spleen in both series. The most used diagnostic technique in the current series was abdominal CT. Simple peritoneal puncture and lavage (PLP) were the most used examinations used in the previous series. Non-surgical treatment (NST) was given in 98 cases and the surgery was indicated in the remaining 48. In the previous series, 97.8% of patients were operated on. In the current series, on the 15 patients with severe liver injuries, 5 right hepatectomies, 2 segmentectomies and 6 packing compressions were performed, with the remaining two dying during surgery due to hepatic avulsion. The overall mortality was 3.4%, being 1% in the NST group and 8.3% in the surgical patients. In the previous series, the overall mortality was 29.3%. The key factor for using NST is to control haemodynamic stability, leaving surgical treatment for haemodynamically unstable patients. Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.

Analyzing time-ordered event data with missed observations.

PubMed

Dokter, Adriaan M; van Loon, E Emiel; Fokkema, Wimke; Lameris, Thomas K; Nolet, Bart A; van der Jeugd, Henk P

2017-09-01

A common problem with observational datasets is that not all events of interest may be detected. For example, observing animals in the wild can difficult when animals move, hide, or cannot be closely approached. We consider time series of events recorded in conditions where events are occasionally missed by observers or observational devices. These time series are not restricted to behavioral protocols, but can be any cyclic or recurring process where discrete outcomes are observed. Undetected events cause biased inferences on the process of interest, and statistical analyses are needed that can identify and correct the compromised detection processes. Missed observations in time series lead to observed time intervals between events at multiples of the true inter-event time, which conveys information on their detection probability. We derive the theoretical probability density function for observed intervals between events that includes a probability of missed detection. Methodology and software tools are provided for analysis of event data with potential observation bias and its removal. The methodology was applied to simulation data and a case study of defecation rate estimation in geese, which is commonly used to estimate their digestive throughput and energetic uptake, or to calculate goose usage of a feeding site from dropping density. Simulations indicate that at a moderate chance to miss arrival events ( p  = 0.3), uncorrected arrival intervals were biased upward by up to a factor 3, while parameter values corrected for missed observations were within 1% of their true simulated value. A field case study shows that not accounting for missed observations leads to substantial underestimates of the true defecation rate in geese, and spurious rate differences between sites, which are introduced by differences in observational conditions. These results show that the derived methodology can be used to effectively remove observational biases in time-ordered event data.

CLUSTERnGO: a user-defined modelling platform for two-stage clustering of time-series data.

PubMed

Fidaner, Işık Barış; Cankorur-Cetinkaya, Ayca; Dikicioglu, Duygu; Kirdar, Betul; Cemgil, Ali Taylan; Oliver, Stephen G

2016-02-01

Simple bioinformatic tools are frequently used to analyse time-series datasets regardless of their ability to deal with transient phenomena, limiting the meaningful information that may be extracted from them. This situation requires the development and exploitation of tailor-made, easy-to-use and flexible tools designed specifically for the analysis of time-series datasets. We present a novel statistical application called CLUSTERnGO, which uses a model-based clustering algorithm that fulfils this need. This algorithm involves two components of operation. Component 1 constructs a Bayesian non-parametric model (Infinite Mixture of Piecewise Linear Sequences) and Component 2, which applies a novel clustering methodology (Two-Stage Clustering). The software can also assign biological meaning to the identified clusters using an appropriate ontology. It applies multiple hypothesis testing to report the significance of these enrichments. The algorithm has a four-phase pipeline. The application can be executed using either command-line tools or a user-friendly Graphical User Interface. The latter has been developed to address the needs of both specialist and non-specialist users. We use three diverse test cases to demonstrate the flexibility of the proposed strategy. In all cases, CLUSTERnGO not only outperformed existing algorithms in assigning unique GO term enrichments to the identified clusters, but also revealed novel insights regarding the biological systems examined, which were not uncovered in the original publications. The C++ and QT source codes, the GUI applications for Windows, OS X and Linux operating systems and user manual are freely available for download under the GNU GPL v3 license at http://www.cmpe.boun.edu.tr/content/CnG. sgo24@cam.ac.uk Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press.

Severe poisoning after self-reported use of 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine, a novel substituted amphetamine: a case series.

PubMed

Hieger, M A; Rose, S R; Cumpston, K L; Stromberg, P E; Miller, S; Wills, B K

2015-12-01

Significant toxicity from amphetamine and cathinone derivatives is being increasingly reported. We describe a series of self-reported exposures to 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine (25-I-NBOME or 25-I), a novel amphetamine derivative. Ten patients with an average age of 17 years presented to local emergency departments (EDs) in our community after ingestion and/or insufflation of a drug referred to as "25-I." Of 10 patients, 6 reported taking 25-I alone; other substances included ethanol; 2,5-dimethoxy-4-ethylphenethylamine; marijuana; and ketamine. Most common effects included tachycardia (90%), hypertension (70%), agitation (60%), and hallucinations (50%). The average heart rate was 123 beats per minute. Two patients were found in status epilepticus, and another was found unresponsive. One patient who had a seizure had multiple, discrete intraparenchymal hemorrhages and acute kidney injury. Six patients were admitted to the intensive care unit, two were treated in the ED and released, and 1 each was admitted to psychiatry or managed in a clinical decision unit and subsequently discharged. Three patients required emergent intubation, and all admitted patients (7/10) were given intravenous benzodiazepines for sedation. Urine and blood specimens were obtained from 1 patient, which showed analytic confirmation of 25-I. In addition to sympathomimetic effects, methoxy and other substituent groups impart serotonergic effects, resulting in hallucinogenic properties. 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine appears to be extremely potent with a reported "dose" of 500 μg resulting in increased potential for inadvertent overdose. This case series describes significant morbidity in a local cluster of young patients after self-reported use of 25-I, a newly identified drug of abuse.

Drug reformulations and repositioning in the pharmaceutical industry and their impact on market access: regulatory implications

PubMed Central

Murteira, Susana; Millier, Aurélie; Ghezaiel, Zied; Lamure, Michel

2014-01-01

Background Repurposing has become a mainstream strategy in drug development, but it faces multiple challenges, amongst them the increasing and ever changing regulatory framework. This is the second study of a series of three-part publication project with the ultimate goal of understanding the market access rationale and conditions attributed to drug repurposing in the United States and in Europe. The aim of the current study to evaluate the regulatory path associated with each type of repurposing strategy according to the previously proposed nomenclature in the first article of this series. Methods From the cases identified, a selection process retrieved a total of 141 case studies in all countries, harmonized for data availability and common approval in the United States and in Europe. Regulatory information for each original and repurposed drug product was extracted, and several related regulatory attributes were also extracted such as, designation change and filing before or after patent expiry, among others. Descriptive analyses were conducted to determine trends and to investigate potential associations between the different regulatory paths and attributes of interest, for reformulation and repositioning cases separately. Results Within the studied European countries, most of the applications for reformulated products were filed through national applications. In contrast, for repositioned products, the centralized procedure was the most frequent regulatory pathway. Most of the repurposing cases were approved before patent expiry, and those cases have followed more complex regulatory pathways in the United States and in Europe. For new molecular entities filed in the United States, a similar number of cases were developed by serendipity and by a hypothesis-driven approach. However, for the new indication's regulatory pathway in the United States, most of the cases were developed through a hypothesis-driven approach. Conclusion The regulations in the United States and in Europe for drug repositionings and reformulations allowed confirming that repositioning strategies were usually filed under a more complex regulatory process than reformulations. Also, it seems that parameters such as patent expiry and type of repositioning approach or reformulation affect the regulatory pathways chosen for each case. PMID:27226839

Biomedical Informatics Approaches to Identifying Drug-Drug Interactions: Application to Insulin Secretagogues

PubMed Central

Han, Xu; Chiang, ChienWei; Leonard, Charles E.; Bilker, Warren B.; Brensinger, Colleen M.; Li, Lang; Hennessy, Sean

2017-01-01

Background Drug-drug interactions with insulin secretagogues are associated with increased risk of serious hypoglycemia in patients with type 2 diabetes. We aimed to systematically screen for drugs that interact with the five most commonly used secretagogues―glipizide, glyburide, glimepiride, repaglinide, and nateglinide―to cause serious hypoglycemia. Methods We screened 400 drugs frequently co-prescribed with the secretagogues as candidate interacting precipitants. We first predicted the drug–drug interaction potential based on the pharmacokinetics of each secretagogue–precipitant pair. We then performed pharmacoepidemiologic screening for each secretagogue of interest, and for metformin as a negative control, using an administrative claims database and the self-controlled case series design. The overall rate ratios (RRs) and those for four predefined risk periods were estimated using Poisson regression. The RRs were adjusted for multiple estimation using semi-Bayes method, and then adjusted for metformin results to distinguish native effects of the precipitant from a drug–drug interaction. Results We predicted 34 pharmacokinetic drug–drug interactions with the secretagogues, nine moderate and 25 weak. There were 140 and 61 secretagogue–precipitant pairs associated with increased rates of serious hypoglycemia before and after the metformin adjustment, respectively. The results from pharmacokinetic prediction correlated poorly with those from pharmacoepidemiologic screening. Conclusions The self-controlled case series design has the potential to be widely applicable to screening for drug–drug interactions that lead to adverse outcomes identifiable in healthcare databases. Coupling pharmacokinetic prediction with pharmacoepidemiologic screening did not notably improve the ability to identify drug–drug interactions in this case. PMID:28169935

Simulation of Ground Winds Time Series for the NASA Crew Launch Vehicle (CLV)

NASA Technical Reports Server (NTRS)

Adelfang, Stanley I.

2008-01-01

Simulation of wind time series based on power spectrum density (PSD) and spectral coherence models for ground wind turbulence is described. The wind models, originally developed for the Shuttle program, are based on wind measurements at the NASA 150-m meteorological tower at Cape Canaveral, FL. The current application is for the design and/or protection of the CLV from wind effects during on-pad exposure during periods from as long as days prior to launch, to seconds or minutes just prior to launch and seconds after launch. The evaluation of vehicle response to wind will influence the design and operation of constraint systems for support of the on-pad vehicle. Longitudinal and lateral wind component time series are simulated at critical vehicle locations. The PSD model for wind turbulence is a function of mean wind speed, elevation and temporal frequency. Integration of the PSD equation over a selected frequency range yields the variance of the time series to be simulated. The square root of the PSD defines a low-pass filter that is applied to adjust the components of the Fast Fourier Transform (FFT) of Gaussian white noise. The first simulated time series near the top of the launch vehicle is the inverse transform of the adjusted FFT. Simulation of the wind component time series at the nearest adjacent location (and all other succeeding next nearest locations) is based on a model for the coherence between winds at two locations as a function of frequency and separation distance, where the adjacent locations are separated vertically and/or horizontally. The coherence function is used to calculate a coherence weighted FFT of the wind at the next nearest location, given the FFT of the simulated time series at the previous location and the essentially incoherent FFT of the wind at the selected location derived a priori from the PSD model. The simulated time series at each adjacent location is the inverse Fourier transform of the coherence weighted FFT. For a selected design case, the equations, the process and the simulated time series at multiple vehicle stations are presented.

On Sums of Numerical Series and Fourier Series

ERIC Educational Resources Information Center

Pavao, H. Germano; de Oliveira, E. Capelas

2008-01-01

We discuss a class of trigonometric functions whose corresponding Fourier series, on a conveniently chosen interval, can be used to calculate several numerical series. Particular cases are presented and two recent results involving numerical series are recovered. (Contains 1 note.)

Testing and analysis of flat and curved panels with multiple cracks

NASA Technical Reports Server (NTRS)

Broek, David; Jeong, David Y.; Thomson, Douglas

1994-01-01

An experimental and analytical investigation of multiple cracking in various types of test specimens is described in this paper. The testing phase is comprised of a flat unstiffened panel series and curved stiffened and unstiffened panel series. The test specimens contained various configurations for initial damage. Static loading was applied to these specimens until ultimate failure, while loads and crack propagation were recorded. This data provides the basis for developing and validating methodologies for predicting linkup of multiple cracks, progression to failure, and overall residual strength. The results from twelve flat coupon and ten full scale curved panel tests are presented. In addition, an engineering analysis procedure was developed to predict multiple crack linkup. Reasonable agreement was found between predictions and actual test results for linkup and residual strength for both flat and curved panels. The results indicate that an engineering analysis approach has the potential to quantitatively assess the effect of multiple cracks in the arrest capability of an aircraft fuselage structure.

Adverse clinical sequelae after skin branding: a case series

PubMed Central

2009-01-01

Introduction Branding refers to a process whereby third degree burns are inflicted on the skin with a hot iron rod or metallic object. Branding employs the phenomenon of "counter irritation," and is widely used by faith healers in developing countries for therapeutic purposes. Some methods, which are very crude and inhuman, carry a large risk of complications. The purpose of this study is to present a series of complications and to familiarize clinicians with this dangerous method of treatment. Case presentation Four Pakistani patients, three male and one female, ranging from 25 to 60 years of age "branded" with a red hot iron rod for various medical reasons presented with severe medical complications to our tertiary care hospital. The mean duration between the procedure and presentation to the hospital was 6 days. At the time of admission, two patients had septic shock, one patient had cavernous sinus thrombosis and one patient had multiple splenic abscesses. All patients received standard care for wound management and systemic infections. Two patients eventually died during the course of treatment. Conclusion Severe complications from branding are troublesome and the potential risks of this treatment outweigh its benefits. Globally, there is a great need for heightened awareness about the dangers of branding among patients and physicians, as this will have an important effect on patients who seek branding for various medical conditions. PMID:19166615

Living donor domino liver transplantation using a maple syrup urine disease donor: A case series of three children - The first report from Japan.

PubMed

Matsunami, Masatoshi; Fukuda, Akinari; Sasaki, Kengo; Uchida, Hajime; Shigeta, Takanobu; Hirata, Yoshihiro; Kanazawa, Hiroyuki; Horikawa, Reiko; Nakazawa, Atsuko; Suzuki, Tatsuya; Mizuta, Koichi; Kasahara, Mureo

2016-08-01

As the priority of LD-Domino LT is the safety of the first recipient, limitations and technical difficulties in the second recipient often occur. The most technically challenging part of LD-Domino LT is the reconstruction of the vessels. For the reconstruction of HVs, the native HVs were exteriorized as far as possible using a CUSA because longer extensive HVs are essential for facilitating the reconstruction. At the back table, the HVs of the domino graft were sutured together, and the single cuff of the HVs was anastomosed to the IVC by joining the orifices. The HAs, the presence of insufficient length, and multiple vessels in the whole liver rendered the reconstruction more difficult. We determined the dividing sites of the vessels according to the preoperative 3D-CT findings obtained in two institutions. This is the first case series using grafts in DLT obtained from LDLT for patients with MSUD between two institutions. In conclusion, LD-Domino LT is a safe and feasible therapeutic option to expand the donor pool by technical refinement in the reconstruction of the second recipient. Further studies with a greater accumulation of patients and a longer follow-up will be necessary to establish LD-Domino LT using an MSUD donor. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Relapsing Painful Ophthalmoplegic Neuropathy: No longer a "Migraine," but Still a Headache.

PubMed

Smith, Stacy V; Schuster, Nathaniel M

2018-06-14

Recurrent painful ophthalmoplegic neuropathy (RPON), formerly known as ophthalmoplegic migraine, is an uncommon disorder with repeated episodes of ocular cranial nerve neuropathy associated with ipsilateral headache. This review discusses the clinical presentation, current understanding of the pathophysiology, key differential diagnoses, and evaluation and treatment of RPON. The literature is limited due to the rarity of the disorder. Recent case reports and series continue to suggest the age of first attack is most often during childhood or adolescence as well as a female predominance. Multiple recent case reports and series demonstrate focal enhancement of the affected cranial nerve, as the nerve root exits the brainstem. This finding contributed to the current classification of the disorder as a neuropathy, with the present understanding that it is due to a relapsing-remitting inflammatory or demyelinating process. The link to migraine remains a cause of disagreement in the literature. RPON is a complex disorder with features of inflammatory neuropathy and an unclear association with migraine. Regardless, the overall prognosis is good for individual episodes, but permanent nerve damage may accumulate with repeated attacks. A better understanding of the pathogenesis is needed to clarify whether it truly represents a single disorder and to guide its treatment. Until that time, a combined approach with acute and preventive therapies can mitigate acute symptoms as well as attempt to limit recurrence of this disabling syndrome.

Development of the NEDO implantable ventricular assist device with Gyro centrifugal pump.

PubMed

Yoshikawa, M; Nonaka, K; Linneweber, J; Kawahito, S; Ohtsuka, G; Nakata, K; Takano, T; Schulte-Eistrup, S; Glueck, J; Schima, H; Wolner, E; Nosé, Y

2000-06-01

The Gyro centrifugal pump, PI (permanently implantable) series, is being developed as a totally implantable artificial heart. Our final goal is to establish a "functional TAH," a totally implantable biventricular assist system (BiVAS) with centrifugal pumps. A plastic prototype pump, Gyro PI 601, was evaluated through in vitro and in vivo studies as a single ventricular assist device (VAD). Based upon these results, the pump head material was converted to a titanium alloy, and the actuator was modified. These titanium Gyro pumps, PI 700 series, also were subjected to in vitro and in vivo studies. The Gyro PI 601 and PI 700 series have the same inner dimensions and characteristics, such as the eccentric inlet port, double pivot bearing system, secondary vane, and magnet coupling system; however, the material of the PI 700 is different from the PI 601. The Gyro PI series is driven by the Vienna DC brushless motor actuator. The inlet cannula of the right ventricular assist system (RVAS) specially made for this system consists of 2 parts: a hat-shaped silicone tip biolized with gelatin and an angled wire reinforced tube made of polyvinylchloride. The pump-actuator package was implanted into 8 calves in the preperitoneal space, bypassing from the left ventricle apex to the descending aorta for the left ventricular assist system (LVAS) and bypassing the right ventricle to the main pulmonary artery for the RVAS. According to the PI 601 feasibility protocol, 2 LVAS cases were terminated after 2 weeks, and 1 LVAS case and 1 RVAS were terminated after 1 month. The PI 700 series was implanted into 4 cases: 3 LVAS cases survived for a long term, 2 of them over 200 days (72-283 days), and 1 RVAS case survived for 1 month and was terminated according to the protocol for a short-term antithrombogenic screening and system feasibility study. Regarding power consumption, the plastic pump cases demonstrated from 6.2 to 12.1 W as LVAS and 7.3 W as RVAS, the titanium pump cases showed from 10.4 to 14.2 W as LVAS and 15.8 W as RVAS. All cases exhibited low hemolysis. The renal function and the liver function were maintained normally in all cases throughout these experimental periods. In the 2 RVAS cases, pulmonary function was normally maintained. No calves demonstrated thromboembolic signs or symptoms throughout the experiments except Case 1 with the plastic pump. However, in the plastic pump cases, bilateral renal infarction was suspected in 2 cases during necropsy whereas no abnormal findings were revealed in the titanium pump cases. There were also no blood clots inside the PI 700 series. As for the 601, the explanted pumps demonstrated slight thrombus formations at the top and bottom pivots except in 1 case. The Gyro PI series, especially the PI 700 series, demonstrated superior performance, biocompatibility, antithrombogenicity and low hemolysis. Also, the durability of the actuator was demonstrated. Based on these results, this titanium centrifugal pump is suitable as an implantable LVAS and RVAS. It is likely that the Gyro PI series is a feasible component of the BiVAS functional TAH.

Endoscopic peroral jejunal fecal microbiota transplantation.

PubMed

Link, Alexander; Lachmund, Tim; Schulz, Christian; Weigt, Jochen; Malfertheiner, Peter

2016-11-01

Fecal microbiota transplantation (FMT) is a valuable treatment modality for recurrent Clostridium difficile (C. difficile) colitis. Multiple questions including the best delivery route and volume remain unanswered. Here, we report a case series of high-volume FMT using endoscopic jejunal application route. In prospective observational study, FMT was performed using fresh specimen from healthy unrelated donors to the patients with recurrent or refractory C. difficile colitis. Selection of the route was based on the patient's preferences. Specimens of at least 50g were dissolved in 500ml of electrolyte solution and administered using endoscope directly in jejunum. All procedures led to cure of C. difficile colitis. With exception of one case the procedure was well tolerated. In two cases, we observed FMT-reflux into the stomach despite deep jejunal application and in single case the FMT-reflux led to tracheal aspiration and severe pneumonia. High-volume FMT via endoscopic jejunal route is an effective treatment option that is well tolerated and easy to perform. Nevertheless, aspiration is potential life-threatening event that needs to be kept in mind during the FMT-procedure. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Methods to control for unmeasured confounding in pharmacoepidemiology: an overview.

PubMed

Uddin, Md Jamal; Groenwold, Rolf H H; Ali, Mohammed Sanni; de Boer, Anthonius; Roes, Kit C B; Chowdhury, Muhammad A B; Klungel, Olaf H

2016-06-01

Background Unmeasured confounding is one of the principal problems in pharmacoepidemiologic studies. Several methods have been proposed to detect or control for unmeasured confounding either at the study design phase or the data analysis phase. Aim of the Review To provide an overview of commonly used methods to detect or control for unmeasured confounding and to provide recommendations for proper application in pharmacoepidemiology. Methods/Results Methods to control for unmeasured confounding in the design phase of a study are case only designs (e.g., case-crossover, case-time control, self-controlled case series) and the prior event rate ratio adjustment method. Methods that can be applied in the data analysis phase include, negative control method, perturbation variable method, instrumental variable methods, sensitivity analysis, and ecological analysis. A separate group of methods are those in which additional information on confounders is collected from a substudy. The latter group includes external adjustment, propensity score calibration, two-stage sampling, and multiple imputation. Conclusion As the performance and application of the methods to handle unmeasured confounding may differ across studies and across databases, we stress the importance of using both statistical evidence and substantial clinical knowledge for interpretation of the study results.

The role of IQSEC2 in syndromic intellectual disability: Narrowing the diagnostic odyssey.

PubMed

Helm, Benjamin M; Powis, Zoe; Prada, Carlos E; Casasbuenas-Alarcon, Olga L; Balmakund, Tonya; Schaefer, G B; Kahler, Stephen G; Kaylor, Julie; Winter, Susan; Zarate, Yuri A; Schrier Vergano, Samantha A

2017-10-01

While X-linked intellectual disability (XLID) syndromes pose a diagnostic challenge for clinicians, an increasing number of recognized disorders and their genetic etiologies are providing answers for patients and their families. The availability of clinical exome sequencing is broadening the ability to identify mutations in genes previously unrecognized as causing XLID. In recent years, the IQSEC2 gene, located at Xp11.22, has emerged as the cause of multiple cases of both nonsyndromic and syndromic XLID. Herein we present a case series of six individuals (five males, one female) with intellectual disability and seizures found to have alterations in IQSEC2. In all cases, the diagnostic odyssey was extensive and expensive, often including invasive testing such as muscle biopsies, before ultimately reaching the diagnosis. We report these cases to demonstrate the exhaustive work-up prior to finding the changes in IQSEC2 gene, recommend that this gene be considered earlier in the diagnostic evaluation of individuals with global developmental delay, microcephaly, and severe, intractable epilepsy, and support the use of intellectual disability panels including IQSEC2 in the first-line evaluation of these patients. © 2017 Wiley Periodicals, Inc.

[Etiologic classification of cerebral infarct. Experience from a prospective data register].

PubMed

Brainin, M

1990-12-01

Most classifications of stroke include clinically heterogeneous subgroups and therefore are of limited value for comparative studies or clinical protocols. The view is held that a classification according to stroke etiology is clinically more reasonable and more consistent for therapeutic strategies. In order to determine the frequency of various etiological subgroups in a series of stroke cases, the results of the Klosterneuburger Schlaganfall-Datenbank (KSDB) are reported. This stroke registry has prospectively recorded over 300 items on all stroke cases referred to one center since March 1988. Investigation rates include CT in almost 100% and the investigation of cerebral vessels in over 90% of all cases. By applying defined etiological categories (undetermined etiology, atherosclerosis of the large craniocervical vessels, cardiogenic embolism, lacunar, primary hemorrhage, and multiple and other causes) to the first 420 patients registered within the first two years it can be shown that even with CT and neurosonology in routine use, in 29% of all cases the cause of the stroke cannot be determined. To investigate this largest subgroup by means of additional new methods as well as by investigating the long-term natural course represents an important challenge for clinical stroke research.

Sporadic Schwannomatosis: A Systematic Review Following the 2005 Consensus Statement.

PubMed

Chick, Gregoire; Victor, Jan; Poujade, Thibault; Hollevoet, Nadine

2018-06-14

 To identify the frequency of reports of sporadic schwannomatosis, the types of patients affected, and the nerves affected.  We identified all case reports and case series that reported on patients with sporadic schwannomatosis according to established criteria.  The initial search yielded 1,597 studies, of which 15 were included. A total of 38 of 55 individuals met the inclusion criteria. The mean age of the patients was 48 years; 41% were male. Thirty-three patients had peripheral nerve tumors, and 17 had spinal tumors. Twelve had tumors in both locations. Tumor distribution was unilateral in 25 of 30 cases (83.3%) and segmental (limited to one limb or five or fewer contiguous segments of the spine) in 28 of 38 cases (73.7%).  This systematic review quantified the number of individuals who meet the criteria for sporadic schwannomatosis and better described this population to facilitate the classification of neurofibromatosis in regard to the 2005 consensus statement. Unilateral or segmental distribution of nerve tumors are key aspects when dealing with multiple noncutaneous schwannomas without involvement of the vestibular nerve. Georg Thieme Verlag KG Stuttgart · New York.

Dynamic Mesh Adaptation for Front Evolution Using Discontinuous Galerkin Based Weighted Condition Number Mesh Relaxation

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

Greene, Patrick T.; Schofield, Samuel P.; Nourgaliev, Robert

2016-06-21

A new mesh smoothing method designed to cluster mesh cells near a dynamically evolving interface is presented. The method is based on weighted condition number mesh relaxation with the weight function being computed from a level set representation of the interface. The weight function is expressed as a Taylor series based discontinuous Galerkin projection, which makes the computation of the derivatives of the weight function needed during the condition number optimization process a trivial matter. For cases when a level set is not available, a fast method for generating a low-order level set from discrete cell-centered elds, such as amore » volume fraction or index function, is provided. Results show that the low-order level set works equally well for the weight function as the actual level set. Meshes generated for a number of interface geometries are presented, including cases with multiple level sets. Dynamic cases for moving interfaces are presented to demonstrate the method's potential usefulness to arbitrary Lagrangian Eulerian (ALE) methods.« less

Scaly scalp associated with crusted scabies: case series.

PubMed

Anbar, T S; El-Domyati, M B; Mansour, H A; Ahmad, H M

2007-07-13

The diagnosis of crusted scabies is becoming more relevant due to the increase in number of immunocompromised patients. To date, more than 200 cases have been reported in the literature. However, crusted scabies seems to be under-diagnosed because of its unusual presentations. In this case series we present history, clinical manifestations, KOH smear, and histopathological findings of a series of four patients with crusted scabies. Scaly scalp was a prominent feature of the disease in all cases. Examination of and treatment of the scalp of patients with suspected crusted scabies should not be neglected. A KOH smear from the scalp offers a simple and reliable technique for diagnosis.

InSAR time series analysis of ALOS-2 ScanSAR data and its implications for NISAR

NASA Astrophysics Data System (ADS)

Liang, C.; Liu, Z.; Fielding, E. J.; Huang, M. H.; Burgmann, R.

2017-12-01

The JAXA's ALOS-2 mission was launched on May 24, 2014. It operates at L-band and can acquire data in multiple modes. ScanSAR is the main operational mode and has a 350 km swath, somewhat larger than the 250 km swath of the SweepSAR mode planned for the NASA-ISRO SAR (NISAR) mission. ALOS-2 has been acquiring a wealth of L-band InSAR data. These data are of particular value in areas of dense vegetation and high relief. The InSAR technical development for ALOS-2 also enables the preparation for the upcoming NISAR mission. We have been developing advanced InSAR processing techniques for ALOS-2 over the past two years. Here, we report the important issues for doing InSAR time series analysis using ALOS-2 ScanSAR data. First, we present ionospheric correction techniques for both regular ScanSAR InSAR and MAI (multiple aperture InSAR) ScanSAR InSAR. We demonstrate the large-scale ionospheric signals in the ScanSAR interferograms. They can be well mitigated by the correction techniques. Second, based on our technical development of burst-by-burst InSAR processing for ALOS-2 ScanSAR data, we find that the azimuth Frequency Modulation (FM) rate error is an important issue not only for MAI, but also for regular InSAR time series analysis. We identify phase errors caused by azimuth FM rate errors during the focusing process of ALOS-2 product. The consequence is mostly a range ramp in the InSAR time series result. This error exists in all of the time series results we have processed. We present the correction techniques for this error following a theoretical analysis. After corrections, we present high quality ALOS-2 ScanSAR InSAR time series results in a number of areas. The development for ALOS-2 can provide important implications for NISAR mission. For example, we find that in most cases the relative azimuth shift caused by ionosphere can be as large as 4 m in a large area imaged by ScanSAR. This azimuth shift is half of the 8 m azimuth resolution of the SweepSAR mode planned for NISAR, which implies that a good coregistration strategy for NISAR's SweepSAR mode is geometrical coregistration followed by MAI or spectral diversity analysis. Besides, our development also provides implications for the processing and system parameter requirements of NISAR, such as the accuracy requirement of azimuth FM rate and range timing.

Deaths from exposure to paramethoxymethamphetamine in Alberta and British Columbia, Canada: a case series.

PubMed

Nicol, Jennifer J E; Yarema, Mark C; Jones, Graham R; Martz, Walter; Purssell, Roy A; MacDonald, Judy C; Wishart, Ian; Durigon, Monica; Tzemis, Despina; Buxton, Jane A

2015-01-01

Paramethoxymethamphetamine (PMMA) is a ring-substituted amphetamine similar in structure to 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy"), but substantially more toxic. We describe the clinical features of fatal exposures in the provinces of Alberta and British Columbia, Canada. We conducted a retrospective case series on deaths in Alberta and BC between June 2011 and April 2012 for which forensic toxicologic analysis was positive for PMMA and the drug was implicated as the primary toxic agent. Data collected included patient demographics, exposure history, clinical features, investigations, therapy provided and postmortem toxicologic findings. A total of 27 PMMA-associated deaths (20 in Alberta, 7 in BC) were reported in the 11-month period. The median age was 24 (range 14-52) years, and 22 (81%) were male. Ten patients were pronounced dead at the scene, and 17 died in hospital. The median time from exposure to death was 17 (range 5-264) hours. The median first-recorded vital signs (and ranges) were: heart rate 160 (86-201) beats/min, blood pressure 89/43 (69/30-162/83) mm Hg, respiratory rate 40 (26-48) breaths/min, oxygen saturation 81% (68%-100%) and temperature 39.4°C (34-43.8°C). Sixteen of the 17 people who died in hospital presented with clinical features consistent with serotonin syndrome. End-organ dysfunction included hepatic (30%) and acute kidney injury (85%), rhabdomyolysis (54%), coagulopathy (61%) and cardiac ischemia (15%). Other drugs identified on toxicologic analysis were MDMA (n = 27), cocaine or its metabolite benzoylecgonine (n = 14) and methamphetamine (n = 12). Exposure to PMMA was characterized by multiorgan dysfunction and serotonin syndrome, followed by cardiovascular collapse. In addition to PMMA, multiple synthetic amphetamines were present on toxicologic analysis. When evaluating patients suspected of exposure to sympathomimetic drugs of abuse, clinicians must anticipate multiple clinical effects from the increased release of dopamine, serotonin, norepinephrine and other neurotransmitters.

Treatment Effects for Dysphagia in Adults with Multiple Sclerosis: A Systematic Review.

PubMed

Alali, Dalal; Ballard, Kirrie; Bogaardt, Hans

2016-10-01

Dysphagia or swallowing difficulties have been reported to be a concern in adults with multiple sclerosis (MS). This problem can result in several complications including aspiration pneumonia, reduced quality of life and an increase in mortality rate. No previous systematic reviews on treatment effects for dysphagia in MS have been published. The main objective of this study is to summarise and qualitatively analyse published studies on treatment effects for dysphagia in MS. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were applied to conduct a systematic search of seven databases, using relevant key words, and subsequent analysis of the identified studies. The studies were required to meet all three inclusion criteria of including a statement on intention to treat, or measure the effects of treatment for dysphagia in adults with MS and data on treatment outcomes for at least one adult diagnosed with MS. Retained studies were evaluated by two independent reviewers using a critical appraisal tool. This study has not been registered. A total of 563 studies were identified from the database searches. After screening and assessment of full articles for eligibility, five studies were included in the review. Three examined electrical stimulation and two examined the use of botulinum toxin. One study testing electrical stimulation was a randomised controlled trial, two were well-designed case series and two were case series lacking experimental control. All studies reported some positive effects on dysphagia; however, treatments that involved the use of electrical stimulation showed larger effect sizes. There is a paucity of evidence to guide treatment of dysphagia in MS, with only electrical stimulation and botulinum toxin treatment represented in the literature search conducted here. While both treatments show initial promise for reducing the swallowing impairment, they require further research using well-controlled experimental designs to determine their clinical applicability and long-term treatment effects for dysphagia across different types and severity of MS.

Successful and safe use of Q-switched lasers in the treatment of nevus of Ota in children with phototypes IV-VI.

PubMed

Belkin, Daniel A; Jeon, Hana; Weiss, Elliot; Brauer, Jeremy A; Geronemus, Roy G

2018-01-01

Nevus of Ota represents congenital dermal melanocytosis in a trigeminal distribution, most commonly occurring in Asian individuals and other individuals with skin of color. Evidence suggests early treatment is beneficial. Multiple reports have shown efficacy and safety of Q-switched laser treatment in adults. There is little data on children and in non-Asian skin types. This series was done to demonstrate safe and effective use of Q-switched laser therapy in children of multiple skin types. Retrospective case series. This was a chart review of patients under 18 years old who presented to our practice from 2002 to 2015 with a clinical diagnosis of nevus of Ota who were treated with Q-switched lasers (694 and 1,064 nm). Patients were treated without the use of general anesthesia or sedation, and corneal shields were used in appropriate cases. Percentage of improvement as well as side effects were rated by five physicians independently. Improvement, when present, was rated in quartiles (1-25%, 26-50%, 51-75%, and 76-100% improvement). Twenty-four children were included. The average age at the start of treatment was 3.9 years old (range of 3 months to 12.4 years), and patients had Fitzpatrick skin types IV through VI. The mean number of treatments was 9.3. Assessment revealed excellent response (76-100% improvement) in 70% of patients and good to excellent response (51-100% improvement) in 86%. Two patients (8%) had post-inflammatory hyperpigmentation, one of whom also had focal hypopigmentation. Treatment of nevus of Ota with Q-switched lasers in children with skin of color, without general anesthesia or sedation, is safe and effective. Early intervention should be encouraged for better efficacy and to prevent psychosocial distress in later childhood and adulthood. Lasers Surg. Med. 50:56-60, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Kapteyn series arising in radiation problems

NASA Astrophysics Data System (ADS)

Lerche, I.; Tautz, R. C.

2008-01-01

In discussing radiation from multiple point charges or magnetic dipoles, moving in circles or ellipses, a variety of Kapteyn series of the second kind arises. Some of the series have been known in closed form for a hundred years or more, others appear not to be available to analytic persuasion. This paper shows how 12 such generic series can be developed to produce either closed analytic expressions or integrals that are not analytically tractable. In addition, the method presented here may be of benefit when one has other Kapteyn series of the second kind to consider, thereby providing an additional reason to consider such series anew.

Reframing Organizations: Artistry, Choice, and Leadership. Jossey-Bass Management Series, Social and Behavioral Science Series, and Higher and Adult Education Series.

ERIC Educational Resources Information Center

Bolman, Lee G.; Deal, Terrence E.

This book shows how educators can become more versatile managers and more artistic leaders. In part 1, chapter 1 shows why reframing--the use of multiple lenses--is vital to effective leadership and management. It introduces the four basic lenses for organizational analysis--the structural, human resource, political, and symbolic frames--and show…

Multiple Sclerosis, Personal Stories | NIH MedlinePlus the Magazine

MedlinePlus

... please turn Javascript on. Feature: Multiple Sclerosis Personal Stories: Nicole Lemelle, Iris Young, Michael Anthony, John Cantú ... Better," an Internet video series that brings the story of MS to life through the eyes of ...

Achieving Good Perioperative Outcomes After Pancreaticoduodenectomy in a Low-Volume Setting: A 25-Year Experience

PubMed Central

Chedid, Aljamir D.; Chedid, Marcio F.; Winkelmann, Leonardo V.; Filho, Tomaz J. M. Grezzana; Kruel, Cleber D. P.

2015-01-01

Perioperative mortality following pancreaticoduodenectomy has improved over time and is lower than 5% in selected high-volume centers. Based on several large literature series on pancreaticoduodenectomy from high-volume centers, some defend that high annual volumes are necessary for good outcomes after pancreaticoduodenectomy. We report here the outcomes of a low annual volume pancreaticoduodenectomy series after incorporating technical expertise from a high-volume center. We included all patients who underwent pancreaticoduodenectomy performed by a single surgeon (ADC.) as treatment for periampullary malignancies from 1981 to 2005. Outcomes of this series were compared to those of 3 high-volume literature series. Additionally, outcomes for first 10 cases in the present series were compared to those of all 37 remaining cases in this series. A total of 47 pancreaticoduodenectomies were performed over a 25-year period. Overall in-hospital mortality was 2 cases (4.3%), and morbidity occurred in 23 patients (48.9%). Both mortality and morbidity were similar to those of each of the three high-volume center comparison series. Comparison of the outcomes for the first 10 to the remaining 37 cases in this series revealed that the latter 37 cases had inferior mortality (20% versus 0%; P = 0.042), less tumor-positive margins (50 versus 13.5%; P = 0.024), less use of intraoperative blood transfusions (90% versus 32.4%; P = 0.003), and tendency to a shorter length of in-hospital stay (20 versus 15.8 days; P = 0.053). Accumulation of surgical experience and incorporation of expertise from high-volume centers may enable achieving satisfactory outcomes after pancreaticoduodenectomy in low-volume settings whenever referral to a high-volume center is limited. PMID:25875555

FY13 Annual Report: PHEV Advanced Series Gen-set Development/Demonstration Activity

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

Chambon, Paul H.

2013-12-01

The objective of this project is to integrate ORNL advancements in vehicle technologies to properly design, and size a gen-set for various vehicle applications and then simulate multiple advanced series hybrid (HEV/PHEV) vehicles with the genset models.

Epidemiological investigation and case-control study: a Legionnaires' disease outbreak associated with cooling towers in Warstein, Germany, August-September 2013.

PubMed

Maisa, Anna; Brockmann, Ansgar; Renken, Frank; Lück, Christian; Pleischl, Stefan; Exner, Martin; Daniels-Haardt, Inka; Jurke, Annette

2015-01-01

Between 1 August and 6 September 2013, an outbreak of Legionnaires' disease (LD) with 159 suspected cases occurred in Warstein, North Rhine-Westphalia, Germany. The outbreak consisted of 78 laboratory-confirmed cases of LD, including one fatality, with a case fatality rate of 1%. Legionella pneumophila, serogroup 1, subtype Knoxville, sequence type 345, was identified as the epidemic strain. A case-control study was conducted to identify possible sources of infection. In univariable analysis, cases were almost five times more likely to smoke than controls (odds ratio (OR): 4.81; 95% confidence interval (CI): 2.33-9.93; p < 0.0001). Furthermore, cases were twice as likely to live within a 3 km distance from one identified infection source as controls (OR: 2.14; 95% CI: 1.09-4.20; p < 0.027). This is the largest outbreak of LD in Germany to date. Due to a series of uncommon events, this outbreak was most likely caused by multiple sources involving industrial cooling towers. Quick epidemiological assessment, source tracing and shutting down of potential sources as well as rapid laboratory testing and early treatment are necessary to reduce morbidity and mortality. Maintenance of cooling towers must be carried out according to specification to prevent similar LD outbreaks in the future.

External bioresorbable airway rigidification to treat refractory localized tracheomalacia.

PubMed

Gorostidi, François; Reinhard, Antoine; Monnier, Philippe; Sandu, Kishore

2016-11-01

Our study evaluates the efficacy of extraluminal bioresorbable plates to treat refractory localized airway malacia in patients undergoing corrective surgery for complex multilevel laryngotracheal stenosis. Retrospective case series. Secondary malacic airway segments were characterized (severity, site, type) by a dynamic transnasal flexible laryngotracheobronchoscopy before surgery. Extraluminal bioresorbable plates were used to stabilize the malacic segment through a transcervical approach under intraoperative flexible endoscopic guidance. Results were evaluated subjectively and by a postoperative dynamic endoscopy. We report our experience in seven patients (6 children, 1 adult). External tracheal stiffening allowed complete or partial resolution of refractory proximal airway malacia in six of seven complex cases described (result in one case is awaited). It allowed quick decannulation in four of seven patients who experienced multiple previous failures. Decannulation failures were due to recurrence of stenosis. With up to 2 years of follow-up, we report no direct complications related to the presence of extraluminal bioresorbable plates around the airway. Extraluminal biodegradable tracheal stiffening represents a valid therapeutic option in select cases of upper airway malacia. It can be highly useful in cases of complex multilevel airway obstructions. External stiffening needs to be planned on a case-to-case basis according to the type of malacia and must be performed under endoscopic guidance. 4. Laryngoscope, 126:2605-2610, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Obsessive Compulsive Disorder Treatment in Patients with Down Syndrome: A Case Series

ERIC Educational Resources Information Center

Sutor, Bruce; Hansen, Mark R.; Black, John L.

2006-01-01

In this case series we report four cases of patients with Down syndrome with symptoms consistent with obsessive compulsive disorder. Each patient experienced substantial reduction in compulsive behaviors with pharmacotherapy of an SSRI alone or with the addition of risperidone to SSRI therapy. None of the patients experienced significant side…

Knocked by the shuttlecock: twelve sight-threatening blunt-eye injuries in Australian badminton players.

PubMed

Jao, Kathy K; Atik, Alp; Jamieson, Michael P; Sheales, Mariana P; Lee, Matthew H; Porter, Ashley; Roufas, Athena; Goldberg, Ivan; Zamir, Ehud; White, Andrew; Skalicky, Simon E

2017-07-01

Non-penetrating ocular injuries from badminton shuttlecocks can result in severe damage and life-long complications. This case series highlights the morbidity of such injuries, particularly in regard to post-traumatic glaucoma. This is a retrospective case series of 12 patients with shuttlecock-related blunt eye injuries sustained during badminton play without eye protection. By approaching colleagues through conference presentations and networking, the authors have attempted to gather all known cases of shuttlecock ocular injury managed in tertiary ocular emergency departments or private ophthalmological clinics in Victoria and New South Wales, Australia in 2015. This is the first multicentre case series to describe badminton-related ocular injuries in Australia. Our case series demonstrates, in particular, long-term glaucoma-related morbidity for patients over a large age range (16 to 77 years), with one patient requiring ongoing management 26 years following their initial injury. The cases reported further add to the literature promoting awareness of badminton-related ocular injury. We encourage player education and advocacy on badminton-related eye injuries and appropriate use of eye protection to reduce associated morbidity. © 2016 Optometry Australia.

Transplantation of Human Embryonic Stem Cells in Patients with Multiple Sclerosis and Lyme Disease

PubMed Central

Shroff, Geeta

2016-01-01

Case series Patient: Male, 42 • Female, 30 Final Diagnosis: Human embryonic stem cells showed good therapeutic potential for treatment of multiple sclerosis with lyme disease Symptoms: Fatigue • weakness in limbs Medication: — Clinical Procedure: Human embryonic stem cells transplantation Specialty: Transplantology Objective: Rare disease Background: Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease in which the myelin sheath of nerve cells is damaged. It can cause delayed neurologic symptoms similar to those seen in Lyme disease (LD) patients. Thymus derived T-cells (myelin reactive) migrate to the blood brain barrier and stimulate an inflammatory cascade in the central nervous system. Cell based therapies play an important role in treating neurological diseases such as MS and LD. Case Report: Human embryonic stem cell (hESC) therapy was used to treat two patients with both MS and LD. The hESCs were administered via different routes including intramuscular, intravenous, and supplemental routes (e.g., deep spinal, caudal, intercostal through eye drops) to regenerate the injured cells. Both the patients showed remarkable improvement in their functional skills, overall stamina, cognitive abilities, and muscle strength. Furthermore, the improvement in the patients’ conditions were assessed by magnetic resonance tractography and single photon emission computed tomography (SPECT). Conclusions: Therapy with hESCs might emerge as an effective and safe treatment for patients with both MS and LD. Well-designed clinical trials and follow-up studies are needed to prove the long-term efficacy and safety of hESC therapy in the treatment of patients with MS and LD. PMID:27956736

Taylor spatial frame fixation in patients with multiple traumatic injuries: study of 57 long-bone fractures.

PubMed

Sala, Francesco; Elbatrawy, Yasser; Thabet, Ahmed M; Zayed, Mahmoud; Capitani, Dario

2013-08-01

To evaluate the Taylor spatial frame (TSF) for primary and definitive fixation of lower limb long-bone fractures in patients with multiple traumatic injuries. Retrospective. Level I trauma center. Consecutive series of 52 patients, 57 fractures (25 femoral and 32 tibial), treated between 2005 and 2009. Forty-nine fractures (86%) were open. Injury Severity Score ≥16 for all patients. Fifty-four fractures (95%) underwent definitive fixation with the TSF and 3 were treated primarily within 48 hours of injury. In 22 cases (39%), fractures were acutely reduced with the TSF, fixed to bone and the struts in sliding mode without further adjustment, and in 35 cases (61%), the total residual deformity correction program was undertaken. Clinical and radiological. Complete union was obtained in 52 fractures (91%) without additional surgery at an average of 29 weeks. Four nonunions and 1 delayed union occurred. Results based on Association for the Study and Application of the Method of Ilizarov criteria: 74% excellent, 16% good, 4% fair, and 7% poor for bone outcomes and 35% excellent, 47% good, and 18% fair for functional outcomes. Eighty-eight percent of patients returned to preinjury work activities. Primary and definitive fixation with the TSF is effective. Advantages include continuity of device until union, reduced risk of infection, early mobilization, restoration of primary defect caused by bone loss, easy and accurate application, convertibility and versatility compared with a monolateral fixator, and improved union rate and range of motion for lower extremity long-bone fractures in patients with multiple traumatic injuries.

Fragmentation of organic ions bearing fixed multiple charges observed in MALDI MS.

PubMed

Lou, Xianwen; Li, Bao; de Waal, Bas F M; Schill, Jurgen; Baker, Matthew B; Bovee, Ralf A A; van Dongen, Joost L J; Milroy, Lech-Gustav; Meijer, E W

2018-01-01

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF MS) was used to analyze a series of synthetic organic ions bearing fixed multiple charges. Despite the multiple intrinsic charges, only singly charged ions were recorded in each case. In addition to the pseudo-molecular ions formed by counterion adduction, deprotonation and electron capture, a number of fragment ions were also observed. Charge splitting by fragmentation was found to be a viable route for charge reduction leading to the formation of the observed singly charged fragment ions. Unlike multivalent metal ions, organic ions can rearrange and/or fragment during charge reduction. This fragmentation process will evidently complicate the interpretation of the MALDI MS spectrum. Because MALDI MS is usually considered as a soft ionization technique, the fragment ion peaks can easily be erroneously interpreted as impurities. Therefore, the awareness and understanding of the underlying MALDI-induced fragmentation pathways is essential for a proper interpretation of the corresponding mass spectra. Due to the fragment ions generated during charge reduction, special care should be taken in the MALDI MS analysis of multiply charged ions. In this work, the possible mechanisms by which the organic ions bearing fixed multiple charges fragment are investigated. With an improved understanding of the fragmentation mechanisms, MALDI TOF MS should still be a useful technique for the characterization of organic ions with fixed multiple charges. Copyright © 2017 John Wiley & Sons, Ltd.

Branchial anomalies in children.

PubMed

Bajaj, Y; Ifeacho, S; Tweedie, D; Jephson, C G; Albert, D M; Cochrane, L A; Wyatt, M E; Jonas, N; Hartley, B E J

2011-08-01

Branchial cleft anomalies are the second most common head and neck congenital lesions seen in children. Amongst the branchial cleft malformations, second cleft lesions account for 95% of the branchial anomalies. This article analyzes all the cases of branchial cleft anomalies operated on at Great Ormond Street Hospital over the past 10 years. All children who underwent surgery for branchial cleft sinus or fistula from January 2000 to December 2010 were included in this study. In this series, we had 80 patients (38 female and 42 male). The age at the time of operation varied from 1 year to 14 years. Amongst this group, 15 patients had first branchial cleft anomaly, 62 had second branchial cleft anomaly and 3 had fourth branchial pouch anomaly. All the first cleft cases were operated on by a superficial parotidectomy approach with facial nerve identification. Complete excision was achieved in all these first cleft cases. In this series of first cleft anomalies, we had one complication (temporary marginal mandibular nerve weakness. In the 62 children with second branchial cleft anomalies, 50 were unilateral and 12 were bilateral. In the vast majority, the tract extended through the carotid bifurcation and extended up to pharyngeal constrictor muscles. Majority of these cases were operated on through an elliptical incision around the external opening. Complete excision was achieved in all second cleft cases except one who required a repeat excision. In this subgroup, we had two complications one patient developed a seroma and one had incomplete excision. The three patients with fourth pouch anomaly were treated with endoscopic assisted monopolar diathermy to the sinus opening with good outcome. Branchial anomalies are relatively common in children. There are three distinct types, first cleft, second cleft and fourth pouch anomaly. Correct diagnosis is essential to avoid inadequate surgery and multiple procedures. The surgical approach needs to be tailored to the type of anomaly of origin of the anomaly. Complete excision is essential for good outcomes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Critical incident technique analysis applied to perianesthetic cardiac arrests at a university teaching hospital.

PubMed

Hofmeister, Erik H; Reed, Rachel A; Barletta, Michele; Shepard, Molly; Quandt, Jane

2018-05-01

To apply the critical incident technique (CIT) methodology to a series of perianesthetic cardiac arrest events at a university teaching hospital to describe the factors that contributed to cardiac arrest. CIT qualitative analysis of a case series. A group of 16 dogs and cats that suffered a perioperative cardiac arrest between November 2013 and November 2016. If an arrest occurred, the event was discussed among the anesthesiologists. The discussion included a description of the case, a description of the sequence of events leading up to the arrest and a discussion of what could have been done to affect the outcome. A written description of the case and the event including animal signalment and a timeline of events was provided by the supervising anesthesiologist following discussion among the anesthesiologists. Only dogs or cats were included. After the data collection period, information from the medical record was collected. A qualitative document analysis was performed on the summaries provided about each case by the supervising anesthesiologist, the medical record and any supporting documents. Each case was then classified into one or more of the following: animal, human, equipment, drug and procedural factors for cardiac arrest. The most common factor was animal (n=14), followed by human (n=12), procedural (n=4), drugs (n=1) and equipment (n=1). The majority (n=11) of animals had multiple factors identified. Cardiac arrests during anesthesia at a referral teaching hospital were primarily a result of animal and human factors. Arrests because of procedural, drug and equipment factors were uncommon. Most animals experienced more than one factor and two animals arrested after a change in recumbency. Future work should focus on root cause analysis and interventions designed to minimize all factors, particularly human ones. Copyright © 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study

PubMed Central

Bozorgi, Farzad; Shayesteh Azar, Massoud; Montazer, Seyed Hossein; Chabra, Aroona; Heidari, Seyed Farshad; Khalilian, Alireza

2017-01-01

Introduction: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. Methods: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology. Results: 108 patients with the mean age of 44.6 ± 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively. Conclusion The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures. PMID:28286822

Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study.

PubMed

Bozorgi, Farzad; Shayesteh Azar, Massoud; Montazer, Seyed Hossein; Chabra, Aroona; Heidari, Seyed Farshad; Khalilian, Alireza

2017-01-01

Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology. 108 patients with the mean age of 44.6 ± 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively. The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures.

Two cases of multiple ossifying fibromas in the jaws

PubMed Central

2014-01-01

Background The clinicopathologic characteristics of multiple ossifying fibroma (OF) are unclear due to the condition’s rarity, making diagnosis challenging. Sporadic multiple OFs must be distinguished from hyperparathyroidism-jaw tumour syndrome (HPT-JT) related OF and other fibro-osseous lesions. Methods Multiple OF cases were identified from ossifying fibroma cases. Clinical data including age, sex, anatomic site, radiographic features, clinical impression, treatment and available follow-up data as well as serum calcium, phosphorus, and parathyroid hormone (PTH) were recorded. GNAS and HRPT2 genetic mutations were examined in the two present cases. Case reports of sporadic multiple ossifying fibroma and HPT-JT-related OF were also reviewed. Results The two present cases were confirmed as sporadic multiple OF, with no genetic GNAS and HRPT2 mutations found. The incidence of sporadic multiple ossifying fibroma was 2.0% (2/102). The total 18 sporadic multiform OF cases were characterized as followed: 13 (72.2%) female; 5 (27.8%) male; mean age 28.6 years; 2/16 (11.1%) cases only in the mandible; 4/18 (22.2%) cases only in the maxilla; and 12/18 (66.7%) cases in both the maxilla and mandible. Radiographically, the lesions were radiolucent in 5/18 (27.8%) cases and mixed density in 13/18 (72.2%) cases. Along with 24 cases of HPT-JT related OF were reviewed, sixteen (66.7%) patients were diagnosed with a single lesion, and 8 patients (33.3%) were diagnosed with multiple jaw lesions. Conclusions Sporadic multiple OFs are very rare, but must be distinguished from HPT-JT related OF. We strongly recommend that patients diagnosed with multiple ossifying fibromas receive serum PTH testing and mutation screening of HRPT2. Virtual slides http://www.diagnosticpathology.diagnomx.eu/vs/1194507146115753 PMID:24678936

Guidelines and Procedures for Computing Time-Series Suspended-Sediment Concentrations and Loads from In-Stream Turbidity-Sensor and Streamflow Data

USGS Publications Warehouse

Rasmussen, Patrick P.; Gray, John R.; Glysson, G. Douglas; Ziegler, Andrew C.

2009-01-01

In-stream continuous turbidity and streamflow data, calibrated with measured suspended-sediment concentration data, can be used to compute a time series of suspended-sediment concentration and load at a stream site. Development of a simple linear (ordinary least squares) regression model for computing suspended-sediment concentrations from instantaneous turbidity data is the first step in the computation process. If the model standard percentage error (MSPE) of the simple linear regression model meets a minimum criterion, this model should be used to compute a time series of suspended-sediment concentrations. Otherwise, a multiple linear regression model using paired instantaneous turbidity and streamflow data is developed and compared to the simple regression model. If the inclusion of the streamflow variable proves to be statistically significant and the uncertainty associated with the multiple regression model results in an improvement over that for the simple linear model, the turbidity-streamflow multiple linear regression model should be used to compute a suspended-sediment concentration time series. The computed concentration time series is subsequently used with its paired streamflow time series to compute suspended-sediment loads by standard U.S. Geological Survey techniques. Once an acceptable regression model is developed, it can be used to compute suspended-sediment concentration beyond the period of record used in model development with proper ongoing collection and analysis of calibration samples. Regression models to compute suspended-sediment concentrations are generally site specific and should never be considered static, but they represent a set period in a continually dynamic system in which additional data will help verify any change in sediment load, type, and source.

Time-series analysis to study the impact of an intersection on dispersion along a street canyon.

PubMed

Richmond-Bryant, Jennifer; Eisner, Alfred D; Hahn, Intaek; Fortune, Christopher R; Drake-Richman, Zora E; Brixey, Laurie A; Talih, M; Wiener, Russell W; Ellenson, William D

2009-12-01

This paper presents data analysis from the Brooklyn Traffic Real-Time Ambient Pollutant Penetration and Environmental Dispersion (B-TRAPPED) study to assess the transport of ultrafine particulate matter (PM) across urban intersections. Experiments were performed in a street canyon perpendicular to a highway in Brooklyn, NY, USA. Real-time ultrafine PM samplers were positioned on either side of an intersection at multiple locations along a street to collect time-series number concentration data. Meteorology equipment was positioned within the street canyon and at an upstream background site to measure wind speed and direction. Time-series analysis was performed on the PM data to compute a transport velocity along the direction of the street for the cases where background winds were parallel and perpendicular to the street. The data were analyzed for sampler pairs located (1) on opposite sides of the intersection and (2) on the same block. The time-series analysis demonstrated along-street transport, including across the intersection when background winds were parallel to the street canyon and there was minimal transport and no communication across the intersection when background winds were perpendicular to the street canyon. Low but significant values of the cross-correlation function (CCF) underscore the turbulent nature of plume transport along the street canyon. The low correlations suggest that flow switching around corners or traffic-induced turbulence at the intersection may have aided dilution of the PM plume from the highway. This observation supports similar findings in the literature. Furthermore, the time-series analysis methodology applied in this study is introduced as a technique for studying spatiotemporal variation in the urban microscale environment.

[Digital angiography and lipiodol computerized tomography in the anatomopathological framework of hepatocarcinoma].

PubMed

Pozzi-Mucelli, R; Pozzi-Mucelli, R; Pagnan, L; Dalla Palma, L

1994-12-01

The introduction of therapies other than conventional surgery of hepatocellular carcinoma (HCC) requires an accurate pathologic classification, which is important because it is well known that HCC may have multicentric growth. The Liver Cancer Study Group of Japan has proposed a classification dividing HCCs into three macroscopic forms from the pathologic point of view: nodular, massive and infiltrating HCCs. The nodular type is subdivided into four types: single nodular type, single nodular type with surrounding proliferation, multinodular fused type and multinodular type. Forty-six HCC patients were examined with Lipiodol Computed Tomography (LCT) to investigate the agreement between pathologic and imaging findings. LCT proved to be in close agreement with pathologic findings. Sixteen cases were classified as type I (single nodular type), 8 as type II (single nodular type with limited foci), 1 as type III (multinodular fused type), 18 as type IV (multiple nodular type with diffuse foci) and 3 cases as type V (massive form). No cases of infiltrative forms were observed in our series. Based on LCT findings, the capabilities of digital subtraction angiography (DSA) were studied in the pathologic classification of HCCs. DSA exhibited some limitations in the pathologic classification of HCCs in 5 of 16 patients with type I lesions. In these cases DSA suggested false-positive diagnoses because of regenerative nodules in cirrhotic liver in 3 cases and of daughter nodules (not confirmed at LCT) in 2 cases. In 7 of 8 patients with type II HCCs, DSA failed to show the daughter nodules surrounding the main nodule. In the 18 patients with multiple distant nodules (type IV), DSA was less sensitive in defining nodule number and site. In the massive form, the information obtained with LCT and DSA was comparable. In conclusion, LCT should be considered a basic examination in the study of HCC extent. Based on LCT findings, the most appropriate treatment can be selected, be it surgery, alcohol injection, or intraarterial chemoembolization.

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres.

PubMed

van Lent, Wineke A M; de Beer, Relinde D; van Harten, Wim H

2010-08-31

Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations.Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals.

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

PubMed Central

2010-01-01

Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. Conclusions The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals. PMID:20807408

Surrogacy: outcomes for surrogate mothers, children and the resulting families-a systematic review.

PubMed

Söderström-Anttila, Viveca; Wennerholm, Ulla-Britt; Loft, Anne; Pinborg, Anja; Aittomäki, Kristiina; Romundstad, Liv Bente; Bergh, Christina

2016-01-01

Surrogacy is a highly debated method mainly used for treating women with infertility caused by uterine factors. This systematic review summarizes current levels of knowledge of the obstetric, medical and psychological outcomes for the surrogate mothers, the intended parents and children born as a result of surrogacy. PubMed, Cochrane and Embase databases up to February 2015 were searched. Cohort studies and case series were included. Original studies published in English and the Scandinavian languages were included. In case of double publications, the latest study was included. Abstracts only and case reports were excluded. Studies with a control group and case series (more than three cases) were included. Cohort studies, but not case series, were assessed for methodological quality, in terms of risk of bias. We examined a variety of main outcomes for the surrogate mothers, children and intended mothers, including obstetric outcome, relationship between surrogate mother and intended couple, surrogate's experiences after relinquishing the child, preterm birth, low birthweight, birth defects, perinatal mortality, child psychological development, parent-child relationship, and disclosure to the child. The search returned 1795 articles of which 55 met the inclusion criteria. The medical outcome for the children was satisfactory and comparable to previous results for children conceived after fresh IVF and oocyte donation. The rate of multiple pregnancies was 2.6-75.0%. Preterm birth rate in singletons varied between 0 and 11.5% and low birthweight occurred in between 0 and 11.1% of cases. At the age of 10 years there were no major psychological differences between children born after surrogacy and children born after other types of assisted reproductive technology (ART) or after natural conception. The obstetric outcomes for the surrogate mothers were mainly reported from case series. Hypertensive disorders in pregnancy were reported in between 3.2 and 10% of cases and placenta praevia/placental abruption in 4.9%. Cases with hysterectomies have also been reported. Most surrogate mothers scored within the normal range on personality tests. Most psychosocial variables were satisfactory, although difficulties related to handing over the child did occur. The psychological well-being of children whose mother had been a surrogate mother between 5 and 15 years earlier was found to be good. No major differences in psychological state were found between intended mothers, mothers who conceived after other types of ART and mothers whose pregnancies were the result of natural conception. Most studies reporting on surrogacy have serious methodological limitations. According to these studies, most surrogacy arrangements are successfully implemented and most surrogate mothers are well-motivated and have little difficulty separating from the children born as a result of the arrangement. The perinatal outcome of the children is comparable to standard IVF and oocyte donation and there is no evidence of harm to the children born as a result of surrogacy. However, these conclusions should be interpreted with caution. To date, there are no studies on children born after cross-border surrogacy or growing up with gay fathers. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Boolean dynamics of genetic regulatory networks inferred from microarray time series data

DOE PAGES

Martin, Shawn; Zhang, Zhaoduo; Martino, Anthony; ...

2007-01-31

Methods available for the inference of genetic regulatory networks strive to produce a single network, usually by optimizing some quantity to fit the experimental observations. In this paper we investigate the possibility that multiple networks can be inferred, all resulting in similar dynamics. This idea is motivated by theoretical work which suggests that biological networks are robust and adaptable to change, and that the overall behavior of a genetic regulatory network might be captured in terms of dynamical basins of attraction. We have developed and implemented a method for inferring genetic regulatory networks for time series microarray data. Our methodmore » first clusters and discretizes the gene expression data using k-means and support vector regression. We then enumerate Boolean activation–inhibition networks to match the discretized data. In conclusion, the dynamics of the Boolean networks are examined. We have tested our method on two immunology microarray datasets: an IL-2-stimulated T cell response dataset and a LPS-stimulated macrophage response dataset. In both cases, we discovered that many networks matched the data, and that most of these networks had similar dynamics.« less

Rotational Motion of Axisymmetric Marangoni Swimmers

NASA Astrophysics Data System (ADS)

Rothstein, Jonathan; Uvanovic, Nick

2017-11-01

A series of experiments will be presented investigating the motion of millimeter-sized particles on the surface of water. The particles were partially coated with ethanol and carefully placed on a water interface in a series of Petri dishes with different diameters. High speed particle motion was driven by strong surface tension gradients as the ethanol slowly diffuses from the particles into the water resulting in a Marangoni flow. The velocity and acceleration of the particles where measured. In addition to straight line motion, the presence of the bounding walls of the circular Petri dish was found to induce an asymmetric, rotational motion of the axisymmetric Marangoni swimmers. The rotation rate and radius of curvature was found to be a function of the size of the Petri dish and the curvature of the air-water interface near the edge of the dish. For large Petri dishes or small particles, rotation motion was observed far from the bounding walls. In these cases, the symmetry break appears to be the result of the onset of votex shedding. Finally, multiple spherical particles were observed to undergo assembly driven by capillary forces followed by explosive disassembly.

Locating the Discontinuities of a Bounded Function by the Partial Sums of its Fourier Series I: Periodical Case

NASA Technical Reports Server (NTRS)

Kvernadze, George; Hagstrom,Thomas; Shapiro, Henry

1997-01-01

A key step for some methods dealing with the reconstruction of a function with jump discontinuities is the accurate approximation of the jumps and their locations. Various methods have been suggested in the literature to obtain this valuable information. In the present paper, we develop an algorithm based on identities which determine the jumps of a 2(pi)-periodic bounded not-too-highly oscillating function by the partial sums of its differentiated Fourier series. The algorithm enables one to approximate the locations of discontinuities and the magnitudes of jumps of a bounded function. We study the accuracy of approximation and establish asymptotic expansions for the approximations of a 27(pi)-periodic piecewise smooth function with one discontinuity. By an appropriate linear combination, obtained via derivatives of different order, we significantly improve the accuracy. Next, we use Richardson's extrapolation method to enhance the accuracy even more. For a function with multiple discontinuities we establish simple formulae which "eliminate" all discontinuities of the function but one. Then we treat the function as if it had one singularity following the method described above.

Rapid amelioration of severe manic episodes with right unilateral ultrabrief pulse ECT: a case series of four patients.

PubMed

Sidorov, Alexey; Mayur, Prashanth

2017-02-01

The aim of this small case series is to describe four cases of severe mania, where ultrabrief pulse electroconvulsive therapy (ECT) was used as a primary mode of treatment. A retrospective file review was undertaken of four patients identified as having received ultrabrief pulse ECT for severe mania. The outcome measures for treatment efficacy were the Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI). All the patients showed significant clinical improvement. A comparison of pre- and post-treatment YMRS and CGI scores showed a dramatic decrease in all four cases. However, one patient was shifted to brief pulse ECT due to inadequate response. Ultrabrief pulse ECT may be an effective treatment in cases of severe mania. Due to the very small number of cases in the current case series, no specific conclusions regarding efficacy may be drawn; however, larger, controlled studies would be indicated.

Application of a time-series methodology to Federal program allocations. [Modified Box and Jenkins method

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

Bronfman, B. H.

Time-series analysis provides a useful tool in the evaluation of public policy outputs. It is shown that the general Box and Jenkins method, when extended to allow for multiple interrupts, enables researchers simultaneously to examine changes in drift and level of a series, and to select the best fit model for the series. As applied to urban renewal allocations, results show significant changes in the level of the series, corresponding to changes in party control of the Executive. No support is given to the ''incrementalism'' hypotheses as no significant changes in drift are found.

Ataxia Telangiectasia in Siblings: Oral Motor and Swallowing Characterization

PubMed Central

Rondon-Melo, Silmara; de Almeida, Isabel Junqueira; de Andrade, Claudia Regina Furquim; Sassi, Fernanda Chiarion; Molini-Avejonas, Daniela Regina

2017-01-01

Case series Patient: Male, 23 • Female, 20 Final Diagnosis: Ataxia telnagiectasia Symptoms: Gagging • coughing • hoarseness • articulatory inaccuracy Medication: — Clinical Procedure: Oral motor and swallowing assessment Specialty: Neurology Objective: Rare disease Background: The body of literature on oral motor and swallowing disorders in patients with ataxia telangiectasia (AT) is limited. Case Report: The purpose of this study was to characterize oral motor and swallowing disorders in two siblings with AT, based on oral motor and swallowing assessments. Specific procedures were applied for oral motor and swallowing assessments and both patients underwent videofluoroscopy (VFS). Case 1 presented vocal instability, change in postural control during feeding; food retention in oral cavity; slower oral transit time; and multiple swallowing (signs for solid and liquid). Case 2 presented parted lips at rest and reduced muscle strength; reduced strength and mobility of the tongue; vocal weakness and instability; reduced speech precision and intelligibility; decreased intonation pattern; food retention in oral cavity during feeding; slower oral transit time; multiple swallowing (signs for solid and liquid); poor bolus ejection; incoordination and difficulty in controlling the sips of water taken from the cup; altered cervical auscultation after swallowing and respiratory distress (liquid and puree). For both patients VFS results revealed laryngeal penetration for liquid. Conclusions: Although the literature describes the occurrence of dysarthria and swallowing disorders in patients with AT, little attention has been given to describing which oral motor deficits are responsible for these disorders. Early identification of swallowing alterations and rehabilitation could decrease the risk of aspiration pneumonia. Future studies are necessary in order to investigate the deterioration process of swallowing in AT and the influence of rehabilitation in maintaining functional health. PMID:28698541

Chromosomal Gains at 9q Characterize Enteropathy-Type T-Cell Lymphoma

PubMed Central

Zettl, Andreas; Ott, German; Makulik, Angela; Katzenberger, Tiemo; Starostik, Petr; Eichler, Thorsten; Puppe, Bernhard; Bentz, Martin; Müller-Hermelink, Hans Konrad; Chott, Andreas

2002-01-01

Genetic alterations in enteropathy-type T-cell lymphoma (ETL) are unknown so far. In this series, 38 cases of ETL were analyzed by comparative genomic hybridization (CGH). CGH revealed chromosomal imbalances in 87% of cases analyzed, with recurrent gains of genetic material involving chromosomes 9q (in 58% of cases), 7q (24%), 5q (18%), and 1q (16%). Recurrent losses of genetic material occurred on chromosomes 8p and 13q (24% each), and 9p (18%). In this first systematic genetic study on ETL, chromosomal gains on 9q (minimal overlapping region 9q33-q34) were found to be highly characteristic of ETL. Fluorescence in situ hybridization analysis on four cases of ETL, using a probe for 9q34, indicated frequent and multiple gains of chromosomal material at 9q34 (up to nine signals per case). Among 16 patients with ETL who survived initial disease presentation, patients with more than three chromosomal gains or losses (n = 11) followed a worse clinical course than those with three or less imbalances (n = 5). The observation of similar genetic alterations in ETL and in primary gastric (n = 4) and colonic (n = 1) T-cell lymphoma, not otherwise specified, is suggestive of a genetic relationship of gastrointestinal T-cell lymphomas at either localization. PMID:12414511

Unilateral retinitis pigmentosa and cone-rod dystrophy

PubMed Central

Farrell, Donald F

2009-01-01

Purpose: The purpose of this paper is to report 14 new cases of unilateral retinitis pigmentosa and three new cases of cone-rod dystrophy and to compare the similarities and dissimilarities to those found in the bilateral forms of these disorders. Methods: A total of 272 cases of retinitis pigmentosa and 167 cases of cone-rod dystrophy were studied by corneal full field electroretinograms and electrooculograms. The student t-test was used to compare categories. Results: The percentage of familial and nonfamilial cases was the same for the bilateral and unilateral forms of the disease. In our series, unilateral retinitis pigmentosa makes up approximately 5% of the total population of retinitis pigmentosa, while unilateral cone-rod dystrophy makes up only about 2% of the total. In the familial forms of unilateral retinitis pigmentosa the most common inheritance pattern was autosomal dominant and all affected relatives had bilateral disease. Conclusion: Unilateral retinitis pigmentosa and cone-rod dystrophy appear to be directly related to the more common bilateral forms of these disorders. The genetic mechanisms which account for asymmetric disorders are not currently understood. It may be a different unidentified mutation at a single loci or it is possible that nonlinked mutations in multiple loci account for this unusual disorder. PMID:19668577

Case series: toxicity from 25B-NBOMe--a cluster of N-bomb cases.

PubMed

Gee, Paul; Schep, Leo J; Jensen, Berit P; Moore, Grant; Barrington, Stuart

2016-01-01

Background A new class of hallucinogens called NBOMes has emerged. This class includes analogues 25I-NBOMe, 25C-NBOMe and 25B-NBOMe. Case reports and judicial seizures indicate that 25I-NBOMe and 25C-NBOMe are more prevalently abused. There have been a few confirmed reports of 25B-NBOMe use or toxicity. Report Observational case series. This report describes a series of 10 patients who suffered adverse effects from 25B-NBOMe. Hallucinations and violent agitation predominate along with serotonergic/stimulant signs such as mydriasis, tachycardia, hypertension and hyperthermia. The majority (7/10) required sedation with benzodiazepines. Analytical method 25B-NBOMe concentrations in plasma and urine were quantified in all patients using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Peak plasma levels were measured between 0.7-10.1 ng/ml. Discussion The NBOMes are desired by users because of their hallucinogenic and stimulant effects. They are often sold as LSD or synthetic LSD. Reported cases of 25B- NBOMe toxicity are reviewed and compared to our series. Seizures and one pharmacological death have been described but neither were observed in our series. Based on our experience with cases of mild to moderate toxicity, we suggest that management should be supportive and focused on preventing further (self) harm. High doses of benzodiazepines may be required to control agitation. Patients who develop significant hyperthermia need to be actively managed. Conclusions Effects from 25B-NBOMe in our series were similar to previous individual case reports. The clinical features were also similar to effects from other analogues in the class (25I-NBOMe, 25C-NBOMe). Violent agitation frequently present along with signs of serotonergic stimulation. Hyperthermia, rhabdomyolysis and kidney injury were also observed.

Lenticular neovascularization subsequent to traumatic cataract formation.

PubMed

Kabat, Alan G

2011-09-01

To report a series of cases involving neovascularization within the human crystalline lens-a normally avascular structure-after ocular trauma. This is a retrospective, consecutive observational case series with review of the prevailing literature. Four individuals with a history of ocular trauma and subsequent cataract development were examined between May 2004 and April 2007. All had hypermature cataracts and intraocular inflammation, presumably secondary to phacolysis; two of the four had concurrent hyphema and ocular hypertension in the involved eye. All subjects in this series were found to display a discrete network of blood vessels within the structure of the crystalline lens, just beneath the anterior lens capsule. Neovascularization of the crystalline lens has received little attention in the ophthalmic literature, having been described only rarely in individual case reports. This manuscript details the first known case series involving lenticular neovascularization, and offers insight into its possible developmental mechanism.

Amniotic fluid embolism mortality rate.

PubMed

Benson, Michael D

2017-11-01

The objective of this study was to determine the mortality rate of amniotic fluid embolism (AFE) using population-based studies and case series. A literature search was conducted using the two key words: 'amniotic fluid embolism (AFE)' AND 'mortality rate'. Thirteen population-based studies were evaluated, as well as 36 case series including at least two patients. The mortality rate from population-based studies varied from 11% to 44%. When nine population-based studies with over 17 000 000 live births were aggregated, the maternal mortality rate was 20.4%. In contrast, the mortality rate of AFE in case series varies from 0% to 100% with numerous rates in between. The AFE mortality rate in population-based studies varied from 11% to 44% with the best available evidence supporting an overall mortality rate of 20.4%. Data from case series should no longer be used as a basis for describing the lethality of AFE. © 2017 Japan Society of Obstetrics and Gynecology.

Multifractal analysis of visibility graph-based Ito-related connectivity time series.

PubMed

Czechowski, Zbigniew; Lovallo, Michele; Telesca, Luciano

2016-02-01

In this study, we investigate multifractal properties of connectivity time series resulting from the visibility graph applied to normally distributed time series generated by the Ito equations with multiplicative power-law noise. We show that multifractality of the connectivity time series (i.e., the series of numbers of links outgoing any node) increases with the exponent of the power-law noise. The multifractality of the connectivity time series could be due to the width of connectivity degree distribution that can be related to the exit time of the associated Ito time series. Furthermore, the connectivity time series are characterized by persistence, although the original Ito time series are random; this is due to the procedure of visibility graph that, connecting the values of the time series, generates persistence but destroys most of the nonlinear correlations. Moreover, the visibility graph is sensitive for detecting wide "depressions" in input time series.

PSO-MISMO modeling strategy for multistep-ahead time series prediction.

PubMed

Bao, Yukun; Xiong, Tao; Hu, Zhongyi

2014-05-01

Multistep-ahead time series prediction is one of the most challenging research topics in the field of time series modeling and prediction, and is continually under research. Recently, the multiple-input several multiple-outputs (MISMO) modeling strategy has been proposed as a promising alternative for multistep-ahead time series prediction, exhibiting advantages compared with the two currently dominating strategies, the iterated and the direct strategies. Built on the established MISMO strategy, this paper proposes a particle swarm optimization (PSO)-based MISMO modeling strategy, which is capable of determining the number of sub-models in a self-adaptive mode, with varying prediction horizons. Rather than deriving crisp divides with equal-size s prediction horizons from the established MISMO, the proposed PSO-MISMO strategy, implemented with neural networks, employs a heuristic to create flexible divides with varying sizes of prediction horizons and to generate corresponding sub-models, providing considerable flexibility in model construction, which has been validated with simulated and real datasets.

Plastic or metal stents for benign extrahepatic biliary strictures: a systematic review

PubMed Central

2009-01-01

Background Benign biliary strictures may be a consequence of surgical procedures, chronic pancreatitis or iatrogenic injuries to the ampulla. Stents are increasingly being used for this indication, however it is not completely clear which stent type should be preferred. Methods A systematic review on stent placement for benign extrahepatic biliary strictures was performed after searching PubMed and EMBASE databases. Data were pooled and evaluated for technical success, clinical success and complications. Results In total, 47 studies (1116 patients) on outcome of stent placement were identified. No randomized controlled trials (RCTs), one non-randomized comparative studies and 46 case series were found. Technical success was 98,9% for uncovered self-expandable metal stents (uSEMS), 94,8% for single plastic stents and 94,0% for multiple plastic stents. Overall clinical success rate was highest for placement of multiple plastic stents (94,3%) followed by uSEMS (79,5%) and single plastic stents (59.6%). Complications occurred more frequently with uSEMS (39.5%) compared with single plastic stents (36.0%) and multiple plastic stents (20,3%). Conclusion Based on clinical success and risk of complications, placement of multiple plastic stents is currently the best choice. The evolving role of cSEMS placement as a more patient friendly and cost effective treatment for benign biliary strictures needs further elucidation. There is a need for RCTs comparing different stent types for this indication. PMID:20017920

Long-term Outcome of Multiple Small-diameter Drilling Decompression Combined with Hip Arthroscopy versus Drilling Alone for Early Avascular Necrosis of the Femoral Head

PubMed Central

Li, Ji; Li, Zhong-Li; Zhang, Hao; Su, Xiang-Zheng; Wang, Ke-Tao; Yang, Yi-Meng

2017-01-01

Background: Avascular necrosis of femoral head (AVNFH) typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone. Methods: This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients (98 hips) with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips (Group A) or drilling decompression alone in 34 cases/55 hips (Group B). Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test. Results: All patients were followed up for an average of 57.6 months (range: 17–108 months). Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris’ scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 (t = −7.21, P = 0.001) than Group B with mean Harris’ scores improved from 69.46 ± 9.71 to 75.79 ± 4.13 (t = –9.47, P = 0.037) (significantly different: t = –2.54, P = 0.017). The total surgery effective rate was also significantly different between Groups A and B (86.0% vs. 74.5%; χ2 = 3.69, P = 0.02). Conclusion: For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone. PMID:28584206

Multiple Questions Require Multiple Designs: An Evaluation of the 1981 Changes to the AFDC Program.

ERIC Educational Resources Information Center

Hedrick, Terry E.; Shipman, Stephanie L.

1988-01-01

Changes made in 1981 to the Aid to Families with Dependent Children (AFDC) program under the Omnibus Budget Reconciliation Act were evaluated. Multiple quasi-experimental designs (interrupted time series, non-equivalent comparison groups, and simple pre-post designs) used to address evaluation questions illustrate the issues faced by evaluators in…

Development of a Prototype System for Accessing Linked NCES Data. Working Paper Series.

ERIC Educational Resources Information Center

Salvucci, Sameena; Wenck, Stephen; Tyson, James

A project has been developed to advance the capabilities of the National Center for Education Statistics (NCES) to support the dissemination of linked data from multiple surveys, multiple components within a survey, and multiple time points. An essential element of this study is the development of a software prototype system to facilitate NCES…

Refined composite multiscale weighted-permutation entropy of financial time series

NASA Astrophysics Data System (ADS)

Zhang, Yongping; Shang, Pengjian

2018-04-01

For quantifying the complexity of nonlinear systems, multiscale weighted-permutation entropy (MWPE) has recently been proposed. MWPE has incorporated amplitude information and been applied to account for the multiple inherent dynamics of time series. However, MWPE may be unreliable, because its estimated values show large fluctuation for slight variation of the data locations, and a significant distinction only for the different length of time series. Therefore, we propose the refined composite multiscale weighted-permutation entropy (RCMWPE). By comparing the RCMWPE results with other methods' results on both synthetic data and financial time series, RCMWPE method shows not only the advantages inherited from MWPE but also lower sensitivity to the data locations, more stable and much less dependent on the length of time series. Moreover, we present and discuss the results of RCMWPE method on the daily price return series from Asian and European stock markets. There are significant differences between Asian markets and European markets, and the entropy values of Hang Seng Index (HSI) are close to but higher than those of European markets. The reliability of the proposed RCMWPE method has been supported by simulations on generated and real data. It could be applied to a variety of fields to quantify the complexity of the systems over multiple scales more accurately.

The short-term effects of air pollutants on respiratory disease mortality in Wuhan, China: comparison of time-series and case-crossover analyses.

PubMed

Ren, Meng; Li, Na; Wang, Zhan; Liu, Yisi; Chen, Xi; Chu, Yuanyuan; Li, Xiangyu; Zhu, Zhongmin; Tian, Liqiao; Xiang, Hao

2017-01-13

Few studies have compared different methods when exploring the short-term effects of air pollutants on respiratory disease mortality in Wuhan, China. This study assesses the association between air pollutants and respiratory disease mortality with both time-series and time-stratified-case-crossover designs. The generalized additive model (GAM) and the conditional logistic regression model were used to assess the short-term effects of air pollutants on respiratory disease mortality. Stratified analyses were performed by age, sex, and diseases. A 10 μg/m 3 increment in SO 2 level was associated with an increase in relative risk for all respiratory disease mortality of 2.4% and 1.9% in the case-crossover and time-series analyses in single pollutant models, respectively. Strong evidence of an association between NO 2 and daily respiratory disease mortality among men or people older than 65 years was found in the case-crossover study. There was a positive association between air pollutants and respiratory disease mortality in Wuhan, China. Both time-series and case-crossover analyses consistently reveal the association between three air pollutants and respiratory disease mortality. The estimates of association between air pollution and respiratory disease mortality from the case-crossover analysis displayed greater variation than that from the time-series analysis.

The short-term effects of air pollutants on respiratory disease mortality in Wuhan, China: comparison of time-series and case-crossover analyses

NASA Astrophysics Data System (ADS)

Ren, Meng; Li, Na; Wang, Zhan; Liu, Yisi; Chen, Xi; Chu, Yuanyuan; Li, Xiangyu; Zhu, Zhongmin; Tian, Liqiao; Xiang, Hao

2017-01-01

Few studies have compared different methods when exploring the short-term effects of air pollutants on respiratory disease mortality in Wuhan, China. This study assesses the association between air pollutants and respiratory disease mortality with both time-series and time-stratified-case-crossover designs. The generalized additive model (GAM) and the conditional logistic regression model were used to assess the short-term effects of air pollutants on respiratory disease mortality. Stratified analyses were performed by age, sex, and diseases. A 10 μg/m3 increment in SO2 level was associated with an increase in relative risk for all respiratory disease mortality of 2.4% and 1.9% in the case-crossover and time-series analyses in single pollutant models, respectively. Strong evidence of an association between NO2 and daily respiratory disease mortality among men or people older than 65 years was found in the case-crossover study. There was a positive association between air pollutants and respiratory disease mortality in Wuhan, China. Both time-series and case-crossover analyses consistently reveal the association between three air pollutants and respiratory disease mortality. The estimates of association between air pollution and respiratory disease mortality from the case-crossover analysis displayed greater variation than that from the time-series analysis.

Scientific literacy and discursive identity: A theoretical framework for understanding science learning

NASA Astrophysics Data System (ADS)

Brown, Bryan A.; Reveles, John M.; Kelly, Gregory J.

2005-09-01

In this paper we propose the construct of discursive identity as a way to examine student discourse. We drew from the work of Gee (2001, Review of Research in Education, 25, 99-125) and Nasir and Saxe (2003, Educational Researcher, 32(5), 14-18) to consider the multiple contexts and developmental timescales of student discursive identity development. We argue that theories of scientific literacy need to consider the sociocultural contexts of language use in order to examine fully affiliation and alienation associated with appropriation of scientific discourse. As an illustrative case, we apply discursive identity to series of short exchanges in a fifth-grade classroom of African-American students. The discussion examines potential co-construction of student identity and scientific literacy.

FEM: Feature-enhanced map

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

Afonine, Pavel V.; Moriarty, Nigel W.; Mustyakimov, Marat

A method is presented that modifies a 2 m F obs- D F modelσ A-weighted map such that the resulting map can strengthen a weak signal, if present, and can reduce model bias and noise. The method consists of first randomizing the starting map and filling in missing reflections using multiple methods. This is followed by restricting the map to regions with convincing density and the application of sharpening. The final map is then created by combining a series of histogram-equalized intermediate maps. In the test cases shown, the maps produced in this way are found to have increased interpretabilitymore » and decreased model bias compared with the starting 2 m F obs- D F modelσ A-weighted map.« less

Water vapor-nitrogen absorption at CO2 laser frequencies

NASA Technical Reports Server (NTRS)

Peterson, J. C.; Thomas, M. E.; Nordstrom, R. J.; Damon, E. K.; Long, R. K.

1979-01-01

The paper reports the results of a series of pressure-broadened water vapor absorption measurements at 27 CO2 laser frequencies between 935 and 1082 kaysers. Both multiple traversal cell and optoacoustic (spectrophone) techniques were utilized together with an electronically stabilized CW CO2 laser. Comparison of the results obtained by these two methods shows remarkable agreement, indicating a precision which has not been previously achieved in pressure-broadened studies of water vapor. The data of 10.59 microns substantiate the existence of the large (greater than 200) self-broadening coefficients determined in an earlier study by McCoy. In this work, the case of water vapor in N2 at a total pressure of 1 atm has been treated.