Writing about Clients: Ethical Considerations and Options

ERIC Educational Resources Information Center

Sperry, Len; Pies, Ronald

2010-01-01

Today, the decision to prepare clinical case material for publication is a decision that cannot be taken lightly. The decision involves reviewing ethical considerations and choosing among various options to safeguard client privacy. Such options include seeking the client's permission, disguising case material, and developing composite case…

Economic assessment of climate adaptation options for urban drainage design in Odense, Denmark.

PubMed

Zhou, Q; Halsnæs, K; Arnbjerg-Nielsen, K

2012-01-01

Climate change is likely to influence the water cycle by changing the precipitation patterns, in some cases leading to increased occurrences of precipitation extremes. Urban landscapes are vulnerable to such changes due to the concentrated population and socio-economic values in cities. Feasible adaptation requires better flood risk quantification and assessment of appropriate adaptation actions in term of costs and benefits. This paper presents an economic assessment of three prevailing climate adaptation options for urban drainage design in a Danish case study, Odense. A risk-based evaluation framework is used to give detailed insights of the physical and economic feasibilities of each option. Estimation of marginal benefits of adaptation options are carried out through a step-by-step cost-benefit analysis. The results are aimed at providing important information for decision making on how best to adapt to urban pluvial flooding due to climate impacts in cities.

Feynman perturbation expansion for the price of coupon bond options and swaptions in quantum finance. I. Theory

NASA Astrophysics Data System (ADS)

Baaquie, Belal E.

2007-01-01

European options on coupon bonds are studied in a quantum field theory model of forward interest rates. Swaptions are briefly reviewed. An approximation scheme for the coupon bond option price is developed based on the fact that the volatility of the forward interest rates is a small quantity. The field theory for the forward interest rates is Gaussian, but when the payoff function for the coupon bond option is included it makes the field theory nonlocal and nonlinear. A perturbation expansion using Feynman diagrams gives a closed form approximation for the price of coupon bond option. A special case of the approximate bond option is shown to yield the industry standard one-factor HJM formula with exponential volatility.

Feynman perturbation expansion for the price of coupon bond options and swaptions in quantum finance. I. Theory.

PubMed

Baaquie, Belal E

2007-01-01

European options on coupon bonds are studied in a quantum field theory model of forward interest rates. Swaptions are briefly reviewed. An approximation scheme for the coupon bond option price is developed based on the fact that the volatility of the forward interest rates is a small quantity. The field theory for the forward interest rates is Gaussian, but when the payoff function for the coupon bond option is included it makes the field theory nonlocal and nonlinear. A perturbation expansion using Feynman diagrams gives a closed form approximation for the price of coupon bond option. A special case of the approximate bond option is shown to yield the industry standard one-factor HJM formula with exponential volatility.

[Cost-effectiveness ratio of using rapid tests for malaria diagnosis in the Peruvian Amazon].

PubMed

Rosas Aguirre, Angel Martín; Llanos Zavalaga, Luis Fernando; Trelles de Belaunde, Miguel

2009-05-01

To determine the cost-effectiveness ratios of three options for diagnosing malaria at the local health provider in 50 communities near the Peruvian Amazon. Calculation of the incremental cost-effectiveness ratios of three options for diagnosing malaria-not using rapid tests, using rapid tests, and accessing microscopy-in patients presenting with fever in 50 communities near Iquitos in the Peruvian Amazon, communities with limited access to microscopy that depend on a network of local health providers. The incremental costs and effects of the two latter options were calculated and compared with the first option (currently in use). By dividing the incremental costs among the incremental effects, the incremental cost-effectiveness ratio was calculated. Using rapid tests would save the Ministry of Health of Peru: US$191 for each new case of Plasmodium falciparum malaria treated promptly and appropriately; US$31 per new case of P. vivax malaria treated promptly and appropriately; US$1,051 per case of acute malaria averted; and US$17,655 for each death avoided. Access to microscopy by all the communities would generate an additional cost of: US$198 per new case of P. falciparum malaria treated promptly and appropriately; US$31 per new case of P. vivax malaria treated promptly and appropriately; US$1,086 per case of acute malaria averted; and US$18,255 for each death avoided. The use of rapid tests by local health providers can improve the effectiveness of malaria diagnosis in patients with fever in the 50 communities studied, at a cost lower than the current method. The recommendation is to expand the use of rapid tests among the health providers in communities similar to those studied.

Going Large or Going Small in Plant Design: Comparison between a P.P. with three small Kaplan turbines and a P.P. with just one Large Kaplan turbine

NASA Astrophysics Data System (ADS)

Castro-Otero, C.

2017-04-01

Very often small turbine manufacturers are requested to produce sizeable turbines, too large in terms of physical dimensions, power or designing capacity. In these cases clever alternative solutions should be found to meet customers’ needs. For instance: in the old times twin runner Francis turbines were an option instead of one large machine, or if a too large Pelton turbine cannot be manufactured or designed, a good option is to install a medium size Francis and a small Pelton. Likewise, a similar approach needs to be taken should the manufacturer be asked for a too large Kaplan. Facing this situation a good option is to install three or more small Kaplan turbines. This particular case was studied in depth and after all the considerations had been made, the following question arouse: Is this a way out for the manufacturer or is it really the best option for the customer? The choice made as a way out for the manufacturer became the best option for the customer and a success for both parties. This paper aims to encourage developers and engineering firms to search for more options than the traditional one to find the best option in plant design.

A real options approach to biotechnology investment policy-the case of developing a Campylobacter vaccine to poultry.

PubMed

Lund, Mogens; Jensen, Jørgen Dejgård

2016-06-01

The aim of the article is to identify and analyse public-private incentives for the development and marketing of new animal vaccines within a real options methodological framework, and to investigate how real options methodology can be utilized to support economic incentives for vaccine development in a cost-effective way. The development of a vaccine against Campylobacter jejuni in poultry is applied as a case study. Employing the real options methodology, the net present value of the vaccine R&D project becomes larger than a purely probabilistic expected present value throughout the different stages of the project - and the net present value becomes larger, when more types of real options are taken into consideration. The insight from the real options analysis reveals opportunities for new policies to promote the development of animal vaccines. One such approach might be to develop schemes combining stage-by-stage optimized subsidies in the individual development stages, with proper account taken of investors'/developers' economic incentives to proceed, sell or cancel the project in the respective stages. Another way of using the real options approach to support the development of desirable animal vaccines could be to issue put options for the vaccine candidate, enabling vaccine developers to hedge against the economic risk from market volatility. Copyright © 2016 Elsevier B.V. All rights reserved.

Physics of Materials.

ERIC Educational Resources Information Center

Archenhold, W. F.; And Others

1987-01-01

Describes a new high school physics option in Great Britain which uses the model of a technological approach to the study of materials. Discusses the components of the program, including the development of a student book for independent learning and six case studies. Provides a case study about turbine blades. (TW)

Investigation of non-Gaussian effects in the Brazilian option market

NASA Astrophysics Data System (ADS)

Sosa-Correa, William O.; Ramos, Antônio M. T.; Vasconcelos, Giovani L.

2018-04-01

An empirical study of the Brazilian option market is presented in light of three option pricing models, namely the Black-Scholes model, the exponential model, and a model based on a power law distribution, the so-called q-Gaussian distribution or Tsallis distribution. It is found that the q-Gaussian model performs better than the Black-Scholes model in about one third of the option chains analyzed. But among these cases, the exponential model performs better than the q-Gaussian model in 75% of the time. The superiority of the exponential model over the q-Gaussian model is particularly impressive for options close to the expiration date, where its success rate rises above ninety percent.

Strategies for Countering Terrorist Safe Havens

DTIC Science & Technology

2013-12-01

tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to examine these strategies...safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to examine...pseudo operations—provide viable potential options for USSOF to counter the complex problem of safe havens. Overall, the case studies will demonstrate

Clarifying evacuation options through fire behavior and traffic modeling

Treesearch

Carol L. Rice; Ronny J. Coleman; Mike Price

2011-01-01

Communities are becoming increasingly concerned with the variety of choices related to wildfire evacuation. We used ArcView with Network Analyst to evaluate the different options for evacuations during wildfire in a case study community. We tested overlaying fire growth patterns with the road network and population characteristics to determine recommendations for...

Managing Recurrence in Intraarticular Melorheostosis Involving the Knee Joint: A Case Report

PubMed Central

John, Bobby; Sharma, Anirudh; Pandey, Ritesh A

2017-01-01

Introduction: Melorheostosis is a rare benign sclerosing dysplasia affecting bone, which causes significant morbidity in the form of pain and restriction of joint movement. Treatment options are varied, and recurrence is common after surgical treatment. Choosing the most appropriate treatment option in the management of a recurrent case is challenging, with very little supporting evidence in literature owing to the rarity of the disease. We hereby present a case of recurrent melorheostosis involving the knee; discuss treatment options and the rationale of our treatment. Case Report: We present the case of a 42-year-old female who was operated at our institution previously 7 years ago for melorheostosis of her left knee and had undergone excision of intrarticular hyperostotic masses. However, pain and limitation of motion recurred in the operated knee 4 years later, and radiographs and computed tomography revealed a mineralized mass situated behind the patella in the patellofemoral joint. She was treated with repeat open excision of the mass and put on a regimen of physiotherapy and bisphosphonates. Conclusion: Open excision of symptomatic hyperostotic or mineralized soft tissue masses is perhaps the favored treatment option in such cases, the other options being arthroscopic excision and total knee arthroplasty. Limited knee motion and size of the mass often make arthroscopy an unfeasible option. Total knee arthroplasty should be reserved for cases with significant flexion contractures of the knee, or where multiple excisions have failed. PMID:29242791

Managing Recurrence in Intraarticular Melorheostosis Involving the Knee Joint: A Case Report.

PubMed

John, Bobby; Sharma, Anirudh; Pandey, Ritesh A

2017-01-01

Melorheostosis is a rare benign sclerosing dysplasia affecting bone, which causes significant morbidity in the form of pain and restriction of joint movement. Treatment options are varied, and recurrence is common after surgical treatment. Choosing the most appropriate treatment option in the management of a recurrent case is challenging, with very little supporting evidence in literature owing to the rarity of the disease. We hereby present a case of recurrent melorheostosis involving the knee; discuss treatment options and the rationale of our treatment. We present the case of a 42-year-old female who was operated at our institution previously 7 years ago for melorheostosis of her left knee and had undergone excision of intrarticular hyperostotic masses. However, pain and limitation of motion recurred in the operated knee 4 years later, and radiographs and computed tomography revealed a mineralized mass situated behind the patella in the patellofemoral joint. She was treated with repeat open excision of the mass and put on a regimen of physiotherapy and bisphosphonates. Open excision of symptomatic hyperostotic or mineralized soft tissue masses is perhaps the favored treatment option in such cases, the other options being arthroscopic excision and total knee arthroplasty. Limited knee motion and size of the mass often make arthroscopy an unfeasible option. Total knee arthroplasty should be reserved for cases with significant flexion contractures of the knee, or where multiple excisions have failed.

Screening regional management options for their impact on climate resilience: an approach and case study in the Venen-Vechtstreek wetlands in the Netherlands.

PubMed

Wardekker, J A; Wildschut, D; Stemberger, S; van der Sluijs, J P

2016-01-01

Freshwater systems provide various resources and services. These are often vulnerable to climate change and other pressures. Therefore, enhancing resilience to climate change is important for their long term viability. This paper explores how management options can be evaluated on their resilience implications. The approach included five steps: (1) characterizing the system, (2) characterizing the impacts of climate change and other disturbances, (3) inventorying management options, (4) assessing the impacts of these on climate resilience, and (5) follow-up analysis. For the resilience assessment, we used a set of 'resilience principles': homeostasis, omnivory, high flux, flatness, buffering, and redundancy. We applied the approach in a case study in a Dutch wetlands region. Many options in the region's management plan contribute to resilience, however, the plan underutilised several principles, particularly flatness, but also redundancy and omnivory for agriculture, and high flux for nature. Co-benefits was identified as an important additional criterion to obtain support for adaptation from local stakeholders, such as farmers. The approach provided a relatively quick and participatory way to screen options. It allowed us to consider multiple impacts and sectors, multiple dimensions of resilience, and stakeholder perspectives. The results can be used to identify gaps or pitfalls, and set priorities for follow-up analyses.

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.

Cannabinoid Hyperemesis Syndrome and the Consulting Psychiatrist: A Case Study of Diagnosis and Treatment for an Emerging Disorder in Psychiatric Practice.

PubMed

Kast, Kristopher A; Gershengoren, Liliya

2018-01-01

The increasing prevalence of cannabis use in the United States requires awareness of cannabis-related disorders and familiarity with treatment options. We present a case of cannabinoid hyperemesis syndrome that required psychiatric consultation for diagnostic clarification and effective treatment with intravenous haloperidol. Literature from emergency medicine, toxicology, and gastroenterology is reviewed, including proposed diagnostic criteria for cannabinoid hyperemesis syndrome and reported off-label treatment options, with a specific focus on clinical questions facing the practicing psychiatrist regarding this emerging disorder.

Contaminated product water as the source of Phialemonium curvatum bloodstream infection among patients undergoing hemodialysis.

PubMed

Rao, Carol Y; Pachucki, Constance; Cali, Salvatore; Santhiraj, Mangai; Krankoski, Kathi L K; Noble-Wang, Judith A; Leehey, David; Popli, Subhash; Brandt, Mary E; Lindsley, Mark D; Fridkin, Scott K; Arduino, Matthew J

2009-09-01

We investigated a cluster of cases of bloodstream infection (BSI) due to the mold Phialemonium at a hemodialysis center in Illinois and conducted a cohort study to identify risk factors. Environmental assessment and cohort study. A hemodialysis center in a tertiary care hospital. A case patient was defined as a person who underwent dialysis at the center and had a blood sample that tested positive for Phialemonium curvatum on culture. We reviewed microbiology and medical records and tested water, surface, and dialysate samples by culture. Molds isolated from environmental and clinical specimens were identified by their morphological features and confirmed by sequencing DNA. We identified 2 case patients with BSI due to P. curvatum. Both became febrile and hypotensive while undergoing dialysis on the same machine at the same treatment station, although on different days. Dialysis machines were equipped with waste handling option ports that are used to discard dialyzer priming fluid. We isolated P. curvatum from the product water (ie, water used for dialysis purposes) at 2 of 19 treatment stations, one of which was the implicated station. The source of P. curvatum was likely the water distribution system. To our knowledge, this is the first report of patients acquiring a mold BSI from contaminated product water. The route of exposure in these cases of BSI due to P. curvatum may be related to the malfunction and improper maintenance of the waste handling option ports. Waste handling option ports have been previously implicated as the source of bacterial BSI due to the backflow of waste fluid into a patient's blood line. No additional cases of infection were noted after remediation of the water distribution system and after discontinuing use of waste handling option ports at the facility.

Format of Options in Multiple Choice Test vis-a-vis Test Performance

ERIC Educational Resources Information Center

Bendulo, Hermabeth O.; Tibus, Erlinda D.; Bande, Rhodora A.; Oyzon, Voltaire Q.; Milla, Norberto E.; Macalinao, Myrna L.

2017-01-01

Testing or evaluation in an educational context is primarily used to measure or evaluate and authenticate the academic readiness, learning advancement, acquisition of skills, or instructional needs of learners. This study tried to determine whether the varied combinations of arrangements of options and letter cases in a Multiple-Choice Test (MCT)…

76 FR 40798 - Antidrug and Alcohol Misuse Prevention Programs for Personnel Engaged in Specified Aviation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... includes contractors and subcontractors. Contracting companies have two testing options: Option one is for... case today and as such, there are no alternatives to the final rule that could have been considered and... stations would be classified as small business under NAICS 488180, the FAA reviewed a recent study...

Transfemoral Filter Eversion Technique following Unsuccessful Retrieval of Option Inferior Vena Cava Filters: A Single Center Experience.

PubMed

Posham, Raghuram; Fischman, Aaron M; Nowakowski, Francis S; Bishay, Vivian L; Biederman, Derek M; Virk, Jaskirat S; Kim, Edward; Patel, Rahul S; Lookstein, Robert A

2017-06-01

This report describes the technical feasibility of using the filter eversion technique after unsuccessful retrieval attempts of Option and Option ELITE (Argon Medical Devices, Inc, Athens, Texas) inferior vena cava (IVC) filters. This technique entails the use of endoscopic forceps to evert this specific brand of IVC filter into a sheath inserted into the common femoral vein, in the opposite direction in which the filter is designed to be removed. Filter eversion was attempted in 25 cases with a median dwell time of 134 days (range, 44-2,124 d). Retrieval success was 100% (25/25 cases), with an overall complication rate of 8%. This technique warrants further study. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

The next $120,000: a case study to illustrate analysis of alternative farm investments in fixed assets.

PubMed

St-Pierre, N R; Shoemaker, D; Jones, L R

2000-05-01

Dairy scientists specializing in the area of farm management are increasingly involved in analysis of farm investments in fixed assets. There have been instances where the wrong procedures were used to assess investments in fixed assets, leading to erroneous and possibly disastrous conclusions. A detailed case study of a dairy farm facing the decision of where best to invest an unexpected $120,000 windfall is used to illustrate the various facets of financial analysis. Indicators of profitability, liquidity, solvency, repayment capacity, and financial efficiency are explained and applied to the farm case to produce a detailed analysis of the current financial position of the firm. Long-range budgets of four alternate investment options and their impact on all financial indicators are presented. The four options are: 1) to pay down debt, 2) to purchase an additional 100 cows, 3) to install automatic milk yield recording in the parlor, and 4) to build new heifer facilities. All four investments are profitable. Therefore, an analysis limited to profitability indicators would conclude that any of the four options is a good investment. However, liquidity and financial efficiency issues showed that the option of purchasing 100 cows is far superior to the three others. We conclude that a complete and thorough financial analysis is required to evaluate the impact of long-run investments in fixed assets.

Risk management with substitution options: Valuing flexibility in small-scale energy systems

NASA Astrophysics Data System (ADS)

Knapp, Karl Eric

Several features of small-scale energy systems make them more easily adapted to a changing operating environment than large centralized designs. This flexibility is often manifested as the ability to substitute inputs. This research explores the value of this substitution flexibility and the marginal value of becoming a "little more flexible" in the context of real project investment in developing countries. The elasticity of substitution is proposed as a stylized measure of flexibility and a choice variable. A flexible alternative (elasticity > 0) can be thought of as holding a fixed-proportions "nflexible" asset plus a sequence of exchange options---the option to move to another feasible "recipe" each period. Substitutability derives value from following a contour of anticipated variations and from responding to new information. Substitutability value, a "cost savings option", increases with elasticity and price risk. However, the required premium to incrementally increase flexibility can in some cases decrease with an increase in risk. Variance is not always a measure of risk. Tools from stochastic dominance are newly applied to real options with convex payoffs to correct some misperceptions and clarify many common modeling situations that meet the criteria for increased variance to imply increased risk. The behavior of the cost savings option is explored subject to a stochastic input price process. At the point where costs are identical for all alternatives, the stochastic process for cost savings becomes deterministic, with savings directly proportional to elasticity of substitution and price variance. The option is also formulated as a derivative security via dynamic programming. The partial differential equation is solved for the special case of Cobb-Douglas (elasticity = 1) (also shown are linear (infinite elasticity), Leontief (elasticity = 0)). Risk aversion is insufficient to prefer a more flexible alternative with the same expected value. Intertemporal links convert the sequence of independent options to a single compound option and require an expansion of the flexibility concept. Additional options increase the value of the project but generally decrease flexibility value. The framework is applied to case study in India: an urban industry electricity strategy decision with reliability risk.

Issues in Retrospective Conversion for a Small Special Collection: A Case Study.

ERIC Educational Resources Information Center

Hieb, Fern

1997-01-01

Small special collections present unique problems for retrospective conversion of catalogs to machine-readable form. Examines retrospective conversion using the Moravian Music Foundation as a case study. Discusses advantages to automation, options for conversion process, quantifying conversion effort, costs, in-house conversion, national standards…

Integrated Bioprocess Design: A Case Study for Undergraduates.

ERIC Educational Resources Information Center

Titchener-Hooker, Nigel; Zhou, Yu-Hong

2000-01-01

Presents a case study for use in the teaching of bioprocess design. Taking the production and isolation of the intracellular protein s. cerevisae, demonstrates how undergraduates can use a range of data to construct and then investigate the range of processes flowsheet options available for a process duty. (Author/SAH)

Is Social Media Too Social for Class? A Case Study of Twitter Use

ERIC Educational Resources Information Center

Lin, Meng-Fen Grace; Hoffman, Ellen S.; Borengasser, Claire

2013-01-01

This qualitative case study examined Twitter use by undergraduate and graduate students in three classes. Previous studies have shown that while some faculty use Twitter, few are incorporating it into classes despite many recommendations for such use. This study examined how students perceived Twitter as a classroom tool. As an optional activity,…

Technical and economic assessment of different options for minor actinide transmutation: the French case

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

Chabert, C.; Coquelet-Pascal, C.; Saturnin, A.

Studies have been performed to assess the industrial perspectives of partitioning and transmutation of long-lived elements. These studies were carried out in tight connection with GEN-IV systems development. The results include the technical and economic evaluation of fuel cycle scenarios along with different options for optimizing the processes between the minor actinide transmutation in fast neutron reactors, their interim storage and geological disposal of ultimate waste. The results are analysed through several criteria (impacts on waste, on waste repository, on fuel cycle plants, on radiological exposure of workers, on costs and on industrial risks). These scenario evaluations take place inmore » the French context which considers the deployment of the first Sodium-cooled Fast Reactor (SFR) in 2040. 3 management options of minor actinides have been studied: no transmutation, transmutation in SFR and transmutation in an accelerator-driven system (ADS). Concerning economics the study shows that the cost overrun related to the transmutation process could vary between 5 to 9% in SFR and 26 % in the case of ADS.« less

When Opting Out Is Not a Choice: Implications for NCLB's Transfer Option from Charlotte, North Carolina

ERIC Educational Resources Information Center

Mickelson, Roslyn Arlin; Southworth, Stephanie

2005-01-01

A key provision of No Child Left Behind is the opportunity for students to transfer from a low-performing school to a high-performing one. Drawing from a case study of school reform in Charlotte, North Carolina, this article examines the implementation and early outcomes of NCLB's voluntary transfer option for the Charlotte-Mecklenburg School…

Study of a Secondary Power System Based on an Intermediate Bus Converter and POLs

NASA Astrophysics Data System (ADS)

Santoja, Almudena; Fernandez, Arturo; Tonicello, Ferdinando

2014-08-01

Secondary power systems in satellites are everything but standard nowadays. All sorts of options can be found and, in the end, a new custom design is used in most of the cases. Even though this might be interesting in some specific cases, for most of them it would be more convenient to have a straightforward system based on standard components. One of the options to achieve this is to design the secondary power system with an Intermediate Bus Converter (IBC) and Point of Load converters (POLs). This paper presents a study of this architecture and some experimental verifications to establish some basic rules devoted to achieve an optimum design of this system.

Path integral pricing of Wasabi option in the Black-Scholes model

NASA Astrophysics Data System (ADS)

Cassagnes, Aurelien; Chen, Yu; Ohashi, Hirotada

2014-11-01

In this paper, using path integral techniques, we derive a formula for a propagator arising in the study of occupation time derivatives. Using this result we derive a fair price for the case of the cumulative Parisian option. After confirming the validity of the derived result using Monte Carlo simulation, a new type of heavily path dependent derivative product is investigated. We derive an approximation for our so-called Wasabi option fair price and check the accuracy of our result with a Monte Carlo simulation.

Designing sustainable and economically attractive brownfield revitalization options using an integrated assessment model.

PubMed

Schädler, S; Morio, M; Bartke, S; Rohr-Zänker, R; Finkel, M

2011-03-01

We describe the development of an integrated assessment model which evaluates redevelopment options of large contaminated brownfields and we present the application of the model in a case study. Aiming to support efficient and sustainable revitalization and communication between stakeholders, the presented assessment model integrates three pinnacles of brownfield revitalization: (i) subsurface remediation and site preparation costs, (ii) market-oriented economic appraisal, and (iii) the expected contribution of planned future land use to sustainable community and regional development. For the assessment, focus is set on the early stage of the brownfield redevelopment process, which is characterized by limited data availability and by flexibility in land use planning and development scope. At this stage, revealing the consequences of adjustments and alterations in planning options can foster efficiency in communication between the involved parties and thereby facilitates the brownfield revitalization process. Results from the case-study application indicate that the integrated assessment provides help in the identification of land use options beneficial in both a sustainable and an economical sense. For the study site it is shown on one hand that brownfield redevelopment is not automatically in line with sustainable regional development, and on the other hand it is demonstrated that additional contributions to sustainability are not intrinsically tied to increased costs. Copyright © 2010 Elsevier Ltd. All rights reserved.

Management Options for Reducing the Release of Antibiotics and Antibiotic Resistance Genes to the Environment

PubMed Central

Pruden, Amy; Amézquita, Alejandro; Collignon, Peter; Brandt, Kristian K.; Graham, David W.; Lazorchak, James M.; Suzuki, Satoru; Silley, Peter; Snape, Jason R.; Topp, Edward; Zhang, Tong; Zhu, Yong-Guan

2013-01-01

Background: There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance. Objective: Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic-resistance determinants via environmental pathways, with the ultimate goal of extending the useful life span of antibiotics. We also examined incentives and disincentives for action. Methods: We focused on management options with respect to limiting agricultural sources; treatment of domestic, hospital, and industrial wastewater; and aquaculture. Discussion: We identified several options, such as nutrient management, runoff control, and infrastructure upgrades. Where appropriate, a cross-section of examples from various regions of the world is provided. The importance of monitoring and validating effectiveness of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action. Conclusions: Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little or no cost. Some management options are synergistic with existing policies and goals. The anticipated benefit is an extended useful life span for current and future antibiotics. Although risk reductions are often difficult to quantify, the severity of accelerating worldwide morbidity and mortality rates associated with antibiotic resistance strongly indicate the need for action. PMID:23735422

Economical and environmental analysis of thermal and photovoltaic solar energy as source of heat for industrial processes

NASA Astrophysics Data System (ADS)

Pérez-Aparicio, Elena; Lillo-Bravo, Isidoro; Moreno-Tejera, Sara; Silva-Pérez, Manuel

2017-06-01

Thermal energy for industrial processes can be generated using thermal (ST) or photovoltaic (PV) solar energy. ST energy has traditionally been the most favorable option due to its cost and efficiency. Current costs and efficiencies values make the PV solar energy become an alternative to ST energy as supplier of industrial process heat. The aim of this study is to provide a useful tool to decide in each case which option is economically and environmentally the most suitable alternative. The methodology used to compare ST and PV systems is based on the calculation of the levelized cost of energy (LCOE) and greenhouse gas emissions (GHG) avoided by using renewable technologies instead of conventional sources of energy. In both cases, these calculations depend on costs and efficiencies associated with ST or PV systems and the conversion factor from thermal or electrical energy to GHG. To make these calculations, a series of hypotheses are assumed related to consumer and energy prices, operation, maintenance and replacement costs, lifetime of the system or working temperature of the industrial process. This study applies the methodology at five different sites which have been selected taking into account their radiometric and meteorological characteristics. In the case of ST energy three technologies are taken into account, compound parabolic concentrator (CPC), linear Fresnel collector (LFC) and parabolic trough collector (PTC). The PV option includes two ways of use of generated electricity, an electrical resistance or a combination of an electrical resistance and a heat pump (HP). Current values of costs and efficiencies make ST system remains as the most favorable option. These parameters may vary significantly over time. The evolution of these parameters may convert PV systems into the most favorable option for particular applications.

Case Study: Online Continuing Education for New Librarians

ERIC Educational Resources Information Center

Hendrix, Beth R.; McKeal, Alyse E.

2017-01-01

Continuing education is vital for new librarians to gain skills and knowledge beyond library school. Professional development offered free in an online environment is often the best option for staying current on the issues and trends necessary for young librarians to grow and flourish. This paper presents a case study of an online professional…

Student Perceptions of Online Writing Center Designs for Fully Online Programs

ERIC Educational Resources Information Center

Simpson, Shelah Y.

2017-01-01

In this multiple-case study, the author investigated fully online students' perceptions of and experiences with asynchronous and synchronous writing support options of an institutional writing center and a commercial tutoring service. This dissertation used a multiple-case study design (Merriam, 1998, 2009; Yin, 2009) to ascertain which features…

Therapeutic options for intractable hematuria in advanced bladder cancer.

PubMed

Abt, Dominik; Bywater, Mirjam; Engeler, Daniel Stephan; Schmid, Hans-Peter

2013-07-01

Intractable hematuria is a common and severe complication in patients with inoperable bladder carcinoma. The aim was to provide an overview of therapeutic options for such cases, and analyze their effectiveness and risk profile, so a systematic literature search of peer-reviewed papers published up to September 2012 was carried out. Various options are available to treat hematuria in patients with inoperable bladder cancer; these include orally administered epsilon-aminocaproic acid, intravesical formalin, alum or prostaglandin irrigation, hydrostatic pressure, urinary diversion, radiotherapy, embolization and intraarterial mitoxantrone perfusion. These treatment options are associated with different prospects of success, risks and side-effects. Well-designed and large studies comparing options are completely lacking. Despite various treatment options, management of intractable hematuria in patients with inoperable bladder cancer remains a challenge, and most of the reported methods should be seen as experimental. Interventional radiology and alum instillation seem to be suitable alternative options for patients who, after critical consideration, cannot be treated by irrigation, transurethral resection or palliative cystectomy. © 2013 The Japanese Urological Association.

Implementing Comprehensive Reform of Introductory Physics at a Primarily Undergraduate Institution: A Longitudinal Case Study

ERIC Educational Resources Information Center

Rogers, Michael; Keller, Luke D .; Price, Matthew F.; Crouse, Andrew

2015-01-01

Education research provides a range of curricular reform options that can lead to improved student course outcomes. These options can appear easy to implement with the hope of immediate increases in student learning. In 2006 the Ithaca College Physics Department went down this path by moving all of their 100-level courses out of lecture halls and…

Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument.

PubMed

Couët, Nicolas; Desroches, Sophie; Robitaille, Hubert; Vaillancourt, Hugues; Leblanc, Annie; Turcotte, Stéphane; Elwyn, Glyn; Légaré, France

2015-08-01

We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking. (i) OPTION scores as reported outcomes and (ii) health-care providers and patients as study participants. For analysis, we only included studies using the revised scale. Extracted data included: (i) study and participant characteristics and (ii) OPTION outcomes (scores, statistical associations and reported psychometric results). We also assessed the quality of OPTION outcomes reporting. We found 33 eligible studies, 29 of which used the revised scale. Overall, we found low levels of patient-involving behaviours: in cases where no intervention was used to implement shared decision making (SDM), the mean OPTION score was 23 ± 14 (0-100 scale). When assessed, the variables most consistently associated with higher OPTION scores were interventions to implement SDM (n = 8/9) and duration of consultations (n = 8/15). Whatever the clinical context, few health-care providers consistently attempt to facilitate patient involvement, and even fewer adjust care to patient preferences. However, both SDM interventions and longer consultations could improve this. © 2013 John Wiley & Sons Ltd.

Pre-eruptive intracoronal resorption in a third upper molar: clinical, tomographic and histological analysis.

PubMed

Lenzi, R; Marceliano-Alves, M F; Alves, Frf; Pires, F R; Fidel, S

2017-06-01

Radiolucent or hypodense lesions in the crown of unerupted teeth may be due to pre-eruptive intracoronal resorption. Clinicians must be aware of this risk so that they can diagnose and appropriately treat this condition. The purpose of this study is to present a well-documented clinical case of pre-eruptive intracoronal resorption in an impacted third upper left molar of a 63 year old female patient. This was an unexpected finding, which occurred after cone-beam computed tomography was used to investigate the first upper left molar, which had an acute periradicular abscess. A multidisciplinary team followed up the case to describe clinical, radiographic and histological findings. The available treatment options were discussed, and the tooth extraction was the option chosen. Previous case studies describing such resorption in third upper molars have not been reported. This case shows that all permanent teeth in a pre-eruptive stage must be analysed radiographically to detect early pre-eruptive intracoronal resorption. © 2016 Australian Dental Association.

European option pricing under the Student's t noise with jumps

NASA Astrophysics Data System (ADS)

Wang, Xiao-Tian; Li, Zhe; Zhuang, Le

2017-03-01

In this paper we present a new approach to price European options under the Student's t noise with jumps. Through the conditional delta hedging strategy and the minimal mean-square-error hedging, a closed-form solution of the European option value is obtained under the incomplete information case. In particular, we propose a Value-at-Risk-type procedure to estimate the volatility parameter σ such that the pricing error is in accord with the risk preferences of investors. In addition, the numerical results of us show that options are not priced in some cases in an incomplete information market.

Penalty methods for the numerical solution of American multi-asset option problems

NASA Astrophysics Data System (ADS)

Nielsen, Bjørn Fredrik; Skavhaug, Ola; Tveito, Aslak

2008-12-01

We derive and analyze a penalty method for solving American multi-asset option problems. A small, non-linear penalty term is added to the Black-Scholes equation. This approach gives a fixed solution domain, removing the free and moving boundary imposed by the early exercise feature of the contract. Explicit, implicit and semi-implicit finite difference schemes are derived, and in the case of independent assets, we prove that the approximate option prices satisfy some basic properties of the American option problem. Several numerical experiments are carried out in order to investigate the performance of the schemes. We give examples indicating that our results are sharp. Finally, the experiments indicate that in the case of correlated underlying assets, the same properties are valid as in the independent case.

DEVELOPING AN INTEGRATED MANAGEMENT SYSTEM FOR URBAN AND ENERGY PLANNING TOWARDS A LOW-CARBON CITY

NASA Astrophysics Data System (ADS)

Maeda, Hideto; Nakakubo, Toyohiko; Tokai, Akihiro

In this study, we developed an integrated management model that supports local government to make a promising energy saving measure on a block-scale combined with urban planning. We applied the model to Osaka city and estimated CO2 emissions from the residential and commercial buildings to 2050. The urban renewal cases selected in this study included advanced multipole accumulation case, normal multipole accumulation case, and actual trend continuation case. The energy saving options introduced in each case included all-electric HP system, micro grid system, and we also set the option where the greater CO2 reduction one is selected in each block. The results showed that CO2 emission in 2050 would be reduced by 54.8-57.6% relative to the actual condition by introducing the new energy system in all cases. In addition, the amount of CO2 reduction in actual trend continuation case was highest. The major factor was that the effect of CO2 emission reductions by installing the solar power generation panel was higher than the effect by utilizing heated water mutually on the high-density blocks in terms of total urban buildings' energy consumption.

Mercury orbiter transport study

NASA Technical Reports Server (NTRS)

Friedlander, A. L.; Feingold, H.

1977-01-01

A data base and comparative performance analyses of alternative flight mode options for delivering a range of payload masses to Mercury orbit are provided. Launch opportunities over the period 1980-2000 are considered. Extensive data trades are developed for the ballistic flight mode option utilizing one or more swingbys of Venus. Advanced transport options studied include solar electric propulsion and solar sailing. Results show the significant performance tradeoffs among such key parameters as trip time, payload mass, propulsion system mass, orbit size, launch year sensitivity and relative cost-effectiveness. Handbook-type presentation formats, particularly in the case of ballistic mode data, provide planetary program planners with an easily used source of reference information essential in the preliminary steps of mission selection and planning.

Options for accounting carbon sequestration in German forests

PubMed Central

Krug, Joachim; Koehl, Michael; Riedel, Thomas; Bormann, Kristin; Rueter, Sebastian; Elsasser, Peter

2009-01-01

Background The Accra climate change talks held from 21–27 August 2008 in Accra, Ghana, were part of an ongoing series of meetings leading up to the Copenhagen meeting in December 2009. During the meeting a set of options for accounting carbon sequestration in forestry on a post-2012 framework was presented. The options include gross-net and net-net accounting and approaches for establishing baselines. Results This article demonstrates the embedded consequences of Accra Accounting Options for the case study of German national GHG accounting. It presents the most current assessment of sequestration rates by forest management for the period 1990 – 2007, provides an outlook of future emissions and removals (up to the year 2042) as related to three different management scenarios, and shows that implementation of some Accra options may reverse sources to sinks, or sinks to sources. Conclusion The results of the study highlight the importance of elaborating an accounting system that would prioritize the climate convention goals, not national preferences. PMID:19650896

Options for accounting carbon sequestration in German forests.

PubMed

Krug, Joachim; Koehl, Michael; Riedel, Thomas; Bormann, Kristin; Rueter, Sebastian; Elsasser, Peter

2009-08-03

The Accra climate change talks held from 21-27 August 2008 in Accra, Ghana, were part of an ongoing series of meetings leading up to the Copenhagen meeting in December 2009. During the meeting a set of options for accounting carbon sequestration in forestry on a post-2012 framework was presented. The options include gross-net and net-net accounting and approaches for establishing baselines. This article demonstrates the embedded consequences of Accra Accounting Options for the case study of German national GHG accounting. It presents the most current assessment of sequestration rates by forest management for the period 1990 - 2007, provides an outlook of future emissions and removals (up to the year 2042) as related to three different management scenarios, and shows that implementation of some Accra options may reverse sources to sinks, or sinks to sources. The results of the study highlight the importance of elaborating an accounting system that would prioritize the climate convention goals, not national preferences.

A Framework to Improve Surgeon Communication in High-Stakes Surgical Decisions: Best Case/Worst Case.

PubMed

Taylor, Lauren J; Nabozny, Michael J; Steffens, Nicole M; Tucholka, Jennifer L; Brasel, Karen J; Johnson, Sara K; Zelenski, Amy; Rathouz, Paul J; Zhao, Qianqian; Kwekkeboom, Kristine L; Campbell, Toby C; Schwarze, Margaret L

2017-06-01

Although many older adults prefer to avoid burdensome interventions with limited ability to preserve their functional status, aggressive treatments, including surgery, are common near the end of life. Shared decision making is critical to achieve value-concordant treatment decisions and minimize unwanted care. However, communication in the acute inpatient setting is challenging. To evaluate the proof of concept of an intervention to teach surgeons to use the Best Case/Worst Case framework as a strategy to change surgeon communication and promote shared decision making during high-stakes surgical decisions. Our prospective pre-post study was conducted from June 2014 to August 2015, and data were analyzed using a mixed methods approach. The data were drawn from decision-making conversations between 32 older inpatients with an acute nonemergent surgical problem, 30 family members, and 25 surgeons at 1 tertiary care hospital in Madison, Wisconsin. A 2-hour training session to teach each study-enrolled surgeon to use the Best Case/Worst Case communication framework. We scored conversation transcripts using OPTION 5, an observer measure of shared decision making, and used qualitative content analysis to characterize patterns in conversation structure, description of outcomes, and deliberation over treatment alternatives. The study participants were patients aged 68 to 95 years (n = 32), 44% of whom had 5 or more comorbid conditions; family members of patients (n = 30); and surgeons (n = 17). The median OPTION 5 score improved from 41 preintervention (interquartile range, 26-66) to 74 after Best Case/Worst Case training (interquartile range, 60-81). Before training, surgeons described the patient's problem in conjunction with an operative solution, directed deliberation over options, listed discrete procedural risks, and did not integrate preferences into a treatment recommendation. After training, surgeons using Best Case/Worst Case clearly presented a choice between treatments, described a range of postoperative trajectories including functional decline, and involved patients and families in deliberation. Using the Best Case/Worst Case framework changed surgeon communication by shifting the focus of decision-making conversations from an isolated surgical problem to a discussion about treatment alternatives and outcomes. This intervention can help surgeons structure challenging conversations to promote shared decision making in the acute setting.

Energy efficiency business options for industrial end users in Latin American competitive energy markets: The case of Colombia

NASA Astrophysics Data System (ADS)

Botero, Sergio

2002-01-01

Energy markets today in Latin America and worldwide are being restructured from monopolies, either state-owned or privately-owned, to be more openly competitive and incorporate more participation from the private sector. Thus, the schemes that were formerly developed to foster end use energy efficiency are no longer applicable because they were based on mandatory regulations made with political decisions, without sufficiently considering economic feasibility. A consensus exists that the only way energy efficiency could survive in this new paradigm is by being market oriented, giving better services, and additional options to users. However; there is very little information on what end users prefer, and which options would most satisfy customers. Using Colombia as a case study, this research determines and categorizes the energy efficiency business options for large energy end users that can freely participate in the competitive energy market. The energy efficiency market is understood as a market of services aiming to increase efficiency in energy use. These services can be grouped into seven business options. A survey, following the descriptive method, was sent to energy end users in order to determine their preferences for specific energy efficiency business options, as well as the decision-making criteria taken into account for such options. This data was categorized in ten industry groups. As a conclusion, energy efficiency providers should adapt not only to the economic activity or processes of each customer, but also to the potential business options. It was also found that not all industries consider performance contracting as their most preferred option, as a matter of fact, some industries show much higher preference for conventional business options. Among end users, the divergence in option preferences contrasted with the convergence in decision-making criteria. The decision-making criteria "cost-benefit ratio" overwhelmed all other criterion. End users appear to chose a specific energy efficiency option based mostly on obtaining better economic returns, giving low consideration to other criterion that feature differences among the energy efficiency options.

Optional games on cycles and complete graphs.

PubMed

Jeong, Hyeong-Chai; Oh, Seung-Yoon; Allen, Benjamin; Nowak, Martin A

2014-09-07

We study stochastic evolution of optional games on simple graphs. There are two strategies, A and B, whose interaction is described by a general payoff matrix. In addition, there are one or several possibilities to opt out from the game by adopting loner strategies. Optional games lead to relaxed social dilemmas. Here we explore the interaction between spatial structure and optional games. We find that increasing the number of loner strategies (or equivalently increasing mutational bias toward loner strategies) facilitates evolution of cooperation both in well-mixed and in structured populations. We derive various limits for weak selection and large population size. For some cases we derive analytic results for strong selection. We also analyze strategy selection numerically for finite selection intensity and discuss combined effects of optionality and spatial structure. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Case Study of Sustainability and Civic Engagement in a Sociology of Food Course

ERIC Educational Resources Information Center

De Welde, Kris

2015-01-01

This article presents a case study of a "Sociology of Food" course premised on issues of social justice and ethical and sustainable food practices. Through sustainability-inspired service-learning projects, students learn about the consequences of the industrial food system (e.g., farm-to-plate issues, local and organic options, animal…

Creating Regional Futures: A Scenario-Based Inter- and Transdisciplinary Case Study as a Model for Applied Student-Centred Learning in Geography

ERIC Educational Resources Information Center

Fromhold-Eisebith, Martina; Freyer, Bernhard; Mose, Ingo; Muhar, Andreas; Vilsmaier, Ulli

2009-01-01

Human geography students face changing qualification requirements due to a shift towards new topics, educational tasks and professional options regarding issues of spatial development. This "practical turn" raises the importance of inter- and transdisciplinary work, management and capability building skills, with case study projects and…

A Case Study of School Choice and Special Education in the 21st Century

ERIC Educational Resources Information Center

Bernier, Lisa E.

2017-01-01

School choice is deeply rooted in the marketization theories originally presented by Milton Friedman in the 1950s. There are many school choice options available in Arizona. The purpose and primary research question of this case study explored how a Free Appropriate Public Education (FAPE) and other factors influenced the parents' decisions to…

Transportation: Destination Mars

NASA Technical Reports Server (NTRS)

Eoff, Bill

1998-01-01

As the agency space transportation lead center, Marshall Space Flight Center has been conducting transportation assessments for future robotic and human Mars missions to identify critical technologies. Five human Mars options are currently under assessment with each option including all transportation requirements from Earth to Mars and return. The primary difference for each option is the propulsion source from Earth to Mars. In case any of the options require heavy launch capability that is not currently projected as available, an in-house study has been initiated to determine the most cost effective means of providing such launch capability. This assessment is only considering launch architectures that support the overall human Mars mission cost goal of $25B. The guidelines for the launch capability study included delivery of 80 metric ton (176 KLB) payloads, 25 feet diameter x 92 feet long, to 220 nmi orbits at 28.5 degrees. The launch vehicle concept of the study was designated "Magnum" to differentiate from prior heavy launch vehicle assessments. This assessment along with the assessment of options for all transportation phases of a Mars mission are on-going.

A feasibility study of municipal solid waste incineration fly ash utilisation in Estonia.

PubMed

Berber, Hakan; Frey, Ruedi; Voronova, Viktoria; Koroljova, Arina

2017-09-01

The purpose of this paper is to discuss the alternative environmental management options for the utilisation of municipal solid waste (MSW) incineration fly ash (FA), which is generated at Iru Power Plant where MSW is incinerated in Estonia. To determine sustainable and economically feasible environmental management options for MSW incineration FA in Estonia, CO 2 sequestration with a further carbonation process was examined. A partial Cost & Benefit Analysis has been conducted to compare the carbonation process to the current situation. Two carbonation options were developed. Option 1 is to use carbonated FA in any other processes based on the waste-to-product principle. Option 2 is to send carbonated FA to the non-hazardous landfill in Tallinn, Estonia. Important parameters, such as Net Present Value (NPV), Internal Rate of Return (IRR), Benefit-Cost Ratio (BCR) and Break Even Point (BEP), have been calculated for carbonation options and the current case. In addition, a sensitivity analysis has been conducted to examine its robustness. The results showed that the best option is carbonation Option 1 with NPV of 9,209,662 EUR, IRR of 43%, BCR of 2.63 and BEP between 2018 and 2019. Both Options 1 and 2 constitute more sustainable and environmentally friendly management options compared to the current situation. It can be concluded that this preliminary feasibility study showed that running a carbonation plant may be profitable and sustainable for Estonia. Currently, there is no treatment technology for MSW incineration FA in Estonia and FA is sent to a neighbouring country for further utilisation. This is the first study to demonstrate FA management options with economic and environmental benefits.

Standardised surveillance of Clostridium difficile infection in European acute care hospitals: a pilot study, 2013.

PubMed

van Dorp, Sofie M; Kinross, Pete; Gastmeier, Petra; Behnke, Michael; Kola, Axel; Delmée, Michel; Pavelkovich, Anastasia; Mentula, Silja; Barbut, Frédéric; Hajdu, Agnes; Ingebretsen, André; Pituch, Hanna; Macovei, Ioana S; Jovanović, Milica; Wiuff, Camilla; Schmid, Daniela; Olsen, Katharina Ep; Wilcox, Mark H; Suetens, Carl; Kuijper, Ed J

2016-07-21

Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for CDI cases) and an 'enhanced' option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe. This article is copyright of The Authors, 2016.

Technical and economic assessment of processes for the production of butanol and acetone. Phase two: analysis of research advances. Energy Conversion and Utilization Technologies Program

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

None

1984-08-01

The initial objective of this work was to develop a methodology for analyzing the impact of technological advances as a tool to help establish priorities for R and D options in the field of biocatalysis. As an example of a biocatalyzed process, butanol/acetone fermentation (ABE process) was selected as the specific topic of study. A base case model characterizing the technology and economics associated with the ABE process was developed in the previous first phase of study. The project objectives were broadened in this second phase of work to provide parametric estimates of the economic and energy impacts of amore » variety of research advances in the hydrolysis, fermentation and purification sections of the process. The research advances analyzed in this study were based on a comprehensive literature review. The six process options analyzed were: continuous ABE fermentaton; vacuum ABE fermentation; Baelene solvent extraction; HRI's Lignol process; improved prehydrolysis/dual enzyme hydrolysis; and improved microorganism tolerance to butanol toxicity. Of the six options analyzed, only improved microorganism tolerance to butanol toxicity had a significant positive effect on energy efficiency and economics. This particular process option reduced the base case production cost (including 10% DCF return) by 20% and energy consumption by 16%. Figures and tables.« less

Early Pregnancy Loss

MedlinePlus

... known pregnancies. What causes early pregnancy loss? About one half of cases of early pregnancy loss are caused by a ... do not show any signs of an infection, one option is to wait and let the ... may take longer in some cases. Another option is to take medication that helps ...

Cone beam volume tomography: an imaging option for diagnosis of complex mandibular third molar anatomical relationships.

PubMed

Danforth, Robert A; Peck, Jerry; Hall, Paul

2003-11-01

Complex impacted third molars present potential treatment complications and possible patient morbidity. Objectives of diagnostic imaging are to facilitate diagnosis, decision making, and enhance treatment outcomes. As cases become more complex, advanced multiplane imaging methods allowing for a 3-D view are more likely to meet these objectives than traditional 2-D radiography. Until recently, advanced imaging options were somewhat limited to standard film tomography or medical CT, but development of cone beam volume tomography (CBVT) multiplane 3-D imaging systems specifically for dental use now provides an alternative imaging option. Two cases were utilized to compare the role of CBVT to these other imaging options and to illustrate how multiplane visualization can assist the pretreatment evaluation and decision-making process for complex impacted mandibular third molar cases.

A Path Integral Approach to Option Pricing with Stochastic Volatility: Some Exact Results

NASA Astrophysics Data System (ADS)

Baaquie, Belal E.

1997-12-01

The Black-Scholes formula for pricing options on stocks and other securities has been generalized by Merton and Garman to the case when stock volatility is stochastic. The derivation of the price of a security derivative with stochastic volatility is reviewed starting from the first principles of finance. The equation of Merton and Garman is then recast using the path integration technique of theoretical physics. The price of the stock option is shown to be the analogue of the Schrödinger wavefunction of quantum mechanics and the exact Hamiltonian and Lagrangian of the system is obtained. The results of Hull and White are generalized to the case when stock price and volatility have non-zero correlation. Some exact results for pricing stock options for the general correlated case are derived.

45 CFR 7.4 - Option to acquire foreign rights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Option to acquire foreign rights. 7.4 Section 7.4... Option to acquire foreign rights. In any case where it is determined that all domestic rights should be...-wide regulations issued thereunder, that the Government shall reserve an option to require the...

Strategies for Countering Terrorist Safe Havens

DTIC Science & Technology

2014-02-20

within safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to...leadership targeting within safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case ...surrogate forces and pseudo operations—provide viable potential options for USSOF to counter the complex problem of safe havens. Overall, the case

Enhancing Leadership in Colleges and Universities: A Case Approach

ERIC Educational Resources Information Center

Sandeen, Arthur

2011-01-01

In view of the serious challenges facing college and university administrators, it is encouraging to note the increased interest in improving leadership knowledge and skills. This book presents an additional option to college and university administrators in their efforts to enhance their leadership skills. The case study approach to improving…

Implementing and Analyzing Social Media in Higher Education

ERIC Educational Resources Information Center

Davis, Jenny L.; Compton, D'Lane; Farris, D. Nicole; Love, Tony P.

2015-01-01

This article examines how social media can incorporate into the higher education setting in meaningful ways using optional participation, active content production, and active moderation. The authors use two authoethnographic case studies. The first case pertains to pedagogical use through a student created and maintained Facebook group for a…

Efficient Trajectory Options Allocation for the Collaborative Trajectory Options Program

NASA Technical Reports Server (NTRS)

Rodionova, Olga; Arneson, Heather; Sridhar, Banavar; Evans, Antony

2017-01-01

The Collaborative Trajectory Options Program (CTOP) is a Traffic Management Initiative (TMI) intended to control the air traffic flow rates at multiple specified Flow Constrained Areas (FCAs), where demand exceeds capacity. CTOP allows flight operators to submit the desired Trajectory Options Set (TOS) for each affected flight with associated Relative Trajectory Cost (RTC) for each option. CTOP then creates a feasible schedule that complies with capacity constraints by assigning affected flights with routes and departure delays in such a way as to minimize the total cost while maintaining equity across flight operators. The current version of CTOP implements a Ration-by-Schedule (RBS) scheme, which assigns the best available options to flights based on a First-Scheduled-First-Served heuristic. In the present study, an alternative flight scheduling approach is developed based on linear optimization. Results suggest that such an approach can significantly reduce flight delays, in the deterministic case, while maintaining equity as defined using a Max-Min fairness scheme.

Interest rates in quantum finance: Caps, swaptions and bond options

NASA Astrophysics Data System (ADS)

Baaquie, Belal E.

2010-01-01

The prices of the main interest rate options in the financial markets, derived from the Libor (London Interbank Overnight Rate), are studied in the quantum finance model of interest rates. The option prices show new features for the Libor Market Model arising from the fact that, in the quantum finance formulation, all the different Libor payments are coupled and (imperfectly) correlated. Black’s caplet formula for quantum finance is given an exact path integral derivation. The coupon and zero coupon bond options as well as the Libor European and Asian swaptions are derived in the framework of quantum finance. The approximate Libor option prices are derived using the volatility expansion. The BGM-Jamshidian (Gatarek et al. (1996) [1], Jamshidian (1997) [2]) result for the Libor swaption prices is obtained as the limiting case when all the Libors are exactly correlated. A path integral derivation is given of the approximate BGM-Jamshidian approximate price.

Palliative Care Options for a Young Adult Patient with a Diffuse Intrinsic Pontine Glioma.

PubMed

Sison, Julian; Tran, Hung; Margol, Ashley; Tiwari, Nishant; Garcia, Karla M; Cotter, Jennifer; Kiehna, Erin; Olch, Arthur J; Wong, Kenneth

2017-08-18

Diffuse intrinsic pontine gliomas (DIPGs) are rare but devastating brain tumors that occur primarily in children. These gliomas have poor prognoses and present options focus on palliation of symptoms and prolongation of life. Here, we present a case of a 16-year-old female diagnosed with a DIPG whose age group has been mostly left out of discussions regarding psychosocial support options. This report is meant to start a conversation about the different support options available at our institution that have shown promising results in the literature for palliative care applications. These options can include camps for patients with brain tumors, psychological counseling, the Ronald McDonald House, and other psychosocial programs. Many of these programs can be tailored to meet the specific needs of adolescent and young adult (AYA) patients and will hopefully be integrated into a comprehensive palliative care regimen in future studies.

Teaching as Coaching: A Case Study of Awareness and Learning in Engineering Education

ERIC Educational Resources Information Center

Gynnild, Vidar; Holstad, Anders; Myrhaug, Dag

2007-01-01

This paper presents a number of case studies in Oceanography, an optional module in the third/fourth year of a Master of Science programme at Norwegian University of Science and Technology. The main objective was to gain more thorough insights into student learning by examining two sets of individual oral examinations. In addition, all students…

Learning Te Reo Maori via Online Distance Education: A Case Study

ERIC Educational Resources Information Center

Jeurissen, Maree

2015-01-01

Despite some gains in the regeneration of te reo Maori, the indigenous language of Aotearoa New Zealand, its long-term survival remains threatened. One avenue for regeneration seldom considered is the English-medium secondary school. This article reports on a case study where students in one such school chose te reo Maori as an option and, and,…

Technological Diversity: A Case Study into Language Learners' Mobile Technology Use Inside and Outside the Classroom

ERIC Educational Resources Information Center

Brick, Billy; Cervi-Wilson, Tiziana

2015-01-01

The speed of technological advance in the mobile phone, netbook and tablet markets has meant that learners increasingly have access to digital devices capable of enhancing their learning experience. This case study reports on how language learners, taking Italian as an option on the Institution Wide Languages Programme (IWLP) at Coventry…

Leadership in Boys' Education: 16 Case Studies from Public and Private, Rural and Urban, Primary and Secondary Schools.

ERIC Educational Resources Information Center

Fletcher, Richard, Ed.; Hartman, Deborah, Ed.; Browne, Rollo, Ed.

Concern about boys' education in Australia and New Zealand led to the Leadership in Boys' Education Conference in May 1999. This book contains edited conference presentations focusing on boys' educational needs. The book also presents case studies related to academic achievement, school structure, discipline and bullying, broadening boys' options,…

Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review

PubMed Central

Choi, Haemi; McCartney, Michael; Best, Thomas M

2013-01-01

Objectives The authors examined the most current evidence for treatment options in athletes with osteitis pubis and osteomyelitis pubis, attempting to determine which options provide optimal pain relief with rapid return to sport and prevention of symptom reoccurrence. Methods Three databases—MEDLINE, Cochrane Database of Systematic Reviews and CINAHL—were searched using the OVID interface for all years between 1985 and May 2008. References were analysed from included studies, and additional relevant articles were obtained for inclusion. Inclusion criteria included (1) humans only, (2) subjects had no apparent risk factors for development of osteitis pubis or osteomyelitis of the pubic symphysis other than athletic involvement, (3) both physical exam findings and diagnostic imaging were used to confirm either diagnosis, and (4) a definitive treatment strategy was identifiable for management of osteitis pubis or osteomyelitis of the pubic symphysis. In total, 25 articles were included in the review. Results There were no randomised controlled trials identified with this study’s search strategy. A total of 195 athletes were diagnosed as having osteitis pubis (186 males, nine females) and treated with either conservative measures/physical therapy, local injection with corticosteroids and/or local anaesthetic, dextrose prolotherapy, surgery or antibiotic therapy. Six case reports/series described conservative treatment measures (physical therapy, rest, non-steroid anti-inflammatory drugs). Four case series explored the use of corticosteroid injections in treatment. One case series described the use of dextrose prolotherapy as a treatment modality. Six case series described various surgical techniques (pubic symphysis curettage, polypropylene mesh placement and pubic bone stabilisation) in treatment. Ten case reports/ series (10 subjects) outlined antibiotic treatment of osteomyelitis of the pubic symphysis. Conclusions The current medical literature shows only level 4 evidence of the treatment for osteitis pubis in 24 case reports/series in athletes. Without any direct comparison of treatment modalities, it is difficult to determine which individual treatment option is the most efficacious. Further study comparing the different treatment options is necessary to determine which modality provides the fastest return to sport. PMID:18812419

Validation Test Report For The CRWMS Analysis and Logistics Visually Interactive Model Calvin Version 3.0, 10074-Vtr-3.0-00

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

S. Gillespie

2000-07-27

This report describes the tests performed to validate the CRWMS ''Analysis and Logistics Visually Interactive'' Model (CALVIN) Version 3.0 (V3.0) computer code (STN: 10074-3.0-00). To validate the code, a series of test cases was developed in the CALVIN V3.0 Validation Test Plan (CRWMS M&O 1999a) that exercises the principal calculation models and options of CALVIN V3.0. Twenty-five test cases were developed: 18 logistics test cases and 7 cost test cases. These cases test the features of CALVIN in a sequential manner, so that the validation of each test case is used to demonstrate the accuracy of the input to subsequentmore » calculations. Where necessary, the test cases utilize reduced-size data tables to make the hand calculations used to verify the results more tractable, while still adequately testing the code's capabilities. Acceptance criteria, were established for the logistics and cost test cases in the Validation Test Plan (CRWMS M&O 1999a). The Logistics test cases were developed to test the following CALVIN calculation models: Spent nuclear fuel (SNF) and reactivity calculations; Options for altering reactor life; Adjustment of commercial SNF (CSNF) acceptance rates for fiscal year calculations and mid-year acceptance start; Fuel selection, transportation cask loading, and shipping to the Monitored Geologic Repository (MGR); Transportation cask shipping to and storage at an Interim Storage Facility (ISF); Reactor pool allocation options; and Disposal options at the MGR. Two types of cost test cases were developed: cases to validate the detailed transportation costs, and cases to validate the costs associated with the Civilian Radioactive Waste Management System (CRWMS) Management and Operating Contractor (M&O) and Regional Servicing Contractors (RSCs). For each test case, values calculated using Microsoft Excel 97 worksheets were compared to CALVIN V3.0 scenarios with the same input data and assumptions. All of the test case results compare with the CALVIN V3.0 results within the bounds of the acceptance criteria. Therefore, it is concluded that the CALVIN V3.0 calculation models and options tested in this report are validated.« less

Endovascular Management of Central Retinal Arterial Occlusion.

PubMed

Agarwal, Nitin; Gala, Nihar B; Baumrind, Benjamin; Hansberry, David R; Thabet, Ahmad M; Gandhi, Chirag D; Prestigiacomo, Charles J

2016-11-01

Central retinal artery occlusion (CRAO) is an ophthalmologic emergency due to the sudden cessation of circulation to the inner retinal layer. Without immediate treatment, permanent blindness may ensue. Several treatment options exist, ranging from noninvasive medical management to thrombolysis. Nonetheless, ongoing debate exists regarding the best therapeutic strategy. The authors present the case of a 78-year-old woman with a medical history of hypercholesterolemia and rheumatoid arthritis who experienced complete loss of vision in her left eye. Following ophthalmologic evaluation demonstrating left CRAO, anterior chamber paracentesis was performed. Endovascular intervention was performed via local intra-arterial fibrinolysis with alteplase. Her vision returned to 20/20 following the procedure. In general, conventional therapies have not significantly improved patient outcomes. Several management options exist for CRAO. In general, conservative measures have not been reported to yield better patient outcomes as compared to the natural history of this medical emergency. Endovascular approaches are another option as observed with this case reported. In cases of CRAO, therapeutic strategies such as intra-arterial fibrinolysis utilize a local infusion of reactive tissue plasminogen activator directly at the site of occlusion via catheterization of the ophthalmic artery. Although several case series do show promising results after treating CRAO with intra-arterial fibrinolysis, further studies are required given the reports of complications.

Comparison of different options for harvest of a therapeutic protein product from high cell density yeast fermentation broth.

PubMed

Wang, Alice; Lewus, Rachael; Rathore, Anurag S

2006-05-05

Recovery of therapeutic protein from high cell density yeast fermentations at commercial scale is a challenging task. In this study, we investigate and compare three different harvest approaches, namely centrifugation followed by depth filtration, centrifugation followed by filter-aid enhanced depth filtration, and microfiltration. This is achieved by presenting a case study involving recovery of a therapeutic protein from Pichia pastoris fermentation broth. The focus of this study is on performance of the depth filtration and the microfiltration steps. The experimental data has been fitted to the conventional models for cake filtration to evaluate specific cake resistance and cake compressibility. In the case of microfiltration, the experimental data agrees well with flux predicted by shear induced diffusion model. It is shown that, under optimal conditions, all three options can deliver the desired product recovery ( >80%), harvest time ( <15 h including sequential concentration/diafiltration step), and clarification ( <6 NTU). However, the three options differ in terms of process development time required, capital cost, consumable cost, ease of scale-ability and process robustness. It is recommended that these be kept under consideration when making a final decision on a harvesting approach.

A curative treatment option for Complex Regional Pain Syndrome (CRPS) Type I: dorsal root entry zone operation (report of two cases).

PubMed

Kanpolat, Yucel; Al-Beyati, Eyyub; Ugur, Hasan Caglar; Akpinar, Gokhan; Kahilogullari, Gokmen; Bozkurt, Melih

2014-01-01

Complex Regional Pain Syndrome Type I (CRPS-I) is a debated health problem concerning its pathophysiology and treatment strategies. A 12-year-old boy and a 35-year-old woman were diagnosed with CRPS-I at different times. They had previously undergone various types of interventions with no success. After one year of follow-up and observation, DREZ lesioning operation was performed. Afterwards, both cases had transient lower extremity ataxia. The first case was followed for 60 months with no recurrence and total cure. The second case was pain-free until the 6th month, when she required psychological support; she was followed for 33 months with partial satisfactory outcome. Although not a first-line option, DREZ lesioning procedure can be chosen and may be a curative option in selected cases of CRPS-I who are unresponsive to conventional therapies.

What Works Clearinghouse Standards and Generalization of Single-Case Design Evidence

ERIC Educational Resources Information Center

Hitchcock, John H.; Kratochwill, Thomas R.; Chezan, Laura C.

2015-01-01

A recent review of existing rubrics designed to help researchers evaluate the internal and external validity of single-case design (SCD) studies found that the various options yield consistent results when examining causal arguments. The authors of the review, however, noted considerable differences across the rubrics when addressing the…

The option to abandon: stimulating innovative groundwater remediation technologies characterized by technological uncertainty.

PubMed

Compernolle, T; Van Passel, S; Huisman, K; Kort, P

2014-10-15

Many studies on technology adoption demonstrate that uncertainty leads to a postponement of investments by integrating a wait option in the economic analysis. The aim of this study however is to demonstrate how the investment in new technologies can be stimulated by integrating an option to abandon. Furthermore, this real option analysis not only considers the ex ante decision analysis of the investment in a new technology under uncertainty, but also allows for an ex post evaluation of the investment. Based on a case study regarding the adoption of an innovative groundwater remediation strategy, it is demonstrated that when the option to abandon the innovative technology is taken into account, the decision maker decides to invest in this technology, while at the same time it determines an optimal timing to abandon the technology if its operation proves to be inefficient. To reduce uncertainty about the effectiveness of groundwater remediation technologies, samples are taken. Our analysis shows that when the initial belief in an effective innovative technology is low, it is important that these samples provide correct information in order to justify the adoption of the innovative technology. Copyright © 2014 Elsevier B.V. All rights reserved.

After a merger: the dilemma of the best leadership approach for nursing.

PubMed

Porter-O'Grady, T; Bradley, C; Crow, G; Hendrich, A L

1997-01-01

The following case study exemplifies for the nurse leader some of the difficulties involved in making a merger work and selecting the best options to sustain nursing services following the merger. Three nurse leaders look at the case study from a variety of viewpoints and suggest a range of responses that gives the reader an opportunity to consider a selection of insights that best address the issues presented in the case study. All of the respondents have been involved in complex mergers and bring a depth of experience to their review of the case.

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

PubMed

Windfuhr, Jochen P

2016-01-01

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

Addressing uncertainty in adaptation planning for agriculture.

PubMed

Vermeulen, Sonja J; Challinor, Andrew J; Thornton, Philip K; Campbell, Bruce M; Eriyagama, Nishadi; Vervoort, Joost M; Kinyangi, James; Jarvis, Andy; Läderach, Peter; Ramirez-Villegas, Julian; Nicklin, Kathryn J; Hawkins, Ed; Smith, Daniel R

2013-05-21

We present a framework for prioritizing adaptation approaches at a range of timeframes. The framework is illustrated by four case studies from developing countries, each with associated characterization of uncertainty. Two cases on near-term adaptation planning in Sri Lanka and on stakeholder scenario exercises in East Africa show how the relative utility of capacity vs. impact approaches to adaptation planning differ with level of uncertainty and associated lead time. An additional two cases demonstrate that it is possible to identify uncertainties that are relevant to decision making in specific timeframes and circumstances. The case on coffee in Latin America identifies altitudinal thresholds at which incremental vs. transformative adaptation pathways are robust options. The final case uses three crop-climate simulation studies to demonstrate how uncertainty can be characterized at different time horizons to discriminate where robust adaptation options are possible. We find that impact approaches, which use predictive models, are increasingly useful over longer lead times and at higher levels of greenhouse gas emissions. We also find that extreme events are important in determining predictability across a broad range of timescales. The results demonstrate the potential for robust knowledge and actions in the face of uncertainty.

Addressing uncertainty in adaptation planning for agriculture

PubMed Central

Vermeulen, Sonja J.; Challinor, Andrew J.; Thornton, Philip K.; Campbell, Bruce M.; Eriyagama, Nishadi; Vervoort, Joost M.; Kinyangi, James; Jarvis, Andy; Läderach, Peter; Ramirez-Villegas, Julian; Nicklin, Kathryn J.; Hawkins, Ed; Smith, Daniel R.

2013-01-01

We present a framework for prioritizing adaptation approaches at a range of timeframes. The framework is illustrated by four case studies from developing countries, each with associated characterization of uncertainty. Two cases on near-term adaptation planning in Sri Lanka and on stakeholder scenario exercises in East Africa show how the relative utility of capacity vs. impact approaches to adaptation planning differ with level of uncertainty and associated lead time. An additional two cases demonstrate that it is possible to identify uncertainties that are relevant to decision making in specific timeframes and circumstances. The case on coffee in Latin America identifies altitudinal thresholds at which incremental vs. transformative adaptation pathways are robust options. The final case uses three crop–climate simulation studies to demonstrate how uncertainty can be characterized at different time horizons to discriminate where robust adaptation options are possible. We find that impact approaches, which use predictive models, are increasingly useful over longer lead times and at higher levels of greenhouse gas emissions. We also find that extreme events are important in determining predictability across a broad range of timescales. The results demonstrate the potential for robust knowledge and actions in the face of uncertainty. PMID:23674681

The utility of case formulation in treatment decision making; the effect of experience and expertise.

PubMed

Dudley, Robert; Ingham, Barry; Sowerby, Katy; Freeston, Mark

2015-09-01

We examined whether case formulation guides the endorsement of appropriate treatment strategies. We also considered whether experience and training led to more effective treatment decisions. To examine these questions two related studies were conducted both of which used a novel paradigm using clinically relevant decision-making tasks with multiple sources of information. Study one examined how clinicians utilised a pre-constructed CBT case formulation to plan treatment. Study two utilised a clinician-generated formulation to further examine the process of formulation development and the impact on treatment planning. Both studies considered the effect of therapist experience. Both studies indicated that clinicians used the case formulation to select treatment choices that were highly matched to the case as described in the vignette. However, differences between experts and novice clinicians were only demonstrated when clinicians developed their own formulations of case material. When they developed their own formulations the experts' formulations were more parsimonious, internally consistent, and contained fewer errors and the experts were less swayed by irrelevant treatment options. The nature of the experimental task, involving ratings of suitability of possible treatment options suggested for the case, limits the interpretation that formulation directs the development or generation of the clinician's treatment plan. In study two the task may still have limited the capacity to demonstrate further differences between expert and novice therapists. Formulation helps guide certain aspects of effective treatment decision making. When asked to generate a formulation clinicians with greater experience and expertise do this more effectively. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Negative pressure wound therapy with Bio-Dome dressing technology in the treatment of complex wounds: a case series.

PubMed

Penny, H L; Spinazzola, J; Green, A; Rifkah, M; Faretta, M; Youshaw, D; Weaver, A; Zaki, P

2014-04-01

The treatment of complex wounds is difficult and not always effective. Various treatment options are used with varying degrees of success. Negative pressure wound therapy (NPWT) is a cost-efficient and effective way to help treat these wounds. The use of a vacuum device applies the negative pressure to the site of the wound and promotes waste removal and increases circulation and tissue formation. While various NPWT systems are currently on the market, we utilised the ConvaTec Engenex® system with Bio-DomeTM technology; however, our case study is not intended to advocate the specific use of this system, but instead focuses on the use of NPWT as a viable option for wound healing. Each of the following case study patients presented with difficult-to-heal wounds that failed traditional therapeutic approaches. Through the use of NPWT, our patients saw major wound size reductions. Each patient exhibited at least a 94% reduction in wound area, wound volume or both.

Incorporation of Outcome-Based Contract Requirements in a Real Options Approach for Maintenance Planning

DTIC Science & Technology

2016-04-30

focus on novel onshore/offshore and small/large scale wind turbine designs for expanding their operational range and increasing their efficiency at...of maintenance options created by the implementation of PHM in wind turbines . When an RUL is predicted for a subsystem, there are multiple choices...The section titled Example— Wind Turbine With an Outcome-Based Contract presents a case study for a PHM enabled wind turbine with and without an

Greenhouse gas emission reduction: A case study of Sri Lanka

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

Meier, P.; Munasinghe, M.

1995-12-31

In this paper we describe a case study for Sri Lanka that explores a wide range of options for reducing greenhouse gas (GHG) emissions. Options range from renewable technologies to carbon taxes and transportation sector initiatives. We find that setting electricity prices to reflect long-run marginal cost has a significant beneficial impact on the environment, and the expected benefits predicted on theoretical grounds are confirmed by the empirical results. Pricing reform also has a much broader impact than physical approaches to demand side management, although several options such as compact fluorescent lighting appear to have great potential. Options to reducemore » GHG emissions are limited as Sri Lanka lacks natural gas, and nuclear power is not practical until the system reaches a much larger size. Building the few remaining large hydro facilities would significantly reduce GHG emissions, but these would require costly resettlement programs. Given the inevitability for fossil-fuel base load generation, both clean coal technologies such as pressurized fluidized bed combustion, as well as steam-cycle residual oil fueled plants merit consideration as alternatives to the conventional pulverized coal-fired plants currently being considered. Transportation sector measures necessary to ameliorate local urban air pollution problems, such as vehicle inspection and maintenance programs, also bring about significant reductions of GHG emissions. 51 refs., 10 figs., 3 tabs.« less

Greenhouse Gas and Ammonia Emissions from Different Stages of Liquid Manure Management Chains: Abatement Options and Emission Interactions.

PubMed

Mohankumar Sajeev, Erangu Purath; Winiwarter, Wilfried; Amon, Barbara

2018-01-01

Farm livestock manure is an important source of ammonia and greenhouse gases. Concerns over the environmental impact of emissions from manure management have resulted in research efforts focusing on emission abatement. However, questions regarding the successful abatement of manure-related emissions remain. This study uses a meta-analytical approach comprising 89 peer-reviewed studies to quantify emission reduction potentials of abatement options for liquid manure management chains from cattle and pigs. Analyses of emission reductions highlight the importance of accounting for interactions between emissions. Only three out of the eight abatement options considered (frequent removal of manure, anaerobic digesters, and manure acidification) reduced ammonia (3-60%), nitrous oxide (21-55%), and methane (29-74%) emissions simultaneously, whereas in all other cases, tradeoffs were identified. The results demonstrate that a shift from single-stage emission abatement options towards a whole-chain perspective is vital in reducing overall emissions along the manure management chain. The study also identifies some key elements like proper clustering, reporting of influencing factors, and explicitly describing assumptions associated with abatement options that can reduce variability in emission reduction estimates. Prioritization of abatement options according to their functioning can help to determine low-risk emission reduction options, specifically options that alter manure characteristics (e.g., reduced protein diets, anaerobic digestion, or slurry acidification). These insights supported by comprehensive emission measurement studies can help improve the effectiveness of emission abatement and harmonize strategies aimed at reducing air pollution and climate change simultaneously. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Identifying the values and preferences of prosthetic users: a case study series using the repertory grid technique.

PubMed

Schaffalitzky, Elisabeth; NiMhurchadha, Sinead; Gallagher, Pamela; Hofkamp, Susan; MacLachlan, Malcolm; Wegener, Stephen T

2009-06-01

The matching of prosthetic devices to the needs of the individual is a challenge for providers and patients. The aims of this study are to explore the values and preferences that prosthetic users have of their prosthetic devices; to investigate users' perceptions of alternative prosthetic options and to demonstrate a novel method for exploring the values and preferences of prosthetic users. This study describes four case studies of upper limb and lower limb high tech and conventional prosthetic users. Participants were interviewed using the repertory grid technique (RGT), a qualitative technique to explore individual values and preferences regarding specific choices and events. The participants generated distinctive patterns of personal constructs and ratings regarding prosthetic use and different prosthetic options available. The RGT produced a unique profile of preferences regarding prosthetic technologies for each participant. User choice is an important factor when matching prosthetic technology to the user. The consumer's values regarding different prosthetic options are likely to be a critical factor in prosthetic acceptance and ultimate quality of life. The RGT offers a structured method of exploring these attitudes and values without imposing researcher or practitioner bias and identifies personalized dimensions for providers and users to evaluate the individuals' preferences in prosthetic technology.

Remotely Piloted Innovation: Terrorism, Drones and Supportive Technology

DTIC Science & Technology

2016-10-01

study aims to elevate the discussion of this phenomenon beyond one -off cases to a consideration of what is, at least for some groups, a more...Off Cases Are Mixed—More Inspired and Less Networked Only one of the thirteen individual cases reviewed for this report has proven ties to al-Qa`ida...harm on innocents, they likely tell a different story. To put it simply, these two private cases highlight options beyond what other terrorist entities

Case studies of pre-engineered and manufactured sound isolation rooms for music practice and radio broadcast

NASA Astrophysics Data System (ADS)

Probst, Ron N.; Rypka, Dann

2005-09-01

Pre-engineered and manufactured sound isolation rooms were developed to ensure guaranteed sound isolation while offering the unique ability to be disassembled and relocated without loss of acoustic performance. Case studies of pre-engineered sound isolation rooms used for music practice and various radio broadcast purposes are highlighted. Three prominent universities wrestle with the challenges of growth and expansion while responding to the specialized acoustic requirements of these spaces. Reduced state funding for universities requires close examination of all options while ensuring sound isolation requirements are achieved. Changing curriculum, renovation, and new construction make pre-engineered and manufactured rooms with guaranteed acoustical performance good investments now and for the future. An added benefit is the optional integration of active acoustics to provide simulations of other spaces or venues along with the benefit of sound isolation.

Voice and choice by delegation.

PubMed

van de Bovenkamp, Hester; Vollaard, Hans; Trappenburg, Margo; Grit, Kor

2013-02-01

In many Western countries, options for citizens to influence public services are increased to improve the quality of services and democratize decision making. Possibilities to influence are often cast into Albert Hirschman's taxonomy of exit (choice), voice, and loyalty. In this article we identify delegation as an important addition to this framework. Delegation gives individuals the chance to practice exit/choice or voice without all the hard work that is usually involved in these options. Empirical research shows that not many people use their individual options of exit and voice, which could lead to inequality between users and nonusers. We identify delegation as a possible solution to this problem, using Dutch health care as a case study to explore this option. Notwithstanding various advantages, we show that voice and choice by delegation also entail problems of inequality and representativeness.

Defense Health Care: Additional Analysis of Costs and Benefits of Potential Governance Structures Is Needed

DTIC Science & Technology

2012-09-01

options, (2) a business case analysis and strategy for implementing its shared services concept, and (3) more complete analyses of the options’ strengths...and weaknesses. DoD concurred with developing a business case analysis for its shared services concept. DoD did not concur with the other two

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

Vanderbei, Robert J., E-mail: rvdb@princeton.edu; P Latin-Small-Letter-Dotless-I nar, Mustafa C., E-mail: mustafap@bilkent.edu.tr; Bozkaya, Efe B.

An American option (or, warrant) is the right, but not the obligation, to purchase or sell an underlying equity at any time up to a predetermined expiration date for a predetermined amount. A perpetual American option differs from a plain American option in that it does not expire. In this study, we solve the optimal stopping problem of a perpetual American option (both call and put) in discrete time using linear programming duality. Under the assumption that the underlying stock price follows a discrete time and discrete state Markov process, namely a geometric random walk, we formulate the pricing problemmore » as an infinite dimensional linear programming (LP) problem using the excessive-majorant property of the value function. This formulation allows us to solve complementary slackness conditions in closed-form, revealing an optimal stopping strategy which highlights the set of stock-prices where the option should be exercised. The analysis for the call option reveals that such a critical value exists only in some cases, depending on a combination of state-transition probabilities and the economic discount factor (i.e., the prevailing interest rate) whereas it ceases to be an issue for the put.« less

Reaching High-Risk Youth through Model AIDS Education Programs: A Case by Case Study.

ERIC Educational Resources Information Center

Center for Population Options, Washington, DC.

This report evaluates the High Risk Youth Demonstration Project, which is predicated on the idea that youth-serving agencies (YSAs) can be key sources for adolescent AIDS education. When the Center for Population Options (CPO) conceptualized a strategy for bringing AIDS education to underserved youth, it was responding to the following three areas…

Developing a Customized Program Assessment Methodology for Assurance of Learning: A Case Study

ERIC Educational Resources Information Center

Baker, Hope; Brawley, Dorothy; Campbell, Jane; Capozzoli, Ernest; Malgeri, Linda; Roberts, Gary

2007-01-01

For most academic institutions, selecting and/or designing a Program Assessment methodology for Assurance of Learning is a challenging task. This paper describes the steps taken to establish goals, values and criteria driving this process for a College of Business. In this case analysis, we document the options we explored in finding the right…

Pre-defined and optional staging for the deployment of enterprise systems: a case study and a framework

NASA Astrophysics Data System (ADS)

Lichtenstein, Yossi; Cucuy, Shy; Fink, Lior

2017-03-01

The effective deployment of enterprise systems has been a major challenge for many organisations. Customising the new system, changing business processes, and integrating multiple information sources are all difficult tasks. As such, they are typically done in carefully planned stages in a process known as phased implementation. Using ideas from Option Theory, this article critiques aspects of phased implementation. One customer relationship management (CRM) project and its phased implementation are described in detail and ten other enterprise system deployments are summarised as a basis for the observation that almost all deployment stages are pre-defined operational steps rather than decision points. However, Option Theory suggests that optional stages, to be used only when risk materialises, should be integral parts of project plans. Although such optional stages are often more valuable than pre-defined stages, the evidence presented in this article shows that they are only rarely utilised. Therefore, a simple framework is presented; it first identifies risks related to the deployment of enterprise systems, then identifies optional stages that can mitigate these risks, and finally compares the costs and benefits of both pre-defined and optional stages.

Mapping public policy options responding to obesity: the case of Spain.

PubMed

González-Zapata, L I; Ortiz-Moncada, R; Alvarez-Dardet, C

2007-05-01

This study assesses the opinions of the main Spanish stakeholders from food and physical exercise policy networks on public policy options for responding to obesity. We followed the multi-criteria mapping methodology in the framework of the European project 'Policy options in responding to obesity' (PorGrow), through a structured interview to 21 stakeholders. A four-step approach was taken: options, criteria, scoring and weighting, obtaining in this way a measure of the performance of each option which integrates qualitative and quantitative information. In an overall analysis, the more popular policy options where those grouped as educational initiatives: include food and health in the school curriculum, improve health education to the general public, improve the training of health professionals in obesity care and prevention, incentives to caterers to provide healthier menus and improve community sports facilities. Fiscal measures as subsidies and taxes had the lowest support. The criteria assessed as priorities were grouped as efficacy and societal benefits. Obesity in Spain can be approached through public policies, although the process will not be easy or immediate. The feasibility of changes requires concerned public policymakers developing long-term actions taking into account the map of prioritized options by the stakeholders.

Using real options analysis to support strategic management decisions

NASA Astrophysics Data System (ADS)

Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

2013-12-01

Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.

Case Studies in Describing Scientific Research Efforts as Linked Data

NASA Astrophysics Data System (ADS)

Gandara, A.; Villanueva-Rosales, N.; Gates, A.

2013-12-01

The Web is growing with numerous scientific resources, prompting increased efforts in information management to consider integration and exchange of scientific resources. Scientists have many options to share scientific resources on the Web; however, existing options provide limited support to scientists in annotating and relating research resources resulting from a scientific research effort. Moreover, there is no systematic approach to documenting scientific research and sharing it on the Web. This research proposes the Collect-Annotate-Refine-Publish (CARP) Methodology as an approach for guiding documentation of scientific research on the Semantic Web as scientific collections. Scientific collections are structured descriptions about scientific research that make scientific results accessible based on context. In addition, scientific collections enhance the Linked Data data space and can be queried by machines. Three case studies were conducted on research efforts at the Cyber-ShARE Research Center of Excellence in order to assess the effectiveness of the methodology to create scientific collections. The case studies exposed the challenges and benefits of leveraging the Semantic Web and Linked Data data space to facilitate access, integration and processing of Web-accessible scientific resources and research documentation. As such, we present the case study findings and lessons learned in documenting scientific research using CARP.

Carbamide peroxide whitening of nonvital single discolored teeth: case reports.

PubMed

Caughman, W F; Frazier, K B; Haywood, V B

1999-03-01

Patients who present with a single discolored tooth represent a significant restorative challenge. These case reports describe an economic and conservative treatment option for these patients. The situations presented demonstrate techniques for bleaching with carbamide peroxide in a traditional nightguard or with an inside-outside technique to achieve acceptable esthetic results on isolated nonvital discolored teeth. Although these techniques may not be effective in all cases, they do not compromise or eliminate any future treatment options.

‘Obesogenic’ School Food Environments? An Urban Case Study in The Netherlands

PubMed Central

Timmermans, Joris; Dijkstra, Coosje; Kamphuis, Carlijn; van der Zee, Egbert; Poelman, Maartje

2018-01-01

(1) Background: This study aimed to explore and define socio-economic (SES) differences in urban school food environments in The Netherlands. (2) Methods: Retail food outlets, ready-to-eat products, in-store food promotions and food advertisements in public space were determined within 400 m walking distance of all secondary schools in the 4th largest city of The Netherlands. Fisher’s exact tests were conducted. (3) Results: In total, 115 retail outlets sold ready-to-eat food and drink products during school hours. Fast food outlets were more often in the vicinity of schools in lower SES (28.6%) than in higher SES areas (11.5%). In general, unhealthy options (e.g., fried snacks, sugar-sweetened beverages (SSB)) were more often for sale, in-store promoted or advertised in comparison with healthy options (e.g., fruit, vegetables, bottled water). Sport/energy drinks were more often for sale, and fried snacks/fries, hamburgers/kebab and SSB were more often promoted or advertised in lower SES areas than in higher SES-areas. (4) Conclusion: In general, unhealthy food options were more often presented than the healthy options, but only a few SES differences were observed. The results, however, imply that efforts in all school areas are needed to make the healthy option the default option during school time. PMID:29597308

Understanding China in the 21st Century: Political, Economic, and Security Issues in the Asia/Pacific Region. Part I, U.S. and Japanese Relations with China: Case Studies of Cooperation and Competition.

ERIC Educational Resources Information Center

Mukai, Gary; Moore, Carey; Young, Jocelyn; Cheng, Amy; Fairbrother, Greg

This curriculum unit is part one of a three-part series. The unit introduces students to policy options for U.S. and Japanese relations with China at the beginning of the 21st century. By identifying and examining these options, students gain an awareness of U.S., Japanese, and Chinese perspectives on political, economic, and security issues.…

Malignant Hidradenocarcinoma in the Lower Extremity: A Case Report of a Rare Tumor.

PubMed

Kane, Brendan; Adler, Evan; Bhandari, Tarun; Rose, Michael; DiGuglielmo, Nicola; Sun, Xiu

Malignant hidradenocarcinomas are rare soft tissue tumors of sweat gland origin. We present the case of a soft tissue, fungating tumor of 15 years' duration of the medial ankle in an 85-year-old male that exhibited malignant features clinically and radiographically. Subsequent punch biopsy revealed a diagnosis of malignant hidradenocarcinoma. Given the risk of recurrence and the poor radiation and chemotherapy options, the patient initially decided to leave the lesion untreated. However, he soon developed lower extremity cellulitis from the exposed lesion and decided to have the tumor excised, eliminating the source of the infection. In the present case study, we discuss the etiology, clinical and radiographic characteristics, and treatment options for this rare lesion. At the 18-month follow-up visit, he had had no recurrence of the lesion. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants.

PubMed

Holschen, M; Franetzki, B; Witt, K-A; Liem, D; Steinbeck, J

2017-08-01

Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants. Due to humeral or glenoid bone-loss and rotator cuff insufficiency reverse total shoulder arthroplasty often means the only remaining treatment option in revision shoulder arthroplasty. This study investigates the clinical outcome of patients treated with a reverse total shoulder in revision cases with special regard to stemless and stemmed primary implants. From 2010 to 2012 60 failed shoulder arthroplasties were converted to reverse total shoulder arthroplasty. Forty-four patients were available for follow-up after a mean of 24 months. Patients were assessed with X-rays, Constant- and ASES Score and a questionnaire about their subjective satisfaction. The total number of observed complications was seven (16%). Ninety-eight percent of the patients were satisfied with their clinical result. Patients achieved a mean normalized constant score of 70.2% and a mean ASES Score of 65.3. Patients with stemless primary implants achieved a higher normalized constant score than patients with stemmed primary implants (82 vs. 61.8%; p = 0009). Reverse total shoulder arthroplasty provides satisfactory clinical results and a high patient satisfaction in revision shoulder arthroplasty. The complication rate needs to be considered and discussed with the patient prior to surgery. Presence or absence of a stem of revised shoulder arthroplasties interferes with the outcome. LEVEL OF EVIDENCE IV: (Retrospective study).

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

The National Model for Minority Education and Training Demonstration (NMMETD) Case Study

EPA Pesticide Factsheets

NMMETD targeted minority and indigent residents by educating homeowners about the management of onsite systems and assisting residents with funding options for managing, installing, and disseminating information about onsite wastewater systems.

Surgical Treatment Options for Subacute Ischemia of the Hand: Case Report and Literature Review

PubMed Central

Dunn, Ashley A.; Belek, Kyle A.; Devcic, Zlatko; Rathnayake, Samira; Kuo, Jennifer H.; Kuri, Mauricio; Chang, David S.; Hansen, Scott L.

2010-01-01

Purpose: The most effective surgical approach to the treatment of digital ischemia has not yet been established. The purpose of this study is to review currently accepted options for revascularization in acute and chronic settings of digital ischemia, and to augment this discussion by describing the approach of our surgical team in a unique case of subacute ischemia. Operative Technique: To restore blood flow to a patient's ischemic hand, we performed a microvascular reconstruction, using a reverse interpositional vein graft with 3 anastomoses: the ulnar artery was used for inflow and the superficial palmar arch and the common digital artery were used for outflow. Results: The patient experienced immediate postoperative pain relief. Blood flow was restored, which prevented digital amputation. The graft remained patent at 18 months' follow-up and the patient exhibited normal motor and sensory function. Conclusions: Surgical reconstruction of the hand is a viable treatment option for carefully selected patients presenting with subacute digital ischemia. Other medical and surgical techniques have been described in the recent literature, but further study is needed to determine the long-term success of newer microsurgical interventions. PMID:20396617

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

PubMed Central

Windfuhr, Jochen P.

2016-01-01

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

7 CFR 457.122 - Walnut crop insurance provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... optional units by section, section equivalent, or FSA farm serial number and by irrigated and non-irrigated practices are not applicable. Optional units may be established only if each optional unit is located on non... group, in which case you may select one price election for each walnut variety or varietal group...

7 CFR 457.122 - Walnut crop insurance provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... optional units by section, section equivalent, or FSA farm serial number and by irrigated and non-irrigated practices are not applicable. Optional units may be established only if each optional unit is located on non... group, in which case you may select one price election for each walnut variety or varietal group...

7 CFR 457.122 - Walnut crop insurance provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... optional units by section, section equivalent, or FSA farm serial number and by irrigated and non-irrigated practices are not applicable. Optional units may be established only if each optional unit is located on non... group, in which case you may select one price election for each walnut variety or varietal group...

Vessel co-option is common in human lung metastases and mediates resistance to anti-angiogenic therapy in preclinical lung metastasis models.

PubMed

Bridgeman, Victoria L; Vermeulen, Peter B; Foo, Shane; Bilecz, Agnes; Daley, Frances; Kostaras, Eleftherios; Nathan, Mark R; Wan, Elaine; Frentzas, Sophia; Schweiger, Thomas; Hegedus, Balazs; Hoetzenecker, Konrad; Renyi-Vamos, Ferenc; Kuczynski, Elizabeth A; Vasudev, Naveen S; Larkin, James; Gore, Martin; Dvorak, Harold F; Paku, Sandor; Kerbel, Robert S; Dome, Balazs; Reynolds, Andrew R

2017-02-01

Anti-angiogenic therapies have shown limited efficacy in the clinical management of metastatic disease, including lung metastases. Moreover, the mechanisms via which tumours resist anti-angiogenic therapies are poorly understood. Importantly, rather than utilizing angiogenesis, some metastases may instead incorporate pre-existing vessels from surrounding tissue (vessel co-option). As anti-angiogenic therapies were designed to target only new blood vessel growth, vessel co-option has been proposed as a mechanism that could drive resistance to anti-angiogenic therapy. However, vessel co-option has not been extensively studied in lung metastases, and its potential to mediate resistance to anti-angiogenic therapy in lung metastases is not established. Here, we examined the mechanism of tumour vascularization in 164 human lung metastasis specimens (composed of breast, colorectal and renal cancer lung metastasis cases). We identified four distinct histopathological growth patterns (HGPs) of lung metastasis (alveolar, interstitial, perivascular cuffing, and pushing), each of which vascularized via a different mechanism. In the alveolar HGP, cancer cells invaded the alveolar air spaces, facilitating the co-option of alveolar capillaries. In the interstitial HGP, cancer cells invaded the alveolar walls to co-opt alveolar capillaries. In the perivascular cuffing HGP, cancer cells grew by co-opting larger vessels of the lung. Only in the pushing HGP did the tumours vascularize by angiogenesis. Importantly, vessel co-option occurred with high frequency, being present in >80% of the cases examined. Moreover, we provide evidence that vessel co-option mediates resistance to the anti-angiogenic drug sunitinib in preclinical lung metastasis models. Assuming that our interpretation of the data is correct, we conclude that vessel co-option in lung metastases occurs through at least three distinct mechanisms, that vessel co-option occurs frequently in lung metastases, and that vessel co-option could mediate resistance to anti-angiogenic therapy in lung metastases. Novel therapies designed to target both angiogenesis and vessel co-option are therefore warranted. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

Teleconsultation in paediatric orthopaedics in Djibouti: evaluation of response performance.

PubMed

Bertani, A; Launay, F; Candoni, P; Mathieu, L; Rongieras, F; Chauvin, F

2012-11-01

Djibouti has no paediatric orthopaedics department and three options are available for difficult cases: transfer of the patient to another country; overseas mission transfer to Djibouti by a specialised surgical team; and management by a local orthopaedic surgeon receiving guidance from an expert. The extreme poverty of part of the population of Djibouti often precludes the first two options. Telemedecine can allow the local orthopaedic surgeon to receive expert advice. HYPOTHESES AND STUDY DESIGN: We prospectively recorded all the paediatric orthopaedics teleconsultations that occurred between November 2009 and November 2011. Our objective was to assess the performance of the teleconsultations. We hypothetized that this option was influential in decision making. We assessed the influence of the teleconsultation on patient management (i.e., change in the surgical indication and/or procedure). We then used the electronic patient records to compare the actual management to that recommended retrospectively by two independent orthopaedic surgeon consultants who had experience working overseas. Finally, we assessed the clinical outcomes in the patients. Of 48 teleconsultations for 39 patients, 13 dealt with diagnostic problems and 35 with therapeutic problems. The teleconsultation resolved the diagnostic uncertainties in 90% of cases. Advice from the expert modified the management in 37 (77%) teleconsultations; the change was related to the surgical indication in 18 cases, the surgical technique in 13 cases, and both in six cases. Agreement between the advice from the independent consultants and the treatment delivered by the local surgeon was 2.2/3. Clinical outcomes were good or very good in 31 (81%) of the 38 treated patients. This study establishes the feasibility and usefulness of paediatric orthopaedics teleconsultations in Djibouti. The introduction of telemedicine has changed our approach to challenges raised by patients in remote locations or precarious situations. Input from experts considerably benefits patient management. III, prospective comparative study. Copyright © 2012. Published by Elsevier Masson SAS.

Path integral approach to closed-form option pricing formulas with applications to stochastic volatility and interest rate models

NASA Astrophysics Data System (ADS)

Lemmens, D.; Wouters, M.; Tempere, J.; Foulon, S.

2008-07-01

We present a path integral method to derive closed-form solutions for option prices in a stochastic volatility model. The method is explained in detail for the pricing of a plain vanilla option. The flexibility of our approach is demonstrated by extending the realm of closed-form option price formulas to the case where both the volatility and interest rates are stochastic. This flexibility is promising for the treatment of exotic options. Our analytical formulas are tested with numerical Monte Carlo simulations.

Comparative Study Of Resonator Optics For Lidar Applications

NASA Technical Reports Server (NTRS)

Tratt, David M.; Menzies, Robert T.

1992-01-01

Report discusses overall transmit/receive performances of laser-radar transceivers. Gaussian case and hard-edged case selected for comparison because of their practical importance. Intercomparison shows that for multi-joule-output pulsed CO2 lasers, Gaussian profiled optics offers little improvement over hard-edged option, while greater hardiness and superior energy extraction capability of latter constitutes strong argument in favor of its application.

Guidelines for the Bioremediation of Oil-Contaminated Salt Marshes

EPA Pesticide Factsheets

This document includes a review and critique of the literature and theories pertinent to oil biodegradation and nutrient dynamics and provides examples of bioremediation options and case studies of oil bioremediation in coastal wetland environments.

"Provoking conversations": case studies of organizations where Option Grid™ decision aids have become 'normalized'.

PubMed

Scalia, Peter; Elwyn, Glyn; Durand, Marie-Anne

2017-08-18

Implementing patient decision aids in clinic workflow has proven to be a challenge for healthcare organizations and physicians. Our aim was to determine the organizational strategies, motivations, and facilitating factors to the routine implementation of Option Grid™ encounter decision aids at two independent settings. Case studies conducted by semi-structured interview, using the Normalization Process Theory (NPT) as a framework for thematic analysis. Twenty three interviews with physicians, nurses, hospital staff and stakeholders were conducted at: 1) CapitalCare Medical Group in Albany, New York; 2) HealthPartners Clinics in Minneapolis, Minnesota. 'Coherent' motivations were guided by financial incentives at CapitalCare, and by a 'champion' physician at HealthPartners. Nurses worked 'collectively' at both settings and played an important role at sites where successful implementation occurred. Some physicians did not understand the perceived utility of Option Grid™, which led to varying degrees of implementation success across sites. The appraisal work (reflexive monitoring) identified benefits, particularly in terms of information provision. Physicians at both settings, however, were concerned with time pressures and the suitability of the tool for patients with low levels of health literacy. Although both practice settings illustrated the mechanisms of normalization postulated by the theory, the extent to which Option Grid™ was routinely embedded in clinic workflow varied between sites, and between clinicians. Implementation of new interventions will require attention to an identified rationale (coherence), and to the collective action, cognitive participation, and assessment of value by organizational members of the organization.

Tubercular prosthetic joint infection: two case reports and literature review.

PubMed

Veloci, Sara; Mencarini, Jessica; Lagi, Filippo; Beltrami, Giovanni; Campanacci, Domenico Andrea; Bartoloni, Alessandro; Bartalesi, Filippo

2018-02-01

Tubercular prosthetic joint infection (TB-PJI) is an uncommon complication. Lack of evidence of systemic tuberculosis and clinical suspicion could bring a delay in the time of the diagnosis. The aims of this study are to underline the importance of awareness and suspicion of mycobacterial infection in the differential diagnosis in PJI and to evaluate the appropriateness of different therapeutic options. Case report and literature review. We report two cases of TB-PJI after total knee arthroplasty in Caucasian patients without prior history of tubercular disease or exposure. In both cases, the diagnosis was obtained years after the onset of symptoms. Despite that, both patients improved during antitubercular treatment (a four-drug regimen consisting of rifampicin, isoniazid, ethambutol, and pyrazinamide for 2 months, followed by rifampicin and isoniazid). Moreover, after an 18-month course of treatment, there was no need for surgical therapy. The result of the literature review allows us to identify 64 cases of TB-PJI. Many differences in both medical and surgical management have been found, among those reviewed cases. Considering our experience and the literature review, we recommend considering a conservative approach (debridement and adequate antituberculous chemotherapy) as a suitable and safe option.

Caval penetration by retrievable inferior vena cava filters: a retrospective comparison of Option and Günther Tulip filters.

PubMed

Olorunsola, Olufoladare G; Kohi, Maureen P; Fidelman, Nicholas; Westphalen, Antonio C; Kolli, Pallav K; Taylor, Andrew G; Gordon, Roy L; LaBerge, Jeanne M; Kerlan, Robert K

2013-04-01

To compare the frequency of vena caval penetration by the struts of the Option and Günther Tulip cone filters on postplacement computed tomography (CT) imaging. All patients who had an Option or Günther Tulip inferior vena cava (IVC) filter placed between January 2010 and May 2012 were identified retrospectively from medical records. Of the 208 IVC filters placed, the positions of 58 devices (21 Option filters, 37 Günther Tulip filters [GTFs]) were documented on follow-up CT examinations obtained for reasons unrelated to filter placement. In cases when multiple CT studies were obtained after placement, each study was reviewed, for a total of 80 examinations. Images were assessed for evidence of caval wall penetration by filter components, noting the number of penetrating struts and any effect on pericaval tissues. Penetration of at least one strut was observed in 17% of all filters imaged by CT between 1 and 447 days following placement. Although there was no significant difference in the overall prevalence of penetration when comparing the Option filter and GTF (Option, 10%; GTF, 22%), only GTFs showed time-dependent penetration, with penetration becoming more likely after prolonged indwelling times. No patient had damage to pericaval tissues or documented symptoms attributed to penetration. Although the Günther Tulip and Option filters exhibit caval penetration at CT imaging, only the GTF exhibits progressive penetration over time. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

Facilitating Employees' and Students' Process towards Nascent Entrepreneurship

ERIC Educational Resources Information Center

Hietanen, Lenita

2015-01-01

Purpose: The purpose of this paper is to investigate a model for facilitating employees' and full-time, non-business students' entrepreneurial capabilities during their optional entrepreneurship studies at one Finnish Open University. Design/methodology/approach: The case study investigates the course in which transitions from employees or…

Plant parasite control and soil fauna diversity.

PubMed

Lavelle, Patrick; Blouin, Manuel; Boyer, Johnny; Cadet, Patrice; Laffray, Daniel; Pham-Thi, Anh-Thu; Reversat, Georges; Settle, William; Zuily, Yasmine

2004-07-01

The use of pesticides to control plant parasites and diseases has generated serious problems of public health and environmental quality, leading to the promotion of alternative Integrated Pest Management strategies that tend to rely more on natural processes and the active participation of farmers as observers and experimenters in their own fields. We present three case studies that point at different options provided by locally available populations of soil organisms, the maintenance of diverse populations of pests or increased resistance of plants to pest attacks by their interactions with earthworms and other useful soil organisms. These examples demonstrate the diversity of options offered by the non-planned agro-ecosystem diversity in pest control and the need to identify management options that maintain this biodiversity.

17 CFR 1.46 - Application and closing out of offsetting long and short positions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... short or long futures or option position, as the case may be, and shall, for futures transactions... oldest open position. In all instances wherein the short or long futures or option position in such...) of the Act Provided, That no contract market or futures commission merchant shall permit such option...

Schockmed Valve: A Novel Surgical Option for Uncontrolled Glaucoma in Eyes with Poor Conjunctiva and Encircling Bands.

PubMed

Fleischman, David; Kim, Bryan

2017-01-01

Surgical management of elevated intraocular pressure (IOP) in an eye with scarred conjunctiva, an encircling band, and silicone oil has limited options. By combining the flow restrictor of the Ahmed Glaucoma Valve (New World Medical, Rancho Cucamonga, California) and the capsule of the encircling band as a conduit for aqueous flow, immediate pressure reduction could theoretically be achieved in eyes with limited conjunctival mobilization. This is a description of a surgical technique in a case of a patient with multiple ocular surgeries with uncontrolled multimechanism glaucoma despite using all available topical and oral glaucoma medications. A combination of the Ahmed valve with a modification of the Schocket shunt technique was used in this case of an encircling band and poor conjunctiva. At 10-month follow-up, the patient maintains controlled pressures on dorzolamide-timolol drops. The combined Ahmed-Schocket (or Schockmed) technique may be another surgical option for management of uncontrolled IOP in cases of scarred conjunctiva and encircling bands needing immediate pressure reduction. A novel surgical option for uncontrolled glaucoma in eyes with poor conjunctiva and encircling bands. How to cite this article: Fleischman D, Kim B. Schockmed Valve: A Novel Surgical Option for Uncontrolled Glaucoma in Eyes with Poor Conjunctiva and Encircling Bands. J Curr Glaucoma Pract 2017;11(3):120-124.

Feasibility of a medium-size central cogenerated energy facility, energy management memorandum

NASA Astrophysics Data System (ADS)

Porter, R. W.

1982-09-01

The thermal-economic feasibility was studied of a medium-size central cogenerated energy facility designed to serve five varied industries. Generation options included one dual-fuel diesel and one gas turbine, both with waste heat boilers, and five fired boilers. Fuels included natural gas, and for the fired-boiler cases, also low-sulphur coal and municipal refuse. The fired-boiler cogeneration systems employed back-pressure steam turbines. For coal and refuse, the option of steam only without cogeneration was also assessed. The refuse-fired cases utilized modular incinerators. The options provided for a wide range of steam and electrical capacities. Deficient steam was assumed generated independently in existing equipment. Excess electrical power over that which could be displaced was assumed sold to Commonwealth Edison Company under PURPA (Public Utility Regulator Policies Act). The facility was assumed operated by a mutually owned corporation formed by the cogenerated power users. The economic analysis was predicted on currently applicable energy-investment tax credits and accelerated depreciation for a January 1985 startup date. Based on 100% equity financing, the results indicated that the best alternative was the modular-incinerator cogeneration system.

Case Histories of Six Consumers and Their Families in Cash and Counseling

PubMed Central

San Antonio, Patricia M; Simon-Rusinowitz, Lori; Loughlin, Dawn; Eckert, J Kevin; Mahoney, Kevin J

2007-01-01

Objective To examine how the lives of consumers and their caregivers were affected by making choices and controlling their own resources with the cash option, this paper focuses on six case studies from the Cash and Counseling Demonstration Program. Data Sources Twenty-one consumers, caregivers, and state consultants were interviewed about their experiences in the program. Study Design The data come from a larger study of over 200 interviews conducted from June 2000 to August 2004. Interview data were analyzed for themes about caregiving and program satisfaction. Principal Findings Cash and Counseling benefited consumers and caregivers by allowing consumers increased continuity and reliability of care, increased ability to set hours of care, more satisfaction with how caregiving is offered and more satisfaction with the quality of care. Conclusions The cash option allowed consumers to create, schedule, and manage their own model of care. Some consumers faced challenges in the program with paperwork, accounting, worries about receiving care, and some ineffective state consultants who could have been more helpful. PMID:17244296

Resolution of a periodontoid rheumatoid pannus mass in an elderly patient treated with a rigid cervical collar: A case report and literature review.

PubMed

Oseni, Abidemi; Kakavas, Georg; Scholz, Martin; Petridis, Athanasios

2016-06-17

In patients with C2 rheumatoid pannus with spinal cord compression the treatment of choice is extensive surgery either through a transoral resection of the dens axis or a dorsal stabilisation, or both. We present a case of an 11-mm rheumatoid pannus with significant compression of the spinal cord, which failed surgical treatment with respect to dorsal stabilisation. Therefore, rigid cervical collar for 8 weeks followed by soft collar for another 4 weeks was chosen as a treatment option. During the follow-up period of 1 year, the pannus reduced significantly and the spinal cord decompressed. In cases where surgery is not an option or is technically very demanding, the alternative of cervical collar immobilisation is a satisfying option.

Treatment of gynecomastia in patients with prostate cancer and androgen deprivation.

PubMed

Bautista-Vidal, C; Barnoiu, O; García-Galisteo, E; Gómez-Lechuga, P; Baena-González, V

2014-01-01

Gynecomastia, defined as benign proliferation of glandular breast tissue has a prevalence of 32% to 72% in the male. In the urology setting, it is associated to patients with prostate cancer and hormone treatment with a prevalence of 15% in the case of complete hormone blockage and 75% in monotherapy. The different options of treatment in prostate cancer have changed in recent decades. Thus, we have focused on this subject to evaluate the different therapy options of hormone manipulation induced gynecomastia in prostate cancer patients. To synthesize the available evidence on the different therapeutic options in prostate cancer patients who develop gynecomastia due to the use of nonsteroidal antiandrogens and to generate a diagnostic algorithm and treatment. Using the PICO type structured search strategy (Patient or problem, Intervention, Comparison, Outcome or result) in the data bases of PubMed-Medline and Cochrane, identification was made of the relevant studies related to the treatment of gynecomastia in Prostate Cancer patients treated with nonsteroidal antiandrogens. We have found 3 possible therapeutic options for the treatment of gynecomastia and mastodynia in patients with hormone deprivation therapy for prostate cancer. The 10Gy radiotherapy would be an option for the treatment of gynecomastia, although not all the patients need prophylactic treatment since only 50% report moderate-severe discomfort. Another option is the use of drugs such as tamoxifen 20mg/day that lead to a significant decrease in the mammary effects. Gynecomastia and mastodynia, given their high incidence, make the physical examination a fundamental tool for all patients before initiating treatment with antiandrogens. The use of tamoxifen 20mg/day is the best treatment and prevention option against gynecomastia and mastodynia, while in the case of long-course established gynecomastia, surgery is the gold standard. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

Knowledge and Practices Relating to Acute Pesticide Poisoning Among Health Care Providers in Selected Regions of Tanzania.

PubMed

Lekei, Elikana; Ngowi, Aiwerasia V; Mkalanga, Habib; London, Leslie

2017-01-01

Acute pesticide poisoning (APP) is commonly underdiagnosed in Tanzania. Studies in developing countries suggest that a lack of diagnostic skills among health care providers (HCPs) undermines surveillance for APP. This study aimed at characterizing experience and skills of Tanzanian HCPs regarding APP diagnosis and management. The population included HCPs responsible for managing APP in Kilimanjaro and Arusha regions (n = 91). The resulting sample included 66 respondents (response rate: 73%). The data were collected in 2005 using a standardized questionnaire. Half of all respondents (50%) reported handling at least 1 APP case with 15% reporting handling more than 5 cases in the past. Reported experience of handling an APP case was marginally higher in respondents who reported ⩾4 years of work experience in the health sector compared with those with <4 years of work experience (odds ratio = 1.32; 95% confidence interval = 0.9-1.5). Most of the respondents had high knowledge of exposure routes, reporting awareness of oral (98.5%), inhalational (93.9%), and dermal (77%) routes. The study revealed low awareness of pesticide classification by chemical groups (29%) or World Health Organization hazard (0%) and weak knowledge on pesticide label instructions (55%). Organophosphates accounted for 35% of the pesticide products reported by respondents as being responsible for poisoning. Some treatment options were incorrectly reported as first aid options, and some reported first aid options were wrong or inappropriate. The study revealed that HCPs in northern Tanzania lack adequate skills to diagnose and manage APP. For effective surveillance of APP, there is a need to include training on hazards, classification, diagnosis, and health effects in the training programmes for all HCPs in Tanzania.

Knowledge and Practices Relating to Acute Pesticide Poisoning Among Health Care Providers in Selected Regions of Tanzania

PubMed Central

Lekei, Elikana; Ngowi, Aiwerasia V; Mkalanga, Habib; London, Leslie

2017-01-01

Background: Acute pesticide poisoning (APP) is commonly underdiagnosed in Tanzania. Studies in developing countries suggest that a lack of diagnostic skills among health care providers (HCPs) undermines surveillance for APP. This study aimed at characterizing experience and skills of Tanzanian HCPs regarding APP diagnosis and management. Methodology: The population included HCPs responsible for managing APP in Kilimanjaro and Arusha regions (n = 91). The resulting sample included 66 respondents (response rate: 73%). The data were collected in 2005 using a standardized questionnaire. Results: Half of all respondents (50%) reported handling at least 1 APP case with 15% reporting handling more than 5 cases in the past. Reported experience of handling an APP case was marginally higher in respondents who reported ⩾4 years of work experience in the health sector compared with those with <4 years of work experience (odds ratio = 1.32; 95% confidence interval = 0.9-1.5). Most of the respondents had high knowledge of exposure routes, reporting awareness of oral (98.5%), inhalational (93.9%), and dermal (77%) routes. The study revealed low awareness of pesticide classification by chemical groups (29%) or World Health Organization hazard (0%) and weak knowledge on pesticide label instructions (55%). Organophosphates accounted for 35% of the pesticide products reported by respondents as being responsible for poisoning. Some treatment options were incorrectly reported as first aid options, and some reported first aid options were wrong or inappropriate. Conclusions: The study revealed that HCPs in northern Tanzania lack adequate skills to diagnose and manage APP. For effective surveillance of APP, there is a need to include training on hazards, classification, diagnosis, and health effects in the training programmes for all HCPs in Tanzania. PMID:28469444

Uncommons: Transforming Dusty Reading Rooms into Artefactual "Third Space" Library Learning Labs

ERIC Educational Resources Information Center

Schadl, Suzanne Michele; Nelson, Molly; Valencia, Kristen S.

2015-01-01

This article describes the implementation of two inexpensive social learning library laboratories for advanced students in Latin American and Chicana/o studies. Drawing on philosophical literature from these interdisciplinary areas and ethnic studies, these cases present a "third space" option for library learning called…

Group Therapy for Eating Disorders: A Retrospective Case Study

ERIC Educational Resources Information Center

Wanlass, Janine; Moreno, J. Kelly; Thomson, Hannah M.

2005-01-01

An increasing amount of research supports group therapy as an effective treatment option for eating disorders (Moreno, 1994). In an attempt to further delineate therapeutic factors associated with productive group work, this study represents an exploratory, descriptive analysis of client and therapist perspectives on group process and outcome.…

Treatment of anorexia nervosa with long-term risperidone in an outpatient setting: case study.

PubMed

Kracke, Elsa J; Tosh, Aneesh K

2014-01-01

There are currently few studies focusing on the efficacy of long-term atypical antipsychotics to treat anorexia nervosa in the pediatric population. This case report follows the treatment of a 17 year-old female with anorexia nervosa over her four-year undergraduate career. After two years of multidisciplinary treatment, low-dose risperidone was initiated due to persistence of her disease. She expressed decreased rigidity around meal times, her weight improved and she had resumption of menses. She was compliant with treatment through graduation and maintained her weight gain. Atypical antipsychotics are a treatment option in the management of anorexia nervosa. Risperidone has not been studied as frequently as olanzapine for eating disorders. Risperidone was chosen for its more favorable side effect profile and decreased cost to the patient. Previous studies on anorexia nervosa treatment have occurred during inpatient treatment and have limited follow-up due to patients' refusal to initiate or maintain medication compliance. This case presents 17 months of outpatient data. The efficacy of risperidone therapy was evaluated with frequent weight checks, subjective decrease in rigidity, serial complete metabolic panels, and restoration of menses. In this case report, an adolescent female treated with low-dose risperidone had decreased rigid thinking, weight gain and resolution of secondary amenorrhea without medication side effects. Therefore, the atypical antipsychotic risperidone may be an effective long-term outpatient treatment option for patients with anorexia nervosa.

UFO-a multi-analyser option for IN12

NASA Astrophysics Data System (ADS)

Schmidt, Wolfgang; Rheinstädter, Maikel C.; Raymond, Stephane; Ohl, Michael

2004-07-01

The IN12 instrument is operated by FZ Jülich in collaboration with CEA Grenoble as a CRG-B instrument at the Institut Laue Langevin in Grenoble. As a three-axis spectrometer for cold neutrons it is dedicated for high-resolution studies of low-energy excitations. In the past years the instrument has been continuously improved and it has demonstrated its excellent performance for neutron scattering research. To meet further challenges as a state-of-the-art instrument in the next funding period we will propose to upgrade IN12 with a multi-analyser option similar to planned or existing RITA-type instruments. IN12 will then be optionally equipped with an array of individual analyser blades which can be positioned separately in order to map the scattered beam on a user-chosen path in (Q,ω)-space. We refer to this set-up as IN12-UFO (universal focusing option). Both, the feasibility and the scientific case are currently being studied. On the conference we will show details of the planned instrumental set-up and demonstrate its flexibility and multiplex advantages for specific physical applications.

Incorporating Human Readiness Levels at Sandia National Laboratories

DOE PAGES

See, Judi E.; Morris, Jason; Craft, Richard; ...

2018-01-24

Since 2010, the concept of human readiness levels has been under development as a possible supplement to the existing technology readiness level (TRL) scale. The intent is to provide a mechanism to address safety and performance risks associated with the human component in a system that parallels the TRL structure already familiar to the systems engineering community. Sandia National Laboratories in Albuquerque, New Mexico, initiated a study in 2015 to evaluate options to incorporate human readiness planning for Sandia processes and products. The study team has collected the majority of baseline assessment data and has conducted interviews to understand staffmore » perceptions of four different options for human readiness planning. Preliminary results suggest that all four options may have a vital role, depending on the type of work performed and the phase of product development. Upon completion of data collection, the utility of identified solutions will be assessed in one or more test cases.« less

Incorporating Human Readiness Levels at Sandia National Laboratories

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

See, Judi E.; Morris, Jason; Craft, Richard

Since 2010, the concept of human readiness levels has been under development as a possible supplement to the existing technology readiness level (TRL) scale. The intent is to provide a mechanism to address safety and performance risks associated with the human component in a system that parallels the TRL structure already familiar to the systems engineering community. Sandia National Laboratories in Albuquerque, New Mexico, initiated a study in 2015 to evaluate options to incorporate human readiness planning for Sandia processes and products. The study team has collected the majority of baseline assessment data and has conducted interviews to understand staffmore » perceptions of four different options for human readiness planning. Preliminary results suggest that all four options may have a vital role, depending on the type of work performed and the phase of product development. Upon completion of data collection, the utility of identified solutions will be assessed in one or more test cases.« less

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

Raszewski, F; Tommy Edwards, T; David Peeler, D

The Liquid Waste Organization (LWO) has requested that the Savannah River National Laboratory (SRNL) to assess the impact of a 100K gallon decant volume from Tank 40H on the existing sludge-only Sludge Batch 4 (SB4)-Frit 510 flowsheet and the coupled operations flowsheet (SB4 with the Actinide Removal Process (ARP)). Another potential SB4 flowsheet modification of interest includes the addition of 3 wt% sodium (on a calcined oxide basis) to a decanted sludge-only or coupled operations flowsheet. These potential SB4 flowsheet modifications could result in significant compositional shifts to the SB4 system. This paper study provides an assessment of the impactmore » of these compositional changes to the projected glass operating windows and to the variability study for the Frit 510-SB4 system. The influence of the compositional changes on melt rate was not assessed in this study nor was it requested. Nominal Stage paper study assessments were completed using the projected compositions for the various flowsheet options coupled with Frit 510 (i.e., variation was not applied to the sludge and frit compositions). In order to gain insight into the impacts of sludge variation and/or frit variation (due to the procurement specifications) on the projected operating windows, three versions of the Variation Stage assessment were performed: (1) the traditional Variation Stage assessment in which the nominal Frit 510 composition was coupled with the extreme vertices (EVs) of each sludge, (2) an assessment of the impact of possible frit variation (within the accepted frit specification tolerances) on each nominal SB4 option, and (3) an assessment of the impact of possible variation in the Frit 510 composition due to the vendor's acceptance specifications coupled with the EVs of each sludge case. The results of the Nominal Stage assessment indicate very little difference among the various flowsheet options. All of the flowsheets provide DWPF with the possibility of targeting waste loadings (WLs) from the low 30s to the low 40s with Frit 510. In general, the Tank 40H decant has a slight negative impact on the operating window, but DWPF still has the ability to target current WLs (34%) and higher WLs if needed. While the decant does not affect practical WL targets in DWPF, melt rate could be reduced due to the lower Na{sub 2}O content. If true, the addition of 3 wt% Na{sub 2}O to the glass system may regain melt rate, assuming that the source of alkali is independent of the impact on melt rate. Coupled operations with Frit 510 via the addition of ARP to the decanted SB4 flowsheet also appears to be viable based on the projected operating windows. The addition of both ARP and 3 wt% Na{sub 2}O to a decanted Tank 40H sludge may be problematic using Frit 510. Although the Nominal Stage assessments provide reasonable operating windows for the SB4 flowsheets being considered with Frit 510, introduction of potential sludge and/or frit compositional variation does have a negative impact. The magnitude of the impact on the projected operating windows is dependent on the specific flowsheet options as well as the applied variation. The results of the traditional Variation Stage assessments indicate that the three proposed Tank 40H decanted flowsheet options (Case No.2--100K gallon decant, Case No.3--100K gallon decant and 3 wt% Na{sub 2}O addition and Case No.4--100K gallon decant and ARP) demonstrate a relatively high degree of robustness to possible sludge variation over WLs of interest with Frit 510. However, the case where the addition of both ARP and 3 wt% Na{sub 2}O is considered was problematic during the traditional Variation Stage assessment. The impact of coupling the frit specifications with the nominal SB4 flowsheet options on the projected operating windows is highly dependent on whether the upper WLs are low viscosity or liquidus temperature limited in the Nominal Stage assessments. Systems that are liquidus temperature limited exhibit a high degree of robustness to the applied frit and sludge variation, while those that are low viscosity limited show significant reductions (6 percentage points) in the upper WLs that can be obtained. When both frit and sludge variations are applied, the paper study results indicate that DWPF could be severely restricted in terms of projected operating windows for the ARP and Na{sub 2}O addition options. An experimental variability study was not performed using the final SB4 composition and Frit 510 since glasses in the ComPro{trademark} data base were identified that bounded the potential operating window of this system. The bounding ARP case was not considered in that assessment. After the flowsheet cases were identified, an electronic search of ComPro{trademark} identified approximately 12 historical glasses within the compositional regions defined by at least one of the five flowsheet options, but the compositional coverage did not appear adequate to bound all cases.« less

26 CFR 1.59-1 - Optional 10-year writeoff of certain tax preferences.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Optional 10-year writeoff of certain tax... INCOME TAX INCOME TAXES Tax Preference Regulations § 1.59-1 Optional 10-year writeoff of certain tax... 59(e) applies to be deducted ratably over the 10-year period (3-year period in the case of...

26 CFR 1.59-1 - Optional 10-year writeoff of certain tax preferences.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Optional 10-year writeoff of certain tax... INCOME TAX INCOME TAXES Tax Preference Regulations § 1.59-1 Optional 10-year writeoff of certain tax... 59(e) applies to be deducted ratably over the 10-year period (3-year period in the case of...

The Decoy Effect Within Alcohol Purchasing Decisions.

PubMed

Monk, Rebecca L; Qureshi, Adam W; Leatherbarrow, Thomas; Hughes, Annalise

2016-08-23

The decoy effect is the phenomenon where the introduction of a third choice to a decision dyad changes the distribution of preferences between options. Examine whether this effect exists in alcohol purchasing decisions and whether testing context impacts this. Fifty-two participants tested in either a bar or library context and were asked to choose one of a series of beer and water deals presented for timed intervals. In some cases, two options were presented (with similar attractiveness) and in other cases a third, less preferable, decoy option was added. A basic decoy effect in both alcohol and water purchasing decisions. Specifically, there were reductions in the selection of both the original options when the decoy was added into choice dyads. A significant interaction demonstrated in the bar context there was a significant difference such that there was a slight increase in participants selecting the most cost effective option when the decoy was added, and a simultaneous decrease in those choosing the moderately cost effective option. There were no such differences observed in the library condition. The same product may be perceived differently across contexts and, as such, consumers in a pub environment may be particularly vulnerable to the decoy effect.

Ocean acidification: Linking science to management solutions using the Great Barrier Reef as a case study.

PubMed

Albright, Rebecca; Anthony, Kenneth R N; Baird, Mark; Beeden, Roger; Byrne, Maria; Collier, Catherine; Dove, Sophie; Fabricius, Katharina; Hoegh-Guldberg, Ove; Kelly, Ryan P; Lough, Janice; Mongin, Mathieu; Munday, Philip L; Pears, Rachel J; Russell, Bayden D; Tilbrook, Bronte; Abal, Eva

2016-11-01

Coral reefs are one of the most vulnerable ecosystems to ocean acidification. While our understanding of the potential impacts of ocean acidification on coral reef ecosystems is growing, gaps remain that limit our ability to translate scientific knowledge into management action. To guide solution-based research, we review the current knowledge of ocean acidification impacts on coral reefs alongside management needs and priorities. We use the world's largest continuous reef system, Australia's Great Barrier Reef (GBR), as a case study. We integrate scientific knowledge gained from a variety of approaches (e.g., laboratory studies, field observations, and ecosystem modelling) and scales (e.g., cell, organism, ecosystem) that underpin a systems-level understanding of how ocean acidification is likely to impact the GBR and associated goods and services. We then discuss local and regional management options that may be effective to help mitigate the effects of ocean acidification on the GBR, with likely application to other coral reef systems. We develop a research framework for linking solution-based ocean acidification research to practical management options. The framework assists in identifying effective and cost-efficient options for supporting ecosystem resilience. The framework enables on-the-ground OA management to be the focus, while not losing sight of CO2 mitigation as the ultimate solution. Copyright © 2016 Elsevier Ltd. All rights reserved.

Measuring the subjective value of risky and ambiguous options using experimental economics and functional MRI methods.

PubMed

Levy, Ifat; Rosenberg Belmaker, Lior; Manson, Kirk; Tymula, Agnieszka; Glimcher, Paul W

2012-09-19

Most of the choices we make have uncertain consequences. In some cases the probabilities for different possible outcomes are precisely known, a condition termed "risky". In other cases when probabilities cannot be estimated, this is a condition described as "ambiguous". While most people are averse to both risk and ambiguity(1,2), the degree of those aversions vary substantially across individuals, such that the subjective value of the same risky or ambiguous option can be very different for different individuals. We combine functional MRI (fMRI) with an experimental economics-based method(3 )to assess the neural representation of the subjective values of risky and ambiguous options(4). This technique can be now used to study these neural representations in different populations, such as different age groups and different patient populations. In our experiment, subjects make consequential choices between two alternatives while their neural activation is tracked using fMRI. On each trial subjects choose between lotteries that vary in their monetary amount and in either the probability of winning that amount or the ambiguity level associated with winning. Our parametric design allows us to use each individual's choice behavior to estimate their attitudes towards risk and ambiguity, and thus to estimate the subjective values that each option held for them. Another important feature of the design is that the outcome of the chosen lottery is not revealed during the experiment, so that no learning can take place, and thus the ambiguous options remain ambiguous and risk attitudes are stable. Instead, at the end of the scanning session one or few trials are randomly selected and played for real money. Since subjects do not know beforehand which trials will be selected, they must treat each and every trial as if it and it alone was the one trial on which they will be paid. This design ensures that we can estimate the true subjective value of each option to each subject. We then look for areas in the brain whose activation is correlated with the subjective value of risky options and for areas whose activation is correlated with the subjective value of ambiguous options.

Evidence for medium chain triglycerides in the treatment of primary intestinal lymphangiectasia.

PubMed

Desai, A P; Guvenc, B H; Carachi, R

2009-08-01

Primary intestinal lymphangiectasia is an uncommon congenital anomaly. It is an intrinsic abnormality of the intestinal lymphatics system. Over the years, various treatment options such as diuretics, albumin transfusions and a medium chain triglycerides (MCT) diet as well as surgical options such as resection of isolated segments and peritoneal-venous shunts have been used. An MCT diet, which is a low fat, high protein diet, is increasingly used in the management of this anomaly. The aim was to review the evidence for medium chain triglycerides as a therapeutic option in patients with primary intestinal lymphangiectasia. A literature search was performed and individual case details were extracted. We found 55 cases, of which 3 were from our own institute. The cases were divided in 2 groups: Group A (n=27) consisted of patients treated with MCT, and Group B (n=28) consisted patients not treated with MCT. Cases were analysed for symptomatic response to MCT as well as mortality. 17 of 27 cases (63%) treated with MCT had complete resolution of symptoms while only 10 of 28 (35.7%) patients in group B showed complete resolution. Mortality for Group A was 1 out of 27 (3.7%), while mortality in group B was 5 of 28 (17.85%) patients. We conclude that, although an MCT diet is not completely curative in all cases, it does improve the symptoms of primary intestinal lymphangiectasia and reduces mortality. Hence it is a valid option in the paediatric age group. Copyright Georg Thieme Verlag KG Stuttgart . New York.

Rituximab desensitization in three patients with severe rituximab allergy.

PubMed

Öztürk, Erman; Özyiğit, Leyla Pur; Öztürk, Ayşe Bilge; Akay, Meltem Olga; Çetiner, Mustafa; Ferhanoğlu, Burhan

Rituximab is a chimeric monoclonal antibody that targets CD20 positive B cells and has a positive effect on both overall and progression-free survival in B-cell lymphoid malignancies. Combination rituximab with chemotherapy treatment provide survival improvement. Although rituximab is an important treatment option in hematological malignancies, the risk of allergic reactions is high. These reactions are usually IgE-mediated and can be varied in regard of severity from urticaria to anaphylaxis. It is an option to interrupt the treatment and ommit rituximab therapy who had allergic reactions. Drug desensitization is another option and successful results have been reported by applying desensitization to such reactions. Drug desensitization alters the immune response to induce a state of temporary clinical tolerance to the allergic drug by giving gradual increasing of doses of drug at fixed time intervals. Herein, we present 3 cases successfully treated with rituximab desensitization. The cases were using rituximab with the diagnosis of Burkitt lymphoma, follicular lymphoma, and marginal zone lymphoma, respectively. Two cases had grade 2 and 1 case had grade 3 systemic allergic reaction with rituximab. There was no known allergy history in all 3 cases. All patients tolerated the desensitization protocol. The subsequent treatments of the patients were also given by desensitization protocol. A total of 12 desensitizations were administered to 3 cases. No severe or life-threating reactions were observed in subsequent applications. To date applying desensitization protocols ensure rituximab treatment safely. Rituximab desensitization can be performed at trained allergy centers, and it may be an appropriate option for rituximab allergic patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparing multistate expected damages, option price and cumulative prospect measures for valuing flood protection

NASA Astrophysics Data System (ADS)

Farrow, Scott; Scott, Michael

2013-05-01

Floods are risky events ranging from small to catastrophic. Although expected flood damages are frequently used for economic policy analysis, alternative measures such as option price (OP) and cumulative prospect value exist. The empirical magnitude of these measures whose theoretical preference is ambiguous is investigated using case study data from Baltimore City. The outcome for the base case OP measure increases mean willingness to pay over the expected damage value by about 3%, a value which is increased with greater risk aversion, reduced by increased wealth, and only slightly altered by higher limits of integration. The base measure based on cumulative prospect theory is about 46% less than expected damages with estimates declining when alternative parameters are used. The method of aggregation is shown to be important in the cumulative prospect case which can lead to an estimate up to 41% larger than expected damages. Expected damages remain a plausible and the most easily computed measure for analysts.

Life-threatening hypersplenism due to idiopathic portal hypertension in early childhood: case report and review of the literature

PubMed Central

2010-01-01

Background Idiopathic portal hypertension (IPH) is a disorder of unknown etiology and is characterized clinically by portal hypertension, splenomegaly, and hypersplenism accompanied by pancytopenia. This study evaluates the pathogenic concept of the disease by a systematic review of the literature and illustrates novel pathologic and laboratory findings. Case Presentation We report the first case of uncontrolled splenic hyperperfusion and enlargement with subsequent hypersplenism leading to life-threatening complications of IPH in infancy and emergent splenectomy. Conclusions Our results suggest that splenic NO and VCAM-1, rather than ET-1, have a significant impact on the development of IPH, even at a very early stage of disease. The success of surgical interventions targeting the splenic hyperperfusion suggests that the primary defect in the regulation of splenic blood flow seems to be crucial for the development of IPH. Thus, beside other treatment options splenectomy needs to be considered as a prime therapeutic option for IPH. PMID:20961440

[Management experience of acute renal failure induced by unilateral ureteral calculi obstruction].

PubMed

Tan, Fu-qing; Shen, Bo-hua; Xie, Li-ping; Meng, Hong-zhou; Fang, Dan-bo; Wang, Chao-jun

2013-05-28

To explore the causes and treatment options of acute renal failure induced by unilateral ureteral calculi obstruction. The clinical data of 12 cases of acute renal failure induced by unilateral ureteral calculi obstruction between August 2008 and July 2012 were reviewed retrospectively. There were 5 males and 7 females with an average age of 65.7 years. Their clinical data and treatment options were retrospectively analyzed and summarized. Seven cases showed right side ureteral calculus with hydronephrosis while another 5 presented left side ureteral calculus with hydronephrosis. Serum creatinine was higher than 310 µmol/L in 12 cases. Anuria appeared in 4 cases for 1-7 days while oliguria in 8 cases for 2-10 days. High fever was present in 11 cases, the highest of whom was 40 °C. White blood cell count increased in 10 cases (>10×10(9)/L) and decreased in 2 cases (<4 × 10(9)/L). The therapeutic options included insertion of double J stent for internal drainage (n = 1), percutaneous nephrostomy for external drainage (n = 10) and open operation (n = 1). Traditional treatments were performed to manage ureteral calculus in the above 11 cases with drainage. All cases had improved renal function after comprehensive treatment of anti-infection, antishock, rinsing stones and relieving obstruction. All 12 cases were treated successfully. Unilateral ureteral calculus may impair contralateral renal function and cause acute renal failure due to the absorption of toxin at obstructive side. The keys of management are eliminating toxin and relieving obstruction.

Incorporating environmental concerns into power sector decision-making: A case study of Sri Lanka. World Bank Environment Paper 6

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

Meier, P.; Munasinghe, M.; Team, S.L.S.

1994-04-01

Weighs Sri Lanka`s options for addressing environmental concerns during the planning stages of energy policymaking. Here is a holistic approach to analyzing the environmental impact of various power systems. Unlike standard impact studies that begin at the project level, this method calls for environmental assessments that start at the planning stage of a national framework for energy policymaking. The framework would take into account the energy needs of Sri Lanka`s total economy. It also would make it easier to incorporate environmental goals into power sector decisionmaking at the critical investment stage. Sri Lanka`s development options for the power sector aremore » reviewed in detail. Topics include alternative ways to assess the economic value of a power plant`s impact on biodiversity, human health, and air and water pollution. The study also assesses which energy planning options work best and recommends ways in which the Ceylon Electricity Board can improve its environmental policies.« less

Integra®-Dermal Regeneration Template and Split-Thickness Skin Grafting: A Therapy Approach to Correct Aplasia Cutis Congenita and Epidermolysis Bullosa in Carmi Syndrome.

PubMed

Trah, Julian; Has, Christina; Hausser, Ingrid; Kutzner, Heinz; Reinshagen, Konrad; Königs, Ingo

2018-05-18

The association of junctional epidermolysis bullosa with pyloric atresia (JEB-PA) and aplasia cutis congenita (ACC) was described by El Shafie et al. (J Pediatr Surg 14(4):446-449, 1979) and Carmi et al. (Am J Med Genet 11:319-328, 1982). Most patients die in the first weeks of life, and no curative treatment options are available so far. We describe a patient with JEB-PA and ACC (OMIM # 226730) who was treated for extensive areas of ACC by Integra ® -Dermal Regeneration Template and split-thickness skin grafting (STSG). Clinically, the dermal template changed into well-vascularized neodermis, and after STSG, full take of the transplants was detected. No infections of the huge ACC areas were seen. Further studies must validate this treatment option in severe and acute cases of JEB-PA with ACC. Based on clinical findings, we postulate that placement of Integra ® -Dermal Regeneration Template with STSG could be a new treatment option for patients having JEB-PA with ACC to prevent severe infection, compartment-syndrome-like conditions, and deformities. Based on literature findings, we assume that Integra ® -Dermal Regeneration Template with STSG could even be able to prevent new blistering and thereby be a treatment option in cases of ACC and JEB.

Kawasaki Disease: Etiopathogenesis and Novel Treatment Strategies

PubMed Central

Agarwal, Shreya; Agrawal, Devendra K.

2017-01-01

Introduction Kawasaki disease is an acute febrile systemic vasculitis that predominantly occurs in children below five years of age. Its etiopathogenesis is still not clear, but it is thought to be a complex interplay of genetic factors, infections and immunity. Areas covered This review article discusses in detail Kawasaki disease, with particular emphasis on the recent updates on its pathogenesis and upcoming alternate treatment options. Though self-limiting in many cases, it can lead to severe complications like coronary artery aneurysms and thrombo-embolic occlusions, and hence requires early diagnosis and urgent attention to avoid them. Intravenous immunoglobulin (IVIG) with or without aspirin has remained the sole treatment option for these cases, but 10-15% cases develop resistance to this treatment. Expert Commentary There is a need to develop additional treatment strategies for children with Kawasaki disease. Targeting different steps of pathogenesis could provide us with alternate therapeutic options. PMID:27590181

78 FR 64563 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... preference to not have a mix of options with open interest that expire on different days in a single month... that European-style options can be exercised only on the expiration date if such day is a business day or, in the case of option contracts expiring on a day that is not a business day, the last business...

78 FR 62722 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Order Granting...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... proposed rule change is intended to apply to any OCC Cleared OTC Option.\\7\\ \\5\\ See Securities Exchange Act... standardized index option.\\38\\ FINRA Rule 2330(b)(5)(A)(i)(b) generally requires only those members that are... FINRA, as is the case for all conventional options.\\40\\ \\37\\ Id. \\38\\ Id. See also FINRA Rule 2360(b)(5...

NORMATIVE SCIENCE: A CORRUPTING INFLUENCE IN ECOLOGICAL POLICY?

EPA Science Inventory

Is normative science corrupting the proper use of science in evaluating ecological policy options? Science is "normative" when it contains tacit policy values and thus, by extension, supports particular policy preferences. He will use the case study of "ecosystem health" as an ...

[Treatment Methods for Patients with Dupuytren's Disease in Switzerland].

PubMed

Marks, M; Krefter, C; Herren, D B

2016-06-01

The objective of this study was to investigate what treatment options are currently used in Switzerland for Dupuytren's disease. Furthermore, regional preferences and treatment differences based on surgeon experience were analysed. In this survey, an electronic questionnaire was sent to all members of the Swiss Society for Hand Surgery. Participants were asked to indicate their current treatment methods for Dupuytren's disease. In addition, 8 standard patient cases were presented to identify the preferred treatment option. Furthermore, sociodemographic data of the participants were gathered. In total, 70 questionnaires were completed, corresponding to a response rate of 34%. Fasciectomy is performed by 94% of participants, while 59% inject collagenase in certain cases, 40% perform open fasciotomy, and 24% carry out percutaneous needle aponeurotomy if the indication is given. 20% of responders offer one of these techniques, 50% offer 2, 23% offer 3, and 7% offer all 4 treatment techniques. In the case of isolated metacarpophalangeal joint contracture, 51% of participants inject collagenase, whereas fasciectomy is preferred for the treatment of proximal interphalangeal joint contractures or in cases of recurrence. In German-speaking Switzerland, the treatment strategy has changed towards applying collagenase injections in the past 5 years. In this part of the country, 83% of surgeons now use more collagenase than 5 years ago, whereas only 33% of surgeons in French-speaking Switzerland have changed their treatment strategy in favour of collagenase injections (p=0.027). Surgeons with less than 10 years of experience apply more collagenase than their more experienced colleagues (79 vs. 54%, p=0.131). In Switzerland, fasciectomy is the preferred option for treating patients with Dupuytren's disease. In recent years, however, collagenase injection has become more and more popular. More research is needed to define guidelines for the treatment of patients with Dupuytren's disease considering the effectiveness of the different treatment options and regional preferences. © Georg Thieme Verlag KG Stuttgart · New York.

A Case Study of Gifted Education in Two Oklahoma School Districts

ERIC Educational Resources Information Center

Rains, Marcia

2015-01-01

The purpose of this study was to investigate and study the importance of educational services mandated for Oklahoma's gifted and talented students with the conclusion being likely able to assist educators in providing gifted service options to meet the needs of gifted learners. Research has shown the need to provide educational services to gifted…

Selective Attention in Web Forms: An Exploratory Case Study with Older People

ERIC Educational Resources Information Center

Sayago, Sergio; Guijarro, Jose-Maria; Blat, Josep

2012-01-01

This article reports on an exploratory study aimed to identify which ways of marking required and optional fields help older people fill in web forms correctly. Drawing on a pilot study and selective attention research in ageing, modified versions of widely used forms were created, in which standard asterisks were replaced with one of three…

Teaching Future Crop Protection Practitioners through the Use of On-Line Cases: Practicing IPM Spray Decisions in New Zealand Apple Orchards

ERIC Educational Resources Information Center

Stewart, Terry Mark

2015-01-01

Purpose: There are many complexities to be considered when selecting tactical control options in crops grown under an Integrated Pest Management (IPM) regime. Students being trained in IPM are made aware of this complexity but do not always get the chance to experience IPM decision-making first-hand. This case study describes a web-based…

Pneumoperitoneum after virtual colonoscopy: causes, risk factors, and management.

PubMed

Baccaro, Leopoldo M; Markelov, Alexey; Wilhelm, Jakub; Bloch, Robert

2014-06-01

Computed tomographic virtual colonoscopy (CTVC) is a safe and minimally invasive modality when compared with fiberoptic colonoscopy for evaluating the colon and rectum. We have reviewed the risks for colonic perforation by investigating the relevant literature. The objectives of this study were to assess the risk of colonic perforation during CTVC, describe risk factors, evaluate ways to reduce the incidence complications, and to review management and treatment options. A formal search of indexed publications was performed through PubMed. Search queries using keywords "CT colonography," "CT virtual colonoscopy," "virtual colonoscopy," and "perforation" yielded a total of 133 articles. A total of eight case reports and four review articles were selected. Combining case reports and review articles, a total of 25 cases of colonic perforation after CTVC have been reported. Causes include, but are not limited to, diverticular disease, irritable bowel diseases, obstructive processes, malignancies, and iatrogenic injury. Both operative and nonoperative management has been described. Nonoperative management has been proven safe and successful in minimally symptomatic and stable patients. Colonic perforation after CTVC is a rare complication and very few cases have been reported. Several risk factors are recurrent in the literature and must be acknowledged at the time of the study. Management options vary and should be tailored to each individual patient.

Selection of Sustainable Processes using Sustainability Footprint Method: A Case Study of Methanol Production from Carbon Dioxide

EPA Science Inventory

Chemical products can be obtained by process pathways involving varying amounts and types of resources, utilities, and byproduct formation. When such competing process options such as six processes for making methanol as are considered in this study, it is necessary to identify t...

The Value of ICT from a Learning Game-Playing Perspective

ERIC Educational Resources Information Center

McNeill, Michael C.; Fry, Joan M.

2012-01-01

This study evaluated an Information and Communication Technology (ICT) case study in physical education teacher education from a student perspective. Action research evaluated the impact of a range of ICT options on student teachers' learning to play as well as learning to teach games in a secondary school context. Although multiple media were…

Latino/a Cultural Perspectives of Social Presence: A Case Study

ERIC Educational Resources Information Center

Plotts, Courtney

2018-01-01

Many Latino/a students select online learning as a viable option for completing a college degree. Yet, Latino/a perspectives regarding online social presence is unknown. This study explored Latino/a students' perceptions of social presence in online courses as related to their culture perspectives of interpersonal communication, values, norms and…

Reconstruction of mandibular defects with autogenous bone grafts: a review of 30 cases.

PubMed

Sajid, Malik Ali Hassan; Warraich, Riaz Ahmed; Abid, Hina; Ehsan-ul-Haq, Muhammad; Shah, Khurram Latif; Khan, Zafar

2011-01-01

Multitudes of options are available for reconstruction of functional and cosmetic defects of the mandible, caused by various ailments. At the present time, autogenous bone grafting is the gold standard by which all other techniques of reconstruction of the mandible can be judged. The purpose of this study was to evaluate the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstruction. This Interventional study was conducted at Department of Oral and Maxillofacial Surgery, King Edward Medical University/Mayo Hospital Lahore, from January 2008 to July 2009 including one year follow-up. The study was carried out on thirty patients having bony mandibular defects. They were reconstructed with the autogenous bone grafts from different graft donor sites. On post-operative visits they were evaluated for outcome variables. Success rate of autogenous bone grafts in this study was 90%. Only 10% of the cases showed poor results regarding infection, resorption and graft failure. Autogenous bone grafts, non-vascularised or vascularised, are a reliable treatment modality for the reconstruction of the bony mandibular defects with predictable functional and aesthetic outcome.

Effectiveness of Riluzole as a pharmacotherapeutic treatment option for early cervical myelopathy: a double-blinded, placebo-controlled randomised controlled trial.

PubMed

Rajasekaran, S; Aiyer, Siddharth N; Shetty, Ajoy Prasad; Kanna, Rishi Mugesh; Maheswaran, Anupama; Shetty, Janardhan Yerram

2016-06-01

To evaluate the effectiveness of Riluzole as a pharmacotherapeutic treatment option for early cervical myelopathy using clinical parameters and DTI analysis. Early cervical myelopathy cases with MJOA scores ≥13, were recruited for the double-blinded, placebo-controlled randomised control trial. Thirty cases with fifteen cases each in the test and placebo group were studied. Analysis was done using diffusion tensor imaging (DTI) and clinical evaluation, pre- and post-institution of sodium channel blocker Riluzole for a period of 1 month (50 mg twice daily). Placebo group was treated with Vitamin B complex tablets. Diffusion co-efficient fractional anisotrophy (FA), apparent diffusion co-efficient (ADC), volume ratio (VR), relative anisotrophy (RA) and Eigen vectors were calculated. Outcomes analysis was based on clinical scores of MJOA, Nurick grading, SF-12, NDI, and statistical analysis of DTI datametrics. The mean MJOA score was 15.6 (13-17) with no significant change in the test and control groups. The mean ADC, FA values were 1533.36 (1238-1779) and 494.36 (364-628) and changed to 1531.57 (1312-2091) and 484.86 (294-597), respectively, in the Riluzole group. However, the changes in the values of ADC, FA, and other co-efficients including VR, RA and eigenvectors in the two groups were not statistically significant. The functional scores in the SF-12 and NDI questionnaires did not change significantly. Our study did not show a significant change in the clinical outcome and DTI Indices with the use of Riluzole as a standalone pharmacotherapeutic agent for early cervical myelopathy. More studies may be needed to confirm the usefulness of Riluzole as a treatment option for cervical myelopathy.

Evidence basis for management of spine and chest wall deformities in children.

PubMed

Sponseller, Paul D; Yazici, Muharrem; Demetracopoulos, Constantine; Emans, John B

2007-09-01

: Review of relevant studies, including levels of evidence. : To review research on growth of the spine and chest wall and treatment of deformities. To place this knowledge in context of evidence-based assessment. : Knowledge of the growth of the spine, chest wall, and lung in the normal and deformity states has evolved among independent specialties over the past 60 years. Interest in the interrelationship has blossomed as more tools for assessment and treatment have developed. Spine-based and chest wall-based treatment options now exist, as well as options of resection versus gradual distraction. : Peer-reviewed research published on the growth of the spine, lung, chest wall, and treatment of their deformities was reviewed. Treatment methods and outcomes were compared. Ranking of the levels of evidence was performed where possible. : Most studies of these topics are Level III and IV studies, consisting of case-control studies and case series. This limitation arises because of the rarity and heterogeneity of the disorders affecting the growing spine and chest wall. The natural history of most types of spinal/chest wall deformities is not known with accuracy. Some experimental evidence informs the treatments which involve modulation of the growth of the spine. However, accurate models of the deformities themselves are lacking. Improvements in imaging and measurement offer options for more accurate patient comparison. : The natural history and results of treatment of deformities of the spine and chest wall offer much opportunity for further evidence-based research.

Cost-effectiveness of the management of rh-negative pregnant women.

PubMed

Duplantie, Julie; Gonzales, Odilon Martinez; Bois, Antoine; Nshimyumukiza, Léon; Gekas, Jean; Bujold, Emmanuel; Morin, Valérie; Vallée, Maud; Giguère, Yves; Gagné, Christian; Rousseau, François; Reinharz, Daniel

2013-08-01

The purpose of this study was to determine the most cost-effective option to prevent alloimmunization against the Rh factor. A virtual population of Rh-negative pregnant women in Quebec was built to simulate the cost-effectiveness of preventing alloimmunization. The model considered four options: (1) systematic use of anti-D immunoglobulin; (2) fetal Rh(D) genotyping; (3) immunological determination of the father's Rh type; (4) mixed screening: immunological determination of the father's Rh type, followed if positive by fetal Rh(D) genotyping. Two outcomes were considered, in addition to the estimated costs: (1) the number of babies without hemolytic disease, and (2) the number of surviving infants. In a first pregnancy, two options emerged as the most cost-effective options: systematic prophylaxis and immunological Rh typing of the father, with overlapping confidence intervals between them. In a second pregnancy, the results were similar. In all cases (first or second pregnancy or a combination of the two) fetal genotyping was not found to be a cost-effective option. Routine prophylaxis and immunological Rh typing of the father are the most cost-effective options for the prevention of Rh alloimmunization. Considering that immunological typing of the father would probably not be carried out by the majority of clinicians, routine prophylaxis remains the preferred option. However, this could change if the cost of Rh(D) fetal genotyping fell below $140 per sample.

Endovascular Approach for Management of Bullet Embolization to the Heart.

PubMed

Mojtahedi, Alireza; Contractor, Sohail; Kisza, Piotr S

2018-05-01

Bullet embolization to the right heart through the vasculature is seen infrequently in cases presenting with penetrating trauma. Patients with unstable hemodynamic status are managed operatively. For a patient with stable hemodynamic parameters, diagnostic evaluation such as computed tomography angiogram, echocardiogram, or angiography could be performed to select the best treatment option. Endovascular treatment is employed infrequently in these cases but can be a viable option for select patients. We present a case of a bullet embolus to the right ventricle treated successfully with endovascular approach and discuss the technical aspects of this approach.

Economics of Utility Scale Photovoltaics at Purdue University

NASA Astrophysics Data System (ADS)

Arnett, William

The research for this case study shows that utility scale solar photovoltaics has become a competitive energy investment option, even when a campus operates a power plant at low electricity rates. To evaluate this an economic model called SEEMS (Solar Economic Evaluation Modelling Spreadsheets) was developed to evaluate a number of financial scenarios in Real Time Pricing for universities. The three main financing structures considered are 1) land leasing, 2) university direct purchase, and 3) third party purchase. Unlike other commercially available models SEEMS specifically accounts for real time pricing, where the local utility provides electricity at an hourly rate that changes with the expected demand. In addition, SEEMS also includes a random simulation that allows the model to predict the likelihood of success for a given solar installation strategy. The research showed that there are several options for utility scale solar that are financially attractive. The most practical financing structure is with a third party partnership because of the opportunity to take advantage of tax incentives. Other options could become more attractive if non-financial benefits are considered. The case study for this research, Purdue University, has a unique opportunity to integrate utility-scale solar electricity into its strategic planning. Currently Purdue is updating its master plan which will define how land is developed. Purdue is also developing a sustainability plan that will define long term environmental goals. In addition, the university is developing over 500 acres of land west of campus as part of its Aerospace Innovation District. This research helps make the case for including utility-scale solar electricity as part of the university's strategic planning.

Including the online feedback site, Patient Opinion, in the nursing curriculum: Exploratory study.

PubMed

Jones, Ray; Young, Kim; Munro, James; Miller, Heather; Brelsford, Stephanie; Aronsson, Jennie; Goodman, Benny; Peters, Jane

2017-10-01

Globally, universities aim to involve people who use health services to enrich the nursing curriculum for students, but there can be barriers to this involvement. Many also want students to contribute to local communities. Online communication can help connect students to service users to achieve these aims. The online British patient feedback site, Patient Opinion, gathers comments from service users about services and encourages service responses to the comments. To explore the feasibility and acceptability of five ways of including Patient Opinion in the undergraduate nursing curriculum. Five case studies using mixed data collection methods. British University with nursing students across two campuses, accustomed to using webinars, video presentations and social media. Students from different years participated in the five approaches of making use of Patient Opinion in the curriculum; 18 students took part in an online forum to discuss Patient Opinion in the curriculum. We trialled timetabled webinars, video-linked lectures, optional enhanced access for self-study, optional audit of service user comments for two local hospitals, and optional Twitter and Tweetchat. Students discussed the aims and approaches in an online forum. Of the five approaches trialled, webinars seemed effective in ensuring that all nursing students engaged with the topic. Video-linked lectures provided an alternative when timetabling did not allow webinars, but were less interactive. The three optional approaches (Tweetchats, audit exercise, self-directed study) provided opportunities for some students to enhance their learning but students needed guidance. Sending a summary of student reviews of patients' feedback to local hospitals illustrated how students might be agents of change in local health services. Experience from these case studies suggests that webinars followed by use of Patient Opinion preparing for placements may be a sustainable way of embedding feedback sites in the nursing curriculum. Copyright © 2017 Elsevier Ltd. All rights reserved.

Economic Impact of Harvesting Corn Stover under Time Constraint: The Case of North Dakota

DOE PAGES

Maung, Thein A.; Gustafson, Cole R.

2013-01-01

This study examines the impact of stochastic harvest field time on profit maximizing potential of corn cob/stover collection in North Dakota. Three harvest options are analyzed using mathematical programming models. Our findings show that under the first corn grain only harvest option, farmers are able to complete harvesting corn grain and achieve maximum net income in a fairly short amount of time with existing combine technology. However, under the second simultaneous corn grain and cob (one-pass) harvest option, farmers generate lower net income compared to the net income of the first option. This is due to the slowdown in combinemore » harvest capacity as a consequence of harvesting corn cobs. Under the third option of separate corn grain and stover (two-pass) harvest option, time allocation is the main challenge and our evidence shows that with limited harvest field time available, farmers find it optimal to allocate most of their time harvesting grain and then proceed to harvest and bale stover if time permits at the end of harvest season. The overall findings suggest is that it would be more economically efficient to allow a firm that is specialized in collecting biomass feedstock to participate in cob/stover harvest business.« less

Economic Impact of Harvesting Corn Stover under Time Constraint: The Case of North Dakota

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

Maung, Thein A.; Gustafson, Cole R.

This study examines the impact of stochastic harvest field time on profit maximizing potential of corn cob/stover collection in North Dakota. Three harvest options are analyzed using mathematical programming models. Our findings show that under the first corn grain only harvest option, farmers are able to complete harvesting corn grain and achieve maximum net income in a fairly short amount of time with existing combine technology. However, under the second simultaneous corn grain and cob (one-pass) harvest option, farmers generate lower net income compared to the net income of the first option. This is due to the slowdown in combinemore » harvest capacity as a consequence of harvesting corn cobs. Under the third option of separate corn grain and stover (two-pass) harvest option, time allocation is the main challenge and our evidence shows that with limited harvest field time available, farmers find it optimal to allocate most of their time harvesting grain and then proceed to harvest and bale stover if time permits at the end of harvest season. The overall findings suggest is that it would be more economically efficient to allow a firm that is specialized in collecting biomass feedstock to participate in cob/stover harvest business.« less

Options for biodiversity conservation in managed forest landscapes of multiple ownerships in Oregon and Washington, USA.

Treesearch

N. Suzuki; D.H. Olson

2007-01-01

We review the policies and management approaches used in U.S. Pacific Northwest planted forest to address biodiversity protection. We provide a case-study watershed design from southern Oregon, integrating various stand-to-landscape biodiversity-management approaches.

Case histories of six consumers and their families in Cash and Counseling.

PubMed

San Antonio, Patricia M; Simon-Rusinowitz, Lori; Loughlin, Dawn; Eckert, J Kevin; Mahoney, Kevin J

2007-02-01

To examine how the lives of consumers and their caregivers were affected by making choices and controlling their own resources with the cash option, this paper focuses on six case studies from the Cash and Counseling Demonstration Program. Twenty-one consumers, caregivers, and state consultants were interviewed about their experiences in the program. The data come from a larger study of over 200 interviews conducted from June 2000 to August 2004. Interview data were analyzed for themes about caregiving and program satisfaction. Cash and Counseling benefited consumers and caregivers by allowing consumers increased continuity and reliability of care, increased ability to set hours of care, more satisfaction with how caregiving is offered and more satisfaction with the quality of care. The cash option allowed consumers to create, schedule, and manage their own model of care. Some consumers faced challenges in the program with paperwork, accounting, worries about receiving care, and some ineffective state consultants who could have been more helpful.

Liquid–Liquid Mixing Studies in Annular Centrifugal Contactors Comparing Stationary Mixing Vane Options

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

Wardle, Kent E.

2015-11-10

Comparative studies of multiphase operation of annular centrifugal contactors showing the impact of housing stationary mixing vane configuration. A number of experimental results for several different mixing vane options are reported with selected measurements in a lab-scale 5 cm contactor and 12.5 cm engineering-scale unit. Fewer straight vanes give greater mixingzone hold-up compared to curved vanes. Quantitative comparison of droplet size distribution also showed a significant decrease in mean diameter for four straight vanes versus eight curved vanes. This set of measurements gives a compelling case for careful consideration of mixing vane geometry when evaluating hydraulic operation and extraction processmore » efficiency of annular centrifugal contactors.« less

Liquid–liquid mixing studies in annular centrifugal contactors comparing stationary mixing vane options

DOE PAGES

Wardle, Kent E.

2015-09-11

Comparative studies of multiphase operation of an annular centrifugal contactor show the impact of housing stationary mixing vane configuration. A number of experimental results for several different mixing vane options are reported for operation of a 12.5 cm engineering-scale contactor unit. Fewer straight vanes give greater mixing-zone hold-up compared to curved vanes. Quantitative comparison of droplet size distribution also showed a significant decrease in mean diameter for four straight vanes versus eight curved vanes. This set of measurements gives a compelling case for careful consideration of mixing vane geometry when evaluating hydraulic operation and extraction process efficiency of annular centrifugalmore » contactors.« less

Assessment of follicle viability using fluorescence microscopy before and after ovarian thawing.

PubMed

Sofoudis, C; Zervomanolakis, I; Galani, I; Grigoriou, V; Botsis, D; Vlahos, N

2017-01-01

The incidence of young women diagnosed with cancer has been globally increasing. In many cases the surgical approach followed by chemotherapy, radiotherapy or hormonal therapy could lead to infertility or premature ovarian failure. Several options are available in order to preserve fertility and increase the future gestation rate. Among embryo cryopreservation and oocyte cryopreservation, ovarian tissue cryopreservation represents an ideal option, especially for premenopausal women and for those who cannot delay the start of chemotherapy. The purpose of this study was to examine the follicle viability using fluorescence microscope before and after ovarian thawing.

Option pricing from wavelet-filtered financial series

NASA Astrophysics Data System (ADS)

de Almeida, V. T. X.; Moriconi, L.

2012-10-01

We perform wavelet decomposition of high frequency financial time series into large and small time scale components. Taking the FTSE100 index as a case study, and working with the Haar basis, it turns out that the small scale component defined by most (≃99.6%) of the wavelet coefficients can be neglected for the purpose of option premium evaluation. The relevance of the hugely compressed information provided by low-pass wavelet-filtering is related to the fact that the non-gaussian statistical structure of the original financial time series is essentially preserved for expiration times which are larger than just one trading day.

Rapid Response R&D for the Propulsion Directorate. Delivery Order 0019: Advanced Alternative Energy Technologies, Subtask: Life Cycle Greenhouse Gas Analysis of Advanced Jet Propulsion Fuels: Fischer-Tropsch Based SPK-1 Case Study

DTIC Science & Technology

2011-09-01

carry finished jet fuel from the CBTL facility. The pipeline connects the CBTL facility to a petroleum refinery located in Wood River, Illinois...Under Option 1, all the blended jet fuel is transported via pipeline from the refinery in Wood River to Chicago’s O’Hare airport. Under Option 2...shipping F-T jet fuel to a refinery in Wood River, Illinois (near St. Louis, Missouri) for blending and final transport of the blended jet fuel to

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

Rearden, Bradley T; Marshall, William BJ J

In the course of criticality code validation, outlier cases are frequently encountered. Historically, the causes of these unexpected results could be diagnosed only through comparison with other similar cases or through the known presence of a unique component of the critical experiment. The sensitivity and uncertainty (S/U) analysis tools available in the SCALE 6.1 code system provide a much broader range of options to examine underlying causes of outlier cases. This paper presents some case studies performed as a part of the recent validation of the KENO codes in SCALE 6.1 using S/U tools to examine potential causes of biases.

Tracing the decision-making process of physicians with a Decision Process Matrix.

PubMed

Hausmann, Daniel; Zulian, Cristina; Battegay, Edouard; Zimmerli, Lukas

2016-10-18

Decision-making processes in a medical setting are complex, dynamic and under time pressure, often with serious consequences for a patient's condition. The principal aim of the present study was to trace and map the individual diagnostic process of real medical cases using a Decision Process Matrix [DPM]). The naturalistic decision-making process of 11 residents and a total of 55 medical cases were recorded in an emergency department, and a DPM was drawn up according to a semi-structured technique following four steps: 1) observing and recording relevant information throughout the entire diagnostic process, 2) assessing options in terms of suspected diagnoses, 3) drawing up an initial version of the DPM, and 4) verifying the DPM, while adding the confidence ratings. The DPM comprised an average of 3.2 suspected diagnoses and 7.9 information units (cues). The following three-phase pattern could be observed: option generation, option verification, and final diagnosis determination. Residents strove for the highest possible level of confidence before making the final diagnoses (in two-thirds of the medical cases with a rating of practically certain) or excluding suspected diagnoses (with practically impossible in half of the cases). The following challenges have to be addressed in the future: real-time capturing of emerging suspected diagnoses in the memory of the physician, definition of meaningful information units, and a more contemporary measurement of confidence. DPM is a useful tool for tracing real and individual diagnostic processes. The methodological approach with DPM allows further investigations into the underlying cognitive diagnostic processes on a theoretical level and improvement of individual clinical reasoning skills in practice.

Identifying Underlying Emotional Instability and Utilizing a Combined Intervention in the Treatment of Childhood Constipation and Encopresis-A Case Report.

PubMed

Davis, Jamie L

2016-06-01

Childhood constipation is a common ailment that in certain cases can lead to encopresis or fecal incontinence. The literature suggests that standard care varies in effectiveness, especially in the long term. Fecal incontinence can lead to frustration, guilt, and shame for both the child and family and has untold long-term psychological and physical consequences. To address alternative treatment options for pediatric constipation and encopresis by using acupuncture and Chinese medicine. Patient and Setting: This is a case study of a 6-year-old girl seen in a private practice acupuncture clinic in the northwestern United States. Treatment involved acupuncture, massage, and Chinese herbal medicine. The patient in this study began to have regular bowel movements on her own, from a type 5 on the modified Bristol Stool Form Scale for Children to a type 3, with no laxative use and few to no fecal accidents. Emotional stability and support seem to play an important role in pediatric constipation and encopresis. Acupuncture may be an effective treatment option in the integrative care model to address both the emotional and physical components of childhood constipation.

The precautionary principle and emerging biological risks: lessons from swine flu and HIV in blood products.

PubMed Central

Stoto, Michael A.

2002-01-01

Two examples-the "swine flu affair" in 1976 and the emergence of HIV in the blood supply in the early 1980s-illustrate the difficulties of decision-making in public health. Both cases illustrate trade-offs between product risks and public health benefits, especially with regard to uncertainty in estimates of product risks, public health risks, and the benefits of prevention. The cases also illustrate the tendency of public health policy makers to go all the way or do nothing at all, rather than consider intermediate options that can be adapted as new information emerges. This review suggests three lessons for public health policy makers: (1) be open and honest about scientific uncertainty; (2) communicate with the public, even when the facts are not clear; and (3) consider intermediate, adaptable policy options, such as obtaining more information, thus reducing uncertainty, and building in decision points to reconsider initial policies. Underlying all of these lessons is the need to commission studies to resolve important uncertainties and increase the information base for public communication, and to review regulations and other policy options in the light of the new data that emerge. PMID:12576534

The precautionary principle and emerging biological risks: lessons from swine flu and HIV in blood products.

PubMed

Stoto, Michael A

2002-01-01

Two examples-the "swine flu affair" in 1976 and the emergence of HIV in the blood supply in the early 1980s-illustrate the difficulties of decision-making in public health. Both cases illustrate trade-offs between product risks and public health benefits, especially with regard to uncertainty in estimates of product risks, public health risks, and the benefits of prevention. The cases also illustrate the tendency of public health policy makers to go all the way or do nothing at all, rather than consider intermediate options that can be adapted as new information emerges. This review suggests three lessons for public health policy makers: (1) be open and honest about scientific uncertainty; (2) communicate with the public, even when the facts are not clear; and (3) consider intermediate, adaptable policy options, such as obtaining more information, thus reducing uncertainty, and building in decision points to reconsider initial policies. Underlying all of these lessons is the need to commission studies to resolve important uncertainties and increase the information base for public communication, and to review regulations and other policy options in the light of the new data that emerge.

Cleaner production options for reducing industrial waste: the case of batik industry in Malang, East Java-Indonesia

NASA Astrophysics Data System (ADS)

Sirait, M.

2018-01-01

The aim of this research is to conduct cleaner production options for improving the environmental performance during the production of batik industry, the case of UKM batik, Malang, East Java. Batik industry is one of small and medium textile industry which has contribution to economic growth in Malang. However, during production the batik, it generates wastewater that has potential to decrease the environmental performance. Wastewater from Celaket batik industry has BOD, COD, TSS, and pH level is far larger than the threshold of water quality standard as a result of use chemical substance during the dyes processing. In order to prevent generating wastewater, this study utilized cleaner production options, such as substitution of input material.Substitution of input material for dyes process was implemented by replacement chemical dyes (e.g.indigosol, nafthol, rapid) with natural dyes (e.g. Indigofero Tintoria). Modifying of technology/equipment was conducted by developing wastewater treatment equipment to reduce waste of batik production. The implementation of this strategy was carried out by changing input material from chemical dyes with natural dyes. The CP uptake could reduce significantly the environmental impact in term of reduction of COD, BOD, and TSS.

Novel implications in the treatment of hepatocellular carcinoma

PubMed Central

Best, Jan; Schotten, Clemens; Theysohn, Jens M.; Wetter, Axel; Müller, Stefan; Radünz, Sonia; Schulze, Maren; Canbay, Ali; Dechêne, Alexander; Gerken, Guido

2017-01-01

Worldwide hepatocellular carcinoma remains one of the leading causes of cancer-related death, associated with a poor prognosis due to late diagnosis in the majority of cases. Physicians at care are frequently confronted with patients who are ineligible for curative treatment such as liver resection, transplantation or radiofrequency ablation. Besides established palliative locoregional therapies, such as ablation or chemoembolization, new treatment options, such as microwave ablation, drug-eluting bead transarterial chemoembolization or selective internal radiation therapy, are emerging; however, data from randomized controlled trials are still lacking. In order to achieve optimal tumor control, patients should receive tailored treatment concepts, considering their tumor burden, liver function and performance status, instead of strictly assigning patients to treatment modalities following algorithms that may be partly very restrictive. Palliative locoregional pretreatment might facilitate downstaging to ensure later curative resection or transplantation. In addition, the combined utilization of different locoregional treatment options or systemic co-treatment has been the subject of several trials. In cases where local tumor control cannot be achieved, or in the scenario of extrahepatic spread, sorafenib remains the only approved systemic therapy option. Alternative targeted therapies, such as immune checkpoint inhibitors have shown encouraging preliminary results, while data from phase III studies are pending. PMID:28042235

Electroconvulsive therapy (ECT) for treating agitation in dementia (major neurocognitive disorder) - a promising option.

PubMed

Glass, Oliver M; Forester, Brent P; Hermida, Adriana P

2017-05-01

Agitation in patients with dementia increases caretaker burden, increases healthcare costs, and worsens the patient's quality of life. Antipsychotic medications, commonly used for the treatment of agitation in patients with dementia have a box warning from the FDA for elevated mortality risk. Electroconvulsive therapy (ECT) has made significant advances over the past several years, and is efficacious in treating a wide range of psychiatric conditions. We provide a systematic review of published literature regarding the efficacy of ECT for the treatment of agitation in patients with dementia (major neurocognitive disorder). We searched PubMed, Medline, Google Scholar, UptoDate, Embase, and Cochrane for literature concerning ECT for treating agitation in dementia using the title search terms "ECT agitation dementia;" "ECT aggression dementia;" "ECT Behavior and Psychological Symptoms of Dementia;" and "ECT BPSD." The term "dementia" was also interchanged with "Major Neurocognitive Disorder." No time frame restriction was placed. We attempted to include all publications that were found to ensure a comprehensive review. We found 11 papers, with a total (N) of 216 patients. Limited to case reports, case series, retrospective chart review, retrospective case-control, and an open label prospective study, ECT has demonstrated promising results in decreasing agitation in patients with dementia. Patients who relapsed were found to benefit from maintenance ECT. Available studies are often limited by concomitant psychotropic medications, inconsistent use of objective rating scales, short follow-up, lack of a control group, small sample sizes, and publication bias. A future randomized controlled trial will pose ethical and methodological challenges. A randomized controlled trial must carefully consider the definition of usual care as a comparison group. Well-documented prospective studies and/or additional case series with explicit selection criteria, a wide range of outcome measures, and less selection bias of the study sample that may favor treatment response, is warranted. ECT may be a promising option for the treatment of aggression and agitation in patients with severe dementia who are refractory to other treatment options, but the limitations of available studies suggest that a cautious approach to future randomized controlled trials is warranted.

Defining principles for good practice: using case studies to inform health systems action on health inequalities.

PubMed

Simpson, Sarah; Kelly, Michael P; Morgan, Antony

2013-02-01

This paper presents work using case studies as a source of data to see if we could extrapolate from the specific to the general particularly with regard to understanding what constitutes effective practice in taking action on SDHI and as a way of enabling policy makers to make better use of knowledge within the case studies and as a way of better understanding what works, in what context and why. Case studies are important to evaluators in that they are relatively straightforward to undertake and because those involved in implementing an intervention are usually keen to profile the intervention. A checklist described in this paper will enable policy advisers and evaluators to quickly review a case study and right away see if it contains enough information to assist in the development of policy options for reducing socially determined health inequalities. Copyright © 2012 Elsevier Ltd. All rights reserved.

"I Gained a Skill and a Change in Attitude": A Case Study Describing How an Online Continuing Professional Education Course for Pharmacists Supported Achievement of Its Transfer-to-Practice Outcomes

ERIC Educational Resources Information Center

Marks, Pia Zeni; Jennings, Brad; Farrell, Barbara; Kennie-Kaulbach, Natalie; Jorgenson, Derek; Sharpe, Jane Pearson; Waite, Nancy

2014-01-01

The convenience and flexibility of online learning clearly make it an attractive option for learners in professional development contexts. There is less clarity, however, about how it fares as a vehicle for enabling the applied, practice-oriented outcomes typically associated with professional development learning. This paper presents a case study…

Management of failed rotator cuff repair: a systematic review

PubMed Central

Lädermann, Alexandre; Denard, Patrick J; Burkhart, Stephen S

2016-01-01

Importance Recurrent tear after rotator cuff repair (RCR) is common. Conservative, and open and arthroscopic revisions, have been advocated to treat these failures. Aim or objective The purpose of this systematic review was to evaluate the different options for managing recurrent rotator cuff tears. Evidence review A search was conducted of level I through 4 studies from January 2000 to October 2015, to identify studies reporting on failed RCR. 10 articles were identified. The overall quality of evidence was very low. Findings Mid-term to long-term follow-up of patients treated conservatively revealed acceptable results; a persistent defect is a well-tolerated condition that only occasionally requires subsequent surgery. Conservative treatment might be indicated in most patients, particularly in case of posterosuperior involvement and poor preoperative range of motion. Revision surgery might be indicated in a young patient with a repairable lesion, a 3 tendon tear, and in those with involvement of the subscapularis. Conclusions and relevance The current review indicates that arthroscopic revision RCR can lead to improvement in functional outcome despite a high retear rate. Further studies are needed to develop specific rehabilitation in the case of primary rotator cuff failure, to better understand the place of each treatment option, and, in case of repair, to optimise tendon healing. PMID:27134759

SALMON RECOVERY: A CASE STUDY OF CONTESTED ISSUES IN ECOLOGICAL SCIENCE AND POLICY

EPA Science Inventory

The primary goal of the Salmon 2100 Project is to identify practical options that have a high probability of maintaining biologically significant, sustainable populations of wild salmon in California, Oregon, Washington, Idaho, and British Columbia. The Project does not support o...

[An exceptional association between retroperitoneal dedifferentiated liposarcoma and well differentiated pericolonic liposarcoma: about a case].

PubMed

Sinaa, Mohamed

2016-01-01

Liposarcoma is an extremely rare malignant adipose mesenchymal tumor. World Health Organization classifies liposarcomas into five subtypes: well differentiated, myxoid, pleomorphic, dedifferentiated and mixed. The association between multiple and synchronous location of several subtypes of liposarcomas is exceptional. Only 34 cases have been reported in the literature. We report the case of synchronous association between retroperitoneal dedifferentiated liposarcoma and two small well-differentiated lipoma-like pericolic liposarcomas. Anatomopathological aspects, therapeutic options and prognostic factors of liposarcomas have been reviewed in this study.

Health treaty dilution: a case study of Japan's influence on the language of the WHO Framework Convention on Tobacco Control

PubMed Central

Assunta, Mary; Chapman, Simon

2006-01-01

Background The Japanese government is an important shareholder in the Japanese tobacco industry. Negotiations to develop the WHO's historic Framework Convention on Tobacco Control (FCTC) were based on consensus, resulting in countries needing to agree to the lowest acceptable common denominator in clause development. Objective To illustrate Japan's role in negotiating key optional language in the FCTC text. Methods Summary reports, text proposals, conference papers, and speeches related to the six FCTC negotiation sessions were reviewed for repeated words, concepts and emerging themes. Key stakeholders were interviewed. Key words such as “sovereignty”, “appropriate”, “latitude”, “individual”, “flexibility”, and “may” representing optional language were examined. Results The Japanese government's proposals for “appropriate” and optional measures are reflected in the final FCTC text that accommodates flexibility on interpretation and implementation on key tobacco controls. While Japan was not alone in proposing optional language, consensus accommodated their proposals. Conclusion Japan's success in arguing for extensive optional language seriously weakened the FCTC. Accordingly, international tobacco control can be expected to be less successful in reducing the burden of disease caused by tobacco use. PMID:16905717

Cost-comparison of different management policies for tuberculosis patients in Italy. AIPO TB Study Group.

PubMed Central

Migliori, G. B.; Ambrosetti, M.; Besozzi, G.; Farris, B.; Nutini, S.; Saini, L.; Casali, L.; Nardini, S.; Bugiani, M.; Neri, M.; Raviglione, M. C.

1999-01-01

Although in developing countries the treatment of tuberculosis (TB) cases is among the most cost-effective health interventions, few studies have evaluated the cost-effectiveness of TB control in low-prevalence countries. The aim of the present study was to carry out an economic analysis in Italy that takes into account both the perspective of the resource-allocating authority (i.e. the Ministry of Health) and the broader social perspective, including a cost description based on current outcomes applied to a representative sample of TB patients nationwide (admission and directly observed treatment (DOT) during the initial intensive phase of treatment); a cost-comparison analysis of two alternative programmes: current policy based on available data (scenario 1) and an hypothetical policy oriented more towards outpatient care (scenario 2) (both scenarios included the option of including or not including DOT outside hospital admission, and incentives) were compared in terms of cost per case treated successfully. Indirect costs (such as loss of productivity) were included in considerations of the broader social perspective. The study was designed as a prospective monitoring activity based on the supervised collection of forms from a representative sample of Italian TB units. Individual data were collected and analysed to obtain a complete economic profile of the patients enrolled and to evaluate the effectiveness of the intervention. A separate analysis was done for each scenario to determine the end-point at different levels of cure rate (50-90%). The mean length of treatment was 6.6 months (i.e. patients hospitalized during the intensive phase; length of stay was significantly higher in smear-positive patients and in human immunodeficiency virus (HIV) seropositive patients). Roughly six direct smear and culture examinations were performed during hospital admission and three during ambulatory treatment. The cost of a single bed day was US$186.90, whereas that of a single outpatient visit ranged, according to the different options, from US$2.50 to US$11. Scenario 2 was consistently less costly than scenario 1. The cost per case cured for smear-positive cases was US$16,703 in scenario 1 and US$5946 in scenario 2. The difference in cost between the cheapest option (no DOT) and the more expensive option (DOT, additional staff, incentives) ranged from US$1407 (scenario 1, smear-negative and extrapulmonary cases) to US$1814 (scenario 2, smear-positive cases). The additional cost to society including indirect costs ranged from US$1800 to US$4200. The possible savings at the national level were in the order of US$50 million per year. In conclusion, cost-comparison analysis showed that a relatively minor change in policy can result in significant savings and that the adoption of DOT will represent a relatively modest economic burden, although the real gain in effectiveness resulting from DOT in Italy requires further evaluation. PMID:10427931

Cap-and-trade policy: The influence on investments in carbon dioxide reducing technologies in Indiana

NASA Astrophysics Data System (ADS)

Fahie, Monique

With most of the energy produced in the state of Indiana coming from coal, the implementation of policy instruments such as cap-and-trade, which is included in the most recent climate bill, will have significant effects. This thesis provides an analysis of the effects that a cap-and-trade policy might have on the investment decisions for alternative technologies in the power plant sector in Indiana. Two economic models of representative coal-fired power plants, Gallagher (600MW) and Rockport (2600MW), are selected and used to evaluate the repowering decision of a plant for several technologies: integrated gasification combined cycle (IGCC), wind farm combined with natural gas combined cycle (NGCC) and supercritical pulverized coal (SCPC). The firm will make its decisions based on the net present value (NPV) of cost estimates for these CO2 reducing technologies, the cost of purchasing offsets and CO 2 allowances. This model is applied to a base case and three American Clean Energy and Security Act of 2009 cases derived from the Energy Information Administration (EIA, 2009b). A sensitivity analysis is done on the discount rate and capital costs. The results of the study indicate that a SCPC plant without carbon capture and storage (CCS) is the least costly compliance option for both plants under all of the cases while retrofitting the existing plant with CCS is the most expensive. Gallagher's three least expensive options across most scenarios were SCPC without CCS, the operation of the existing plant as is and investment in wind plus NGCC. Rockport's three least expensive compliance options across most scenarios were SCPC without CCS, the operation of the existing plant as is and IGCC without CCS. For both plants, when a 12% discount rate is utilized, NPV of costs are generally lower and the operation of the existing plant technology with the aid of allowances and offsets to be in compliance is the cheapest option. If capital costs were to decrease by 30%, a SCPC without CCS would remain the least costly option to invest in for both plants, but if costs were to increase by 30% operating the existing plant as is becomes the least pricey option.

A conservative approach to pediatric mandibular fracture management: outcome and advantages.

PubMed

Khatri, Amit; Kalra, Namita

2011-01-01

Pediatric mandibular fractures are rare and their treatment remains controversial. Management is extremely complicated in mixed dentition as it is inherently dynamic and unstable. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. This case report describes and evaluates the conservative technique of acrylic splint in the treatment of pediatric mandible fracture in a 12-year-old female child. The patient with isolated mandibular fracture was treated with acrylic splint and interdental wiring followed by evaluation of clinical and radiographic healing as well as the somatosensory status. Patient demonstrated clinical union to her pre-injury occlusion by three to four weeks. Panoramic finding supported the finding of clinical examination throughout the study. High osteogenic potential of the pediatric mandible allowed conservative management to be successful in this case.

Summary of Data from the Sixth AIAA CFD Drag Prediction Workshop: CRM Cases 2 to 5

NASA Technical Reports Server (NTRS)

Tinoco, Edward N.; Brodersen, Olaf P.; Keye, Stefan; Laflin, Kelly R.; Feltrop, Edward; Vassberg, John C.; Mani, Mori; Rider, Ben; Wahls, Richard A.; Morrison, Joseph H.;

Space station ventilation study

NASA Technical Reports Server (NTRS)

Colombo, G. V.; Allen, G. E.

1972-01-01

A ventilation system design and selection method which is applicable to any manned vehicle were developed. The method was used to generate design options for the NASA 33-foot diameter space station, all of which meet the ventilation system design requirements. System characteristics such as weight, volume, and power were normalized to dollar costs for each option. Total system costs for the various options ranged from a worst case $8 million to a group of four which were all approximately $2 million. A system design was then chosen from the $2 million group and is presented in detail. A ventilation system layout was designed for the MSFC space station mockup which provided comfortable, efficient ventilation of the mockup. A conditioned air distribution system design for the 14-foot diameter modular space station, using the same techniques, is also presented. The tradeoff study resulted in the selection of a system which costs $1.9 million, as compared to the alternate configuration which would have cost $2.6 million.

Risk-based decision-making framework for the selection of sediment dredging option.

PubMed

Manap, Norpadzlihatun; Voulvoulis, Nikolaos

2014-10-15

The aim of this study was to develop a risk-based decision-making framework for the selection of sediment dredging option. Descriptions using case studies of the newly integrated, holistic and staged framework were followed. The first stage utilized the historical dredging monitoring data and the contamination level in media data into Ecological Risk Assessment phases, which have been altered for benefits in cost, time and simplicity. How Multi-Criteria Decision Analysis (MCDA) can be used to analyze and prioritize dredging areas based on environmental, socio-economic and managerial criteria was described for the next stage. The results from MCDA will be integrated into Ecological Risk Assessment to characterize the degree of contamination in the prioritized areas. The last stage was later described using these findings and analyzed using MCDA, in order to identify the best sediment dredging option, accounting for the economic, environmental and technical aspects of dredging, which is beneficial for dredging and sediment management industries. Copyright © 2014 Elsevier B.V. All rights reserved.

Case series of 17 modified Weil's osteotomies for Freiberg's and Köhler's II AVN, with AOFAS scoring pre- and post-operatively.

PubMed

Edmondson, M C; Sherry, K R; Afolayan, J; Armitage, A R; Skyrme, A D

2011-03-01

Treatment for metatarsal head avascular necrosis is largely conservative. For severe or refractory cases there are various surgical options. We have performed a 'modified Weil's osteotomy' of the distal metatarsal in order to manage this problem. We present the largest case series, to our knowledge, with 17 such cases. The patients were scored pre- and post-operatively using the AOFAS Forefoot scoring system. We found that this procedure provided a mean score improvement of 36 points, with a complication rate of 5.9%. We would advocate this modified osteotomy as an effective, reliable and safe treatment option. Copyright © 2009 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Design and Testing of an Active Heat Rejection Radiator with Digital Turn-Down Capability

NASA Technical Reports Server (NTRS)

Sunada, Eric; Birur, Gajanana C.; Ganapathi, Gani B.; Miller, Jennifer; Berisford, Daniel; Stephan, Ryan

2010-01-01

NASA's proposed lunar lander, Altair, will be exposed to vastly different external environment temperatures. The challenges to the active thermal control system (ATCS) are compounded by unfavorable transients in the internal waste heat dissipation profile: the lowest heat load occurs in the coldest environment while peak loads coincide with the warmest environment. The current baseline for this fluid is a 50/50 inhibited propylene glycol/water mixture with a freeze temperature around -35 C. While the overall size of the radiator's heat rejection area is dictated by the worst case hot scenario, a turn-down feature is necessary to tolerate the worst case cold scenario. A radiator with digital turn-down capability is being designed as a robust means to maintain cabin environment and equipment temperatures while minimizing mass and power consumption. It utilizes active valving to isolate and render ineffective any number of parallel flow tubes which span across the ATCS radiator. Several options were assessed in a trade-study to accommodate flow tube isolation and how to deal with the stagnant fluid that would otherwise remain in the tube. Bread-board environmental tests were conducted for options to drain the fluid from a turned-down leg as well an option to allow a leg to freeze/thaw. Each drain option involved a positive displacement gear pump with different methods of providing a pressure head to feed it. Test results showed that a start-up heater used to generate vapor at the tube inlet held the most promise for tube evacuation. Based on these test results and conclusions drawn from the trade-study, a full-scale radiator design is being worked for the Altair mission profile.

The Optional VenaTech{sup Trade-Mark-Sign} Convertible{sup Trade-Mark-Sign} Vena Cava Filter: Experimental Study in Sheep

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

Le Blanche, Alain F., E-mail: le_blanche.alain@chu-amiens.fr; Ricco, Jean-Baptiste; Bonneau, Michel

Purpose: Retrieval of optional caval filters may be impaired by filter tilting, migration, fracture, or embedding in the IVC wall. The goal of this experimental study was to evaluate a new optional filter, convertible by unlocking and removing the filter head. Methods: Forty-nine Pre-Alp sheep (average weight, 55 kg) were anesthetized. IVC was catheterized via the right femoral vein (n = 46) or via the internal jugular vein (n = 3) with a 12.9-F sheath. VenaTech{sup Trade-Mark-Sign} Convertible{sup Trade-Mark-Sign} IVC filters were inserted as either permanent filters (n = 14) or as filters to be converted. Conversion was immediately aftermore » deployment (n = 19) or delayed after 1, 3, or 6 months (n = 20). Filter delivery, deployment, and conversion with measurement of migration and tilting were evaluated by cavography. Incorporation of the filter's stabilizers and arms in the IVC wall was assessed by gross anatomy. Results: Delivery system insertion, filter release, and immediate conversion were successful in all cases. Delayed conversion was completed in all but one sheep, due to insufficient snare tension. Complimentary balloon-catheter inflation was required in 12 of 20 delayed conversions to achieve filter opening. In all 49 sheep, no thrombosis, migration, or significant tilting occurred. Within 4 weeks of conversion, the filter's stabilizers and arms were incorporated into the IVC wall. Upon removal, the filter head was free of intimal growth. Conclusions: The VenaTech{sup Trade-Mark-Sign} Convertible{sup Trade-Mark-Sign} optional IVC filter was successfully implanted in all sheep with no migration or tilting. Conversion at various dates by filter head removal was feasible in all but one case.« less

Prospect balancing theory: Bounded rationality of drivers' speed choice.

PubMed

Schmidt-Daffy, Martin

2014-02-01

This paper introduces a new approach to model the psychological determinants of drivers' speed choice: prospect-balancing theory. The theory transfers psychological insight into the bounded rationality of human decision-making to the field of driving behaviour. Speed choice is conceptualized as a trade-off between two options for action: the option to drive slower and the option to drive faster. Each option is weighted according to a subjective value and a subjectively weighted probability attributed to the achievement of the associated action goal; e.g. to avoid an accident by driving more slowly. The theory proposes that the subjective values and weightings of probability differ systematically from the objective conditions and thereby usually favour a cautious speed choice. A driving simulation study with 24 male participants supports this assumption. In a conflict between a monetary gain in case of fast arrival and a monetary loss in case of a collision with a deer, participants chose a velocity lower than that which would maximize their pay-out. Participants' subjective certainty of arriving in time and of avoiding a deer collision assessed at different driving speeds diverged from the respective objective probabilities in accordance with the observed bias in choice of speed. Results suggest that the bounded rationality of drivers' speed choice might be used to support attempts to improve road safety. Thus, understanding the motivational and perceptual determinants of this intuitive mode of decision-making might be a worthwhile focus of future research. Copyright © 2013 Elsevier Ltd. All rights reserved.

Optimization of European call options considering physical delivery network and reservoir operation rules

NASA Astrophysics Data System (ADS)

Cheng, Wei-Chen; Hsu, Nien-Sheng; Cheng, Wen-Ming; Yeh, William W.-G.

2011-10-01

This paper develops alternative strategies for European call options for water purchase under hydrological uncertainties that can be used by water resources managers for decision making. Each alternative strategy maximizes its own objective over a selected sequence of future hydrology that is characterized by exceedance probability. Water trade provides flexibility and enhances water distribution system reliability. However, water trade between two parties in a regional water distribution system involves many issues, such as delivery network, reservoir operation rules, storage space, demand, water availability, uncertainty, and any existing contracts. An option is a security giving the right to buy or sell an asset; in our case, the asset is water. We extend a flow path-based water distribution model to include reservoir operation rules. The model simultaneously considers both the physical distribution network as well as the relationships between water sellers and buyers. We first test the model extension. Then we apply the proposed optimization model for European call options to the Tainan water distribution system in southern Taiwan. The formulation lends itself to a mixed integer linear programming model. We use the weighing method to formulate a composite function for a multiobjective problem. The proposed methodology provides water resources managers with an overall picture of water trade strategies and the consequence of each strategy. The results from the case study indicate that the strategy associated with a streamflow exceedence probability of 50% or smaller should be adopted as the reference strategy for the Tainan water distribution system.

Summary of Propagation Cases of the Second AIAA Sonic Boom Prediction Workshop

NASA Technical Reports Server (NTRS)

Rallabhandi, Sriram; Loubeau, Alexandra

2017-01-01

A summary is provided for the propagation portion of the second AIAA Sonic Boom Workshop held January 8, 2017 in conjunction with the AIAA SciTech 2017 conference. Near-field pressure waveforms for two cases were supplied and ground signatures at multiple azimuthal angles as well as their corresponding loudness metrics were requested from 10 participants, representing 3 countries. Each case had some required runs, as well as some optional runs. The required cases included atmospheric profiles with measured data including winds, using Radiosonde balloon data at multiple geographically spread locations, while the optional cases included temperature and pressure profiles from the US Standard atmosphere. The humidity profiles provided for the optional cases were taken from ANSI guidance, as the authors were unaware of an accepted standard at the time the cases were released to the participants. Participants provided ground signatures along with the requested data, including some loudness metrics using their best practices, which included lossy as well as lossless schemes. All the participants' submissions, for each case, are compared and discussed. Noise or loudness measures are calculated and detailed comparisons and statistical analyses are performed and presented. It has been observed that the variation in the loudness measures and spread between participants' submissions increased as the computation proceeded from under-track locations towards the lateral cut-off. Lessons learned during this workshop are discussed and recommendations are made for potential improvements and possible subsequent workshops as we collectively attempt to refine our analysis methods.

Evaluating holistic environmental consequences of brownfield management options using consequential life cycle assessment for different perspectives.

PubMed

Lesage, Pascal; Deschênes, Louise; Samson, Réjean

2007-08-01

Brownfields are abandoned, idled, or underused sites whose reuse necessitates some sort of intervention. These sites are largely urban and are frequently contaminated. Brownfield management options can be associated with three types of environmental consequences: those resulting from changes in the site's environmental quality (primary impacts); those resulting from the actual intervention stage (secondary impacts); and, if the vocation of the site changes, those resulting from effects on regional land use (tertiary impacts). Different stakeholders and decision-making contexts will place a different importance on each of these types of impacts. This article proposes a framework for comparing brownfield management options in regard to these three types of environmental impacts and for interpreting these results from different perspectives. The assessment framework is based on consequential life cycle assessment (LCA), which is shown to provide environmental information on the three types of impacts. The results for a case study are presented, where a "rehabilitation" option allowing residential redevelopment is compared to an "exposure minimization" option not resulting in the site being reused. Calculated primary and tertiary impacts are favorable to the rehabilitation option, whereas secondary impacts are favorable to the exposure minimization option. A ternary diagram presents the favorable option for different stereotypical perspectives. Tertiary impacts are much greater than secondary impacts, and consequently all perspectives that consider tertiary impacts favor rehabilitation. The perspective that considers primary and secondary impacts receives conflicting information. The ternary diagram, showing results for all perspectives, could possibly be useful for consensus-building among stakeholders.

Evaluating Holistic Environmental Consequences of Brownfield Management Options Using Consequential Life Cycle Assessment for Different Perspectives

NASA Astrophysics Data System (ADS)

Lesage, Pascal; Deschênes, Louise; Samson, Réjean

2007-08-01

Brownfields are abandoned, idled, or underused sites whose reuse necessitates some sort of intervention. These sites are largely urban and are frequently contaminated. Brownfield management options can be associated with three types of environmental consequences: those resulting from changes in the site’s environmental quality (primary impacts); those resulting from the actual intervention stage (secondary impacts); and, if the vocation of the site changes, those resulting from effects on regional land use (tertiary impacts). Different stakeholders and decision-making contexts will place a different importance on each of these types of impacts. This article proposes a framework for comparing brownfield management options in regard to these three types of environmental impacts and for interpreting these results from different perspectives. The assessment framework is based on consequential life cycle assessment (LCA), which is shown to provide environmental information on the three types of impacts. The results for a case study are presented, where a “rehabilitation” option allowing residential redevelopment is compared to an “exposure minimization” option not resulting in the site being reused. Calculated primary and tertiary impacts are favorable to the rehabilitation option, whereas secondary impacts are favorable to the exposure minimization option. A ternary diagram presents the favorable option for different stereotypical perspectives. Tertiary impacts are much greater than secondary impacts, and consequently all perspectives that consider tertiary impacts favor rehabilitation. The perspective that considers primary and secondary impacts receives conflicting information. The ternary diagram, showing results for all perspectives, could possibly be useful for consensus-building among stakeholders.

Risky forward interest rates and swaptions: Quantum finance model and empirical results

NASA Astrophysics Data System (ADS)

Baaquie, Belal Ehsan; Yu, Miao; Bhanap, Jitendra

2018-02-01

Risk free forward interest rates (Diebold and Li, 2006 [1]; Jamshidian, 1991 [2 ]) - and their realization by US Treasury bonds as the leading exemplar - have been studied extensively. In Baaquie (2010), models of risk free bonds and their forward interest rates based on the quantum field theoretic formulation of the risk free forward interest rates have been discussed, including the empirical evidence supporting these models. The quantum finance formulation of risk free forward interest rates is extended to the case of risky forward interest rates. The examples of the Singapore and Malaysian forward interest rates are used as specific cases. The main feature of the quantum finance model is that the risky forward interest rates are modeled both a) as a stand-alone case as well as b) being driven by the US forward interest rates plus a spread - having its own term structure -above the US forward interest rates. Both the US forward interest rates and the term structure for the spread are modeled by a two dimensional Euclidean quantum field. As a precursor to the evaluation of put option of the Singapore coupon bond, the quantum finance model for swaptions is tested using empirical study of swaptions for the US Dollar -showing that the model is quite accurate. A prediction for the market price of the put option for the Singapore coupon bonds is obtained. The quantum finance model is generalized to study the Malaysian case and the Malaysian forward interest rates are shown to have anomalies absent for the US and Singapore case. The model's prediction for a Malaysian interest rate swap is obtained.

Endometriosis: Survey of Current Diagnostic and Therapeutic Options and Latest Research Work

PubMed Central

Juhasz-Böss, I.; Laschke, M. W.; Müller, F.; Rosenbaum, P.; Baum, S.; Solomayer, E. F.; Ulrich, U.

2014-01-01

Endometriosis is one of the most frequent benign diseases in women of child-bearing age. The main symptoms are chronic upper abdominal pain and infertility. However, the aetiology and pathogenesis of endometriosis are as yet insufficiently clarified. Thus, therapy is mainly symptomatic with laparoscopic surgery being the gold standard. The aim of drug therapy is to achieve a hypo-oestrogenic condition. In cases of severe endometriosis and a desire to have children there is often an indication for assisted reproduction. The present article illustrates almost all current aspects on the diagnosis of and therapy of endometriosis. From the clinical viewpoint, emphasis is placed on the rare cases of deeply infiltrating endometriosis that are, however, accompanied with a high morbidity. Current therapeutic options in cases of infertility are also presented in more detail. Furthermore, special attention is paid to the latest research results from both clinical and basic research fields in order to demonstrate our current knowledge on the pathogenesis and, where possible, potentially related therapeutic options. PMID:25221341

Option pricing, stochastic volatility, singular dynamics and constrained path integrals

NASA Astrophysics Data System (ADS)

Contreras, Mauricio; Hojman, Sergio A.

2014-01-01

Stochastic volatility models have been widely studied and used in the financial world. The Heston model (Heston, 1993) [7] is one of the best known models to deal with this issue. These stochastic volatility models are characterized by the fact that they explicitly depend on a correlation parameter ρ which relates the two Brownian motions that drive the stochastic dynamics associated to the volatility and the underlying asset. Solutions to the Heston model in the context of option pricing, using a path integral approach, are found in Lemmens et al. (2008) [21] while in Baaquie (2007,1997) [12,13] propagators for different stochastic volatility models are constructed. In all previous cases, the propagator is not defined for extreme cases ρ=±1. It is therefore necessary to obtain a solution for these extreme cases and also to understand the origin of the divergence of the propagator. In this paper we study in detail a general class of stochastic volatility models for extreme values ρ=±1 and show that in these two cases, the associated classical dynamics corresponds to a system with second class constraints, which must be dealt with using Dirac’s method for constrained systems (Dirac, 1958,1967) [22,23] in order to properly obtain the propagator in the form of a Euclidean Hamiltonian path integral (Henneaux and Teitelboim, 1992) [25]. After integrating over momenta, one gets an Euclidean Lagrangian path integral without constraints, which in the case of the Heston model corresponds to a path integral of a repulsive radial harmonic oscillator. In all the cases studied, the price of the underlying asset is completely determined by one of the second class constraints in terms of volatility and plays no active role in the path integral.

Bridging CALL & HCI: Input from Participatory Design

ERIC Educational Resources Information Center

Cardenas-Claros, Monica S.; Gruba, Paul A.

2010-01-01

Participatory design (PD), or the collaboration between software engineers and end users throughout the design process, may help improve CALL design practices. In this case study, four ESL learners, a software designer, and a language teacher created and evaluated a series of paper prototypes concerning help options in computer-based second…

Partnerships for Career-Centered High School Reform in an Urban School System.

ERIC Educational Resources Information Center

MacIver, Martha Abele; Legters, Nettie

2001-01-01

A case study of a large urban school district analyzed partnerships that brought together career-centered high school reforms. The initiative regularly convened partners and generated important conversations about educational options. Environmental conditions limited change efforts, including tensions between the school system and employment…

Market Research and Magazine Circulation Promotion: A Case Study.

ERIC Educational Resources Information Center

Van Tubergen, G. Norman

When a major national news magazine decided to advertise on television to increase circulation, market researchers had to design research procedures that would assess the effectiveness of various advertising options. The system was designed around the toll-free telephone number given in the advertisement, with the receiving operator recording the…

Issues with Access to Acquisition Data and Information in the Department of Defense: Policy and Practice

DTIC Science & Technology

2015-01-01

39 C. Central Repository Case Studies...Subject-Matter Experts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 C.1. Comparison of OSD Central Repositories...are also several options to addressing the confusion regarding policy. • OUSD(AT&L) could create and maintain a central , authoritative online resource

A Tale of English Polytechnic Lecturers' Decision Making

ERIC Educational Resources Information Center

Abdullah, Suhaily; Majid, Faizah Abd

2016-01-01

Teacher decision making involves a selection of options that leads to thinking processes, underlying teaching in language classroom contexts. Due to this, as a small part of an on-going postgraduate research, this exploratory case study shares the initial findings on the lecturers' decision-making effects on their classroom orientation. Four…

Connecting Ed & Tech: Partnering to Drive Student Outcomes

ERIC Educational Resources Information Center

Arnett, Thomas

2016-01-01

All too often, the connection between teachers and technology falls flat. Pioneering schools and educators search for technology to support new instructional models, only to find that existing options do not align with their evolving classroom practices. This case study describes how Leadership Public Schools (LPS), a charter school management…

Decision analysis to address extreme weather : extreme weather effects on ridership and modeling the decision to invest in canopy coverage.

DOT National Transportation Integrated Search

2016-09-01

This project applies a decision analytic methodology that takes considerations of extreme weather events to quantify and assess canopy investment options. The project collected data for two cases studies in two different transit agencies: Chicago Tra...

Communicating in the '80s. New Options for the Nonprofit Community.

ERIC Educational Resources Information Center

Green, Alan

This booklet includes descriptions of new communications technologies and case studies of how they can be used in planning for appropriate and effective use of technology to enhance service to the public. Single-page overviews of satellites, broadcasting, videotex, cable television, microcomputers, teleconferencing, personal video, and telephones…

Call It Trash, Garbage or Refuse: Four Case Studies Illustrate Community Waste Management Options.

ERIC Educational Resources Information Center

Kazzi, John W.

1990-01-01

Describes four successful community programs dealing with waste management issues, developed with assistance from Keep America Beautiful System: litter prevention (Beatrice, Nebraska); composting yard waste (Centralia, Illinois); recycling (Lake Jackson, Texas); and waste-to-energy incineration (Gastonia, North Carolina). Notes related education…

A Case Study of the Development of an Early Retirement Program for University Faculty.

ERIC Educational Resources Information Center

Chronister, Jay L.; Trainer, Aileen

1985-01-01

To offset declining enrollments, financial constraints, younger faculties, and high tenure ratios, some institutions are considering early retirement programs to facilitate faculty turnover. A University of Virginia faculty committee reviewed several early retirement options and selected a cost-effective bridging program with ample incentives and…

Integration of a Community Pharmacy Simulation Program into a Therapeutics Course.

PubMed

Shin, Jaekyu; Tabatabai, Daryush; Boscardin, Christy; Ferrone, Marcus; Brock, Tina

2018-02-01

Objective. To demonstrate the feasibility of integrating the computer simulation, MyDispense, into a therapeutics course and to measure its effects on student perception and learning. Methods. We conducted a prospective study with an experimental phase and an implementation phase. In the first phase, students were randomized to complete a therapeutics case using MyDispense or traditional paper methods in class. In the second phase, all students completed two therapeutic cases using MyDispense in class with the option to complete four additional outside-of-class cases using MyDispense. Students completed pre- and post-tests in class and three surveys. Results. In the experimental phase, mean test scores increased from pre- to post-test for both MyDispense and traditional paper groups, but the difference between the groups was not statistically significant. Students in the traditional paper group reported statistically significant gains in confidence compared to the MyDispense group. In the implementation phase, mean test scores again increased, however, student perception of the use of MyDispense for therapeutics was negative. Completing the optional outside-of-class cases, however, was positively and significantly correlated with the midterm and final examination scores. Conclusion. Implementation of MyDispense in therapeutics may be feasible and has positive effects (eg, correlation with exam scores, capacity for immediate feedback, and potential for effective self-study). With short-term use and in the absence of assessment methods that also require seeking information from patients, students prefer to learn via traditional paper cases.

Design Evolution Study - Aging Options

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

P. McDaniel

The purpose of this study is to identify options and issues for aging commercial spent nuclear fuel received for disposal at the Yucca Mountain Mined Geologic Repository. Some early shipments of commercial spent nuclear fuel to the repository may be received with high-heat-output (younger) fuel assemblies that will need to be managed to meet thermal goals for emplacement. The capability to age as much as 40,000 metric tons of heavy metal of commercial spent nuclear he1 would provide more flexibility in the design to manage this younger fuel and to decouple waste receipt and waste emplacement. The following potential agingmore » location options are evaluated: (1) Surface aging at four locations near the North Portal; (2) Subsurface aging in the permanent emplacement drifts; and (3) Subsurface aging in a new subsurface area. The following aging container options are evaluated: (1) Complete Waste Package; (2) Stainless Steel inner liner of the waste package; (3) Dual Purpose Canisters; (4) Multi-Purpose Canisters; and (5) New disposable canister for uncanistered commercial spent nuclear fuel. Each option is compared to a ''Base Case,'' which is the expected normal waste packaging process without aging. A Value Engineering approach is used to score each option against nine technical criteria and rank the options. Open issues with each of the options and suggested future actions are also presented. Costs for aging containers and aging locations are evaluated separately. Capital costs are developed for direct costs and distributable field costs. To the extent practical, unit costs are presented. Indirect costs, operating costs, and total system life cycle costs will be evaluated outside of this study. Three recommendations for aging commercial spent nuclear fuel--subsurface, surface, and combined surface and subsurface are presented for further review in the overall design re-evaluation effort. Options that were evaluated but not recommended are: subsurface aging in a new subsurface area (high cost); surface aging in the complete waste package (risk to the waste package and impact on the Waste Handling Facility); and aging in the stainless steel liner (impact on the waste package design and new high risk operations added to the waste packaging process). The selection of a design basis for aging will be made in conjunction with the other design re-evaluation studies.« less

Therapeutic options to manage bleeding in a dentist’s office

PubMed

Rostetter, Claudio; Finkenstädt, Tim; Rücker, Martin; Lübbers, Heinz-Theo

2018-06-18

This manuscript provides an overview of therapeutic options for the problem of bleeding in a dentist’s office. Bleeding after tooth extraction is a very common finding in dental medicine and persistent blood in the mouth is obviously uncomfortable and sometimes terrifying for the patient. Most bleedings can be stopped simply with compression, in some cases a homeostatic therapy is necessary. For local compression, a swab with tranexamic acid is useful. If local compression is not sufficient, sutures are often an option. A very effective therapy would also be Tabotamp®, a local hemostypticum which is placed onto the bleeding and should increase the thrombocytic aggregation. In the worst case Floseal®, a human Thrombin, can be placed locally. It stops the bleeding very fast and sufficiently.

RHIC Prefire Protection Masks

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

Drees, A.; Biscardi, C.; Curcio, T.

2015-01-07

The protection of the RHIC experimental detectors from damage due to beam hitting close upstream elements in cases of abort kicker prefires requires some dedicated precautionary measures with two general options: to bring the beam close to a limiting aperture (i.e. the beam pipe wall), as far upstream of the detector components as possible or, alternatively, to bring a limiting aperture close to the circulating beam. During the FY 2014 RHIC Heavy Ion run the first option was chosen because of the limited time available for preparation before the start of the run. For future runs the second option, inmore » this case the installation of dual-sided movable masks, is preferred. The installation of the masks, one per ring, is planned before the start of the FY 2015 run.« less

[Are therapeutics decisions homogeneous in multidisciplinary onco-urology staff meeting? Comparison of therapeutic options taken in four departments from Paris].

PubMed

Audenet, F; Lejay, V; Mejean, A; De La Taille, A; Abbou, C-C; Lebret, T; Botto, H; Bitker, M-O; Roupret, M

2012-06-01

One of the priorities of the "Plan against the Cancer" in France is to ensure the discussion of all cancer cases in a multidisciplinary meeting staff (RCP). The multidisciplinary collaboration is proposed to guarantee a discussion between specialists in every cases, particularly in complex cases. The aim of this study was to compare the therapeutic decision taken in four RCP in Paris Île-de-France academic centres for three identical cases. Three cases of urological oncology (prostate cancer [PCa], renal cell carcinoma [RCC] and bladder tumour) were selected by a single urologist, not involved in further discussion. These cases were blindly presented in four academic urology department from Paris: Pitié-Salpêtrière Hospital, Mondor Hospital, the Georges-Pompidou European Hospital and Foch Hospital. The four centres met the criteria of quality of RCP in terms of multidisciplinarity, frequency and standardization. The therapeutic suggestions were similar in the RCC cases, there were differences in the surgical approaches and preoperative work-up in the PCa case and, lastly, the proposals were different for the bladder cancer case. The decisions relies on clinical data and preoperative work-up but also on the experience and habits of the centre of excellence. For complex cases that does not fit with current guidelines, the panel discussion can lead to different therapeutic options from a centre to another and is largely influenced by the local organisation of the RCP. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

The experience of maternal and child health nurses responding to women with postpartum depression.

PubMed

Rush, Penelope

2012-02-01

Previous studies have shown that maternal and child health nurses (MCH nurses) are in a unique position to help mothers with postpartum depression (PPD), but little has been done to understand the MCH nurses' day-to-day experience. This Australian study addresses that issue by analyzing the results of eight in-depth interviews with MCH nurses. The data obtained from these interviews was analyzed using the phenomenological method described by Creswell, adapted from Moustakas. From this analysis five themes emerge: how MCH nurses recognize symptoms of PPD; the importance of having treatment options available; the role of rapport; the limits of MCH nurses in responding to PPD; and how MCH nurses respond when recognizing new cases of PPD. The results of the study reveal several areas for policy review, most significantly the need for more MCH nurse training to recognize the symptoms of PPD and identify the appropriate treatment option. In addition, a review of staff retention and mobility policies is recommended to improve rapport with mothers and maintain and grow knowledge of local treatment options.

Occurrence of otitis media in children and assessment of treatment options.

PubMed

Nwokoye, N N; Egwari, L O; Olubi, O O

2015-08-01

Otitis media is a more frequent occurrence in children, and the disease may progress from an acute to chronic state if appropriate and timely intervention is not initiated. A total of 212 children aged 6 months to 10 years were examined and treated for otitis media, in a 13-month hospital-based study. Acute otitis media was diagnosed in 130 (61.3 per cent) of the patients. There were 82 (38.7 per cent) chronic suppurative otitis media cases. The incidence of acute otitis media and chronic suppurative otitis media in the first year of life was 54.6 per cent and 45.1 per cent respectively. Chronic suppurative otitis media patients were assigned to one of three treatment groups. Recovery occurred in 70.4 per cent of amoxicillin-treated patients, in 88.9 per cent of amoxicillin-clavulanic acid treated patients and in 96.4 per cent of culture and antibiotic sensitivity test patients. Relapses were seen only in the amoxicillin (five cases) and amoxicillin-clavulanic acid (two cases) groups. The success rate in patients treated with antibiotics makes this option mandatory for an established diagnosis.

[Rupture of membranes: pathophysiology, diagnosis, consequences and management].

PubMed

Blanchon, L; Accoceberry, M; Belville, C; Delabaere, A; Prat, C; Lemery, D; Sapin, V; Gallot, D

2013-04-01

Rupture of membranes (ROM) depends on mechanical stretch, extracellular matrix components imbalance and increased apoptosis. It occurs in 2 to 3% of all pregnancies before 37 weeks' gestation (WG) and in up to 10% at term. Main consequences are labor induction and risk of maternal-fetal infection. ROM is associated with one third of preterm births and about 20% of perinatal mortality. This review deals with recent knowledge concerning ROM including diagnosis and management. In many cases, ROM is easily identified by clinical examination. In other cases, the use of vaginal pH appears to be less efficient than the use of immunochromatographic strips based on IGFBP-1 or PAMG-1 detection. Before 34WG, conservative management consists in in utero transfer, antibioprophylaxis and corticosteroids. After 37WG, delivery is the most appropriate option. Between 34 and 37WG, recent studies demonstrate that induction of labour does not improve pregnancy outcomes. Therefore, expectant management can be the first option between 34 and 37WG when no active infection is suspected especially in case of unfavourable cervix. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Treatment options and barriers to case management of neonatal pneumonia in India: a protocol for a scoping review.

PubMed

Nair, N Sreekumaran; Lewis, Leslie Edward; Murthy, Shruti; Godinho, Myron Anthony; Lakiang, Theophilus; Venkatesh, Bhumika T

2017-09-15

India contributes to the highest neonatal deaths globally. Case management is said to be the cornerstone of pneumonia control. Much of the published evidence focuses on children aged 1 to 59 months. This scoping review, thus, aims to identify the treatment options for and barriers to case management of neonatal pneumonia in India. This protocol is part of a series of three reviews on neonatal pneumonia in India. Studies addressing treatment of or barriers to case management of neonatal pneumonia in Indian context, published in English in peer-reviewed and indexed journals will be eligible for inclusion. Electronic search will be conducted on nine databases. Hand searching and snowballing will be done for published and grey literature. Selection of studies will be done in title, abstract and full-text stages. A narrative summary will be performed to summarise the details of evidence. As this is a review involving analysis of secondary data which is available in the public domain and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to ultimately transfer the evidence tailored to the stakeholder (eg, policy briefs, publications, information booklets and so on). PROSPERO 2016: CRD42016045449. © 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.

Suppressing ghost beams: Backlink options for LISA

NASA Astrophysics Data System (ADS)

Isleif, K.-S.; Gerberding, O.; Penkert, D.; Fitzsimons, E.; Ward, H.; Robertson, D.; Livas, J.; Mueller, G.; Reiche, J.; Heinzel, G.; Danzmann, K.

2017-05-01

In this article we discuss possible design options for the optical phase reference system, the so called backlink, between two moving optical benches in a LISA satellite. The candidates are based on two approaches: Fiber backlinks, with additional features like mode cleaning cavities and Faraday isolators, and free beam backlinks with angle compensation techniques. We will indicate dedicated ghost beam mitigation strategies for the design options and we will point out critical aspects in case of an implementation in LISA.

PANDAS: A systematic review of treatment options.

PubMed

Farhood, Zachary; Ong, Adrian A; Discolo, Christopher M

2016-10-01

Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) is a rare but important condition for pediatric otolaryngologists to recognize. Several treatment options exist including tonsillectomy, antibiotic treatment/prophylaxis, intravenous immunoglobulin (IVIG), and psychiatric medications/therapy. A systematic review of the PubMed, EMBASE, and Scopus databases was performed searching for articles that focused exclusively on the aforementioned treatment modalities in the PANDAS population. Review articles, single patient case reports, and studies examining the natural history or diagnostic strategies were excluded. Five articles regarding tonsillectomy treatments with level of evidence (LOE) 4 were found but no clear benefit could be determined. Three articles were selected involving the use of antibiotic therapy. One prospective study and one double-blind randomized control trial (DB RCT) supported the use of antibiotics but a separate DB RCT showed no benefit. Two selected articles described the use of IVIG: one unblinded RCT and one retrospective study. One prospective study on cognitive-behavioral therapy (CBT) showed benefit in PANDAS. There is a paucity of high-level studies regarding this rare disorder and no hard treatment recommendations can be made. Tonsillectomy should only be performed in those who are surgical candidates based on current published guidelines. Antibiotics are an option but provide uncertain benefit. CBT remains a low-risk option. Studies support the use of IVIG, however more investigation is needed prior to widespread adoption of this treatment given its potential risks. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Surgical options for chronic pancreatitis].

PubMed

Tan, C L; Nuer, Emms; Abulaiti, Aizezi; Zhang, H; Chen, Y H; Liu, X B

2016-11-01

Objective: Discuss the surgical options for the chronic pancreatitis on the basis of anatomical morphological changes. Methods: A retrospective review of chronic pancreatitis patients in Department of Pancreatic Surgery, West China Hospital, Sichuan University between January 2010 and December 2014 was performed. The data of medical records, image feature, surgical types and records of follow-up were collected. Total 295 patients including 275 male and 20 female aged from 14 to 74 years with median age of 51 years. The clinical symptoms included abdominal pain in 280 cases, jaundice in 3 cases, single hemorrhage in digestive tract, diarrhea or mellitus in 12 cases. The anatomical morphological changes included pancreatic fibrosis and atrophy of the main pancreatic duct lesions in 44 cases (14.9%), inflammatory mass in the pancreatic head in 69 cases (22.4%), sporadic stones with calcification in the pancreatic head in 165 cases(55.9%), hyperplasia mass of pancreatic head and body in 14 cases (4.8%), sporadic stones with calcification in whole branch ducts accompanied with different degree of hyperplasia in whole pancreas in 3 cases (1.0%). The surgical options included longitudinal pancreaticojejunostomy, duodenum-preserving pancreatic head resection, Frey/Frey+ distal pancreatectomy, total and subtotal pancreatectomy. All patients were followed-up for 3 to 6 months in the outpatient. A cross-sectional study was carried out by telephone, letters, questionnaire and outpatient from April to June 2016. Results: Among 295 patients, 267 cases were followed-up for an average time of 40 months(18 to 78 months), 28 cases were lost to followed-up(9.5%). Pain remission rate of pancreatic fibrosis and atrophy of the main pancreatic duct lesions patients was 97.0%, of inflammatory mass in the pancreatic head patients was 96.8%, of sporadic stones with calcification in the pancreatic head patients was 96.6%, of hyperplasia mass of pancreatic head and body patients was 12/13, of sporadic stones with calcification in whole branch ducts accompanied with different degree of hyperplasia in whole pancreas patients was 3/3. There were 19 cases(9.6%) with blood glucose rising. Conclusion: According to the pathological changes of chronic pancreatitis, the reasonable choice of surgical procedures can be done to maximize the removal of the cause of pain and the preservation of pancreatic tissue.

Subintimal Recanalization of Occluded Stents: The Substent Technique

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

Diamantopoulos, Athanasios, E-mail: adiamant@upatras.gr; Katsanos, Konstantinos; Spiliopoulos, Stavros

2013-08-01

PurposeApplication of metal stents is complicated by neointimal hyperplasia leading to vessel restenosis and reocclusion. Treatment options in cases presenting with complete occlusion of the stented segment and recurrent critical limb ischemia (CLI) are limited. We present the option of the subintimal/substent technique in dealing with occluded stents.MethodsThe study included patients presenting with recurrent CLI due to impaired blood flow as a result of complete occlusion of previously inserted metal stents and unsuccessful intraluminal crossing of the lesion via either the antegrade or retrograde approach. In these cases, crossing the occlusion through the subintimal/substent plane was attempted. Primary end pointsmore » included technical success, safety of the procedure, clinical improvement, and limb salvage, while secondary end points were patient survival, primary patency, and vessel restenosis rates at 1-year follow-up. Study end points were calculated by Kaplan-Meier survival analysis.ResultsBetween July 2006 and October 2011, a total of 14 patients (mean age 69.14 {+-} 12.59 years, 12 men) were treated with the substent technique and included in the analysis. Technical success rate was 85.71 % (12 of 14), with a total lesion length of 193.57 {+-} 90.78 mm. The mean occluded stented segment length was 90.21 {+-} 44.34 mm. In 10 (83.33 %) of 12 cases, a new stent had to be placed by the side of the old occluded one, while the remaining two cases (16.67 %) were treated only with balloon angioplasty. No serious adverse events were noted during the immediate postprocedural period. All successfully treated patients improved clinically. Estimated limb salvage was 90.9 %, and patient survival rate was 90.0 % at 1 year's follow-up. Primary patency was 45.50 % and vessel restenosis 77.30 %.ConclusionSubintimal recanalization of occluded metal stents through the substent plane is a valuable alternative treatment option, especially in patients with recurrent CLI with few alternatives.« less

Environmental and economic analyses of waste disposal options for traditional markets in Indonesia.

PubMed

Aye, Lu; Widjaya, E R

2006-01-01

Waste from traditional markets in Indonesia is the second largest stream of municipal solid waste after household waste. It has a higher organic fraction and may have greater potential to be managed on a business scale compared to household wastes. The attributed reason is that in general the wastes generated from traditional markets are more uniform, more concentrated and less hazardous than waste from other sources. This paper presents the results of environmental and economic assessments to compare the options available for traditional market waste disposal in Indonesia. The options compared were composting in labour intensive plants, composting in a centralised plant that utilised a simple wheel loader, centralised biogas production and landfill for electricity production. The current open dumping practice was included as the baseline case. A life cycle assessment (LCA) was used for environmental analysis. All options compared have lower environmental impacts than the current practice of open dumping. The biogas production option has the lowest environmental impacts. A cost-benefit analysis, which considered greenhouse gas savings, was used for the economic assessment. It was found that composting at a centralised plant is the most economically feasible option under the present Indonesian conditions. The approach reported in this study could be applied for 'a pre-feasibility first cut comparison' that includes environmental aspects in a decision-making framework for developing countries even though European emission factors were used.

Implementation of a state of the art automated system for the production of cloud/water vapor motion winds from geostationary satellites

NASA Technical Reports Server (NTRS)

Velden, Christopher

1994-01-01

Significant progress was attained in this reporting period towards the overall goal of improving the CIMSS satellite wind algorithms through incorporation of new processing options, and testing/evaluating these options on data sets and through case studies. Several new strategies were implemented, and these are outlined. In addition, data from GOES-8 have recently become available during system check-out and evaluation. Initial testing and software adjustments necessary to handle this new and improved data are briefly touched upon in this summary, and will be a main focus of the remaining funds and efforts under this contract.

17 CFR 34.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... decomposed into an option payout or payouts, is measured by the absolute net value of the put option premia with strike prices less than or equal to the reference price plus the absolute net value of the call... which a commodity-dependent payment becomes non-zero, or, in the case where two potential reference...

17 CFR 34.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... decomposed into an option payout or payouts, is measured by the absolute net value of the put option premia with strike prices less than or equal to the reference price plus the absolute net value of the call... which a commodity-dependent payment becomes non-zero, or, in the case where two potential reference...

17 CFR 34.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... decomposed into an option payout or payouts, is measured by the absolute net value of the put option premia with strike prices less than or equal to the reference price plus the absolute net value of the call... which a commodity-dependent payment becomes non-zero, or, in the case where two potential reference...

17 CFR 34.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... decomposed into an option payout or payouts, is measured by the absolute net value of the put option premia with strike prices less than or equal to the reference price plus the absolute net value of the call... which a commodity-dependent payment becomes non-zero, or, in the case where two potential reference...

17 CFR 34.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... decomposed into an option payout or payouts, is measured by the absolute net value of the put option premia with strike prices less than or equal to the reference price plus the absolute net value of the call... which a commodity-dependent payment becomes non-zero, or, in the case where two potential reference...

Building-integrated photovoltaics: A case study

NASA Astrophysics Data System (ADS)

Kiss, G.; Kinkead, J.; Raman, M.

1995-03-01

In 1992, Kiss Cathcart Anders Architects performed a study for NREL on Building-Integrated Photovoltaics (BIPV) issues as seen from the perspective of the building community. In general, the purpose of the study was to list major issues and potential applications; by it's nature it asked more questions than it answered. This second phase study was to produce quantitative data on the performance of specific BIPV systems. Only roof systems are evaluated. The energy performance, construction cost and simple payback for five different BIPV roof options are evaluated in six different locations: Oakland, New York, Miami, Phoenix, Chicago, and Cincinnati. The roof options evaluated include the following: single-glazed PV roof using glass-substrate PVs; double-glazed PV roof with insulating PV modules; ballasted roof-mounted system; sawtooth light monitor roof with indirect north daylighting; sawtooth roof with north light and active heat recovery.

Undergraduate Students' Ownership of Musical Learning: Obstacles and Options in One-to-One Teaching

ERIC Educational Resources Information Center

Johansson, Karin

2013-01-01

This paper describes a longitudinal, collaborative case study, made in the framework of the project Students' Ownership of Learning (SOL) during one academic year with one vocal teacher and two female students. The aim of the study was to relate the interaction between the teacher's and the students' intentions and expectations to…

Kicking the Habitus: Power, Culture and Pedagogy in the Secondary School Music Curriculum

ERIC Educational Resources Information Center

Wright, Ruth

2008-01-01

Within a theoretical framework drawn from sociologists of education Bourdieu and Bernstein, this paper will examine some of the findings of an ethnographic case study conducted with a secondary school music teacher and one class of her pupils in Wales. This teacher attracted 25% of Year 10 (14-year-old) pupils to study music as an optional subject…

Profiles in Retention Part 1: Design Characteristics of a Graduate Synchronous Online Program

ERIC Educational Resources Information Center

Aversa, Elizabeth; MacCall, Steven

2013-01-01

This paper is a case study of a Master of Library and Information Studies degree program online option that has been unusually successful in retaining and graduating students. Design characteristics of this program that has maintained a retention rate of over 90 percent over five years are described and mapped to the literature on distance…

Assessing CO2 Mitigation Options Utilizing Detailed Electricity Characteristics and Including Renewable Generation

NASA Astrophysics Data System (ADS)

Bensaida, K.; Alie, Colin; Elkamel, A.; Almansoori, A.

2017-08-01

This paper presents a novel techno-economic optimization model for assessing the effectiveness of CO2 mitigation options for the electricity generation sub-sector that includes renewable energy generation. The optimization problem was formulated as a MINLP model using the GAMS modeling system. The model seeks the minimization of the power generation costs under CO2 emission constraints by dispatching power from low CO2 emission-intensity units. The model considers the detailed operation of the electricity system to effectively assess the performance of GHG mitigation strategies and integrates load balancing, carbon capture and carbon taxes as methods for reducing CO2 emissions. Two case studies are discussed to analyze the benefits and challenges of the CO2 reduction methods in the electricity system. The proposed mitigations options would not only benefit the environment, but they will as well improve the marginal cost of producing energy which represents an advantage for stakeholders.

Exploratory Analysis of Fast-Food Chain Restaurant Menus Before and After Implementation of Local Calorie-Labeling Policies, 2005–2011

PubMed Central

Namba, Alexa; Leonberg, Beth L.; Wootan, Margo G.

2013-01-01

Introduction Since 2008, several states and municipalities have implemented regulations requiring provision of nutrition information at chain restaurants to address obesity. Although early research into the effect of such labels on consumer decisions has shown mixed results, little information exists on the restaurant industry’s response to labeling. The objective of this exploratory study was to evaluate the effect of menu labeling on fast-food menu offerings over 7 years, from 2005 through 2011. Methods Menus from 5 fast-food chains that had outlets in jurisdictions subject to menu-labeling laws (cases) were compared with menus from 4 fast-food chains operating in jurisdictions not requiring labeling (controls). A trend analysis assessed whether case restaurants improved the healthfulness of their menus relative to the control restaurants. Results Although the overall prevalence of “healthier” food options remained low, a noteworthy increase was seen after 2008 in locations with menu-labeling laws relative to those without such laws. Healthier food options increased from 13% to 20% at case locations while remaining static at 8% at control locations (test for difference in the trend, P = .02). Since 2005, the average calories for an à la carte entrée remained moderately high (approximately 450 kilocalories), with less than 25% of all entrées and sides qualifying as healthier and no clear systematic differences in the trend between chain restaurants in case versus control areas (P ≥ .50). Conclusion These findings suggest that menu labeling has thus far not affected the average nutritional content of fast-food menu items, but it may motivate restaurants to increase the availability of healthier options. PMID:23786908

Exploratory analysis of fast-food chain restaurant menus before and after implementation of local calorie-labeling policies, 2005-2011.

PubMed

Namba, Alexa; Auchincloss, Amy; Leonberg, Beth L; Wootan, Margo G

2013-06-20

Since 2008, several states and municipalities have implemented regulations requiring provision of nutrition information at chain restaurants to address obesity. Although early research into the effect of such labels on consumer decisions has shown mixed results, little information exists on the restaurant industry's response to labeling. The objective of this exploratory study was to evaluate the effect of menu labeling on fast-food menu offerings over 7 years, from 2005 through 2011. Menus from 5 fast-food chains that had outlets in jurisdictions subject to menu-labeling laws (cases) were compared with menus from 4 fast-food chains operating in jurisdictions not requiring labeling (controls). A trend analysis assessed whether case restaurants improved the healthfulness of their menus relative to the control restaurants. Although the overall prevalence of "healthier" food options remained low, a noteworthy increase was seen after 2008 in locations with menu-labeling laws relative to those without such laws. Healthier food options increased from 13% to 20% at case locations while remaining static at 8% at control locations (test for difference in the trend, P = .02). Since 2005, the average calories for an à la carte entrée remained moderately high (approximately 450 kilocalories), with less than 25% of all entrées and sides qualifying as healthier and no clear systematic differences in the trend between chain restaurants in case versus control areas (P ≥ .50). These findings suggest that menu labeling has thus far not affected the average nutritional content of fast-food menu items, but it may motivate restaurants to increase the availability of healthier options.

Successful treatment of bullous lichen planus with acitretin monotherapy. Review of treatment options for bullous lichen planus and case report.

PubMed

Rallis, Efstathios; Liakopoulou, Angeliki; Christodoulopoulos, Constantinos; Katoulis, Alexandros

2016-12-31

Bullous lichen planus (BLP) is a rare variant of lichen planus, characterized by the development of vesicular and bullous lesions, of skin, nails, hair and/or mucosa. We present a case of 63-year-old woman with BLP, unresponsive to previous therapies with topical corticosteroids, topical calcipotriol, antihistamines and oral cyclosporine (4 mg/kg/day for 4 months). She was already receiving treatment for arterial hypertension, hyperlipidemia, atrial fibrillation and uncontrolled diabetes mellitus. Acitretin was administered for 5 months with complete remission of BLP lesions and no major side effects. This is probably the first reported case of BLP treated with acitretin monotherapy. In this case acitretin was an efficacious and well-tolerated therapeutic option for BLP.

Therapeutic strategy and outcome of spine tumors in pregnancy: a report of 21 cases and literature review.

PubMed

Meng, Tong; Yin, Huabin; Li, Zhenxi; Li, Bo; Zhou, Wang; Wang, Jing; Zhou, Lei; Song, Dianwen; Xiao, Jianru

2015-02-01

A retrospective study was performed. To illustrate the characteristics of spine tumors during pregnancy and obtain better insight into therapeutic strategies of such tumors by analyzing 21 cases treated in Changzheng Hospital and reviewing previous reports in the literature. The concurrence of spine tumors and pregnancy is relatively rare. There are controversies over the treatment options for this disease, which increase the difficulty of the clinical treatment. Between 2002 and 2013, 21 pregnant patients were identified with spine tumors. Clinical data including symptoms, signs, treatment options, and obstetrical and neonatal outcomes were recorded and preserved. Clinical data and treatment efficacy were analyzed via medical record review. The median age of the 21 patients was 28.87 years (interquartile range, 6.00 yr). Tumor types in this series were giant cell tumor (5 cases), hemangioma (5 cases), schwannoma (4 cases), eosinophilic granuloma (2 cases), neurofibroma (1 case), multiple myeloma (1 case), and with metastatic tumor (3 cases). Two patients underwent spine surgery during pregnancy and 8 patients accepted tumor resection immediately after delivery. Pregnancy termination occurred in 5 patients, whereas the rest of the patients smoothly gave birth to healthy babies including 3 premature infants. Two patients died and 2 patients experienced local recurrence during follow-up. With close observation, it was found that most of pregnant patients with benign spine tumors could postpone surgery after delivery. Surgical treatment should be adopted during pregnancy when patients are with highly malignant tumor or experience a sharp deterioration and the guard of it is safer than radiotherapy and chemotherapy during pregnancy. 4.

Stricturoplasty-a bowel-sparing option for long segment small bowel Crohn's disease.

PubMed

Limmer, Alexandra M; Koh, Hoey C; Gilmore, Andrew

2017-08-01

Stricturoplasty is a surgical option for management of severe stricturing Crohn's disease of the small bowel. It avoids the need for small bowel resection and the associated metabolic complications. This report contrasts the indications and technical aspects of two different stricturoplasty techniques. Case 1 describes an extensive Michelassi (side-to-side isoperistaltic) stricturoplasty performed for a 100 cm segment of diseased small bowel in a 45-year-old patient. Case 2 describes the performance of 12 Heineke-Mikulicz stricturoplasties in a 23-year-old patient with multiple short fibrotic strictures.

Neurogenic detrusor overactivity in patients with spinal cord injury: evaluation and management.

PubMed

Sahai, Arun; Cortes, Eduardo; Seth, Jai; Khan, Muhammad Shamim; Panicker, Jalesh; Kelleher, Cornelius; Kessler, Thomas M; Fowler, Clare J; Dasgupta, Prokar

2011-12-01

Lower urinary tract dysfunction can have a significant impact on patients with spinal cord injury. Over the years, many treatment options have become available. This article reviews the assessment and management of neurogenic detrusor overactivity, with a particular focus on articles from the recent literature. Recent guidelines on the subject will be discussed. Management options include antimuscarinics and bladder emptying measures, botulinum toxin A, and neuromodulation in refractory cases and surgery for intractable cases. Recent and relevant publications in these areas will be summarized and discussed.

Use of botulinum A toxin for proctalgia fugax-a case report of successful treatment.

PubMed

Grigoriou, Marios; Ioannidis, Aristeidis; Kofina, Konstantinia; Efthimiadis, Christoforos

2017-11-01

Proctalgia fugax is considered as intermittent anal pain of unknown etiology; a variety of treatments have been used, without, however, permanent results. Injection of botulinum A toxin is recently suggested as an alternative option. We present the case of a woman presenting proctalgia fugax that was untreatable through other current forms of treatment. After two administrations of botulinum A toxin, 80 units and 100 units each, the patient remained asymptomatic on 8-month follow-up control. Botulinum A toxin injection can reduce internal anal sphincter pressure, leading to relief of symptoms, and seems a promising option with minimal morbidity in cases on proctalgia fugax that does not respond to other current treatments.

Hair toe tourniquets: a review of two case studies.

PubMed

Booth, Julia; Morse, Tim

2018-05-22

Digit hair tourniquets are relatively uncommon. There are reports in the literature of hair tourniquets involving other appendages, such as the penis and uvula, however the phenomenon is not widely recognised and is often overlooked by healthcare professionals. This article discusses two case studies in which hair was responsible for creating a tourniquet around a digit. The article explores possible causes and management options for patients, with reference to the case studies. Midwives and health visitors are central to minimising the risk of injury to children as they can educate expectant mothers about this potential problem. © 2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Remarks on a financial inverse problem by means of Monte Carlo Methods

NASA Astrophysics Data System (ADS)

Cuomo, Salvatore; Di Somma, Vittorio; Sica, Federica

2017-10-01

Estimating the price of a barrier option is a typical inverse problem. In this paper we present a numerical and statistical framework for a market with risk-free interest rate and a risk asset, described by a Geometric Brownian Motion (GBM). After approximating the risk asset with a numerical method, we find the final option price by following an approach based on sequential Monte Carlo methods. All theoretical results are applied to the case of an option whose underlying is a real stock.

Evaluating Options for Measurement of Neighborhood Socioeconomic Context: Evidence from a Myocardial Infarction Case-Control Study

PubMed Central

Lovasi, Gina S.; Moudon, Anne Vernez; Smith, Nicholas L.; Lumley, Thomas; Larson, Eric B.; Sohn, Dong W; Siscovick, David S; Psaty, Bruce M

2008-01-01

We hypothesized that neighborhood socioeconomic context would be most stronly associated with risk of myocardial infarction (MI) for smaller “neighborhood” definitions. We used data on 487 non-fatal, incident MI cases and 1,873 controls from a case-control study in Washington State. Census data on income, home ownership, and education were used to estimate socioeconomic context across four neighborhood definitions: one-kilometer buffer, block group, census tract, and ZIP code. No neighborhood definition led to consistently stronger associations with MI. Although we confirmed the association between neighborhood socioeconomic measures and risk of MI, we did not find these associations sensitive to neighborhood definition. PMID:17950024

Integrated Heat Pump HVAC Systems for Near-Zero-Energy Homes - Business Case Assessment

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

Baxter, Van D

2007-05-01

The long range strategic goal of the Department of Energy's Building Technologies (DOE/BT) Program is to create, by 2020, technologies and design approaches that enable the construction of net-zero energy homes at low incremental cost (DOE/BT 2005). A net zero energy home (NZEH) is a residential building with greatly reduced needs for energy through efficiency gains, with the balance of energy needs supplied by renewable technologies. While initially focused on new construction, these technologies and design approaches are intended to have application to buildings constructed before 2020 as well resulting in substantial reduction in energy use for all building typesmore » and ages. DOE/BT's Emerging Technologies (ET) team is working to support this strategic goal by identifying and developing advanced heating, ventilating, air-conditioning, and water heating (HVAC/WH) technology options applicable to NZEHs. Although the energy efficiency of heating, ventilating, and air-conditioning (HVAC) equipment has increased substantially in recent years, new approaches are needed to continue this trend. Dramatic efficiency improvements are necessary to enable progress toward the NZEH goals, and will require a radical rethinking of opportunities to improve system performance. The large reductions in HVAC energy consumption necessary to support the NZEH goals require a systems-oriented analysis approach that characterizes each element of energy consumption, identifies alternatives, and determines the most cost-effective combination of options. In particular, HVAC equipment must be developed that addresses the range of special needs of NZEH applications in the areas of reduced HVAC and water heating energy use, humidity control, ventilation, uniform comfort, and ease of zoning. In FY05 ORNL conducted an initial Stage 1 (Applied Research) scoping assessment of HVAC/WH systems options for future NZEHs to help DOE/BT identify and prioritize alternative approaches for further development. Eleven system concepts with central air distribution ducting and nine multi-zone systems were selected and their annual and peak demand performance estimated for five locations: Atlanta (mixed-humid), Houston (hot-humid), Phoenix (hot-dry), San Francisco (marine), and Chicago (cold). Performance was estimated by simulating the systems using the TRNSYS simulation engine (Solar Energy Laboratory et al. 2006) in two 1800-ft{sup 2} houses--a Building America (BA) benchmark house and a prototype NZEH taken from BEopt results at the take-off (or crossover) point (i.e., a house incorporating those design features such that further progress towards ZEH is through the addition of photovoltaic power sources, as determined by current BEopt analyses conducted by NREL). Results were summarized in a project report, 'HVAC Equipment Design options for Near-Zero-Energy Homes--A Stage 2 Scoping Assessment', ORNL/TM-2005/194 (Baxter 2005). The 2005 study report describes the HVAC options considered, the ranking criteria used, and the system rankings by priority. Table 1 summarizes the energy savings potential of the highest scoring options from the 2005 study for all five locations. All system options were scored by the ORNL building equipment research team and by William Goetzler of Navigant Consulting. These scores were reviewed by DOE/BT's Residential Integration program leaders and Building America team members. Based on these results, the two centrally ducted integrated heat pump (IHP) systems (air source and ground source versions) were selected for advancement to Stage 2 (Exploratory Development) business case assessments in FY06. This report describes results of these business case assessments. It is a compilation of three separate reports describing the initial business case study (Baxter 2006a), an update to evaluate the impact of an economizer cooling option (Baxter 2006b), and a second update to evaluate the impact of a winter humidification option (Baxter 2007). In addition it reports some corrections made subsequent to release of the first two reports to correct some errors in the TRNSYS building model for Atlanta and in the refrigerant pressure drop calculation in the water-to-refrigerant evaporator module of the ORNL Heat Pump Design Model (HPDM) used for the IHP analyses. These changes resulted in some minor differences between IHP performance as reported in Baxter (2006a, b) and in this report.« less

Surgical Options for the Refractive Correction of Keratoconus: Myth or Reality

PubMed Central

Zaldivar, R.; Aiello, F.; Madrid-Costa, D.

2017-01-01

Keratoconus provides a decrease of quality of life to the patients who suffer from it. The treatment used as well as the method to correct the refractive error of these patients may influence on the impact of the disease on their quality of life. The purpose of this review is to describe the evidence about the conservative surgical treatment for keratoconus aiming to therapeutic and refractive effect. The visual rehabilitation for keratoconic corneas requires addressing three concerns: halting the ectatic process, improving corneal shape, and minimizing the residual refractive error. Cross-linking can halt the disease progression, intrastromal corneal ring segments can improve the corneal shape and hence the visual quality and reduce the refractive error, PRK can correct mild-moderate refractive error, and intraocular lenses can correct from low to high refractive error associated with keratoconus. Any of these surgical options can be performed alone or combined with the other techniques depending on what the case requires. Although it could be considered that the surgical option for the refracto-therapeutic treatment of the keratoconus is a reality, controlled, randomized studies with larger cohorts and longer follow-up periods are needed to determine which refractive procedure and/or sequence are most suitable for each case. PMID:29403662

The combined endonasal and transoral approach for the management of skull base and nasopharyngeal pathology: a case series.

PubMed

Sreenath, Satyan B; Rawal, Rounak B; Zanation, Adam M

2014-01-01

The posterior skull base and the nasopharynx have historically represented technically difficult regions to approach surgically given their central anatomical locations. Through continued improvements in endoscopic instrumentation and technology, the expanded endonasal approach (EEA) has introduced a new array of surgical options in the management of pathology involving these anatomically complex areas. Similarly, the transoral robotic surgical (TORS) approach was introduced as a minimally invasive surgical option to approach tongue base, nasopharyngeal, parapharyngeal, and laryngeal lesions. Although both the EEA and the TORS approach have been extensively described as viable surgical options in managing nasopharyngeal and centrally located head and neck pathology, both endonasal and transoral techniques have inherent limitations. Given these limitations, several institutions have published feasibility studies with the combined EEA and TORS approaches for a variety of skull base and nasopharyngeal pathologies. In this article, the authors present their clinical experience with the combined endonasal and transoral approach through a case series presentation, and discuss advantages and limitations of this approach for surgical management of the middle and posterior skull base and nasopharynx. In addition, a presentation is included of a unique, simultaneous endonasal and transoral dissection of the nasopharynx through an innovative intraoperative setup.

Cheilitis glandularis: Case report with respect to immunohistochemical findings

PubMed Central

Friedrich, Reinhard E.; Löning, Thomas

2016-01-01

Cheilitis glandularis (CG) is a rare benign affection of the lip mucosa. The etiology and pathogenesis of CG are unknown. Surgical measures are the leading therapeutic options to treat CG. This case report on a 55-year-old female illustrates the recurrent affection of the lips over several years and local therapy. Furthermore, the study of the resected glands intends to differentiate the lesions with respect to the recently introduced concept of immunoglobulin G4-related diseases. PMID:26816670

Preserving the Whole: A Two-Track Approach to Rescuing Social Science Data and Metadata.

ERIC Educational Resources Information Center

Green, Ann; Dionne, JoAnn; Dennis, Martin

Focusing on the experience of the Yale University (Connecticut) social science data preservation project, this document presents a case study of migration as a preservation strategy, exploring options for migrating data stored in a technically obsolete format and their associated documentation stored on paper. The first section provides background…

Municipal Sludge Application in Forests of Northern Michigan: a Case Study.

Treesearch

D.G. Brockway; P.V. Nguyen

1986-01-01

A large-scale operational demonstration and research project was cooperatively established by the US. Environmental Protection Agency, Michigan Department of Natural Resources, and Michigan State University to evaluate the practice of forest land application as an option for sludge utilization. Project objectives included completing (1) a logistic and economic...

Job Attainment and Perceived Role Differences of Cyberschool Leaders

ERIC Educational Resources Information Center

Richardson, Jayson W.; Beck, Dennis; LaFrance, Jason; McLeod, Scott

2016-01-01

As cyberschooling options expand, it is vital that we understand the nuances of these particular learning opportunities. Because little research exists on leaders of K-12 cyberschools, this exploratory case study had two purposes. We first examined how 18 cyberschool leaders in the United States obtained their position. Second, we explored the…

"I'm the New Girl": The Meanings Positions Hold for Students

ERIC Educational Resources Information Center

Lassonde, Cynthia A.

2005-01-01

This study offers ways to understand how a fifth-grade student and her teacher co-constructed academic and social positions within classroom writing practices and how these positions constrained and enabled literacy learning. Positioning is viewed as central rather than optional to learning. Classroom writing practices enabled the case-study…

A Lost Opportunity? Vocational Education in Physical Education

ERIC Educational Resources Information Center

Brown, Seth Earl; Macdonald, Doune

2011-01-01

Background: Vocational education in Australia and elsewhere has a history of being gendered and classed, thereby limiting the post-school options of students undertaking this form of study. Drawing on Foucauldian theory, the authors used Gore's eight techniques of power to examine the micro-functioning of power relations at two case sites.…

Improving Dispute Resolution in Australian Universities: Options for the Future

ERIC Educational Resources Information Center

Astor, Hilary

2005-01-01

Disputes in Australian universities cost millions of dollars each year that could be spent more fruitfully on core activities such as research and teaching. This paper uses three case studies to examine what we know about disputes and dispute resolution in Australian universities. The impact of changing higher education funding and policy on…

Resilient Transportation Systems in a Post-Disaster Environment: A Case Study of Opportunities Realized and Missed in New Orleans and the Louisiana Coastal Region

DOT National Transportation Integrated Search

2010-10-01

Based upon our research in Post-Katrina New Orleans, we define transportation resiliency as a systems ability to function before, during and after major disruptions through reliance upon multiple mobility options. The importance of a resilient tra...

Professional Development for the Novice Teacher: One University's Initiative to Support the Alternatively Certified Educator

ERIC Educational Resources Information Center

Porter, Marclyn D.

2011-01-01

Many alternatively certified teachers, as was the case in this study, are employed as the teacher of record while simultaneously enrolled in education courses. Therefore, experiencing the collaborative, supportive, peer mentoring environmental elements that are present in many traditional "fieldwork" settings is not an option. By…

Deconstructing the Discourse of Opportunity: Computer-Assisted Credit Recovery in Alternative Education

ERIC Educational Resources Information Center

Miller, Elizabeth R.

2013-01-01

Alternative schools educate students who have previously been unsuccessful in the traditional school setting. Many alternative school students are behind on high school credits, and the schools provide options for credit recovery. Computer-assisted instruction is often used for this purpose. Using case study methodology and a critical theoretical…

In Canada, Business Schools Lead Push for Globalization

ERIC Educational Resources Information Center

Lewington, Jennifer

2012-01-01

At Canadian universities, business schools are light-years ahead of the rest of the campus in raising their global profile. Intensive foreign-student-recruitment efforts, friendly Canadian immigration rules, mandatory study-abroad requirements, and, in some cases, the option to pursue programs in multiple languages have combined to pack a punch in…

Songs in Our Hearts: The Affordances and Constraints of an Intergenerational Multimodal Arts Curriculum

ERIC Educational Resources Information Center

Heydon, Rachel; O'Neill, Susan

2014-01-01

This qualitative case study examines the affordances and constraints of an intergenerational multimodal arts curriculum that was designed to expand communication and identity options for children and elder participants. The authors drew on actor-network theory to conceptualize curriculum as a network effect and refer to literature on multimodal…

Social Justice or Status Quo? Blended Learning in a Western Canadian Teacher Education Program

ERIC Educational Resources Information Center

Snow, Kathy

2016-01-01

Sustainable pre-service teacher education is needed to encourage academic success for under-represented populations, through both culturally responsive and alternative programming options (Carr-Stewart, Balzer, & Cottrell, 2013). In 2013, the Western Canadian University that served as the basis for this case study, implemented a blended…

Physics at an upgraded Fermilab proton driver

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

Geer, S.; /Fermilab

2005-07-01

In 2004 the Fermilab Long Range Planning Committee identified a new high intensity Proton Driver as an attractive option for the future, primarily motivated by the recent exciting developments in neutrino physics. Over the last few months a physics study has developed the physics case for the Fermilab Proton Driver. The potential physics opportunities are discussed.

Group Therapy for Abused and Neglected Youth: Therapeutic and Child Advocacy Challenges

ERIC Educational Resources Information Center

Wanlass, Janine; Moreno, J. Kelly; Thomson, Hannah M.

2006-01-01

Although group therapy for abused and neglected youth is a viable and efficacious treatment option, facilitation is challenging. Group leaders must contain intense affect, manage multiple transferences, and advocate for their clients within the larger social welfare system. Using a case study of a group for sexually abused girls, this paper…

Colombian English Teachers' Professional Development: The Case of Master Programs

ERIC Educational Resources Information Center

Viáfara, John Jairo; Largo, José David

2018-01-01

Master degree programs have rapidly increased in Colombia to the point where they are one of the most favored options for English teachers seeking to bolster their professional development. This survey study characterizes eighty participants, their five master programs, and their perceptions concerning the influence these graduate courses exerted…

Recent trends in preservative treatments for timber bridges

Treesearch

James P. Wacker

2004-01-01

An overview of wood preservatives currently used for timber bridges is presented through a series of case studies from different regions of the United States. New wood species and preservative treatment options for timber bridges have made choosing the appropriate preservative more complicated. The compatibility of wood species and preservative treatment is often...

Real Options as a Strategic Management Framework: A Case Study of the Operationally Responsive Space Initiative

DTIC Science & Technology

2007-03-01

of the project, and the Weighted Average Cost of Capital ( WACC ). WACC is defined as the after-tax marginal cost of capital (Copeland & Antikarov...Initial Investment t = Life Expectancy of Project (Start =1, to Finish=N) E(FCF) = Expected Free-Cash Flow WACC = Weighted Average Cost of

Stuttering in Preschool Children: Direct versus Indirect Treatment

ERIC Educational Resources Information Center

Nippold, Marilyn A.

2018-01-01

Purpose: The purpose of this article is to discuss the controversial topic of stuttering in preschool children and how to evaluate the options for treatment, emphasizing the role of external research evidence. Method: A hypothetical but realistic case study of a 3-year-old boy who stutters is described. Two contrasting approaches to treatment are…

Advanced Stent Graft Treatment of Venous Stenosis Affecting Hemodialysis Vascular Access: Case Illustrations

PubMed Central

Patel, Darshan; Ray, Charles E.; Lokken, R. Peter; Bui, James T.; Lipnik, Andrew J.; Gaba, Ron C.

2016-01-01

Surgically placed dialysis access is an important component of dialysis replacement therapy. The vast majority of patients undergoing dialysis will have surgically placed accesses at some point in the course of their disease, and for many patients these accesses may represent their definitive renal replacement option. Most, if not all, arteriovenous fistulae and grafts will require interventions at some point in time. Percutaneous angioplasty is the typical first treatment performed for venous stenoses, with stents and stent grafts being reserved for patients in whom angioplasty and surgical options are exhausted. In some salvage situations, stent graft placement may be the only or best option for patients. This article describes, using case illustrations, placement of stent grafts in such patients; a focus will also be made on the techniques utilized in such salvage situations. PMID:27011426

The minimally invasive approach to the symptomatic isthmocele - what does the literature say? A step-by-step primer on laparoscopic isthmocele - excision and repair.

PubMed

Sipahi, Sevgi; Sasaki, Kirsten; Miller, Charles E

2017-08-01

The purpose of this review is to understand the minimally invasive approach to the excision and repair of an isthmocele. Previous small trials and case reports have shown that the minimally invasive approach by hysteroscopy and/or laparoscopy can cure symptoms of a uterine isthmocele, including abnormal bleeding, pelvic pain and secondary infertility. A recent larger prospective study has been published that evaluates outcomes of minimally invasive isthmocele repair. Smaller studies and individual case reports echo the positive results of this larger trial. The cesarean section scar defect, also known as an isthmocele, has become an important diagnosis for women who present with abnormal uterine bleeding, pelvic pain and secondary infertility. It is important for providers to be aware of the effective surgical treatment options for the symptomatic isthmocele. A minimally invasive approach, whether it be laparoscopic or hysteroscopic, has proven to be a safe and effective option in reducing symptoms and improving fertility. VIDEO ABSTRACT: http://links.lww.com/COOG/A37.

Vending Assessment and Program Implementation in Four Iowa Worksites.

PubMed

Lillehoj, Catherine J; Nothwehr, Faryle; Shipley, Kala; Voss, Carol

2015-11-01

The worksite food environment, including vending options, has been explored as an important contributor to dietary decisions made every day. The current study describes the vending environment, and efforts to change it, in four Iowa worksites using a series of case studies. Data were gathered by local coordinators as part of the Iowa Community Transformation Grant project. Data were collected from three sources. First, the Nutrition Environment Measures Survey-Vending was used to assess healthy vending options in worksite machines before and after the intervention. Second, employee vending behavior was evaluated with a pre-, post-intervention survey. Items assessed attitudes and behaviors regarding vending, plus awareness and reaction to intervention activities. Third, program coordinators documented vending machine intervention strategies used, such as social marketing materials and product labels. The Nutrition Environment Measures Survey-Vending documented that the majority of vending options did not meet criteria for healthfulness. The vending survey found that employees were generally satisfied with the healthier items offered. Some differences were noted over time at the four worksites related to employee behavior and attitudes concerning healthy options. There were also differences in intervention implementation and the extent of changes made by vending companies. Overall, findings demonstrate that a large percentage of employees are constrained in their ability to access healthy foods due to limited worksite vending options. There also remain challenges to making changes in this environment. Findings have implications for public health practitioners to consider when designing healthy vending interventions in worksites. © 2015 Society for Public Health Education.

Reproductive rights and options available to women infected with HIV in Ghana: perspectives of service providers from three Ghanaian health facilities.

PubMed

Laar, Amos Kankponang

2013-03-15

Owing to improved management of HIV and its associated opportunistic infections, many HIV-positive persons of reproductive age are choosing to exercise their right of parenthood. This study explored the knowledge of health workers from two Ghanaian districts on the reproductive rights and options available to HIV-positive women who wish to conceive. Facility-based cross-sectional in design, the study involved the entire population of nurse counselors (32) and medical officers (3) who provide counseling and testing services to clients infected with HIV. Both structured and in-depth interviews were conducted after informed consent. Two main perspectives were revealed. There was an overwhelmingly high level of approbation by the providers on HIV-positive women's right to reproduction (94.3%). At the same time, the providers demonstrated a lack of knowledge regarding the various reproductive options available to women infected with HIV. Site of facility, and being younger were associated with practices that violated client's right to contraceptive counseling (p < 0.05) in each case. Some of the providers openly expressed their inability to give qualified guidance to HIV-positive women on the various reproductive options. Taken together, these findings suggest that many HIV-positive clients do not receive comprehensive information about their reproductive options. These findings highlight some of the problems that service providers face as HIV counselors. Both service providers and policy makers need to recognize these realities and incorporate reproductive health issues of HIV-persons into the existing guidelines.

Using Supercomputers to Speed Execution of the CAISO/PLEXOS 33% RPS Study

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

Meyers, C; Streitz, F; Yao, Y

2011-09-19

The study's official title is 'ISO Study of Operational Requirements and Market Impacts at 33% Renewable Portfolio Standard (RPS).' The stated objectives are twofold: (1) identifying operational requirements and resource options to reliably operate the ISO-controlled grid under a 33% RPS in 2020; and (2) inform market, planning, and policy/regulatory decisions by the ISO, state agencies, market participants, and other stakeholders. The first of these objectives requires the hourly estimates of integration requirements, measured in terms of operational ramp, load following and regulation capacity and ramp rates, as well as additional capacity to resolve operational violations. It also involves considerationmore » of other variables that affect the results, such as the impact of different mixes of renewable technologies, and the impact of forecasting error and variability. The second objective entails supporting the CPUC to identify long-term procurement planning needs, costs, and options, as well as informing other decisions made by the CPUC and state agencies. For the ISO itself this includes informing state-wide transmission planning needs for renewables up to a 33% RPS, and informing design of wholesale markets for energy and ancillary services to facilitate provision of integration capacities. The study is designed in two phases. The first (current) phase is focused on operational requirements and addressing these requirements with existing and new conventional fossil generation; for instance, gas turbines and/or combined cycle units. The second (planned) phase will address the same operational requirements with a combination of conventional fossil generation resources, new non-generation resources, and a renewable resource dispatch. There are seven different scenarios considered in the current phase: a 20% RPS reference case; four 33% RPS cases (a reference case, a high out-of-state case, a high distributed generation case, and a low load case); an alternative 27.5% RPS case; and an all-gas case (no new renewables after 2008). In addition, the CPUC is planning a new set of cases that will alter the anticipated sets of runs.« less

75 FR 37406 - Order Exempting the Trading and Clearing of Certain Products Related to ETFS Physical Swiss Gold...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... to security futures), and in either case cleared through the Options Clearing Corporation (``OCC... contract market or derivatives transaction execution facility for transactions for future delivery in any... of the Options and Security Futures on Gold and Silver Products. In enacting Section 4(c), Congress...

29 CFR 8.6 - Disposition by the Administrative Review Board.

Code of Federal Regulations, 2010 CFR

2010-07-01

... inappropriate because of lack of timeliness, the nature of the relief sought, the case involves only settled... will not review a wage determination after award, exercise of option, or extension of a contract....5 of part 4 of this title. (c) A wage determination may be reviewed after award, exercise of option...

Logic of Accounting: The Case of Reporting Previous Options in Norwegian Activation Encounters

ERIC Educational Resources Information Center

Solberg, Janne

2017-01-01

The article deals with the enactment of client resistance in Norwegian vocational rehabilitation encounters. More specific, a practice here called "reporting previous options" is analyzed by using the resources of ethnomethodological conversation analysis (CA) in five instances as doing some sort of accounting. In response to the…

Food waste disposal units in UK households: the need for policy intervention.

PubMed

Iacovidou, Eleni; Ohandja, Dieudonne-Guy; Voulvoulis, Nikolaos

2012-04-15

The EU Landfill Directive requires Member States to reduce the amount of biodegradable waste disposed of to landfill. This has been a key driver for the establishment of new waste management options, particularly in the UK, which in the past relied heavily on landfill for the disposal of municipal solid waste (MSW). MSW in the UK is managed by Local Authorities, some of which in a less conventional way have been encouraging the installation and use of household food waste disposal units (FWDs) as an option to divert food waste from landfill. This study aimed to evaluate the additional burden to water industry operations in the UK associated with this option, compared with the benefits and related savings from the subsequent reductions in MSW collection and disposal. A simple economic analysis was undertaken for different FWD uptake scenarios, using the Anglian Region as a case study. Results demonstrated that the significant savings from waste collection arising from a large-scale uptake of FWDs would outweigh the costs associated with the impacts to the water industry. However, in the case of a low uptake, such savings would not be enough to cover the increased costs associated with the wastewater provision. As a result, this study highlights the need for policy intervention in terms of regulating the use of FWDs, either promoting them as an alternative to landfill to increase savings from waste management, or banning them as a threat to wastewater operations to reduce potential costs to the water industry. Copyright © 2012 Elsevier B.V. All rights reserved.

Benefits and Limitations of Real Options Analysis for the Practice of River Flood Risk Management

NASA Astrophysics Data System (ADS)

Kind, Jarl M.; Baayen, Jorn H.; Botzen, W. J. Wouter

2018-04-01

Decisions on long-lived flood risk management (FRM) investments are complex because the future is uncertain. Flexibility and robustness can be used to deal with future uncertainty. Real options analysis (ROA) provides a welfare-economics framework to design and evaluate robust and flexible FRM strategies under risk or uncertainty. Although its potential benefits are large, ROA is hardly used in todays' FRM practice. In this paper, we investigate benefits and limitations of a ROA, by applying it to a realistic FRM case study for an entire river branch. We illustrate how ROA identifies optimal short-term investments and values future options. We develop robust dike investment strategies and value the flexibility offered by additional room for the river measures. We benchmark the results of ROA against those of a standard cost-benefit analysis and show ROA's potential policy implications. The ROA for a realistic case requires a high level of geographical detail, a large ensemble of scenarios, and the inclusion of stakeholders' preferences. We found several limitations of applying the ROA. It is complex. In particular, relevant sources of uncertainty need to be recognized, quantified, integrated, and discretized in scenarios, requiring subjective choices and expert judgment. Decision trees have to be generated and stakeholders' preferences have to be translated into decision rules. On basis of this study, we give general recommendations to use high discharge scenarios for the design of measures with high fixed costs and few alternatives. Lower scenarios may be used when alternatives offer future flexibility.

Summary of Data from the Fifth AIAA CFD Drag Prediction Workshop

NASA Technical Reports Server (NTRS)

Levy, David W.; Laflin, Kelly R.; Tinoco, Edward N.; Vassberg, John C.; Mani, Mori; Rider, Ben; Rumsey, Chris; Wahls, Richard A.; Morrison, Joseph H.; Brodersen, Olaf P.;

Focal therapy in prostate cancer: the current situation

PubMed Central

Jácome-Pita, FX; Sánchez-Salas, R; Barret, E; Amaruch, N; Gonzalez-Enguita, C; Cathelineau, X

2014-01-01

Prostate cancer is one of the most significant pathologies in the field of urology. The adoption of screening strategies and improvements in biopsies have resulted in an increase in early-stage tumour detection. Radical global therapies provide very good oncological results in localised prostate cancer. However, excess treatment in low- and, in some cases, intermediate-risk groups affects the quality of life of these patients. In the case of localised prostate cancer, focal therapies offer a minimally invasive option with good results with respect to established treatments. Although this is currently not a standard treatment, it represents the therapeutic approach with the greatest potential. This literature review has the following objectives: to define selection criteria for patients who are candidates for focal therapy, to assess the current situation and results of the different therapeutic options, and to define procedures in cases of recurrence and for follow-ups. We concluded that focal therapy is a viable therapeutic alternative for localised prostate cancer, specifically cryosurgery and high-intensity targeted ultrasound, which have acceptable oncologic results and a lower comorbidity compared with global treatments. Studies with a high level of scientific evidence are still needed to validate these results. Acquisition of evidence A search was carried out on the Medline (PubMed), EMBASE, Web of Science and Cochrane databases of all papers published before 31 July 2013. We included clinical studies and literature reviews that evaluated primary focal therapy for prostate cancer confirmed by biopsy and excluded focal rescue therapy studies. The keywords used were focal therapy and prostate cancer. Initially, we found 42 articles; 15 studies were excluded because they did not meet the minimum criteria for inclusion. A total of 1350 cases were treated throughout 27 studies. PMID:24944577

An assessment of functioning and non-functioning distractors in multiple-choice questions: a descriptive analysis.

PubMed

Tarrant, Marie; Ware, James; Mohammed, Ahmed M

2009-07-07

Four- or five-option multiple choice questions (MCQs) are the standard in health-science disciplines, both on certification-level examinations and on in-house developed tests. Previous research has shown, however, that few MCQs have three or four functioning distractors. The purpose of this study was to investigate non-functioning distractors in teacher-developed tests in one nursing program in an English-language university in Hong Kong. Using item-analysis data, we assessed the proportion of non-functioning distractors on a sample of seven test papers administered to undergraduate nursing students. A total of 514 items were reviewed, including 2056 options (1542 distractors and 514 correct responses). Non-functioning options were defined as ones that were chosen by fewer than 5% of examinees and those with a positive option discrimination statistic. The proportion of items containing 0, 1, 2, and 3 functioning distractors was 12.3%, 34.8%, 39.1%, and 13.8% respectively. Overall, items contained an average of 1.54 (SD = 0.88) functioning distractors. Only 52.2% (n = 805) of all distractors were functioning effectively and 10.2% (n = 158) had a choice frequency of 0. Items with more functioning distractors were more difficult and more discriminating. The low frequency of items with three functioning distractors in the four-option items in this study suggests that teachers have difficulty developing plausible distractors for most MCQs. Test items should consist of as many options as is feasible given the item content and the number of plausible distractors; in most cases this would be three. Item analysis results can be used to identify and remove non-functioning distractors from MCQs that have been used in previous tests.

Multimedia Activities in L2 Course Websites--A Case Study of a Site Dedicated to Cultural Topics of Portuguese-Speaking Countries

ERIC Educational Resources Information Center

Vasconcelos, Ricardo

2012-01-01

This study examines student preferences and behavior when navigating online multimedia modules dedicated to teaching cultural aspects associated with an L2, and the contribution of the online multimedia format of the modules to raising interest in these cultural topics. It focuses on student options regarding reading texts on the modules' main…

An Investigation of the Effectiveness of Online Text-to-Speech Tools in Improving EFL Teacher Trainees' Pronunciation

ERIC Educational Resources Information Center

Eksi, Gonca Yangin; Yesilçinar, Sabahattin

2016-01-01

Given the limited time for instruction in the classroom, pronunciation often ends up as the most neglected aspect of language teaching. However, in cases when the learner's pronunciation is expected to be good or native-like, as is expected of language teacher trainees, out-of-class self-study options become prominent. This study aimed to…

The results of therapeutic plasma exchange in patients with severe hyperthyroidism: a retrospective multicenter study.

PubMed

Keklik, Muzaffer; Kaynar, Leylagul; Yilmaz, Mehmet; Sivgin, Serdar; Solmaz, Musa; Pala, Cigdem; Aribas, Sulbiye; Akyol, Gulsah; Unluhizarci, Kursat; Cetin, Mustafa; Eser, Bulent; Unal, Ali

2013-06-01

Hyperthyroidism characterized by elevated serum levels of circulating thyroid hormones. The aim of hyperthyroidism treatment is to achieve a euthyroid state as soon as possible and to maintain euthyroid status. However, drug withdrawal and utilization of alternative therapies are needed in cases in which leucopenia or impairment in liver functions is observed during medical therapy. In the present study, we aimed to present our cases which underwent therapeutic plasma exchange (TPE) due to severe hyperthyroidism. The results of 22 patients who underwent therapeutic plasma exchange due to hyperthyroidism in Apheresis Units of Erciyes University and Gaziantep University, between 2006 and 2012, were retrospectively reviewed. These cases had severe thyrotoxic values despite anti-thyroid drug use. After TPE, we observed a significant decrease in free thyroxin (FT4) (p<0.001) and free triiodotyhronin (FT3) (p<0.004) levels. There was statistically significant increase in the mean values of TSH levels after TPE (p<0.001). Clinical improvement was achieved in hyperthyroidism by TPE in 20 cases (91%). Both FT3 and FT4 levels remained above the normal limits in two of 22 patients. TPE should be considered as an effective and safe therapeutic option to achieve euthyroid state before surgery or radioactive iodine treatment. TPE is a useful option in cases with severe hyperthyroidism unresponsive to anti-thyroid agents and in those with clinical manifestations of cardiac failure and in patients with severe adverse events during anti-thyroid therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Pannus regression after posterior decompression and occipito-cervical fixation in occipito-atlanto-axial instability due to rheumatoid arthritis: case report and literature review.

PubMed

Landi, Alessandro; Marotta, Nicola; Morselli, Carlotta; Marongiu, Alessandra; Delfini, Roberto

2013-02-01

Several techniques have been proposed for treating cervical spine instability due to rheumatoid arthritis. The aim of this study was to screen the different treatment options used in this pathology to evaluate the best form of treatment when the progression of rheumatoid disease affected the cranio-vertebral junction (CVJ) stability. The most important purpose of this study was to achieve both the efficacy of occipito-cervical fusion (OCF) to stabilize the occipitocervical junction and stop pannus progression. The authors describe their case example and stress, in the light of a literature review, the hypothesis that a stable biomechanical system extended to all the spaces involved, has both direct and indirect effects on RA pannus progression and the condition responsible for its formation, such as inflammation and articular hypermobility. Hence, the aim of this study is to advance this thesis, which may be extended to a wider statistical sample, with the same characteristics. A systematic literature research of case report articles, review articles, original articles, and prospective cohort studies, published from 1978 to 2011, was performed using PUBMED to analyze the different surgical strategies of RA involving CVJ and the role of OCF in these conditions. The key words used for the search the were: "inflammatory cervical pannus regression", "rheumatoid arthritis of the cranio-cervical junction", "occipito-cervical fusion", "treatment option in rheumatoid cervical instability", "altanto-axial dislocation", "craniovertebral junction" and "surgical technique". In addition, the authors reported their experience in a patient affected by erosive rheumatoid arthritis (ERA) with an anterior and posterior pannus involving C0-C1-C2. They decided to report this exemplative case to emphasize their own assumptions concerning the association between a posterior bony fusion, the arrest of anterior pannus progression and the improvement of functional outcome, without, however, a direct intervention on the anterior pannus. Thirty-seven different studies were identified that reflected search criteria, five of which were literature reviews. The different surgical treatment options in cervical RA disease are described in relation to neurological outcome according to the Ranawat grading system, functional outcome or quality of life according to the Steinbrocker classification, and progression of cervical instability and radiographic index of cranial settling, focusing on the role of OCF. Copyright © 2012 Elsevier B.V. All rights reserved.

Building-integrated photovoltaics: A case study

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

Kiss, G.; Kinkead, J.; Raman, M.

1995-03-01

In 1992, Kiss Cathcart Anders Architects performed a study for NREL on Building-Integrated Photovoltaics (BIPV) issues as seen from the perspective of the building community. In general, the purpose of the study was to list major issues and potential applications; by it`s nature it asked more questions than it answered. This second phase study was to produce quantitative data on the performance of specific BIPV systems. Only roof systems are evaluated. The energy performance, construction cost and simple payback for five different BIPV roof options are evaluated in six different locations: Oakland, New York, Miami, Phoenix, Chicago, and Cincinnati. Themore » roof options evaluated include the following: single-glazed PV roof using glass-substrate PVs; double-glazed PV roof with insulating PV modules; ballasted roof-mounted system; sawtooth light monitor roof with indirect north daylighting; sawtooth roof with north light and active heat recovery.« less

Single-session radiofrequency ablation on benign thyroid nodules: a prospective single center study : Radiofrequency ablation on thyroid.

PubMed

Aysan, Erhan; Idiz, Ufuk Oguz; Akbulut, Huseyin; Elmas, Leyla

2016-05-01

The activity of the application of single-session ultrasonography (US)-guided percutaneous radio frequency ablation (RFA) in benign thyroid nodules was investigated in this prospective clinical study. RFA treatment was applied to 100 nodules in 100 patients (78 women, 22 men; average age 44.5 years old; age range 18-71) who had euthyroid condition, nodule size larger than 1 cm in the ultrasonography, proven to be benign by fine needle aspiration cytology. The nodules were separated into three groups according to the content: solid, cystic and mixed. In first 73 cases, the process performed under local anesthesia and the other 27 cases were performed under general anesthesia. RFA process was standardized to 70 W in all of the patients, and a moving shot technique was used. The results acquired in the third and sixth months of the controls were evaluated, and the volume of the nodules was screened. No differences between the thyroid function tests performed before and after RFA were detected (p > 0.05). The mean volume of the nodules before the process, in the third month after the process, and in the sixth month were 16.8, 4.8, and 2.6 ml, respectively (p < 0.001). The decrease in cystic nodules was greater than solid and mixed structures. Temporary hoarseness occurred in one case and skin edema was detected in a patient at the isthmus. RFA is an option for treatment, with minimal invasiveness and a low complication rate, and it is effective primarily in cases with benign nodules and nodular goiter. In cases with good compliance, the likelihood of success is greater. General anesthesia can be a good option for anxious cases to gather better results.

SUBTOTAL THYROIDECTOMY IN THE MANAGEMENT OF GRAVE'S DISEASE.

PubMed

Vincent, P J; Garg, M K; Singh, Y; Bhalla, V P; Datta, S

2001-07-01

Treatment options for Grave's disease include radio-iodine ablation, which is the standard treatment in the USA, antithyroid drug therapy, which is popular in Japan, and surgery, which is commonly employed in Europe and India. There are very few reports about the outcome of surgery in Grave's disease in the Indian setting. Surgery for Grave's disease is an attractive option in under developed countries to cut short prolonged drug treatment, costly follow up and avoid the need for radio-isotope facilities for 1311 ablation. Aim of the present study was to assess the result of subtotal thyroidectomy in 32 cases of Grave's Disease referred for surgery by the endocrinologist in a teaching hospital. Patients were prepared for surgery with Lugol's iodine and propranalol. Subtotal thyroidectomy was performed by a standard technique, which included dissection and exposure of recurrent laryngeal nerves and parathyroid glands. Actual estimation of weight of the remnant gland was not part of the study. Duration of follow up ranged from 6 months to 4 years. 13 of 32 cases were males. Age ranged from 20 to 57 years. There was 1 death in the immediate post-operative period. There were no cases of permanent hypoparathyroidism or recurrent laryngeal nerve palsy. 1 patient developed temporary hypoparathyroidism. 1 patient developed recurrence of hyperthyroidism and 3 cases developed hypothyroidism all within 2 years of surgery. The study has demonstrated the safety and effectiveness of surgery for Grave's Disease in comparison to the reported high incidence of hypothyroidism following radio-iodine therapy and high recurrence rate after anti thyroid drug therapy.

Environmental and economic analyses of waste disposal options for traditional markets in Indonesia

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

Aye, Lu; Widjaya, E.R.

2006-07-01

Waste from traditional markets in Indonesia is the second largest stream of municipal solid waste after household waste. It has a higher organic fraction and may have greater potential to be managed on a business scale compared to household wastes. The attributed reason is that in general the wastes generated from traditional markets are more uniform, more concentrated and less hazardous than waste from other sources. This paper presents the results of environmental and economic assessments to compare the options available for traditional market waste disposal in Indonesia. The options compared were composting in labour intensive plants, composting in amore » centralised plant that utilised a simple wheel loader, centralised biogas production and landfill for electricity production. The current open dumping practice was included as the baseline case. A life cycle assessment (LCA) was used for environmental analysis. All options compared have lower environmental impacts than the current practice of open dumping. The biogas production option has the lowest environmental impacts. A cost-benefit analysis, which considered greenhouse gas savings, was used for the economic assessment. It was found that composting at a centralised plant is the most economically feasible option under the present Indonesian conditions. The approach reported in this study could be applied for 'a pre-feasibility first cut comparison' that includes environmental aspects in a decision-making framework for developing countries even though European emission factors were used.« less

Use of botulinum A toxin for proctalgia fugax—a case report of successful treatment

PubMed Central

Grigoriou, Marios; Ioannidis, Aristeidis; Efthimiadis, Christoforos

2017-01-01

Abstract Proctalgia fugax is considered as intermittent anal pain of unknown etiology; a variety of treatments have been used, without, however, permanent results. Injection of botulinum A toxin is recently suggested as an alternative option. We present the case of a woman presenting proctalgia fugax that was untreatable through other current forms of treatment. After two administrations of botulinum A toxin, 80 units and 100 units each, the patient remained asymptomatic on 8-month follow-up control. Botulinum A toxin injection can reduce internal anal sphincter pressure, leading to relief of symptoms, and seems a promising option with minimal morbidity in cases on proctalgia fugax that does not respond to other current treatments. PMID:29218214

Combined orthodontic-restorative management of maxillary central incisors lost following traumatic injury: a case report.

PubMed

Fleming, Padhraig S; Seehra, Jadbinder; Dibiase, Andrew T

2011-01-01

A history of traumatic dental injury to the maxillary central incisors during preadolescence or adolescence is common and may result in premature loss. Treatment options include prosthetic implant replacement, autotransplantation, and orthodontic space closure with direct composite recontouring. This case report describes the treatment of an adolescent girl who presented with a crowded Class I malocclusion complicated by a history of trauma to the maxillary central incisors. The treatment plan consisted of orthodontic space closure following loss of both maxillary central incisors and mandibular premolars. This case highlights that orthodontic space closure can be a valuable treatment option in selected Class I crowded and Class II uncrowded malocclusions, producing predictable and efficient results.

One health approach to influenza: assessment of critical issues and options.

PubMed

Powdrill, Thomas F; Nipp, Terry L; Rinderknecht, Jennifer L

2010-08-01

A task force of experts on influenza, public health, and animal health met at the conference One Health Approach to Influenza: Assessment of Critical Issues and Options in Washington, DC, on December 1-2, 2009. These experts discussed the role of the One Health approach in preparing for and responding to an influenza pandemic or other emerging zoonotic disease by using pandemic (H1N1) 2009 as a case study. The meeting was convened by the US Department of Homeland Security National Center for Foreign Animal and Zoonotic Disease Defense, and the National Institute of Allergy and Infectious Diseases/National Institutes of Health Western Regional Center of Excellence for Biodefense and Emerging Infectious Diseases.

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

Ar Latin-Small-Letter-Dotless-I bas, Bilgin Kadri, E-mail: bilginaribas@hotmail.com; Dingil, Guerbuez; Koeroglu, Mert

The aim of this case study is to present effectiveness of percutaneous drainage as a treatment option of ruptured lung and liver hydatid cysts. A 65-year-old male patient was admitted with complicated liver and lung hydatid cysts. A liver hydatid cyst had ruptured transdiaphragmatically, and a lung hydatid cyst had ruptured both into bronchi and pleural space. The patient could not undergo surgery because of decreased respiratory function. Both cysts were drained percutaneously using oral albendazole. Povidone-iodine was used to treat the liver cyst after closure of the diaphragmatic rupture. The drainage was considered successful, and the patient had nomore » recurrence of signs and symptoms. Clinical, laboratory, and radiologic recovery was observed during 2.5 months of catheterization. The patient was asymptomatic after catheter drainage. No recurrence was detected during 86 months of follow-up. For inoperable patients with ruptured liver and lung hydatid cysts, percutaneous drainage with oral albendazole is an alternative treatment option to surgery. The percutaneous approach can be life-saving in such cases.« less

Successful palliation of malignant ascites from peritoneal mesothelioma by laparoscopic intraperitoneal hyperthermic chemotherapy.

PubMed

Patriti, Alberto; Cavazzoni, Emanuel; Graziosi, Luigina; Pisciaroli, Antonio; Luzi, Debora; Gullà, Nino; Donini, Annibale

2008-08-01

A variety of options have been proposed to treat malignant ascites but most of them have failed to reach a significant impact in terms of palliation. Laparoscopic hyperthermic intraperitoneal chemotherapy (LHIPEC) could represent a good therapeutic tool for patients in whom medical therapies have failed and peritoneovenous shunting is contraindicated. Here we present a case of a 49-year-old woman with malignant ascites secondary to peritoneal spreading of a right pleural mesothelioma. After failure of medical therapy, the patient underwent LHIPEC with Cisplatin 25 mg/m/L and Doxorubicin 7 mg/m/L. A dramatic reduction of ascites was documented in the postoperative period and the patient experienced complete abdominal symptom relief. Ascites did not recur during a follow-up period of 6 months. LHIPEC could be a good therapeutic option to palliate malignant ascites from mesothelioma in cases not eligible for a radical treatment. Further studies are needed to standardize dosage and perfusion parameters.

Pituitary-Directed Therapies for Cushing’s Disease

PubMed Central

Langlois, Fabienne; Chu, Jennifer; Fleseriu, Maria

2018-01-01

Cushing’s disease (CD) is caused by a pituitary corticotroph neuroendocrine tumor inducing uncontrolled hypercortisolism. Transsphenoidal surgery is the first-line treatment in most cases. Nonetheless, some patients will not achieve cure even in expert hands, others may not be surgical candidates and a significant percentage will experience recurrence. Many patients will thus require medical therapy to achieve disease control. Pharmacologic options to treat CD have increased in recent years, with an explosion in knowledge related to pathophysiology at the molecular level. In this review, we focus on medications targeting specifically pituitary adrenocorticotropic hormone-secreting tumors. The only medication in this group approved for the treatment of CD is pasireotide, a somatostatin receptor ligand. Cabergoline and temozolomide may also be used in select cases. Previously studied and abandoned medical options are briefly discussed, and emphasis is made on upcoming medications. Mechanism of action and available data on efficacy and safety of cell cycle inhibitor roscovitine, epidermal growth factor receptor inhibitor gefitinib, retinoic acid, and silibinin, a heat shock protein 90 inhibitor are also presented. PMID:29765354

Pituitary-Directed Therapies for Cushing's Disease.

PubMed

Langlois, Fabienne; Chu, Jennifer; Fleseriu, Maria

2018-01-01

Cushing's disease (CD) is caused by a pituitary corticotroph neuroendocrine tumor inducing uncontrolled hypercortisolism. Transsphenoidal surgery is the first-line treatment in most cases. Nonetheless, some patients will not achieve cure even in expert hands, others may not be surgical candidates and a significant percentage will experience recurrence. Many patients will thus require medical therapy to achieve disease control. Pharmacologic options to treat CD have increased in recent years, with an explosion in knowledge related to pathophysiology at the molecular level. In this review, we focus on medications targeting specifically pituitary adrenocorticotropic hormone-secreting tumors. The only medication in this group approved for the treatment of CD is pasireotide, a somatostatin receptor ligand. Cabergoline and temozolomide may also be used in select cases. Previously studied and abandoned medical options are briefly discussed, and emphasis is made on upcoming medications. Mechanism of action and available data on efficacy and safety of cell cycle inhibitor roscovitine, epidermal growth factor receptor inhibitor gefitinib, retinoic acid, and silibinin, a heat shock protein 90 inhibitor are also presented.

Gamma Knife Radiosurgery of the Superior Laryngeal Neuralgia: A report of three cases.

PubMed

Fu, Peng; Xiong, Nan-Xiang; Abdelmaksoud, Ahmed; Huang, Yi-Zhi; Song, Guo-Bin; Zhao, Hong-Yang

2018-05-19

Superior laryngeal neuralgia (SLN) is a relatively rare disorder that is characterized by neck pain. There are only a few reported cases and treatment options for SLN to date. In this study, we reported 3 patients with SLN who were treated with gamma knife radiosurgery (GKRS) at the time of diagnosis. For all 3 patients, GKRS was administered using a 4-mm collimator to deliver a single shot of 80 Gy of radiation (the 100% isodose line). The target was set at the jugular foramen where the vagus and glossopharyngeal nerves emerge from the skull. Follow-up assessments were performed at 32 months,31 months, and 30 months after GKRS. The 3 patients described pain relief at 3 months, 2 days and 6 weeks. None of the patients developed neurological deficits during the follow-up period. This preliminary report provides encouraging evidence that GKRS represents an effective, safe and relatively durable noninvasive treatment option for patients with SLN. Copyright © 2018 Elsevier Inc. All rights reserved.

Integrating algaculture into small wastewater treatment plants: process flow options and life cycle impacts.

PubMed

Steele, Muriel M; Anctil, Annick; Ladner, David A

2014-05-01

Algaculture has the potential to be a sustainable option for nutrient removal at wastewater treatment plants. The purpose of this study was to compare the environmental impacts of three likely algaculture integration strategies to a conventional nutrient removal strategy. Process modeling was used to determine life cycle inventory data and a comparative life cycle assessment was used to determine environmental impacts. Treatment scenarios included a base case treatment plant without nutrient removal, a plant with conventional nutrient removal, and three other cases with algal unit processes placed at the head of the plant, in a side stream, and at the end of the plant, respectively. Impact categories included eutrophication, global warming, ecotoxicity, and primary energy demand. Integrating algaculture prior to activated sludge proved to be most beneficial of the scenarios considered for all impact categories; however, this scenario would also require primary sedimentation and impacts of that unit process should be considered for implementation of such a system.

Optical urethrotomy under local anaesthesia is a feasible option in urethral stricture disease.

PubMed

Munks, D G; Alli, M O; Goad, E H Abdel

2010-01-01

The aim of our study was to assess the feasibility of performing optical urethrotomy for urethral stricture disease under local anaesthesia. A total of 33 patients with radiologically proven urethral stricture underwent optical urethrotomy by a single operator under local anaesthesia. Of these patients, 23 (70%) had stricture involving the corpora spongiosum and 18 (55%) of the patients were dependent on supra-pubic catheters. The procedure was successful in 30 cases (91%). The procedure was very well tolerated (average visual analogue pain score of 2/10) with an extremely low complication rate. The large number of patients with urethral stricture disease and the premium on operating time on formal theatre slates encouraged us to perform these procedures under local anaesthetic. Although most patients had severe stricture disease, the majority of cases were successful and very well tolerated. Optical urethrotomy under local anesthesia could be a viable option in the absence of formal theatre time and the facilities to perform general anaesthesia.

Stricturoplasty—a bowel-sparing option for long segment small bowel Crohn's disease

PubMed Central

Koh, Hoey C.; Gilmore, Andrew

2017-01-01

Abstract Stricturoplasty is a surgical option for management of severe stricturing Crohn's disease of the small bowel. It avoids the need for small bowel resection and the associated metabolic complications. This report contrasts the indications and technical aspects of two different stricturoplasty techniques. Case 1 describes an extensive Michelassi (side-to-side isoperistaltic) stricturoplasty performed for a 100 cm segment of diseased small bowel in a 45-year-old patient. Case 2 describes the performance of 12 Heineke-Mikulicz stricturoplasties in a 23-year-old patient with multiple short fibrotic strictures. PMID:29423160

Monophasic synovial sarcoma of posterior pharyngeal wall: a rare case report with unique reconstruction using lateral trapezius flap.

PubMed

Agarwal, Mudit; Singh, Abhishek; Abrari, Adleeb; Singh, Naveen

2017-04-01

Synovial sarcoma is a rare entity to be encountered in the head and neck region and is always a challenge in terms of diagnosis, treatment planning and reconstruction of the surgical defect. In our case, we faced a similar challenge for diagnosis and also have ventured for lateral trapezius flap as a new reconstructive option for such bulky tumour defects. We hereby present a 25-year old male patient with monophasic synovial sarcoma of posterior pharyngeal wall. The radiological and clinicopathological features along with various diagnostic tests and treatment options are discussed.

A New Technique for Surgical Treatment of Proximal Hamstring Tendinopathy in a Triathlon Athlete

PubMed Central

Costa, Lincoln Paiva; Barros, Antônio Augusto Guimarães; Vassalo, Carlos Cesar; Sonnery-Cottet, Bertrand; Barbosa, Victor Atsushi Kasuya; Temponi, Eduardo Frois

2016-01-01

Introduction: Proximal hamstring tendinopathy (PHT) is the result of chronic overload caused by repetitive eccentric contraction. Surgical treatment becomes an option for patients with chronic symptoms that do not respond to conservative treatment. Case Report: This report describes a case of a 48-year-old man, an amateur triathlete, with deep gluteal pain in the left hip for 12 months, leading to a decline in sports performance. Magnetic resonance imaging revealed abnormalities that suggested a PHT. Surgery was indicated following the failure of conservative treatments. Debridement of the conjoint tendon and its reinsertion associated with semimembranosus tenotomy showed good results and is thus an option for the treatment of this pathology after 12 months of follow-up. Conclusion: This article provides surgeons with a new surgical option for this debilitating condition with clinical and functional improvement after 12 months of follow-up. PMID:28507970

Professionals' and laypersons' appreciation of various options for Class III surgical correction.

PubMed

Fabré, M; Mossaz, C; Christou, P; Kiliaridis, S

2010-08-01

The objectives of this study were to evaluate the assessments of maxillofacial surgeons, orthodontists, and laypersons on the predicted aesthetic outcome of various surgical options in Class III correction and the associations between certain initial cephalometric values and the judges' preferred option. Pre-surgical lateral headfilms and coloured profile photographs of 18 skeletal Class III Caucasian adult patients (10 males and 8 females) with a mean age of 24.5 years were used. The headfilms were hand traced and digitized. Conventional cephalometric analysis was performed. Computerized predictions of three surgical options, mandibular setback, Le Fort I advancement, and bimaxillary surgery, were made. For each case, the pre-surgical profile photograph with the three predictions was presented on a printed page. The questionnaire was sent to 51 maxillofacial surgeons (response rate 45.1 per cent), 78 orthodontists (response rate 71.8 per cent), and 61 laypersons (response rate 100 per cent) to aesthetically evaluate the pre-surgical photographs and the surgical predictions by placing a mark along a 10-graded visual analogue scale (VAS) using a standard profile for calibration. Confidence interval was calculated for each patient. An independent samples t-test was used to detect initial cephalometric values associated with the judges' preferred option and analysis of variance/Tukey's honestly significant differences to evaluate differences between judges. Intra-observer reliability was assessed with a paired t-test. All treatment predictions led to improved scoring of facial aesthetics with the exception of the setback option for three patients. For 14 patients, general agreement for the preferred option existed between the three groups of judges. Laypersons tended to give lower improvement scores than professionals. Overjet, nasofacial, and nasomental angles were important in decision making between the mandibular setback and Le Fort I options (the more negative the overjet, the larger the nasofacial angle, the smaller the nasomental angle, the greater the preference for the Le Fort I option). Wits appraisal seemed to be important in decision making between the mandibular setback and bimaxillary options (the more negative the Wits appraisal, the greater the preference for the latter option).

76 FR 6838 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving a...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

.... I. Introduction On December 1, 2010, the Chicago Board Options Exchange, Incorporated (``Exchange.... CBOE's proposed rules would require no margin in the case of a spread (i.e., long and short Credit... requires margin of 50% of the margin required on the long or short (credit default swap), whichever is...

Colleges Making SAT Optional as Admissions Requirement

ERIC Educational Resources Information Center

Gilroy, Marilyn

2007-01-01

This article reports that more colleges are dropping the SAT as a requirement for admission and, in many cases, these institutions are attracting a larger and more diverse pool of applicants. According to the National Center for Fair & Open Testing (FairTest), 740 schools have made the SATs optional. The list includes some of the nation's most…

75 FR 57020 - Agency Information Collection Activities: Final Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... use only in those cases where the company chooses to make use of some aspects of the additional... the option of ``Ex-Im Bank Sole Risk'' as an obligor type; added the option ``CAD or SDDP'' to the...: 3048-0021. Type of Review: Regular. Need and Use: The information collected enables Ex-Im Bank to...

75 FR 71431 - Agency Information Collection Activities: Final Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-23

... use only in those cases where the company chooses to make use of some aspects of the additional... the option of ``Ex-Im Bank Sole Risk'' as an obligor type; added the option ``CAD or SDDP'' to the... Payable for Financial Institutions Only. OMB Number: 3048-0021. Type of Review: Regular. Need and Use: The...

Detection of fetal sex chromosome aneuploidy by massively parallel sequencing of maternal plasma DNA: initial experience in a Chinese hospital.

PubMed

Yao, H; Jiang, F; Hu, H; Gao, Y; Zhu, Z; Zhang, H; Wang, Y; Guo, Y; Liu, L; Yuan, Y; Zhou, L; Wang, J; Du, B; Qu, N; Zhang, R; Dong, Y; Xu, H; Chen, F; Jiang, H; Liu, Y; Zhang, L; Tian, Z; Liu, Q; Zhang, C; Pan, X; Yang, S; Zhao, L; Wang, W; Liang, Z

2014-07-01

To evaluate the performance of a massively parallel sequencing (MPS)-based test in detecting fetal sex chromosome aneuploidy (SCA) and to present a comprehensive clinical counseling protocol for SCA-positive patients. This was a retrospective study in a large patient cohort of 5950 singleton pregnancies which underwent MPS-based testing as a prenatal screening test for trisomies 21, 18 and 13, with X and Y chromosomes as secondary findings, in Southwest Hospital in China. MPS-based SCA-positive women were offered the choice of knowing whether their SCA results were positive and those who did commenced a two-stage post-test clinical counseling protocol. In Stage 1, general information about SCA was given, and women were given the option of invasive testing for confirmation of findings; in Stage 2, those who had chosen to undergo invasive testing were informed about the specific SCA affecting their fetus and their management options. Thirty-three cases were classified as SCA-positive by MPS-based testing. After Stage 1 of the two-stage post-test clinical counseling session, 33 (100%) of these pregnant women chose to know the screening test results, and 25 (75.76%) underwent an invasive diagnostic procedure and karyotype analysis, in one of whom karyotyping failed. In thirteen cases, karyotyping confirmed the MPS-based test results (two X0 cases, seven XXX cases, three XXY cases and one XYY case), giving a positive predictive value of 54.17% (13/24 cases confirmed by karyotyping). After post-test clinical counseling session Stage 2, seven women chose to terminate the pregnancy: one X0 case, two XXX cases, the three XXY cases and the single XYY case. Six women decided to continue with pregnancy: one X0 case and five XXX cases. Our study showed the feasibility of clinical application of the MPS-based test in the non-invasive detection of fetal SCA. Together with a two-stage post-test clinical counseling protocol, it leads to a well-informed decision-making procedure. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

Original research: Giving sexual assault survivors time to decide: an exploration of the use and effects of the nonreport option.

PubMed

Heffron, Laurie Cook; Busch-Armendariz, Noël Bridget; Vohra, Shetal S; Johnson, Regina Jones; Camp, Victoria

2014-03-01

Forensic nurses, sexual assault nurse examiners (SANEs), and victim advocates have long recognized the trauma of sexual assault crimes and the significance of survivors' decisions around reporting these crimes to law enforcement agencies. Until recently, survivors who didn't report the crime were not entitled to a free medical forensic examination. In a significant policy shift, the Violence Against Women and Department of Justice Reauthorization Act of 2005 provided an additional decision option with regard to the medical examination for survivors of sexual assault. This provision, referred to here as the nonreport option, was established to offer survivors a full range of reporting options and to ensure exemplary health care, with evidence collection as an important secondary goal. This study sought to examine the implementation of the nonreport option in Texas; explore its impact on SANEs, survivors, and the criminal justice system; and identify strengths and challenges of the nonreport process. A mixed-method approach was used that included qualitative interviews with 79 professionals who regularly respond to sexual assault crimes, a Web-based survey questionnaire of such professionals that yielded 131 completed surveys, and a review of existing data. The step-by-step process involved in a nonreport case was described, and findings in three descriptive areas emerged: confidentiality processes, storage and shipment of evidence, and the use of the nonreport option. Beneficial effects of the nonreport option were identified in five areas: the role of SANEs, the impact on survivors, collaborative relationships, collateral crimes, and anonymous reporting strategies. Seven areas of remaining dilemmas were also identified. Findings indicate that the nonreport option has had a considerable positive impact on SANEs, survivors of sexual assault, and the criminal justice system. But challenges remain if this option is to be fully utilized in the future; further research is warranted. The authors also present recommendations to improve health care delivery.

Economic comparison between conventional and disposables-based technology for the production of biopharmaceuticals.

PubMed

Novais, J L; Titchener-Hooker, N J; Hoare, M

2001-10-20

Time to market, cost effectiveness, and flexibility are key issues in today's biopharmaceutical market. Bioprocessing plants based on fully disposable, presterilized, and prevalidated components appear as an attractive alternative to conventional stainless steel plants, potentially allowing for shorter implementation times, smaller initial investments, and increased flexibility. To evaluate the economic case of such an alternative it was necessary to develop an appropriate costing model which allows an economic comparison between conventional and disposables-based engineering to be made. The production of an antibody fragment from an E. coli fermentation was used to provide a case study for both routes. The conventional bioprocessing option was costed through available models, which were then modified to account for the intrinsic differences observed in a disposables-based option. The outcome of the analysis indicates that the capital investment required for a disposables-based option is substantially reduced at less than 60% of that for a conventional option. The disposables-based running costs were evaluated as being 70% higher than those of the conventional equivalent. Despite this higher value, the net present value (NPV) of the disposables-based plant is positive and within 25% of that for the conventional plant. Sensitivity analysis performed on key variables indicated the robustness of the economic analysis presented. In particular a 9-month reduction in time to market arising from the adoption of a disposables-based approach, results in a NPV which is identical to that of the conventional option. Finally, the effect of any possible loss in yield resulting from the use of disposables was also examined. This had only a limited impact on the NPV: for example, a 50% lower yield in the disposable chromatography step results in a 10% reduction of the disposable NPV. The results provide the necessary framework for the economic comparison of disposables and conventional bioprocessing technologies. Copyright 2001 John Wiley & Sons, Inc.

Failed Ventriculoperitoneal Shunt: Is Retrograde Ventriculosinus Shunt a Reliable Option?

PubMed

Oliveira, Matheus Fernandes de; Teixeira, Manoel Jacobsen; Reis, Rodolfo Casimiro; Petitto, Carlo Emanuel; Gomes Pinto, Fernando Campos

2016-08-01

Currently, the treatment of hydrocephalus is mainly carried out through a ventriculoperitoneal shunt (VPS) insertion. However, in some cases, there may be surgical revisions and requirement of an alternative distal site for shunting. There are several described distal sites, and secondary options after VPS include ventriculopleural and ventriculoatrial shunt, which have technical difficulties and harmful complications. In this preliminary report we describe our initial experience with retrograde ventriculosinus shunt (RVSS) after failed VPS. In 3 consecutive cases we applied RVSS to treat hydrocephalus in shunt-dependent patients who had previously undergone VPS revision and in which peritoneal space was full of adhesions and fibrosis. RVSS was performed as described by Shafei et al., with some modifications to each case. All 3 patients kept the same clinical profile after RVSS, with no perioperative or postoperative complications. However, revision surgery was performed in the first operative day in 1 out of 3 patients, in which the catheter was not positioned in the superior sagittal sinus. We propose that in cases where VPS is not feasible, RVSS may be a safe and applicable second option. Nevertheless, the long-term follow-up of patients and further learning curve must bring stronger evidence. Copyright © 2016 Elsevier Inc. All rights reserved.

Woody biomass outreach in the southern United States: A case study

Treesearch

Martha Monroe; Annie Oxarart

2011-01-01

Woody biomass is one potential renewable energy source that is technically feasible where environmental and economic factors are promising. It becomes a realistic option when it is also socially acceptable. Public acceptance and support of wood to energy proposals require community education and outreach. The Wood to Energy Outreach Program provides science-based...

Computer simulation modeling of recreation use: Current status, case studies, and future directions

Treesearch

David N. Cole

2005-01-01

This report compiles information about recent progress in the application of computer simulation modeling to planning and management of recreation use, particularly in parks and wilderness. Early modeling efforts are described in a chapter that provides an historical perspective. Another chapter provides an overview of modeling options, common data input requirements,...

Breaking Ground: Improving Undergraduate Engineering Projects through Flipped Teaching of Literature Search Techniques

ERIC Educational Resources Information Center

Maddison, Tasha; Beneteau, Donna; Sokoloski, Brandy

2014-01-01

This case study describes the use of flipped teaching for information literacy instruction in a new course, "Drill, Blast, and Excavate GeoE 498," within the mining option for geological engineering (GeoE) students. These students will enter the mining industry with less discipline-specific knowledge than a student that graduated with a…

Teaching, an Alternative to Leisure: Ozark Case Studies of Mid-Life Retirees.

ERIC Educational Resources Information Center

Bell, David; Reed, Stan

This document identifies characteristics and patterns of characteristics of those who have leisure as a mid-life option. A comparison was made between individuals electing to pursue leisure and those electing to enter teaching at this life stage. Results of structured interviews, statistical results, and an analysis of a life satisfaction scale…

Does Knowing Lead to Doing in the Case of Learning Platforms?

ERIC Educational Resources Information Center

Underwood, Jean D. M.; Stiller, James

2014-01-01

There have been significant advance in educational technology but they have not always brought about measurable shifts in user behavior. This study examined the relationship between teachers' knowledge about a tool and their use of that tool. In many secondary schools use of a Learning Platforms (LPs) is no longer optional although the degree of…

Digitization of Full-Text Documents Before Publishing on the Internet: A Case Study Reviewing the Latest Optical Character Recognition Technologies.

ERIC Educational Resources Information Center

McClean, Clare M.

1998-01-01

Reviews strengths and weaknesses of five optical character recognition (OCR) software packages used to digitize paper documents before publishing on the Internet. Outlines options available and stages of the conversion process. Describes the learning experience of Eurotext, a United Kingdom-based electronic libraries project (eLib). (PEN)

Medical Pluralism in the Life of a Mexican Immigrant Woman

ERIC Educational Resources Information Center

Belliard, Juan Carlos; Ramirez-Johnson, Johnny

2005-01-01

This case study reflects on the variety of approaches to health care in a pluralistic immigrant urban enclave in Southern California. In-depth interviews were conducted with a Mexican immigrant woman to explore and understand her health worldview and the strategies she uses in deciding among the diverse health care options available to protect and…

Teaching Entrepreneurship to Children: A Case Study

ERIC Educational Resources Information Center

do Paco, Arminda; Palinhas, Maria Joao

2011-01-01

Nowadays few young people are prepared to consider setting up and managing their own business as a realistic and attractive career option. It is therefore necessary to expose children to the concept of entrepreneurship from a very early age, which means that the school has a fundamental role to play in this task. This research seeks to understand…

Sustaining Youth Participation in a Long-Term Tobacco Control Initiative: Consideration of a Social Justice Perspective

ERIC Educational Resources Information Center

Ross, Laurie

2011-01-01

This article presents an in-depth case study of the Healthy Options for Prevention and Education Coalition's Teens Tackle Tobacco initiative, a 3-year community-based participatory research (CBPR) project about the distribution of tobacco vendors and tobacco advertising in Worcester, Massachusetts. Using two theoretical frameworks, positive youth…

Welfare Reform and American Indian Tribes: Critical Decisions for the Future of Indian Families.

ERIC Educational Resources Information Center

Kauffman, Jo Ann

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRETORIA) gives American Indian tribes the option to run their own Temporary Assistance for Needy Families (TANF) program or leave these services under state administration. Eight case studies were conducted in Oregon, Wisconsin, and Arizona with the Klamath Tribes,…

Learning to Become a CLIL Teacher: Teaching, Reflection and Professional Development

ERIC Educational Resources Information Center

Urmeneta, Cristina Escobar

2013-01-01

This case study is part of a larger project which aims to determine the usefulness and validity of a model of a pre-service content and language integrated learning (CLIL) teacher education programme inserted in a Master's degree, whose main pedagogical option is to achieve teacher empowerment through cycles of collaborative teaching and shared…

Rank-Order and Paired Comparisons as the Basis for Measurement.

ERIC Educational Resources Information Center

Linacre, John M.

Three case studies are presented demonstrating the application of straight-forward Rasch techniques to rank order data. Paired comparisons are the simplest form of rank ordering. A consumer preference test with 56 pairs of cups of coffee tasted by each of 26 consumers illustrates analysis of these rankings. When subjects are allowed the option of…

The Inclusion Puzzle: A Case Study of Inclusion in a Rural Elementary School

ERIC Educational Resources Information Center

Arnold, Linda N.

2010-01-01

Inclusion of special education students in general education classrooms has come to general acceptance by educators as one option in the continuum of special education service delivery. Another view of inclusion is the ideal of providing for all the varied individual needs of a diverse population of students: learning needs, physical needs,…

78 FR 26773 - Proposed Information Collection Request; Comment Request; Willingness To Pay Survey for Santa...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-08

... lengths, are derived from natural science research. For the survey, a choice experiment framework is used... survey is public value research. The Santa Cruz River is a case study of a waterway highly impacted by... Request; Comment Request; Willingness To Pay Survey for Santa Cruz River Management Options in Southern...

Powering the Women in Agriculture: Lessons on Women Led Farm Mechanisation in South India

ERIC Educational Resources Information Center

Alex, Jiju P.

2013-01-01

Purpose: This article analyses how an initiative on farm mechanisation by a local government in Kerala in South India evolved into a formal organisation that provides sustainable livelihood options to women and small and marginal farmers and revived the rice production system. Design/methodology/approach: The study followed the case analysis…

Examining Entrepreneurial Competencies and their Relationship to Self-Employment Intentions among Engineering Students: A Case Study from India

ERIC Educational Resources Information Center

Kumara, S. A. Vasantha; Kumar, Y. Vijaya

2010-01-01

The growth of technological institutions in India has been exponential and supply has exceeded demand in the job market. Against this background, it is a social responsibility of universities to provide alternative career options for engineering graduates. To encourage entrepreneurship careers among engineering graduates, the Visvesvarayya…

Amelioration of pregnancy-associated osteoporosis after treatment with vitamin K₂: a report of four patients.

PubMed

Tsuchie, Hiroyuki; Miyakoshi, Naohisa; Hongo, Michio; Kasukawa, Yuji; Ishikawa, Yoshinori; Shimada, Yoichi

2012-08-01

Abstract We demonstrate for the first time therapeutic effects of vitamin K₂ (menatetrenone) on pregnancy-associated osteoporosis with multiple vertebral fractures in four cases. Due to its safety, vitamin K₂ presents itself as a treatment option for women with pregnancy-associated osteoporosis. Desirably, future controlled studies should verify these findings.

Flexible engineering designs for urban water management in Lusaka, Zambia.

PubMed

Tembo, Lucy; Pathirana, Assela; van der Steen, Peter; Zevenbergen, Chris

2015-01-01

Urban water systems are often designed using deterministic single values as design parameters. Subsequently the different design alternatives are compared using a discounted cash flow analysis that assumes that all parameters remain as-predicted for the entire project period. In reality the future is unknown and at best a possible range of values for design parameters can be estimated. A Monte Carlo simulation could then be used to calculate the expected Net Present Value of project alternatives, as well as so-called target curves (cumulative frequency distribution of possible Net Present Values). The same analysis could be done after flexibilities were incorporated in the design, either by using decision rules to decide about the moment of capacity increase, or by buying Real Options (in this case land) to cater for potential capacity increases in the future. This procedure was applied to a sanitation and wastewater treatment case in Lusaka, Zambia. It included various combinations of on-site anaerobic baffled reactors and off-site waste stabilisation ponds. For the case study, it was found that the expected net value of wastewater treatment systems can be increased by 35-60% by designing a small flexible system with Real Options, rather than a large inflexible system.

[Adult Grisel Syndrome and Cervical Skull instability. Transnasal endoscopic odontoidectomy and occipito-cervical fusion. Case report and literature review].

PubMed

Herrera, Roberto; Rojas, Héctor; Estramian, Ariel; Gómez, Julieta; Ledesma, José Luis; Pablo, José; Pastore, Julián

2018-01-01

Craniocervical junction pathology is infrequent in daily neurosurgical practice. In general, most of these lesions are of traumatic or rheumatic origin. Atlantoaxial instability of inflammatory origin (Grisel syndrome) is a rare entity of which only 16 adult cases have been reported in the literature. This pathology is characterized by the development of an osteolytic lesion at the level of the atlantoaxial joint after an infectious event, usually of the upper airways. We present the case of a 76-year-old patient who attended our office for clinical symptoms of spinal instability secondary to an osteolytic lesion, with involvement of C1 and C2. The symptomatology began after an infectious respiratory process. A posterior cervical occiput fixation and an endoscopic transnasal odontoidectomy with anterior decompression were performed. The patient evolved with complete resolution of symptoms. The cultures were negative, and the pathological anatomy study concluded nonspecific inflammatory changes. Until a few years ago, the only option to address this pathology was the transoral pathway with microsurgical technique. Nowadays, endoscopy offers many technical advantages. This is an option to be considered when planning approaches to craniocervical junction.

Telephone-administered cognitive behavioral therapy: a case study of anxiety and depression in Parkinson's disease.

PubMed

Veazey, Connie; Cook, Karon F; Stanley, Melinda; Lai, Eugene C; Kunik, Mark E

2009-09-01

Parkinson's disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD.

Unilateral occipital nerve stimulation for bilateral occipital neuralgia: a case report and literature review

PubMed Central

Liu, Aijun; Jiao, Yongcheng; Ji, Huijun; Zhang, Zhiwen

2017-01-01

Objectives The aim of this study is to present a case of successful relief of bilateral occipital neuralgia (ON) using unilateral occipital nerve stimulation (ONS) and to discuss the possible underlying mechanisms. Materials and methods We present the case of a 59-year-old female patient with severe bilateral ON treated with unilateral ONS. We systematically reviewed previous studies of ONS for ON, discussing the possible mechanisms of ONS in the relief of ON. Results The patient reported complete pain relief after consistent unilateral ONS during the follow-up period. The underlying mechanisms may be linked to the relationship between pain and several brain regions, including the pons, midbrain, and periaqueductal gray. Conclusion ONS is an effective and safe option for treating ON. Future studies will be required to clarify the mechanisms by which unilateral occipital stimulation provided relief for bilateral neuralgia in this case. PMID:28176938

Unilateral occipital nerve stimulation for bilateral occipital neuralgia: a case report and literature review.

PubMed

Liu, Aijun; Jiao, Yongcheng; Ji, Huijun; Zhang, Zhiwen

2017-01-01

The aim of this study is to present a case of successful relief of bilateral occipital neuralgia (ON) using unilateral occipital nerve stimulation (ONS) and to discuss the possible underlying mechanisms. We present the case of a 59-year-old female patient with severe bilateral ON treated with unilateral ONS. We systematically reviewed previous studies of ONS for ON, discussing the possible mechanisms of ONS in the relief of ON. The patient reported complete pain relief after consistent unilateral ONS during the follow-up period. The underlying mechanisms may be linked to the relationship between pain and several brain regions, including the pons, midbrain, and periaqueductal gray. ONS is an effective and safe option for treating ON. Future studies will be required to clarify the mechanisms by which unilateral occipital stimulation provided relief for bilateral neuralgia in this case.

Numerical simulation of a rare winter hailstorm event over Delhi, India on 17 January 2013

NASA Astrophysics Data System (ADS)

Chevuturi, A.; Dimri, A. P.; Gunturu, U. B.

2014-12-01

This study analyzes the cause of the rare occurrence of a winter hailstorm over New Delhi/NCR (National Capital Region), India. The absence of increased surface temperature or low level of moisture incursion during winter cannot generate the deep convection required for sustaining a hailstorm. Consequently, NCR shows very few cases of hailstorms in the months of December-January-February, making the winter hail formation a question of interest. For this study, a recent winter hailstorm event on 17 January 2013 (16:00-18:00 UTC) occurring over NCR is investigated. The storm is simulated using the Weather Research and Forecasting (WRF) model with the Goddard Cumulus Ensemble (GCE) microphysics scheme with two different options: hail and graupel. The aim of the study is to understand and describe the cause of hailstorm event during over NCR with a comparative analysis of the two options of GCE microphysics. Upon evaluating the model simulations, it is observed that the hail option shows a more similar precipitation intensity with the Tropical Rainfall Measuring Mission (TRMM) observation than the graupel option does, and it is able to simulate hail precipitation. Using the model-simulated output with the hail option; detailed investigation on understanding the dynamics of hailstorm is performed. The analysis based on a numerical simulation suggests that the deep instability in the atmospheric column led to the formation of hailstones as the cloud formation reached up to the glaciated zone promoting ice nucleation. In winters, such instability conditions rarely form due to low level available potential energy and moisture incursion along with upper level baroclinic instability due to the presence of a western disturbance (WD). Such rare positioning is found to be lowering the tropopause with increased temperature gradient, leading to winter hailstorm formation.

Numerical simulation of a winter hailstorm event over Delhi, India on 17 January 2013

NASA Astrophysics Data System (ADS)

Chevuturi, A.; Dimri, A. P.; Gunturu, U. B.

2014-09-01

This study analyzes the cause of rare occurrence of winter hailstorm over New Delhi/NCR (National Capital Region), India. The absence of increased surface temperature or low level of moisture incursion during winter cannot generate the deep convection required for sustaining a hailstorm. Consequently, NCR shows very few cases of hailstorms in the months of December-January-February, making the winter hail formation a question of interest. For this study, recent winter hailstorm event on 17 January 2013 (16:00-18:00 UTC) occurring over NCR is investigated. The storm is simulated using Weather Research and Forecasting (WRF) model with Goddard Cumulus Ensemble (GCE) microphysics scheme with two different options, hail or graupel. The aim of the study is to understand and describe the cause of hailstorm event during over NCR with comparative analysis of the two options of GCE microphysics. On evaluating the model simulations, it is observed that hail option shows similar precipitation intensity with TRMM observation than the graupel option and is able to simulate hail precipitation. Using the model simulated output with hail option; detailed investigation on understanding the dynamics of hailstorm is performed. The analysis based on numerical simulation suggests that the deep instability in the atmospheric column led to the formation of hailstones as the cloud formation reached upto the glaciated zone promoting ice nucleation. In winters, such instability conditions rarely form due to low level available potential energy and moisture incursion along with upper level baroclinic instability due to the presence of WD. Such rare positioning is found to be lowering the tropopause with increased temperature gradient, leading to winter hailstorm formation.

Assessment of applicability index for better management of municipal solid waste: a case study of Dhanbad, India.

PubMed

Yadav, Pooja; Samadder, S R

2018-06-01

Selection of suitable municipal solid waste management (MSWM) options is one of the major challenges in urban areas of the developing countries. Success of MSWM requires accurate data of generation rate, composition and physico-chemical characteristics of solid wastes. Improper handling of solid waste can have significant environmental and aesthetical impacts. The present study proposes a new method (applicability index - P ik values) for identifying the most appropriate disposal option with the help of applicability values of Composting-C P , Incineration-I P and Landfill-L P for individual components of MSW based on the results of the physico-chemical analysis of the collected representative solid waste samples from the study area, Dhanbad, India. The mean values of moisture content, carbon, hydrogen, oxygen, nitrogen, sulfur, volatile organic carbon, fixed carbon, ash content, density and calorific values (CV) of individual components were used as input values in this process. Based on the proposed applicability index (P ik ), the highest P ik values were obtained for incineration (I P ) for plastics, polythene, paper, coconut shell, wood, cardboard, textile, thermocol (polystyrene), rubber, sugarcane bagasse, cow dung and leather wastes (I P  > C P  > L P ) due to high CV of these solid waste components; the highest P ik values were obtained for composting (C P ) of kitchen waste (C P  > I P  > L P ); and the highest P ik values for inert wastes were obtained for landfill option (L P  > I P  > C P ). The highest P ik value for a particular waste for a specific treatment option signifies that the waste is suitable for treatment/disposal using that option.

Impact of variational assimilation using multivariate background error covariances on the simulation of monsoon depressions over India

NASA Astrophysics Data System (ADS)

Dhanya, M.; Chandrasekar, A.

2016-02-01

The background error covariance structure influences a variational data assimilation system immensely. The simulation of a weather phenomenon like monsoon depression can hence be influenced by the background correlation information used in the analysis formulation. The Weather Research and Forecasting Model Data assimilation (WRFDA) system includes an option for formulating multivariate background correlations for its three-dimensional variational (3DVar) system (cv6 option). The impact of using such a formulation in the simulation of three monsoon depressions over India is investigated in this study. Analysis and forecast fields generated using this option are compared with those obtained using the default formulation for regional background error correlations (cv5) in WRFDA and with a base run without any assimilation. The model rainfall forecasts are compared with rainfall observations from the Tropical Rainfall Measurement Mission (TRMM) and the other model forecast fields are compared with a high-resolution analysis as well as with European Centre for Medium-Range Weather Forecasts (ECMWF) ERA-Interim reanalysis. The results of the study indicate that inclusion of additional correlation information in background error statistics has a moderate impact on the vertical profiles of relative humidity, moisture convergence, horizontal divergence and the temperature structure at the depression centre at the analysis time of the cv5/cv6 sensitivity experiments. Moderate improvements are seen in two of the three depressions investigated in this study. An improved thermodynamic and moisture structure at the initial time is expected to provide for improved rainfall simulation. The results of the study indicate that the skill scores of accumulated rainfall are somewhat better for the cv6 option as compared to the cv5 option for at least two of the three depression cases studied, especially at the higher threshold levels. Considering the importance of utilising improved flow-dependent correlation structures for efficient data assimilation, the need for more studies on the impact of background error covariances is obvious.

Current treatment for vitreous floaters.

PubMed

Sendrowski, David P; Bronstein, Mark A

2010-03-01

Vitreous floaters are a common complaint in the ophthalmic care setting. Patients seek explanation and advice regarding possible treatment options. Because the condition is considered benign, ophthalmic care practitioners have little to offer regarding treatment options. The majority of cases encountered are managed with patient education and reassurance. Although almost all patients accept the conservative management option, there is a small subset of patients who may desire a more aggressive treatment intervention for resolution of their visual symptoms. Information with regard to treatment options is readily available to patients through Internet searches and non-peer reviewed educational Web sites. The risks and benefits for these treatment options are not fully covered. Management of floaters should include education regarding "off-label" procedures as well as discussion about benefits and risks associated with such treatment options. It is vital that eye care practitioners advise and counsel patients with symptomatic floaters for optimum ocular health care. This article reviews the current conventional and "off-label" treatment options for symptomatic patients with vitreous floaters. Copyright (c) 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

Infective endocarditis due to Enterobacter cloacae resistant to third- and fourth-generation cephalosporins.

PubMed

Yoshino, Yusuke; Okugawa, Shu; Kimura, Satoshi; Makita, Eiko; Seo, Kazunori; Koga, Ichiro; Matsunaga, Naohisa; Kitazawa, Takatoshi; Ota, Yasuo

2015-04-01

We report the case of using a long-term combination of meropenem and amikacin to treat infective endocarditis caused by Enterobacter cloacae resistant to third- and fourth-generation cephalosporins. Multi-drug resistant Gram-negative bacilli, such as the E. cloacae in our study, may become possible pathogens of infective endocarditis. Our experience with this case indicates that long-term use of a combination of β-lactam and aminoglycosides might represent a suitable management option for future infective endocarditis cases due to non-Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella spp. (HACEK group) Gram-negative bacilli such as ours. Copyright © 2012. Published by Elsevier B.V.

Water Management Planning: A Case Study at Blue Grass Army Depot

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

Solana, Amy E.; Mcmordie, Katherine

2006-04-03

Executive Order 13123, Greening the Government Through Efficient Energy Management, mandates an aggressive policy for reducing potable water consumption at federal facilities. Implementation guid¬ance from the U.S. Department of Energy (DOE) set a requirement for each federal agency to “reduce potable water usage by implementing life cycle, cost-effective water efficiency programs that include a water management plan, and not less than four Federal Energy Management Program (FEMP) Best Manage¬ment Practices (BMPs).” The objective of this plan is to gain full compliance with Executive Order 13123 and associated DOE implementation guidance on behalf of Blue Grass Army Depot (BGAD), Richmond, Kentucky.more » In accordance with this plan, BGAD must: • Incorporate the plan as a component of the Installation energy conservation plan • Investigate the water savings potential and life-cycle cost effectiveness of the Operations and Maintenance (O&M) and retrofit/replacement options associated with the ten FEMP BMPs • Put into practice all applicable O&M options • Identify retrofit/replacement options appropriate for implementation (based upon calculation of the simple payback periods) • Establish a schedule for implementation of applicable and cost-effective retrofit/replacement options.« less

Salmonella paratyphi spondylitis: a case report.

PubMed

Kumar, Pradeep; Mahmoodi, Seyed Mohsen; Kalaparambil Moosa, Nooruddin; Edgar, Michael; Samt, Hussain Al; Hussain, Riyaz Amirali

2008-05-01

This is a case report of acute L3/4 vertebral osteomyelitis due to Salmonella paratyphi A confirmed by culture from vertebral needle biopsy. From a review of the literature this is the first reported case with bacteriological confirmation. The rarity of Salmonella paratyphi spondylitis and the options for treatment are discussed.

Molecular Pathology of Anaplastic Thyroid Carcinomas: A Retrospective Study of 144 Cases.

PubMed

Bonhomme, Benjamin; Godbert, Yann; Perot, Gaelle; Al Ghuzlan, Abir; Bardet, Stéphane; Belleannée, Geneviève; Crinière, Lise; Do Cao, Christine; Fouilloux, Geneviève; Guyetant, Serge; Kelly, Antony; Leboulleux, Sophie; Buffet, Camille; Leteurtre, Emmanuelle; Michels, Jean-Jacques; Tissier, Frédérique; Toubert, Marie-Elisabeth; Wassef, Michel; Pinard, Clémence; Hostein, Isabelle; Soubeyran, Isabelle

2017-05-01

Anaplastic thyroid carcinoma (ATC) is a rare tumor, with poorly defined oncogenic molecular mechanisms and limited therapeutic options contributing to its poor prognosis. The aims of this retrospective study were to determine the frequency of anaplastic lymphoma kinase (ALK) translocations and to identify the mutational profile of ATC including TERT promoter mutations. One hundred and forty-four ATC cases were collected from 10 centers that are a part of the national French network for management of refractory thyroid tumors. Fluorescence in situ hybridization analysis for ALK rearrangement was performed on tissue microarrays. A panel of 50 genes using next-generation sequencing and TERT promoter mutations using Sanger sequencing were also screened. Fluorescence in situ hybridization was interpretable for 90 (62.5%) cases. One (1.1%) case was positive for an ALK rearrangement with a borderline threshold (15% positive cells). Next-generation sequencing results were interpretable for 94 (65.3%) cases, and Sanger sequencing (TERT) for 98 (68.1%) cases. A total of 210 mutations (intronic and exonic) were identified. TP53 alterations were the most frequent (54.4%). Forty-three percent harbored a mutation in the (H-K-N)RAS genes, 13.8% a mutation in the BRAF gene (essentially p.V600E), 17% a PI3K-AKT pathway mutation, 6.4% both RAS and PI3K pathway mutations, and 4.3% both TP53 and PTEN mutations. Nearly 10% of the cases showed no mutations of the RAS, PI3K-AKT pathways, or TP53, with mutations of ALK, ATM, APC, CDKN2A, ERBB2, RET, or SMAD4, including mutations not yet described in thyroid tumors. Genes encoding potentially druggable targets included: mutations in the ATM gene in four (4.3%) cases, in ERBB2 in one (1.1%) case, in MET in one (1.1%) case, and in ALK in one (1.1%) case. A TERT promoter alteration was found in 53 (54.0%) cases, including 43 C228T and 10 C250T mutations. Three out of our cases did not harbor mutations in the panel of genes with therapeutic interest. This study confirms that ALK rearrangements in ATC are rare and that the mutational landscape of ATC is heterogeneous, with many genes implicated in the follicular epithelial cell dedifferentiation process. This may explain the limited effectiveness of targeted therapeutic options tested so far.

Toward Verification of USM3D Extensions for Mixed Element Grids

NASA Technical Reports Server (NTRS)

Pandya, Mohagna J.; Frink, Neal T.; Ding, Ejiang; Parlette, Edward B.

2013-01-01

The unstructured tetrahedral grid cell-centered finite volume flow solver USM3D has been recently extended to handle mixed element grids composed of hexahedral, prismatic, pyramidal, and tetrahedral cells. Presently, two turbulence models, namely, baseline Spalart-Allmaras (SA) and Menter Shear Stress Transport (SST), support mixed element grids. This paper provides an overview of the various numerical discretization options available in the newly enhanced USM3D. Using the SA model, the flow solver extensions are verified on three two-dimensional test cases available on the Turbulence Modeling Resource website at the NASA Langley Research Center. The test cases are zero pressure gradient flat plate, planar shear, and bump-inchannel. The effect of cell topologies on the flow solution is also investigated using the planar shear case. Finally, the assessment of various cell and face gradient options is performed on the zero pressure gradient flat plate case.

Reproductive rights and options available to women infected with HIV in Ghana: perspectives of service providers from three Ghanaian health facilities

PubMed Central

2013-01-01

Background Owing to improved management of HIV and its associated opportunistic infections, many HIV-positive persons of reproductive age are choosing to exercise their right of parenthood. This study explored the knowledge of health workers from two Ghanaian districts on the reproductive rights and options available to HIV-positive women who wish to conceive. Methods Facility-based cross-sectional in design, the study involved the entire population of nurse counselors (32) and medical officers (3) who provide counseling and testing services to clients infected with HIV. Both structured and in-depth interviews were conducted after informed consent. Results Two main perspectives were revealed. There was an overwhelmingly high level of approbation by the providers on HIV-positive women’s right to reproduction (94.3%). At the same time, the providers demonstrated a lack of knowledge regarding the various reproductive options available to women infected with HIV. Site of facility, and being younger were associated with practices that violated client’s right to contraceptive counseling (p < 0.05) in each case. Some of the providers openly expressed their inability to give qualified guidance to HIV-positive women on the various reproductive options. Conclusions Taken together, these findings suggest that many HIV-positive clients do not receive comprehensive information about their reproductive options. These findings highlight some of the problems that service providers face as HIV counselors. Both service providers and policy makers need to recognize these realities and incorporate reproductive health issues of HIV-persons into the existing guidelines. PMID:23496943

Gender and Programming.

PubMed

Crittenden, Courtney A; Koons-Witt, Barbara A

2017-05-01

The current study examines U.S. prison programming availability and participation by gender on a national level. The authors build upon previous literature by using national-level data, something that has been done in very limited cases previously. The main concern of this study is gender and its effects on programming availability and participation. The U.S. corrections field has undergone major changes in regard to population trends, fiscal constraints, policies, and research over the last few decades without a large-scale examination of the effects of these changes on programming across the United States. In this study, multiple types of programming areas were examined and results indicated that often female prisons (i.e., prisons housing only females) were more likely to offer programs (e.g., mental health options) and women were more likely to participate in many programming options compared with male prisons and men, respectively. We discuss the possible reasons for this and implications for future research.

Modeling of Solid Waste Processing Options in BIO-Plex

NASA Technical Reports Server (NTRS)

Rodriguez, Luis F.; Finn, Cory; Kang, Sukwon; Hogan, John; Luna, Bernadette (Technical Monitor)

2000-01-01

BIO-Plex is a ground-based test bed currently under development by NASA for testing technologies and practices that may be utilized in future long-term life support missions. All aspects of such an Advanced Life Support (ALS) System must be considered to confidently construct a reliable system, which will not only allow the crew to survive in harsh environments, but allow the crew time to perform meaningful research. Effective handling of solid wastes is a critical aspect of the system, especially when recovery of resources contained in the waste is required. This is particularly important for ALS Systems configurations that include a Biomass Production Chamber. In these cases, significant amounts of inedible biomass waste may be produced, which can ultimately serve as a repository of necessary resources for sustaining life, notably carbon, water, and plant nutrients. Numerous biological and physicochemical solid waste processing options have been considered. Biological options include composting, aerobic digestion, and anaerobic digestion. Physicochemical options include pyrolysis, SCWO (supercritical water oxidation), various incineration configurations, microwave incineration, magnetically assisted gasification, and low temperature plasma reaction. Modeling of these options is a necessary step to assist in the design process. A previously developed top-level model of BIO-Plex implemented in MATLAB Simulink (r) for the use of systems analysis and design has been adopted for this analysis. Presently, this model only considered incineration for solid waste processing. Present work, reported here, includes the expansion of this model to include a wider array of solid waste processing options selected from the above options, bearing in mind potential, near term solid waste treatment systems. Furthermore, a trade study has also been performed among these solid waste processing technologies in an effort to determine the ideal technology for long-term life support missions.

Parental Preference Assessment for Vesicoureteral Reflux Management in Children.

PubMed

Tran, Geraldine N; Bodapati, Anand V; Routh, Jonathan C; Saigal, Christopher S; Copp, Hillary L

2017-03-01

Parents of children with vesicoureteral reflux are presented with a variety of management options, which in many cases offer a similar risk-benefit ratio. To facilitate shared decision making, parental preferences regarding vesicoureteral reflux treatment options need to be acknowledged. We aimed to characterize the clinical experience of parents and elicit core themes affecting decision making in regard to managing vesicoureteral reflux in their child. A semistructured, qualitative interview script was developed and vetted by 25 pediatric urologists to discuss treatment options for vesicoureteral reflux. Additional patient interviews were conducted until new themes failed to arise. Content analysis was performed to extract all statements that described treatment options. Similar statements were combined until a final list of unique themes emerged. A total of 26 interviews were performed, yielding 689 statements about overall parent experiences with managing vesicoureteral reflux in the child and 450 statements (65%) pertaining to treatment options. Of the 13 themes that emerged, those most commonly considered were the prevention of future urinary tract infections by 85% of parents, the efficacy rate of treatment options by 85%, the burden of daily maintenance or compliance by 77%, antibiotic resistance by 69%, chronic kidney damage by 62% and invasiveness by 58%. Our study emphasizes that when choosing a treatment option for vesicoureteral reflux in their child, parent preferences regarding risks and benefits are variable. However, their chief concerns include whether a method decreases the risk of urinary tract infections, has an acceptable efficacy rate and aligns itself with the capabilities of the family. These themes help frame discussions between families and clinicians regarding vesicoureteral reflux management, and they can facilitate shared decision making. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Cost benefit analysis of two policy options for cannabis: status quo and legalisation.

PubMed

Shanahan, Marian; Ritter, Alison

2014-01-01

To date there has been limited analysis of the economic costs and benefits associated with cannabis legalisation. This study redresses this gap. A cost benefit analysis of two cannabis policy options the status quo (where cannabis use is illegal) and a legalised-regulated option was conducted. A cost benefit analysis was used to value the costs and benefits of the two policies in monetary terms. Costs and benefits of each policy option were classified into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill over events). The results are expressed as a net social benefit (NSB). The mean NSB per annum from Monte Carlo simulations (with the 5 and 95 percentiles) for the status quo was $294.6 million AUD ($201.1 to $392.7 million) not substantially different from the $234.2 million AUD ($136.4 to $331.1 million) for the legalised-regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised-regulated is higher than for status quo. Sensitivity analyses demonstrate the significant impact of educational attainment and wellbeing as drivers for the NSB result. Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case.

Cost Benefit Analysis of Two Policy Options for Cannabis: Status Quo and Legalisation

PubMed Central

Shanahan, Marian; Ritter, Alison

2014-01-01

Aims To date there has been limited analysis of the economic costs and benefits associated with cannabis legalisation. This study redresses this gap. A cost benefit analysis of two cannabis policy options the status quo (where cannabis use is illegal) and a legalised–regulated option was conducted. Method A cost benefit analysis was used to value the costs and benefits of the two policies in monetary terms. Costs and benefits of each policy option were classified into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill over events). The results are expressed as a net social benefit (NSB). Findings The mean NSB per annum from Monte Carlo simulations (with the 5 and 95 percentiles) for the status quo was $294.6 million AUD ($201.1 to $392.7 million) not substantially different from the $234.2 million AUD ($136.4 to $331.1 million) for the legalised–regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised–regulated is higher than for status quo. Sensitivity analyses demonstrate the significant impact of educational attainment and wellbeing as drivers for the NSB result. Conclusion Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case. PMID:24755942

[Role of stem cell transplantation in treatment of primary cutaneous T‑cell lymphoma].

PubMed

Stranzenbach, R; Theurich, S; Schlaak, M

2017-09-01

Within the heterogeneous group of cutaneous T‑cell lymphomas (CTCL) the therapeutic options for advanced and progressive forms are particularly limited. The therapeutic value of hematopoietic stem cell transplantation in CTCL was analyzed. A literature search using the keywords "hematopoietic stem cell transplantation" and "cutaneous T‑cell lymphoma" was performed in PubMed. Studies between 1990 and 2017 were taken into account. The studies identified were analyzed for relevance and being up to date. After reviewing the currently available literature no prospective randomized studies were found. Wu et al. showed a superiority of allogeneic transplantation in a comparison of autologous and allogeneic stem cell transplantation for cutaneous lymphoma. The graft-versus-lymphoma effect plays a significant role in a prolonged progression-free survival after allogeneic transplantation. By using a non-myeloablative conditioning regimen, stem cell transplantation can also be an option for elderly patients. The most extensive long-term data after allogeneic stem cell transplantation were reported by Duarte et al. in 2014. Autologous stem cell transplantation does not currently represent a therapeutic option, whereas allogeneic stem cell transplantation for advanced cutaneous T‑cell lymphoma, using a non-myeloablative conditioning scheme, does represent a therapeutic option. However, there is no consensus on the appropriate patients and the right timing. Morbidity and mortality of complications should be taken into account. Thus, this procedure is currently subject to an individual case decision.

Community-based interventions in prepared-food sources: a systematic review.

PubMed

Gittelsohn, Joel; Lee-Kwan, Seung Hee; Batorsky, Benjamin

2013-10-31

Food purchased from prepared-food sources has become a major part of the American diet and is linked to increased rates of chronic disease. Many interventions targeting prepared-food sources have been initiated with the goal of promoting healthful options. The objective of this study was to provide a systematic review of interventions in prepared-food sources in community settings. We used PubMed and Google Scholar and identified 13 interventions that met these criteria: 1) focused on prepared-food sources in public community settings, 2) used an impact evaluation, 3) had written documentation, and 4) took place after 1990. We conducted interviews with intervention staff to obtain additional information. Reviewers extracted and reported data in table format to ensure comparability. Interventions mostly targeted an urban population, predominantly white, in a range of income levels. The most common framework used was social marketing theory. Most interventions used a nonexperimental design. All made use of signage and menu labeling to promote healthful food options. Several promoted more healthful cooking methods; only one introduced new healthful menu options. Levels of feasibility and sustainability were high; sales results showed increased purchasing of healthful options. Measures among consumers were limited but in many cases showed improved awareness and frequency of purchase of promoted foods. Interventions in prepared-food sources show initial promising results at the store level. Future studies should focus on improved study designs, expanding intervention strategies beyond signage and assessing impact among consumers.

Community-Based Interventions in Prepared-Food Sources: A Systematic Review

PubMed Central

Lee-Kwan, Seung Hee; Batorsky, Benjamin

2013-01-01

Introduction Food purchased from prepared-food sources has become a major part of the American diet and is linked to increased rates of chronic disease. Many interventions targeting prepared-food sources have been initiated with the goal of promoting healthful options. The objective of this study was to provide a systematic review of interventions in prepared-food sources in community settings. Methods We used PubMed and Google Scholar and identified 13 interventions that met these criteria: 1) focused on prepared-food sources in public community settings, 2) used an impact evaluation, 3) had written documentation, and 4) took place after 1990. We conducted interviews with intervention staff to obtain additional information. Reviewers extracted and reported data in table format to ensure comparability. Results Interventions mostly targeted an urban population, predominantly white, in a range of income levels. The most common framework used was social marketing theory. Most interventions used a nonexperimental design. All made use of signage and menu labeling to promote healthful food options. Several promoted more healthful cooking methods; only one introduced new healthful menu options. Levels of feasibility and sustainability were high; sales results showed increased purchasing of healthful options. Measures among consumers were limited but in many cases showed improved awareness and frequency of purchase of promoted foods. Conclusion Interventions in prepared-food sources show initial promising results at the store level. Future studies should focus on improved study designs, expanding intervention strategies beyond signage and assessing impact among consumers. PMID:24176084

The performance-variability paradox, financial decision making, and the curious case of negative Hurst exponents.

PubMed

Guastello, Stephen J; Reiter, Katherine; Shircel, Anton; Timm, Paul; Malon, Matthew; Fabisch, Megan

2014-07-01

This study examined the relationship between performance variability and actual performance of financial decision makers who were working under experimental conditions of increasing workload and fatigue. The rescaled range statistic, also known as the Hurst exponent (H) was used as an index of variability. Although H is defined as having a range between 0 and 1, 45% of the 172 time series generated by undergraduates were negative. Participants in the study chose the optimum investment out of sets of 3 to 5 options that were presented a series of 350 displays. The sets of options varied in both the complexity of the options and number of options under simultaneous consideration. One experimental condition required participants to make their choices within 15 sec, and the other condition required them to choose within 7.5 sec. Results showed that (a) negative H was possible and not a result of psychometric error; (b) negative H was associated with negative autocorrelations in a time series. (c) H was the best predictor of performance of the variables studied; (d) three other significant predictors were scores on an anagrams test and ratings of physical demands and performance demands; (e) persistence as evidenced by the autocorrelations was associated with ratings of greater time pressure. It was concluded, furthermore, that persistence and overall performance were correlated, that 'healthy' variability only exists within a limited range, and other individual differences related to ability and resistance to stress or fatigue are also involved in the prediction of performance.

A structured multi-stakeholder learning process for Sustainable Land Management.

PubMed

Schwilch, Gudrun; Bachmann, Felicitas; Valente, Sandra; Coelho, Celeste; Moreira, Jorge; Laouina, Abdellah; Chaker, Miloud; Aderghal, Mohamed; Santos, Patricia; Reed, Mark S

2012-09-30

There are many, often competing, options for Sustainable Land Management (SLM). Each must be assessed - and sometimes negotiated - prior to implementation. Participatory, multi-stakeholder approaches to identification and selection of SLM options are increasingly popular, often motivated by social learning and empowerment goals. Yet there are few practical tools for facilitating processes in which land managers may share, select, and decide on the most appropriate SLM options. The research presented here aims to close the gap between the theory and the practice of stakeholder participation/learning in SLM decision-making processes. The paper describes a three-part participatory methodology for selecting SLM options that was tested in 14 desertification-prone study sites within the EU-DESIRE project. Cross-site analysis and in-depth evaluation of the Moroccan and Portuguese sites were used to evaluate how well the proposed process facilitated stakeholder learning and selection of appropriate SLM options for local implementation. The structured nature of the process - starting with SLM goal setting - was found to facilitate mutual understanding and collaboration between stakeholders. The deliberation process led to a high degree of consensus over the outcome and, though not an initial aim, it fostered social learning in many cases. This solution-oriented methodology is applicable in a wide range of contexts and may be implemented with limited time and resources. Copyright © 2012 Elsevier Ltd. All rights reserved.

Sildenafil Citrate in Fetal Growth Restriction

PubMed Central

Panda, Subrat; Das, Ananya; Md Nowroz, Hossain

2014-01-01

Background Pregnancies with early onset fetal growth restriction have poor perinatal outcome. Sildenafil citrate (PDE -5 inhibitor) as a vasodilator increases utero-placental blood flow and potentiates fetal growth. Case Presentation In this study, a case was examined and Sildenafil was administered for her. It was found that Sildenafil improved the uterine blood flow with a favorable fetal outcome at delivery. Conclusion Sildenafil, as a vasodilator has emerged as a potential management option in the treatment of Intra Uterine Growth Retardation (IUGR) and preeclampsia by later normalization in velocimetric profile. PMID:25202677

Case studies in forensic soil examinations.

PubMed

Petraco, Nicholas; Kubic, Thomas A; Petraco, Nicholas D K

2008-07-04

The examination and comparison of forensic soil samples is discussed. The origin of a simple and easy to learn procedure used and modified by the authors is reviewed. The process begins with a preliminary observation, removal of artifacts, and sieving of each specimen. A specific size fraction is split into three fractions for color matching, polarized light microscopy (PLM) examination (particle counting) and optional gradient comparison. Next, several cases are reviewed in which the modified method was used to evaluate the likelihood of common origin for questioned and known specimens.

Weather Research and Forecasting Model Wind Sensitivity Study at Edwards Air Force Base, CA

NASA Technical Reports Server (NTRS)

Watson, Leela R.; Bauman, William H., III; Hoeth, Brian

2009-01-01

This abstract describes work that will be done by the Applied Meteorology Unit (AMU) in assessing the success of different model configurations in predicting "wind cycling" cases at Edwards Air Force Base, CA (EAFB), in which the wind speeds and directions oscillate among towers near the EAFB runway. The Weather Research and Forecasting (WRF) model allows users to choose among two dynamical cores - the Advanced Research WRF (ARW) and the Non-hydrostatic Mesoscale Model (NMM). There are also data assimilation analysis packages available for the initialization of the WRF model - the Local Analysis and Prediction System (LAPS) and the Advanced Regional Prediction System (ARPS) Data Analysis System (ADAS). Having a series of initialization options and WRF cores, as well as many options within each core, creates challenges for local forecasters, such as determining which configuration options are best to address specific forecast concerns. The goal of this project is to assess the different configurations available and determine which configuration will best predict surface wind speed and direction at EAFB.

Impacts of fleet types and charging modes for electric vehicles on emissions under different penetrations of wind power

NASA Astrophysics Data System (ADS)

Chen, Xinyu; Zhang, Hongcai; Xu, Zhiwei; Nielsen, Chris P.; McElroy, Michael B.; Lv, Jiajun

2018-05-01

Current Chinese policy promotes the development of both electricity-propelled vehicles and carbon-free sources of power. Concern has been expressed that electric vehicles on average may emit more CO2 and conventional pollutants in China. Here, we explore the environmental implications of investments in different types of electric vehicle (public buses, taxis and private light-duty vehicles) and different modes (fast or slow) for charging under a range of different wind penetration levels. To do this, we take Beijing in 2020 as a case study and employ hourly simulation of vehicle charging behaviour and power system operation. Assuming the slow-charging option, we find that investments in electric private light-duty vehicles can result in an effective reduction in the emission of CO2 at several levels of wind penetration. The fast-charging option, however, is counter-productive. Electrifying buses and taxis offers the most effective option to reduce emissions of NOx, a major precursor for air pollution.

Sustainable sewerage servicing options for peri-urban areas with failing septic systems.

PubMed

Sharma, A K; Tjandraatmadja, G; Grant, A L; Grant, T; Pamminger, F

2010-01-01

The provision of water and wastewater services to peri-urban areas faces very different challenges to providing services to cities. Sustainable solutions for such areas are increasingly being sought, in order to solve the environmental and health risks posed by failing septic systems. These solutions should have the capability to reduce potable water demand, provide fit for purpose reuse options, and minimise impacts on the local and global environment. A methodology for the selection of sustainable sewerage servicing systems and technologies is presented in this paper. This paper describes the outcomes of applying this methodology to a case study in rural community near Melbourne, Australia, and describes the economic and environmental implications of various sewerage servicing options. Applying this methodology has found that it is possible to deliver environmental improvements at a lower community cost, by choosing servicing configurations not historically used by urban water utilities. The selected solution is currently being implemented, with the aim being to generate further transferable learnings for the water industry.

Contemporary best practice in the evaluation and management of stuttering priapism.

PubMed

Kousournas, Georgios; Muneer, Asif; Ralph, David; Zacharakis, Evangelos

2017-01-01

Stuttering priapism is rare and under-investigated clinical entity. Although it shares similarities with ischaemic priapism, by definition, stuttering priapism has distinct characteristics that advocate for a different management in the clinical setting. Therefore, the management of stuttering priapism aims primarily to prevent recurrence rather than the resolution of spontaneous attacks. A multimodal approach and the individualization of each case are essential because of the diversity of the condition and the plethora of proposed therapeutic strategies. Understanding the underlying pathophysiology and familiarity with contemporary, past and emerging future agents and therapeutic options are required in order to provide an optimal solution for each patient. In addition, patient counselling and the option to combine therapeutic strategies and challenge second-line therapies are essential weapons in the armament of the urologist. Although further clinical trials and studies are mandatory in order to obtain solid data and provide recommendations, all therapeutic options are analysed, with specific interest in the potential advantages and disadvantages. A structured evaluation procedure is also described.

Gastroesophageal Reflux Management with the LINX® System for Gastroesophageal Reflux Disease Following Laparoscopic Sleeve Gastrectomy.

PubMed

Desart, Kenneth; Rossidis, Georgios; Michel, Michael; Lux, Tamara; Ben-David, Kfir

2015-10-01

Laparoscopic sleeve gastrectomy (LSG) has gained significant popularity in the USA, and consequently resulted in patients experiencing new-onset gastroesophageal reflux disease (GERD) following this bariatric procedure. Patients with GERD refractory to medical therapy present a more challenging situation limiting the surgical options to further treat the de novo GERD symptoms since the gastric fundus to perform a fundoplication is no longer an option. The aim of this study is to determine if the LINX® magnetic sphincter augmentation system is a safe and effective option for patients with new gastroesophageal reflux disease following laparoscopic sleeve gastrectomy. This study was conducted at the University Medical Center. This is a retrospective review of seven consecutive patients who had a laparoscopic LINX® magnetic sphincter device placement for patients with refractory gastroesophageal reflux disease after laparoscopic sleeve gastrectomy between July 2014 and April 2015. All patients were noted to have self-reported greatly improved gastroesophageal reflux symptoms 2-4 weeks after their procedure. They were all noted to have statistically significant improved severity and frequency of their reflux, regurgitation, epigastric pain, sensation of fullness, dysphagia, and cough symptoms in their postoperative GERD symptoms compared with their preoperative evaluation. This is the first reported pilot case series, illustrating that the LINX® device is a safe and effective option in patients with de novo refractory gastroesophageal reflux disease after a laparoscopic sleeve gastrectomy despite appropriate weight loss.

Private Education in the Absence of a Public Option: The Cases of the United Arab Emirates and Qatar

ERIC Educational Resources Information Center

Ridge, Natasha Y.; Shami, Soha; Kippels, Susan M.

2016-01-01

In the face of rising demand for private schooling in the United Arab Emirates (UAE) and Qatar, a lack of affordable schooling options, monopolistic behavior of private education providers, and unpredictable government regulations have created a complex and unequal education sector. This research employs a mixed methods comparative approach to…

26 CFR 1.612-4 - Charges to capital and to expense in case of oil and gas wells.

Code of Federal Regulations, 2014 CFR

2014-04-01

... expense. This option applies to all expenditures made by an operator for wages, fuel, repairs, hauling... applies are, all amounts paid for labor, fuel, repairs, hauling, and supplies, or any of them, which are... themselves do not have a salvage value. For the purpose of this option, labor, fuel, repairs, hauling...

26 CFR 1.612-4 - Charges to capital and to expense in case of oil and gas wells.

Code of Federal Regulations, 2012 CFR

2012-04-01

... expense. This option applies to all expenditures made by an operator for wages, fuel, repairs, hauling... applies are, all amounts paid for labor, fuel, repairs, hauling, and supplies, or any of them, which are... themselves do not have a salvage value. For the purpose of this option, labor, fuel, repairs, hauling...

26 CFR 1.612-4 - Charges to capital and to expense in case of oil and gas wells.

Code of Federal Regulations, 2013 CFR

2013-04-01

... expense. This option applies to all expenditures made by an operator for wages, fuel, repairs, hauling... applies are, all amounts paid for labor, fuel, repairs, hauling, and supplies, or any of them, which are... themselves do not have a salvage value. For the purpose of this option, labor, fuel, repairs, hauling...

26 CFR 1.417(a)(3)-1 - Required explanation of qualified joint and survivor annuity and qualified preretirement survivor...

Code of Federal Regulations, 2010 CFR

2010-04-01

... grouping rules of paragraph (c)(2)(iii) of this section. Separate charts are provided for ages 55, 60, and...) Simplified presentations permitted—(A) Grouping of certain optional forms. Two or more optional forms of... starting date, a reasonable assumption for the age of the participant's spouse, or, in the case of a...

Combined Pharmacomechanical Thrombolysis of Complete Portomesenteric Thrombosis in a Liver Transplant Recipient

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

Lorenz, Jonathan M., E-mail: jlorenz@radiology.bsd.uchicago.edu; Bennett, Shelby; Patel, Jay

2013-01-30

Treatment options for portomesenteric venous thrombosis range from anticoagulation to surgery, depending on chronicity, severity of symptoms, extent of thrombosis, and the availability of local expertise. For acute and subacute cases, a variety of endovascular options have been described in limited published series and case reports, including thrombolysis and mechanical thrombectomy. We report what is to our knowledge the first case in which the Trellis pharmacomechanical thrombolysis device was used successfully to treat complete acute thrombosis of the entire superior mesenteric vein and the entire portal vein with extension into all segmental intrahepatic portal branches in a young adult aftermore » liver transplantation. This device, coupled with adjunctive techniques using balloon catheters, facilitated complete restoration of flow, resulting in graft salvage and long-term patency.« less

Simple resection arthroplasty for treatment of 4th and 5th tarsometatarsal joint problems. A technical tip and a small case series.

PubMed

Koenis, M J J; Louwerens, J W K

2015-03-01

Osteoarthritis, primary or secondary, of the fourth and/or fifth tarsometatarsal (TMT) joint is a rare condition. When conservative treatment fails or proves to be unacceptable for the patient, operative treatment is an option. In this article the technique of resection arthroplasty is described and a retrospective case series of 6 patients is presented. Three patients underwent tendon interposition arthroplasty after resection of the two joints and in the last three cases no interposition at all was performed. Results suggest that resection arthroplasty without interposition may be as effective as other operative treatment options for patients with fourth and fifth TMT pathology. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Neuroimaging in aphasia treatment research: Standards for establishing the effects of treatment

PubMed Central

Kiran, Swathi; Ansaldo, Ana; Bastiaanse, Roelien; Cherney, Leora R.; Howard, David; Faroqi-Shah, Yasmeen; Meinzer, Marcus; Thompson, Cynthia K

2012-01-01

The goal of this paper is to discuss experimental design options available for establishing the effects of treatment in studies that aim to examine the neural mechanisms associated with treatment-induced language recovery in aphasia, using functional magnetic resonance imaging (fMRI). We present both group and single-subject experimental or case-series design options for doing this and address advantages and disadvantages of each. We also discuss general components of and requirements for treatment research studies, including operational definitions of variables, criteria for defining behavioral change and treatment efficacy, and reliability of measurement. Important considerations that are unique to neuroimaging-based treatment research are addressed, pertaining to the relation between the selected treatment approach and anticipated changes in language processes/functions and how such changes are hypothesized to map onto the brain. PMID:23063559

Management of thyroid gland abscess.

PubMed

García Callejo, Javier; Redondo Martínez, Jaume; Civera, Miguel; Verdú Colomina, José; Pellicer Zoghbi, Verónica; Martínez Beneyto, M Paz

2018-06-08

Thyroid abscess or acute suppurative thyroiditis is an unusual clinical condition. We present our experience with cases attended over 41 years. A retrospective study was performed on these patients reviewing their epidemiological characteristics and the diagnostic and therapeutic manoeuvres chosen for them all, as well as their clinical outcome. A group of 9 males and 5 females was studied, with ages ranging from 19 to 68 (mean of 40.6±15.4). These patients suffered 22 acute episodes, and 2 patients each had 4 episodes. Suppurative thyroiditis comprised 0.29% of the neck abscesses. Fine needle aspiration was performed in 13 cases to evacuate the collection and isolate the aetiological agent. Mycobacterium tuberculosis and Staphylococcus aureus were the most frequently identified. Nine patients underwent ultrasound and 7 computed tomography imaging studies. Surgery was the option for 10 patients, including drainage for 7, thyroidectomy for 4 and hemithyroidectomy for the remaining 2. Systemic or intralesional antibiotics and sclerosis of the gland were also carried out. Although one case presented with hyperthyroidism and thyrotoxicosis in the acute phase, definitive hypothyroidism was observed in 5 patients at 6 months following discharge. The rate of success was 100%. Thyroid gland suppuration is a very infrequent circumstance in neck pathology, and the options for its treatment are varied, from conservative to invasive techniques according to the microbial and radiologic findings. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Evolution of physician-hospital alignment models: a case study of comanagement.

PubMed

Sowers, Kevin W; Newman, Paul R; Langdon, Jeffrey C

2013-06-01

Recently, quality, financial, and regulatory demands have driven physicians to seek alignment opportunities with hospitals. The motivation for alignment on the part of physicians and hospitals is now accelerating because the new paradigm under healthcare reform requires an increased focus on improving quality, cost, and efficiency. We (1) identify the key drivers for physician-hospital alignment models; (2) summarize comanagement as a physician-hospital alignment model; and (3) explore a detailed case study of comanagement as an option to better align physicians with hospital goals on quality, safety, and outcomes. A Medline abstract review was performed that identified 45 references that discuss options for physician-hospital alignment. None of the articles identified provide a detailed example of successful alignment structures. A detailed case study of a successful comanagement alignment program is reviewed. The key drivers for alignment are inpatient growth rates, declining reimbursements, and the opportunity to improve quality, decrease costs, and increase efficiency. Two general strategies of alignment involve noneconomic and/or economic integration. In our example, comanagement with economic integration was chosen as the preferred structure for physician-hospital alignment. The choice of structure will vary depending on the existing relationships and governance of the hospital and the physicians in the targeted area of focus. The measure of success in building physician-hospital alignment is measured in improvements in care for the patient, reduced cost of care delivery, and improved relations between physicians and hospital leadership.

Intraductal Tubulopapillary Neoplasm of the Pancreas: An Update From a Pathologist's Perspective.

PubMed

Rooney, Sarah L; Shi, Jiaqi

2016-10-01

-Intraductal tubulopapillary neoplasm (ITPN) is a rare intraductal epithelial neoplasm of the pancreas recently recognized as a distinct entity by the World Health Organization classification in 2010. It is defined as an intraductal, grossly visible, tubule-forming epithelial neoplasm with high-grade dysplasia and ductal differentiation without overt production of mucin. The diagnosis can be challenging owing to morphologic overlap with other intraductal lesions and its rarity. While recent advances in molecular genetic studies of ITPN have provided new tools to facilitate clinical diagnosis, the limited number of cases has yielded limited follow-up data to guide management. -To provide a clinical, pathologic, and molecular update on ITPN with respect to clinical presentation, imaging findings, histopathologic features, differential diagnosis, biological behavior, molecular characteristics, and treatment options. -Analysis of the pertinent literature (PubMed) and authors' research and clinical practice experience based on institutional and consultation materials. -Clinical presentation, imaging findings, histopathology, immunohistochemistry studies, molecular characteristics, prognosis, and treatment options of ITPN are reviewed. Important differential diagnoses with other intraductal neoplasms of the pancreas-especially intraductal papillary mucinous neoplasm-using histopathologic, molecular, and immunohistochemical studies, are discussed. Despite the recent progress, more studies are necessary to assess the biology and genetics of ITPN for a better understanding of the prognostic factors and treatment options.

Supply chain dynamics in healthcare services.

PubMed

Samuel, Cherian; Gonapa, Kasiviswanadh; Chaudhary, P K; Mishra, Ananya

2010-01-01

The purpose of this paper is to analyse health service supply chain systems. A great deal of literature is available on supply chain management in finished goods inventory situations; however, little research exists on managing service capacity when finished goods inventories are absent. System dynamics models for a typical service-oriented supply chain such as healthcare processes are developed, wherein three service stages are presented sequentially. Just like supply chains with finished goods inventory, healthcare service supply chains also show dynamic behaviour. Comparing options, service reduction, and capacity adjustment delays showed that reducing capacity adjustment and service delays gives better results. The study is confined to health service-oriented supply chains. Further work includes extending the study to service-oriented supply chains with parallel processing, i.e. having more than one stage to perform a similar operation and also to study the behaviour in service-oriented supply chains that have re-entrant orders and applications. Specific case studies can also be developed to reveal factors relevant to particular service-oriented supply chains. The paper explains the bullwhip effect in healthcare service-oriented supply chains. Reducing stages and capacity adjustment are strategic options for service-oriented supply chains. The paper throws light on policy options for managing healthcare service-oriented supply chain dynamics.

Bladder stone management: an update.

PubMed

Cicione, Antonio; DE Nunzio, Cosimo; Manno, Stefano; Damiano, Rocco; Posti, Alessandro; Lima, Estevao; Tubaro, Andrea; Balloni, Filippo

2018-02-01

Bladder stone (BS) is a rare disease curable with several options. Herein, we reviewed the specific literature in order to update the current BS management. A comprehensive systematic MEDLINE search was performed for English language reports published before April 2017 using the BS related terms, i.e. bladder-vesical calculi, lithotripsy. Then manuscripts references were screened to identify unfounded studies. Studies regarding BS in children were excluded. Retrieved studies were classified according to their main item as: etiology, diagnosis, treatment, treatment in specific illnesses and advances in BS management. Treatment option was mainly related to stone size and number as well as concomitant causative disease. However, stone nature was not analyzed in all the retrieved studies. Both trans-urethral and percutaneous lithotripsy were efficacy for stone fragmentation although the last one was suggested to avoid urethral injuries. Holmiun:Yag laser lithotripsy has made stone fragmentation feasible by using local anesthesia however in selected patients only. The urological dogma to perform concomitant prostate surgery in men with BS has been recently questioned by some observational case-series studies however, the lack of randomization and long follow up preserve that knowledge. Bladder stone is a rare and ancient disease. Nowadays new technologies have been developed in the effort to make less invasive stone treatment. The retrieved studies show that stone fragmentation can be archived by using several surgical approaches and devices whereas comparative randomized studies are still unavailable to identify the best option.

Long-Term Monitoring of Cased Pipelines Using Longrange Guided-Wave Technique

DOT National Transportation Integrated Search

2009-05-19

Integrity management programs for gas transmission pipelines are required by The Office of Pipeline Safety (OPS)/DOT. Direct Assessment (DA) and 'Other Technologies' have become the focus of assessment options for pipeline integrity on cased crossing...

Plateau Iris - Therapeutic options and functional results after treatment.

PubMed

Feraru, Crenguța; Bâlha, Andrei; Aursulesei, Victor; Filip, Andrei; Pantalon, Anca

2017-01-01

We present the therapeutic options and functional results in patients with plateau iris (syndrome or configuration) in consecutive case series. Material and method: Our study included newly diagnosed patients with acute angle closure by "plateau iris" (configuration or syndrome), between June 2016 and April 2017. Series of 8 consecutive patients met the inclusion criteria, all being females. All the patients underwent an individualized treatment according to the underlying mechanism and evolution. Functional results (visual acuity, IOP, topical medication) were reported in the current paper. Results: For 10 months, we diagnosed 14 eyes, from 9 patients with acute angle closure by Plateau Iris, distributed as it follows: 6 eyes with closed angle glaucoma (optic disk and visual field changes), 8 eyes with plateau iris syndrome and 2 eyes with plateau iris configuration. 7/ 8 patients were misdiagnosed with primary open angle glaucoma, whereas only one patient had the correct diagnosis of closed angle glaucoma and underwent peripheral laser iridotomy. As treatment options in our study, we recommended and performed argon laser peripheral iridoplasty + iridotomy in 10/ 14 eyes, cataract lens was extracted in 4 eyes and then replaced with PC-IOL, whereas 2 eyes required a filtering anti-glaucoma surgery (trabeculectomy + PI). 2 eyes from the same patient could not be treated as intended as the patient refused the treatment. In this unique case, Pilocarpine (4%) was temporarily indicated. Conclusion: Plateau iris represents a diagnostic trap, but based on a thorough gonioscopic examination and a good patient history, the right diagnosis can be made, all along with a correct therapeutic approach.

Validation in daily clinical situations of Diascope®, a software developed to help healthcare professionals individualize antidiabetic treatment in type 2 diabetes.

PubMed

Ampudia-Blasco, Francisco Javier; García-Soidán, Francisco Javier; Rubio Sánchez, Manuela; Phan, Tra-Mi

2017-03-01

DiaScope ® is a software to help in individualized prescription of antidiabetic treatment in type 2 diabetes. This study assessed its value and acceptability by different professionals. DiaScope ® was developed based on the ADA-EASD 2012 algorithm and on the recommendation of 12 international diabetes experts using the RAND/UCLA appropriateness method. The current study was performed at a single session. In the first phase, 5 clinical scenarios were evaluated, selecting the most appropriated therapeutic option among 4 possibilities (initial test). In a second phase, the same clinical cases were evaluated with DiaScope ® (final test).Opinion surveys on DiaScope ® were also performed (questionnaire). DiaScope ® changed the selected option 1 or more times in 70.5% of cases. Among 275 evaluated questionnaires, 54.0% strongly agree that DiaScope ® allowed finding easily a similar therapeutic scenario to the corresponding patient, and 52.5 among the obtained answers were clinically plausible. Up to 58.3% will recommend it to a colleague. In particular, primary care physicians with >20 years of professional dedication found with DiaScope ® the most appropriate option for a particular situation against specialists or those with less professional dedication (p<.05). DiaScope ® is an easy to use tool for antidiabetic drug prescription that provides plausible solutions and is especially useful for primary care physicians with more years of professional practice. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Outcome of Keratoconus Management: Review of the Past 20 Years' Contemporary Treatment Modalities.

PubMed

Mandathara, Preeji S; Stapleton, Fiona J; Willcox, Mark D P

2017-05-01

To describe the past 20 years' contemporary management modalities for keratoconus (KC) and their outcomes and failures and to propose recommendations in reporting their outcomes. A systematic review of the literature on KC management options for the last 20 years was performed. Original articles that reported the outcome of any form of KC management other than full-thickness or lamellar corneal graft were reviewed to collect information on their outcomes and complications and the level of scientific evidence of the study. A total of 1,147 articles retrieved and of those, 241 satisfied the inclusion criteria, and 41.1% of them were prospective case series. The higher level of evidence studies, that is, randomized controlled trials (RCTs), were limited to only one intervention, that is, corneal collagen cross-linking (CXL). However, the quality of most RCTs was limited because of performance and detection bias. Contact lenses (CLs) remain the mainstream of KC management and were associated with reversible and non-sight-threatening complications. Surgical options such as intracorneal segment implantation and phakic intraocular lens are considered in the visual rehabilitation of CL intolerants, and CXL is the only available option to stop or delay the disease progression. Generally, these surgical procedures are associated with transient inflammatory events and permanent sequelae. The published studies on KC management options varied significantly with respect to the study population, age of participants, severity of KC, clinical outcome measurements, and follow-up period. High-quality longer follow-up RCTs are required to evaluate the long-term effects of KC interventions.

The Evolution of Discovery Systems in Academic Libraries: A Case Study at the University of Houston Libraries

ERIC Educational Resources Information Center

Guajardo, Richard; Brett, Kelsey; Young, Frederick

2017-01-01

For the past several years academic libraries have been adopting discovery systems to provide a search experience that reflects user expectations and improves access to electronic resources. University of Houston Libraries has kept pace with this evolving trend by pursuing various discovery options; these include an open-source tool, a federated…

Failures and Reform in Mathematics Education: The Case of Engineering. National Institute Briefing Note No. 5.

ERIC Educational Resources Information Center

Wolf, Alison

The structure of education for 16- to 18-year-olds in Great Britain discourages them from making mathematics, science, and engineering serious options for future study. The emerging structure of the labor market, in which a large proportion of high-status jobs do not require higher mathematics, increases the numbers who decide not to commit…

Role Play in Blended Learning: A Case Study Exploring the Impact of Story and Other Elements

ERIC Educational Resources Information Center

Dracup, Mary

2008-01-01

Role play is an increasingly popular technique in tertiary education, being student centred, constructivist and suitable for a range of subject areas. The choice of formats is wide open, with options ranging from the traditional face to face performance through to multi-user online computer games. Some teachers prefer to take advantage of features…

Space station needs, attributes and architectural options study commercialization working group briefing

NASA Technical Reports Server (NTRS)

1983-01-01

The benefits for each of the following commercial areas was investigated: communications, remote sensing, materials processing in space, low Earth orbit (LEO) satellite assembly, testing, and servicing, and space tourism. In each case, where economic benefits are derived, the costs for accomplishing tasks with the Space Station are compared with the cost with the Space Transportation System only.

Developing and implementing climate change adaptation options in forest ecosystems: a case study in southwestern Oregon, USA

Treesearch

Jessica E. Halofsky; David L. Peterson; Kerry L. Metlen; Gwyneth M. Myer; Alaric V. Sample

2016-01-01

Climate change will likely have significant effects on forest ecosystems worldwide. In Mediterranean regions, such as that in southwestern Oregon, USA, changes will likely be driven mainly by wildfire and drought. To minimize the negative effects of climate change, resource managers require tools and information to assess climate change vulnerabilities and to develop...

Shadowing "The Boys" Sixteen Years out of the Program: A Case Study of Three Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Williams, Melissa

2011-01-01

Self-determination skills allow individuals to become contributors to society and their own lives, without these skills individuals with cognitive disabilities are left few options other than to rely on family, friends, and social service agencies to meet the most basic of needs. Effective curricular programming including functional academic,…

78 FR 59017 - Information Collection Request Submitted to OMB for Review and Approval; Comment Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... survey is public value research. The Santa Cruz River is a case study of a waterway highly impacted by... Submitted to OMB for Review and Approval; Comment Request; Willingness To Pay Survey for Santa Cruz River...), ``Willingness To Pay Survey for Santa Cruz River Management Options in Southern Arizona (New)'' (EPA ICR No...

Investigating habitat value to inform contaminant remediation options: case study

Treesearch

Rebecca A. Efroymson; Mark J. Peterson; Neil R. Giffen; Michael G. Ryon; John G. Smith; William W. Hargrove; W. Kelly Roy; Christopher J. Welsh; Daniel L. Druckenbrod; Harry D. Quarles

2008-01-01

Habitat valuation methods were implemented to support remedial decisions for aquatic and terrestrial contaminated sites at the East Tennessee Technology Park (ETTP) on the US Department of Energy (DOE) Oak Ridge Reservation in Oak Ridge, TN, USA. The habitat valuation was undertaken for six contaminated sites: Contractor’s Spoil Area, K-901-N Disposal Area, K-770...

Syntactic Reflexes of Emerging Optionality in Spanish as a Heritage Language: The Case of Dative-Experiencer Verbs

ERIC Educational Resources Information Center

Pascual y Cabo, Diego

2016-01-01

This study contributes to current trends of heritage speaker bilingualism research by examining the syntax of so-called Spanish dative-experiencer predicates ("gustar"-like verbs). Building on previous findings (e.g., Silva-Corvalán 1994; Toribio and Nye 2006), it is hypothesized that Spanish heritage speakers can project an optional…

Successful retreatment with osimertinib after osimertinib-induced acute pulmonary embolism in a patient with lung adenocarcinoma: A case report.

PubMed

Shiroyama, Takayuki; Hayama, Manabu; Satoh, Shingo; Nasu, Shingo; Tanaka, Ayako; Morita, Satomu; Morishita, Naoko; Suzuki, Hidekazu; Okamoto, Norio; Hirashima, Tomonori

2017-01-01

Pulmonary embolism (PE) can be life-threatening, and it is challenging to diagnose because of its nonspecific signs and symptoms. PE is also an important potential risk of osimertinib treatment, however, clinical courses regarding retreatment after osimertinib-induced acute pulmonary embolism remain unclear. We described a 77-year-old woman with postoperative recurrent lung adenocarcinoma who developed osimertinib-induced acute PE. She received apixaban and was later successfully retreated with osimertinib. This case suggests that retreatment with osimertinib after osimertinib-induced acute PE may be a treatment option when alternative therapeutic options are limited.

Intraventricular catheter placement by electromagnetic navigation safely applied in a paediatric major head injury patient.

PubMed

Aufdenblatten, Christoph Alexander; Altermatt, Stefan

2008-09-01

In the management of severe head injuries, the use of intraventricular catheters for intracranial pressure (ICP) monitoring and the option of cerebrospinal fluid drainage is gold standard. In children and adolescents, the insertion of a cannula in a compressed ventricle in case of elevated intracranial pressure is difficult; therefore, a pressure sensor is placed more often intraparenchymal as an alternative option. In cases of persistent elevated ICP despite maximal brain pressure management, the use of an intraventricular monitoring device with the possibility of cerebrospinal fluid drainage is favourable. We present the method of intracranial catheter placement by means of an electromagnetic navigation technique.

Intentional intra-arterial injection of midazolam in a patient with status epilepticus in the Intensive Care Unit

PubMed Central

Ali, Muhammad Asghar; Yahya, Muhammad

2017-01-01

Fundamental medical care includes intravenous (IV) access which provides prompt resuscitation and reliable delivery of analgesics, antibiotics, and vasoactive medication. Difficult access populations, especially in critical area, continue to challenge providers to consider and utilize alternative means to provide IV access. Potential options under such circumstances include intramuscular, intraosseous, and intratracheal drug administration, but in extreme cases where no other options are available, intra-arterial route might be considered. We present a case where midazolam was intentionally injected intra-arterially to abort seizure activity in a patient with status epilepticus in the Intensive Care Unit. PMID:29033730

Distribution of arsenic and copper in sediment pore water: an ecological risk assessment case study for offshore drilling waste discharges.

PubMed

Sadiq, Rehan; Husain, Tahir; Veitch, Brian; Bose, Neil

2003-12-01

Due to the hydrophobic nature of synthetic based fluids (SBFs), drilling cuttings are not very dispersive in the water column and settle down close to the disposal site. Arsenic and copper are two important toxic heavy metals, among others, found in the drilling waste. In this article, the concentrations of heavy metals are determined using a steady state "aquivalence-based" fate model in a probabilistic mode. Monte Carlo simulations are employed to determine pore water concentrations. A hypothetical case study is used to determine the water quality impacts for two discharge options: 4% and 10% attached SBFs, which correspond to the best available technology option and the current discharge practice in the U.S. offshore. The exposure concentration (CE) is a predicted environmental concentration, which is adjusted for exposure probability and bioavailable fraction of heavy metals. The response of the ecosystem (RE) is defined by developing an empirical distribution function of predicted no-effect concentration. The pollutants' pore water concentrations within the radius of 750 m are estimated and cumulative distributions of risk quotient (RQ=CE/RE) are developed to determine the probability of RQ greater than 1.

Continuous-Time Public Good Contribution Under Uncertainty: A Stochastic Control Approach

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

Ferrari, Giorgio, E-mail: giorgio.ferrari@uni-bielefeld.de; Riedel, Frank, E-mail: frank.riedel@uni-bielefeld.de; Steg, Jan-Henrik, E-mail: jsteg@uni-bielefeld.de

In this paper we study continuous-time stochastic control problems with both monotone and classical controls motivated by the so-called public good contribution problem. That is the problem of n economic agents aiming to maximize their expected utility allocating initial wealth over a given time period between private consumption and irreversible contributions to increase the level of some public good. We investigate the corresponding social planner problem and the case of strategic interaction between the agents, i.e. the public good contribution game. We show existence and uniqueness of the social planner’s optimal policy, we characterize it by necessary and sufficient stochasticmore » Kuhn–Tucker conditions and we provide its expression in terms of the unique optional solution of a stochastic backward equation. Similar stochastic first order conditions prove to be very useful for studying any Nash equilibria of the public good contribution game. In the symmetric case they allow us to prove (qualitative) uniqueness of the Nash equilibrium, which we again construct as the unique optional solution of a stochastic backward equation. We finally also provide a detailed analysis of the so-called free rider effect.« less

The Usefulness of 0.2% Topical Nitroglycerin for Chondrodermatitis Nodularis Helicis.

PubMed

Sanz-Motilva, V; Martorell-Calatayud, A; Gutiérrez García-Rodrigo, C; Hueso-Gabriel, L; García-Melgares, M L; Pelufo-Enguix, C; Alfaro-Rubio, A; Vanaclocha-Sebastián, F

2015-09-01

Chondrodermatitis nodularis helicis (CNH) is a painful idiopathic degenerative condition involving the skin and cartilage of the helix or antihelix of the ear. Topical nitroglycerin 2% is a relatively recent treatment option for CNH that has produced good results, although with adverse effects (17% of cases). The use of a lower concentration would probably achieve similar results with fewer adverse effects. The aim of this study was to evaluate the effectiveness and safety of topical nitroglycerin 0.2% in the treatment of CNH. We performed a retrospective observational study of patients treated in 2 Spanish hospitals between 2012 and 2014. The effectiveness of treatment was determined by clinical photography and assessment of symptoms using a verbal numerical rating scale. Of the 29 patients treated, 93% showed clinical improvement. In the group of responders, mean treatment duration was 1.8 months and mean follow-up was 5.9 months. Overall tolerance was good in all cases. Topical nitroglycerin 0.2% is an effective and well-tolerated conservative treatment option that improves the appearance of lesions and provides symptomatic relief in the majority of patients with CNH. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

Computation of a Canadian SCWR unit cell with deterministic and Monte Carlo codes

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

Harrisson, G.; Marleau, G.

2012-07-01

The Canadian SCWR has the potential to achieve the goals that the generation IV nuclear reactors must meet. As part of the optimization process for this design concept, lattice cell calculations are routinely performed using deterministic codes. In this study, the first step (self-shielding treatment) of the computation scheme developed with the deterministic code DRAGON for the Canadian SCWR has been validated. Some options available in the module responsible for the resonance self-shielding calculation in DRAGON 3.06 and different microscopic cross section libraries based on the ENDF/B-VII.0 evaluated nuclear data file have been tested and compared to a reference calculationmore » performed with the Monte Carlo code SERPENT under the same conditions. Compared to SERPENT, DRAGON underestimates the infinite multiplication factor in all cases. In general, the original Stammler model with the Livolant-Jeanpierre approximations are the most appropriate self-shielding options to use in this case of study. In addition, the 89 groups WIMS-AECL library for slight enriched uranium and the 172 groups WLUP library for a mixture of plutonium and thorium give the most consistent results with those of SERPENT. (authors)« less

Iron-induced hypophosphatemia: an emerging complication.

PubMed

Zoller, Heinz; Schaefer, Benedikt; Glodny, Bernhard

2017-07-01

Iron-induced hypophosphatemia is a well documented side-effect but associated complications are largely neglected, because the results from single dosing studies suggest that transient decreases in plasma phosphate concentrations are asymptomatic and fully reversible. However, an increasing number of case reports and case series suggest that some patients develop severe and symptomatic hypophosphatemia. Long-term complications from hypophosphatemia include osteomalacia and bone fractures, which can result from repeated intravenous administration of certain high-dose iron preparations. Results from clinical trials suggest that the highest risk for the development of hypophosphatemia is associated with ferric carboxymaltose, iron polymaltose, and saccharated iron oxide. Clinical studies show that renal phosphate wasting mediated by increased fibroblast growth factor 23 causes hypophosphatemia after iron therapy. Impaired renal function therefore protects from hypophosphatemia, whereas the highest incidences and most severe manifestations have been reported in patients in whom the underlying cause of iron deficiency cannot be corrected. Diagnosis of iron-induced hypophosphatemia requires clinical suspicion. Treatment is guided by the severity of hypophosphatemia, and most patients will require oral or intravenous phosphate substitution. Future treatment options could involve therapeutic anti-FGF23 antibody (KRN23). Prevention and correction of vitamin D deficiency represents a supportive treatment option.

Managing the patient with oculomotor nerve palsy.

PubMed

Sadagopan, Karthikeyan A; Wasserman, Barry N

2013-09-01

To provide clinically relevant information regarding the evaluation and current treatment options for oculomotor nerve palsies. We survey recent literature and provide some insights into these studies. Recent case reports highlight emerging new causes of oculomotor cranial nerve palsies, including sellar chordoma, odontogenic abscess, nonaneurysmal subarachnoid hemorrhage, polycythemia, sphenoiditis, neurobrucellosis, interpeduncular fossa lipoma, metastatic pancreatic cancer, leukemia, and lymphoma. Surgical studies have focused on modifications and innovations regarding strabismus surgery for this condition. New globe fixation procedures may include fixation to the medial orbital wall by precaruncular and retrocaruncular approaches, apically based orbital bone periosteal flap fixation and the suture/T-plate anchoring platform system. Management of oculomotor nerve palsy depends in part upon the underlying cause and anatomical location of the lesion. Careful clinical evaluation and appropriate imaging can identify a definitive cause in most cases. Surgical options depend on the number, extent, and severity of the muscles involved as well as the presence or absence of signs of aberrant regeneration. The clinician should also address issues that arise due to involvement of the pupil and accommodation. Strabismus surgery can be challenging but also rewarding with appropriate selection and staging of procedures.

Environmental strategies: A case study of systematic evaluation

NASA Astrophysics Data System (ADS)

Sherman, Douglas J.; Garès, Paul A.

1982-09-01

A major problem facing environmental managers is the necessity to effectively evaluate management alternatives. Traditional environmental assessments have emphasized the use of economic analyses. These approaches are often deficient due to difficulty in assigning dollar values to environmental systems and to social amenities. A more flexible decisionmaking model has been developed to analyze management options for coping with beach erosion problems at the Sandy Hook Unit of Gateway National Recreation Area in New Jersey. This model is comprised of decision-making variables which are formulated from a combination of environmental and management criteria, and it has an accept-reject format in which the management options are analyzed in terms of the variables. Through logical ordering of the insertion of the variables into the model, stepwise elimination of alternatives is possible. A hierarchy of variables is determined through estimating work required to complete an assessment of the alternatives for each variable. The assessment requiring the least work is performed first so that the more difficult evaluation will be limited to fewer alternatives. The application of this approach is illustrated with a case study in which beach protection alternatives were evaluated for the United States National Park Service.

A maximum (non-extensive) entropy approach to equity options bid-ask spread

NASA Astrophysics Data System (ADS)

Tapiero, Oren J.

2013-07-01

The cross-section of options bid-ask spreads with their strikes are modelled by maximising the Kaniadakis entropy. A theoretical model results with the bid-ask spread depending explicitly on the implied volatility; the probability of expiring at-the-money and an asymmetric information parameter (κ). Considering AIG as a test case for the period between January 2006 and October 2008, we find that information flows uniquely from the trading activity in the underlying asset to its derivatives. Suggesting that κ is possibly an option implied measure of the current state of trading liquidity in the underlying asset.

Applications of δ-function perturbation to the pricing of derivative securities

NASA Astrophysics Data System (ADS)

Decamps, Marc; De Schepper, Ann; Goovaerts, Marc

2004-11-01

In the recent econophysics literature, the use of functional integrals is widespread for the calculation of option prices. In this paper, we extend this approach in several directions by means of δ-function perturbations. First, we show that results about infinitely repulsive δ-function are applicable to the pricing of barrier options. We also introduce functional integrals over skew paths that give rise to a new European option formula when combined with δ-function potential. We propose accurate closed-form approximations based on the theory of comonotonic risks in case the functional integrals are not analytically computable.

Medical Student Interest in Flexible Residency Training Options.

PubMed

Piotrowski, Madison; Stulberg, Debra; Egan, Mari

2018-05-01

Medical residents continue to experience high rates of burnout during residency training even after implementation of the 2003 Accreditation Council for Graduate Medical Education duty-hour restrictions. The purpose of this study is to determine medical student interest in flexible residency training options. Researchers developed an 11-question survey for second through fourth-year medical students. The populations surveyed included medical students who were: (1) attending the 2015 American Academy of Family Physicians National Conference, the 2015 Family Medicine Midwest Conference, and (2) enrolled at University of Chicago Pritzker School of Medicine, University of Illinois College of Medicine at Chicago, Drexel University College of Medicine, and Case Western Reserve University School of Medicine. The survey was completed by 789 medical students. Over half of medical students surveyed indicated that they would be interested in working part-time during some portion of their residency training (51%), and that access to part-time training options would increase their likelihood of applying to a particular residency program (52%). When given the option of three residency training schedules of varying lengths, 41% of male students and 60% of female students chose a 60-hour workweek, even when that meant extending the residency length by 33% and reducing their yearly salary to $39,000. There is considerable interest among medical students in access to part-time residency training options and reduced-hour residency programs. This level of interest indicates that offering flexible training options could be an effective recruitment tool for residency programs and could improve students' perception of their work-life balance during residency.

CorRECTreatment: A Web-based Decision Support Tool for Rectal Cancer Treatment that Uses the Analytic Hierarchy Process and Decision Tree

PubMed Central

Karakülah, G.; Dicle, O.; Sökmen, S.; Çelikoğlu, C.C.

2015-01-01

Summary Background The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians’ decision making. Objective The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. Methods The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. Results In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. Conclusions The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options. PMID:25848413

CorRECTreatment: a web-based decision support tool for rectal cancer treatment that uses the analytic hierarchy process and decision tree.

PubMed

Suner, A; Karakülah, G; Dicle, O; Sökmen, S; Çelikoğlu, C C

2015-01-01

The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians' decision making. The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options.

Using Revolving Loan Funds to Finance Energy Savings Performance Contracts in State and Local Agency Applications

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

Booth, S.; Doris, E.; Knutson, D.

2011-05-01

Numerous pre-existing and newly emerging state- and locally-managed revolving loan funds (RLFs) are being used in conjunction with energy savings performance contracts (ESPCs) as an option for financing of energy efficiency projects. This document presents an overview of ESPCs and how they fit within the RLF framework. There are a variety of options available to state and local governments to catalyze the disbursement of available capital from RLFs and increase the number of ESPC projects within their jurisdictions. To demonstrate the implementation of this type of financing program in action, this report concludes with four program case studies of state-sponsoredmore » RLFs where ESPCs are an allowed use of funds.« less

Salmonella paratyphi spondylitis: a case report

PubMed Central

Mahmoodi, Seyed Mohsen; Kalaparambil Moosa, Nooruddin; Edgar, Michael; Samt, Hussain Al; Hussain, Riyaz Amirali

2007-01-01

This is a case report of acute L3/4 vertebral osteomyelitis due to Salmonella paratyphi A confirmed by culture from vertebral needle biopsy. From a review of the literature this is the first reported case with bacteriological confirmation. The rarity of Salmonella paratyphi spondylitis and the options for treatment are discussed. PMID:18008092

The case-control design in veterinary sciences: A survey.

PubMed

Cullen, Jonah N; Sargeant, Jan M; Makielski, Kelly M; O'Connor, Annette M

2016-11-01

The case-control study design is deceptively simple. However, many design considerations influence the estimated effect measure. An investigation of case-control studies in the human health literature suggested that some of these considerations are not described in reports of case-control studies. Our hypothesis was that the majority of veterinary studies labeled as case-controls would be incident density designs, and many would not interpret the effect measure obtained from those studies as the rate ratio rather than the odds ratio. Reference databases were searched for author-designated case-control studies. A survey of 100 randomly selected studies was conducted to examine the different design options described and estimated effect measures. Of the 100 author-identified case-control studies, 83 assessed an exposure-outcome association and, of those, only 54 (65.1%) sampled the study population based on an outcome and would thus be considered case-control designs. Twelve studies were incidence density designs but none used this terminology. Of the studies that reported an odds ratio as the effect measure, none reported on additional considerations that would have enabled a more interpretable result. This survey indicated many case-control-labeled studies were not case-control designs and among case-control studies, key design aspects were not often described. The absence of information about study design elements and underlying assumptions in case-control studies limits the ability to establish the effect measured by the study and the evidentiary value of the study might be underestimated. Copyright © 2016 Elsevier B.V. All rights reserved.

Life cycle design metrics for energy generation technologies: Method, data, and case study

NASA Astrophysics Data System (ADS)

Cooper, Joyce; Lee, Seung-Jin; Elter, John; Boussu, Jeff; Boman, Sarah

A method to assist in the rapid preparation of Life Cycle Assessments of emerging energy generation technologies is presented and applied to distributed proton exchange membrane fuel cell systems. The method develops life cycle environmental design metrics and allows variations in hardware materials, transportation scenarios, assembly energy use, operating performance and consumables, and fuels and fuel production scenarios to be modeled and comparisons to competing systems to be made. Data and results are based on publicly available U.S. Life Cycle Assessment data sources and are formulated to allow the environmental impact weighting scheme to be specified. A case study evaluates improvements in efficiency and in materials recycling and compares distributed proton exchange membrane fuel cell systems to other distributed generation options. The results reveal the importance of sensitivity analysis and system efficiency in interpreting case studies.

[Clinical and radiological evolution of a group of untreated acoustic neuromas].

PubMed

Escorihuela-García, Vicente; Llópez-Carratalá, Ignacio; Orts-Alborch, Miguel; Marco-Algarra, Jaime

2014-01-01

The acoustic neuroma is a benign tumour that originates in the vestibular branch of the eighth cranial nerve. The main treatment is surgery, but many authors suggest that with elderly patients or in small neuromas we can opt for watchful waiting. This was a retrospective study from 2007 to 2013 that included 27 patients diagnosed of acoustic neuroma that had not been treated due to the size of the tumour, age and comorbidities, or by patient choice. We evaluated overall condition, hearing thresholds, degree of canal paresis and central disorders. After 6 years of follow up, clinical manifestations of 18 patients remained unchanged, 5 patients underwent hearing loss and developed tinnitus, 2 cases had more intense tinnitus and 2 cases had dizziness. The radiological controls by magnetic resonance imaging showed that the initial maximum diameters (5-16mm) increased by 1.7mm on average, with annual growth rates below 0.5mm. In selected cases, such as for small neuromas and in elderly patients, the conservative option of close monitoring with magnetic resonance imaging is an important alternative given that, in our cases, clinical features and radiological image did not suffer major changes. If there were any such changes, therapeutic options could be proposed. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

"Best Case/Worst Case": Qualitative Evaluation of a Novel Communication Tool for Difficult in-the-Moment Surgical Decisions.

PubMed

Kruser, Jacqueline M; Nabozny, Michael J; Steffens, Nicole M; Brasel, Karen J; Campbell, Toby C; Gaines, Martha E; Schwarze, Margaret L

2015-09-01

To evaluate a communication tool called "Best Case/Worst Case" (BC/WC) based on an established conceptual model of shared decision-making. Focus group study. Older adults (four focus groups) and surgeons (two focus groups) using modified questions from the Decision Aid Acceptability Scale and the Decisional Conflict Scale to evaluate and revise the communication tool. Individuals aged 60 and older recruited from senior centers (n = 37) and surgeons from academic and private practices in Wisconsin (n = 17). Qualitative content analysis was used to explore themes and concepts that focus group respondents identified. Seniors and surgeons praised the tool for the unambiguous illustration of multiple treatment options and the clarity gained from presentation of an array of treatment outcomes. Participants noted that the tool provides an opportunity for in-the-moment, preference-based deliberation about options and a platform for further discussion with other clinicians and loved ones. Older adults worried that the format of the tool was not universally accessible for people with different educational backgrounds, and surgeons had concerns that the tool was vulnerable to physicians' subjective biases. The BC/WC tool is a novel decision support intervention that may help facilitate difficult decision-making for older adults and their physicians when considering invasive, acute medical treatments such as surgery. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Upfront chemotherapy and subsequent resection for molecularly defined gliomas.

PubMed

Sasaki, Hikaru; Hirose, Yuichi; Yazaki, Takahito; Kitamura, Yohei; Katayama, Makoto; Kimura, Tokuhiro; Fujiwara, Hirokazu; Toda, Masahiro; Ohira, Takayuki; Yoshida, Kazunari

2015-08-01

Functional preservation is critical in glioma surgery, and the extent of resection influences survival outcome. Neoadjuvant chemotherapy is a promising option because of its potential to facilitate tumor shrinkage and maximum tumor resection. The object of this study was to assess the utility of the neoadjuvant strategy in a prospective series of gliomas with favorable molecular status. Twenty-six consecutive cases of diffuse gliomas of WHO grade II or III with either 1p19q codeletion or MGMT methylation were treated with upfront chemotherapy following maximal safe removal. In cases of incomplete initial surgery, second-look resection was intended after tumor volume decrease by chemotherapy. Among 22 evaluable cases, chemotherapy led to a median change in the sum of the product of perpendicular diameters of -35 %, and 14 out of the 22 cases (64 %) showed objective response. Second-look resection after tumor volume decrease was performed in 12 out of 19 cases of incomplete initial surgery (GTR/STR 9, removal of residual methionine PET uptake 3). The median progression-free survival among the 22 patients with grade II tumors was 57 months, with some cases showing durable progression-free survival after second-look resection. MIB-1 indices of the second-look resected tumors were lower than those of the initial tumors, and the methylation status of the MGMT gene was unchanged. Neoadjuvant chemotherapy based on molecular guidance often produces significant volume decrease of incompletely resected gliomas. Radical second-look resection is an optional advantage of upfront chemotherapy for chemosensitive gliomas compared with initial radiotherapy.

Surgical options for treatment of traumatic subdural hematomas in children younger than 2 years of age.

PubMed

Melo, José Roberto Tude; Di Rocco, Federico; Bourgeois, Marie; Puget, Stephanie; Blauwblomme, Thomas; Sainte-Rose, Christian; Meyer, Philippe G; Zerah, Michel

2014-04-01

Subdural hematoma (SDH) is the most common finding on cranial CT in pediatric victims of abusive head trauma (AHT). The hematomas are commonly bilateral and sometimes associated with interhemispheric hyperdensity and/or convexity hemorrhages. There is no consensus regarding the best surgical treatment in such cases nor are there standardized surgical protocols. The authors report their experience and discuss the routine surgical options in the management of traumatic SDH at a Level 1 Pediatric Trauma Center. In this paper, the authors describe a cross-sectional study with consecutive revision of data described in the medical records of Hôpital Universitaire Necker-Enfants Malades between January 2008 and January 2013. During this period, all children younger than 2 years of age who were admitted with a traumatic SDH identified on CT scans were included in this study. One hundred eighty-four children who had SDH and were younger than 2 years of age were included. Their median age was 5.8 months (range 5 days-23 months), and 70% of the children were male. On admission CT scans, the SDH was bilateral in 52% of cases and homogeneously hypodense in 77%. Neurosurgical treatment was undertaken in 111 children (60%) with an admission Glasgow Coma Scale score of 12 or less, bulging fontanels, or other signs suggestive of intracranial hypertension. The first surgical option was craniotomy in 1.8% (2) of these 111 cases, decompressive craniectomy in 1.8% (2), transcutaneous subdural puncture in 15% (17), external subdural drainage in 16% (18), subdural-subgaleal shunt placement in 17% (19), and subdural-peritoneal shunt placement in 48% (53). In 82% of the children initially treated with transcutaneous subdural puncture and in 50% of those treated with external subdural drainage, increase or persistence of the SDH, CSF or skin infection, or shunt system malfunction was observed and further surgical intervention was required. There was a 26% rate of complications in patients initially treated with a subdural-peritoneal shunt. Although 52% of the patients had bilateral SDH, bilateral drainage was only required in 9.4%. The choice of treatment should be determined by the clinical and radiological characteristics of the individual case. Although effective on an emergency basis, subdural puncture and external subdural drainage are frequently insufficient to obtain complete resolution of SDH, and temporary placement of a subdural-peritoneal shunt is needed in most cases.

Bupivacaine administered intrathecally versus rectally in the management of intractable rectal cancer pain in palliative care

PubMed Central

Zaporowska-Stachowiak, Iwona; Kowalski, Grzegorz; Łuczak, Jacek; Kosicka, Katarzyna; Kotlinska-Lemieszek, Aleksandra; Sopata, Maciej; Główka, Franciszek

2014-01-01

Background Unacceptable adverse effects, contraindications to and/or ineffectiveness of World Health Organization step III “pain ladder” drugs causes needless suffering among a population of cancer patients. Successful management of severe cancer pain may require invasive treatment. However, a patient’s refusal of an invasive procedure necessitates that clinicians consider alternative options. Objective Intrathecal bupivacaine delivery as a viable treatment of intractable pain is well documented. There are no data on rectal bupivacaine use in cancer patients or in the treatment of cancer tenesmoid pain. This study aims to demonstrate that bupivacaine administered rectally could be a step in between the current treatment options for intractable cancer pain (conventional/conservative analgesia or invasive procedures), and to evaluate the effect of the mode of administration (intrathecal versus rectal) on the bupivacaine plasma concentration. Cases We present two Caucasian, elderly inpatients admitted to hospice due to intractable rectal/tenesmoid pain. The first case is a female with vulvar cancer, and malignant infiltration of the rectum/vagina. Bupivacaine was used intrathecally (0.25–0.5%, 1–2 mL every 6 hours). The second case is a female with ovarian cancer and malignant rectal infiltration. Bupivacaine was adminstered rectally (0.05–0.1%, 100 mL every 4.5–11 hours). Methods Total bupivacaine plasma concentrations were determined using the high-performance liquid chromatography-ultraviolet method. Results Effective pain control was achieved with intrathecal bupivacaine (0.077–0.154 mg·kg−1) and bupivacaine in enema (1.820 mg·kg−1). Intrathecal bupivacaine (0.5%, 2 mL) caused a drop in blood pressure; other side effects were absent in both cases. Total plasma bupivacaine concentrations following intrathecal and rectal bupivacaine application did not exceed 317.2 ng·mL−1 and 235.7 ng·mL−1, respectively. Bupivacaine elimination was slower after rectal than after intrathecal administration (t½= 5.50 versus 2.02 hours, respectively). Limitations This study reports two cases only, and there could be inter-patient variation. Conclusion Bupivacaine in boluses administered intrathecally (0.25%, 2 mL) provided effective, safe analgesia in advanced cancer patients. Bupivacaine enema (100 mg·100 mL−1) was shown to be a valuable option for control of end-of-life tenesmoid cancer pain. PMID:25336967

The Governance Divide: A Report on a Four-State Study on Improving College Readiness and Success. National Center Report #05-3

ERIC Educational Resources Information Center

Venezia, Andrea; Callan, Patrick M.; Finney, Joni E.; Kirst, Michael W.; Usdan, Michael D.

2005-01-01

This report, supported by case studies in Florida (ED508098), Georgia (ED508099), New York (ED508100), and Oregon (ED508101), identifies and examines policy options available to states that are interested in creating sustained K-16 reform. The findings move the K-16 agenda forward by proposing a set of state policy levers that can be used to…

Valuing natural gas power generation assets in the new competitive marketplace

NASA Astrophysics Data System (ADS)

Hsu, Michael Chun-Wei

1999-10-01

The profitability of natural gas fired power plants depends critically on the spread between electricity and natural gas prices. The price levels of these two energy commodities are the key uncertain variables in determining the operating margin and therefore the value of a power plant. The owner of a generation unit has the decision of dispatching the plant only when profit margins are positive. This operating flexibility is a real option with real value. In this dissertation I introduce the spark spread call options and illustrate how such paper contracts replicate the uncertain payoff space facing power asset owners and, therefore, how the financial options framework can be applied in estimating the value of natural gas generation plants. The intrinsic value of gas power plants is approximated as the sum of a series of spark spread call options with succeeding maturity dates. The Black-Scholes spread option pricing model, with volatility and correlation term structure adjustments, is utilized to price the spark spread options. Sensitivity analysis is also performed on the BS spread option formulation to compare different asset types. In addition I explore the potential of using compound and compound-exchange option concepts to evaluate, respectively, the benefits of delaying investment in new generation and in repowering existing antiquated units. The compound option designates an option on top of another option. In this case the series of spark spread call options is the 'underlying' option while the option to delay new investments is the 'overlying.' The compound-exchange option characterizes the opportunity to 'exchange' the old power plant, with its series of spark spread call options, for a set of new spark spread call options that comes with the new generation unit. The strike price of the compound-exchange option is the repowering capital investment and typically includes the purchase of new steam generators and combustion turbines, as well as other facility upgrades. The pricing results using the proposed repowering option approach is compared to the sale prices from recent power plant auctions. Sensitivity of the repowering option model is also examined and the critical parameters al parameters identified.

Kinematic and fatigue biomechanics of an interpositional facet arthroplasty device.

PubMed

Dahl, Michael C; Freeman, Andrew L

2016-04-01

Although approximately 30% of chronic lumbar pain can be attributed to the facets, limited surgical options exist for patients. Interpositional facet arthroplasty (IFA) is a novel treatment for lumbar facetogenic pain designed to provide patients who gain insufficient relief from medical interventional treatment options with long-term relief, filling a void in the facet pain treatment continuum. This study aimed to quantify the effect of IFA on segmental range of motion (ROM) compared with the intact state, and to observe device position and condition after 10,000 cycles of worst-case loading. In situ biomechanical analysis of the lumbar spine following implantation of a novel IFA device was carried out. Twelve cadaveric functional spinal units (L2-L3 and L5-S1) were tested in 7.5 Nm flexion-extension, lateral bending, and torsion while intact and following device implantation. Additionally, specimens underwent 10,000 cycles of worst-case complex loading and were testing in ROM again. Load-displacement and fluoroscopic data were analyzed to determine ROM and to evaluate device position during cyclic testing. Devices and facets were evaluated post testing. Institutional support for implant evaluation was received by Zyga Technology. Range of motion post implantation decreased versus intact, and then was restored post cyclic-testing. Of the tested devices, 6.5% displayed slight movement (0.5-2 mm), all from tight L2-L3 facet joints with misplaced devices or insufficient cartilage. No damage was observed on the devices, and wear patterns were primarily linear. The results from this in situ cadaveric biomechanics and cyclic fatigue study demonstrate that a low-profile, conformable IFA device can maintain position and facet functionality post implantation and through 10,000 complex loading cycles. In vivo conditions were not accounted for in this model, which may affect implant behavior not predictable via a biomechanical study. However, these data along with published 1-year clinical results suggest that IFA may be a valid treatment option in patients with chronic lumbar zygapophysial pain who have exhausted medical interventional options. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Energy conserving site design case study: Shenandoah, Georgia. Final report

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

Not Available

The case study examines the means by which energy conservation can be achieved at an aggregate community level by using proper planning and analytical techniques for a new town, Shenandoah, Georgia, located twenty-five miles southwest of Atlanta's Hartsfield International Airport. A potentially implementable energy conservation community plan is achieved by a study team examining the land use options, siting characteristics of each building type, alternate infrastructure plans, possible decentralized energy options, and central utility schemes to determine how community energy conservation can be achieved by use of pre-construction planning. The concept for the development of mixed land uses as amore » passively sited, energy conserving community is based on a plan (Level 1 Plan) that uses the natural site characteristics, maximizes on passive energy siting requirement, and allows flexibility for the changing needs of the developers. The Level 2 Plan is identical with Level 1 plan plus a series of decentraized systems that have been added to the residential units: the single-family detached, the apartments, and the townhouses. Level 3 Plan is similar to the Level 1 Plan except that higher density dwellings have been moved to areas adjacent to central site. The total energy savings for each plan relative to the conventional plan are indicated. (MCW)« less

Development of sustainable waste management toward zero landfill waste for the petrochemical industry in Thailand using a comprehensive 3R methodology: A case study.

PubMed

Usapein, Parnuwat; Chavalparit, Orathai

2014-06-01

Sustainable waste management was introduced more than ten years ago, but it has not yet been applied to the Thai petrochemical industry. Therefore, under the philosophy of sustainable waste management, this research aims to apply the reduce, reuse, and recycle (3R) concept at the petrochemical factory level to achieve a more sustainable industrial solid waste management system. Three olefin plants in Thailand were surveyed for the case study. The sources and types of waste and existing waste management options were identified. The results indicate that there are four sources of waste generation: (1) production, (2) maintenance, (3) waste treatment, and (4) waste packaging, which correspond to 45.18%, 36.71%, 9.73%, and 8.37% of the waste generated, respectively. From the survey, 59 different types of industrial wastes were generated from the different factory activities. The proposed 3R options could reduce the amount of landfill waste to 79.01% of the amount produced during the survey period; this reduction would occur over a period of 2 years and would result in reduced disposal costs and reduced consumption of natural resources. This study could be used as an example of an improved waste management system in the petrochemical industry. © The Author(s) 2014.

Making the business case for enhanced depression care: the National Institute of Mental Health-harvard Work Outcomes Research and Cost-effectiveness Study.

PubMed

Wang, Philip S; Simon, Gregory E; Kessler, Ronald C

2008-04-01

Explore the business case for enhanced depression care and establish a return on investment rationale for increased organizational involvement by employer-purchasers. Literature review, focused on the National Institute of Mental Health-sponsored Work Outcomes Research and Cost-effectiveness Study. This randomized controlled trial compared telephone outreach, care management, and optional psychotherapy to usual care among depressed workers in large national corporations. By 12 months, the intervention significantly improved depression outcomes, work retention, and hours worked among the employed. Results of the Work Outcomes Research and Cost-effectiveness Study trial and other studies suggest that enhanced depression care programs represent a human capital investment opportunity for employers.

26 CFR 1.612-4 - Charges to capital and to expense in case of oil and gas wells.

Code of Federal Regulations, 2010 CFR

2010-04-01

... rights) in the development of oil and gas properties may at his option be chargeable to capital or to... installation of physical property which has a salvage value. Included in this option are all costs of drilling and development undertaken (directly or through a contract) by an operator of an oil and gas property...

The modified Black-Scholes model via constant elasticity of variance for stock options valuation

NASA Astrophysics Data System (ADS)

Edeki, S. O.; Owoloko, E. A.; Ugbebor, O. O.

2016-02-01

In this paper, the classical Black-Scholes option pricing model is visited. We present a modified version of the Black-Scholes model via the application of the constant elasticity of variance model (CEVM); in this case, the volatility of the stock price is shown to be a non-constant function unlike the assumption of the classical Black-Scholes model.

Bounds for Asian basket options

NASA Astrophysics Data System (ADS)

Deelstra, Griselda; Diallo, Ibrahima; Vanmaele, Michèle

2008-09-01

In this paper we propose pricing bounds for European-style discrete arithmetic Asian basket options in a Black and Scholes framework. We start from methods used for basket options and Asian options. First, we use the general approach for deriving upper and lower bounds for stop-loss premia of sums of non-independent random variables as in Kaas et al. [Upper and lower bounds for sums of random variables, Insurance Math. Econom. 27 (2000) 151-168] or Dhaene et al. [The concept of comonotonicity in actuarial science and finance: theory, Insurance Math. Econom. 31(1) (2002) 3-33]. We generalize the methods in Deelstra et al. [Pricing of arithmetic basket options by conditioning, Insurance Math. Econom. 34 (2004) 55-57] and Vanmaele et al. [Bounds for the price of discrete sampled arithmetic Asian options, J. Comput. Appl. Math. 185(1) (2006) 51-90]. Afterwards we show how to derive an analytical closed-form expression for a lower bound in the non-comonotonic case. Finally, we derive upper bounds for Asian basket options by applying techniques as in Thompson [Fast narrow bounds on the value of Asian options, Working Paper, University of Cambridge, 1999] and Lord [Partially exact and bounded approximations for arithmetic Asian options, J. Comput. Finance 10 (2) (2006) 1-52]. Numerical results are included and on the basis of our numerical tests, we explain which method we recommend depending on moneyness and time-to-maturity.

[Aneurysms of the deep femoral artery: a systematic review of literature].

PubMed

Tsilimparis, N; Faber, E; Zindler, K; Mohammad, W; Hanack, U; Yousefi, S; Rückert, R I

2012-10-01

True aneurysms of the deep femoral artery (APFA) are rare and are usually presented as case reports. Recommendations for diagnostics and therapy of APFAs are based on low-level evidence only. The purpose of this paper was to summarise the existing world experience with APFA. On the occasion of our own case a systematic review of the literature was performed for diagnostics and therapy for true APFA. Publications retrieved from PubMed, EMBASE, and the Cochrane Collaboration as well as by hand search from their references were reviewed. From 2002 onwards 25 papers on true APFAs were published in the English and German literature. Apart from two retrospective studies over a longer period of time these were exclusively case reports. A total of 55 true APFAs were reported in 47 patients with a mean age of 63 years. Therapeutic intervention was due to a rupture in 10 cases (18 %). The mean maximal diameter of APFA at presentation was 5.4 cm (2-18 cm). APFAs that were not ruptured presented frequently as a painful pulsatile mass in the groin and thigh. Therapeutic options for APFA included, apart from surgical resection with or without reconstruction of the deep femoral artery, the endovascular repair. Symptoms of swelling and pain in the presence of a mass at the proximal thigh should raise the suspicion of an APFA. Surgical therapy should be performed electively in APFAs with a diameter of more than 2 cm or in cases of rapid progression as well as in all symptomatic or ruptured cases. The endovascular approach should be considered as an alternative option in all cases. Georg Thieme Verlag KG Stuttgart · New York.

Pudendal nerve neuromodulation with neurophysiology guidance: a potential treatment option for refractory chronic pelvi-perineal pain.

PubMed

Carmel, Maude; Lebel, Michel; Tu, Le Mai

2010-05-01

Refractory chronic pelvi-perineal pain (RCPPP) is a challenging entity that has devastating consequences for patient's quality of life. Many etiologies have been proposed including pudendal neuralgia. Multiple treatment options are used but the reported results are sub-optimal and temporary. In this article, we present the technique of pudendal nerve neuromodulation with neurophysiology guidance as a treatment option for RCPPP. This technique is a two-step procedure that includes electrode implantation under neurophysiology guidance followed by the implantation of a permanent generator after a successful trial period. We report the cases of three women who underwent this procedure as a last-resort treatment option. After 2 years of follow-up, their symptoms are still significantly improved. No major complication occurred.

Broadening the use of antiretroviral therapy: the case for feline leukemia virus

PubMed Central

Greggs, Willie M; Clouser, Christine L; Patterson, Steven E; Mansky, Louis M

2011-01-01

Antiretroviral drugs have saved and extended the lives of millions of individuals infected with HIV. The major classes of anti-HIV drugs include reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, and entry/fusion inhibitors. While antiretroviral drug regimens are not commonly used to treat other types of retroviral infections, there are instances where there is a perceived need for re-evaluation of the benefits of antiretroviral therapy. One case in point is that of feline leukemia virus (FeLV), an infection of companion felines. While vaccines exist to prevent FeLV infection and spread, they have not eliminated FeLV infection. For FeLV-infected felines and their human companions, antiretroviral therapy would be desirable and of practical importance if good options were available. Here, we discuss FeLV biology and current treatment options, and propose that there is a need for antiretroviral treatment options for FeLV infection. The comparative use and analysis of antiretroviral therapy can provide new insights into the mechanism of antiretroviral drug action. PMID:21479142

There's life in the old dog yet: vitamin C as a therapeutic option in endothelial dysfunction.

PubMed

Rodemeister, Sandra; Biesalski, Hans K

2014-08-27

The use of vitamin C against different diseases has been controversially and emotionally discussed since Linus Pauling published his cancer studies. In vitro and animal studies showed promising results and explained the impact of vitamin C, particularly in cases with endothelial dysfunction. Indeed, studies (reviewed in this issue of Critical Care by Oudemans-van Straaten and colleagues) using high-dose vitamin C and the parenteral route of application seem to be more successful than oral vitamin C delivery.

For the last time: stock options are an expense.

PubMed

Bodie, Zvi; Kaplan, Robert S; Merton, Robert C

2003-03-01

Should stock options be recorded as an expense on a company's income statement and balance sheet, or should they remain where they are, relegated to footnotes? The extraordinary boom in share prices during the Internet bubble made critics of option expensing look like spoilsports. But since the crash, the debate has returned with a vengeance. And no wonder: The authors believe the case for expensing options is overwhelming. In this article, Nobel Iaureate Robert Merton, one of the inventors of the Black-Scholes option-pricing model; his coauthor on the classic textbook Finance, Zvi Bodie; and Robert Kaplan, creator of the Balanced Scorecard, examine and dismiss the principal claims put forward by those who continue to oppose options expensing. They demonstrate that stock-option grants do indeed have real cash-flow implications that need to be reported. They show that effective ways certainly exist to quantify those implications. They detail the distortions that relegating stock-option accounting to footnotes creates. And they show why reporting option costs should in no way hamper young companies in their efforts to provide incentives. Options are indeed a powerful incentive, the authors agree, and failing to record a transaction that creates such powerful effects is economically indefensible. Worse, it encourages companies to favor options over alternative incentive systems. It is not the proper role of accounting standards, the authors argue, to distort executive and employee compensation by subsidizing one particular form of compensation and no other. Companies should choose compensation methods according to their economic benefits--not the way they are reported.

Risk Segmentation Related to the Offering of a Consumer-Directed Health Plan: A Case Study of Humana Inc.

PubMed Central

Tollen, Laura A; Ross, Murray N; Poor, Stephen

2004-01-01

Objective To determine whether the offering of a consumer-directed health plan (CDHP) is likely to cause risk segmentation in an employer group. Study Setting and Data Source The study population comprises the approximately 10,000 people (employees and dependents) enrolled as members of the employee health benefit program of Humana Inc. at its headquarters in Louisville, Kentucky, during the benefit years starting July 1, 2000, and July 1, 2001. This analysis is based on primary collection of claims, enrollment, and employment data for those employees and dependents. Study Design This is a case study of the experience of a single employer in offering two consumer-directed health plan options (“Coverage First 1” and “Coverage First 2”) to its employees. We assessed the risk profile of those choosing the Coverage First plans and those remaining in more traditional health maintenance organization (HMO) and preferred provider organization (PPO) coverage. Risk was measured using prior claims (in dollars per member per month), prior utilization (admissions/1,000; average length of stay; prescriptions/1,000; physician office visit services/1,000), a pharmacy-based risk assessment tool (developed by Ingenix), and demographics. Data Collection/Extraction Methods Complete claims and administrative data were provided by Humana Inc. for the two-year study period. Unique identifiers enabled us to track subscribers' individual enrollment and utilization over this period. Principal Findings Based on demographic data alone, there did not appear to be a difference in the risk profiles of those choosing versus not choosing Coverage First. However, based on prior claims and prior use data, it appeared that those who chose Coverage First were healthier than those electing to remain in more traditional coverage. For each of five services, prior-year usage by people who subsequently enrolled in Coverage First 1 (CF1) was below 60 percent of the average for the whole group. Hospital and maternity admissions per thousand were less than 30 percent of the overall average; length of stay per hospital admission, physician office services per thousand, and prescriptions per thousand were all between 50 and 60 percent of the overall average. Coverage First 2 (CF2) subscribers' prior use of services was somewhat higher than CF1 subscribers', but it was still below average in every category. As with prior use, prior claims data indicated that Coverage First subscribers were healthier than average, with prior total claims less than 50 percent of average. Conclusions In this case, the offering of high-deductible or consumer-directed health plan options alongside more traditional options caused risk segmentation within an employer group. The extent to which these findings are applicable to other cases will depend on many factors, including the employer premium contribution policies and employees' perception of the value of the various plan options. Further research is needed to determine whether risk segmentation will worsen in future years for this employer and if so, whether it will cause premiums for more traditional health plans to increase. PMID:15230919

Strategy for the Identification of an INL Comprehensive Utility Corridor

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

John Reisenauer

2011-05-01

This report documents the strategy developed to identify a comprehensive utility corridor (CUC) on the Idaho National Laboratory (INL) Site. The strategy established the process for which the Campus Development Office will evaluate land management issues. It is a process that uses geographical information system geospatial technology to layer critical INL mission information in a way that thorough evaluations can be conducted and strategies developed. The objective of the CUC Project was to develop a process that could be implemented to identify potential utility corridor options for consideration. The process had to take into account all the missions occurring onmore » the INL and other land-related issues. The process for developing a CUC strategy consists of the following four basic elements using geographical information system capabilities: 1. Development of an INL base layer map; this base layer map geospatially references all stationary geographical features on INL and sitewide information. 2. Development of current and future mission land-use need maps; this involved working with each directorate to identify current mission land use needs and future land use needs that project 30 years into the future. 3. Development of restricted and potential constraint maps; this included geospatially mapping areas such as wells, contaminated areas, firing ranges, cultural areas, ecological areas, hunting areas, easement, and grazing areas. 4. Development of state highway and power line rights of way map; this included geospatially mapping rights-of-way along existing state highways and power lines running through the INL that support INL operations. It was determined after completing and evaluating the geospatial information that the area with the least impact to INL missions was around the perimeter of the INL Site. Option 1, in this document, identifies this perimeter; however, it does not mean the entire perimeter is viable. Many places along the perimeter corridor cannot be used or are not economically viable. Specific detailed studies will need to be conducted on a case-by-case basis to clearly identify which sections along the perimeter can and cannot be used. Option 2, in this document, identifies areas along existing highways that could be a viable option. However, discussions would have to take place with the State of Idaho to use their easement as part of the corridor and mission impact would need to be evaluated if a specific request was made to the Department of Energy, Idaho Operations Office. Option 3, in this document, is a combination of Options 1 and 2. This option provides the most flexibility to minimize impacts to INL missions. As with the other two options, discussions and agreements with the State of Idaho would be needed and any specific route would need to be thoroughly evaluated for impact, implementation, and operability beyond just a strategy.« less

Industrial Scale Energy Systems Integration; NREL (National Renewable Energy Laboratory)

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

Ruth, Mark

2015-07-28

The industrial sector consumes 25% of the total energy in the U.S. and produces 18% of the greenhouse gas (GHG) emissions. Energy Systems Integration (ESI) opportunities can reduce those values and increase the profitability of that sector. This presentation outlines several options. Combined heat and power (CHP) is an option that is available today for many applications. In some cases, it can be extended to trigeneration by adding absorbtion cooling. Demand response is another option in use by the industrial sector - in 2012, industry provided 47% of demand response capacity. A longer term option that combines the benefits ofmore » CHP with those of demand response is hybrid energy systems (HESs). Two possible HESs are described and development implications discussed. extended to trigeneration by adding absorbtion cooling. Demand response is another option in use by the industrial sector - in 2012, industry provided 47% of demand response capacity. A longer term option that combines the benefits of CHP with those of demand response is hybrid energy systems (HESs). Two possible HESs are described and development implications discussed.« less

Orthodontic management of a dental concrescence: a case report.

PubMed

Stanford, Nicky David; Hosni, Sara; Morris, Tim

2017-09-01

Dental concrescence is a rare dental abnormality resulting in the joining of two teeth at the level of the cementum. This is the first reported case of the orthodontic management of a dental concrescence and the options for patient treatment are discussed. In this case, a compromised occlusal result was accepted with restorative masking of the affected teeth.

Dornase Alfa for Non-Cystic Fibrosis Pediatric Pulmonary Atelectasis.

PubMed

Thornby, Krisy-Ann; Johnson, Ashley; Axtell, Samantha

2014-08-01

To review the literature evaluating the efficacy of dornase alfa for non-cystic fibrosis pediatric patients with pulmonary atelectasis. Articles were retrieved after a search of MEDLINE/PubMed (1946 to April 2014), and International Pharmaceutical Abstracts (1970-April 2014) was performed using the terms dornase alfa, recombinant human deoxyribonuclease, pulmonary, persistent, and atelectasis. Other relevant articles referenced from the MEDLINE search were also utilized. Data sources were limited to English language clinical trials and case studies including only children; 8 clinical trials and 12 case reports met the criteria. Dornase alfa is used as an off-label treatment option for pulmonary atelectasis because limited treatment modalities exist after conventional therapy has failed. We evaluated 8 clinical trials and 12 case reports involving this pediatric population with varying primary diagnoses. The majority of patients experienced improvement in atelectasis, suggesting benefit after receiving treatment with dornase alfa. However, the outcomes were possibly confounded by those receiving combination therapies, varying primary diagnoses, and varying end points evaluated. Dornase alfa was overall well tolerated, with only a few patients experiencing worsening atelectasis posttreatment. Dornase alfa may be considered as a therapeutic option in non-cystic fibrosis pediatric patients with pulmonary atelectasis, who require treatment intervention when conventional therapy is unsuccessful. © The Author(s) 2014.

The combined value of wind and solar power forecasting improvements and electricity storage

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

Hodge, Bri-Mathias; Brancucci Martinez-Anido, Carlo; Wang, Qin

As the penetration rates of variable renewable energy increase, the value of power systems operation flexibility technology options, such as renewable energy forecasting improvements and electricity storage, is also assumed to increase. In this work, we examine the value of these two technologies, when used independently and concurrently, for two real case studies that represent the generation mixes for the California and Midcontinent Independent System Operators (CAISO and MISO). Since both technologies provide additional system flexibility they reduce operational costs and renewable curtailment for both generation mixes under study. Interestingly, the relative impacts are quite similar when both technologies aremore » used together. Though both flexibility options can solve some of the same issues that arise with high penetration levels of renewables, they do not seem to significantly increase or decrease the economic potential of the other technology.« less

The combined value of wind and solar power forecasting improvements and electricity storage

DOE PAGES

Hodge, Bri-Mathias; Brancucci Martinez-Anido, Carlo; Wang, Qin; ...

2018-02-12

As the penetration rates of variable renewable energy increase, the value of power systems operation flexibility technology options, such as renewable energy forecasting improvements and electricity storage, is also assumed to increase. In this work, we examine the value of these two technologies, when used independently and concurrently, for two real case studies that represent the generation mixes for the California and Midcontinent Independent System Operators (CAISO and MISO). Since both technologies provide additional system flexibility they reduce operational costs and renewable curtailment for both generation mixes under study. Interestingly, the relative impacts are quite similar when both technologies aremore » used together. Though both flexibility options can solve some of the same issues that arise with high penetration levels of renewables, they do not seem to significantly increase or decrease the economic potential of the other technology.« less

Modeling trade-offs between fire threat reduction and late-seral forest structure.

Treesearch

David E. Calkin; Susan Stevens Hummel; James K. Agee

2005-01-01

Evaluating the effects of managing for one forest resource in terms of associated impacts on other resources is not easy. Yet methods to identify potential trade-offs among forest resources are necessary to inform people about the implications of management options on public land. This paper uses a case study from a forest reserve in the northwestern United States to...

Integrated modeling of water supply and demand under management options and climate change scenarios in Chifeng City, China

Treesearch

Lu Hao; Ge Sun; Yongqiang Liu; Hong Qian

2015-01-01

Water resource management is becoming increasingly challenging in northern China because of the rapid increase in water demand and decline in water supply due to climate change. We provide a case study demonstrating the importance of integrated watershed management in sustaining water resources in Chifeng City, northern China. We examine the consequences of various...

McCormick's Mayhem: "The Time To Learn To Dance Is Not Five Minutes before the Party." School Crisis Management Case Study.

ERIC Educational Resources Information Center

Bouleris, Sue; Collett, De Ette; Mauntler, Mike; Ray, Shirley

This paper discusses the importance of a school's having procedures in place to deal with possible biological terrorist threats. It begins with a discussion of biological terrorism. It then provides the symptoms of anthrax, treatment options for anthrax, and precautions to take when suspicious of an attack with a hazardous material. The paper goes…

Defining Victory: Three Case Studies of Strategic Guidance and Decision Making

DTIC Science & Technology

2004-06-18

options to formulate guidance? Finally, did the decision makers adequately revisit their decisions in order to adapt to changing situations? The U.S...to leave guidance unchanged in the face of changing political circumstances. Both military and civilian leaders generally discounted the...unpredictable impact of military actions themselves on the strategic goals and therefore failed to adapt to changing situations. iv ACKNOWLEDGMENTS This

Candidate CDTI procedures study

NASA Technical Reports Server (NTRS)

Ace, R. E.

1981-01-01

A concept with potential for increasing airspace capacity by involving the pilot in the separation control loop is discussed. Some candidate options are presented. Both enroute and terminal area procedures are considered and, in many cases, a technologically advanced Air Traffic Control structure is assumed. Minimum display characteristics recommended for each of the described procedures are presented. Recommended sequencing of the operational testing of each of the candidate procedures is presented.

Immunotherapy for lung cancer: advances and prospects.

PubMed

Yang, Li; Wang, Liping; Zhang, Yi

2016-01-01

Lung cancer is the most commonly diagnosed cancer as well as the leading cause of cancer-related deaths worldwide. To date, surgery is the first choice treatment, but most clinically diagnosed cases are inoperable. While chemotherapy and/or radiotherapy are the next considered options for such cases, these treatment modalities have adverse effects and are sometimes lethal to patients. Thus, new effective strategies with minimal side effects are urgently needed. Cancer immunotherapy provides either active or passive immunity to target tumors. Multiple immunotherapy agents have been proposed and tested for potential therapeutic benefit against lung cancer, and some pose fewer side effects as compared to conventional chemotherapy and radiotherapy. In this article, we discuss studies focusing on interactions between lung cancer and the immune system, and we place an emphasis on outcome evidence in order to create a knowledge base well-grounded in clinical reality. Overall, this review highlights the need for new lung cancer treatment options, with much ground to be paved for future advances in the field. We believe that immunotherapy agents alone or with other forms of treatment can be recognized as next modality of lung cancer treatment.

Application of finite element analysis in pre-operative planning for deformity correction of abnormal hip joints--a case series.

PubMed

Rhyu, K H; Kim, Y H; Park, W M; Kim, K; Cho, T-J; Choi, I H

2011-09-01

In experimental and clinical research, it is difficult to directly measure responses in the human body, such as contact pressure and stress in a joint, but finite element analysis (FEA) enables the examination of in vivo responses by contact analysis. Hence, FEA is useful for pre-operative planning prior to orthopaedic surgeries, in order to gain insight into which surgical options will result in the best outcome. The present study develops a numerical simulation technique based on FEA to predict the surgical outcomes of osteotomy methods for the treatment of slipped capital femoral epiphyses. The correlation of biomechanical parameters including contact pressure and stress, for moderate and severe cases, is investigated. For severe slips, a base-of-neck osteotomy is thought to be the most reliable and effective surgical treatment, while any osteotomy may produce dramatic improvement for moderate slips. This technology of pre-operative planning using FEA can provide information regarding biomechanical parameters that might facilitate the selection of optimal osteotomy methods and corresponding surgical options.

Oral rehabilitation of a patient with amelogenesis imperfecta using removable overlay denture: a clinical report.

PubMed

Ghodsi, S; Rasaeipour, S; Vojdani, M

2012-03-01

The aim of this study was oral rehabilitation of 17-year old patient with amelogenesis imperfecta using removable overlay denture in order to satisfy her esthetic and functional expectations and enhance her self-image. Amelogenesis imperfecta (AI) is a group of genetic disorders that primarily affect the quality and quantity of amelogenesis in both primary and permanent dentitions. The main clinical characteristics are severe attrition, tooth sensitivity and unesthetic appearance. This clinical report illustrates the oral rehabilitation of a 17-year-old girl with hypoplastic-hypomature type of AI with cobalt-chromium (Co-Cr) overlay removable partial denture (ORPD) that is one of the most economical and biocompatible replacements for noble metal and nickel-chromium (Ni-Cr) alloy. The presented case report suggests that Co-Cr ORPD can be a good temporary or even permanent treatment option for AI patients with limited budget, low esthetic concerns or medical limitations. There are major advantages in cast metal ORPDs; they are simpler, less traumatic and less expensive than fixed prosthetic options. This case report supports their use in patients with amelogenesis imperfecta.

Drug treatment of hypertensive crisis in children.

PubMed

Thomas, Christopher A

2011-10-01

Hypertensive crisis is a relatively rare event and is associated with significant morbidity and mortality in adults and pediatric patients alike. Rapid, safe, and effective treatment is imperative to alleviate immediate presenting clinical symptoms, prevent devastating morbidity, preserve long-term quality of life, and prevent mortality. Many medications in the hypertensive crisis arsenal have been used for nearly half a century. Nearly all treatment options have been utilized in children for decades, yet reliable data and sound clinical literature remain elusive. Every agent considered to be a first-line, second-line, or adjunctive option has yet to be evaluated in a randomized controlled trial in pediatric patients. With a paucity of clinical data to form evidence-based decisions, the clinician must rely entirely on the extrapolation from adult data and small retrospective studies, case series, and case reports of medication use in pediatric patients. Although more research in the treatment of pediatric hypertensive crisis is desperately needed, current practice demands a sharp knowledge of the pediatric clinical literature and pharmacology in this area as an essential tool to consistently improve patient outcomes with respect to morbidity and mortality.

Berardinelli–Seip syndrome: highlight of treatment challenge

PubMed Central

Ferraria, Nélia; Pedrosa, Cristina; Amaral, Daniela; Lopes, Lurdes

2013-01-01

Berardinelli–Seip congenital lipodystrophy (BSCL) syndrome is a rare autosomal-recessive disease characterised by lipoatrophy and associated with deregulations of glycidic and lipid metabolism. We report three BSCL cases with its typical clinical picture and complications. Clinically, they all show marked atrophy of adipose tissue, acromegaly, acanthosis nigricans and tall stature. Two cases present attention deficit hyperactivity and developmental learning disorders; another patient has hypertrophic myocardiopathy and polycystic ovary syndrome. In all the cases AGPAT2 was the identified mutation. All the cases present hypertriglyceridemia. One case has developed hyperinsulinism controlled with metformin and another case already has type 2 diabetes with a difficult clinical control. There is no curative treatment and the current treatment options are based only on symptomatic control of the complications. Recently, published studies showed that leptin-replacement therapy appears a promising tool in the metabolic correction of BSCL complications, highlighting the importance of further investigations in BSCL treatment. PMID:23362058

Single-case research design in pediatric psychology: considerations regarding data analysis.

PubMed

Cohen, Lindsey L; Feinstein, Amanda; Masuda, Akihiko; Vowles, Kevin E

2014-03-01

Single-case research allows for an examination of behavior and can demonstrate the functional relation between intervention and outcome in pediatric psychology. This review highlights key assumptions, methodological and design considerations, and options for data analysis. Single-case methodology and guidelines are reviewed with an in-depth focus on visual and statistical analyses. Guidelines allow for the careful evaluation of design quality and visual analysis. A number of statistical techniques have been introduced to supplement visual analysis, but to date, there is no consensus on their recommended use in single-case research design. Single-case methodology is invaluable for advancing pediatric psychology science and practice, and guidelines have been introduced to enhance the consistency, validity, and reliability of these studies. Experts generally agree that visual inspection is the optimal method of analysis in single-case design; however, statistical approaches are becoming increasingly evaluated and used to augment data interpretation.

Young children are more generous when others are aware of their actions.

PubMed

Leimgruber, Kristin L; Shaw, Alex; Santos, Laurie R; Olson, Kristina R

2012-01-01

Adults frequently employ reputation-enhancing strategies when engaging in prosocial acts, behaving more generously when their actions are likely to be witnessed by others and even more so when the extent of their generosity is made public. This study examined the developmental origins of sensitivity to cues associated with reputationally motivated prosociality by presenting five-year-olds with the option to provide one or four stickers to a familiar peer recipient at no cost to themselves. We systematically manipulated the recipient's knowledge of the actor's choices in two different ways: (1) occluding the recipient's view of both the actor and the allocation options and (2) presenting allocations in opaque containers whose contents were visible only to the actor. Children were consistently generous only when the recipient was fully aware of the donation options; in all cases in which the recipient was not aware of the donation options, children were strikingly ungenerous. These results demonstrate that five-year-olds exhibit "strategic prosociality," behaving differentially generous as a function of the amount of information available to the recipient about their actions. These findings suggest that long before they develop a rich understanding of the social significance of reputation or are conscious of complex strategic reasoning, children behave more generously when the details of their prosocial actions are available to others.

Towards more sustainable management of European food waste: Methodological approach and numerical application.

PubMed

Manfredi, Simone; Cristobal, Jorge

2016-09-01

Trying to respond to the latest policy needs, the work presented in this article aims at developing a life-cycle based framework methodology to quantitatively evaluate the environmental and economic sustainability of European food waste management options. The methodology is structured into six steps aimed at defining boundaries and scope of the evaluation, evaluating environmental and economic impacts and identifying best performing options. The methodology is able to accommodate additional assessment criteria, for example the social dimension of sustainability, thus moving towards a comprehensive sustainability assessment framework. A numerical case study is also developed to provide an example of application of the proposed methodology to an average European context. Different options for food waste treatment are compared, including landfilling, composting, anaerobic digestion and incineration. The environmental dimension is evaluated with the software EASETECH, while the economic assessment is conducted based on different indicators expressing the costs associated with food waste management. Results show that the proposed methodology allows for a straightforward identification of the most sustainable options for food waste, thus can provide factual support to decision/policy making. However, it was also observed that results markedly depend on a number of user-defined assumptions, for example on the choice of the indicators to express the environmental and economic performance. © The Author(s) 2016.

Alternatives to neonicotinoid insecticides for pest control: case studies in agriculture and forestry.

PubMed

Furlan, Lorenzo; Kreutzweiser, David

2015-01-01

Neonicotinoid insecticides are widely used for control of insect pests around the world and are especially pervasive in agricultural pest management. There is a growing body of evidence indicating that the broad-scale and prophylactic uses of neonicotinoids pose serious risks of harm to beneficial organisms and their ecological function. This provides the impetus for exploring alternatives to neonicotinoid insecticides for controlling insect pests. We draw from examples of alternative pest control options in Italian maize production and Canadian forestry to illustrate the principles of applying alternatives to neonicotinoids under an integrated pest management (IPM) strategy. An IPM approach considers all relevant and available information to make informed management decisions, providing pest control options based on actual need. We explore the benefits and challenges of several options for management of three insect pests in maize crops and an invasive insect pest in forests, including diversifying crop rotations, altering the timing of planting, tillage and irrigation, using less sensitive crops in infested areas, applying biological control agents, and turning to alternative reduced risk insecticides. Continued research into alternatives is warranted, but equally pressing is the need for information transfer and training for farmers and pest managers and the need for policies and regulations to encourage the adoption of IPM strategies and their alternative pest control options.

The moderating role of need for cognition on excessive searching bias: a case of finding romantic partners online.

PubMed

Chiou, Wen-Bin; Yang, Mu-Li

2010-01-01

Using online-dating websites to expand social networks and form close relationships is popular for people in information technology era. Wu and Chiou (2009) demonstrated that more options triggered excessive searching, leading to poorer decision-making and reduced selectivity. They proposed that the more-means-worse effect refers to more searching leads to worse choices by reducing users' cognitive resources, distracting them with irrelevant information and reducing their ability to screen out inferior options. A 2 by 2 experimental study was conducted to investigate the moderating effect of individual differences in need for cognition (NFC) and number of available options on excessive searching and decision quality. A total of 120 undergraduates with experiences of online romantic relationships participated in the experiment. After participants were administrated their need for cognition, they were assigned to review either a small or a large number of options to search for their most desirable romantic partners via a popular online-dating website in Taiwan. Results indicated that high-NFC participants showed more excessive searching than did low-NFC participants. Moreover, the more-means-worse effect was more salient for high-NFC participants than high-NFC participants. The findings suggest that users with high NFC may be more vulnerable to the negative effect of excessive searching.

Default neglect in attempts at social influence.

PubMed

Zlatev, Julian J; Daniels, David P; Kim, Hajin; Neale, Margaret A

2017-12-26

Current theories suggest that people understand how to exploit common biases to influence others. However, these predictions have received little empirical attention. We consider a widely studied bias with special policy relevance: the default effect, which is the tendency to choose whichever option is the status quo. We asked participants (including managers, law/business/medical students, and US adults) to nudge others toward selecting a target option by choosing whether to present that target option as the default. In contrast to theoretical predictions, we find that people often fail to understand and/or use defaults to influence others, i.e., they show "default neglect." First, in one-shot default-setting games, we find that only 50.8% of participants set the target option as the default across 11 samples ( n = 2,844), consistent with people not systematically using defaults at all. Second, when participants have multiple opportunities for experience and feedback, they still do not systematically use defaults. Third, we investigate beliefs related to the default effect. People seem to anticipate some mechanisms that drive default effects, yet most people do not believe in the default effect on average, even in cases where they do use defaults. We discuss implications of default neglect for decision making, social influence, and evidence-based policy.

Boon or bane: 401(k) loans and employee contributions.

PubMed

Wenger, Jeffrey B; Weller, Christian E

2014-09-01

Economic and behavioral theories arrive at different conclusions about the effect of being allowed to borrow from one's defined-contribution (DC) retirement plan on people's contributions to DC plans. Traditional life-cycle models unambiguously suggest that the borrowing option makes people better off than not being able to borrow. Households consequently contribute more to their DC plans than they would absent the borrowing option. Previous research finds that the ability to borrow from a DC plan increases contemporaneous contributions, consistent with traditional models. Behavioral finance, in contrast, suggests that some workers may operate with nonlinear time discounting. They plan on saving more in the future but change their mind and save less than initially planned as time passes. These workers may enjoy higher lifetime utility if they have no loan option because DC plans serve as commitment devices for retirement saving. The money cannot be used prior to retirement. Absent this commitment device, contributions may be lower for some households than would be the case without a DC loan option. We study DC plan contributions for households with heterogeneous preferences about discounting. We separate households into those that demonstrate inconsistent (or paradoxical) borrowing behavior, which may reflect nonlinear time discounting, and those with more consistent borrowing behavior. We find that a DC loan option raises current savings, but does so more for households with consistent borrowing behavior than for those with inconsistent borrowing behavior. © The Author(s) 2013.

Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network.

PubMed

Grass, Fabian; Martin, David; Montemurro, Michael; Mathevet, Patrice; Wolfer, Anita; Coukos, George; Demartines, Nicolas; Hübner, Martin

2018-06-13

The present survey aimed to evaluate current opinion and practice regarding peritoneal metastasis (PM), satisfaction with available treatment options, and need for new therapeutic approaches. This was a qualitative study conducted between October 2016 and October 2017 in the Réseau Suisse Romand d'Oncologie including 101 members of various oncological specialties. Participants' demographics, current practice, knowledge, and satisfaction regarding available treatment options and need for new treatment options were assessed by semantic differential scales through 33 closed questions with automatic reminders at 4-, 8-, 12-, and 16-week intervals. Twenty-seven participants (27%) completed the survey. Participants were gastrointestinal or gynecologic oncologists and surgeons. Most participants (67%) evaluated their knowledge on PM as moderate, while 22% considered themselves as experts. Clinical usefulness of systemic chemotherapy and hyperthermic intraperitoneal chemotherapy was judged to be moderate to high for PM of ovarian and colorectal origin and moderate to poor for gastric origin. Satisfaction with available treatment options was 6/10 (interquartile range [IQR] 4-7) for ovarian, 5/10 (IQR 3-7) for colorectal, and 3/10 (IQR 1-3) for gastric PM. Treatment strategies varied widely for typical case vignettes. The need for new treatment modalities was rated as 8/10 (IQR 6-10). Usefulness of and satisfaction with available treatment options for PM were rated as moderate at best by oncological experts, and treatment strategies differed importantly among participants. There appears to be a clear need for standardization and new treatment modalities. © 2018 S. Karger AG, Basel.

Acute left main coronary artery occlusion

PubMed Central

Burgazli, K. Mehmet; Bilgin, Mehmet; Soydan, Nedim; Chasan, Ridvan; Erdogan, Ali

2013-01-01

The treatment of an acute left main coronary artery occlusion still poses a challenge. In this case report we present a 50-year-old patient with an acute occlusion of the left main artery. After a successful angioplasty without “stenting” due to the complexity of the stenosis the patient underwent a successful bypass surgery. We discuss the therapeutic options of acute left main occlusion regarding medical, interventional and surgical options. PMID:24353543

Biological and chemical weapons of mass destruction: updated clinical therapeutic countermeasures since 2003.

PubMed

Pettineo, Christopher; Aitchison, Robert; Leikin, Scott M; Vogel, Stephen N; Leikin, Jerrold B

2009-01-01

The objective of this article is to provide updated treatment options for bioterrorism agents. This updated synopsis includes recent clinical cases and treatment recommendations that have arisen in the last 5 years. The decontamination, treatment, and disposition of these biologic and chemical agents are presented alphabetically by agent type: biologic, chemical, and radiologic/nuclear. The information provided outlines only new treatment options since 2003.

Malunited fracture of the body and condyle of the mandible : A Case Report.

PubMed

Yeluri, Ramakrishna; Baliga, Sudhindra; Munshi, Autar Krishen

2010-07-01

Mandibular fractures are the most common facial fractures seen in hospitalized children and their incidence increases with age. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. Many factors complicate the management of pediatric mixed-dentition mandibular fractures: tooth eruption, short roots, developing tooth buds and growth issues. One major factor is the inherent instability of the occlusion in the mixed deciduous-permanent tooth phase. This case report documents a child in mixed dentition period with a complication arising due to direct fixation of the fractured mandible.

Adjunctive Treatment in Juvenile Nasopharyngeal Angiofibroma: How Should We Approach Recurrence?

PubMed

Scholfield, Daniel W; Brundler, Marie-Anne; McDermott, Ann-Louise; Mussai, Francis; Kearns, Pamela

2016-04-01

A recent case of advanced, recurrent juvenile nasopharyngeal angiofibroma (JNA) at our institution has highlighted the limited evidence regarding adjunctive treatment. We present the case of a 10-year-old boy who is the first to undergo multiple-staged surgical resections alongside vincristine treatment. We performed a review of the literature analyzing the roles of radiation therapy, cytotoxic drugs, and novel targeted agents in JNA relapse. Small cohort studies suggest radiotherapy and flutamide are the most rational treatment options for residual and recurrent JNA. Our review highlights the need for further research into the management of primary and recurrent JNA.

Current Treatment Options for Penile Fractures

PubMed Central

Jack, Gregory S; Garraway, Isla; Reznichek, Richard; Rajfer, Jacob

2004-01-01

The diagnosis of “penile fracture” describes the traumatic rupture of the tunica albuginea of an erect penis. Penile fractures typically occur when the engorged penile corpora are forced to buckle and literally “pop” under the pressure of a blunt sexual trauma. Patients typically describe immediate detumescence, severe pain, and swelling as a result of the injury. Prompt surgical exploration and corporal repair is the most efficacious therapy. Although a majority of cases can be diagnosed from the history and physical examination alone, radiographic studies, including retrograde urethrography and corporal cavernosography can aid in the diagnosis of unusual cases. PMID:16985591

Pouching a draining duodenal cutaneous fistula: a case study.

PubMed

Zwanziger, P J

1999-01-01

Blockage of the mesenteric artery typically causes necrosis to the colon, requiring extensive surgical resection. In severe cases, the necrosis requires removal of the entire colon, creating numerous problems for the WOC nurse when pouching the opening created for effluent. This article describes the management of a draining duodenal fistula in a middle-aged woman, who survived surgery for a blocked mesenteric artery that necessitated the removal of the majority of the small and large intestine. Nutrition, skin management, and pouch options are described over a number of months as the fistula evolved and a stoma was created.

A case of motor neuropathy after cryolipolysis of the arm.

PubMed

Lee, Sang Jun; Kim, Young Jin; Park, Jae Beom; Suh, Dong Hye; Kwon, Do Young; Ryu, Hwa Jung

2016-11-01

Cryolipolysis treatment is a non-invasive option for localized fat reduction without damaging the surrounding tissue. Clinical studies about cryolipolysis show various side effects, including temporary erythema, bruising, and transient numbness. But, no reports are available on motor nerve malfunction after cryolipolysis. A 24-year-old female received cryolipolysis treatment on abdomen, both arms. After 10 days, patient complained of weakness and inability to lift heavy objects. Symptoms continued for 6 months, and fully recovered without treatment. Thus, we report a case of motor neuropathy after cryolipolysis, which is a rare complication of cryolipolysis.

Curvularia lunata endophthalmitis.

PubMed

Berbel, Rodrigo Fabri; Casella, Antonio Marcelo Barbante; de Freitas, Denise; Höfling-Lima, Ana Luisa

2011-10-01

The aim of this study was to report a case of a 52-year-old man with a rare fungal endophthalmitis after penetrating ocular trauma with a fish hook. The patient was submitted to wound repair and hook extraction. Three weeks after the trauma, a cataract extraction with phacoemulsification and in-the-bag intraocular lens implantation was performed. After the development of endophthalmitis, vitrectomy and lens explantation with positive culture for Curvularia lunata were carried out. The infection was controlled with the administration of systemic itraconazole and intraocular voriconazole. The use of intravitreal voriconazole injection is a viable option in cases of Curvularia fungal endophthalmitis.

Statistical methods for studying disease subtype heterogeneity.

PubMed

Wang, Molin; Spiegelman, Donna; Kuchiba, Aya; Lochhead, Paul; Kim, Sehee; Chan, Andrew T; Poole, Elizabeth M; Tamimi, Rulla; Tworoger, Shelley S; Giovannucci, Edward; Rosner, Bernard; Ogino, Shuji

2016-02-28

A fundamental goal of epidemiologic research is to investigate the relationship between exposures and disease risk. Cases of the disease are often considered a single outcome and assumed to share a common etiology. However, evidence indicates that many human diseases arise and evolve through a range of heterogeneous molecular pathologic processes, influenced by diverse exposures. Pathogenic heterogeneity has been considered in various neoplasms such as colorectal, lung, prostate, and breast cancers, leukemia and lymphoma, and non-neoplastic diseases, including obesity, type II diabetes, glaucoma, stroke, cardiovascular disease, autism, and autoimmune disease. In this article, we discuss analytic options for studying disease subtype heterogeneity, emphasizing methods for evaluating whether the association of a potential risk factor with disease varies by disease subtype. Methods are described for scenarios where disease subtypes are categorical and ordinal and for cohort studies, matched and unmatched case-control studies, and case-case study designs. For illustration, we apply the methods to a molecular pathological epidemiology study of alcohol intake and colon cancer risk by tumor LINE-1 methylation subtypes. User-friendly software to implement the methods is publicly available. Copyright © 2015 John Wiley & Sons, Ltd.

Cracked tooth syndrome: A report of three cases.

PubMed

Sadasiva, Kadandale; Ramalingam, Sathishmuthukumar; Rajaram, Krishnaraj; Meiyappan, Alagappan

2015-08-01

Cracked tooth syndrome (CTS), the term was coined by Cameron in 1964, which refers to an incomplete fracture of a vital posterior tooth extending to the dentin and occasionally into the pulp. CTS has always been a nightmare to the patient because of its unpredictable symptoms and a diagnostic dilemma for the dental practitioner due to its variable, bizarre clinical presentation. The treatment planning and management of CTS has also given problems and challenges the dentist as there is no specific treatment option. The management of CTS varies from one case to another or from one tooth to another in the same individual based on the severity of the symptoms and depth of tooth structure involved. After all, the prognosis of such tooth is still questionable and requires continuous evaluation. This article aims at presenting a series three cases of CTS with an overview on the clinical presentation, diagnosis and the different treatment options that varies from one case to another.

Cracked tooth syndrome: A report of three cases

PubMed Central

Sadasiva, Kadandale; Ramalingam, Sathishmuthukumar; Rajaram, Krishnaraj; Meiyappan, Alagappan

2015-01-01

Cracked tooth syndrome (CTS), the term was coined by Cameron in 1964, which refers to an incomplete fracture of a vital posterior tooth extending to the dentin and occasionally into the pulp. CTS has always been a nightmare to the patient because of its unpredictable symptoms and a diagnostic dilemma for the dental practitioner due to its variable, bizarre clinical presentation. The treatment planning and management of CTS has also given problems and challenges the dentist as there is no specific treatment option. The management of CTS varies from one case to another or from one tooth to another in the same individual based on the severity of the symptoms and depth of tooth structure involved. After all, the prognosis of such tooth is still questionable and requires continuous evaluation. This article aims at presenting a series three cases of CTS with an overview on the clinical presentation, diagnosis and the different treatment options that varies from one case to another. PMID:26538947

Occipital Artery to Middle Cerebral Artery Bypass: Operative Nuances.

PubMed

Kimura, Toshikazu; Morita, Akio

2017-12-01

Superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis is a common procedure for vascular neurosurgeons, and it is used in a variety of diseases. However, there are cases in which the STA is absent or is too hypoplastic to be used as a donor for revascularization. Occipital artery (OA)-MCA bypass may be a treatment option in these cases. We encountered 4 cases of symptomatic cerebral ischemia in which the STA was absent or unavailable. These cases were treated by revascularization from the OA to the periphery of the MCA. By meticulous dissection of the OA to the level of the superior temporal line, the OA could reach the periphery of the angular artery and be anastomosed to it in the usual fashion. The patency of the donor artery was confirmed by magnetic resonance angiography soon after the operation and 3 years later. OA-MCA bypass may be a surgical option for cerebral revascularization when the STA is not available. Copyright © 2017 Elsevier Inc. All rights reserved.

A review on technological options of waste to energy for effective management of municipal solid waste.

PubMed

Kumar, Atul; Samadder, S R

2017-11-01

Approximately one-fourth population across the world rely on traditional fuels (kerosene, natural gas, biomass residue, firewood, coal, animal dung, etc.) for domestic use despite significant socioeconomic and technological development. Fossil fuel reserves are being exploited at a very fast rate to meet the increasing energy demands, so there is a need to find alternative sources of energy before all the fossil fuel reserves are depleted. Waste to energy (WTE) can be considered as a potential alternative source of energy, which is economically viable and environmentally sustainable. The present study reviewed the current global scenario of WTE technological options (incineration, pyrolysis, gasification, anaerobic digestion, and landfilling with gas recovery) for effective energy recovery and the challenges faced by developed and developing countries. This review will provide a framework for evaluating WTE technological options based on case studies of developed and developing countries. Unsanitary landfilling is the most commonly practiced waste disposal option in the developing countries. However, developed countries have realised the potential of WTE technologies for effective municipal solid waste management (MSWM). This review will help the policy makers and the implementing authorities involved in MSWM to understand the current status, challenges and barriers for effective management of municipal solid waste. This review concluded WTE as a potential renewable source of energy, which will partly meet the energy demand and ensure effective MSWM. Copyright © 2017 Elsevier Ltd. All rights reserved.

Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study.

PubMed

Eastwood, K; Paterson, B J; Levi, C; Givney, R; Loewenthal, M; DE Malmanche, T; Lai, K; Granerod, J; Durrheim, D N

2015-11-01

Few countries routinely collect comprehensive encephalitis data, yet understanding the epidemiology of this condition has value for clinical management, detecting novel and emerging pathogens, and guiding timely public health interventions. When this study was conducted there was no standardized diagnostic algorithm to aid identification of encephalitis or systematic surveillance for adult encephalitis. In July 2012 we tested three pragmatic surveillance options aimed at identifying possible adult encephalitis cases admitted to a major Australian hospital: hospital admissions searches, clinician notifications and laboratory test alerts (CSF herpes simplex virus requests). Eligible cases underwent structured laboratory investigation and a specialist panel arbitrated on the final diagnosis. One hundred and thirteen patients were initially recruited into the 10-month study; 20/113 (18%) met the study case definition, seven were diagnosed with infectious or immune-mediated encephalitis and the remainder were assigned alternative diagnoses. The laboratory alert identified 90% (102/113) of recruited cases including six of the seven cases of confirmed encephalitis suggesting that this may be a practical data source for case ascertainment. The application of a standardized diagnostic algorithm and specialist review by an expert clinical panel aided diagnosis of patients with encephalitis.

Risk-Based Approach for Microbiological Food Safety Management in the Dairy Industry: The Case of Listeria monocytogenes in Soft Cheese Made from Pasteurized Milk.

PubMed

Tenenhaus-Aziza, Fanny; Daudin, Jean-Jacques; Maffre, Alexandre; Sanaa, Moez

2014-01-01

According to Codex Alimentarius Commission recommendations, management options applied at the process production level should be based on good hygiene practices, HACCP system, and new risk management metrics such as the food safety objective. To follow this last recommendation, the use of quantitative microbiological risk assessment is an appealing approach to link new risk-based metrics to management options that may be applied by food operators. Through a specific case study, Listeria monocytogenes in soft cheese made from pasteurized milk, the objective of the present article is to practically show how quantitative risk assessment could be used to direct potential intervention strategies at different food processing steps. Based on many assumptions, the model developed estimates the risk of listeriosis at the moment of consumption taking into account the entire manufacturing process and potential sources of contamination. From pasteurization to consumption, the amplification of a primo-contamination event of the milk, the fresh cheese or the process environment is simulated, over time, space, and between products, accounting for the impact of management options, such as hygienic operations and sampling plans. A sensitivity analysis of the model will help orientating data to be collected prioritarily for the improvement and the validation of the model. What-if scenarios were simulated and allowed for the identification of major parameters contributing to the risk of listeriosis and the optimization of preventive and corrective measures. © 2013 Society for Risk Analysis.

Repetitive Transcranial Magnetic Stimulation (rTMS) to Treat Social Anxiety Disorder: Case Reports and a Review of the Literature

PubMed Central

Paes, Flávia; Baczynski, Tathiana; Novaes, Felipe; Marinho, Tamires; Arias-Carrión, Oscar; Budde, Henning; Sack, Alexander T.; Huston, Joseph P.; Almada, Leonardo Ferreira; Carta, Mauro; Silva, Adriana Cardoso; Nardi, Antonio E.; Machado, Sergio

2013-01-01

Objectives: Social anxiety disorder (SAD) is a common and debilitating anxiety disorders. However, few studies had been dedicated to the neurobiology underlying SAD until the last decade. Rates of non-responders to standard methods of treatment remain unsatisfactorily high of approximately 25%, including SAD. Advances in our understanding of SAD could lead to new treatment strategies. A potential non invasive therapeutic option is repetitive transcranial magnetic stimulation (rTMS). Thus, we reported two cases of SAD treated with rTMS Methods: The bibliographical search used Pubmed/Medline, ISI Web of Knowledge and Scielo databases. The terms chosen for the search were: anxiety disorders, neuroimaging, repetitive transcranial magnetic stimulation. Results: In most of the studies conducted on anxiety disorders, except SAD, the right prefrontal cortex (PFC), more specifically dorsolateral PFC was stimulated, with marked results when applying high-rTMS compared with studies stimulating the opposite side. However, according to the “valence hypothesis”, anxiety disorders might be characterized by an interhemispheric imbalance associated with increased right-hemispheric activity. With regard to the two cases treated with rTMS, we found a decrease in BDI, BAI and LSAS scores from baseline to follow-up. Conclusion: We hypothesize that the application of low-rTMS over the right medial PFC (mPFC; the main structure involved in SAD circuitry) combined with high-rTMS over the left mPFC, for at least 4 weeks on consecutive weekdays, may induce a balance in brain activity, opening an attractive therapeutic option for the treatment of SAD. PMID:24278088

Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions.

PubMed

Bell, Cynthia J; Zimet, Gregory D; Hinds, Pamela S; Broome, Marion E; McDaniel, Anna M; Mays, Rose M; Champion, Victoria L

Adolescents living with incurable cancer require ongoing support to process grief, emotions, and information as disease progresses including treatment options (phase 1 clinical trials and/or hospice/palliative care). Little is known about how adolescents become ready for such discussions. The purpose of this study was to explore the process of adolescent readiness for end-of-life preparedness discussions, generating a theoretical understanding for guiding clinical conversations when curative options are limited. We explored 2 in-depth cases across time using case-study methodology. An à priori conceptual model based on current end-of-life research guided data collection and analysis. Multiple sources including in-depth adolescent interviews generated data collection on model constructs. Analysis followed a logical sequence establishing a chain of evidence linking raw data to study conclusions. Synthesis and data triangulation across cases and time led to theoretical generalizations. Initially, we proposed a linear process of readiness with 3 domains: a cognitive domain (awareness), an emotional domain (acceptance), and a behavioral domain (willingness), which preceded preparedness. Findings led to conceptual model refinement showing readiness is a dynamic internal process that interacts with preparedness. Current awareness context facilitates the type of preparedness discussions (cognitive or emotional). Furthermore, social constraint inhibits discussions. Data support theoretical understanding of the dynamism of readiness. Future research that validates adolescent conceptualization will ensure age-appropriate readiness representation. Understanding the dynamic process of readiness for engaging in end-of-life preparedness provides clinician insight for guiding discussions that facilitate shared decision making and promote quality of life for adolescents and their families.

Cost of malaria control in Sri Lanka.

PubMed

Konradsen, F; Steele, P; Perera, D; van der Hoek, W; Amerasinghe, P H; Amerasinghe, F P

1999-01-01

The study provides estimates of the cost of various malaria control measures in an area of North-Central Province of Sri Lanka where the disease is endemic. We assumed that each measure was equally effective. In these terms, impregnating privately purchased bednets with insecticide was estimated to cost Rs 48 (US(40.87) per individual protected per year, less than half the cost of spraying houses with residual insecticides. Larviciding of vector breeding sites and especially the elimination of breeding habitats by flushing streams through seasonal release of water from upstream reservoirs was estimated to be cheaper than other preventive measures (Rs 27 (US$ 0.49) and Rs 13 (US$ 0.24) per individual protected, respectively). Inclusion of both operational and capital costs of treatment indicates that the most cost-effective intervention for the government was a centrally located hospital with a relatively large catchment area (Rs 71 (US$ 1.29) per malaria case treated). Mobile clinics (Rs 153 (US$ 2.78) per malaria case treated) and a village treatment centre (Rs 112 (US$ 2.04)) per malaria case treated) were more expensive options for the government, but were considerably cheaper for households than the traditional hospital facilities. This information can guide health planners and government decision-makers in choosing the most appropriate combination of curative and preventive measures to control malaria. However, the option that is cheapest for the government may not be so for the householders, and further studies are needed to estimate the effectiveness of the various preventive measures.

Cost of malaria control in Sri Lanka.

PubMed Central

Konradsen, F.; Steele, P.; Perera, D.; van der Hoek, W.; Amerasinghe, P. H.; Amerasinghe, F. P.

1999-01-01

The study provides estimates of the cost of various malaria control measures in an area of North-Central Province of Sri Lanka where the disease is endemic. We assumed that each measure was equally effective. In these terms, impregnating privately purchased bednets with insecticide was estimated to cost Rs 48 (US(40.87) per individual protected per year, less than half the cost of spraying houses with residual insecticides. Larviciding of vector breeding sites and especially the elimination of breeding habitats by flushing streams through seasonal release of water from upstream reservoirs was estimated to be cheaper than other preventive measures (Rs 27 (US$ 0.49) and Rs 13 (US$ 0.24) per individual protected, respectively). Inclusion of both operational and capital costs of treatment indicates that the most cost-effective intervention for the government was a centrally located hospital with a relatively large catchment area (Rs 71 (US$ 1.29) per malaria case treated). Mobile clinics (Rs 153 (US$ 2.78) per malaria case treated) and a village treatment centre (Rs 112 (US$ 2.04)) per malaria case treated) were more expensive options for the government, but were considerably cheaper for households than the traditional hospital facilities. This information can guide health planners and government decision-makers in choosing the most appropriate combination of curative and preventive measures to control malaria. However, the option that is cheapest for the government may not be so for the householders, and further studies are needed to estimate the effectiveness of the various preventive measures. PMID:10327708

Allergies in orthopaedic and trauma surgery.

PubMed

Lohmann, C H; Hameister, R; Singh, G

2017-02-01

Hypersensitivity reactions to implants in orthopaedic and trauma surgery are a rare but devastating complication. They are considered as a delayed-type of hypersensitivity reaction (type IV), characterized by an antigen activation of sensitized T-lymphocytes releasing various cytokines and may result in osteoclast activation and bone resorption. Potential haptens are originated from metal alloys or bone-cement. A meta-analysis has confirmed a higher probability of developing a metal hypersensitivity postoperatively and noted a greater risk of failed replacements compared to stable implants. Hypersensitivity to implants may present with a variety of symptoms such as pain, joint effusion, delayed wound/bone healing, persistent secretion, allergic dermatitis (localized or systemic), clicking noises, loss of joint function, instability and failure of the implant. Various diagnostic options have been offered, including patch testing, metal alloy patch testing, histology, lymphocyte transformation test (LTT), memory lymphocyte immunostimulation assay (MELISA), leukocyte migration inhibition test (LIF) and lymphocyte activation test (LAT). No significant differences between in vivo and in vitro methods have been found. Due to unconvincing evidence for screening methods, predictive tests are not recommended for routine performance. Infectious aetiology always needs to be excluded. As there is a lack of evidence on large-scale studies with regards to the optimal treatment option, management currently relies on individual case-by-case decisions. Several options for patients with (suspected) metal-related hypersensitivity exist and may include materials based on ceramic, titanium or oxinium or modified surfaces. Promising results have been reported, but long-term experience is lacking. More large-scaled studies are needed in this context. In patients with bone-cement hypersensitivity, the component suspected for hypersensitivity should be avoided. The development of (predictive) biomarkers is considered as a major contribution for the future. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures.

PubMed

Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

2016-01-01

When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22-65 years) and mean followup period was 52.1 months (range 27-72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion.

Case study of a non-destructive treatment method for the remediation of military structures containing polychlorinated biphenyl contaminated paint.

PubMed

Saitta, Erin K H; Gittings, Michael J; Novaes-Card, Simone; Quinn, Jacqueline; Clausen, Christian; O'Hara, Suzanne; Yestrebsky, Cherie L

2015-08-01

Restricted by federal regulations and limited remediation options, buildings contaminated with paint laden with polychlorinated biphenyls (PCBs) have high costs associated with the disposal of hazardous materials. As opposed to current remediation methods which are often destructive and a risk to the surrounding environment, this study suggests a non-metal treatment system (NMTS) and a bimetallic treatment system (BTS) as versatile remediation options for painted industrial structures including concrete buildings, and metal machine parts. In this field study, four areas of a discontinued Department of Defense site were treated and monitored over 3 weeks. PCB levels in paint and treatment system samples were analyzed through gas chromatography/electron capture detection (GC-ECD). PCB concentrations were reduced by 95 percent on painted concrete and by 60-97 percent on painted metal with the majority of the PCB removal occurring within the first week of application. Post treatment laboratory studies including the utilization of an activated metal treatment system (AMTS) further degraded PCBs in BTS and NMTS by up to 82 percent and 99 percent, respectively, indicating that a two-step remediation option is viable. These findings demonstrate that the NMTS and BTS can be an effective, nondestructive, remediation process for large painted structures, allowing for the reuse or sale of remediated materials that otherwise may have been disposed. Copyright © 2015 Elsevier Ltd. All rights reserved.

An optimal painless treatment for early hemorrhoids; our experience in Government Medical College and Hospital

PubMed Central

Singal, R; Gupta, S; Dalal, AK; Dalal, U; Attri, AK

2013-01-01

Objective - To evaluate the efficacy of Infrared Coagulation Therapy (IRC) for hemorrhoids. IRC is a painless, safe and successful procedure. Place and duration of study - Department of Surgery, Government Medical College and Hospital, Sector-32, Chandigarh, India, from August 2006 to October 2008. The choice of procedure depends on the patient's symptoms, the extent of the hemorrhoidal disease, and the experience of the surgeon along with the availability of the techniques/instruments. Materials and methods - This is a prospective study done from August 2006 to October 2008. Total number of 155 patients was included in the study. Infrared Coagulation Therapy (IRC) was performed through a special designed proctoscope. Patients excluded were with coagulopathy disorders, fissure in ano, and anal ulcers. Results - It is an outpatient Department (OPD), non-surgical, ambulatory, painless and bloodless procedure, without any hospital stay. Early recovery and minimal recurrence of hemorrhoids were noted without any morbidity or mortality. We have studied 155 patients, treated with IRC on OPD basis. Surgery was required in few patients in whom IRC failed or was contraindicated. Out of the total 155 patients, 127 came for follow up. After the 1st sitting of IRC therapy: out of 127; 43 patients got a total relief, mass shrinkage was of > 75% in 57 cases and < 50% in 14 cases. Twenty-eight cases did not come for follow-up. In the 2nd sitting, out of 84/127; 58 patients got a total relief, >75% relief in 15 cases and >50 % relief in 11 patients. In the 3rd sitting out of 26/84 cases: 13 cases got a total relief and 13 cases refused to take the third sitting; however, in 7 cases the hemorrhoidal mass shrank up to 50% after the two sittings. These 14 were operated as there was no relief from bleeding after giving two sittings of IRC. Our opinion is that, in the above 14 cases, the patient might have not followed the instructions properly for dietary habits. Conclusion - IRC is a safe, simple and effective procedure for early hemorrhoids without any complications. IRC is nowadays the world’s leading office treatment for hemorrhoids. IRC is a better option than the surgical treatment as it is easy, well tolerated, and remarkably complication-free. In our study, we have not used any course of antibiotics. In the management of early hemorrhoids, IRC should be considered as a simple trouble-free and painless option. PMID:24146691

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

Dillon, Heather E.; Antonopoulos, Chrissi A.; Solana, Amy E.

As the model energy codes are improved to reach efficiency levels 50 percent greater than current codes, use of on-site renewable energy generation is likely to become a code requirement. This requirement will be needed because traditional mechanisms for code improvement, including envelope, mechanical and lighting, have been pressed to the end of reasonable limits. Research has been conducted to determine the mechanism for implementing this requirement (Kaufman 2011). Kaufmann et al. determined that the most appropriate way to structure an on-site renewable requirement for commercial buildings is to define the requirement in terms of an installed power density permore » unit of roof area. This provides a mechanism that is suitable for the installation of photovoltaic (PV) systems on future buildings to offset electricity and reduce the total building energy load. Kaufmann et al. suggested that an appropriate maximum for the requirement in the commercial sector would be 4 W/ft{sup 2} of roof area or 0.5 W/ft{sup 2} of conditioned floor area. As with all code requirements, there must be an alternative compliance path for buildings that may not reasonably meet the renewables requirement. This might include conditions like shading (which makes rooftop PV arrays less effective), unusual architecture, undesirable roof pitch, unsuitable building orientation, or other issues. In the short term, alternative compliance paths including high performance mechanical equipment, dramatic envelope changes, or controls changes may be feasible. These options may be less expensive than many renewable systems, which will require careful balance of energy measures when setting the code requirement levels. As the stringency of the code continues to increase however, efficiency trade-offs will be maximized, requiring alternative compliance options to be focused solely on renewable electricity trade-offs or equivalent programs. One alternate compliance path includes purchase of Renewable Energy Credits (RECs). Each REC represents a specified amount of renewable electricity production and provides an offset of environmental externalities associated with non-renewable electricity production. The purpose of this paper is to explore the possible issues with RECs and comparable alternative compliance options. Existing codes have been examined to determine energy equivalence between the energy generation requirement and the RECs alternative over the life of the building. The price equivalence of the requirement and the alternative are determined to consider the economic drivers for a market decision. This research includes case studies that review how the few existing codes have incorporated RECs and some of the issues inherent with REC markets. Section 1 of the report reviews compliance options including RECs, green energy purchase programs, shared solar agreements and leases, and other options. Section 2 provides detailed case studies on codes that include RECs and community based alternative compliance methods. The methods the existing code requirements structure alternative compliance options like RECs are the focus of the case studies. Section 3 explores the possible structure of the renewable energy generation requirement in the context of energy and price equivalence. The price of RECs have shown high variation by market and over time which makes it critical to for code language to be updated frequently for a renewable energy generation requirement or the requirement will not remain price-equivalent over time. Section 4 of the report provides a maximum case estimate for impact to the PV market and the REC market based on the Kaufmann et al. proposed requirement levels. If all new buildings in the commercial sector complied with the requirement to install rooftop PV arrays, nearly 4,700 MW of solar would be installed in 2012, a major increase from EIA estimates of 640 MW of solar generation capacity installed in 2009. The residential sector could contribute roughly an additional 2,300 MW based on the same code requirement levels of 4 W/ft{sup 2} of roof area. Section 5 of the report provides a basic framework for draft code language recommendations based on the analysis of the alternative compliance levels.« less

Management Options for Twisted Gastric Tube after Laparoscopic Sleeve Gastrectomy.

PubMed

Abd Ellatif, Mohamed E; Abbas, Ashraf; El Nakeeb, Ayman; Magdy, Alaa; Salama, Asaad F; Bashah, Moataz M; Dawoud, Ibrahim; Gamal, Maged Ali; Sargsyan, Davit

2017-09-01

This study aims to determine the incidence, etiology, and management options for symptomatic gastric obstruction caused by axially twisted sleeve gastrectomy. In this retrospective study, we reviewed medical charts of all morbidly obese patients who underwent laparoscopic sleeve gastrectomy. Patients who developed gastric obstruction symptoms and were diagnosed with twisted sleeve gastrectomy were identified and included in this study. From October 2005 to December 2015, there are 3634 morbidly obese patients who underwent laparoscopic sleeve gastrectomy (LSG). Eighty-six (2.3%) patients developed symptoms of gastric obstruction. Forty-five (1.23%) patients were included in this study. The mean time of presentation was 59.8 days after surgery. Upper GI contrast study was done routinely, and it was positive for axial twist in 37 (82%) patients. Abdominal CT with oral and IV contrast was done in eight (18%) when swallow study was equivocal. Endoscopic treatment was successful in 43 patients (95.5%). Sixteen patients were successfully managed by endoscopic stenting, and 29 patients had balloon dilation. The average numbers of dilation sessions were 1.7. Out of these 29 patients, 18 responded well to a single session of dilatation and did not require any further dilatation sessions. Two patients who failed to respond to three subsequent sessions of balloon dilation underwent laparoscopic adhesiolysis and gastropexy. Endoscopic stenting is an effective tool in management of axial rotation of sleeved stomach. Balloon dilation can also be effective in selected cases. Few cases might require laparoscopic adhesiolysis and gastropexy.

How can sludge dewatering devices be assessed? Development of a new DSS and its application to real case studies.

PubMed

Bertanza, Giorgio; Papa, Matteo; Canato, Matteo; Collivignarelli, Maria Cristina; Pedrazzani, Roberta

2014-05-01

A key issue in biological Waste Water Treatment Plants (WWTPs) operation is represented by the sludge management. Mechanical dewatering is a crucial stage for sludge volume reduction; though, being a costly operation, its optimization is required. We developed an original experimental methodology to evaluate the technical (dewatering efficiency) and financial (total treatment costs) performance of dewatering devices, which might be used as a DSS (Decision Support System) for WWTP managers. This tool was then applied to two real case studies for comparing, respectively, three industrial size centrifuges, and two different operation modes of the same machine (fixed installation vs. outsourcing service). In both the cases, the best option was identified, based jointly on economic and (site-specific) technical evaluations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Management options for recycling radioactive scrap metals

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

Dehmel, J.C.; MacKinney, J.; Bartlett, J.

1997-02-01

The feasibility and advantages of recycling radioactive scrap metals (RSM) have yet to be assessed, given the unique technical, regulatory, safety, and cost-benefit issues that have already been raised by a concerned recycling industry. As is known, this industry has been repeatedly involved with the accidental recycling of radioactive sources and, in some cases, with costly consequences. If recycling were deemed to be a viable option, it might have to be implemented with regulatory monitoring and controls. Its implementation may have to consider various and complex issues and address the requirements and concerns of distinctly different industries. There are threemore » basic options for the recycling of such scraps. They are: (1) recycling through the existing network of metal-scrap dealers and brokers, (2) recycling directly and only with specific steelmills, or (3) recycling through regional processing centers. Under the first option, scrap dealers and brokers would receive material from RSM generators and determine at which steelmills such scraps would be recycled. For the second option, RSM generators would deal directly with selected steelmills under specific agreements. For the third option, generators would ship scraps only to regional centers for processing and shipment to participating steelmills. This paper addresses the potential advantages of each option, identifies the types of arrangements that would need to be secured among all parties, and attempts to assess the receptivity of the recycling industry to each option.« less