Implementation of generalized quantum measurements for unambiguous discrimination of multiple non-orthogonal coherent states.

PubMed

Becerra, F E; Fan, J; Migdall, A

2013-01-01

Generalized quantum measurements implemented to allow for measurement outcomes termed inconclusive can perform perfect discrimination of non-orthogonal states, a task which is impossible using only measurements with definitive outcomes. Here we demonstrate such generalized quantum measurements for unambiguous discrimination of four non-orthogonal coherent states and obtain their quantum mechanical description, the positive-operator valued measure. For practical realizations of this positive-operator valued measure, where noise and realistic imperfections prevent perfect unambiguous discrimination, we show that our experimental implementation outperforms any ideal standard-quantum-limited measurement performing the same non-ideal unambiguous state discrimination task for coherent states with low mean photon numbers.

Convergence of moment expansions for expectation values with embedded random matrix ensembles and quantum chaos

NASA Astrophysics Data System (ADS)

Kota, V. K. B.

2003-07-01

Smoothed forms for expectation values < K> E of positive definite operators K follow from the K-density moments either directly or in many other ways each giving a series expansion (involving polynomials in E). In large spectroscopic spaces one has to partition the many particle spaces into subspaces. Partitioning leads to new expansions for expectation values. It is shown that all the expansions converge to compact forms depending on the nature of the operator K and the operation of embedded random matrix ensembles and quantum chaos in many particle spaces. Explicit results are given for occupancies < ni> E, spin-cutoff factors < JZ2> E and strength sums < O†O> E, where O is a one-body transition operator.

Simultaneous qubit-loss-free fusion of three multiple W states

NASA Astrophysics Data System (ADS)

Wang, Meiyu; Hao, Quanzhi; Yan, Fengli; Gao, Ting

2018-05-01

Qubit-loss-free fusion for two W states introduced by Li K et al (2016 Phys. Rev. A 94 062315) clearly increases the final size of the obtained W state and greatly reduces the number of fusion steps to achieve a W state of a target size. Motivated by this idea, we propose a qubit-loss-free fusion scheme for fusing three polarization entangled W states simultaneously. The elements of a two-outcome positive-operator valued measurement and the appropriate joint unitary operation for realizing a positive-operator valued measurement measurement are given. As an example, with the assistance of weak cross-Kerr nonlinearities, an optical setup for fusing three W states is proposed. We analyze the success probability of the scheme and the resource cost of the present scheme, as compared to previous work.

Time-dependent middle ear pressure changes under general anaesthesia in children: N2O-O2 mixture versus air-oxygen mixture.

PubMed

Apan, A; Muluk, N Bayar; Güler, S; Budak, B

2013-01-01

The aim of this study was to investigate the effects of N2O-O2 mixture (Inspired O2 30%) on middle ear pressure (MEP) in children compared with the effects of an air-oxygen mixture (Inspired O2 50%). The study included thirty child patients who underwent general anaesthesia for different reasons, with the exception of ENT problems and ear interventions. They were randomly divided into two groups. Group 1 (15 children: 10 male and 5 female) received a N2O-O2 mixture (Inspired O2 30%); and group 2 (15 children: 10 male and 5 female) were given an air-oxygen mixture (Inspired O2 50%). MEP was measured using a portable impedance analyser before the operation (PreO),10 minutes after intubation (10AEn), 30 minutes after intubation (30AEn), 10 minutes before extubation (10BEx), 15 minutes after the operation (PO15), 30 minutes after the operation (PO30), 1 hour after the operation (PO1h) and 6 hours after the operation (PO6h). The pressure and compliance values were the same in groups 1 and 2. The pressure-time graphs for the two groups were different: in Group 2, MEP rose quickly at 10AEn and positive pressure values were seen in the middle ear. MEP then fell rapidly until the end of the surgery and lower and negative pressures (Mean -50 daPa) were observed at PO6h. In Group 1, MEP was elevated at 10AEn and positive pressure was found (but not as high as in Group 2). MEP then fell more slowly. In other words, positive pressure in the middle ear persisted longer and the middle ear was subjected to positive pressure and nitrogen over a longer period. Separate analyses were made in Groups 1 and 2 of pressure differences and of compliance values at eight measurement points using the Friedman test. Differences in pressure values were found to be statistically significant in both Group 1 (p = 0.000) and Group 2 (p = 0.000). In Group 1, all the 10AEn and 30AEn values were significantly higher than the PreO, PO30, PO1h and PO6h values. The 10BEx value was significantly higher than the PreO and PO1h values. The PO15 value was significantly higher than the PreO value. In Group 2, the PO6h value was significantly lower than the 10BEx, 10AEn and 30AEn values. The PO1h value was significantly lower than the 30AEn values. The MEP values increased in Group 1 in younger and taller children and in children receiving anaesthesia for shorter periods. MEP values increased in Group 2 in younger and taller children, and in heavier children. MEP values fell with the length of anaesthesia. In brief anaesthesia, nitrogen was not removed from the middle ear quickly in Group 1: middle ear pressure values were higher. The nitrous oxide remained in the middle ear longer and so the possibility of ear toxicity may increase. In Group 2, 50% O2 was rapidly absorbed and removed from the middle ear and so middle ear pressure was not as high. It may be concluded that air-oxygen mixture (Inspired O2 50%) anaesthesia should be recommended as being more reliable in tympanoplasties and other middle ear interventions than a N2O-O2 mixture (Inspired O2 30%).

Systems and methods for thermal imaging technique for measuring mixing of fluids

DOEpatents

Booten, Charles; Tomerlin, Jeff; Winkler, Jon

2016-06-14

Systems and methods for thermal imaging for measuring mixing of fluids are provided. In one embodiment, a method for measuring mixing of gaseous fluids using thermal imaging comprises: positioning a thermal test medium parallel to a direction gaseous fluid flow from an outlet vent of a momentum source, wherein when the source is operating, the fluid flows across a surface of the medium; obtaining an ambient temperature value from a baseline thermal image of the surface; obtaining at least one operational thermal image of the surface when the fluid is flowing from the outlet vent across the surface, wherein the fluid has a temperature different than the ambient temperature; and calculating at least one temperature-difference fraction associated with at least a first position on the surface based on a difference between temperature measurements obtained from the at least one operational thermal image and the ambient temperature value.

Operating characteristics of depression and anxiety disorder phenotype dimensions and trait neuroticism: a theoretical examination of the fear and distress disorders from the Netherlands study of depression and anxiety.

PubMed

Tully, Phillip J; Wardenaar, Klaas J; Penninx, Brenda W J H

2015-03-15

The receiver operating characteristics (ROC) of anhedonic depression and anxious arousal to detect the distress- (major depression, dysthymia, generalized anxiety disorder) and fear-disorder clusters (i.e. panic disorder, agoraphobia, social phobia) have not been reported in a large sample. A sample of 2981 persons underwent structured psychiatric interview; n=652 were without lifetime depression and anxiety disorder history. Participants also completed a neuroticism scale (Revised NEO Five Factor Inventory [NEO-FFI]), and the 30-item short adaptation of the Mood and Anxiety Symptoms Questionnaire (MASQ-D30) measuring anhedonic depression, anxious arousal and general distress. Maximal sensitivity and specificity was determined by the Youden Index and the area-under-the-curve (AUC) in ROC analysis. A total of 2624 completed all measures (age M=42.4 years±13.1, 1760 females [67.1%]), including 1060 (40.4%) persons who met criteria for a distress-disorder, and 973 (37.1%) who met criteria for a fear-disorder. The general distress dimension provided the highest ROC values in the detection of the distress-disorders (AUC=.814, sensitivity=71.95%, specificity=76.34%, positive predictive value=67.33, negative predictive value=80.07). None of the measures provided suitable operating characteristics in the detection of the fear-disorders with specificity values <75%. Over sampling of depression and anxiety disorders may lead to inflated positive- and negative predictive values. The MASQ-D30 general distress dimension showed clinically suitable operating characteristics in the detection of distress-disorders. Neither neuroticism nor the MASQ-D30 dimensions provided suitable operating characteristics in the detection of the fear-disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

Performance of magnetic resonance imaging in the evaluation of first-time and reoperative primary hyperparathyroidism.

PubMed

Kluijfhout, Wouter P; Venkatesh, Shriya; Beninato, Toni; Vriens, Menno R; Duh, Quan-Yang; Wilson, David M; Hope, Thomas A; Suh, Insoo

2016-09-01

Preoperative imaging in patients with primary hyperparathyroidism and a previous parathyroid operation is essential; however, performance of conventional imaging is poor in this subgroup. Magnetic resonance imaging appears to be a good alternative, though overall evidence remains scarce. We retrospectively investigated the performance of magnetic resonance imaging in patients with and without a previous parathyroid operation, with a separate comparison for dynamic gadolinium-enhanced magnetic resonance imaging. All patients undergoing magnetic resonance imaging prior to parathyroidectomy for primary hyperparathyroidism (first time or recurrent) between January 2000 and August 2015 at a high-volume, tertiary care, referral center for endocrine operations were included. We compared the sensitivity and positive predictive value of magnetic resonance imaging with conventional ultrasound and sestamibi on a per-lesion level. A total of 3,450 patients underwent parathyroidectomy, of which 84 patients with recurrent (n = 10) or persistent (n = 74) disease and 41 patients with a primary operation were included. Magnetic resonance imaging had a sensitivity and positive predictive value of 79.9% and 84.7%, respectively, and performance was good in both patients with and without a previous parathyroid operation. Adding magnetic resonance imaging to the combination of ultrasound and sestamibi resulted in a significant increase in sensitivity from 75.2% to 91.5%. Dynamic magnetic resonance imaging produced excellent results in the reoperative group, with sensitivity and a positive predictive value of 90.1%. Technologic advances have enabled faster and more accurate magnetic resonance imaging protocols, making magnetic resonance imaging an excellent alternative modality without associated ionizing radiation. Our study shows that the sensitivity of multimodality imaging for parathyroid adenomas improved significantly with the use of conventional and dynamic magnetic resonance imaging, even in the case of recurrent or persistent disease. Published by Elsevier Inc.

Optimal waist circumference cutoff value for defining the metabolic syndrome in postmenopausal Latin American women.

PubMed

Blümel, Juan E; Legorreta, Deborah; Chedraui, Peter; Ayala, Felix; Bencosme, Ascanio; Danckers, Luis; Lange, Diego; Espinoza, Maria T; Gomez, Gustavo; Grandia, Elena; Izaguirre, Humberto; Manriquez, Valentin; Martino, Mabel; Navarro, Daysi; Ojeda, Eliana; Onatra, William; Pozzo, Estela; Prada, Mariela; Royer, Monique; Saavedra, Javier M; Sayegh, Fabiana; Tserotas, Konstantinos; Vallejo, Maria S; Zuñiga, Cristina

2012-04-01

The aim of this study was to determine an optimal waist circumference (WC) cutoff value for defining the metabolic syndrome (METS) in postmenopausal Latin American women. A total of 3,965 postmenopausal women (age, 45-64 y), with self-reported good health, attending routine consultation at 12 gynecological centers in major Latin American cities were included in this cross-sectional study. Modified guidelines of the US National Cholesterol Education Program, Adult Treatment Panel III were used to assess METS risk factors. Receiver operator characteristic curve analysis was used to obtain an optimal WC cutoff value best predicting at least two other METS components. Optimal cutoff values were calculated by plotting the true-positive rate (sensitivity) against the false-positive rate (1 - specificity). In addition, total accuracy, distance to receiver operator characteristic curve, and the Youden Index were calculated. Of the participants, 51.6% (n = 2,047) were identified as having two or more nonadipose METS risk components (excluding a positive WC component). These women were older, had more years since menopause onset, used hormone therapy less frequently, and had higher body mass indices than women with fewer metabolic risk factors. The optimal WC cutoff value best predicting at least two other METS components was determined to be 88 cm, equal to that defined by the Adult Treatment Panel III. A WC cutoff value of 88 cm is optimal for defining METS in this postmenopausal Latin American series.

Fatty liver index and hepatic steatosis index for prediction of non-alcoholic fatty liver disease in type 1 diabetes.

PubMed

Sviklāne, Laura; Olmane, Evija; Dzērve, Zane; Kupčs, Kārlis; Pīrāgs, Valdis; Sokolovska, Jeļizaveta

2018-01-01

Little is known about the diagnostic value of hepatic steatosis index (HSI) and fatty liver index (FLI), as well as their link to metabolic syndrome in type 1 diabetes mellitus. We have screened the effectiveness of FLI and HSI in an observational pilot study of 40 patients with type 1 diabetes. FLI and HSI were calculated for 201 patients with type 1 diabetes. Forty patients with FLI/HSI values corresponding to different risk of liver steatosis were invited for liver magnetic resonance study. In-phase/opposed-phase technique of magnetic resonance was used. Accuracy of indices was assessed from the area under the receiver operating characteristic curve. Twelve (30.0%) patients had liver steatosis. For FLI, sensitivity was 90%; specificity, 74%; positive likelihood ratio, 3.46; negative likelihood ratio, 0.14; positive predictive value, 0.64; and negative predictive value, 0.93. For HSI, sensitivity was 86%; specificity, 66%; positive likelihood ratio, 1.95; negative likelihood ratio, 0.21; positive predictive value, 0.50; and negative predictive value, 0.92. Area under the receiver operating characteristic curve for FLI was 0.86 (95% confidence interval [0.72; 0.99]); for HSI 0.75 [0.58; 0.91]. Liver fat correlated with liver enzymes, waist circumference, triglycerides, and C-reactive protein. FLI correlated with C-reactive protein, liver enzymes, and blood pressure. HSI correlated with waist circumference and C-reactive protein. FLI ≥ 60 and HSI ≥ 36 were significantly associated with metabolic syndrome and nephropathy. The tested indices, especially FLI, can serve as surrogate markers for liver fat content and metabolic syndrome in type 1 diabetes. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Extended space expectation values in quantum dynamical system evolutions

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

Demiralp, Metin

2014-10-06

The time variant power series expansion for the expectation value of a given quantum dynamical operator is well-known and well-investigated issue in quantum dynamics. However, depending on the operator and Hamiltonian singularities this expansion either may not exist or may not converge for all time instances except the beginning of the evolution. This work focuses on this issue and seeks certain cures for the negativities. We work in the extended space obtained by adding all images of the initial wave function under the system Hamiltonian’s positive integer powers. This requires the introduction of certain appropriately defined weight operators. The resultingmore » better convergence in the temporal power series urges us to call the new defined entities “extended space expectation values” even though they are constructed over certain weight operators and are somehow pseudo expectation values.« less

Effects of Prone Position and Positive End-Expiratory Pressure on Noninvasive Estimators of ICP: A Pilot Study.

PubMed

Robba, Chiara; Bragazzi, Nicola Luigi; Bertuccio, Alessandro; Cardim, Danilo; Donnelly, Joseph; Sekhon, Mypinder; Lavinio, Andrea; Duane, Derek; Burnstein, Rowan; Matta, Basil; Bacigaluppi, Susanna; Lattuada, Marco; Czosnyka, Marek

2017-07-01

Prone positioning and positive end-expiratory pressure can improve pulmonary gas exchange and respiratory mechanics. However, they may be associated with the development of intracranial hypertension. Intracranial pressure (ICP) can be noninvasively estimated from the sonographic measurement of the optic nerve sheath diameter (ONSD) and from the transcranial Doppler analysis of the pulsatility (ICPPI) and the diastolic component (ICPFVd) of the velocity waveform. The effect of the prone positioning and positive end-expiratory pressure on ONSD, ICPFVd, and ICPPI was assessed in a prospective study of 30 patients undergoing spine surgery. One-way repeated measures analysis of variance, fixed-effect multivariate regression models, and receiver operating characteristic analyses were used to analyze numerical data. The mean values of ONSD, ICPFVd, and ICPPI significantly increased after change from supine to prone position. Receiver operating characteristic analyses demonstrated that, among the noninvasive methods, the mean ONSD measure had the greatest area under the curve signifying it is the most effective in distinguishing a hypothetical change in ICP between supine and prone positioning (0.86±0.034 [0.79 to 0.92]). A cutoff of 0.43 cm was found to be a best separator of ONSD value between supine and prone with a specificity of 75.0 and a sensitivity of 86.7. Noninvasive ICP estimation may be useful in patients at risk of developing intracranial hypertension who require prone positioning.

Differential diagnosis of benign and malignant breast masses using diffusion-weighted magnetic resonance imaging.

PubMed

Min, Qinghua; Shao, Kangwei; Zhai, Lulan; Liu, Wei; Zhu, Caisong; Yuan, Lixin; Yang, Jun

2015-02-07

Diffusion-weighted magnetic resonance imaging (DW-MRI) is different from conventional diagnostic methods and has the potential to delineate the microscopic anatomy of a target tissue or organ. The purpose of our study was to evaluate the value of DW-MRI in the diagnosis of benign and malignant breast masses, which would help the clinical surgeon to decide the scope and pattern of operation. A total of 52 female patients with palpable solid breast masses received breast MRI scans using routine sequences, dynamic contrast-enhanced imaging, and diffusion-weighted echo-planar imaging at b values of 400, 600, and 800 s/mm(2), respectively. Two regions of interest (ROIs) were plotted, with a smaller ROI for the highest signal and a larger ROI for the overall lesion. Apparent diffusion coefficient (ADC) values were calculated at three different b values for all detectable lesions and from two different ROIs. The sensitivity, specificity, positive predictive value, and positive likelihood ratio of DW-MRI were determined for comparison with histological results. A total of 49 (49/52, 94.2%) lesions were detected using DW-MRI, including 20 benign lesions (two lesions detected in the same patient) and 29 malignant lesions. Benign lesion had a higher mean ADC value than their malignant counterparts, regardless of b value. According to the receiver operating characteristic (ROC) curve, the smaller-range ROI was more effective in differentiation between benign and malignant lesions. The area under the ROC curve was the largest at a b value of 800 s/mm(2). With a threshold ADC value at 1.23 × 10(-3) mm(2)/s, DW-MRI achieved a sensitivity of 82.8%, specificity of 90.0%, positive predictive value of 92.3%, and positive likelihood ratio of 8.3 for differentiating benign and malignant lesions. DW-MRI is an accurate diagnostic tool for differentiation between benign and malignant breast lesions, with an optimal b value of 800 s/mm(2). A smaller-range ROI focusing on the highest signal has a better differential value.

Branchial cleft anomalies: accuracy of pre-operative diagnosis, clinical presentation and management.

PubMed

Guldfred, L-A; Philipsen, B B; Siim, C

2012-06-01

To examine the accuracy of the pre-operative diagnosis of branchial cleft anomalies, and also to describe their occurrence, clinical presentation and management. Retrospective review of the records of patients diagnosed with a branchial cleft anomaly between 1997 and 2006. One hundred and twenty-six patients were included. Pre-operative diagnosis had a positive predictive value of 0.856 (95 per cent confidence interval, 0.771-0.918) and a sensitivity of 0.944 (95 per cent confidence interval, 0.869-0.979). These patients' demographic data, investigations, findings and management are presented, along with a possible strategy for dealing with solitary cystic masses in the neck. As pre-operative diagnosis has a positive predictive value of 86 per cent, cystic lesions in the neck should be presumed to be carcinomatous until proven otherwise. Branchial fistulae and sinuses seem to be a disease of childhood, while branchial cysts occur mainly in adults. Branchial cleft anomalies are equally frequent in men and women, and equally distributed on the left and right side of the neck.

Phase-space representations of symmetric informationally complete positive-operator-valued-measure fiducial states

NASA Astrophysics Data System (ADS)

Saraceno, Marcos; Ermann, Leonardo; Cormick, Cecilia

2017-03-01

The problem of finding symmetric informationally complete positive-operator-valued-measures (SIC-POVMs) has been solved numerically for all dimensions d up to 67 [A. J. Scott and M. Grassl, J. Math. Phys. 51, 042203 (2010), 10.1063/1.3374022], but a general proof of existence is still lacking. For each dimension, it was shown that it is possible to find a SIC-POVM that is generated from a fiducial state upon application of the operators of the Heisenberg-Weyl group. We draw on the numerically determined fiducial states to study their phase-space features, as displayed by the characteristic function and the Wigner, Bargmann, and Husimi representations, adapted to a Hilbert space of finite dimension. We analyze the phase-space localization of fiducial states, and observe that the SIC-POVM condition is equivalent to a maximal delocalization property. Finally, we explore the consequences in phase space of the conjectured Zauner symmetry. In particular, we construct a Hermitian operator commuting with this symmetry that leads to a representation of fiducial states in terms of eigenfunctions with definite semiclassical features.

Method of improving a digital image

NASA Technical Reports Server (NTRS)

Jobson, Daniel J. (Inventor); Woodell, Glenn A. (Inventor); Rahman, Zia-ur (Inventor)

1999-01-01

A method of improving a digital image is provided. The image is initially represented by digital data indexed to represent positions on a display. The digital data is indicative of an intensity value I.sub.i (x,y) for each position (x,y) in each i-th spectral band. The intensity value for each position in each i-th spectral band is adjusted to generate an adjusted intensity value for each position in each i-th spectral band in accordance with ##EQU1## where S is the number of unique spectral bands included in said digital data, W.sub.n is a weighting factor and * denotes the convolution operator. Each surround function F.sub.n (x,y) is uniquely scaled to improve an aspect of the digital image, e.g., dynamic range compression, color constancy, and lightness rendition. The adjusted intensity value for each position in each i-th spectral band is filtered with a common function and then presented to a display device. For color images, a novel color restoration step is added to give the image true-to-life color that closely matches human observation.

43 CFR 404.39 - What factors will Reclamation consider in evaluating my capability to pay 25 percent or more of...

Code of Federal Regulations, 2014 CFR

2014-10-01

... and depreciation, maintenance and repair); (6) Cash flow from operating activities (positive value... financial obligations; (9) Collateral/equity as appropriate; (10) Cash flows from capital and related financing activities (negative value from principle paid on bonds and interest payments); (11) Net cash flow...

43 CFR 404.39 - What factors will Reclamation consider in evaluating my capability to pay 25 percent or more of...

Code of Federal Regulations, 2011 CFR

2011-10-01

... and depreciation, maintenance and repair); (6) Cash flow from operating activities (positive value... financial obligations; (9) Collateral/equity as appropriate; (10) Cash flows from capital and related financing activities (negative value from principle paid on bonds and interest payments); (11) Net cash flow...

43 CFR 404.39 - What factors will Reclamation consider in evaluating my capability to pay 25 percent or more of...

Code of Federal Regulations, 2012 CFR

2012-10-01

... and depreciation, maintenance and repair); (6) Cash flow from operating activities (positive value... financial obligations; (9) Collateral/equity as appropriate; (10) Cash flows from capital and related financing activities (negative value from principle paid on bonds and interest payments); (11) Net cash flow...

43 CFR 404.39 - What factors will Reclamation consider in evaluating my capability to pay 25 percent or more of...

Code of Federal Regulations, 2013 CFR

2013-10-01

... and depreciation, maintenance and repair); (6) Cash flow from operating activities (positive value... financial obligations; (9) Collateral/equity as appropriate; (10) Cash flows from capital and related financing activities (negative value from principle paid on bonds and interest payments); (11) Net cash flow...

Positioning the Learning Asset Portfolio as a Key Component in an Organization's Enterprise Risk Management Strategy

ERIC Educational Resources Information Center

McAliney, Peter J.

2009-01-01

This article presents a process for valuing a portfolio of learning assets used by line executives across industries to value traditional business assets. Embedded within the context of enterprise risk management, this strategic asset allocation process is presented step by step, providing readers the operational considerations to implement this…

Influence of the vibro-acoustic sensor position on cavitation detection in a Kaplan turbine

NASA Astrophysics Data System (ADS)

Schmidt, H.; Kirschner, O.; Riedelbauch, S.; Necker, J.; Kopf, E.; Rieg, M.; Arantes, G.; Wessiak, M.; Mayrhuber, J.

2014-03-01

Hydraulic turbines can be operated close to the limits of the operating range to meet the demand of the grid. When operated close to the limits, the risk increases that cavitation phenomena may occur at the runner and / or at the guide vanes of the turbine. Cavitation in a hydraulic turbine can cause material erosion on the runner and other turbine parts and reduce the durability of the machine leading to required outage time and related repair costs. Therefore it is important to get reliable information about the appearance of cavitation during prototype operation. In this experimental investigation the high frequency acoustic emissions and vibrations were measured at 20 operating points with different cavitation behaviour at different positions in a large prototype Kaplan turbine. The main goal was a comparison of the measured signals at different sensor positions to identify the sensitivity of the location for cavitation detection. The measured signals were analysed statistically and specific values were derived. Based on the measured signals, it is possible to confirm the cavitation limit of the examined turbine. The result of the investigation shows that the position of the sensors has a significant influence on the detection of cavitation.

Well-posedness of nonlocal parabolic differential problems with dependent operators.

PubMed

Ashyralyev, Allaberen; Hanalyev, Asker

2014-01-01

The nonlocal boundary value problem for the parabolic differential equation v'(t) + A(t)v(t) = f(t) (0 ≤ t ≤ T), v(0) = v(λ) + φ, 0 < λ ≤ T in an arbitrary Banach space E with the dependent linear positive operator A(t) is investigated. The well-posedness of this problem is established in Banach spaces C 0 (β,γ) (E α-β ) of all E α-β -valued continuous functions φ(t) on [0, T] satisfying a Hölder condition with a weight (t + τ)(γ). New Schauder type exact estimates in Hölder norms for the solution of two nonlocal boundary value problems for parabolic equations with dependent coefficients are established.

Sonographic evaluation of the fetal spine position and success rate of manual rotation of the fetus in occiput posterior position: A randomized controlled trial.

PubMed

Masturzo, Bianca; Farina, Antonio; Attamante, Lorenza; Piazzese, Annalisa; Rolfo, Alessandro; Gaglioti, Pietro; Todros, Tullia

2017-10-01

To evaluate whether sonographic (US) diagnosis of the fetal spine position could increase the success rate of manual rotation of the fetal occiput (MRFO) in second-stage arrest in persistent occiput posterior position (OPP). In this randomized controlled parallel single-center trial, 58 nulliparous in second-stage arrest of labor with fetus in cephalic presentation and OPP diagnosed by US were randomly assigned to group A where the fetal spine position was not known by the operator or to group B where the operator knew it. The main outcome was the success of MRFO in the two groups. Secondary outcomes were perineal injuries, blood loss, duration of expulsive period, and neonatal APGAR at 5 minutes. A priori knowledge of the spine position improves the success of the MRFO (41.4% group A versus 82.8% group B, p value < 0.001), the percentage of spontaneous deliveries (27.6% group A versus 69% group B, p value = 0.01), and maternal outcome (intact perineum and blood loss). No differences were detected on the neonatal side. MRFO is a safe and useful procedure that should be performed in second-stage arrest in OPP. A better performance was observed when supported by the US knowledge of the spine position. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:472-476, 2017. © 2017 Wiley Periodicals, Inc.

Enough positive rate of paraspinal mapping and diffusion tensor imaging with levels which should be decompressed in lumbar spinal stenosis.

PubMed

Chen, Hua-Biao; Zhong, Zhi-Wei; Li, Chun-Sheng; Bai, Bo

2016-07-01

In lumbar spinal stenosis, correlating symptoms and physical examination findings with decompression levels based on common imaging is not reliable. Paraspinal mapping (PM) and diffusion tensor imaging (DTI) may be possible to prevent the false positive occurrences with MRI and show clear benefits to reduce the decompression levels of lumbar spinal stenosis than conventional magnetic resonance imaging (MRI) + neurogenic examination (NE). However, they must have enough positive rate with levels which should be decompressed at first. The study aimed to confirm that the positive of DTI and PM is enough in levels which should be decompressed in lumbar spinal stenosis. The study analyzed the positive of DTI and PM as well as compared the preoperation scores to the postoperation scores, which were assessed preoperatively and at 2 weeks, 3 months 6 months, and 12 months postoperatively. 96 patients underwent the single level decompression surgery. The positive rate among PM, DTI, and (PM or DTI) was 76%, 98%, 100%, respectively. All post-operative Oswestry Disability Index (ODI), visual analog scale for back pain (VAS-BP) and visual analog scale for leg pain (VAS-LP) scores at 2 weeks postoperatively were measured improvement than the preoperative ODI, VAS-BP and VAS-LP scores with statistically significance (p-value = 0.000, p-value = 0.000, p-value = 0.000, respectively). In degenetive lumbar spinal stenosis, the positive rate of (DTI or PM) is enough in levels which should be decompressed, thence using the PM and DTI to determine decompression levels will not miss the level which should be operated. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Effectiveness of computer-aided diagnosis (CADx) of breast pathology using immunohistochemistry results of core needle biopsy samples for synaptophysin, oestrogen receptor and CK14/p63 for classification of epithelial proliferative lesions of the breast.

PubMed

Maeda, Ichiro; Kubota, Manabu; Ohta, Jiro; Shinno, Kimika; Tajima, Shinya; Ariizumi, Yasushi; Doi, Masatomo; Oana, Yoshiyasu; Kanemaki, Yoshihide; Tsugawa, Koichiro; Ueno, Takahiko; Takagi, Masayuki

2017-12-01

The aim of this study was to develop a computer-aided diagnosis (CADx) system for identifying breast pathology. Two sets of 100 consecutive core needle biopsy (CNB) specimens were collected for test and validation studies. All 200 CNB specimens were stained with antibodies targeting oestrogen receptor (ER), synaptophysin and CK14/p63. All stained slides were scanned in a whole-slide imaging system and photographed. The photographs were analysed using software to identify the proportions of tumour cells that were positive and negative for each marker. In the test study, the cut-off values for synaptophysin (negative and positive) and CK14/p63 (negative and positive) were decided using receiver operating characteristic (ROC) analysis. For ER analysis, samples were divided into groups with <10% positive or >10% positive cells and decided using receiver operating characteristic (ROC) analysis. Finally, these two groups categorised as ER-low, ER-intermediate (non-low and non-high) and ER-high groups. In the validation study, the second set of immunohistochemical slides were analysed using these cut-off values. The cut-off values for synaptophysin, <10% ER positive, >10% ER positive and CK14/p63 were 0.14%, 2.17%, 77.93% and 18.66%, respectively. The positive predictive value for malignancy (PPV) was 100% for synaptophysin-positive/ER-high/(CK14/p63)-any or synaptophysin-positive/ER-low/(CK14/p63)-any. The PPV was 25% for synaptophysin-positive/ER-intermediate/(CK14/p63)-positive. For synaptophysin-negative/(CK14/p63)-negative, the PPVs for ER-low, ER-intermediate and ER-high were 100%, 80.0% and 95.8%, respectively. The PPV was 4.5% for synaptophysin-negative/ER-intermediate/(CK14/p63)-positive. The CADx system was able to analyse sufficient data for all types of epithelial proliferative lesions of the breast including invasive breast cancer. This system may be useful for pathological diagnosis of breast CNB in routine investigations. © 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.

Quantum Strategies and Local Operations

NASA Astrophysics Data System (ADS)

Gutoski, Gus

2010-02-01

This thesis is divided into two parts. In Part I we introduce a new formalism for quantum strategies, which specify the actions of one party in any multi-party interaction involving the exchange of multiple quantum messages among the parties. This formalism associates with each strategy a single positive semidefinite operator acting only upon the tensor product of the input and output message spaces for the strategy. We establish three fundamental properties of this new representation for quantum strategies and we list several applications, including a quantum version of von Neumann's celebrated 1928 Min-Max Theorem for zero-sum games and an efficient algorithm for computing the value of such a game. In Part II we establish several properties of a class of quantum operations that can be implemented locally with shared quantum entanglement or classical randomness. In particular, we establish the existence of a ball of local operations with shared randomness lying within the space spanned by the no-signaling operations and centred at the completely noisy channel. The existence of this ball is employed to prove that the weak membership problem for local operations with shared entanglement is strongly NP-hard. We also provide characterizations of local operations in terms of linear functionals that are positive and "completely" positive on a certain cone of Hermitian operators, under a natural notion of complete positivity appropriate to that cone. We end the thesis with a discussion of the properties of no-signaling quantum operations.

40 CFR 1065.340 - Diluted exhaust flow (CVS) calibration.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-open position. (6) Operate the PDP for at least 3 min to stabilize the system. Continue operating the PDP and record the mean values of at least 30 seconds of sampled data of each of the following... the PDP, p in. (8) Repeat the steps in paragraphs (e)(6) and (7) of this section to record data at a...

The Relationship between Patron-Dependence, Communication and Development: A Look into Social Integration and Socio-Economic Control.

ERIC Educational Resources Information Center

Quesada, Gustavo M.

Personal interviews were conducted in July, 1967, with 315 farm operators in rural Brazil where the local extension service had been in operation for more than four years. Patron-dependence (PD) was described as the subscription to a value system, according to the individual's position in the status structure, which produces dependency at…

Displaying Force and Torque of A Manipulator

NASA Technical Reports Server (NTRS)

Bejczy, A. K.; Dotson, R. S.; Primus, H. C.

1984-01-01

Display combines bar charts, vector diagrams, and numerical values to inform operator of forces and torques exerted by end effector of manipulator. On voice or keyboard command, eight-channel strip-chart recorder traces force and torque components and claw position of raw measurements from eight strain gage sensors in end effector. Especially helpful when operator's view of end effector is obscured.

Advisory Algorithm for Scheduling Open Sectors, Operating Positions, and Workstations

NASA Technical Reports Server (NTRS)

Bloem, Michael; Drew, Michael; Lai, Chok Fung; Bilimoria, Karl D.

2012-01-01

Air traffic controller supervisors configure available sector, operating position, and work-station resources to safely and efficiently control air traffic in a region of airspace. In this paper, an algorithm for assisting supervisors with this task is described and demonstrated on two sample problem instances. The algorithm produces configuration schedule advisories that minimize a cost. The cost is a weighted sum of two competing costs: one penalizing mismatches between configurations and predicted air traffic demand and another penalizing the effort associated with changing configurations. The problem considered by the algorithm is a shortest path problem that is solved with a dynamic programming value iteration algorithm. The cost function contains numerous parameters. Default values for most of these are suggested based on descriptions of air traffic control procedures and subject-matter expert feedback. The parameter determining the relative importance of the two competing costs is tuned by comparing historical configurations with corresponding algorithm advisories. Two sample problem instances for which appropriate configuration advisories are obvious were designed to illustrate characteristics of the algorithm. Results demonstrate how the algorithm suggests advisories that appropriately utilize changes in airspace configurations and changes in the number of operating positions allocated to each open sector. The results also demonstrate how the advisories suggest appropriate times for configuration changes.

Spectrally Encoded Confocal Microscopy (SECM) for Diagnosing of Breast Cancer in Excision and Margin Specimens

PubMed Central

Brachtel, Elena F.; Johnson, Nicole B.; Huck, Amelia E.; Rice-Stitt, Travis L.; Vangel, Mark G.; Smith, Barbara L.; Tearney, Guillermo J.; Kang, Dongkyun

2016-01-01

A large percentage of breast cancer patients treated with breast conserving surgery need to undergo multiple surgeries due to positive margins found during post-operative margin assessment. Carcinomas could be removed completely during the initial surgery and additional surgery avoided if positive margins can be determined intra-operatively. Spectrally-encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technology that has a potential to rapidly image the entire surgical margin at sub-cellular resolution and accurately determine margin status intra-operatively. In this paper, in order to test feasibility of using SECM for intra-operative margin assessment, we have evaluated the diagnostic accuracy of SECM for detecting various types of breast cancers. Forty-six surgically-removed breast specimens were imaged with a SECM system. Side-by-side comparison between SECM and histologic images showed that SECM images can visualize key histomorphologic patterns of normal/benign and malignant breast tissues. Small (500 µm × 500 µm) spatially-registered SECM and histologic images (n=124 for each) were diagnosed independently by three pathologists with expertise in breast pathology. Diagnostic accuracy of SECM for determining malignant tissues was high, average sensitivity of 0.91, specificity of 0.93, positive predictive value of 0.95, and negative predictive value of 0.87. Intra-observer agreement and inter-observer agreement for SECM were also high, 0.87 and 0.84, respectively. Results from this study suggest that SECM may be developed into an intra-operative margin assessment tool for guiding breast cancer excisions. PMID:26779830

Optimal ergonomics for laparoscopic surgery in minimally invasive surgery suites: a review and guidelines.

PubMed

van Det, M J; Meijerink, W J H J; Hoff, C; Totté, E R; Pierie, J P E N

2009-06-01

With minimally invasive surgery (MIS), a man-machine environment was brought into the operating room, which created mental and physical challenges for the operating team. The science of ergonomics analyzes these challenges and formulates guidelines for creating a work environment that is safe and comfortable for its operators while effectiveness and efficiency of the process are maintained. This review aimed to formulate the ergonomic challenges related to monitor positioning in MIS. Background and guidelines are formulated for optimal ergonomic monitor positioning within the possibilities of the modern MIS suite, using multiple monitors suspended from the ceiling. All evidence-based experimental ergonomic studies conducted in the fields of laparoscopic surgery and applied ergonomics for other professions working with a display were identified by PubMed searches and selected for quality and applicability. Data from ergonomic studies were evaluated in terms of effectiveness and efficiency as well as comfort and safety aspects. Recommendations for individual monitor positioning are formulated to create a personal balance between these two ergonomic aspects. Misalignment in the eye-hand-target axis because of limited freedom in monitor positioning is recognized as an important ergonomic drawback during MIS. Realignment of the eye-hand-target axis improves personal values of comfort and safety as well as procedural values of effectiveness and efficiency. Monitor position is an important ergonomic factor during MIS. In the horizontal plain, the monitor should be straight in front of each person and aligned with the forearm-instrument motor axis to avoid axial rotation of the spine. In the sagittal plain, the monitor should be positioned lower than eye level to avoid neck extension.

A Study of Discharge Coefficient in Bileaflet Valves

DTIC Science & Technology

2001-10-25

Granados J. Garcia MA. Luque I. Concha M. “Conservative operation for mitral stenosis with densely fibrosed or partially calcified valves. An eight...for aortic valves, whereas a lower value (around 0.7) has been proposed for valves mounted in the mitralic position, on account of the larger upstream...section; in the mitral position, then, a valve will have a smaller discharge coefficient (or Aeff/A ratio) than in the aortic position. Using dC =1

Classical Information Storage in an n-Level Quantum System

NASA Astrophysics Data System (ADS)

Frenkel, Péter E.; Weiner, Mihály

2015-12-01

A game is played by a team of two—say Alice and Bob—in which the value of a random variable x is revealed to Alice only, who cannot freely communicate with Bob. Instead, she is given a quantum n-level system, respectively a classical n-state system, which she can put in possession of Bob in any state she wishes. We evaluate how successfully they managed to store and recover the value of x by requiring Bob to specify a value z and giving a reward of value f ( x, z) to the team. We show that whatever the probability distribution of x and the reward function f are, when using a quantum n-level system, the maximum expected reward obtainable with the best possible team strategy is equal to that obtainable with the use of a classical n-state system. The proof relies on mixed discriminants of positive matrices and—perhaps surprisingly—an application of the Supply-Demand Theorem for bipartite graphs. As a corollary, we get an infinite set of new, dimension dependent inequalities regarding positive operator valued measures and density operators on complex n-space. As a further corollary, we see that the greatest value, with respect to a given distribution of x, of the mutual information I ( x; z) that is obtainable using an n-level quantum system equals the analogous maximum for a classical n-state system.

Value as a parameter to consider in operational strategies for CSP plants

NASA Astrophysics Data System (ADS)

de Meyer, Oelof; Dinter, Frank; Govender, Saneshan

2017-06-01

This paper introduced a value parameter to consider when analyzing operational strategies for CSP plants. The electric system in South Africa, used as case study, is severely constrained with an influx of renewables in the early phase of deployment. The energy demand curve for the system is analyzed showing the total wind and solar photovoltaic contributions for winter and summer. Due to the intermittent nature and meteorological operating conditions of wind and solar photovoltaic plants, the value of CSP plants within the electric system is introduced. Analyzing CSP plants based on the value parameter alone will remain only a philosophical view. Currently there is no quantifiable measure to translate the philosophical view or subjective value and it solely remains the position of the stakeholder. By introducing three other parameters, Cost, Plant and System to a holistic representation of the Operating Strategies of generation plants, the Value parameter can be translated into a quantifiable measure. Utilizing the country's current procurement program as case study, CSP operating under the various PPA within the Bid Windows are analyzed. The Value Cost Plant System diagram developed is used to quantify the value parameter. This paper concluded that no value is obtained from CSP plants operating under the Bid Window 1 & 2 Power Purchase Agreement. However, by recognizing the dispatchability potential of CSP plants in Bid Window 3 & 3.5, the value of CSP in the electric system can be quantified utilizing Value Added Relationship VCPS-diagram. Similarly ancillary services to the system were analyzed. One of the relationships that have not yet been explored within the industry is an interdependent relationship. It was emphasized that the cost and value structure is shared between the plant and system. Although this relationship is functional when the plant and system belongs to the same entity, additional value is achieved by marginalizing the cost structure. A tradeoff between the plant performance indicators and system operations are achieved. CSP plants have demonstrated its capabilities by adapting to various operating strategies. With adequate storage capabilities and appropriate system boundary conditions in place, CSP plants offer solutions as base-load generation plants, peaking plants, intermittent generation and ancillary services to the system. Depending on the electric system structure, the value obtained from CSP plants are quantifiable under the right boundary conditions. An interdependent relationship between the plant and system attains the most value in operating strategies for CSP.

On approximately symmetric informationally complete positive operator-valued measures and related systems of quantum states

NASA Astrophysics Data System (ADS)

Klappenecker, Andreas; Rötteler, Martin; Shparlinski, Igor E.; Winterhof, Arne

2005-08-01

We address the problem of constructing positive operator-valued measures (POVMs) in finite dimension n consisting of n2 operators of rank one which have an inner product close to uniform. This is motivated by the related question of constructing symmetric informationally complete POVMs (SIC-POVMs) for which the inner products are perfectly uniform. However, SIC-POVMs are notoriously hard to construct and, despite some success of constructing them numerically, there is no analytic construction known. We present two constructions of approximate versions of SIC-POVMs, where a small deviation from uniformity of the inner products is allowed. The first construction is based on selecting vectors from a maximal collection of mutually unbiased bases and works whenever the dimension of the system is a prime power. The second construction is based on perturbing the matrix elements of a subset of mutually unbiased bases. Moreover, we construct vector systems in Cn which are almost orthogonal and which might turn out to be useful for quantum computation. Our constructions are based on results of analytic number theory.

Evolution of seismicity in relation to fluid injection in the North-Western part of The Geysers geothermal field

NASA Astrophysics Data System (ADS)

Leptokaropoulos, Konstantinos; Staszek, Monika; Lasocki, Stanisław; Martínez-Garzón, Patricia; Kwiatek, Grzegorz

2018-02-01

The Geysers geothermal field located in California, USA, is the largest geothermal site in the world, operating since the 1960s. We here investigate and quantify the correlation between temporal seismicity evolution and variation of the injection data by examination of time-series through specified statistical tools (binomial test to investigate significant rate changes, cross correlation between seismic and injection data, b-value variation analysis). To do so, we utilize seismicity and operational data associated with two injection wells (Prati-9 and Prati-29) which cover a time period of approximately 7 yr (from November 2007 to August 2014). The seismicity is found to be significantly positively correlated with the injection rate. The maximum correlation occurs with a seismic response delay of ˜2 weeks, following injection operations. Those results are very stable even after considering hypocentral uncertainties, by applying a vertical shift of the events foci up to 300 m. Our analysis indicates also time variations of b-value, which exhibits significant positive correlation with injection rates.

Effect of processing on nutritive values of milk protein.

PubMed

Borad, Sanket G; Kumar, Anuj; Singh, Ashish K

2017-11-22

Milk is an essential source of nutritionally excellent quality protein in human, particularly in vegan diet. Before consumption, milk is invariably processed depending upon final product requirement. This processing may alter the nutritive value of protein in a significant manner. The processing operations like thermal treatment, chemical treatment, biochemical processing, physical treatments, nonconventional treatments, etc. may exert positive or negative influence on nutritional quality of milk proteins. On one side, processing enhances the nutritive and therapeutic values of protein while on other side intermediate or end products generated during protein reactions may cause toxicity and/or antigenicity upon consumption at elevated level. The review discusses the changes occurring in nutritive quality of milk proteins under the influence of various processing operations.

CRP in acute appendicitis--is it a necessary investigation?

PubMed

Amalesh, T; Shankar, M; Shankar, R

2004-01-01

Appendectomy is one of the commonest procedures in surgery. In spite of various investigations used to improve the accuracy of diagnosis, the rate of normal appendices removed is still about 15-30%. Many studies have investigated the role of C-reactive protein (CRP) in acute appendicitis, but with conflicting results. In a prospective, double blind study, blood for the measurement of serum C-reactive protein was collected pre-operatively from 192 children before going to the operating theatre for appendectomy. The histopathology was grouped into positive (acute appendicitis) and negative (normal appendix) and this was correlated with CRP values. CRP was normal in 14 out of 33 negative explorations (normal appendix on histopathology). The specificity and sensitivity of serum CRP was 42% and 91% respectively. The predictive value of a positive (raised CRP) and negative (normal CRP) test is 88% and 48% respectively. We conclude that neither raised nor normal CRP value is helpful in the diagnosis of acute appendicitis. CRP is not a good tool for helping the surgeon make the diagnosis of appendicitis and it should not be measured in suspected appendicitis.

Method and system for controlling a permanent magnet machine

DOEpatents

Walters, James E.

2003-05-20

Method and system for controlling the start of a permanent magnet machine are provided. The method allows to assign a parameter value indicative of an estimated initial rotor position of the machine. The method further allows to energize the machine with a level of current being sufficiently high to start rotor motion in a desired direction in the event the initial rotor position estimate is sufficiently close to the actual rotor position of the machine. A sensing action allows to sense whether any incremental changes in rotor position occur in response to the energizing action. In the event no changes in rotor position are sensed, the method allows to incrementally adjust the estimated rotor position by a first set of angular values until changes in rotor position are sensed. In the event changes in rotor position are sensed, the method allows to provide a rotor alignment signal as rotor motion continues. The alignment signal allows to align the estimated rotor position relative to the actual rotor position. This alignment action allows for operating the machine over a wide speed range.

Diver Relative UUV Navigation for Joint Human-Robot Operations

DTIC Science & Technology

2013-09-01

loop response: (10) where Kej is the gain that scales the position error to force . Substituting the measured values for ζ and ων as well as the...Underwater Vehicle; Tethered ; Hovering; Autonomous Underwater Vehicle; Joint human-robot operations; dynamic, uncertain environments 15. NUMBER OF PAGES...4   Figure 3.   The SeaBotix vLBV300 tethered AUV platform (left), and the planar vectored thruster

Use of day 1 early morning cortisol to predict the need for glucocorticoid replacement after pituitary surgery.

PubMed

Bondugulapati, L N Rao; Campbell, Christopher; Chowdhury, Sharmistha Roy; Goetz, Pablo; Davies, J Stephen; Rees, D Aled; Hayhurst, Caroline

2016-01-01

Assessment of adrenal reserve in patients who have undergone pituitary surgery is crucial. However, there is no clear consensus with regards to the type and timing of the test that should be used in the immediate post-operative period. Recently, there has been increased interest in measuring post-operative cortisol levels. We present our data utilising day 1 post-operative early morning cortisol as a tool to assess adrenal reserve in steroid-naive patients. A retrospective analysis of endoscopic pituitary surgery undertaken over a 2-year period. 82 patients underwent 84 surgeries in total. Patients who were already on glucocorticoids pre-operatively and patients with Cushing's disease, pituitary apoplexy and those without follow-up data were excluded, leaving a study group of 44 patients with 45 operations. A 9am day 1 post-operative cortisol value of > 400 nmol/L was taken as an indicator of adequate adrenal reserve. All the patients were reassessed at 6 weeks with a standard short synacthen test (SST) using 250 micrograms of intravenous synacthen. 22 out of 45 patients had a cortisol value of > 400 nmol/L on day 1 post-operatively and were discharged without glucocorticoid supplementation. Of these, only 2 patients subsequently failed the SST when reassessed at 6-8 weeks. The remaining 23 patients had a cortisol value of < 400 nmol/L on day 1 post-operatively and were discharged on hydrocortisone 10 mg twice daily. At 6-8 weeks, nine continued to show suboptimal stimulated cortisol levels whereas the remaining fourteen patients showed adequate adrenal reserve. The 9 am cortisol value had high specificity (81.8%) and positive predictive value (90.9%) for integrity of the HPA axis. Sensitivity was 58.8% and negative predictive value was 39.1%. A day 1 post-operative early morning cortisol is a useful tool to predict adrenal reserve post-pituitary surgery, enabling clinicians to avoid unnecessary blanket glucocorticoid replacement.

Fail-fixed servovalve with positive fluid feedback

NASA Technical Reports Server (NTRS)

Kast, Howard B. (Inventor)

1984-01-01

The servovalve includes a primary jet of fluid. A variable control signal is adapted to vary the angular position of the primary jet from its maximum recovery position. A first fluid path is adapted to supply fluid to a servopiston at a variable pressure determined at least in part by the control signal. A second fluid path is adapted to receive a predetermined portion of the primary jet fluid when the control signal reaches a predetermined value. The second fluid path terminates in the vicinity of the primary jet and is adapted to direct a secondary jet of fluid at the primary jet to deflect the primary jet toward the input orifice of the second fluid path. The resultant positive fluid feedback in the second fluid path causes the primary jet to latch in a first angular position relative to the maximum recovery position when the control signal reaches a predetermined value. The servovalve may further include a means to discharge the fluid and a means to block the first fluid path to the servopiston when the control signal falls below a second predetermined value. A method of operating a fail-fixed servovalve is also described.

Sniffing position combined with mouth opening improves facemask ventilation in children with adenotonsillar hypertrophy.

PubMed

Cuvas, O; Dikmen, B; Yucel, F

2011-05-01

This study evaluates the influence of sniffing position combined with mouth opening on the effectiveness of facemask ventilation in paralyzed pediatric patients undergoing adenotonsillectomy during sevoflurane-N(2)O anesthesia. After Institutional Ethics Committee approval, 40 children 5-11 years of age who were scheduled for an elective adenotonsillectomy operation were enrolled in this prospective randomized study. After routine monitoring and pre-oxygenation, anesthesia was induced with sevoflurane 8% in a mixture of 50% N(2)O-O(2). Three minutes after the administration of vecuronium, the sequence of the positions was randomized. Three positions were applied during facemask ventilation: Position CN (closed mouth - neutral head and neck position), position CS (closed mouth-sniffing position) and position OS (opened mouth-sniffing position). Volume-controlled ventilation was started. Peak inspiratory pressure (PIP), tidal volume (V(T)), expired tidal volume (V(Texp)) and end-tidal CO(2) pressure were recorded. The percent of leakage was calculated. The primary endpoint of this study was the expired tidal volume (V(Texp)). There was a statistically significant difference among the three positions for V(Texp) and PIP values. The OS resulted in higher V(Texp) values when compared with CN (P=0.022). The OS was significantly better than the other two positions, resulting in lower PIP values (P<0.001 and P=0.004, for CN and CS, respectively). The OS also resulted in less leakage during facemask ventilation when compared with CN and CS. Sniffing position combined with mouth opening improves V(Texp) and PIP values during facemask ventilation during sevoflurane-N(2)O anesthesia in paralyzed pediatric patients with adenotonsillar hypertrophy.

Measuring Non-Market Values for Hydropower Production and Water Storage on the Colorado River: A White Paper Investigation

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

Lowry, Thomas Stephen; Chermak, Janie M.; Brookshire, David S.

This study presents a conceptual framework for capturing the spatial and temporal aspects of non-market dimensions of value (DOV) and how they vary as the result of policy changes for hydropower generation and developed water uses. The foundation of this project is a literature review that reveals that focused, sector specific valuations are no longer adequate if the goal is to provide decision makers with a complete understanding of their decisions. Rather, estimates of non-market values for informing decisions regarding dam operations and/or other water management alternatives must consider the entire spectrum of market and non-market values, and the tradeoffsmore » (both positive and negative) between those values over time and space, while considering shifting preferences in an uncertain environment. This document describes the history and reasoning for these conclusions and presents a conceptual framework for understanding non-market values as a function of changes to hydropower operations and water resources management.« less

Occupational exposure assessment of magnetic fields generated by induction heating equipment-the role of spatial averaging.

PubMed

Kos, Bor; Valič, Blaž; Kotnik, Tadej; Gajšek, Peter

2012-10-07

Induction heating equipment is a source of strong and nonhomogeneous magnetic fields, which can exceed occupational reference levels. We investigated a case of an induction tempering tunnel furnace. Measurements of the emitted magnetic flux density (B) were performed during its operation and used to validate a numerical model of the furnace. This model was used to compute the values of B and the induced in situ electric field (E) for 15 different body positions relative to the source. For each body position, the computed B values were used to determine their maximum and average values, using six spatial averaging schemes (9-285 averaging points) and two averaging algorithms (arithmetic mean and quadratic mean). Maximum and average B values were compared to the ICNIRP reference level, and E values to the ICNIRP basic restriction. Our results show that in nonhomogeneous fields, the maximum B is an overly conservative predictor of overexposure, as it yields many false positives. The average B yielded fewer false positives, but as the number of averaging points increased, false negatives emerged. The most reliable averaging schemes were obtained for averaging over the torso with quadratic averaging, with no false negatives even for the maximum number of averaging points investigated.

Comparison between presepsin and procalcitonin in early diagnosis of neonatal sepsis.

PubMed

Iskandar, Agustin; Arthamin, Maimun Z; Indriana, Kristin; Anshory, Muhammad; Hur, Mina; Di Somma, Salvatore

2018-05-09

Neonatal sepsis remains worldwide one of the leading causes of morbidity and mortality in both term and preterm infants. Lower mortality rates are related to timely diagnostic evaluation and prompt initiation of empiric antibiotic therapy. Blood culture, as gold standard examination for sepsis, has several limitations for early diagnosis, so that sepsis biomarkers could play an important role in this regard. This study was aimed to compare the value of the two biomarkers presepsin and procalcitonin in early diagnosis of neonatal sepsis. This was a prospective cross-sectional study performed, in Saiful Anwar General Hospital Malang, Indonesia, in 51 neonates that fulfill the criteria of systemic inflammatory response syndrome (SIRS) with blood culture as diagnostic gold standard for sepsis. At reviewer operating characteristic (ROC) curve analyses, using a presepsin cutoff of 706,5 pg/mL, the obtained area under the curve (AUCs) were: sensitivity = 85.7%, specificity = 68.8%, positive predictive value = 85.7%, negative predictive value = 68.8%, positive likelihood ratio = 2.75, negative likelihood ratio = 0.21, and accuracy = 80.4%. On the other hand, with a procalcitonin cutoff value of 161.33 pg/mL the obtained AUCs showed: sensitivity = 68.6%, specificity = 62.5%, positive predictive value = 80%, negative predictive value = 47.6%, positive likelihood ratio = 1.83, the odds ratio negative = 0.5, and accuracy = 66.7%. In early diagnosis of neonatal sepsis, compared with procalcitonin, presepsin seems to provide better early diagnostic value with consequent possible faster therapeutical decision making and possible positive impact on outcome of neonates.

[Exposure to whole-body vibration of forklift truck operators in dockyards--actual exposure in Japan and evaluation by EN 13059].

PubMed

Tsujimura, Hiroji; Taoda, Kazushi; Nishiyama, Katsuo

2006-09-01

Low-back disorders are well documented as occupational hazards among forklift truck operators. The potential risk factors that may lead to low-back pain include exposure to whole-body vibration (WBV). In Europe, test methods were developed to evaluate WBV in industrial trucks, and the European Standard which defines the methods has been published. We measured the vibrations of forklift trucks operated in the Hanshin harbour area adopting procedures based on the CEN test and report the evaluation results. If the WBV magnitudes of the ride on forklift trucks in the workplace were less than or comparable to those in the CEN test, the CEN test could be considered useful for the risk assessment of forklift truck operators exposed to WBV. In order to verify the applicability of the CEN test to the evaluation of WBV exposure in the field, we conducted measurements of the WBV of four forklift trucks for 19 d. The trucks had already been examined by the CEN test. The truck velocity, driver position (sitting or not), and gear lever position were also measured, and video footage was obtained for the study. The results indicate that the vertical WBV magnitudes of the four forklift trucks were below the CEN test values. No dominant WBV direction was observed on any of the measurement days. The Health value (obtained by combining the values determined from the vibration in orthogonal coordinates) was comparable to that from the CEN test for one truck. The values for the other three trucks were lower. The data obtained for three forklift trucks were analyzed in each operating condition. The vertical WBV magnitudes and Health values for the three trucks were below the CEN test values when the trucks were travelling forwards with a load. The WBV in the anterior-posterior direction had the largest adverse effect on the human body of the three orthogonal directions when the trucks were used for loading and unloading. The results suggest the CEN test can be applied to the evaluation of exposure to WBV from forklift trucks operating in the vicinity of the Hanshin harbour. It was observed that the anterior-posterior WBV is considerable, mostly through exposure occurring in the lifting mode. However, the CEN test is based on the travelling mode, and further WBV measurements under real working conditions with exact descriptions of detailed work situations and operating conditions are required.

Clinical values of AFP, GPC3 mRNA in peripheral blood for prediction of hepatocellular carcinoma recurrence following OLT: AFP, GPC3 mRNA for prediction of HCC.

PubMed

Wang, Yuliang; Shen, Zhongyang; Zhu, Zhijun; Han, Ruifa; Huai, Mingsheng

2011-03-01

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Annually, about 200,000 patients died of HCC in China. Liver transplantation (LT) holds great theoretical appeal in treating HCC. However, the high recurrence rate after transplantation is the most important limiting factor for long-term survival. To assess the value of alpha-fetoprotein (AFP) messenger RNA (mRNA), Glypican-3 (GPC3) mRNA-expressing cells in the peripheral blood (PB) for prediction of HCC recurrence following orthotopic liver transplantation (OLT). 29 patients with HCC who underwent OLT with a minimum clinical follow-up of 12 months were included in this retrospective study. We detected AFP mRNA, GPC3 mRNA-expressing cells in the PB by TaqMan real-time reverse transcriptase-polymerase chain reaction (RT-PCR), pre-, intra- and post-operatively. The early recurrence of patients was evaluated. 8 (28%), 15 (52%), and 9 (31%) patients had AFP mRNA detected pre-, intra-, and post-operatively, respectively. With 12 months of follow-up, HCC recurred in 7 (24%) patients. Univariate analysis revealed that positive pre- and post-operative AFP mRNA, TNM stage as well as vascular invasion were significant predictors for the HCC recurrence. Multivariate analysis revealed that being positive for AFP mRNA pre-operatively remained a significant risk factor for HCC recurrence after OLT. GPC3 mRNA was expressed in all PB samples. There was no significant difference in the expression levels of GPC3 mRNA between the HCC and control groups. There were no significant differences in GPC3 mRNA expression values between those patients with and without tumor recurrence. The pre-operative detection of circulating AFP mRNA-expressing cells could be a useful predictor for HCC recurrence following OLT. GPC3 mRNA-expressing cells in PB seem to have no diagnostic value.

A double-blinded, prospective study to define antigenemia and quantitative real-time polymerase chain reaction cutoffs to start preemptive therapy in low-risk, seropositive, renal transplanted recipients.

PubMed

David-Neto, Elias; Triboni, Ana H K; Paula, Flavio J; Vilas Boas, Lucy S; Machado, Clarisse M; Agena, Fabiana; Latif, Acram Z A; Alencar, Cecília S; Pierrotti, Ligia C; Nahas, William C; Caiaffa-Filho, Helio H; Pannuti, Claudio S

2014-11-27

Cytomegalovirus (CMV) disease occurs in 16% to 20% of low-risk, CMV-positive renal transplant recipients. The cutoffs for quantitative real-time polymerase chain reaction (qPCR) or phosphoprotein (pp65) antigenemia (pp65emia) for starting preemptive therapy have not been well established. We measured qPCR and pp65emia weekly from day 7 to day 120 after transplantation, in anti-CMV immunoglobulin G–positive donor and recipient pairs. Patients and physicians were blinded to the test results. Suspicion of CMV disease led to the order of new tests. In asymptomatic viremic patients, the highest pp65emia and qPCR values were used, whereas we considered the last value before diagnosis in those with CMV disease. We collected a total of 1,481 blood samples from 102 adult patients. Seventeen patients developed CMV disease, 54 presented at least one episode of viremia that cleared spontaneously, and 31 never presented viremia. Five patients developed CMV disease after the end of the study period. The median (95% confidence interval) pp65emia and qPCR values were higher before CMV disease than during asymptomatic viremia (6 [9–82] vs. 3 [1–14] cells/10(6) cells; P<0.001 and 3,080 [1,263–15,605] vs. 258 [258–1,679] copies/mL; P=0.008, respectively). The receiver operating characteristic curve showed that pp65emia 4 cells/10(6) cells or greater showed a sensitivity and specificity to predict CMV disease of 69% and 81%, respectively (area, 0.769; P=0.001), with a positive predictive value of 37% and a negative predictive value of 93%. For qPCR 2,000 copies/mL or higher, the positive predictive value and negative predictive value were 57% and 91%, respectively (receiver operating characteristic area, 0.782; P=0.000). With these cutoffs, both methods are appropriate for detecting CMV disease.

Accuracy of a digital impression system based on parallel confocal laser technology for implants with consideration of operator experience and implant angulation and depth.

PubMed

Giménez, Beatriz; Özcan, Mutlu; Martínez-Rus, Francisco; Pradíes, Guillermo

2014-01-01

To evaluate the accuracy of a digital impression system based on parallel confocal red laser technology, taking into consideration clinical parameters such as operator experience and angulation and depth of implants. A maxillary master model with six implants (located bilaterally in the second molar, second premolar, and lateral incisor positions) was fitted with six polyether ether ketone scan bodies. One second premolar implant was placed with 30 degrees of mesial angulation; the opposite implant was positioned with 30 degrees of distal angulation. The lateral incisor implants were placed 2 or 4 mm subgingivally. Two experienced and two inexperienced operators performed intraoral scanning. Five different interimplant distances were then measured. The files obtained from the scans were imported with reverse-engineering software. Measurements were then made with a coordinate measurement machine, with values from the master model used as reference values. The deviations from the actual values were then calculated. The differences between experienced and inexperienced operators and the effects of different implant angulations and depths were compared statistically. Overall, operator 3 obtained significantly less accurate results. The angulated implants did not significantly influence accuracy compared to the parallel implants. Differences were found in the amount of error in the different quadrants. The second scanned quadrant had significantly worse results than the first scanned quadrant. Impressions of the implants placed at the tissue level were less accurate than implants placed 2 and 4 mm subgingivally. The operator affected the accuracy of measurements, but the performance of the operator was not necessarily dependent on experience. Angulated implants did not decrease the accuracy of the digital impression system tested. The scanned distance affected the predictability of the accuracy of the scanner, and the error increased with the increased length of the scanned section.

Naval Classical Thinkers and Operational Art

DTIC Science & Technology

2009-01-01

Principles and Practice of Military Operations on Land, published in 1911, did not attract as much attention as his previous two major works...thinker. He failed, for example, to consider factors such as social and cultural conditions in the rise of sea power; the rise of the English middle...three key ideas: the inherent value of a strategic central or interior position, the principle of concentration, and the close relationship between

Role of imprint cytology in intra operative diagnosis of thyroid lesions.

PubMed

Anila, K R; Krishna, G

2014-07-01

Intra-operative imprint cytology is an important diagnostic modality in the diagnosis of thyroid lesions. A correct intra-operative diagnosis helps eliminate the need for second surgery. To study diagnostic accuracy of imprint cytology and to compare the imprint cytology results with that of the corresponding paraffin section diagnosis in thyroidectomy cases. This is a prospective study of 84 patients who have undergone thyroidectomies over a period of one year at the Department of Surgery, Thiruvananthapuram, Kerala, India. The intraoperative imprint cytology smears were stained by Papanicolaou method. The imprint cytology interpretation was later compared with the paraffin section diagnosis. Of the 84 patients using haematoxylin and eosin stained histopathology sections as the gold standard, the diagnostic sensitivity of imprint cytology was 75% and specificity was 100%. Positive predictive value was 100%. Negative predictive value was 98.74%. Imprint cytology has high sensitivity and specificity in diagnosing lesions of the thyroid. The problems faced were in diagnosing follicular carcinomas and differentiating low grade lymphoma from lymphocytic thyroiditis. Imprint cytology is a simple, reliable diagnostic technique. It has high sensitivity and specificity in intra-operative diagnosis of lesions of thyroid. In spite of the advent of newer diagnostic modalities like frozen sections, imprint cytology still holds its unique position in the current perspective.

Noninvasive prediction of shunt operation outcome in idiopathic normal pressure hydrocephalus

PubMed Central

Aoki, Yasunori; Kazui, Hiroaki; Tanaka, Toshihisa; Ishii, Ryouhei; Wada, Tamiki; Ikeda, Shunichiro; Hata, Masahiro; Canuet, Leonides; Katsimichas, Themistoklis; Musha, Toshimitsu; Matsuzaki, Haruyasu; Imajo, Kaoru; Kanemoto, Hideki; Yoshida, Tetsuhiko; Nomura, Keiko; Yoshiyama, Kenji; Iwase, Masao; Takeda, Masatoshi

2015-01-01

Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by gait disturbance, cognitive deterioration and urinary incontinence in elderly individuals. These symptoms can be improved by shunt operation in some but not all patients. Therefore, discovering predictive factors for the surgical outcome is of great clinical importance. We used normalized power variance (NPV) of electroencephalography (EEG) waves, a sensitive measure of the instability of cortical electrical activity, and found significantly higher NPV in beta frequency band at the right fronto-temporo-occipital electrodes (Fp2, T4 and O2) in shunt responders compared to non-responders. By utilizing these differences, we were able to correctly identify responders and non-responders to shunt operation with a positive predictive value of 80% and a negative predictive value of 88%. Our findings indicate that NPV can be useful in noninvasively predicting the clinical outcome of shunt operation in patients with iNPH. PMID:25585705

Induced simplified neutrosophic correlated aggregation operators for multi-criteria group decision-making

NASA Astrophysics Data System (ADS)

Şahin, Rıdvan; Zhang, Hong-yu

2018-03-01

Induced Choquet integral is a powerful tool to deal with imprecise or uncertain nature. This study proposes a combination process of the induced Choquet integral and neutrosophic information. We first give the operational properties of simplified neutrosophic numbers (SNNs). Then, we develop some new information aggregation operators, including an induced simplified neutrosophic correlated averaging (I-SNCA) operator and an induced simplified neutrosophic correlated geometric (I-SNCG) operator. These operators not only consider the importance of elements or their ordered positions, but also take into account the interactions phenomena among decision criteria or their ordered positions under multiple decision-makers. Moreover, we present a detailed analysis of I-SNCA and I-SNCG operators, including the properties of idempotency, commutativity and monotonicity, and study the relationships among the proposed operators and existing simplified neutrosophic aggregation operators. In order to handle the multi-criteria group decision-making (MCGDM) situations where the weights of criteria and decision-makers usually correlative and the criterion values are considered as SNNs, an approach is established based on I-SNCA operator. Finally, a numerical example is presented to demonstrate the proposed approach and to verify its effectiveness and practicality.

Dexterous programmable robot and control system

NASA Astrophysics Data System (ADS)

Engler, Charles D., Jr.

1995-09-01

An anatomically correct, humanlike, mechanical arm and hand is provided that an operator can control to perform with the dexterity and compliance of a human hand. Being humanlike and robotic enhances the device's control and gripper dexterity. Control of the movement of the arm and hand is performed or guided by a 'teach glove' worn by the operator. As he or she performs some hand manipulation, a controller stores signals from sensors on the exoskeleton. The sensors monitor the operator's finger-joint movement positions. These values are later translated into actuator control signals for servomotors, eventually duplicating the operator's movement.

Commissioning and quality assurance of an integrated system for patient positioning and setup verification in particle therapy.

PubMed

Pella, A; Riboldi, M; Tagaste, B; Bianculli, D; Desplanques, M; Fontana, G; Cerveri, P; Seregni, M; Fattori, G; Orecchia, R; Baroni, G

2014-08-01

In an increasing number of clinical indications, radiotherapy with accelerated particles shows relevant advantages when compared with high energy X-ray irradiation. However, due to the finite range of ions, particle therapy can be severely compromised by setup errors and geometric uncertainties. The purpose of this work is to describe the commissioning and the design of the quality assurance procedures for patient positioning and setup verification systems at the Italian National Center for Oncological Hadrontherapy (CNAO). The accuracy of systems installed in CNAO and devoted to patient positioning and setup verification have been assessed using a laser tracking device. The accuracy in calibration and image based setup verification relying on in room X-ray imaging system was also quantified. Quality assurance tests to check the integration among all patient setup systems were designed, and records of daily QA tests since the start of clinical operation (2011) are presented. The overall accuracy of the patient positioning system and the patient verification system motion was proved to be below 0.5 mm under all the examined conditions, with median values below the 0.3 mm threshold. Image based registration in phantom studies exhibited sub-millimetric accuracy in setup verification at both cranial and extra-cranial sites. The calibration residuals of the OTS were found consistent with the expectations, with peak values below 0.3 mm. Quality assurance tests, daily performed before clinical operation, confirm adequate integration and sub-millimetric setup accuracy. Robotic patient positioning was successfully integrated with optical tracking and stereoscopic X-ray verification for patient setup in particle therapy. Sub-millimetric setup accuracy was achieved and consistently verified in daily clinical operation.

On a Lagrange-Hamilton formalism describing position and momentum uncertainties

NASA Technical Reports Server (NTRS)

Schuch, Dieter

1993-01-01

According to Heisenberg's uncertainty relation, in quantum mechanics it is not possible to determine, simultaneously, exact values for the position and the momentum of a material system. Calculating the mean value of the Hamiltonian operator with the aid of exact analytic Gaussian wave packet solutions, these uncertainties cause an energy contribution additional to the classical energy of the system. For the harmonic oscillator, e.g., this nonclassical energy represents the ground state energy. It will be shown that this additional energy contribution can be considered as a Hamiltonian function, if it is written in appropriate variables. With the help of the usual Lagrange-Hamilton formalism known from classical particle mechanics, but now considering this new Hamiltonian function, it is possible to obtain the equations of motion for position and momentum uncertainties.

Control method for turbocharged diesel engines having exhaust gas recirculation

DOEpatents

Kolmanovsky, Ilya V.; Jankovic, Mrdjan J; Jankovic, Miroslava

2000-03-14

A method of controlling the airflow into a compression ignition engine having an EGR and a VGT. The control strategy includes the steps of generating desired EGR and VGT turbine mass flow rates as a function of the desired and measured compressor mass airflow values and exhaust manifold pressure values. The desired compressor mass airflow and exhaust manifold pressure values are generated as a function of the operator-requested fueling rate and engine speed. The EGR and VGT turbine mass flow rates are then inverted to corresponding EGR and VGT actuator positions to achieve the desired compressor mass airflow rate and exhaust manifold pressure. The control strategy also includes a method of estimating the intake manifold pressure used in generating the EGR valve and VGT turbine positions.

TU-FG-201-09: Predicting Accelerator Dysfunction

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

Able, C; Nguyen, C; Baydush, A

Purpose: To develop an integrated statistical process control (SPC) framework using digital performance and component data accumulated within the accelerator system that can detect dysfunction prior to unscheduled downtime. Methods: Seven digital accelerators were monitored for twelve to 18 months. The accelerators were operated in a ‘run to failure mode’ with the individual institutions determining when service would be initiated. Institutions were required to submit detailed service reports. Trajectory and text log files resulting from a robust daily VMAT QA delivery were decoded and evaluated using Individual and Moving Range (I/MR) control charts. The SPC evaluation was presented in amore » customized dashboard interface that allows the user to review 525 monitored parameters (480 MLC parameters). Chart limits were calculated using a hybrid technique that includes the standard SPC 3σ limits and an empirical factor based on the parameter/system specification. The individual (I) grand mean values and control limit ranges of the I/MR charts of all accelerators were compared using statistical (ranked analysis of variance (ANOVA)) and graphical analyses to determine consistency of operating parameters. Results: When an alarm or warning was directly connected to field service, process control charts predicted dysfunction consistently on beam generation related parameters (BGP)– RF Driver Voltage, Gun Grid Voltage, and Forward Power (W); beam uniformity parameters – angle and position steering coil currents; and Gantry position accuracy parameter: cross correlation max-value. Control charts for individual MLC – cross correlation max-value/position detected 50% to 60% of MLCs serviced prior to dysfunction or failure. In general, non-random changes were detected 5 to 80 days prior to a service intervention. The ANOVA comparison of BGP determined that each accelerator parameter operated at a distinct value. Conclusion: The SPC framework shows promise. Long term monitoring coordinated with service will be required to definitively determine the effectiveness of the model. Varian Medical System, Inc. provided funding in support of the research presented.« less

Transverse occiput position: Using manual Rotation to aid Normal birth and improve delivery OUTcomes (TURN-OUT): A study protocol for a randomised controlled trial.

PubMed

de Vries, Bradley; Phipps, Hala; Kuah, Sabrina; Pardey, John; Ludlow, Joanne; Bisits, Andrew; Park, Felicity; Kowalski, David; Hyett, Jon A

2015-08-18

Fetal occiput transverse position in the form of deep transverse arrest has long been associated with caesarean section and instrumental vaginal delivery. Occiput transverse position incidentally found in the second stage of labour is also associated with operative delivery in high risk cohorts. There is evidence from cohort studies that prophylactic manual rotation reduces the caesarean section rate. This is a protocol for a double blind, multicentre, randomised, controlled clinical trial to define whether this intervention decreases the operative delivery (caesarean section, forceps or vacuum delivery) rate. Eligible participants will be ≥37 weeks pregnant, with a singleton pregnancy, and a cephalic presentation in the occiput transverse position on transabdominal ultrasound early in the second stage of labour. Based on a background risk of operative delivery of 49%, for a reduction to 35%, an alpha value of 0.05 and a beta value of 0.2, 416 participants will need to be enrolled. Participants will be randomised to either prophylactic manual rotation or a sham procedure. The primary outcome will be operative delivery. Secondary outcomes will be caesarean section, significant maternal mortality and morbidity, and significant perinatal mortality and morbidity. Analysis will be on an intention-to-treat basis. Primary and secondary outcomes will be compared using a chi-squared test. A logistic regression for the primary outcome will be undertaken to account for potential confounders. This study has been approved by the Ethics Review Committee (RPAH Zone) of the Sydney Local Health District, Sydney, Australia, (protocol number: X110410). This trial addresses an important clinical question concerning a commonly used procedure which has the potential to reduce operative delivery and its associated complications. Some issues discussed in the protocol include methods of assessing risk of bias due to inadequate masking of a procedural interventions, variations in intervention efficacy due to operator experience and the recruitment difficulties associated with intrapartum studies. This trial was registered with the Australian New Zealand Clinical Trials Registry (identifier: ACTRN12613000005752 ) on 4 January 2013.

Otto Skorzeny and the Real Conduct of Unternehmen Eiche and Unternehmen Panzerfaust

DTIC Science & Technology

2017-12-01

for Skorzeny and his men. These psychological operations had positive effects; American troops who protected General Eisenhower became increasingly on...edge, and American troops as a whole became agitated when numerous American Prisoners of War were claimed to be Germans or German agents.168...Skorzeny as “the most dangerous man in Europe.”1 The Austrian SS-Obersturmbannführer successfully led several high -value-target special operations for

Experimental scheme for qubit and qutrit symmetric informationally complete positive operator-valued measurements using multiport devices

NASA Astrophysics Data System (ADS)

Tabia, Gelo Noel M.

2012-12-01

It is crucial for various quantum information processing tasks that the state of a quantum system can be determined reliably and efficiently from general quantum measurements. One important class of measurements for this purpose is symmetric informationally complete positive operator-valued measurements (SIC-POVMs). SIC-POVMs have the advantage of providing an unbiased estimator for the quantum state with the minimal number of outcomes needed for full tomography. By virtue of Naimark's dilation theorem, any POVM can always be realized with a suitable coupling between the system and an auxiliary system and by performing a projective measurement on the joint system. In practice, finding the appropriate coupling is rather nontrivial. Here we propose an experimental design for directly implementing SIC-POVMs using multiport devices and path-encoded qubits and qutrits, the utility of which has recently been demonstrated by several experimental groups around the world. Furthermore, we describe how these multiports can be attained in practice with an integrated photonic system composed of nested linear optical elements.

Causal localizations in relativistic quantum mechanics

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

Castrigiano, Domenico P. L., E-mail: castrig@ma.tum.de; Leiseifer, Andreas D., E-mail: andreas.leiseifer@tum.de

2015-07-15

Causal localizations describe the position of quantum systems moving not faster than light. They are constructed for the systems with finite spinor dimension. At the center of interest are the massive relativistic systems. For every positive mass, there is the sequence of Dirac tensor-localizations, which provides a complete set of inequivalent irreducible causal localizations. They obey the principle of special relativity and are fully Poincaré covariant. The boosters are determined by the causal position operator and the other Poincaré generators. The localization with minimal spinor dimension is the Dirac localization. Thus, the Dirac equation is derived here as a meremore » consequence of the principle of causality. Moreover, the higher tensor-localizations, not known so far, follow from Dirac’s localization by a simple construction. The probability of localization for positive energy states results to be described by causal positive operator valued (PO-) localizations, which are the traces of the causal localizations on the subspaces of positive energy. These causal Poincaré covariant PO-localizations for every irreducible massive relativistic system were, all the more, not known before. They are shown to be separated. Hence, the positive energy systems can be localized within every open region by a suitable preparation as accurately as desired. Finally, the attempt is made to provide an interpretation of the PO-localization operators within the frame of conventional quantum mechanics attributing an important role to the negative energy states.« less

Causal localizations in relativistic quantum mechanics

NASA Astrophysics Data System (ADS)

Castrigiano, Domenico P. L.; Leiseifer, Andreas D.

2015-07-01

Causal localizations describe the position of quantum systems moving not faster than light. They are constructed for the systems with finite spinor dimension. At the center of interest are the massive relativistic systems. For every positive mass, there is the sequence of Dirac tensor-localizations, which provides a complete set of inequivalent irreducible causal localizations. They obey the principle of special relativity and are fully Poincaré covariant. The boosters are determined by the causal position operator and the other Poincaré generators. The localization with minimal spinor dimension is the Dirac localization. Thus, the Dirac equation is derived here as a mere consequence of the principle of causality. Moreover, the higher tensor-localizations, not known so far, follow from Dirac's localization by a simple construction. The probability of localization for positive energy states results to be described by causal positive operator valued (PO-) localizations, which are the traces of the causal localizations on the subspaces of positive energy. These causal Poincaré covariant PO-localizations for every irreducible massive relativistic system were, all the more, not known before. They are shown to be separated. Hence, the positive energy systems can be localized within every open region by a suitable preparation as accurately as desired. Finally, the attempt is made to provide an interpretation of the PO-localization operators within the frame of conventional quantum mechanics attributing an important role to the negative energy states.

Simulation and Analysis of Electric Field for the Disconnector Switch Incomplete Opening Position Based on 220kV GIS

NASA Astrophysics Data System (ADS)

Wang, Feifeng; Huang, Huimin; Su, Yi; Yan, Dandan; Lu, Yufeng; Xia, Xiaofei; Yang, Jian

2018-05-01

It has accounted for a large proportion of GIS equipment defects, which cause the disconnector switches to incomplete open-close position. Once opening operation is not in place, it will arouse continuous arcing between contacts to reduce insulation strength. Otherwise, the intense heat give rise to burn the contact, which has a severe effect on the safe operation of power grid. This paper analyzes some typical defection cases about the opening operation incomplete for disconnector switches of GIS. The COMSOL Multiphysics is applied to verify the influence on electric field distribution. The results show that moving contact out shield is 20 mm, the electric field distribution of the moving contact surface is uneven, and the maximum electric field value can reach 9.74 kV/mm.

Methods to Improve Sustainability of a Large Academic Biorepository

PubMed Central

Wiehagen, Luke T.; Schumacher, Philip E.; Dhir, Rajiv

2017-01-01

This article discusses the evolution of the University of Pittsburgh (UPitt) Health Sciences Tissue Bank (HSTB) operation and how it has successfully positioned itself, manages to sustain its value, and remains viable in today's research landscape. We describe the various components of our biobanking operation, which are valued by our researchers, thus leading to sustainability for our biorepository. Operating within the infrastructure of a large academic university, we have access to the most cutting-edge database resources for collecting, tracking, and annotating thousands of specimens. We are constantly improving upon our ability to provide real-time longitudinal follow-up data for our collections, thus providing researchers with valuable, highly annotated research specimens. We believe the combination of all that is described within this article helps to create a biobank that will remain sustainable well into the future. PMID:27860489

Considerations for NSLS-II Synchrotron Radiation Protection When Operating Damping Wigglers at Low Machine Energy

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

Seletskiy, S.; Podobedov, B.

2015-12-30

The NSLS-II storage ring vacuum chamber, including frontends (FE) and beamlines (BL), is protected from possible damage from synchrotron radiation (SR) emitted from insertion devices (IDs) by a dedicated active interlock system (AIS). The system monitors electron beam position and angle and triggers a beam dump if the beam orbit is outside of the active interlock envelope (AIE). The AIE was calculated under the assumptions of 3 GeV beam energy and ID gaps set to their minimum operating values (i.e. “fully closed”). Recently it was proposed to perform machine studies that would ramp the stored beam energy significantly below themore » nominal operational value of 3 GeV. These studies may potentially include the use of NSLS-II damping wigglers (DWs) for electron beam emittance reduction and control.« less

Point-of-care ultrasound versus auscultation in determining the position of double-lumen tube

PubMed Central

Hu, Wei-Cai; Xu, Lei; Zhang, Quan; Wei, Li; Zhang, Wei

2018-01-01

Abstract This study was designed to assess the accuracy of point-of-care ultrasound in determining the position of double-lumen tubes (DLTs). A total of 103 patients who required DLT intubation were enrolled into the study. After DLTs were tracheal intubated in the supine position, an auscultation researcher and ultrasound researcher were sequentially invited in the operating room to conduct their evaluation of the DLT. After the end of their evaluation, fiberscope researchers (FRs) were invited in the operating room to evaluate the position of DLT using a fiberscope. After the patients were changed to the lateral position, the same evaluation process was repeated. These 3 researchers were blind to each other when they made their conclusions. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were obtained by statistical analysis. When left DLTs (LDLTs) were used, the accuracy of ultrasound (84.2% [72.1%, 92.5%]) was higher than the accuracy of auscultation (59.7% [45.8%, 72.4%]) (P < .01). When right DLTs (RDLTs) were used, the accuracy of ultrasound (89.1% [76.4%, 96.4%]) was higher than the accuracy of auscultation (67.4% [52.0%, 80.5%]) (P < .01). When LDLTs were used in the lateral position, the accuracy of ultrasound (75.4% [62.2%, 85.9%]) was higher than the accuracy of auscultation (54.4% [40.7%, 67.6%]) (P < .05). When RDLT were used, the accuracy of ultrasound (73.9% [58.9%, 85.7%]) was higher than the accuracy of auscultation (47.8% [32.9%, 63.1%]) (P < .05). Assessment via point-of-care ultrasound is superior to auscultation in determining the position of DLTs. PMID:29595696

Point-of-care ultrasound versus auscultation in determining the position of double-lumen tube.

PubMed

Hu, Wei-Cai; Xu, Lei; Zhang, Quan; Wei, Li; Zhang, Wei

2018-03-01

This study was designed to assess the accuracy of point-of-care ultrasound in determining the position of double-lumen tubes (DLTs).A total of 103 patients who required DLT intubation were enrolled into the study. After DLTs were tracheal intubated in the supine position, an auscultation researcher and ultrasound researcher were sequentially invited in the operating room to conduct their evaluation of the DLT. After the end of their evaluation, fiberscope researchers (FRs) were invited in the operating room to evaluate the position of DLT using a fiberscope. After the patients were changed to the lateral position, the same evaluation process was repeated. These 3 researchers were blind to each other when they made their conclusions. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were obtained by statistical analysis.When left DLTs (LDLTs) were used, the accuracy of ultrasound (84.2% [72.1%, 92.5%]) was higher than the accuracy of auscultation (59.7% [45.8%, 72.4%]) (P < .01). When right DLTs (RDLTs) were used, the accuracy of ultrasound (89.1% [76.4%, 96.4%]) was higher than the accuracy of auscultation (67.4% [52.0%, 80.5%]) (P < .01). When LDLTs were used in the lateral position, the accuracy of ultrasound (75.4% [62.2%, 85.9%]) was higher than the accuracy of auscultation (54.4% [40.7%, 67.6%]) (P < .05). When RDLT were used, the accuracy of ultrasound (73.9% [58.9%, 85.7%]) was higher than the accuracy of auscultation (47.8% [32.9%, 63.1%]) (P < .05).Assessment via point-of-care ultrasound is superior to auscultation in determining the position of DLTs.

Composite operators in the hopping parameter expansion in the free quark model

NASA Astrophysics Data System (ADS)

Kunszt, Z.

1983-11-01

I have calculated hopping parameter series of meson and baryon propagators up to O(K32) in the Wilson formulation of the free quark model. The position of branch point singularities has been found with the help of Padé approximants. The values of the position of the singularities in K agreed with the exact values within 1-2% in case of mesons and 4-5% in case of baryons. It is argued that in QCD at the cross-over region the systematic errors of the method must be even smaller. Part of this work has been done while the author was visiting the Rutherford and Appleton Laboratories, UK.

Quantitative Value of Aldosterone-Renin Ratio for Detection of Aldosterone-Producing Adenoma: The Aldosterone-Renin Ratio for Primary Aldosteronism (AQUARR) Study.

PubMed

Maiolino, Giuseppe; Rossitto, Giacomo; Bisogni, Valeria; Cesari, Maurizio; Seccia, Teresa Maria; Plebani, Mario; Rossi, Gian Paolo

2017-05-21

Current guidelines recommend use of the aldosterone-renin ratio (ARR) for the case detection of primary aldosteronism followed by confirmatory tests to exclude false-positive results from further diagnostic workup. We investigated the hypothesis that this could be unnecessary in patients with a high ARR value if the quantitative information carried by the ARR is taken into due consideration. We interrogated 2 large data sets of prospectively collected patients studied with the same predefined protocol, which included the captopril challenge test. We used an unambiguous diagnosis of aldosterone-producing adenoma as reference index. We also assessed whether the post-captopril ARR and plasma aldosterone concentration fall furnished a diagnostic gain over baseline ARR values. We found that the false-positive rate fell exponentially, and, conversely, the specificity increased with rising ARR values. At receiver operating characteristics curves and diagnostic odds ratio analysis, the high baseline ARR values implied very high positive likelihood ratio and diagnostic odds ratio values. The baseline and post-captopril ARR showed similar diagnostic accuracy (area under the receiver operating characteristics curve) in both the exploratory and validation cohorts, indicating lack of diagnostic gain with this confirmatory test (between-area under the curve difference, 0.005; 95% CI, -0.031 to 0.040; P =0.7 for comparison, and 0.05; 95% CI, -0.061 to 0.064; P =0.051 for comparison, respectively). These results indicate that the ARR conveys key quantitative information that, if properly used, can simplify the diagnostic workup, resulting in saving of money and resources. This can offer the chance of diagnosis and ensuing adrenalectomy to a larger number of hypertensive patients, ultimately resulting in better control of blood pressure. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Effects of positive end-expiratory pressure on arthroscopic shoulder surgery under general anesthesia.

PubMed

Ersoy, Ayşın; Çakırgöz, Mensure; Ervatan, Zekeriya; Kıran, Özlem; Türkmen, Aygen; Esenyel, Cem Zeki

2016-01-01

Our study is a prospective, randomized study on patients undergoing arthroscopic shoulder surgery in the beach-chair position to evaluate the effects of positive end-expiratory pressure (PEEP) on hemodynamic stability, providing a bloodless surgical field and surgical satisfaction. Fifty patients were divided into two groups. Group I (n=25) had zero end-expiratory pressure (ZEEP) administered under general anesthesia, and group II (n=25) had +5 PEEP administered. During surgery, intraarticular hemorrhage and surgical satisfaction were evaluated on a scale of 0-10. During surgery, at the 5th, 30th, 60th, and 90th minutes and at the end of surgery, heart rate, mean arterial pressure (MAP), and positive inspiratory pressure were recorded. At the end of the surgery, the amount of bleeding and duration of the operation were recorded. In group I, the duration of operation and amount of bleeding were found to be significantly greater than those in group II (p<0.05). The surgical satisfaction score and clarity of the surgical field were found to be significantly lower in group I than in group II (p<0.05). MAP values in group I were significantly lower than those in group II. The SPO² values in group I were significantly lower than those in group II. Adding PEEP to the ventilation parameters of arthroscopic shoulder surgery in the beach-chair position reduces the amount of hemorrhage in the surgical field and thus increases surgical satisfaction without requiring the creation of controlled hypotension.

Effectiveness of Unmanned Surface Vehicles in Anti-submarine Warfare with the Goal of Protecting a High Value Unit

DTIC Science & Technology

2015-06-01

headquarters Services , Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and...are positioned on the outer ASW screen to protect an HVU from submarine attacks. This baseline scenario provides a standardized benchmark on current...are positioned on the outer ASW screen to protect an HVU from submarine attacks. This baseline scenario provides us a standardized benchmark . In the

A Balanced Scorecard With Strategy Map: Measuring the Value of a Nursing Sabbatical.

PubMed

Embree, Jennifer L; Swenty, Constance F; Schaar, Gina

2015-01-01

Seasoned nurses frequently resign from their positions due to burnout. An innovative idea that could support nurse retention is nurse sabbaticals. Balanced scorecards with strategy maps can display financial benefit, positive customer experience, and operational and human capital development required to initiate and sustain a professional nurse sabbatical. A balanced scorecard with strategy map is an effective tool that demonstrates connection between the organizational mission and the outcomes of a nurse sabbatical program.

Evaluation of predictive capacities of biomarkers based on research synthesis.

PubMed

Hattori, Satoshi; Zhou, Xiao-Hua

2016-11-10

The objective of diagnostic studies or prognostic studies is to evaluate and compare predictive capacities of biomarkers. Suppose we are interested in evaluation and comparison of predictive capacities of continuous biomarkers for a binary outcome based on research synthesis. In analysis of each study, subjects are often classified into two groups of the high-expression and low-expression groups according to a cut-off value, and statistical analysis is based on a 2 × 2 table defined by the response and the high expression or low expression of the biomarker. Because the cut-off is study specific, it is difficult to interpret a combined summary measure such as an odds ratio based on the standard meta-analysis techniques. The summary receiver operating characteristic curve is a useful method for meta-analysis of diagnostic studies in the presence of heterogeneity of cut-off values to examine discriminative capacities of biomarkers. We develop a method to estimate positive or negative predictive curves, which are alternative to the receiver operating characteristic curve based on information reported in published papers of each study. These predictive curves provide a useful graphical presentation of pairs of positive and negative predictive values and allow us to compare predictive capacities of biomarkers of different scales in the presence of heterogeneity in cut-off values among studies. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Working with Value: Industry-Specific Approaches to Workforce Development. A Synthesis of Findings.

ERIC Educational Resources Information Center

Rademacher, Ida, Ed.

Multi-year applied research studied operations and outcomes of six employment initiatives that developed industry-based approaches to workforce development. Findings from the longitudinal survey of 732 individuals indicated participants in sectoral programs improved their position within local labor markets; increased wages, hours worked, and…

Behavioral Treatment of Hysterical Coughing and Mutism: A Case Study

ERIC Educational Resources Information Center

Munford, Paul R.; And Others

1976-01-01

This case study demonstrates the value of conceptualizing functional somatic disorders as operants. The subject, an adolescent girl, diagnosed as having a "hysterical neurosis," manifested the symptoms of incessant coughing and mutism. The cough and mutism were treated by extinction and shaping, respectively. Positive results were obtained.…

The insertional torque of a pedicle screw has a positive correlation with bone mineral density in posterior lumbar pedicle screw fixation.

PubMed

Lee, J H; Lee, J-H; Park, J W; Shin, Y H

2012-01-01

In patients with osteoporosis there is always a strong possibility that pedicle screws will loosen. This makes it difficult to select the appropriate osteoporotic patient for a spinal fusion. The purpose of this study was to determine the correlation between bone mineral density (BMD) and the magnitude of torque required to insert a pedicle screw. To accomplish this, 181 patients with degenerative disease of the lumbar spine were studied prospectively. Each underwent dual-energy x-ray absorptiometry (DEXA) and intra-operative measurement of the torque required to insert each pedicle screw. The levels of torque generated in patients with osteoporosis and osteopenia were significantly lower than those achieved in normal patients. Positive correlations were observed between BMD and T-value at the instrumented lumbar vertebrae, mean BMD and mean T-value of the lumbar vertebrae, and mean BMD and mean T-value of the proximal femur. The predictive torque (Nm) generated during pedicle screw insertion was [-0.127 + 1.62 × (BMD at the corresponding lumbar vertebrae)], as measured by linear regression analysis. The positive correlation between BMD and the maximum torque required to insert a pedicle screw suggests that pre-operative assessment of BMD may be useful in determining the ultimate strength of fixation of a device, as well as the number of levels that need to be fixed with pedicle screws in patients who are suspected of having osteoporosis.

Technical Suitability and Static Stability of Sungkur Fishing Boats for Fish and Shrimp Catching

NASA Astrophysics Data System (ADS)

Rusmilyansari; Rosadi, E.; Iriansyah

2017-10-01

Sungkur fishing gear is operated actively on one the side of fishing boat, which requires technical suitability and fishing gear stability to ensure success in fish catching. This is a case study which aimed to analyze some technical issues related to the boat, boat’s hydrostatic parameters, and the boat’s stability. The data were collected though observation, measuring the boat to obtain the offset table. The data were analyzed numerically and descriptively. The data were processed with technical formula, Microsoft Office’s Excel software, graphic display, minitab, statistical data processing, and maxsurf program. The research results showed that: (1) the sungkur fishing boat dimensional ratio L/B (6.47 - 7.00); L/D (10.90 - 11.20) and B/D (1.60 - 1.668) is within the range value of Indonesian fishing boats suitable to operate the fishing gear by towing or dragging. However, during fish catching operation, there have been problems in a hydrodynamic force due to the fishing gear movement, which affect the fish catching efficiency. (2) The boat’s coefficient of fineness is in the fine type shape; the displacement on each waterline has increased; the loads of the boat are getting larger following the increase of waterline from one to five; this is also shown from the increasing midship area value. Ton per centimeter immersion to change wl 1 by 1 cm needs 0.04 tons of weight. (3) Sungkur fishing boat have a good static stability, which is proven by the positive value of angle of maximum GZ by 79.1 - 83.6. In other words, the boat has the ability to return to its original position after tilting; however, stability dynamics happens because fishing gear operation are located on just one side of boat.

Convergence of damped inertial dynamics governed by regularized maximally monotone operators

NASA Astrophysics Data System (ADS)

Attouch, Hedy; Cabot, Alexandre

2018-06-01

In a Hilbert space setting, we study the asymptotic behavior, as time t goes to infinity, of the trajectories of a second-order differential equation governed by the Yosida regularization of a maximally monotone operator with time-varying positive index λ (t). The dissipative and convergence properties are attached to the presence of a viscous damping term with positive coefficient γ (t). A suitable tuning of the parameters γ (t) and λ (t) makes it possible to prove the weak convergence of the trajectories towards zeros of the operator. When the operator is the subdifferential of a closed convex proper function, we estimate the rate of convergence of the values. These results are in line with the recent articles by Attouch-Cabot [3], and Attouch-Peypouquet [8]. In this last paper, the authors considered the case γ (t) = α/t, which is naturally linked to Nesterov's accelerated method. We unify, and often improve the results already present in the literature.

Time operators in stroboscopic wave-packet basis and the time scales in tunneling

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

Bokes, P.

2011-03-15

We demonstrate that the time operator that measures the time of arrival of a quantum particle into a chosen state can be defined as a self-adjoint quantum-mechanical operator using periodic boundary conditions and applied to wave functions in energy representation. The time becomes quantized into discrete eigenvalues; and the eigenstates of the time operator, i.e., the stroboscopic wave packets introduced recently [Phys. Rev. Lett. 101, 046402 (2008)], form an orthogonal system of states. The formalism provides simple physical interpretation of the time-measurement process and direct construction of normalized, positive definite probability distribution for the quantized values of the arrival time.more » The average value of the time is equal to the phase time but in general depends on the choice of zero time eigenstate, whereas the uncertainty of the average is related to the traversal time and is independent of this choice. The general formalism is applied to a particle tunneling through a resonant tunneling barrier in one dimension.« less

Application value of different transformation zone types and its genetic relationship with high-risk HPV type in diagnosis and therapy of cervical disease.

PubMed

Chen, Yan; Zhou, Jia-De

2015-01-01

This study aims to discuss the influence of different types of transformation zone (TZ) on positive surgical margin of loop electrosurgical excision procedure (LEEP) and the significance of infection of different genetic high-risk HPV for cervical intraepithelial neoplasm. The clinical data of patients who had CIN2+ and received LEEP during January to December 2013 was investigated. The conditions of positive surgical margin of patients of different transformation zone (type I, II, III) were analyzed. The clinical high-risk types of HPV were divided into three groups, including A5/6, A7 and A9, compared with the pathological conditions of pre-operation and post-operation of the patients in respective group. The results indicated that type III transformation zone is more likely to cause positive cutting margin. For CIN2+ patients, sensitivity and specificity are 0.89% and 79.56% in group A5/6, and negative and positive predicted value (NPV, PPV) are 40% and 5%. The sensitivity, specificity, NPV, PPV in group A7 is 12.5%, 44.08%, 29.49% and 21.21%, respectively. The sensitivity, specificity, NPV, PPV in group A9 is 88.99%, 87.09%, 85.26%, 81.51%, respectively. Transformation zone type was correlated positively with positive cutting margin percentage (r = 0.8732, P < 0.05). Compared with type I, type II and III transformation zone is more likely to cause pathological upgrades. In conclusion, different types of transformation zone and high-risk HPV have clinical significance in causing positive cutting margin of surgery and disease extent.

The CURB65 pneumonia severity score outperforms generic sepsis and early warning scores in predicting mortality in community‐acquired pneumonia

PubMed Central

Barlow, Gavin; Nathwani, Dilip; Davey, Peter

2007-01-01

Background The performance of CURB65 in predicting mortality in community‐acquired pneumonia (CAP) has been tested in two large observational studies. However, it has not been tested against generic sepsis and early warning scores, which are increasingly being advocated for identification of high‐risk patients in acute medical wards. Method A retrospective analysis was performed of data prospectively collected for a CAP quality improvement study. The ability to stratify mortality and performance characteristics (sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating curve) were calculated for stratifications of CURB65, CRB65, the systemic inflammatory response syndrome (SIRS) criteria and the standardised early warning score (SEWS). Results 419 patients were included in the main analysis with a median age of 74 years (men = 47%). CURB65 and CRB65 stratified mortality in a more clinically useful way and had more favourable operating characteristics than SIRS or SEWS; for example, mortality in low‐risk patients was 2% when defined by CURB65, but 9% when defined by SEWS and 11–17% when defined by variations of the SIRS criteria. The sensitivity, specificity, positive predictive value and negative predictive value of CURB65 was 71%, 69%, 35% and 91%, respectively, compared with 62%, 73%, 35% and 89% for the best performing version of SIRS and 52%, 67%, 27% and 86% for SEWS. CURB65 had the greatest area under the receiver operating curve (0.78 v 0.73 for CRB65, 0.68 for SIRS and 0.64 for SEWS). Conclusions CURB65 should not be supplanted by SIRS or SEWS for initial prognostic assessment in CAP. Further research to identify better generic prognostic tools is required. PMID:16928720

Mapping an operator's perception of a parameter space

NASA Technical Reports Server (NTRS)

Pew, R. W.; Jagacinski, R. J.

1972-01-01

Operators monitored the output of two versions of the crossover model having a common random input. Their task was to make discrete, real-time adjustments of the parameters k and tau of one of the models to make its output time history converge to that of the other, fixed model. A plot was obtained of the direction of parameter change as a function of position in the (tau, k) parameter space relative to the nominal value. The plot has a great deal of structure and serves as one form of representation of the operator's perception of the parameter space.

Differentiation between microcystin contaminated and uncontaminated fish by determination of unconjugated MCs using an ELISA anti-Adda test based on receiver-operating characteristic curves threshold values: application to Tinca tinca from natural ponds.

PubMed

Moreno, Isabel María; Herrador, M Ángeles; Atencio, Loyda; Puerto, María; González, A Gustavo; Cameán, Ana María

2011-02-01

The aim of this study was to evaluate whether the enzyme-linked immunosorbent assay (ELISA) anti-Adda technique could be used to monitor free microcystins (MCs) in biological samples from fish naturally exposed to toxic cyanobacteria by using receiver operating characteristic (ROC) curve software to establish an optimal cut-off value for MCs. The cut-off value determined by ROC curve analysis in tench (Tinca tinca) exposed to MCs under laboratory conditions by ROC curve analysis was 5.90-μg MCs/kg tissue dry weight (d.w.) with a sensitivity of 93.3%. This value was applied in fish samples from natural ponds (Extremadura, Spain) in order to asses its potential MCs bioaccumulation by classifying samples as either true positive (TP), false positive (FP), true negative (TN), or false negative (FN). In this work, it has been demonstrated that toxic cyanobacteria, mainly Microcystis aeruginosa, Aphanizomenon issatchenkoi, and Anabaena spiroides, were present in two of these ponds, Barruecos de Abajo (BDown) and Barruecos de Arriba (BUp). The MCs levels were detected in waters from both ponds with an anti-MC-LR ELISA immunoassay and were of similar values (between 3.8-6.5-μg MC-LR equivalent/L in BDown pond and 4.8-6.0-μg MC-LR equivalent/L in BUp). The MCs cut-off values were applied in livers from fish collected from these two ponds using the ELISA anti-Adda technique. A total of 83% of samples from BDown pond and only 42% from BUp were TP with values of free MCs higher than 8.8-μg MCs/kg tissue (d.w.). Copyright © 2009 Wiley Periodicals, Inc.

Comparative study between cytotoxicity and flowcytometry crossmatches before and after renal transplantation.

PubMed

Abdel Rahman, Afaf S; Fahim, Nehal M A; El Sayed, Abeer A; El Hady, Soha A R; Ahmad, Yasser S

2005-01-01

Renal transplantation, in most countries, is based on human leukocyte antigen (HLA) matching of the donor kidney with the recipient. Traditional human leukocyte antigen matching is based on defining human leukocyte antigen specificities by antibodies utilizing cytotoxicity crossmatch techniques. Newer techniques have emerged, which challenge the accuracy of serological typing and crossmatching. We compared the results of the standard complement-dependent cytotoxicity crossmatch (CDCXM) with the anti-human globulin augmented cytotoxicity (AHG-CDC), and Flowcytometry crossmatch (FCXM) for the detection of anti-HLA antibodies in 150 pre-transplant patients. The development of post-transplantation sensitization was screened utilizing these three techniques within two weeks post-operative and correlated with rejection episodes. Comparison between the results of CDCXM and AHG-CDC in 150 recipients, revealed no significant correlation (P>0.05). When comparing these results with that of FCXM in 50 recipients a significant correlation was shown (P<0.05). Relative to CDCXM, the sensitivity of AHG-CDC was 100%, specificity 97.4%, positive predictive value 92.3%, and negative predictive value 100%. On the other hand, the sensitivity of FCXM was 100%, specificity 76.3%, positive predictive value 57.1%, and negative predictive value 100%. According to the results of CDCXM, AHG-CDC, and FCXM, no difference was detected between pre- and posttransplant anti-HLA sensitization within two weeks after the operation. Patients with negative cytotoxicity crossmatch (CDCXM and AHG-CDC) and positive FCXM may have an increased risk of early graft loss and may represent a relative contraindication to transplantation. Given the important theoretical advantages of FCXM over the CDC XM, further testing of the clinical relevance is warranted.

Comparison of Arterial Oxygenation Following Head-Down and Head-Up Laparoscopic Surgery.

PubMed

Imani, Farsad; Shirani Amniyeh, Fatemeh; Bastan Hagh, Ehsan; Khajavi, Mohammad Reza; Samimi, Saghar; Yousefshahi, Fardin

2017-12-01

Regarding the role of gas entry in abdomen and cardiorespiratory effects, the ability of anesthesiologists would be challenged in laparoscopic surgeries. Considering few studies in this area and the relevance of the subject, this study was performed to compare the arterial oxygen alterations before operation in comparison with after surgery between laparoscopic cholecystectomy and ovarian cystectomy. In this prospective cohort, 70 consecutive women aged from 20 to 60 years who were candidate for laparoscopic cholecystectomy (n = 35) and ovarian cystectomy (n = 35) with reverse (20 degrees) and direct (30 degrees) Trendelenburg positions, respectively, with ASA class I or II were enrolled. After intubation and before operation, for the first time, the arterial blood gas from radial artery in supine position was obtained for laboratory assessment. Then, the second blood sample was collected from radial artery in supine position and sent to the lab to be assessed with the same device after 30 minutes from surgery termination. The measured variables from arterial blood gas were arterial partial pressure of oxygen (PaO 2 ) and Oxygen saturation (SpO 2 ) alterations. Total PaO 2 was higher in the first measurement. The higher values of PaO 2 in cholecystectomy (upward) than in ovarian cystectomy (downward) were not significant in univariate (P = 0.060) and multivariate analysis (P = 0.654). Furthermore, higher values of SpO 2 in cholecystectomy (upward) than in ovarian cystectomy (downward) were not significant in univariate (P = 0.412) and multivariate analysis (P = 0.984). In general, based on the results of this study, the values of PaO 2 in cholecystectomy (upward) were not significantly higher than the values in cystectomy (downward) in laparoscopic surgeries when measured 30 minutes after surgery.

Comparison of Arterial Oxygenation Following Head-Down and Head-Up Laparoscopic Surgery

PubMed Central

Imani, Farsad; Shirani Amniyeh, Fatemeh; Bastan Hagh, Ehsan; Khajavi, Mohammad Reza; Samimi, Saghar; Yousefshahi, Fardin

2017-01-01

Background Regarding the role of gas entry in abdomen and cardiorespiratory effects, the ability of anesthesiologists would be challenged in laparoscopic surgeries. Considering few studies in this area and the relevance of the subject, this study was performed to compare the arterial oxygen alterations before operation in comparison with after surgery between laparoscopic cholecystectomy and ovarian cystectomy. Methods In this prospective cohort, 70 consecutive women aged from 20 to 60 years who were candidate for laparoscopic cholecystectomy (n = 35) and ovarian cystectomy (n = 35) with reverse (20 degrees) and direct (30 degrees) Trendelenburg positions, respectively, with ASA class I or II were enrolled. After intubation and before operation, for the first time, the arterial blood gas from radial artery in supine position was obtained for laboratory assessment. Then, the second blood sample was collected from radial artery in supine position and sent to the lab to be assessed with the same device after 30 minutes from surgery termination. The measured variables from arterial blood gas were arterial partial pressure of oxygen (PaO2) and Oxygen saturation (SpO2) alterations. Results Total PaO2 was higher in the first measurement. The higher values of PaO2 in cholecystectomy (upward) than in ovarian cystectomy (downward) were not significant in univariate (P = 0.060) and multivariate analysis (P = 0.654). Furthermore, higher values of SpO2 in cholecystectomy (upward) than in ovarian cystectomy (downward) were not significant in univariate (P = 0.412) and multivariate analysis (P = 0.984). Conclusions In general, based on the results of this study, the values of PaO2 in cholecystectomy (upward) were not significantly higher than the values in cystectomy (downward) in laparoscopic surgeries when measured 30 minutes after surgery. PMID:29696125

Spine surgeon's kinematics during discectomy, part II: operating table height and visualization methods, including microscope.

PubMed

Park, Jeong Yoon; Kim, Kyung Hyun; Kuh, Sung Uk; Chin, Dong Kyu; Kim, Keun Su; Cho, Yong Eun

2014-05-01

Surgeon spine angle during surgery was studied ergonomically and the kinematics of the surgeon's spine was related with musculoskeletal fatigue and pain. Spine angles varied depending on operation table height and visualization method, and in a previous paper we showed that the use of a loupe and a table height at the midpoint between the umbilicus and the sternum are optimal for reducing musculoskeletal loading. However, no studies have previously included a microscope as a possible visualization method. The objective of this study is to assess differences in surgeon spine angles depending on operating table height and visualization method, including microscope. We enrolled 18 experienced spine surgeons for this study, who each performed a discectomy using a spine surgery simulator. Three different methods were used to visualize the surgical field (naked eye, loupe, microscope) and three different operating table heights (anterior superior iliac spine, umbilicus, the midpoint between the umbilicus and the sternum) were studied. Whole spine angles were compared for three different views during the discectomy simulation: midline, ipsilateral, and contralateral. A 16-camera optoelectronic motion analysis system was used, and 16 markers were placed from the head to the pelvis. Lumbar lordosis, thoracic kyphosis, cervical lordosis, and occipital angle were compared between the different operating table heights and visualization methods as well as a natural standing position. Whole spine angles differed significantly depending on visualization method. All parameters were closer to natural standing values when discectomy was performed with a microscope, and there were no differences between the naked eye and the loupe. Whole spine angles were also found to differ from the natural standing position depending on operating table height, and became closer to natural standing position values as the operating table height increased, independent of the visualization method. When using a microscope, lumbar lordosis, thoracic kyphosis, and cervical lordosis showed no differences according to table heights above the umbilicus. This study suggests that the use of a microscope and a table height above the umbilicus are optimal for reducing surgeon musculoskeletal fatigue.

Minimally invasive positioning robot system of femoral neck hollow screw implants based on x-ray error correction

NASA Astrophysics Data System (ADS)

Zou, Yunpeng; Xu, Ying; Hu, Lei; Guo, Na; Wang, Lifeng

2017-01-01

Aiming the high failure rate, the high radiation quantity and the poor positioning accuracy of femoral neck traditional surgery, this article develops a set of new positioning robot system of femoral neck hollow screw implants based on X-rays error correction, which bases on the study of x-rays perspective principle and the Motion Principle of 6 DOF(degree of freedom) series robot UR(Universal Robots). Compared with Computer Assisted Navigation System, this system owns better positioning accuracy and more simple operation. In addition, without extra Equipment of Visual Tracking, this system can reduce a lot of cost. During the surgery, Doctor can plan the operation path and the pose of mark needle according to the positive and lateral X-rays images of patients. Then they can calculate the pixel ratio according to the ratio of the actual length of mark line and the length on image. After that, they can calculate the amount of exercise of UR Robot according to the relative position between operation path and guide pin and the fixed relationship between guide pin and UR robot. Then, they can control UR to drive the positioning guide pin to the operation path. At this point, check the positioning guide pin and the planning path is coincident, if not, repeat the previous steps, until the positioning guide pin and the planning path coincide which will eventually complete the positioning operation. Moreover, to verify the positioning accuracy, this paper make an errors analysis aiming to thirty cases of the experimental model of bone. The result shows that the motion accuracy of the UR Robot is 0.15mm and the Integral error precision is within 0.8mm. To verify the clinical feasibility of this system, this article analysis on three cases of the clinical experiment. In the whole process of positioning, the X-rays irradiation time is 2-3s, the number of perspective is 3-5 and the whole positioning time is 7-10min. The result shows that this system can complete accurately femoral neck positioning surgery. Meanwhile, it can greatly reduce the X-rays radiation of medical staff and patients. To summarize, it has a significant value in clinical application.

The existence of semiregular solutions to elliptic spectral problems with discontinuous nonlinearities

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

Pavlenko, V N; Potapov, D K

2015-09-30

This paper is concerned with the existence of semiregular solutions to the Dirichlet problem for an equation of elliptic type with discontinuous nonlinearity and when the differential operator is not assumed to be formally self-adjoint. Theorems on the existence of semiregular (positive and negative) solutions for the problem under consideration are given, and a principle of upper and lower solutions giving the existence of semiregular solutions is established. For positive values of the spectral parameter, elliptic spectral problems with discontinuous nonlinearities are shown to have nontrivial semiregular (positive and negative) solutions. Bibliography: 32 titles.

Self-evaluation on Motion Adaptation for Service Robots

NASA Astrophysics Data System (ADS)

Funabora, Yuki; Yano, Yoshikazu; Doki, Shinji; Okuma, Shigeru

We suggest self motion evaluation method to adapt to environmental changes for service robots. Several motions such as walking, dancing, demonstration and so on are described with time series patterns. These motions are optimized with the architecture of the robot and under certain surrounding environment. Under unknown operating environment, robots cannot accomplish their tasks. We propose autonomous motion generation techniques based on heuristic search with histories of internal sensor values. New motion patterns are explored under unknown operating environment based on self-evaluation. Robot has some prepared motions which realize the tasks under the designed environment. Internal sensor values observed under the designed environment with prepared motions show the interaction results with the environment. Self-evaluation is composed of difference of internal sensor values between designed environment and unknown operating environment. Proposed method modifies the motions to synchronize the interaction results on both environment. New motion patterns are generated to maximize self-evaluation function without external information, such as run length, global position of robot, human observation and so on. Experimental results show that the possibility to adapt autonomously patterned motions to environmental changes.

Study on relationship of performance shaping factor in human error probability with prevalent stress of PUSPATI TRIGA reactor operators

NASA Astrophysics Data System (ADS)

Rahim, Ahmad Nabil Bin Ab; Mohamed, Faizal; Farid, Mohd Fairus Abdul; Fazli Zakaria, Mohd; Sangau Ligam, Alfred; Ramli, Nurhayati Binti

2018-01-01

Human factor can be affected by prevalence stress measured using Depression, Anxiety and Stress Scale (DASS). From the respondents feedback can be summarized that the main factor causes the highest prevalence stress is due to the working conditions that require operators to handle critical situation and make a prompt critical decisions. The relationship between the prevalence stress and performance shaping factors found that PSFFitness and PSFWork Process showed positive Pearson’s Correlation with the score of .763 and .826 while the level of significance, p = .028 and p = .012. These positive correlations with good significant values between prevalence stress and human performance shaping factor (PSF) related to fitness, work processes and procedures. The higher the stress level of the respondents, the higher the score of selected for the PSFs. This is due to the higher levels of stress lead to deteriorating physical health and cognitive also worsened. In addition, the lack of understanding in the work procedures can also be a factor that causes a growing stress. The higher these values will lead to the higher the probabilities of human error occur. Thus, monitoring the level of stress among operators RTP is important to ensure the safety of RTP.

The position of a standard optical computer mouse affects cardiorespiratory responses during the operation of a computer under time constraints.

PubMed

Sako, Shunji; Sugiura, Hiromichi; Tanoue, Hironori; Kojima, Makoto; Kono, Mitsunobu; Inaba, Ryoichi

2014-08-01

This study investigated the association between task-induced stress and fatigue by examining the cardiovascular responses of subjects using different mouse positions while operating a computer under time constraints. The study was participated by 16 young, healthy men and examined the use of optical mouse devices affixed to laptop computers. Two mouse positions were investigated: (1) the distal position (DP), in which the subjects place their forearms on the desk accompanied by the abduction and flexion of their shoulder joints, and (2) the proximal position (PP), in which the subjects place only their wrists on the desk without using an armrest. The subjects continued each task for 16 min. We assessed differences in several characteristics according to mouse position, including expired gas values, autonomic nerve activities (based on cardiorespiratory responses), operating efficiencies (based on word counts), and fatigue levels (based on the visual analog scale - VAS). Oxygen consumption (VO(2)), the ratio of inspiration time to respiration time (T(i)/T(total)), respiratory rate (RR), minute ventilation (VE), and the ratio of expiration to inspiration (Te/T(i)) were significantly lower when the participants were performing the task in the DP than those obtained in the PP. Tidal volume (VT), carbon dioxide output rates (VCO(2)/VE), and oxygen extraction fractions (VO(2)/VE) were significantly higher for the DP than they were for the PP. No significant difference in VAS was observed between the positions; however, as the task progressed, autonomic nerve activities were lower and operating efficiencies were significantly higher for the DP than they were for the PP. Our results suggest that the DP has fewer effects on cardiorespiratory functions, causes lower levels of sympathetic nerve activity and mental stress, and produces a higher total workload than the PP. This suggests that the DP is preferable to the PP when operating a computer.

[Evaluation of performance of five bioinformatics software for the prediction of missense mutations].

PubMed

Chen, Qianting; Dai, Congling; Zhang, Qianjun; Du, Juan; Li, Wen

2016-10-01

To study the prediction performance evaluation with five kinds of bioinformatics software (SIFT, PolyPhen2, MutationTaster, Provean, MutationAssessor). From own database for genetic mutations collected over the past five years, Chinese literature database, Human Gene Mutation Database, and dbSNP, 121 missense mutations confirmed by functional studies, and 121 missense mutations suspected to be pathogenic by pedigree analysis were used as positive gold standard, while 242 missense mutations with minor allele frequency (MAF)>5% in dominant hereditary diseases were used as negative gold standard. The selected mutations were predicted with the five software. Based on the results, the performance of the five software was evaluated for their sensitivity, specificity, positive predict value, false positive rate, negative predict value, false negative rate, false discovery rate, accuracy, and receiver operating characteristic curve (ROC). In terms of sensitivity, negative predictive value and false negative rate, the rank was MutationTaster, PolyPhen2, Provean, SIFT, and MutationAssessor. For specificity and false positive rate, the rank was MutationTaster, Provean, MutationAssessor, SIFT, and PolyPhen2. For positive predict value and false discovery rate, the rank was MutationTaster, Provean, MutationAssessor, PolyPhen2, and SIFT. For area under the ROC curve (AUC) and accuracy, the rank was MutationTaster, Provean, PolyPhen2, MutationAssessor, and SIFT. The prediction performance of software may be different when using different parameters. Among the five software, MutationTaster has the best prediction performance.

Usefulness of Two Aspergillus PCR Assays and Aspergillus Galactomannan and β-d-Glucan Testing of Bronchoalveolar Lavage Fluid for Diagnosis of Chronic Pulmonary Aspergillosis

PubMed Central

Urabe, Naohisa; Sano, Go; Suzuki, Junko; Hebisawa, Akira; Nakamura, Yasuhiko; Koyama, Kazuya; Ishii, Yoshikazu; Tateda, Kazuhiro; Homma, Sakae

2017-01-01

ABSTRACT We evaluated the usefulness of an Aspergillus galactomannan (GM) test, a β-d-glucan (βDG) test, and two different Aspergillus PCR assays of bronchoalveolar lavage fluid (BALF) samples for the diagnosis of chronic pulmonary aspergillosis (CPA). BALF samples from 30 patients with and 120 patients without CPA were collected. We calculated the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for each test individually and in combination with other tests. The optical density index values, as determined by receiver operating characteristic analysis, for the diagnosis of CPA were 0.5 and 100 for GM and βDG testing of BALF, respectively. The sensitivity and specificity of the GM test, βDG test, and PCR assays 1 and 2 were 77.8% and 90.0%, 77.8% and 72.5%, 86.7% and 84.2%, and 66.7% and 94.2%, respectively. A comparison of the PCR assays showed that PCR assay 1 had a better sensitivity, a better negative predictive value, and a better negative likelihood ratio and PCR assay 2 had a better specificity, a better positive predictive value, and a better positive likelihood ratio. The combination of the GM and βDG tests had the highest diagnostic odds ratio. The combination of the GM and βDG tests on BALF was more useful than any single test for diagnosing CPA. PMID:28330887

Severe community-acquired pneumonia. Assessment of severity criteria.

PubMed

Ewig, S; Ruiz, M; Mensa, J; Marcos, M A; Martinez, J A; Arancibia, F; Niederman, M S; Torres, A

1998-10-01

The purpose of the study was to validate the criteria used in the guidelines of the American Thoracic Society (ATS) for severe community-acquired pneumonia (CAP). Severe pneumonia was defined as admission to the intensive care unit (ICU). Overall 331 nonsevere (84%) and 64 severe cases (16%) of CAP were prospectively studied. Mortality was 19 of 395 (5%) and 19 of 64 (30%), respectively. Single severity criteria as well as the ATS definition of severe pneumonia were assessed calculating the operative indices. A modified prediction rule including minor (baseline) and major (baseline or evolutionary) criteria was derived. Single minor criteria at admission had a low sensitivity and positive predictive value. Defining severe pneumonia according to the ATS guidelines had a high sensitivity (98%). However, specificity and positive predictive value were low (32% and 24%, respectively). A modified prediction rule (presence of two or three minor criteria [systolic blood pressure < 90 mm Hg, multilobar involvement, PaO2/FIO2 < 250] or one of two major criteria [requirement of mechanical ventilation, presence of septic shock]) had a sensitivity of 78%, a specificity of 94%, a positive predictive value of 75%, and a negative predictive value of 95%. The ATS definition of severe pneumonia was highly sensitive but insufficiently specific and had a low positive predictive value. Our suggested modified rule had a more balanced performance and, if validated in an independent population, may represent a more accurate definition of severe CAP.

Traditional Chinese medicine and the positive correlation with homeostatic evolution of human being: based on medical perspective.

PubMed

Wang, Jie-Hua

2012-08-01

Adaptation is an eternal theme of biological evolution. The paper aims at exploring the conception of positive correlation between traditional Chinese medicine (TCM) and human homeostatic evolution based on medical perspective. Discussions mainly involve TCM conforming to natural laws and natural evolution of life, spontaneous harmonization of yin and yang and operating system of human self-healing, modern human immunology and human endogenous immune function in TCM, self-homeostasis of human micro-ecological state and balance mechanism on regulating base in TCM, as well as adaptation-eternal theme of biological evolution and safeguarding adaptability-value of TCM. In perspective of medicine, theory and practice of TCM are in positive correlation with human homeostatic evolution, and what TCM tries to maintain is human intrinsic adaptive capability to disease and nature. Therefore, it is the core value of TCM, which is to be further studied, explored, realized and known to the world.

ASD-1000: High-resolution, high-temperature acetylene spectroscopic databank

NASA Astrophysics Data System (ADS)

Lyulin, O. M.; Perevalov, V. I.

2017-11-01

We present a high-resolution, high-temperature version of the Acetylene Spectroscopic Databank called ASD-1000. The databank contains the line parameters (position, intensity, Einstein coefficient for spontaneous emission, term value of the lower states, self- and air-broadening coefficients, temperature dependence exponents of the self- and air-broadening coefficients) of the principal isotopologue of C2H2. The reference temperature for line intensity is 296 K and the intensity cutoff is 10-27 cm-1/(molecule cm-2) at 1000 K. The databank has 33,890,981 entries and covers the 3-10,000 cm-1 spectral range. The databank is based on the global modeling of the line positions and intensities performed within the framework of the method of effective operators. The parameters of the effective Hamiltonian and the effective dipole moment operator have been fitted to the observed values of the line positions and intensities collected from the literature. The broadening coefficients as well as their temperature dependence exponents were calculated using the empirical equations. The databank is useful for studying high-temperature radiative properties of C2H2. ASD-1000 is freely accessible via the Internet site of V.E. Zuev Institute of Atmospheric Optics SB RAS ftp://ftp.iao.ru/pub/ASD1000/.

Diagnostic value of contrast-enhanced ultrasound in thyroid nodules with calcification.

PubMed

Jiang, Jue; Shang, Xu; Wang, Hua; Xu, Yong-Bo; Gao, Ya; Zhou, Qi

2015-03-01

The aim of this study was to investigate the diagnostic values of conventional ultrasound and contrast-enhanced ultrasound (CEUS) in benign and malignant thyroid nodules with calcification. Conventional ultrasound and CEUS were performed in 122 patients with thyroid nodules with calcification. The thyroid nodules were characterized as benign or malignant by pathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accordance rate of the two imaging methods were determined. The area under the receiver operating characteristics curve (AUC) was used to assess the diagnostic values of the two imaging methods. In 122 cases of thyroid nodules with calcification, 73 benign nodules and 49 malignant nodules were verified by pathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accordance rate of conventional ultrasound were 50%, 77%, 59%, 69%, and 66%, respectively, and those of CEUS were 90%, 92%, 88%, 93%, and 91%, respectively. There were significant differences between the two imaging methods. AUCs of conventional ultrasound and CEUS were 0.628 ± 0.052 and 0.908 ± 0.031, suggesting low and high diagnostic values, respectively. CEUS has high diagnostic values, being significantly greater than those of conventional ultrasound, in differential diagnosis of benign and malignant thyroid nodules with calcification. Copyright © 2014. Published by Elsevier Taiwan.

Assessing Breast Cancer Risk with an Artificial Neural Network

PubMed

Sepandi, Mojtaba; Taghdir, Maryam; Rezaianzadeh, Abbas; Rahimikazerooni, Salar

2018-04-25

Objectives: Radiologists face uncertainty in making decisions based on their judgment of breast cancer risk. Artificial intelligence and machine learning techniques have been widely applied in detection/recognition of cancer. This study aimed to establish a model to aid radiologists in breast cancer risk estimation. This incorporated imaging methods and fine needle aspiration biopsy (FNAB) for cyto-pathological diagnosis. Methods: An artificial neural network (ANN) technique was used on a retrospectively collected dataset including mammographic results, risk factors, and clinical findings to accurately predict the probability of breast cancer in individual patients. Area under the receiver-operating characteristic curve (AUC), accuracy, sensitivity, specificity, and positive and negative predictive values were used to evaluate discriminative performance. Result: The network incorporating the selected features performed best (AUC = 0.955). Sensitivity and specificity of the ANN were respectively calculated as 0.82 and 0.90. In addition, negative and positive predictive values were respectively computed as 0.90 and 0.80. Conclusion: ANN has potential applications as a decision-support tool to help underperforming practitioners to improve the positive predictive value of biopsy recommendations. Creative Commons Attribution License

Predictive value of bacterial analysis of laparotomy wounds.

PubMed

Minutolo, Mario; Blandino, Giovanna; Arena, Manuel; Licciardello, Alessio; Di Stefano, Biagio; Lanteri, Raffaele; Puleo, Stefano; Licata, Antonio; Minutolo, Vincenzo

2014-01-01

Despite improvements in antibiotic prophylaxis, surgical site infections represent the most common postoperative complication with important clinical consequences for patients. The hypothesis that a bacterial analysis of the surgical wound in the operating room could predict the likelihood of developing a clinical infection, and might allow a tailored and preemptive approach, aimed to reduce the consequences of an infection, seems appealing. We would like to present a prospective study on the predictive value of the bacterial analysis of laparotomy wounds. Seventy eight prospective patients undergoing surgery were included in the study. To evaluate the risk factors associated with increased rate of wound infection, we performed a bacterial analysis of the wound. 48 patients out of 78 (61%) had positive cultures. 23 patients out of 32 patients (72%) who didn't receive antibiotic prophylaxis were positive to the wound culture whereas 25 patients out of 46 patients (54%) grew positive cultures in the group of patients that received antibiotic prophylaxis. None of the 30 patients with negative cultures developed clinical infection. Only 6 patients out of 48 patients who had positive cultures (12.5%) developed wound infection. Clinical infection occurred in 5 patients who had gram-negative contamination of the wound. No clinical infection occurred in patients who had gram-positive contamination. Wound cultures and their positivity are predictive tools to identify the patients that are at risk to develop wound infection. The positive predictive value of the bacterial analysis of the wound was 12.5%. Abdominal surgery, Bacterial analysis, Wound infection.

40 CFR 63.5995 - What are my monitoring installation, operation, and maintenance requirements?

Code of Federal Regulations, 2010 CFR

2010-07-01

... paragraphs (a) and (b)(1) through (8) of this section. (1) Locate the temperature sensor in a position that provides a representative temperature. (2) For a non-cryogenic temperature range, use a temperature sensor... value, whichever is larger. (3) For a cryogenic temperature range, use a temperature sensor with a...

46 CFR 56.50-15 - Steam and exhaust piping.

Code of Federal Regulations, 2010 CFR

2010-10-01

... stress for the material shall not exceed that corresponding to the saturated steam temperature at drum... normal rated operating condition. In both cases, the value of allowable stress shall be selected using a... hot water for heating systems may not exceed 375 °F. (i) Where positive shutoff valves are fitted in...

40 CFR 63.2269 - What are my monitoring installation, operation, and maintenance requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Locate the temperature sensor in a position that provides a representative temperature. (2) Use a temperature sensor with a minimum accuracy of 4 °F or 0.75 percent of the temperature value, whichever is... manufacturer's owners manual. Following the electronic calibration, you must conduct a temperature sensor...

40 CFR 63.4768 - What are the requirements for continuous parameter monitoring system installation, operation, and...

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Locate the temperature sensor in a position that provides a representative temperature. (ii) Use a temperature sensor with a measurement sensitivity of 4 degrees Fahrenheit or 0.75 percent of the temperature value, whichever is larger. (iii) Shield the temperature sensor system from electromagnetic interference...

40 CFR 63.4768 - What are the requirements for continuous parameter monitoring system installation, operation, and...

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Locate the temperature sensor in a position that provides a representative temperature. (ii) Use a temperature sensor with a measurement sensitivity of 4 degrees Fahrenheit or 0.75 percent of the temperature value, whichever is larger. (iii) Shield the temperature sensor system from electromagnetic interference...

40 CFR 63.2269 - What are my monitoring installation, operation, and maintenance requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Locate the temperature sensor in a position that provides a representative temperature. (2) Use a temperature sensor with a minimum accuracy of 4 °F or 0.75 percent of the temperature value, whichever is... manufacturer's owners manual. Following the electronic calibration, you must conduct a temperature sensor...

40 CFR 63.2269 - What are my monitoring installation, operation, and maintenance requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Locate the temperature sensor in a position that provides a representative temperature. (2) Use a temperature sensor with a minimum accuracy of 4 °F or 0.75 percent of the temperature value, whichever is... manufacturer's owners manual. Following the electronic calibration, you must conduct a temperature sensor...

Inducing the Einstein action in QCD-like theories

NASA Astrophysics Data System (ADS)

Donoghue, John F.; Menezes, Gabriel

2018-03-01

We evaluate the induced value of Newton's constant which would arise in QCD. The ingredients are modern lattice results, perturbation theory and the operator product expansion. The resulting shift in the Planck mass is positive. A scaled-up version of such a theory may be part of a quantum field theory treatment of gravity.

Controlling Costs. Managing Resources Module. Operational Management Programme. Second Edition.

ERIC Educational Resources Information Center

Hayter, Roy

This self-study unit focuses on managing resources--materials, equipment, personnel, money, energy, time, and information. The material is designed primarily for those in a supervisory or junior management position working within their company's policies and systems. The unit may be of value to the small business proprietor, as an introduction to…

Object detection with a multistatic array using singular value decomposition

DOEpatents

Hallquist, Aaron T.; Chambers, David H.

2014-07-01

A method and system for detecting the presence of subsurface objects within a medium is provided. In some embodiments, the detection system operates in a multistatic mode to collect radar return signals generated by an array of transceiver antenna pairs that is positioned across a surface and that travels down the surface. The detection system converts the return signals from a time domain to a frequency domain, resulting in frequency return signals. The detection system then performs a singular value decomposition for each frequency to identify singular values for each frequency. The detection system then detects the presence of a subsurface object based on a comparison of the identified singular values to expected singular values when no subsurface object is present.

Delay banking for air traffic management

NASA Technical Reports Server (NTRS)

Green, Steven M. (Inventor)

2007-01-01

A method and associated system for time delay banking for aircraft arrival time, aircraft departure time and/or en route flight position. The delay credit value for a given flight may decrease with passage of time and may be transferred to or traded with other flights having the same or a different user (airline owner or operator). The delay credit value for a given aircraft flight depends upon an initial delay credit value, which is determined by a central system and depends upon one or more other flight characteristics. Optionally, the delay credit value decreases with passage of time. Optionally, a transaction cost is assessed against a delay credit value that is used on behalf of another flight with the same user or is traded with a different user.

Mate call as reward: Acoustic communication signals can acquire positive reinforcing values during adulthood in female zebra finches (Taeniopygia guttata).

PubMed

Hernandez, Alexandra M; Perez, Emilie C; Mulard, Hervé; Mathevon, Nicolas; Vignal, Clémentine

2016-02-01

Social stimuli can have rewarding properties and promote learning. In birds, conspecific vocalizations like song can act as a reinforcer, and specific song variants can acquire particular rewarding values during early life exposure. Here we ask if, during adulthood, an acoustic signal simpler and shorter than song can become a reward for a female songbird because of its particular social value. Using an operant choice apparatus, we showed that female zebra finches display a preferential response toward their mate's calls. This reinforcing value of mate's calls could be involved in the maintenance of the monogamous pair-bond of the zebra finch. (c) 2016 APA, all rights reserved).

Real option valuation of a decremental regulation service provided by electricity storage.

PubMed

Szabó, Dávid Zoltán; Martyr, Randall

2017-08-13

This paper is a quantitative study of a reserve contract for real-time balancing of a power system. Under this contract, the owner of a storage device, such as a battery, helps smooth fluctuations in electricity demand and supply by using the device to increase electricity consumption. The battery owner must be able to provide immediate physical cover, and should therefore have sufficient storage available in the battery before entering the contract. Accordingly, the following problem can be formulated for the battery owner: determine the optimal time to enter the contract and, if necessary, the optimal time to discharge electricity before entering the contract. This problem is formulated as one of optimal stopping, and is solved explicitly in terms of the model parameters and instantaneous values of the power system imbalance. The optimal operational strategies thus obtained ensure that the battery owner has positive expected economic profit from the contract. Furthermore, they provide explicit conditions under which the optimal discharge time is consistent with the overall objective of power system balancing. This paper also carries out a preliminary investigation of the 'lifetime value' aggregated from an infinite sequence of these balancing reserve contracts. This lifetime value, which can be viewed as a single project valuation of the battery, is shown to be positive and bounded. Therefore, in the long run such reserve contracts can be beneficial to commercial operators of electricity storage, while reducing some of the financial and operational risks in power system balancing.This article is part of the themed issue 'Energy management: flexibility, risk and optimization'. © 2017 The Author(s).

Predictive genetic testing for the identification of high-risk groups: a simulation study on the impact of predictive ability

PubMed Central

2011-01-01

Background Genetic risk models could potentially be useful in identifying high-risk groups for the prevention of complex diseases. We investigated the performance of this risk stratification strategy by examining epidemiological parameters that impact the predictive ability of risk models. Methods We assessed sensitivity, specificity, and positive and negative predictive value for all possible risk thresholds that can define high-risk groups and investigated how these measures depend on the frequency of disease in the population, the frequency of the high-risk group, and the discriminative accuracy of the risk model, as assessed by the area under the receiver-operating characteristic curve (AUC). In a simulation study, we modeled genetic risk scores of 50 genes with equal odds ratios and genotype frequencies, and varied the odds ratios and the disease frequency across scenarios. We also performed a simulation of age-related macular degeneration risk prediction based on published odds ratios and frequencies for six genetic risk variants. Results We show that when the frequency of the high-risk group was lower than the disease frequency, positive predictive value increased with the AUC but sensitivity remained low. When the frequency of the high-risk group was higher than the disease frequency, sensitivity was high but positive predictive value remained low. When both frequencies were equal, both positive predictive value and sensitivity increased with increasing AUC, but higher AUC was needed to maximize both measures. Conclusions The performance of risk stratification is strongly determined by the frequency of the high-risk group relative to the frequency of disease in the population. The identification of high-risk groups with appreciable combinations of sensitivity and positive predictive value requires higher AUC. PMID:21797996

Carotid artery B-mode ultrasound image segmentation based on morphology, geometry and gradient direction

NASA Astrophysics Data System (ADS)

Sunarya, I. Made Gede; Yuniarno, Eko Mulyanto; Purnomo, Mauridhi Hery; Sardjono, Tri Arief; Sunu, Ismoyo; Purnama, I. Ketut Eddy

2017-06-01

Carotid Artery (CA) is one of the vital organs in the human body. CA features that can be used are position, size and volume. Position feature can used to determine the preliminary initialization of the tracking. Examination of the CA features can use Ultrasound. Ultrasound imaging can be operated dependently by an skilled operator, hence there could be some differences in the images result obtained by two or more different operators. This can affect the process of determining of CA. To reduce the level of subjectivity among operators, it can determine the position of the CA automatically. In this study, the proposed method is to segment CA in B-Mode Ultrasound Image based on morphology, geometry and gradient direction. This study consists of three steps, the data collection, preprocessing and artery segmentation. The data used in this study were taken directly by the researchers and taken from the Brno university's signal processing lab database. Each data set contains 100 carotid artery B-Mode ultrasound image. Artery is modeled using ellipse with center c, major axis a and minor axis b. The proposed method has a high value on each data set, 97% (data set 1), 73 % (data set 2), 87% (data set 3). This segmentation results will then be used in the process of tracking the CA.

Stillwater Hybrid Geo-Solar Power Plant Optimization Analyses

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

Wendt, Daniel S.; Mines, Gregory L.; Turchi, Craig S.

2015-09-02

The Stillwater Power Plant is the first hybrid plant in the world able to bring together a medium-enthalpy geothermal unit with solar thermal and solar photovoltaic systems. Solar field and power plant models have been developed to predict the performance of the Stillwater geothermal / solar-thermal hybrid power plant. The models have been validated using operational data from the Stillwater plant. A preliminary effort to optimize performance of the Stillwater hybrid plant using optical characterization of the solar field has been completed. The Stillwater solar field optical characterization involved measurement of mirror reflectance, mirror slope error, and receiver position error.more » The measurements indicate that the solar field may generate 9% less energy than the design value if an appropriate tracking offset is not employed. A perfect tracking offset algorithm may be able to boost the solar field performance by about 15%. The validated Stillwater hybrid plant models were used to evaluate hybrid plant operating strategies including turbine IGV position optimization, ACC fan speed and turbine IGV position optimization, turbine inlet entropy control using optimization of multiple process variables, and mixed working fluid substitution. The hybrid plant models predict that each of these operating strategies could increase net power generation relative to the baseline Stillwater hybrid plant operations.« less

[Hygienic Inspections of Ventilation Systems Under Resting Conditions (According to DIN 1946-4:1999-03) - A Retrospective Assessment].

PubMed

Friedrich, Lena; Boeckelmann, Irina

2018-01-11

Hygienic and microbiologically sterile air quality is essential for successful guideline-based work in operating theatres. To ensure clean air and to reduce contamination during surgery, ventilation systems are indispensable. Ventilation systems should be especially designed to keep the number of particles and germs under statutory limits. Therefore, they must be operated to recognised standards of good practice and be periodically inspected and maintained. The objective of this study was to prove, through the analysis of observation outside surgery time (rest condition), the effects of ventilation systems on air quality in a medical facility. Measurements were taken in 34 operating theatres annually over a period of ten years outside surgery time (resting condition) but with the air ventilation system operating under full load. 29 operating theatres were provided with laminar air flow and five theatres with turbulent air flow systems. In each operating theatre, air cleanliness was analysed by measuring the amount of airborne particles and airborne germs. Measuring points were determined 10 mm beneath the supply-air ceiling in the centre of the operating theatre and at one position outside the supply-air ceiling. The number of airborne particles at the supply-air ceiling was between 0/m³ and 4,441/m³ of air and, as such, the limiting factor was never exceeded. However, airborne germ measurements of between 0 CFU/m³ and 200 CFU/m³ (CFU: colony forming units) demonstrated that the limiting factor for this criterion was exceeded in 10.9% of occasions. In general, the values in the middle of the room were higher than at the supply-air ceiling. There were significant differences (p < 0.001) between the values at the supply-air ceiling, the surgery table and the values outside the supply-air ceiling. The results show the positive impact of ventilation systems on the air cleanliness in operating theatres. However, laminar airflow systems seem to create cleaner air than conventional ventilation systems. The size of the supply-air ceiling plays an important role in the prevention of the contamination of the staff, the surgical field, the instrument table and the patient. However, the effect on surgical site infections has not been verified. Improved measuring methods should be considered. Georg Thieme Verlag KG Stuttgart · New York.

Medical chart validation of an algorithm for identifying multiple sclerosis relapse in healthcare claims.

PubMed

Chastek, Benjamin J; Oleen-Burkey, Merrikay; Lopez-Bresnahan, Maria V

2010-01-01

Relapse is a common measure of disease activity in relapsing-remitting multiple sclerosis (MS). The objective of this study was to test the content validity of an operational algorithm for detecting relapse in claims data. A claims-based relapse detection algorithm was tested by comparing its detection rate over a 1-year period with relapses identified based on medical chart review. According to the algorithm, MS patients in a US healthcare claims database who had either (1) a primary claim for MS during hospitalization or (2) a corticosteroid claim following a MS-related outpatient visit were designated as having a relapse. Patient charts were examined for explicit indication of relapse or care suggestive of relapse. Positive and negative predictive values were calculated. Medical charts were reviewed for 300 MS patients, half of whom had a relapse according to the algorithm. The claims-based criteria correctly classified 67.3% of patients with relapses (positive predictive value) and 70.0% of patients without relapses (negative predictive value; kappa 0.373: p < 0.001). Alternative algorithms did not improve on the predictive value of the operational algorithm. Limitations of the algorithm include lack of differentiation between relapsing-remitting MS and other types, and that it does not incorporate measures of function and disability. The claims-based algorithm appeared to successfully detect moderate-to-severe MS relapse. This validated definition can be applied to future claims-based MS studies.

Linkage of microbial kinetics and bacterial community structure of MBR and hybrid MBBR-MBR systems to treat salinity-amended urban wastewater.

PubMed

Rodriguez-Sanchez, Alejandro; Leyva-Diaz, Juan Carlos; Gonzalez-Martinez, Alejandro; Poyatos, Jose Manuel

2017-11-01

Three pilot-scale bioreactors were started up and operated under salinity-amended urban wastewater feeding. The bioreactors were configured as membrane bioreactor and two different hybrid, moving bed biofilm reactor-membrane bioreactor and operated with a hydraulic retention time of 9.5 h, a solid residence time of 11.75 days and a total solids concentration of 2500 mg L -1 . The three systems showed excellent performance in suspended solids, BOD 5 , and COD removal (values of 96-100%, 97-99%, and 88-90%, respectively), but poor nitrogen removal (values of 20-30%). The bacterial community structure during the start-up phase and the stabilization phase were different, as showed by β-diversity analyses. The differences between aerobic and anoxic biomass-and between suspended and attached biomass-were higher at the start-up phase than at the stabilization phase. The start-up phase showed high abundances of Chiayiivirga (mean values around 3-12% relative abundance) and Luteimonas (5-8%), but in the stabilization phase, the domination belonged to Thermomonas (3-14%), Nitrobacter (3-7%), Ottowia (3-11.5%), and Comamonas (2-6%), among others. Multivariate redundancy analyses showed that Thermomonas and Nitrosomonas were positively correlated with fast autotrophic kinetics, while Caulobacter and Ottowia were positively correlated with fast heterotrophic kinetics. Nitrobacter, Rhodanobacter, and Comamonas were positively correlated with fast autotrophic and heterotrophic kinetics. © 2017 American Institute of Chemical Engineers Biotechnol. Prog., 33:1483-1495, 2017. © 2017 American Institute of Chemical Engineers.

Relative reward effects on operant behavior: Incentive contrast, induction and variety effects

PubMed Central

Webber, E.S.; Chambers, N. E.; Kostek, J.A.; Mankin, D.E; Cromwell, H.C.

2015-01-01

Comparing different rewards automatically produces dynamic relative outcome effects on behavior. Each new outcome exposure is to an updated version evaluated relative to alternatives. Relative reward effects include incentive contrast, positive induction and variety effects. The present study utilized a novel behavioral design to examine relative reward effects on a chain of operant behavior using auditory cues. Incentive contrast is the most often examined effect and focuses on increases or decreases in behavioral performance after value upshifts (positive) or downshifts (negative) relative to another outcome. We examined the impact of comparing two reward outcomes in a repeated measures design with three sessions: a single outcome and a mixed outcome and a final single outcome session. Relative reward effects should be apparent when comparing trials for the identical outcome between the single and mixed session types. An auditory cue triggered a series of operant responses (nosepoke-leverpress-food retrieval), and we measured possible contrast effects for different reward magnitude combinations. We found positive contrast for trials with the greatest magnitude differential but positive induction or variety effects in other combinations. This behavioral task could be useful for analyzing environmental or neurobiological factors involved in reward comparisons, decision-making and choice during instrumental, goal-directed action. PMID:25979604

q-bosons and the q-analogue quantized field

NASA Technical Reports Server (NTRS)

Nelson, Charles A.

1995-01-01

The q-analogue coherent states are used to identify physical signatures for the presence of a 1-analogue quantized radiation field in the q-CS classical limits where the absolute value of z is large. In this quantum-optics-like limit, the fractional uncertainties of most physical quantities (momentum, position, amplitude, phase) which characterize the quantum field are O(1). They only vanish as O(1/absolute value of z) when q = 1. However, for the number operator, N, and the N-Hamiltonian for a free q-boson gas, H(sub N) = h(omega)(N + 1/2), the fractional uncertainties do still approach zero. A signature for q-boson counting statistics is that (Delta N)(exp 2)/ (N) approaches 0 as the absolute value of z approaches infinity. Except for its O(1) fractional uncertainty, the q-generalization of the Hermitian phase operator of Pegg and Barnett, phi(sub q), still exhibits normal classical behavior. The standard number-phase uncertainty-relation, Delta(N) Delta phi(sub q) = 1/2, and the approximate commutation relation, (N, phi(sub q)) = i, still hold for the single-mode q-analogue quantized field. So, N and phi(sub q) are almost canonically conjugate operators in the q-CS classical limit. The q-analogue CS's minimize this uncertainty relation for moderate (absolute value of z)(exp 2).

Operative contractility: a functional concept of the inotropic state.

PubMed

Curiel, Roberto; Perez-Gonzalez, Juan; Torres, Edwar; Landaeta, Ruben; Cerrolaza, Miguel

2005-10-01

1. Initial unsuccessful attempts to evaluate ventricular function in terms of the 'heart as a pump' led to focusing on the 'heart as a muscle' and to the concept of myocardial contractility. However, no clinically ideal index exists to assess the contractile state. The aim of the present study was to develop a mathematical model to assess cardiac contractility. 2. A tri-axial system was conceived for preload (PL), afterload (AL) and contractility, where stroke volume (SV) was represented as the volume of the tetrahedron. Based on this model, 'operative' contractility ('OperCon') was calculated from the readily measured values of PL, AL and SV. The model was tested retrospectively under a variety of different experimental and clinical conditions, in 71 studies in humans and 29 studies in dogs. A prospective echocardiographic study was performed in 143 consecutive subjects to evaluate the ability of the model to assess contractility when SV and PL were measured volumetrically (mL) or dimensionally (cm). 3. With inotropic interventions, OperCon changes were comparable to those of ejection fraction (EF), velocity of shortening (Vcf) and dP/dt-max. Only with positive inotropic interventions did elastance (Ees) show significantly larger changes. With load manipulations, OperCon showed significantly smaller changes than EF and Ees and comparable changes to Vcf and dP/dt-max. Values of OperCon were similar when AL was represented by systolic blood pressure or wall stress and when volumetric or dimensional values were used. 4. Operative contractility is a reliable, simple and versatile method to assess cardiac contractility.

Restricted numerical range: A versatile tool in the theory of quantum information

NASA Astrophysics Data System (ADS)

Gawron, Piotr; Puchała, Zbigniew; Miszczak, Jarosław Adam; Skowronek, Łukasz; Życzkowski, Karol

2010-10-01

Numerical range of a Hermitian operator X is defined as the set of all possible expectation values of this observable among a normalized quantum state. We analyze a modification of this definition in which the expectation value is taken among a certain subset of the set of all quantum states. One considers, for instance, the set of real states, the set of product states, separable states, or the set of maximally entangled states. We show exemplary applications of these algebraic tools in the theory of quantum information: analysis of k-positive maps and entanglement witnesses, as well as study of the minimal output entropy of a quantum channel. Product numerical range of a unitary operator is used to solve the problem of local distinguishability of a family of two unitary gates.

Digital image color analysis compared to direct dental CIE colorimeter assessment under different ambient conditions.

PubMed

Knösel, Michael; Attin, Rengin; Jung, Klaus; Brunner, Edgar; Kubein-Meesenburg, Dietmar; Attin, Thomas

2009-04-01

To evaluate the concordance and repeatability of two in vivo methods for dental color assessment and to clarify the influence of different ambient light conditions and subject's head position on the assessed color variables. Color assessments were performed by two examiners on 16 arbitrarily selected subjects under two different, standardized conditions of illumination and at two different standardized head angulations. CIE (L*a*b*) data for upper and lower central incisors were recorded in two different ways: (1) by an intra-oral contact dental colorimeter and (2) by processing digital images for performing color calculation using Adobe Photoshop software. The influence of the different ambient conditions on both methods, as well as the concordance of measurements was analyzed statistically using several mixed linear models. Ambient light as a single factor had no significant influence on maxillary L*, a* and b* values, but it did have an effect on mandible assessments. Head angulation variation resulted in significant L* value differences using the photo method. The operator had a significant influence on values a* and b* for the photo method and on a* values for the colorimeter method. In fully lit ambient condition, the operator had a significant influence on the segregated L*, a*, and b* values. With dimmed lights, head angulation became significant, but not the operator. Evaluation of segregated L* values was error prone in both methods. Comparing both methods, deltaE values did not exceed 2.85 units, indicating that color differences between methods and recorded under varying ambient conditions were well below the sensitivity of the naked eye.

The utility of repeat sestamibi scans in patients with primary hyperparathyroidism after an initial negative scan.

PubMed

Krishnamurthy, Vikram D; Sound, Sara; Okoh, Alexis K; Yazici, Pinar; Yigitbas, Hakan; Neumann, Donald; Doshi, Krupa; Berber, Eren

2017-06-01

We analyzed the utility of repeated sestambi scans in patients with primary hyperparathyroidism and its effects on operative referral. We carried out a retrospective review of patients with primary hyperparathyroidism who underwent repeated sestambi scans exclusively within our health system between 1996-2015. Patient demographic, presentation, laboratory, imaging, operative, and pathologic data were reviewed. Univariate analysis with JMP Pro v12 was used to identify factors associated with conversion from an initial negative to a subsequent positive scan. After exclusion criteria (including reoperations), we identified 49 patients in whom 59% (n = 29) of subsequent scans remained negative and 41% (n = 20) converted to positive. Factors associated with an initial negative to a subsequent positive scan included classic presentation and second scans with iodine subtraction (P = .04). Nonsurgeons were less likely to order an iodine-subtraction scan (P < .05). Fewer patients with negative imaging were referred to surgery (33% vs 100%, P = .005), and median time to operation after the first negative scan was 25 months (range 1.4-119). Surgeon-performed ultrasonography had greater sensitivity and positive predictive value than repeated sestamibi scans. Negative sestambi scans decreased and delayed operative referral. Consequently, we identified several process improvement initiatives, including education regarding superior institutional imaging. Combining all findings, we created an algorithm for evaluating patients with primary hyperparathyroidism after initially negative sestamibi scans, which incorporates surgeon-performed ultrasonography. Copyright © 2016 Elsevier Inc. All rights reserved.

Control Performance of General Electric Fuel and Torque Regulator Operating on T31-3 Turbine-Propeller Engine in Sea-Level Test Stand

NASA Technical Reports Server (NTRS)

Oppenheimer, Frank L.; Lazar, James

1951-01-01

A .General Electric fuel and torque regulator was tested in conjunction with a T31-3 turbine-propeller engine in the sea-level static test stand at the NACA Lewis laboratory. The engine and control were operated over the entire speed range: 11,000 rpm, nominal flight idle, to 13,000 rpm, full power. Steady-state and transient data were recorded and are presented with a description of the four control loops being used in the system. Results of this investigation indicated that single-lever control operation was satisfactory under conditions of test. Transient data presented showed that turbine-outlet temperature did overshoot maximum operating value on acceleration but that the time duration of overshoot did not exceed approximately 1 second. This temperature limiting resulted from a control on fuel flow as a function of engine speed. Speed and torque first reached their desired values 0.4 second from the time of change in power-setting lever position. Maximum speed overshoot was 3 percent.

Role of intravoxel incoherent motion MR imaging in preoperative assessing HER2 status of gastric cancers.

PubMed

Ji, Changfeng; Zhang, Qinglei; Guan, Wenxian; Guo, Tingting; Chen, Ling; Liu, Song; He, Jian; Zhou, Zhengyang

2017-07-25

To explore the role of intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging in evaluating human epidermal growth factor receptor 2 (HER2) status of gastric cancers preoperatively. The apparent diffusion coefficient (ADC) and pure diffusion coefficient (D) values correlated positively with HER2 scores of gastric cancers significantly (r = 0.276, P = 0.048; r = 0.481, P < 0.001, respectively). The ADC and D values of HER2 positive gastric cancers were significantly higher than those of HER2 negative tumors (P = 0.033, 0.007, respectively). With a cut-off value of 1.321 and 1.123 × 10-3 mm2/sec, the ADC and D values could distinguish HER2 positive gastric cancers from HER2 negative ones with an area under the curve of 0.733 and 0.762, respectively (P = 0.023, 0.011, respectively). Fifty-three patients with gastric cancers underwent IVIM MR imaging preoperatively. The values of ADC, D, pseudo diffusion coefficient (D*) and perfusion related fraction (f) of the lesions were obtained. Partial correlation test including tumor volume was performed to analyze correlations between IVIM values and HER2 scores excluding the impact of tumor size. IVIM parameters of gastric cancers with different HER2 status were compared using independent samples t test. Diagnostic performance of IVIM parameters in distinguishing HER2 positive gastric cancers from negative ones was tested with receiver operating characteristic analysis. We confirmed the feasibility of IVIM MR imaging in preoperative assessment of HER2 status of gastric cancers, which might make up the shortfall of biopsy and facilitate personalized treatment for patients with gastric cancers.

Accidental falls in hospital inpatients: evaluation of sensitivity and specificity of two risk assessment tools.

PubMed

Lovallo, Carmela; Rolandi, Stefano; Rossetti, Anna Maria; Lusignani, Maura

2010-03-01

This paper is a report of a study comparing the effectiveness of two falls risk assessment tools (Conley Scale and Hendrich Risk Model) by using them simultaneously with the same sample of hospital inpatients. Different risk assessment tools are available in literature. However, neither recent critical reviews nor international guidelines on fall prevention have identified tools that can be generalized to all categories of hospitalized patients. A prospective observational study was carried out in acute medical, surgical wards and rehabilitation units. From October 2007 to January 2008, 1148 patients were assessed with both instruments, subsequently noting the occurrence of falls. The sensitivity, specificity, positive and negative predictive values, and Receiver Operating Characteristics curves were calculated. The number of patients correctly identified with the Conley Scale (n = 41) was higher than with the Hendrich Model (n = 27). The Conley Scale gave sensitivity and specificity values of 69.49% and 61% respectively. The Hendrich Model gave a sensitivity value of 45.76% and a specificity value of 71%. Positive and negative predictive values were comparable. The Conley Scale is indicated for use in the medical sector, on the strength of its high sensitivity. However, since its specificity is very low, it is deemed useful to submit individual patients giving positive results to more in-depth clinical evaluation in order to decide whether preventive measures need to be taken. In surgical sectors, the low sensitivity values given by both scales suggest that further studies are warranted.

Procalcitonin levels in gram-positive, gram-negative, and fungal bloodstream infections.

PubMed

Leli, Christian; Ferranti, Marta; Moretti, Amedeo; Al Dhahab, Zainab Salim; Cenci, Elio; Mencacci, Antonella

2015-01-01

Procalcitonin (PCT) can discriminate bacterial from viral systemic infections and true bacteremia from contaminated blood cultures. The aim of this study was to evaluate PCT diagnostic accuracy in discriminating Gram-positive, Gram-negative, and fungal bloodstream infections. A total of 1,949 samples from patients with suspected bloodstream infections were included in the study. Median PCT value in Gram-negative (13.8 ng/mL, interquartile range (IQR) 3.4-44.1) bacteremias was significantly higher than in Gram-positive (2.1 ng/mL, IQR 0.6-7.6) or fungal (0.5 ng/mL, IQR 0.4-1) infections (P < 0.0001). Receiver operating characteristic analysis showed an area under the curve (AUC) for PCT of 0.765 (95% CI 0.725-0.805, P < 0.0001) in discriminating Gram-negatives from Gram-positives at the best cut-off value of 10.8 ng/mL and an AUC of 0.944 (95% CI 0.919-0.969, P < 0.0001) in discriminating Gram-negatives from fungi at the best cut-off of 1.6 ng/mL. Additional results showed a significant difference in median PCT values between Enterobacteriaceae and nonfermentative Gram-negative bacteria (17.1 ng/mL, IQR 5.9-48.5 versus 3.5 ng/mL, IQR 0.8-21.5; P < 0.0001). This study suggests that PCT may be of value to distinguish Gram-negative from Gram-positive and fungal bloodstream infections. Nevertheless, its utility to predict different microorganisms needs to be assessed in further studies.

Combined panel of serum human tissue kallikreins and CA-125 for the detection of epithelial ovarian cancer.

PubMed

Koh, Stephen Chee Liang; Huak, Chan Yiong; Lutan, Delfi; Marpuang, Johny; Ketut, Suwiyoga; Budiana, Nyoma Gede; Saleh, Agustria Zainu; Aziz, Mohamad Farid; Winarto, Hariyono; Pradjatmo, Heru; Hoan, Nguyen Khac Han; Thanh, Pham Viet; Choolani, Mahesh

2012-07-01

To determine the predictive accuracy of the combined panels of serum human tissue kallikreins (hKs) and CA-125 for the detection of epithelial ovarian cancer. Serum specimens collected from 5 Indonesian centers and 1 Vietnamese center were analyzed for CA-125, hK6, and hK10 levels. A total of 375 specimens from patients presenting with ovarian tumors, which include 156 benign cysts, 172 epithelial ovarian cancers (stage I/II, n=72; stage III/IV, n=100), 36 germ cell tumors and 11 borderline tumors, were included in the study analysis. Receiver operating characteristic analysis were performed to determine the cutoffs for age, CA-125, hK6, and hK10. Sensitivity, specificity, negative, and positive predictive values were determined for various combinations of the biomarkers. The levels of hK6 and hK10 were significantly elevated in ovarian cancer cases compared to benign cysts. Combination of 3 markers, age/CA-125/hk6 or CA-125/hk6/hk10, showed improved specificity (100%) and positive predictive value (100%) for prediction of ovarian cancer, when compared to the performance of single markers having 80-92% specificity and 74-87% positive predictive value. Four-marker combination, age/CA-125/hK6/hK10 also showed 100% specificity and 100% positive predictive value, although it demonstrated low sensitivity (11.9%) and negative predictive value (52.8%). The combination of human tissue kallikreins and CA-125 showed potential for improving prediction of epithelial ovarian cancer in patients presenting with ovarian tumors.

Effect of obesity on preterm delivery prediction by transabdominal recording of uterine electromyography.

PubMed

Lucovnik, Miha; Chambliss, Linda R; Blumrick, Richard; Balducci, James; Gersak, Ksenija; Garfield, Robert E

2016-10-01

It has been shown that noninvasive uterine electromyography (EMG) can identify true preterm labor more accurately than methods available to clinicians today. The objective of this study was to evaluate the effect of body mass index (BMI) on the accuracy of uterine EMG in predicting preterm delivery. Predictive values of uterine EMG for preterm delivery were compared in obese versus overweight/normal BMI patients. Hanley-McNeil test was used to compare receiver operator characteristics curves in these groups. Previously reported EMG cutoffs were used to determine groups with false positive/false negative and true positive/true negative EMG results. BMI in these groups was compared with Student t test (p < 0.05 significant). A total of 88 patients were included: 20 obese, 64 overweight, and four with normal BMI. EMG predicted preterm delivery within 7 days with area under the curve = 0.95 in the normal/overweight group, and with area under the curve = 1.00 in the obese group (p = 0.08). Six patients in true preterm labor (delivering within 7 days from EMG measurement) had low EMG values (false negative group). There were no false positive results. No significant differences in patient's BMI were noted between false negative group patients and preterm labor patients with high EMG values (true positive group) and nonlabor patients with low EMG values (true negative group; p = 0.32). Accuracy of noninvasive uterine EMG monitoring and its predictive value for preterm delivery are not affected by obesity. Copyright © 2016. Published by Elsevier B.V.

Usefulness of Two Aspergillus PCR Assays and Aspergillus Galactomannan and β-d-Glucan Testing of Bronchoalveolar Lavage Fluid for Diagnosis of Chronic Pulmonary Aspergillosis.

PubMed

Urabe, Naohisa; Sakamoto, Susumu; Sano, Go; Suzuki, Junko; Hebisawa, Akira; Nakamura, Yasuhiko; Koyama, Kazuya; Ishii, Yoshikazu; Tateda, Kazuhiro; Homma, Sakae

2017-06-01

We evaluated the usefulness of an Aspergillus galactomannan (GM) test, a β-d-glucan (βDG) test, and two different Aspergillus PCR assays of bronchoalveolar lavage fluid (BALF) samples for the diagnosis of chronic pulmonary aspergillosis (CPA). BALF samples from 30 patients with and 120 patients without CPA were collected. We calculated the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for each test individually and in combination with other tests. The optical density index values, as determined by receiver operating characteristic analysis, for the diagnosis of CPA were 0.5 and 100 for GM and βDG testing of BALF, respectively. The sensitivity and specificity of the GM test, βDG test, and PCR assays 1 and 2 were 77.8% and 90.0%, 77.8% and 72.5%, 86.7% and 84.2%, and 66.7% and 94.2%, respectively. A comparison of the PCR assays showed that PCR assay 1 had a better sensitivity, a better negative predictive value, and a better negative likelihood ratio and PCR assay 2 had a better specificity, a better positive predictive value, and a better positive likelihood ratio. The combination of the GM and βDG tests had the highest diagnostic odds ratio. The combination of the GM and βDG tests on BALF was more useful than any single test for diagnosing CPA. Copyright © 2017 American Society for Microbiology.

A high resolution computer tomography scoring system to predict culture-positive pulmonary tuberculosis in the emergency department.

PubMed

Yeh, Jun-Jun; Neoh, Choo-Aun; Chen, Cheng-Ren; Chou, Christine Yi-Ting; Wu, Ming-Ting

2014-01-01

This study evaluated the use of high-resolution computed tomography (HRCT) to predict the presence of culture-positive pulmonary tuberculosis (PTB) in adult patients with pulmonary lesions in the emergency department (ED). The study included a derivation phase and validation phase with a total of 8,245 patients with pulmonary disease. There were 132 patients with culture-positive PTB in the derivation phase and 147 patients with culture-positive PTB in the validation phase. Imaging evaluation of pulmonary lesions included morphology and segmental distribution. The post-test probability ratios between both phases in three prevalence areas were analyzed. In the derivation phase, a multivariate analysis model identified cavitation, consolidation, and clusters/nodules in right or left upper lobe (except anterior segment) and consolidation of the superior segment of the right or left lower lobe as independent positive factors for culture-positive PTB, while consolidation of the right or left lower lobe (except superior segment) were independent negative factors. An ideal cutoff point based on the receiver operating characteristic (ROC) curve analysis was obtained at a score of 1. The sensitivity, specificity, positivity predictive value, and negative predictive value from derivation phase were 98.5% (130/132), 99.7% (3997/4008), 92.2% (130/141), and 99.9% (3997/3999). Based on the predicted positive likelihood ratio value of 328.33 in derivation phase, the post-test probability was observed to be 91.5% in the derivation phase, 92.5% in the validation phase, 94.5% in a high TB prevalence area, 91.0% in a moderate prevalence area, and 76.8% in moderate-to-low prevalence area. Our model using HRCT, which is feasible to perform in the ED, can promptly diagnose culture-positive PTB in moderate and moderate-to-low prevalence areas.

F-8C adaptive control law refinement and software development

NASA Technical Reports Server (NTRS)

Hartmann, G. L.; Stein, G.

1981-01-01

An explicit adaptive control algorithm based on maximum likelihood estimation of parameters was designed. To avoid iterative calculations, the algorithm uses parallel channels of Kalman filters operating at fixed locations in parameter space. This algorithm was implemented in NASA/DFRC's Remotely Augmented Vehicle (RAV) facility. Real-time sensor outputs (rate gyro, accelerometer, surface position) are telemetered to a ground computer which sends new gain values to an on-board system. Ground test data and flight records were used to establish design values of noise statistics and to verify the ground-based adaptive software.

Clinical utility of balloon expulsion test for functional defecation disorders

PubMed Central

2016-01-01

Purpose I investigated the diagnostic accuracy of balloon expulsion test (BET) with various techniques to find out the most appropriate method, and tried to confirm its clinical utility in diagnosing functional defecation disorders (FDD) in constipated patients. Methods Eighty-seven patients constituted the study population. FDD was defined when patients had at least two positive findings in defecography, manometry, and electromyography. BET was done 4 times in each patient with 2 different positions and 2 different volumes. The positions were seated position (SP) and left lateral decubitus position (LDP). The volumes were fixed volume (FV) of 60 mL and individualized volume with which patient felt a constant desire to defecate (CDV). The results of BETs with 4 different settings (LDP-FV, LDP-CDV, SP-FV, and SP-CDV) were statistically compared and analyzed. Results Of 87 patients, 23 patients (26.4%) had at least two positive findings in 3 tests and thus were diagnosed to have FDD. On receiver operating characteristic curve analysis, area under curve was highest in BET with SP-FV. With a cutoff value of 30 seconds, the specificity of BET with SP-FV was 86.0%, sensitivity was 73.9%, negative predictive value was 89.8%, positive predictive value was 65.4%, and accuracy rate was 82.8% for diagnosing FDD. Conclusion SP-FV is the most appropriate method for BET. In this setting, BET has a diagnostic accuracy sufficient to identify constipated patients who do not have FDD. Patients with negative results in BET with SP-FV may not need other onerous tests to exclude FDD. PMID:26878016

Clinical utility of balloon expulsion test for functional defecation disorders.

PubMed

Seong, Moo-Kyung

2016-02-01

I investigated the diagnostic accuracy of balloon expulsion test (BET) with various techniques to find out the most appropriate method, and tried to confirm its clinical utility in diagnosing functional defecation disorders (FDD) in constipated patients. Eighty-seven patients constituted the study population. FDD was defined when patients had at least two positive findings in defecography, manometry, and electromyography. BET was done 4 times in each patient with 2 different positions and 2 different volumes. The positions were seated position (SP) and left lateral decubitus position (LDP). The volumes were fixed volume (FV) of 60 mL and individualized volume with which patient felt a constant desire to defecate (CDV). The results of BETs with 4 different settings (LDP-FV, LDP-CDV, SP-FV, and SP-CDV) were statistically compared and analyzed. Of 87 patients, 23 patients (26.4%) had at least two positive findings in 3 tests and thus were diagnosed to have FDD. On receiver operating characteristic curve analysis, area under curve was highest in BET with SP-FV. With a cutoff value of 30 seconds, the specificity of BET with SP-FV was 86.0%, sensitivity was 73.9%, negative predictive value was 89.8%, positive predictive value was 65.4%, and accuracy rate was 82.8% for diagnosing FDD. SP-FV is the most appropriate method for BET. In this setting, BET has a diagnostic accuracy sufficient to identify constipated patients who do not have FDD. Patients with negative results in BET with SP-FV may not need other onerous tests to exclude FDD.

[Development and validation of an algorithm to identify cancer recurrences from hospital data bases].

PubMed

Manzanares-Laya, S; Burón, A; Murta-Nascimento, C; Servitja, S; Castells, X; Macià, F

2014-01-01

Hospital cancer registries and hospital databases are valuable and efficient sources of information for research into cancer recurrences. The aim of this study was to develop and validate algorithms for the detection of breast cancer recurrence. A retrospective observational study was conducted on breast cancer cases from the cancer registry of a third level university hospital diagnosed between 2003 and 2009. Different probable cancer recurrence algorithms were obtained by linking the hospital databases and the construction of several operational definitions, with their corresponding sensitivity, specificity, positive predictive value and negative predictive value. A total of 1,523 patients were diagnosed of breast cancer between 2003 and 2009. A request for bone gammagraphy after 6 months from the first oncological treatment showed the highest sensitivity (53.8%) and negative predictive value (93.8%), and a pathology test after 6 months after the diagnosis showed the highest specificity (93.8%) and negative predictive value (92.6%). The combination of different definitions increased the specificity and the positive predictive value, but decreased the sensitivity. Several diagnostic algorithms were obtained, and the different definitions could be useful depending on the interest and resources of the researcher. A higher positive predictive value could be interesting for a quick estimation of the number of cases, and a higher negative predictive value for a more exact estimation if more resources are available. It is a versatile and adaptable tool for other types of tumors, as well as for the needs of the researcher. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Fetal nasal bone hypoplasia in the second trimester: Comparison of diagnostic methods for predicting trisomy 21 (Down syndrome).

PubMed

Has, Recep; Akel, Esra Gilbaz; Kalelioglu, Ibrahim H; Dural, Ozlem; Yasa, Cenk; Esmer, Aytül Corbacioglu; Yuksel, Atıl; Yildirim, Alkan; Ibrahimoglu, Lemi; Ermis, Hayri

2016-02-01

The aim of this prospective observational study was to identify the best method for use in diagnosing fetal nasal bone (NB) hypoplasia in the second trimester as a means of predicting trisomy 21 (Down syndrome). The NB length (NBL), NBL percentiles, and NBL multiple-of-median (MoM) values and the biparietal diameter-to-NBL ratios were calculated and compared in an attempt to identify the best predictive method and most appropriate cutoff value. Predictive values for several cutoff points were calculated. Receiver operating characteristic curves at a fixed 5% false-positive rate were used to compare the four methods. NBL measurements were obtained from 2,211 (95.6%) of a total of 2,314 fetuses. Data from 1,689 of those 2,211 fetuses were used to obtain reference ranges, derive a linear regression equation, and calculate NBL percentiles and MoM values. Using a fixed 5% false-positive rate, we found 25.5% sensitivity for NBL (95% confidence interval [CI], 15-39.1) and 23.5% sensitivity for NBL percentiles (95% CI, 13.4-37), NBL MoM values (95% CI, 13.4-37), and biparietal diameter-to-NBL ratios (95% CI, 13.4-37). Our study demonstrated that all four methods can be used in the second trimester for diagnosing fetal NB hypoplasia as a means of predicting trisomy 21 because their predictive values are similar at a fixed 5% false-positive rate. For simplicity of use, we recommend using 3 mm as the NBL cutoff value. © 2015 Wiley Periodicals, Inc.

Review of variations in Mw < 7 earthquake motions on position and TEC (Mw = 6.5 Aegean Sea earthquake sample)

NASA Astrophysics Data System (ADS)

Yildirim, Omer; Inyurt, Samed; Mekik, Cetin

2016-02-01

Turkey is a country located in the middle latitude zone, where tectonic activity is intensive. Recently, an earthquake of magnitude 6.5 Mw occurred offshore in the Aegean Sea on 24 May 2014 at 09:25 UTC, which lasted about 40 s. The earthquake was also felt in Greece, Romania, and Bulgaria in addition to Turkey. In recent years, ionospheric anomaly detection studies have been carried out because of seismicity with total electron content (TEC) computed from the global navigation satellite system's (GNSS) signal delays and several interesting findings have been published. In this study, both TEC and positional variations have been examined separately following a moderate size earthquake in the Aegean Sea. The correlation of the aforementioned ionospheric variation with the positional variation has also been investigated. For this purpose, a total of 15 stations was used, including four continuously operating reference stations in Turkey (CORS-TR) and stations in the seismic zone (AYVL, CANA, IPSA, and YENC), as well as international GNSS service (IGS) and European reference frame permanent network (EPN) stations. The ionospheric and positional variations of the AYVL, CANA, IPSA, and YENC stations were examined using Bernese v5.0 software. When the precise point positioning TEC (PPP-TEC) values were examined, it was observed that the TEC values were approximately 4 TECU (total electron content unit) above the upper-limit TEC value at four stations located in Turkey, 3 days before the earthquake at 08:00 and 10:00 UTC. At the same stations, on the day before the earthquake at 06:00, 08:00, and 10:00 UTC, the TEC values were approximately 5 TECU below the lower-limit TEC value. The global ionosphere model TEC (GIM-TEC) values published by the Centre for Orbit Determination in Europe (CODE) were also examined. Three days before the earthquake, at all stations, it was observed that the TEC values in the time period between 08:00 and 10:00 UTC were approximately 2 TECU above the upper-limit TEC value; 1 day before the earthquake at 06:00, 08:00, and 10:00 UTC, the TEC values were approximately 4 TECU below the lower-limit TEC value. Again, by using the same 15 stations, positional variation investigation for before and after the earthquake was undertaken for the AYVL, CANA, IPSA, and YENC stations. As a result of the conducted analysis, positional displacements were seen before and after the earthquake at the CANA station, which is the nearest station to the earthquake centre. Before and after the earthquake, positional displacements were observed as 10 and 3 cm respectively.

Real-time reflectometry measurement validation in H-mode regimes for plasma position control.

PubMed

Santos, J; Guimarais, L; Manso, M

2010-10-01

It has been shown that in H-mode regimes, reflectometry electron density profiles and an estimate for the density at the separatrix can be jointly used to track the separatrix within the precision required for plasma position control on ITER. We present a method to automatically remove, from the position estimation procedure, measurements performed during collapse and recovery phases of edge localized modes (ELMs). Based on the rejection mechanism, the method also produces an estimate confidence value to be fed to the position feedback controller. Preliminary results show that the method improves the real-time experimental separatrix tracking capabilities and has the potential to eliminate the need for an external online source of ELM event signaling during control feedback operation.

Energy Flux Positivity and Unitarity in Conformal Field Theories

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

Kulaxizi, Manuela; Parnachev, Andrei

2011-01-07

We show that in most conformal field theories the condition of the energy flux positivity, proposed by Hofman and Maldacena, is equivalent to the absence of ghosts. At finite temperature and large energy and momenta, the two-point functions of the stress energy tensor develop light like poles. The residues of the poles can be computed, as long as the only spin-two conserved current, which appears in the stress energy tensor operator-product expansion and acquires a nonvanishing expectation value at finite temperature, is the stress energy tensor. The condition for the residues to stay positive and the theory to remain ghost-freemore » is equivalent to the condition of positivity of energy flux.« less

A Prospective Analysis on Functional Outcomes Following Extended Latissimus Dorsi Flap Breast Reconstruction.

PubMed

Eyjolfsdottir, H; Haraldsdottir, B; Ragnarsdottir, M; Asgeirsson, K S

2017-06-01

To prospectively assess the functional effect of using the extended latissimus dorsi flap in immediate breast reconstructions. A total of 15 consecutive patients undergoing breast reconstruction with extended latissimus dorsi flap participated. Shoulder range of motion, muscle strength, lateral flexion of the torso, and position of scapula were measured pre-operatively and 1, 6, and 12 months post-operatively, in addition to donor-site post-operative complications. At 12 months post-operatively, patients had achieved full range of shoulder movement, when compared to pre-operative values. Lateral flexion of the torso was, however, significantly reduced bilaterally at 1 and 6 months post-operatively (p = 0.001, p = 0.01) and to the not operated side at 12 months (p = 0.01). Muscle strength in flexion-extension-internal rotation was significantly (p = 0.01) reduced on the operated side 12 months post-operatively. All but one patient had numbness around the donor-site scar 12 months post-operatively, 33% had slight adhesions but all were pain free. Although invariably, patients having extended latissimus dorsi flap may expect to achieve full range of shoulder movement, they should be informed of possible functional consequences and the time and effort it takes to recover. Further research is needed to investigate the potential long-term functional implications that extended latissimus dorsi flap may have as a result of changes in the lateral flexion of the torso and scapula position.

Electronic digital display watch having solar and geographical functions

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

Salah, I.M.

1984-10-30

In order to provide easily accessible knowledge of the correlations between time, the geographical locale and the solar positions, the watch in question in addition to time-keeping means capable of displaying the current time also provides means capable of storing, processing in a microprocessor mode and displaying in a particular panel mode data of solar elevation and azimuth as well as date data, a computer performing correlating operations between these various values. Pushbuttons (BPH', BPM', BPB') allow using this watch in various operational and correction situations, and other pushbuttons (BPH, BPM, BPB) allow more specific commands for correction, for searchmore » operations regarding date and place based on the solar data, for storage and call from memory of the various processed data. This watch can easily be implemented as a small wrist watch. It will be advantageously used by those interested in knowing the solar positions, by solar facility engineers, architects, airline pilots, believers in the Moslem faith etc.« less

Coherent states and parasupersymmetric quantum mechanics

NASA Technical Reports Server (NTRS)

Debergh, Nathalie

1992-01-01

It is well known that Parafermi and Parabose statistics are natural extensions of the usual Fermi and Bose ones, enhancing trilinear (anti)commutation relations instead of bilinear ones. Due to this generalization, positive parameters appear: the so-called orders of paraquantization p (= 1, 2, 3, ...) and h sub 0 (= 1/2, 1, 3/2, ...), respectively, the first value leading in each case to the usual statistics. The superpostion of the parabosonic and parafermionic operators gives rise to parasupermultiplets for which mixed trilinear relations have already been studied leading to two (nonequivalent) sets: the relative Parabose and the relative Parafermi ones. For the specific values p = 1 = 2h sub 0, these sets reduce to the well known supersymmetry. Coherent states associated with this last model have been recently put in evidence through the annihilation operator point of view and the group theoretical approach or displacement operator context. We propose to realize the corresponding studies within the new context p = 2 = 2h sub 0, being then directly extended to any order of paraquantization.

B-mode Ultrasound Versus Color Doppler Twinkling Artifact in Detecting Kidney Stones

PubMed Central

Harper, Jonathan D.; Hsi, Ryan S.; Shah, Anup R.; Dighe, Manjiri K.; Carter, Stephen J.; Moshiri, Mariam; Paun, Marla; Lu, Wei; Bailey, Michael R.

2013-01-01

Abstract Purpose To compare color Doppler twinkling artifact and B-mode ultrasonography in detecting kidney stones. Patients and Methods Nine patients with recent CT scans prospectively underwent B-mode and twinkling artifact color Doppler ultrasonography on a commercial ultrasound machine. Video segments of the upper pole, interpolar area, and lower pole were created, randomized, and independently reviewed by three radiologists. Receiver operator characteristics were determined. Results There were 32 stones in 18 kidneys with a mean stone size of 8.9±7.5 mm. B-mode ultrasonography had 71% sensitivity, 48% specificity, 52% positive predictive value, and 68% negative predictive value, while twinkling artifact Doppler ultrasonography had 56% sensitivity, 74% specificity, 62% positive predictive value, and 68% negative predictive value. Conclusions When used alone, B-mode is more sensitive, but twinkling artifact is more specific in detecting kidney stones. This information may help users employ twinkling and B-mode to identify stones and developers to improve signal processing to harness the fundamental acoustic differences to ultimately improve stone detection. PMID:23067207

Intraoperative evaluation of sentinel lymph nodes for metastatic melanoma by imprint cytology.

PubMed

Soo, Victoria; Shen, Perry; Pichardo, Rita; Azzazy, Hossam; Stewart, John H; Geisinger, Kim R; Levine, Edward A

2007-05-01

Sentinel lymph node biopsy (SLN) has revolutionized nodal staging. Accurate intraoperative evaluation of SLN permits a single procedure, with lymphadenectomy being performed during the initial operative procedure when the SLN is positive. There is a paucity of literature on intraoperative imprint cytology (IIC) evaluation of the SLN in melanoma. The purpose of this article is to present an update to our experience with IIC for SLN in melanoma. Melanoma patients had SLNs examined by IIC. SLNs were bisected, and imprints were made from each half. Imprints were stained with hematoxylin and eosin and with Diff-Quik. Paraffin-embedded sections were examined with multiple hematoxylin and eosin-stained sections from the SLNs in conjunction with immunohistochemical staining for S-100, Melan-A, and HMB-45 proteins. Metastases were identified in 40 (17%) of 229 patients. Of these, 13 patients were detected by IIC (sensitivity, 33%). The negative predictive value was 88%. No false-positive results were identified (specificity, 100%). The positive predictive value was 100%. The accuracy of IIC was 78%. The sensitivity for detecting macrometastases (>2 mm) was better than that for detecting micrometastases (< or =2 mm): 62% vs. 16% (P < .01). Patients with positive SLNs by IIC had lymphadenectomy under the same anesthetic. A total of 533 nonsentinel lymph nodes were identified in 42 patients. Only two patients (8%) had positive nonsentinel lymph nodes after a negative IIC. IIC is a viable alternative to frozen sectioning when intraoperative evaluation is desired. IIC is significantly more sensitive for macrometastases. IIC evaluation of SLNs in melanoma makes a single operative procedure possible for a significant proportion of patients with regional nodal metastases.

Angiotensin-converting Enzyme as a Predictor of Extrathoracic Involvement of Sarcoidosis.

PubMed

Yasar, Zehra; Özgül, Mehmet Akif; Cetinkaya, Erdoğan; Kargi, Aysel; Gül, Şule; Talay, Fahrettin; Tanriverdi, Elif; Dincer, H Erhan

2016-01-18

Sarcoidosis is a multisystem disease, with extrathoracic involvement occurring in 25-50% of patients. Multi-organ involvement is often associated with a more chronic and severe course. The value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in diagnosing extrathoracic involvement in sarcoidosis has been demonstrated; however, because of the radiation dose and high cost, indications for its use must be well defined. Angiotensin-converting enzyme (ACE) is produced by active granuloma cells; thus, serum ACE (sACE) levels may reflect the total granuloma load. In this retrospective study, we evaluated the diagnostic value of sACE in the detection of extrathoracic involvement in sarcoidosis. 43 patients with biopsy-proven sarcoidosis underwent FDG-PET/CT during the initial workup. Positive findings were classified as thoracic and/or extrathoracic. The diagnostic value of sACE was estimated using sensitivity, specificity, and area under the receiver operating characteristic curves (AUCs). Of the 43 patients studied, 17 (39.7%) had extrathoracic involvement. In this group, sACE values were higher than in patients without extrathoracic involvement (331 vs. 150, p=0.002) and correlated positively with extrathoracic involvement (R:0.532 p=0.02). Receiver operator characteristic curve analysis revealed an AUC of 0.816 [95% confidence interval: 0.669-0.963, p=0.002], 70.6% sensitivity and 80% specificity at the sACE cut-off value. In sarcoidosis, extrathoracic involvement may be life threatening or indicative of poor outcome. sACE levels are easily determined and may predict extrathoracic involvement. In patients with sarcoidosis, sACE levels can be used to better define those who would benefit from FDG-PET/CT examination to detect extrathoracic involvement.

[3-Tesla MRI vs. arthroscopy for diagnostics of degenerative knee cartilage diseases: preliminary clinical results].

PubMed

von Engelhardt, L V; Schmitz, A; Burian, B; Pennekamp, P H; Schild, H H; Kraft, C N; von Falkenhausen, M

2008-09-01

The literature contains only a few studies investigating the magnetic resonance imaging (MRI) diagnostics of degenerative cartilage diseases. Studies on MRI diagnostics of the cartilage using field strengths of 3-Tesla demonstrate promising results. To assess the value of 3-Tesla MRI for decision making regarding conservative or operative treatment possibilities, this study focused on patients with degenerative cartilage diseases. Thirty-two patients with chronic knee pain, a minimum age of 40 years, a negative history of trauma, and at least grade II degenerative cartilage disease were included. Cartilage abnormalities detected at preoperative 3-Tesla MRI (axial/koronar/sagittal PD-TSE-SPAIR, axial/sagittal 3D-T1-FFE, axial T2-FFE; Intera 3.0T, Philips Medical Systems) were classified (grades I-IV) and compared with arthroscopic findings. Thirty-six percent (70/192) of the examined cartilage surfaces demonstrated no agreement between MRI and arthroscopic grading. In most of these cases, grades II and III cartilage lesions were confounded with each other. Regarding the positive predictive values, the probability that a positive finding in MRI would be exactly confirmed by arthroscopy was 39-72%. In contrast, specificities and negative predictive values of different grades of cartilage diseases were 85-95%. Regarding the high specificities and negative predictive values, 3-Tesla MRI is a reliable method for excluding even slight cartilage degeneration. In summary, in degenerative cartilage diseases, 3-Tesla MRI is a supportive, noninvasive method for clinical decision making regarding conservative or operative treatment possibilities. However, the value of diagnostic arthroscopy for a definitive assessment of the articular surfaces and for therapeutic planning currently cannot be replaced by 3-Tesla MRI. This applies especially to treatment options in which a differentiation between grade II and III cartilage lesions is of interest.

[The Clinical Application of Video Mediastinoscopy and CT in the N Staging of Preoperative Lung Cancer.].

PubMed

Wang, Zhiheng; Qi, Weibo; Zhu, Yong; Lin, Ruobai

2009-10-20

Preoperative lung cancer with mediastinal lymph nodes metastasis can be diagnosed by vedio mediastinoscopy (VM) and CT. This study was to explore the value of VM and CT in the diagnosis of N staging of preoperative lung cancer, and to discuss the difference between the two methods. Forty-eight cases diagnosed of lung cancer by CT or PET-CT were examined by VM. The sensitivity, specificity, validity, positive predictive value and negative predictive value of VM and CT were speculated according to the postoperative pathological reports, and the difference between VM and CT in the diagnosis of lung cancer with mediastinal lymph nodes metastasis was discussed. (1)Under the examination of VM, 31 patients with the negative outcome received the direct operation; 14 patients with N2 received 2 courses of neoadjuvant chemotherapy before operation; 3 patients with N3 received chemotherapy and/or radiotherapy. (2)Forty-one cases with final diagnosis of lung cancer were used as samples to speculate the sensitivity, specificity, validity, positive predictive value and negative predictive value of VM. They were 93.3%, 100%, 97.6%, 100%, 96.3%, which of CT were 66.7%, 53.8%, 58.5%, 45.5%, 73.7% (Chi-square=4.083, P=0.039), the difference between VM and CT was statistically significant. (3)In this group, the complications of VM incidence rate was 2.08% (1/48), and the case was pneumothorax. VM is superior to CT in the diagnosis of N staging of preoperative lung cancer; Due to its safety and effectiveness, VM will be wildly used in the field of thoracic surgery.

Prostate Cancer Predictive Simulation Modelling, Assessing the Risk Technique (PCP-SMART): Introduction and Initial Clinical Efficacy Evaluation Data Presentation of a Simple Novel Mathematical Simulation Modelling Method, Devised to Predict the Outcome of Prostate Biopsy on an Individual Basis.

PubMed

Spyropoulos, Evangelos; Kotsiris, Dimitrios; Spyropoulos, Katherine; Panagopoulos, Aggelos; Galanakis, Ioannis; Mavrikos, Stamatios

2017-02-01

We developed a mathematical "prostate cancer (PCa) conditions simulating" predictive model (PCP-SMART), from which we derived a novel PCa predictor (prostate cancer risk determinator [PCRD] index) and a PCa risk equation. We used these to estimate the probability of finding PCa on prostate biopsy, on an individual basis. A total of 371 men who had undergone transrectal ultrasound-guided prostate biopsy were enrolled in the present study. Given that PCa risk relates to the total prostate-specific antigen (tPSA) level, age, prostate volume, free PSA (fPSA), fPSA/tPSA ratio, and PSA density and that tPSA ≥ 50 ng/mL has a 98.5% positive predictive value for a PCa diagnosis, we hypothesized that correlating 2 variables composed of 3 ratios (1, tPSA/age; 2, tPSA/prostate volume; and 3, fPSA/tPSA; 1 variable including the patient's tPSA and the other, a tPSA value of 50 ng/mL) could operate as a PCa conditions imitating/simulating model. Linear regression analysis was used to derive the coefficient of determination (R 2 ), termed the PCRD index. To estimate the PCRD index's predictive validity, we used the χ 2 test, multiple logistic regression analysis with PCa risk equation formation, calculation of test performance characteristics, and area under the receiver operating characteristic curve analysis using SPSS, version 22 (P < .05). The biopsy findings were positive for PCa in 167 patients (45.1%) and negative in 164 (44.2%). The PCRD index was positively signed in 89.82% positive PCa cases and negative in 91.46% negative PCa cases (χ 2 test; P < .001; relative risk, 8.98). The sensitivity was 89.8%, specificity was 91.5%, positive predictive value was 91.5%, negative predictive value was 89.8%, positive likelihood ratio was 10.5, negative likelihood ratio was 0.11, and accuracy was 90.6%. Multiple logistic regression revealed the PCRD index as an independent PCa predictor, and the formulated risk equation was 91% accurate in predicting the probability of finding PCa. On the receiver operating characteristic analysis, the PCRD index (area under the curve, 0.926) significantly (P < .001) outperformed other, established PCa predictors. The PCRD index effectively predicted the prostate biopsy outcome, correctly identifying 9 of 10 men who were eventually diagnosed with PCa and correctly ruling out PCa for 9 of 10 men who did not have PCa. Its predictive power significantly outperformed established PCa predictors, and the formulated risk equation accurately calculated the probability of finding cancer on biopsy, on an individual patient basis. Copyright © 2016 Elsevier Inc. All rights reserved.

[Injury to the Scapholunate Ligament in Distal Radius Fractures: Peri-Operative Diagnosis and Treatment Results].

PubMed

Gajdoš, R; Pilný, J; Pokorná, A

2016-01-01

PURPOSE OF THE STUDY Injury to the scapholunate ligament is frequently associated with a fracture of the distal radius. At present neither a unified concept of treatment nor a standard method of diagnosis in these concomitant injuries is available. The aim of the study was to evaluate a group of surgically treated patients with distal radius fractures in order to assess a contribution of combined conventional X-ray and intra-operative fluoroscopic examinations to the diagnosis of associated lesions and to compare short-term functional outcomes of sugically treated patients with those of patients treated conservatively. MATERIAL AND METHODS A group of patients undergoiong surgery for distal radius fractures using plate osteosynthesis was evaluated retrospectively. The peri-operative diagnosis of associated injury to the scapholunate ligament was based on pre-operative standard X-ray views and intra-operative fluoroscopy. The latter consisted of images of maximum radial and ulnar deviation as well as an image of the forearm in traction exerted manually along the long axis. All views were in postero-anterior projection. Results were read directly on the monitor of a fluoroscopic device after its calibration or were obtained by comparing the thickness of an attached Kirschner wire with the distance to be measured. Subsequently, pixels were converted to millimetres. When a scapholunate ligament injury was found and confirmed by examination of the contralateral wrist, the finding was verified by open reduction or arthroscopy. Both static and dynamic instabilities were treated together with the distal radius fracture at one-stage surgery. After surgery, the patients without ligament injury had the wrist immobilised for 4 weeks, then rehabilitation followed. In the patients with a damaged ligament, immobilisation in a short brace lasted until transarticular wires were removed. All patients were followed up for a year at least. At follow-up, the injured wrist was examined for signs of clinical instability of the scapholunate joint, functional outcome was assessed using the Mayo Wrist Score (MWS) and pain intensity was evaluated on the Visual Analoque Scale (VAS). Restriction in daily activities was rated by the Quick Disabilities of the Arm, Shoulder and Hand (QDASH) score and plain X-ray was done. If any of the results was not satisfactory, MRI examination was indicated. RESULTS Of a total of 265 patients, 35 had injury to the scapholunate joint, 16 had static instability diagnosed by a standard fluoroscopic examination and nine patients with an acute phase of injury remained undiagnosed. For detection of associated scapholunate injuries, a standard X-ray examination had sensitivity of 46%, specificity of 99%, accuracy of 92%, positive predictive value of 84%, negative predictive value of 92%, positive likelihood ratio = 35.05 and negative likelihood ratio = 0.55. Dynamic fluoroscopic examination showed sensitivity of 53%, specificity of 99%, accuracy of 95%, positive predictive value of 77%, negative predictive value of 96%, positive likelihood ratio = 36.49 and negative likelihood ratio = 0.48. Using the MWS system, no differences in the outcome of scapholunate instability treatment were found between the patients undergoing surgery and those treated conservatively (p=0.35). Statistically significant differences were detected in the evaluation of subjective parameters - both VAS and QDASH scores were better in the treated than non-treated patients (p=0.02 and p=0.04, respectively). DISCUSSION The high negative predictive values of both standard X-ray and intra-operative fluoroscopy showed that combined use of the two method is more relevant for excluding than for confirming an injury to the scapholunate ligament concomitant with distal radius fracture. Similarly, the low negative likelihood ratio showed that a negative result decreases the pre-test probability of concomitant injury. CONCLUSIONS Negative findings of scapholunate ligament injury on standard X-ray views and intra-operative fluoroscopic images make it unnecessary to perform any further intra-operative examination to detect injury to the scapholunate ligament. Positive findings require verification of the degree of injury by another intra-operative modality, most ideally by arthroscopy. Patients with untreated instability associated with distal radius fracture have, at short-term follow-up, no statistically significant differences in functioning of the injured extremity in comparison with treated patients. Subjectively, however, they feel more pain and more restriction in performing daily activities. Therefore, the treatment of an injured scapholunate ligament together with distal radius fracture at one-stage surgery seems to be a good alternative for the patient. Key words: distal radius fractures, scapholunate ligament, radiographic, diagnosis, outcome distal radius fracture.

An ergonomic study of the optimum operating table height for laparoscopic surgery.

PubMed

Berquer, R; Smith, W D; Davis, S

2002-03-01

Laparoscopic surgery requires the use of longer instruments than open surgery, thus changing the relation between the height of the surgeon's hands and the desirable height of the operating room table. The optimum height of the operating room table for laparoscopic surgery is investigated in this study. Twenty-one surgeons performed a two-handed, one-fourth circle cutting task using a laparoscopic video system and laparoscopic instruments positioned at five instrument handle heights relative to subjects' elbow height (-20, -10, 0, +10, and +20 cm) by adjusting the height of the trainer box. Subjects rated the difficulty and discomfort experienced during each task on a visual analog scale. Skin conductance (SC) was measured in Micromhos via paired surface electrodes placed near the ulnar edge of the palm of the right (cutting) hand. The mean electromyographic (EMG) signal from the right deltoid and trapezius muscles was measured. Arm orientation was measured in three dimensions using a magnetometer/accelerometer. Signals were acquired using analog circuitry and digitally sampled using a National Instruments DAQCard 700 connected to a Macintosh PowerBook 5300c running LabVIEW software. Statistical analysis was carried out by analysis of variance and post hoc testing. Statistically significant changes were found in the subjective rating of discomfort (p <0.002), deltoid EMG (p <0.0006), trapezius EMG (p <0.0001), and arm elevation (p <0.0001) between instrument handle heights. SC values and task times did not change significantly. Discomfort and difficulty ratings were lowest when instrument handles were positioned at elbow height. EMG values and arm elevation all decreased with lower instrument height. This study suggests that the optimum table height for laparoscopic surgery should position the laparoscopic instrument handles close to surgeons' elbow level to minimize discomfort and upper arm and shoulder muscle work. This corresponds to an approximate table height of 64 to 77 cm above floor level. A redesign of current operating room tables may be required to meet these ergonomic guidelines.

The Value of Visa-Score and Colour Flow Imaging in the Follow-Up of Non-Athletes Operated for Jumpers Knee.

PubMed

Salvesen, Eirik S; Holen, Ketil J

2016-12-01

The objective of this study was to assess if the Victorian Institute of Sport Assessment (VISA) questionnaire was suitable in the evaluation of patients from a mixed population with normal levels of sports activity, and if neovascularization of the patellar tendon demonstrated by color flow imaging (CFI) was more frequent in patients with lasting symptoms after surgical treatment for jumpers knee (JK). This study was conducted at St. Olavs Hospital, University Hospital of Trondheim, Norway, and included 21 men and 18 women who were operated for JK. Symptoms were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and VISA questionnaires. Clinical and ultrasonographic examinations of the knees, including CFI, were done at a mean follow-up duration of 82 (range, 16-136) months after surgery. Patients with positive CFI also had significantly lower KOOS scores, whereas the total VISA-P (Victorian Institute of Sport Assessment - Patella) score showed no association. Patients with a positive clinical examination had significantly more frequent positive CFI findings than did patients with negative examinations. The operated patellar tendon was significantly thicker and had more frequent hypoechoic signal in the proximal part than the contralateral unoperated tendon. The post-operative VISA-P score seems less valuable in the evaluation of patients from a mixed population with normal levels of sports activity. CFI may be a valuable diagnostic tool in the evaluation of patients operated for JK.

GUI for Computational Simulation of a Propellant Mixer

NASA Technical Reports Server (NTRS)

Figueroa, Fernando; Richter, Hanz; Barbieri, Enrique; Granger, Jamie

2005-01-01

Control Panel is a computer program that generates a graphical user interface (GUI) for computational simulation of a rocket-test-stand propellant mixer in which gaseous hydrogen (GH2) is injected into flowing liquid hydrogen (LH2) to obtain a combined flow having desired thermodynamic properties. The GUI is used in conjunction with software that models the mixer as a system having three inputs (the positions of the GH2 and LH2 inlet valves and an outlet valve) and three outputs (the pressure inside the mixer and the outlet flow temperature and flow rate). The user can specify valve characteristics and thermodynamic properties of the input fluids via userfriendly dialog boxes. The user can enter temporally varying input values or temporally varying desired output values. The GUI provides (1) a set-point calculator function for determining fixed valve positions that yield desired output values and (2) simulation functions that predict the response of the mixer to variations in the properties of the LH2 and GH2 and manual- or feedback-control variations in valve positions. The GUI enables scheduling of a sequence of operations that includes switching from manual to feedback control when a certain event occurs.

Reliability of Waveform Analysis as an Adjunct to Loss of Resistance for Thoracic Epidural Blocks.

PubMed

Leurcharusmee, Prangmalee; Arnuntasupakul, Vanlapa; Chora De La Garza, Daniel; Vijitpavan, Amorn; Ah-Kye, Sonia; Saelao, Abhidej; Tiyaprasertkul, Worakamol; Finlayson, Roderick J; Tran, De Q H

2015-01-01

The epidural space is most commonly identified with loss of resistance (LOR). Although sensitive, LOR lacks specificity, as cysts in interspinous ligaments, gaps in ligamentum flavum, paravertebral muscles, thoracic paravertebral spaces, and intermuscular planes can yield nonepidural LOR. Epidural waveform analysis (EWA) provides a simple confirmatory adjunct for LOR. When the needle is correctly positioned inside the epidural space, measurement of the pressure at its tip results in a pulsatile waveform. In this observational study, we set out to assess the sensitivity, specificity, as well as positive and negative predictive values of EWA for thoracic epidural blocks. We enrolled a convenience sample of 160 patients undergoing thoracic epidural blocks for thoracic surgery, abdominal surgery, or rib fractures. The choice of patient position (sitting or lateral decubitus), approach (midline or paramedian), and LOR medium (air or normal saline) was left to the operator (attending anesthesiologist, fellow, or resident). After obtaining a satisfactory LOR, the operator injected 5 mL of normal saline through the epidural needle. A sterile tubing, connected to a pressure transducer, was attached to the needle to measure the pressure at the needle tip. A 4-mL bolus of lidocaine 2% with epinephrine 5 μg/mL was then administered and, after 10 minutes, the patient was assessed for sensory blockade to ice. The failure rate (incorrect identification of the epidural space with LOR) was 23.1%. Of these 37 failed epidural blocks, 27 provided no sensory anesthesia at 10 minutes. In 10 subjects, the operator was unable to thread the catheter through the needle. When compared with the ice test, the sensitivity, specificity, and positive and negative predictive values of EWA were 91.1%, 83.8%, 94.9%, and 73.8%, respectively. Epidural waveform analysis (with pressure transduction through the needle) provides a simple adjunct to LOR for thoracic epidural blocks. Although its use was devoid of complications, further confirmatory studies are required before its routine implementation in clinical practice.

Measurement and Modeling of Acoustic Fields in a Gel Phantom at High Intensities

NASA Astrophysics Data System (ADS)

Canney, Michael S.; Bailey, Michael R.; Khokhlova, Vera A.; Crum, Lawrence A.

2006-05-01

The goal of this work was to compare measured and numerically predicted HIFU pressure waveforms in water and a tissue-mimicking phantom. Waveforms were measured at the focus of a 2-MHz HIFU transducer with a fiber optic hydrophone. The transducer was operated with acoustic powers ranging from 2W to 300W. A KZK-type equation was used for modeling the experimental conditions. Strongly asymmetric nonlinear waves with peak positive pressure up to 80 MPa and peak negative pressure up to 20 MPa were measured in water, while waves up to 50 MPa peak positive pressure and 15 MPa peak negative pressure were measured in tissue phantoms. The values of peak negative pressure corresponded well with numerical simulations and were significantly smaller than predicted by linear extrapolation from low-level measurements. The values of peak positive pressures differed only at high levels of excitation where bandwidth limitations of the hydrophone failed to fully capture the predicted sharp shock fronts.

Naalyehe Ba Hooghan--"House of Merchandise": The Navajo Trading Post as an Institution of Cultural Change, 1900 to 1930.

ERIC Educational Resources Information Center

McPherson, Robert S.

1992-01-01

Navajo Reservation trading posts held an influential position between two cultures and operated on Navajo terms but also were an assimilative force emphasizing white values through the marketing of Navajo wool and rugs, traffic in prehistoric artifacts, and employment of Navajos in a mixed barter and wage economy. (SV)

Improved separability criteria via some classes of measurements

NASA Astrophysics Data System (ADS)

Shen, Shu-Qian; Li, Ming; Li-Jost, Xianqing; Fei, Shao-Ming

2018-05-01

The entanglement detection via local measurements can be experimentally implemented. Based on mutually unbiased measurements and general symmetric informationally complete positive-operator-valued measures, we present separability criteria for bipartite quantum states, which, by theoretical analysis, are stronger than the related existing criteria via these measurements. Two detailed examples are supplemented to show the efficiency of the presented separability criteria.

Use of a wireless, inertial sensor-based system to objectively evaluate flexion tests in the horse.

PubMed

Marshall, J F; Lund, D G; Voute, L C

2012-12-01

A wireless, inertial sensor-based system has previously been validated for evaluation of equine lameness. However, threshold values have not been determined for the assessment of responses to flexion tests. The aim of this investigation was to evaluate a sensor-based system for objective assessment of the response to flexion. Healthy adult horses (n = 17) in work were recruited prospectively. Horses were instrumented with sensors on the head (accelerometer), pelvis (accelerometer) and right forelimb (gyroscope), before trotting in a straight line (minimum 25 strides) for 2 consecutive trials. Sensors measured 1) vertical pelvic movement asymmetry (PMA) for both right and left hindlimb strides and 2) average difference in maximum and minimum pelvic height (PDMax and PDMin) between right and left hindlimb strides in millimetres. A hindlimb was randomly selected for proximal flexion (60 s), after which the horse trotted a minimum of 10 strides. Response to flexion was blindly assessed as negative or positive by an experienced observer. Changes in PMA, PDMax and PDMin between baseline and flexion examinations were calculated for each test. Statistical analysis consisted of a Pearson's product moment test and linear regression on baseline trials, Mann-Whitney rank sum test for effect of flexion and receiver operator curve (ROC) analysis of test parameters. There was a strong correlation between trials for PMA, PDMin and PDMax measurements (P < 0.001). A positive flexion test resulted in a significant increase in PMA (P = 0.021) and PDMax (P = 0.05) only. Receiver-operator curve analysis established cut-off values for change in PMA and PDMax of 0.068 and 4.47 mm, respectively (sensitivity = 0.71, specificity = 0.65) to indicate a positive response to flexion. A positive response to flexion resulted in significant changes to objective measurements of pelvic symmetry. Findings support the use of inertial sensor systems to objectively assess response to flexion tests. Further investigation is warranted to establish cut-off values for objective assessment of other diagnostic procedures.

Cloud-to-ground lightning activity in Colombia: A 14-year study using lightning location system data

NASA Astrophysics Data System (ADS)

Herrera, J.; Younes, C.; Porras, L.

2018-05-01

This paper presents the analysis of 14 years of cloud-to-ground lightning activity observation in Colombia using lightning location systems (LLS) data. The first Colombian LLS operated from 1997 to 2001. After a few years, this system was upgraded and a new LLS has been operating since 2007. Data obtained from these two systems was analyzed in order to obtain lightning parameters used in designing lightning protection systems. The flash detection efficiency was estimated using average peak current maps and some theoretical results previously published. Lightning flash multiplicity was evaluated using a stroke grouping algorithm resulting in average values of about 1.0 and 1.6 for positive and negative flashes respectively and for both LLS. The time variation of this parameter changes slightly for the years considered in this study. The first stroke peak current for negative and positive flashes shows median values close to 29 kA and 17 kA respectively for both networks showing a great dependence on the flash detection efficiency. The average percentage of negative and positive flashes shows a 74.04% and 25.95% of occurrence respectively. The daily variation shows a peak between 23 and 02 h. The monthly variation of this parameter exhibits a bimodal behavior typical of the regions located near The Equator. The lightning flash density was obtained dividing the study area in 3 × 3 km cells and resulting in maximum average values of 25 and 35 flashes km- 2 year- 1 for each network respectively. A comparison of these results with global lightning activity hotspots was performed showing good correlation. Besides, the lightning flash density variation with altitude shows an inverse relation between these two variables.

Evidence for an involvement of 5-hydroxytryptaminergic neurones in the maintenance of operant behaviour by positive reinforcement.

PubMed

Wogar, M A; Bradshaw, C M; Szabadi, E

1991-01-01

The possible involvement of the ascending 5-hydroxytryptaminergic (5HTergic) pathways in the maintenance of operant behaviour by positive reinforcement was examined using a quantitative paradigm based on Herrnstein's (1970) equation which defines a hyperbolic relationship between steady-state response rate and reinforcement frequency in variable-interval schedules. Nine rats received injections of 5,7-dihydroxytryptamine into the dorsal and median raphe nuclei; 12 rats received sham injections. The rats were trained to steady-state in a series of variable-interval schedules of sucrose reinforcement affording a range of reinforcement frequencies. Herrnstein's equation was fitted to the data obtained from each rat and to the averaged data obtained from the two groups. The value of KH (the parameter expressing the reinforcement frequency needed to obtain the half-maximum response rate) was significantly lower in the lesioned group than in the control group; the values of Rmax (the parameter expressing the maximum response rate) did not differ significantly between the two groups. The levels of 5HT and 5-hydroxyindoleacetic acid in the parietal cortex, hippocampus, nucleus accumbens and hypothalamus were markedly reduced in all four regions in the lesioned group, but the levels of noradrenaline and dopamine were not significantly affected. The results indicate that damage to the central 5HTergic pathways resulted in an increase in the "value" of the sucrose reinforcer, without affecting the animals' response capacity. The results are consistent with the suggestion that the 5HTergic pathways may exert some limiting control on the "values" of certain reinforcers.

Anthropometric measurements as predictors of cephalopelvic disproportion: Can the diagnostic accuracy be improved?

PubMed

Benjamin, Santosh J; Daniel, Anjali B; Kamath, Asha; Ramkumar, Vani

2012-01-01

We assessed the efficacy of maternal anthropometric measurements and clinical estimates of fetal weight in isolation and in combination as predictors of cephalopelvic disproportion (CPD). Prospective cohort study. Tertiary care teaching hospital, two affiliated hospitals with facilities for conducting cesarean delivery and seven affiliated primary care facilities with no operation theaters. Primigravidae over 37 weeks' gestation attending these facilities during a 20-month period with a singleton pregnancy in vertex presentation. Several anthropometric measurements were taken in 249 primigravidae. Fetal weight was estimated. Differences in these measurements between the vaginal delivery and CPD groups were analyzed. The validity of these measurements in predicting CPD was analyzed by plotting receiver operating characteristic curves and by logistic regression analysis. Mode of delivery. Maternal height, foot size, inter-trochanteric diameter and bis-acromial diameter showed the highest positive predictive values for CPD. Combining some maternal measurements with estimates of fetal weight increased predictive values modestly, which are likely to be greater if the estimates of fetal weight are close to the actual birth weight. Based on multivariate analysis the risk factors for CPD in our population were foot length ≤23cm, inter-trochanteric diameter ≤30cm and estimated fetal weight ≥3 000g. Maternal anthropometric measurements can predict CPD to some extent. Combining maternal measurements with clinical estimates of fetal weight only enhances the predictive value to a relatively modest degree (positive predictive value 24%). © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

Validation of the Hospital Anxiety and Depression Scale in patients with epilepsy.

PubMed

Wiglusz, Mariusz S; Landowski, Jerzy; Michalak, Lidia; Cubała, Wiesław J

2016-05-01

Despite the fact that depressive disorders are the most common comorbidities among patients with epilepsy (PWEs), they often go unrecognized and untreated. The availability of validated screening instruments to detect depression in PWEs is limited. The aim of the present study was to validate the Hospital Anxiety and Depression Scale (HADS) in adult PWEs. A consecutive group of 118 outpatient PWEs was invited to participate in the study. Ninety-six patients met inclusion criteria, completed HADS, and were examined by a trained psychiatrist using Structured Clinical Interview (SCID-I) for DSM-IV-TR. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold scores for the HADS depression subscale (HADS-D). Receiver operating characteristic analyses showed areas under the curve at approximately 84%. For diagnoses of MDD, the HADS-D demonstrated the best psychometric properties for a cutoff score ≥7 with sensitivity of 90.5%, specificity of 70.7%, positive predictive value of 46.3%, and negative predictive value of 96.4%. In the case of the group with 'any depressive disorder', the HADS-D optimum cutoff score was ≥6 with sensitivity of 82.5%, specificity of 73.2%, positive predictive value of 68.8%, and negative predictive value of 85.4%. The HADS-D proved to be a valid and reliable psychometric instrument in terms of screening for depressive disorders in PWEs. In the epilepsy setting, HADS-D maintains adequate sensitivity, acceptable specificity, and high NPV but low PPV for diagnosing MDD with an optimum cutoff score ≥7. Copyright © 2016 Elsevier Inc. All rights reserved.

The utility of the Edmonton Symptom Assessment System in screening for anxiety and depression.

PubMed

Bagha, S M; Macedo, A; Jacks, L M; Lo, C; Zimmermann, C; Rodin, G; Li, M

2013-01-01

The Edmonton Symptom Assessment System (ESAS) is a common screening tool in cancer, although its validity for distress screening is unproven. Here, screening performance of the ESAS anxiety (ESAS-A) and depression (ESAS-D) items were validated against the anxiety [Generalised Anxiety Disorder-7 (GAD-7)] and depression [Patient Health Questionnaire-9 (PHQ-9)] subscales of the PHQ. A total of 1215 cancer patients completed the Distress Assessment and Response Tool (DART), a computerised distress screening instrument. Spearman's rank correlation coefficients and receiver operating characteristic curve analyses were used to evaluate the ability of ESAS-A and ESAS-D to identify moderate distress (GAD-7/PHQ-9 ≥ 10). Spearman's rank correlation coefficients comparing ESAS-A and ESAS-D with GAD-7 and PHQ-9 were 0.74 and 0.72 respectively. Areas under the receiver operating characteristic curves were 0.89 and 0.88 for anxiety and depression respectively. A cut-off of ≥3 on ESAS-A demonstrated a sensitivity of 0.91, specificity of 0.68, positive predictive value of 0.34 and negative predictive value of 0.97. A cut-off of ≥2 on the ESAS-D demonstrated a sensitivity of 0.86, specificity of 0.72, positive predictive value of 0.46 and negative predictive value of 0.95. High sensitivities of ESAS-A and ESAS-D at certain cut-offs suggest they have use in ruling-out distress. However, their low specificities indicate secondary screening is needed to rule-in anxiety or depression for case-finding. © 2012 Blackwell Publishing Ltd.

A positive Babinski reflex predicts delayed neuropsychiatric sequelae in Chinese patients with carbon monoxide poisoning.

PubMed

Zou, Jian-Fang; Guo, Qiming; Shao, Hua; Li, Bin; Du, Yuxiu; Liu, Maofeng; Liu, Fengling; Dai, Lixin; Chung, Min-Hsien; Lin, Hung-Jung; Guo, How-Ran; Yang, Tzu-Meng; Huang, Chien-Cheng; Hsu, Chien-Chin

2014-01-01

As the human population increased in China, the carbon monoxide is a serious environmental toxin in public health. However, predicting the delayed neuropsychiatric sequelae (DNS) of carbon monoxide poisoning (COP) has not been well studied. We investigated the independent predictors of DNS in patients with COP. This study was conducted at four hospitals in China. Data were retrospectively collected from 258 patients with COP between November 1990 and October 2011. DNS was the primary endpoint. A positive Babinski reflex was the independent predictor for DNS: sensitivity = 53.8% (95% confidence interval [CI]: 26.1-79.6), specificity = 88.6% (95% CI: 83.7-92.1), positive predictive value (PPV) = 20.0% (95% CI: 9.1-37.5), and negative predictive value (NPV) = 97.3% (95% CI: 94.0-98.9). The area under the receiver operating characteristic curve = 0.712 (95% CI: 0.544-0.880). A positive Babinski reflex was very memorable, immediately available, and applicable in clinical practice. Even when the sensitivity and PPV of a positive Babinski reflex were unsatisfactory, it had a good specificity and NPV for excluding the risk of DNS. In patients without a positive Babinski reflex, the risk for DNS was only 2.7%. This finding may help physicians make decisions about dispositions for patients with COP.

Disappearing Q operator

NASA Astrophysics Data System (ADS)

Jones, H. F.; Rivers, R. J.

2007-01-01

In the Schrödinger formulation of non-Hermitian quantum theories a positive-definite metric operator η≡e-Q must be introduced in order to ensure their probabilistic interpretation. This operator also gives an equivalent Hermitian theory, by means of a similarity transformation. If, however, quantum mechanics is formulated in terms of functional integrals, we show that the Q operator makes only a subliminal appearance and is not needed for the calculation of expectation values. Instead, the relation to the Hermitian theory is encoded via the external source j(t). These points are illustrated and amplified for two non-Hermitian quantum theories: the Swanson model, a non-Hermitian transform of the simple harmonic oscillator, and the wrong-sign quartic oscillator, which has been shown to be equivalent to a conventional asymmetric quartic oscillator.

Disappearing Q operator

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

Jones, H. F.; Rivers, R. J.

In the Schroedinger formulation of non-Hermitian quantum theories a positive-definite metric operator {eta}{identical_to}e{sup -Q} must be introduced in order to ensure their probabilistic interpretation. This operator also gives an equivalent Hermitian theory, by means of a similarity transformation. If, however, quantum mechanics is formulated in terms of functional integrals, we show that the Q operator makes only a subliminal appearance and is not needed for the calculation of expectation values. Instead, the relation to the Hermitian theory is encoded via the external source j(t). These points are illustrated and amplified for two non-Hermitian quantum theories: the Swanson model, a non-Hermitianmore » transform of the simple harmonic oscillator, and the wrong-sign quartic oscillator, which has been shown to be equivalent to a conventional asymmetric quartic oscillator.« less

Multidimensional Simulation Applied to Water Resources Management

NASA Astrophysics Data System (ADS)

Camara, A. S.; Ferreira, F. C.; Loucks, D. P.; Seixas, M. J.

1990-09-01

A framework for an integrated decision aiding simulation (IDEAS) methodology using numerical, linguistic, and pictorial entities and operations is introduced. IDEAS relies upon traditional numerical formulations, logical rules to handle linguistic entities with linguistic values, and a set of pictorial operations. Pictorial entities are defined by their shape, size, color, and position. Pictorial operators include reproduction (copy of a pictorial entity), mutation (expansion, rotation, translation, change in color), fertile encounters (intersection, reunion), and sterile encounters (absorption). Interaction between numerical, linguistic, and pictorial entities is handled through logical rules or a simplified vector calculus operation. This approach is shown to be applicable to various environmental and water resources management analyses using a model to assess the impacts of an oil spill. Future developments, including IDEAS implementation on parallel processing machines, are also discussed.

The sitting position during neurosurgical procedures does not influence serum biomarkers of pulmonary parenchymal injury.

PubMed

Duda, Izabela; Grzybowska, Konstancja; Jędrzejowska-Szypułka, Halina; Lewin-Kowalik, Joanna

2012-12-05

The sitting position during neurosurgical operations predisposes to air penetration through veins and the movement of the air through the pulmonary circulation. Contact of an air bubble with the endothelium can lead to acute lung injury. The presence of specific pulmonary proteins in the plasma such as surfactant protein D (SP-D) and Clara cell protein (CC16) is a biomarker of damaging processes at the air-blood barrier. The aim of our study was to examine the hypothesis that the level of investigated pulmonary biomarkers in plasma is higher in patients operated on in the sitting position. The study included patients undergoing planned neurosurgical operations, who were divided into two groups: the sitting group (40 patients, operated on in the sitting position) and the supine group (24 patients, operated in the supine position). After the operation blood samples were drawn, centrifuged, frozen and stored until analyses were conducted. The determination of the SP-D and CC16 levels was performed using an ELISA test. Air embolism (VAE) was defined as a sudden drop in etCO2 of more than 2 mmHg and the presence of air bubbles in the aspirated blood from the central cannula. In all patients, the number of hospitalization days in the postoperative period was calculated. There were no differences in the average levels of SP-D between the groups (the mean in the sitting group was 95.56 ng/mL and the mean in the supine group was 101.21 ng/mL). The average levels of CC16 were similar in both groups as well (6.56 ng/mL in the sitting group and 6.79 ng/mL in the supine group). There was a statistically significant positive correlation between SP-D and CC16 values in both groups. VAE was diagnosed clinically in 12.5% of cases in the sitting group without a significant increase in SP-D and CC16 levels. On average, patients in both groups were discharged from the hospital within 9 days of surgery. The sitting position and intraoperative VAE during neurosurgical procedures do not affect the concentration of plasma biomarkers of pulmonary parenchymal injury such as SP-D and CC16.

Monte Carlo simulation of the operational quantities at the realistic mixed neutron-photon radiation fields CANEL and SIGMA.

PubMed

Lacoste, V; Gressier, V

2007-01-01

The Institute for Radiological Protection and Nuclear Safety owns two facilities producing realistic mixed neutron-photon radiation fields, CANEL, an accelerator driven moderator modular device, and SIGMA, a graphite moderated americium-beryllium assembly. These fields are representative of some of those encountered at nuclear workplaces, and the corresponding facilities are designed and used for calibration of various instruments, such as survey meters, personal dosimeters or spectrometric devices. In the framework of the European project EVIDOS, irradiations of personal dosimeters were performed at CANEL and SIGMA. Monte Carlo calculations were performed to estimate the reference values of the personal dose equivalent at both facilities. The Hp(10) values were calculated for three different angular positions, 0 degrees, 45 degrees and 75 degrees, of an ICRU phantom located at the position of irradiation.

Need for Affect and Attitudes Toward Drugs: The Mediating Role of Values.

PubMed

Lins de Holanda Coelho, Gabriel; H P Hanel, Paul; Vilar, Roosevelt; P Monteiro, Renan; Gouveia, Valdiney V; R Maio, Gregory

2018-05-04

Human values and affective traits were found to predict attitudes toward the use of different types of drugs (e.g., alcohol, marijuana, and other illegal drugs). In this study (N = 196, M age = 23.09), we aimed to gain a more comprehensive understanding of those predictors of attitudes toward drug use in a mediated structural equation model, providing a better overview of a possible motivational path that drives to such a risky behavior. Specifically, we predicted and found that the relations between need for affect and attitudes toward drug use were mediated by excitement values. Also, results showed that excitement values and need for affect positively predicted attitudes toward the use of drugs, whereas normative values predicted it negatively. The pattern of results remained the same when we investigated attitudes toward alcohol, marijuana, or illegal drugs separately. Overall, the findings indicate that emotions operate via excitement and normative values to influence risk behavior.

Ethical challenges for medical professionals in middle manager positions: a debate article.

PubMed

Schnoor, Joerg; Heyde, Christoph-Eckhard; Ghanem, Mohamed

2015-01-01

Demographic changes increase the financing needs of all social services. This change also generates new and complex demands on the medical staff. Accordingly, medical professionals in middle management positions hold a characteristic sandwich position between top management and the operational core. This sandwich position often constitutes new challenges. In the industrial field, the growing importance of the middle management for the company's success has already been recognized. Accordingly, the growing demand on economy urges an analysis for the medical field. While there are nearly no differences in the nature of the tasks of medical middle manager in the areas of strategy, role function, performance pressure and qualifications compared to those tasks of the industrial sector, there are basic differences as well. Especially the character of "independence" of the medical profession and its ethical values justifies these differences. Consequently, qualification of medical professionals may not be solely based on medical academic career. It is also based on the personal ability or potential to lead and to manage. Above all, the character of "independence" of the medical profession and its ethical values justifies medical action that is based on the patient's well-being and not exclusively on economic outcomes. In the future, medical middle managers are supposed to achieve an optimized balance between a patient-centered medicine and economic measures. It will be a basic requirement that middle managers accept their position and the resultant tasks putting themselves in a more active position. Because of that, middle managers can become "value-added bridge-builders".

Procalcitonin Levels in Gram-Positive, Gram-Negative, and Fungal Bloodstream Infections

PubMed Central

Ferranti, Marta; Moretti, Amedeo; Al Dhahab, Zainab Salim; Cenci, Elio; Mencacci, Antonella

2015-01-01

Procalcitonin (PCT) can discriminate bacterial from viral systemic infections and true bacteremia from contaminated blood cultures. The aim of this study was to evaluate PCT diagnostic accuracy in discriminating Gram-positive, Gram-negative, and fungal bloodstream infections. A total of 1,949 samples from patients with suspected bloodstream infections were included in the study. Median PCT value in Gram-negative (13.8 ng/mL, interquartile range (IQR) 3.4–44.1) bacteremias was significantly higher than in Gram-positive (2.1 ng/mL, IQR 0.6–7.6) or fungal (0.5 ng/mL, IQR 0.4–1) infections (P < 0.0001). Receiver operating characteristic analysis showed an area under the curve (AUC) for PCT of 0.765 (95% CI 0.725–0.805, P < 0.0001) in discriminating Gram-negatives from Gram-positives at the best cut-off value of 10.8 ng/mL and an AUC of 0.944 (95% CI 0.919–0.969, P < 0.0001) in discriminating Gram-negatives from fungi at the best cut-off of 1.6 ng/mL. Additional results showed a significant difference in median PCT values between Enterobacteriaceae and nonfermentative Gram-negative bacteria (17.1 ng/mL, IQR 5.9–48.5 versus 3.5 ng/mL, IQR 0.8–21.5; P < 0.0001). This study suggests that PCT may be of value to distinguish Gram-negative from Gram-positive and fungal bloodstream infections. Nevertheless, its utility to predict different microorganisms needs to be assessed in further studies. PMID:25852221

A retrospective evaluation method for in vitro mammalian genotoxicity tests using cytotoxicity index transformation formulae.

PubMed

Fujita, Yurika; Kasamatsu, Toshio; Ikeda, Naohiro; Nishiyama, Naohiro; Honda, Hiroshi

2016-01-15

Although in vitro chromosomal aberration tests and micronucleus tests have been widely used for genotoxicity evaluation, false-positive results have been reported under strong cytotoxic conditions. To reduce false-positive results, the new Organization for Economic Co-operation and Development (OECD) test guideline (TG) recommends the use of a new cytotoxicity index, relative increase in cell count or relative population doubling (RICC/RPD), instead of the traditionally used index, relative cell count (RCC). Although the use of the RICC/RPD may result in different outcomes and require re-evaluation of tested substances, it is impractical to re-evaluate all existing data. Therefore, we established a method to estimate test results from existing RCC data. First, we developed formulae to estimate RICC/RPD from RCC without cell counts by considering cell doubling time and experiment time. Next, the accuracy of the cytotoxicity index transformation formulae was verified by comparing estimated RICC/RPD and measured RICC/RPD for 3 major chemicals associated with false-positive genotoxicity test results: ethyl acrylate, eugenol and p-nitrophenol. Moreover, 25 compounds with false-positive in vitro chromosomal aberration (CA) test results were re-evaluated to establish a retrospective evaluation method based on derived estimated RICC/RPD values. The estimated RICC/RPD values were in good agreement with the measured RICC/RPD values for every concentration and chemical, and the estimated RICC suggested the possibility that 12 chemicals (48%) with previously judged false-positive results in fact had negative results. Our method enables transformation of RCC data into RICC/RPD values with a high degree of accuracy and will facilitate comprehensive retrospective evaluation of test results. Copyright © 2015 Elsevier B.V. All rights reserved.

The reliability of cone-beam computed tomography to assess bone density at dental implant recipient sites: a histomorphometric analysis by micro-CT.

PubMed

González-García, Raúl; Monje, Florencio

2013-08-01

The aim of this study was to objectively assess the reliability of the cone-beam computed tomography (CBCT) as a tool to pre-operatively determine radiographic bone density (RBD) by the density values provided by the system, analyzing its relationship with histomorphometric bone density expressed as bone volumetric fraction (BV/TV) assessed by micro-CT of bone biopsies at the site of insertion of dental implants in the maxillary bones. Thirty-nine bone biopsies of the maxillary bones at the sites of 39 dental implants from 31 edentulous healthy patients were analyzed. The NobelGuide™ software was used for implant planning, which also allowed fabrication of individual stereolithographic surgical guides. The analysis of CBCT images allowed pre-operative determination of mean density values of implant recipient sites along the major axis of the planned implants (axial RBD). Stereolithographic surgical guides were used to guide implant insertion and also to extract cylindrical bone biopsies from the core of the exact implant site. Further analysis of several osseous micro-structural variables including BV/TV was performed by micro-CT of the extracted bone biopsies. Mean axial RBD was 478 ± 212 (range: 144-953). A statistically significant difference (P = 0.02) was observed among density values of the cortical bone of the upper maxilla and mandible. A high positive Pearson's correlation coefficient (r = 0.858, P < 0.001) was observed between RBD and BV/TV, with the regression equations: (1) Axial RBD = -19.974 + 10.238·BV/TV; (2) BV/TV = 14.258 + 0.72·Axial RBD. RBD was also positively correlated with the trabecular thickness (Tb.Th) and trabecular number (Tb.N), but negatively correlated with trabecular separation (Tb.Sp), structural model index, and inverse connectivity (Tb.Pf). Density values upper than 450 were associated with BV/TV upper than 50%, mean Tb.Th upper than 0.2 mm, mean Tb.Sp lower than 0.3 mm, and mean Tb.N upper than 2. RBD assessed by CBCT has a strong positive correlation with BV/TV assessed by micro-CT at the site of dental implants in the maxillary bones. Pre-operative estimation of density values by CBCT is a reliable tool to objectively determine bone density. © 2012 John Wiley & Sons A/S.

High speed flux feedback for tuning a universal field oriented controller capable of operating in direct and indirect field orientation modes

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

De Doncker, Rik W. A. A.

The direct (d) and quadrature (q) components of flux, as sensed by flux sensors or determined from voltage and current measurements in a direct field orientation scheme, are processed rapidly and accurately to provide flux amplitude and angular position values for use by the vector rotator of a universal field-oriented (UFO) controller. Flux amplitude (linear or squared) is provided as feedback to tune the UFO controller for operation in direct and indirect field orientation modes and enables smooth transitions from one mode to the other.

High speed flux feedback for tuning a universal field oriented controller capable of operating in direct and indirect field orientation modes

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

De Doncker, R.W.A.A.

The direct (d) and quadrature (q) components of flux, as sensed by flux sensors or determined from voltage and current measurements in a direct field orientation scheme, are processed rapidly and accurately to provide flux amplitude and angular position values for use by the vector rotator of a universal field-oriented (UFO) controller. Flux amplitude (linear or squared) is provided as feedback to tune the UFO controller for operation in direct and indirect field orientation modes and enables smooth transitions from one mode to the other. 3 figs.

High speed flux feedback for tuning a universal field oriented controller capable of operating in direct and indirect field orientation modes

DOEpatents

De Doncker, R.W.A.A.

1992-09-01

The direct (d) and quadrature (q) components of flux, as sensed by flux sensors or determined from voltage and current measurements in a direct field orientation scheme, are processed rapidly and accurately to provide flux amplitude and angular position values for use by the vector rotator of a universal field-oriented (UFO) controller. Flux amplitude (linear or squared) is provided as feedback to tune the UFO controller for operation in direct and indirect field orientation modes and enables smooth transitions from one mode to the other. 3 figs.

Amplification of Angular Rotations Using Weak Measurements

NASA Astrophysics Data System (ADS)

Magaña-Loaiza, Omar S.; Mirhosseini, Mohammad; Rodenburg, Brandon; Boyd, Robert W.

2014-05-01

We present a weak measurement protocol that permits a sensitive estimation of angular rotations based on the concept of weak-value amplification. The shift in the state of a pointer, in both angular position and the conjugate orbital angular momentum bases, is used to estimate angular rotations. This is done by an amplification of both the real and imaginary parts of the weak-value of a polarization operator that has been coupled to the pointer, which is a spatial mode, via a spin-orbit coupling. Our experiment demonstrates the first realization of weak-value amplification in the azimuthal degree of freedom. We have achieved effective amplification factors as large as 100, providing a sensitivity that is on par with more complicated methods that employ quantum states of light or extremely large values of orbital angular momentum.

Alteration in transthoracic impedance following cardiac surgery.

PubMed

Khan, Nouman U; Strang, Tim; Bonsheck, Claire; Krishnamurty, Bhuvana; Hooper, Timothy L

2008-06-01

Haemodynamically significant ventricular tachyarrhythmias are a frequent complication in the immediate post-operative period after cardiac surgery. Successful cardioversion depends on delivery of sufficient current, which in turn is dependent on transthoracic impedance (TTI). However, it is uncertain if there is a change in TTI immediately following cardiac surgery using cardiopulmonary bypass (CPB). TTI was measured on 40 patients undergoing first time isolated cardiac surgery using CPB. TTI was recorded at 30 kHz using Bodystat Multiscan 5000 equipment before operation (with and without a positive end-expiratory pressure (PEEP) of 5 cm of H(2)O) and then at 1, 4 and 24 h after the operation. Data was analyzed to determine the relationship between pre- and post-operative variables and TTI values. Mean pre-operative TTI was 54.5+/-10.55 ohms without PEEP and 61.8+/-15.4 ohms on a PEEP of 5 cm of H(2)O. TTI dropped significantly (p<0.001) after the operation to 47.2+/-10.6 ohms at 1 h, 42.6+/-10.2 ohms at 4 h and 41.8+/-10.4 ohms at 24 h. A positive correlation was noted between duration of operation and TTI change at 1 h (r=0.38; p=0.016). There was no significant correlation between the duration of bypass and change in TTI. TTI decreases by more than 30% in the immediate post-operative period following cardiac surgery. This state may favour defibrillation at lower energy levels.

Validity of Alcohol Use Disorder Identification Test-Korean Revised Version for Screening Alcohol Use Disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Criteria.

PubMed

Chang, Jung Wei; Kim, Jong Sung; Jung, Jin Gyu; Kim, Sung Soo; Yoon, Seok Joon; Jang, Hak Sun

2016-11-01

The Alcohol Use Disorder Identification Test (AUDIT) has been widely used to identify alcohol use disorder (AUD). This study evaluated the validity of the AUDIT-Korean revised version (AUDIT-KR) for screening AUD according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria. This research was conducted with 443 subjects who visited the Chungnam National University Hospital for a comprehensive medical examination. All subjects completed the demographic questionnaire and AUDIT-KR without assistance. Subjects were divided into two groups according to DSM-5 criteria: an AUD group, which included patients that fit the criteria for AUD (120 males and 21 females), and a non-AUD group, which included 146 males and 156 females that did not meet AUD criteria. The appropriate cut-off values, sensitivity, specificity, and positive and negative predictive values of the AUDIT-KR were evaluated. The mean±standard deviation AUDIT-KR scores were 10.32±7.48 points in males and 3.23±4.42 points in females. The area under the receiver operating characteristic curve (95% confidence interval, CI) of the AUDIT-KR for identifying AUD was 0.884 (0.840-0.920) in males and 0.962 (0.923-0.985) in females. The optimal cut-off value of the AUDIT-KR was 10 points for males (sensitivity, 81.90%; specificity, 81.33%; positive predictive value, 77.2%; negative predictive value, 85.3%) and 5 points for females (sensitivity, 100.00%; specificity, 88.54%; positive predictive value, 52.6%; negative predictive value, 100.0%). The AUDIT-KR has high reliability and validity for identifying AUD according to DSM-5 criteria.

Prediction of obeche wood-induced asthma by specific skin prick testing.

PubMed

Hannu, T; Lindström, I; Palmroos, P; Kuuliala, O; Sauni, R

2013-09-01

It has previously been shown that a positive skin prick test (SPT) result is a good predictor of a positive specific inhalation challenge (SIC) in patients with occupational asthma (OA) related to wheat or rye flours. This association has not been previously studied in OA attributable to obeche wood. To describe a clinical series of patients with OA induced by obeche wood. To investigate if the SPT result can be used as a predictor for the outcome of SIC tests. OA was diagnosed according to patient history, lung function examinations and SIC tests, as well as the determination of obeche SPTs. We analysed sensitivity, specificity and positive (PPV) and negative predictive values (NPV) at different wheal sizes of the SPTs and drew receiver-operating characteristic plots using the SIC test result as the gold standard. Obeche wood SIC tests were performed on 34 symptomatic workers. Of these, 27 workers had a positive test result and were diagnosed as having OA. The minimal cut-off value with a PPV of 100% was an SPT wheal of 3.5 mm from obeche wood. This means that all workers with a wheal size of ≥ 3.5 mm from obeche wood had a positive SIC. Positive SPT results in symptomatic workers were good predictors of a positive SIC. SIC with obeche wood may be unnecessary in strongly sensitized workers.

Computer-designed surgical guide template compared with free-hand operation for mesiodens extraction in premaxilla using “trapdoor” method

PubMed Central

Hu, Ying Kai; Xie, Qian Yang; Yang, Chi; Xu, Guang Zhou

2017-01-01

Abstract The aim of this study was to introduce a novel method of mesiodens extraction using a vascularized pedicled bone flap by piezosurgery and to compare the differences between a computer-aided design surgical guide template and free-hand operation. A total of 8 patients with mesiodens, 4 with a surgical guide (group I), and 4 without it (group II) were included in the study. The surgical design was to construct a trapdoor pedicle on the superior mucoperiosteal attachment with application of piezosurgery. The bone lid was repositioned after mesiodens extraction. Group I patients underwent surgeries based on the preoperative planning with surgical guide templates, while group II patients underwent free-hand operation. The outcome variables were success rate, intraoperative time, anterior nasal spine (ANS) position, changes of nasolabial angle (NLA), and major complications. Data from the 2 groups were compared by SPSS 17.0, using Wilcoxon test. The operative time was significantly shorter in group I patients. All the mesiodentes were extracted successfully and no obvious differences of preoperative and postoperative ANS position and NLA value were found in both groups. The patients were all recovered uneventfully. Surgical guide templates can enhance clinical accuracy and reduce operative time by facilitating accurate osteotomies. PMID:28658139

Workshop on AI (Artificial Intelligence) and Simulation (2nd) Held in Seattle, Washington on 14 July 1987,

DTIC Science & Technology

1987-07-01

position of the camshaft (for example), the position of each other kinematic pair will have a definite computable value. Thus the only state variables needed...DF CONNROD _CON ROD DIF C OD WF CYL /N. D I T.~ UN ,BLO CT!L \\ CYL C"YL CYL Y I C BLO"cB BLO CYL BLO Figure 2 CSG Tree for Crank .Mechanism program...ships plate. The actual representation is a binary tree who-e - internal nodes are set operation, and rigid motions and The first step for kinematic

Application of Receiver Operating Characteristic Analysis to Refine the Prediction of Potential Digoxin Drug Interactions

PubMed Central

Ellens, Harma; Deng, Shibing; Coleman, JoAnn; Bentz, Joe; Taub, Mitchell E.; Ragueneau-Majlessi, Isabelle; Chung, Sophie P.; Herédi-Szabó, Krisztina; Neuhoff, Sibylle; Palm, Johan; Balimane, Praveen; Zhang, Lei; Jamei, Masoud; Hanna, Imad; O’Connor, Michael; Bednarczyk, Dallas; Forsgard, Malin; Chu, Xiaoyan; Funk, Christoph; Guo, Ailan; Hillgren, Kathleen M.; Li, LiBin; Pak, Anne Y.; Perloff, Elke S.; Rajaraman, Ganesh; Salphati, Laurent; Taur, Jan-Shiang; Weitz, Dietmar; Wortelboer, Heleen M.; Xia, Cindy Q.; Xiao, Guangqing; Yamagata, Tetsuo

2013-01-01

In the 2012 Food and Drug Administration (FDA) draft guidance on drug-drug interactions (DDIs), a new molecular entity that inhibits P-glycoprotein (P-gp) may need a clinical DDI study with a P-gp substrate such as digoxin when the maximum concentration of inhibitor at steady state divided by IC50 ([I1]/IC50) is ≥0.1 or concentration of inhibitor based on highest approved dose dissolved in 250 ml divide by IC50 ([I2]/IC50) is ≥10. In this article, refined criteria are presented, determined by receiver operating characteristic analysis, using IC50 values generated by 23 laboratories. P-gp probe substrates were digoxin for polarized cell-lines and N-methyl quinidine or vinblastine for P-gp overexpressed vesicles. Inhibition of probe substrate transport was evaluated using 15 known P-gp inhibitors. Importantly, the criteria derived in this article take into account variability in IC50 values. Moreover, they are statistically derived based on the highest degree of accuracy in predicting true positive and true negative digoxin DDI results. The refined criteria of [I1]/IC50 ≥ 0.03 and [I2]/IC50 ≥ 45 and FDA criteria were applied to a test set of 101 in vitro-in vivo digoxin DDI pairs collated from the literature. The number of false negatives (none predicted but DDI observed) were similar, 10 and 12%, whereas the number of false positives (DDI predicted but not observed) substantially decreased from 51 to 40%, relative to the FDA criteria. On the basis of estimated overall variability in IC50 values, a theoretical 95% confidence interval calculation was developed for single laboratory IC50 values, translating into a range of [I1]/IC50 and [I2]/IC50 values. The extent by which this range falls above the criteria is a measure of risk associated with the decision, attributable to variability in IC50 values. PMID:23620486

Fibonacci-Lucas SIC-POVMs

NASA Astrophysics Data System (ADS)

Grassl, Markus; Scott, Andrew J.

2017-12-01

We present a conjectured family of symmetric informationally complete positive operator valued measures which have an additional symmetry group whose size is growing with the dimension. The symmetry group is related to Fibonacci numbers, while the dimension is related to Lucas numbers. The conjecture is supported by exact solutions for dimensions d = 4, 8, 19, 48, 124, and 323 as well as a numerical solution for dimension d = 844.

Delay Banking for Managing Air Traffic

NASA Technical Reports Server (NTRS)

Green, Steve

2008-01-01

Delay banking has been invented to enhance air-traffic management in a way that would increase the degree of fairness in assigning arrival, departure, and en-route delays and trajectory deviations to aircraft impacted by congestion in the national airspace system. In delay banking, an aircraft operator (airline, military, general aviation, etc.) would be assigned a numerical credit when any of their flights are delayed because of an air-traffic flow restriction. The operator could subsequently bid against other operators competing for access to congested airspace to utilize part or all of its accumulated credit. Operators utilize credits to obtain higher priority for the same flight, or other flights operating at the same time, or later, in the same airspace, or elsewhere. Operators could also trade delay credits, according to market rules that would be determined by stakeholders in the national airspace system. Delay banking would be administered by an independent third party who would use delay banking automation to continually monitor flights, allocate delay credits, maintain accounts of delay credits for participating airlines, mediate bidding and the consumption of credits of winning bidders, analyze potential transfers of credits within and between operators, implement accepted transfers, and ensure fair treatment of all participating operators. A flow restriction can manifest itself in the form of a delay in assigned takeoff time, a reduction in assigned airspeed, a change in the position for the aircraft in a queue of all aircraft in a common stream of traffic (e.g., similar route), a change in the planned altitude profile for an aircraft, or change in the planned route for the aircraft. Flow restrictions are typically imposed to mitigate traffic congestion at an airport or in a region of airspace, particularly congestion due to inclement weather, or the unavailability of a runway or region of airspace. A delay credit would be allocated to an operator of a flight that has accepted, or upon which was imposed, a flow restriction. The amount of the credit would increase with the amount of delay caused by the flow restriction, the exact amount depending on which of several candidate formulas is eventually chosen. For example, according to one formula, there would be no credit for a delay smaller than some threshold value (e.g., 30 seconds) and the amount of the credit for a longer delay would be set at the amount of the delay minus the threshold value. Optionally, the value of a delay credit could be made to decay with time according to a suitable formula (e.g., an exponential decay). Also, optionally, a transaction charge could be assessed against the value of a delay credit that an operator used on a flight different from the one for which the delay originated or that was traded with a different operator. The delay credits accumulated by a given airline could be utilized in various ways. For example, an operator could enter a bid for priority handling in a new flow restriction that impacts one or more of the operator s flights; if the bid were unsuccessful, all or a portion of the credit would be returned to the bidder. If the bid pertained to a single aircraft that was in a queue, delay credits could be consumed in moving the aircraft to an earlier position within the queue. In the case of a flow restriction involving a choice of alternate routes, planned altitude profile, aircraft spacing, or other non-queue flow restrictions, delay credits could be used to bid for an alternative assignment.

Early pregnancy angiogenic markers and spontaneous abortion: an Odense Child Cohort study.

PubMed

Andersen, Louise B; Dechend, Ralf; Karumanchi, S Ananth; Nielsen, Jan; Joergensen, Jan S; Jensen, Tina K; Christesen, Henrik T

2016-11-01

Spontaneous abortion is the most commonly observed adverse pregnancy outcome. The angiogenic factors soluble Fms-like kinase 1 and placental growth factor are critical for normal pregnancy and may be associated to spontaneous abortion. We investigated the association between maternal serum concentrations of soluble Fms-like kinase 1 and placental growth factor, and subsequent spontaneous abortion. In the prospective observational Odense Child Cohort, 1676 pregnant women donated serum in early pregnancy, gestational week <22 (median 83 days of gestation, interquartile range 71-103). Concentrations of soluble Fms-like kinase 1 and placental growth factor were determined with novel automated assays. Spontaneous abortion was defined as complete or incomplete spontaneous abortion, missed abortion, or blighted ovum <22+0 gestational weeks, and the prevalence was 3.52% (59 cases). The time-dependent effect of maternal serum concentrations of soluble Fms-like kinase 1 and placental growth factor on subsequent late first-trimester or second-trimester spontaneous abortion (n = 59) was evaluated using a Cox proportional hazards regression model, adjusting for body mass index, parity, season of blood sampling, and age. Furthermore, receiver operating characteristics were employed to identify predictive values and optimal cut-off values. In the adjusted Cox regression analysis, increasing continuous concentrations of both soluble Fms-like kinase 1 and placental growth factor were significantly associated with a decreased hazard ratio for spontaneous abortion: soluble Fms-like kinase 1, 0.996 (95% confidence interval, 0.995-0.997), and placental growth factor, 0.89 (95% confidence interval, 0.86-0.93). When analyzed by receiver operating characteristic cut-offs, women with soluble Fms-like kinase 1 <742 pg/mL had an odds ratio for spontaneous abortion of 12.1 (95% confidence interval, 6.64-22.2), positive predictive value of 11.70%, negative predictive value of 98.90%, positive likelihood ratio of 3.64 (3.07-4.32), and negative likelihood ratio of 0.30 (0.19-0.48). For placental growth factor <19.7 pg/mL, odds ratio was 13.2 (7.09-24.4), positive predictive value was 11.80%, negative predictive value was 99.0%, positive likelihood ratio was 3.68 (3.12-4.34), and negative likelihood ratio was 0.28 (0.17-0.45). In the sensitivity analysis of 54 spontaneous abortions matched 1:4 to controls on gestational age at blood sampling, the highest area under the curve was seen for soluble Fms-like kinase 1 in prediction of first-trimester spontaneous abortion, 0.898 (0.834-0.962), and at the optimum cut-off of 725 pg/mL, negative predictive value was 51.4%, positive predictive value was 94.6%, positive likelihood ratio was 4.04 (2.57-6.35), and negative likelihood ratio was 0.22 (0.09-0.54). A strong, novel prospective association was identified between lower concentrations of soluble Fms-like kinase 1 and placental growth factor measured in early pregnancy and spontaneous abortion. A soluble Fms-like kinase 1 cut-off <742 pg/mL in maternal serum was optimal to stratify women at high vs low risk of spontaneous abortion. The cause and effect of angiogenic factor alterations in spontaneous abortions remain to be elucidated. Copyright © 2016 Elsevier Inc. All rights reserved.

Tale of two sites: capillary versus arterial blood glucose testing in the operating room.

PubMed

Akinbami, Felix; Segal, Scott; Schnipper, Jeffrey L; Stopfkuchen-Evans, Matthias; Mills, Jonathan; Rogers, Selwyn O

2012-04-01

Pre- and intraoperative glycemic control has been identified as a putative target to improve outcomes of surgical patients. Glycemic control requires frequent monitoring of blood glucose levels with appropriate adjustments. However, monitoring standards have been called into question, especially in cases in which capillary samples are used. Point-of-care testing (POCT) using capillary samples and glucometers has been noted to give relatively accurate results for critically ill patients. However, the package inserts of most glucometers warn that they should not be used for patients in shock. This has led clinicians to doubt their accuracy in the operating room. The accuracy of capillary samples when tested in patients undergoing surgical procedures has not been proven. This study aims to determine the accuracy of intraoperative blood glucose values using capillary samples relative to arterial samples. A prospective study was conducted by collecting paired capillary and arterial samples of patients undergoing major operations at a tertiary medical center from August 2009 to May 2011. Subjects were a convenience sample of patients who had arterial lines and needed glucose testing while undergoing the procedure. Precision Xceed Pro (Abbott) handheld glucometers were used to obtain the blood glucose values. Our primary outcome of interest was the degree of correlation between capillary and arterial blood glucose values or the degree to which arterial glucose levels can be predicted by capillary glucose samples. We used linear regression and the Student t tests for statistical analyses. Seventy-two-paired samples were collected. Of the cases, 54% were major abdominal operations, whereas 24% were vascular operations. The mean values ± standard deviation for glucose levels were 146 ± 35 mg/dL (capillary) and 147 ± 36 mg/dL (arterial). The mean time ± standard deviation between the collection of both samples was 3.5 ± 1.3 minutes. The regression coefficient showed a strong positive correlation of .91 between capillary glucose values and arterial values (P < .001) although correlation was less stringent at the hyperglycemic range of values. The R(2) statistic was 84%. Differences in values between capillary and arterial samples would not have altered the diagnosis of hypo- and hyperglycemia using typical thresholds. Capillary samples collected intraoperatively are strongly correlated with arterial samples. Glucose monitoring in the operating room can be safely performed by collecting capillary samples for POCT. However, clinicians should still be cautious when interpreting glucose levels that are high, either by repeating the blood glucose test or by having samples sent to the laboratory. Copyright © 2012 Elsevier Inc. All rights reserved.

Supine or prone position for mini-PNL procedure: does it matter.

PubMed

Tokatlı, Zafer; Gokce, Mehmet Ilker; Süer, Evren; Sağlam, Remzi

2015-06-01

In this study it is aimed to compare the success and complication rates of mini-PNL procedure in supine and prone positions. In this retrospective study data of 180 patients treated with MPNL either in supine (n = 54) or prone (n = 126) positions between May 2009 and August 2014 was investigated. Success was defined as no visible stones >2 mm. Perioperative complications were classified using the modified Clavien system. Groups were compared with Chi square test or Student t test and for statistical significance p value of 0.05 was accepted. Mean age of the population was 42.5 ± 8.2 years and mean stone size was 23.9 ± 4.1 mm. The two groups were similar with regard to demographic characteristics and stone related characteristics except the ASA status. Success rates of the supine and prone groups were 85.1 and 87.3%, respectively (p = 0.701). No statistically significant differences in terms of complications were observed. Mean operative time was the only parameter different between the two groups (55 vs 82 min, p = 0.001). Supine position for PNL seems to be promising and the complication and success rates are shown to be similar to the prone position with MPNL technique. The only significant benefit of this technique is shorter operative time.

[Comparison of the anterior corneal asphericity after small incision lenticule extraction and femtosecond laser in situ keratomileusis].

PubMed

Su, X L; Wang, Y; Wu, W J; Wu, Z Q; Wu, Y N; Yu, C J

2016-09-11

To evaluate and compare the anterior corneal asphericity after small incision lenticule extraction(SMILE)and femtosecond laser in situ keratomileusis(FS-LASIK). In this case-control study, 45 subjects who underwent SMILE operation comprised the study group, and 33 subjects with FS-LASIK operation comprised the control group. The asphericity coefficient Q-value of the right eyes in both groups was measured at diameters of 6, 7, 8 and 9 mm, respectively, before surgery and at 1 day, 1 week, 1 month and 6 months following surgery. The correlation between the variation of Q-value and the central cutting depth was analyzed. The Q-value of anterior corneal surface was 0.85 ± 0.31, 0.80±0.28, 0.69±0.25 and 0.51±0.23 after SMILE, and 1.13±0.56, 1.01±0.47, 0.80±0.39 and 0.51±0.31 after FS-LASIK at 1 week. In both groups, the Q-value was significantly different before and after surgery(P< 0.05); there were interaction effects between the operation method and time; the difference between the two groups at 6-mm and 7-mm diameters was statistically significant(P<0.05). The variation of the Q-value before and after operation(ΔQ)showed significant difference(P6mm=0.004, P7mm=0.014)between the two groups at 6-mm and 7-mm diameters. The cap diameter of the SMILE group was smaller than that of the FS-LASIK group, but the cutting depth was larger. There was no correlation between ΔQ and the cap/disc diameter. It showed a linear relationship(P<0.05)between ΔQ and the central cutting depth at all examined diameters in the two groups, and the relation degree in the FS-LASIK group was superior to the SMILE group. Both SMILE and FS-LASIK operations can change the negative Q-value of the anterior corneal surface to the positive. The impact of SMILE on the asphericity is smaller than that of FS-LASIK. (Chin J Ophthalmol, 2016, 52: 681-685).

[Establishment of MDCK-pHaMDR cell model and standard operation procedure for assessing blood-brain barrier permeability of chemical components of traditional Chinese medicine].

PubMed

Yang, Yan-Fang; Wu, Ni; Yang, Xiu-Wei

2016-07-01

To establish MDCK-pHaMDR cell model and standard operation procedure for assessing the blood-brain barrier permeability of chemical components of traditional Chinese medicine. MDCK-pHaMDR cell model was evaluated by determining the morphology features, transepithelial electrical resistance, bidirectional transport and intracellular accumulation of Rhodamine 123 and the apparent permeability of positive control drugs caffeine and atenolol. The MDCK-pHaMDR cell model had satisfactory integrity and tightness, and stable expression of P-gp. In addition, the transport results of the positive control drugs were consistent with the reported values in literature. All the parameters tested of the MDCK-pHaMDR cell model were consistent with the requirements, so the model can be used to study the blood-brain barrier permeability of chemical components of traditional Chinese medicine. Copyright© by the Chinese Pharmaceutical Association.

An improved asynchronous brain interface: making use of the temporal history of the LF-ASD feature vectors

NASA Astrophysics Data System (ADS)

Bashashati, Ali; Mason, Steve; Ward, Rabab K.; Birch, Gary E.

2006-06-01

The low-frequency asynchronous switch design (LF-ASD) has been introduced as a direct brain interface (BI) for asynchronous control applications. Asynchronous interfaces, as opposed to synchronous interfaces, have the advantage of being operational at all times and not only at specific system-defined periods. This paper modifies the LF-ASD design by incorporating into the system more knowledge about the attempted movements. Specifically, the history of feature values extracted from the EEG signal is used to detect a right index finger movement attempt. Using data collected from individuals with high-level spinal cord injuries and able-bodied subjects, it is shown that the error characteristics of the modified design are significantly better than the previous LF-ASD design. The true positive rate percentage increased by up to 15 which corresponds to 50% improvement when the system is operating with false positive rates in the 1-2% range.

Intra-hospital use of a telepathology system.

PubMed

Ongürü, O; Celasun, B

2000-01-01

Utilization of telepathology systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for closer distances does not seem to be widely appreciated. In this study, we present data on the use of a simple telepathology system connecting the pathology department and the intra-operative consultation room within the operating theaters of the hospital. Ninety-eight frozen section cases from a past period have been re-evaluated using a real-time setup. Forty-eight of the cases have been re-evaluated in the customary fashion; allowing both ends to communicate and cooperate freely. Fifty of the cases, however, were evaluated by the consultant while the operating room end behaved like a robot; moving the stage of the microscope, changing and focusing the objectives. The deferral rate was lower than the original frozen section evaluations. Overall, the sensitivity was 100%, specificity 98%, negative predictive value 96, 5% and positive predictive value 100%. No significant difference was found for the diagnostic performances between the cooperative and robotic simulation methods.Our results strengthen the belief that telepathology is a valuable tool in offering pathology services to remote areas. The far side of a hospital building can also be a remote area and a low cost system can be helpful for intraoperative consultations. Educational value of such a system is also commendable.

[Diagnosis of obstructive sleep apnea syndrome using pulse oximeter derived photoplethysmographic signals].

PubMed

Pan, H; Huang, G P; Ren, R; Lei, F; Tang, X D

2016-05-24

To evaluate the diagnosis value of photoplethysmography (PPG)-based device for detecting obstructive sleep apnea syndrome. Patients who visited sleep medicine center in West China hospital from March 2014 to March 2015 with a main complain of snoring were selected into this study, and they were simultaneously monitored with the PPG-based device while undergoing polysomnography (PSG). Using PSG as"gold standard", the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) as well as corresponding areas under the receiver operator curves for an apnea hypopnea index (AHI) ≥5/h, ≥15/h and ≥30/h were calculated for PPG. Valid results were available for 93 subjects, among them there were 64 men and 29 women with a mean age of (44±13) years old.There were no significant difference between total sleep time, wake time after sleep onset, AHI and oxygen saturation derived by PPG and PSG.Positive correlation was found between PPG-derived and PSG-derived AHI (r=0.945). For AHI≥5/h, ≥15/h and ≥30/h respectively according PSG, sensitivity was 93%, 88%, 92%, specificity was 79%, 93%, 95%, PPV was 95%, 97%, 96%, NPV 75%, 76%, 91% for PPG. The corresponding areas under the receiver operator characteristic curves were 0.981, 0.996 and 0.995 respectively. PPG-derived data is consistent with simultaneous in-lab PSG in the diagnosis of obstructive sleep apnea syndrome.

Differentiation of benign from malignant liver masses with Acoustic Radiation Force Impulse technique.

PubMed

Yu, Hojun; Wilson, Stephanie R

2011-12-01

The objective of the study was to determine the performance of Acoustic Radiation Force Impulse (ARFI) imaging to differentiate benign from malignant liver masses, both of hepatocellular origin and metastases, by quantification of their stiffness. This study has institutional review board approval and informed consent. Eighty-nine patients (42 female and 47 male patients) with 105 liver masses had ARFI evaluation on ultrasound, S2000 (Siemens, Mountain View, Calif). Mean age of the patients was 53.67 years (range, 27-83 years). Mean diameter of the masses was 2.77 cm (range, 1.0-13.0 cm). Final diagnoses, confirmed by imaging on contrast-enhanced computed tomography, magnetic resonance, or ultrasound or biopsy, include hepatocellular carcinoma (n = 28), metastasis (n = 13), hemangioma (n = 35), focal nodular hyperplasia (n = 15), focal fat sparing (n = 8), focal fat deposit (n = 4), and adenoma (n = 2). Receiver operating characteristic analysis was performed to evaluate the diagnostic accuracy of the ARFI measurement and to extract the optimal cutoff values in the differentiation of benign from malignant disease. Acoustic Radiation Force Impulse values showed a statistically significant difference between benign (1.73 [SD, 0.8] m/sec) and malignant masses (2.57 [SD, 1.01] m/sec) (P < 0.001). However, the area under the receiver operating characteristic curve was 0.744, suggesting only fair accuracy. For differentiation of malignant from benign masses, the sensitivity, specificity, positive predictive value, and negative predictive value were 68% (28/41), 69% (44/64), 58% (28/48), and 77% (44/57), respectively, when 1.9 m/sec was chosen as a cutoff value, reflective of a wide variation of ARFI values in each diagnosis. For differentiation of metastasis from benign masses, sensitivity, specificity, positive predictive value, and NPV were 69% (9/13), 89% (57/64), 56% (9/16), and 93% (57/61), respectively, when 2.72 m/sec was chosen as a cutoff value. Acoustic Radiation Force Impulse measurement may be helpful to differentiate benign masses from metastases, in particular. Otherwise, ARFI measurements alone do not differentiate benign and malignant masses because of variations in stiffness of all types of masses.

Detection of breast cancer metastasis in sentinel lymph nodes using intra-operative real time GeneSearch BLN Assay in the operating room: results of the Cardiff study.

PubMed

Mansel, Robert E; Goyal, Amit; Douglas-Jones, Anthony; Woods, Victoria; Goyal, Sumit; Monypenny, Ian; Sweetland, Helen; Newcombe, Robert G; Jasani, Bharat

2009-06-01

Intra-operative assessment is not routinely performed in the UK due to poor sensitivity of available methods and overburdened pathology resources. We conducted a prospective clinical feasibility study of the GeneSearch Breast Lymph Node (BLN) Assay (Veridex, LLC, Warren, NJ) to confirm its potential usefulness within the UK healthcare system. In the assay 50% of the lymph node was processed to detect the presence of cytokeratin-19 and mammaglobin mRNA. The assay was calibrated to detect metastases >0.2 mm. Assay results were compared to H&E performed on each face of approximately 2 mm alternating node slabs and 3 additional sections cut at approximately 150 microm interval from each face of the node slab. 124 sentinel lymph nodes were removed from 82 breast cancer patients. The assay correctly identified all 6 patients with sentinel node macrometastases (>2.0 mm), and 2 of 3 patients with sentinel node micrometastases (0.2-2.0 mm). Sentinel lymph nodes in 4 patients were assay positive but histology negative. Two of these four patients had isolated tumor cells seen by histology. The overall concordance with histology was 93.9% (77/82), with sensitivity of 88.9% (8/9, 95% CI 56.5-98%), specificity of 94.6% (69/73, 95% CI 86.7-97.8%), positive predictive value of 66.7% (8/12, 95% CI 39.1-86.2%) and negative predictive value of 98.6% (69/70, 95% CI 92.3-99.7%). The assay was performed in a median time of 32 min (range 26-69 min). Intra-operative assessment of sentinel lymph node can be performed rapidly and accurately using the GeneSearch BLN Assay.

PHYSICAL EXAMINATIONS FOR DIAGNOSING MENISCAL INJURIES: CORRELATION WITH SURGICAL FINDINGS

PubMed Central

Gobbo, Ricardo da Rocha; Rangel, Victor de Oliveira; Karam, Francisco Consoli; Pires, Luiz Antônio Simões

2015-01-01

Objective: A set of five maneuvers for meniscal injuries (McMurray, Apley, Childress and Steinmann 1 and 2) was evaluated and their sensitivity, specificity, accuracy and likelihood were calculated. The same methods were applied to each test individually. Methods: One hundred and fifty-two patients of both sexes who were going to undergo videoarthroscopy on the knee were examined blindly by one of five residents at this hospital, without knowledge of the clinical data and why the patient was going to undergo an operation. This examination was conducted immediately before the videoarthroscopy and its results were recorded in an electronic spreadsheet. The set of maneuvers was considered positive when one was positive. In the individual analysis, it was enough for the test to be positive. Results: The analysis showed that the set of five meniscal tests presented sensitivity of 89%, specificity of 42%, accuracy of 75%, positive likelihood of 1.53 and negative likelihood of 0.26. Individually, the tests presented accuracy of between 48% and 53%. Conclusion: The set of maneuvers for meniscal injuries presented a good accuracy and significant value, especially for ruling out injury. Individually, the tests had less diagnostic value, although the Apley test had better specificity. PMID:27047833

Structural positioning of nurse leaders and empowerment.

PubMed

Hughes, Kerri-Ann; Carryer, Jennifer Barbara; White, Jill

2015-08-01

To analyse the reporting structures of nursing leaders of publicly funded hospitals and seek both the views of nurse leaders and Chief Executive Officers/Chief Operating Officers on the structural positioning of nurse leaders in the organisation. Concern that the continuing restructuring within hospital structures and focus on economic outputs in health services is diminishing the value of nursing leadership. Qualitative surveys with Nursing leaders and Chief Executive Officers of public hospitals. Seventeen Directors of Nursing and 10 Chief Executive Officer/Chief Operating Officers' responses were received using two semi-structured questionnaires. Themes were developed from data coded and analysed by hand. Four broad themes emerged from analysis of the data: (1) variable positional reporting between Director of Nursing and Chief Executive Officers occurred; (2) variable levels of inclusion and influence at the executive decision-making level; (3) ambiguous financial responsibilities and accountabilities held by Director of Nursing; and (4) blurred lines existed between operational and professional reporting lines. Findings unique to the research indicate that the varying levels of visibility and inclusion impact on the structural positioning of nurse leaders which influences authority and empowerment. Responses from the data analysis indicate that the structural power of nurse leaders defined by the factors of opportunity, power and proportion were hindered by dual accountability reporting lines and a lack of financial control. The structural positioning of nurse leaders is vital to ensure that they are empowered and able to meet the adaptations required in a changing environment that supports the delivery of effective, quality healthcare. © 2015 John Wiley & Sons Ltd.

Building an ethical organizational culture.

PubMed

Nelson, William A; Taylor, Emily; Walsh, Thom

2014-01-01

The success of a health care institution-as defined by delivering high-quality, high-value care, positive patient outcomes, and financial solvency-is inextricably tied to the culture within that organization. The ability to achieve and sustain alignment between its mission, values, and everyday practices defines a positive organizational culture. An institution that has a diminished organizational culture, reflected in the failure to consistently align management and clinical decisions and practices with its mission and values, will struggle. The presence of misalignment or of ethics gaps affects the quality of care being delivered, the morale of the staff, and the organization's image in the community. Transforming an organizational culture will provide a foundation for success and a framework for daily ethics-grounded operations in any organization. However, building an ethics-grounded organization is a challenging process requiring strong organization leadership and planning. Using a case study, the authors provide a multiyear, continuous step-by-step strategy consisting of identifying ethics culture gaps, establishing an ethics taskforce, clarifying and prioritizing the problems, developing strategy for change, implementing the strategy, and evaluating outcomes. This process will assist organizations in aligning its actions with its mission and values, to find success on all fronts.

LMS tables for waist circumference and waist–height ratio in Colombian adults: analysis of nationwide data 2010

PubMed Central

Ramírez-Vélez, R; Correa-Bautista, J E; Martínez-Torres, J; Méneses-Echavez, J F; González-Ruiz, K; González-Jiménez, E; Schmidt-RioValle, J; Lobelo, F

2016-01-01

Background/Objectives: Indices predictive of central obesity include waist circumference (WC) and waist-to-height ratio (WHtR). These data are lacking for Colombian adults. This study aims at establishing smoothed centile charts and LMS tables for WC and WHtR; appropriate cutoffs were selected using receiver-operating characteristic analysis based on data from the representative sample. Subjects/Methods: We used data from the cross-sectional, national representative nutrition survey (ENSIN, 2010). A total of 83 220 participants (aged 20–64) were enroled. Weight, height, body mass index (BMI), WC and WHtR were measured and percentiles calculated using the LMS method (L (curve Box-Cox), M (curve median), and S (curve coefficient of variation)). Receiver operating characteristics curve analyses were used to evaluate the optimal cutoff point of WC and WHtR for overweight and obesity based on WHO definitions. Results: Reference values for WC and WHtR are presented. Mean WC and WHtR increased with age for both genders. We found a strong positive correlation between WC and BMI (r=0.847, P< 0.01) and WHtR and BMI (r=0.878, P<0.01). In obese men, the cutoff point value is 96.6 cm for the WC. In women, the cutoff point value is 91.0 cm for the WC. Receiver operating characteristic curve for WHtR was also obtained and the cutoff point value of 0.579 in men, and in women the cutoff point value was 0.587. A high sensitivity and specificity were obtained. Conclusions: This study presents first reference values of WC and WHtR for Colombians aged 20–64. Through LMS tables for adults, we hope to provide quantitative tools to study obesity and its complications. PMID:27026425

Behavior of the Position-Spread Tensor in Diatomic Systems.

PubMed

Brea, Oriana; El Khatib, Muammar; Angeli, Celestino; Bendazzoli, Gian Luigi; Evangelisti, Stefano; Leininger, Thierry

2013-12-10

The behavior of the Position-Spread Tensor (Λ) in a series of light diatomic molecules (either neutral or negative ions) is investigated at a Full Configuration Interaction level. This tensor, which is the second moment cumulant of the total position operator, is invariant with respect to molecular translations, while its trace is also rotationally invariant. Moreover, the tensor is additive in the case of noninteracting subsystems and can be seen as an intrinsic property of a molecule. In the present work, it is shown that the longitudinal component of the tensor, Λ∥, which is small for internuclear distances close to the equilibrium, tends to grow if the bond is stretched. A maximum is reached in the region of the bond breaking, then Λ∥ decreases and converges toward the isolated-atom value. The degenerate transversal components, Λ⊥, on the other hand, usually have a monotonic growth toward the atomic value. The Position Spread is extremely sensitive to reorganization of the molecular wave function, and it becomes larger in the case of an increase of the electron mobility, as illustrated by the neutral-ionic avoided crossing in LiF. For these reasons, the Position Spread can be an extremely useful property that characterizes the nature of the wave function in a molecular system.

The Feline Josephus Problem

NASA Astrophysics Data System (ADS)

Ruskey, Frank; Williams, Aaron

In the classic Josephus problem, elements 1, 2,...,n are placed in order around a circle and a skip value k is chosen. The problem proceeds in n rounds, where each round consists of traveling around the circle from the current position, and selecting the kth remaining element to be eliminated from the circle. After n rounds, every element is eliminated. Special attention is given to the last surviving element, denote it by j. We generalize this popular problem by introducing a uniform number of lives ℓ, so that elements are not eliminated until they have been selected for the ℓth time. We prove two main results: 1) When n and k are fixed, then j is constant for all values of ℓ larger than the nth Fibonacci number. In other words, the last surviving element stabilizes with respect to increasing the number of lives. 2) When n and j are fixed, then there exists a value of k that allows j to be the last survivor simultaneously for all values of ℓ. In other words, certain skip values ensure that a given position is the last survivor, regardless of the number of lives. For the first result we give an algorithm for determining j (and the entire sequence of selections) that uses O(n 2) arithmetic operations.

Using APV (adjusted present value): a better tool for valuing operations.

PubMed

Luehrman, T A

1997-01-01

Anyone who learned valuation techniques more than a few years ago is probably due for a refresher course. For the past 25 years, managers have been taught that the best practice for valuing assets-that is, an existing business, factory, product line, or market position-is to use a discounted-cash-flow (DCF) methodology. That is still true. But the particular version of DCF that has been accepted as the standard-using the weighted-average cost of capital (WACC)-is now obsolete. Today's better alternative, adjusted present value (APV), is especially versatile and reliable. It will likely replace WACC as the DCF methodology of choice among generalists. Like WACC, APV is used to value operations, or assets-in-place-that is, any existing asset that will generate a stream of future cash flows. Timothy Luehrman explains APV and walks readers through a case example designed to teach them how to use it. He argues that APV always works when WACC does-and sometimes when WACC doesn't, because it requires fewer restrictive assumptions. And APV is less prone to yield serious errors than WACC is. But, most important, general managers will find that APV's power lies in the managerially relevant information it provides. APV can help managers analyze not only how much an asset is worth but also where the value comes from.

Fusion of Positive Energy Representations of LSpin(2n)

NASA Astrophysics Data System (ADS)

Toledano-Laredo, V.

2004-09-01

Building upon the Jones-Wassermann program of studying Conformal Field Theory using operator algebraic tools, and the work of A. Wassermann on the loop group of LSU(n) (Invent. Math. 133 (1998), 467-538), we give a solution to the problem of fusion for the loop group of Spin(2n). Our approach relies on the use of A. Connes' tensor product of bimodules over a von Neumann algebra to define a multiplicative operation (Connes fusion) on the (integrable) positive energy representations of a given level. The notion of bimodules arises by restricting these representations to loops with support contained in an interval I of the circle or its complement. We study the corresponding Grothendieck ring and show that fusion with the vector representation is given by the Verlinde rules. The computation rests on 1) the solution of a 6-parameter family of Knizhnik-Zamolodchikhov equations and the determination of its monodromy, 2) the explicit construction of the primary fields of the theory, which allows to prove that they define operator-valued distributions and 3) the algebraic theory of superselection sectors developed by Doplicher-Haag-Roberts.

On the possibility of connecting a non-operating main circulation pump with three pumps in operation without preliminary coast-down of power-generating unit No. 5 in the Novovoronezh nuclear power plant

NASA Astrophysics Data System (ADS)

Vitkovskii, I. L.; Nikonov, S. P.; Ryasnyi, S. I.

2014-02-01

The subject of this paper is a transient caused by connection of a standby loop to three operating circulation pumps at the initial reactor heat rate equal to 70% of the rated value without preliminarily reducing it to 30% of the rated level as required by the safe operation regulations. Failure of the following normal operation systems is supposed: the first- and the second-type warning protection systems, all quick-acting reducing devices releasing steam into the auxiliary manifold, the electric heaters of the pressurizer, the pressurizer injection system, the primary cooling circuit fluid makeup/blow-through systems, and the blocking systems to shut down the main circulation pump after the level in the steam generator is exceeded. In addition, it is supposed that, under transient conditions, the valves of the turbine regulation system will be in the position in which they were at the moment of the initial event until generation of the signal for positive closing of the turbine stop valves. The first signal to actuate the reactor emergency protection system (EPS) is skipped. The failure of all quick-acting reducing devices releasing steam into the atmosphere is assumed. In addition to equipment failure, at the moment when the main circulation pump is connected, the operator erroneously puts in a new setting to maintain the power allowable for four pumps in operation-in the calculations it was taken equal to 104% of the rated level at most considering the accuracy of evaluating and maintaining the reactor heat rate-and the working group of the reactor protection and control system (P&CS) starts moving upward. On reaching the set power level, the automatic reactor power regulator stops operating and the P&CS elements remain in the position in which they are at the moment. Compliance with the design safety criteria for the adopted scenario of the transient is demonstrated.

Mechanism of bandwidth improvement in passively cooled SMA position actuators

NASA Astrophysics Data System (ADS)

Gorbet, R. B.; Morris, K. A.; Chau, R. C. C.

2009-09-01

The heating of shape memory alloy (SMA) materials leads to a thermally driven phase change which can be used to do work. An SMA wire can be thermally cycled by controlling electric current through the wire, creating an electro-mechanical actuator. Such actuators are typically heated electrically and cooled through convection. The thermal time constants and lack of active cooling limit the operating frequencies. In this work, the bandwidth of a still-air-cooled SMA wire controlled with a PID controller is improved through optimization of the controller gains. Results confirm that optimization can improve the ability of the actuator to operate at a given frequency. Overshoot is observed in the optimal controllers at low frequencies. This is a result of hysteresis in the wire's contraction-temperature characteristic, since different input temperatures can achieve the same output value. The optimal controllers generate overshoot during heating, in order to cause the system to operate at a point on the hysteresis curve where faster cooling can be achieved. The optimization results in a controller which effectively takes advantage of the multi-valued nature of the hysteresis to improve performance.

Introducing a teaching module to impart communication skills in the learning anaesthesiologists

PubMed Central

Gadre, Vaijayanti Nitin; Kelkar, Kalpana V; Kelkar, Vidya S; Jamkar, Maya A

2015-01-01

Background and Aims: Pre-operative negative valence communications adversely affect intra and post-operative pain experience. This study was conducted to evaluate the teaching of communication skills by teachers in anaesthesia department and whether the post-operative pain is effectively modified due to the skill of communication acquired by students. Methods: All students and teachers in the department participated in the study. Patients with uncomplicated pregnancy posted for elective lower segment caesarean section were involved. Students were taught to explain the anaesthesia plan pre-operatively to the patients in a positive manner. They were taught the practice of giving positive suggestions before any potentially painful stimulus. Pre-operatively all students informed the patients about the conduct of spinal anaesthesia. The teachers evaluated the students performing spinal block. The performance was rated for procedural and interpersonal skills (direct observation of procedural skills [DOPS] and Smith and Kendall Behavioural scale [SKBS] respectively). The extent of cooperation and the ease with which spinal block could be administered correctly by the student was judged by the teacher. Post-operatively students were randomly provided questionnaires to elicit answers from patients. Results: P value DOPS and SKBS (0.567, 0.867) show no significant statistical variation. P > 0.05 = not significant, indicates no significant variation in procedural and behavioural skills of students in two groups. Conclusion: Teaching of communication skills to students showed a demonstrable effect on their pre-operative dialogue with patients. Pain mechanism was effectively modulated by improving patients’ psychology to undergo anaesthesia. PMID:26195834

[Comparison of perforated metal ceiling systems (supported airflow ceilings) with laminar airflow ceilings in type A (DIN 1946 T.4) operating rooms under surgical conditions].

PubMed

Bischoff, W E; Kindermann, A; Sander, U; Sander, J

1995-10-01

In eleven centrally ventilated operating theatres the concentration of particles and airborne germs in wound vicinity was measured on three workdays. Five theatres were equipped with air supply ceilings with supporting flow outlets (supporting flow ceilings), five with laminar air flow ceilings and one with an air supply ceiling, a body exhaust system and a partition wall between the anesthetic and operating areas. Under routine conditions the air supply of the laminar air flow ceiling with its lower turbulence shielded the operating field from the largely staff-related air contamination in the rest of the theatre better than in the case of the supporting flow ceilings. Particles and airborne germs were removed from the endangered wound area faster. A spatial separation between the anesthetic and the operating areas as well as a body exhaust system lead to a considerable reduction of the contamination. Two theatres were conspicuous by reason of their considerably raised values due to defective control engineering and the wrongly positioning of the operating table. From the point of view of ventilation technique the laminar air flow ceilings with lower turbulence are superior to air supply ceilings with supporting flow outlets in the working day of an operating theatre. In order to minimize the influence of the staff, which up till now has been neglected in testing specifications, constructional possibilities such as the size of ceiling, the partitioning off of operating and anaesthetic areas and the positioning of the operating table in relation to the incoming air should be coordinated rationally. Taking measurements regularly during operations can provide the impulse for considerable improvements in both operational and planning phases.

Evaluating the predictive accuracy and the clinical benefit of a nomogram aimed to predict survival in node-positive prostate cancer patients: External validation on a multi-institutional database.

PubMed

Bianchi, Lorenzo; Schiavina, Riccardo; Borghesi, Marco; Bianchi, Federico Mineo; Briganti, Alberto; Carini, Marco; Terrone, Carlo; Mottrie, Alex; Gacci, Mauro; Gontero, Paolo; Imbimbo, Ciro; Marchioro, Giansilvio; Milanese, Giulio; Mirone, Vincenzo; Montorsi, Francesco; Morgia, Giuseppe; Novara, Giacomo; Porreca, Angelo; Volpe, Alessandro; Brunocilla, Eugenio

2018-04-06

To assess the predictive accuracy and the clinical value of a recent nomogram predicting cancer-specific mortality-free survival after surgery in pN1 prostate cancer patients through an external validation. We evaluated 518 prostate cancer patients treated with radical prostatectomy and pelvic lymph node dissection with evidence of nodal metastases at final pathology, at 10 tertiary centers. External validation was carried out using regression coefficients of the previously published nomogram. The performance characteristics of the model were assessed by quantifying predictive accuracy, according to the area under the curve in the receiver operating characteristic curve and model calibration. Furthermore, we systematically analyzed the specificity, sensitivity, positive predictive value and negative predictive value for each nomogram-derived probability cut-off. Finally, we implemented decision curve analysis, in order to quantify the nomogram's clinical value in routine practice. External validation showed inferior predictive accuracy as referred to in the internal validation (65.8% vs 83.3%, respectively). The discrimination (area under the curve) of the multivariable model was 66.7% (95% CI 60.1-73.0%) by testing with receiver operating characteristic curve analysis. The calibration plot showed an overestimation throughout the range of predicted cancer-specific mortality-free survival rates probabilities. However, in decision curve analysis, the nomogram's use showed a net benefit when compared with the scenarios of treating all patients or none. In an external setting, the nomogram showed inferior predictive accuracy and suboptimal calibration characteristics as compared to that reported in the original population. However, decision curve analysis showed a clinical net benefit, suggesting a clinical implication to correctly manage pN1 prostate cancer patients after surgery. © 2018 The Japanese Urological Association.

Feasibility of α-fetoprotein as a diagnostic tool for hepatocellular carcinoma in Korea

PubMed Central

Ahn, Dae Geon; Kim, Hyung Joon; Kang, Hyun; Lee, Hyun Woong; Bae, Si Hyun; Lee, Joon Hyoek; Paik, Yong Han; Lee, June Sung

2016-01-01

Background/Aims: The aim of this study was to evaluate the feasibility of α-fetoprotein (AFP) as a diagnostic tool for hepatocellular carcinoma (HCC) in Korean patients. Methods: We retrospectively reviewed the medical records of HCC and cirrhosis patients at three hospitals. For each HCC patient, a cirrhosis patient matched for age, sex, etiology, and Child-Pugh classification was selected by simple random sampling. The performance of AFP in the diagnosis of HCC was determined using receiver operating characteristic curve analysis. Results: A total of 732 patients with HCC or cirrhosis were selected for each case and the control groups. The mean age was 54 years, and 72.4% of patients were male. The mean serum AFP levels in the HCC group and cirrhosis group were 3,315.6 and 117.2 ng/mL, respectively (p < 0.001). The area under the receiver operating characteristic curve for all HCC patients was 0.757. The sensitivity, specificity, and positive predictive value of AFP was 50.55%, 87.70%, and 80.43%, respectively, at a cut-off of 20 ng/mL; 37.70%, 95.90%, and 90.20%, respectively, at a cut-off of 100 ng/mL, and 30.05%, 97.27%, and 91.67%, respectively, at a cut-off of 200 ng/mL. A cut-off of 100 ng/mL was more sensitive than one of 200 ng/mL with equivalent specificity and positive predictive value. Conclusions: The cut-off AFP value for early-stage HCC was 17.4 ng/mL. Our study cautiously suggests that AFP has a role in the diagnosis of HCC, and that the appropriate value of AFP for the diagnosis of HCC may be 100 ng/mL rather than 200 ng/mL. PMID:26767857

Feasibility of α-fetoprotein as a diagnostic tool for hepatocellular carcinoma in Korea.

PubMed

Ahn, Dae Geon; Kim, Hyung Joon; Kang, Hyun; Lee, Hyun Woong; Bae, Si Hyun; Lee, Joon Hyoek; Paik, Yong Han; Lee, June Sung

2016-01-01

The aim of this study was to evaluate the feasibility of α-fetoprotein (AFP) as a diagnostic tool for hepatocellular carcinoma (HCC) in Korean patients. We retrospectively reviewed the medical records of HCC and cirrhosis patients at three hospitals. For each HCC patient, a cirrhosis patient matched for age, sex, etiology, and Child-Pugh classification was selected by simple random sampling. The performance of AFP in the diagnosis of HCC was determined using receiver operating characteristic curve analysis. A total of 732 patients with HCC or cirrhosis were selected for each case and the control groups. The mean age was 54 years, and 72.4% of patients were male. The mean serum AFP levels in the HCC group and cirrhosis group were 3,315.6 and 117.2 ng/mL, respectively (p < 0.001). The area under the receiver operating characteristic curve for all HCC patients was 0.757. The sensitivity, specificity, and positive predictive value of AFP was 50.55%, 87.70%, and 80.43%, respectively, at a cut-off of 20 ng/mL; 37.70%, 95.90%, and 90.20%, respectively, at a cut-off of 100 ng/mL, and 30.05%, 97.27%, and 91.67%, respectively, at a cut-off of 200 ng/mL. A cut-off of 100 ng/mL was more sensitive than one of 200 ng/mL with equivalent specificity and positive predictive value. The cut-off AFP value for early-stage HCC was 17.4 ng/mL. Our study cautiously suggests that AFP has a role in the diagnosis of HCC, and that the appropriate value of AFP for the diagnosis of HCC may be 100 ng/mL rather than 200 ng/mL.

Value of water-soluble contrast (meglumine amidotrizoate) in the diagnosis and management of small bowel obstruction.

PubMed

Al Salamah, Saleh Moh'd Al; Fahim, Fraz; Mirza, Shaukat Mahmood

2006-07-01

The object of the present study was to determine the effectiveness of a water-soluble contrast follow-through study for differentiating complete from incomplete small bowel obstruction (SBO) and for predicting the need for surgery. This prospective study was conducted at Riyadh Medical Complex, Saudi Arabia and spanned 2 years. All adult patients admitted with SBO were included, except those with obstructed hernias, peritonitis, or postabdominal irradiation. The initial resuscitation meglumine amidotrizoate (Gastrografin) follow-though was performed and was considered positive for complete obstruction if the contrast failed to reach the colon as shown on the 24-hour film. Patients were operated on only if they developed signs of strangulation or failed to improve within 48 hours. Our study group consisted of 73 patients, 48 (65.7%) of whom were male. The mean age was 35.70+/-12.65 years. In 60 (82.2%) patients, contrast reached the ascending colon within 24 hours, giving a definitive diagnosis of incomplete obstruction; among these 60 cases, 49 (81.7%) resolved on conservative management. The other 13 (17.8%) patients were diagnosed as having a complete obstruction; 4 (30.8%) of them were treated conservatively, and 9 (69.2%) underwent surgery. Therefore the sensitivity, specificity, positive predictive value, and negative predictive value for meglumine amidotrizoate follow-through as an indicator for operative treatment of SBO were 45.0, 92.5, 81.7, and 69.2, respectively. The P value using Fisher's exact test was 0.0006. We can confidently diagnose complete and incomplete SBO and differentiate one from the other. This accurate diagnosis indicates a high chance of success with conservative management for incomplete obstruction but does not always correlate with the need for surgical intervention.

Mortality risk prediction in burn injury: Comparison of logistic regression with machine learning approaches.

PubMed

Stylianou, Neophytos; Akbarov, Artur; Kontopantelis, Evangelos; Buchan, Iain; Dunn, Ken W

2015-08-01

Predicting mortality from burn injury has traditionally employed logistic regression models. Alternative machine learning methods have been introduced in some areas of clinical prediction as the necessary software and computational facilities have become accessible. Here we compare logistic regression and machine learning predictions of mortality from burn. An established logistic mortality model was compared to machine learning methods (artificial neural network, support vector machine, random forests and naïve Bayes) using a population-based (England & Wales) case-cohort registry. Predictive evaluation used: area under the receiver operating characteristic curve; sensitivity; specificity; positive predictive value and Youden's index. All methods had comparable discriminatory abilities, similar sensitivities, specificities and positive predictive values. Although some machine learning methods performed marginally better than logistic regression the differences were seldom statistically significant and clinically insubstantial. Random forests were marginally better for high positive predictive value and reasonable sensitivity. Neural networks yielded slightly better prediction overall. Logistic regression gives an optimal mix of performance and interpretability. The established logistic regression model of burn mortality performs well against more complex alternatives. Clinical prediction with a small set of strong, stable, independent predictors is unlikely to gain much from machine learning outside specialist research contexts. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

A position-dependent mass harmonic oscillator and deformed space

NASA Astrophysics Data System (ADS)

da Costa, Bruno G.; Borges, Ernesto P.

2018-04-01

We consider canonically conjugated generalized space and linear momentum operators x^ q and p^ q in quantum mechanics, associated with a generalized translation operator which produces infinitesimal deformed displacements controlled by a deformation parameter q. A canonical transformation (x ^ ,p ^ ) →(x^ q,p^ q ) leads the Hamiltonian of a position-dependent mass particle in usual space to another Hamiltonian of a particle with constant mass in a conservative force field of the deformed space. The equation of motion for the classical phase space (x, p) may be expressed in terms of the deformed (dual) q-derivative. We revisit the problem of a q-deformed oscillator in both classical and quantum formalisms. Particularly, this canonical transformation leads a particle with position-dependent mass in a harmonic potential to a particle with constant mass in a Morse potential. The trajectories in phase spaces (x, p) and (xq, pq) are analyzed for different values of the deformation parameter. Finally, we compare the results of the problem in classical and quantum formalisms through the principle of correspondence and the WKB approximation.

A systematic study on the effect of electron beam irradiation on structural, electrical, thermo-electric power and magnetic property of LaCoO3

NASA Astrophysics Data System (ADS)

Benedict, Christopher J.; Rao, Ashok; Sanjeev, Ganesh; Okram, G. S.; Babu, P. D.

2016-01-01

In this communication, the effect of electron beam irradiation on the structural, electrical, thermo-electric power and magnetic properties of LaCoO3 cobaltites have been investigated. Rietveld refinement of XRD data reveals that all samples are single phased with rhombohedral structure. Increase in electrical resistivity data is observed with increase in dosage of electron beam irradiation. Analysis of the measured electrical resistivity data indicates that the small polaron hopping model is operative in the high temperature regime for all samples. The Seebeck coefficient (S) of the pristine and the irradiated samples exhibits a crossover from positive to negative values, and a colossal value of Seebeck coefficient (32.65 mV/K) is obtained for pristine sample, however, the value of S decreases with increase in dosage of irradiation. The analysis of Seebeck coefficient data confirms that the small polaron hopping model is operative in the high temperature region. The magnetization results give clear evidence of increase in effective magnetic moment due to increase in dosage of electron beam irradiation.

Realization of station for testing asynchronous three-phase motors

NASA Astrophysics Data System (ADS)

Wróbel, A.; Surma, W.

2016-08-01

Nowadays, you cannot imagine the construction and operation of machines without the use of electric motors [13-15]. The proposed position is designed to allow testing of asynchronous three-phase motors. The position consists of a tested engine and the engine running as a load, both engines combined with a mechanical clutch [2]. The value of the load is recorded by measuring shaft created with Strain Gauge Bridge. This concept will allow to study the basic parameters of the engines, visualization motor parameters both vector and scalar controlled, during varying load drive system. In addition, registration during the variable physical parameters of the working electric motor, controlled by a frequency converter or controlled by a contactor will be possible. Position is designed as a teaching and research position to characterize the engines. It will be also possible selection of inverter parameters.

Miniature Dual-Corona Ionizer for Bipolar Charging of Aerosol

PubMed Central

Qi, Chaolong; Kulkarni, Pramod

2015-01-01

A corona-based bipolar charger has been developed for use in compact, field-portable mobility size spectrometers. The charger employs an aerosol flow cavity exposed to two corona ionizers producing ions of opposite polarity. Each corona ionizer houses two electrodes in parallel needle-mesh configuration and is operated at the same magnitude of corona current. Experimental measurement of detailed charge distribution of near-monodisperse particles of different diameter in the submicrometer size range showed that the charger is capable of producing well-defined, consistent bipolar charge distributions for flow rates up to 1.5 L/min and aerosol concentration up to 107 per cm3. For particles with preexisting charge of +1, 0, and −1, the measured charge distributions agreed well with the theoretical distributions within the range of experimental and theoretical uncertainties. The transmission efficiency of the charger was measured to be 80% for 10 nm particles (at 0.3 L/min and 5 μA corona current) and increased with increasing diameter beyond this size. Measurement of uncharged fractions at various combinations of positive and negative corona currents showed the charger performance to be insensitive to fluctuations in corona current. Ion concentrations under positive and negative unipolar operation were estimated to be 8.2 × 107 and 3.37 × 108 cm−3 for positive and negative ions; the n·t product value under positive corona operation was independently estimated to be 8.5 × 105 s/cm3. The ion concentration estimates indicate the charger to be capable of “neutralizing” typical atmospheric and industrial aerosols in most measurement applications. The miniature size, simple and robust operation makes the charger suitable for portable mobility spectrometers. PMID:26512158

Miniature Dual-Corona Ionizer for Bipolar Charging of Aerosol.

PubMed

Qi, Chaolong; Kulkarni, Pramod

2013-01-01

A corona-based bipolar charger has been developed for use in compact, field-portable mobility size spectrometers. The charger employs an aerosol flow cavity exposed to two corona ionizers producing ions of opposite polarity. Each corona ionizer houses two electrodes in parallel needle-mesh configuration and is operated at the same magnitude of corona current. Experimental measurement of detailed charge distribution of near-monodisperse particles of different diameter in the submicrometer size range showed that the charger is capable of producing well-defined, consistent bipolar charge distributions for flow rates up to 1.5 L/min and aerosol concentration up to 10 7 per cm 3 . For particles with preexisting charge of +1, 0, and -1, the measured charge distributions agreed well with the theoretical distributions within the range of experimental and theoretical uncertainties. The transmission efficiency of the charger was measured to be 80% for 10 nm particles (at 0.3 L/min and 5 μ A corona current) and increased with increasing diameter beyond this size. Measurement of uncharged fractions at various combinations of positive and negative corona currents showed the charger performance to be insensitive to fluctuations in corona current. Ion concentrations under positive and negative unipolar operation were estimated to be 8.2 × 10 7 and 3.37 × 10 8 cm -3 for positive and negative ions; the n · t product value under positive corona operation was independently estimated to be 8.5 × 10 5 s/cm 3 . The ion concentration estimates indicate the charger to be capable of "neutralizing" typical atmospheric and industrial aerosols in most measurement applications. The miniature size, simple and robust operation makes the charger suitable for portable mobility spectrometers.

Accuracy of two digital implant impression systems based on confocal microscopy with variations in customized software and clinical parameters.

PubMed

Giménez, Beatriz; Pradíes, Guillermo; Martínez-Rus, Francisco; Özcan, Mutlu

2015-01-01

To evaluate the accuracy of two digital impression systems based on the same technology but different postprocessing correction modes of customized software, with consideration of several clinical parameters. A maxillary master model with six implants located in the second molar, second premolar, and lateral incisor positions was fitted with six cylindrical scan bodies. Scan bodies were placed at different angulations or depths apical to the gingiva. Two experienced and two inexperienced operators performed scans with either 3D Progress (MHT) or ZFX Intrascan (Zimmer Dental). Five different distances between implants (scan bodies) were measured, yielding five data points per impression and 100 per impression system. Measurements made with a high-accuracy three-dimensional coordinate measuring machine (CMM) of the master model acted as the true values. The values obtained from the digital impressions were subtracted from the CMM values to identify the deviations. The differences between experienced and inexperienced operators and implant angulation and depth were compared statistically. Experience of the operator, implant angulation, and implant depth were not associated with significant differences in deviation from the true values with both 3D Progress and ZFX Intrascan. Accuracy in the first scanned quadrant was significantly better with 3D Progress, but ZFX Intrascan presented better accuracy in the full arch. Neither of the two systems tested would be suitable for digital impression of multiple-implant prostheses. Because of the errors, further development of both systems is required.

DoD Program for Stability of Civilian Employment

DTIC Science & Technology

1990-02-01

Custom House - 2nd & Chestnut Streets AC 215, 597-4736 Army ATTN: CENAD-PE-P Philadelphia, PA 19106-2991 NUMBER OF CIVILIAN POSITIONS: 500 TWX ADDRESS...soldier and family, and a valued relationship with the civilian community. U. S. Army Engineer District, New Orleans Priority Placement Officer 405A P.O...property disposal operations worldwide including reutilization of serviceable assets in support of the military services and other authorized customers

Computer Storage and Retrieval of Position - Dependent Data.

DTIC Science & Technology

1982-06-01

This thesis covers the design of a new digital database system to replace the merged (observation and geographic location) record, one file per cruise...68 "The Digital Data Library System: Library Storage and Retrieval of Digital Geophysical Data" by Robert C. Groan) provided a relatively simple...dependent, ’geophysical’ data. The system is operational on a Digital Equipment Corporation VAX-11/780 computer. Values of measured and computed

Leishmania Infection: Laboratory Diagnosing in the Absence of a “Gold Standard”

PubMed Central

Rodríguez-Cortés, Alhelí; Ojeda, Ana; Francino, Olga; López-Fuertes, Laura; Timón, Marcos; Alberola, Jordi

2010-01-01

There is no gold standard for diagnosing leishmaniases. Our aim was to assess the operative validity of tests used in detecting Leishmania infection using samples from experimental infections, a reliable equivalent to the classic definition of gold standard. Without statistical differences, the highest sensitivity was achieved by protein A (ProtA), immunoglobulin (Ig)G2, indirect fluorescenece antibody test (IFAT), lymphocyte proliferation assay, quantitative real-time polymerase chain reaction of bone marrow (qPCR-BM), qPCR-Blood, and IgG; and the highest specificity by IgG1, IgM, IgA, qPCR-Blood, IgG, IgG2, and qPCR-BM. Maximum positive predictive value was obtained simultaneously by IgG2, qPCR-Blood, and IgG; and maximum negative predictive value by qPCR-BM. Best positive and negative likelihood ratios were obtained by IgG2. The test having the greatest, statistically significant, area under the receiver operating characteristics curve was IgG2 enzyme-linked immunosorbent assay (ELISA). Thus, according to the gold standard used, IFAT and qPCR are far from fulfilling the requirements to be considered gold standards, and the test showing the highest potential to detect Leishmania infection is Leishmania-specific ELISA IgG2. PMID:20134001

Leishmania infection: laboratory diagnosing in the absence of a "gold standard".

PubMed

Rodríguez-Cortés, Alhelí; Ojeda, Ana; Francino, Olga; López-Fuertes, Laura; Timón, Marcos; Alberola, Jordi

2010-02-01

There is no gold standard for diagnosing leishmaniases. Our aim was to assess the operative validity of tests used in detecting Leishmania infection using samples from experimental infections, a reliable equivalent to the classic definition of gold standard. Without statistical differences, the highest sensitivity was achieved by protein A (ProtA), immunoglobulin (Ig)G2, indirect fluorescenece antibody test (IFAT), lymphocyte proliferation assay, quantitative real-time polymerase chain reaction of bone marrow (qPCR-BM), qPCR-Blood, and IgG; and the highest specificity by IgG1, IgM, IgA, qPCR-Blood, IgG, IgG2, and qPCR-BM. Maximum positive predictive value was obtained simultaneously by IgG2, qPCR-Blood, and IgG; and maximum negative predictive value by qPCR-BM. Best positive and negative likelihood ratios were obtained by IgG2. The test having the greatest, statistically significant, area under the receiver operating characteristics curve was IgG2 enzyme-linked immunosorbent assay (ELISA). Thus, according to the gold standard used, IFAT and qPCR are far from fulfilling the requirements to be considered gold standards, and the test showing the highest potential to detect Leishmania infection is Leishmania-specific ELISA IgG2.

Possible Overlaps Between Blobs, Grism Apertures, and Dithers

NASA Astrophysics Data System (ADS)

Ryan, R. E.; McCullough, P. R.

2017-06-01

We present a investigation into possible overlaps between the known IR blobs with the grism aperture reference positions and the IR dither patterns. Each aperture was designed to place the science target (e.g. a specific star) on a cosmetically clean area of the IR detector. Similarly, the dither patterns were designed to mitigate cosmetic defects by rarely (or ideally never) placing such targets on known defects. Because blobs accumulate with time, the originally defined apertures and dither patterns may no longer accomplish their goals, it is important to reverify these combinations. We find two potential overlaps between the blob, aperture, and dither combinations, but do not recommend any changes to the current suite of aperture references positions and/or dither patterns for two reasons. First, one of the overlaps occurs with a dither/aperture combination that is seldom used for high-value science operations, but rather more common for wide-field surveys/mosaics. Second, the other overlap is 8.7 pix from a blob that has a fiducial radius of 10 pix, which already represents a very conservative distance. We conclude that a similar analysis should be repeated as new blobs occur, to continue to ensure ideal operations for high-value science targets. The purpose of this report is to document the analysis in order to facilitate its repetition in the future.

Reading Gate Positions with a Smartphone

NASA Astrophysics Data System (ADS)

van Overloop, Peter-Jules; Hut, Rolf

2015-04-01

Worldwide many flow gates are built in water networks in order to direct water to appropriate locations. Most of these gates are adjusted manually by field operators of water management organizations and it is often centrally not known what the new position of the gate is. This makes centralized management of the entire water network difficult. One of the reasons why the measurement of the gate position is usually not executed, is that for certain gates it is not easy to do such a reading. Tilting weirs or radial gates are examples where operators need special equipment (measuring rod and long level) to determine the position and it could even be a risky procedure. Another issue is that once the measurement is done, the value is jotted down in a notebook and later, at the office, entered in a computer system. So the entire monitoring procedure is not real-time and prone to human errors. A new way of monitoring gate positions is introduced. It consists of a level that is attached to the gate and an app with which a picture can be taken from the level. Using dedicated pattern recognition algorithms, the gate position can be read by using the angle of the level versus reference points on the gate, the radius of that gate and the absolute level of the joint around which the gate turn. The method uses gps-localization of the smartphone to store the gate position in the right location in the central database.

Raman spectroscopy based screening of IgG positive and negative sera for dengue virus infection

NASA Astrophysics Data System (ADS)

Bilal, M.; Saleem, M.; Bial, Maria; Khan, Saranjam; Ullah, Rahat; Ali, Hina; Ahmed, M.; Ikram, Masroor

2017-11-01

A quantitative analysis for the screening of immunoglobulin-G (IgG) positive human sera samples is presented for the dengue virus infection. The regression model was developed using 79 samples while 20 samples were used to test the performance of the model. The R-square (r 2) value of 0.91 was found through a leave-one-sample-out cross validation method, which shows the validity of this model. This model incorporates the molecular changes associated with IgG. Molecular analysis based on regression coefficients revealed that myristic acid, coenzyme-A, alanine, arabinose, arginine, vitamin C, carotene, fumarate, galactosamine, glutamate, lactic acid, stearic acid, tryptophan and vaccenic acid are positively correlated with IgG; while amide III, collagen, proteins, fatty acids, phospholipids and fucose are negatively correlated. For blindly tested samples, an excellent agreement has been found between the model predicted, and the clinical values of IgG. The parameters, which include sensitivity, specificity, accuracy and the area under the receiver operator characteristic curve, are found to be 100%, 83.3%, 95% and 0.99, respectively, which confirms the high quality of the model.

The validation of a human force model to predict dynamic forces resulting from multi-joint motions

NASA Technical Reports Server (NTRS)

Pandya, Abhilash K.; Maida, James C.; Aldridge, Ann M.; Hasson, Scott M.; Woolford, Barbara J.

1992-01-01

The development and validation is examined of a dynamic strength model for humans. This model is based on empirical data. The shoulder, elbow, and wrist joints were characterized in terms of maximum isolated torque, or position and velocity, in all rotational planes. This data was reduced by a least squares regression technique into a table of single variable second degree polynomial equations determining torque as a function of position and velocity. The isolated joint torque equations were then used to compute forces resulting from a composite motion, in this case, a ratchet wrench push and pull operation. A comparison of the predicted results of the model with the actual measured values for the composite motion indicates that forces derived from a composite motion of joints (ratcheting) can be predicted from isolated joint measures. Calculated T values comparing model versus measured values for 14 subjects were well within the statistically acceptable limits and regression analysis revealed coefficient of variation between actual and measured to be within 0.72 and 0.80.

Can 3-dimensional power Doppler indices improve the prenatal diagnosis of a potentially morbidly adherent placenta in patients with placenta previa?

PubMed

Haidar, Ziad A; Papanna, Ramesha; Sibai, Baha M; Tatevian, Nina; Viteri, Oscar A; Vowels, Patricia C; Blackwell, Sean C; Moise, Kenneth J

2017-08-01

Traditionally, 2-dimensional ultrasound parameters have been used for the diagnosis of a suspected morbidly adherent placenta previa. More objective techniques have not been well studied yet. The objective of the study was to determine the ability of prenatal 3-dimensional power Doppler analysis of flow and vascular indices to predict the morbidly adherent placenta objectively. A prospective cohort study was performed in women between 28 and 32 gestational weeks with known placenta previa. Patients underwent a two-dimensional gray-scale ultrasound that determined management decisions. 3-Dimensional power Doppler volumes were obtained during the same examination and vascular, flow, and vascular flow indices were calculated after manual tracing of the viewed placenta in the sweep; data were blinded to obstetricians. Morbidly adherent placenta was confirmed by histology. Severe morbidly adherent placenta was defined as increta/percreta on histology, blood loss >2000 mL, and >2 units of PRBC transfused. Sensitivities, specificities, predictive values, and likelihood ratios were calculated. Student t and χ 2 tests, logistic regression, receiver-operating characteristic curves, and intra- and interrater agreements using Kappa statistics were performed. The following results were found: (1) 50 women were studied: 23 had morbidly adherent placenta, of which 12 (52.2%) were severe morbidly adherent placenta; (2) 2-dimensional parameters diagnosed morbidly adherent placenta with a sensitivity of 82.6% (95% confidence interval, 60.4-94.2), a specificity of 88.9% (95% confidence interval, 69.7-97.1), a positive predictive value of 86.3% (95% confidence interval, 64.0-96.4), a negative predictive value of 85.7% (95% confidence interval, 66.4-95.3), a positive likelihood ratio of 7.4 (95% confidence interval, 2.5-21.9), and a negative likelihood ratio of 0.2 (95% confidence interval, 0.08-0.48); (3) mean values of the vascular index (32.8 ± 7.4) and the vascular flow index (14.2 ± 3.8) were higher in morbidly adherent placenta (P < .001); (4) area under the receiver-operating characteristic curve for the vascular and vascular flow indices were 0.99 and 0.97, respectively; (5) the vascular index ≥21 predicted morbidly adherent placenta with a sensitivity and a specificity of 95% (95% confidence interval, 88.2-96.9) and 91%, respectively (95% confidence interval, 87.5-92.4), 92% positive predictive value (95% confidence interval, 85.5-94.3), 90% negative predictive value (95% confidence interval, 79.9-95.3), positive likelihood ratio of 10.55 (95% confidence interval, 7.06-12.75), and negative likelihood ratio of 0.05 (95% confidence interval, 0.03-0.13); and (6) for the severe morbidly adherent placenta, 2-dimensional ultrasound had a sensitivity of 33.3% (95% confidence interval, 11.3-64.6), a specificity of 81.8% (95% confidence interval, 47.8-96.8), a positive predictive value of 66.7% (95% confidence interval, 24.1-94.1), a negative predictive value of 52.9% (95% confidence interval, 28.5-76.1), a positive likelihood ratio of 1.83 (95% confidence interval, 0.41-8.11), and a negative likelihood ratio of 0.81 (95% confidence interval, 0.52-1.26). A vascular index ≥31 predicted the diagnosis of a severe morbidly adherent placenta with a 100% sensitivity (95% confidence interval, 72-100), a 90% specificity (95% confidence interval, 81.7-93.8), an 88% positive predictive value (95% confidence interval, 55.0-91.3), a 100% negative predictive value (95% confidence interval, 90.9-100), a positive likelihood ratio of 10.0 (95% confidence interval, 3.93-16.13), and a negative likelihood ratio of 0 (95% confidence interval, 0-0.34). Intrarater and interrater agreements were 94% (P < .001) and 93% (P < .001), respectively. The vascular index accurately predicts the morbidly adherent placenta in patients with placenta previa. In addition, 3-dimensional power Doppler vascular and vascular flow indices were more predictive of severe cases of morbidly adherent placenta compared with 2-dimensional ultrasound. This objective technique may limit the variations in diagnosing morbidly adherent placenta because of the subjectivity of 2-dimensional ultrasound interpretations. Copyright © 2017 Elsevier Inc. All rights reserved.

Post-operative re-bleeding in patients with hypertensive ICH is closely associated with the CT blend sign.

PubMed

Wu, Guofeng; Shen, Zhengkui; Wang, Likun; Sun, Shujie; Luo, Jinbiao; Mao, Yuanhong

2017-07-06

Intracranial post-operative re-haemorrhage is an important complication in patients with hypertensive intracerebral haemorrhage (ICH). The purpose of the present study was to determine the value of the computed tomography (CT) blend sign in predicting post-operative re-haemorrhage in patients with ICH. A total of 126 patients with ICH were included in the present study. All the patients underwent standard stereotactic minimally invasive surgery(MIS) to remove the ICH within 24 h following admission. There were 41 patients with a blend sign on initial CT and 85 patients without a blend sign on the initial CT. Multivariable logistic regression analyses were performed to assess the relationship between the presence of the blend sign on the non-enhanced admission CT scan and post-operative re-haemorrhage. Post-operative re-haemorrhage occurred in 24 of the 41 patients with the blend sign, and in 9 of the 85 patients without the blend sign. The incidence of re-haemorrhage was significantly different between the groups. The multivariate logistic regression analysis demonstrated that the initial Glasgow coma scale score (p = 0.002) and blend sign (P < 0.00) on the initial CT scan are independent predictors of post-operative re-haemorrhage. The sensitivity, specificity, and positive and negative predictive values of the blend sign for predicting post-operative re-haemorrhage were 72.7, 81.7, 58.5 and 89.4%, respectively. The presence of the blend sign on the initial CT scan is closely associated with post-operative re-haemorrhage in patients with ICH who undergo stereotactic MIS.

Ion mobility spectrometric analysis of vaporous chemical warfare agents by the instrument with corona discharge ionization ammonia dopant ambient temperature operation.

PubMed

Satoh, Takafumi; Kishi, Shintaro; Nagashima, Hisayuki; Tachikawa, Masumi; Kanamori-Kataoka, Mieko; Nakagawa, Takao; Kitagawa, Nobuyoshi; Tokita, Kenichi; Yamamoto, Soichiro; Seto, Yasuo

2015-03-20

The ion mobility behavior of nineteen chemical warfare agents (7 nerve gases, 5 blister agents, 2 lachrymators, 2 blood agents, 3 choking agents) and related compounds including simulants (8 agents) and organic solvents (39) was comparably investigated by the ion mobility spectrometry instrument utilizing weak electric field linear drift tube with corona discharge ionization, ammonia doping, purified inner air drift flow circulation operated at ambient temperature and pressure. Three alkyl methylphosphonofluoridates, tabun, and four organophosphorus simulants gave the intense characteristic positive monomer-derived ion peaks and small dimer-derived ion peaks, and the later ion peaks were increased with the vapor concentrations. VX, RVX and tabun gave both characteristic positive monomer-derived ions and degradation product ions. Nitrogen mustards gave the intense characteristic positive ion peaks, and in addition distinctive negative ion peak appeared from HN3. Mustard gas, lewisite 1, o-chlorobenzylidenemalononitrile and 2-mercaptoethanol gave the characteristic negative ion peaks. Methylphosphonyl difluoride, 2-chloroacetophenone and 1,4-thioxane gave the characteristic ion peaks both in the positive and negative ion mode. 2-Chloroethylethylsulfide and allylisothiocyanate gave weak ion peaks. The marker ion peaks derived from two blood agents and three choking agents were very close to the reactant ion peak in negative ion mode and the respective reduced ion mobility was fluctuated. The reduced ion mobility of the CWA monomer-derived peaks were positively correlated with molecular masses among structurally similar agents such as G-type nerve gases and organophosphorus simulants; V-type nerve gases and nitrogen mustards. The slope values of the calibration plots of the peak heights of the characteristic marker ions versus the vapor concentrations are related to the detection sensitivity, and within chemical warfare agents examined the slope values for sarin, soman, tabun and nitrogen mustards were higher. Some CWA simulants and organic solvents gave the ion peaks eluting at the similar positions of the CWAs, resulting in false positive alarms. Copyright © 2015 Elsevier B.V. All rights reserved.

14 CFR 137.47 - Operation without position lights.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Operation without position lights. 137.47... AIRCRAFT OPERATIONS Operating Rules § 137.47 Operation without position lights. Notwithstanding part 91 of this chapter, an aircraft may be operated without position lights if prominent unlighted objects are...

14 CFR 137.47 - Operation without position lights.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Operation without position lights. 137.47... AIRCRAFT OPERATIONS Operating Rules § 137.47 Operation without position lights. Notwithstanding part 91 of this chapter, an aircraft may be operated without position lights if prominent unlighted objects are...

14 CFR 137.47 - Operation without position lights.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Operation without position lights. 137.47... AIRCRAFT OPERATIONS Operating Rules § 137.47 Operation without position lights. Notwithstanding part 91 of this chapter, an aircraft may be operated without position lights if prominent unlighted objects are...

14 CFR 137.47 - Operation without position lights.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Operation without position lights. 137.47... AIRCRAFT OPERATIONS Operating Rules § 137.47 Operation without position lights. Notwithstanding part 91 of this chapter, an aircraft may be operated without position lights if prominent unlighted objects are...

WE-H-BRC-05: Catastrophic Error Metrics for Radiation Therapy

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

Murphy, S; Molloy, J

Purpose: Intuitive evaluation of complex radiotherapy treatments is impractical, while data transfer anomalies create the potential for catastrophic treatment delivery errors. Contrary to prevailing wisdom, logical scrutiny can be applied to patient-specific machine settings. Such tests can be automated, applied at the point of treatment delivery and can be dissociated from prior states of the treatment plan, potentially revealing errors introduced early in the process. Methods: Analytical metrics were formulated for conventional and intensity modulated RT (IMRT) treatments. These were designed to assess consistency between monitor unit settings, wedge values, prescription dose and leaf positioning (IMRT). Institutional metric averages formore » 218 clinical plans were stratified over multiple anatomical sites. Treatment delivery errors were simulated using a commercial treatment planning system and metric behavior assessed via receiver-operator-characteristic (ROC) analysis. A positive result was returned if the erred plan metric value exceeded a given number of standard deviations, e.g. 2. The finding was declared true positive if the dosimetric impact exceeded 25%. ROC curves were generated over a range of metric standard deviations. Results: Data for the conventional treatment metric indicated standard deviations of 3%, 12%, 11%, 8%, and 5 % for brain, pelvis, abdomen, lung and breast sites, respectively. Optimum error declaration thresholds yielded true positive rates (TPR) between 0.7 and 1, and false positive rates (FPR) between 0 and 0.2. Two proposed IMRT metrics possessed standard deviations of 23% and 37%. The superior metric returned TPR and FPR of 0.7 and 0.2, respectively, when both leaf position and MUs were modelled. Isolation to only leaf position errors yielded TPR and FPR values of 0.9 and 0.1. Conclusion: Logical tests can reveal treatment delivery errors and prevent large, catastrophic errors. Analytical metrics are able to identify errors in monitor units, wedging and leaf positions with favorable sensitivity and specificity. In part by Varian.« less

Optimal quantum observables

NASA Astrophysics Data System (ADS)

Haapasalo, Erkka; Pellonpää, Juha-Pekka

2017-12-01

Various forms of optimality for quantum observables described as normalized positive-operator-valued measures (POVMs) are studied in this paper. We give characterizations for observables that determine the values of the measured quantity with probabilistic certainty or a state of the system before or after the measurement. We investigate observables that are free from noise caused by classical post-processing, mixing, or pre-processing of quantum nature. Especially, a complete characterization of pre-processing and post-processing clean observables is given, and necessary and sufficient conditions are imposed on informationally complete POVMs within the set of pure states. We also discuss joint and sequential measurements of optimal quantum observables.

Robust Operation of Tendon-Driven Robot Fingers Using Force and Position-Based Control Laws

NASA Technical Reports Server (NTRS)

Hargrave, Brian (Inventor); Abdallah, Muhammad E (Inventor); Reiland, Matthew J (Inventor); Diftler, Myron A (Inventor); Strawser, Philip A (Inventor); Platt, Jr., Robert J. (Inventor); Ihrke, Chris A. (Inventor)

2013-01-01

A robotic system includes a tendon-driven finger and a control system. The system controls the finger via a force-based control law when a tension sensor is available, and via a position-based control law when a sensor is not available. Multiple tendons may each have a corresponding sensor. The system selectively injects a compliance value into the position-based control law when only some sensors are available. A control system includes a host machine and a non-transitory computer-readable medium having a control process, which is executed by the host machine to control the finger via the force- or position-based control law. A method for controlling the finger includes determining the availability of a tension sensor(s), and selectively controlling the finger, using the control system, via the force or position-based control law. The position control law allows the control system to resist disturbances while nominally maintaining the initial state of internal tendon tensions.

Long-term evaluation of three satellite ocean color algorithms for identifying harmful algal blooms (Karenia brevis) along the west coast of Florida: A matchup assessment

PubMed Central

Carvalho, Gustavo A.; Minnett, Peter J.; Banzon, Viva F.; Baringer, Warner; Heil, Cynthia A.

2011-01-01

We present a simple algorithm to identify Karenia brevis blooms in the Gulf of Mexico along the west coast of Florida in satellite imagery. It is based on an empirical analysis of collocated matchups of satellite and in situ measurements. The results of this Empirical Approach is compared to those of a Bio-optical Technique – taken from the published literature – and the Operational Method currently implemented by the NOAA Harmful Algal Bloom Forecasting System for K. brevis blooms. These three algorithms are evaluated using a multi-year MODIS data set (from July, 2002 to October, 2006) and a long-term in situ database. Matchup pairs, consisting of remotely-sensed ocean color parameters and near-coincident field measurements of K. brevis concentration, are used to assess the accuracy of the algorithms. Fair evaluation of the algorithms was only possible in the central west Florida shelf (i.e. between 25.75°N and 28.25°N) during the boreal Summer and Fall months (i.e. July to December) due to the availability of valid cloud-free matchups. Even though the predictive values of the three algorithms are similar, the statistical measure of success in red tide identification (defined as cell counts in excess of 1.5 × 104 cells L−1) varied considerably (sensitivity—Empirical: 86%; Bio-optical: 77%; Operational: 26%), as did their effectiveness in identifying non-bloom cases (specificity—Empirical: 53%; Bio-optical: 65%; Operational: 84%). As the Operational Method had an elevated frequency of false-negative cases (i.e. presented low accuracy in detecting known red tides), and because of the considerable overlap between the optical characteristics of the red tide and non-bloom population, only the other two algorithms underwent a procedure for further inspecting possible detection improvements. Both optimized versions of the Empirical and Bio-optical algorithms performed similarly, being equally specific and sensitive (~70% for both) and showing low levels of uncertainties (i.e. few cases of false-negatives and false-positives: ~30%)—improved positive predictive values (~60%) were also observed along with good negative predictive values (~80%). PMID:22180667

Diagnostic value of cerebrospinal fluid Aβ ratios in preclinical Alzheimer's disease.

PubMed

Adamczuk, Katarzyna; Schaeverbeke, Jolien; Vanderstichele, Hugo M J; Lilja, Johan; Nelissen, Natalie; Van Laere, Koen; Dupont, Patrick; Hilven, Kelly; Poesen, Koen; Vandenberghe, Rik

2015-12-18

In this study of preclinical Alzheimer's disease (AD) we assessed the added diagnostic value of using cerebrospinal fluid (CSF) Aβ ratios rather than Aβ42 in isolation for detecting individuals who are positive on amyloid positron emission tomography (PET). Thirty-eight community-recruited cognitively intact older adults (mean age 73, range 65-80 years) underwent (18)F-flutemetamol PET and CSF measurement of Aβ1-42, Aβ1-40, Aβ1-38, and total tau (ttau). (18)F-flutemetamol retention was quantified using standardized uptake value ratios in a composite cortical region (SUVRcomp) with reference to cerebellar grey matter. Based on a prior autopsy validation study, the SUVRcomp cut-off was 1.57. Sensitivities, specificities and cut-offs were defined based on receiver operating characteristic analysis with CSF analytes as variables of interest and (18)F-flutemetamol positivity as the classifier. We also determined sensitivities and CSF cut-off values at fixed specificities of 90 % and 95 %. Seven out of 38 subjects (18 %) were positive on amyloid PET. Aβ42/ttau, Aβ42/Aβ40, Aβ42/Aβ38, and Aβ42 had the highest accuracy to identify amyloid-positive subjects (area under the curve (AUC) ≥ 0.908). Aβ40 and Aβ38 had significantly lower discriminative power (AUC = 0.571). When specificity was fixed at 90 % and 95 %, Aβ42/ttau had the highest sensitivity among the different CSF markers (85.71 % and 71.43 %, respectively). Sensitivity of Aβ42 alone was significantly lower under these conditions (57.14 % and 42.86 %, respectively). For the CSF-based definition of preclinical AD, if a high specificity is required, our data support the use of Aβ42/ttau rather than using Aβ42 in isolation.

Validity of administrative database code algorithms to identify vascular access placement, surgical revisions, and secondary patency.

PubMed

Al-Jaishi, Ahmed A; Moist, Louise M; Oliver, Matthew J; Nash, Danielle M; Fleet, Jamie L; Garg, Amit X; Lok, Charmaine E

2018-03-01

We assessed the validity of physician billing codes and hospital admission using International Classification of Diseases 10th revision codes to identify vascular access placement, secondary patency, and surgical revisions in administrative data. We included adults (≥18 years) with a vascular access placed between 1 April 2004 and 31 March 2013 at the University Health Network, Toronto. Our reference standard was a prospective vascular access database (VASPRO) that contains information on vascular access type and dates of placement, dates for failure, and any revisions. We used VASPRO to assess the validity of different administrative coding algorithms by calculating the sensitivity, specificity, and positive predictive values of vascular access events. The sensitivity (95% confidence interval) of the best performing algorithm to identify arteriovenous access placement was 86% (83%, 89%) and specificity was 92% (89%, 93%). The corresponding numbers to identify catheter insertion were 84% (82%, 86%) and 84% (80%, 87%), respectively. The sensitivity of the best performing coding algorithm to identify arteriovenous access surgical revisions was 81% (67%, 90%) and specificity was 89% (87%, 90%). The algorithm capturing arteriovenous access placement and catheter insertion had a positive predictive value greater than 90% and arteriovenous access surgical revisions had a positive predictive value of 20%. The duration of arteriovenous access secondary patency was on average 578 (553, 603) days in VASPRO and 555 (530, 580) days in administrative databases. Administrative data algorithms have fair to good operating characteristics to identify vascular access placement and arteriovenous access secondary patency. Low positive predictive values for surgical revisions algorithm suggest that administrative data should only be used to rule out the occurrence of an event.

Accuracy of FDG-PET to diagnose lung cancer in a region of endemic granulomatous disease.

PubMed

Deppen, Stephen; Putnam, Joe B; Andrade, Gabriela; Speroff, Theodore; Nesbitt, Jonathan C; Lambright, Eric S; Massion, Pierre P; Walker, Ron; Grogan, Eric L

2011-08-01

The 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET) is used to evaluate suspicious pulmonary lesions due to its diagnostic accuracy. The southeastern United States has a high prevalence of infectious granulomatous lung disease, and the accuracy of FDG-PET may be reduced in this population. We examined the diagnostic accuracy of FDG-PET in patients with known or suspected non-small cell lung cancer treated at our institution. A total of 279 patients, identified through our prospective database, underwent an operation for known or suspected lung cancer. Preoperative FDG-PET in 211 eligible patients was defined by standardized uptake value greater than 2.5 or by description ("moderate" or "intense") as avid. Sensitivity, specificity, positive and negative predictive values, likelihood ratios, and decision diagrams were calculated for FDG-PET in all patients and in patients with indeterminate nodules. In all eligible patients (n=211), sensitivity and specificity of FDG-PET were 92% and 40%, respectively. Positive and negative predictive values were 86% and 55%. Overall FDG-PET accuracy to diagnose lung cancer was 81%. Preoperative positive likelihood ratio for FDG-PET diagnosis of lung cancer in this population was 1.5 compared with previously published values of 7.1. In 113 indeterminate lesions, 65% had lung cancer and the sensitivity and specificity were 89% and 40%, respectively. Twenty-four benign nodules (60%) had false positive FDG-PET scans. Twenty-two of 43 benign nodules (51%) were granulomas. In a region with endemic granulomatous diseases, the specificity of FDG-PET for diagnosis of lung cancer was 40%. Clinical decisions and future clinical predictive models for lung cancer must accommodate regional variation of FDG-PET scan results. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Utility of Shear Wave Elastography for Differentiating Biliary Atresia From Infantile Hepatitis Syndrome.

PubMed

Wang, Xiaoman; Qian, Linxue; Jia, Liqun; Bellah, Richard; Wang, Ning; Xin, Yue; Liu, Qinglin

2016-07-01

The purpose of this study was to investigate the potential utility of shear wave elastography (SWE) for diagnosis of biliary atresia and for differentiating biliary atresia from infantile hepatitis syndrome by measuring liver stiffness. Thirty-eight patients with biliary atresia and 17 patients with infantile hepatitis syndrome were included, along with 31 healthy control infants. The 3 groups underwent SWE. The hepatic tissue of each patient with biliary atresia had been surgically biopsied. Statistical analyses for mean values of the 3 groups were performed. Optimum cutoff values using SWE for differentiation between the biliary atresia and control groups were calculated by a receiver operating characteristic (ROC) analysis. The mean SWE values ± SD for the 3 groups were as follows: biliary atresia group, 20.46 ± 10.19 kPa; infantile hepatitis syndrome group, 6.29 ± 0.99 kPa; and control group, 6.41 ± 1.08 kPa. The mean SWE value for the biliary atresia group was higher than the values for the control and infantile hepatitis syndrome groups (P < .01). The mean SWE values between the control and infantile hepatitis syndrome groups were not statistically different. The ROC analysis showed a cutoff value of 8.68 kPa for differentiation between the biliary atresia and control groups. The area under the ROC curve was 0.997, with sensitivity of 97.4%, specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 96.9%. Correlation analysis suggested a positive correlation between SWE values and age for patients with biliary atresia, with a Pearson correlation coefficient of 0.463 (P < .05). The significant increase in liver SWE values in neonates and infants with biliary atresia supports their application for differentiating biliary atresia from infantile hepatitis syndrome.

Effect of mobile unidirectional air flow unit on microbial contamination of air in standard urologic procedures.

PubMed

Ferretti, Stefania; Pasquarella, Cesira; Fornia, Samanta; Saccani, Elisa; Signorelli, Carlo; Vitali, Pietro; Sansebastiano, Giuliano Ezio

2009-12-01

Infection is one of the most feared complications of surgery. New instrumentation is being developed to reduce deposition of bacteria. We investigated 45 major surgical procedures (21 radical nephrectomies [RN] and 24 radical retropubic prostatectomies [RRP]) in our urology department during 2007. In about one-half of the interventions, an ultraclean air flow mobile (UAF) unit was used. Bacterial sedimentation was evaluated by nitrocellulose membranes placed on the instrument tray and by settle plates positioned at four points in the operating room. In 27 operations, an additional membrane was located near the incision. Bacterial counts on the nitrocellulose membranes during RN were 230 colony-forming units (cfu)/m(2)/h with the UAF unit and 2,254 cfu/m(2)/h without the unit (p = 0.001). During RRP, the values were 288 cfu/m(2)/h and 3,126 cfu/m(2)/h respectively (p = 0.001). The membrane placed near the incision during RN showed a microbial count of 1,235 cfu/m(2)/h with the UAF unit and 5,093 cfu/m(2)/h without the unit (p = 0.002); during RRP, the values were 1,845 cfu/m(2)/h and 3,790 cfu/m(2)/h, respectively (difference not significant). Bacterial contamination detected by settle plates during RN showed a mean value of 2,273 cfu/m(2)/h when the UAF unit was used and 2,054 cfu/m(2)/h without the unit; during RRP, the values were 2,332 cfu/m(2)/h and 2,629 cfu/m(2)/h with and without the UAF unit, respectively (NS). No statistically significant differences were detected in the clinical data registered in patients operated on under standard conditions and while the UAF unit was functioning. The UAF appears able to reduce microbial contamination at the operating table, reaching a bacterial number obtained in ultraclean operating theatres.

Field evaluation of the 22 rapid diagnostic tests for community management of malaria with artemisinin combination therapy in Cameroon.

PubMed

Ali, Innocent M; Bigoga, Jude D; Forsah, Dorothy A; Cho-Ngwa, Fidelis; Tchinda, Vivian; Moor, Vicky Ama; Fogako, Josephine; Nyongalema, Philomena; Nkoa, Theresa; Same-Ekobo, Albert; Mbede, Joseph; Fondjo, Etienne; Mbacham, Wilfred F; Leke, Rose G F

2016-01-20

All suspected cases of malaria should receive a diagnostic test prior to treatment with artemisinin-based combinations based on the new WHO malaria treatment guidelines. This study compared the accuracy and some operational characteristics of 22 different immunochromatographic antigen capture point-of- malaria tests (RDTs) in Cameroon to inform test procurement prior to deployment of artemisinin-based combinations for malaria treatment. One hundred human blood samples (50 positive and 50 negative) collected from consenting febrile patients in two health centres at Yaoundé were used for evaluation of the 22 RDTs categorized as "Pf Only" (9) or "Pf + PAN" (13) based on parasite antigen captured [histidine rich protein II (HRP2) or lactate dehydrogenase (pLDH) or aldolase]. RDTs were coded to blind technicians performing the tests. The sensitivity, specificity, and predictive values of the positive and negative tests (PPV and NPV) as well as the likelihood ratios were assessed. The reliability and some operational characteristics were determined as the mean values from two assessors, and the Cohen's kappa statistic was then used to compare agreement. Light microscopy was the referent. Of all RDTs tested, 94.2 % (21/22) had sensitivity values greater than 90% among which 14 (63.6%) were 'Pf + PAN' RDTs. The specificity was generally lower than the sensitivity for all RDTs and poorer for "Pf Only" RDTs. The predictive values and likelihood ratios were better for non-HRP2 analytes for "Pf + PAN" RDTs. The Kappa value for most of the tests obtained was around 67% (95% CI 50-69%), corresponding to a moderate agreement. Overall, 94.2% (21/22) of RDTs tested had accuracy within the range recommended by the WHO, while one performed poorly, below acceptable levels. Seven "Pf + PAN" and 3 "Pf Only" RDTs were selected for further assessment based on performance characteristics. Harmonizing RDT test presentation and procedures would prevent mistakes of test performance and interpretation.

THE RESULTS OF PARATHYROID HORMONE ASSAY IN PARATHYROID ASPIRATES IN PRE-OPERATIVE LOCALIZATION OF PARATHYROID ADENOMAS FOR FOCUSED PARATHYROIDECTOMY IN PATIENTS WITH NEGATIVE OR SUSPICIOUS TECHNETIUM-99M-SESTAMIBI SCANS.

PubMed

Ozderya, Aysenur; Temizkan, Sule; Cetin, Kenan; Ozugur, Sule; Gul, Aylin Ege; Aydin, Kadriye

2017-09-01

This study aimed to evaluate the results of parathyroid hormone (PTH) assay in parathyroid aspirates to determine uniglandular disease by an endocrinologist-performed ultrasound (US) in patients with discordant or negative technetium-sestamibi scans and to evaluate whether this procedure increases the number of focused parathyroidectomies (FPs). We analyzed the data of 65 patients who underwent an endocrinologist-performed US-guided parathyroid fine-needle aspiration (FNA) with PTH wash-out, retrospectively. The results of PTH wash-out procedure and the reports of parathyroid surgery and pathology were reviewed. Of 65 patients, 54 had positive PTH wash-out results. The median serum PTH level of patients with positive and negative PTH wash-out results was 143 (25 and 75% interquartile range [IQR], 114 to 197) versus 154 (IQR, 115 to 255) pg/mL (P = .45), and the median PTH in FNA was 3,533 (IQR, 1,481 to 3,534) versus 6.0 (IQR, 1 to 6) pg/mL (P<.001), respectively. Forty-five patients underwent surgery. Of the operated patients, 42 had positive PTH wash-out results and had successful FP. Four patients with redo surgery had positive PTH wash-out results and were successfully re-operated with FP. Of 11 patients with negative PTH wash-out results, 3 had bilateral neck exploration (BNE) surgery and 2 patients were successfully operated, while surgery was unsuccessful in 1 patient, despite BNE. Our study results suggest that endocrinologist-performed US and parathyroid FNA with PTH wash-out increases the number and success of FPs. In particular, patients with redo surgery may benefit from this procedure. 4D-CT = four-dimensional computed tomography BNE = bilateral neck exploration FNA = fine-needle aspiration FNAB = fine-needle aspiration biopsy FP = focused parathyroidectomy IQR = 25 and 75% inter-quartile range PHPT = primary hyperparathyroidism PPV = positive predictive value PTH = parathyroid hormone 99m Tc = technetium US = ultrasound.

Some induced intuitionistic fuzzy aggregation operators applied to multi-attribute group decision making

NASA Astrophysics Data System (ADS)

Su, Zhi-xin; Xia, Guo-ping; Chen, Ming-yuan

2011-11-01

In this paper, we define various induced intuitionistic fuzzy aggregation operators, including induced intuitionistic fuzzy ordered weighted averaging (OWA) operator, induced intuitionistic fuzzy hybrid averaging (I-IFHA) operator, induced interval-valued intuitionistic fuzzy OWA operator, and induced interval-valued intuitionistic fuzzy hybrid averaging (I-IIFHA) operator. We also establish various properties of these operators. And then, an approach based on I-IFHA operator and intuitionistic fuzzy weighted averaging (WA) operator is developed to solve multi-attribute group decision-making (MAGDM) problems. In such problems, attribute weights and the decision makers' (DMs') weights are real numbers and attribute values provided by the DMs are intuitionistic fuzzy numbers (IFNs), and an approach based on I-IIFHA operator and interval-valued intuitionistic fuzzy WA operator is developed to solve MAGDM problems where the attribute values provided by the DMs are interval-valued IFNs. Furthermore, induced intuitionistic fuzzy hybrid geometric operator and induced interval-valued intuitionistic fuzzy hybrid geometric operator are proposed. Finally, a numerical example is presented to illustrate the developed approaches.

Periodic differential equations with self-adjoint monodromy operator

NASA Astrophysics Data System (ADS)

Yudovich, V. I.

2001-04-01

A linear differential equation \\dot u=A(t)u with p-periodic (generally speaking, unbounded) operator coefficient in a Euclidean or a Hilbert space \\mathbb H is considered. It is proved under natural constraints that the monodromy operator U_p is self-adjoint and strictly positive if A^*(-t)=A(t) for all t\\in\\mathbb R.It is shown that Hamiltonian systems in the class under consideration are usually unstable and, if they are stable, then the operator U_p reduces to the identity and all solutions are p-periodic.For higher frequencies averaged equations are derived. Remarkably, high-frequency modulation may double the number of critical values.General results are applied to rotational flows with cylindrical components of the velocity a_r=a_z=0, a_\\theta=\\lambda c(t)r^\\beta, \\beta<-1, c(t) is an even p-periodic function, and also to several problems of free gravitational convection of fluids in periodic fields.

Computed intraoperative navigation guidance--a preliminary report on a new technique.

PubMed

Enislidis, G; Wagner, A; Ploder, O; Ewers, R

1997-08-01

To assess the value of a computer-assisted three-dimensional guidance system (Virtual Patient System) in maxillofacial operations. Laboratory and open clinical study. Teaching Hospital, Austria. 6 patients undergoing various procedures including removal of foreign body (n=3) and biopsy, maxillary advancement, and insertion of implants (n=1 each). Storage of computed tomographic (CT) pictures on an optical disc, and imposition of intraoperative video images on to these. The resulting display is shown to the surgeon on a micromonitor in his head-up display for guidance during the operations. To improve orientation during complex or minimally invasive maxillofacial procedures and to make such operations easier and less traumatic. Successful transferral of computed navigation technology into an operation room environment and positive evaluation of the method by the surgeons involved. Computer-assisted three-dimensional guidance systems have the potential for making complex or minimally invasive procedures easier to do, thereby reducing postoperative morbidity.

Impact of the injection dose of exhaust gases, on work parameters of combustion engine

NASA Astrophysics Data System (ADS)

Marek, W.; Śliwiński, K.

2016-09-01

This article is another one from the series in which were presented research results indicated the possible areas of application of the pneumatic injection using hot combustion gases proposed by Professor Jarnuszkiewicz. This publication present the results of the control system of exhaust gas recirculation. The main aim of this research was to determine the effect of exhaust gas recirculation to the operating parameters of the internal combustion engine on the basis of laboratory measurements. All measurements were performed at a constant engine speed. These conditions correspond to the operation of the motor operating an electrical generator. The study was conducted on the four-stroke two-cylinder engine with spark ignition. The study were specifically tested on the air injection system and therefore the selection of the rotational speed was not bound, as in conventional versions of operating parameters of the electrical machine. During the measurement there were applied criterion which used power control corresponding to the requirements of load power, at minimal values of engine speed. Recirculation value determined by the following recurrent position control valve of the injection doses inflator gas for pneumatic injection system. They were studied and recorded, the impact of dose of gases recirculation to the operating and ecological engine parameters such as power, torque, specific fuel consumption, efficiency, air fuel ratio, exhaust gas temperature and nitrogen oxides and hydrocarbons.

Operators' perception of comfort in two tractor cabs.

PubMed

Ferrari, E; Cavallo, E

2013-01-01

Workspace characteristics affect the perceived comfort level of the operator and uncomfortable working conditions have been found to have a negative impact on productivity and safety. The comfort of the operator is increasingly recognized by manufacturers as a product's added value. Comfort can positively distinguish a product and increase its competitiveness. The concept of comfort is controversial, and a clear operational definition is missing. Nevertheless, it is widely accepted that comfort is a subjective phenomenon that can be evaluated by the final users. In this study, comfort aspects of the tractor workspace interior (i.e., the cab) were investigated. Users with various levels of expertise and two medium-power utility tractors of different brands were used in a 2 x 2 mixed-factorial experimental design. Participants were involved in a dynamic assessment of the cabs, and their opinions about the different workspaces were collected through a questionnaire. Additionally, objective measurements were taken on both tractors, and subjective data were compared with objective data. Results indicate significant differences in terms of the ease of locating and operating the controls (i.e., rear-mounted three-point linkage, hydraulic system, and power take-off), the ease of starting the tractor, the ease exiting the cab, the required level of concentration in executing the tasks, the adequacy of lateral visibility from the driving station, and the level of noise at the operator's position. This article provides guidance for improving the comfort of tractor workspace interiors. Agricultural machinery manufactures would benefit from research results, differentiating themselves from competitors.

a Micro-Uav with the Capability of Direct Georeferencing

NASA Astrophysics Data System (ADS)

Rehak, M.; Mabillard, R.; Skaloud, J.

2013-08-01

This paper presents the development of a low cost UAV (Unmanned Aerial Vehicle) with the capability of direct georeferencing. The advantage of such system lies in its high maneuverability, operation flexibility as well as capability to acquire image data without the need of establishing ground control points (GCPs). Moreover, the precise georeferencing offers an improvement in the final mapping accuracy when employing integrated sensor orientation. Such mode of operation limits the number and distribution of GCPs, which in turns save time in their signalization and surveying. Although the UAV systems feature high flexibility and capability of flying into areas that are inhospitable or inaccessible to humans, the lack of precision in positioning and attitude estimation on-board decrease the gained value of the captured imagery and limits their mode of operation to specific configurations and need of groundreference. Within a scope of this study we show the potential of present technologies in the field of position and orientation determination on a small UAV. The hardware implementation and especially the non-trivial synchronization of all components is clarified. Thanks to the implementation of a multi-frequency, low power GNSS receiver and its coupling with redundant MEMSIMU, we can attain the characteristic of a much larger systems flown on large carries while keeping the sensor size and weight suitable for MAV operations.

Relationship Between Respiratory Dynamics and Body Mass Index in Patients Undergoing General Anesthesia with Laryngeal Mask Airway (LMA) and Comparison Between Lithotomy and Supine Positions

PubMed Central

Zhao, Xiao; Huang, Shiwei; Wang, Zhaomin; Chen, Lianhua; Li, Shitong

2016-01-01

Background This study aimed to compare respiratory dynamics in patients undergoing general anesthesia with a laryngeal mask airway (LMA) in lithotomy and supine positions and to validate the impact of operational position on effectiveness of LMA ventilation. Material/Methods A total of 90 patients (age range, 18–65 years) who underwent general anesthesia were selected and divided into supine position (SP group) and lithotomy position groups (LP group). Vital signs and respiratory dynamic parameters of the 2 groups were measured at different time points and after implantation of an LMA. The arterial blood gas was monitored at 15 min after induction. The intraoperative changes of hemodynamic indexes and postoperative adverse reactions of LMA were recorded. The possible correlation between body mass index (BMI) and respiratory dynamic indexes was analyzed. Results With prolonged duration of the operation, the inspiratory plateau pressure (Pplat), inspiratory resistance (RI), and work of breathing (WOB) gradually increased, while chest-lung compliance (Compl) and partial pressure of carbon dioxide in end-expiratory gas (PetCO2) gradually decreased (all P value <0.05). The mean airway pressure (Pmean), Pplat, and expiratory resistance (Re) in the LP group were significantly higher than in the SP group (P<0.05), while the peak inspiratory flow (FImax), peak expiratory flow (FEmax), WOB, and Compl in the LP group were significantly lower than in the SP group (P<0.05). BMI was positively correlated with peak airway pressure (PIP/Ppeak), Pplat, and airway resistance (Raw) and was negatively correlated with Compl; the differences among patients in lithotomy position were more remarkable (P<0.05). Conclusions The inspiratory plateau pressure and airway resistance increased with prolonged duration of the operation, accompanied by decreased chest-lung compliance. Peak airway pressure and airway resistance were positively correlated with BMI, and chest-lung compliance was negatively correlated with BMI. Changes among patients in lithotomy position were more remarkable than those in supine position. PMID:27476762

Model simulation of the Manasquan water-supply system in Monmouth County, New Jersey

USGS Publications Warehouse

Chang, Ming; Tasker, Gary D.; Nieswand, Steven

2001-01-01

Model simulation of the Manasquan Water Supply System in Monmouth County, New Jersey, was completed using historic hydrologic data to evaluate the effects of operational and withdrawal alternatives on the Manasquan reservoir and pumping system. Changes in the system operations can be simulated with the model using precipitation forecasts. The Manasquan Reservoir system model operates by using daily streamflow values, which were reconstructed from historical U.S. Geological Survey streamflow-gaging station records. The model is able to run in two modes--General Risk analysis Model (GRAM) and Position Analysis Model (POSA). The GRAM simulation procedure uses reconstructed historical streamflow records to provide probability estimates of certain events, such as reservoir storage levels declining below a specific level, when given an assumed set of operating rules and withdrawal rates. POSA can be used to forecast the likelihood of specified outcomes, such as streamflows falling below statutory passing flows, associated with a specific working plan for the water-supply system over a period of months. The user can manipulate the model and generate graphs and tables of streamflows and storage, for example. This model can be used as a management tool to facilitate the development of drought warning and drought emergency rule curves and safe yield values for the water-supply system.

Ankle fracture spur sign is pathognomonic for a variant ankle fracture.

PubMed

Hinds, Richard M; Garner, Matthew R; Lazaro, Lionel E; Warner, Stephen J; Loftus, Michael L; Birnbaum, Jacqueline F; Burket, Jayme C; Lorich, Dean G

2015-02-01

The hyperplantarflexion variant ankle fracture is composed of a posterior tibial lip fracture with posterolateral and posteromedial fracture fragments separated by a vertical fracture line. This infrequently reported injury pattern often includes an associated "spur sign" or double cortical density at the inferomedial tibial metaphysis. The objective of this study was to quantitatively establish the association of the ankle fracture spur sign with the hyperplantarflexion variant ankle fracture. Our clinical database of operative ankle fractures was retrospectively reviewed for the incidence of hyperplantarflexion variant and nonvariant ankle fractures as determined by assessment of injury radiographs, preoperative advanced imaging, and intraoperative observation. Injury radiographs were then evaluated for the presence of the spur sign, and association between the spur sign and variant fractures was analyzed. The incidence of the hyperplantarflexion variant fracture among all ankle fractures was 6.7% (43/640). The spur sign was present in 79% (34/43) of variant fractures and absent in all nonvariant fractures, conferring a specificity of 100% in identifying variant fractures. Positive predictive value and negative predictive value were 100% and 99%, respectively. The ankle fracture spur sign was pathognomonic for the hyperplantarflexion variant ankle fracture. It is important to identify variant fractures preoperatively as patient positioning, operative approach, and fixation construct of variant fractures often differ from those employed for osteosynthesis of nonvariant fractures. Identification of the spur sign should prompt acquisition of advanced imaging to formulate an appropriate operative plan to address the variant fracture pattern. Level III, retrospective comparative study. © The Author(s) 2014.

Accuracy in identifying patients with loss of consciousness in a police-operated emergency call centre - first step in the chain of survival.

PubMed

Bach, A; Christensen, E F

2007-07-01

The first link in the 'chain of survival' is the activation of Emergency Medical Services (EMS). In the major part of Denmark, police officers operate the alarm 1-1-2 centre, including calls for EMS. Our aim was to study the police 1-1-2 operators' accuracy in identifying calls concerning patients with loss of consciousness as a key symptom of life-threatening conditions. 'Unconsciousness' was defined as patients with a Glasgow Coma Scale (GCS) score of < 9, scored by the on-scene anaesthesiologist from the Mobile Emergency Care Unit (MECU). This study was an observational cohort study based on data from the Police 1-1-2 Database and the Aarhus County Pre-hospital Database containing data from MECU cases during 6 months in 2004-05. Two thousand, three hundred and forty-three emergency calls with MECU dispatch were identified. In 1655 cases, both 1-1-2 data and the GCS score were recorded. Two hundred and ninety-five patients were found with a GCS score of < 9 at MECU arrival, 243 of whom were reported 'unconscious' by 1-1-2, giving a sensitivity of 82%. One thousand, three hundred and sixty patients were found with a GCS score of > or = 9, 972 of whom were reported 'awake', giving a specificity of 72%. The positive predictive value (percentage of patients found with a GCS score of < 9 at MECU arrival amongst patients reported as 'unconscious') was 39%. The accuracy was moderate with room for improvement. The positive predictive value was low, indicating over-triage of MECU.

Diagenetic gypsum related to sulfur deposits in evaporites (Libros Gypsum, Miocene, NE Spain)

NASA Astrophysics Data System (ADS)

Ortí, Federico; Rosell, Laura; Anadón, Pere

2010-07-01

The Libros Gypsum is the thickest evaporite unit of the Miocene infill of the Teruel Basin in NE Spain. During the deposition of this unit, intense bacterial sulfate-reducing (BSR) activity in the lake depocenter generated a native sulfur deposit. Diagenetic gypsum resulted from subsequent sulfur oxidation. The different processes involved in these transformations were first investigated by Anadón et al. (1992). The present paper is concerned with this diagenetic gypsum from the stratigraphic, petrographic, isotopic and genetic points of view. Diagenetic gypsum occurs mainly as continuous or discontinuous layers, individual levels or lenses, irregular masses, nodules and micronodules, and veins. Its main textures are coarse-crystalline anhedral and fine-grained (alabastrine), both of which can replace any former lithology (carbonate, gypsum, and sulfur). The following sequence of processes and mineral/textural transformations is deduced: primary gypsum deposition — BSR and biodiagenetic carbonate/H 2S production — growth of native sulfur — growth of diagenetic gypsum — partial recrystallization of the diagenetic gypsum textures. The gypsification of the native sulfur generated two types of banded structures in the diagenetic gypsum: (1) concentric structures of centripetal growth, and (2) expansive, roughly concentric structures. In the first type, the gypsification operated from the outer boundaries towards the inner parts. In the second type, part of the carbonate hosting the sulfur was also gypsified (replaced/cemented). In the diagenetic gypsum, the δ34S values are in agreement with a native sulfur and H 2S provenance. The δ18O sulfate values, however, enable us to differentiate two main groups of values: one with positive values and the other with negative values. In the group of positive values, interstitial (evaporated) solutions participated in the sulfur oxidation; this process presumably occurred in a first oxidation stage during shallow-to-deeper burial of the Libros Gypsum unit. In the group of negative values, however, only meteoric waters participated in the oxidation, which presumably occurred in a second oxidation stage during the final exhumation of the unit. A third group of values is characterized by very high sulfur and oxygen values, suggesting that BSR residual solutions also participated in the oxidation processes locally. During the two oxidation stages, both the textural characteristics and the isotopic composition of the diagenetic gypsum indicate that gypsification operated as a multistadic process.

The value of intraoperative Gram stain in revision spine surgery.

PubMed

Shifflett, Grant D; Nwachukwu, Benedict U; Bjerke-Kroll, Benjamin T; Kueper, Janina; Koltsov, Jayme B; Sama, Andrew A; Girardi, Federico P; Cammisa, Frank P; Hughes, Alexander P

2015-10-01

Intraoperative cultures and Gram stains are often obtained in cases of revision spine surgery even when clinical signs of infection are not present. The clinical utility and cost-effectiveness of this behavior remain unproven. The aim was to evaluate the clinical utility and cost-effectiveness of routine intraoperative Gram stains in revision spine surgery. This was a retrospective clinical review performed at an academic center in an urban setting. One hundred twenty-nine consecutive adult revision spine surgeries were performed. The outcome measures included intraoperative Gram stains. We retrospectively reviewed the records of 594 consecutive revision spine surgeries performed by four senior surgeons between 2008 and 2013 to identify patients who had operative cultures and Gram stains performed. All revision cases including cervical, thoracic, and lumbar fusion and non-fusion, with and without instrumentation were reviewed. One hundred twenty-nine (21.7%) patients had operative cultures obtained and were included in the study. The most common primary diagnosis code at the time of revision surgery was pseudarthrosis, which was present in 41.9% of cases (54 of 129). Infection was the primary diagnosis in 10.1% (13 of 129) of cases. Operative cultures were obtained in 129 of 595 (21.7%) cases, and 47.3% (61 of 129) were positive. Gram stains were performed in 98 of 129 (76.0%) cases and were positive in 5 of 98 (5.1%) cases. Overall, there was no correlation between revision diagnosis and whether or not a Gram stain was obtained (p=.697). Patients with a history of prior instrumentation were more likely to have a positive Gram stain (p<.0444). Intraoperative Gram staining was found to have a sensitivity of 10.9% (confidence interval [CI] 3.9%-23.6%) and specificity of 100% (CI 93.1%-100%). The positive and negative predictive values were 100% (CI 48.0%-100%) and 57.3% (CI 45.2%-66.2%), respectively. Kappa coefficient was calculated to be 0.1172 (CI 0.0194-0.2151). The cost per discrepant diagnosis (total cost/number discrepant) was $172.10. This study demonstrates that while very specific for infection, the sensitivity of intraoperative Gram staining is low, and agreement between positive cultures and Gram stains is very poor. Gram staining demonstrated limited cost-effectiveness because of the low prevalence of findings that altered patient management. Copyright © 2015 Elsevier Inc. All rights reserved.

Variation in functional pelvic tilt in patients undergoing total hip arthroplasty.

PubMed

Pierrepont, J; Hawdon, G; Miles, B P; Connor, B O'; Baré, J; Walter, L R; Marel, E; Solomon, M; McMahon, S; Shimmin, A J

2017-02-01

The pelvis rotates in the sagittal plane during daily activities. These rotations have a direct effect on the functional orientation of the acetabulum. The aim of this study was to quantify changes in pelvic tilt between different functional positions. Pre-operatively, pelvic tilt was measured in 1517 patients undergoing total hip arthroplasty (THA) in three functional positions - supine, standing and flexed seated (the moment when patients initiate rising from a seated position). Supine pelvic tilt was measured from CT scans, standing and flexed seated pelvic tilts were measured from standardised lateral radiographs. Anterior pelvic tilt was assigned a positive value. The mean pelvic tilt was 4.2° (-20.5° to 24.5°), -1.3° (-30.2° to 27.9°) and 0.6° (-42.0° to 41.3°) in the three positions, respectively. The mean sagittal pelvic rotation from supine to standing was -5.5° (-21.8° to 8.4°), from supine to flexed seated was -3.7° (-48.3° to 38.6°) and from standing to flexed seated was 1.8° (-51.8° to 39.5°). In 259 patients (17%), the extent of sagittal pelvic rotation could lead to functional malorientation of the acetabular component. Factoring in an intra-operative delivery error of ± 5° extends this risk to 51% of patients. Planning and measurement of the intended position of the acetabular component in the supine position may fail to predict clinically significant changes in its orientation during functional activities, as a consequence of individual pelvic kinematics. Optimal orientation is patient-specific and requires an evaluation of functional pelvic tilt pre-operatively. Cite this article: Bone Joint J 2017;99-B:184-91. ©2017 The British Editorial Society of Bone & Joint Surgery.

Unambiguous quantum-state filtering

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

Takeoka, Masahiro; Sasaki, Masahide; CREST, Japan Science and Technology Corporation, Tokyo,

2003-07-01

In this paper, we consider a generalized measurement where one particular quantum signal is unambiguously extracted from a set of noncommutative quantum signals and the other signals are filtered out. Simple expressions for the maximum detection probability and its positive operator valued measure are derived. We apply such unambiguous quantum state filtering to evaluation of the sensing of decoherence channels. The bounds of the precision limit for a given quantum state of probes and possible device implementations are discussed.

Correcting the anion gap for hypoalbuminaemia does not improve detection of hyperlactataemia

PubMed Central

Dinh, C H; Ng, R; Grandinetti, A; Joffe, A; Chow, D C

2006-01-01

Background An elevated lactate level reflects impaired tissue oxygenation and is a predictor of mortality. Studies have shown that the anion gap is inadequate as a screen for hyperlactataemia, particularly in critically ill and trauma patients. A proposed explanation for the anion gap's poor sensitivity and specificity in detecting hyperlactataemia is that the serum albumin is frequently low. This study therefore, sought to compare the predictive values of the anion gap and the anion gap corrected for albumin (cAG) as an indicator of hyperlactataemia as defined by a lactate ⩾2.5 mmol/l. Methods A retrospective review of 639 sets of laboratory values from a tertiary care hospital. Patients' laboratory results were included in the study if serum chemistries and lactate were drawn consecutively. The sensitivity, specificity, and predictive values were obtained. A receiver operator characteristics curve (ROC) was drawn and the area under the curve (AUC) was calculated. Results An anion gap ⩾12 provided a sensitivity, specificity, positive predictive value, and negative predictive value of 39%, 89%, 79%, and 58%, respectively, and a cAG ⩾12 provided a sensitivity, specificity, positive predictive value, and negative predictive value of 75%, 59%, 66%, and 69%, respectively. The ROC curves between anion gap and cAG as a predictor of hyperlactataemia were almost identical. The AUC was 0.757 and 0.750, respectively. Conclusions The sensitivities, specificities, and predictive values of the anion gap and cAG were inadequate in predicting the presence of hyperlactataemia. The cAG provides no additional advantage over the anion gap in the detection of hyperlactataemia. PMID:16858097

The Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio for Detecting Early-onset Neonatal Sepsis.

PubMed

Can, Emrah; Hamilcikan, Şahin; Can, Ceren

2018-05-01

The purpose of this study was to investigate the relationship between neonate early-onset sepsis (EOS) and the neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) of term neonates. This prospective observational study was conducted with term neonates diagnosed with EOS compared with 44 healthy controls. Exclusion criteria were prematurity, postmaturity, small or large for gestational age according to week of pregnancy, preeclampsia, gestational diabetes mellitus, chorioamnionitis, congenital major anomalies, and cyanotic congenital heart disease. A total of 122 term neonates were included in the study. Of these, 78 were diagnosed with EOS and 44 were healthy controls. Tachycardia and apnea with bradycardia were the most common clinical signs of the onset of EOS in neonates in the EOS group. This group had significantly higher neutrophil counts, axillary temperatures, NLRs, PLRs, C-reactive proteins, and procalcitonin levels compared with the control group. There was a positive association between neutrophil counts, NLR, and PLR in the EOS group. An NLR of 6.76 was determined as the predictive cutoff value of neonate EOS (sensitivity 97.4%; specificity 100%; area under the receiver-operating characteristic curve 0.99; P=0.001). A PLR of 94.05 was determined as the predictive cutoff value of neonate EOS (sensitivity 97.4; specificity 100%; area under the receiver-operating characteristic curve 0.93; P=0.001). NLRs and PLRs were positively correlated with EOS in term neonates, and these ratios can be used as diagnostic adjunct tests for neonate EOS workups.

Gigapixel surface imaging of radical prostatectomy specimens for comprehensive detection of cancer-positive surgical margins using structured illumination microscopy

PubMed Central

Wang, Mei; Tulman, David B.; Sholl, Andrew B.; Kimbrell, Hillary Z.; Mandava, Sree H.; Elfer, Katherine N.; Luethy, Samuel; Maddox, Michael M.; Lai, Weil; Lee, Benjamin R.; Brown, J. Quincy

2016-01-01

Achieving cancer-free surgical margins in oncologic surgery is critical to reduce the need for additional adjuvant treatments and minimize tumor recurrence; however, there is a delicate balance between completeness of tumor removal and preservation of adjacent tissues critical for normal post-operative function. We sought to establish the feasibility of video-rate structured illumination microscopy (VR-SIM) of the intact removed tumor surface as a practical and non-destructive alternative to intra-operative frozen section pathology, using prostate cancer as an initial target. We present the first images of the intact human prostate surface obtained with pathologically-relevant contrast and subcellular detail, obtained in 24 radical prostatectomy specimens immediately after excision. We demonstrate that it is feasible to routinely image the full prostate circumference, generating gigapixel panorama images of the surface that are readily interpreted by pathologists. VR-SIM confirmed detection of positive surgical margins in 3 out of 4 prostates with pathology-confirmed adenocarcinoma at the circumferential surgical margin, and furthermore detected extensive residual cancer at the circumferential margin in a case post-operatively classified by histopathology as having negative surgical margins. Our results suggest that the increased surface coverage of VR-SIM could also provide added value for detection and characterization of positive surgical margins over traditional histopathology. PMID:27257084

The usefulness of fluorine-18 fluorodeoxyglucose PET in the detection of recurrence in patients with differentiated thyroid cancer with elevated thyroglobulin and negative radioiodine whole-body scan.

PubMed

Stangierski, Adam; Kaznowski, Jaroslaw; Wolinski, Kosma; Jodlowska, Elzbieta; Michaliszyn, Piotr; Kubiak, Katarzyna; Czepczynski, Rafal; Ruchala, Marek

2016-09-01

PET/computed tomography (CT) using fluorine-18 fluorodeoxyglucose (F-FDG) has been used in the diagnosis of recurrence and metastases of differentiated thyroid cancer (DTC) in cases of negative whole-body scan (WBS) despite elevated concentrations of stimulated thyroglobulin (Tg). To assess the utility of PET/CT in the detection of recurrence among patients with DTC with increased Tg levels and negative results of WBS. PET/CT results were retrospectively analyzed in patients with DTC with increased Tg and negative results of WBS as well as negative cervical ultrasonography and chest radiography. PET-CT was performed 1-2 weeks after recent diagnostics under conditions of endogenous or exogenous thyroid-stimulating hormone stimulation. PET/CT was performed using a Discovery ST scanner 1 h after an intravenously F-FDG injection (activity 4-5 MBq/kg). To determine the cutoff value of Tg, receiver operating characteristic curves were analyzed. Sixty-nine patients with DTC (48 women, 21 men) aged 22-83 years (mean 50.9±17.5 years) were qualified. In 44 patients (63.8%), PET/CT indicated lesions of DTC. Thirty (43.5%) patients had F-FDG positive findings. In the remaining 14 patients (20.3%), lesions were found in CT only. Patients with a positive PET/CT scan had significantly higher Tg values than patients with a negative PET/CT (mean 143.8 vs. 26.5 ng/ml, P=0.03). The cutoff value of Tg concentration measured with the receiver operating characteristic analysis was 32.9 ng/ml. PET/CT is a useful tool in the detection of recurrence among thyroid cancer patients in cases of conflicting results of standard procedures, particularly for those with high Tg levels and negative WBS. The probability of obtaining a positive PET-CT result increases with the level of Tg.

Technique for enhancing the power output of an electrostatic generator employing parametric resonance

DOEpatents

Post, Richard F.

2016-02-23

A circuit-based technique enhances the power output of electrostatic generators employing an array of axially oriented rods or tubes or azimuthal corrugated metal surfaces for their electrodes. During generator operation, the peak voltage across the electrodes occurs at an azimuthal position that is intermediate between the position of minimum gap and maximum gap. If this position is also close to the azimuthal angle where the rate of change of capacity is a maximum, then the highest rf power output possible for a given maximum allowable voltage at the minimum gap can be attained. This rf power output is then coupled to the generator load through a coupling condenser that prevents suppression of the dc charging potential by conduction through the load. Optimized circuit values produce phase shifts in the rf output voltage that allow higher power output to occur at the same voltage limit at the minimum gap position.

Zeno subspace in quantum-walk dynamics

NASA Astrophysics Data System (ADS)

Chandrashekar, C. M.

2010-11-01

We investigate discrete-time quantum-walk evolution under the influence of periodic measurements in position subspace. The undisturbed survival probability of the particle at the position subspace P(0,t) is compared with the survival probability after frequent (n) measurements at interval τ=t/n, P(0,τ)n. We show that P(0,τ)n>P(0,t) leads to the quantum Zeno effect in position subspace when a parameter θ in the quantum coin operations and frequency of measurements is greater than the critical value, θ>θc and n>nc. This Zeno effect in the subspace preserves the dynamics in coin Hilbert space of the walk dynamics and has the potential to play a significant role in quantum tasks such as preserving the quantum state of the particle at any particular position, and to understand the Zeno dynamics in a multidimensional system that is highly transient in nature.

Ring polymer dynamics in curved spaces

NASA Astrophysics Data System (ADS)

Wolf, S.; Curotto, E.

2012-07-01

We formulate an extension of the ring polymer dynamics approach to curved spaces using stereographic projection coordinates. We test the theory by simulating the particle in a ring, {T}^1, mapped by a stereographic projection using three potentials. Two of these are quadratic, and one is a nonconfining sinusoidal model. We propose a new class of algorithms for the integration of the ring polymer Hamilton equations in curved spaces. These are designed to improve the energy conservation of symplectic integrators based on the split operator approach. For manifolds, the position-position autocorrelation function can be formulated in numerous ways. We find that the position-position autocorrelation function computed from configurations in the Euclidean space {R}^2 that contains {T}^1 as a submanifold has the best statistical properties. The agreement with exact results obtained with vector space methods is excellent for all three potentials, for all values of time in the interval simulated, and for a relatively broad range of temperatures.

On Nth roots of positive operators

NASA Technical Reports Server (NTRS)

Brown, D. R.; Omalley, M. J.

1978-01-01

A bounded operator A on a Hilbert space H was positive. These operators were symmetric, and as such constitute a natural generalization of nonnegative real diagonal matrices. The following result is thus both well known and not surprising: A positive operator has a unique positive square root (under operator composition).

NV Energy Electricity Storage Valuation

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

Ellison, James F.; Bhatnagar, Dhruv; Samaan, Nader A.

2013-06-30

This study examines how grid-level electricity storage may benet the operations of NV Energy in 2020, and assesses whether those benets justify the cost of the storage system. In order to determine how grid-level storage might impact NV Energy, an hourly production cost model of the Nevada Balancing Authority (\\BA") as projected for 2020 was built and used for the study. Storage facilities were found to add value primarily by providing reserve. Value provided by the provision of time-of-day shifting was found to be limited. If regulating reserve from storage is valued the same as that from slower ramp ratemore » resources, then it appears that a reciprocating engine generator could provide additional capacity at a lower cost than a pumped storage hydro plant or large storage capacity battery system. In addition, a 25-MW battery storage facility would need to cost $650/kW or less in order to produce a positive Net Present Value (NPV). However, if regulating reserve provided by storage is considered to be more useful to the grid than that from slower ramp rate resources, then a grid-level storage facility may have a positive NPV even at today's storage system capital costs. The value of having storage provide services beyond reserve and time-of-day shifting was not assessed in this study, and was therefore not included in storage cost-benefit calculations.« less

Cerebral oxygenation in the beach chair position for shoulder surgery in regional anesthesia: impact on cerebral blood flow and neurobehavioral outcome.

PubMed

Aguirre, José A; Märzendorfer, Olivia; Brada, Muriel; Saporito, Andrea; Borgeat, Alain; Bühler, Philipp

2016-12-01

Beach chair position is considered a potential risk factor for central neurological events particularly if combined with low blood pressure. The aim of this study was to assess the impact of regional anesthesia on cerebral blood flow and neurobehavioral outcome. This is a prospective, assessor-blinded observational study evaluating patients in the beach chair position undergoing shoulder surgery under regional anesthesia. University hospital operating room. Forty patients with American Society of Anesthesiologists classes I-II physical status scheduled for elective shoulder surgery. Cerebral saturation and blood flow of the middle cerebral artery were measured prior to anesthesia and continued after beach chair positioning until discharge to the postanesthesia care unit. The anesthesiologist was blinded for these values. Controlled hypotension with systolic blood pressure≤100mm Hg was maintained during surgery. Neurobehavioral tests and values of regional cerebral saturation, bispectral index, the mean maximal blood flow of the middle cerebral artery, and invasive blood pressure were measured prior to regional anesthesia, and measurements were repeated after placement of the patient on the beach chair position and every 20 minutes thereafter until discharge to postanesthesia care unit. The neurobehavioral tests were repeated the day after surgery. The incidence of cerebral desaturation events was 5%. All patients had a significant blood pressure drop 5 minutes after beach chair positioning, measured at the heart as well as the acoustic meatus levels, when compared with baseline values (P<.05). There was no decrease in either the regional cerebral saturation (P=.136) or the maximal blood flow of the middle cerebral artery (P=.212) at the same time points. Some neurocognitive tests showed an impairment 24 hours after surgery (P<.001 for 2 of 3 tests). Beach chair position in patients undergoing regional anesthesia for shoulder surgery had no major impact on cerebral blood flow and cerebral oxygenation. However, some impact on neurobehavioral outcome 24 hours after surgery was observed. Copyright © 2016 Elsevier Inc. All rights reserved.

Diagnostic Performance of Ultrasonography for Pediatric Appendicitis: A Night and Day Difference?

PubMed

Mangona, Kate Louise M; Guillerman, R Paul; Mangona, Victor S; Carpenter, Jennifer; Zhang, Wei; Lopez, Monica; Orth, Robert C

2017-12-01

For imaging pediatric appendicitis, ultrasonography (US) is preferred because of its lack of ionizing radiation, but is limited by operator dependence. This study investigates the US diagnostic performance during night shifts covered by radiology trainees compared to day shifts covered by attending radiologists. Appy-Scores (1 = completely visualized normal appendix; 2 = partially visualized normal appendix; 3 = nonvisualized appendix with no inflammatory changes in the expected region of the appendix; 4 = equivocal; 5a = nonperforated appendicitis; 5b = perforated appendicitis) from 2935 US examinations (2161:774, day-to-night) from July 2013 to 2014 were correlated with the intraoperative diagnoses and the clinical follow-up. The diagnostic performance of trainees and attendings was compared with Fisher exact test. Interobserver agreement was measured by Cohen kappa coefficient. Appendicitis prevalence was 25.3% (day) and 22.5% (night). Sensitivity, specificity, accuracy, negative predictive value, and positive predictive vale were 94.0%, 93.7%, 93.8%, 97.9%, and 83.4% during the day and 92.0%, 91.2%, 91.3%, 97.5%, and 75.2% at night. Specificity (P = .048) and positive predictive value (P = .011) differed, with more false positives at night (7%) than during the day (4.7%). Trainee and attending agreement was high (k = 0.995), with Appy-Scores of 1, 4, and 5a most frequently discordant. US has a high diagnostic performance and interobserver agreement for pediatric appendicitis when interpreted by radiology trainees during night shifts or attending radiologists during day shifts. However, lower specificity and positive predictive value at night warrants a thorough trainee education to avoid false-positive examinations. Published by Elsevier Inc.

Early diagnostic value of plasma PCT and BG assay for CRBSI after OLT.

PubMed

Chen, J; Wang, Y; Shen, Z; Zhu, Z; Song, Y; Han, R

2011-06-01

The aim was to evaluate the role of procalcitonin (PCT) and (1-3)-β-D-glucan (BG) tests for early detection or exclusion of central venous catheter-related bloodstream infections (CRBSI) in patients after orthotopic liver transplantation (OLT). Fifty-five patients with clinically suspected CRBSI were assessed after OLT in this prospective study. On the day of clinical suspicion of CRBSI, blood samples were obtained from central venous catheters and a peripheral vein for blood cultures and from a peripheral vein for PCT and BG tests. Plasma PCT and BG values were measured by using an immunoluminometric assay and Fungitell BG assay, respectively. No prisoners or organs from prisoners were used in this study. Twenty-five patients (45%) were diagnosed with CRBIS. Among them, 13 (52%) displayed gram-positive bacteriemia, 11 (44%) gram-negative bacteriemia, and 1 (4%) fungemia. The PCT values were higher in CRBSI than in non-CRBSI patients (P = .003). CRBSI patients did not show significant increases in plasma BG values compared with non-CRBSI subjects (P = .051). PCT and BG area under receiver operating characteristic curves were 0.840 and 0.486, respectively. Sensitivity, specificity, and positive and negative predictive values of a PCT of ≥ 3.1 ng/mL for the diagnosis of CRBSI were 0.72, 0.87, 0.82, and 0.79, respectively. The figures for a BG of ≥ 83 pg/mL were 0.32, 0.90, 0.73, and 0.61, respectively. Among the 24 patients with bacteria infections, PCT was higher in patients with gram-negative than those with gram-positive bacterial infections (P = .022). We concluded that the PCT assay may be a useful rapid diagnostic adjunct for the diagnosis of suspected CRBSI in OLT patients. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparison of outcomes obtained in murine local lymph node assays using CBA/J or CBA/Ca mice.

PubMed

Maeda, Yosuke; Hirosaki, Haruka; Yakata, Naoaki; Takeyoshi, Masahiro

2016-08-01

CBA/J and CBA/Ca mice are the recommended strains for local lymph node assays (LLNAs). Here, we report quantitative and qualitative comparisons between both mouse strains to provide useful information for the strain selection of sensitization testing. LLNA was conducted, in accordance with Organisation for Economic Co-operation and Development Test Guideline No. 429, with CBA/J and CBA/Ca mice using five chemicals including typical contact sensitizers and non-sensitizers: 2,4-dinitrochlorobenzene (DNCB), isoeugenol, α-hexylcinnamic aldehyde (HCA), propylene glycol (PG), and hexane; then outcomes were compared based on the raw data (disintegrations per minute, DPM), stimulation index (SI) values, EC3 values and positive/negative decisions. Although a significant difference was noted between DPM values derived from each strain of mice, SI values exhibited no considerable difference. The EC3 values for DNCB in CBA/J and CBA/Ca mice were 0.04 and 0.03, those for isoeugenol were 1.4 and 0.9, and those for HCA were 7.7 and 6.0, respectively. All EC values derived from each test system were almost equivalent and were within the range of acceptance criteria of the ICCVAM performance standard for LLNA. Positive/negative outcomes for all test chemicals were consistent. In conclusion, no considerable differences were observed in the final outcomes derived from CBA/J and CBA/Ca mice in LLNA. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Diagnostic accuracy of APRI and FIB-4 for predicting hepatitis B virus-related liver fibrosis accompanied with hepatocellular carcinoma.

PubMed

Xiao, Guangqin; Zhu, Feng; Wang, Min; Zhang, Hang; Ye, Dawei; Yang, Jiayin; Jiang, Li; Liu, Chang; Yan, Lunan; Qin, Renyi

2016-10-01

Aspartate aminotransferase to platelet ratio index (APRI) and the fibrosis index based on four factors (FIB-4) are the two most focused non-invasive models to assess liver fibrosis. We aimed to examine the validity of these two models for predicting hepatitis B virus (HBV)-related liver fibrosis accompanied with hepatocellular carcinoma (HCC). We enrolled HBV-infected patients with liver cancer who had received hepatectomy. The accuracy of APRI and FIB-4 for diagnosing liver fibrosis was assessed based on their sensitivity, specificity, diagnostic efficiency, positive predictive value (PPV), negative predictive value (NPV), kappa (κ) value and area under the receiver-operating characteristic curve (AUC). Finally 2176 patients were included, with 1682 retrospective subjects and 494 prospective subjects. APRI (rs=0.310) and FIB-4 (rs=0.278) were positively correlated with liver fibrosis. And χ(2) analysis demonstrated that APRI and FIB-4 values correlated with different levels of liver fibrosis with all P values less than 0.01. The AUC values for APRI and FIB-4 were 0.685 and 0.626 (P=0.73) for predicting significant fibrosis, 0.681 and 0.648 (P=0.81) for differentiation of advanced fibrosis and 0.676 and 0.652 (P=0.77) for diagnosing cirrhosis. APRI and FIB-4 correlate with liver fibrosis. However these two models have low accuracy for predicting HBV-related liver fibrosis in HCC patients. Copyright © 2016. Published by Elsevier Ltd.

Comparison between the lumbar infusion and CSF tap tests to predict outcome after shunt surgery in suspected normal pressure hydrocephalus

PubMed Central

Kahlon, B; Sundbarg, G; Rehncrona, S

2002-01-01

Objective: To compare the lumbar infusion test and the cerebrospinal fluid (CSF) tap test for predicting the outcome of shunt surgery in patients with suspected normal pressure hydrocephalus. Methods: 68 patients with suspected normal pressure hydrocephalus were studied. The absence of preceding history indicated idiopathic disease in 75% of these. All patients were assessed twice with walking and psychometric tests before lumbar infusion test and tap test assessments. The lumbar infusion test was done using a constant infusion rate (0.80 ml/min) and regarded as positive if the steady state CSF plateau pressure reached levels of > 22 mm Hg (resistance to outflow > 14 mm Hg/ml/min). The tap test was regarded as positive if two or more of four different test items improved after CSF removal. As the variability in baseline test results was large, the better of two evaluations was used in comparisons with the results after CSF removal, as well as to evaluate the outcome after shunt surgery. Only patients with a positive lumbar infusion test or a positive tap test had surgery. Results: The results of the CSF tap test and the lumbar infusion test agreed in only 45% of the patients. Of the total cohort, 47 (69%) had positive test results and were operated on; 45 (96%) of these reported subjective improvement, and postoperative assessments verified the improvements in 38 (81%). Improvements were highly significant in walking, memory, and reaction time tests (p < 0.001). Most of the patients improved by surgery (84%) were selected by a positive lumbar infusion test, and only 42% by a positive tap test. Positive predictive values were 80% for lumbar infusion test and 94% for tap test. The false negative predictions in the operated group were much higher (58%) with the tap test than with the lumbar infusion test (16%). Conclusions: Both the lumbar infusion test and the tap test can predict a positive outcome of shunt operations in unselected patients with suspected normal pressure hydrocephalus. The two tests are complementary and should be used together for optimal patient selection. PMID:12438477

Comparison between the lumbar infusion and CSF tap tests to predict outcome after shunt surgery in suspected normal pressure hydrocephalus.

PubMed

Kahlon, B; Sundbärg, G; Rehncrona, S

2002-12-01

To compare the lumbar infusion test and the cerebrospinal fluid (CSF) tap test for predicting the outcome of shunt surgery in patients with suspected normal pressure hydrocephalus. 68 patients with suspected normal pressure hydrocephalus were studied. The absence of preceding history indicated idiopathic disease in 75% of these. All patients were assessed twice with walking and psychometric tests before lumbar infusion test and tap test assessments. The lumbar infusion test was done using a constant infusion rate (0.80 ml/min) and regarded as positive if the steady state CSF plateau pressure reached levels of > 22 mm Hg (resistance to outflow > 14 mm Hg/ml/min). The tap test was regarded as positive if two or more of four different test items improved after CSF removal. As the variability in baseline test results was large, the better of two evaluations was used in comparisons with the results after CSF removal, as well as to evaluate the outcome after shunt surgery. Only patients with a positive lumbar infusion test or a positive tap test had surgery. The results of the CSF tap test and the lumbar infusion test agreed in only 45% of the patients. Of the total cohort, 47 (69%) had positive test results and were operated on; 45 (96%) of these reported subjective improvement, and postoperative assessments verified the improvements in 38 (81%). Improvements were highly significant in walking, memory, and reaction time tests (p < 0.001). Most of the patients improved by surgery (84%) were selected by a positive lumbar infusion test, and only 42% by a positive tap test. Positive predictive values were 80% for lumbar infusion test and 94% for tap test. The false negative predictions in the operated group were much higher (58%) with the tap test than with the lumbar infusion test (16%). Both the lumbar infusion test and the tap test can predict a positive outcome of shunt operations in unselected patients with suspected normal pressure hydrocephalus. The two tests are complementary and should be used together for optimal patient selection.

Comparison of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study and conventional contrast radiographic colostography in children with anorectal malformation

PubMed Central

Ekwunife, Okechukwu Hyginus; Umeh, Eric Okechukwu; Ugwu, Jideofor Okechukwu; Ebubedike, Uzoamaka Rufina; Okoli, Chinedu Christian; Modekwe, Victor Ifeanyichukwu; Elendu, Kelechi Collins

2016-01-01

Background: In children with high and intermediate anorectal malformation, distal colostography is an important investigation done to determine the relationship between the position of the rectal pouch and the probable site of the neo-anus as well as the presence or absence of a fistula. Conventionally, this is done using contrast with fluoroscopy or still X-ray imaging. This, however, has the challenges of irradiation, availability and affordability, especially in developing countries. This study compared the accuracy of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study (SCDS) with conventional contrast distal colostography (CCDC) in the determination of the precise location of the distal rectal pouch and in detecting the presence and site of fistulous communication between the rectum and the urogenital tract was studied. Materials and Methods: Trans-perineal ultrasound-guided pressure augmented SCDS, CCDC and intra-operative measurements were done sequentially for qualified infants with anorectal malformation and colostomy. Pouch skin distance and presence or absence of recto urinary or genital fistula was measured prospectively in each case. Statistical significance was inferred at P-value of <0.01. Results: There were thirteen infants, 9 males and 4 females. The age at onset of investigation ranged from 2 to 12 months with a median value of 9 months. Using paired t-test at a confidence interval of 95%, the P value when SCDS values are compared with CCDC is 0.19; and 0.06 when SCDS was compared with intra-operative measurements. Hence, there is no statistical difference as P > 0.01. On its ability to detect presence or absence of a fistula: SCDS had a sensitivity of 50.0%, specificity of 100.0%, accuracy of 69.2%, negative predictive value of fistulas of 55.6% and a positive predictive value of fistulas of 100.0%. Conclusion: Ultrasound-guided pressure augmented SCDS can safely and reliably be used to assess the distal colonic anatomy and the presence of fistula in infants with Anorectal malformation who are on colostomy. PMID:27251520

Comparison of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study and conventional contrast radiographic colostography in children with anorectal malformation.

PubMed

Ekwunife, Okechukwu Hyginus; Umeh, Eric Okechukwu; Ugwu, Jideofor Okechukwu; Ebubedike, Uzoamaka Rufina; Okoli, Chinedu Christian; Modekwe, Victor Ifeanyichukwu; Elendu, Kelechi Collins

2016-01-01

In children with high and intermediate anorectal malformation, distal colostography is an important investigation done to determine the relationship between the position of the rectal pouch and the probable site of the neo-anus as well as the presence or absence of a fistula. Conventionally, this is done using contrast with fluoroscopy or still X-ray imaging. This, however, has the challenges of irradiation, availability and affordability, especially in developing countries. This study compared the accuracy of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study (SCDS) with conventional contrast distal colostography (CCDC) in the determination of the precise location of the distal rectal pouch and in detecting the presence and site of fistulous communication between the rectum and the urogenital tract was studied. Trans-perineal ultrasound-guided pressure augmented SCDS, CCDC and intra-operative measurements were done sequentially for qualified infants with anorectal malformation and colostomy. Pouch skin distance and presence or absence of recto urinary or genital fistula was measured prospectively in each case. Statistical significance was inferred at P-value of <0.01. There were thirteen infants, 9 males and 4 females. The age at onset of investigation ranged from 2 to 12 months with a median value of 9 months. Using paired t-test at a confidence interval of 95%, the P value when SCDS values are compared with CCDC is 0.19; and 0.06 when SCDS was compared with intra-operative measurements. Hence, there is no statistical difference as P > 0.01. On its ability to detect presence or absence of a fistula: SCDS had a sensitivity of 50.0%, specificity of 100.0%, accuracy of 69.2%, negative predictive value of fistulas of 55.6% and a positive predictive value of fistulas of 100.0%. Ultrasound-guided pressure augmented SCDS can safely and reliably be used to assess the distal colonic anatomy and the presence of fistula in infants with Anorectal malformation who are on colostomy.

Evaluation of a Public Child Eye Health Tertiary Facility for Pediatric Cataract in Southern Nigeria I: Visual Acuity Outcome

PubMed Central

Duke, Roseline E.; Adio, Adedayo; Oparah, Sidney K.; Odey, Friday; Eyo, Okon A.

2016-01-01

Purpose: A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation. Materials and Method: Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery. Results: Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000). Conclusion: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit. PMID:27347247

Expression of vascular endothelial growth factor in Juvenile Angiofibroma.

PubMed

Hota, Ashutosh; Sarkar, Chitra; Gupta, Siddhartha Datta; Kumar, Rakesh; Bhalla, Ashu Seith; Thakar, Alok

2015-06-01

To examine Juvenile Angiofibroma (JA) tissue for expression of vascular endothelial growth factor (VEGF), and to explore its relationship with puberty status, stage, recurrence and the intraoperative blood loss. Retrospective cohort study of 36 histologically proven cases of JA. Minimum follow up period was 3 years. VEGF expression on tumor cells assessed by immunohistochemistry and graded on two criteria--percentage of cells expressing positivity and the intensity of positivity. These two parameters assessed for impact on puberty status, stage, recurrence, and blood loss. VEGF expression noted on the tumor endothelial cells in 36/36, and on the tumor stromal cells in 34/36. The percentage of cells expressing VEGF and the intensity of expression were not significantly related to puberty status, tumor stage, recurrence, or intra-operative blood loss (p values 0.3-1.0). VEGF expression is near universal in JA. Such expression is independent of puberty status and stage, and does not impact on intra operative blood loss and recurrence. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sufficient condition for a quantum state to be genuinely quantum non-Gaussian

NASA Astrophysics Data System (ADS)

Happ, L.; Efremov, M. A.; Nha, H.; Schleich, W. P.

2018-02-01

We show that the expectation value of the operator \\hat{{ \\mathcal O }}\\equiv \\exp (-c{\\hat{x}}2)+\\exp (-c{\\hat{p}}2) defined by the position and momentum operators \\hat{x} and \\hat{p} with a positive parameter c can serve as a tool to identify quantum non-Gaussian states, that is states that cannot be represented as a mixture of Gaussian states. Our condition can be readily tested employing a highly efficient homodyne detection which unlike quantum-state tomography requires the measurements of only two orthogonal quadratures. We demonstrate that our method is even able to detect quantum non-Gaussian states with positive–definite Wigner functions. This situation cannot be addressed in terms of the negativity of the phase-space distribution. Moreover, we demonstrate that our condition can characterize quantum non-Gaussianity for the class of superposition states consisting of a vacuum and integer multiples of four photons under more than 50 % signal attenuation.

Pure state `really' informationally complete with rank-1 POVM

NASA Astrophysics Data System (ADS)

Wang, Yu; Shang, Yun

2018-03-01

What is the minimal number of elements in a rank-1 positive operator-valued measure (POVM) which can uniquely determine any pure state in d-dimensional Hilbert space H_d? The known result is that the number is no less than 3d-2. We show that this lower bound is not tight except for d=2 or 4. Then we give an upper bound 4d-3. For d=2, many rank-1 POVMs with four elements can determine any pure states in H_2. For d=3, we show eight is the minimal number by construction. For d=4, the minimal number is in the set of {10,11,12,13}. We show that if this number is greater than 10, an unsettled open problem can be solved that three orthonormal bases cannot distinguish all pure states in H_4. For any dimension d, we construct d+2k-2 adaptive rank-1 positive operators for the reconstruction of any unknown pure state in H_d, where 1≤ k ≤ d.

Configuring Airspace Sectors with Approximate Dynamic Programming

NASA Technical Reports Server (NTRS)

Bloem, Michael; Gupta, Pramod

2010-01-01

In response to changing traffic and staffing conditions, supervisors dynamically configure airspace sectors by assigning them to control positions. A finite horizon airspace sector configuration problem models this supervisor decision. The problem is to select an airspace configuration at each time step while considering a workload cost, a reconfiguration cost, and a constraint on the number of control positions at each time step. Three algorithms for this problem are proposed and evaluated: a myopic heuristic, an exact dynamic programming algorithm, and a rollouts approximate dynamic programming algorithm. On problem instances from current operations with only dozens of possible configurations, an exact dynamic programming solution gives the optimal cost value. The rollouts algorithm achieves costs within 2% of optimal for these instances, on average. For larger problem instances that are representative of future operations and have thousands of possible configurations, excessive computation time prohibits the use of exact dynamic programming. On such problem instances, the rollouts algorithm reduces the cost achieved by the heuristic by more than 15% on average with an acceptable computation time.

A Novel Technology for Localization of Parathyroid Adenoma: Ultrasound-Guided Fine Needle Aspiration Combined With Rapid Parathyroid Hormone Detection and Nano-Carbon Technology.

PubMed

Yan, Shouyi; Zhao, Wenxin; Wang, Bo; Zhang, Liyong

2018-06-01

The study aims to evaluate the clinic feasibility of rapid parathyroid hormone (PTH) detection and nano-carbon technology in preoperative diagnosis and localization of parathyroid adenoma. With the guidance of ultrasound, the operator performed the parathyroid puncture and tested the PTH value by using a PTH test kit, and then injected nano-carbon into parathyroid adenoma as a marker to observe whether the parathyroid adenoma was stained black during the final operation. Meanwhile, a part of excised specimen was made into homogenate and detected rapidly again by using the PTH test kit. The remaining was confirmed by intraoperative frozen pathological examination. The sensitivity (12/12) of preoperative diagnosis was significantly higher than that of ultrasound (6/12), magnetic resonance imaging (7/12), and MIBI (9/12). During the operation, we found that the inner part of the parathyroid adenoma was stained black, and the PTH value of the specimen homogenate confirmed as parathyroid adenoma was more than 3000 pg/mL. This novel technology, as a very positive method for localization of parathyroid adenoma, plays an important role in guaranteeing the surgical reliability of parathyroid adenoma with help of nano-carbon technology.

Effects of Sampling and Spatio/Temporal Granularity in Traffic Monitoring on Anomaly Detectability

NASA Astrophysics Data System (ADS)

Ishibashi, Keisuke; Kawahara, Ryoichi; Mori, Tatsuya; Kondoh, Tsuyoshi; Asano, Shoichiro

We quantitatively evaluate how sampling and spatio/temporal granularity in traffic monitoring affect the detectability of anomalous traffic. Those parameters also affect the monitoring burden, so network operators face a trade-off between the monitoring burden and detectability and need to know which are the optimal paramter values. We derive equations to calculate the false positive ratio and false negative ratio for given values of the sampling rate, granularity, statistics of normal traffic, and volume of anomalies to be detected. Specifically, assuming that the normal traffic has a Gaussian distribution, which is parameterized by its mean and standard deviation, we analyze how sampling and monitoring granularity change these distribution parameters. This analysis is based on observation of the backbone traffic, which exhibits spatially uncorrelated and temporally long-range dependence. Then we derive the equations for detectability. With those equations, we can answer the practical questions that arise in actual network operations: what sampling rate to set to find the given volume of anomaly, or, if the sampling is too high for actual operation, what granularity is optimal to find the anomaly for a given lower limit of sampling rate.

Predictive Value of Matrix Metalloproteinases and Their Inhibitors for Mortality in Septic Patients: A Cohort Study.

PubMed

Serrano-Gomez, Sergio; Burgos-Angulo, Gabriel; Niño-Vargas, Daniela Camila; Niño, María Eugenia; Cárdenas, María Eugenia; Chacón-Valenzuela, Estephania; McCosham, Diana Margarita; Peinado-Acevedo, Juan Sebastián; Lopez, M Marcos; Cunha, Fernando; Pazin-Filho, Antonio; Ilarraza, Ramses; Schulz, Richard; Torres-Dueñas, Diego

2017-01-01

Over 170 biomarkers are being investigated regarding their prognostic and diagnostic accuracy in sepsis in order to find new tools to reduce morbidity and mortality. Matrix metalloproteinases (MMPs) and their inhibitors have been recently studied as promising new prognostic biomarkers in patients with sepsis. This study is aimed at determining the utility of several cutoff points of these biomarkers to predict mortality in patients with sepsis. A multicenter, prospective, analytic cohort study was performed in the metropolitan area of Bucaramanga, Colombia. A total of 289 patients with sepsis and septic shock were included. MMP-9, MMP-2, tissue inhibitor of metalloproteinase 1 (TIMP-1), TIMP-2, TIMP-1/MMP-9 ratio, and TIMP-2/MMP-2 ratio were determined in blood samples. Value ranges were correlated with mortality to estimate sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiving operating characteristic curve. Sensitivity ranged from 33.3% (MMP-9/TIMP-1 ratio) to 60.6% (TIMP-1) and specificity varied from 38.8% (MMP-2/TIMP-2 ratio) to 58.5% (TIMP-1). As for predictive values, positive predictive value range was from 17.5% (MMP-9/TIMP-1 ratio) to 70.4% (MMP-2/TIMP-2 ratio), whereas negative predictive values were between 23.2% (MMP-2/TIMP-2 ratio) and 80.9% (TIMP-1). Finally, area under the curve scores ranged from 0.31 (MMP-9/TIMP-1 ratio) to 0.623 (TIMP-1). Although TIMP-1 showed higher sensitivity, specificity, and negative predictive value, with a representative population sample, we conclude that none of the evaluated biomarkers had significant predictive value for mortality.

[Whole-body vibration risk among operators in railway engines shunting ].

PubMed

Abbate, A; Saffioti, G; Malara, G; Licordari, P; Carrello, S; De Pasquale, D; Giorgianni, C

2007-01-01

Purpose of the present note is to assess the risk from Whole-body vibration (WBV) in operators employed in the shunting of engines within the railway stations. The study has been conducted in the cockpits of the shunting engines used within the railway station of Villa S. Giovanni (RC). The measures have been taken through accelerometer IHVM 100 Larson-Davis, placed on the seat of each locomotives for a recording time of around 15 minutes. A standard measure has been effected besides, positioning the sensor on the floor of the same locomotives. The measurements indicate that the risk to these workers is negligible because in any case the value is exceeded action daily 0.5 m/s2, having recorded values range from 0.1 to 0.2 m / s2. In conclusion it holds him necessary, to the preventive goals, in respect to how much anticipated from the D.L.gs 187/05 the necessary technical, organizational and formative measures to the containment of the risk.

Cardiovascular risk scores for coronary atherosclerosis.

PubMed

Yalcin, Murat; Kardesoglu, Ejder; Aparci, Mustafa; Isilak, Zafer; Uz, Omer; Yiginer, Omer; Ozmen, Namik; Cingozbay, Bekir Yilmaz; Uzun, Mehmet; Cebeci, Bekir Sitki

2012-10-01

The objective of this study was to compare frequently used cardiovascular risk scores in predicting the presence of coronary artery disease (CAD) and 3-vessel disease. In 350 consecutive patients (218 men and 132 women) who underwent coronary angiography, the cardiovascular risk level was determined using the Framingham Risk Score (FRS), the Modified Framingham Risk Score (MFRS), the Prospective Cardiovascular Münster (PROCAM) score, and the Systematic Coronary Risk Evaluation (SCORE). The area under the curve for receiver operating characteristic curves showed that FRS had more predictive value than the other scores for CAD (area under curve, 0.76, P < or = 0.001), but all scores had good specificity and positive predictive value. For 3-vessel disease, the FRS had better predictive value than the other scores (area under curve, 0.74, P < or = 0.001), but all scores had good specificity and negative predictive value. The risk scores (FRS, MFRS, PROCAM, and SCORE) may predict the presence and severity of coronary atherosclerosis.The FRS had better predictive value than the other scores.

Social values and biodiversity conservation in a dynamic world.

PubMed

Dietsch, Alia M; Teel, Tara L; Manfredo, Michael J

2016-12-01

Understanding what shape values (which ultimately shape human behavior) will help improve the effectiveness of conservation solutions that depend on public support. To contribute to this understanding, we investigated the influence of societal-level changes, such as modernization, on values in a multilevel framework. We collected survey responses (n = 4183) to questionnaires mailed to a random selection of households within each county in Washington (U.S.A.) (response rate 32%). We used multilevel modeling to determine the relationship between modernization (e.g., county-level urbanization, wealth, and education) and wildlife value orientations (values that shape thought about wildlife) while controlling for individual-level sociodemographics. We then explored how values influence conservation support at different levels (e.g., individual and county) and how values explain conservation support in a case study of public responses to wolf (Canis lupis) recovery. We found positive associations between county-level examples of modernization and mutualism (a wildlife value orientation that prioritizes the perceived needs of wildlife) independent of a respondent's sociodemographics, and negative associations between modernization and domination (a wildlife value orientation that prioritizes human needs). Our results suggest that context has an additive impact on one's values; certain locations exhibited domination values, whereas others exhibited a mix of value types. This finding is important because actions that restrict human interests to promote biodiversity were negatively associated with domination and positively associated with mutualism. In the wolf case study, mutualism was strongly correlated with less social conflict over wolf recovery in many, but not all, counties (e.g., Pearson's r correlation = 0.59 in one county and a nonsignificant correlation in another). Our findings suggest that modernization operates on values within a state with implications for biodiversity, but other factors in addition to values must be investigated to fully understand what leads to proconservation behavior. © 2016 Society for Conservation Biology.

Emerging Futures for Sao Tome & Principe’s International Airport Campus

DTIC Science & Technology

2007-12-03

appointment to manage daily operations of the airport. Upon his appointment in 2006, he realized the airport needed to be upgraded to meet International...International Airpon air-traffic control tower. ’rhis facility contains all of the opetational and ptimary management functions of the airport, Funding for any...views ofSTP citizens of the true value ofoil and its potential for positive effects. The addition of more people working on oil rigs, managing the

A Study of the Relationship between Member Attitudes and Organizational Effectiveness in a Strategic Missile Wing (SAC) Operations Directorate.

DTIC Science & Technology

1978-09-01

interaction with other persons and which relate him to various subsets within the domain with varying degrees of positive or negative affect[31:300...and downs of the homeostatic functioning of an organism or with small changes in stimulus conditions. 3. Attitudes imply a relationship between a person ...and objects. These objects may be other persons , groups, institutions, inert physical objects, values, social issues, or ideologies. 4. The

Maslow and the motivation hierarchy: measuring satisfaction of the needs.

PubMed

Taormina, Robert J; Gao, Jennifer H

2013-01-01

For each of the 5 needs in Maslow's motivational hierarchy (physiological, safety-security, belongingness, esteem, and self-actualization), operational definitions were developed from Maslow's theory of motivation. New measures were created based on the operational definitions (1) to assess the satisfaction of each need, (2) to assess their expected correlations (a) with each of the other needs and (b) with four social and personality measures (i.e., family support, traditional values, anxiety/worry, and life satisfaction), and (3) to test the ability of the satisfaction level of each need to statistically predict the satisfaction level of the next higher-level need. Psychometric tests of the scales conducted on questionnaire results from 386 adult respondents from the general population lent strong support for the validity and reliability of all 5 needs measures. Significant positive correlations among the scales were also found; that is, the more each lower-level need was satisfied, the more the next higher-level need was satisfied. Additionally, as predicted, family support, traditional values, and life satisfaction had significant positive correlations with the satisfaction of all 5 needs, and the anxiety/worry facet of neuroticism had significant negative correlations with the satisfaction of all the needs. Multiple regression analyses revealed that the satisfaction of each higher-level need was statistically predicted by the satisfaction of the need immediately below it in the hierarchy, as expected from Maslow's theory.

An application of the Caputo-Fabrizio operator to replicator-mutator dynamics: Bifurcation, chaotic limit cycles and control

NASA Astrophysics Data System (ADS)

Doungmo Goufo, Emile Franc

2018-02-01

The physical behaviors of replicator-mutator processes found in theoretical biophysics, physical chemistry, biochemistry and population biology remain complex with unlimited expressibility. People languages, for instance, have impressively and unpredictably changed over the time in human history. This is mainly due to the collection of small changes and collaboration with other languages. In this paper, the Caputo-Fabrizio operator is applied to a replicator-mutator dynamic taking place in midsts with movement. The model is fully analyzed and solved numerically via the Crank-Nicolson scheme. Stability and convergence results are provided. A concrete application to replicator-mutator dynamics for a population with three strategies is performed with numerical simulations provided for some fixed values of the physical position of the population symbolized by r and the grid points. Physically, it happens that limit cycles appear, not only in function of the mutation parameter μ but also in function of the values given to r . The amplitudes of limit cycles also appear to be proportional to r but the stability of the system remains unaffected. However, those limit cycles instead of disappearing as expected, are immediately followed by chaotic and unpredictable behaviors certainly due to the non-singular kernel used in the model and suitable to non-linear dynamics. Hence, the appearance and disappearance of limit cycles might be controlled by the position variable r which can also apprehend chaos.

Software for illustrative presentation of basic clinical characteristics of laboratory tests--GraphROC for Windows.

PubMed

Kairisto, V; Poola, A

1995-01-01

GraphROC for Windows is a program for clinical test evaluation. It was designed for the handling of large datasets obtained from clinical laboratory databases. In the user interface, graphical and numerical presentations are combined. For simplicity, numerical data is not shown unless requested. Relevant numbers can be "picked up" from the graph by simple mouse operations. Reference distributions can be displayed by using automatically optimized bin widths. Any percentile of the distribution with corresponding confidence limits can be chosen for display. In sensitivity-specificity analysis, both illness- and health-related distributions are shown in the same graph. The following data for any cutoff limit can be shown in a separate click window: clinical sensitivity and specificity with corresponding confidence limits, positive and negative likelihood ratios, positive and negative predictive values and efficiency. Predictive values and clinical efficiency of the cutoff limit can be updated for any prior probability of disease. Receiver Operating Characteristics (ROC) curves can be generated and combined into the same graph for comparison of several different tests. The area under the curve with corresponding confidence interval is calculated for each ROC curve. Numerical results of analyses and graphs can be printed or exported to other Microsoft Windows programs. GraphROC for Windows also employs a new method, developed by us, for the indirect estimation of health-related limits and change limits from mixed distributions of clinical laboratory data.

Viking Orbiter 1975 articulation control subsystem design analysis

NASA Technical Reports Server (NTRS)

Horiuchi, H. H.; Vallas, L. J.

1973-01-01

The articulation control subsystem, developed for the Viking Orbiter 1975 spacecraft, is a digital, multiplexed, closed-loop servo system used to control the pointing and positioning of the science scan platform and the high-gain communication antenna, and to position the solar-energy controller louver blades for the thermal control of the propellant tanks. The development, design, and anlaysis of the subsystem is preliminary. The subsystem consists of a block-redundant control electronics multiplexed among eight control actuators. Each electronics block is capable of operating either individually or simultaneously with the second block. This provides the subsystem the capability of simultaneous two-actuator control or a single actuator control with the second block in a stand-by redundant mode. The result of the preliminary design and analysis indicates that the subsystem will perform satisfactorily in the Viking Orbiter 1975 mission. Some of the parameter values used, particularly those in the subsystem dynamics and the error estimates, are preliminary and the results will be updated as more accurate parameter values become available.

Advanced electrorefiner design

DOEpatents

Miller, W.E.; Gay, E.C.; Tomczuk, Z.

1996-07-02

A combination anode and cathode is described for an electrorefiner which includes a hollow cathode and an anode positioned inside the hollow cathode such that a portion of the anode is near the cathode. A retaining member is positioned at the bottom of the cathode. Mechanism is included for providing relative movement between the anode and the cathode during deposition of metal on the inside surface of the cathode during operation of the electrorefiner to refine spent nuclear fuel. A method is also disclosed which includes electrical power means selectively connectable to the anode and the hollow cathode for providing electrical power to the cell components, electrically transferring uranium values and plutonium values from the anode to the electrolyte, and electrolytically depositing substantially pure uranium on the hollow cathode. Uranium and plutonium are deposited at a liquid cathode together after the PuCl{sub 3} to UCl{sub 3} ratio is greater than 2:1. Slots in the hollow cathode provides close anode access for the liquid pool in the liquid cathode. 6 figs.

Advanced electrorefiner design

DOEpatents

Miller, William E.; Gay, Eddie C.; Tomczuk, Zygmunt

1996-01-01

A combination anode and cathode for an electrorefiner which includes a hollow cathode and an anode positioned inside the hollow cathode such that a portion of the anode is near the cathode. A retaining member is positioned at the bottom of the cathode. Mechanism is included for providing relative movement between the anode and the cathode during deposition of metal on the inside surface of the cathode during operation of the electrorefiner to refine spent nuclear fuel. A method is also disclosed which includes electrical power means selectively connectable to the anode and the hollow cathode for providing electrical power to the cell components, electrically transferring uranium values and plutonium values from the anode to the electrolyte, and electrolytically depositing substantially pure uranium on the hollow cathode. Uranium and plutonium are deposited at a liquid cathode together after the PuCl.sub.3 to UCl.sub.3 ratio is greater than 2:1. Slots in the hollow cathode provides close anode access for the liquid pool in the liquid cathode.

Automatic brain tumor detection in MRI: methodology and statistical validation

NASA Astrophysics Data System (ADS)

Iftekharuddin, Khan M.; Islam, Mohammad A.; Shaik, Jahangheer; Parra, Carlos; Ogg, Robert

2005-04-01

Automated brain tumor segmentation and detection are immensely important in medical diagnostics because it provides information associated to anatomical structures as well as potential abnormal tissue necessary to delineate appropriate surgical planning. In this work, we propose a novel automated brain tumor segmentation technique based on multiresolution texture information that combines fractal Brownian motion (fBm) and wavelet multiresolution analysis. Our wavelet-fractal technique combines the excellent multiresolution localization property of wavelets to texture extraction of fractal. We prove the efficacy of our technique by successfully segmenting pediatric brain MR images (MRIs) from St. Jude Children"s Research Hospital. We use self-organizing map (SOM) as our clustering tool wherein we exploit both pixel intensity and multiresolution texture features to obtain segmented tumor. Our test results show that our technique successfully segments abnormal brain tissues in a set of T1 images. In the next step, we design a classifier using Feed-Forward (FF) neural network to statistically validate the presence of tumor in MRI using both the multiresolution texture and the pixel intensity features. We estimate the corresponding receiver operating curve (ROC) based on the findings of true positive fractions and false positive fractions estimated from our classifier at different threshold values. An ROC, which can be considered as a gold standard to prove the competence of a classifier, is obtained to ascertain the sensitivity and specificity of our classifier. We observe that at threshold 0.4 we achieve true positive value of 1.0 (100%) sacrificing only 0.16 (16%) false positive value for the set of 50 T1 MRI analyzed in this experiment.

Solution to the mean king's problem with mutually unbiased bases for arbitrary levels

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

Kimura, Gen; Tanaka, Hajime; Ozawa, Masanao

2006-05-15

The mean king's problem with mutually unbiased bases is reconsidered for arbitrary d-level systems. Hayashi et al. [Phys. Rev. A 71, 052331 (2005)] related the problem to the existence of a maximal set of d-1 mutually orthogonal Latin squares, in their restricted setting that allows only measurements of projection-valued measures. However, we then cannot find a solution to the problem when, e.g., d=6 or d=10. In contrast to their result, we show that the king's problem always has a solution for arbitrary levels if we also allow positive operator-valued measures. In constructing the solution, we use orthogonal arrays in combinatorialmore » design theory.« less

Flight data processing with the F-8 adaptive algorithm

NASA Technical Reports Server (NTRS)

Hartmann, G.; Stein, G.; Petersen, K.

1977-01-01

An explicit adaptive control algorithm based on maximum likelihood estimation of parameters has been designed for NASA's DFBW F-8 aircraft. To avoid iterative calculations, the algorithm uses parallel channels of Kalman filters operating at fixed locations in parameter space. This algorithm has been implemented in NASA/DFRC's Remotely Augmented Vehicle (RAV) facility. Real-time sensor outputs (rate gyro, accelerometer and surface position) are telemetered to a ground computer which sends new gain values to an on-board system. Ground test data and flight records were used to establish design values of noise statistics and to verify the ground-based adaptive software. The software and its performance evaluation based on flight data are described

Reliability of N-terminal proBNP assay in diagnosis of left ventricular systolic dysfunction within representative and high risk populations.

PubMed

Hobbs, F D R; Davis, R C; Roalfe, A K; Hare, R; Davies, M K

2004-08-01

To determine the performance of a new NT-proBNP assay in comparison with brain natriuretic peptide (BNP) in identifying left ventricular systolic dysfunction (LVSD) in randomly selected community populations. Blood samples were taken prospectively in the community from 591 randomly sampled individuals over the age of 45 years, stratified for age and socioeconomic status and divided into four cohorts (general population; clinically diagnosed heart failure; patients on diuretics; and patients deemed at high risk of heart failure). Definite heart failure (left ventricular ejection fraction (LVEF) < 40%) was identified in 33 people. Samples were handled as though in routine clinical practice. The laboratories undertaking the assays were blinded. Using NT-proBNP to diagnose LVEF < 40% in the general population, a level of > 40 pmol/l had 80% sensitivity, 73% specificity, 5% positive predictive value (PPV), 100% negative predictive value (NPV), and an area under the receiver-operator characteristic curve (AUC) of 76% (95% confidence interval (CI) 46% to 100%). For BNP to diagnose LVSD, a cut off level of > 33 pmol/l had 80% sensitivity, 88% specificity, 10% PPV, 100% NPV, and AUC of 88% (95% CI 75% to 100%). Similar NPVs were found for patients randomly screened from the three other populations. Both NT-proBNP and BNP have value in diagnosing LVSD in a community setting, with similar sensitivities and specificities. Using a high cut off for positivity will confirm the diagnosis of LVSD but will miss cases. At lower cut off values, positive results will require cardiac imaging to confirm LVSD.

Comparative performance of Aspergillus galactomannan ELISA and PCR in sputum from patients with ABPA and CPA.

PubMed

Fayemiwo, Samuel; Moore, Caroline B; Foden, Philip; Denning, David W; Richardson, Malcolm D

2017-09-01

Galactomannan (GM) and Aspergillus DNA detection are useful tools for the diagnosis of invasive pulmonary aspergillosis (IPA), primarily in blood and bronchoscopy samples. This study aimed to evaluate the utility of both markers for detection of Aspergillus in sputum from patients with allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). ABPA or CPA demographic patient data were retrieved. This retrospective observational audit included 159 patients with at least one sputum pair. 223 sputum sample pairs were analysed, as well as six control samples for GM only. Real time PCR was performed following sputum DNA extraction using the MycAssay™ Aspergillus kit and cycle thresholds were subtracted from 38 to give positive values (transformed Ct, TCt). The mean age of the patients was 61.81years (SD: ±11.06; range 29-100). One hundred and twenty-six (79.2%) had CPA. Cultures were positive for fungi in 13.1% of the samples, and A. fumigatus was the commonest (11.9%) fungus isolated. Receiver operating characteristic (ROC curve) analysis of sputum GM comparing TCt of >0.0, and >2.0 to derive GMI cut-off values showed a cut-off of 6.5. About 50% of sputa with strongly positive PCR values had GM values>6.5. Two of six (33%) control samples had GM indices>6.5. It is not clear that GM determinations in sputum are useful for diagnosis of either CPA or ABPA, or following therapy. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Operator Variability in Scan Positioning is a Major Component of HR-pQCT Precision Error and is Reduced by Standardized Training

PubMed Central

Bonaretti, Serena; Vilayphiou, Nicolas; Chan, Caroline Mai; Yu, Andrew; Nishiyama, Kyle; Liu, Danmei; Boutroy, Stephanie; Ghasem-Zadeh, Ali; Boyd, Steven K.; Chapurlat, Roland; McKay, Heather; Shane, Elizabeth; Bouxsein, Mary L.; Black, Dennis M.; Majumdar, Sharmila; Orwoll, Eric S.; Lang, Thomas F.; Khosla, Sundeep; Burghardt, Andrew J.

2017-01-01

Introduction HR-pQCT is increasingly used to assess bone quality, fracture risk and anti-fracture interventions. The contribution of the operator has not been adequately accounted in measurement precision. Operators acquire a 2D projection (“scout view image”) and define the region to be scanned by positioning a “reference line” on a standard anatomical landmark. In this study, we (i) evaluated the contribution of positioning variability to in vivo measurement precision, (ii) measured intra- and inter-operator positioning variability, and (iii) tested if custom training software led to superior reproducibility in new operators compared to experienced operators. Methods To evaluate the operator in vivo measurement precision we compared precision errors calculated in 64 co-registered and non-co-registered scan-rescan images. To quantify operator variability, we developed software that simulates the positioning process of the scanner’s software. Eight experienced operators positioned reference lines on scout view images designed to test intra- and inter-operator reproducibility. Finally, we developed modules for training and evaluation of reference line positioning. We enrolled 6 new operators to participate in a common training, followed by the same reproducibility experiments performed by the experienced group. Results In vivo precision errors were up to three-fold greater (Tt.BMD and Ct.Th) when variability in scan positioning was included. Inter-operator precision errors were significantly greater than short-term intra-operator precision (p<0.001). New trained operators achieved comparable intra-operator reproducibility to experienced operators, and lower inter-operator reproducibility (p<0.001). Precision errors were significantly greater for the radius than for the tibia. Conclusion Operator reference line positioning contributes significantly to in vivo measurement precision and is significantly greater for multi-operator datasets. Inter-operator variability can be significantly reduced using a systematic training platform, now available online (http://webapps.radiology.ucsf.edu/refline/). PMID:27475931

The reliability of fine-needle aspiration biopsy in terms of malignancy in patients with Hashimoto thyroiditis.

PubMed

Kapan, Murat; Onder, Akin; Girgin, Sadullah; Ulger, Burak Veli; Firat, Ugur; Uslukaya, Omer; Oguz, Abdullah

2015-02-01

The aim of this study was to analyze the presence of malignancy in patients with Hashimoto's thyroiditis and to investigate the reliability of preoperative fine-needle aspiration biopsy (FNAB). The retrospective study included 44 patients who were operated on for nodular goiter between December 2010 and October 2011. The patients underwent thyroidectomy following a cytologic analysis plus FNAB. Hashimoto's thyroiditis was confirmed on histopathology in all patients. FNAB results were defined as benign in 14 (31.8%), suspicion for malignancy in 17 (38.6%), malignant in 9 (20.5%), and inadequate in 4 (9.1%). Following the thyroidectomy, presence of papillary thyroid carcinoma and follicular variant of papillary thyroid carcinoma were detected in 10 patients (22.7%) and 1 (2.3%) patient, respectively. The FNAB results were interpreted in terms of malignancy, which revealed the sensitivity as 80%; specificity, 40%; false positives, 69.2%; false negatives, 14.3%; positive predictive value, 31.8%; negative predictive value, 85.7%; and diagnostic accuracy, 50%. The coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma is quite common. The FNAB results for such cases are hard to evaluate, and they are likely to increase the number of false positives.

Using urinary leucocyte esterase tests as an indicator of infection with gonorrhoea or chlamydia in asymptomatic males in a primary health care setting.

PubMed

Rahman, Md Saifur; Beever, Warwick; Skov, Steven; Boffa, John

2014-02-01

To evaluate a leucocyte esterase test as a predictor of gonorrhoea or chlamydia in asymptomatic Aboriginal males at the Central Australian Aboriginal Congress Male Clinic (Ingkintja), first-void urine samples and clinical information were collected from consecutive asymptomatic males presenting to the Ingkintja in Alice Springs between March 2008 and December 2009. Urine was tested immediately with a leucocyte esterase test dipstick and then by polymerase chain reaction for gonorrhoea and chlamydia. Among the 292 specimens from asymptomatic males, 15.4% were positive for gonorrhoea or chlamydia. In this group, compared with polymerase chain reaction result for gonorrhoea or chlamydia, leucocyte esterase test alone and in combination with age ≤35 years showed sensitivities of 66.7% and 60%, specificities of 90.7% and 94.7%, positive predictive values of 56.6% and 67.5%, negative predictive values of 93.7% and 92.8% and the area under receiver operating characteristics curve values of 0.79 and 0.85, respectively. Leucocyte esterase tests can reasonably be used as a basis for immediate empirical treatment for gonorrhoea or chlamydia in asymptomatic central Australian Aboriginal men under 35 years of age.

Prognostic value of Helicobacter pylori sinonasal colonization for efficacy of endoscopic sinus surgery.

PubMed

Jelavic, Boris; Grgić, Marko; Cupić, Hrvoje; Kordić, Mirko; Vasilj, Mirjana; Baudoin, Tomislav

2012-10-01

Compared with rhinologic patients without chronic rhinosinusitis (CRS), a higher prevalence of sinonasal Helicobacter pylori (HP) in patients with CRS was found. This study investigated if HP sinonasal colonization has a prognostic value for efficacy of functional endoscopic sinus surgery (FESS). Nasal polyps of 40 patients with CRS, undergoing FESS, were analyzed for presence of HP using immunohistochemistry (IHC). Patients were categorized as to whether the IHC was positive (HP+ group) or negative (HP- group). HP+ group and HP- group were compared according to the nasal polyp eosinophil density, and to the improvement (difference between pre- and post-operative scores) of the subjective symptom scores, and the nasal endoscopic scores. Nasal polyps in 28 (70%) patients were positive for HP. There were no significant differences between HP+ group and HP- group comparing the eosinophils, and the improvement of the single symptom and the total symptom scores. HP+ group had significantly greater improvement of the nasal endoscopic scores (F[1.38] = 6.212; P = 0.017). There is no influence of sinonasal HP on tissue eosinophilia and on CRS symptoms. There is a prognostic value for endonasal findings: CRS patients with HP have statistically significant greater improvement of the postoperative endoscopic scores.

Combining Gabor and Talbot bands techniques to enhance the sensitivity with depth in Fourier domain optical coherence tomography

NASA Astrophysics Data System (ADS)

Bradu, Adrian; Marques, Manuel J.; Bouchal, Petr; Podoleanu, Adrian Gh.

2013-03-01

The purpose of this study was to show how to favorably mix two e_ects to improve the sensitivity with depth in Fourier domain optical coherence tomography (OCT): Talbot bands (TB) and Gabor-based fusion (GF) technique. TB operation is achieved by directing the two beams, from the object arm and from the reference arm in the OCT interferometer, along parallel separate paths towards the spectrometer. By changing the lateral gap between the two beams in their path towards the spectrometer, the position for the maximum sensitivity versus the optical path difference in the interferometer is adjusted. For five values of the focus position, the gap between the two beams is readjusted to reach maximum sensitivity. Then, similar to the procedure employed in the GF technique, a composite image is formed by edging together the parts of the five images that exhibited maximum brightness. The combined procedure, TB/GF is examined for four different values of the beam diameters of the two beams. Also we demonstrate volumetric FD-OCT images with mirror term attenuation and sensitivity profile shifted towards higher OPD values by applying a Talbot bands configuration.

Intrapartum fetal head circumference and estimated fetal weight as predictors of operative delivery.

PubMed

Rabei, Noha H; El-Helaly, Amr M; Farag, Amr H; El-Naggar, Ahmed K; Etman, Mohamed K; El-Moteily, Moataz M

2017-04-01

To assess intrapartum sonographic measurements of fetal head circumference (HC) and estimated fetal weight (EFW) to predict operative delivery. In a prospective study, 200 spontaneously parturient primiparous women aged 20-30 years were enrolled at a teaching hospital in Cairo, Egypt, between October 2, 2015, and January 28, 2016. HC and EFW were measured by transabdominal ultrasonography. After delivery, the association between type of delivery and ultrasonography findings was assessed. Intrapartum HC and EFW were significantly higher among women with operative delivery (n=76) than among those with normal vaginal delivery (n=124; P<0.001 for both). Intrapartum HC of 36.8 cm or more was associated with an increased risk of operative delivery (relative risk [RR] 2.87, 95% CI 1.87-4.41), as was EFW of 3920 g or more (RR 3.69, 95% CI 2.13-6.40). The area under the receiver operating characteristic curve was 0.807 and 0.748 for HC and EFW, respectively (P<0.001 for both). At 36.8-cm cutoff, HC had 44.7% sensitivity, 91.9% specificity, 77.3% positive predictive value (PPV), and 73.1% negative predictive value (NPV). At 3920-g cutoff, EFW had 68.4% sensitivity, 82.3% specificity, 70.3% PPV, and 81.0% NPV. Intrapartum HC and EFW were directly correlated with second-stage duration (P=0.005 and 0.002, respectively). Intrapartum HC and EFW seem to be good predictors of operative delivery. © 2017 International Federation of Gynecology and Obstetrics.

The Keck keyword layer

NASA Technical Reports Server (NTRS)

Conrad, A. R.; Lupton, W. F.

1992-01-01

Each Keck instrument presents a consistent software view to the user interface programmer. The view consists of a small library of functions, which are identical for all instruments, and a large set of keywords, that vary from instrument to instrument. All knowledge of the underlying task structure is hidden from the application programmer by the keyword layer. Image capture software uses the same function library to collect data for the image header. Because the image capture software and the instrument control software are built on top of the same keyword layer, a given observation can be 'replayed' by extracting keyword-value pairs from the image header and passing them back to the control system. The keyword layer features non-blocking as well as blocking I/O. A non-blocking keyword write operation (such as setting a filter position) specifies a callback to be invoked when the operation is complete. A non-blocking keyword read operation specifies a callback to be invoked whenever the keyword changes state. The keyword-callback style meshes well with the widget-callback style commonly used in X window programs. The first keyword library was built for the two Keck optical instruments. More recently, keyword libraries have been developed for the infrared instruments and for telescope control. Although the underlying mechanisms used for inter-process communication by each of these systems vary widely (Lick MUSIC, Sun RPC, and direct socket I/O, respectively), a basic user interface has been written that can be used with any of these systems. Since the keyword libraries are bound to user interface programs dynamically at run time, only a single set of user interface executables is needed. For example, the same program, 'xshow', can be used to display continuously the telescope's position, the time left in an instrument's exposure, or both values simultaneously. Less generic tools that operate on specific keywords, for example an X display that controls optical instrument exposures, have also been written using the keyword layer.

Diagnostic Capability of Peripapillary Three-dimensional Retinal Nerve Fiber Layer Volume for Glaucoma Using Optical Coherence Tomography Volume Scans.

PubMed

Khoueir, Ziad; Jassim, Firas; Poon, Linda Yi-Chieh; Tsikata, Edem; Ben-David, Geulah S; Liu, Yingna; Shieh, Eric; Lee, Ramon; Guo, Rong; Papadogeorgou, Georgia; Braaf, Boy; Simavli, Huseyin; Que, Christian; Vakoc, Benjamin J; Bouma, Brett E; de Boer, Johannes F; Chen, Teresa C

2017-10-01

To determine the diagnostic capability of peripapillary 3-dimensional (3D) retinal nerve fiber layer (RNFL) volume measurements from spectral-domain optical coherence tomography (OCT) volume scans for open-angle glaucoma (OAG). Assessment of diagnostic accuracy. Setting: Academic clinical setting. Total of 180 patients (113 OAG and 67 normal subjects). One eye per subject was included. Peripapillary 3D RNFL volumes were calculated for global, quadrant, and sector regions, using 4 different-size annuli. Peripapillary 2D RNFL thickness circle scans were also obtained. Area under the receiver operating characteristic curve (AUROC) values, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios. Among all 2D and 3D RNFL parameters, best diagnostic capability was associated with inferior quadrant 3D RNFL volume of the smallest annulus (AUROC value 0.977). Otherwise, global 3D RNFL volume AUROC values were comparable to global 2D RNFL thickness AUROC values for all 4 annulus sizes (P values: .0593 to .6866). When comparing the 4 annulus sizes for global RNFL volume, the smallest annulus had the best AUROC values (P values: .0317 to .0380). The smallest-size annulus may have the best diagnostic potential, partly owing to having no areas excluded for being larger than the 6 × 6 mm 2 scanned region. Peripapillary 3D RNFL volume showed excellent diagnostic performance for detecting glaucoma. Peripapillary 3D RNFL volume parameters have the same or better diagnostic capability compared to peripapillary 2D RNFL thickness measurements, although differences were not statistically significant. Copyright © 2017 Elsevier Inc. All rights reserved.

Research regarding the influence of driving-wires length change on positioning precision of a robotic arm

NASA Astrophysics Data System (ADS)

Ciofu, C.; Stan, G.

2016-08-01

The paper emphasise positioning precision of an elephant's trunk robotic arm which has joints driven by wires with variable length while operating The considered 5 degrees of freedom robotic arm has a particular structure of joint that makes possible inner actuation with wire-driven mechanism. We analyse solely the length change of wires as a consequence due inner winding and unwinding on joints for certain values of rotational angles. Variations in wires length entail joint angular displacements. We analyse positioning precision by taking into consideration equations from inverse kinematics of the elephant's trunk robotic arm. The angular displacements of joints are considered into computational method after partial derivation of positioning equations. We obtain variations of wires length at about tenths of micrometers. These variations employ angular displacements which are about minutes of sexagesimal degree and, thus, define positioning precision of elephant's trunk robotic arms. The analytical method is used for determining aftermath design structure of an elephant's trunk robotic arm with inner actuation through wires on positioning precision. Thus, designers could take suitable decisions on accuracy specifications limits of the robotic arm.

Quantum incompatibility of channels with general outcome operator algebras

NASA Astrophysics Data System (ADS)

Kuramochi, Yui

2018-04-01

A pair of quantum channels is said to be incompatible if they cannot be realized as marginals of a single channel. This paper addresses the general structure of the incompatibility of completely positive channels with a fixed quantum input space and with general outcome operator algebras. We define a compatibility relation for such channels by identifying the composite outcome space as the maximal (projective) C*-tensor product of outcome algebras. We show theorems that characterize this compatibility relation in terms of the concatenation and conjugation of channels, generalizing the recent result for channels with quantum outcome spaces. These results are applied to the positive operator valued measures (POVMs) by identifying each of them with the corresponding quantum-classical (QC) channel. We also give a characterization of the maximality of a POVM with respect to the post-processing preorder in terms of the conjugate channel of the QC channel. We consider another definition of compatibility of normal channels by identifying the composite outcome space with the normal tensor product of the outcome von Neumann algebras. We prove that for a given normal channel, the class of normally compatible channels is upper bounded by a special class of channels called tensor conjugate channels. We show the inequivalence of the C*- and normal compatibility relations for QC channels, which originates from the possibility and impossibility of copying operations for commutative von Neumann algebras in C*- and normal compatibility relations, respectively.

Hemoglobin A1c can be helpful in predicting progression to diabetes after Whipple procedure.

PubMed

Hamilton, Lisa; Jeyarajah, D Rohan

2007-01-01

Normoglycemic patients undergoing pancreaticoduodenectomy (Whipple procedure) often inquire whether they will be diabetic postoperatively. There is limited information on this issue. We therefore looked at a more subtle measurement of long-term glycemic control, hemoglobin A1c (HgbA1c), as a prognostic tool in predicting progression to diabetes post Whipple. A retrospective review over a 6-year period of all patients undergoing Whipple procedures at a single institution was conducted. In all, 27 patients had no prior history of diabetes, complete follow-up, and measured preoperative HgbA1c values. Postoperative diabetes was defined as the need for oral hypoglycemic agents or insulin. These charts were analyzed for progression to diabetes after Whipple. Of the 27 patients, 10 were considered to have postoperative diabetes. The average preoperative HgbA1c value for these patients was 6.3+/-0.66. This was statistically different from the 17 patients without postoperative diabetes (average HgbA1c 5.2+/-0.39, p<0.001). The positive predictive value, negative predictive value, sensitivity, and specificity were 82%, 94%, 90%, and 88%, respectively. This study demonstrates that progression to diabetes is very unlikely after Whipple operation if the preoperative HgbA1c value is in the normal range. The apparent utility of HgbA1c in predicting postoperative diabetes in this small study suggests that this laboratory test may be very helpful in counseling patients for Whipple operation.

The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma.

PubMed

Bennie, George; Vorster, Mariza; Buscombe, John; Sathekge, Mike

2015-01-01

Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation.

The stable microbubble test for determining continuous positive airway pressure (CPAP) success in very preterm infants receiving nasal CPAP from birth.

PubMed

Bhatia, Risha; Morley, Colin J; Argus, Brenda; Tingay, David G; Donath, Susan; Davis, Peter G

2013-01-01

Very preterm infants can be treated with nasal continuous positive airway pressure (CPAP) from birth, but some fail. A rapid test, such as the stable microbubble test (SMT) on gastric aspirate, may identify those who can be managed successfully using CPAP. To determine if SMT can identify soon after birth, very preterm infants who may be successfully managed on CPAP alone. Stable microbubbles (diameter <15 µm) were counted in gastric aspirates taken <1 h of age from infants <30 weeks' gestation, who received CPAP from birth. Infants failed CPAP if intubated at <72 h of age. Clinicians were masked to SMT results. A receiver operating characteristic curve was generated to determine the relationship between number of microbubbles/mm(2) and subsequent intubation. 68 infants of mean (SD) 28.1 (1.4) weeks' gestation received CPAP in the delivery room at a median (interquartile range) pressure 7 (6-8) cmH2O and FiO2 0.25 (0.21-0.3). Gastric aspirates were taken at a median (interquartile range) age of 0.5 (0.3-0.6) hours. The best cut-off point for predicting CPAP success or failure was a SMT count of 8 microbubbles/mm(2). The area under the receiver operating characteristic curve was 0.8 (95% CI 0.7-0.9). A SMT count ≥8 microbubbles/mm(2) had a sensitivity of 53%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 60% for predicting CPAP success. Infants treated with CPAP from birth, who had SMT counts ≥8 microbubbles/mm(2) on their gastric aspirate, did not fail CPAP. Copyright © 2013 S. Karger AG, Basel.

Evaluation of white blood cell count, neutrophil percentage, and elevated temperature as predictors of bloodstream infection in burn patients.

PubMed

Murray, Clinton K; Hoffmaster, Roselle M; Schmit, David R; Hospenthal, Duane R; Ward, John A; Cancio, Leopoldo C; Wolf, Steven E

2007-07-01

To investigate whether specific values of or changes in temperature, white blood cell count, or neutrophil percentage were predictive of bloodstream infection in burn patients. Retrospective review of electronic records. Intensive care center at the US Army Institute of Surgical Research Burn Center. Burn patients with blood cultures obtained from 2001 to 2004. Temperature recorded at the time blood cultures were obtained; highest temperature in each 6-hour interval during the 24 hours prior to this; white blood cell count and neutrophil percentage at the time of obtaining the blood culture and during the 24 hours preceding the blood culture; demographic data; and total body surface area burned. A total of 1063 blood cultures were obtained from 223 patients. Seventy-three people had 140 blood cultures from which microorganisms were recovered. Organisms that were recovered from blood cultures included 80 that were gram negative, 54 that were gram positive, 3 that were mixed gram positive/gram negative, and 3 yeasts. Although white blood cell count and neutrophil percentage at the time of the culture were statistically different between patients with and patients without bloodstream infection, receiver operating characteristic curve analysis revealed these values to be poor discriminators (receiver operating characteristic curve area = 0.624). Temperature or alterations in temperature in the preceding 24-hour period did not predict presence, absence, or type of bloodstream infection. Temperature, white blood cell count, neutrophil percentage, or changes in these values were not clinically reliable in predicting bloodstream infection. Further work is needed to identify alternative clinical parameters, which should prompt blood culture evaluations in this population.

Diagnostic capability of spectral-domain optical coherence tomography for glaucoma.

PubMed

Wu, Huijuan; de Boer, Johannes F; Chen, Teresa C

2012-05-01

To determine the diagnostic capability of spectral-domain optical coherence tomography in glaucoma patients with visual field defects. Prospective, cross-sectional study. Participants were recruited from a university hospital clinic. One eye of 85 normal subjects and 61 glaucoma patients with average visual field mean deviation of -9.61 ± 8.76 dB was selected randomly for the study. A subgroup of the glaucoma patients with early visual field defects was calculated separately. Spectralis optical coherence tomography (Heidelberg Engineering, Inc) circular scans were performed to obtain peripapillary retinal nerve fiber layer (RNFL) thicknesses. The RNFL diagnostic parameters based on the normative database were used alone or in combination for identifying glaucomatous RNFL thinning. To evaluate diagnostic performance, calculations included areas under the receiver operating characteristic curve, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio. Overall RNFL thickness had the highest area under the receiver operating characteristic curve values: 0.952 for all patients and 0.895 for the early glaucoma subgroup. For all patients, the highest sensitivity (98.4%; 95% confidence interval, 96.3% to 100%) was achieved by using 2 criteria: ≥ 1 RNFL sectors being abnormal at the < 5% level and overall classification of borderline or outside normal limits, with specificities of 88.9% (95% confidence interval, 84.0% to 94.0%) and 87.1% (95% confidence interval, 81.6% to 92.5%), respectively, for these 2 criteria. Statistical parameters for evaluating the diagnostic performance of the Spectralis spectral-domain optical coherence tomography were good for early perimetric glaucoma and were excellent for moderately advanced perimetric glaucoma. Copyright © 2012 Elsevier Inc. All rights reserved.

Ghost busting: PT-symmetric interpretation of the Lee model

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

Bender, Carl M.; Brandt, Sebastian F.; Chen, J.-H.

2005-01-15

The Lee model was introduced in the 1950s as an elementary quantum field theory in which mass, wave function, and charge renormalization could be carried out exactly. In early studies of this model it was found that there is a critical value of g{sup 2}, the square of the renormalized coupling constant, above which g{sub 0}{sup 2}, the square of the unrenormalized coupling constant, is negative. Thus, for g{sup 2} larger than this critical value, the Hamiltonian of the Lee model becomes non-Hermitian. It was also discovered that in this non-Hermitian regime a new state appears whose norm is negative.more » This state is called a ghost state. It has always been assumed that in this ghost regime the Lee model is an unacceptable quantum theory because unitarity appears to be violated. However, in this regime while the Hamiltonian is not Hermitian, it does possess PT symmetry. It has recently been discovered that a non-Hermitian Hamiltonian having PT symmetry may define a quantum theory that is unitary. The proof of unitarity requires the construction of a new time-independent operator called C. In terms of C one can define a new inner product with respect to which the norms of the states in the Hilbert space are positive. Furthermore, it has been shown that time evolution in such a theory is unitary. In this paper the C operator for the Lee model in the ghost regime is constructed in the V/N{theta} sector. It is then shown that the ghost state has a positive norm and that the Lee model is an acceptable unitary quantum field theory for all values of g{sup 2}.« less

Regional Cerebral Blood Flow In Dementia: Receiver-Operating-Characteristic Analysis

NASA Astrophysics Data System (ADS)

Zemcov, Alexander; Barclay, Laurie; Sansone, Joseph; Blass, John P.; Metz, Charles E.

1985-06-01

The coupling of mentation to regional cerebral blood flow (rCBF) has prompted the application of the Xe-133 inhalation method of measuring rCBF in the differential diagnosis of the two most common dementing diseases, Alzheimer's disease and multi-infarct dementia (MID). In this study receiver-operating-characteristic (ROC) curve analysis was used to assess the effectiveness of a 32 detector Xe-133 inhalation system in discriminating between patients with Alzheimer's disease and normal controls, MID patients and normal controls and between patients with Alzheimer's disease and MID. The populations were clinically evaluated as 1) normal (age 63.1 + 13.1, n=23), 2) Alzheimer's disease (age 72.7 + 7.0, n=82), 3) MID (age 76.4 + 7.6, n=27): The mean flow values for all detectors were lowest for the Alzheimer's disease group, larger for the MID group and largest for the normal controls. The dynamic relationship between the correct identifications (true posi-tives) versus incorrect identifications (false positives) per detector for any 2 pairs of clinical groups varies as the cutoff value of flow is changed over the range of experimental blood flow values. Therefore a quantitative characterization of the "decision" or ROC curve (TP vs FP) for each detector and for each pair of clinical groups provides a measure of the overall diagnostic efficacy of the detector. Detectors directed approximately toward the speech, auditory and association cortices were most effective in disciminatinq between each of the dementia groups and the controls. Frontal detectors were diagnostically inefficient. The Xe-133 inhalation system provided virtually no diagnostic power in discriminating between the two forms of dementia, however. Therefore this imaging technology is most useful when assessing the general diagnostic state of dementia (Alz-heimer's disease and MID) from normal cognitive function.

The prognostic and risk-stratified value of heart-type fatty acid-binding protein in septic patients in the emergency department.

PubMed

Chen, Yun-Xia; Li, Chun-Sheng

2014-08-01

To evaluate the prognostic and risk-stratified ability of heart-type fatty acid-binding protein (H-FABP) in septic patients in the emergency department (ED). From August to November 2012, 295 consecutive septic patients were enrolled. Circulating H-FABP was measured. The predictive value of H-FABP for 28-day mortality, organ dysfunction on ED arrival, and requirement for mechanical ventilation or a vasopressor within 6 hours after ED arrival was assessed by the receiver operating characteristic curve and logistic regression and was compared with Acute Physiology and Chronic Health Evaluation (APACHE) II score, Mortality in Emergency Department Sepsis (MEDS) score, and Sequential Organ Failure Assessment score. The 28-day mortality, APACHE II, MEDS, and Sequential Organ Failure Assessment scores were much higher in H-FABP-positive patients. The incidence of organ dysfunction at ED arrival and requirement for mechanical ventilation or a vasopressor within 6 hours after ED arrival was higher in H-FABP-positive patients. Heart-type fatty acid-binding protein was an independent predictor of 28-day mortality and organ dysfunction. The area under the receiver operating characteristic curve for H-FABP predicting 28-day mortality and organ dysfunction was 0.784 and 0.755, respectively. Combination of H-FABP and MEDS improved the performance of MEDS in predicting organ dysfunction, and the difference of AUC was statistically significant (P<.05). The combinations of H-FABP and MEDS or H-FABP and APACHE II also improved the prognostic value of MEDS and APACHE II, but the areas under the curve were not statistically different. Heart-type fatty acid-binding protein was helpful for prognosis and risk stratification of septic patients in the ED. Copyright © 2014 Elsevier Inc. All rights reserved.

A comparative analysis of toluidine blue with frozen section in oral squamous cell carcinoma

PubMed Central

2012-01-01

Background Surgical excision of the primary tumor with safe margins remains the mainstay of treatment for oral cavity squamous cell carcinoma (OSCC). The standard of care for assessment of intraoperative margins is frozen section histopathology. Unfortunately the facility is not available at most centers in limited resource countries. Toluidine blue, a metachromatic dye, has been well described in clinical identification of malignant and premalignant lesion in the oral cavity. Considering this we decided to explore intraoperative use of toluidine blue staining, in comparison with frozen sections, for the assessment of tumor-free margins. Methods After obtaining clearance from the in-house ethical review committee, a prospective study was conducted at Aga Khan University Hospital, Karachi, from August 15, 2009 to March 14, 2010. A sample of 56 consenting patients with biopsy-proven OSCC were included in the study, giving us 280 tumor margins. Margins were analyzed using toluidine blue staining and frozen section histopathology. A receiver operator curve (ROC) was then applied to compare assessment of margin status by toluidine blue and frozen section. Results Of the 280 examined margins 11 stained positive with toluidine blue, three were positive on frozen section biopsy, and three were positive on final histopathology. Toluidine blue staining had sensitivity and specificity of 100% and 97%, respectively. The diagnostic accuracy of toluidine blue was found to be 97.1% with a positive predictive value (PPV) of 27.2% and a negative predictive value (NPV) of 100%. Conclusions Toluidine blue can be used as an effective screening modality for the assessment of intraoperative margins in resource limited environments and reducing the number of frozen section biopsies performed. Further by providing real-time clinical information within minutes it can reduce indirect costs such as operating room time. It may also be used as an ad hoc for frozen section biopsies where frozen section facilities are available. PMID:22500814

The focused abdominal sonography for trauma examination can reliably identify patients with significant intra-abdominal hemorrhage in life-threatening pelvic fractures.

PubMed

Christian, Nicole Townsend; Burlew, Clay Cothren; Moore, Ernest E; Geddes, Andrea E; Wagenaar, Amy E; Fox, Charles J; Pieracci, Fredric M

2018-06-01

The focused abdominal sonography for trauma (FAST) examination has been reported to be unreliable in pelvic fracture patients. Additionally, given the advent of new therapeutic interventions, such as resuscitative endovascular balloon occlusion of the aorta (REBOA), rapid identification of intra-abdominal hemorrhage compared with Zone III hemorrhage may guide different therapeutic strategies. We hypothesized that FAST is reliable for detecting clinically significant intra-abdominal hemorrhage in the face of complex pelvic fractures. Our pelvic fracture database of all hemodynamically unstable patients requiring intervention from January 1, 2005, to July 1, 2015, was reviewed. The FAST examination was compared with operative and computed tomography (CT) scan findings. Confirmatory evaluation for FAST(-) patients was considered positive if therapeutic intervention was required. During the study period, 81 patients in refractory shock with FAST imaging in our emergency department (ED) underwent pelvic packing. Mean age was 45 ± 2 years and Injury Severity Score was 50 ± 1.5. The FAST examination was negative in 53 patients; 52 patients did not require operative intervention for abdominal bleeding while one patient required splenectomy. The FAST examination was positive in 28 patients; 26 had findings confirmed by CT or laparotomy while two patients did not have intra-abdominal hemorrhage on further evaluation. The sensitivity and specificity for FAST in this population was 96% and 96%, respectively, positive predictive value was 93%, and negative predictive value was 98%. The false-negative and -positive rates for FAST were 2% and 7%. Focused abdominal sonography for trauma examination reliably identifies clinically significant hemoperitoneum in life-threatening, pelvic fracture related hemorrhage. The incidence of a false-negative FAST in this unstable pelvic fracture population was 2%. FAST results may be used when determining the role of REBOA in these multisystem trauma patients and requires further study. REBOA placement should be considered in hemodynamically unstable pelvic fracture patients who are FAST(-), while laparotomy should be used in FAST(+) patients. Therapeutic, level IV.

Partitioned key-value store with atomic memory operations

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

Bent, John M.; Faibish, Sorin; Grider, Gary

A partitioned key-value store is provided that supports atomic memory operations. A server performs a memory operation in a partitioned key-value store by receiving a request from an application for at least one atomic memory operation, the atomic memory operation comprising a memory address identifier; and, in response to the atomic memory operation, performing one or more of (i) reading a client-side memory location identified by the memory address identifier and storing one or more key-value pairs from the client-side memory location in a local key-value store of the server; and (ii) obtaining one or more key-value pairs from themore » local key-value store of the server and writing the obtained one or more key-value pairs into the client-side memory location identified by the memory address identifier. The server can perform functions obtained from a client-side memory location and return a result to the client using one or more of the atomic memory operations.« less

A New Weighted Injury Severity Scoring System: Better Predictive Power for Pediatric Trauma Mortality.

PubMed

Shi, Junxin; Shen, Jiabin; Caupp, Sarah; Wang, Angela; Nuss, Kathryn E; Kenney, Brian; Wheeler, Krista K; Lu, Bo; Xiang, Henry

2018-05-02

An accurate injury severity measurement is essential for the evaluation of pediatric trauma care and outcome research. The traditional Injury Severity Score (ISS) does not consider the differential risks of the Abbreviated Injury Scale (AIS) from different body regions nor is it pediatric specific. The objective of this study was to develop a weighted injury severity scoring (wISS) system for pediatric blunt trauma patients with better predictive power than ISS. Based on the association between mortality and AIS from each of the six ISS body regions, we generated different weights for the component AIS scores used in the calculation of ISS. The weights and wISS were generated using the National Trauma Data Bank (NTDB). The Nationwide Emergency Department Sample (NEDS) was used to validate our main results. Pediatric blunt trauma patients less than 16 years were included, and mortality was the outcome. Discrimination (areas under the receiver operating characteristic curve, sensitivity, specificity, positive predictive value, negative predictive value, concordance) and calibration (Hosmer-Lemeshow statistic) were compared between the wISS and ISS. The areas under the receiver operating characteristic curves from the wISS and ISS are 0.88 vs. 0.86 in ISS=1-74 and 0.77 vs. 0.64 in ISS=25-74 (p<0.0001). The wISS showed higher specificity, positive predictive value, negative predictive value, and concordance when they were compared at similar levels of sensitivity. The wISS had better calibration (smaller Hosmer-Lemeshow statistic) than the ISS (11.6 versus 19.7 for ISS=1-74 and 10.9 versus 12.6 for ISS= 25-74). The wISS showed even better discrimination with the NEDS. By weighting the AIS from different body regions, the wISS had significantly better predictive power for mortality than the ISS, especially in critically injured children.Level of Evidence and study typeLevel IV Prognostic/Epidemiological.

EUS elastography (strain ratio) and fractal-based quantitative analysis for the diagnosis of solid pancreatic lesions.

PubMed

Carrara, Silvia; Di Leo, Milena; Grizzi, Fabio; Correale, Loredana; Rahal, Daoud; Anderloni, Andrea; Auriemma, Francesco; Fugazza, Alessandro; Preatoni, Paoletta; Maselli, Roberta; Hassan, Cesare; Finati, Elena; Mangiavillano, Benedetto; Repici, Alessandro

2018-06-01

EUS elastography is useful in characterizing solid pancreatic lesions (SPLs), and fractal analysis-based technology has been used to evaluate geometric complexity in oncology. The aim of this study was to evaluate EUS elastography (strain ratio) and fractal analysis for the characterization of SPLs. Consecutive patients with SPLs were prospectively enrolled between December 2015 and February 2017. Elastographic evaluation included parenchymal strain ratio (pSR) and wall strain ratio (wSR) and was performed with a new compact US processor. Elastographic images were analyzed using a computer program to determine the 3-dimensional histogram fractal dimension. A composite cytology/histology/clinical reference standard was used to assess sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve. Overall, 102 SPLs from 100 patients were studied. At final diagnosis, 69 (68%) were malignant and 33 benign. At elastography, both pSR and wSR appeared to be significantly higher in malignant as compared with benign SPLs (pSR, 24.5 vs 6.4 [P < .001]; wSR, 56.6 vs 15.3 [P < .001]). When the best cut-off levels of pSR and wSR at 9.10 and 16.2, respectively, were used, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve were 88.4%, 78.8%, 89.7%, 76.9%, and 86.7% and 91.3%, 69.7%, 86.5%, 80%, and 85.7%, respectively. Fractal analysis showed a significant statistical difference (P = .0087) between the mean surface fractal dimension of malignant lesions (D = 2.66 ± .01) versus neuroendocrine tumor (D = 2.73 ± .03) and a statistical difference for all 3 channels red, green, and blue (P < .0001). EUS elastography with pSR and fractal-based analysis are useful in characterizing SPLs. (Clinical trial registration number: NCT02855151.). Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Quantitative T2 mapping evaluation for articular cartilage lesions in a rabbit model of anterior cruciate ligament transection osteoarthritis.

PubMed

Wei, Zheng-mao; Du, Xiang-ke; Huo, Tian-long; Li, Xu-bin; Quan, Guang-nan; Li, Tian-ran; Cheng, Jin; Zhang, Wei-tao

2012-03-01

Quantitative T2 mapping has been a widely used method for the evaluation of pathological cartilage properties, and the histological assessment system of osteoarthritis in the rabbit has been published recently. The aim of the study was to investigate the effectiveness of quantitative T2 mapping evaluation for articular cartilage lesions of a rabbit model of anterior cruciate ligament transection (ACLT) osteoarthritis. Twenty New Zealand White (NZW) rabbits were divided into ACLT surgical group and sham operated group equally. The anterior cruciate ligaments of the rabbits in ACLT group were transected, while the joints were closed intactly in sham operated group. Magnetic resonance (MR) examinations were performed on 3.0T MR unit at week 0, week 6, and week 12. T2 values were computed on GE ADW4.3 workstation. All rabbits were killed at week 13, and left knees were stained with Haematoxylin and Eosin. Semiquantitative histological grading was obtained according to the osteoarthritis cartilage histopathology assessment system. Computerized image analysis was performed to quantitate the immunostained collagen type II. The average MR T2 value of whole left knee cartilage in ACLT surgical group ((29.05±12.01) ms) was significantly higher than that in sham operated group ((24.52±7.97) ms) (P=0.024) at week 6. The average T2 value increased to (32.18±12.79) ms in ACLT group at week 12, but remained near the baseline level ((27.66±8.08) ms) in the sham operated group (P=0.03). The cartilage lesion level of left knee in ACLT group was significantly increased at week 6 (P=0.005) and week 12 (P<0.001). T2 values had positive correlation with histological grading scores, but inverse correlation with optical densities (OD) of type II collagen. This study demonstrated the reliability and practicability of quantitative T2 mapping for the cartilage injury of rabbit ACLT osteoarthritis model.

Introducing difference recurrence relations for faster semi-global alignment of long sequences.

PubMed

Suzuki, Hajime; Kasahara, Masahiro

2018-02-19

The read length of single-molecule DNA sequencers is reaching 1 Mb. Popular alignment software tools widely used for analyzing such long reads often take advantage of single-instruction multiple-data (SIMD) operations to accelerate calculation of dynamic programming (DP) matrices in the Smith-Waterman-Gotoh (SWG) algorithm with a fixed alignment start position at the origin. Nonetheless, 16-bit or 32-bit integers are necessary for storing the values in a DP matrix when sequences to be aligned are long; this situation hampers the use of the full SIMD width of modern processors. We proposed a faster semi-global alignment algorithm, "difference recurrence relations," that runs more rapidly than the state-of-the-art algorithm by a factor of 2.1. Instead of calculating and storing all the values in a DP matrix directly, our algorithm computes and stores mainly the differences between the values of adjacent cells in the matrix. Although the SWG algorithm and our algorithm can output exactly the same result, our algorithm mainly involves 8-bit integer operations, enabling us to exploit the full width of SIMD operations (e.g., 32) on modern processors. We also developed a library, libgaba, so that developers can easily integrate our algorithm into alignment programs. Our novel algorithm and optimized library implementation will facilitate accelerating nucleotide long-read analysis algorithms that use pairwise alignment stages. The library is implemented in the C programming language and available at https://github.com/ocxtal/libgaba .

Ambulatory measurement of the scapulohumeral rhythm: intra- and inter-operator agreement of a protocol based on inertial and magnetic sensors.

PubMed

Parel, I; Cutti, A G; Fiumana, G; Porcellini, G; Verni, G; Accardo, A P

2012-04-01

To measure the scapulohumeral rhythm (SHR) in outpatient settings, the motion analysis protocol named ISEO (INAIL Shoulder and Elbow Outpatient protocol) was developed, based on inertial and magnetic sensors. To complete the sensor-to-segment calibration, ISEO requires the involvement of an operator for sensor placement and for positioning the patient's arm in a predefined posture. Since this can affect the measure, this study aimed at quantifying ISEO intra- and inter-operator agreement. Forty subjects were considered, together with two operators, A and B. Three measurement sessions were completed for each subject: two by A and one by B. In each session, the humerus and scapula rotations were measured during sagittal and scapular plane elevation movements. ISEO intra- and inter-operator agreement were assessed by computing, between sessions, the: (1) similarity of the scapulohumeral patterns through the Coefficient of Multiple Correlation (CMC(2)), both considering and excluding the difference of the initial value of the scapula rotations between two sessions (inter-session offset); (2) 95% Smallest Detectable Difference (SDD(95)) in scapula range of motion. Results for CMC(2) showed that the intra- and inter-operator agreement is acceptable (median≥0.85, lower-whisker ≥ 0.75) for most of the scapula rotations, independently from the movement and the inter-session offset. The only exception is the agreement for scapula protraction-retraction and for scapula medio-lateral rotation during abduction (inter-operator), which is acceptable only if the inter-session offset is removed. SDD(95) values ranged from 4.4° to 8.6° for the inter-operator and between 4.9° and 8.5° for the intra-operator agreement. In conclusion, ISEO presents a high intra- and inter-operator agreement, particularly with the scapula inter-session offset removed. Copyright © 2011 Elsevier B.V. All rights reserved.

Association of quality of life and job stress in occupational workforce of India: Findings from a cross-sectional study on software professionals

PubMed Central

Babu, Giridhara R.; Sudhir, Paulomi M.; Mahapatra, Tanmay; Das, Aritra; Rathnaiah, Mohanbabu; Anand, Indiresh; Detels, Roger

2016-01-01

Background: There is limited scientific evidence on the relationship of job stress with quality of life (QoL). Purpose: This study aims to explore different domains of job stress affecting IT/ITES professionals and estimate the levels of stress that these professionals endure to reach positive levels of QoL given that other determinants operating between these two variables are accounted for. Materials and Methods: We estimated levels of stress that software professionals would have endured to reach positive levels of QoL considering that other factors operating between these two variables are accounted for. The study participants comprised 1071 software professionals who were recruited using a mixed sampling method. Participants answered a self-administered questionnaire containing questions on job stress, QoL, and confounders. Results: All the domains (physical, psychological, social, and environmental) of QoL showed statistically significant positive associations with increasing stress domains of autonomy, physical infrastructure, work environment, and emotional factors. Conclusions: The respondents clearly found the trade-off of higher stress to be acceptable for the improved QoL they enjoyed. It is also possible that stress might actually be responsible for improvements in QoL either directly or through mediation of variables such as personal values and aspirations. Yerkes-Dodson law and stress appraisal models of Folkman and Lazarus may explain the plausible positive association. PMID:28194085

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

Demkowicz-Dobrzanski, Rafal; Lewenstein, Maciej; Institut fuer Theoretische Physik, Universitaet Hannover, D-30167 Hannover

We solve the problem of the optimal cloning of pure entangled two-qubit states with a fixed degree of entanglement using local operations and classical communication. We show that, amazingly, classical communication between the parties can improve the fidelity of local cloning if and only if the initial entanglement is higher than a certain critical value. It is completely useless for weakly entangled states. We also show that bound entangled states with positive partial transpose are not useful as a resource to improve the best local cloning fidelity.

Prehospital Heart Rate and Blood Pressure Increase the Positive Predictive Value of the Glasgow Coma Scale for High-Mortality Traumatic Brain Injury

DTIC Science & Technology

2014-05-15

TBI versus those with abnormalities in GCS alone. This could be useful for mobilizing resources (e.g., neurosurgeons and operating rooms at the...have high-mortality TBI versus those with abnormalities in GCS alone. This could be useful for mobilizing resources (e.g., neurosurgeons and... neurosurgeon at the earliest juncture. Third, improved risk stratification could be used to develop more rational clinical de- cision-making algorithms for

Effect of Hilbert space truncation on Anderson localization

NASA Astrophysics Data System (ADS)

Krishna, Akshay; Bhatt, R. N.

2018-05-01

The 1D Anderson model possesses a completely localized spectrum of eigenstates for all values of the disorder. We consider the effect of projecting the Hamiltonian to a truncated Hilbert space, destroying time-reversal symmetry. We analyze the ensuing eigenstates using different measures such as inverse participation ratio and sample-averaged moments of the position operator. In addition, we examine amplitude fluctuations in detail to detect the possibility of multifractal behavior (characteristic of mobility edges) that may arise as a result of the truncation procedure.

Applying quantum principles to psychology

NASA Astrophysics Data System (ADS)

Busemeyer, Jerome R.; Wang, Zheng; Khrennikov, Andrei; Basieva, Irina

2014-12-01

This article starts out with a detailed example illustrating the utility of applying quantum probability to psychology. Then it describes several alternative mathematical methods for mapping fundamental quantum concepts (such as state preparation, measurement, state evolution) to fundamental psychological concepts (such as stimulus, response, information processing). For state preparation, we consider both pure states and densities with mixtures. For measurement, we consider projective measurements and positive operator valued measurements. The advantages and disadvantages of each method with respect to applications in psychology are discussed.

The mediating role of integration of safety by activity versus operator between organizational culture and safety climate.

PubMed

Auzoult, Laurent; Gangloff, Bernard

2018-04-20

In this study, we analyse the impact of the organizational culture and introduce a new variable, the integration of safety, which relates to the modalities for the implementation and adoption of safety in the work process, either through the activity or by the operator. One hundred and eighty employees replied to a questionnaire measuring the organizational climate, the safety climate and the integration of safety. We expected that implementation centred on the activity or on the operator would mediate the relationship between the organizational culture and the safety climate. The results support our assumptions. A regression analysis highlights the positive impact on the safety climate of organizational values of the 'rule' and 'support' type, as well as of integration by the operator and activity. Moreover, integration mediates the relation between these variables. The results suggest to take into account organizational culture and to introduce different implementation modalities to improve the safety climate.

Fundamental procedures of geographic information analysis

NASA Technical Reports Server (NTRS)

Berry, J. K.; Tomlin, C. D.

1981-01-01

Analytical procedures common to most computer-oriented geographic information systems are composed of fundamental map processing operations. A conceptual framework for such procedures is developed and basic operations common to a broad range of applications are described. Among the major classes of primitive operations identified are those associated with: reclassifying map categories as a function of the initial classification, the shape, the position, or the size of the spatial configuration associated with each category; overlaying maps on a point-by-point, a category-wide, or a map-wide basis; measuring distance; establishing visual or optimal path connectivity; and characterizing cartographic neighborhoods based on the thematic or spatial attributes of the data values within each neighborhood. By organizing such operations in a coherent manner, the basis for a generalized cartographic modeling structure can be developed which accommodates a variety of needs in a common, flexible and intuitive manner. The use of each is limited only by the general thematic and spatial nature of the data to which it is applied.

Spatial distribution of tropospheric ozone in national parks of California: interpretation of passive-sampler data.

PubMed

Ray, J D

2001-09-28

The National Park Service (NPS) has tested and used passive ozone samplers for several years to get baseline values for parks and to determine the spatial variability within parks. Experience has shown that the Ogawa passive samplers can provide +/-10% accuracy when used with a quality assurance program consisting of blanks, duplicates, collocated instrumentation, and a standard operating procedure that carefully guides site operators. Although the passive device does not meet EPA criteria as a certified method (mainly, that hourly values be measured), it does provide seasonal summed values of ozone. The seasonal ozone concentrations from the passive devices can be compared to other monitoring to determine baseline values, trends, and spatial variations. This point is illustrated with some kriged interpolation maps of ozone statistics. Passive ozone samplers were used to get elevational gradients and spatial distributions of ozone within a park. This was done in varying degrees at Mount Rainier, Olympic, Sequoia-Kings Canyon, Yosemite, Joshua Tree, Rocky Mountain, and Great Smoky Mountains national parks. The ozone has been found to vary by factors of 2 and 3 within a park when average ozone is compared between locations. Specific examples of the spatial distributions of ozone in three parks within California are given using interpolation maps. Positive aspects and limitations of the passive sampling approach are presented.

High-Density Free Fluid on Computed Tomography: a Predictor of Surgical Intervention in Patients with Adhesive Small Bowel Obstruction.

PubMed

Matsushima, Kazuhide; Inaba, Kenji; Dollbaum, Ryan; Cheng, Vincent; Khan, Moazzam; Herr, Keith; Strumwasser, Aaron; Asturias, Sabrina; Dilektasli, Evren; Demetriades, Demetrios

2016-11-01

Patients with adhesive small bowel obstruction (ASBO) often develop intraabdominal free fluid (IFF). While IFF is a finding on abdominopelvic computed tomography (CT) associated with the need for surgical intervention, many patients with IFF can be still managed non-operatively. A previous study suggested that a higher red blood cell count of IFF is highly predictive of strangulated ASBO. We hypothesized that radiodensity in IFF (Hounsfield unit (HU)) on CT would predict the need for surgical intervention. Patients with clinicoradiological evidence of ASBO between January 2009 and December 2013 were identified. In patients with IFF > 3 cm 2 identified on CT, the HU was measured in the largest pocket of IFF. A sensitivity analysis was performed to determine a high-density HU threshold. The HU of patients who underwent therapeutic laparotomy was compared with those successfully discharged with non-operative management. A total of 318 patients with ASBO (median age 52 years, 56.0 % male) were identified. Of 111 patients who had IFF on CT, 55.9 % underwent therapeutic laparotomy and 15.3 % required bowel resection. Radiodensity of IFF in the operative group was significantly higher than that in the non-operative group (18.2 vs. 7.0 HU, p < 0.01). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of high-density IFF (>10 HU) to predict the need for surgical intervention were 83.9, 65.3, 75.4, 76.2, and 75.6 %, respectively. High-density IFF on CT was significantly associated with the need for surgical intervention in patients with ASBO. Prospective study to validate the predictive value of high-density IFF on CT will be warranted.

Assessing operating characteristics of CAD algorithms in the absence of a gold standard

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

Roy Choudhury, Kingshuk; Paik, David S.; Yi, Chin A.

2010-04-15

Purpose: The authors examine potential bias when using a reference reader panel as ''gold standard'' for estimating operating characteristics of CAD algorithms for detecting lesions. As an alternative, the authors propose latent class analysis (LCA), which does not require an external gold standard to evaluate diagnostic accuracy. Methods: A binomial model for multiple reader detections using different diagnostic protocols was constructed, assuming conditional independence of readings given true lesion status. Operating characteristics of all protocols were estimated by maximum likelihood LCA. Reader panel and LCA based estimates were compared using data simulated from the binomial model for a range ofmore » operating characteristics. LCA was applied to 36 thin section thoracic computed tomography data sets from the Lung Image Database Consortium (LIDC): Free search markings of four radiologists were compared to markings from four different CAD assisted radiologists. For real data, bootstrap-based resampling methods, which accommodate dependence in reader detections, are proposed to test of hypotheses of differences between detection protocols. Results: In simulation studies, reader panel based sensitivity estimates had an average relative bias (ARB) of -23% to -27%, significantly higher (p-value <0.0001) than LCA (ARB -2% to -6%). Specificity was well estimated by both reader panel (ARB -0.6% to -0.5%) and LCA (ARB 1.4%-0.5%). Among 1145 lesion candidates LIDC considered, LCA estimated sensitivity of reference readers (55%) was significantly lower (p-value 0.006) than CAD assisted readers' (68%). Average false positives per patient for reference readers (0.95) was not significantly lower (p-value 0.28) than CAD assisted readers' (1.27). Conclusions: Whereas a gold standard based on a consensus of readers may substantially bias sensitivity estimates, LCA may be a significantly more accurate and consistent means for evaluating diagnostic accuracy.« less

Intraoperative computed tomography guided neuronavigation: concepts, efficiency, and work flow.

PubMed

Matula, C; Rössler, K; Reddy, M; Schindler, E; Koos, W T

1998-01-01

Image-guided surgery is currently considered to be of undisputed value in microsurgical and endoscopical neurosurgery, but one of its major drawbacks is the degradation of accuracy during frameless stereotactic neuronavigation due to brain and/or lesion shift. A computed tomography (CT) scanner system (Philips Tomoscan M) developed for the operating room was connected to a pointer device navigation system for image-guided surgery (Philips EasyGuide system) in order to provide an integrated solution to this problem, and the advantages of this combination were evaluated in 20 cases (15 microsurgical and 5 endoscopic). The integration of the scanner into the operating room setup was successful in all procedures. The patients were positioned on a specially developed scanner table, which permitted movement to a scanning position then back to the operating position at any time during surgery. Contrast-enhanced preoperative CCTs performed following positioning and draping were of high quality in all cases, because a radiolucent head fixation technique was used. The accuracy achieved with this combination was significantly better (1.6:1.22.2). The overall concept is one of working in a closed system where everything is done in the same room, and the efficiency of this is clearly proven in different ways. The most important fact is the time saved in the overall treatment process (about 55 h for one operating room over a 6-month period). The combination of an intraoperative CCT scanner with the pointer device neuronavigation system permits not only the intraoperative control of resection of brain tumors, but also (in about 20% of cases) the identification of otherwise invisible residual tumor tissue by intraoperative update of the neuronavigation data set. Additionally, an image update solves the problem of intraoperative brain and/or tumor shifts during image-guided resection. Having the option of making an intraoperative quality check at any time leads to significantly increased efficiency, improves the operating work flow because of the closed-system concept, and offers an integrated solution for improved patient work flow and clinical outcome.

Excessive lateral patellar translation on axial computed tomography indicates positive patellar J sign.

PubMed

Xue, Zhe; Song, Guan-Yang; Liu, Xin; Zhang, Hui; Wu, Guan; Qian, Yi; Feng, Hua

2018-03-20

The purpose of the study was to quantify the patellar J sign using traditional computed tomography (CT) scans. Fifty-three patients (fifty-three knees) who suffered from recurrent patellar instability were included and analyzed. The patellar J sign was evaluated pre-operatively during active knee flexion and extension. It was defined as positive when there was obvious lateral patellar translation, and negative when there was not. The CT scans were performed in all patients with full knee extension; and the parameters including bisect offset index (BOI), patellar-trochlear-groove (PTG) distance, and patellar lateral tilt angle (PLTA) were measured on the axial slices. All the three parameters were compared between the J sign-positive group (study group) and the J sign-negative group (control group). In addition, the optimal thresholds of the three CT scan parameters for predicting the positive patellar J sign were determined with receiver operating characteristic (ROC) curves, and the diagnostic values were assessed by the area under the curve (AUC). Among the fifty-three patients (fifty-three knees), thirty-seven (70%) showed obvious lateral patellar translation, which were defined as positive J sign (study group), and the remaining sixteen (30%) who showed no lateral translation were defined as negative J sign (control group). The mean values of the three CT parameters in the study group were all significantly larger compared to the control group, including BOI (121 ± 28% vs 88 ± 12%, P = 0.038), PTG distance (5.2 ± 6.6 mm vs - 4.4 ± 5.2 mm, P < 0.05), and PLTA (34.9 ± 10.5° vs 25.7 ± 3.4°, P = 0.001). Furthermore, the evaluation of ROC analysis showed that the AUC of BOI was the largest (AUC = 0.906) among the three parameters, and the optimal threshold of BOI to predict the positive patellar J sign was 97.5% (Sensitivity = 83.3%, Specificity = 87.5%). In this study, the prevalence of positive patellar J sign was 70%. The BOI measured from the axial CT scans of the knee joint can be used as an appropriate predictor to differentiate the positive J sign from the negative J sign, highlighting that the excessive lateral patellar translation on axial CT scan indicates positive patellar J sign. IV.

Ovarian response to 150 µg corifollitropin alfa in a GnRH-antagonist multiple-dose protocol: a prospective cohort study.

PubMed

Lerman, Tamara; Depenbusch, Marion; Schultze-Mosgau, Askan; von Otte, Soeren; Scheinhardt, Markus; Koenig, Inke; Kamischke, Axel; Macek, Milan; Schwennicke, Arne; Segerer, Sabine; Griesinger, Georg

2017-05-01

The incidence of low (<6 oocytes) and high (>18 oocytes) ovarian response to 150 µg corifollitropin alfa in relation to anti-Müllerian hormone (AMH) and other biomarkers was studied in a multi-centre (n = 5), multi-national, prospective, investigator-initiated, observational cohort study. Infertile women (n = 212), body weight >60 kg, underwent controlled ovarian stimulation in a gonadotrophin-releasing hormone-antagonist multiple-dose protocol. Demographic, sonographic and endocrine parameters were prospectively assessed on cycle day 2 or 3 of a spontaneous menstruation before the administration of 150 µg corifollitropin alfa. Serum AMH showed the best correlation with the number of oocytes obtained among all predictor variables. In receiver-operating characteristic analysis, AMH at a threshold of 0.91 ng/ml showed a sensitivity of 82.4%, specificity of 82.4%, positive predictive value 52.9%and negative predictive value 95.1% for predicting low response (area under the curve [AUC], 95% CI; P-value: 0.853, 0.769-0.936; <0.0001). For predicting high response, the optimal threshold for AMH was 2.58 ng/ml, relating to a sensitivity of 80.0%, specificity 82.1%, positive predictive value 42.5% and negative predictive value 96.1% (AUC, 95% CI; P-value: 0.871, 0.787-0.955; <0.0001). In conclusion, patients with serum AMH concentrations between approximately 0.9 and 2.6 ng/ml were unlikely to show extremes of response. Copyright © 2017. Published by Elsevier Ltd.

Ground noise measurements during landing, take-off, and flyby operations of a four-engine turbopropeller STOL airplane

NASA Technical Reports Server (NTRS)

Hilton, D. A.; Henderson, H. R.; Maglieri, D. J.

1971-01-01

Noise measurements were obtained for a four-engine turbopropeller STOL airplane during a Federal Aviation Administration flight evaluation program at the National Aviation Facilities Experimental Center. These noise measurements involved landing-approach, takeoff-climbout, and flyby operations of the airplane. A total of 13 measuring positions were used to define the noise characteristics around a simulated STOL port. The results are presented in the form of both physical and subjective measurements. An appendix is included to present tabulated values of various subjective reaction units which may be significant for the planning and operation of STOL ports. The main source of noise produced by this vehicle was found to be the propeller, and noise levels decrease generally in accordance with the inverse-distance law for distances up to about 457 meters. For similar slant ranges, somewhat lower noise levels were experienced during flyby than during takeoff or landing.

Systematics of strength function sum rules

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

Johnson, Calvin W.

2015-08-28

Sum rules provide useful insights into transition strength functions and are often expressed as expectation values of an operator. In this letter I demonstrate that non-energy-weighted transition sum rules have strong secular dependences on the energy of the initial state. Such non-trivial systematics have consequences: the simplification suggested by the generalized Brink–Axel hypothesis, for example, does not hold for most cases, though it weakly holds in at least some cases for electric dipole transitions. Furthermore, I show the systematics can be understood through spectral distribution theory, calculated via traces of operators and of products of operators. Seen through this lens,more » violation of the generalized Brink–Axel hypothesis is unsurprising: one expectssum rules to evolve with excitation energy. Moreover, to lowest order the slope of the secular evolution can be traced to a component of the Hamiltonian being positive (repulsive) or negative (attractive).« less

Spatio-temporal environmental data tide corrections for reconnaissance operations

NASA Astrophysics Data System (ADS)

Barbu, Costin; Avera, Will; Harris, Mike; Malpass, Kevyn

2005-06-01

Dynamic, accurate near-real time environmental data is critical to the success of the mine countermeasures operations. Bathymetric data acquired from the AQS-20 mine hunting sensor should be adjusted for local tide variations related to the specific geographic area and time interval. This problem can be overcome by a spatio-temporal estimate of tide corrections provided for the area and time of interest by the Naval Research Laboratory tide prediction code PCTides. For each geographic position of the AQS-20 sonar, a tide height relative to mean sea level is computed by interpolating the tidal information from the K - nearest neighbored stations for the corresponding time. The value is used to correct the measured depth generated by the AQS-20 sonar in that location to mean sea level for fusion with other bathymetric data products. It is argued that this paper provides a useful tool to the MCM decision factors during Mine Warfare operations.

Mechanical stability of the CMS strip tracker measured with a laser alignment system

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

Sirunyan, A. M.; Tumasyan, A.; Adam, W.

Here, the CMS tracker consists of 206 m 2 of silicon strip sensors assembled on carbon fibre composite structures and is designed for operation in the temperature range from –25 to +25°C. The mechanical stability of tracker components during physics operation was monitored with a few μm resolution using a dedicated laser alignment system as well as particle tracks from cosmic rays and hadron-hadron collisions. During the LHC operational period of 2011–2013 at stable temperatures, the components of the tracker were observed to experience relative movements of less than 30μm. In addition, temperature variations were found to cause displacements ofmore » tracker structures of about 2μm°C, which largely revert to their initial positions when the temperature is restored to its original value.« less

Mechanical stability of the CMS strip tracker measured with a laser alignment system

DOE PAGES

Sirunyan, A. M.; Tumasyan, A.; Adam, W.; ...

2017-04-21

Here, the CMS tracker consists of 206 m 2 of silicon strip sensors assembled on carbon fibre composite structures and is designed for operation in the temperature range from –25 to +25°C. The mechanical stability of tracker components during physics operation was monitored with a few μm resolution using a dedicated laser alignment system as well as particle tracks from cosmic rays and hadron-hadron collisions. During the LHC operational period of 2011–2013 at stable temperatures, the components of the tracker were observed to experience relative movements of less than 30μm. In addition, temperature variations were found to cause displacements ofmore » tracker structures of about 2μm°C, which largely revert to their initial positions when the temperature is restored to its original value.« less

Store operation with conditional push of a tag value to a queue

DOEpatents

Heidelberger, Philip; Steinmacher-Burow, Burkhard

2015-07-28

According to one embodiment, a method for a store operation with a conditional push of a tag value to a queue is provided. The method includes configuring a queue that is accessible by an application, setting a value at an address in a memory device including a memory and a controller, receiving a request for an operation using the value at the address and performing the operation. The method also includes the controller writing a result of the operation to the address, thus changing the value at the address, the controller determining if the result of the operation meets a condition and the controller pushing a tag value to the queue based on the condition being met, where the tag value in the queue indicates to the application that the condition is met.

Analysis for the amplitude oscillatory movements of the ship in response to the incidence wave

NASA Astrophysics Data System (ADS)

Chiţu, M. G.; Zăgan, R.; Manea, E.

2015-11-01

Event of major accident navigation near offshore drilling rigs remains unacceptably high, known as the complications arising from the problematic of the general motions of the ship sailing under real sea. Dynamic positioning system is an effective instrument used on board of the ships operating in the extraction of oil and gas in the continental shelf of the seas and oceans, being essential that the personnel on board of the vessel can maintain position and operating point or imposed on a route with high precision. By the adoption of a strict safety in terms of handling and positioning of the vessel in the vicinity of the drilling platform, the risk of accidents can be reduced to a minimum. Possibilities in anticipation amplitudes of the oscillatory movements of the ships navigating in real sea, is a challenge for naval architects and OCTOPUS software is a tool used increasingly more in this respect, complementing navigational facilities offered by dynamic positioning systems. This paper presents a study on the amplitudes of the oscillations categories of supply vessels in severe hydro meteorological conditions of navigation. The study provides information on the RAO (Response Amplitude Operator) response operator of the ship, for the amplitude of the roll movements, in some incident wave systems, interpreted using the energy spectrum Jonswap and whose characteristics are known (significant height of the wave, wave period, pulsation of the wave). Ship responses are analyzed according to different positioning of the ship in relation to the wave front (incident angle ranging from 10 to 10 degree from 0 to 180), highlighting the value of the ship roll motion amplitude. For the study, was used, as a tool for modeling and simulation, the features offered by OCTOPUS software that allows the study of the computerized behavior of the ship on the waves, in the real conditions of navigation. Program library was used for both the vessel itself and navigation modeling environment, for regular waves as well for the irregular waves which was modeled using Jonswap energy spectrum.

Optimizing the performance of a solar liquid piston pump

NASA Astrophysics Data System (ADS)

Murphy, C. L.

Utilization of solar energy for pumping water for irrigation or storage is discussed. Oscillations of a Freon 113 liquid column are generated in a working tube when a continuous flow of hot water, and cooling water, are supplied to heated and cooling coils located in the tube. The oscillations are converted into a pump (SLPP) model exhibited self starting, stable operation over a wide range of conditions, provides the inlet hot water heat source and inlet cooling water heat sink are above and below the critical values for stalling at a given pump head. The operation of the SLPP model, is primarily affected by the heating coil position within the working tube, and the geometries of the inlet and outlet water tubes.

Continuous-wave to pulse regimes for a family of passively mode-locked lasers with saturable nonlinearity

NASA Astrophysics Data System (ADS)

Dikandé, Alain M.; Voma Titafan, J.; Essimbi, B. Z.

2017-10-01

The transition dynamics from continuous-wave to pulse regimes of operation for a generic model of passively mode-locked lasers with saturable absorbers, characterized by an active medium with non-Kerr nonlinearity, are investigated analytically and numerically. The system is described by a complex Ginzburg-Landau equation with a general m:n saturable nonlinearity (i.e {I}m/{(1+{{Γ }}I)}n, where I is the field intensity and m and n are two positive numbers), coupled to a two-level gain equation. An analysis of stability of continuous waves, following the modulational instability approach, provides a global picture of the self-starting dynamics in the system. The analysis reveals two distinct routes depending on values of the couple (m, n), and on the dispersion regime: in the normal dispersion regime, when m = 2 and n is arbitrary, the self-starting requires positive values of the fast saturable absorber and nonlinearity coefficients, but negative values of these two parameters for the family with m = 0. However, when the spectral filter is negative, the laser can self-start for certain values of the input field and the nonlinearity saturation coefficient Γ. The present work provides a general map for the self-starting mechanisms of rare-earth doped figure-eight fiber lasers, as well as Kerr-lens mode-locked solid-state lasers.

[Prognostic value of three different staging schemes based on pN, MLR and LODDS in patients with T3 esophageal cancer].

PubMed

Wang, L; Cai, L; Chen, Q; Jiang, Y H

2017-10-23

Objective: To evaluate the prognostic value of three different staging schemes based on positive lymph nodes (pN), metastatic lymph nodes ratio (MLR) and log odds of positive lymph nodes (LODDS) in patients with T3 esophageal cancer. Methods: From 2007 to 2014, clinicopathological characteristics of 905 patients who were pathologically diagnosed as T3 esophageal cancer and underwent radical esophagectomy in Zhejiang Cancer Hospital were retrospectively analyzed. Kaplan-Meier curves and Multivariate Cox proportional hazards models were used to evaluate the independent prognostic factors. The values of three lymph node staging schemes for predicting 5-year survival were analyzed by using receiver operating characteristic (ROC) curves. Results: The 1-, 3- and 5-year overall survival rates of patients with T3 esophageal cancer were 80.9%, 50.0% and 38.4%, respectively. Multivariate analysis showed that MLR stage, LODDS stage and differentiation were independent prognostic survival factors ( P <0.05 for all). ROC curves showed that the area under the curve of pN stage, MLR stage, LODDS stage was 0.607, 0.613 and 0.618, respectively. However, the differences were not statistically significant ( P >0.05). Conclusions: LODDS is an independent prognostic factor for patients with T3 esophageal cancer. The value of LODDS staging system may be superior to pN staging system for evaluating the prognosis of these patients.

Comparison of Three-Dimensional Planning-Assisted and Conventional Acetabular Cup Positioning in Total Hip Arthroplasty: A Randomized Controlled Trial.

PubMed

Sariali, Elhadi; Boukhelifa, Nadia; Catonne, Yves; Pascal Moussellard, Hugues

2016-01-20

Malpositioning of the acetabular cup during total hip arthroplasty increases the risk of dislocation, edge-loading, squeaking, early wear, and loosening. We hypothesized that the use of three-dimensional (3-D) visualization tools to identify the planned cup position relative to the acetabular edge intraoperatively would increase the accuracy of cup orientation. The purpose of this study was to compare 3-D planning-assisted implantation and freehand insertion of the acetabular cup. This was a prospective randomized controlled study of two groups of twenty-eight patients each. In the first group, cup positioning was guided by 3-D views of the cup within the acetabulum obtained during 3-D preoperative planning. In the control group, the cup was placed freehand. All of the patients were operated on by the same surgeon, through a minimally invasive direct anterior approach with the patient in the supine position. Cup anteversion and abduction angles were measured on 3-D computed tomography (CT) reconstructions. The main evaluation criterion was the percentage of outliers according to the Lewinnek safe zone. Operative time did not differ between the two groups. The cup anteversion was more accurate in the 3-D planning group (mean difference from the planned angle [and standard deviation], -2.7° ± 5.4°) compared with the freehand-placement group (6.6° ± 9.5°). According to the Lewinnek safe zone, overall, the percentage of outliers was lower in the 3-D planning group (21%; six patients) than in the control group (46%; thirteen patients). According to the Callanan safe zone, the percentage of outliers was also lower in the 3-D planning group (25% versus 64%). Although cup abduction was also restored with greater accuracy in the 3-D planning group, on the basis of the Lewinnek safe zone, the percentage of abduction outliers was comparable between groups, with fewer high-abduction values, but more low-abduction values, in the 3-D planning group. Preoperative 3-D planning increased the accuracy of anteversion restoration and reduced the percentage of outliers without increasing the operative time. In this study, the same advantage could not be demonstrated for abduction. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Field Assessment Stroke Triage for Emergency Destination: A Simple and Accurate Prehospital Scale to Detect Large Vessel Occlusion Strokes.

PubMed

Lima, Fabricio O; Silva, Gisele S; Furie, Karen L; Frankel, Michael R; Lev, Michael H; Camargo, Érica C S; Haussen, Diogo C; Singhal, Aneesh B; Koroshetz, Walter J; Smith, Wade S; Nogueira, Raul G

2016-08-01

Patients with large vessel occlusion strokes (LVOS) may be better served by direct transfer to endovascular capable centers avoiding hazardous delays between primary and comprehensive stroke centers. However, accurate stroke field triage remains challenging. We aimed to develop a simple field scale to identify LVOS. The Field Assessment Stroke Triage for Emergency Destination (FAST-ED) scale was based on items of the National Institutes of Health Stroke Scale (NIHSS) with higher predictive value for LVOS and tested in the Screening Technology and Outcomes Project in Stroke (STOPStroke) cohort, in which patients underwent computed tomographic angiography within the first 24 hours of stroke onset. LVOS were defined by total occlusions involving the intracranial internal carotid artery, middle cerebral artery-M1, middle cerebral artery-2, or basilar arteries. Patients with partial, bihemispheric, and anterior+posterior circulation occlusions were excluded. Receiver operating characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value of FAST-ED were compared with the NIHSS, Rapid Arterial Occlusion Evaluation (RACE) scale, and Cincinnati Prehospital Stroke Severity (CPSS) scale. LVO was detected in 240 of the 727 qualifying patients (33%). FAST-ED had comparable accuracy to predict LVO to the NIHSS and higher accuracy than RACE and CPSS (area under the receiver operating characteristic curve: FAST-ED=0.81 as reference; NIHSS=0.80, P=0.28; RACE=0.77, P=0.02; and CPSS=0.75, P=0.002). A FAST-ED ≥4 had sensitivity of 0.60, specificity of 0.89, positive predictive value of 0.72, and negative predictive value of 0.82 versus RACE ≥5 of 0.55, 0.87, 0.68, and 0.79, and CPSS ≥2 of 0.56, 0.85, 0.65, and 0.78, respectively. FAST-ED is a simple scale that if successfully validated in the field, it may be used by medical emergency professionals to identify LVOS in the prehospital setting enabling rapid triage of patients. © 2016 American Heart Association, Inc.

Neutral vs positive oral contrast in diagnosing acute appendicitis with contrast-enhanced CT: sensitivity, specificity, reader confidence and interpretation time

PubMed Central

Naeger, D M; Chang, S D; Kolli, P; Shah, V; Huang, W; Thoeni, R F

2011-01-01

Objective The study compared the sensitivity, specificity, confidence and interpretation time of readers of differing experience in diagnosing acute appendicitis with contrast-enhanced CT using neutral vs positive oral contrast agents. Methods Contrast-enhanced CT for right lower quadrant or right flank pain was performed in 200 patients with neutral and 200 with positive oral contrast including 199 with proven acute appendicitis and 201 with other diagnoses. Test set disease prevalence was 50%. Two experienced gastrointestinal radiologists, one fellow and two first-year residents blindly assessed all studies for appendicitis (2000 readings) and assigned confidence scores (1=poor to 4=excellent). Receiver operating characteristic (ROC) curves were generated. Total interpretation time was recorded. Each reader's interpretation with the two agents was compared using standard statistical methods. Results Average reader sensitivity was found to be 96% (range 91–99%) with positive and 95% (89–98%) with neutral oral contrast; specificity was 96% (92–98%) and 94% (90–97%). For each reader, no statistically significant difference was found between the two agents (sensitivities p-values >0.6; specificities p-values>0.08), in the area under the ROC curve (range 0.95–0.99) or in average interpretation times. In cases without appendicitis, positive oral contrast demonstrated improved appendix identification (average 90% vs 78%) and higher confidence scores for three readers. Average interpretation times showed no statistically significant differences between the agents. Conclusion Neutral vs positive oral contrast does not affect the accuracy of contrast-enhanced CT for diagnosing acute appendicitis. Although positive oral contrast might help to identify normal appendices, we continue to use neutral oral contrast given its other potential benefits. PMID:20959365

Does low dose (13)C-urea breath test maintain a satisfactory accuracy in diagnosing Helicobacter pylori infection?

PubMed

Coelho, Luiz Gonzaga Vaz; Silva, Arilto Eleutério da; Coelho, Maria Clara de Freitas; Penna, Francisco Guilherme Cancela e; Ferreira, Rafael Otto Antunes; Santa-Cecilia, Elisa Viana

2011-01-01

The standard doses of (13)C-urea in (13)C-urea breath test is 75 mg. To assess the diagnostic accuracy of (13)C-urea breath test containing 25 mg of (13)C-urea comparing with the standard doses of 75 mg in the diagnosis of Helicobacter pylori infection. Two hundred seventy adult patients (96 males, 174 females, median age 41 years) performed the standard (13)C-urea breath test (75 mg (13)C-urea) and repeated the (13)C-urea breath test using only 25 mg of (13)C-urea within a 2 week interval. The test was performed using an infrared isotope analyzer. Patients were considered positive if delta over baseline was >4.0‰ at the gold standard test. One hundred sixty-one (59.6%) patients were H. pylori negative and 109 (40.4%) were positive by the gold standard test. Using receiver operating characteristic analysis we established a cut-off value of 3.4% as the best value of 25 mg (13)C-urea breath test to discriminate positive and negative patients, considering the H. pylori prevalence (95% CI: 23.9-37.3) at our setting. Therefore, we obtained to 25 mg (13)C-urea breath test a diagnostic accuracy of 92.9% (95% CI: 88.1-97.9), sensitivity 83.5% (95% CI: 75.4-89.3), specificity 99.4% (95% CI: 96.6-99.9), positive predictive value 98.3% (95% CI: 92.4-99.4), and negative predictive value 93.0% (95% CI: 88.6-96.1). Low-dose (13)C-urea breath test (25 mg (13)C-urea) does not reach accuracy sufficient to be recommended in clinical setting where a 30% prevalence of H. pylori infection is observed. Further studies should be done to determine the diagnostic accuracy of low doses of (13)C-urea in the urea breath test.

Possible Impact of Incremental Cost-Effectiveness Ratio (ICER) on Decision Making for Cancer Screening in Hong Kong: A Systematic Review.

PubMed

Wong, Carlos K H; Lang, Brian H H; Guo, Vivian Y W; Lam, Cindy L K

2016-12-01

The aim of this paper was to critically review the literature on the cost effectiveness of cancer screening interventions, and examine the incremental cost-effectiveness ratios (ICERs) that may influence government recommendations on cancer screening strategies and funding for mass implementation in the Hong Kong healthcare system. We conducted a literature review of cost-effectiveness studies in the Hong Kong population related to cancer screening published up to 2015, through a hand search and database search of PubMed, Web of Science, Embase, and OVID Medline. Binary data on the government's decisions were obtained from the Cancer Expert Working Group, Department of Health. Mixed-effect logistic regression analysis was used to examine the impact of ICERs on decision making. Using Youden's index, an optimal ICER threshold value for positive decisions was examined by area under receiver operating characteristic curve (AUC). Eight studies reporting 30 cost-effectiveness pairwise comparisons of population-based cancer screening were identified. Most studies reported an ICER for a cancer screening strategy versus a comparator with outcomes in terms of cost per life-years (55.6 %), or cost per quality-adjusted life-years (55.6 %). Among comparisons with a mean ICER of US$102,931 (range 800-715,137), the increase in ICER value by 1000 was associated with decreased odds (odds ratio 0.990, 0.981-0.999; p = 0.033) of a positive recommendation. An optimal ICER value of US$61,600 per effectiveness unit yielded a high sensitivity of 90 % and specificity of 85 % for a positive recommendation. A lower ICER threshold value of below US$8044 per effectiveness unit was detected for a positive funding decision. Linking published evidence to Government recommendations and practice on cancer screening, ICERs influence decisions on the adoption of health technologies in Hong Kong. The potential ICER threshold for recommendation in Hong Kong may be higher than those of developed countries.

Performing a local barrier operation

DOEpatents

Archer, Charles J; Blocksome, Michael A; Ratterman, Joseph D; Smith, Brian E

2014-03-04

Performing a local barrier operation with parallel tasks executing on a compute node including, for each task: retrieving a present value of a counter; calculating, in dependence upon the present value of the counter and a total number of tasks performing the local barrier operation, a base value, the base value representing the counter's value prior to any task joining the local barrier; calculating, in dependence upon the base value and the total number of tasks performing the local barrier operation, a target value of the counter, the target value representing the counter's value when all tasks have joined the local barrier; joining the local barrier, including atomically incrementing the value of the counter; and repetitively, until the present value of the counter is no less than the target value of the counter: retrieving the present value of the counter and determining whether the present value equals the target value.

Performing a local barrier operation

DOEpatents

Archer, Charles J; Blocksome, Michael A; Ratterman, Joseph D; Smith, Brian E

2014-03-04

Performing a local barrier operation with parallel tasks executing on a compute node including, for each task: retrieving a present value of a counter; calculating, in dependence upon the present value of the counter and a total number of tasks performing the local barrier operation, a base value of the counter, the base value representing the counter's value prior to any task joining the local barrier; calculating, in dependence upon the base value and the total number of tasks performing the local barrier operation, a target value, the target value representing the counter's value when all tasks have joined the local barrier; joining the local barrier, including atomically incrementing the value of the counter; and repetitively, until the present value of the counter is no less than the target value of the counter: retrieving the present value of the counter and determining whether the present value equals the target value.

Racial/ethnic differences in the influence of cultural values, alcohol resistance self-efficacy, and alcohol expectancies on risk for alcohol initiation.

PubMed

Shih, Regina A; Miles, Jeremy N V; Tucker, Joan S; Zhou, Annie J; D'Amico, Elizabeth J

2012-09-01

Prior research has reported racial/ethnic differences in the early initiation of alcohol use, suggesting that cultural values that are central to specific racial/ethnic groups may be influencing these differences. This 1-year longitudinal study examines associations between two types of cultural values, parental respect (honor for one's parents) and familism (connectedness with family), both measured at baseline, and subsequent alcohol initiation in a sample of 6,054 (approximately 49% male, 57% Hispanic, 22% Asian, 18% non-Hispanic White, and 4% non-Hispanic Black) middle school students in Southern California. We tested whether the associations of cultural values with alcohol initiation could be explained by baseline measures of alcohol resistance self-efficacy (RSE) and alcohol expectancies. We also explored whether these pathways differed by race/ethnicity. In the full sample, adolescents with higher parental respect were less likely to initiate alcohol use, an association that was partially explained by higher RSE and fewer positive alcohol expectancies. Familism was not significantly related to alcohol initiation. Comparing racial/ethnic groups, higher parental respect was protective against alcohol initiation for Whites and Asians, but not Blacks or Hispanics. There were no racial/ethnic differences in the association between familism and alcohol initiation. Results suggest that cultural values are important factors in the decision to use alcohol and these values appear to operate in part, by influencing alcohol positive expectancies and RSE. Interventions that focus on maintaining strong cultural values and building strong bonds between adolescents and their families may help reduce the risk of alcohol initiation. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Screening for Binge Eating Disorders Using the Patient Health Questionnaire in a Community Sample

PubMed Central

Striegel-Moore, Ruth H.; Perrin, Nancy; DeBar, Lynn; Wilson, G. Terence; Rosselli, Francine; Kraemer, Helena C.

2009-01-01

Objective To examine the operating characteristics of the Patient Health Questionnaire eating disorder module (PHQ-ED) for identifying bulimia nervosa/binge eating disorder (BN/BED) or recurrent binge eating (RBE) in a community sample, and to compare true positive (TP) versus false positive (FP) cases on clinical validators. Method 259 screen positive individuals and a random sample of 89 screen negative cases completed a diagnostic interview. Sensitivity, specificity, and Positive Predictive Value (PPV) were calculated. TP and FP cases were compared using t-tests and Chi-Square tests. Results The PHQ-ED had high sensitivity (100%) and specificity (92%) for detecting BN/BED or RBE, but PPV was low (15% or 19%). TP and FP cases did not differ significantly on frequency of subjective bulimic episodes, objective overeating, restraint, on BMI, and on self-rated health. Conclusions The PHQ-ED is recommended for use in large populations only in conjunction with follow-up questions to rule out cases without objective bulimic episodes. PMID:19424976

Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures.

PubMed

Rustagi, Preeti; Patkar, Geeta A; Ourasang, Anil Kumar; Tendolkar, Bharati A

2017-02-01

A sustained and effective oropharyngeal sealing with supraglottic airway is required to maintain the ventilation during laparoscopic surgery. Previous studies have observed the Oropharyngeal Seal Pressure (OSP) for Proseal Laryngeal Mask Airway (PLMA) after pneumoperitoneum in supine and trendelenburg position, where PLMA was found to be an effective airway device. This study was conducted with ProSeal LMA, for laparoscopic Urologic procedures done in lateral position. To measure OSP in supine and lateral position and to observe the effect of pneumoperitoneum in lateral position on OSP. Secondary objectives were to assess adequacy of ventilation and incidence of adverse events. A total number of 25 patients of American Society of Anaesthesiologists (ASA) physical status II and I were enrolled. After induction of anaesthesia using a standardized protocol, PLMA was inserted. Ryle's tube was inserted through drain tube. The position of PLMA was confirmed with ease of insertion of Ryle's tube and fibreoptic grading of vocal cords. Patients were then put in lateral position. The OSP was measured in supine position. This value was baseline comparison for OSP in lateral position and that after pneumoperitoneum. We assessed the efficacy of PLMA for ventilation, after carboperitoneum in lateral position (peak airway pressure, End Tidal Carbon dioxide (EtCO 2 ), SPO 2 ). Incidence of adverse effects (displacement of device, gastric insufflation, regurgitation, coughing, sore throat, blood on device, trauma) was also noted. The OSP was above Peak Airway Pressure (PAP) in supine (22.1±5.4 and 15.4±4.49cm of H 2 O) and lateral position (22.6±5.3 and 16.1±4.6). After pneumoperitoneum, which was in lateral position, there was statistically significant (p-value <0.05) increase in both PAP (19.96±4.015) and OSP (24.32±4.98, p-value 0.03). There was no intraoperative displacement of PLMA. There was no event of suboptimal oxygenation. EtCO 2 was always within normal limits. Gastric insufflation was present in one patient. One patient had coughing and blood was detected on device. Three patients had throat discomfort post-operatively. In this study, Oropharyngeal seal pressures with PLMA were found to increase after pneumoperitoneum in lateral position. PLMA forms an effective seal around airway and is an efficient and safe alternative for airway management in urological laparoscopic surgeries done in lateral position.

Fuel supply control method for internal combustion engines, with adaptability to various engines and controls therefor having different operating characteristics

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

Otobe, Y.; Chikamatsu, M.

1988-03-08

A method of controlling the fuel supply to an internal combustion engine is described, wherein a quantity of fuel for supply to the engine is determined by correcting a basic value of the quantity of fuel determined as a function of at least one operating parameter of the engine by correction values dependent upon operating conditions of the engine and the determined quantity of fuel is supplied to the engine. The method comprises the steps of: (1) detecting a value of at least one predetermined operating parameter of the engine; (2) manually adjusting a single voltage creating means to setmore » an output voltage therefrom to such a desired value as to compensate for deviation of the air/fuel ratio of a mixture supplied to the engine due to variations in operating characteristics of engines between different production lots or aging changes; (3) determining a value of the predetermined one correction value corresponding to the set desired value of output voltage of the single voltage creating means, and then modifying the thus determined value in response to the detected value of the predetermined at least one operating parameter of the engine during engine operation; and (4) correcting the basic value of the quantity of fuel by the value of the predetermined one correction value having the thus modified value, and the other correction values.« less

Development of an empirically based dynamic biomechanical strength model

NASA Technical Reports Server (NTRS)

Pandya, A.; Maida, J.; Aldridge, A.; Hasson, S.; Woolford, B.

1992-01-01

The focus here is on the development of a dynamic strength model for humans. Our model is based on empirical data. The shoulder, elbow, and wrist joints are characterized in terms of maximum isolated torque, position, and velocity in all rotational planes. This information is reduced by a least squares regression technique into a table of single variable second degree polynomial equations determining the torque as a function of position and velocity. The isolated joint torque equations are then used to compute forces resulting from a composite motion, which in this case is a ratchet wrench push and pull operation. What is presented here is a comparison of the computed or predicted results of the model with the actual measured values for the composite motion.

Pickstone v. Freemans plc, 25 March 1987.

PubMed

1987-01-01

The applicants, female warehouse operatives for the defendant, challenged the defendant's policy of paying warehouse checkers more than they were being paid. They claimed that both groups were engaged in work of equal value and should be given equal pay. The case was dismissed by a lower court because the defendant employed men in both positions at the same pay as women in those positions and the Equal Pay Act 1970 prohibited suits in such circumstances. The Court of Appeal reversed this decision, holding that Article 119 of the EEC Treaty authorized the suit and overrode conflicting national legislation. It remanded the case for determination whether the pay differential between the two jobs was due to reasons other than sex discrimination. full text

Survey of departments of health about PKU screening programs.

PubMed Central

Steiner, K C; Smith, H A

1975-01-01

Mailed questionnaires were used to examine the success of PKU (phenylketonuria) screening programs that were operated by departments of health and to examine differences between these programs. Of 55 departments, 44 were returned and 42 departments reported they had a PKU detection program. Thirty-eight respondents considered the PKU detection program to be effective, and 31 respondents indicated that the entire program cost $60,000 or less per year. The answers and comments on the questionnaires showed a generally positive view of the effectiveness about the value of the treatment program in general were also positive. However, a few departments indicated that more clinical evidence and experience were needed to fully evaluate the overall merits of PKU detection and screening programs. PMID:803697

Statistical analysis of RHIC beam position monitors performance

NASA Astrophysics Data System (ADS)

Calaga, R.; Tomás, R.

2004-04-01

A detailed statistical analysis of beam position monitors (BPM) performance at RHIC is a critical factor in improving regular operations and future runs. Robust identification of malfunctioning BPMs plays an important role in any orbit or turn-by-turn analysis. Singular value decomposition and Fourier transform methods, which have evolved as powerful numerical techniques in signal processing, will aid in such identification from BPM data. This is the first attempt at RHIC to use a large set of data to statistically enhance the capability of these two techniques and determine BPM performance. A comparison from run 2003 data shows striking agreement between the two methods and hence can be used to improve BPM functioning at RHIC and possibly other accelerators.

Proposal for a new protein therapeutic immunogenicity titer assay cutpoint.

PubMed

Wakshull, Eric; Hendricks, Robert; Amaya, Caroline; Coleman, Daniel

2011-12-01

Generally, immunogenicity assessment strategies follow this assay triage schema: screen→confirm→titer. Each requires the determination of a threshold value (cutpoint) for decision making. No guidance documents exist for the determination of a specific titration assay cutpoint. The default practice is to use the screening assay cutpoint, frequently leading to controls or samples not reaching this cutpoint. We propose a method for determination of a titration cutpoint based upon the variance of the negative-control sample. Positive-control samples that did not cross a screening cutpoint did cross the titer cutpoint, albeit generating slightly lower titer values. Our approach is consistent with the statistical methods currently recommended for the screening and confirmatory assay cutpoints and is operationally simple and efficient.

Correlation of transient elastography with hepatic venous pressure gradient in patients with cirrhotic portal hypertension: A study of 326 patients from India.

PubMed

Kumar, Ashish; Khan, Noor Muhammad; Anikhindi, Shrihari Anil; Sharma, Praveen; Bansal, Naresh; Singla, Vikas; Arora, Anil

2017-01-28

To study the diagnostic accuracy of transient elastography (TE) for detecting clinically significant portal hypertension (CSPH) in Indian patients with cirrhotic portal hypertension. This retrospective study was conducted at the Institute of Liver, Gastroenterology, and Pancreatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, on consecutive patients with cirrhosis greater than 15 years of age who underwent hepatic venous pressure gradient (HVPG) and TE from July 2011 to May 2016. Correlation between HVPG and TE was analyzed using the Spearman's correlation test. Receiver operating characteristic (ROC) curves were prepared for determining the utility of TE in predicting various stages of portal hypertension. The best cut-off value of TE for the diagnosis of CSPH was obtained using the Youden index. The study included 326 patients [median age 52 (range 16-90) years; 81% males]. The most common etiology of cirrhosis was cryptogenic (45%) followed by alcohol (34%). The median HVPG was 16.0 (range 1.5 to 30.5) mmHg. Eighty-five percent of patients had CSPH. A significant positive correlation was noted between TE and HVPG (rho 0.361, P < 0.001). The area under ROC curve for TE in predicting CSPH was 0.740 (95%CI: 0.662-0.818) ( P < 0.01). A cut-off value of TE of 21.6 kPa best predicted CSPH with a positive predictive value (PPV) of 93%. TE has a fair positive correlation with HVPG; thus, TE can be used as a non-invasive modality to assess the degree of portal hypertension. A cut-off TE value of 21.6 kPa identifies CSPH with a PPV of 93%.

Correlation of transient elastography with hepatic venous pressure gradient in patients with cirrhotic portal hypertension: A study of 326 patients from India

PubMed Central

Kumar, Ashish; Khan, Noor Muhammad; Anikhindi, Shrihari Anil; Sharma, Praveen; Bansal, Naresh; Singla, Vikas; Arora, Anil

2017-01-01

AIM To study the diagnostic accuracy of transient elastography (TE) for detecting clinically significant portal hypertension (CSPH) in Indian patients with cirrhotic portal hypertension. METHODS This retrospective study was conducted at the Institute of Liver, Gastroenterology, and Pancreatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, on consecutive patients with cirrhosis greater than 15 years of age who underwent hepatic venous pressure gradient (HVPG) and TE from July 2011 to May 2016. Correlation between HVPG and TE was analyzed using the Spearman’s correlation test. Receiver operating characteristic (ROC) curves were prepared for determining the utility of TE in predicting various stages of portal hypertension. The best cut-off value of TE for the diagnosis of CSPH was obtained using the Youden index. RESULTS The study included 326 patients [median age 52 (range 16-90) years; 81% males]. The most common etiology of cirrhosis was cryptogenic (45%) followed by alcohol (34%). The median HVPG was 16.0 (range 1.5 to 30.5) mmHg. Eighty-five percent of patients had CSPH. A significant positive correlation was noted between TE and HVPG (rho 0.361, P < 0.001). The area under ROC curve for TE in predicting CSPH was 0.740 (95%CI: 0.662-0.818) (P < 0.01). A cut-off value of TE of 21.6 kPa best predicted CSPH with a positive predictive value (PPV) of 93%. CONCLUSION TE has a fair positive correlation with HVPG; thus, TE can be used as a non-invasive modality to assess the degree of portal hypertension. A cut-off TE value of 21.6 kPa identifies CSPH with a PPV of 93%. PMID:28216976

CSF ADA Determination in Early Diagnosis of Tuberculous Meningitis in HIV-Infected Patients.

PubMed

Ghosh, Gopal Chandra; Sharma, Brijesh; Gupta, B B

2016-01-01

Tuberculous and Cryptococcal meningitis are common in HIV patients. A highly specific and sensitive rapid test for diagnosis of Tuberculous meningitis especially in setting of HIV is not available in developing countries where the burden of disease is high. We measured ADA (adenosine deaminase) levels using spectrophotometric method in the CSF of HIV patients with meningitis to differentiate Tuberculous meningitis from meningitis due to other causes. Kruskal-Wallis test was used to compare ADA values between tuberculous meningitis (TBM) and nontuberculous (non-TB) meningitis patients and a receiver-operating characteristic (ROC) analysis curve was drawn from these values. Levels of ADA in the CSF of patients with TBM were significantly higher than those in patients with meningitis due to other causes. CSF ADA level determination with a cut-off value of 6 IU/L was found to be highly specific and fairly sensitive test for the diagnosis of TBM in HIV positive patients.

A Study of VITOM in Pediatric Surgery and Urology: Evaluation of Technology Acceptance and Usability by Operating Team and Surgeon Musculoskeletal Discomfort.

PubMed

Frykman, Philip K; Freedman, Andrew L; Kane, Timothy D; Cheng, Zhi; Petrosyan, Mikael; Catchpole, Kenneth

2017-02-01

We studied operating team acceptability of Video Telescopic Monitor (VITOM ® ) exoscope by exploring the ease of use of the device in two centers. We also assessed factors affecting surgeon musculoskeletal discomfort. We focused on how the operating team interacted with the VITOM system with surrogate measures of usefulness, image quality, ease of use, workload, and setup time. Multivariable linear regression was used to model the relationships between team role, experience, and setup time. Relationships between localized musculoskeletal discomfort and use of VITOM alone, and with loupes, were also analyzed. Four surgeons, 7 surgical techs, 7 circulating nurses, and 13 surgical residents performed 70 pediatric surgical and urological operations. We found that subjective views of each team member were consistently positive with 69%-74% agreed or strongly agreed that VITOM enhanced their ability to perform their job and improved the surgical process. Unexpectedly, the scrub techs and nurses perceived more value and utility of VITOM, presumably because it provides them a view of the operative field that would otherwise be unavailable to them. Team members rated perceptions of image quality highly and workload generally satisfactory. Not surprisingly, setup time decreased with team experience and multivariable modeling showed significant correlations with surgeon and surgical tech experience, but not circulating nurse. An important finding was that surgeon neck discomfort was reduced with use of VITOM alone for magnification, compared with use of loupes and VITOM. The most likely explanation for these findings is improved posture with the neck at a neutral position when viewing the VITOM images, compared with neck flexion with loupes, and thus, a less favorable ergonomic position. This study suggests that there may be small drawbacks associated with VITOM use initially, but these reduce with increased experience and benefit both the surgeon and the rest of the team.

Cold Test Operation of the German VEK Vitrification Plant

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

Fleisch, J.; Schwaab, E.; Weishaupt, M.

2008-07-01

In 2007 the German High-Level Liquid Waste (HLLW) Vitrification plant VEK (Verglasungseinrichtung Karlsruhe) has passed a three months integral cold test operation as final step before entering the hot phase. The overall performance of the vitrification process equipment with a liquid-fed ceramic glass melter as main component proved to be completely in line with the requirements of the regulatory body. The retention efficiency of main radioactive-bearing elements across melter and wet off-gas treatment system exceeded the design values distinctly. The strategy to produce a specified waste glass could be successfully demonstrated. The results of the cold test operation allow enteringmore » the next step of hot commissioning, i.e. processing of approximately 2 m{sup 3} of diluted HLLW. In summary: An important step of the VEK vitrification plant towards hot operation has been the performance of the cold test operation from April to July 2007. This first integral operation was carried out under boundary conditions and rules established for radioactive operation. Operation and process control were carried out following the procedure as documented in the licensed operational manuals. The function of the process technology and the safe operation could be demonstrated. No severe problems were encountered. Based on the positive results of the cold test, application of the license for hot operation has been initiated and is expected in the near future. (authors)« less

The performance of blood pressure-to-height ratio as a screening measure for identifying children and adolescents with hypertension: a meta-analysis.

PubMed

Ma, Chunming; Liu, Yue; Lu, Qiang; Lu, Na; Liu, Xiaoli; Tian, Yiming; Wang, Rui; Yin, Fuzai

2016-02-01

The blood pressure-to-height ratio (BPHR) has been shown to be an accurate index for screening hypertension in children and adolescents. The aim of the present study was to perform a meta-analysis to assess the performance of BPHR for the assessment of hypertension. Electronic and manual searches were performed to identify studies of the BPHR. After methodological quality assessment and data extraction, pooled estimates of the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, area under the receiver operating characteristic curve and summary receiver operating characteristics were assessed systematically. The extent of heterogeneity for it was assessed. Six studies were identified for analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio values of BPHR, for assessment of hypertension, were 96% [95% confidence interval (CI)=0.95-0.97], 90% (95% CI=0.90-0.91), 10.68 (95% CI=8.03-14.21), 0.04 (95% CI=0.03-0.07) and 247.82 (95% CI=114.50-536.34), respectively. The area under the receiver operating characteristic curve was 0.9472. The BPHR had higher diagnostic accuracies for identifying hypertension in children and adolescents.

Optimization design of submerged propeller in oxidation ditch by computational fluid dynamics and comparison with experiments.

PubMed

Zhang, Yuquan; Zheng, Yuan; Fernandez-Rodriguez, E; Yang, Chunxia; Zhu, Yantao; Liu, Huiwen; Jiang, Hao

The operating condition of a submerged propeller has a significant impact on flow field and energy consumption of the oxidation ditch. An experimentally validated numerical model, based on the computational fluid dynamics (CFD) tool, is presented to optimize the operating condition by considering two important factors: flow field and energy consumption. Performance demonstration and comparison of different operating conditions were carried out in a Carrousel oxidation ditch at the Yingtang wastewater treatment plants in Anhui Province, China. By adjusting the position and rotating speed together with the number of submerged propellers, problems of sludge deposit and the low velocity in the bend could be solved in a most cost-effective way. The simulated results were acceptable compared with the experimental data and the following results were obtained. The CFD model characterized flow pattern and energy consumption in the full-scale oxidation ditch. The predicted flow field values were within -1.28 ± 7.14% difference from the measured values. By determining three sets of propellers under the rotating speed of 6.50 rad/s with one located 5 m from the first curved wall, after numerical simulation and actual measurement, not only the least power density but also the requirement of the flow pattern could be realized.

Value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules.

PubMed

Schwarz, Carsten; Schönfeld, Nicolas; Bittner, Roland C; Mairinger, Thomas; Rüssmann, Holger; Bauer, Torsten T; Kaiser, Dirk; Loddenkemper, Robert

2013-01-01

The diagnostic value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules (SPN) is still under debate among pneumologists, radiologists and thoracic surgeons. In a prospective observational manner, flexible bronchoscopy was routinely performed in 225 patients with SPN of unknown origin. Of the 225 patients, 80.5% had lung cancer, 7.6% had metastasis of an extrapulmonary primary tumour and 12% had benign aetiology. Unsuspected endobronchial involvement was found in 4.4% of all 225 patients (or in 5.5% of patients with lung cancer). In addition, flexible bronchoscopy clarified the underlying aetiology in 41% of the cases. The bronchoscopic biopsy results from the SPN were positive in 84 (46.5%) patients with lung cancer. Surgery was cancelled due to the results of flexible bronchoscopy in four cases (involvement of the right main bronchus (impaired pulmonary function did not allow pneumonectomy) n=1, small cell lung cancer n=1, bacterial pneumonia n=2), and the surgical strategy had to be modified to bilobectomy in one patient. Flexible bronchoscopy changed the planned surgical approach in five cases substantially. These results suggest that routine flexible bronchoscopy should be included in the regular pre-operative work-up of patients with SPN.

Diagnostic quality of 50 and 100 µm computed radiography compared with screen–film mammography in operative breast specimens

PubMed Central

Pagliari, C M; Hoang, T; Reddy, M; Wilkinson, L S; Poloniecki, J D; Given-Wilson, R M

2012-01-01

Objective To compare reader ratings of the clinical diagnostic quality of 50 and 100 μm computed radiography (CR) systems with screen–film mammography (SFM) in operative specimens. Methods Mammograms of 57 fresh operative breast specimens were analysed by 10 readers. Exposures were made with identical position and compression with three mammographic systems (Fuji 100CR, 50CR and SFM). Images were anonymised and readers blinded to the CR system used. A five-point comparative scoring system (−2 to +2) was used to assess seven quality criteria and overall diagnostic value. Statistical analysis was subsequently performed of reader ratings (n=16 925). Results For most quality criteria, both CR systems were rated as equivalent to or better than SFM. The CR systems were significantly better at demonstrating skin edge and background tissue (p<1×10−5). Microcalcification was best demonstrated on the CR50 system (p<1×10−5). The overall diagnostic value of both CR systems was rated as being as good as or better than SFM (p<1×10−5). Conclusion In this clinical setting, the overall diagnostic performance of both CR systems was as good as or better than SFM, with the CR50 system performing better than the CR100. PMID:22096218

Comparison Of Pre-Operative Curvature With Postoperative Curvature In Root Canals Treated With K-3 Rotary Systems.

PubMed

Nagi, Sana Ehsen; Khan, Farhan Raza

2017-01-01

With root canal treatment, the organic debris and micro-organisms from pulp space is removed and an ideal canal preparation is achieved that is conducive of hermetic obturation. The purpose of this study was to correlate the pre-operative canal curvature with the postoperative curvature in human extracted teeth prepared with K-3 rotary systems. The root canal preparation was carried out on extracted human molars and premolars using K-3 endodontic rotary files. A pre and post-operative image of the teeth using digital radiograph were taken in order to compare pre and post-operative canal curvature. The images were saved in an images retrieval system (Gendex software, USA). Change in the canal curvature was measured using the software measuring tool (Vixwin software, USA). Student paired t-test and Pearson correlation test was applied at 0.05 level of significance. There is a statistically significant difference between pre-operative and post-operative canal curvature (p-value <0.001) and a strong positive correlation (91% correlation) between pre-operative and post-operative canal curvature in teeth prepared with the K-3 rotary files. A significant difference between pre and post instrumentation curvature was found. Degree of canal curvature was not correlated with time taken for canal preparation.

Evaluation of ascitic soluble human leukocyte antigen-G for distinguishing malignant ascites from benign ascites.

PubMed

Sun, Juan; Chang, Yan-Xiang; Niu, Chun-Yan

2017-11-01

The overexpression of soluble human leukocyte antigen-G is associated with malignant tumours. The purpose of our study was to detect soluble human leukocyte antigen-G concentrations in ascites and to evaluate the value of ascitic soluble human leukocyte antigen-G for the diagnosis of malignant ascites. Enzyme-linked immunosorbent assay was used to detect soluble human leukocyte antigen-G levels in 64 patients with malignant ascites and 30 patients with benign ascites. Receiver operating characteristic curves were used to evaluate the diagnostic efficacy of ascitic soluble human leukocyte antigen-G for the detection of malignant ascites. Ascitic soluble human leukocyte antigen-G levels were significantly higher in the malignant ascites group than in the benign ascites group (20.718 ± 3.215 versus 12.467 ± 3.678 µg/L, t = 7.425, p < 0.001). The area under the receiver operating characteristic curve for ascitic soluble human leukocyte antigen-G was 0.957 (95% confidence interval, 0.872-0.992). At a cut-off value of 19.60 µg/L, the sensitivity and specificity of ascitic soluble human leukocyte antigen-G were 87.5% (95% confidence interval, 71.0%-96.5%) and 100% (95% confidence interval, 88.4%-100%), respectively. With respect to area under the receiver operating characteristic curve, sensitivity and specificity, ascitic carcinoembryonic antigen (0.810, 68.75% and 83.33%, respectively) and carbohydrate antigen 19-9 (0.710, 65.63% and 70%, respectively) significantly differed (all p < 0.05). In malignant ascites that were cytology-negative and biopsy-positive, the rate of positivity for ascitic soluble human leukocyte antigen-G was 75%, which was higher than the corresponding rates for ascitic carcinoembryonic antigen (31.25%) and carbohydrate antigen 19-9 (6.25%; both p < 0.05). In conclusion, The detection of ascitic soluble human leukocyte antigen-G exhibited good performance for diagnosing malignant ascites, and particularly those that were cytology-negative and biopsy-positive.

A Multimodal Imaging Protocol, (123)I/(99)Tc-Sestamibi, SPECT, and SPECT/CT, in Primary Hyperparathyroidism Adds Limited Benefit for Preoperative Localization.

PubMed

Lee, Grace S; McKenzie, Travis J; Mullan, Brian P; Farley, David R; Thompson, Geoffrey B; Richards, Melanie L

2016-03-01

Focused parathyroidectomy in primary hyperparathyroidism (1°HPT) is possible with accurate preoperative localization and intraoperative PTH monitoring (IOPTH). The added benefit of multimodal imaging techniques for operative success is unknown. Patients with 1°HPT, who underwent parathyroidectomy in 2012-2014 at a single institution, were retrospectively reviewed. Only the patients who underwent the standardized multimodal imaging workup consisting of (123)I/(99)Tc-sestamibi subtraction scintigraphy, SPECT, and SPECT/CT were assessed. Of 360 patients who were identified, a curative operation was performed in 96%, using pre-operative imaging and IOPTH. Imaging analysis showed that (123)I/(99)Tc-sestamibi had a sensitivity of 86% (95% CI 82-90%), positive predictive value (PPV) 93%, and accuracy 81%, based on correct lateralization. SPECT had a sensitivity of 77% (95% CI 72-82%), PPV 92% and accuracy 72%. SPECT/CT had a sensitivity of 75% (95% CI 70-80%), PPV of 94%, and accuracy 71%. There were 3 of 45 (7%) patients with negative sestamibi imaging that had an accurate SPECT and SPECT/CT. Of 312 patients (87%) with positive uptake on sestamibi (93% true positive, 7% false positive), concordant findings were present in 86% SPECT and 84% SPECT/CT. In cases where imaging modalities were discordant, but at least one method was true-positive, (123)I/(99)Tc-sestamibi was significantly better than both SPECT and SPECT/CT (p < 0.001). The inclusion of SPECT and SPECT/CT in 1°HPT imaging protocol increases patient cost up to 2.4-fold. (123)I/(99)Tc-sestamibi subtraction imaging is highly sensitive for preoperative localization in 1°HPT. SPECT and SPECT/CT are commonly concordant with (123)I/(99)Tc-sestamibi and rarely increase the sensitivity. Routine inclusion of multimodality imaging technique adds minimal clinical benefit but increases cost to patient in high-volume setting.

A Practical Predictive Index for Intra-abdominal Septic Complications After Primary Anastomosis for Crohn's Disease: Change in C-Reactive Protein Level Before Surgery.

PubMed

Zuo, Lugen; Li, Yi; Wang, Honggang; Zhu, Weiming; Zhang, Wei; Gong, Jianfeng; Li, Ning; Li, Jieshou

2015-08-01

Postoperative intra-abdominal septic complications are difficult to manage in Crohn's disease, which makes prevention especially important. The purpose of this study was to examine the risk factors for intra-abdominal septic complications after primary anastomosis for Crohn's disease and to seek a practical predictive index for intra-abdominal septic complications. This was a retrospective study. The study was conducted in a tertiary referral hospital. Based on a computerized database of 344 patients with Crohn's disease who underwent primary anastomosis between 2004 and 2013, the patients were placed into an intra-abdominal septic complications group and a group without intra-abdominal septic complications. Univariate and multivariate analyses were performed to identify risk factors, and the predictive accuracy of possible predictors was assessed using receiver operating characteristic curves. Overall, 39 patients (11.34%) developed intra-abdominal septic complications. Preoperative C-reactive protein level >10 mg/L was found to be an independent risk factor (p < 0.01) for intra-abdominal septic complications. For prediction of intra-abdominal septic complications, receiver operating characteristic curve analysis showed that a C-reactive protein cutoff of 14.50 mg/L provided negative and positive predictive values of 96.84% and 34.07%. In addition, the change in C-reactive protein levels over the 2 weeks before surgery was greater in the intra-abdominal septic complications group than the group with no intra-abdominal septic complications (p < 0.01), and the directions of change were opposite, upward in the former and downward in the latter. Apart from being a risk factor for intra-abdominal septic complications (p < 0.01), receiver operating characteristic curve analysis showed that the change in C-reactive protein levels before surgery had a negative predictive value for intra-abdominal septic complications of 98.66% and a positive predictive value of 76.09%. This was a retrospective study. Changes in C-reactive protein before surgical treatment of Crohn's disease could serve as a practical predictive index for postoperative intra-abdominal septic complications.

Computed tomography scan diagnosis of occult groin hernia.

PubMed

Garvey, J F W

2012-06-01

The value of computed tomography (CT) for the diagnosis of clinically occult (hidden) groin hernia was assessed in a series of patients presenting with undiagnosed groin pain. A total of 158 consecutive patients presenting over a period of 5 years with undiagnosed groin pain or lower abdominal pain and negative or equivocal clinical findings were radiologically assessed with non-contrast CT. The decision to manage operatively or conservatively was then based on a combination of the clinical and CT findings. Outcomes were assessed at 10 years follow-up. The study cohort comprised 158 patients presenting with groin or lower abdominal pain and/or swelling, and was studied prospectively. Seven of these patients were re-investigated at a later date after developing new pain on either the ipsilateral or contralateral side, giving a total of 165 CT examinations. One-third of cases (54) had clinically occult groin hernias and most of the remaining cases had diagnoses that could be managed non-operatively. Of those who came to surgery, the pre-operative CT diagnosis of hernia had a positive predictive value (PPV) of 92% and a negative predictive value (NPV) of 96% (overall accuracy 94%). Lipoma of the spermatic cord was responsible for three of five false-positive CT results. The concept of sports hernia/groin disruption injury (GDI) was encountered, and this entity is discussed in this paper. In the group of patients without hernia findings on CT, the most common diagnoses were rectus abdominis and/or pyramidalis muscle injury which could be treated by physiotherapy (22%), GDI (16%), post-surgical problems (14%), miscellaneous (20%) and 'no abnormality' was identified in 15%. Overall, there were 111 patients with a 'non-hernia' CT diagnosis, of which urological, gynaecological, gastrointestinal and neuralgia contributed to the non-musculoskeletal diagnosis. This prospective non-contrast CT study of patients with undiagnosed chronic groin pain detected the majority of occult hernias requiring surgical intervention. These results suggest that CT can be a useful adjunct to the evaluation of patients presenting with chronic undiagnosed groin pain, but that experienced clinical judgment remains a critical element in the diagnostic pathway.

NDSD-1000: High-resolution, high-temperature Nitrogen Dioxide Spectroscopic Databank

NASA Astrophysics Data System (ADS)

Lukashevskaya, A. A.; Lavrentieva, N. N.; Dudaryonok, A. C.; Perevalov, V. I.

2016-11-01

We present a high-resolution, high-temperature version of the Nitrogen Dioxide Spectroscopic Databank called NDSD-1000. The databank contains the line parameters (positions, intensities, self- and air-broadening coefficients, exponents of the temperature dependence of self- and air-broadening coefficients) of the principal isotopologue of NO2. The reference temperature for line intensity is 296 K and the intensity cutoff is 10-25 cm-1/molecule cm-2 at 1000 K. The broadening parameters are presented for two reference temperatures 296 K and 1000 K. The databank has 1,046,808 entries, covers five spectral regions in the 466-4776 cm-1 spectral range and is designed for temperatures up to 1000 K. The databank is based on the global modeling of the line positions and intensities performed within the framework of the method of effective operators. The parameters of the effective Hamiltonian and the effective dipole moment operator have been fitted to the observed values of the line positions and intensities collected from the literature. The broadening coefficients as well as the temperature exponents are calculated using the semi-empirical approach. The databank is useful for studying high-temperature radiative properties of NO2. NDSD-1000 is freely accessible via the internet site of V.E. Zuev Institute of Atmospheric Optics SB RAS ftp://ftp.iao.ru/pub/NDSD/.

Governance Practices in an Era of Healthcare Transformation: Achieving a Successful Turnaround.

PubMed

Sondheim, Samuel E; Patel, Dipesh M; Chin, Nicole; Barwis, Kurt; Werner, Julie; Barclay, Alexus; Mattie, Angela

This article illustrates the successful application of principles established by the American Hospital Association (AHA) to foster hospital transformations (). We examined a small community hospital's successful transition from one emergency care center (ECC) physician group to another and the methods by which significant improvements in outcomes were achieved. The foundation of this transformation included a generative governance style at the board level, a shared governance model at the employee level, a renewed sense of employee and physician engagement, and a sense of individual accountability. Outcomes included improved communication, a more unified vision throughout the ECC (which led to improved efficiency and accountability among staff), improved metrics, and a positive impact on the community's perception of care. Press Ganey scores and ECC operational metrics demonstrated significant increases in patient satisfaction and decreases in wait times for seven operational metrics. These data serve as a proxy for the transformation's success. Structured interviews revealed an increase in employee satisfaction associated with the transition. The positive outcomes demonstrate the importance of the AHA-articulated governance principles. The AHA recommendations for a superior value-based care model closely align with the methods illustrated through Bristol Hospital's successful transformation. Other institutions can apply the lessons from this case study to drive positive change and improve patient care.

Sonic-boom measurements in the focus region during the ascent of Apollo 17. [maximum positive overpressure, positive impulse, signature duration, and bow-shock rise time

NASA Technical Reports Server (NTRS)

Henderson, H. R.; Hilton, D. A.

1974-01-01

Sonic-boom pressure signatures recorded during the ascent phase of Apollo 17 are presented. The measurements were obtained onboard six U.S. Navy ships positioned along the ground track of the spacecraft vehicle in the area of expected focus resulting from the flight path and acceleration of the vehicle. Tracings of the measured signatures are presented along with values of the maximum positive overpressure, positive impulse, signature duration, and bowshock rise time. Also included are brief descriptions of the ships and their location, the deployment of the sonic-boom instrumentation, flight profiles and operating conditions for the launch vehicle and spacecraft, surface-weather and sea-state information at the measuring sites, and high-altitude weather information for the general measurement areas. Comparisons of the measured and predicted sonic-boom overpressures for the Apollo 17 mission are presented. The measured data are also compared with data from the Apollo 15 and 16 missions and data from flight test programs of various aircraft.

Wave-function functionals

NASA Astrophysics Data System (ADS)

Pan, Xiao-Yin; Slamet, Marlina; Sahni, Viraht

2010-04-01

We extend our prior work on the construction of variational wave functions ψ that are functionals of functions χ:ψ=ψ[χ] rather than simply being functions. In this manner, the space of variations is expanded over those of traditional variational wave functions. In this article we perform the constrained search over the functions χ chosen such that the functional ψ[χ] satisfies simultaneously the constraints of normalization and the exact expectation value of an arbitrary single- or two-particle Hermitian operator, while also leading to a rigorous upper bound to the energy. As such the wave function functional is accurate not only in the region of space in which the principal contributions to the energy arise but also in the other region of the space represented by the Hermitian operator. To demonstrate the efficacy of these ideas, we apply such a constrained search to the ground state of the negative ion of atomic hydrogen H-, the helium atom He, and its positive ions Li+ and Be2+. The operators W whose expectations are obtained exactly are the sum of the single-particle operators W=∑irin,n=-2,-1,1,2, W=∑iδ(ri), W=-(1)/(2)∑i∇i2, and the two-particle operators W=∑nun,n=-2,-1,1,2, where u=|ri-rj|. Comparisons with the method of Lagrangian multipliers and of other constructions of wave-function functionals are made. Finally, we present further insights into the construction of wave-function functionals by studying a previously proposed construction of functionals ψ[χ] that lead to the exact expectation of arbitrary Hermitian operators. We discover that analogous to the solutions of the Schrödinger equation, there exist ψ[χ] that are unphysical in that they lead to singular values for the expectations. We also explain the origin of the singularity.

The influence of a Classroom Model of Scientific Scholarship on Four Girls' Trajectories of Identification with Science

NASA Astrophysics Data System (ADS)

Cook, Melissa Sunshine

This study examines the teacher's role in shaping the identity construction resources available in a classroom and the ways in which individual students take up, modify, and appropriate those resources to construct themselves as scientists through interaction with their teacher and peers. Drawing on frameworks of identity construction and social positioning, I propose that the locally-negotiated classroom-level cultural model of what it means to be a "good" science student forms the arena in which students construct a sense of their own competence at, affiliation with, and interest in science. The setting for this study was a 6th grade science class at a progressive urban elementary school whose population roughly represents the ethnic and socioeconomic diversity of the state of California. The teacher was an experienced science and math teacher interested in social justice and inquiry teaching. Drawing from naturalistic observations, video and artifact analysis, survey data, and repeated interviews with students and the teacher, I demonstrated what it meant to be a "good" science student in this particular cultural community by analyzing what was required, reinforced, and rewarded in this classroom. Next, I traced the influence of this particular classroom's conception of what it meant to be good at science on the trajectories of identification with science of four 6th grade girls selected to represent a variety of stances towards science, levels of classroom participation, and personal backgrounds. Scientific scholarship in this class had two parts: values related to science as a discipline, and a more generic set of school-related values one might see in any classroom. Different meanings of and values for science were indexed in the everyday activities of the classroom: science as a language for describing the natural world, science as a set of rhetorical values, science as an adult social community, and science as a place for mess and explosions. Among school-related values, participation, cooperation, and completing work were most important. Individual students leveraged different aspects of the local cultural model of scientific scholarship to construct themselves as competent participants in the science classroom. This study extends and complicates current analyses of classroom norms by showing that to understand identity construction, we must do more than identify a list of norms operating in a classroom---we must map the relationships between norms. This analysis demonstrates how broader discourses, in this case about schooling and science, infiltrated the classroom and influenced the meaning and operation of classroom norms and individual students' efforts to position themselves in relation to the classroom model of a good student. Finally, these findings show the value in examining recognition from three interrelated lenses: self-narratives, other-narratives, and observational accounts of positioning.

The value of genetic information for diabetes risk prediction - differences according to sex, age, family history and obesity.

PubMed

Mühlenbruch, Kristin; Jeppesen, Charlotte; Joost, Hans-Georg; Boeing, Heiner; Schulze, Matthias B

2013-01-01

Genome-wide association studies have identified numerous single nucleotide polymorphisms associated with type 2 diabetes through the past years. In previous studies, the usefulness of these genetic markers for prediction of diabetes was found to be limited. However, differences may exist between substrata of the population according to the presence of major diabetes risk factors. This study aimed to investigate the added predictive value of genetic information (42 single nucleotide polymorphisms) in subgroups of sex, age, family history of diabetes, and obesity. A case-cohort study (random subcohort N = 1,968; incident cases: N = 578) within the European Prospective Investigation into Cancer and Nutrition Potsdam study was used. Prediction models without and with genetic information were evaluated in terms of the area under the receiver operating characteristic curve and the integrated discrimination improvement. Stratified analyses included subgroups of sex, age (<50 or ≥50 years), family history (positive if either father or mother or a sibling has/had diabetes), and obesity (BMI< or ≥30 kg/m(2)). A genetic risk score did not improve prediction above classic and metabolic markers, but - compared to a non-invasive prediction model - genetic information slightly improved the area under the receiver operating characteristic curve (difference [95%-CI]: 0.007 [0.002-0.011]). Stratified analyses showed stronger improvement in the older age group (0.010 [0.002-0.018]), the group with a positive family history (0.012 [0.000-0.023]) and among obese participants (0.015 [-0.005-0.034]) compared to the younger participants (0.005 [-0.004-0.014]), participants with a negative family history (0.003 [-0.001-0.008]) and non-obese (0.007 [0.000-0.014]), respectively. No difference was found between men and women. There was no incremental value of genetic information compared to standard non-invasive and metabolic markers. Our study suggests that inclusion of genetic variants in diabetes risk prediction might be useful for subgroups with already manifest risk factors such as older age, a positive family history and obesity.

Summary of Sonic Boom Rise Times Observed During FAA Community Response Studies over a 6-Month Period in the Oklahoma City Area

NASA Technical Reports Server (NTRS)

Maglieri, Domenic J.; Sothcott, Victor E.

1990-01-01

The sonic boom signature data acquired from about 1225 supersonic flights, over a 6-month period in 1964 in the Oklahoma City area, was enhanced with the addition of data relating to rise times and total signature duration. These later parameters, not available at the time of publication of the original report on the Oklahoma City sonic boom exposures, are listed in tabular form along with overpressure, positive impulse, positive duration, and waveform category. Airplane operating information along with the surface weather observations are also included. Sonic boom rise times include readings to the 1/2, 3/4, and maximum overpressure values. Rise time relative probabilities for various lateral locations from the ground track of 0, 5, and 10 miles are presented along with the variation of rise times with flight altitude. The tabulated signature data, along with corresponding airplane operating conditions and surface and upper level atmospheric information, are also available on electronic files to provide it in the format for more efficient and effective utilization.

Can a Resident's Publication Record Predict Fellowship Publications?

PubMed Central

Prasad, Vinay; Rho, Jason; Selvaraj, Senthil; Cheung, Mike; Vandross, Andrae; Ho, Nancy

2014-01-01

Background Internal medicine fellowship programs have an incentive to select fellows who will ultimately publish. Whether an applicant's publication record predicts long term publishing remains unknown. Methods Using records of fellowship bound internal medicine residents, we analyzed whether publications at time of fellowship application predict publications more than 3 years (2 years into fellowship) and up to 7 years after fellowship match. We calculate the sensitivity, specificity, positive and negative predictive values and likelihood ratios for every cutoff number of application publications, and plot a receiver operator characteristic curve of this test. Results Of 307 fellowship bound residents, 126 (41%) published at least one article 3 to 7 years after matching, and 181 (59%) of residents do not publish in this time period. The area under the receiver operator characteristic curve is 0.59. No cutoff value for application publications possessed adequate test characteristics. Conclusion The number of publications an applicant has at time of fellowship application is a poor predictor of who publishes in the long term. These findings do not validate the practice of using application publications as a tool for selecting fellows. PMID:24658088

Can a resident's publication record predict fellowship publications?

PubMed

Prasad, Vinay; Rho, Jason; Selvaraj, Senthil; Cheung, Mike; Vandross, Andrae; Ho, Nancy

2014-01-01

Internal medicine fellowship programs have an incentive to select fellows who will ultimately publish. Whether an applicant's publication record predicts long term publishing remains unknown. Using records of fellowship bound internal medicine residents, we analyzed whether publications at time of fellowship application predict publications more than 3 years (2 years into fellowship) and up to 7 years after fellowship match. We calculate the sensitivity, specificity, positive and negative predictive values and likelihood ratios for every cutoff number of application publications, and plot a receiver operator characteristic curve of this test. Of 307 fellowship bound residents, 126 (41%) published at least one article 3 to 7 years after matching, and 181 (59%) of residents do not publish in this time period. The area under the receiver operator characteristic curve is 0.59. No cutoff value for application publications possessed adequate test characteristics. The number of publications an applicant has at time of fellowship application is a poor predictor of who publishes in the long term. These findings do not validate the practice of using application publications as a tool for selecting fellows.

Reach a nonlinear consensus for MAS via doubly stochastic quadratic operators

NASA Astrophysics Data System (ADS)

Abdulghafor, Rawad; Turaev, Sherzod; Zeki, Akram; Al-Shaikhli, Imad

2018-06-01

This technical note addresses the new nonlinear protocol class of doubly stochastic quadratic operators (DSQOs) for coordination of consensus problem in multi-agent systems (MAS). We derive the conditions for ensuring that every agent reaches consensus on a desired rate of the group's decision where the group decision value in its agent's initial statuses varies. Besides that, we investigate a nonlinear protocol sub-class of extreme DSQO (EDSQO) to reach a consensus for MAS to a common value with nonlinear low-complexity rules and fast time convergence if the interactions for each agent are not selfish. In addition, to extend the results to reach a consensus and to avoid the selfish case we specify a general class of DSQO for reaching a consensus under any given case of initial states. The case that MAS reach a consensus by DSQO is if each member of the agent group has positive interactions of DSQO (PDSQO) with the others. The convergence of both EDSQO and PDSQO classes is found to be directed towards the centre point. Finally, experimental simulations are given to support the analysis from theoretical aspect.

Improved control of the betatron coupling in the Large Hadron Collider

NASA Astrophysics Data System (ADS)

Persson, T.; Tomás, R.

2014-05-01

The control of the betatron coupling is of importance for safe beam operation in the LHC. In this article we show recent advancements in methods and algorithms to measure and correct coupling. The benefit of using a more precise formula relating the resonance driving term f1001 to the ΔQmin is presented. The quality of the coupling measurements is increased, with about a factor 3, by selecting beam position monitor (BPM) pairs with phase advances close to π/2 and through data cleaning using singular value decomposition with an optimal number of singular values. These improvements are beneficial for the implemented automatic coupling correction, which is based on injection oscillations, presented in the article. Furthermore, a proposed coupling feedback for the LHC is presented. The system will rely on the measurements from BPMs equipped with a new type of high resolution electronics, diode orbit and oscillation, which will be operational when the LHC restarts in 2015. The feedback will combine the coupling measurements from the available BPMs in order to calculate the best correction.

The norms, rules and motivational values driving sustainable remediation of contaminated environments: A study of implementation.

PubMed

Prior, Jason

2016-02-15

Efforts to achieve sustainability are transforming the norms, rules and values that affect the remediation of contaminated environments. This is altering the ways in which remediation impacts on the total environment. Despite this transformation, few studies have provided systematic insights into the diverse norms and rules that drive the implementation of sustainable remediation at contaminated sites, and no studies have investigated how values motivate compliance with these norms and rules. This study is a systematic analysis of the rules, norms and motivational values embedded in sustainable remediation processes at three sites across Australia, using in-depth interviews conducted with 18 participants between 2011 and 2014, through the application of Crawford and Ostrom's Institutional Grammar and Schwartz's value framework. These approaches offered methods for identifying the rules, norms, and motivational values that guided participants' actions within remediation processes at these sites. The findings identify a core set of 16 norms and 18 rules (sanctions) used by participants to implement sustainable remediation at the sites. These norms and rules: define the position of participants within the process, provide means for incorporating sustainability into established remediation practices, and define the scope of outcomes that constitute sustainable remediation. The findings revealed that motivational values focused on public interest and self-interest influenced participants' compliance with norms and rules. The findings also found strong interdependence between the norms and rules (sanctions) within the remediation processes and the normative principles operating within the broader domain of environmental management and planning. The paper concludes with a discussion of: the system of norms operating within sustainable remediation (which far exceed those associated with ESD); their link, through rules (sanctions) to contemporary styles of regulatory enforcement; and the underlying balance of public-interest values and self-interest values that drives participants' involvement in sustainable remediation. Copyright © 2015 Elsevier B.V. All rights reserved.

Value recovery from two mechanized bucking operations in the southeastern United States

Treesearch

Kevin Boston; Glen. Murphy

2003-01-01

The value recovered from two mechanized bucking operations in the southeastern United States was compared with the optimal value computed using an individual-stem log optimization program, AVIS. The first operation recovered 94% of the optimal value. The main cause for the value loss was a failure to capture potential sawlog volume; logs were bucked to a larger average...

Construction of a Cerebral Hemorrhage Test System Operated in Real-time

NASA Astrophysics Data System (ADS)

Li, Gen; Sun, Jian; Ma, Ke; Yan, Qingguang; Zheng, Xiaolin; Qin, Mingxin; Jin, Gui; Ning, Xu; Zhuang, Wei; Feng, Hua; Huang, Shiyuwei

2017-02-01

The real-time monitoring and evaluation of the severity and progression of cerebral hemorrhage is essential to its intensive care and its successful emergency treatment. Based on magnetic induction phase shift technology combined with a PCI data acquisition system and LabVIEW software, this study established a real-time monitoring system for cerebral hemorrhage. To test and evaluate the performance of the system, the authors performed resolution conductivity experiments, salted water simulation experiments and cerebral hemorrhage experiments in rabbits and found that when the conductivity difference was 0.73 S/m, the phase difference was 13.196°. The phase difference change value was positively proportional to the volume of saline water, and the conductivity value was positively related to the phase difference of liquid under the same volume conditions. After injecting 3 mL blood into six rabbits, the average change in the blood phase difference was -2.03783 ± 0.22505°, and it was positively proportional to the volume of blood, which was consistent with the theoretical results. The results show that the system can monitor the progressive development of cerebral hemorrhage in real-time and has the advantages of low cost, small size, high phase accuracy, and good clinical application potentiality.

Fully Automated Complementary DNA Microarray Segmentation using a Novel Fuzzy-based Algorithm.

PubMed

Saberkari, Hamidreza; Bahrami, Sheyda; Shamsi, Mousa; Amoshahy, Mohammad Javad; Ghavifekr, Habib Badri; Sedaaghi, Mohammad Hossein

2015-01-01

DNA microarray is a powerful approach to study simultaneously, the expression of 1000 of genes in a single experiment. The average value of the fluorescent intensity could be calculated in a microarray experiment. The calculated intensity values are very close in amount to the levels of expression of a particular gene. However, determining the appropriate position of every spot in microarray images is a main challenge, which leads to the accurate classification of normal and abnormal (cancer) cells. In this paper, first a preprocessing approach is performed to eliminate the noise and artifacts available in microarray cells using the nonlinear anisotropic diffusion filtering method. Then, the coordinate center of each spot is positioned utilizing the mathematical morphology operations. Finally, the position of each spot is exactly determined through applying a novel hybrid model based on the principle component analysis and the spatial fuzzy c-means clustering (SFCM) algorithm. Using a Gaussian kernel in SFCM algorithm will lead to improving the quality in complementary DNA microarray segmentation. The performance of the proposed algorithm has been evaluated on the real microarray images, which is available in Stanford Microarray Databases. Results illustrate that the accuracy of microarray cells segmentation in the proposed algorithm reaches to 100% and 98% for noiseless/noisy cells, respectively.

Application of Mycobacterium Leprae-specific cellular and serological tests for the differential diagnosis of leprosy from confounding dermatoses.

PubMed

Freitas, Aline Araújo; Hungria, Emerith Mayra; Costa, Maurício Barcelos; Sousa, Ana Lúcia Osório Maroccolo; Castilho, Mirian Lane Oliveira; Gonçalves, Heitor Sá; Pontes, Maria Araci Andrade; Duthie, Malcolm S; Stefani, Mariane Martins Araújo

2016-10-01

Mycobacterium leprae-specific serological and cell-mediated-immunity/CMI test were evaluated for the differential diagnosis of multibacillary/MB, and paucibacillary/PB leprosy from other dermatoses. Whole-blood assay/WBA/IFNγ stimulated with LID-1 antigen and ELISA tests for IgG to LID-1 and IgM to PGL-I were performed. WBA/LID-1/IFNγ production was observed in 72% PB, 11% MB leprosy, 38% dermatoses, 40% healthy endemic controls/EC. The receiver operating curve/ROC for WBA/LID-1 in PB versus other dermatoses showed 72.5% sensitivity, 61.5% specificity and an area-under-the-curve/AUC=0.75; 74% positive predictive value/PPV, 59% negative predictive value/NPV. Anti PGL-I serology was positive in 67% MB, 8% PB leprosy, 6% of other dermatoses; its sensitivity for MB=66%, specificity=93%, AUC=0.89; PPV=91%, NPV=72%. Anti-LID-1 serology was positive in 87% MB, 7% PB leprosy, all other participants were seronegative; 87.5% sensitivity for MB, 100% specificity, AUC=0.97; PPV=100%, NPV=88%. In highly endemic areas anti-LID-1/PGL-I serology and WBA/LID-1-represent useful tools for the differential diagnosis of leprosy from other confounding dermatoses. Copyright © 2016 Elsevier Inc. All rights reserved.

Rogue waves driven by polarization instabilities in a long ring fiber oscillator

NASA Astrophysics Data System (ADS)

Kolpakov, S. A.; Kbashi, Hani; Sergeyev, Sergey

2017-05-01

We present an experimental and theoretical results of a study of a complex nonlinear polarization dynamics in a passively self-mode-locked erbium-doped fiber oscillator implemented in a ring configuration and operating near lasing threshold. The theoretical model consists of seven coupled non-linear equations and takes into account both orthogonal states of polarizations in the fiber. The experiment confirmed the existence of seven eigenfrequencies, predicted by the model due to polarization instability near lasing threshold. By adjusting the state of polarization of the pump and in-cavity birefringence we changed some eigenfrequencies from being different (non-degenerate state) to matching (degenerate state). The non-degenerate states of oscillator lead to the L-shaped probability distribution function and true rogue wave regime with a positive dominant Lyapunov exponent value between 1.4 and 2.6. Small detuning from partially degenerate case also leads to L-shaped probability distribution function with the tail trespassing eight standard deviations threshold, giving periodic patterns of pulses along with positive dominant Lyapunov exponent of a filtered signal between 0.6 and 3.2. The partial degeneration, in turn, guides to quasi-symmetric distribution and the value of dominant Lyapunov exponent of 42 which is a typical value for systems with a source of the strongly nonhomogeneous external noise.

"Remnants of feudalism"? Women's health and their utilization of health services in rural China.

PubMed

Anson, O; Haanappel, F W

1999-01-01

Almost five decades ago, the Chinese Communist Party wished to abolish all "remnants of feudalism," including the patriarchal social order. Just one year after the revolution, the Marriage Law endorsed women's rights within the family, but no operative measures were taken to enforce it. Some of the economic reforms since independence even strengthened patrilocality and, possibly, patriarchal values. The purpose of this study was to explore the degree to which patrilocality served to maintain the traditional patriarchal stratification among women in the household by exploring women's health patterns and utilization of health services. Data were collected from 3859 women residing in rural Hebei, and variation in health and help seeking of six categories of relation to household head--mothers, wives, daughters, daughters-in-law, family heads, and other relatives--were explored. Utilization of health services is not dependent on women's position in the household, but primarily on per-capita income. Health patterns seem to indicate that mothers of the head of the household still have a considerable power to define their roles and share of household work. Women head of family, most of whom are married, appear to be under strain, which could be a result of their culturally "deviant" position. We conclude that old patriarchal values are intertwined with values of equality in current rural China.

The systemic inflammatory response syndrome (SIRS) to identify infected patients in the emergency room.

PubMed

Jaimes, Fabián; Garcés, Jenny; Cuervo, Jorge; Ramírez, Federico; Ramírez, Jorge; Vargas, Andrea; Quintero, Claudia; Ochoa, Jorge; Tandioy, Fabio; Zapata, Láder; Estrada, Juan; Yepes, Maria; Leal, Hiulber

2003-08-01

Evaluation of the usefulness of criteria for systemic inflammatory response syndrome (SIRS) compared with the final diagnosis of infection in patients admitted to the emergency room of two university-based hospitals. Longitudinal cohort study. Hospital Universitario San Vicente de Paul and Hospital General de Medellín, Medellín, Colombia. PATIENTS. Seven hundred thirty-four patients with suspected infection as main diagnosis for admittance into the emergency room. Sensitivity, specificity, predictive values and likelihood ratios (LR) of SIRS criteria at admission were determined using, as gold standards, the diagnosis at the time of discharge based on clinical history and evolution, and microbiological confirmation of infection. SIRS criteria were met by 503 patients (68.5%); the discharge diagnosis of infection was found in 657 (89.4%) and 276 (37%) had microbiological confirmation. SIRS criteria exhibited a sensitivity of 69%, specificity of 35%, positive predictive value (PPV) of 90%, negative predictive value (NPV) of 12% and positive LR of 1.06. There were no differences between the two gold standards. The finding of two or more SIRS criteria was of little usefulness for diagnosis of infection. It is necessary to work with new criteria and probably with biological markers, in order to obtain a simple, precise and operative definition of the sepsis phenomenon.

Electronic Position Sensor for Power Operated Accessory

DOEpatents

Haag, Ronald H.; Chia, Michael I.

2005-05-31

An electronic position sensor for use with a power operated vehicle accessory, such as a power liftgate. The position sensor includes an elongated resistive circuit that is mounted such that it is stationary and extends along the path of a track portion of the power operated accessory. The position sensor further includes a contact nub mounted to a link member that moves within the track portion such that the contact nub is slidingly biased against the elongated circuit. As the link member moves under the force of a motor-driven output gear, the contact nub slides along the surface of the resistive circuit, thereby affecting the overall resistance of the circuit. The position sensor uses the overall resistance to provide an electronic position signal to an ECU, wherein the signal is indicative of the absolute position of the power operated accessory. Accordingly, the electronic position sensor is capable of providing an electronic signal that enables the ECU to track the absolute position of the power operated accessory.

Adaptive model training system and method

DOEpatents

Bickford, Randall L; Palnitkar, Rahul M; Lee, Vo

2014-04-15

An adaptive model training system and method for filtering asset operating data values acquired from a monitored asset for selectively choosing asset operating data values that meet at least one predefined criterion of good data quality while rejecting asset operating data values that fail to meet at least the one predefined criterion of good data quality; and recalibrating a previously trained or calibrated model having a learned scope of normal operation of the asset by utilizing the asset operating data values that meet at least the one predefined criterion of good data quality for adjusting the learned scope of normal operation of the asset for defining a recalibrated model having the adjusted learned scope of normal operation of the asset.

Adaptive model training system and method

DOEpatents

Bickford, Randall L; Palnitkar, Rahul M

2014-11-18

An adaptive model training system and method for filtering asset operating data values acquired from a monitored asset for selectively choosing asset operating data values that meet at least one predefined criterion of good data quality while rejecting asset operating data values that fail to meet at least the one predefined criterion of good data quality; and recalibrating a previously trained or calibrated model having a learned scope of normal operation of the asset by utilizing the asset operating data values that meet at least the one predefined criterion of good data quality for adjusting the learned scope of normal operation of the asset for defining a recalibrated model having the adjusted learned scope of normal operation of the asset.

Evaluation of Echocardiographic Epicardial Fat Thickness as a Sign of Cardiovascular Risk in Positive Exercise Test Patients.

PubMed

Katlandur, Hüseyin; Ulucan, Şeref; Özdil, Hüseyin; Keser, Ahmet; Kaya, Zeynettin; Özbek, Kerem; Ülgen, M Sıddık

2016-11-01

The association between epicardial fat thickness (EFT) and positive exercise test results for the diagnosis of coronary artery diseases (CAD) has yet to be evaluated. This study assessed the predictive value of EFT for CAD on the angiographs of patients with positive exercise tests. A total of 91 subjects were chosen consecutively from stable angina pectoris patients who were referred for coronary angiography due to a positive exercise test result. The EFT measures were obtained by echocardiographic parasternal long-axis views on the free wall of the right ventricle at end-systole of three cardiac cycles. Gensini scores were calculated by a conventional coronary angiography technique using a calculation method previously defined. Receiver operator characteristic (ROC) curve analysis revealed a 0.65 cm (95% confidence interval: 0.628, 0.832, p < 0.001) area under the curve with 74.3% sensitivity and 62.3% specificity at the cut-off value of EFT for the prediction of critical coronary artery stenosis. Following ROC curve analysis, two groups were defined according to EFT cut-off value (groups 1 and 2). The severe coronary stenosis ratio was significantly higher in group 2 compared to group 1 (31.9 % vs. 11%, p < 0.001) and Gensini scores were significantly higher in group 2 (6.3 ± 13.3 vs. 16.5 ± 17.9; p < 0.001). There was no significant correlation between Gensini scores and EFT in group 1 (r = 0.093, p = 0.549), but there was a strong significant correlation in group 2 (r = 0.730, p < 0.001). Linear multivariate regression analysis revealed that EFT (> 0.65 cm) was the only independent risk factor for critical coronary artery stenosis (β = 0.451, p < 0.001). EFT was significantly correlated with the severity and prevalence of coronary artery disease in positive exercise test patients.

Expression and prognostic value of soluble CD97 and its ligand CD55 in intrahepatic cholangiocarcinoma.

PubMed

Meng, Ze-Wu; Liu, Min-Chao; Hong, Hai-Jie; Du, Qiang; Chen, Yan-Ling

2017-03-01

The incidence rate of intrahepatic cholangiocarcinoma is rising, and treatment options are limited. Therefore, new biological markers of intrahepatic cholangiocarcinoma are needed. Immunohistochemistry and enzyme-linked immunosorbent assay were applied to analyze the expressions of CD97, CD55, and soluble CD97 in 71 patients with intrahepatic cholangiocarcinoma and 10 patients with hepatolithiasis. CD97 and CD55 were not expressed in hepatolithiatic tissues, but positive expression was observed in 76.1% (54/71) and 70.4% (50/71) of intrahepatic cholangiocarcinoma patients. The univariate analyses indicated that the positive expressions of CD97 and CD55 were related to short intrahepatic cholangiocarcinoma survival of patients (both p = 0.001). Furthermore, CD97 and CD55 expressions and biliary soluble CD97 levels were significantly associated with histological grade (p = 0.004, 0.002, and 0.012, respectively), lymph node metastases (p = 0.020, 0.038, and 0.001, respectively), and venous invasion (p = 0.003, 0.002, and 0.001, respectively). The multivariate analyses indicated that lymph node metastases (hazard ratio: 2.407, p = 0.003), positive CD55 expression (hazard ratio: 4.096, p = 0.003), and biliary soluble CD97 levels (hazard ratio: 2.434, p = 0.002) were independent risk factors for the intrahepatic cholangiocarcinoma survival. The receiver operating characteristic (ROC) curve analysis indicated that when the cutoff values of biliary soluble CD97 were 1.15 U/mL, the diagnostic value for predicting lymph node metastasis had a sensitivity of 87.5% and a specificity of 51.3%. For intrahepatic cholangiocarcinoma patient death within 60 months at a cutoff value of 0.940 U/mL, the diagnostic value sensitivity was 89.3% and the specificity was 93.3%. Biliary soluble CD97 may be a new biological marker for early diagnosis, prediction of lymph node metastasis and poor prognosis, and discovery of a therapeutic target.

The Accuracy of the Spot Sign and the Blend Sign for Predicting Hematoma Expansion in Patients with Spontaneous Intracerebral Hemorrhage.

PubMed

Zheng, Jun; Yu, Zhiyuan; Xu, Zhao; Li, Mou; Wang, Xiaoze; Lin, Sen; Li, Hao; You, Chao

2017-05-12

BACKGROUND Hematoma expansion is associated with poor outcome in intracerebral hemorrhage (ICH) patients. The spot sign and the blend sign are reliable tools for predicting hematoma expansion in ICH patients. The aim of this study was to compare the accuracy of the two signs in the prediction of hematoma expansion. MATERIAL AND METHODS Patients with spontaneous ICH were screened for the presence of the computed tomography angiography (CTA) spot sign and the non-contrast CT (NCCT) blend sign within 6 hours after onset of symptoms. The sensitivity, specificity, and positive and negative predictive values of the spot sign and the blend sign in predicting hematoma expansion were calculated. The accuracy of the spot sign and the blend sign in predicting hematoma expansion was analyzed by receiver-operator analysis. RESULTS A total of 115 patients were enrolled in this study. The spot sign was observed in 25 (21.74%) patients, whereas the blend sign was observed in 22 (19.13%) patients. Of the 28 patients with hematoma expansion, the CTA spot sign was found on admission CT scans in 16 (57.14%) and the NCCT blend sign in 12 (42.86%), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the spot sign for predicting hematoma expansion were 57.14%, 89.66%, 64.00%, and 86.67%, respectively. In contrast, the sensitivity, specificity, positive predictive value, and negative predictive value of the blend sign were 42.86%, 88.51%, 54.55%, and 82.80%, respectively. The area under the curve (AUC) of the spot sign was 0.734, which was higher than that of the blend sign (0.657). CONCLUSIONS Both the spot sign and the blend sign seemed to be good predictors for hematoma expansion, and the spot sign appeared to have better predictive accuracy.

The Accuracy of the Spot Sign and the Blend Sign for Predicting Hematoma Expansion in Patients with Spontaneous Intracerebral Hemorrhage

PubMed Central

Zheng, Jun; Yu, Zhiyuan; Xu, Zhao; Li, Mou; Wang, Xiaoze; Lin, Sen; Li, Hao; You, Chao

2017-01-01

Background Hematoma expansion is associated with poor outcome in intracerebral hemorrhage (ICH) patients. The spot sign and the blend sign are reliable tools for predicting hematoma expansion in ICH patients. The aim of this study was to compare the accuracy of the two signs in the prediction of hematoma expansion. Material/Methods Patients with spontaneous ICH were screened for the presence of the computed tomography angiography (CTA) spot sign and the non-contrast CT (NCCT) blend sign within 6 hours after onset of symptoms. The sensitivity, specificity, and positive and negative predictive values of the spot sign and the blend sign in predicting hematoma expansion were calculated. The accuracy of the spot sign and the blend sign in predicting hematoma expansion was analyzed by receiver-operator analysis. Results A total of 115 patients were enrolled in this study. The spot sign was observed in 25 (21.74%) patients, whereas the blend sign was observed in 22 (19.13%) patients. Of the 28 patients with hematoma expansion, the CTA spot sign was found on admission CT scans in 16 (57.14%) and the NCCT blend sign in 12 (42.86%), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the spot sign for predicting hematoma expansion were 57.14%, 89.66%, 64.00%, and 86.67%, respectively. In contrast, the sensitivity, specificity, positive predictive value, and negative predictive value of the blend sign were 42.86%, 88.51%, 54.55%, and 82.80%, respectively. The area under the curve (AUC) of the spot sign was 0.734, which was higher than that of the blend sign (0.657). Conclusions Both the spot sign and the blend sign seemed to be good predictors for hematoma expansion, and the spot sign appeared to have better predictive accuracy. PMID:28498827

Validation of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) Serbian version.

PubMed

Ristić, Aleksandar J; Pjevalica, Jelena; Trajković, Goran; Parojčić, Aleksandra; Mihajlović, Ana; Vojvodić, Nikola; Baščarević, Vladimir; Popović, Tamara; Janković, Slavko; Sokić, Dragoslav

2016-04-01

The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was developed and proven efficient for the rapid detection of a major depressive episode in people with epilepsy. This study describes the development, validation, and psychometric properties of the NDDI-E Serbian version. A consecutive sample of 103 patients with epilepsy was assessed using the Beck Depression Inventory (BDI) and the NDDI-E. All patients had no major difficulties in understanding or answering the questions of the Serbian version. Cronbach's alpha coefficient was 0.763. Receiver operating characteristic analysis showed an area under the curve of 0.943 (95% CI; 0.826 to 0.951), a cutoff score of ≥14, a sensitivity of 72.2%, a specificity of 95.2%, a positive predictive value of 81.3%, and a negative predictive value of 94.3%. The NDDI-E Serbian version scores were significantly and positively correlated with those of the BDI (p<0.001). The NDDI-E Serbian version constitutes a concise and consistent depression screening instrument for patients with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

CNV detection method optimized for high-resolution arrayCGH by normality test.

PubMed

Ahn, Jaegyoon; Yoon, Youngmi; Park, Chihyun; Park, Sanghyun

2012-04-01

High-resolution arrayCGH platform makes it possible to detect small gains and losses which previously could not be measured. However, current CNV detection tools fitted to early low-resolution data are not applicable to larger high-resolution data. When CNV detection tools are applied to high-resolution data, they suffer from high false-positives, which increases validation cost. Existing CNV detection tools also require optimal parameter values. In most cases, obtaining these values is a difficult task. This study developed a CNV detection algorithm that is optimized for high-resolution arrayCGH data. This tool operates up to 1500 times faster than existing tools on a high-resolution arrayCGH of whole human chromosomes which has 42 million probes whose average length is 50 bases, while preserving false positive/negative rates. The algorithm also uses a normality test, thereby removing the need for optimal parameters. To our knowledge, this is the first formulation for CNV detecting problems that results in a near-linear empirical overall complexity for real high-resolution data. Copyright © 2012 Elsevier Ltd. All rights reserved.

Unscrambling Egg Allergy: The Diagnostic Value of Specific IgE Concentrations and Skin Prick Tests for Ovomucoid and Egg White in the Management of Children with Hen's Egg Allergy.

PubMed

Marriage, D E; Erlewyn-Lajeunesse, M; Unsworth, D J; Henderson, A J

2012-01-01

Resolution of egg allergy occurs in the majority of egg allergic children. Positive specific IgE antibodies to ovomucoid (OVM) have been suggested to be of greater predictive value for persistent egg allergy than specific IgE to egg white. The performance of OVM-specific IgE antibody levels in a cohort of children referred for a routine egg challenge was compared with egg white specific IgE levels in predicting a positive egg challenge. 24/47 subjects had persistent egg allergy. Receiver operating characteristic analysis showed that OVM-specific IgE testing was the most useful test for the diagnosis of persistent egg allergy. The optimal decision points for the prediction of persistent egg allergy were >0.35 kUA/L for specific IgE levels to both EW and OVM, and ≥3 mm for SPT. Children with specific IgE levels suggestive of persistent egg allergy need not be subject to an egg provocation challenge, reducing both costs and risks to the child.

Dynamics of molecular motors with finite processivity on heterogeneous tracks.

PubMed

Kafri, Yariv; Lubensky, David K; Nelson, David R

2005-04-01

The dynamics of molecular motors which occasionally detach from a heterogeneous track like DNA or RNA is considered. Motivated by recent single-molecule experiments, we study a simple model for a motor moving along a disordered track using chemical energy while an external force opposes its motion. The motors also have finite processivity, i.e., they can leave the track with a position-dependent rate. We show that the response of the system to disorder in the hopping-off rate depends on the value of the external force. For most values of the external force, strong disorder causes the motors which survive for long times on the track to be localized at preferred positions. However, near the stall force, localization occurs for any amount of disorder. To obtain these results, we study the complex eigenvalue spectrum of the time evolution operator. Existence of localized states near the top of the band implies a stretched exponential contribution to the decay of the survival probability. A similar spectral analysis also provides a very efficient method for studying the dynamics of motors with infinite processivity.

Can 3'-Deoxy-3'-((18)F) Fluorothymidine Out Perform 2-Deoxy-2-((18)F) Fluoro-D-Glucose Positron Emission Tomography/Computed Tomography in the Diagnosis of Cervical Lymphadenopathy in Patients With Oral/Head and Neck Cancer?

PubMed

Schaefferkoetter, Joshua D; Carlson, Eric R; Heidel, Robert E

2015-07-01

The present study investigated the performance of cellular metabolism imaging with 2-deoxy-2-((18)F) fluoro-D-glucose (FDG) versus cellular proliferation imaging with 3'-deoxy-3'-((18)F) fluorothymidine (FLT) in the detection of cervical lymph node metastases in oral/head and neck cancer. We conducted a prospective cohort study to assess a head-to-head performance of FLT imaging and clinical FDG imaging for characterizing cervical lymph node metastases in patients with squamous cell carcinoma (SCC) of the oral/head and neck region. The primary predictor variable of the study was the presence of FDG or FLT avidity within the cervical lymph nodes. The primary outcome variable was the histologic presence of metastatic SCC in the cervical lymph nodes. The performance was reported in terms of the sensitivity, specificity, accuracy, and positive and negative predictive values. The overall accuracy for discriminating positive from negative lymph nodes was evaluated as a function of the positron emission tomography (PET) standardized uptake value (SUV). Receiver operating characteristic (ROC) analyses were performed for both tracers. Eleven patients undergoing surgical resection of SCC of the oral/head and neck region underwent preoperative FDG and FLT PET-computed tomography (CT) scans on separate days. The interpretation of the FDG PET-CT imaging resulted in sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 43.2, 99.5, 94.4, 88.9, and 94.7%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for FLT PET-CT imaging was 75.7, 99.2, 97.1, 90.3, and 97.7%, respectively. The areas under the curve for the ROC curves were 0.9 and 0.84 for FDG and FLT, respectively. Poor correlation was observed between the SUV for FDG and FLT within the lymph nodes and tumors. FLT showed better overall performance for detecting lymphadenopathy on qualitative assessment within the total nodal population. This notwithstanding, FDG SUV performed better for pathologic discrimination within the visible lymph nodes. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

12 CFR 217.202 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... securitization position for which all or substantially all of the value of the underlying exposures is based on... not a securitization position or a correlation trading position and that has a value that reacts... securitization position or a correlation trading position and that has a value that reacts primarily to changes...

BEAM DIAGNOSTICS USING BPM SIGNALS FROM INJECTED AND STORED BEAMS IN A STORAGE RING

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

Wang, G.M.; Shaftan; T.

2011-03-28

Many modern light sources are operating in top-off injection mode or are being upgraded to top-off injection mode. The storage ring always has the stored beam and injected beam for top-off injection mode. So the BPM data is the mixture of both beam positions and the injected beam position cannot be measured directly. We propose to use dedicated wide band BPM electronics in the NSLS II storage ring to retrieve the injected beam trajectory with the singular value decomposition (SVD) method. The beam position monitor (BPM) has the capability to measure bunch-by-bunch beam position. Similar electronics can be used tomore » measure the bunch-by-bunch beam current which is necessary to get the injection beam position. The measurement precision of current needs to be evaluated since button BPM sum signal has position dependence. The injected beam trajectory can be measured and monitored all the time without dumping the stored beam. We can adjust and optimize the injected beam trajectory to maximize the injection efficiency. We can also measure the storage ring acceptance by mapping the injected beam trajectory.« less

Limitations of discrete-time quantum walk on a one-dimensional infinite chain

NASA Astrophysics Data System (ADS)

Lin, Jia-Yi; Zhu, Xuanmin; Wu, Shengjun

2018-04-01

How well can we manipulate the state of a particle via a discrete-time quantum walk? We show that the discrete-time quantum walk on a one-dimensional infinite chain with coin operators that are independent of the position can only realize product operators of the form eiξ A ⊗1p, which cannot change the position state of the walker. We present a scheme to construct all possible realizations of all the product operators of the form eiξ A ⊗1p. When the coin operators are dependent on the position, we show that the translation operators on the position can not be realized via a DTQW with coin operators that are either the identity operator 1 or the Pauli operator σx.

Development of customized positioning guides using computer-aided design and manufacturing technology for orthognathic surgery.

PubMed

Lin, Hsiu-Hsia; Chang, Hsin-Wen; Lo, Lun-Jou

2015-12-01

The purpose of this study was to devise a method for producing customized positioning guides for translating virtual plans to actual orthognathic surgery, and evaluation of the feasibility and validity of the devised method. Patients requiring two-jaw orthognathic surgery were enrolled and consented before operation. Two types of positioning guides were designed and fabricated using computer-aided design and manufacturing technology: One of the guides was used for the LeFort I osteotomy, and the other guide was used for positioning the maxillomandibular complex. The guides were fixed to the medial side of maxilla. For validation, the simulation images and postoperative cone beam computed tomography images were superimposed using surface registration to quantify the difference between the images. The data were presented in root-mean-square difference (RMSD) values. Both sets of guides were experienced to provide ideal fit and maximal contact to the maxillary surface to facilitate their accurate management in clinical applications. The validation results indicated that RMSD values between the images ranged from 0.18 to 0.33 mm in the maxilla and from 0.99 to 1.56 mm in the mandible. The patients were followed up for 6 months or more, and all of them were satisfied with the results. The proposed customized positioning guides are practical and reliable for translation of virtual plans to actual surgery. Furthermore, these guides improved the efficiency and outcome of surgery. This approach is uncomplicated in design, cost-effective in fabrication, and particularly convenient to use.

Soft tissue deformation for surgical simulation: a position-based dynamics approach.

PubMed

Camara, Mafalda; Mayer, Erik; Darzi, Ara; Pratt, Philip

2016-06-01

To assist the rehearsal and planning of robot-assisted partial nephrectomy, a real-time simulation platform is presented that allows surgeons to visualise and interact with rapidly constructed patient-specific biomechanical models of the anatomical regions of interest. Coupled to a framework for volumetric deformation, the platform furthermore simulates intracorporeal 2D ultrasound image acquisition, using preoperative imaging as the data source. This not only facilitates the planning of optimal transducer trajectories and viewpoints, but can also act as a validation context for manually operated freehand 3D acquisitions and reconstructions. The simulation platform was implemented within the GPU-accelerated NVIDIA FleX position-based dynamics framework. In order to validate the model and determine material properties and other simulation parameter values, a porcine kidney with embedded fiducial beads was CT-scanned and segmented. Acquisitions for the rest position and three different levels of probe-induced deformation were collected. Optimal values of the cluster stiffness coefficients were determined for a range of different particle radii, where the objective function comprised the mean distance error between real and simulated fiducial positions over the sequence of deformations. The mean fiducial error at each deformation stage was found to be compatible with the level of ultrasound probe calibration error typically observed in clinical practice. Furthermore, the simulation exhibited unconditional stability on account of its use of clustered shape-matching constraints. A novel position-based dynamics implementation of soft tissue deformation has been shown to facilitate several desirable simulation characteristics: real-time performance, unconditional stability, rapid model construction enabling patient-specific behaviour and accuracy with respect to reference CT images.

Hybrid capture 2 viral load and the 2-year cumulative risk of cervical intraepithelial neoplasia grade 3 or cancer.

PubMed

Castle, Philip E; Schiffman, Mark; Wheeler, Cosette M

2004-11-01

The purpose of this study was to determine the clinical value of a semiquantitative measure of human papillomavirus viral load by the hybrid capture 2 assay for stratification of the risk of histologic cervical intraepithelial neoplasia grade 3 or carcinoma. The Atypical Cells of Unknown Significance and Low-Grade Squamous Intraepithelial Lesions Triage Study was a randomized clinical trial of 5060 women with 2 years of follow-up to evaluate treatment strategies for women with equivocal or mildly abnormal cervical cytologic condition. The usefulness of the continuous hybrid capture 2 output relative light units/positive controls that were above the positive threshold (1.0 relative light units/positive controls), which was a surrogate for human papillomavirus viral load, for distinguishing between hybrid capture 2 positive women who were diagnosed with cervical intraepithelial neoplasia grade 3 or carcinoma during the study from those who were not diagnosed with cervical intraepithelial neoplasia grade 3 or carcinoma was examined with the use of receiver-operator characteristic analyses. Relative light units/positive controls values did not further discriminate between hybrid capture 2 positive women with cervical intraepithelial neoplasia grade 3 or carcinoma from those with less than cervical intraepithelial neoplasia grade 3 or carcinoma. The use of a cervical intraepithelial neoplasia grade 2 or more severe or carcinoma case definition did not alter our findings. Among women with atypical cells of unknown significance or low-grade squamous intraepithelial lesion cervical cytologic findings, the hybrid capture 2 viral load measurement did not improve the detection of 2-year cumulative cases of cervical intraepithelial neoplasia grade 3 or carcinoma significantly.

Dual mode ion mobility spectrometer and method for ion mobility spectrometry

DOEpatents

Scott, Jill R [Idaho Falls, ID; Dahl, David A [Idaho Falls, ID; Miller, Carla J [Idaho Falls, ID; Tremblay, Paul L [Idaho Falls, ID; McJunkin, Timothy R [Idaho Falls, ID

2007-08-21

Ion mobility spectrometer apparatus may include an ion interface that is operable to hold positive and negative ions and to simultaneously release positive and negative ions through respective positive and negative ion ports. A first drift chamber is operatively associated with the positive ion port of the ion interface and encloses an electric field therein. A first ion detector operatively associated with the first drift chamber detects positive ions from the first drift chamber. A second drift chamber is operatively associated with the negative ion port of the ion interface and encloses an electric field therein. A second ion detector operatively associated with the second drift chamber detects negative ions from said second drift chamber.

A novel clinical index for the assessment of RVD in acute pulmonary embolism: Blood pressure index.

PubMed

Ates, Hale; Ates, Ihsan; Kundi, Harun; Arikan, Mehmet Fettah; Yilmaz, Fatma Meric

2017-10-01

This study aims to investigate the role of the blood pressure index (BPI), which is a new index that we developed, in detection of right ventricular dysfunction (RVD) in acute pulmonary embolism (APE). A total of 539 patients, (253 males and 286 females), diagnosed with APE using computer tomography pulmonary angiography were included in the study. The BPI was obtained by dividing systolic blood pressure (SBP) by diastolic blood pressure (DBP). Mean DBP (75±11mmHg vs 63±15mmHg; p<0.001, respectively) was found to be higher in RVD patients compared to those without RVD, whereas BPI (1.5±0.1 vs 1.9±0.2; p<0.001, respectively) was lower. Examining the performance of BPI in prediction of RVD using receiver operating characteristic curve analysis (area under curve±SE=0.975±0.006; p<0.001), it was found that BPI could predict RVD with very high sensitivity (92.8%) and specificity (100%) and had a positive predictive value of 100% and a negative predictive value of 42.1%. According to the analysis, the highest youden index for the optimal prediction value was found to be 0.478 and the BPI≤1.4 was found to predict mortality 68.6% sensitivity and 80.8% specificity (Area under curve±SE=0.777±0.051; p<0.001). We found that BPI was an index with high positive predictive value and low negative predictive value in detection of RVD. Copyright © 2017 Elsevier Inc. All rights reserved.

Pilot Study: Detection of Gastric Cancer From Exhaled Air Analyzed With an Electronic Nose in Chinese Patients.

PubMed

Schuermans, Valérie N E; Li, Ziyu; Jongen, Audrey C H M; Wu, Zhouqiao; Shi, Jinyao; Ji, Jiafu; Bouvy, Nicole D

2018-06-01

The aim of this pilot study is to investigate the ability of an electronic nose (e-nose) to distinguish malignant gastric histology from healthy controls in exhaled breath. In a period of 3 weeks, all preoperative gastric carcinoma (GC) patients (n = 16) in the Beijing Oncology Hospital were asked to participate in the study. The control group (n = 28) consisted of family members screened by endoscopy and healthy volunteers. The e-nose consists of 3 sensors with which volatile organic compounds in the exhaled air react. Real-time analysis takes place within the e-nose, and binary data are exported and interpreted by an artificial neuronal network. This is a self-learning computational system. The inclusion rate of the study was 100%. Baseline characteristics differed significantly only for age: the average age of the patient group was 57 years and that of the healthy control group 37 years ( P value = .000). Weight loss was the only significant different symptom ( P value = .040). A total of 16 patients and 28 controls were included; 13 proved to be true positive and 20 proved to be true negative. The receiver operating characteristic curve showed a sensitivity of 81% and a specificity of 71%, with an accuracy of 75%. These results give a positive predictive value of 62% and a negative predictive value of 87%. This pilot study shows that the e-nose has the capability of diagnosing GC based on exhaled air, with promising predictive values for a screening purpose.

Diagnostic Capability of Peripapillary Retinal Thickness in Glaucoma Using 3D Volume Scans

PubMed Central

Simavli, Huseyin; Que, Christian John; Akduman, Mustafa; Rizzo, Jennifer L.; Tsikata, Edem; de Boer, Johannes F.; Chen, Teresa C.

2015-01-01

Purpose To determine the diagnostic capability of spectral domain optical coherence tomography (SD-OCT) peripapillary retinal thickness (RT) measurements from 3-dimensional (3D) volume scans for primary open angle glaucoma (POAG). Design Cross-sectional study. Methods Setting Institutional Study population 156 patients (89 POAG and 67 normal subjects) Observation procedures One eye of each subject was included. SD-OCT peripapillary RT values from 3D volume scans were calculated for four quadrants of three different sized annuli. Peripapillary retinal nerve fiber layer (RNFL) thickness values were also determined. Main outcome measures Area under the receiver operating characteristic curve (AUROC) values, sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios. Results The top five RT AUROCs for all glaucoma patients and for a subset of early glaucoma patients were for the inferior quadrant of outer circumpapillary annulus of circular grid (OCA) 1 (0.959, 0.939), inferior quadrant of OCA2 (0.945, 0.921), superior quadrant of OCA1 (0.890, 0.811), inferior quadrant of OCA3 (0.887, 0.854), and superior quadrant of OCA2 (0.879, 0.807). Smaller RT annuli OCA1 and OCA2 consistently showed better diagnostic performance than the larger RT annulus OCA3. For both RNFL and RT measurements, best AUROC values were found for inferior RT OCA1 and OCA2, followed by inferior and overall RNFL thickness. Conclusion Peripapillary RT measurements from 3D volume scans showed excellent diagnostic performance for detecting both glaucoma and early glaucoma patients. Peripapillary RT values have the same or better diagnostic capability compared to peripapillary RNFL thickness measurements, while also having fewer algorithm errors. PMID:25498354

Improving discrimination in antepartum depression screening using the Edinburgh Postnatal Depression Scale.

PubMed

Venkatesh, Kartik K; Kaimal, Anjali J; Castro, Victor M; Perlis, Roy H

2017-05-01

Universal screening of pregnant women for postpartum depression has recently been recommended; however, optimal application of depression screening tools in stratifying risk has not been defined. The current study examines new approaches to improve the ability of the Edinburgh Postnatal Depression Scale (EPDS) to stratify risk for postpartum depression, including alternate cut points, use of a continuous measure, and incorporation of other putative risk factors. An observational cohort study of 4939 women screened both antepartum and postpartum with a negative EPDS screen antepartum(i.e. EPDS<10). The primary outcome was a probable postpartum major depressive episode(EPDS cut-off ≥10). Area under the receiver operating characteristics curve(AUC), sensitivity, specificity, and predictive values were calculated. 287 women(5.8%) screened positive for postpartum depression. An antepartum EPDS cut-off<5 optimally identified women with a low risk of postpartum depression with a negative predictive value of 97.6%; however, overall discrimination was modest(AUC 0.66, 95%CI: 0.64-0.69); sensitivity was 78.7%, and specificity was 53.8%, and the positive predictive value was low at 9.5%. The negative predictive values were similar(>95%) at all antepartum EPDS cut-off values from 4 to 8. Discrimination was improved(AUC ranging from 0.70 to 0.73) when the antepartum EPDS was combined with a prior history of major depressive disorder before pregnancy. An inability to assess EPDS subscales and a relatively low prevalence of depression in this cohort. Though an antepartum EPDS cut-off score <5 yielded the greatest discrimination identifying women at low risk for postpartum depression, the negative predictive value was insufficient to substitute for postpartum screening. Copyright © 2017. Published by Elsevier B.V.

Reexamination of optimal quantum state estimation of pure states

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

Hayashi, A.; Hashimoto, T.; Horibe, M.

2005-09-15

A direct derivation is given for the optimal mean fidelity of quantum state estimation of a d-dimensional unknown pure state with its N copies given as input, which was first obtained by Hayashi in terms of an infinite set of covariant positive operator valued measures (POVM's) and by Bruss and Macchiavello establishing a connection to optimal quantum cloning. An explicit condition for POVM measurement operators for optimal estimators is obtained, by which we construct optimal estimators with finite POVMs using exact quadratures on a hypersphere. These finite optimal estimators are not generally universal, where universality means the fidelity is independentmore » of input states. However, any optimal estimator with finite POVM for M(>N) copies is universal if it is used for N copies as input.« less

Heat asymptotics for nonminimal Laplace type operators and application to noncommutative tori

NASA Astrophysics Data System (ADS)

Iochum, B.; Masson, T.

2018-07-01

Let P be a Laplace type operator acting on a smooth hermitean vector bundle V of fiber CN over a compact Riemannian manifold given locally by P = - [gμν u(x) ∂μ∂ν +vν(x) ∂ν + w(x) ] where u ,vν , w are MN(C) -valued functions with u(x) positive and invertible. For any a ∈ Γ(End(V)) , we consider the asymptotics Tr(ae-tP) ∼ t↓0+ ∑r=0∞ ar(a , P) t (r - d) / 2 where the coefficients ar(a , P) can be written as an integral of the functions ar(a , P) (x) = tr [ a(x) Rr(x) ] . The computation of R2 is performed opening the opportunity to calculate the modular scalar curvature for noncommutative tori.

Executing scatter operation to parallel computer nodes by repeatedly broadcasting content of send buffer partition corresponding to each node upon bitwise OR operation

DOEpatents

Archer, Charles J [Rochester, MN; Ratterman, Joseph D [Rochester, MN

2009-11-06

Executing a scatter operation on a parallel computer includes: configuring a send buffer on a logical root, the send buffer having positions, each position corresponding to a ranked node in an operational group of compute nodes and for storing contents scattered to that ranked node; and repeatedly for each position in the send buffer: broadcasting, by the logical root to each of the other compute nodes on a global combining network, the contents of the current position of the send buffer using a bitwise OR operation, determining, by each compute node, whether the current position in the send buffer corresponds with the rank of that compute node, if the current position corresponds with the rank, receiving the contents and storing the contents in a reception buffer of that compute node, and if the current position does not correspond with the rank, discarding the contents.

Diagnostic accuracy and reproducibility of pleural and lung ultrasound in discriminating cardiogenic causes of acute dyspnea in the emergency department.

PubMed

Cibinel, Gian Alfonso; Casoli, Giovanna; Elia, Fabrizio; Padoan, Monica; Pivetta, Emanuele; Lupia, Enrico; Goffi, Alberto

2012-02-01

Dyspnea is a common symptom in patients admitted to the Emergency Department (ED), and discriminating between cardiogenic and non-cardiogenic dyspnea is often a clinical dilemma. The initial diagnostic work-up may be inaccurate in defining the etiology and the underlying pathophysiology. The aim of this study was to evaluate the diagnostic accuracy and reproducibility of pleural and lung ultrasound (PLUS), performed by emergency physicians at the time of a patient's initial evaluation in the ED, in identifying cardiac causes of acute dyspnea. Between February and July 2007, 56 patients presenting to the ED with acute dyspnea were prospectively enrolled in this study. In all patients, PLUS was performed by emergency physicians with the purpose of identifying the presence of diffuse alveolar-interstitial syndrome (AIS) or pleural effusion. All scans were later reviewed by two other emergency physicians, expert in PLUS and blinded to clinical parameters, who were the ultimate judges of positivity for diffuse AIS and pleural effusion. A random set of 80 recorded scannings were also reviewed by two inexperienced observers to assess inter-observer variability. The entire medical record was independently reviewed by two expert physicians (an emergency medicine physician and a cardiologist) blinded to the ultrasound (US) results, in order to determine whether, for each patient, dyspnea was due to heart failure, or not. Sensitivity, specificity, and positive/negative predictive values were obtained; likelihood ratio (LR) test was used. Cohen's kappa was used to assess inter-observer agreement. The presence of diffuse AIS was highly predictive for cardiogenic dyspnea (sensitivity 93.6%, specificity 84%, positive predictive value 87.9%, negative predictive value 91.3%). On the contrary, US detection of pleural effusion was not helpful in the differential diagnosis (sensitivity 83.9%, specificity 52%, positive predictive value 68.4%, negative predictive value 72.2%). Finally, the coexistence of diffuse AIS and pleural effusion is less accurate than diffuse AIS alone for cardiogenic dyspnea (sensitivity 81.5%, specificity 82.8%, positive predictive value 81.5%, negative predictive value 82.8%). The positive LR was 5.8 for AIS [95% confidence interval (CI) 4.8-7.1] and 1.7 (95% CI 1.2-2.6) for pleural effusion, negative LR resulted 0.1 (95% CI 0.0-0.4) for AIS and 0.3 (95% CI 0.1-0.8) for pleural effusion. Agreement between experienced and inexperienced operators was 92.2% (p < 0.01) and 95% (p < 0.01) for diagnosis of AIS and pleural effusion, respectively. In early evaluation of patients presenting to the ED with dyspnea, PLUS, performed with the purpose of identifying diffuse AIS, may represent an accurate and reproducible bedside tool in discriminating between cardiogenic and non-cardiogenic dyspnea. On the contrary, US detection of pleural effusions does not allow reliable discrimination between different causes of acute dyspnea in unselected ED patients.

Design of an optical PPM communication link in the presence of component tolerances

NASA Technical Reports Server (NTRS)

Chen, C.-C.

1988-01-01

A systematic approach is described for estimating the performance of an optical direct detection pulse position modulation (PPM) communication link in the presence of parameter tolerances. This approach was incorporated into the JPL optical link analysis program to provide a useful tool for optical link design. Given a set of system parameters and their tolerance specifications, the program will calculate the nominal performance margin and its standard deviation. Through use of these values, the optical link can be designed to perform adequately even under adverse operating conditions.

Magnonic analog of relativistic Zitterbewegung in an antiferromagnetic spin chain

NASA Astrophysics Data System (ADS)

Wang, Weiwei; Gu, Chenjie; Zhou, Yan; Fangohr, Hans

2017-07-01

We theoretically investigate the spin-wave (magnon) excitations in a classical antiferromagnetic spin chain with easy-axis anisotropy. We obtain a Dirac-like equation by linearizing the Landau-Lifshitz-Gilbert equation in this antiferromagnetic system, in contrast to the ferromagnetic system in which a Schrödinger-type equation is derived. The Hamiltonian operator in the Dirac-like equation is a pseudo-Hermitian. We compute and demonstrate relativistic Zitterbewegung (trembling motion) in the antiferromagnetic spin chain by measuring the expectation values of the wave-packet position.

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

Vertesi, T.; Bene, E.

A bipartite Bell inequality is derived which is maximally violated on the two-qubit state space if measurements describable by positive operator valued measure (POVM) elements are allowed, rather than restricting the possible measurements to projective ones. In particular, the presented Bell inequality requires POVMs in order to be maximally violated by a maximally entangled two-qubit state. This answers a question raised by N. Gisin [in Quantum Reality, Relativistic Causality, and Closing the Epistemic Circle: Essays in Honour of Abner Shimony, edited by W. C. Myrvold and J. Christian (Springer, The Netherlands, 2009), pp. 125-138].

Unifying distribution functions: some lesser known distributions.

PubMed

Moya-Cessa, J R; Moya-Cessa, H; Berriel-Valdos, L R; Aguilar-Loreto, O; Barberis-Blostein, P

2008-08-01

We show that there is a way to unify distribution functions that describe simultaneously a classical signal in space and (spatial) frequency and position and momentum for a quantum system. Probably the most well known of them is the Wigner distribution function. We show how to unify functions of the Cohen class, Rihaczek's complex energy function, and Husimi and Glauber-Sudarshan distribution functions. We do this by showing how they may be obtained from ordered forms of creation and annihilation operators and by obtaining them in terms of expectation values in different eigenbases.

Antenna Beam Pattern Characteristics of HAPS User Terminal

NASA Astrophysics Data System (ADS)

Ku, Bon-Jun; Oh, Dae Sub; Kim, Nam; Ahn, Do-Seob

High Altitude Platform Stations (HAPS) are recently considered as a green infrastructure to provide high speed multimedia services. The critical issue of HAPS is frequency sharing with satellite systems. Regulating antenna beam pattern using adaptive antenna schemes is one of means to facilitate the sharing with a space receiver for fixed satellite services on the uplink of a HAPS system operating in U bands. In this letter, we investigate antenna beam pattern characteristics of HAPS user terminals with various values of scan angles of main beam, null position angles, and null width.

Satellite-aided mobile communications, experiments, applications and prospects

NASA Technical Reports Server (NTRS)

Anderson, R. E.; Frey, R. L.; Lewis, J. R.; Milton, R. T.

1980-01-01

NASA's ATS-series of satellites were used in a series of communications and position fixing experiments with automotive vehicles, ships and aircraft. Applications of the communications were demonstrated and evaluated for public services including law enforcement, search and rescue, and medical emergency, and for commercial uses in the land and maritime transportation industries. The technical success of the experiments and the demonstrated potential value of the communications prompted a study that concluded an operational satellite-aided system would be a valuable augmentation of planned trunking or cellular type terrestrial mobile radio telephone systems.

Inductive Non-Contact Position Sensor

NASA Technical Reports Server (NTRS)

Youngquist, Robert; Garcia, Alyssa; Simmons, Stephen

2010-01-01

Optical hardware has been developed to measure the depth of defects in the Space Shuttle Orbiter's windows. In this hardware, a mirror is translated such that its position corresponds to the defect's depth, so the depth measurement problem is transferred to a mirror-position measurement problem. This is preferable because the mirror is internal to the optical system and thus accessible. Based on requirements supplied by the window inspectors, the depth of the defects needs to be measured over a range of 200 microns with a resolution of about 100 nm and an accuracy of about 400 nm. These same requirements then apply to measuring the position of the mirror, and in addition, since this is a scanning system, a response time of about 10 ms is needed. A market search was conducted and no sensor that met these requirements that also fit into the available housing volume (less than one cubic inch) was found, so a novel sensor configuration was constructed to meet the requirements. This new sensor generates a nearly linearly varying magnetic field over a small region of space, which can easily be sampled, resulting in a voltage proportional to position. Experiments were done with a range of inductor values, drive voltages, drive frequencies, and inductor shapes. A rough mathematical model was developed for the device that, in most aspects, describes how it operates and what electrical parameters should be chosen for best performance. The final configuration met all the requirements, yielding a small rugged sensor that was easy to use and had nanometer resolution over more than the 200-micron range required. The inductive position sensor is a compact device (potentially as small as 2 cubic centimeters), which offers nanometer-position resolution over a demonstrated range of nearly 1 mm. One of its advantages is the simplicity of its electrical design. Also, the sensor resolution is nearly uniform across its operational range, which is in contrast to eddy current and capacitive sensors whose sensitivity is dependent upon position.

Is valuing positive emotion associated with life satisfaction?

PubMed

Bastian, Brock; Kuppens, Peter; De Roover, Kim; Diener, Ed

2014-08-01

The experience of positive emotion is closely linked to subjective well-being. For this reason, campaigns aimed at promoting the value of positive emotion have become widespread. What is rarely considered are the cultural implications of this focus on happiness. Promoting positive emotions as important for "the good life" not only has implications for how individuals value these emotional states, but for how they believe others around them value these emotions also. Drawing on data from over 9,000 college students across 47 countries we examined whether individuals' life satisfaction is associated with living in contexts in which positive emotions are socially valued. The findings show that people report more life satisfaction in countries where positive emotions are highly valued and this is linked to an increased frequency of positive emotional experiences in these contexts. They also reveal, however, that increased life satisfaction in countries that place a premium on positive emotion is less evident for people who tend to experience less valued emotional states: people who experience many negative emotions, do not flourish to the same extent in these contexts. The findings demonstrate how the cultural value placed on certain emotion states may shape the relationship between emotional experiences and subjective well-being.

D autoionization states of He and ionic H

NASA Technical Reports Server (NTRS)

Bhatia, A. K.

1972-01-01

Positions of the lowest 1,3De autoionization states of He and H(-) below the n = 2 level of the He(+) and H were calculated variationally, using Feshbach's Q-operator formalism. The trial wave function is of the Hylleraas-type with appropriate angular momentum factors. The widths and the shifts of the states have also been calculated. The shifts are found to be positive for all the states calculated here. The results with 112 terms for most states are lower than any previously calculated. The calculated lowest autoionization states of the He and H(-) (relative to the ground states of He and H respectively) are 59.902 eV and 10.1185 eV, in good agreement with the observed values of 59.9 eV and 10.13 + or 0.015 eV.

Reborn quadrant anode image sensor

NASA Astrophysics Data System (ADS)

Prokazov, Yury; Turbin, Evgeny; Vitali, Marco; Herzog, Andreas; Michaelis, Bernd; Zuschratter, Werner; Kemnitz, Klaus

2009-06-01

We describe a position sensitive photon counting microchannel plate based detector with an improved quadrant anode (QA) readout system. The technique relies on a combination of the four planar elements pattern and an additional fifth electrode. The charge cloud induced by single particle detection is split between the electrodes. The measured charge values uniquely define the position of the initial event. QA has been first published in 1976 by Lampton and Malina. This anode configuration was undeservedly forgotten and its potential has been hardly underestimated. The presented approach extends the operating spatial range to the whole sensitive area of the microchannel plate surface and demonstrates good linearity over the field of view. Therefore, the novel image sensor results in spatial resolution better then 50 μm and count rates up to one million events per second.

Singular values behaviour optimization in the diagnosis of feed misalignments in radioastronomical reflectors

NASA Astrophysics Data System (ADS)

Capozzoli, Amedeo; Curcio, Claudio; Liseno, Angelo; Savarese, Salvatore; Schipani, Pietro

2016-07-01

The communication presents an innovative method for the diagnosis of reflector antennas in radio astronomical applications. The approach is based on the optimization of the number and the distribution of the far field sampling points exploited to retrieve the antenna status in terms of feed misalignments, this to drastically reduce the time length of the measurement process and minimize the effects of variable environmental conditions and simplifying the tracking process of the source. The feed misplacement is modeled in terms of an aberration function of the aperture field. The relationship between the unknowns and the far field pattern samples is linearized thanks to a Principal Component Analysis. The number and the position of the field samples are then determined by optimizing the Singular Values behaviour of the relevant operator.

ZT Optimization: An Application Focus

PubMed Central

Tuley, Richard; Simpson, Kevin

2017-01-01

Significant research has been performed on the challenge of improving thermoelectric materials, with maximum peak figure of merit, ZT, the most common target. We use an approximate thermoelectric material model, matched to real materials, to demonstrate that when an application is known, average ZT is a significantly better optimization target. We quantify this difference with some examples, with one scenario showing that changing the doping to increase peak ZT by 19% can lead to a performance drop of 16%. The importance of average ZT means that the temperature at which the ZT peak occurs should be given similar weight to the value of the peak. An ideal material for an application operates across the maximum peak ZT, otherwise maximum performance occurs when the peak value is reduced in order to improve the peak position. PMID:28772668

On differences of linear positive operators

NASA Astrophysics Data System (ADS)

Aral, Ali; Inoan, Daniela; Raşa, Ioan

2018-04-01

In this paper we consider two different general linear positive operators defined on unbounded interval and obtain estimates for the differences of these operators in quantitative form. Our estimates involve an appropriate K-functional and a weighted modulus of smoothness. Similar estimates are obtained for Chebyshev functional of these operators as well. All considerations are based on rearrangement of the remainder in Taylor's formula. The obtained results are applied for some well known linear positive operators.

Sentinel lymph node biopsy in cutaneous head and neck melanoma.

PubMed

Evrard, D; Routier, E; Mateus, C; Tomasic, G; Lombroso, J; Kolb, F; Robert, C; Moya-Plana, A

2018-05-01

Sentinel lymph node biopsy (SLNB) is now a standard of care for cutaneous melanoma, but it is still controversial for cutaneous head and neck melanoma (CHNM). This study aims to confirm the feasibility, accuracy and low morbidity of SLNB in CHNM and evaluate its prognostic value. A monocentric and retrospective study on patients with CHNM treated in our tertiary care center (Gustave Roussy) between January 2008 and December 2012 was performed. The feasibility, morbidity and prognostic value of this technique were analysed. One hundred and twenty-four consecutive patients were included. SLNB was realized in 97.6% of the cases. No significant post-operative morbidity was observed. Nineteen percents of patients had a positive SN while only 14.3% of complete lymph node dissections (CLND) had additional nodal metastasis. The risk of recurrence after positive SN was significantly higher (69.2 vs 30.8%, p = 0.043). The false omission rate was low with 7.1%. Overall survival and disease-free survival were better in the negative SN group (82 vs 49%, p < 0.001 and 69.3 vs 41.8%, p = 0.0131). The risk of recurrence was significantly higher in the positive SN group (p = 0.043) and when primary tumour was ulcerated (p = 0.031). Only the mitotic rate of the primary tumour was associated with SN positivity (p = 0.049). As in other sites, SLNB status is a strong prognostic factor with comparable false omission rate and no superior morbidity.

Evaluation of cholera surveillance system in Osu Klottey District, Accra, Ghana (2011-2013).

PubMed

Adjei, Eric Yirenkyi; Malm, Keziah Laurencia; Mensah, Kofi Nyarko; Sackey, Samuel Oko; Ameme, Donne; Kenu, Ernest; Abdulai, Marijanatu; Mills, Richael; Afari, Edwin

2017-01-01

Cholera is an acute illness characterized by profuse watery diarrhea. It is caused by vibrio cholera subgroup 01 and 0139. Rapid administration of fluid replacement therapy and supportive treatment can reduce mortality to around 1%. By the close of 2011, 10,628 cases and 100 deaths were reported in Ghana with a case fatality rate of 0.99. It is important to evaluate the cholera surveillance system in Ghana to determine if it is meeting its objective. The study was conducted in Osu Klottey district in the Accra Metropolitan area in January 2014. We assessed the operations (attributes and performance) of the surveillance system for cholera using CDC guidelines (2001). Surveillance data records at the district level from 2011-2013 were extracted and analyzed for frequency using Microsoft excel. Stakeholders and key informants were interviewed using structured questionnaire. Records were also reviewed at some health facilities and at district levels. In 2011 and 2012, case fatality rates (1.3% and 0.65%) respectively. Males were mostly affected. The most affected age group was 20-29. In 2011, Predictive value positive was 69.2% and 50% in 2012.Cholera peaked in March 2011 and April 2012. The Government of Ghana funded the system. The system is sensitive, simple, stable, flexible, acceptable and representative. It was also useful and data quality was relatively good. Predictive Value Positive was also good. The surveillance system is achieving its set out objectives. The system is sensitive, simple, stable, flexible, and acceptable. Predictive value positive was good.

A stochastic model to determine the economic value of changing diagnostic test characteristics for identification of cattle for treatment of bovine respiratory disease.

PubMed

Theurer, M E; White, B J; Larson, R L; Schroeder, T C

2015-03-01

Bovine respiratory disease is an economically important syndrome in the beef industry, and diagnostic accuracy is important for optimal disease management. The objective of this study was to determine whether improving diagnostic sensitivity or specificity was of greater economic value at varied levels of respiratory disease prevalence by using Monte Carlo simulation. Existing literature was used to populate model distributions of published sensitivity, specificity, and performance (ADG, carcass weight, yield grade, quality grade, and mortality risk) differences among calves based on clinical respiratory disease status. Data from multiple cattle feeding operations were used to generate true ranges of respiratory disease prevalence and associated mortality. Input variables were combined into a single model that calculated estimated net returns for animals by diagnostic category (true positive, false positive, false negative, and true negative) based on the prevalence, sensitivity, and specificity for each iteration. Net returns for each diagnostic category were multiplied by the proportion of animals in each diagnostic category to determine group profitability. Apparent prevalence was categorized into low (<15%) and high (≥15%) groups. For both apparent prevalence categories, increasing specificity created more rapid, positive change in net returns than increasing sensitivity. Improvement of diagnostic specificity, perhaps through a confirmatory test interpreted in series or pen-level diagnostics, can increase diagnostic value more than improving sensitivity. Mortality risk was the primary driver for net returns. The results from this study are important for determining future research priorities to analyze diagnostic techniques for bovine respiratory disease and provide a novel way for modeling diagnostic tests.

Recovery of shoulder strength and proprioception after open surgery for recurrent anterior instability: a comparison of two surgical techniques.

PubMed

Rokito, Andrew S; Birdzell, Maureen Gallagher; Cuomo, Frances; Di Paola, Matthew J; Zuckerman, Joseph D

2010-06-01

Previous studies have documented a decrease in proprioceptive capacity in the unstable shoulder. The degree to which surgical approach affects recovery of strength and proprioception is unknown. The recovery of strength and proprioception after open surgery for recurrent anterior glenohumeral instability was compared for 2 surgical procedures. A prospective analysis of 55 consecutive patients with posttraumatic unilateral recurrent anterior glenohumeral instability was performed. Thirty patients (group 1) underwent an open inferior capsular shift with detachment of the subscapularis, and 25 (group 2) underwent an anterior capsulolabral reconstruction. Mean preoperative proprioception and strength values were significantly lower for the affected shoulders in both groups. At 6 months after surgery, there were no significant differences for mean strength and proprioception values between the unaffected and operative sides for group 2 patients. In group 1 patients, however, there were still significant deficits in mean position sense and strength values. Complete restoration of proprioception and strength, however, was evident by 12 months in group 1. This study demonstrates that there are significant deficits in both strength and proprioception in patients with posttraumatic, recurrent anterior glenohumeral instability. Although both are completely restored by 1 year after surgery, a subscapularis-splitting approach allows for complete recovery of strength and position sense as early as 6 months postoperatively. Detachment of the subscapularis delays recovery of strength and position sense for up to 12 months after surgery. Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation.

PubMed

Breisinger, Terry P; Skidmore, Elizabeth R; Niyonkuru, Christian; Terhorst, Lauren; Campbell, Grace B

2014-12-01

To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen. Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital. Patients admitted for inpatient stroke rehabilitation (N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010. Not applicable. Sensitivity, specificity, and area under the curve for Receiver Operating Characteristic Curves of both scales' classifications, based on fall risk score completed upon admission to inpatient stroke rehabilitation. A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen (p < 0.001), with area under the curve of 0.73, positive predictive value of 0.29, and negative predictive value of 0.94. For the Fall Harm Risk Screen, area under the curve was 0.56, positive predictive value was 0.19, and negative predictive value was 0.86. Sensitivity and specificity of the SAFR (0.78 and 0.63, respectively) was higher than the Fall Harm Risk Screen (0.57 and 0.48, respectively). An evidence-derived, population-specific fall risk assessment may more accurately predict fallers than a general fall risk screen for stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted. © The Author(s) 2014.

Designing a Pediatric Severe Sepsis Screening Tool

PubMed Central

Sepanski, Robert J.; Godambe, Sandip A.; Mangum, Christopher D.; Bovat, Christine S.; Zaritsky, Arno L.; Shah, Samir H.

2014-01-01

We sought to create a screening tool with improved predictive value for pediatric severe sepsis (SS) and septic shock that can be incorporated into the electronic medical record and actively screen all patients arriving at a pediatric emergency department (ED). “Gold standard” SS cases were identified using a combination of coded discharge diagnosis and physician chart review from 7,402 children who visited a pediatric ED over 2 months. The tool’s identification of SS was initially based on International Consensus Conference on Pediatric Sepsis (ICCPS) parameters that were refined by an iterative, virtual process that allowed us to propose successive changes in sepsis detection parameters in order to optimize the tool’s predictive value based on receiver operating characteristics (ROC). Age-specific normal and abnormal values for heart rate (HR) and respiratory rate (RR) were empirically derived from 143,603 children seen in a second pediatric ED over 3 years. Univariate analyses were performed for each measure in the tool to assess its association with SS and to characterize it as an “early” or “late” indicator of SS. A split-sample was used to validate the final, optimized tool. The final tool incorporated age-specific thresholds for abnormal HR and RR and employed a linear temperature correction for each category. The final tool’s positive predictive value was 48.7%, a significant, nearly threefold improvement over the original ICCPS tool. False positive systemic inflammatory response syndrome identifications were nearly sixfold lower. PMID:24982852

Real-time value optimization of edging and trimming operations for rough, green hardwood lumber

Treesearch

Daniel L. Schmoldt; Hang Song; Philip A. Araman

2001-01-01

For edging/trimming operations in hardwood sawmills, an operator examines both sides—or just the waney-edged side—of each board, and makes a quick assessment of grade potential. The operator then decides where to edge and/or trim the board to achieve the intended grade and, presumably, maximum value. However, human operators can only achieve lumber values that are 62-...

Performance of the dipstick screening test as a predictor of negative urine culture

PubMed Central

Marques, Alexandre Gimenes; Doi, André Mario; Pasternak, Jacyr; Damascena, Márcio dos Santos; França, Carolina Nunes; Martino, Marinês Dalla Valle

2017-01-01

ABSTRACT Objective To investigate whether the urine dipstick screening test can be used to predict urine culture results. Methods A retrospective study conducted between January and December 2014 based on data from 8,587 patients with a medical order for urine dipstick test, urine sediment analysis and urine culture. Sensitivity, specificity, positive and negative predictive values were determined and ROC curve analysis was performed. Results The percentage of positive cultures was 17.5%. Nitrite had 28% sensitivity and 99% specificity, with positive and negative predictive values of 89% and 87%, respectively. Leukocyte esterase had 79% sensitivity and 84% specificity, with positive and negative predictive values of 51% and 95%, respectively. The combination of positive nitrite or positive leukocyte esterase tests had 85% sensitivity and 84% specificity, with positive and negative predictive values of 53% and 96%, respectively. Positive urinary sediment (more than ten leukocytes per microliter) had 92% sensitivity and 71% specificity, with positive and negative predictive values of 40% and 98%, respectively. The combination of nitrite positive test and positive urinary sediment had 82% sensitivity and 99% specificity, with positive and negative predictive values of 91% and 98%, respectively. The combination of nitrite or leukocyte esterase positive tests and positive urinary sediment had the highest sensitivity (94%) and specificity (84%), with positive and negative predictive values of 58% and 99%, respectively. Based on ROC curve analysis, the best indicator of positive urine culture was the combination of positives leukocyte esterase or nitrite tests and positive urinary sediment, followed by positives leukocyte and nitrite tests, positive urinary sediment alone, positive leukocyte esterase test alone, positive nitrite test alone and finally association of positives nitrite and urinary sediment (AUC: 0.845, 0.844, 0.817, 0.814, 0.635 and 0.626, respectively). Conclusion A negative urine culture can be predicted by negative dipstick test results. Therefore, this test may be a reliable predictor of negative urine culture. PMID:28444086

Conformal, wearable, thin microwave antenna for sub-skin and skin surface monitoring

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

Converse, Mark C.; Chang, John T.; Duoss, Eric B.

A wearable antenna is operably positioned on a wearer's skin and is operably connected the wearer's tissue. A first antenna matched to the wearer's tissue is operably positioned on the wearer's skin. A second antenna matched to the air is operably positioned on the wearer's skin. Transmission lines connect the first antenna and the second antenna.

Electron-Optical System of the Gyrotron Designed for Operation in the DNP-NMR Spectrometer Cryomagnet ("Gyrotrino")

NASA Astrophysics Data System (ADS)

Bratman, V. L.; Fedotov, A. E.; Kalynov, Yu. K.; Manuilov, V. N.

2017-08-01

The formation and utilization of a helical electron beam are studied theoretically for a gyrotron with a very low operating voltage in a range 1.5-1.8 kV. Such a gyrotron ("gyrotrino") was earlier proposed for operation inside a magnetic system of an NMR spectrometer with a dynamic nuclear polarization upgrade. Despite the very low voltage, the optimization of the electrode shape can provide velocity and positional electron spreads not exceeding these values for conventional high-voltage gyrotrons. A very small cathode-anode separation makes the gyrotrino very sensitive to thermal expansion of the gun elements that should be compensated by movement of the cathode. Estimations for long-pulse and CW regimes of the gyrotrino operation show that the ion background significantly decreases the reduction of the beam potential and leads to an acceptable drift of the electron cyclotron frequency at the voltage front. A satisfactory thermal load on the waste-beam collector located in a strong uniform magnetic field can be achieved due to the omnidirectional heat flow regime occurring in the case of thin beam footprint.

SU-E-T-144: Effective Analysis of VMAT QA Generated Trajectory Log Files for Medical Accelerator Predictive Maintenance

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

Able, CM; Baydush, AH; Nguyen, C

Purpose: To determine the effectiveness of SPC analysis for a model predictive maintenance process that uses accelerator generated parameter and performance data contained in trajectory log files. Methods: Each trajectory file is decoded and a total of 131 axes positions are recorded (collimator jaw position, gantry angle, each MLC, etc.). This raw data is processed and either axis positions are extracted at critical points during the delivery or positional change over time is used to determine axis velocity. The focus of our analysis is the accuracy, reproducibility and fidelity of each axis. A reference positional trace of the gantry andmore » each MLC is used as a motion baseline for cross correlation (CC) analysis. A total of 494 parameters (482 MLC related) were analyzed using Individual and Moving Range (I/MR) charts. The chart limits were calculated using a hybrid technique that included the use of the standard 3σ limits and parameter/system specifications. Synthetic errors/changes were introduced to determine the initial effectiveness of I/MR charts in detecting relevant changes in operating parameters. The magnitude of the synthetic errors/changes was based on: TG-142 and published analysis of VMAT delivery accuracy. Results: All errors introduced were detected. Synthetic positional errors of 2mm for collimator jaw and MLC carriage exceeded the chart limits. Gantry speed and each MLC speed are analyzed at two different points in the delivery. Simulated Gantry speed error (0.2 deg/sec) and MLC speed error (0.1 cm/sec) exceeded the speed chart limits. Gantry position error of 0.2 deg was detected by the CC maximum value charts. The MLC position error of 0.1 cm was detected by the CC maximum value location charts for every MLC. Conclusion: SPC I/MR evaluation of trajectory log file parameters may be effective in providing an early warning of performance degradation or component failure for medical accelerator systems.« less

Evaluation of the environmental sustainability of different waste-to-energy plant configurations.

PubMed

Lombardi, Lidia; Carnevale, Ennio A

2018-03-01

Residual municipal solid waste (MSW) has an average lower heating value higher than 10GJ/Mg in the EU, and can be recovered in modern Waste-to-Energy (WtE) plants, producing combined heat and power (CHP) and reaching high levels of energy recovery. CHP is pinpointed as the best technique for energy recovery from waste. However, in some cases, heat recovery is not technically feasible - due to the absence of a thermal user (industrial plant or district heating) in the vicinity of the WtE plant - and power production remains the sole possibility. In these cases, there are some challenges involved in increasing the energy performance as much as possible. High energy recovery efficiency values are very important for the environmental sustainability of WtE plants. The more electricity and heat is produced, the better the saving of natural resources that can be achieved. Within this frame, the aim of this work is to carry out an environmental assessment, through Life Cycle Assessment, of an MSW WtE plant, considering different sizes and operated in different ways, from power production only to full cogeneration. The main assumption is that the electric conversion efficiency increases as the plant size increases, introducing technical improvements thanks to the economies of scale. Impact assessment results were calculated using ReCiPe 2008 methods. The climate change indicator is positive when the WtE plant is operated in power production only mode, with values decreasing for the increasing size. Values for the climate change are negative when cogeneration is applied, requiring increasing cogeneration ratios for decreasing size. Similarly, the fossil fuel depletion indicator benefits from increase of both the plant size and the cogeneration rate, but it is always negative, meaning that the residual MSW burning with energy recovery always provides a saving of fossil primary energy. Other indicator values are in general negative and are also beneficially affected by increasing the plant size, but they worsen when increasing the cogeneration rate. The remaining indicators - i.e. human toxicity and terrestrial ecotoxicity - always have positive values, which decrease for increasing plant size and increase as the cogeneration rate increases. However, the local context should be evaluated carefully with reference to the type of electricity which is substituted and in view of a future massive production of renewable electricity, because conclusions change accordingly. Finally, it was evaluated that the inclusion of bottom ash recovery - instead of landfilling - can significantly improve the values of several impact assessment indicators. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multicriteria Decision-Making Approach with Hesitant Interval-Valued Intuitionistic Fuzzy Sets

PubMed Central

Peng, Juan-juan; Wang, Jian-qiang; Wang, Jing; Chen, Xiao-hong

2014-01-01

The definition of hesitant interval-valued intuitionistic fuzzy sets (HIVIFSs) is developed based on interval-valued intuitionistic fuzzy sets (IVIFSs) and hesitant fuzzy sets (HFSs). Then, some operations on HIVIFSs are introduced in detail, and their properties are further discussed. In addition, some hesitant interval-valued intuitionistic fuzzy number aggregation operators based on t-conorms and t-norms are proposed, which can be used to aggregate decision-makers' information in multicriteria decision-making (MCDM) problems. Some valuable proposals of these operators are studied. In particular, based on algebraic and Einstein t-conorms and t-norms, some hesitant interval-valued intuitionistic fuzzy algebraic aggregation operators and Einstein aggregation operators can be obtained, respectively. Furthermore, an approach of MCDM problems based on the proposed aggregation operators is given using hesitant interval-valued intuitionistic fuzzy information. Finally, an illustrative example is provided to demonstrate the applicability and effectiveness of the developed approach, and the study is supported by a sensitivity analysis and a comparison analysis. PMID:24983009

[Diagnostic accuracy research of needle puncture biopsy during operation for pulmonary single nodules].

PubMed

Chen, Jin-feng; Liu, Yi-nan; Wu, Nan; Feng, Yuan; Wang, Jia; Lü, Chao; Wang, Yu-zhao; Pei, Yu-quan; Yan, Shi; Zheng, Qing-feng; Zhang, Li-jian; Yang, Yue

2012-04-01

To investigate the diagnostic accuracy of needle puncture biopsy and pathological examination of frozen during operation for pulmonary nodules, and whether this diagnostic method can replace tumor resection examination. Totally 50 patients (28 males and 22 females, average age was 59 years) who had the single nodule after imaging examination without any pathological diagnostic from January to October 2010 were selected in this research work. During open operation or video assisted thoracic surgery, needle (14 G model) was used to puncture biopsy for pathological examination of frozen. All the adverse events during puncture biopsy would be recorded. The resection specimens would be accepted paraffin pathological examination. The relationship between puncture frozen pathological and paraffin pathological examination was analyzed. All tumor sizes were ranged from 1.0 cm × 0.6 cm to 5.6 cm × 9.0 cm. The paraffin pathological examination after operation as the golden standard, there were 7 cases of benign tumor and 43 cases of malignant tumor. The diagnostic sensitivity of puncture biopsy was 90.7%, the specificity was 100%, the positive predictive value was 100% and the negative predictive value was 63.6%. There were 11 cases of benign tumor diagnosed by needle puncture biopsy, among which 4 cases were proved as malignant tumor by paraffin pathology, and the false negative rate was 9.3%. The main risk of puncture biopsy was bleeding after puncture immediately, and the rate was 4.0% (2/50). The puncture biopsy during operation had a high specificity for malignant lung tumor, and there was a certain false negative rate for benign tumor. Puncture biopsy and pathological examination of frozen tissue can replace tumor section biopsy in a way.

A comparative study of effect of autograft compared with allograft anterior cruciate ligament reconstruction on expressions of LOXs and MMPs

PubMed Central

Wang, Wei-Ming; Ma, Xiao-Jun; Huang, Shi-Bo; Ren, Liu-Bao

2017-01-01

The present study aimed to compare the effect of autograft or allograft anterior cruciate ligament (ACL) reconstruction on the expressions of lipoxygenases (LOXs) and matrix metalloproteinases (MMPs) in a New Zealand white rabbit model. New Zealand white rabbits were divided randomly into control, sham, autograft and allograft groups. At the 4th and 8th week after operation, biomechanical testing was performed to measure the primary length, cross-sectional area, maximum tensile load and stiffness of ACL, and HE staining was used to observe cell morphology and fibre alignment of ACL. At the 2nd, 4th and 8th week after operation, quantitative real-time PCR (qRT-PCR), Western blotting and immunohistochemistry were applied to detect LOXs and MMPs expressions, and expressions of adenomatous polyposis coli (APC)/Wnt signalling pathway-related proteins. At the 4th and 8th week after operation, the maximum tensile load and stiffness were higher in the autograft group than in the allograft group, and the values at the 8th week were higher than those at the 4th week after operation. The fibroblast proliferation in the allograft group was more significant than that in the autograft group. Compared with the control group, LOXs and MMPs expressions and the positive expression rates of LOXs and MMPs proteins were elevated, and the values in the allograft group were higher than those in the autograft group at all time points. At 8th week after operation, compared with the autograft group, Wnt expression was higher and APC expression was lower in the allograft group. Autograft and allograft ACL reconstruction can promote LOXs and MMPs expressions by activating the APC/Wnt signalling pathway. PMID:28275205

Strategic operations planning - it's not just for wilderness! How the Strategic Operations Planner can help

Treesearch

Charles W. McHugh; Stu Hoyt; Brett Fay

2015-01-01

The Strategic Operational Planner (SOPL) wildland fire management position was created in the United States in 2009 to reflect updated terminology. SOPL merges the former Fire Use Manager positions (FUM1 and FUM2) and is now an established position within the Incident Command System. Traditionally, the FUM positions and the SOPL have been used on incidents managed for...

Method and apparatus for optimized processing of sparse matrices

DOEpatents

Taylor, Valerie E.

1993-01-01

A computer architecture for processing a sparse matrix is disclosed. The apparatus stores a value-row vector corresponding to nonzero values of a sparse matrix. Each of the nonzero values is located at a defined row and column position in the matrix. The value-row vector includes a first vector including nonzero values and delimiting characters indicating a transition from one column to another. The value-row vector also includes a second vector which defines row position values in the matrix corresponding to the nonzero values in the first vector and column position values in the matrix corresponding to the column position of the nonzero values in the first vector. The architecture also includes a circuit for detecting a special character within the value-row vector. Matrix-vector multiplication is executed on the value-row vector. This multiplication is performed by multiplying an index value of the first vector value by a column value from a second matrix to form a matrix-vector product which is added to a previous matrix-vector product.

Determination of the optimal cutoff value for a serological assay: an example using the Johne's Absorbed EIA.

PubMed Central

Ridge, S E; Vizard, A L

1993-01-01

Traditionally, in order to improve diagnostic accuracy, existing tests have been replaced with newly developed diagnostic tests with superior sensitivity and specificity. However, it is possible to improve existing tests by altering the cutoff value chosen to distinguish infected individuals from uninfected individuals. This paper uses data obtained from an investigation of the operating characteristics of the Johne's Absorbed EIA to demonstrate a method of determining a preferred cutoff value from several potentially useful cutoff settings. A method of determining the financial gain from using the preferred rather than the current cutoff value and a decision analysis method to assist in determining the optimal cutoff value when critical population parameters are not known with certainty are demonstrated. The results of this study indicate that the currently recommended cutoff value for the Johne's Absorbed EIA is only close to optimal when the disease prevalence is very low and false-positive test results are deemed to be very costly. In other situations, there were considerable financial advantages to using cutoff values calculated to maximize the benefit of testing. It is probable that the current cutoff values for other diagnostic tests may not be the most appropriate for every testing situation. This paper offers methods for identifying the cutoff value that maximizes the benefit of medical and veterinary diagnostic tests. PMID:8501227

Adaptive servo control for umbilical mating

NASA Technical Reports Server (NTRS)

Zia, Omar

1988-01-01

Robotic applications at Kennedy Space Center are unique and in many cases require the fime positioning of heavy loads in dynamic environments. Performing such operations is beyond the capabilities of an off-the-shelf industrial robot. Therefore Robotics Applications Development Laboratory at Kennedy Space Center has put together an integrated system that coordinates state of the art robotic system providing an excellent easy to use testbed for NASA sensor integration experiments. This paper reviews the ways of improving the dynamic response of the robot operating under force feedback with varying dynamic internal perturbations in order to provide continuous stable operations under variable load conditions. The goal is to improve the stability of the system with force feedback using the adaptive control feature of existing system over a wide range of random motions. The effect of load variations on the dynamics and the transfer function (order or values of the parameters) of the system has been investigated, more accurate models of the system have been determined and analyzed.

Correlation between defect transition levels and thermoelectric operational temperature of doped CrSi2

NASA Astrophysics Data System (ADS)

Singh, Abhishek; Pandey, Tribhuwan

2014-03-01

The performance of a thermoelectric material is quantified by figure of merit ZT. The challenge in achieving high ZT value requires simultaneously high thermopower, high electrical conductivity and low thermal conductivity at optimal carrier concentration. So far doping is the most versatile approach used for modifying thermoelectric properties. Previous studies have shown that doping can significantly improve the thermoelectric performance, however the tuning the operating temperature of a thermoelectric device is a main issue. Using first principles density functional theory, we report for CrSi2, a linear relationship between thermodynamic charge state transition levels of defects and temperature at which thermopower peaks. We show for doped CrSi2 that the peak of thermopower occurs at the temperature Tm, which corresponds to the position of defect transition level. Therefore, by modifying the defect transition level, a thermoelectric material with a given operational temperature can be designed. The authors thankfully acknowledge support from ADA under NpMASS.

Study of scattered radiation during fluoroscopy in hip surgery*

PubMed Central

Lesyuk, Oksana; Sousa, Patrick Emmanuel; Rodrigues, Sónia Isabel do Espirito Santo; Abrantes, António Fernando; de Almeida, Rui Pedro Pereira; Pinheiro, João Pedro; Azevedo, Kevin Barros; Ribeiro, Luís Pedro Vieira

2016-01-01

Objective To measure the scattered radiation dose at different positions simulating hip surgery. Materials and Methods We simulated fluoroscopy-assisted hip surgery in order to study the distribution of scattered radiation in the operating room. To simulate the patient, we used a anthropomorphic whole-body phantom, and we used an X-ray-specific detector to quantify the radiation. Radiographs were obtained with a mobile C-arm X-ray system in continuous scan mode, with the tube at 0º (configuration 1) or 90º (configuration 2). The operating parameters employed (voltage, current, and exposure time) were determined by a statistical analysis based on the observation of orthopedic surgical procedures involving the hip. Results For all measurements, higher exposures were observed in configuration 2. In the measurements obtained as a function of height, the maximum dose rates observed were 1.167 (± 0.023) µSv/s and 2.278 (± 0.023) µSv/s in configurations 1 and 2, respectively, corresponding to the chest level of health care professionals within the operating room. Proximal to the patient, the maximum values were recorded in the position occupied by the surgeon. Conclusion We can conclude that, in the scenario under study, health care professionals workers are exposed to low levels of radiation, and that those levels can be reduced through the use of personal protective equipment. PMID:27777477

Values, Attitudes Toward Interpersonal Violence, and Interpersonal Violent Behavior

PubMed Central

Seddig, Daniel; Davidov, Eldad

2018-01-01

The relevance of human values for the study of the motivational sources of interpersonal violent behavior was investigated in various fields of the social sciences. However, several past studies mixed up values with other dimensions like attitudes, norms, or beliefs, and only a few systematically assessed the effect of values on violent behavior relying on a value theory. Furthermore, in other studies, violence was often analyzed as a composite index of different forms of delinquent behavior rather than as violence per se. In the current study we address these gaps in the literature by building upon Schwartz’ theory of basic human values. We use it to explain attitudes toward interpersonal violence and interpersonal violent behavior. We analyze data of young people (n = 1,810) drawn from a German study in Duisburg, Germany, which assessed various types of self-reported violent behavior as well as values and attitudes toward violence. We test structural equation models in which we explain interpersonal violent behavior with basic human values, and where attitudes toward interpersonal violent behavior mediate this relation. Results show that self-transcendence and conservation values are associated negatively and power and stimulation values positively with interpersonal violent behavior. In addition, attitudes operate as a partial mediator for the former and as a full mediator for the latter in the relation between values and violent behavior. Despite a dominant association between attitudes and behavior, values themselves can significantly contribute to the explanation of violent behavior. PMID:29867623

Values, Attitudes Toward Interpersonal Violence, and Interpersonal Violent Behavior.

PubMed

Seddig, Daniel; Davidov, Eldad

2018-01-01

The relevance of human values for the study of the motivational sources of interpersonal violent behavior was investigated in various fields of the social sciences. However, several past studies mixed up values with other dimensions like attitudes, norms, or beliefs, and only a few systematically assessed the effect of values on violent behavior relying on a value theory. Furthermore, in other studies, violence was often analyzed as a composite index of different forms of delinquent behavior rather than as violence per se . In the current study we address these gaps in the literature by building upon Schwartz' theory of basic human values. We use it to explain attitudes toward interpersonal violence and interpersonal violent behavior. We analyze data of young people ( n = 1,810) drawn from a German study in Duisburg, Germany, which assessed various types of self-reported violent behavior as well as values and attitudes toward violence. We test structural equation models in which we explain interpersonal violent behavior with basic human values, and where attitudes toward interpersonal violent behavior mediate this relation. Results show that self-transcendence and conservation values are associated negatively and power and stimulation values positively with interpersonal violent behavior. In addition, attitudes operate as a partial mediator for the former and as a full mediator for the latter in the relation between values and violent behavior. Despite a dominant association between attitudes and behavior, values themselves can significantly contribute to the explanation of violent behavior.

Correlation of skin test results and specific immunoglobulin E blood levels with nasal provocation testing for house-dust mite allergies.

PubMed

Haxel, Boris R; Huppertz, Tilman; Boessert, Patrick; Bast, Florian; Fruth, Kai

2016-01-01

Allergen-specific immunotherapy for house-dust mite (HDM) allergies is associated with lower success rates when compared with similar treatments for other inhalant allergens, such as grass or birch. One reason might be the greater difficulty in diagnosing patients with assumed HDM allergies because symptoms occur perennially and may differ from those of a conventional allergic rhinitis. The aim of the study was to compare the different methods of diagnosis in patients with assumed HDM allergy. We performed a retrospective analysis of nasal provocation tests (NPT) from patients (n = 161) evaluated for Dermatophagoides pteronyssinus (n = 127) and Dermatophagoides farinae (n = 104) allergies, and compared the results with other allergen testing methods (skin-prick test [SPT], intracutaneous test, and allergen specific immunoglobulin E levels [sIgE] to detect sensitization). Receiver operating characteristic curves were used for the analyses and the areas under the curve were calculated. For D. pteronyssinus and D. farinae, 86 and 70 complete data files, respectively, were available. For both tested HDMs, the results of the receiver operating characteristic curves showed a significant correlation for SPT and sIgE, with the results of the NPT (area under the curve, 0.742 to 0.763) but not for the intracutaneous test. In patients with a positive SPT (≥3 mm), an allergy was confirmed by the NPT in 69% of cases for D. pteronyssinus and 71% for D. farinae. A positive sIgE result (ImmunoCAP class of ≥2) was verified by the NPT in 69% of cases (D. pteronyssinus) and 70% (D. farinae). The predictability value for a positive NPT result is best for SPT and sIgE. Nevertheless, even if the results of both test systems are combined, the positive predictive value that was achieved was only 0.77 for D. pteronyssinus and 0.69 for D. farinae. Therefore, in patients eligible for immunotherapy for HDM, an NPT should be performed before the start of the therapy to verify a clinically relevant allergy.

Operational accuracy and comparative persistent antigenicity of HRP2 rapid diagnostic tests for Plasmodium falciparum malaria in a hyperendemic region of Uganda.

PubMed

Kyabayinze, Daniel J; Tibenderana, James K; Odong, George W; Rwakimari, John B; Counihan, Helen

2008-10-29

Parasite-based diagnosis of malaria by microscopy requires laboratory skills that are generally unavailable at peripheral health facilities. Rapid diagnostic tests (RDTs) require less expertise, but accuracy under operational conditions has not been fully evaluated in Uganda. There are also concerns about RDTs that use the antigen histidine-rich protein 2 (HRP2) to detect Plasmodium falciparum, because this antigen can persist after effective treatment, giving false positive test results in the absence of infection. An assessment of the accuracy of Malaria Pf immuno-chromatographic test (ICT) and description of persistent antigenicity of HRP2 RDTs was undertaken in a hyperendemic area of Uganda. Using a cross-sectional design, a total of 357 febrile patients of all ages were tested using ICT, and compared to microscopy as the gold standard reference. Two independent RDT readings were used to assess accuracy and inter-observer reliability. With a longitudinal design to describe persistent antigenicity of ICT and Paracheck, 224 children aged 6-59 months were followed up at 7-day intervals until the HRP2 antigens where undetectable by the RDTs. Of the 357 patients tested during the cross-sectional component, 40% (139) had positive blood smears for asexual forms of P. falciparum. ICT had an overall sensitivity of 98%, a specificity of 72%, a negative predictive value (NPV) of 98% and a positive predictive value (PPV) of 69%. ICT showed a high inter-observer reliability under operational conditions, with 95% of readings having assigned the same results (kappa statistics 0.921, p < 0.001). In children followed up after successful antimalaria treatment, the mean duration of persistent antigenicity was 32 days, and this duration varied significantly depending on pre-treatment parasitaemia. In patients with parasite density >50,000/microl, the mean duration of persistent antigenicity was 37 days compared to 26 days for parasitaemia less than 1,000/microl (log rank 21.9, p < 0.001). ICT is an accurate and appropriate test for operational use as a diagnostic tool where microscopy is unavailable. However, persistent antigenicity reduces the accuracy of this and other HRP2-based RDTs. The low specificity continues to be of concern, especially in children below five years of age. These pose limitations that need consideration, such as their use for diagnosis of patients returning with symptoms within two to four weeks of treatment. Good clinical skills are essential to interpret test results.

Operational accuracy and comparative persistent antigenicity of HRP2 rapid diagnostic tests for Plasmodium falciparum malaria in a hyperendemic region of Uganda

PubMed Central

Kyabayinze, Daniel J; Tibenderana, James K; Odong, George W; Rwakimari, John B; Counihan, Helen

2008-01-01

Background Parasite-based diagnosis of malaria by microscopy requires laboratory skills that are generally unavailable at peripheral health facilities. Rapid diagnostic tests (RDTs) require less expertise, but accuracy under operational conditions has not been fully evaluated in Uganda. There are also concerns about RDTs that use the antigen histidine-rich protein 2 (HRP2) to detect Plasmodium falciparum, because this antigen can persist after effective treatment, giving false positive test results in the absence of infection. An assessment of the accuracy of Malaria Pf™ immuno-chromatographic test (ICT) and description of persistent antigenicity of HRP2 RDTs was undertaken in a hyperendemic area of Uganda. Methods Using a cross-sectional design, a total of 357 febrile patients of all ages were tested using ICT, and compared to microscopy as the gold standard reference. Two independent RDT readings were used to assess accuracy and inter-observer reliability. With a longitudinal design to describe persistent antigenicity of ICT and Paracheck, 224 children aged 6–59 months were followed up at 7-day intervals until the HRP2 antigens where undetectable by the RDTs. Results Of the 357 patients tested during the cross-sectional component, 40% (139) had positive blood smears for asexual forms of P. falciparum. ICT had an overall sensitivity of 98%, a specificity of 72%, a negative predictive value (NPV) of 98% and a positive predictive value (PPV) of 69%. ICT showed a high inter-observer reliability under operational conditions, with 95% of readings having assigned the same results (kappa statistics 0.921, p < 0.001). In children followed up after successful antimalaria treatment, the mean duration of persistent antigenicity was 32 days, and this duration varied significantly depending on pre-treatment parasitaemia. In patients with parasite density >50,000/μl, the mean duration of persistent antigenicity was 37 days compared to 26 days for parasitaemia less than 1,000/μl (log rank 21.9, p < 0.001). Conclusion ICT is an accurate and appropriate test for operational use as a diagnostic tool where microscopy is unavailable. However, persistent antigenicity reduces the accuracy of this and other HRP2-based RDTs. The low specificity continues to be of concern, especially in children below five years of age. These pose limitations that need consideration, such as their use for diagnosis of patients returning with symptoms within two to four weeks of treatment. Good clinical skills are essential to interpret test results. PMID:18959777

Effect of low water content in protic ionic liquid on ions electrosorption in porous carbon: application to electrochemical capacitors.

PubMed

Gorska, B; Timperman, L; Anouti, M; Béguin, F

2017-05-10

The effect of low water content (<20, 150, 1000, 10 000 ppm) in triethylammonium bis[(trifluoromethyl)sulfonyl]imide - [(C 2 H 5 ) 3 N + H][TFSI - ] - protic ionic liquid (PIL) on the performance of activated carbon (AC) electrodes as well as AC/AC electrochemical capacitors (ECs) is reported. Under negative polarization, hydrogen electrosorption onto carbon is enhanced along with the increase of water content in PIL, whereas the resulting desorption peaks are shifted to lower potential values, evidencing lower sorption energy when hydrogen is stored from moisture containing PIL. Cyclic voltammetry (CV) investigations on PIL-based ECs demonstrated that the evolution of the Stern layer nanostructure at positive and negative potentials is asymmetrical. The results revealed comparable electrochemical performance for PIL containing 150 and 1000 ppm of H 2 O, due to similar operation of the positive electrode, where [TFSI - ] anions are adsorbed in the outer Helmholtz plane, and the negative one, where hydrogen is stored through the reduction of the intermediate hydronium cation. By contrast, a cell with "dry" PIL (<20 ppm of water) displayed a distinctive operation due to hydrogen electrosorption directly through reduction of the protonated cation, and selective adsorption of [TFSI - ] anions, which occurs thanks to the high polarizability and image force (IF) created by their induced charge. Galvanostatic cycling with potential limitation (GCPL) showed comparable capacitance values whatever the water content in PILs up to 1000 ppm, yet electrochemical impedance spectroscopy (EIS) revealed higher capacitance as well as better retention at higher frequencies with the PIL containing 150 ppm of water. Hence, 150 ppm is reasoned to be an optimal value for diffusion and adsorption of ions. The nature of current collectors (aluminum or stainless steel) has a determining role in their polarization behavior, and consequently the potential range of electrodes as well as ion diffusion into the activated carbon porosity, influencing the observed capacitance values (C EIS/2.0V : 170 vs. 128 F g -1 , for Al and SSt, respectively).

Automated Pressure Injury Risk Assessment System Incorporated Into an Electronic Health Record System.

PubMed

Jin, Yinji; Jin, Taixian; Lee, Sun-Mi

Pressure injury risk assessment is the first step toward preventing pressure injuries, but traditional assessment tools are time-consuming, resulting in work overload and fatigue for nurses. The objectives of the study were to build an automated pressure injury risk assessment system (Auto-PIRAS) that can assess pressure injury risk using data, without requiring nurses to collect or input additional data, and to evaluate the validity of this assessment tool. A retrospective case-control study and a system development study were conducted in a 1,355-bed university hospital in Seoul, South Korea. A total of 1,305 pressure injury patients and 5,220 nonpressure injury patients participated for the development of a risk scoring algorithm: 687 and 2,748 for the validation of the algorithm and 237 and 994 for validation after clinical implementation, respectively. A total of 4,211 pressure injury-related clinical variables were extracted from the electronic health record (EHR) systems to develop a risk scoring algorithm, which was validated and incorporated into the EHR. That program was further evaluated for predictive and concurrent validity. Auto-PIRAS, incorporated into the EHR system, assigned a risk assessment score of high, moderate, or low and displayed this on the Kardex nursing record screen. Risk scores were updated nightly according to 10 predetermined risk factors. The predictive validity measures of the algorithm validation stage were as follows: sensitivity = .87, specificity = .90, positive predictive value = .68, negative predictive value = .97, Youden index = .77, and the area under the receiver operating characteristic curve = .95. The predictive validity measures of the Braden Scale were as follows: sensitivity = .77, specificity = .93, positive predictive value = .72, negative predictive value = .95, Youden index = .70, and the area under the receiver operating characteristic curve = .85. The kappa of the Auto-PIRAS and Braden Scale risk classification result was .73. The predictive performance of the Auto-PIRAS was similar to Braden Scale assessments conducted by nurses. Auto-PIRAS is expected to be used as a system that assesses pressure injury risk automatically without additional data collection by nurses.

Accuracy of simple biochemical tests in identifying liver fibrosis in patients co-infected with human immunodeficiency virus and hepatitis C virus.

PubMed

Tural, Cristina; Tor, Jordi; Sanvisens, Arantza; Pérez-Alvarez, Núria; Martínez, Elisenda; Ojanguren, Isabel; García-Samaniego, Javier; Rockstroh, Juergen; Barluenga, Eva; Muga, Robert; Planas, Ramon; Sirera, Guillem; Rey-Joly, Celestino; Clotet, Bonaventura

2009-03-01

We assessed the ability of 3 simple biochemical tests to stage liver fibrosis in patients co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). We analyzed liver biopsy samples from 324 consecutive HIV/HCV-positive patients (72% men; mean age, 38 y; mean CD4+ T-cell counts, 548 cells/mm(3)). Scheuer fibrosis scores were as follows: 30% had F0, 22% had F1, 19% had F2, 23% had F3, and 6% had F4. Logistic regression analyses were used to predict the probability of significant (>or=F2) or advanced (>or=F3) fibrosis, based on numeric scores from the APRI, FORNS, or FIB-4 tests (alone and in combination). Area under the receiver operating characteristic curves were analyzed to assess diagnostic performance. Area under the receiver operating characteristic curves analyses indicated that the 3 tests had similar abilities to identify F2 and F3; the ability of APRI, FORNS, and FIB-4 were as follows: F2 or greater: 0.72, 0.67, and 0.72, respectively; F3 or greater: 0.75, 0.73, and 0.78, respectively. The accuracy of each test in predicting which samples were F3 or greater was significantly higher than for F2 or greater (APRI, FORNS, and FIB-4: >or=F3: 75%, 76%, and 76%, respectively; >or=F2: 66%, 62%, and 68%, respectively). By using the lowest cut-off values for all 3 tests, F3 or greater was ruled out with sensitivity and negative predictive values of 79% to 94% and 87% to 91%, respectively, and 47% to 70% accuracy. Advanced liver fibrosis (>or=F3) was identified using the highest cut-off value, with specificity and positive predictive values of 90% to 96% and 63% to 73%, respectively, and 75% to 77% accuracy. Simple biochemical tests accurately predicted liver fibrosis in more than half the HIV/HCV co-infected patients. The absence and presence of liver fibrosis are predicted fairly using the lowest and highest cut-off levels, respectively.

The RIPASA score is sensitive and specific for the diagnosis of acute appendicitis in a western population.

PubMed

Malik, Muhammad Usman; Connelly, Tara M; Awan, Faisal; Pretorius, Frederik; Fiuza-Castineira, Constantino; El Faedy, Osama; Balfe, Paul

2017-04-01

The definitive diagnosis of acute appendicitis (AA) requires histopathological examination. Various clinical diagnostic scoring systems attempt to reduce negative appendectomy rates. The most commonly used in Western Europe and the USA is the Alvarado score. The Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score achieves better sensitivity and specificity in Asian and Middle Eastern populations. We aimed to determine the diagnostic accuracy of the RIPASA score in Irish patients with AA. All patients who presented to our institution with right iliac fossa pain and clinically suspected AA between January 1 and December 31, 2015, were indentified from our hospital inpatient enquiry database and retrospectively studied. Operating theatre records and histology reports confirmed those who underwent a non-elective operative procedure and the presence or absence of AA. SPSS version 22 was used for statistical analysis. Standard deviation is provided where appropriate. Two hundred eight patients were included in the study (106/51% male, mean age 22.7 ± 9.2 years). One hundred thirty-five (64.9%) had histologically confirmed AA (mean symptom duration = 36.19 ± 15.90 h). At a score ≥7.5, the previously determined score most likely associated with AA in Eastern populations, the RIPASA scoring system demonstrated a sensitivity of 85.39%, specificity of 69.86%, positive predictive value of 84.06%, negative predictive value of 72.86% and diagnostic accuracy of 80% in our cohort. The RIPASA score is a useful tool to aid in the diagnosis of acute appendicitis in the Irish population. A score of ≥7.5 provides sensitivity and specificity exceeding that previously documented for the Alvarado score in Western populations. WHAT DOES THIS PAPER ADD TO THE LITERATURE?: This is the first study evaluating the utility of the RIPASA score in predicting acute appendicitis in a Western population. At a value of 7.5, a cut-off score suggestive of appendicitis in the Eastern population, RIPASA demonstrated a high-sensitivity, specificity, positive predictive value and diagnostic accuracy in our cohort and was more accurate than the commonly used Alvarado score.

Optimising the utility of pleural fluid adenosine deaminase for the diagnosis of adult tuberculous pleural effusion in Hong Kong.

PubMed

Chang, K C; Chan, M C; Leung, W M; Kong, F Y; Mak, C M; Chen, S Pl; Yu, W C

2018-02-01

Pleural fluid adenosine deaminase level can be applied to rapidly detect tuberculous pleural effusion. We aimed to establish a local diagnostic cut-off value for pleural fluid adenosine deaminase to identify patients with tuberculous pleural effusion, and optimise its utility. We retrospectively reviewed the medical records of consecutive adults with pleural fluid adenosine deaminase level measured by the Diazyme commercial kit (Diazyme Laboratories, San Diego [CA], United States) during 1 January to 31 December 2011 in a cluster of public hospitals in Hong Kong. We considered its level alongside early (within 2 weeks) findings in pleural fluid and pleural biopsy, with and without applying Light's criteria in multiple scenarios. For each scenario, we used the receiver operating characteristic curve to identify a diagnostic cut-off value for pleural fluid adenosine deaminase, and estimated its positive and negative predictive values. A total of 860 medical records were reviewed. Pleural effusion was caused by congestive heart failure, chronic renal failure, or hypoalbuminaemia caused by liver or kidney diseases in 246 (28.6%) patients, malignancy in 198 (23.0%), non-tuberculous infection in 168 (19.5%), tuberculous pleural effusion in 157 (18.3%), and miscellaneous causes in 91 (10.6%). All those with tuberculous pleural effusion had a pleural fluid adenosine deaminase level of ≤100 U/L. When analysis was restricted to 689 patients with pleural fluid adenosine deaminase level of ≤100 U/L and early negative findings for malignancy and non-tuberculous infection in pleural fluid, the positive predictive value was significantly increased and the negative predictive value non-significantly reduced. Using this approach, neither additionally restricting analysis to exudates by Light's criteria nor adding closed pleural biopsy would further enhance predictive values. As such, the diagnostic cut-off value for pleural fluid adenosine deaminase is 26.5 U/L, with a sensitivity of 87.3%, specificity of 93.2%, positive predictive value of 79.2%, negative predictive value of 96.1%, and accuracy of 91.9%. Sex, age, and co-morbidity did not significantly affect prediction of tuberculous pleural effusion using the cut-off value. We have established a diagnostic cut-off level for pleural fluid adenosine deaminase in the diagnosis of tuberculous pleural effusion by restricting analysis to a level of ≤100 U/L, and considering early pleural fluid findings for malignancy and non-tuberculous infection, but not Light's criteria.

Reengineering Electronic Fetal Monitoring Interpretation: Using the Fetal Reserve Index to Anticipate the Need for Emergent Operative Delivery.

PubMed

Eden, Robert D; Evans, Mark I; Evans, Shara M; Schifrin, Barry S

2018-04-01

The near-ubiquitous use of electronic fetal monitoring has failed to lower the rates of both cerebral palsy and emergency operative deliveries (EODs). Its performance metrics have low sensitivity, specificity, and predictive values for both. There are many EODs, but the vast majority have normal outcomes. The EODs, however, cause serious disruption in the delivery suite routine with increased complications, anxiety, and concern for all. We developed the fetal reserve index (FRI) as multicomponent algorithm including 4 FHR components (analyzed individually), uterine activity, and maternal, obstetrical, and fetal risk factors to assess risk of cerebral palsy and EOD. Scores were categorized into green, yellow, and red zones. Here, we studied 300 patients by the FRI, all of whom had normal neonatal outcomes. We attempted to distinguish the clinical course of those cases which required an EOD versus controls which did not. 51 cases with EOD had FRIs much lower than 249 non-EOD cases. The red zone was reached more frequently ( P < .001) and lasted longer (1.06 vs 0.05 hours; P < .001). Reaching the red zone had a sensitivity of 92% for EOD, with a positive predictive value of 64% and a false positive rate of 10.4%. Our data suggest the FRI can significantly lower the incidence of EODs by identifying the opportunity for intrauterine resuscitation. Our approach can reduce the disruptive effects of EODs and their concomitant increased risks of complications. The FRI may provide a metric that can refine labor management to reduce CP and EODs.

ISKANDARnet IOMOS: Near real-time equatorial space weather monitoring and alert system in Peninsular Malaysia

NASA Astrophysics Data System (ADS)

Musa, Tajul Ariffin; Leong, Shien Kwun; Abdullah, Khairul Anuar; Othman, Rusli

2012-11-01

This work proposes ISKANDARnet Ionospheric Outburst MOnitoring and alert System (IOMOS), along with Ionospheric Outburst Index (IOX) to develop an operational near real-time space weather service for Malaysia. The IOMOS is based on Global Positioning System (GPS) Network-based Real-Time Kinematic (NRTK) concept which is by nature for atmospheric (ionosphere and troposphere) modeling within the network coverage. The elegance of this solution lies in the fact that IOMOS utilize differential ionospheric residual from network of GPS baselines which incur no additional cost for operation. Users will be informed about the ionospheric perturbation through Short Message Service (SMS), email or Twitter®. This approach will ultimately beneficial for the navigation and satellite positioning communities, particularly during the coming Solar Cycle 24. In addition, a combination of local and global GPS network has been employed to study the equatorial ionosphere geomorphology and climatology in the Malaysian sector. Equatorial Total Electron Content (TEC) over Malaysia shows semi-annual, annual, and seasonal variations with maximum values appearing during equinoctial months and minimum during solstices months. The TEC value during vernal equinox is about 21% higher than autumnal equinox, and December solstice exceeds that at the June solstice by around 14%. It is also found that semi-annual variation is present at all levels of solar activity, whereas June solstice predominates December solstice during high solar activity for annual and seasonal variations. In near future, a near real-time TEC derivation system will be developed to support equatorial ionosphere modeling to enhance space weather service for Malaysia.

Diagnostic Value of Cerebrospinal Fluid T-SPOT.TB for Tuberculousis Meningitis in China.

PubMed

Li, Xue Lian; Xie, Na; Wang, Song Wang; Wu, Qian Hong; Ma, Yan; Shu, Wei; Chen, Hong Mei; Zhang, Li Qun; Wu, Xiao Guang; Ma, Li Ping; Che, Nan Ying; Gao, Meng Qiu

2017-09-01

The aim of this study was to evaluate the diagnostic value of the cerebrospinal fluid (CSF) T-SPOT.TB test for the diagnosis of TB meningitis (TBM). A retrospective analysis of 96 patients with manifested meningitis was conducted; T-SPOT.TB test was performed for diagnosing TBM to determine the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A receiver operating characteristic (ROC) curve was also drawn to assess the diagnostic accuracy. The sensitivity, specificity, PPV, and NPV of CSF T-SPOT.TB test were 97.8%, 78.0%, 80.3%, and 97.5%, respectively, for 52 patients (54.2%) of the 96 enrolled patients. The area under the curve (AUC) was 0.910, and the sensitivities of CSF T-SPOT.TB for patients with stages I, II, and III of TBM were 96.7%, 97.2%, and 98.9%, respectively. CSF T-SPOT.TB test is a rapid and accurate diagnostic method with higher sensitivity and specificity for diagnosing TBM. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Pseudosymmetric features of non-centrosymmetric AB type crystals

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

Gazhulina, A.P., E-mail: asyagazhulina@yandex.ru; Marychev, M.O.

2016-07-15

This work is supplement to our previous investigation (Gazhulina and Marychev, 2015) [1]. We have considered pseudosymmetric features with respect to the operation of inversion (pseudoinversion) for 340 non-centrosymmetric AB type crystals. Analysis of the features of particular structure types allowed us to determine the positions of pseudoinversion centers, subdivide them into separate types, and classify the entire set of crystals studied with respect to the types of pseudoinversion centers and peculiarities of the behavior of the degree of pseudoinversion depending on the ratio of atomic numbers of A and B components. For each group of crystals, average values andmore » lower boundaries of the maximum pseudoinversion are determined and distribution with respect to the degree of pseudoinversion is constructed. - Graphical abstract: A group of 340 non-centrosymmetric AB type crystals have been considered for their pseudosymmetry features with respect to the operation of inversion. Positions of pseudoinversion centers, subdivision of them into separate types, classification of the entire set of crystals studied with respect to the types of pseudoinversion centers and peculiarities of the behavior of the degree of pseudoinversion are established and discussed. Display Omitted - Highlights: • We consider pseudoinversion of 340 non-centrosymmetric AB type crystals. • AB type crystals are divided into three groups with respect to pseudoinversion. • Positions and types of pseudoinversion centers are determined. • Lower boundaries of the maximum pseudoinversion are determined.« less

Preparation and evaluation of highly drug-loaded fine globular granules using a multi-functional rotor processor.

PubMed

Iwao, Yasunori; Kimura, Shin-Ichiro; Ishida, Masayuki; Mise, Ryohei; Yamada, Masaki; Namiki, Noriyuki; Noguchi, Shuji; Itai, Shigeru

2015-01-01

The manufacture of highly drug-loaded fine globular granules eventually applied for orally disintegrating tablets has been investigated using a unique multi-functional rotor processor with acetaminophen, which was used as a model drug substance. Experimental design and statistical analysis were used to evaluate potential relationships between three key operating parameters (i.e., the binder flow rate, atomization pressure and rotating speed) and a series of associated micromeritics (i.e., granule mean size, proportion of fine particles (106-212 µm), flowability, roundness and water content). The results of multiple linear regression analysis revealed several trends, including (1) the binder flow rate and atomization pressure had significant positive and negative effects on the granule mean size value, Carr's flowability index, granular roundness and water content, respectively; (2) the proportion of fine particles was positively affected by the product of interaction between the binder flow rate and atomization pressure; and (3) the granular roundness was negatively and positively affected by the product of interactions between the binder flow rate and the atomization pressure, and the binder flow rate and rotating speed, respectively. The results of this study led to the identification of optimal operating conditions for the preparation of granules, and could therefore be used to provide important information for the development of processes for the manufacture of highly drug-loaded fine globular granules.

Cross-industry standard process for data mining is applicable to the lung cancer surgery domain, improving decision making as well as knowledge and quality management.

PubMed

Rivo, Eduardo; de la Fuente, Javier; Rivo, Ángel; García-Fontán, Eva; Cañizares, Miguel-Ángel; Gil, Pedro

2012-01-01

The aim of this study was to assess the applicability of knowledge discovery in database methodology, based upon data mining techniques, to the investigation of lung cancer surgery. According to CRISP 1.0 methodology, a data mining (DM) project was developed on a data warehouse containing records for 501 patients operated on for lung cancer with curative intention. The modelling technique was logistic regression. The finally selected model presented the following values: sensitivity 9.68%, specificity 100%, global precision 94.02%, positive predictive value 100% and negative predictive value 93.98% for a cut-off point set at 0.5. A receiver operating characteristic (ROC) curve was constructed. The area under the curve (CI 95%) was 0.817 (0.740- 0.893) (p < 0.05). Statistical association with perioperative mortality was found for the following variables [odds ratio (CI 95%)]: age over 70 [2.3822 (1.0338-5.4891)], heart disease [2.4875 (1.0089-6.1334)], peripheral arterial disease [5.7705 (1.9296-17.2570)], pneumonectomy [3.6199 (1.4939-8.7715)] and length of surgery (min) [1.0067 (1.0008-1.0126)]. The CRISP-DM process model is very suitable for lung cancer surgery analysis, improving decision making as well as knowledge and quality management.