Evolution of the patient characteristics of candidates for radical prostatectomy and the results obtained with the technique.

PubMed

Sanchís-Bonet, A; Arribas-Gómez, I; Sánchez-Rodríguez, C; Sánchez-Chapado, M

2015-03-01

To evaluate the oncological profile and risk of biochemical recurrence of patients with prostate cancer who underwent radical prostatectomy based on the time period in which the patients were operated. To evaluate the differences in prostate-specific antigen (PSA) at diagnosis of patients with or without biochemical recurrence based on these time periods. Observation carried forward study of a cohort of 972 radical prostatectomies performed during 3 time periods (1994-2000, 2001-2006, 2007-2011). The importance of PSA at diagnosis on the time periods and on biochemical recurrence was assessed using a generalized linear model. The independent predictive behavior of biochemical recurrence was analyzed using Cox regression. The median follow-up was 38 (16-76) months. PSA levels at diagnosis were higher in the period 1994-2000 (12.97ng/mL, P<.001). Seventy-two percent of the patients from the period 2007-2011 were diagnosed as clinical stage T1c (P<.001), compared with 55% from the period 1994-2000. The percentage of extracapsular extension in the specimen decreased from 27% to 18% from the period 1994-2000 to the period 2007-2011 (p<.001). The percentage of patients with biochemical recurrence went from 38% to 14% from the first to the third period (P>.001). The difference between PSA levels at diagnosis for the patients with or without biochemical recurrence was independent of the period (P=.84). The period during which surgery was performed was not an independent predictive factor for biochemical recurrence (P=.09). Patients from the 2007-2011 period had less extracapsular disease in the radical prostatectomy. The period was not an independent predictive factor for biochemical recurrence. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Radiological detection of extracapsular spread in head and neck squamous cell carcinoma (HNSCC) cervical metastases.

PubMed

Url, C; Schartinger, V H; Riechelmann, H; Glückert, R; Maier, H; Trumpp, M; Widmann, G

2013-10-01

Extracapsular spread of cervical lymph nodes deteriorates the prognosis of patients with head and neck squamous cell carcinoma. Postoperative radiochemotherapy is superior to postoperative radiotherapy alone in patients with histologically proven extracapsular spread. If extracapsular spread can be detected preoperatively, patients may favor primary radiochemotherapy instead of primary surgery plus postoperative radiochemotherapy. Computed tomography (CT) scans of nodal positive head and neck squamous cell carcinoma patients treated between 2008 and 2010 with comprehensive neck dissection as part of first line surgical treatment were retrospectively scanned for extracapsular spread by two blinded radiologists. If a positive lymph node was identified by the pathologist, CT scans were assessed for extracapsular spread retrospectively. CT criteria for Extracapsular spread were apparent fat and soft tissue infiltration or infiltration of sternocleidomastoid muscle, internal jugular vein or carotid artery. Radiologic judgment was compared with histological evidence of extracapsular spread and specificity and sensitivity of CT detection was calculated. Forty-nine patients with histologically proven positive lymph nodes (pN+) were included. Extracapsular spread was histologically proven in 17 cases; the number of all affected lymph nodes was not listed. Radiologist 1 found extracapsular spread in CT scans of 15/49 patients and radiologist 2 in 16/49 patients (Cohen's kappa=0.86; p<0.01). Sensitivity of radiologic extracapsular spread detection was 73% (95% confidential index (CI): 44.0-89.7%) and specificity 91% (75.0-98.0%). Extracapsular spread depicted on computed tomography using strict criteria has high specificity. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Predictors and Patterns of Local, Regional, and Distant Failure in Squamous Cell Carcinoma of the Vulva.

PubMed

Bogani, Giorgio; Cromi, Antonella; Serati, Maurizio; Uccella, Stefano; Donato, Violante Di; Casarin, Jvan; Naro, Edoardo Di; Ghezzi, Fabio

2017-06-01

To identify factors predicting for recurrence in vulvar cancer patients undergoing surgical treatment. We retrospectively evaluated data of consecutive patients with squamous cell vulvar cancer treated between January 1, 1990 and December 31, 2013. Basic descriptive statistics and multivariable analysis were used to design predicting models influencing outcomes. Five-year disease-free survival (DFS) and overall survival (OS) were analyzed using the Cox model. The study included 101 patients affected by vulvar cancer: 64 (63%) stage I, 12 (12%) stage II, 20 (20%) stage III, and 5 (5%) stage IV. After a mean (SD) follow-up of 37.6 (22.1) months, 21 (21%) recurrences occurred. Local, regional, and distant failures were recorded in 14 (14%), 6 (6%), and 3 (3%) patients, respectively. Five-year DFS and OS were 77% and 82%, respectively. At multivariate analysis only stromal invasion >2 mm (hazard ratio: 4.9 [95% confidence interval, 1.17-21.1]; P=0.04) and extracapsular lymph node involvement (hazard ratio: 9.0 (95% confidence interval, 1.17-69.5); P=0.03) correlated with worse DFS, although no factor independently correlated with OS. Looking at factors influencing local and regional failure, we observed that stromal invasion >2 mm was the only factor predicting for local recurrence, whereas lymph node extracapsular involvement predicted for regional recurrence. Stromal invasion >2 mm and lymph node extracapsular spread are the most important factors predicting for local and regional failure, respectively. Studies evaluating the effectiveness of adjuvant treatment in high-risk patients are warranted.

Tumor cell anaplasia and multinucleation are predictors of disease recurrence in oropharyngeal squamous cell carcinoma, including among just the human papillomavirus-related cancers.

PubMed

Lewis, James S; Scantlebury, Juliette B; Luo, Jingqin; Thorstad, Wade L

2012-07-01

Oropharyngeal squamous cell carcinoma (SCC) is frequently related to high risk human papillomavirus. This tumor expresses p16, frequently has a nonkeratinizing morphology, and has improved outcomes. Despite having a good prognosis, tumors can have focal or diffuse nuclear anaplasia or multinucleation, the significance of which is unknown. From a database of 270 oropharyngeal SCCs with known histologic typing (using our established system) and p16 immunohistochemistry, all surgically resected cases (149) were reviewed. Anaplasia was defined as any × 40 field with ≥ 3 tumor nuclei with diameters ≥ 5 lymphocyte nuclei (~25 μm), and multinucleation was defined as any × 40 field with ≥ 3 tumor cells with multiple nuclei. p16 was positive in 128 cases (85.9%), 64 cases (43.0%) showed anaplasia, and 71 (47.7%) showed multinucleation. Anaplasia and multinucleation were highly related (P<0.001), and both also correlated with histologic type (P<0.001 and P=0.01, respectively), p16 status (P=0.09 and 0.03, respectively), and partially with nodal extracapsular extension. There was no correlation with any of the other variables. In univariate analysis, cases showing anaplasia or multinucleation had worse overall, disease-specific, and disease-free survival (P<0.006 for all). Higher T-stage, keratinizing histologic type, extracapsular extension, and smoking also all correlated with worse survival. In multivariate analysis, anaplasia and multinucleation both predicted worse disease-specific survival (hazard ratio 9.9, P=0.04; and hazard ratio 11.9, P=0.02, respectively) independent of the other variables. In summary, among surgically resectable oropharyngeal SCC (including among just the p16-positive cohort), tumor cell anaplasia and multinucleation independently correlated with disease recurrence and poorer survival.

Tumor Cell Anaplasia and Multinucleation Are Predictors of Disease Recurrence in Oropharyngeal Squamous Cell Carcinoma, Including Among Just the Human Papillomavirus-Related Cancers

PubMed Central

Lewis, James S.; Scantlebury, Juliette B.; Luo, Jingqin; Thorstad, Wade L.

2013-01-01

Oropharyngeal squamous cell carcinoma (SCC) is frequently related to high risk human papillomavirus. This tumor expresses p16, frequently has a nonkeratinizing morphology, and has improved outcomes. Despite having a good prognosis, tumors can have focal or diffuse nuclear anaplasia or multinucleation, the significance of which is unknown. From a database of 270 oropharyngeal SCCs with known histologic typing (using our established system) and p16 immunohistochemistry, all surgically resected cases (149) were reviewed. Anaplasia was defined as any ×40 field with ≥ 3 tumor nuclei with diameters ≥ 5 lymphocyte nuclei (~25 μm), and multinucleation was defined as any ×40 field with ≥ 3 tumor cells with multiple nuclei. p16 was positive in 128 cases (85.9%), 64 cases (43.0%) showed anaplasia, and 71 (47.7%) showed multinucleation. Anaplasia and multinucleation were highly related (P < 0.001), and both also correlated with histologic type (P < 0.001 and P = 0.01, respectively), p16 status (P = 0.09 and 0.03, respectively), and partially with nodal extracapsular extension. There was no correlation with any of the other variables. In univariate analysis, cases showing anaplasia or multinucleation had worse overall, disease-specific, and disease-free survival (P < 0.006 for all). Higher T-stage, keratinizing histologic type, extracapsular extension, and smoking also all correlated with worse survival. In multivariate analysis, anaplasia and multinucleation both predicted worse disease-specific survival (hazard ratio 9.9, P = 0.04; and hazard ratio 11.9, P = 0.02, respectively) independent of the other variables. In summary, among surgically resectable oropharyngeal SCC (including among just the p16-positive cohort), tumor cell anaplasia and multinucleation independently correlated with disease recurrence and poorer survival. PMID:22743286

Extracapsular extension of pelvic lymph node metastases is of prognostic value in carcinoma of the cervix uteri.

PubMed

Horn, Lars-Christian; Hentschel, Bettina; Galle, Dana; Bilek, Karl

2008-01-01

Pelvic lymph node involvement is a well-recognized prognostic factor in cervical carcinoma (CX). Limited knowledge exists about extranodal extension of the tumor outside the lymph node capsule, i.e. extracapsular spread (ECS). Two hundred fifty-six cases of surgically treated CX (FIGO stage IB1 to IIB) with pelvic lymph node involvement were evaluated regarding the occurrence of extranodal spread of the metastatic deposits outside the lymph node capsule (ECS), determined on standardized handled lymphadenectomy specimens, regarding their impact of recurrent disease and overall survival during a median follow-up time of 62 months (95% CI 51-73 months). ECS was seen in 30.9% (79/256) of the cases. The occurrence of ECS showed a significant correlation to advanced stage disease (p=0.02), the number of involved nodes (p<0.001) and the size of metastatic deposits (p<0.01). The 5-year recurrence-free survival rate in patients with ECS was significant lower compared to patients without ECS (59.7% [95% CI: 46.3%-73.2%] versus 67.2% [95% CI: 58.9%-75.5%]; (p=0.04). The 5-year overall survival rate was significant lower in patients with ECS (33.5% [95% CI: 20.6%-46.3%] vs. 60.5% [95% CI: 52.3%-68.6%]; p<0.001). In multivariate analysis, tumor stage, number of involved pelvic nodes, tumor differentiation and ECS were independent prognostic factors. The results indicate that extracapsular spread (ECS) of pelvic lymph node metastases is of prognostic impact in cervical carcinomas. A revised FIGO/TNM classification system for pelvic lymph node disease is recommended: ECS 0 = lymph node involvement without extranodal spread of the metastatic deposits and ECS 1 = lymph node involvement with extranodal spread of the metastatic deposits.

Comparison of pelvic phased-array versus endorectal coil magnetic resonance imaging at 3 Tesla for local staging of prostate cancer.

PubMed

Kim, Bum Soo; Kim, Tae-Hwan; Kwon, Tae Gyun; Yoo, Eun Sang

2012-05-01

Several studies have demonstrated the superiority of endorectal coil magnetic resonance imaging (MRI) over pelvic phased-array coil MRI at 1.5 Tesla for local staging of prostate cancer. However, few have studied which evaluation is more accurate at 3 Tesla MRI. In this study, we compared the accuracy of local staging of prostate cancer using pelvic phased-array coil or endorectal coil MRI at 3 Tesla. Between January 2005 and May 2010, 151 patients underwent radical prostatectomy. All patients were evaluated with either pelvic phased-array coil or endorectal coil prostate MRI prior to surgery (63 endorectal coils and 88 pelvic phased-array coils). Tumor stage based on MRI was compared with pathologic stage. We calculated the specificity, sensitivity and accuracy of each group in the evaluation of extracapsular extension and seminal vesicle invasion. Both endorectal coil and pelvic phased-array coil MRI achieved high specificity, low sensitivity and moderate accuracy for the detection of extracapsular extension and seminal vesicle invasion. There were statistically no differences in specificity, sensitivity and accuracy between the two groups. Overall staging accuracy, sensitivity and specificity were not significantly different between endorectal coil and pelvic phased-array coil MRI.

Comparative evaluation of urinary PCA3 and TMPRSS2: ERG scores and serum PHI in predicting prostate cancer aggressiveness.

PubMed

Tallon, Lucile; Luangphakdy, Devillier; Ruffion, Alain; Colombel, Marc; Devonec, Marian; Champetier, Denis; Paparel, Philippe; Decaussin-Petrucci, Myriam; Perrin, Paul; Vlaeminck-Guillem, Virginie

2014-07-30

It has been suggested that urinary PCA3 and TMPRSS2:ERG fusion tests and serum PHI correlate to cancer aggressiveness-related pathological criteria at prostatectomy. To evaluate and compare their ability in predicting prostate cancer aggressiveness, PHI and urinary PCA3 and TMPRSS2:ERG (T2) scores were assessed in 154 patients who underwent radical prostatectomy for biopsy-proven prostate cancer. Univariate and multivariate analyses using logistic regression and decision curve analyses were performed. All three markers were predictors of a tumor volume≥0.5 mL. Only PHI predicted Gleason score≥7. T2 score and PHI were both independent predictors of extracapsular extension(≥pT3), while multifocality was only predicted by PCA3 score. Moreover, when compared to a base model (age, digital rectal examination, serum PSA, and Gleason sum at biopsy), the addition of both PCA3 score and PHI to the base model induced a significant increase (+12%) when predicting tumor volume>0.5 mL. PHI and urinary PCA3 and T2 scores can be considered as complementary predictors of cancer aggressiveness at prostatectomy.

Comparison of Pelvic Phased-Array versus Endorectal Coil Magnetic Resonance Imaging at 3 Tesla for Local Staging of Prostate Cancer

PubMed Central

Kim, Bum Soo; Kim, Tae-Hwan; Kwon, Tae Gyun

2012-01-01

Purpose Several studies have demonstrated the superiority of endorectal coil magnetic resonance imaging (MRI) over pelvic phased-array coil MRI at 1.5 Tesla for local staging of prostate cancer. However, few have studied which evaluation is more accurate at 3 Tesla MRI. In this study, we compared the accuracy of local staging of prostate cancer using pelvic phased-array coil or endorectal coil MRI at 3 Tesla. Materials and Methods Between January 2005 and May 2010, 151 patients underwent radical prostatectomy. All patients were evaluated with either pelvic phased-array coil or endorectal coil prostate MRI prior to surgery (63 endorectal coils and 88 pelvic phased-array coils). Tumor stage based on MRI was compared with pathologic stage. We calculated the specificity, sensitivity and accuracy of each group in the evaluation of extracapsular extension and seminal vesicle invasion. Results Both endorectal coil and pelvic phased-array coil MRI achieved high specificity, low sensitivity and moderate accuracy for the detection of extracapsular extension and seminal vesicle invasion. There were statistically no differences in specificity, sensitivity and accuracy between the two groups. Conclusion Overall staging accuracy, sensitivity and specificity were not significantly different between endorectal coil and pelvic phased-array coil MRI. PMID:22476999

Extracapsular dissection for Warthin tumor in the tail of parotid gland.

PubMed

Lee, Dong Hoon; Yoon, Tae Mi; Lee, Joon Kyoo; Lim, Sang Chul

2017-09-01

Extracapsular dissection conferred the advantage of reduced operation time and morbidity without any recurrence, and it could be considered as the treatment of choice for Warthin tumors in the tail of the parotid gland. The purpose of this study is to confirm the appropriate surgical procedure for Warthin tumor in the tail of the parotid gland, by comparing the results of extracapsular dissection and superficial parotidectomy. The medical records of 72 patients with Warthin tumor in the tail of the parotid gland who underwent surgery between January 2006 and December 2016 were retrospectively reviewed. In the extracapsular dissection group, a total of 44 parotid gland operations were performed in 40 patients. In the superficial parotidectomy group, a total of 34 parotid gland operations were performed in 32 patients. The operation time was significantly shorter in the extracapsular dissection group than in the superficial parotidectomy group (p<.001, Table 1). One patient in the extracapsular dissection group and five patients in the superficial parotidectomy group had postoperative facial nerve palsy. Recurrence of Warthin tumor in the tail portion of the parotid gland was identified in one patient who underwent superficial parotidectomy.

Is Ki67 prognostic for aggressive prostate cancer? A multicenter real-world study.

PubMed

Fantony, Joseph J; Howard, Lauren E; Csizmadi, Ilona; Armstrong, Andrew J; Lark, Amy L; Galet, Colette; Aronson, William J; Freedland, Stephen J

2018-06-15

To test if Ki67 expression is prognostic for biochemical recurrence (BCR) after radical prostatectomy (RP). Ki67 immunohistochemistry was performed on tissue microarrays constructed from specimens obtained from 464 men undergoing RP at the Durham and West LA Veterans Affairs Hospitals. Hazard ratios (HR) for Ki67 expression and time to BCR were estimated using Cox regression. Ki67 was associated with more recent surgery year (p < 0.001), positive margins (p = 0.001) and extracapsular extension (p < 0.001). In center-stratified analyses, the adjusted HR for Ki67 expression and BCR approached statistical significance for west LA (HR: 1.54; p = 0.06), but not Durham (HR: 1.10; p = 0.74). This multi-institutional 'real-world' study provides limited evidence for the prognostic role of Ki67 in predicting outcome after RP.

Pathological upgrading in prostate cancer patients eligible for active surveillance: Does prostate-specific antigen density matter?

PubMed

Jin, Byung-Soo; Kang, Seok-Hyun; Kim, Duk-Yoon; Oh, Hoon-Gyu; Kim, Chun-Il; Moon, Gi-Hak; Kwon, Tae-Gyun; Park, Jae-Shin

2015-09-01

To evaluate prospectively the role of prostate-specific antigen (PSA) density in predicting Gleason score upgrading in prostate cancer patients eligible for active surveillance (T1/T2, biopsy Gleason score≤6, PSA≤10 ng/mL, and ≤2 positive biopsy cores). Between January 2010 and November 2013, among patients who underwent greater than 10-core transrectal ultrasound-guided biopsy, 60 patients eligible for active surveillance underwent radical prostatectomy. By use of the modified Gleason criteria, the tumor grade of the surgical specimens was examined and compared with the biopsy results. Tumor upgrading occurred in 24 patients (40.0%). Extracapsular disease and positive surgical margins were found in 6 patients (10.0%) and 8 patients (17.30%), respectively. A statistically significant correlation between PSA density and postoperative upgrading was found (p=0.030); this was in contrast with the other studied parameters, which failed to reach significance, including PSA, prostate volume, number of biopsy cores, and number of positive cores. Tumor upgrading was also highly associated with extracapsular cancer extension (p=0.000). The estimated optimal cutoff value of PSA density was 0.13 ng/mL(2), obtained by receiver operating characteristic analysis (area under the curve=0.66; p=0.020; 95% confidence interval, 0.53-0.78). PSA density is a strong predictor of Gleason score upgrading after radical prostatectomy in patients eligible for active surveillance. Because tumor upgrading increases the potential for postoperative pathological adverse findings and prognosis, PSA density should be considered when treating and consulting patients eligible for active surveillance.

Use of an extracapsular stabilization technique to repair cruciate ligament ruptures in two avian species.

PubMed

Chinnadurai, Sathya K; Spodnick, Gary; Degernes, Laurel; DeVoe, Ryan S; Marcellin-Little, Denis J

2009-12-01

An extracapsular stabilization technique was used to repair cruciate ligament ruptures in a trumpeter hornbill (Bycanistes bucinator) and an African grey parrot (Psittacus erithacus). The hornbill demonstrated cranial drawer motion and severe rotational instability of the stifle from ruptures of the cranial and caudal cruciate ligaments and stifle joint capsule. The luxation was reduced, and the fibula was cranially transposed, in relation to the tibiotarsus, and anchored with 2 positive profile threaded acrylic pins. A lateral extracapsular stabilization was then performed. The African grey parrot had a traumatic stifle luxation, and an open reduction and a lateral extracapsular stabilization were performed. Both birds regained function of the affected leg by 1 month after surgery. Extracapsular stabilization allows motion of the stifle joint to be maintained during the postoperative recovery period, an advantage over rigid stabilization. Maintaining motion in the stifle joint facilitates physical therapy and can aid in full recovery after avian stifle injuries.

Outcomes of Patients With Head-and-Neck Cancer of Unknown Primary Origin Treated With Intensity-Modulated Radiotherapy

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

Shoushtari, Asal; Saylor, Drew; Kerr, Kara-Lynne

2011-11-01

Purpose: To analyze survival, failure patterns, and toxicity in patients with head-and-neck carcinoma of unknown primary origin (HNCUP) treated with intensity-modulated radiotherapy (IMRT). Methods and materials: Records from 27 patients with HNCUP treated during the period 2002-2008 with IMRT were reviewed retrospectively. Nodal staging ranged from N1 to N3. The mean preoperative dose to gross or suspected disease, Waldeyer's ring, and uninvolved bilateral cervical nodes was 59.4, 53.5, and 51.0 Gy, respectively. Sixteen patients underwent neck dissection after radiation and 4 patients before radiation. Eight patients with advanced nodal disease (N2b-c, N3) or extracapsular extension received chemotherapy. Results: With amore » median follow-up of 41.9 months (range, 25.3-93.9 months) for nondeceased patients, the 5-year actuarial overall survival, disease-free survival, and nodal control rates were 70.9%, 85.2%, and 88.5%, respectively. Actuarial disease-free survival rates for N1, N2, and N3 disease were 100%, 94.1%, and 50.0%, respectively, at 5 years. When stratified by nonadvanced (N1, N2a nodal disease without extracapsular spread) vs. advanced nodal disease (N2b, N2c, N3), the 5-year actuarial disease-free survival rate for the nonadvanced nodal disease group was 100%, whereas for the advanced nodal disease group it was significantly lower at 66.7% (p = 0.017). Three nodal recurrences were observed: in 1 patient with bulky N2b disease and 2 in patients with N3 disease. No nodal failures occurred in patients with N1 or N2a disease who received only radiation and surgery. Conclusion: Definitive IMRT to 50-56 Gy followed by neck dissection results in excellent nodal control and overall and disease-free survival, with acceptable toxicity for patients with T0N1 or nonbulky T0N2a disease without extracapsular spread. Patients with extracapsular spread, advanced N2 disease, or N3 disease may benefit from concurrent chemotherapy, targeted therapeutic agents, or accelerated radiation regimens in addition to surgery.« less

Tibial anatomy in normal small breed dogs including anisometry of various extracapsular stabilizing suture attachment sites.

PubMed

Witte, P G

2015-01-01

To investigate proximal tibial anatomy and its influence on anisometry of extracapsular stabilizing sutures in small dog breeds. Mediolateral radiographs of the femora, stifles, and tibiae of 12 small breed dogs were acquired with the stifles positioned at various angles. Measurements taken included tibial plateau angle (TPA), diaphyseal: proximal tibial angle (DPA), patellar tendon angle (PTA), Z-angle, relative tibial tuberosity width (rTTW), and the distance between six combinations of two femoral and three tibial extra-capsular stabilizing suture (ECS) attachment sites. Theoretical strain through stifle range-of-motion was recorded. The TPA (32° ± 5.8°), DPA (10.2° ± 7.3°), PTA (103.7° ± 6.2°), and Z-angle (70.4° ± 9.0°) were positively correlated with one another (R >0.7), but none were correlated with rTTW (0.93 ± 0.10). The F2-T1 combination of ECS attachment sites had lowest strain for nine stifles. The shortest attachment site separation was at a stifle flexion of 50° for nine stifles. Proximal tibial anatomy measurements could not predict optimal attachment site combination, optimal stifle angle for suture placement, or ECS strain. There is individual variation in the optimal attachment site combination and stifle angle for suture placement, which may influence consistency of outcomes with ECS.

External Validation of the Updated Partin Tables in a Cohort of French and Italian Men

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

Bhojani, Naeem; Department of Urology, University of Montreal, Montreal, PQ; Salomon, Laurent

2009-02-01

Purpose: To test the discrimination and calibration properties of the newly developed 2007 Partin Tables in two European cohorts with localized prostate cancer. Methods: Data on clinical and pathologic characteristics were obtained for 1,064 men treated with radical prostatectomy at the Creteil University Health Center in France (n = 839) and at the Milan University Vita-Salute in Italy (n = 225). Overall discrimination was assessed with receiver operating characteristic curve analysis, which quantified the accuracy of stage predictions for each center. Calibration plots graphically explored the relationship between predicted and observed rates of extracapsular extension (ECE), seminal vesicle invasion (SVI)more » and lymph node invasion (LNI). Results: The rates of ECE, SVI, and LNI were 28%, 14%, and 2% in the Creteil cohort vs. 11%, 5%, and 5% in the Milan cohort. In the Creteil cohort, the accuracy of ECE, SVI, and LNI prediction was 61%, 71%, and 82% vs. 66%, 92% and 75% for the Milan cohort. Important departures were recorded between Partin Tables' predicted and observed rates of ECE, SVI, and LNI within both cohorts. Conclusions: The 2007 Partin Tables demonstrated worse performance in European men than they originally did in North American men. This indicates that predictive models need to be externally validated before their implementation into clinical practice.« less

Traumatic Extra-capsular and Intra-capsular Floating Fat: Fat-fluid Levels of the Knee Revisited

PubMed Central

Davis, Derik L; Vachhani, Prasann

2015-01-01

Floating fat is a sign of acute bone injury at the knee following trauma. The goal of this article is to review the etiology, patterns, and mimickers of extra-capsular and intra-capsular floating fat, with the major emphasis on knee trauma in the acute setting. We will discuss the spectrum of multimodal imaging findings for rare presentations of extra-capsular floating fat, and contrast these with common and atypical forms of intra-capsular lipohemarthrosis, as an aid to the assessment of acute bone trauma at the knee. PMID:26713176

Decision Making in the Management of Extracapsular Fractures of the Proximal Femur - is the Dynamic Hip Screw the Prevailing Gold Standard?

PubMed

Jacob, Joshua; Desai, Ankit; Trompeter, Alex

2017-01-01

Currently, approximately half of all hip fractures are extracapsular, with an incidence as high as 50 in 100,000 in some countries. The common classification systems fail to explain the logistics of fracture classification and whether they all behave in the same manner. The Muller AO classification system is a useful platform to delineate stable and unstable fractures. The Dynamic hip screw (DHS) however, has remained the 'gold standard' implant of choice for application in all extracapsular fractures. The DHS relies on the integrity and strength of the lateral femoral wall as well as the postero-medial fragment. An analysis of several studies indicates significant improvements in design and techniques to ensure a better outcome with intramedullary nails. This article reviews the historical trends that helped to evolve the DHS implant as well as discussing if the surgeon should remain content with this implant. We suggest that the gold standard surgical management of extracapsular fractures can, and should, evolve.

Multimodality Imaging-based Evaluation of Single-Lumen Silicone Breast Implants for Rupture.

PubMed

Seiler, Stephen J; Sharma, Pooja B; Hayes, Jody C; Ganti, Ramapriya; Mootz, Ann R; Eads, Emily D; Teotia, Sumeet S; Evans, W Phil

2017-01-01

Breast implants are frequently encountered on breast imaging studies, and it is essential for any radiologist interpreting these studies to be able to correctly assess implant integrity. Ruptures of silicone gel-filled implants often occur without becoming clinically obvious and are incidentally detected at imaging. Early diagnosis of implant rupture is important because surgical removal of extracapsular silicone in the breast parenchyma and lymphatics is difficult. Conversely, misdiagnosis of rupture may prompt a patient to undergo unnecessary additional surgery to remove the implant. Mammography is the most common breast imaging examination performed and can readily depict extracapsular free silicone, although it is insensitive for detection of intracapsular implant rupture. Ultrasonography (US) can be used to assess the internal structure of the implant and may provide an economical method for initial implant assessment. Common US signs of intracapsular rupture include the "keyhole" or "noose" sign, subcapsular line sign, and "stepladder" sign; extracapsular silicone has a distinctive "snowstorm" or echogenic noise appearance. Magnetic resonance (MR) imaging is the most accurate and reliable means for assessment of implant rupture and is highly sensitive for detection of both intracapsular and extracapsular rupture. MR imaging findings of intracapsular rupture include the keyhole or noose sign, subcapsular line sign, and "linguine" sign, and silicone-selective MR imaging sequences are highly sensitive to small amounts of extracapsular silicone. © RSNA, 2017.

Using 3 Tesla magnetic resonance imaging in the pre-operative evaluation of tongue carcinoma.

PubMed

Moreno, K F; Cornelius, R S; Lucas, F V; Meinzen-Derr, J; Patil, Y J

2017-09-01

This study aimed to evaluate the role of 3 Tesla magnetic resonance imaging in predicting tongue tumour thickness via direct and reconstructed measures, and their correlations with corresponding histological measures, nodal metastasis and extracapsular spread. A prospective study was conducted of 25 patients with histologically proven squamous cell carcinoma of the tongue and pre-operative 3 Tesla magnetic resonance imaging from 2009 to 2012. Correlations between 3 Tesla magnetic resonance imaging and histological measures of tongue tumour thickness were assessed using the Pearson correlation coefficient: r values were 0.84 (p < 0.0001) and 0.81 (p < 0.0001) for direct and reconstructed measurements, respectively. For magnetic resonance imaging, direct measures of tumour thickness (mean ± standard deviation, 18.2 ± 7.3 mm) did not significantly differ from the reconstructed measures (mean ± standard deviation, 17.9 ± 7.2 mm; r = 0.879). Moreover, 3 Tesla magnetic resonance imaging had 83 per cent sensitivity, 82 per cent specificity, 82 per cent accuracy and a 90 per cent negative predictive value for detecting cervical lymph node metastasis. In this cohort, 3 Tesla magnetic resonance imaging measures of tumour thickness correlated highly with the corresponding histological measures. Further, 3 Tesla magnetic resonance imaging was an effective method of detecting malignant adenopathy with extracapsular spread.

Accuracy of high resolution (1.5 tesla) pelvic phased array magnetic resonance imaging (MRI) in staging prostate cancer in candidates for radical prostatectomy: results from a prospective study.

PubMed

Renard-Penna, Raphaële; Rouprêt, Morgan; Comperat, Eva; Ayed, Amine; Coudert, Mathieu; Mozer, Pierre; Xylinas, Evanguelos; Bitker, Marc-Olivier; Grenier, Philippe

2013-05-01

To evaluate the role of pelvic phased array MRI in staging prostate cancer (CaP). We prospectively collected data over 12 months on CaP patients who underwent preoperative MR imaging with a pelvic phased array before radical prostatectomy. MR images were analyzed prospectively by 2 radiologists. MR imaging findings were then correlated with pathologic findings. Overall, 101 patients were included with a mean PSA level of 8 (range 1.8-30). Reader 1 (AUC 0.895, 95% CI 0.791-0.999) had a higher performance than reader 2 (AUC 0.687, 95% CI, 0.555-0.819) and than DRE (AUC 0.728, 95% CI, 0.599-0.857) in discriminating T2 from T3 CaP (P = 0.01). The κ-index of inter-observer agreement was 0.56. A model that combines MRI findings, DRE, PSA, and Gleason score was the most competitive for staging (AUC 0.895, 95% CI, 0.791-0.999). For the multivariate analysis, 3 criteria were significantly associated with extracapsular extension: asymmetry of the neuro-vascular bundles (P = 0.001), asymmetric enhancement of neurovascular bundles (P = 0.02), and bulging of the capsule (P = 0.0003). Pelvic phased array MRI presented satisfying results in its ability to adequately stage CaP and notably in detecting the extracapsular extension of tumors. It is likely to provide reliable information but rather in the hands of an experienced radiologist. Copyright © 2013 Elsevier Inc. All rights reserved.

Surgical perspective of T1799A BRAF mutation diagnostic value in papillary thyroid carcinoma.

PubMed

Brahma, Bayu; Yulian, Erwin Danil; Ramli, Muchlis; Setianingsih, Iswari; Gautama, Walta; Brahma, Putri; Sastroasmoro, Sudigdo; Harimurti, Kuntjoro

2013-01-01

Throughout Indonesia, thyroid cancer is one of the ten commonest malignancies, with papillary thyroid carcinoma (PTC) in our hospital accounting for about 60% of all thyroid nodules. Although fine needle aspiration biopsy (FNAB) is the most reliable diagnostic tool, some nodules are diagnosed as indeterminate and second surgery is common for PTC. The aim of this study was to establish the diagnostic value and feasibility of testing the BRAF T1799A mutation on FNA specimens for improving PTC diagnosis. This prospective study enrolled 95 patients with thyroid nodules and future surgery planned. Results of mutational status were compared with surgical pathology diagnosis. Of the 70 cases included in the final analysis, 62.8% were PTC and the prevalence of BRAF mutation was 38.6%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for BRAF mutation analysis were 36%, 100%, 100% and 48%, respectively. With other data findings, nodules with "onset less than 5 year" and "hard consistency" were proven as diagnostic determinants for BRAF mutation with a probability of 62.5%. This mutation was also a significant risk factor for extra-capsular extension. Molecular analysis of the BRAF T1799A mutation in FNAB specimens has high specificity and positive predictive value for PTC. It could be used in the selective patients with clinical characteristics to facilitate PTC diagnosis and for guidance regarding extent of thyroidectomy.

Surgical Treatment for Extracapsular Condylar Fractures of the Mandible.

PubMed

Closs Ono, Maria C; de Morais, André D; Freitas, Renato da S; de Oliveira E Cruz, Gilvani A

2018-02-26

Condylar fractures are considered the most controversial mandibular fractures, regarding both the diagnosis and the treatment. With the increase in surgical indications for handling this type of fracture, it is important to discuss about the advantages and disadvantages of the several surgical approaches available. This article describes the surgical details and postoperative results of the mini-retromandibular transparotid approach for treating extracapsular condylar fractures of the mandible. In a 1-year period, 16 patients affected by extracapsular condylar fractures with surgical indication were treated with the mini-retromandibular transparotid approach. All the surgeries were executed by the same surgeon. Preoperative and postoperative details of each patient were analyzed. In the postoperatory, only 2 patients had purulent drainage in the associated fractures area and only 1 patient had paresis of the buccal branch of the facial nerve. No scar issues concerning the surgical wound were observed and reintervention was not necessary in any of the patients. The mini-retromandibular transparotid approach offers advantages and should be included as an option for the open treatment of extracapsular condylar fractures of the mandible.

Decision Making in the Management of Extracapsular Fractures of the Proximal Femur – is the Dynamic Hip Screw the Prevailing Gold Standard?

PubMed Central

Jacob, Joshua; Desai, Ankit; Trompeter, Alex

2017-01-01

Currently, approximately half of all hip fractures are extracapsular, with an incidence as high as 50 in 100,000 in some countries. The common classification systems fail to explain the logistics of fracture classification and whether they all behave in the same manner. The Muller AO classification system is a useful platform to delineate stable and unstable fractures. The Dynamic hip screw (DHS) however, has remained the ‘gold standard’ implant of choice for application in all extracapsular fractures. The DHS relies on the integrity and strength of the lateral femoral wall as well as the postero-medial fragment. An analysis of several studies indicates significant improvements in design and techniques to ensure a better outcome with intramedullary nails. This article reviews the historical trends that helped to evolve the DHS implant as well as discussing if the surgeon should remain content with this implant. We suggest that the gold standard surgical management of extracapsular fractures can, and should, evolve. PMID:29290858

[Oncological results of active surveillance in prostate cancer: A retrospective multicentric cohort].

PubMed

Mortier, P; Bastide, C; Lechevallier, E; Walz, J; Fournier, R; Savoie, P-H; Ben Othman, K; Giorgi, R; André, M; Giusiano, S; Rossi, D

2017-01-01

To report oncological outcomes of patients with prostate cancer undergoing active surveillance according to SURACAP criteria. This multicentric study included patients who were initially treated with active surveillance for localized prostate cancer according to the SURACAP criteria. The duration of active surveillance as well as the causes of discontinuing the protocol and the definitive pathological results of patients who further underwent radical prostatectomy were retrospectively evaluated. The predictors of discontinuing active surveillance were assessed using a univariable Cox Model. In addition, the predictive value of initial MRI was assessed for patients who performed such imagery. Between 2007 and 2013, 80 patients were included, with a median age of 64 years [47-74]. Median follow-up was 52.9 months [24-108]. At 5 years follow-up, 43.4% patients were still under surveillance. Among patients that underwent surgery, 17.8% had an extra-capsular extension. The risk of discontinuing was not significantly greater for patients with tumor size of 2 or 3mm versus 1mm (HR=0.9 [0.46-1.75], P=0.763), 2 positives cores versus 1 (HR=0.98 [0.48-2.02], P=0.967), T2a vs. T1c stage (HR=2.18 [0.77-6.18], P=0.133), increased PSA level (HR=1 [0.96-1.15], P=0.975) or the patient's age (HR=1 [0.93-1.16], P=0.966). Among the 50 patients who performed initial MRI, the results of such imagery was not significantly associated to the risk of discontinuing active surveillance MRI (HR=1.49 [0.63-3.52], P=0.36). Although this study reveals a high rate of release from active surveillance at 5 years, the rate of extra-capsular tumors reported in the group of patients that underwent surgery is among the lowest in literature. 4. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Germline PRKACA amplification leads to Cushing syndrome caused by 3 adrenocortical pathologic phenotypes.

PubMed

Carney, J Aidan; Lyssikatos, Charalampos; Lodish, Maya B; Stratakis, Constantine A

2015-01-01

We describe the pathology of 5 patients with germline PRKACA copy number gain and Cushing syndrome: 4 males and 1 female, aged 2 to 43 years, including a mother and son. Imaging showed normal or slightly enlarged adrenal glands in 4 patients and a unilateral mass in the fifth. Biochemically, the patients had corticotropin-independent hypercortisolism. Four underwent bilateral adrenalectomy; unilateral adrenalectomy was performed in the patient with the adrenal mass. Pathologically, 3 patients, including the 1 with the tumor (adenoma), had primary pigmented nodular adrenocortical disease with extranodular cortical atrophy and mild intracapsular and extracapsular extension of cortical cells. The other 2 patients had cortical hyperplasia and prominent capsular and extracapsular micronodular cortical hyperplasia. Immunoperoxidase staining revealed differences for synaptophysin, inhibin-A, and Ki-67 (nuclei) in the atrophic cortices (patients 1, 2, and 3) and hyperplastic cortices (patients 4 and 5) and for Ki-67 (nuclei) and vimentin in the extracortical nodules in the 2 groups of patients. β-Catenin stained the cell membrane, cytoplasm, and nuclei of the adenoma. The patients were well at follow-up (1-23 years); 24-hour urinary cortisol excretion was elevated in the patient who had unilateral adrenalectomy. Copyright © 2014 Elsevier Inc. All rights reserved.

Management of extra-capsular temporo-mandibular joint ankylosis: does conservative approach to treatment have a role?

PubMed

Anyanechi, C E; Osunde, O D; Bassey, G O

2015-06-01

The conventional management of fibrous extracapsular temporo-mandibular joint (TMJ) ankylosis, a debilitating disease, is associated with surgical complications and financial burden on the patients. To assess the outcome of conservative approach to the management of fibrous extracapsular TMJ ankylosis. This is a prospective study of patients who presented at the Dental and Maxillofacial Surgery Clinic of the University of Calabar Teaching Hospital, Nigeria, during the period from January 1999 to December 2012 with a history of inability to open the mouth diagnosed as fibrous extracapsular TMJ ankylosis. Twenty-one subjects were treated and their ages ranged from 11 to 22 years with mean at 15.0 years. There were 13 (61.9 %) males and 8 (38.1 %) females with male: female ratio of 1.6:1. The aetiological factor that predisposed to formation of extracapsular TMJ ankylosis was facial trauma. There was no facial asymmetry and the side distribution of the affliction showed that 1 (4.8 %) was bilateral while 20 (95.2 %) were unilateral. Eight cases (38.1 %) were incomplete ankylosis while the rest (n = 13, 61.9 %) were complete. The shorter the duration of fibrous ankylosis and the greater the initial inter-incisal distance before treatment, the better the treatment outcome. The outcome of treatment suggests that the conservative approach to management of this condition was beneficial to these patients because they presented early. However, randomized controlled clinical trials are needed to validate this treatment option.

Manual small incision extracapsular cataract surgery in Australia.

PubMed

van Zyl, Lourens; Kahawita, Shyalle; Goggin, Michael

2014-11-01

Examination of the results and describing the technique of manual small incision extracapsular cataract extraction on patients with advanced cataracts in urban Australia. A descriptive case series. Thirty-eight patients at three public hospitals, one tertiary and two secondary ophthalmic units in urban Australia. Forty eyes with dense mature cataracts with hand movement vision or worse underwent a planned manual small incision extracapsular cataract extraction instead of traditional phaco-emulsification. Postoperative visual aquity, surgically induced astigmatism and complications. Seventy-eight per cent of patients had an uncorrected visual acuity of 6/12 or better on the first postoperative day. Eighty-three per cent of patients had a distance corrected visual acuity of 6/9 or better 3 months postoperatively. One case was complicated by a posterior capsule rupture. No cases of endophthalmitis were reported. The summated vector mean of the surgically induced astigmatism was 0.089D at 93°. Manual small incision extracapsular cataract extraction is an efficacious cataract surgery technique with good visual outcome and is a safe alternative to phaco-emulsification in suitable cases in a first-world setting. © 2014 Royal Australian and New Zealand College of Ophthalmologists.

Small size of metastatic lymph nodes with extracapsular spread greatly impacts treatment outcomes in oral squamous cell carcinoma patients.

PubMed

Michikawa, C; Izumo, T; Sumino, J; Morita, T; Ohyama, Y; Michi, Y; Uzawa, N

2018-07-01

Extracapsular spread (ECS) of metastatic lymph nodes from oral carcinoma is the most significant prognostic predictor of a poor treatment outcome. However, only a few reports on prognostic factors in ECS-positive cases have been investigated. To address this problem, a detailed examination of ECS pathology was conducted to determine the prognostic factors of oral squamous cell carcinoma (OSCC) with ECS of metastatic lymph nodes. This study involved 63 OSCC patients with at least one pathologically metastatic node with ECS. Among the 229 metastatic lymph nodes, 149 exhibited ECS. Univariate analysis revealed that a poor outcome and recurrence were significantly associated with the number of ECS-positive nodes, density of ECS, and the minor axis of the smallest ECS-positive node. However, multivariate analysis identified only small size of ECS-positive nodes as a significant and independent factor predicting recurrence and a poor outcome. Thus, small size of ECS-positive nodes is the most important prognostic indicator for OSCC with ECS in metastatic lymph nodes. The classification of ECS status using the minor axis of ECS-positive nodes may be useful for further prediction of a poorer prognosis in OSCC cases. Standardization of ECS diagnosis and multicenter prospective studies will be required to confirm and refine these findings. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Determining Which Patients Require Irradiation of the Supraclavicular Nodal Area After Surgery for N1 Breast Cancer

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

Yu, Jeong Il; Park, Won, E-mail: wonp68@skku.ed; Huh, Seung Jae

2010-11-15

Purpose: We designed this study to determine which patients have a high risk of supraclavicular node recurrence in N1 breast cancer previously treated with surgery but not having received supraclavicular radiation therapy (SCRT) and to identify which patients needed SCRT. Methods and Materials: We performed a retrospective review of 448 pathologic N1 breast cancer patients treated with mastectomy or breast-conserving treatment, but without SCRT, between 1994 and 2003. Mastectomy was performed in 302 patients (67.4%). The median number of axillary nodes dissected was 17 (range, 5-53). Systemic chemotherapy was administered in 443 patients (98.9%), and 144 patients received radiation aftermore » breast-conserving surgery. The median follow-up was 88 months (range, 15-170 months). Results: At follow-up, the treatment failed in 101 patients (22.5%), and 39 patients (8.7%) had supraclavicular node recurrence. Prognostic factors in supraclavicular node recurrence included lymphovascular invasion (p < 0.0001), extracapsular extension (p < 0.0001), the number of involved axillary nodes (p = 0.0003), and the level of involved axillary nodes (p = 0.012) in univariate and multivariate analyses. The total number of prognostic factors correlated well with supraclavicular node recurrence. In the analysis of 5-year supraclavicular node recurrence-free survival, patients with two or more factors showed a significantly higher recurrence rate than did patients with fewer than two factors (96.8% and 72.9%, respectively; p < 0.0001). Conclusions: The prognostic factors associated with supraclavicular node recurrence were lymphovascular invasion, extracapsular extension, and the number and level of involved axillary nodes. Patients with two or more prognostic factors might benefit from SCRT.« less

Solid Lymph Nodes as an Imaging Biomarker for Risk Stratification in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma.

PubMed

Rath, T J; Narayanan, S; Hughes, M A; Ferris, R L; Chiosea, S I; Branstetter, B F

2017-07-01

Human papillomavirus-related oropharyngeal squamous cell carcinoma is associated with cystic lymph nodes on CT and has a favorable prognosis. A subset of patients with aggressive disease experience treatment failure. Our aim was to determine whether the extent of cystic lymph node burden on staging CT can serve as an imaging biomarker to predict treatment failure in human papillomavirus-related oropharyngeal squamous cell carcinoma. We identified patients with human papilloma virus-related oropharyngeal squamous cell carcinoma and staging neck CTs. Demographic and clinical variables were recorded. We retrospectively classified the metastatic lymph node burden on CT as cystic or solid and assessed radiologic extracapsular spread. Biopsy, subsequent imaging, or clinical follow-up was the reference standard for treatment failure. The primary end point was disease-free survival. Cox proportional hazard regression analyses of clinical, demographic, and anatomic variables for treatment failure were performed. One hundred eighty-three patients were included with a mean follow-up of 38 months. In univariate analysis, the following variables had a statistically significant association with treatment failure: solid-versus-cystic lymph nodes, clinical T-stage, clinical N-stage, and radiologic evidence of extracapsular spread. The multivariate Cox proportional hazard model resulted in a model that included solid-versus-cystic lymph nodes, T-stage, and radiologic evidence of extracapsular spread as independent predictors of treatment failure. Patients with cystic nodal metastasis at staging had significantly better disease-free survival than patients with solid lymph nodes. In human papilloma virus-related oropharyngeal squamous cell carcinoma, patients with solid lymph node metastases are at higher risk for treatment failure with worse disease-free survival. Solid lymph nodes may serve as an imaging biomarker to tailor individual treatment regimens. © 2017 by American Journal of Neuroradiology.

Computed tomography detection of extracapsular spread of squamous cell carcinoma of the head and neck in metastatic cervical lymph nodes.

PubMed

Carlton, Joshua A; Maxwell, Adam W; Bauer, Lyndsey B; McElroy, Sara M; Layfield, Lester J; Ahsan, Humera; Agarwal, Ajay

2017-06-01

Background and purpose In patients with squamous cell carcinoma of the head and neck (HNSCC), extracapsular spread (ECS) of metastases in cervical lymph nodes affects prognosis and therapy. We assessed the accuracy of intravenous contrast-enhanced computed tomography (CT) and the utility of imaging criteria for preoperative detection of ECS in metastatic cervical lymph nodes in patients with HNSCC. Materials and methods Preoperative intravenous contrast-enhanced neck CT images of 93 patients with histopathological HNSCC metastatic nodes were retrospectively assessed by two neuroradiologists for ECS status and ECS imaging criteria. Radiological assessments were compared with histopathological assessments of neck dissection specimens, and interobserver agreement of ECS status and ECS imaging criteria were measured. Results Sensitivity, specificity, positive predictive value, and accuracy for overall ECS assessment were 57%, 81%, 82% and 67% for observer 1, and 66%, 76%, 80% and 70% for observer 2, respectively. Correlating three or more ECS imaging criteria with histopathological ECS increased specificity and positive predictive value, but decreased sensitivity and accuracy. Interobserver agreement for overall ECS assessment demonstrated a kappa of 0.59. Central necrosis had the highest kappa of 0.74. Conclusion CT has moderate specificity for ECS assessment in HNSCC metastatic cervical nodes. Identifying three or more ECS imaging criteria raises specificity and positive predictive value, therefore preoperative identification of multiple criteria may be clinically useful. Interobserver agreement is moderate for overall ECS assessment, substantial for central necrosis. Other ECS CT criteria had moderate agreement at best and therefore should not be used individually as criteria for detecting ECS by CT.

Treatment of medial shoulder joint instability in dogs by extracapsular stabilization with a prosthetic ligament: 39 cases (2008-2013).

PubMed

O'Donnell, Erica M; Canapp, Sherman O; Cook, James L; Pike, Fred

2017-11-01

OBJECTIVE To investigate clinical outcomes for dogs surgically treated for medial shoulder joint instability (MSI) by extracapsular stabilization with a prosthetic ligament. DESIGN Retrospective multicenter case series. ANIMALS 39 client-owned dogs. PROCEDURES Medical records of 3 veterinary medical centers were searched to identify dogs with MSI diagnosed by clinical examination and arthroscopic assessment and treated by extracapsular stabilization with a prosthetic ligament. A minimum 6-month follow-up period was required for study inclusion. Signalment, function or use of the dog, duration of clinical signs, clinical and diagnostic imaging data, MSI grade (1 [mild] to 4 [complete luxation]), follow-up duration, complications, and outcome data were recorded. RESULTS All grades of MSI were represented. Implants were placed successfully in all dogs. Complications (4 major and 2 minor) were recorded for 6 of 39 (15%) dogs; all were treated successfully. Function at the time of last follow-up (6 to 68 months) was deemed full in 30 of 39 (77%) dogs and acceptable in 9 (23%). CONCLUSIONS AND CLINICAL RELEVANCE Surgical treatment of MSI in dogs by extracapsular stabilization with a prosthetic ligament was associated with a complication rate considered acceptable for orthopedic procedures. All patient outcomes were considered successful.

Independent Predictors of Prognosis Based on Oral Cavity Squamous Cell Carcinoma Surgical Margins.

PubMed

Buchakjian, Marisa R; Ginader, Timothy; Tasche, Kendall K; Pagedar, Nitin A; Smith, Brian J; Sperry, Steven M

2018-05-01

Objective To conduct a multivariate analysis of a large cohort of oral cavity squamous cell carcinoma (OCSCC) cases for independent predictors of local recurrence (LR) and overall survival (OS), with emphasis on the relationship between (1) prognosis and (2) main specimen permanent margins and intraoperative tumor bed frozen margins. Study Design Retrospective cohort study. Setting Tertiary academic head and neck cancer program. Subjects and Methods This study included 426 patients treated with OCSCC resection between 2005 and 2014 at University of Iowa Hospitals and Clinics. Patients underwent excision of OCSCC with intraoperative tumor bed frozen margin sampling and main specimen permanent margin assessment. Multivariate analysis of the data set to predict LR and OS was performed. Results Independent predictors of LR included nodal involvement, histologic grade, and main specimen permanent margin status. Specifically, the presence of a positive margin (odds ratio, 6.21; 95% CI, 3.3-11.9) or <1-mm/carcinoma in situ margin (odds ratio, 2.41; 95% CI, 1.19-4.87) on the main specimen was an independent predictor of LR, whereas intraoperative tumor bed margins were not predictive of LR on multivariate analysis. Similarly, independent predictors of OS on multivariate analysis included nodal involvement, extracapsular extension, and a positive main specimen margin. Tumor bed margins did not independently predict OS. Conclusion The main specimen margin is a strong independent predictor of LR and OS on multivariate analysis. Intraoperative tumor bed frozen margins do not independently predict prognosis. We conclude that emphasis should be placed on evaluating the main specimen margins when estimating prognosis after OCSCC resection.

Management of well-differentiated thyroid cancer in 2010: perspectives of a head and neck surgical oncologist.

PubMed

Urken, Mark L

2010-01-01

To review the terminology and controversy regarding the performance of prophylactic lymph node dissection for patients without evidence suggestive of pathologic adenopathy. Terminology of lymph node levels in the neck and chest, and the issues regarding lymph node dissection, are reviewed. In addition, differences between lymph nodes are reviewed and discussed. Management of lymph nodes in this disease process has become the most contentious aspect of surgical decision-making due to the ambiguity of their prognostic significance and the prevalence of nodal metastases in very early primary tumors. Performance of prophylactic central compartment node dissection is not technically any more difficult than therapeutic node dissection when clinically significant nodes are encountered. It is therefore reasonable to consider this technique as an important adjunct to a total thyroidectomy for the purpose of enhanced disease staging, prevention of nodal recurrence, and avoidance of having to re-enter the previously operated central compartment. A recent study is reviewed and discussed in detail. The literature regarding the prognostic significance of extracapsular spread in lymph nodes is also presented. Morphologic characteristics of metastatic lymph nodes in thyroid cancer vary greatly. However, the reporting of these differences is lacking. The presence of extracapsular extension in a lymph node has prognostic significance. The clinician should be aware of these variations and the impact that they may have on recurrence risk and disease-specific survival.

The human anterior lens capsule--an attempted chemical debridement of epithelial cells by ethylenediaminetetracetic acid (EDTA) and trypsin.

PubMed Central

Humphry, R C; Davies, E G; Jacob, T J; Thompson, G M

1988-01-01

The addition of edetic acid (EDTA) or trypsin to the infusion during a simulated extracapsular cataract extraction on cadaver eyes facilitates the removal of lens epithelial cells from the anterior capsule. Modification of the chemical composition of infusions used during extracapsular surgery may maximise lens epithelial cell removal and hence reduce the incidence of opacification of the posterior capsule after cataract extraction. Images PMID:3134044

An outbreak of endophthalmitis after extracapsular cataract surgery probably caused by endotoxin contaminated distilled water used to dissolve acetylcholine.

PubMed

Boks, T; van Dissel, J T; Teterissa, N; Ros, F; Mahmut, M H; Utama, E D; Rol, M; van Asdonk, P; Airiani, S; van Meurs, J C

2006-09-01

To study possible causes of an outbreak of severe endophthalmitis after planned extracapsular cataract surgery in Medan, Indonesia. In a 3 week period in November 2001, 17 of 43 patients developed signs of endophthalmitis after planned extracapsular cataract surgery. A search for possible causes was undertaken 4 months later. In autoclaved stored distilled water used to dissolve acetylcholine (used in 16 of 17 patients with endophthalmitis) a high amount of endotoxin was detected in a human blood essay, as well as a small number of non-typeable Pseudomonas spp. These findings suggest that distilled water used as solvent for acetylcholine was responsible for this outbreak of endophthalmitis. As a consequence, we now rely on solvents that are regularly checked for impurities such as an intravenous infusion fluid, rather than on vials with distilled water that is presumed to be sterile and kept for some time.

Pleomorphic adenoma of the accessory parotid gland: case report and reappraisal of intraoral extracapsular dissection for management.

PubMed

Tsegga, Tibebu M; Britt, Jennifer D; Ellwanger, Aragon R

2015-03-01

Pleomorphic adenoma is the most common tumor of the major and minor salivary glands. Rarely is it found evolving from an ectopic location of major salivary glandular tissue in the mid cheek. A healthy 56-year-old woman presented to our institution with a 20-year duration of a slowly growing right cheek soft tissue mass that was causing facial asymmetry. No significant functional or neurosensory dysfunction was appreciated. Radiologic examination showed a heterogeneous, hyperintense, well-delineated mass within the region of the right buccal fat pad. Fine-needle aspiration biopsy showed benign salivary gland elements consistent with pleomorphic adenoma. The decision was made to perform intraoral extracapsular dissection for removal. Discussion of the clinical assessment and magnetic resonance imaging evaluation with an emphasis on intraoral extracapsular dissection for definitive surgical therapy of longstanding benign salivary gland tumors is emphasized. Published by Elsevier Inc.

Extracapsular cataract extraction with and without intra-ocular lenses in black patients.

PubMed

Welsh, N H

1992-04-04

Cataracts are the commonest cause of blindness in Third-World countries and cataract extraction is the commonest eye operation performed anywhere. Patients require optical correction after surgery either in the form of an intra-ocular lens (IOL) or bifocal aphakic glasses. The standard operative procedure in First-World countries is an extracapsular cataract extraction with an IOL. This type of operation has been thought to be contraindicated in black patients because of the complications and lack of adequate postoperative follow-up. During 1987-1989 3,144 cataract extractions, of which 2,157 were simple extracapsular extractions and 987 had IOLs inserted, were performed at the above hospitals. The two groups were compared for complications and visual results. The complications were similar in both groups and were acceptable, therefore posterior lens implantation confers no additional risk on routine extracapsular cataract extraction. The visual results in the IOL group with and without additional glasses were compared with those patients who had correcting aphakic glasses. In the corrected IOL group, 98% of patients saw better than 6/24, whereas in the aphakic spectacle group, 87.5% saw 6/24 or better. Since the majority of black patients cannot afford costly prescribed spectacles, it was important to analyse the visual acuity in patients who had IOLs and were uncorrected; 81.6% saw 6/24 or better. IOLs in black patients are therefore indicated but the disadvantage is the cost.

Identification of Differentially Expressed Proteins in Direct Expressed Prostatic Secretions of Men with Organ-confined Versus Extracapsular Prostate Cancer*

PubMed Central

Kim, Yunee; Ignatchenko, Vladimir; Yao, Cindy Q.; Kalatskaya, Irina; Nyalwidhe, Julius O.; Lance, Raymond S.; Gramolini, Anthony O.; Troyer, Dean A.; Stein, Lincoln D.; Boutros, Paul C.; Medin, Jeffrey A.; Semmes, O. John; Drake, Richard R.; Kislinger, Thomas

2012-01-01

Current protocols for the screening of prostate cancer cannot accurately discriminate clinically indolent tumors from more aggressive ones. One reliable indicator of outcome has been the determination of organ-confined versus nonorgan-confined disease but even this determination is often only made following prostatectomy. This underscores the need to explore alternate avenues to enhance outcome prediction of prostate cancer patients. Fluids that are proximal to the prostate, such as expressed prostatic secretions (EPS), are attractive sources of potential prostate cancer biomarkers as these fluids likely bathe the tumor. Direct-EPS samples from 16 individuals with extracapsular (n = 8) or organ-confined (n = 8) prostate cancer were used as a discovery cohort, and were analyzed in duplicate by a nine-step MudPIT on a LTQ-Orbitrap XL mass spectrometer. A total of 624 unique proteins were identified by at least two unique peptides with a 0.2% false discovery rate. A semiquantitative spectral counting algorithm identified 133 significantly differentially expressed proteins in the discovery cohort. Integrative data mining prioritized 14 candidates, including two known prostate cancer biomarkers: prostate-specific antigen and prostatic acid phosphatase, which were significantly elevated in the direct-EPS from the organ-confined cancer group. These and five other candidates (SFN, MME, PARK7, TIMP1, and TGM4) were verified by Western blotting in an independent set of direct-EPS from patients with biochemically recurrent disease (n = 5) versus patients with no evidence of recurrence upon follow-up (n = 10). Lastly, we performed proof-of-concept SRM-MS-based relative quantification of the five candidates using unpurified heavy isotope-labeled synthetic peptides spiked into pools of EPS-urines from men with extracapsular and organ-confined prostate tumors. This study represents the first efforts to define the direct-EPS proteome from two major subclasses of prostate cancer using shotgun proteomics and verification in EPS-urine by SRM-MS. PMID:22986220

An outbreak of endophthalmitis after extracapsular cataract surgery probably caused by endotoxin contaminated distilled water used to dissolve acetylcholine

PubMed Central

Boks, T; van Dissel, J T; Teterissa, N; Ros, F; Mahmut, M H; Utama, E D; Rol, M; van Asdonk, P; Airiani, S; van Meurs, J C

2006-01-01

Aim To study possible causes of an outbreak of severe endophthalmitis after planned extracapsular cataract surgery in Medan, Indonesia. Methods In a 3 week period in November 2001, 17 of 43 patients developed signs of endophthalmitis after planned extracapsular cataract surgery. A search for possible causes was undertaken 4 months later. Results In autoclaved stored distilled water used to dissolve acetylcholine (used in 16 of 17 patients with endophthalmitis) a high amount of endotoxin was detected in a human blood essay, as well as a small number of non‐typeable Pseudomonas spp. Conclusions These findings suggest that distilled water used as solvent for acetylcholine was responsible for this outbreak of endophthalmitis. As a consequence, we now rely on solvents that are regularly checked for impurities such as an intravenous infusion fluid, rather than on vials with distilled water that is presumed to be sterile and kept for some time. PMID:16687451

Once-Daily Radiation Therapy for Inflammatory Breast Cancer

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

Brown, Lindsay; Harmsen, William; Blanchard, Miran

2014-08-01

Purpose: Inflammatory breast cancer (IBC) is a rare and aggressive breast cancer variant treated with multimodality therapy. A variety of approaches intended to escalate the intensity and efficacy of radiation therapy have been reported, including twice-daily radiation therapy, dose escalation, and aggressive use of bolus. Herein, we examine our outcomes for patients treated with once-daily radiation therapy with aggressive bolus utilization, focusing on treatment technique. Methods and Materials: A retrospective review of patients with nonmetastatic IBC treated from January 1, 2000, through December 31, 2010, was performed. Locoregional control (LRC), disease-free survival (DFS), overall survival (OS) and predictors thereof weremore » assessed. Results: Fifty-two women with IBC were identified, 49 (94%) of whom were treated with neoadjuvant chemotherapy. All underwent mastectomy followed by adjuvant radiation therapy. Radiation was delivered in once-daily fractions of 1.8 to 2.25 Gy (median, 2 Gy). Patients were typically treated with daily 1-cm bolus throughout treatment, and 33 (63%) received a subsequent boost to the mastectomy scar. Five-year Kaplan Meier survival estimates for LRC, DFS, and OS were 81%, 56%, and 64%, respectively. Locoregional recurrence was associated with poorer OS (P<.001; hazard ratio [HR], 4.1). Extracapsular extension was associated with worse LRC (P=.02), DFS (P=.007), and OS (P=.002). Age greater than 50 years was associated with better DFS (P=.03). Pathologic complete response was associated with a trend toward improved LRC (P=.06). Conclusions: Once-daily radiation therapy with aggressive use of bolus for IBC results in outcomes consistent with previous reports using various intensified radiation therapy regimens. LRC remains a challenge despite modern systemic therapy. Extracapsular extension, age ≤50 years, and lack of complete response to chemotherapy appear to be associated with worse outcomes. Novel strategies are needed in IBC, particularly among these subsets of patients.« less

A new technique of extracapsular restoration with a tie made of ethylene tetrafluoroethylene (ETFE) for rupture of the cranial cruciate ligament in dogs.

PubMed

Yamada, E; Imayama, Y; Katano, S; Nagashima, F; Shibata, T

1996-06-01

A new extracapsular technique for repair of canine cranial cruciate ligament rupture using an ethylene tetrafluoroethylene (ETFE) tie was presented. Eighteen dogs (body weight: 6.0-46 kg) with this problem were used for this study. The advantages of this method were 1) the operation was easily performed. 2) Joint could be stabilized by proper fixation with microadjustment during operation. 3) This method presented less surgical invasion than the intracapsular one, since wide incision was not conducted over peripheral tissue of the stifle joint.

The significance of circulating tumor cells in prostate cancer patients undergoing adjuvant or salvage radiation therapy

PubMed Central

Lowes, L E; Lock, M; Rodrigues, G; D'Souza, D; Bauman, G; Ahmad, B; Venkatesan, V; Allan, A L; Sexton, T

2015-01-01

Background: Following radical prostatectomy, success of adjuvant and salvage radiation therapy (RT) is dependent on the absence of micrometastatic disease. However, reliable prognostic/predictive factors for determining this are lacking. Therefore, novel biomarkers are needed to assist with clinical decision-making in this setting. Enumeration of circulating tumor cells (CTCs) using the regulatory-approved CellSearch System (CSS) is prognostic in metastatic prostate cancer. We hypothesize that CTCs may also be prognostic in the post-prostatectomy setting. Methods: Patient blood samples (n=55) were processed on the CSS to enumerate CTCs at 0, 6, 12 and 24 months after completion of RT. CTC values were correlated with predictive/prognostic factors and progression-free survival. Results: CTC status (presence/absence) correlated significantly with positive margins (increased likelihood of CTCneg disease; P=0.032), and trended toward significance with the presence of seminal vesicle invasion (CTCpos; P=0.113) and extracapsular extension (CTCneg; P=0.116). Although there was a trend toward a decreased time to biochemical failure (BCF) in baseline CTC-positive patients (n=9), this trend was not significant (hazard ratio (HR)=0.3505; P=0.166). However, CTC-positive status at any point (n=16) predicted for time to BCF (HR=0.2868; P=0.0437). Conclusions: One caveat of this study is the small sample size utilized (n=55) and the low number of patients with CTC-positive disease (n=16). However, our results suggest that CTCs may be indicative of disseminated disease and assessment of CTCs during RT may be helpful in clinical decision-making to determine, which patients may benefit from RT versus those who may benefit more from systemic treatments. PMID:26238233

Prostate cancer: role of pretreatment multiparametric 3-T MRI in predicting biochemical recurrence after radical prostatectomy.

PubMed

Park, Jung Jae; Kim, Chan Kyo; Park, Sung Yoon; Park, Byung Kwan; Lee, Hyun Moo; Cho, Seong Whi

2014-05-01

The purpose of this study is to retrospectively investigate whether pretreatment multiparametric MRI findings can predict biochemical recurrence in patients who underwent radical prostatectomy (RP) for localized prostate cancer. In this study, 282 patients with biopsy-proven prostate cancer who received RP underwent pretreatment MRI using a phased-array coil at 3 T, including T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI). MRI variables included apparent tumor presence on combined imaging sequences, extracapsular extension, and tumor size on DWI or DCE-MRI. Clinical variables included baseline prostate-specific antigen (PSA) level, clinical stage, and Gleason score at biopsy. The relationship between clinical and imaging variables and biochemical recurrence was evaluated using Cox regression analysis. After a median follow-up of 26 months, biochemical recurrence developed in 61 patients (22%). Univariate analysis revealed that all the imaging and clinical variables were significantly associated with biochemical recurrence (p < 0.01). On multivariate analysis, however, baseline PSA level (p = 0.002), Gleason score at biopsy (p = 0.024), and apparent tumor presence on combined T2WI, DWI, and DCE-MRI (p = 0.047) were the only significant independent predictors of biochemical recurrence. Of the independent predictors, apparent tumor presence on combined T2WI, DWI, and DCE-MRI showed the highest hazard ratio (2.38) compared with baseline PSA level (hazard ratio, 1.05) and Gleason score at biopsy (hazard ratio, 1.34). The apparent tumor presence on combined T2WI, DWI, and DCE-MRI of pretreatment MRI is an independent predictor of biochemical recurrence after RP. This finding may be used to construct a predictive model for biochemical recurrence after surgery.

Depth of invasion, size and number of metastatic nodes predicts extracapsular spread in early oral cancers with occult metastases.

PubMed

Mair, Manish D; Shetty, Rathan; Nair, Deepa; Mathur, Yash; Nair, Sudhir; Deshmukh, Anuja; Thiagarajan, Shiva; Pantvaidya, Gouri; Lashkar, Sarbani; Prabhash, Kumar; Chaukar, Devendra; Pai, Prathmesh; Cruz, Anil D; Chaturvedi, Pankaj

2018-06-01

Presence of extracapsular spread (ECS) significantly decreases survival in oral cancer patients. Considering its prognostic impact, we have studied the incidence and factors predicting ECS in clinically node negative early oral cancers. We performed a retrospective chart review of 354 treatment naïve clinically node negative early oral cancer patients operated between 2012 and 2014. Chi-square test and logistic regression were used for identifying predictors of ECS, while cox-regression test was used for survival analysis. The incidence of occult nodal metastasis was 28.5% (101/354). Among them, ECS was seen in 15.3%(54/354) patients. The incidence of ECS in T1 and T2 lesion was 13.4% (21/157) and 16.8% (33/197), respectively. The overall incidence of ECS was 48% and 29% in lymph nodes smaller than 10 mm and 5 mm respectively. We found that tumor depth of invasion (>5 mm; p-0.027) and node (metastatic) size >15 mm (p-0.018) were significant predictors of ECS. p N2b disease was seen in 41/354 (11.6%) of which 31/354 (8.7%) had ECS, i.e. 75.6% of pN2b patients been ECS positive (p-0.000). The 3-year OS of patients without nodal metastasis, nodal metastasis without ECS and nodal metastasis with ECS was 88.4%, 66.9% and 59.2% (p-0.000) respectively. A significant number of patients with metastatic nodal size less than 1 cm have ECS which suggests aggressive behavior of the primary tumor. Thus, elective neck dissection is the only way of detecting ECS in these patients which may warrant treatment intensification. Copyright © 2018 Elsevier Ltd. All rights reserved.

Pretreatment Endorectal Coil Magnetic Resonance Imaging Findings Predict Biochemical Tumor Control in Prostate Cancer Patients Treated With Combination Brachytherapy and External-Beam Radiotherapy

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

Riaz, Nadeem; Afaq, Asim; Akin, Oguz

Purpose: To investigate the utility of endorectal coil magenetic resonance imaging (eMRI) in predicting biochemical relapse in prostate cancer patients treated with combination brachytherapy and external-beam radiotherapy. Methods and Materials: Between 2000 and 2008, 279 men with intermediate- or high-risk prostate cancer underwent eMRI of their prostate before receiving brachytherapy and supplemental intensity-modulated radiotherapy. Endorectal coil MRI was performed before treatment and retrospectively reviewed by two radiologists experienced in genitourinary MRI. Image-based variables, including tumor diameter, location, number of sextants involved, and the presence of extracapsular extension (ECE), were incorporated with other established clinical variables to predict biochemical control outcomes.more » The median follow-up was 49 months (range, 1-13 years). Results: The 5-year biochemical relapse-free survival for the cohort was 92%. Clinical findings predicting recurrence on univariate analysis included Gleason score (hazard ratio [HR] 3.6, p = 0.001), PSA (HR 1.04, p = 0.005), and National Comprehensive Cancer Network risk group (HR 4.1, p = 0.002). Clinical T stage and the use of androgen deprivation therapy were not correlated with biochemical failure. Imaging findings on univariate analysis associated with relapse included ECE on MRI (HR 3.79, p = 0.003), tumor size (HR 2.58, p = 0.04), and T stage (HR 1.71, p = 0.004). On multivariate analysis incorporating both clinical and imaging findings, only ECE on MRI and Gleason score were independent predictors of recurrence. Conclusions: Pretreatment eMRI findings predict for biochemical recurrence in intermediate- and high-risk prostate cancer patients treated with combination brachytherapy and external-beam radiotherapy. Gleason score and the presence of ECE on MRI were the only significant predictors of biochemical relapse in this group of patients.« less

Extracapsular dissection for warthin tumors despite the risk of ipsilateral metachronous occurrence.

PubMed

Mantsopoulos, Konstantinos; Goncalves, Miguel; Koch, Michael; Iro, Heinrich

2018-03-24

The ideal extent of surgical intervention for cystadenolymphomas of the parotid gland remains a matter of controversy. The aim of our study was to assess the surgical outcome after extracapsular dissection for cystadenolymphomas of the parotid gland. A further purpose of this study was to examine how the number of primary cystadenolymphomas or the size of the primary lesion influences the possibility of an ipsilateral metachronous tumor occurrence. Retrospective clinical study. A retrospective evaluation of the records was carried out for all patients treated for cystadenolymphomas of the parotid gland by means of extracapsular dissection at a tertiary referral center between 2000 and 2012. Three hundred twenty-seven patients were included in the study. Our analysis detected an overall occurrence rate of ipsilateral metachronous tumors of 3.1% (10/327) with a mean follow-up of 108.4 months. A significant difference in the rate of metachronous lesions between unilocular (1.7%) and multilocular (11.6%) tumors could be detected (χ 2 (1) = 7.342, P < .001). Our analysis was not able to find any significant influence of the maximal tumor size on the rate of metachronous tumors (χ 2 (1) = 0.634, P = .426). One of the most controversial issues in the treatment of cystadenolymphomas of the parotid gland concerns the question of which is the best therapeutic approach to be taken in such patients. Our analysis was able to demonstrate the benefits of extracapsular dissection in the management of solitary as well as carefully selected multicentric cystadenolymphomas with a consistently acceptable surgical outcome. 4. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

[Multiparametric 3T MRI in the routine staging of prostate cancer].

PubMed

Largeron, J P; Galonnier, F; Védrine, N; Alfidja, A; Boyer, L; Pereira, B; Boiteux, J P; Kemeny, J L; Guy, L

2014-03-01

To analyse the detection ability of a multiparametric 3T MRI with phased-array coil in comparison with the pathological data provided by the prostatectomy specimens. Prospective study of 30 months, including 74 patients for whom a diagnosis of prostate cancer had been made on randomized prostate biopsies, and all eligible to a radical prostatectomy. They all underwent multiparametric 3T MRI with pelvic phased-array coil including T2-weighted imaging (T2W), dynamic contrast-enhanced (DCE) and diffusion-weighted imaging (DWI) with an ADC mapping. Each gland was divided in octants. Three specific criteria have been sought (detection ability, capsular contact [CC] and extracapsular extension [ECE]), in comparison with the pathological data provided by the prostatectomy specimens. Five hundred and ninety-two octants were considered with 124 significant tumors (volume ≥ 0.1cm(3)). The general ability of tumor detection had a sensitivity, specificity, PPV and NPV respectively to 72.3%, 87.4%, 83.2% and 78.5%. The estimate of the CC and ECE had a high negative predictive power with specificities and VPN respectively to 96.4% and 95.4% for CC, and 97.5 and 97.7% for ECE. Multiparametric 3T MRI with pelvic phased-array coil appeared to be a reliable imaging technique in clinical and routine practice for the detection of localized prostate cancer. Estimation of the CC and millimeter ECE remains to be clarified, even if the negative predictive power for these parameters seems encouraging. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The Impact of Magnetic Resonance Imaging on Prediction of Extraprostatic Extension and Prostatectomy Outcome in Patients with Low-, Intermediate- and High-Risk Prostate Cancer: Try to Find a Standard.

PubMed

Radtke, Jan Philipp; Hadaschik, Boris A; Wolf, Maya B; Freitag, Martin T; Schwab, Constantin; Alt, Celine; Roth, Wilfried; Duensing, Stefan; Pahernik, Sascha A; Roethke, Matthias C; Schlemmer, Heinz-Peter; Hohenfellner, Markus; Teber, Dogu

2015-12-01

To investigate the value of multiparametric magnetic resonance imaging (mpMRI) and to predict extracapsular extension (ECE), seminal vesicle (SV) infiltration, and a negative surgical margin (SM) status at radical prostatectomy (RP) for different prostate cancer (PC) risk groups. In the study, 805 men underwent 3 tesla mpMRI without endorectal coil before MRI/transrectal ultrasonography-fusion guided prostate biopsy. MRIs were analyzed using the prostate imaging reporting and data system. The cohort was classified into risk groups according to National Comprehensive Cancer Network (NCCN) criteria. Of 132 men who subsequently underwent RP, pathologic stage and SM status at RP were used as reference. Retrospectively, we investigated a European Society of Urogenital Radiology (ESUR) score for ECE and SV-infiltration. Statistical analyses included regression analyses, receiver operating characteristics (ROC), and Youden Index to assess an ESUR-score cutoff. Area under the curve in ROC curve analyses was 0.82 for ESUR-ECE score to detect pT(3a)-disease and 0.77 for ESUR-SV score for pT(3b). Using a cutoff of 4 for ECE and of 2 for SV, the positive predictive value of the ECE-score for harboring pT(3) was 50.0%, 90.0%, and 88.8% for the low-, intermediate- and high-risk cohort. Retrospectively, the use of the ESUR-ECE score preoperatively would have changed the initial surgical plan, according to NCCN criteria, in 31.1% of patients. In the high-risk subgroup, 9/35 (25.7%) patients were correctly assessed as not harboring pT(3) by imaging (ECE score <4), and would have allowed secure robot-assisted radical prostatectomy and nerve-sparing surgery (NSS). When T3 suspicion on preoperative MRI would be taken into account, intraoperative frozen-sections (IFS) might avoid positive SM in 12/18 high-risk patients and an oncologic secure NSS in 8/20 intermediate-risk patients. Prediction of pT(3) disease is crucial to plan NSS and to achieve negative SM in RP. Standardized ECE scoring on mpMRI is an independent predictor of pT(3) and may help to plan RP with oncologic security, even in high-risk patients. In addition, it allows more accurate selection of a subgroup of patients for systematic and MRI-guided IFS.

Linguine sign in musculoskeletal imaging: calf silicone implant rupture.

PubMed

Duryea, Dennis; Petscavage-Thomas, Jonelle; Frauenhoffer, Elizabeth E; Walker, Eric A

2015-08-01

Imaging findings of breast silicone implant rupture are well described in the literature. On MRI, the linguine sign indicates intracapsular rupture, while the presence of silicone particles outside the fibrous capsule indicates extracapsular rupture. The linguine sign is described as the thin, wavy hypodense wall of the implant within the hyperintense silicone on T2-weighted images indicative of rupture of the implant within the naturally formed fibrous capsule. Hyperintense T2 signal outside of the fibrous capsule is indicative of an extracapsular rupture with silicone granuloma formation. We present a rare case of a patient with a silicone calf implant rupture and discuss the MRI findings associated with this condition.

Extraoral approach to mandibular condylar fractures: our experience with 100 cases.

PubMed

Colletti, Giacomo; Battista, Valeria Marinella Augusta; Allevi, Fabiana; Giovanditto, Federica; Rabbiosi, Dimitri; Biglioli, Federico

2014-07-01

Mandibular condylar fractures are very common. The current literature contains many indications and methods of treatment. Extraoral approaches are complicated by the need to avoid injury to the facial nerve. On the other hand intraoral approaches can make fracture reduction and/or fixation difficult. The mini-retromandibular approach provides an excellent view of the surgical field, minimises the risk of injury to the facial nerve, and allows rapid and easy management of condylar fractures. We have collected and reviewed our first 100 condylar fractures treated by means of a mini-retromandibular approach. Between June 2006 and June 2012, Eighty-seven patients with extracapsular condylar fractures underwent open reduction and rigid fixation for 100 extracapsular condylar fractures via a mini-retromandibular approach. Dental occlusion and anatomic reduction were restored in all 100 condylar fractures. Postoperative infection developed in three patients. There was one sialocele and one case of plate fracture. Four patients experienced transient palsy of the buccal branch of the facial nerve. No permanent deficit of any facial nerve branch was observed. No patient showed condylar head resorption. Our experience with the treatment of the first 100 condylar fractures using the mini-retromandibular approach has demonstrated that this technique has allowed the Authors to safely manage extracapsular condylar fractures at all levels. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The effect of extracapsular injuries on growth and development of the mandible condyle: an experimental study in growing dogs.

PubMed

Liu, Siying; Tian, Lei; Ding, Mingchao; Liu, Yanpu; Li, Guiyu; Chen, Jinwu; Ding, Yin

2016-11-01

To investigate the effects of condylar extracapsular injuries on the development of the mandibular condyle and try to find a way to treat condylar hyperplasia by electively using such injuries to restrict the overdeveloped mandibular condyle. Sixty 6-month-old beagle puppies were divided randomly into five groups: blank control; unilateral fracture to the condylar neck; unilateral fracture to the condylar neck treated with rigid internal fixation; unilateral periosteum injury; unilateral decortication of the condylar neck. Computed tomography, 99 m Tc single-photon emission computed tomography, and tetracycline-calcein double-labeling were performed after surgery. The puppies were sacrificed 12 and 24 weeks after surgery. Morphologic analyses and examination of growth activity were done. Unilateral fracture of the condylar neck without fixation caused local morphologic changes during the early postoperative period, but compensatory growth of the condyle altered such changes after healing. The other types of injury failed to inhibit the growth of the condyle and the mandible, whereas functional deviation of the chin was found after unilateral fracture of the condylar neck with or without fixation. The four types of extracapsular injury described here failed to inhibit the growth of the mandibular condyle and could not be selected as alternatives to treat condylar hyperplasia. Copyright © 2016 Elsevier Inc. All rights reserved.

Femoral neck-shaft angle in extra-capsular proximal femoral fracture fixation; does it make a TAD of difference?

PubMed

Walton, N P; Wynn-Jones, H; Ward, M S; Wimhurst, J A

2005-11-01

The effect of femoral neck-shaft angle and implant type on the accuracy of lag screw placement in extra-capsular proximal femoral fracture fixation was investigated. Radiographs of all extra-capsular proximal femoral fractures seen in one unit over 18 months were reviewed. Of 399 cases, 307 (237 female, 70 male) were included in the study as they had no contra-lateral proximal femoral metal work. Femoral neck-shaft angle (NSA) of the uninjured hip and magnification adjusted tip-apex distance (TAD) of femoral head lag screw were measured. Type of fixation implant was 135 degrees classic hip screw (CHS) (n=144) or 130 degrees intra-medullary hip screw (IMHS) (n=163). Mean contra-lateral NSA was 130.2 degrees (112.9--148 degrees ) and 64 patients (58 female, 6 male) had a NSA <125 degrees . Mean adjusted TAD was 18.7 mm (5.8--43.8mm) and 88.9% of cases had a TAD of less than 25 mm. TAD values were significantly greater using an IMHS if NSA was <125 degrees than if NSA was >125 degrees (p=0.028). This was not the case with the CHS. The use of the 130 degrees -IMHS in patients with a NSA <125 degrees leads to poorer lag screw placement than if NSA >125 degrees and caution is advocated when using this device in such cases.

Radiotherapy on hidradenocarcinoma.

PubMed

Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

2011-01-01

Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. POST OPERATIVE RADIOTHERAPY ALLOWS BETTER LOCAL CONTROL AND SHOULD BE MANDATORY WHEN HISTOLOGICAL FEATURES PREDICTIVE OF RECURRENCE ARE PRESENT: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread.

Postoperative staging of the neck dissection using extracapsular spread and lymph node ratio as prognostic factors in HPV-negative head and neck squamous cell carcinoma patients.

PubMed

Majercakova, Katarina; Valero, Cristina; López, Montserrat; García, Jacinto; Farré, Nuria; Quer, Miquel; León, Xavier

2018-02-01

The presence of nodes with extracapsular spread (ECS) and the lymph node ratio (LNR) have prognostic competence in the pathologic evaluation of patients with a head and neck squamous cell carcinoma (HNSCC) treated with a neck dissection. The purpose of this study is to assess the effect of ECS & LNR on prognosis of HPV negative HNSCC patients treated with neck dissection and to compare to 8th edition TNM/AJCC classification. We carried out a retrospective study of 1383 patients with HNSCC treated with a neck dissection between 1985 and 2013. We developed a classification of the patients according to the presence of nodes with ECS and the LNR value with a recursive partitioning analysis (RPA) model. We obtained a classification tree with four terminal nodes: for patients without ECS (including patients pN0) the cut-off point for LNR was 1.6%, while for patients with lymph nodes with ECS it was 11.4%. The 5-year disease-specific survival for patients without ECS/LNR < 1.6% was 83.3%; for patients without ECS/LNR ≥ 1.6% it was 61.5%; for patients with ECS/LNR < 11.4% it was 33.7%; and for patients with ECS/LNR ≥ 11.4% it was 18.5%. The classification obtained with RPA had better discrimination between categories than the 8th edition of the TNM/AJCC classification. ECS status and LNR value proved high prognostic capacity in the pathological evaluation of the neck dissection. The combination of ECS and LNR improved the predictive capacity of the 8th edition of the TNM/AJCC classification in HPV-negative HNSCC patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Role of sentinel lymph node biopsy in oral cancer.

PubMed

Calabrese, L; Bruschini, R; Ansarin, M; Giugliano, G; De Cicco, C; Ionna, F; Paganelli, G; Maffini, F; Werner, J A; Soutar, D

2006-12-01

Squamous cell carcinoma of the oral cavity represents about 2% of all malignant neoplasms and 47% of those developing in the head and neck area. The tongue is the most common site involved, and this incidence is increasing mainly in young people, possibly related to human papilloma virus infections. Prognosis depends on the stage: the 5-year survival rate of tongue squamous cell carcinoma, whatever the T stage, is 73% in pN0 cases, 40% in patients with positive nodes without extracapsular spread (pNl ECS-), and 29% when nodes are metastatic with extracapsular spread (pNl ECS+: p > or = 0.0001). Nodal micrometastases (cN0 pN1) are found in up to 50% of cN0 tongue squamous cell carcinoma patients operated on the neck. At present, no clinical, imaging staging modalities or biological markers are available to diagnose nodal micrometastases. The sentinel node biopsy has been tested since 1996 in order to find a solution to this problem. The sentinel node is the first node reached by the lymphatic stream, assuming an orderly and sequential drainage from the tumour site, and should be predictive of the nodal stage. According to the literature, sentinel node biopsy is a reliable technique in selected cN0 cases, but the procedure is still experimental and should not be performed outside validation trials. Successful application of sentinel node biopsy in the head and neck region requires surgical experience and specific technical devices, including pre-operative lymphoscintigraphy and intra-operative gamma-probe. Moreover, dynamic lymphoscintigraphy seems to be able to show the lymphatic stream from the primary tumour and could allow a selective neck dissection to be tailored thus reducing the related morbidity.

Arthroscopy of the Nondistractable Hip: A Novel Extracapsular Approach

PubMed Central

Doron, Ran; Amar, Eyal; Rath, Ehud; Sampson, Thomas; Ochiai, Derek; Matsuda, Dean K.

2014-01-01

Adequate traction to achieve hip joint distraction is essential for avoiding iatrogenic injury to the joint during hip arthroscopy. An inability to distract the joint is a relative contraindication for hip arthroscopy. This report describes a novel technique involving an extracapsular approach to gain safe access to a hip joint that fails a trial of traction during positioning for hip arthroscopy. The anterolateral portal is established under fluoroscopic guidance. The arthroscope is positioned on the lateral rim of the acetabulum. A shaver, introduced through a modified anterior portal, is used to facilitate capsular exposure. An arthroscopic capsular incision is made proximal to the lateral acetabular rim and extended anteriorly with a radiofrequency probe. Osteoplasty of the anterolateral acetabular rim is carried out with a burr while protecting the labrum. Distraction of the hip is then possible, allowing safe central-compartment access and subsequent chondrolabral procedures. PMID:25685682

Extracapsular local infiltration analgesia in hip arthroscopy: a retrospective study

PubMed Central

Kahn, Timothy L; Adeyemi, Temitope F; Maak, Travis G

2018-01-01

ABSTRACT Many hip arthroscopy patients experience significant pain in the immediate postoperative period. Although peripheral nerve blocks have demonstrated efficacy in alleviating some of this pain, they come with significant costs. Local infiltration analgesia (LIA) may be a significantly cheaper and efficacious treatment modality. Although LIA has been well studied in hip and knee arthroplasty, its efficacy in hip arthroscopy is unclear. The purpose of this retrospective study is to determine the efficacy of a single extracapsular injection of bupivacaine–epinephrine during hip arthroscopy in reducing the rate of elective postoperative femoral nerve blocks. A retrospective review of 100 consecutive patients who underwent primary hip arthroscopy at a single medical center was performed. The control group consisted of 50 patients before the implementation of the current LIA protocol, whereas another 50 patients received a 20-ml extracapsular injection of 0.25% bupivacaine–epinephrine under direct arthroscopic visualization after capsular closure. In the post-anesthesia care unit (PACU), patients were offered a femoral nerve block for uncontrolled pain. The rate of femoral nerve block, and total opioid consumption, was compared between groups. The proportion of patients receiving elective femoral nerve blocks was significantly less in the LIA group (34%) as compared with the control group (56%; P = 0.027). There was no significant difference in total PACU opioid consumption between groups (P = 0.740). The decreased utilization of postoperative nerve blocks observed in the LIA group suggests that LIA may improve postoperative pain management and should be considered as a potentially cost-effective tool in pain management in hip arthroscopy patients. Level of Evidence: III PMID:29423252

A prospective study about the preoperative total blood loss in older people with hip fracture.

PubMed

Wu, Jie-Zhou; Liu, Peng-Cheng; Ge, Wei; Cai, Ming

2016-01-01

Our study is to confirm that hemoglobin (Hb) level is significantly reduced before operation in elderly patients with hip fracture and to specify potential amounts of bleeding and Hb decline in different types of fractures. A prospective analysis was made on the clinical data of 349 patients with both a diagnosis of hip fracture and an operative delay of greater than 72 hours between April 2014 and February 2016. Hb concentration was measured on a daily basis before the surgery. Patients were grouped according to the type of fracture (intracapsular and extracapsular) for calculation of the total blood loss (TBL). All data analyses were done by SPSS version 21 software. There was a significant decrease preoperatively in the Hb concentration of nearly 21.55 g/L (standard error of the mean [SEM] 7.67) in patients with extracapsular hip fractures and nearly 15.63 g/L (SEM 6.01) in patients with intracapsular hip fractures. The preoperative TBL in patients with extracapsular fracture was significantly larger compared to that in patients with intracapsular fracture (790.3 mL and 581.7 mL, respectively, P <0.05 using Student's t -test). We found no significant difference in the preoperative TBL between the male and female groups. Hip fracture patients have an obvious blood loss after the injury, yet prior to the surgery the Hb levels were found to be normal. Anesthetic and orthopedic staff should pay additional attention to the problem of low preoperative Hb concentration, even if the initial Hb level was apparently normal.

Nd: YAG photodisruptors. American Academy of Ophthalmology

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

Not Available

Nd: YAG laser surgery can cut lens capsule, vitreous and capsular membranes, strands, and adhesions, and the iris within the surgically unopened eye, thereby avoiding infection, wound leaks, and other complications of conventional intraocular surgery. The technique has found its most widespread use in performing posterior capsulotomies after extracapsular cataract surgery. It has an extremely low complication rate when used in the anterior segment and is a preferred alternative to surgical discission. The uncertainties regarding its safety in creating iridotomies in phakic eyes have lessened with its extensive use in patients with pupillary-block glaucoma. However, caution is urged in othermore » applications in phakic eyes. Following each Nd: YAG laser procedure, the eye should be monitored for elevation of intraocular pressure during the first two hours, and for retinal tears, retinal detachment, or cystoid macular edema during the first month after the procedure. Uncertainties persist regarding the circumstances under which the laser in its current configuration should be used in the vitreous cavity.« less

Salvage high-intensity focused ultrasound ablation for prostate cancer local recurrence after external-beam radiation therapy: prognostic value of prostate MRI.

PubMed

Rouvière, O; Sbihi, L; Gelet, A; Chapelon, J-Y

2013-07-01

To assess the prognostic value of magnetic resonance imaging (MRI) before salvage high-intensity focused ultrasound (HIFU) for locally recurrent prostate cancer after external-beam radiotherapy (EBRT). Forty-six patients who underwent prostate MRI before salvage HIFU for locally recurrent prostate cancer after EBRT were retrospectively studied. HIFU failure was defined as a prostate-specific antigen (PSA) value >nadir + 2 ng/ml (Phoenix criteria) or positive follow-up biopsy or initiation of any other salvage therapy. The following prognostic parameters were assessed: neoadjuvant hormone therapy, clinical stage and Gleason score of recurrence, PSA level and velocity at HIFU treatment, and six MRI-derived parameters (prostate volume, tumour volume, extracapsular extension, seminal vesicle invasion, tumour extension into the apex or anterior to the urethra). Two factors were significant independent predictors of salvage HIFU failure: the PSA level at HIFU treatment (p < 0.012; risk ratio: 1.15, 95% CI: 1.03-1.29) and the tumour extension anterior to the urethra, as assessed by MRI (p = 0.046, risk ratio: 2.51, 95% CI: 1.02-6.16). The location of cancer recurrence anterior to the urethra on MRI is an independent significant predictor of salvage HIFU failure for locally recurrent prostate cancer after EBRT. Therefore, MRI may be useful for patient selection before post-EBRT salvage HIFU ablation. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Outcomes of surgically treated human papillomavirus-related oropharyngeal squamous cell carcinoma with N3 disease.

PubMed

Zenga, Joseph; Haughey, Bruce H; Jackson, Ryan S; Adkins, Douglas R; Aranake-Chrisinger, John; Bhatt, Neel; Gay, Hiram A; Kallogjeri, Dorina; Martin, Eliot J; Moore, Eric J; Paniello, Randal C; Rich, Jason T; Thorstad, Wade L; Nussenbaum, Brian

2017-09-01

To evaluate outcomes for patients with pathological N3 (pN3) neck disease from human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and determine variables predictive of survival. Retrospective case series with chart review. This study was conducted between 1998 and 2013 and included patients with HPV-related OPSCC treated with surgery with or without adjuvant therapy and who had pN3 nodal disease. The primary outcome was disease-specific survival (DSS). Secondary outcomes included overall survival (OS), disease-free survival (DFS), adverse events, and gastrostomy tube rates. Thirty-nine patients were included, of whom 36 (90%) underwent adjuvant therapy. Median follow-up was 39 months (range, 2-147 months). Mean age was 56 years, and 87% were male. Seventeen patients (44%) underwent selective neck dissection, whereas six (15%) underwent radical (n = 2) or extended radical (n = 4) neck dissection. Ninety-two percent had extracapsular extension. Five-year Kaplan-Meier estimated DSS, OS, and DFS were 89% (95% confidence interval [CI]: 79%-99%), 87% (95% CI: 75%-99%), and 84% (95% CI: 72%-96%), respectively. The disease recurrence rate was 10% (5% regional, 5% distant metastasis). Patients with less than 5 pathologically positive lymph nodes (P = .041) had improved DFS. Patients with HPV-related OPSCC and pN3 nodal disease treated with surgery and adjuvant therapy have very favorable long-term survival and regional control. Patients with five or more pathologically positive lymph nodes may be at higher risk for recurrence. 4. Laryngoscope, 127:2033-2037, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Real-time transrectal ultrasound guidance during laparoscopic radical prostatectomy: impact on surgical margins.

PubMed

Ukimura, Osamu; Magi-Galluzzi, Cristina; Gill, Inderbir S

2006-04-01

We evaluated whether intraoperative real-time TRUS navigation during LRP can decrease the incidence of positive surgical margins. Since March 2001, 294 patients with clinically organ confined prostate cancer undergoing LRP have been retrospectively divided into 2 groups, including group 1-217 who underwent LRP without TRUS from March 2001 to February 2003 and group 2-77 who have undergone LRP with TRUS since March 2003. Various baseline parameters were similar between the groups. Before March 2001 the senior surgeon had already performed more than 50 cases of LRP, thus, gaining reasonable familiarity with the technique. Compared to group 1, group 2 had a significantly decreased rate of positive surgical margins in patients with pT3 disease (57% vs 18%, p = 0.002). Positive margin rates also decreased in our overall experience (29% vs 9%, p = 0.0002). Intraoperative TRUS correctly predicted pT2 and pT3 disease in 85% and 86% of patients, respectively. Of the 54 TRUS visualized hypoechoic lesions at sites corresponding to biopsy proven cancer extracapsular extension was suspected in 31, leading to a real-time recommendation of calibrated wider, site specific dissection to achieve negative surgical margins. Intraoperative TRUS monitoring during LRP allows individualized, precise dissection tailored to the specific prostate contour anatomy, thus, compensating for the muted tactile feedback of laparoscopy. In what is to our knowledge the initial experience real-time TRUS guidance significantly decreased the incidence of positive surgical margins during LRP. In the future this concept of rectum based, intraoperative real-time navigation may facilitate a more sophisticated performance of radical prostatectomy.

Metabolomic signatures of aggressive prostate cancer.

PubMed

McDunn, Jonathan E; Li, Zhen; Adam, Klaus-Peter; Neri, Bruce P; Wolfert, Robert L; Milburn, Michael V; Lotan, Yair; Wheeler, Thomas M

2013-10-01

Current diagnostic techniques have increased the detection of prostate cancer; however, these tools inadequately stratify patients to minimize mortality. Recent studies have identified a biochemical signature of prostate cancer metastasis, including increased sarcosine abundance. This study examined the association of tissue metabolites with other clinically significant findings. A state of the art metabolomics platform analyzed prostatectomy tissues (331 prostate tumor, 178 cancer-free prostate tissues) from two independent sites. Biochemicals were analyzed by gas chromatography-mass spectrometry and ultrahigh performance liquid chromatography-tandem mass spectrometry. Statistical analyses identified metabolites associated with cancer aggressiveness: Gleason score, extracapsular extension, and seminal vesicle and lymph node involvement. Prostate tumors had significantly altered metabolite profiles compared to cancer-free prostate tissues, including biochemicals associated with cell growth, energetics, stress, and loss of prostate-specific biochemistry. Many metabolites were further associated with clinical findings of aggressive disease. Aggressiveness-associated metabolites stratified prostate tumor tissues with high abundances of compounds associated with normal prostate function (e.g., citrate and polyamines) from more clinically advanced prostate tumors. These aggressive prostate tumors were further subdivided by abundance profiles of metabolites including NAD+ and kynurenine. When added to multiparametric nomograms, metabolites improved prediction of organ confinement (AUROC from 0.53 to 0.62) and 5-year recurrence (AUROC from 0.53 to 0.64). These findings support and extend earlier metabolomic studies in prostate cancer and studies where metabolic enzymes have been associated with carcinogenesis and/or outcome. Furthermore, these data suggest that panels of analytes may be valuable to translate metabolomic findings to clinically useful diagnostic tests. Copyright © 2013 Wiley Periodicals, Inc.

Prognostic factors and relative risk for survival in N1-3 oral squamous cell carcinoma: a multivariate analysis using Cox's hazard model.

PubMed

Noguchi, M; Kido, Y; Kubota, H; Kinjo, H; Kohama, G

1999-12-01

The records of 136 patients with N1-3 oral squamous cell carcinoma treated by surgery were investigated retrospectively, with the aim of finding out which factors were predictive of survival on multivariate analysis. Four independent factors significantly influenced survival in the following order: pN stage; T stage; histological grade; and N stage. The most significant was pN stage, the five-year survival for patients with pN0 being 91% and for patients with pN1-3 41%. A further study was carried out on the 80 patients with pN1-3 to find out their prognostic factors for survival and the independent factors identified by multivariate analysis were T stage and presence or absence of extracapsular spread to metastatic lymph nodes.

Radiotherapy on hidradenocarcinoma

PubMed Central

Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

2011-01-01

Context: Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. Case Report: We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. Conclusion: Post operative radiotherapy allows better local control and should be mandatory when histological features predictive of recurrence are present: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread. PMID:22540063

Targeted proteomics identifies liquid-biopsy signatures for extracapsular prostate cancer

PubMed Central

Kim, Yunee; Jeon, Jouhyun; Mejia, Salvador; Yao, Cindy Q; Ignatchenko, Vladimir; Nyalwidhe, Julius O; Gramolini, Anthony O; Lance, Raymond S; Troyer, Dean A; Drake, Richard R; Boutros, Paul C; Semmes, O. John; Kislinger, Thomas

2016-01-01

Biomarkers are rapidly gaining importance in personalized medicine. Although numerous molecular signatures have been developed over the past decade, there is a lack of overlap and many biomarkers fail to validate in independent patient cohorts and hence are not useful for clinical application. For these reasons, identification of novel and robust biomarkers remains a formidable challenge. We combine targeted proteomics with computational biology to discover robust proteomic signatures for prostate cancer. Quantitative proteomics conducted in expressed prostatic secretions from men with extraprostatic and organ-confined prostate cancers identified 133 differentially expressed proteins. Using synthetic peptides, we evaluate them by targeted proteomics in a 74-patient cohort of expressed prostatic secretions in urine. We quantify a panel of 34 candidates in an independent 207-patient cohort. We apply machine-learning approaches to develop clinical predictive models for prostate cancer diagnosis and prognosis. Our results demonstrate that computationally guided proteomics can discover highly accurate non-invasive biomarkers. PMID:27350604

Prostate weight: an independent predictor for positive surgical margins during robotic-assisted laparoscopic radical prostatectomy.

PubMed

Msezane, Lambda P; Gofrit, Ofer N; Lin, Shang; Shalhav, Arieh L; Zagaja, Gregory P; Zorn, Kevin C

2007-10-01

Pre-operative prediction of pathological stage represents the cornerstone of prostate cancer management. Patient counseling is routinely based on pre-operative PSA, Gleason score and clinical stage. In this study, we evaluated whether prostate weight (PW) is an independent predictor of extracapsular extension (ECE) and positive surgical margin (PSM). Between February 2003 and November 2006, 709 men underwent robotic-assisted laparoscopic radical prostatectomy (RLRP). Pre-operative parameters (patient age, pre-operative PSA, biopsy Gleason score, clinical stage) as well as pathological data (prostate weight, pathological stage) were prospectively gathered after internal-review board (IRB) approval. Evaluation of the influence of these variables on ECE and PSM outcomes were assessed using both univariate and multivariate logistic regression analysis. Mean overall patient age, pre-operative PSA and PW were 59.6 years, 6.5 ng/ml and 52.9 g (range 5.5 g-198.7 g), respectively. Of the 393, 209 and 107 men with PW < 50 g, 50 g-< 70 g and < 70 g, ECE was observed in 20.1%, 15.3% and 9.3%, respectively (p = 0.015). In the same patient cohorts, PSM was observed in 25.4%, 14.4% and 7.5%, respectively (p < 0.001). In a multivariate logistic regression analysis, PW, in addition to pre-operative PSA, biopsy Gleason score and clinical stage, was an independent risk factor for ECE (p < 0.001). Similarly, in multi-variate analysis, PW was observed to be a risk factor for PSM (p < 0.001). PW is an independent predictor of both ECE and PSM, with an inverse relationship having been demonstrated between both variables. PW should be considered when counseling patients with prostate cancer treatment.

Quality assurance of HDR prostate plans: program implementation at a community hospital.

PubMed

Rush, Jennifer B; Thomas, Michael D

2005-01-01

Adenocarcinoma of the prostate is currently the most commonly diagnosed cancer in men in the United States, and the second leading cause of cancer mortality. The utilization of radiation therapy is regarded as the definitive local therapy of choice for intermediate- and high-risk disease, in which there is increased risk for extracapsular extension, seminal vesicle invasion, or regional node involvement. High-dose-rate (HDR) brachytherapy is a logical treatment modality to deliver the boost dose to an external beam radiation therapy (EBRT) treatment to increase local control rates. From a treatment perspective, the utilization of a complicated treatment delivery system, the compressed time frame in which the procedure is performed, and the small number of large dose fractions make the implementation of a comprehensive quality assurance (QA) program imperative. One aspect of this program is the QA of the HDR treatment plan. Review of regulatory and medical physics professional publications shows that substantial general guidance is available. We provide some insight to the implementation of an HDR prostate plan program at a community hospital. One aspect addressed is the utilization of the low-dose-rate (LDR) planning system and the use of existing ultrasound image sets to familiarize the radiation therapy team with respect to acceptable HDR implant geometries. Additionally, the use of the LDR treatment planning system provided a means to prospectively determine the relationship between the treated isodose volume and the product of activity and time for the department's planning protocol prior to the first HDR implant. For the first 12 HDR prostate implants, the root-mean-square (RMS) deviation was 3.05% between the predicted product of activity and time vs. the actual plan values. Retrospective re-evaluation of the actual implant data reduced the RMS deviation to 2.36%.

Phase 2 trial of neoadjuvant chemotherapy and transoral endoscopic surgery with risk-adapted adjuvant therapy for squamous cell carcinoma of the head and neck.

PubMed

Weiss, Jared M; Grilley-Olson, Juneko E; Deal, Allison Mary; Zevallos, Jose P; Chera, Bhishamjit S; Paul, Jennifer; Knowles, Mary Fleming; Usenko, Dmitriy; Weissler, Mark C; Patel, Samip; Hayes, David N; Hackman, Trevor

2018-05-09

The objective of this study was to demonstrate the feasibility and efficacy of induction chemotherapy, surgery, and pathology-guided adjuvant therapy to treat transorally resectable squamous head and neck cancer. Patients had squamous head and neck cancer that was resectable by the transoral route and advanced-stage disease (American Joint Committee on Cancer stage III-IV, T3-T4 tumors, and/or positive lymph nodes). They received treatment with weekly carboplatin at an area under the curve of 2, plus paclitaxel 135 mg/m 2 , and daily lapatinib 1000mg for 6 weeks followed by surgical resection. Pathology that revealed margins <5 mm, extracapsular extension, N2a of N2b lymph node status, perineural invasion, or lymphovascular space invasion resulted in adjuvant radiotherapy concurrent with weekly cisplatin. Pathology with N2c/N3 lymph node status or positive margins resulted in radiation with bolus cisplatin. The primary endpoint was the clinical response rate to induction chemotherapy, and a key secondary endpoint was feasibility. Toxicity was modest, and 37 of 40 patients completed study procedures as planned. The clinical response rate was 93%, the pathologic complete response rate was 36%, and the clinical response did not predict for a pathologic complete response. No patient on study follow-up has recurred or died. Twenty-nine of 39 patients who underwent surgery avoided radiation. Speech and swallowing function were well preserved. The study met both its primary efficacy endpoint and the secondary feasibility endpoint. Neoadjuvant, systemic therapy and surgical resection followed by risk-adapted adjuvant therapy resulted in high response rates and excellent long-term outcomes and should be further studied. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Squamous Cell Carcinoma Antigen-encoding Genes SERPINB3/B4 as Potentially Useful Markers for the Stratification of HNSCC Tumours.

PubMed

Saidak, Zuzana; Morisse, Mony Chenda; Chatelain, Denis; Sauzay, Chloé; Houessinon, Aline; Guilain, Nelly; Soyez, Marion; Chauffert, Bruno; Dakpé, Stéphanie; Galmiche, Antoine

2018-03-01

The squamous cell carcinoma antigen (SCCA), encoded by the genes SERPINB3/B4, is a tumour marker produced by head and neck squamous cell carcinoma (HNSCC). We aimed to examine SERPINB3/B4 mRNA levels and its clinical significance in the therapeutic context. We retrieved mRNA expression levels, clinical, pathological and genomic data for 520 HNSCC from The Cancer Genome Atlas (TCGA). HNSCC tumours express high levels of SERPINB3/B4 mRNA. SERPINB3 expression differs depending on Human papillomavirus (HPV) infection status, primary tumour location, grade and differentiation, extension to lymph nodes and extracapsular spread. Interestingly, we observed an association between SERPINB3/B4 and the presence of tumour immune infiltrate as well as the expression of the immune checkpoint regulators PD-L1/PD-L2 that depended on HPV status. Our findings point to potential interest of SERPINB3/B4 for the stratification of HNSCC patients in the therapeutic context. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

[Trabeculotomy ab interno combined with extracapsular cataract extraction and IOL implantation].

PubMed

Alekseev, B N; Ermolaev, A P

2003-01-01

We made a total of 96 surgeries of extracapsular cataract extraction and IOL implantation combined with trabeculotomy ab interno during a period of 7 years. Patients with both open-angle and narrow-angle glaucoma of stages I and II and with the intraocular pressure (IOP) below or equal to 23 mm Hg according to Goldman under the conditions of hypotensive medicamental regimen were selected for surgery. After IOL was implanted into the lens bag, trabeculotomy ab interno was implemented as stage 2. A special mirror, introduced through the cataract incision, was used for direct gonioscopic monitoring. The trabecula was incised by the edge of a curved surgical knife under direct visual control. We regarded bleeding from the opened sinus as a favorable sign indicative of that the intrascleral collectors were intact. Only minor hyphemas were registered as postoperative complications; there was not a single case of ciliary-and-choroidal detachment. IOP was compensated for, in 6 months after surgery, in 94% of patients--69.8% of them did not use any hypotensive drops.

PIP breast implants: rupture rate and correlation with breast cancer

PubMed Central

MOSCHETTA, M.; TELEGRAFO, M.; CORNACCHIA, I.; VINCENTI, L.; RANIERI, V.; CIRILLI, A.; RELLA, L.; IANORA, A.A. STABILE; ANGELELLI, G.

2014-01-01

Aim To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the potential correlation with breast carcinoma. Patients and methods 67 patients with silicone breast implants and clinical indications for breast MRI were evaluated for a total of 125 implants: 40 (32%) PIP in 21 patients and 85 non-PIP in 46 patients (68%), the latest considered as control group. A 1.5-T MR imaging device was used in order to assess implant integrity with dedicated sequences and in 6 cases a dynamic study was performed for characterizing breast lesions. Two radiologists with more than 5 years’ experience in the field of MRI evaluated in consensus all MR images searching for the presence of clear signs of intra or extra-capsular implant rupture. Results 20/40 (50%) PIP implants presented signs of intra-capsular rupture: linguine sign in 20 cases (100%), tear-drop sign in 6 (30%). In 12/20 cases (60%), MRI signs of extra-capsular rupture were detected. In the control group, an intra-capsular rupture was diagnosed in 12/85 cases (14%) associated with extra-capsular one in 5/12 cases (42%). Among the six cases with suspected breast lesions, in 2/21 patients with PIP implants (10%) a breast carcinoma was diagnosed (mucinous carcinoma, n=1; invasive ductal carcinoma, n=1). In 4/46 patients (9%) with non-PIP implants, an invasive ductal carcinoma was diagnosed. Conclusion The rupture rate of PIP breast implants is significantly higher than non-PIP (50% vs 14%). MRI represents the most accurate imaging tool for evaluating breast prostheses and the linguine sign is the most common MRI sign to be searched. The incidence of breast carcinoma does not significantly differ between the PIP and non-PIP implants and a direct correlation with breast cancer can not been demonstrated. PMID:25644728

PIP breast implants: rupture rate and correlation with breast cancer.

PubMed

Moschetta, M; Telegrafo, M; Cornacchia, I; Vincenti, L; Ranieri, V; Cirili, A; Rella, L; Stabile Ianora, A A; Angelelli, G

2014-01-01

To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the potential correlation with breast carcinoma. 67 patients with silicone breast implants and clinical indications for breast MRI were evaluated for a total of 125 implants: 40 (32%) PIP in 21 patients and 85 non-PIP in 46 patients (68%), the latest considered as control group. A 1.5-T MR imaging device was used in order to assess implant integrity with dedicated sequences and in 6 cases a dynamic study was performed for characterizing breast lesions. Two radiologists with more than 5 years' experience in the field of MRI evaluated in consensus all MR images searching for the presence of clear signs of intra or extra-capsular implant rupture. 20/40 (50%) PIP implants presented signs of intra-capsular rupture: linguine sign in 20 cases (100%), tear-drop sign in 6 (30%). In 12/20 cases (60%), MRI signs of extra-capsular rupture were detected. In the control group, an intra-capsular rupture was diagnosed in 12/85 cases (14%) associated with extra-capsular one in 5/12 cases (42%). Among the six cases with suspected breast lesions, in 2/21 patients with PIP implants (10%) a breast carcinoma was diagnosed (mucinous carcinoma, n=1; invasive ductal carcinoma, n=1). In 4/46 patients (9%) with non-PIP implants, an invasive ductal carcinoma was diagnosed. The rupture rate of PIP breast implants is significantly higher than non-PIP (50% vs 14%). MRI represents the most accurate imaging tool for evaluating breast prostheses and the linguine sign is the most common MRI sign to be searched. The incidence of breast carcinoma does not significantly differ between the PIP and non-PIP implants and a direct correlation with breast cancer can not been demonstrated.

Risk Factors for Central Neck Lymph Node Metastases in Micro- Versus Macro- Clinically Node Negative Papillary Thyroid Carcinoma.

PubMed

Sessa, Luca; Lombardi, Celestino Pio; De Crea, Carmela; Tempera, Serena Elisa; Bellantone, Rocco; Raffaelli, Marco

2018-03-01

Tumor size has been advocated as possible risk factors for occult central lymph node metastases (CNM) in papillary thyroid carcinoma (PTC) patients. This prospective study evaluated factors that could identify patients at higher risk of occult CNM, especially comparing micro-PTC and macro-PTC. One hundred and eighty-six patients were recruited. All the patients had cN0 clinically unifocal PTC and underwent total thyroidectomy and bilateral prophylactic central neck dissection. Risk factors for occult CNM in micro- and macro-PTC patients were evaluated. Eighty-two patients showed CNM. The rate of CNM did not differ among different sizes cut off (≤20 mm, ≤10 mm, ≤5 mm P = NS). Significantly more pN1a than pN0 patients had pT3 tumors (35/82 vs. 26/104) (P < 0.05), extracapsular invasion (35/82 vs. 22/104) (P < 0.01) and microscopic multifocal disease (50/82 vs. 47/104) (P < 0.05). Independent risk factors for CNM were extracapsular invasion and multifocality at multivariate analysis. Risk factors for CNM in 77 micro-PTC were extracapsular invasion (16/31 pN1 vs. 10/46 pN0, P < 0.05) and multifocality (21/31 pN1 vs. 16/46 pN0, P < 0.01). Among 109 macro-PTC, risk factors for CNM were angioinvasion (15/51 pN1 vs. 7/58 pN0, P < 0.05) and classic PTC at the final histology (PTC vs. tall cell variant vs. follicular variant PTC) (P < 0.05). Risk factors for CNM can differ between micro- and macro-PTC, but no preoperatively known clinical parameter is predictor of CNM in cN0 clinically unifocal PTC.

Can extracapsular lymph node involvement be a tool to fine-tune pN1 for adenocarcinoma of the oesophagus and gastro-oesophageal junction in the Union Internationale contre le Cancer (UICC) TNM 7th edition?†.

PubMed

Nafteux, Philippe; Lerut, Toni; De Hertogh, Gert; Moons, Johnny; Coosemans, Willy; Decker, Georges; Van Veer, Hans; De Leyn, Paul

2014-06-01

The current (7th) International Union Against Cancer (UICC) pN staging system is based on the number of positive lymph nodes but does not take into consideration the characteristics of the metastatic lymph nodes itself. In particular, it has been suggested that tumour penetration beyond the lymph node capsule in metastatic lymph nodes, which is also called extracapsular lymph node involvement, has a prognostic impact. The aim of the current study was to assess the prognostic value of extracapsular (EC) and intracapsular (IC) lymph node involvement (LNI) in adenocarcinoma of the oesophagus and gastro-oesophageal junction (GOJ) and to assess its potential impact on the 7th edition of the UICC TNM manual. From 2000 to 2010, all consecutive adenocarcinoma patients with primary R0-resection (n = 499) were prospectively included for analysis. The number of resected lymph nodes, number of positive lymph nodes and number of EC-LNI/IC-LNI were determined. Extracapsular spread was defined as infiltration of cancer cells beyond the capsule of the positive lymph node. Two hundred and eighteen (43%) patients had positive lymph nodes. Cancer-specific 5-year survival in lymph node-positive patients was significantly (P < 0.0001) worse compared with lymph node-negative patients, being 88.3 vs 28.7%, respectively. In 128 (58.7%) cases EC-LNI was detected. EC-LNI showed significantly worse cancer-specific 5-year survival compared with IC-LNI, 19.6 vs 44.0% (P < 0.0001). In the pN1 category (1 or 2 positive LN's-UICC stages IIB and IIIA), this was 30.4% vs 58%; (P = 0.029). In higher pN categories, this effect was no longer noticed. Integrating these findings into an adapted TNM classification resulted in improved homogeneity, monotonicity of gradients and discriminatory ability indicating an improved performance of the staging system. EC-LNI is associated with worse survival compared with IC-LNI. EC-LNI patients show survival rates that are more closely associated with the current TNM stage IIIB, while IC-LNI patients have a survival more similar to TNM stage IIB. Incorporating the EC-IC factor in the TNM classification results in an increased performance of the TNM model. Further confirmation from other centres is required within the context of future adaptations of the UICC/AJCC (American Joint Committee on Cancer) staging system for oesophageal cancer. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Role of Radiotherapy in the Treatment of Cervical Lymph Node Metastases From an Unknown Primary Site: Retrospective Analysis of 113 Patients

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

Beldi, Debora; Jereczek-Fossa, Barbara A.; University of Milan, Milan

2007-11-15

Purpose: The management of patients with cervical lymph-node metastases from unknown primary site (UPS) remains a matter of discussion. This study aimed to analyze the results and prognostic factors in a series of patients treated with radiotherapy. Methods and Materials: Data from 113 patients who presented with cervical lymph nodes metastases from UPS treated from 1980 to 2004 were reviewed. Eighty-seven patients (77.0%) were squamous cell carcinoma (SCC). Ninety-one patients were treated with curative and 22 with palliative intent. Fifty-nine of 113 patients (52.2%) received surgery followed by radiotherapy and 54 of 113 (47.8%) received radiotherapy alone. Radiotherapy was deliveredmore » to the neck and pharyngeal mucosa in 67 patients and to the ipsilateral or bilateral neck in 45 patients. Twenty-one patients (18.5%) also received chemotherapy. Results: The 5-year overall survival rates were 40.7% for the entire group and 46.6% for the SCC subgroup. The occurrence of the occult primary was observed in 23 of 113 patients (20.3%), 19 (82.6%) within the head and neck region. At multivariate analysis, treatment with curative intent and extensive irradiation of bilateral neck and pharyngeal mucosa were favorable prognostic factors for the whole series, and treatment with curative intent, extensive irradiation of bilateral neck and pharyngeal mucosa, and absence of extracapsular spread were favorable prognostic factors for the SCC subgroup. Conclusions: Patients with cervical lymph node metastases from UPS have a similar prognosis to those affected by other head and neck malignancies. Curative treatment strategies including neck dissection and extensive irradiation by three-dimensional conformal radiation therapy resulted in significantly better outcomes.« less

Practice Patterns of Radiation Field Design for Sentinel Lymph Node-Positive Early-Stage Breast Cancer.

PubMed

Azghadi, Soheila; Daly, Megan; Mayadev, Jyoti

2016-10-01

Recent randomized trials have led to decreased use of completion axillary lymph node dissection (ALND) in early-stage breast cancer patients with a positive sentinel lymph node (SLN), causing controversy surrounding radiotherapy coverage of the axilla. We investigated the practice variation among radiation oncologists for regional nodal coverage for clinicopathologic scenarios and evaluated axillary field design decision-making processes. A customized, web-based questionnaire was e-mailed to 983 community (n = 617) and academic (n = 366) radiation oncologists with a breast cancer subspecialty practicing in the United States. The survey consisted of 18 multiple-choice questions evaluating general clinical preferences surrounding radiation therapy (RT) field design for patients with early-stage breast cancer and a positive SLN. Seven case scenarios were developed to investigate the field design in the setting of specific clinical and pathologic risk factors. Nodal coverage was classified as standard tangents (STs), high tangents (HTs), STs and a supraclavicular field (SCF), or STs and full axillary coverage (AX). A total of 145 evaluable responses were collected, with a response rate of 15.0%. Of the respondents, 12 (8.3%) reported using completion ALND for patients with 1 to 3 positive SLNs without extracapsular extension (ECE) and 66 (45.5%) performed ALND with 1 to 3 positive SLNs with ECE. For micrometastatic SLNs, with no lymphovascular system invasion, 115 (87.1%) used STs or HTs. The use of neoadjuvant chemotherapy (NAC) influenced RT field design for patients with a positive SLN without ECE, with 64 (48.5%) using STs and SCF or STs and AX treatment without NAC and 94 (70.7%) using SCF and AX after NAC. With macrometastatic SLN involvement, most respondents preferred SCF (45.27%) and AX (45.66%). In contrast, for micrometastatic involvement, HTs (43.61%) were frequently chosen. Forty (27.8%) reported using online predictive nomograms to predict further axillary involvement, with no difference between the academic and community radiation oncologists (P = .11). In SLN biopsy-positive early-stage breast cancer with omission of completion ALND, axillary RT is increasing used to cover the undissected axilla. Most respondents use SCF or AX for patients with low to intermediate pathologic features. Online prediction nomograms are used by a few practitioners to assist in clinical decision-making in this setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Immunocompromised patients with metastatic cutaneous nodal squamous cell carcinoma of the head and neck: Poor outcome unrelated to the index lesion.

PubMed

Lam, Johnson K S; Sundaresan, Puma; Gebski, Val; Veness, Michael J

2018-05-01

Immunocompromised patients with metastatic cutaneous nodal head and neck squamous cell carcinoma (HNSCC) have worse outcomes compared to the immunocompetent. The purpose of this study was to investigate the characteristics of the primary cutaneous squamous cell carcinoma (SCC), nodal pathology, and outcome between these 2 groups. Analysis of a prospective database was performed. A 2:1 pooled analysis selected 46 immunocompetent patients matched with 23 immunocompromised patients. Overall survival (OS) and relapse-free survival (RFS) were calculated using the Kaplan-Meier method. No significant difference was found in the primary tumor characteristics between the 2 groups. In the immunocompromised group, RFS (hazard ratio [HR] 2.70; P = .01) and OS (HR 2.32; P = .04) were significantly worse. Extracapsular spread was present in 100% of the immunocompromised patients. No significant difference was identified in the primary cutaneous SCC between the immunocompetent and immunocompromised patients. Immunosuppression predicted worse outcome. © 2018 Wiley Periodicals, Inc.

Single- and double- lumen silicone breast implant integrity: prospective evaluation of MR and US criteria.

PubMed

Berg, W A; Caskey, C I; Hamper, U M; Kuhlman, J E; Anderson, N D; Chang, B W; Sheth, S; Zerhouni, E A

1995-10-01

To evaluate the accuracy of magnetic resonance (MR) and ultrasound (US) criteria for breast implant integrity. One hundred twenty-two single-lumen silicone breast implants and 22 bilumen implants were evaluated with surface coil MR imaging and US and surgically removed. MR criteria for implant failure were a collapsed implant shell ("linguine sign"), foci of silicone outside the shell ("noose sign"), and extracapsular gel, US criteria were collapsed shell, low-level echoes within the gel, and "snowstorm" echoes of extracapsular silicone. Among single-lumen implants, MR imaging depicted 39 of 40 ruptures, 14 of 28 with minimal leakage; 49 of 54 intact implants were correctly interpreted. US depicted 26 of 40 ruptured implants, four of 28 with minimal leakage, and 30 of 54 intact implants. Among bilumen implants, MR imaging depicted four of five implants with rupture of both lumina and nine of 10 as intact; US depicted one rupture and helped identify two of 10 as intact. Mammography accurately depicted the status of 29 of 30 bilumen implants with MR imaging correlation. MR imaging depicts implant integrity more accurately than US; neither method reliably depicts minimal leakage with shell collapse. Mammography is useful in screening bilumen implant integrity.

Risk Factors Associated with Disease Recurrence in Patients with Stage III/IV Squamous Cell Carcinoma of the Oral Cavity Treated with Surgery and Postoperative Radiotherapy.

PubMed

Noble, Anisha R; Greskovich, John F; Han, Jaehong; Reddy, Chandana A; Nwizu, Tobenna I; Khan, Mumtaz F; Scharpf, Joseph; Adelstein, David J; Burkey, Brian B; Koyfman, Shlomo A

2016-02-01

The purpose of the present study was to identify variables associated with high risk of failure in patients with locally advanced squamous cell carcinoma of the oral cavity (SCC-OC). This retrospective study included 191 patients with stage III-IVb SCC-OC treated with post-operative radiotherapy (RT) or chemoradiotherapy (CRT) between 1995 and 2013. Disease-free (DFS) and overall survival (OS) were analyzed; variables associated with inferior DFS were identified. Seventy-five patients (39%) recurred. DFS and five-year OS were 52% and 54%, respectively. Poorly differentiated tumors (p=0.03), recurrent tumors (p=0.02) and high nodal ratio (p=0.02) were associated with an increased risk of recurrence. CRT was associated with improved DFS in patients with positive margins and/or extracapsular extension (p=0.021). Tumors that are recurrent, high grade, or have high nodal ratio are at risk of recurrence. Presence of these disease features should be taken into consideration for better risk stratification. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

A 20-Year Review of 75 Cases of Salivary Duct Carcinoma.

PubMed

Gilbert, Mark R; Sharma, Arun; Schmitt, Nicole C; Johnson, Jonas T; Ferris, Robert L; Duvvuri, Umamaheswar; Kim, Seungwon

2016-05-01

Salivary duct carcinoma is a rare, aggressive malignancy of the salivary glands. Owing to its rare nature, clinical data are limited, and only a few clinical studies comprise more than 50 patients. To review the University of Pittsburgh Medical Center's experience with salivary duct carcinoma over a 20-year period, focusing on demographics, presentation, treatment, and outcome. This investigation was a retrospective cohort study in a multihospital institution with tertiary referral. A pathology database was reviewed for all cases of histopathologically diagnosed salivary duct carcinoma from January 1, 1995, to October 20, 2014. Patients who were referrals for pathology review only and were never seen at the institution were excluded. In total, 75 study patients were identified. The electronic medical record was reviewed for details regarding demographics, presentation, treatment, and outcome, including overall survival (OS) and disease-free survival (DFS). This study was supplemented with a review of the institution's Head and Neck Oncology Database for further clinical details. Primary outcome measures consisted of OS and DFS. The study sample comprised 75 participants with a mean age at diagnosis of 66.0 years (age range, 33-93 years), and 29% (n = 22) were female. Most primary tumors were from the parotid gland (83%), with the next most frequent site being the submandibular gland (12%). Overall, 41% of the cases were carcinoma ex pleomorphic adenoma. Rates of other histologic features included the following: perineural invasion (69%), extracapsular spread (58%), ERBB2 (formerly HER2) positivity (31%) (62% of those who were tested), and vascular invasion (61%). The median OS was 3.1 years, and the median DFS was 2.7 years. Univariate Kaplan-Meier survival analyses demonstrated that facial nerve sacrifice and extracapsular spread were associated with lower OS (2.38 vs 5.11 years and 2.29 vs 6.56 years, respectively) and DFS (2.4 vs 3.88 years and 1.44 vs 4.5 years, respectively). Although underpowered, multivariable analysis demonstrated significantly worse OS in patients with N2 and N3 disease (hazard ratio [HR] 8.42, 95% CI, 1.84-38.5) but did not show significantly worse DFS or OS for facial nerve sacrifice or extracapsular spread. There was no association between ERBB2 positivity and survival and no difference in survival between patients receiving radiation therapy vs radiation therapy plus chemotherapy. No patients had recurrence or distant metastasis after 5 disease-free years. Salivary duct carcinoma is an aggressive disease. A large number of cases in this review were carcinoma ex pleomorphic adenoma and had classic negative prognostic indicators, such as perineural invasion, vascular invasion, and extracapsular spread. ERBB2 positivity was not associated with any difference in survival. Facial nerve involvement appears to indicate worse prognosis, as does nodal stage higher than N1. Recurrence and metastasis after 5 years are rare.

Multiparametric magnetic resonance imaging for the assessment of extracapsular invasion and other staging parameters in patients with prostate cancer candidates for radical prostatectomy.

PubMed

Lista, F; Gimbernat, H; Cáceres, F; Rodríguez-Barbero, J M; Castillo, E; Angulo, J C

2014-06-01

the proper evaluation of the extracapsular extension (ECE), the invasion of seminal vesicles and regional lymph nodes are necessary to plan the treatment of localized prostate cancer. A model that assesses the risk of ECE in the specimen considering the clinical, histological and imaging findings is defined. prospective study in 85 patients with prostate cancer treated with radical prostatectomy. Prostate biopsy was performed 4 weeks before multiparametric study (mpMRI). mpMRI included T2-weighted endorectal magnetic resonance imaging (T2W-MRI), diffusion-weighted magnetic resonance imaging (DW-MRI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). The apparent diffusion coefficient (ADC) was also measured. A study of consistency (k) was assessed comparing receiver operating characteristic (ROC) curve and area under the curve (AUC), which were obtained in each case (Z). Finally, a regression model was performed to predict ECE. the mean age was 63.7 ± 6.9 years and the mean value of PSA 12.6 ± 13.8. In 31.7% of cases, digital rectal examination was suspicious for malignancy. Prostatectomy specimen showed pT2a in 12 cases (14%), pT2b in 3 (3%), pT2c in 37 (43%), pT3a in 19(22%) and pT3b 14 cases (17%). ECE was evidenced in 33 (39%) of the specimens, seminal vesicle invasion in 14 (16.5%) and pelvic node involvement in 5 patients (6%). The consistency in the evaluation of ECE (image and pathological studies) was .35 for MRI (sensitivity .33, specificity .96) and .62 for mpMRI (sensitivity .58, specificity .98). Mean value of ADC was .76 ± .2 in patients with ECE. This value was not associated with Gleason score (P = .2) or with PSA value (P = .6). AUC value as predictor of ECE was of 65% for MRI, 78% for mpMRI and 50% ADC (Z = .008). Univariate analysis demonstrated that ECE probability increases with each Gleason score point, whilst this probability increases 1.06 times with each PSA point, and decreases .3 times with each point of ADC. Multivariate analysis confirmed that ADC value is a slight protective factor against ECE (OR = .01; CI 95% .002-.14). The consistency in the evaluation of seminal vesicles was .43 for MRI and .67 for mpMRI. AUC was 69% and 82% respectively (Z = .02). The consistency in the evaluation of positive lymph nodes was .4 for MRI and .7 for mpMRI. AUC was 68% and 88% respectively (Z = .36). multiparametric study allows to carry out a more proper preoperative evaluation of ECE than convectional MRI. The most reliable predictors of ECE are DW-MRI combined with DCE-MRI, ADC coefficient and Gleason score. The superiority of mpMRI is also demonstrated for detection of seminal vesicles invasion, but not for the evaluation of lymph nodes invasion. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

Patterns of Care and Comparative Effectiveness of Intensified Adjuvant Therapy for Resected Oropharyngeal Squamous Cell Carcinoma in the Human Papillomavirus Era.

PubMed

Sher, David J; Nedzi, Lucien; Khan, Saad; Hughes, Randy; Sumer, Baran D; Myers, Larry L; Truelson, John M; Koshy, Matthew

2016-08-01

There is a growing debate on the relative benefits of adjuvant chemoradiotherapy (CRT) and boost doses of postoperative radiotherapy (B-PORT) in oropharyngeal squamous cell carcinoma (OPSCC) treated with primary surgery, especially for patients with human papillomavirus (HPV)-driven disease. To characterize the recent patterns of care in and overall survival (OS) outcomes following the use of adjuvant CRT and B-PORT after primary surgery for OPSCC. Retrospective analysis of patients in the National Cancer Database with stage III to IVA-B OPSCC treated with surgery and adjuvant radiotherapy between 2010 and 2012 at Commission on Cancer-accredited facilities. The data analysis was performed between June 15, 2015, and May 4, 2016. The primary outcomes were prevalence of CRT and B-PORT, and OS. The primary predictors were HPV positivity and high-risk pathologic features (HRPFs) (extracapsular extension and positive surgical margins). Of the 1409 patients (1153 [82%] male; median age, 57 [interquartile range {IQR}, 51-63] years), 873 (62%) and 789 (56%) patients received CRT and B-PORT, respectively; most patients (n = 583 [79%]) with HRPFs received CRT, and many patients (n = 227 [40%]) without HRPFs received CRT. Multivariable predictors of CRT included adverse pathologic features (extracapsular extension [OR, 6.99; 95% CI, 5.22-9.35], positive surgical margins [OR, 2.07; 95% CI, 1.50-2.87], ≥6 involved nodes [OR, 2.34; 95% CI, 1.39-3.92], or low-neck disease [OR, 1.52; 95% CI, 1.01-2.28]), and treatment at a nonacademic institution (OR, 1.59 [95% CI, 1.21-2.10] for comprehensive community cancer center vs academic program). Patients with HPV-positive disease (OR, 0.47; 95% CI, 0.33-0.68) were less likely to receive CRT; this decrease was limited to absent HRPF treated at academic institutions (n = 173, 44 [25%] received CRT). With a median follow-up of surviving patients of 27 (IQR, 21-33) months, the 2-year OS probability was 92% (95% CI, 90%-94%). Multivariable analysis including age, sex, pathologic T stage, 6 or more positive nodes, and educational status confirmed the prognostic impact of HPV positivity (hazard ratio [HR], 0.41; 95% CI, 0.21-0.80) and HRPFs (positive surgical margins [HR, 2.15; 95% CI, 1.27-3.66] and ≥6 involved nodes [HR, 2.11; 95% CI, 1.13-3.93]), but neither CRT (HR, 1.27; 95% CI, 0.70-2.30) nor B-PORT (HR, 1.04; 95% CI, 0.63-1.73) was associated with improved OS. Postoperative CRT and B-PORT following resection of OPSCC were dependent on factors beyond HRPFs, including HPV status and treatment at an academic institution. No benefit was seen with intensified adjuvant therapy, supporting enrollment of the HPV-positive population into deintensification trials.

Evaluation of an interlaced triple procedure: penetrating keratoplasty, extracapsular cataract extraction, and nonopen-sky intraocular lens implantation.

PubMed

Yang, Shuo; Wang, Bin; Zhang, Yangyang; Zhai, Hualei; Wang, Junyi; Wang, Shuang; Xie, Lixin

2017-09-01

To evaluate an interlaced triple procedure that involved penetrating keratoplasty (PKP), extracapsular cataract extraction (ECCE) using diathermy capsulotomy, and nonopen-sky intraocular lens (IOL) implantation.This retrospective study involved data from 34 patients who were diagnosed with severe corneal opacities and cataracts. These patients were divided into an interlaced procedure group (21 patients) and a traditional procedure group (13 patients). In the interlaced group, the method of continuous curvilinear capsulorhexis (CCC) was completed via diathermy capsulotomy. The donor corneal button was sutured at 8 positions (at equal intervals) using 10-0 nylon sutures, and the IOL was inserted into the capsular bag using a closed anterior chamber approach at the 10:30 to 12 o'clock positions between the sutures. In the traditional group, CCC was completed using side-port capsular forceps, and the IOL was implanted using an open anterior chamber approach.In the interlaced group, the CCC, open-sky, and total operation times were significantly shorter than in the traditional group (P < .05). Neither the best-corrected visual acuity (BCVA) nor corneal endothelial cell density was significantly different between the groups at 1 and 6 months after the operation.This interlaced triple procedure for the treatment of corneal diseases with cataracts appears to be feasible and practical.

Complications of hip fractures: A review

PubMed Central

Carpintero, Pedro; Caeiro, Jose Ramón; Carpintero, Rocío; Morales, Angela; Silva, Samuel; Mesa, Manuel

2014-01-01

Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections (alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum -a major contributor to fracture healing- in the femoral neck. In extracapsular fractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients. PMID:25232517

Preoperative 3-Tesla Multiparametric Endorectal Magnetic Resonance Imaging Findings and the Odds of Upgrading and Upstaging at Radical Prostatectomy in Men With Clinically Localized Prostate Cancer

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

Hegde, John V.; Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Chen, Ming-Hui

Purpose: To investigate whether 3-T esla (3T) multiparametric endorectal MRI (erMRI) can add information to established predictors regarding occult extraprostatic or high-grade prostate cancer (PC) in men with clinically localized PC. Methods and Materials: At a single academic medical center, this retrospective study's cohort included 118 men with clinically localized PC who underwent 3T multiparametric erMRI followed by radical prostatectomy, from 2008 to 2011. Multivariable logistic regression analyses in all men and in 100 with favorable-risk PC addressed whether erMRI evidence of T3 disease was associated with prostatectomy T3 or Gleason score (GS) 8-10 (in patients with biopsy GS {<=}7)more » PC, adjusting for age, prostate-specific antigen level, clinical T category, biopsy GS, and percent positive biopsies. Results: The accuracy of erMRI prediction of extracapsular extension and seminal vesicle invasion was 75% and 95%, respectively. For all men, erMRI evidence of a T3 lesion versus T2 was associated with an increased odds of having pT3 disease (adjusted odds ratio [AOR] 4.81, 95% confidence interval [CI] 1.36-16.98, P=.015) and pGS 8-10 (AOR 5.56, 95% CI 1.10-28.18, P=.038). In the favorable-risk population, these results were AOR 4.14 (95% CI 1.03-16.56), P=.045 and AOR 7.71 (95% CI 1.36-43.62), P=.021, respectively. Conclusions: Three-Tesla multiparametric erMRI in men with favorable-risk PC provides information beyond that contained in known preoperative predictors about the presence of occult extraprostatic and/or high-grade PC. If validated in additional studies, this information can be used to counsel men planning to undergo radical prostatectomy or radiation therapy about the possible need for adjuvant radiation therapy or the utility of adding hormone therapy, respectively.« less

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

Gentile, Michelle S.; Usman, Asad A.; Neuschler, Erin I.

Purpose: The purpose of this study was to identify the axillary lymph nodes on pretreatment diagnostic computed tomography (CT) of the chest to determine their position relative to the anatomic axillary borders as defined by the Radiation Therapy Oncology Group (RTOG) breast cancer atlas for radiation therapy planning. Methods and Materials: Pretreatment diagnostic CT chest scans available for 30 breast cancer patients with clinically involved lymph nodes were fused with simulation CT. Contouring of axillary levels I, II, and III according to the RTOG guidelines was performed. Measurements were made from the area of distal tumor to the anatomic bordersmore » in 6 dimensions for each level. Results: Of the 30 patients, 100%, 93%, and 37% had clinical involvement of levels I, II, and III, respectively. The mean number of lymph nodes dissected was 13.6. The mean size of the largest lymph node was 2.4 cm. Extracapsular extension was seen in 23% of patients. In 97% of patients, an aspect of the involved lymph node lay outside of the anatomic border of a level. In 80% and 83% of patients, tumor extension was seen outside the cranial (1.78 ± 1.0 cm; range, 0.28-3.58 cm) and anterior (1.27 ± 0.92 cm; range, 0.24-3.58 cm) borders of level I, respectively. In 80% of patients, tumor extension was seen outside the caudal border of level II (1.36 ± 1.0 cm, range, 0.27-3.86 cm), and 0% to 33% of patients had tumor extension outside the remaining borders of all levels. Conclusions: To cover 95% of lymph nodes at the cranial and anterior borders of level I, an additional clinical target volume margin of 3.78 cm and 3.11 cm, respectively, is necessary. The RTOG guidelines may be insufficient for coverage of axillary disease in patients with clinical nodal involvement who are undergoing neoadjuvant chemotherapy, incomplete axillary dissection, or treatment with intensity modulated radiation therapy. In patients with pretreatment diagnostic CT chest scans, fusion with simulation CT should be considered for tumor delineation.« less

[The value of methods for morphofunctional analysis of cornea in cataract surgery].

PubMed

Borodina, N B; Kobzova, M V; Musaeva, G M

2011-01-01

The characteristics of morphofunctional status of cornea after extracapsular cataract extraction and phakoemulsification with IOL implantation (30 and 58 operations respectively) were analyzed in detail using up-to-date diagnostic techniques. The results of examination using developed algorithm including study of light transmission, refraction and protective function of cornea show advantage of microinvasive ultrasound technique of cataract surgery in terms of minimal impact on corneal structure, optical and biomechanical characteristics.

One-stop shop whole-body 68Ga-PSMA-11 PET/MRI compared to clinical Nomograms for preoperative T- and N-Staging of High-Risk Prostate Cancer.

PubMed

Thalgott, Mark; Düwel, Charlotte; Rauscher, Isabel; Heck, Matthias M; Haller, Bernhard; Gafita, Andrei; Gschwend, Jürgen E; Schwaiger, Markus; Maurer, Tobias; Eiber, Matthias

2018-05-24

Our aim was to assess the diagnostic potential of one-stop shop Prostate-specific membrane antigen-ligand Positron Emission Tomography/Magnetic Resonance Imaging ( 68 Ga-PSMA-11 PET/MRI) compared to preoperative staging nomograms in patients with high-risk prostate cancer (PC). Methods: A total of 102 patients underwent 68 Ga-PSMA-11 PET/MRI before intended radical prostatectomy (RP) with lymph node dissection. Preoperative variables determined the probabilities for lymph node metastases (LNM), extracapsular extension (ECE) and seminal vesical involvement (SVI) using the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and Partin tables. Receiver operating characteristic (ROC) analyses were performed to determine best discriminatory cutoffs. On cohort base, positivity rates of imaging and nomograms were compared to pathological prevalence. On patient base, sensitivity, specificity and its area under the curves (AUCs) were calculated. Finally, the full concordance of each method to postoperative T- and N-stage was determined. Results: 73 patients were finally analysed. On cohort base, the MSKCC nomogram (39.7%) positivity rate was most concordant with pathological prevalence for LNM (34.3%) compared to Partin tables (14.1%) and imaging (20.6). Prevalence of ECE (72.6%) was best predicted by MSKCC nomograms and imaging (83.6% each), compared to Partin tables (38.4%). For prevalence of SVI (45.2%), imaging (47.9%) performed superior to MSKCC (37.6%) and Partin tables (19.3%). On patient base, AUCs for LNM, ECE and SVI did not differ significantly between tests (p>0.05). Imaging revealed a high specificity (100%) for LNM and a sensitivity (60%) comparable to the MSKCC nomogram (68%) and Partin tables (60%). For ECE, imaging revealed the highest sensitivity (94.3%) compared to the MSKCC nomogram (66%) and Partin tables (71.1%). For SVI, sensitivity and specificity of imaging and MSKCC nomogram were comparable (81.5% and 80% vs. 87.9% and 75%). The rate of concordance to the final pTN-stage was 60.3% for imaging, 52.1% for the MSKCC nomogram and 39.7% for Partin tables. Conclusion: In our analysis, preoperative one-stop shop 68 Ga-PSMA-11 PET/MRI performs at least equally for T- and N-stage prediction compared to nomograms in high-risk PC patients. Despite, an improved prediction of the full final stage and the yield of additional anatomical information, the use of 68 Ga-PSMA-11 PET/MRI warrants further prospective evaluation. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Impact of Primary Gleason Grade on Risk Stratification for Gleason Score 7 Prostate Cancers

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

Koontz, Bridget F., E-mail: bridget.koontz@duke.edu; Tsivian, Matvey; Mouraviev, Vladimir

Purpose: To evaluate the primary Gleason grade (GG) in Gleason score (GS) 7 prostate cancers for risk of non-organ-confined disease with the goal of optimizing radiotherapy treatment option counseling. Methods: One thousand three hundred thirty-three patients with pathologic GS7 were identified in the Duke Prostate Center research database. Clinical factors including age, race, clinical stage, prostate-specific antigen at diagnosis, and pathologic stage were obtained. Data were stratified by prostate-specific antigen and clinical stage at diagnosis into adapted D'Amico risk groups. Univariate and multivariate analyses were performed evaluating for association of primary GG with pathologic outcome. Results: Nine hundred seventy-nine patientsmore » had primary GG3 and 354 had GG4. On univariate analyses, GG4 was associated with an increased risk of non-organ-confined disease. On multivariate analysis, GG4 was independently associated with seminal vesicle invasion (SVI) but not extracapsular extension. Patients with otherwise low-risk disease and primary GG3 had a very low risk of SVI (4%). Conclusions: Primary GG4 in GS7 cancers is associated with increased risk of SVI compared with primary GG3. Otherwise low-risk patients with GS 3+4 have a very low risk of SVI and may be candidates for prostate-only radiotherapy modalities.« less

Impact of primary Gleason grade on risk stratification for Gleason score 7 prostate cancers.

PubMed

Koontz, Bridget F; Tsivian, Matvey; Mouraviev, Vladimir; Sun, Leon; Vujaskovic, Zeljko; Moul, Judd; Lee, W Robert

2012-01-01

To evaluate the primary Gleason grade (GG) in Gleason score (GS) 7 prostate cancers for risk of non-organ-confined disease with the goal of optimizing radiotherapy treatment option counseling. One thousand three hundred thirty-three patients with pathologic GS7 were identified in the Duke Prostate Center research database. Clinical factors including age, race, clinical stage, prostate-specific antigen at diagnosis, and pathologic stage were obtained. Data were stratified by prostate-specific antigen and clinical stage at diagnosis into adapted D'Amico risk groups. Univariate and multivariate analyses were performed evaluating for association of primary GG with pathologic outcome. Nine hundred seventy-nine patients had primary GG3 and 354 had GG4. On univariate analyses, GG4 was associated with an increased risk of non-organ-confined disease. On multivariate analysis, GG4 was independently associated with seminal vesicle invasion (SVI) but not extracapsular extension. Patients with otherwise low-risk disease and primary GG3 had a very low risk of SVI (4%). Primary GG4 in GS7 cancers is associated with increased risk of SVI compared with primary GG3. Otherwise low-risk patients with GS 3+4 have a very low risk of SVI and may be candidates for prostate-only radiotherapy modalities. Copyright © 2012 Elsevier Inc. All rights reserved.

Unknown primary squamous cell carcinoma of the head and neck: retrospective analysis of 80 cases.

PubMed

Mizuta, Masanobu; Kitamura, Morimasa; Tateya, Ichiro; Tamaki, Hisanobu; Tanaka, Shinzo; Asato, Ryo; Shinohara, Shogo; Takebayashi, Shinji; Maetani, Toshiki; Kitani, Yoshiharu; Kumabe, Yohei; Kojima, Tsuyoshi; Ushiro, Koji; Ichimaru, Kazuyuki; Honda, Keigo; Yamada, Koichiro; Omori, Koichi

2018-06-01

The management of patients with cervical metastasis in head and neck cancer of unknown primary (HNCUP) remains controversial. This current multicenter retrospective study investigated the treatment outcomes of patients with HNCUP. The study included patients who were treated curatively at 12 institutions in Japan from January 2006 to December 2015. Eighty patients with HNCUP were included. The median follow-up period was 34 months. The three-year overall survival (OS), disease-specific survival (DSS), regional relapse-free survival (RRFS), local progression-free survival (LPFS), and distant metastasis-free survival (DMFS) rates were 72.5%, 80.3%, 74.0%, 89.7%, and 86.9%, respectively. Nodal status was a significant factor for OS, DSS, RRFS, and DMFS; and extracapsular extension (ECE) was significant for OS and DSS. There was a distinct difference between the survival rates of patients with N1-2a and N2b-3 disease. RT was a significant positive factor for LPFS (3-year LPFS, RT 93.0% vs. no RT 83.0%, p = .043). For N2a as well as N1 disease without ECE, a single treatment modality, including ND or RT alone is acceptable. When ND alone is performed, thorough monitoring should be continued during follow-up to identify the emergence of the primary lesion.

Patterns of care and outcomes of adjuvant therapy for high-risk head and neck cancer after surgery.

PubMed

Osborn, Virginia Wedell; Givi, Babak; Rineer, Justin; Roden, Dylan; Sheth, Niki; Lederman, Ariel; Katsoulakis, Evangelia; Hu, Kenneth; Schreiber, David

2018-06-01

Postoperative chemoradiotherapy (CRT) is considered standard of care in patients with locally advanced head and neck cancer with positive margins and/or extracapsular extension (ECE). The National Cancer Data Base (NCDB) was queried to identify patients with squamous cell carcinoma of the head and neck with stages III to IVB disease or with positive margins and/or ECE diagnosed between 2004 and 2012 receiving postoperative radiotherapy (RT). Using univariable and multivariable logistic and Cox regression, we assessed for predictors of CRT use and covariables impacting overall survival (OS), including in a propensity-matched subset. Of 12 224 patients, 67.1% with positive margins and/or ECE received CRT as well as 54.0% without positive margins and/or ECE. The 5-year OS was 61.6% for RT alone versus 67.4% for CRT. In the propensity-matched cohort, OS benefit persisted with CRT, including in a subset with positive margins and/or ECE but not without. Postoperative CRT seems underutilized with positive margins and/or ECE and overutilized without positive margins and/or ECE. The CRT was associated with improved OS but the benefit persisted only in the subset with positive margins and/or ECE. © 2018 Wiley Periodicals, Inc.

Is arthroplasty preferable to internal fixation for the treatment of extracapsular fracture of the upper femur in the elderly?

PubMed

Duriez, P; Devaux, T; Chantelot, C; Baudrier, N; Hery, J-Y; Mainard, D; Favier, T; Massin, P

2016-10-01

Although internal fixation is the reference treatment for extracapsular fracture of the upper femur, indications for arthroplasty are broadening, especially in unstable comminutive fracture in fragile bone. The present study hypothesis was that arthroplasty reduces early mortality and morbidity and provides better recovery of autonomy in over-80 year-old patients than does internal fixation. A prospective multicenter study was conducted on 8 sites. Internal fixation was systematically used in 5 centers; arthroplasty was used systematically in 1 center, and reserved for unstable fracture in 2 centers. A total of 697 patients aged over 80 years (mean age, 85±5 years), presenting with extracapsular fracture, were included; 521 were treated by internal fixation and 176 by arthroplasty. Results were studied on multivariate analysis of ASA score, blood loss, transfusion, and also of treatment modality as an independent factor for early (first 6 months) mortality and morbidity (mechanical, general and nutritional complications) and functional outcome (autonomy and dependence). Overall mortality was 19.2%. Autonomy deteriorated in 56% of patients alive at 6 months and dependence worsened in 44%. Two percent of those managed by internal fixation underwent revision for disassembly (n=8) or infection (n=1). Eight percent of those managed by arthroplasty underwent revision for dislocation (n=4), implant loosening (n=3) or infection (n=7). On univariate analysis, mortality was higher in the arthroplasty group (25%) than with internal fixation (17%; P=0.002), as were blood loss (425±286mL versus 333±223mL; P<0.0001), transfusion rate (61% versus 32%; P<0.0001) and infection (4% versus 0.2%; P<0.001). On multivariate analysis, however, treatment modality no longer showed impact on mortality or on morbidity and autonomy at 6 months. Nutritional status was better conserved at 6 months following arthroplasty, but dependence worsened. Poor preoperative autonomy, ASA score, and nutritional status and time to treatment were independent factors for mortality. Transfusion, associated with onset of mechanical complications, significantly increased dependence. Type of treatment had little impact on mortality, morbidity or functional outcome. Differences seemed more related to preoperative functional and nutritional status. III, prospective case-control study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

[Ganglions of the wrist: proposals for topographical systematization and natural history].

PubMed

Kuhlmann, J-N; Luboinski, J; Baux, S; Mimoun, M

2003-06-01

We looked for the anatomic origin and mechanism of constitution of the so-called "ganglions" of the wrist. Fifty-nine formations considered to be synovial ganglions were dissected and removed according to the same protocol by the same surgeon. Eleven were re-examined by a pathologist. All ganglions were extra-articular but had intra- and extra-capsular components. The extra-capsular part was the clinically palpable main cyst. The intra-capsular part was composed of the cystic stalk and its base of implantation. An intra-capsular stalk was present in 58 cases. The stalk was situated between the joint synovium and the capsula which it perforated at a weak point between two ligaments, forming a collar before expanding outwardly. Based on our findings, we propose a topographical systematization and natural history of ganglions of the wrist. The stalk's implantation base was always located on bone and found in the intermediate area of Colomniati and Soubbotine, which lies outside the articular cartilage between the synovium and the ligamentous capsula. This area is exposed to mechanical stress initiating histological degenerative lesions, particularly mucoid degeneration. At the radiocarpal joint, the stalk's base of implantation was located at the distal end of the lateral dorsal or volar edge of the lunate bone or at the corresponding part of the scaphoid. The collar of the proximal ganglions was situated between the dorsal radiocarpal and transverse scaphotriquetral ligament. The collar of distal dorsal ganglions was situated between the transverse scaphotriquetral and the trapezotriquetral ligament. The collar of the lateral ganglions was situated between the lateral collateral and the transverse ligament. The collar of the volar ganglions was situated between the stylocarpal ligament and the radiolunotriquetral ligament, or between the different stylocarpal ligaments. At the level of the scaphotrapezal joint, the stalk's base of implantation was located near the collateral edge of the distal surface of the joint with the collar between the distal scaphoidal ligaments. The palmar cysts exhibited a collar between the stylocarpal ligaments and the radiolunotriquetral ligament or between the different stylocarpal ligaments. At pathology examination, the lesions were not found to be different from those observed in other connective tissues exposed to overuse or repeated microtrauma (sports, occupational exposure). Anatomic conditions inside the joint capsula excluded extension of the mucoid degeneration transversally. The only issue was through the capsula, allowing the mucus enclosed in the connective tissue fibers to form the main cyst. Knowledge of these different processes enabled a topographical systematization useful for complete surgical or arthroscopic removal of the ganglion. Complete resection would prevent recurrence.

TRAIL Death Receptor-4 Expression Positively Correlates With the Tumor Grade in Breast Cancer Patients With Invasive Ductal Carcinoma

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

Sanlioglu, Ahter D.; Department of Medical Biology and Genetics, Akdeniz University Faculty of Medicine, Antalya; Korcum, Aylin F.

2007-11-01

Purpose: Tumor necrosis factor-related apoptosis inducing ligand (TRAIL) selectively induces apoptosis in cancer cells but not in normal cells, and a number of clinical trials have recently been initiated to test the safety and antitumoral potential of TRAIL in cancer patients. Four different receptors have been identified to interact with TRAIL: two are death-inducing receptors (TRAIL-R1 [DR4] and TRAIL-R2 [DR5]), whereas the other two (TRAIL-R3 [DcR1] and TRAIL-R4 [DcR2]) do not induce death upon ligation and are believed to counteract TRAIL-induced cytotoxicity. Because high levels of DcR2 expression have recently been correlated with carcinogenesis in the prostate and lung, thismore » study investigated the importance of TRAIL and TRAIL receptor expression in breast cancer patients with invasive ductal carcinoma, taking various prognostic markers into consideration. Methods and Materials: Immunohistochemical analyses were performed on 90 breast cancer patients with invasive ductal carcinoma using TRAIL and TRAIL receptor-specific antibodies. Age, menopausal status, tumor size, lymph node status, tumor grade, lymphovascular invasion, perineural invasion, extracapsular tumor extension, presence of an extensive intraductal component, multicentricity, estrogen and progesterone receptor status, and CerbB2 expression levels were analyzed with respect to TRAIL/TRAIL receptor expression patterns. Results: The highest TRAIL receptor expressed in patients with invasive ductal carcinoma was DR4. Although progesterone receptor-positive patients exhibited lower DR5 expression, CerbB2-positive tissues displayed higher levels of both DR5 and TRAIL expressions. Conclusions: DR4 expression positively correlates with the tumor grade in breast cancer patients with invasive ductal carcinoma.« less

Changes in corneal shape after suture cutting using the argon laser for postoperative astigmatism following cataract extraction.

PubMed

Hayashi, K; Nakao, F; Hayashi, F

1993-03-01

We studied the changes in corneal shape after suture cutting with an argon laser to reduce corneal astigmatism following cataract extraction. Sixty-two patients who exhibited high with-the-rule astigmatism (> 3 diopters [D]) following extracapsular lens extraction had argon laser suture cutting. The patients were classified into three groups: Group A comprised 30 patients whose sutures were cut two to three months after planned extracapsular cataract extraction (p-ECCE); Group B consisted of eight patients who had the same treatment five to nine months after p-ECCE; Group C comprised 24 patients who had the treatment one to two months after phacoemulsification (PE). The dioptric reduction of corneal astigmatism (the percent reduction of astigmatism) was 1.83 +/- 0.98 D (37.4 +/- 18.3%) in Group A, 3.20 +/- 2.35 D (55.6 +/- 34.4%) in Group B, and 2.08 +/- 1.20 D (41.4 +/- 20.4%) in Group C. There was no statistical significance in the dioptric reduction and the percent reduction among Groups A, B, and C. This suggests that the wound size and time of cutting are not directly correlated to the effect of argon laser suture cutting. To examine the relationship between the effect and changes in corneal shape from suture cutting, we divided the patients into two subgroups; one was Subgroup (+) in which the percent reduction of astigmatism was above 25%; the other was Subgroup (-) in which the percent reduction was below 25%.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavior of squamous cell carcinoma of the floor of the mouth. Is supraomohyoid neck dissection sufficiently safe to manage clinically N0 patients?

PubMed

Cariati, Paolo; Cabello Serrano, Almudena; Roman Ramos, Maria; Sanchez Lopez, Dario; Fernandez Solis, Jose; Martinez Lara, Ildefonso

2018-05-11

The main aim of the present report is to study the behavior of SCC of the floor of the mouth. A retrospective analysis was conducted using the records of patients diagnosed with squamous cell carcinoma of the floor of the mouth between 2000 and 2012 in the HUVN. Ninety-three patients with squamous cell carcinoma of the floor of the mouth treated with tumourectomy and selective neck dissection were included in the study. The pattern of distribution of cervical metastases and numerous histological features such as T-stage, N stage, surgical margins, tumor thickness, ECS (extracapsular spread) and vascular invasion were analyzed. Level I was the most affected level, followed by Level II. T stage, tumor thickness, and surgical margins showed a strong relationship with the risk of developing a local or cervical failure at follow-up. Overall survival was 52.7%. T stage, tumor thickness, N stage, recurrence, extracapsular spread, and vascular invasion were also associated with a poor prognosis. SCC of the floor of the mouth is an aggressive disease even at early stages. Due to the low rate of positive nodes observed at level IV and V in clinically N0 patients, supraomohyoid neck dissection might be considered sufficiently safe in this group. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Prognostic impact of perineural invasion and lymphovascular invasion in advanced stage oral squamous cell carcinoma.

PubMed

Jardim, J F; Francisco, A L N; Gondak, R; Damascena, A; Kowalski, L P

2015-01-01

Perineural invasion (PNI) and lymphovascular invasion (LVI) have been associated with the risk of local recurrences and lymph node metastasis. The aim of this study was to evaluate the prognostic impact of PNI and LVI in patients with advanced stage squamous cell carcinoma of the tongue and floor of the mouth. One hundred and forty-two patients without previous treatment were selected. These patients underwent radical surgery with neck dissection and adjuvant treatment. Clinicopathological data were retrieved from the medical charts, including histopathology and surgery reports. Univariate analysis was performed to assess the impact of studied variables on survival. Overall survival was negatively influenced by six tumour-related factors: increasing T stage (P = 0.003), more than two clinically positive nodes (P = 0.002), extracapsular spread of lymph node metastasis (P < 0.001), tumour thickness (P = 0.04), PNI (P < 0.001), and LVI (P = 0.012). Disease-free survival was influenced by PNI (P = 0.04), extracapsular spread of lymph node metastasis (P = 0.008), and N stage (P = 0.006). Multivariate analysis showed PNI to be an independent predictor for overall survival (P = 0.01) and disease-free survival (P = 0.03). Thus the presence of PNI in oral carcinoma surgical specimens has a significant impact on survival outcomes in patients with advanced stage tumours submitted to radical surgery and adjuvant radiotherapy/radiochemotherapy. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Locoregional Control and Toxicity in Head and Neck Carcinoma Patients following Helical Tomotherapy-Delivered Intensity-Modulated Radiation Therapy Compared with 3D-CRT Data.

PubMed

Santa Cruz, Olalla; Tsoutsou, Pelagia; Castella, Cyril; Khanfir, Kaouthar; Anchisi, Sandro; Bouayed, Salim; Matzinger, Oscar; Ozsahin, Mahmut

2018-06-12

To assess the feasibility and efficacy of intensity-modulated radiation implemented with helical tomotherapy image-guided with daily megavoltage computed tomography for head and neck cancer. Between May 2010 and May 2013, 72 patients were treated with curative intent. The median age was 64 years, with 57% undergoing definitive and 43% postoperative radiotherapy. Primary tumour sites were oral cavity (21%), oropharynx (26%), hypopharynx (20%), larynx (22%), and others (11%). Staging included 4% stage I, 15% II, 26% III, 48% IVa, and 7% IVb. Radiotherapy was combined with chemotherapy in 64%. Primary endpoint was locoregional control, and secondary endpoints survival and toxicity. Median follow-up was 20 months, with 11 locoregional recurrences. Three-year disease-free survival was 58% and overall survival 57%. In the multivariate analysis, age under 64 years, no extracapsular extension, postoperative radiotherapy, induction chemotherapy, and non-oral cavity tumour were significant favourable prognostic factors for disease-free-survival. The overall incidence of acute grade ≥3 toxicities were mucositis 32%, pain 11%, xerostomia 7%, dysphagia 53%, radiodermatitis 44%, and osteonecrosis 1%. Late grade ≥3 toxicities were fibrosis 6%, dysphagia 21%, fistula 1%, and skin necrosis 1%. Intensity-modulated radiation with helical tomotherapy achieved respectable locoregional control and overall survival, with acceptable toxicity, in head and neck cancer patients. © 2018 S. Karger AG, Basel.

Outcomes of oral cavity cancer patients treated with surgery followed by postoperative intensity modulated radiation therapy.

PubMed

Quinlan-Davidson, Sean R; Mohamed, Abdallah S R; Myers, Jeffrey N; Gunn, Gary B; Johnson, Faye M; Skinner, Heath; Beadle, Beth M; Gillenwater, Ann M; Phan, Jack; Frank, Steven J; William, William N; Wong, Andrew J; Lai, Stephen Y; Fuller, Clifton D; Morrison, William H; Rosenthal, David I; Garden, Adam S

2017-09-01

Although treatment paradigms have not changed significantly, radiotherapy, surgery, and imaging techniques have improved, leading us to investigate oncologic and survival outcomes for oral cavity squamous cell cancer (OCSCC) patients treated with surgery followed by postoperative IMRT. Records of patients with pathological diagnosis of OCSCC treated between 2000 and 2012 were retrospectively reviewed. Patients' demographic, disease, and treatment criteria were extracted. Kaplan-Meier method was used to calculate survival curves. Two hundred eighty-nine patients were analyzed. Median follow-up was 35months. Two hundred sixty-eight had neck dissections (93%), of which 66% had nodal involvement, and 51% of those positive dissections had extracapsular extension. Forty patients received induction chemotherapy and 107 received concurrent chemotherapy. Median dose to high risk clinical target volume was 60Gy/30 fractions. The 5-year locoregional control and overall survival rates were 76% and 57%, respectively. Tumors with >1.5cm depth of invasion had significantly higher risk of local failure compared with ≤1.5cm (p<0.001). In multivariate analysis, positive and no neck dissection (p=0.01), positive lymphovascular invasion (p=0.006) and >1.5cm depth of invasion (p=0.003) were independent predictors of poorer survival. Disease outcomes were consistent with historical data and did not appear compromised by the use of IMRT. Copyright © 2017 Elsevier Ltd. All rights reserved.

Outcomes of oral cavity cancer patients treated with surgery followed by postoperative intensity modulated radiation therapy

PubMed Central

Quinlan-Davidson, Sean R.; Mohamed, Abdallah S. R.; Myers, Jeffrey N.; Gunn, Gary B.; Johnson, Faye M.; Skinner, Heath; Beadle, Beth M; Gillenwater, Ann M.; Phan, Jack; Frank, Steven J.; William, William N.; Wong, Andrew J.; Lai, Stephen Y.; Fuller, Clifton D.; Morrison, William H.; Rosenthal, David I.; Garden, Adam S.

2018-01-01

Objectives Although treatment paradigms have not changed significantly, radiotherapy, surgery, and imaging techniques have improved, leading us to investigate oncologic and survival outcomes for oral cavity squamous cell cancer (OCSCC) patients treated with surgery followed by postoperative IMRT. Material and Methods Records of patients with pathological diagnosis of OCSCC treated between 2000–2012 were retrospectively reviewed. Patients’ demographic, disease, and treatment criteria were extracted. Kaplan-Meier method was used to calculate survival curves. Results Two hundred eighty-nine patients were analyzed. Median follow-up was 35 months. Two hundred sixty-eight had neck dissections (93%), of which 66% had nodal involvement, and 51% of those positive dissections had extracapsular extension. Forty patients received induction chemotherapy and 107 received concurrent chemotherapy. Median dose to high risk clinical target volume was 60 Gy/30 fractions. The 5-year locoregional control and overall survival rates were 76% and 57%, respectively. Tumors with >1.5 cm depth of invasion had significantly higher risk of local failure compared with ≤1.5 cm (p<0.001). In multivariate analysis, positive and no neck dissection (p=0.01), positive lymphovascular invasion (p=0.006) and >1.5 cm depth of invasion (p=0.003) were independent predictors of poorer survival. Conclusions Disease outcomes were consistent with historical data and did not appear compromised by the use of IMRT. PMID:28797467

Regional Radiation Therapy Impacts Outcome for Node-Positive Cutaneous Melanoma.

PubMed

Strom, Tobin; Torres-Roca, Javier F; Parekh, Akash; Naghavi, Arash O; Caudell, Jimmy J; Oliver, Daniel E; Messina, Jane L; Khushalani, Nikhil I; Zager, Jonathan S; Sarnaik, Amod; Mulé, James J; Trotti, Andy M; Eschrich, Steven A; Sondak, Vernon K; Harrison, Louis B

2017-04-01

Background: Regional radiation therapy (RT) has been shown to reduce the risk of regional recurrence with node-positive cutaneous melanoma. However, risk factors for regional recurrence, especially in the era of sentinel lymph node biopsy (SLNB), are less clear. Our goals were to identify risk factors associated with regional recurrence and to determine whether a radiosensitivity index (RSI) gene expression signature (GES) could identify patients who experience a survival benefit with regional RT. Methods: A single-institution, Institutional Review Board-approved study was performed including 410 patients treated with either SLNB with or without completion lymph node dissection (LND; n=270) or therapeutic LND (n=91). Postoperative regional RT was delivered to the involved nodal basin in 83 cases (20.2%), to a median dose of 54 Gy (range, 30-60 Gy) in 27 fractions (range, 5-30). Primary outcomes were regional control and overall survival by RSI GES status. Results: Median follow-up was 69 months (range, 13-180). Postoperative regional RT was associated with a reduced risk of regional recurrence among all patients on univariate (5-year estimate: 95.0% vs 83.3%; P =.036) and multivariate analysis (hazard ratio[HR], 0.15; 95% CI, 0.05-0.43; P <.001). Among higher-risk subgroups, regional RT was associated with a lower risk of regional recurrence among patients with clinically detected lymph nodes (n=175; 5-year regional control: 94.1% vs 69.5%; P =.003) and extracapsular extension (ECE) present (n=138; 5-year regional control: 96.7% vs 62.2%; P <.001). Among a subset of radiated patients with gene expression data available, a low RSI GES (radiosensitive) tumor status was associated with improved survival compared with a high RSI GES (5-year: 75% vs 0%; HR, 10.68; 95% CI, 1.24-92.14). Conclusions: Regional RT was associated with a reduced risk of regional recurrence among patients with ECE and clinically detected nodal disease. Gene expression data show promise for better predicting radiocurable patients in the future. In the era of increasingly effective systemic therapies, the value of improved regional control potentially takes on greater significance. Copyright © 2017 by the National Comprehensive Cancer Network.

Two-Phase Helical Computed Tomography Study of Salivary Gland Warthin Tumors: A Radiologic Findings and Surgical Applications

PubMed Central

Joo, Yeon Hee; Kim, Jin Pyeong; Park, Jung Je

2014-01-01

Objectives The goal of this study was to define the radiologic characteristics of two-phase computed tomography (CT) of salivary gland Warthin tumors and to compare them to pleomorphic adenomas. We also aimed to provide a foundation for selecting a surgical method on the basis of radiologic findings. Methods We prospectively enrolled 116 patients with parotid gland tumors, who underwent two-phase CT preoperatively. Early and delayed phase scans were obtained, with scanning delays of 30 and 120 seconds, respectively. The attenuation changes and enhancement patterns were analyzed. In cases when the attenuation changes were decreased, we presumed Warthin tumor preoperatively and performed extracapsular dissection. When the attenuation changes were increased, superficial parotidectomy was performed on the parotid gland tumors. We analyzed the operation times, incision sizes, complications, and recurrence rates. Results Attenuation of Warthin tumors was decreased from early to delayed scans. The ratio of CT numbers in Warthin tumors was also significantly different from other tumors. Warthin tumors were diagnosed with a sensitivity of 96.1% and specificity of 97% using two-phase CT. The mean operation time was 38 minutes and the mean incision size was 36.2 mm for Warthin tumors. However, for the other parotid tumors, the average operation time was 122 minutes and the average incision size was 91.8 mm (P<0.05). Conclusion Salivary Warthin tumor has a distinct pattern of contrast enhancement on two-phase CT, which can guide treatment decisions. The preoperative diagnosis of Warthin tumor made extracapsular dissection possible instead of superficial parotidectomy. PMID:25177439

Two-phase helical computed tomography study of salivary gland warthin tumors: a radiologic findings and surgical applications.

PubMed

Joo, Yeon Hee; Kim, Jin Pyeong; Park, Jung Je; Woo, Seung Hoon

2014-09-01

The goal of this study was to define the radiologic characteristics of two-phase computed tomography (CT) of salivary gland Warthin tumors and to compare them to pleomorphic adenomas. We also aimed to provide a foundation for selecting a surgical method on the basis of radiologic findings. We prospectively enrolled 116 patients with parotid gland tumors, who underwent two-phase CT preoperatively. Early and delayed phase scans were obtained, with scanning delays of 30 and 120 seconds, respectively. The attenuation changes and enhancement patterns were analyzed. In cases when the attenuation changes were decreased, we presumed Warthin tumor preoperatively and performed extracapsular dissection. When the attenuation changes were increased, superficial parotidectomy was performed on the parotid gland tumors. We analyzed the operation times, incision sizes, complications, and recurrence rates. Attenuation of Warthin tumors was decreased from early to delayed scans. The ratio of CT numbers in Warthin tumors was also significantly different from other tumors. Warthin tumors were diagnosed with a sensitivity of 96.1% and specificity of 97% using two-phase CT. The mean operation time was 38 minutes and the mean incision size was 36.2 mm for Warthin tumors. However, for the other parotid tumors, the average operation time was 122 minutes and the average incision size was 91.8 mm (P<0.05). Salivary Warthin tumor has a distinct pattern of contrast enhancement on two-phase CT, which can guide treatment decisions. The preoperative diagnosis of Warthin tumor made extracapsular dissection possible instead of superficial parotidectomy.

[Extracapsular hepatic adenoma. Case report and literature review].

PubMed

Vargas-Flores, Edgar; Pérez-Aguilar, Francisco; Valdez-Mendieta, Yanet

Hepatic adenomas are uncommon epithelial tumours. They usually appear in women between 20 and 44 years old. They are commonly located in the right hepatic lobe and are typically solitary masses. Multiple adenomas can present in patients with prolonged use of oral contraceptive pills, glycogen storage diseases and hepatic adenomatosis. A 35 year-old woman without any significant past medical history, with a chief complaint that started in December 2012 with oppressive, mild intensity abdominal pain located in right upper quadrant in the abdomen on deep palpation. With an abdominal ultrasound showing a mass of 91×82×65cm located in the right flank, isoechogenic with internal vascularity. Contrast computed tomography scan showing an ovoid tumour with circumscribed borders, with heterogenic intense reinforcement and displacement of adjacent structures with dimensions of 88×71×80cm. In laparotomy, excision of the tumour and cholecystectomy with the trans surgical findings of an 8cm tumour with a pedicle containing one artery and one vein coming from the hepatic free border with strong adhesions to the gallbladder. Pathologic diagnosis: Extracapsular hepatic adenoma. Incidence of hepatic adenomas has increased in the last decades, in a parallel fashion with the introduction of oral contraceptive pills, showing association with glycogen storage diseases and to a lesser degree with diabetes and pregnancy. Diagnosis is clinical with the aid of imaging studies. Prognosis of hepatic adenomas is not well established, therefore, management depends on symptoms, size, number, location and certainty of diagnosis. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Long Term Functional Outcome of Tibial Tuberosity Advancement vs. Tibial Plateau Leveling Osteotomy and Extracapsular Repair in a Heterogeneous Population of Dogs.

PubMed

Krotscheck, Ursula; Nelson, Samantha A; Todhunter, Rory J; Stone, Marisa; Zhang, Zhiwu

2016-02-01

To determine a long term function of tibial tuberosity advancement (TTA) for treatment of ruptured cranial cruciate ligament (CCL) in dogs, and to compare this to the long term function of previously reported tibial plateau leveling osteotomy (TPLO), extracapsular reconstruction (ECR), and a population of normal dogs. Prospective clinical trial. Dogs with unilateral ruptured CCL treated with TTA (n = 14), TPLO (n = 15), and ECR (n = 23), and normal adult dogs (control, n = 80). Force plate gait analysis was performed at 1 time point for the normal control group and preoperatively, and at 2 and 8 weeks and 6 and 12 months postoperatively for the treatment groups. Using serial force plates, symmetry indices (SI) were calculated between the operated and unoperated pelvic limbs for peak vertical force (PVF), contact time (CT), and vertical impulse (VI). Ground reaction forces (GRF) of the treatment and control group were compared using a general linear model. Walk SI for dogs with TTA were not significantly different from the control group at 12 months postoperatively. At the trot, neither TTA nor ECR achieved normal GRF. SI of the TPLO group were not different from the normal control group by 6-12 months postoperatively. At the walk, TTA achieves normal function by 12 months; however, at the trot TTA is indistinguishable from ECR. TPLO resulted in operated limb function that was similar to the control population by 6-12 months postoperatively at the walk and the trot. © Copyright 2016 by The American College of Veterinary Surgeons.

Surgical options in benign parotid tumors: a proposal for classification.

PubMed

Quer, Miquel; Vander Poorten, Vincent; Takes, Robert P; Silver, Carl E; Boedeker, Carsten C; de Bree, Remco; Rinaldo, Alessandra; Sanabria, Alvaro; Shaha, Ashok R; Pujol, Albert; Zbären, Peter; Ferlito, Alfio

2017-11-01

Different surgical options are currently available for treating benign tumors of the parotid gland, and the discussion on optimal treatment continues despite several meta-analyses. These options include more limited resections (extracapsular dissection, partial lateral parotidectomy) versus more extensive and traditional options (lateral parotid lobectomy, total parotidectomy). Different schools favor one option or another based on their experience, skills and tradition. This review provides a critical analysis of the literature regarding these options. The main limitation of all the studies is the bias of selection for different surgical approaches. For this reason, we propose a staging system that could facilitate clinical decision making and the comparison of results. We propose four categories based on the size of the tumor and its location within the parotid gland. Category I includes tumors up to 3 cm, which are mobile, close to the outer surface and close to the parotid borders. Category II includes deeper tumors up to 3 cm. Category III comprises tumors greater than 3 cm involving two levels of the parotid gland, and category IV tumors are greater than 3 cm and involve more than 2 levels. For each category and for the various pathologic types, a guideline of surgical extent is proposed. The objective of this classification is to facilitate prospective multicentric studies on surgical techniques in the treatment of benign parotid tumors and to enable the comparison of results of different clinical studies.

Ultrasound elastography as a tool for imaging guidance during prostatectomy: Initial experience

PubMed Central

Fleming, Ioana Nicolaescu; Kut, Carmen; Macura, Katarzyna J.; Su, Li-Ming; Rivaz, Hassan; Schneider, Caitlin; Hamper, Ulrike; Lotan, Tamara; Taylor, Russ; Hager, Gregory; Boctor, Emad

2012-01-01

Summary Background During laparoscopic or robotic assisted laparoscopic prostatectomy, the surgeon lacks tactile feedback which can help him tailor the size of the excision. Ultrasound elastography (USE) is an emerging imaging technology which maps the stiffness of tissue. In the paper we are evaluating USE as a palpation equivalent tool for intraoperative image guided robotic assisted laparoscopic prostatectomy. Material/Methods Two studies were performed: 1) A laparoscopic ultrasound probe was used in a comparative study of manual palpation versus USE in detecting tumor surrogates in synthetic and ex-vivo tissue phantoms; N=25 participants (students) were asked to provide the presence, size and depth of these simulated lesions, and 2) A standard ultrasound probe was used for the evaluation of USE on ex-vivo human prostate specimens (N=10 lesions in N=6 specimens) to differentiate hard versus soft lesions with pathology correlation. Results were validated by pathology findings, and also by in-vivo and ex-vivo MR imaging correlation. Results In the comparative study, USE displayed higher accuracy and specificity in tumor detection (sensitivity=84%, specificity=74%). Tumor diameters and depths were better estimated using USE versus with manual palpation. USE also proved consistent in identification of lesions in ex-vivo prostate specimens; hard and soft, malignant and benign, central and peripheral. Conclusions USE is a strong candidate for assisting surgeons by providing palpation equivalent evaluation of the tumor location, boundaries and extra-capsular extension. The results encourage us to pursue further testing in the robotic laparoscopic environment. PMID:23111738

Role of chronic lymphocytic thyroiditis in central node metastasis of papillary thyroid carcinoma.

PubMed

Paulson, Lorien M; Shindo, Maisie L; Schuff, Kathryn G

2012-09-01

(1) To investigate the role of chronic lymphocytic thyroiditis (CLT) in central node metastasis of papillary thyroid carcinoma (PTC) and (2) to evaluate the presence of chronic lymphocytic thyroiditis according to PTC-specific molecular markers. Historical cohort study. Academic medical center. All patients who underwent total thyroidectomy with central neck dissection for PTC at Oregon Health & Science University between 2005 and 2010 were screened for the presence of CLT and reviewed for clinical prognostic factors. Patients with inadequate central neck dissections were excluded. Molecular markers for PTC were analyzed on archived tumor samples. A total of 139 patients met selection criteria. The rate of CLT was 43.8%. The rate of central node positivity was 63%. Presence of CLT was associated with a significantly lower proportion of central node metastases (49% vs 74%, P = .003) and angiolymphatic invasion (31% vs 15%, P = .03). There was no significant difference in mean age, tumor size, and extracapsular extension. Molecular genotyping did not reveal a significant difference in the types of mutations found in both groups. The data indicate a lower incidence of central compartment lymph node metastasis in those with CLT in this patient population, suggesting a potential protective role in tumor spread. The equal distribution of tumor mutations between the carcinomas with and without evidence of CLT argues against a mutation-specific antigen as the immunologic stimulus. Further research is needed to characterize the role of autoimmunity in thyroid cancer.

Preoperative [18F]fluorodeoxyglucose positron emission tomography standardized uptake value of neck lymph nodes predicts neck cancer control and survival rates in patients with oral cavity squamous cell carcinoma and pathologically positive lymph nodes.

PubMed

Liao, Chun-Ta; Chang, Joseph Tung-Chieh; Wang, Hung-Ming; Ng, Shu-Hang; Hsueh, Chuen; Lee, Li-Yu; Lin, Chih-Hung; Chen, I-How; Huang, Shiang-Fu; Cheng, Ann-Joy; Yen, Tzu-Chen

2009-07-15

Survival in oral cavity squamous cell carcinoma (OSCC) depends heavily on locoregional control. In this prospective study, we sought to investigate whether preoperative maximum standardized uptake value of the neck lymph nodes (SUVnodal-max) may predict prognosis in OSCC patients. A total of 120 OSCC patients with pathologically positive lymph nodes were investigated. All subjects underwent a [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) scan within 2 weeks before radical surgery and neck dissection. All patients were followed up for at least 24 months after surgery or until death. Postoperative adjuvant therapy was performed in the presence of pathologic risk factors. Optimal cutoff values of SUVnodal-max were chosen based on 5-year disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Independent prognosticators were identified by Cox regression analysis. The median follow-up for surviving patients was 41 months. The optimal cutoff value for SUVnodal-max was 5.7. Multivariate analyses identified the following independent predictors of poor outcome: SUVnodal-max >or=5.7 for the 5-year neck cancer control rate, distant metastatic rate, DFS, DSS, and extracapsular spread (ECS) for the 5-year DSS and OS. Among ECS patients, the presence of a SUVnodal-max >or=5.7 identified patients with the worst prognosis. A SUVnodal-max of 5.7, either alone or in combination with ECS, is an independent prognosticator for 5-year neck cancer control and survival rates in OSCC patients with pathologically positive lymph nodes.

Long-term survival outcomes in patients with surgically treated oropharyngeal cancer and defined human papilloma virus status.

PubMed

Dale, O T; Sood, S; Shah, K A; Han, C; Rapozo, D; Mehanna, H; Winter, S C

2016-11-01

This study investigated long-term survival outcomes in surgically treated oropharyngeal cancer patients with known human papilloma virus status. A case note review was performed of all patients undergoing primary surgery for oropharyngeal cancer in a single centre over a 10-year period. Human papilloma virus status was determined via dual modality testing. Associations between clinicopathological variables and survival were identified using a log-rank test. Of the 107 cases in the study, 40 per cent (n = 41) were human papilloma virus positive. The positive and negative predictive values of p16 immunohistochemistry for human papilloma virus status were 57 per cent and 100 per cent, respectively. At a mean follow up of 59.5 months, 5-year overall and disease-specific survival estimates were 78 per cent and 69 per cent, respectively. Human papilloma virus status (p = 0.014), smoking status (p = 0.021) and tumour stage (p = 0.03) were significant prognostic indicators. The long-term survival rates in surgically treated oropharyngeal cancer patients were comparable to other studies. Variables including human papilloma virus status and tumour stage were associated with survival in patients treated with primary surgery; however, nodal stage and presence of extracapsular spread were non-prognostic.

Outcome Analysis of Patients With Oral Cavity Cancer and Extracapsular Spread in Neck Lymph Nodes

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

Liao, Chun-Ta, E-mail: liaoct@adm.cgmh.org.tw; Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Lee, Li-Yu

Purpose: Extracapsular spread (ECS) in neck lymph nodes is a major adverse prognostic factor in patients with oral cavity squamous cell carcinoma (OSCC). We conducted a retrospective analysis of prognostic factors in this patient group and tried to identify a subset of patients with a worse prognosis suitable for more aggressive therapeutic interventions. Methods and Materials: Enrolled in the study were 255 OSCC patients with ECS in neck nodes and without evidence of distant metastasis. All participants were followed-up for at least 2 years or censored at last follow-up. The 5-year rates of control, distant metastasis, and survival were themore » main outcome measures. Results: Level IV/V lymph node metastases and tumor depth {>=}12 mm were independent predictors of 5-year survival and identified three prognostic groups. In the low-risk group (no level IV/V metastases and tumor depth <12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 60%, 66%, and 50%, respectively. In the intermediate-risk group (no level IV/V metastases and tumor depth {>=}12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 39%, 41%, and 28%, respectively. In the high-risk group (evidence of level IV/V metastases), the 5-year disease-free, disease-specific, and overall survival rates were 14%, 12%, and 10%, respectively. Conclusions: Among OSCC patients with ECS, those with level IV/V metastases appear to have the worst prognosis followed by without level IV/V metastases and tumor depth {>=}12 mm. An aggressive therapeutic approach may be suitable for intermediate- and high-risk patients.« less

Intra- and extra-capsular hip fractures in the elderly: Two different pathologies?

PubMed

Dinamarca-Montecinos, J L; Prados-Olleta, N; Rubio-Herrera, R; Castellón-Sánchez del Pino, A; Carrasco-Buvinic, A

2015-01-01

To compare intracapsular (IC) and extracapsular (EC) hip fractures (HIF) in elderly patients in order to determine if they are different pathologies. Longitudinal, observational, descriptive, analytical prospective design, using a non-probabilistic sample from a full sample collection with 647 subjects (male and female), of 60 or more years old, admitted with HIF to the Department of Orthopedics and Traumatology of the Hospital, between January 1, 2010 and December 31, 2012. Follow-up was for 1 year post HIF. Socio-demographic, etiological, developmental, therapeutic and prognostic variables are compared. This is the first study on this subject with Latin American population. EC HIF incidence was superior to IC, contrary to that published in European/American populations. There are significant differences in etiological variables (χ(2)=6.34, p<0.042), with traumatic etiology in EC and non-traumatic in IC. There are also differences in therapeutic interventions performed (osteosynthesis for EC, arthroplasty for IC), with the decision on not to operate being lower in IC (both p<0.0000). The variables associated with the decision on not to perform surgery are age, etiology and postoperative mortality. The results are similar to other studies, adding the IC association with non-traumatic origin, in particular the trend of statistical association between IC and non-primary osteoporotic pathology (neoplasms, renal osteodystrophy, primary hyperparathyroidism). A further analysis was performed on the differences between Latin American and European/American populations in the incidence of either type of HIF. There are important etiological and therapeutic differences between IC and EC HIF; therefore it would be advisable to consider them as distinct disease entities. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

MR imaging of silicone breast implants: evaluation of prospective and retrospective interpretations and interobserver agreement.

PubMed

Quinn, S F; Neubauer, N M; Sheley, R C; Demlow, T A; Szumowski, J

1996-01-01

MR imaging was used to evaluate the integrity of silicone breast implants in 54 women with 108 implants. MR images were interpreted by relatively inexperienced readers who tried to reproduce the experiences reported in the literature. The study examines the interobserver agreement using different diagnostic signs and the influence of experience on interpretation errors. Prospective and retrospective interpretations were compared with surgical findings at the time of explanation. Diagnostic indicators, including the linguine sign, the inverted tear drop sign, the C sign, water droplets mixed with silicone, and extracapsular globules of silicone, were evaluated for diagnostic efficacy and interobserver agreement. The prospective sensitivity and specificity were 87% and 78%, respectively. With the retrospective interpretations, the sensitivity and specificity increased to 93% and 92%, respectively. Most of the prospective false-positive interpretations were due to misinterpreting radial folds as signs of implant rupture. Six implants interpreted retrospectively as false positives had gross amounts of silicone around the implants at surgery but there were no obvious rents in the implant shells. There was fair to excellent interobserver agreement with the individual diagnostic signs except for extracapsular globules of silicone. All of the signs had specificities of greater than 90%. The sensitivities of the individual signs were less than the overall retrospective sensitivity. With experience, the sensitivity improved from 87% to 93% and the specificity improved from 78% to 92%. This study helps substantiate the use of diagnostic signs used by other authors to detect silicone loss from breast implants by MR imaging; however, questions remain as to the clinical role of MR imaging in evaluating implants for silicone loss.

Factors influencing the indication for tonsillectomy: a historical overview and current concepts.

PubMed

Hultcrantz, Elisabeth; Ericsson, Elisabeth

2013-01-01

Tonsil surgery has been performed for more than 3,000 years. During the 19th century when anesthesia became available, techniques were refined and the number of procedures performed increased. Repeated throat infections often causing big tonsils was the reason why parents asked for the procedure. During the preantibiotic era, scarlet fever was feared since potential heart or kidney complications were life-threatening. The technique used before 1900 was tonsillotomy since neither a fingernail, snare nor the later 'guillotine' were used extracapsularly. Bleeding was small and the surgery ambulatory. Extracapsular tonsillectomy developed around the turn of the 20th century with the purpose of avoiding remnants - the 'focal infection theory' was prevailing. The whole tonsil was now extirpated with good visibility of the tonsillar area in a deeply anesthetized patient. During the first half of the 20th century, the two methods competed, but by 1950, total tonsillectomy had become the only 'correct' tonsil surgery. The indication was still recurrent infections. The risk for serious bleeding increased; therefore large clinics arose where patients remained for at least a week after tonsillectomy. When oral penicillin for children became available during the 1960s, the threat of throat infection decreased and the number of tonsillectomies declined. The awareness of obstructive problems in children rose at the same time when obstructive sleep apnea syndrome became a disease for adults (1970s). Tonsillotomy was revived during the 1990s and is today used increasingly in many countries. The indication is mainly obstructive sleep apnea syndromeor sleep-disordered breathing, especially in small children. Total tonsillectomy is still preferred for recurrent infections, which include periodic fever/adenitis/pharyngitis/aphthous ulcer syndrome and recurrent peritonsillitis. Copyright © 2013 S. Karger AG, Basel.

A survey of perceived training differences between ophthalmology residents in Hong Kong and China.

PubMed

Young, Alvin L; Jhanji, Vishal; Liang, Yuanbo; Congdon, Nathan; Chow, Simon; Wang, Fenghua; Zhang, Xiujuan; Man, Xiaofei; Yang, Mingming; Lin, Zhong; Yuen, Hunter G L; Lam, Dennis S C

2015-09-28

To study the differences in ophthalmology resident training between China and the Hong Kong Special Administrative Region (HKSAR). Training programs were selected from among the largest and best-known teaching hospitals. Ophthalmology residents were sent an anonymous 48-item questionnaire by mail. Work satisfaction, time allocation between training activities and volume of surgery performed were determined. 50/75 residents (66.7 %) from China and 20/26 (76.9 %) from HKSAR completed the survey. Age (28.9 ± 2.5 vs. 30.2 ± 2.9 years, p = 0.15) and number of years in training (3.4 ± 1.6 vs. 2.8 ± 1.5, p = 0.19) were comparable between groups. The number of cataract procedures performed by HKSAR trainees (extra-capsular, median 80.0, quartile range: 30.0, 100.0; phacoemulsification, median: 20.0, quartile range: 0.0, 100.0) exceeded that for Chinese residents (extra-capsular: median = 0, p < 0.0001; phacoemulsification: median = 0, p < 0.0001). Chinese trainees spent more time completing medical charts (>50 % of time on charts: 62.5 % versus 5.3 %, p < 0.0001) and received less supervision (≥90 % of training supervised: 4.4 % versus 65 %, p < 0.0001). Chinese residents were more likely to feel underpaid (96.0 % vs. 31.6 %, p < 0.0001) and hoped their children would not practice medicine (69.4 % vs. 5.0 %, p = 0.0001) compared HKSAR residents. In this study, ophthalmology residents in China report strikingly less surgical experience and supervision, and lower satisfaction than HKSAR residents. The HKSAR model of hands-on resident training might be useful in improving the low cataract surgical rate in China.

An eleven gene molecular signature for extra-capsular spread in oral squamous cell carcinoma serves as a prognosticator of outcome in patients without nodal metastases.

PubMed

Wang, Weining; Lim, Weng Khong; Leong, Hui Sun; Chong, Fui Teen; Lim, Tony K H; Tan, Daniel S W; Teh, Bin Tean; Iyer, N Gopalakrishna

2015-04-01

Extracapsular spread (ECS) is an important prognostic factor for oral squamous cell carcinoma (OSCC) and is used to guide management. In this study, we aimed to identify an expression profile signature for ECS in node-positive OSCC using data derived from two different sources: a cohort of OSCC patients from our institution (National Cancer Centre Singapore) and The Cancer Genome Atlas (TCGA) head and neck squamous cell carcinoma (HNSCC) cohort. We also sought to determine if this signature could serve as a prognostic factor in node negative cancers. Patients with a histological diagnosis of OSCC were identified from an institutional database and fresh tumor samples were retrieved. RNA was extracted and gene expression profiling was performed using the Affymetrix GeneChip Human Genome U133 Plus 2.0 microarray platform. RNA sequence data and corresponding clinical data for the TCGA HNSCC cohort were downloaded from the TCGA Data Portal. All data analyses were conducted using R package and SPSS. We identified an 11 gene signature (GGH, MTFR1, CDKN3, PSRC1, SMIM3, CA9, IRX4, CPA3, ZSCAN16, CBX7 and ZFP3) which was robust in segregating tumors by ECS status. In node negative patients, patients harboring this ECS signature had a significantly worse overall survival (p=0.04). An eleven gene signature for ECS was derived. Our results also suggest that this signature is prognostic in a separate subset of patients with no nodal metastasis Further validation of this signature on other datasets and immunohistochemical studies are required to establish utility of this signature in stratifying early stage OSCC patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

The epidemiology and functional outcomes of operative fixation of extracapsular proximal femoral fractures (AO 31-A) in young adults.

PubMed

Ramoutar, D N; Kodumuri, P; Rodrigues, J N; Olewicz, S; Moran, C G; Ollivere, B J; Forward, D P

2017-02-01

Proximal femoral fractures in adults under 50 years are not as common as in the elderly, but may have just as significant an impact. There is little in the literature describing the functional outcomes of fixation in this age group. Our aim was to assess the clinical and functional outcomes of operative management of extracapsular proximal femoral fractures (AO 31-A) in the young adult (<50 years). Consecutive skeletally mature patients <50 years undergoing operative fixation of these fractures were obtained from a prospective database over a 12-year period. Complications and mortality data were obtained from this database and case note review. Outcome scores were obtained via postal questionnaires. Eighty-eight patients were included in the study of which 74 (84%) had fixation with the dynamic hip screw. The mean age was 39 years (range 17-50) with a male preponderance (73.8%). Mean hospital stay was 14 days (range 2-94). Seventeen (19.3%) patients had died at a mean of 40 months from their operation date. The 1-year mortality was 4.5%. There were five complications (5.7%). SF-36 and EuroQol 5D scores showed that 5-10% had severe problems with a 20% decrease in quality of life compared to population norms. The biggest differences were in the physical function modalities. One-third had fair to poor hip function as assessed by the Oxford Hip Score. Though these injuries are relatively rare in this age group, they do have significant mortality and functional impairment reflecting a higher energy of injury rather than the frailty seen in the elderly.

Surgical treatment of scapulohumeral subluxation in an alpaca (Vicugna pacos) using osteotomy of the acromion, open reduction and extracapsular tension sutures.

PubMed

Kofler, J; Eberspächer, E; Fischl, K; Vidoni, B

2016-05-01

A 3.3-year-old male alpaca, weighing 60 kg was referred for investigation of a severe left forelimb lameness of 4 weeks duration. A scapulohumeral subluxation had been diagnosed radiographically by the referring veterinarian. Based on clinical, ultrasonographic and radiographic findings the diagnosis of cranio-lateral subluxation of the left humeral head was confirmed. In addition, a full thickness lesion (approximately 1×1 cm) of the articular cartilage on the caudomedial aspect of the humeral head was diagnosed by arthroscopy. Treatment included open reduction with internal fixation. Severe muscle contraction and local tissue fibrosis around the scapulohumeral joint (SHJ) required osteotomy of the acromion 3 cm proximal to the distal acromial edge, to allow adequate access. Internal stabilisation was achieved by placing tension band sutures between one cortical screw in the scapular neck and two cortical screws, with washers, craniolaterally on the greater tubercle of the humerus. Post-surgery, a carpal flexion sling was applied with the carpus maintained in 70° flexion for 4 weeks to avoid postoperative weight-bearing. An exercise programme was started 8 days after surgery and continued for 12 weeks. The alpaca had an uneventful postsurgical recovery and showed no lameness after 8 weeks. The long-term outcome was excellent; 21 months after surgery the alpaca was sound and the range of movement of the left SHJ was equal to the right SHJ. Even in this chronic case of subluxation of the SHJ of 4 weeks duration, surgical treatment using osteotomy of the acromion, open reduction and internal fixation with extracapsular scapulohumeral tension sutures resulted in an excellent long-term outcome in this alpaca, despite the presence of a cartilage lesion.

Evaluation of a computational model to predict elbow range of motion

PubMed Central

Nishiwaki, Masao; Johnson, James A.; King, Graham J. W.; Athwal, George S.

2014-01-01

Computer models capable of predicting elbow flexion and extension range of motion (ROM) limits would be useful for assisting surgeons in improving the outcomes of surgical treatment of patients with elbow contractures. A simple and robust computer-based model was developed that predicts elbow joint ROM using bone geometries calculated from computed tomography image data. The model assumes a hinge-like flexion-extension axis, and that elbow passive ROM limits can be based on terminal bony impingement. The model was validated against experimental results with a cadaveric specimen, and was able to predict the flexion and extension limits of the intact joint to 0° and 3°, respectively. The model was also able to predict the flexion and extension limits to 1° and 2°, respectively, when simulated osteophytes were inserted into the joint. Future studies based on this approach will be used for the prediction of elbow flexion-extension ROM in patients with primary osteoarthritis to help identify motion-limiting hypertrophic osteophytes, and will eventually permit real-time computer-assisted navigated excisions. PMID:24841799

Predicting the extent of metabolism using in vitro permeability rate measurements and in silico permeability rate predictions

PubMed Central

Hosey, Chelsea M; Benet, Leslie Z

2015-01-01

The Biopharmaceutics Drug Disposition Classification System (BDDCS) can be utilized to predict drug disposition, including interactions with other drugs and transporter or metabolizing enzyme effects based on the extent of metabolism and solubility of a drug. However, defining the extent of metabolism relies upon clinical data. Drugs exhibiting high passive intestinal permeability rates are extensively metabolized. Therefore, we aimed to determine if in vitro measures of permeability rate or in silico permeability rate predictions could predict the extent of metabolism, to determine a reference compound representing the permeability rate above which compounds would be expected to be extensively metabolized, and to predict the major route of elimination of compounds in a two-tier approach utilizing permeability rate and a previously published model predicting the major route of elimination of parent drug. Twenty-two in vitro permeability rate measurement data sets in Caco-2 and MDCK cell lines and PAMPA were collected from the literature, while in silico permeability rate predictions were calculated using ADMET Predictor™ or VolSurf+. The potential for permeability rate to differentiate between extensively and poorly metabolized compounds was analyzed with receiver operating characteristic curves. Compounds that yielded the highest sensitivity-specificity average were selected as permeability rate reference standards. The major route of elimination of poorly permeable drugs was predicted by our previously published model and the accuracies and predictive values were calculated. The areas under the receiver operating curves were >0.90 for in vitro measures of permeability rate and >0.80 for the VolSurf+ model of permeability rate, indicating they were able to predict the extent of metabolism of compounds. Labetalol and zidovudine predicted greater than 80% of extensively metabolized drugs correctly and greater than 80% of poorly metabolized drugs correctly in Caco-2 and MDCK, respectively, while theophylline predicted greater than 80% of extensively and poorly metabolized drugs correctly in PAMPA. A two-tier approach predicting elimination route predicts 72±9%, 49±10%, and 66±7% of extensively metabolized, biliarily eliminated, and renally eliminated parent drugs correctly when the permeability rate is predicted in silico and 74±7%, 85±2%, and 73±8% of extensively metabolized, biliarily eliminated, and renally eliminated parent drugs correctly, respectively when the permeability rate is determined in vitro. PMID:25816851

Patterns of practice of regional nodal irradiation in breast cancer: results of the European Organization for Research and Treatment of Cancer (EORTC) NOdal Radiotherapy (NORA) survey.

PubMed

Belkacemi, Y; Kaidar-Person, O; Poortmans, P; Ozsahin, M; Valli, M-C; Russell, N; Kunkler, I; Hermans, J; Kuten, A; van Tienhoven, G; Westenberg, H

2015-03-01

Predicting outcome of breast cancer (BC) patients based on sentinel lymph node (SLN) status without axillary lymph node dissection (ALND) is an area of uncertainty. It influences the decision-making for regional nodal irradiation (RNI). The aim of the NORA (NOdal RAdiotherapy) survey was to examine the patterns of RNI. A web-questionnaire, including several clinical scenarios, was distributed to 88 EORTC-affiliated centers. Responses were received between July 2013 and January 2014. A total of 84 responses were analyzed. While three-dimensional (3D) radiotherapy (RT) planning is carried out in 81 (96%) centers, nodal areas are delineated in only 51 (61%) centers. Only 14 (17%) centers routinely link internal mammary chain (IMC) and supraclavicular node (SCN) RT indications. In patients undergoing total mastectomy (TM) with ALND, SCN-RT is recommend by 5 (6%), 53 (63%) and 51 (61%) centers for patients with pN0(i+), pN(mi) and pN1, respectively. Extra-capsular extension (ECE) is the main factor influencing decision-making RNI after breast conserving surgery (BCS) and TM. After primary systemic therapy (PST), 49 (58%) centers take into account nodal fibrotic changes in ypN0 patients for RNI indications. In ypN0 patients with inner/central tumors, 23 (27%) centers indicate SCN-RT and IMC-RT. In ypN1 patients, SCN-RT is delivered by less than half of the centers in patients with ypN(i+) and ypN(mi). Twenty-one (25%) of the centers recommend ALN-RT in patients with ypN(mi) or 1-2N+ after ALND. Seventy-five (90%) centers state that age is not considered a limiting factor for RNI. The NORA survey is unique in evaluating the impact of SLNB/ALND status on adjuvant RNI decision-making and volumes after BCS/TM with or without PST. ALN-RT is often indicated in pN1 patients, particularly in the case of ECE. Besides the ongoing NSABP-B51/RTOG and ALLIANCE trials, NORA could help to design future specific RNI trials in the SLNB era without ALND in patients receiving or not PST. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Preoperative [18F]Fluorodeoxyglucose Positron Emission Tomography Standardized Uptake Value of Neck Lymph Nodes Predicts Neck Cancer Control and Survival Rates in Patients With Oral Cavity Squamous Cell Carcinoma and Pathologically Positive Lymph Nodes

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

Liao, C.-T.; Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Chang, J.T.-C.

Purpose: Survival in oral cavity squamous cell carcinoma (OSCC) depends heavily on locoregional control. In this prospective study, we sought to investigate whether preoperative maximum standardized uptake value of the neck lymph nodes (SUVnodal-max) may predict prognosis in OSCC patients. Methods and Materials: A total of 120 OSCC patients with pathologically positive lymph nodes were investigated. All subjects underwent a [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) scan within 2 weeks before radical surgery and neck dissection. All patients were followed up for at least 24 months after surgery or until death. Postoperative adjuvant therapy was performed in the presence ofmore » pathologic risk factors. Optimal cutoff values of SUVnodal-max were chosen based on 5-year disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Independent prognosticators were identified by Cox regression analysis. Results: The median follow-up for surviving patients was 41 months. The optimal cutoff value for SUVnodal-max was 5.7. Multivariate analyses identified the following independent predictors of poor outcome: SUVnodal-max {>=}5.7 for the 5-year neck cancer control rate, distant metastatic rate, DFS, DSS, and extracapsular spread (ECS) for the 5-year DSS and OS. Among ECS patients, the presence of a SUVnodal-max {>=}5.7 identified patients with the worst prognosis. Conclusion: A SUVnodal-max of 5.7, either alone or in combination with ECS, is an independent prognosticator for 5-year neck cancer control and survival rates in OSCC patients with pathologically positive lymph nodes.« less

Positive Margins by Oropharyngeal Subsite in Transoral Robotic Surgery for T1/T2 Squamous Cell Carcinoma.

PubMed

Persky, Michael J; Albergotti, William G; Rath, Tanya J; Kubik, Mark W; Abberbock, Shira; Geltzeiler, Mathew; Kim, Seungwon; Duvvuri, Umamaheswar; Ferris, Robert L

2018-04-01

Objective To compare positive margin rates between the 2 most common subsites of oropharyngeal transoral robotic surgery (TORS), the base of tongue (BOT) and the tonsil, as well as identify preoperative imaging characteristics that predispose toward positive margins. Study Design Case series with chart review. Setting Tertiary care referral center. Subjects and Methods We compared the final and intraoperative positive margin rate between TORS resections for tonsil and BOT oropharyngeal squamous cell carcinoma (OPSCC), as well as the effect of margins on treatment. A blinded neuroradiologist examined the preoperative imaging of BOT tumors to measure their dimensions and patterns of spread and provided a prediction of final margin results. Results Between January 2010 and May 2016, a total of 254 patients underwent TORS for OPSCC. A total of 140 patients who underwent TORS for T1/T2 OPSCC met inclusion criteria. A final positive margin is significantly more likely for BOT tumors than tonsil tumors (19.6% vs 4.5%, respectively, P = .004) and likewise for intraoperative margins of BOT and tonsil tumors (35.3% vs 12.4%, respectively; P = .002). A positive final margin is 10 times more likely to receive chemoradiation compared to a negative margin, controlling for extracapsular spread and nodal status (odds ratio, 9.6; 95% confidence interval, 1.6-59.6; P = .02). Preoperative imaging characteristics and subjective radiologic examination of BOT tumors did not correlate with final margin status. Conclusion Positive margins are significantly more likely during TORS BOT resections compared to tonsil resections. More research is needed to help surgeons predict which T1/T2 tumors will be difficult to completely extirpate.

All-season flash flood forecasting system for real-time operations

USDA-ARS?s Scientific Manuscript database

Flash floods can cause extensive damage to both life and property, especially because they are difficult to predict. Flash flood prediction requires high-resolution meteorologic observations and predictions, as well as calibrated hydrologic models in addition to extensive data handling. We have de...

Predicting the Extension of Biomedical Ontologies

PubMed Central

Pesquita, Catia; Couto, Francisco M.

2012-01-01

Developing and extending a biomedical ontology is a very demanding task that can never be considered complete given our ever-evolving understanding of the life sciences. Extension in particular can benefit from the automation of some of its steps, thus releasing experts to focus on harder tasks. Here we present a strategy to support the automation of change capturing within ontology extension where the need for new concepts or relations is identified. Our strategy is based on predicting areas of an ontology that will undergo extension in a future version by applying supervised learning over features of previous ontology versions. We used the Gene Ontology as our test bed and obtained encouraging results with average f-measure reaching 0.79 for a subset of biological process terms. Our strategy was also able to outperform state of the art change capturing methods. In addition we have identified several issues concerning prediction of ontology evolution, and have delineated a general framework for ontology extension prediction. Our strategy can be applied to any biomedical ontology with versioning, to help focus either manual or semi-automated extension methods on areas of the ontology that need extension. PMID:23028267

Robot-assisted laparoscopic prostatectomy is not associated with early postoperative radiation therapy.

PubMed

Chino, Junzo; Schroeck, Florian R; Sun, Leon; Lee, W Robert; Albala, David M; Moul, Judd W; Koontz, Bridget F

2009-11-01

To compare open radical prostatectomy (RP) and robot-assisted laparoscopic prostatectomy (RALP), and to determine whether RALP is associated with a higher risk of features that determine recommendations for postoperative radiation therapy (RT). Patients undergoing RP from 2003 to 2007 were stratified into two groups: open RP and RALP. Preoperative (PSA level, T stage and Gleason score), pathological factors (T stage, Gleason score, extracapsular extension [ECE] and the status of surgical margins and seminal vesicle invasion [SVI]) and early treatment with RT or referral for RT within 6 months were compared between the groups. Multivariate analysis was used to control for selection bias in the RALP group. In all, 904 patients were identified; 368 underwent RALP and 536 underwent open RP (retropubic or perineal). Patients undergoing open RP had a higher pathological stage with ECE present in 24.8% vs 19.3% in RALP (P = 0.05) and SVI in 10.3% vs 3.8% (P < 0.001). In the RALP vs open RP group, there were positive surgical margins in 31.5% vs 31.9% (P = 0.9) and there were postoperative PSA levels of (3) 0.2 ng/mL in 5.7% vs 6.3% (P = 0.7), respectively. On multivariate analysis to control for selection bias, RALP was not associated with indication for RT (odds ratio (OR) 1.10, P = 0.55), or referral for RT (OR 1.04, P = 0.86). RALP was not associated with an increase in either indication or referral for early postoperative RT.

Planning magnetic resonance imaging for prostate cancer intensity-modulated radiation therapy: Impact on target volumes, radiotherapy dose and androgen deprivation administration.

PubMed

Horsley, Patrick J; Aherne, Noel J; Edwards, Grace V; Benjamin, Linus C; Wilcox, Shea W; McLachlan, Craig S; Assareh, Hassan; Welshman, Richard; McKay, Michael J; Shakespeare, Thomas P

2015-03-01

Magnetic resonance imaging (MRI) scans are increasingly utilized for radiotherapy planning to contour the primary tumors of patients undergoing intensity-modulated radiation therapy (IMRT). These scans may also demonstrate cancer extent and may affect the treatment plan. We assessed the impact of planning MRI detection of extracapsular extension, seminal vesicle invasion, or adjacent organ invasion on the staging, target volume delineation, doses, and hormonal therapy of patients with prostate cancer undergoing IMRT. The records of 509 consecutive patients with planning MRI scans being treated with IMRT for prostate cancer between January 2010 and July 2012 were retrospectively reviewed. Tumor staging and treatment plans before and after MRI were compared. Of the 509 patients, 103 (20%) were upstaged and 44 (9%) were migrated to a higher risk category as a result of findings at MRI. In 94 of 509 patients (18%), the MRI findings altered management. Ninety-four of 509 patients (18%) had a change to their clinical target volume (CTV) or treatment technique, and in 41 of 509 patients (8%) the duration of hormone therapy was changed because of MRI findings. The use of radiotherapy planning MRI altered CTV design, dose and/or duration of androgen deprivation in 18% of patients in this large, single institution series of men planned for dose-escalated prostate IMRT. This has substantial implications for radiotherapy target volumes and doses, as well as duration of androgen deprivation. Further research is required to investigate whether newer MRI techniques can simultaneously fulfill staging and radiotherapy contouring roles. © 2014 Wiley Publishing Asia Pty Ltd.

Altered mitochondrial genome content signals worse pathology and prognosis in prostate cancer.

PubMed

Kalsbeek, Anton M F; Chan, Eva K F; Grogan, Judith; Petersen, Desiree C; Jaratlerdsiri, Weerachai; Gupta, Ruta; Lyons, Ruth J; Haynes, Anne-Maree; Horvath, Lisa G; Kench, James G; Stricker, Phillip D; Hayes, Vanessa M

2018-01-01

Mitochondrial genome (mtDNA) content is depleted in many cancers. In prostate cancer, there is intra-glandular as well as inter-patient mtDNA copy number variation. In this study, we determine if mtDNA content can be used as a predictor for prostate cancer staging and outcomes. Fresh prostate cancer biopsies from 115 patients were obtained at time of surgery. All cores underwent pathological review, followed by isolation of cancer and normal tissue. DNA was extracted and qPCR performed to quantify the total amount of mtDNA as a ratio to genomic DNA. Differences in mtDNA content were compared for prostate cancer pathology features and disease outcomes. We showed a significantly reduced mtDNA content in prostate cancer compared with normal adjacent prostate tissue (mean difference 1.73-fold, P-value <0.001). Prostate cancer with increased mtDNA content showed unfavorable pathologic characteristics including, higher disease stage (PT2 vs PT3 P-value = 0.018), extracapsular extension (P-value = 0.02) and a trend toward an increased Gleason score (P-value = 0.064). No significant association was observed between changes in mtDNA content and biochemical recurrence (median follow up of 107 months). Contrary to other cancer types, prostate cancer tissue shows no universally depleted mtDNA content. Rather, the change in mtDNA content is highly variable, mirroring known prostate cancer genome heterogeneity. Patients with high mtDNA content have an unfavorable pathology, while a high mtDNA content in normal adjacent prostate tissue is associated with worse prognosis. © 2017 Wiley Periodicals, Inc.

Postoperative Radiation Therapy after Nipple-Sparing or Skin-Sparing Mastectomy: A Survey of European, North American, and South American Practices.

PubMed

Marta, Gustavo Nader; Poortmans, Philip M; Buchholz, Thomas A; Hijal, Tarek

2017-01-01

Skin sparing mastectomy, a surgical procedure sparing a large portion of the overlying skin of the breast, and nipple-sparing mastectomy, sparing the whole nipple-areolar complex, are increasingly used, although their oncologic efficacy remains unclear. The aim of this study was to assess the radiation oncologists' opinions regarding the indications of radiation therapy (RT) after skin-sparing mastectomy and nipple-sparing mastectomy. Radiation oncology members of four national and international societies were invited to complete a questionnaire comprising of 22 questions to assess their opinions regarding RT indications in the context of skin-sparing and nipple-sparing mastectomy. A total of 298 radiation oncologists answered the questionnaire. 90.9% of respondents affirmed that breast cancer is one of their specializations. The majority declared that post-mastectomy RT is indicated for early-stage (stages I and II) breast cancer patients who present with risk factors for recurrence after skin-sparing or nipple-sparing mastectomy (87.2% and 80.2%, respectively). All suggested risk factors (tumor size, lymph node involvement, extracapsular extension, lymphovascular space invasion, positive surgical margins, triple negative tumor, multicentric tumor, and age) were considered as major elements (important or very important). There is no consensus regarding the necessity of evaluating residual breast tissue or the definition of residual breast tissue after mastectomy. All classic factors were considered as major elements, potentially influencing the decision to advice or not postoperative RT. Many uncertainties remain about the indications for RT after skin-sparing mastectomy or nipple-sparing mastectomy. © 2016 Wiley Periodicals, Inc.

75 FR 80354 - Satellite Television Extension and Localism Act of 2010 and Satellite Home Viewer Extension and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-22

... Commission, adopts a point-to-point predictive model for determining the ability of individual locations to... predictive model for reliably and presumptively determining the ability of individual locations, through the... adopted a point-to-point predictive model for determining the ability of individual locations to receive...

Long-term functional outcome after surgical repair of cranial cruciate ligament disease in dogs.

PubMed

Mölsä, Sari H; Hyytiäinen, Heli K; Hielm-Björkman, Anna K; Laitinen-Vapaavuori, Outi M

2014-11-19

Cranial cruciate ligament (CCL) rupture is a very common cause of pelvic limb lameness in dogs. Few studies, using objective and validated outcome evaluation methods, have been published to evaluate long-term (>1 year) outcome after CCL repair. A group of 47 dogs with CCL rupture treated with intracapsular, extracapsular, and osteotomy techniques, and 21 healthy control dogs were enrolled in this study. To evaluate long-term surgical outcome, at a minimum of 1.5 years after unilateral CCL surgery, force plate, orthopedic, radiographic, and physiotherapeutic examinations, including evaluation of active range of motion (AROM), symmetry of thrust from the ground, symmetry of muscle mass, and static weight bearing (SWB) of pelvic limbs, and goniometry of the stifle and tarsal joints, were done. At a mean of 2.8 ± 0.9 years after surgery, no significant differences were found in average ground reaction forces or SWB between the surgically treated and control dog limbs, when dogs with no other orthopedic findings were included (n = 21). However, in surgically treated limbs, approximately 30% of the dogs had decreased static or dynamic weight bearing when symmetry of weight bearing was evaluated, 40-50% of dogs showed limitations of AROM in sitting position, and two-thirds of dogs had weakness in thrust from the ground. The stifle joint extension angles were lower (P <0.001) and flexion angles higher (P <0.001) in surgically treated than in contralateral joints, when dogs with no contralateral stifle problems were included (n = 33). In dogs treated using the intracapsular technique, the distribution percentage per limb of peak vertical force (DPVF) in surgically treated limbs was significantly lower than in dogs treated with osteotomy techniques (P =0.044). The average long-term dynamic and static weight bearing of the surgically treated limbs returned to the level of healthy limbs. However, extension and flexion angles of the surgically treated stifles remained inferior to healthy joints, and impairment of AROM and weakness in thrust from the ground in the surgically treated limbs were frequently present. Ground reaction forces may be inadequate as a sole method for assessing functional outcome after cranial cruciate ligament repair.

Accelerated versus conventional fractionated postoperative radiotherapy for advanced head and neck cancer: results of a multicenter Phase III study.

PubMed

Sanguineti, Giuseppe; Richetti, Antonella; Bignardi, Mario; Corvo', Renzo; Gabriele, Pietro; Sormani, Maria Pia; Antognoni, Paolo

2005-03-01

To determine whether, in the postoperative setting, accelerated fractionation (AF) radiotherapy (RT) yields a superior locoregional control rate compared with conventional fractionation (CF) RT in locally advanced squamous cell carcinomas of the oral cavity, oropharynx, larynx, or hypopharynx. Patients from four institutions with one or more high-risk features (pT4, positive resection margins, pN >1, perineural/lymphovascular invasion, extracapsular extension, subglottic extension) after surgery were randomly assigned to either RT with one daily session of 2 Gy up to 60 Gy in 6 weeks or AF. Accelerated fractionation consisted of a "biphasic concomitant boost" schedule, with the boost delivered during the first and last weeks of treatment, to deliver 64 Gy in 5 weeks. Informed consent was obtained. The primary endpoint of the study was locoregional control. Analysis was on an intention-to-treat basis. From March 1994 to August 2000, 226 patients were randomized. At a median follow-up of 30.6 months (range, 0-110 months), 2-year locoregional control estimates were 80% +/- 4% for CF and 78% +/- 5% for AF (p = 0.52), and 2-year overall survival estimates were 67% +/- 5% for CF and 64% +/- 5% for AF (p = 0.84). The lack of difference in outcome between the two treatment arms was confirmed by multivariate analysis. However, interaction analysis with median values as cut-offs showed a trend for improved locoregional control for those patients who had a delay in starting RT and who were treated with AF compared with those with a similar delay but who were treated with CF (hazard ratio = 0.5, 95% confidence interval 0.2-1.1). Fifty percent of patients treated with AF developed confluent mucositis, compared with only 27% of those treated with CF (p = 0.006). However, mucositis duration was not different between arms. Although preliminary, actuarial Grade 3+ late toxicity estimates at 2 years were 18% +/- 4% and 27% +/- 6% for CF and AF, respectively (p = 0.10). Accelerated fractionation does not seem to be worthwhile for squamous cell carcinoma of the head and neck after resection; however, AF might be an option for patients who delay starting RT.

Extracapsular cataract extraction training: junior ophthalmology residents' self-reported satisfaction level with their proficiency and initial learning barrier.

PubMed

Ting, Daniel Shu Wei; Tan, Sarah; Lee, Shu Yen; Rosman, Mohamad; Aw, Ai Tee; Yeo, Ian Yew San

2015-07-01

To investigate residents' self-reported satisfaction level with their proficiency in extracapsular cataract extraction (ECCE) surgery and the initial barriers to learning the procedure. This is a single-centre prospective descriptive case series involving eight first-year ophthalmology residents in Singapore National Eye Center. We recorded the demographics, frequency of review by the residents of their own surgical videos and their satisfaction level with their proficiency at each of the ECCE steps using a 5-point Likert scale. All ECCE surgical videos between October 2013 and May 2014 were collected and analysed for the overall time taken for the surgery and the time taken to perform the individual steps of the procedure. The mean age of the residents was 27.6 ± 1.5 years and 62.5% (5/8) were women. More than half (62.5%, 5/8) reviewed their own surgical videos while 37.5% (3/8) discussed the surgical videos with their peers or supervisors. Of the ECCE steps, the residents were most dissatisfied with their proficiency in performing irrigation and aspiration (87.5%, 7/8), followed by suturing (62.5%, 5/8), intraocular lens insertion (62.5%, 5/8) and tin can capsulotomy (62.5%, 5/8). The average time taken for each ECCE case was 55.0 ± 12.2 min and, of all the steps, most time was spent on suturing (20.5 ± 6.8 min), followed by irrigation and aspiration (5.5 ± 3.6 min) and tin can capsulotomy (3.3 ± 1.8 min). The first-year ophthalmology residents were most dissatisfied with their proficiency in irrigation/aspiration, suturing and tin can capsulotomy. More training needs to be directed to these areas during teaching sessions in the operating room, wet laboratory or cataract simulation training sessions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Analysis of 30 breast implant rupture cases.

PubMed

Tark, Kwan Chul; Jeong, Hii Sun; Roh, Tae Suk; Choi, Jong Woo

2005-01-01

Breast implants used for augmentation mammoplasty or breast reconstruction could rupture from various causes such as trauma or spontaneous failure. The objectives of this study were to investigate the relationships between the causes of implant rupture and the degree of capsular contracture, and then to evaluate the relative efficacies of specific signs on magnetic resonance imaging (MRI) known to be beneficial for diagnosing the rupture. A retrospective review identified patients with prosthetic implant rupture or impending rupture treated by the senior author. The 30 cases of implant rupture available for review were classified into two groups: intracapsular and extracapsular ruptures. The 30 cases of breast implant ruptures were analyzed with respect to the clinical symptoms and signs, the causes of rupture, the degree of capsular contracture, and therapeutic plans. Among the 30 cases, 14 patients who had undergone MRI during the diagnostic period were analyzed with respect to the relationships between MRI readings and operative findings. Spontaneous rupture of membranes was most common (80%), followed by failure because of trauma (7%) and valve or implant base (4%). The symptoms during implant rupture were contour deformity, palpated mass-like lesions, pain, and focal inflammation. According to the analysis of specific MRI signs, the sensitivity and specificity of the linguine sign were 87% and 100%, respectively, for intracapsular rupture. For extracapsular rupture, the sensitivity and specificity of the linguine sign were, respectively, 67% and 75%. The sensitivity and specificity of the rat-tail sign and tear drop sign were 14% and 50%, respectively. Breast implant rupture was correlated with the degree of capsular contracture in our study. Among the various specific MRI signs used in diagnosing the rupture, the linguine sign was reliable and had a high sensitivity and specificity, especially in cases of intracapsular rupture. On the other hand, the rat-tail and tear drop signs were nonspecific signs for diagnosing the rupture of breast implant.

Improving consent in patients undergoing surgery for fractured neck of femur.

PubMed

Thiruchandran, Gajendiran; McKean, Andrew R; Rudran, Branavan; Imam, Mohamed A; Yeong, Keefai; Hassan, Abdel

2018-05-02

Background Neck of femur fractures and their subsequent operative fixation are associated with high rates of perioperative morbidity and mortality. Consenting in this setting is suboptimal with the Montgomery court ruling changing the perspective of consent. This quality improvement project assessed the adequacy of consenting against British Orthopaedic Association-endorsed guidance and implemented a series of changes to improve the documentation of risks associated with surgery for fractured neck of femur. Methods Seventy consecutive patients who underwent any operative fixation of a neck of femur fracture were included over a 6-month period at a single centre. Patients unable to consent or without electronic notes were excluded. Consent forms were analysed and the documented potential risks or complications associated with surgery were compared to British Orthopaedic Association-endorsed guidance. A series of changes (using the plan, do study, act (PDSA) approach) was implemented to improve the adequacy of consent. Results Documentation of four out of 12 potential risks or complications was recorded in <50% of cases for patients with intracapsular fractures (n=35), and documentation of seven out of 12 potential risks or complications was recorded in <50% of cases for patients with extracapsular fractures (n=35). Re-audit following raising awareness and attaching consent guidance showed 100% documentation of potential risks or complications in patients with intracapsular and extracapsular fractures (n=70). A neck of femur fracture-specific consent form has been implemented which will hopefully lead to sustained improvement. Conclusions Consenting patients with fractured neck of femur for surgery in the authors' unit was suboptimal when compared to British Orthopaedic Association-endorsed consent guidance. This project has shown that ensuring such guidance is readily available has improved the adequacy of consent. The authors hope that introduction of a neck of femur fracture-specific consent form within their unit will lead to sustained adequate documentation of risks associated with surgery.

Agent Orange and long-term outcomes after radical prostatectomy.

PubMed

Ovadia, Aaron E; Terris, Martha K; Aronson, William J; Kane, Christopher J; Amling, Christopher L; Cooperberg, Matthew R; Freedland, Stephen J; Abern, Michael R

2015-07-01

To investigate the association between Agent Orange (AO) exposure and long-term prostate cancer (PC) outcomes. Data from 1,882 men undergoing radical prostatectomy for PC between 1988 and 2011 at Veterans Affairs Health Care Facilities were analyzed from the Shared Equal Access Regional Cancer Hospital database. Men were stratified by AO exposure (binary). Associations between AO exposure and biopsy and pathologic Gleason sum (GS) and pathologic stage were determined by logistic regression models adjusted for preoperative characteristics. Hazard ratios for biochemical recurrence (BCR), secondary treatment, metastases, and PC-specific mortality were determined by Cox models adjusted for preoperative characteristics. There were 333 (17.7%) men with AO exposure. AO-exposed men were younger (median 59 vs. 62 y), had lower preoperative prostate-specific antigen levels (5.8 vs. 6.7 ng/ml), lower clinical category (25% vs. 38% palpable), and higher body mass index (28.2 vs. 27.6 kg/m(2)), all P<0.01. Biopsy GS, pathologic GS, positive surgical margins, lymph node positivity, and extracapsular extension did not differ with AO exposure. At a median follow-up of 85 months, 702 (37.4%) patients had BCR, 603 (32.2%) patients received secondary treatment, 78 (4.1%) had metastases, and 39 (2.1%) died of PC. On multivariable analysis, AO exposure was not associated with BCR, secondary treatment, metastases, or PC mortality. AO exposure was not associated with worse preoperative characteristics such as elevated prostate-specific antigen levels or biopsy GS nor with BCR, secondary treatment, metastases, or PC death. Thus, as data on AO-exposed men mature, possible differences in PC outcomes observed previously are no longer apparent. Copyright © 2015 Elsevier Inc. All rights reserved.

Contemporary Population-Based Comparison of Localized Ductal Adenocarcinoma and High-Risk Acinar Adenocarcinoma of the Prostate.

PubMed

Packiam, Vignesh T; Patel, Sanjay G; Pariser, Joseph J; Richards, Kyle A; Weiner, Adam B; Paner, Gladell P; VanderWeele, David J; Zagaja, Gregory P; Eggener, Scott E

2015-10-01

To compare pathological characteristics, treatment patterns, and survival in patients with ductal adenocarcinoma (DC) compared to those with acinar adenocarcinoma (AC). Using the National Cancer Database, we identified patients diagnosed with clinically localized (cN0, cM0) pure DC (n = 1328) and AC (n = 751,635) between 1998 and 2011. High-risk AC was defined as Gleason 8-10. Demographic, treatment, pathological, and survival characteristics of patients were compared. Compared to patients with Gleason 8-10 AC, those with DC presented with lower mean prostate-specific antigen (10.3 vs 16.2 ng/mL, P <.001), had similar rates (11.7% vs 11.5%, P = .8) of clinical extra-capsular extension (stage ≥ cT3), and were more likely to undergo prostatectomy (54% vs 36%, P <.001). Compared to patients with Gleason 8-10 AC undergoing prostatectomy, those with DC had more favorable pathology: stage ≥ T3 (39% vs 52%, P <.001), fewer positive lymph nodes (4% vs 11%, P <.001), and fewer positive margins (25% vs 33%, P <.001). On Kaplan-Meier analysis, patients with DC had similar 5-year survival (75.0%, 95% confidence interval [CI] [71.7-78.9]) compared to those with Gleason 8-10 AC (77.1%, 95% CI [76.6%-77.6%], P = .2). On Cox multivariable analysis, patients with Gleason 8-10 AC had a similar risk of death compared to those with DC (hazards ratio = 0.92, 95% CI [0.69-1.23], P = 6). In this large contemporary population-based series, patients with DC of the prostate presented with lower prostate-specific antigen, had more favorable pathological features, and similar overall survival compared to men with Gleason 8-10 AC. Copyright © 2015 Elsevier Inc. All rights reserved.

Augmented Reality Robot-assisted Radical Prostatectomy: Preliminary Experience.

PubMed

Porpiglia, Francesco; Fiori, Cristian; Checcucci, Enrico; Amparore, Daniele; Bertolo, Riccardo

2018-05-01

To present our preliminary experience with augmented reality robot-assisted radical prostatectomy (AR-RARP). From June to August 2017, patients candidate to RARP were enrolled and underwent high-resolution multi-parametric magnetic resonance imaging (1-mm slices) according to dedicated protocol. The obtained three-dimensional (3D) reconstruction was integrated in the robotic console to perform AR-RARP. According to the staging at magnetic resonance imaging or reconstruction, in case of cT2 prostate cancer, intrafascial nerve sparing (NS) was performed: a mark was placed on the prostate capsule to indicate the virtual underlying intraprostatic lesion; in case of cT3, standard NS AR-RARP was scheduled with AR-guided biopsy at the level of suspected extracapsular extension (ECE). Prostate specimens were scanned to assess the 3D model concordance. Sixteen patients underwent intrafascial NS technique (cT2), whereas 14 underwent standard NS+ selective biopsy of suspected ECE (cT3). Final pathology confirmed clinical staging. Positive surgical margins' rate was 30% (no positive surgical margins in pT2). In patients whose intraprostatic lesions were marked, final pathology confirmed lesion location. In patients with suspected ECE, AR-guided selective biopsies confirmed the ECE location, with 11 of 14 biopsies (78%) positive for prostate cancer. Prostate specimens were scanned with finding of a good overlap. The mismatch between 3D reconstruction and scanning ranged from 1 to 5 mm. In 85% of the entire surface, the mismatch was <3 mm. In our preliminary experience, AR-RARP seems to be safe and effective. The accuracy of 3D reconstruction seemed to be promising. This technology has still limitations: the virtual models are manually oriented and rigid. Future collaborations with bioengineers will allow overcoming these limitations. Copyright © 2018 Elsevier Inc. All rights reserved.

A natural language processing program effectively extracts key pathologic findings from radical prostatectomy reports.

PubMed

Kim, Brian J; Merchant, Madhur; Zheng, Chengyi; Thomas, Anil A; Contreras, Richard; Jacobsen, Steven J; Chien, Gary W

2014-12-01

Natural language processing (NLP) software programs have been widely developed to transform complex free text into simplified organized data. Potential applications in the field of medicine include automated report summaries, physician alerts, patient repositories, electronic medical record (EMR) billing, and quality metric reports. Despite these prospects and the recent widespread adoption of EMR, NLP has been relatively underutilized. The objective of this study was to evaluate the performance of an internally developed NLP program in extracting select pathologic findings from radical prostatectomy specimen reports in the EMR. An NLP program was generated by a software engineer to extract key variables from prostatectomy reports in the EMR within our healthcare system, which included the TNM stage, Gleason grade, presence of a tertiary Gleason pattern, histologic subtype, size of dominant tumor nodule, seminal vesicle invasion (SVI), perineural invasion (PNI), angiolymphatic invasion (ALI), extracapsular extension (ECE), and surgical margin status (SMS). The program was validated by comparing NLP results to a gold standard compiled by two blinded manual reviewers for 100 random pathology reports. NLP demonstrated 100% accuracy for identifying the Gleason grade, presence of a tertiary Gleason pattern, SVI, ALI, and ECE. It also demonstrated near-perfect accuracy for extracting histologic subtype (99.0%), PNI (98.9%), TNM stage (98.0%), SMS (97.0%), and dominant tumor size (95.7%). The overall accuracy of NLP was 98.7%. NLP generated a result in <1 second, whereas the manual reviewers averaged 3.2 minutes per report. This novel program demonstrated high accuracy and efficiency identifying key pathologic details from the prostatectomy report within an EMR system. NLP has the potential to assist urologists by summarizing and highlighting relevant information from verbose pathology reports. It may also facilitate future urologic research through the rapid and automated creation of large databases.

Endoscopic Endonasal Resection of Retrochiasmatic Craniopharyngioma with Fascia Lata Button and Nasoseptal Flap Reconstruction.

PubMed

Kshettry, Varun R; Nyquist, Gurston; Evans, James J

2018-02-01

Surgery for craniopharyngiomas can be challenging due to the involvement of multiple critical neurovascular structures. The expanded endoscopic endonasal approach can provide superior access to suprasellar craniopharyngiomas, particularly with retrochiasmatic extension and significant hypothalamic involvement. We describe the surgical technique used to treat a 30-year-old patient who presented with 4 weeks of worsening vision, fatigue, and memory loss. His vision was counting fingers at 1 feet on the right and 20/800 on the left with a temporal hemianopsia. Laboratory evaluation demonstrated central hypoadrenalism, hypothyroidism, and hypogonadism. Imaging showed a large solid and cystic suprasellar mass. The transtubercular approach with removal of the lateral tubercular strut can provide wide bilateral access to the opticocarotid region. The superior intercavernous sinus must be coagulated and ligated. Initial arachnoid dissection is centered at the midline, mobilizing the superior hypophyseal branches to the optic apparatus laterally. The cyst capsule is opened and care is taken to minimize spillage of cyst fluid into the subarachnoid space. Central debulking and then extracapsular dissection is performed under direct visualization using sharp dissection. Reconstruction of the dura is performed with an inlay/onlay fascia lata button that is held together with four sutures that hold the graft edges against the native dural edges. This is followed by vascularized nasoseptal flap reconstruction. No lumbar drain or nonabsorbable packing is required. The patient's vision had dramatic improvement and by 1 week postoperatively was 20/20 with full visual fields. Postoperative diabetes insipidus was managed with nasal desmopressin. Postoperative MRI demonstrated complete removal. The link to the video can be found at: https://youtu.be/QQxCNUcq1qg .

Total Mucosal Irradiation with Intensity-modulated Radiotherapy in Patients with Head and Neck Carcinoma of Unknown Primary: A Pooled Analysis of Two Prospective Studies.

PubMed

Richards, T M; Bhide, S A; Miah, A B; Del Rosario, L; Bodla, S; Thway, K; Gujral, D M; Rooney, K P; Schick, U; McGovern, T; Grove, L; Newbold, K L; Harrington, K J; Nutting, C M

2016-09-01

To determine the clinical outcomes of an intensity-modulated radiotherapy technique for total mucosal irradiation (TM-IMRT) in patients with head and neck carcinoma of unknown primary (HNCUP). A single-centre prospective phase II trial design was used in two sequential studies to evaluate TM-IMRT for HNCUP. Patients were investigated for primary tumour site using examination under anaesthetic and biopsies, computed tomography ± magnetic resonance imaging (MRI) or 18-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT). Patients received IMRT to the potential primary tumour sites and elective cervical nodes. Concomitant chemotherapy was used in patients who received primary radiotherapy or those with nodal extracapsular extension. Thirty-six patients with HNCUP were recruited; 72% male. Twenty-five patients (69.4%) had p16-positive disease. Two year mucosal and local nodal control rates were 97.1% (95% confidence interval 91.4-100) and 89.8% (78.4-100), respectively. One mucosal primary was detected 7.3 months after TM-IMRT and three patients died from recurrent/metastatic squamous cell carcinoma of the head and neck. Twelve patients (33%) developed grade 3 (Late Effects in Normal Tissue-Subjective, Objective, Management and Analytical; LENT-SOMA) dysphagia with a 1 year enteric tube feeding rate of 2.7%. The high-grade subjective xerostomia rate (LENT-SOMA) at 24 months after IMRT was 15%. At a median follow-up of 36.1 months, the use of TM-IMRT was associated with good local control. Toxicity was comparable with previously reported TM-IMRT regimens encompassing similar mucosal volumes. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Effects of omitting elective neck irradiation to nodal Level IB in nasopharyngeal carcinoma patients with negative Level IB lymph nodes treated by intensity-modulated radiotherapy: a Phase 2 study.

PubMed

Li, Mei; Huang, Xiao-Guang; Yang, Zhi-Ning; Lu, Jia-Yang; Zhan, Yi-Zhou; Xie, Wen-Jia; Zhou, Dong-Jie; Wang, Li; Zhu, Di-Xia; Lin, Zhi-Xiong

2016-09-01

To investigate the need for elective neck irradiation (ENI) to nodal Level IB in patients with nasopharyngeal carcinoma (NPC) with negative Level IB lymph nodes (IB-negative) treated by intensity-modulated radiotherapy (IMRT). We conducted a Phase 2 prospective study in 123 newly diagnosed IB-negative patients with NPC treated by IMRT, who met at least 1 of the following criteria: (1) unilateral or bilateral Level II involvement with 1 of the following: Level IIA involvement or any Level II node ≥2 cm/with extracapsular spread; (2) ≥2 unilateral node-positive regions. Bilateral Level IB nodes were not contoured as part of the treatment target and treated electively. Level IB regional recurrence rate; pattern of treatment failure; 3-year overall survival (3y-OS), 3-year local control (3y-LC) and 3-year regional control (3y-RC) rates; toxicities; and dosimetric data for planning target volumes, organs at risk, Level IB and submandibular glands (SMGs) were evaluated. Two patients developed failures at Level IB (1.6%). The 3y-LC, 3y-RC and 3y-OS rates were 93.5%, 93.5% and 78.0%, respectively. Bilateral Level IB received unplanned high-dose irradiation with a mean dose (Dmean) ≥50 Gy in 60% of patients. The average Dmean of bilateral SMGs was approximately 53 Gy. ENI to Level IB may be unnecessary in IB-negative patients with NPC treated by IMRT. A further Phase 3 study is warranted. Based on the results of this first Phase 2 study, we suggest omitting ENI to Level IB in Ib-negative patients with NPC with extensive nodal disease treated by IMRT.

[Acute traumatic and especially neglected traumatic hip dislocations are very rare in children].

PubMed

Fernandez, F F; Wirth, T; Eberhardt, O

2012-09-01

We report about the first hip arthroscopies of extracapsular neglected hip dislocations with concomitant injuries in two children (2 and 4 years old). The major problem of traumatic hip dislocation is avascular necrosis. Further problems are possible concomitant injuries. It is important not to cause further damage by therapeutic procedures. In a 4-year-old child the hip could be reduced under visualization and in a 2-year-old child with epiphyseal fracture the extent of the operation could be reduced. In both children large avulsion injuries of the ligamentum capitis femoris could be resected via hip arthroscopy. Hip arthroscopy can reduce surgical morbidity considerably and can possibly contribute to prevention of the feared avascular necrosis of the femoral head.

[Results after planned extracapsular cataract extraction with the Klöti stripper and implantation of UV light-absorbent Simcoe lenses with a 10-degree loop tilt].

PubMed

Gnad, H D; Skorpik, C; Paroussis, P

1985-08-09

Planned ECCE remains a valuable alternative to phacoemulsification due to its protection of the endothelial cells of the cornea. In contrast to the most commonly used infusion-aspiration systems, Kloeti's vitreous stripper provides, in addition, an excellent cutting mechanism enabling the removal of hard parts of the parenchyma or capsular remnants. The aspheric shaped UV light absorbing Simcoe lenses with a 10 grade loop angle used as lens replacement over the past 2 years in 300 cases did not cause any noteworthy complications. In 94% of cases a visual acuity of at least 0.5 was achieved; no case of cystoid macular edema has been observed so far.

[Laser magnetotherapy after cataract extraction with implantation of intraocular lens].

PubMed

Maksimov, V Iu; Zakharova, N V; Maksimova, I S; Golushkov, G A; Evseev, S Iu

2002-01-01

Effects of low-intensive laser and alternating magnetic field on the course of the postoperative period were studied in patients with exudative reaction after extracapsular cataract extraction with implantation of intraocular lens (IOL). The results are analyzed for 148 eyes with early exudative reaction after IOL implantation (136 patients aged 42-75 years). The patients were observed for up to 6 months. The treatment efficiency was evaluated by the clinical picture of inflammatory reaction, visual acuity, and results of biochemical analysis of the lacrimal fluid (the ratio of lipid peroxidation products to antioxidants in cell membrane). The course of the postoperative period was more benign and recovery sooner in patients of the main group in comparison with the control.

Extension-twist coupling of composite circular tubes with application to tilt rotor blade design

NASA Technical Reports Server (NTRS)

Nixon, Mark W.

1987-01-01

This investigation was conducted to determine if twist deformation required for the design of full-scale extension-twist-coupled tilt-rotor blades can be achieved within material design limit loads, and to demonstrate the accuracy of a coupled-beam analysis in predicting twist deformations. Two extension-twist-coupled tilt-rotor blade designs were developed based on theoretically optimum aerodynamic twist distributions. The designs indicated a twist rate requirement of between .216 and .333 deg/in. Agreement between axial tests and analytical predictions was within 10 percent at design limit loads. Agreement between the torsion tests and predictions was within 11 percent.

Confined Turbulent Swirling Recirculating Flow Predictions. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Abujelala, M. T.

1984-01-01

Turbulent swirling flow, the STARPIC computer code, turbulence modeling of turbulent flows, the k-xi turbulence model and extensions, turbulence parameters deduction from swirling confined flow measurements, extension of the k-xi to confined swirling recirculating flows, and general predictions for confined turbulent swirling flow are discussed.

Suggestions for Lymph Node Classification of UICC/AJCC Staging System: A Retrospective Study Based on 1197 Nasopharyngeal Carcinoma Patients Treated With Intensity-Modulated Radiation Therapy

PubMed Central

Guo, Qiaojuan; Pan, Jianji; Zong, Jingfeng; Zheng, Wei; Zhang, Chun; Tang, Linbo; Chen, Bijuan; Cui, Xiaofei; Xiao, Youping; Chen, Yunbin; Lin, Shaojun

2015-01-01

Abstract This article provides suggestions for N classification of Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system of nasopharyngeal carcinoma (NPC), purely based on magnetic resonance imaging (MRI) in intensity-modulated radiation therapy (IMRT) era. A total of 1197 nonmetastatic NPC patients treated with IMRT were enrolled, and all were scanned by MRI at nasopharynx and neck before treatment. MRI-based nodal variables including level, laterality, maximal axial diameter (MAD), extracapsular spread (ECS), and necrosis were analyzed as potential prognostic factors. Modifications of N classification were then proposed and verified. Only nodal level and laterality were considered to be significant variables affecting the treatment outcome. N classification was thus proposed accordingly: N0, no regional lymph node (LN) metastasis; N1, retropharyngeal LNs involvement (regardless of laterality), and/or unilateral levels I, II, III, and/or Va involvement; N2, bilateral levels I, II, III, and/or Va involvement; and N3, levels IV, Vb, and Vc involvement. This proposal showed significant predicting value in multivariate analysis. N3 patients indicated relatively inferior overall survival (OS) and distant metastasis-free survival (DMFS) than N2 patients; however, the difference showed no statistical significance (P = 0.673 and 0.265 for OS and DMFS, respectively), and this was considered to be correlated with the small sample sizes of N3 patients (79 patients, 6.6%). Nodal level and laterality, but not MAD, ECS, and necrosis, were considered to be significant predicting factors for NPC. The proposed N classification was proved to be powerfully predictive in our cohort; however, treatment outcome of the proposed N2 and N3 patients could not differ significantly from each other. This insignificance may be because of the small sample sizes of N3 patients. Our results are based on a single-center data, to develop a new N classification that is universally acceptable; further verification by data from multicenter is warranted. PMID:25997052

Torsional actuation with extension-torsion composite coupling and a magnetostrictive actuator

NASA Astrophysics Data System (ADS)

Bothwell, Christopher M.; Chandra, Ramesh; Chopra, Inderjit

1995-04-01

An analytical-experimental study of using magnetostrictive actuators in conjunction with an extension-torsion coupled composite tube to actuate a rotor blade trailing-edge flap to actively control helicopter vibration is presented. Thin walled beam analysis based on Vlasov theory was used to predict the induced twist and extension in a composite tube with magnetostrictive actuation. The study achieved good correlation between theory and experiment. The Kevlar-epoxy systems showed good correlation between measured and predicted twist values.

Effect of oxybuprocaine 0.4% in preventing surgically induced miosis.

PubMed Central

van Rij, G; Renardel de Lavalette, J G; Baarsma, G S; Jansen, J T

1984-01-01

In a group of 68 patients a double-blind study was performed to assess the effect of preoperative oxybuprocaine 0.4% (Dorsacaine, Novesin) eye drops in comparison with a placebo in preventing surgically induced miosis during extracapsular cataract extraction. One drop of oxybuprocaine 0.4% or placebo was instilled 10 and 5 minutes preoperatively. The pupil diameter was recorded at different stages of the operation. It was found that oxybuprocaine reduced the amount of pupil constriction during the operation significantly as compared with the placebo group, facilitating the removal of lens material and the implantation of an intraocular lens. The effect of oxybuprocaine is considered to be due to anaesthetic action on sensory nerves in the eye, which may inhibit the release of a miotic substance. PMID:6367812

Effect of oxybuprocaine 0.4% in preventing surgically induced miosis.

PubMed

van Rij, G; Renardel de Lavalette, J G; Baarsma, G S; Jansen, J T

1984-04-01

In a group of 68 patients a double-blind study was performed to assess the effect of preoperative oxybuprocaine 0.4% (Dorsacaine, Novesin) eye drops in comparison with a placebo in preventing surgically induced miosis during extracapsular cataract extraction. One drop of oxybuprocaine 0.4% or placebo was instilled 10 and 5 minutes preoperatively. The pupil diameter was recorded at different stages of the operation. It was found that oxybuprocaine reduced the amount of pupil constriction during the operation significantly as compared with the placebo group, facilitating the removal of lens material and the implantation of an intraocular lens. The effect of oxybuprocaine is considered to be due to anaesthetic action on sensory nerves in the eye, which may inhibit the release of a miotic substance.

Eye health care in the Czech Republic.

PubMed

Kocur, Ivo; Kuchynka, Pavel

2002-01-01

An analysis of eye health care in the Czech Republic as of 1998 was performed. A questionnaire was used to obtain information from all 59 in-patient eye departments. The number of ophthalmologists per 1 million inhabitants was 95. The number of cataract operations per 1 million inhabitants was 4,209: phaco-emulsification (36,926 surgeries, 85.2%), extracapsular extraction (6,094 surgeries, 14.1%) and intracapsular extraction (90 surgeries, 0.2%). Intra-ocular lenses were implanted in 99% of cases; 404 corneal transplantations and 1,220 operations for retinal detachment were performed. The number of pars plana vitrectomies for diabetic eye complications was 661. Selected regional clinical centres should be equipped and preferred by health insurance companies to provide comprehensive eye health care services and training. Copyright 2002 S. Karger AG, Basel

Anterior Cruciate Ligament Injury, Reconstruction, and the Optimization of Outcome

PubMed Central

Bliss, James Philip

2017-01-01

Anterior cruciate ligament reconstruction (ACLR) provides an established surgical intervention to control pathological tibiofemoral translational and rotational movement. ACLR is a safe and reproducible intervention, but there remains an underlying rate of failure to return to preinjury sporting activity levels. Postoperative pathological laxity and graft reinjury remain concerns. Previously, unrecognized meniscal lesions, disruption of the lateral capsule, and extracapsular structures offer potential avenues to treat and to therefore improve kinematic outcome and functional results, following reconstruction. Addressing laterally based injuries may also improve the durability of intraarticular ACLR. Improving the anterior cruciate ligament (ACL) graft replication of the normal ACL attachment points on the femur and the tibia, using either double bundle or anatomical single bundle techniques, improves kinematics, which may benefit outcome and functionality, following reconstruction. PMID:28966384

The effect of hip positioning on the projected femoral neck-shaft angle: a modeling study.

PubMed

Bhashyam, Abhiram R; Rodriguez, Edward K; Appleton, Paul; Wixted, John J

2018-04-03

The femoral neck-shaft angle (NSA) is used to restore normal hip geometry during hip fracture repair. Femoral rotation is known to affect NSA measurement, but the effect of hip flexion-extension is unknown. The goals of this study were to determine and test mathematical models of the relationship between hip flexion-extension, femoral rotation and NSA. We hypothesized that hip flexion-extension and femoral rotation would result in NSA measurement error. Two mathematical models were developed to predict NSA in varying degrees of hip flexion-extension and femoral rotation. The predictions of the equations were tested in vitro using a model that varied hip flexion-extension while keeping rotation constant, and vice versa. The NSA was measured from an AP radiograph obtained with a C-arm. Attributable measurement error based on hip positioning was calculated from the models. The predictions of the model correlated well with the experimental data (correlation coefficient = 0.82 - 0.90). A wide range of patient positioning was found to result in less than 5-10 degree error in the measurement of NSA. Hip flexion-extension and femoral rotation had a synergistic effect in measurement error of the NSA. Measurement error was minimized when hip flexion-extension was within 10 degrees of neutral. This study demonstrates that hip flexion-extension and femoral rotation significantly affect the measurement of the NSA. To avoid inadvertently fixing the proximal femur in varus or valgus, the hip should be positioned within 10 degrees of neutral flexion-extension with respect to the C-arm to minimize positional measurement error. N/A, basic science study.

Biochemical, endocrine, and hematological factors in human oxygen tolerance extension: Predictive studies 6

NASA Technical Reports Server (NTRS)

Lambertsen, C. J.; Clark, J. M.

1992-01-01

The Predictive Studies VI (Biochemical, endocrine, and hematological factors in human oxygen tolerance extension) Program consisted of two related areas of research activity, integrated in design and performance, that were each based on an ongoing analysis of human organ oxygen tolerance data obtained for the continuous oxygen exposures of the prior Predictive Studies V Program. The two research areas effectively blended broad investigation of systematically varied intermittent exposure patterns in animals with very selective evaluation of specific exposure patterns in man.

Searching for a relevant definition of sarcopenia: results from the cross-sectional EPIDOS study

PubMed Central

Dupuy, Charlotte; Lauwers-Cances, Valérie; Guyonnet, Sophie; Gentil, Catherine; Abellan Van Kan, Gabor; Beauchet, Olivier; Schott, Anne-Marie; Vellas, Bruno; Rolland, Yves

2015-01-01

Background The diversity of definitions proposed for sarcopenia has been rarely tested in the same population, and so far, their clinical utilities for predicting physical difficulties could not be clearly understood. Our objective is to report the prevalence of sarcopenia and the characteristics of sarcopenic community-dwelling older women according to the different definitions of sarcopenia currently proposed. We also assessed these definitions for their incremental predictive value over currently standard predictors for some self-reported difficulties in physical function and knee extension strength. Methods Cross-sectional analysis included data from 3025 non-disabled women aged 75 years or older without previous history of hip fracture from the inclusion visit of the EPIDémiologie de l'OStéoporose study. A total body composition evaluation was available for 2725 women. Sarcopenia was defined using six different definitions of sarcopenia based on different muscle mass, gait speed, and grip strength cut-offs. Self-reported difficulties in physical function and knee extension strength were collected. Logistic regression and multiple linear regression models were built for each physical dysfunction, and the predictive capacity of sarcopenia (one model for each definition) was studied using the C-statistic, the net reclassification index, or adjusted R2. Results The estimated prevalence of sarcopenia ranged from 3.3–20.0%. Only 85 participants (3.1%) were identified having sarcopenia according to all definitions. All definitions were, to some degree, associated with self-reported difficulties in physical function and knee extension strength, but none improved the predictive ability of the self-reported difficulties in physical function. Conversely, all definitions accounted for a small but significant amount of explained variation for predicting knee extension strength. Conclusions Prevalence of sarcopenia varies widely depending on the definition adopted. Based on this research, the current definitions for sarcopenia does not substantially increment the predictive value of clinical characteristics of patients to predict self-reported physical difficulties and knee extension strength. PMID:26136190

Causes and treatment of mandibular and condylar fractures in children and adolescents: a review of 104 cases.

PubMed

Shi, Jun; Chen, Zhibiao; Xu, Bing

2014-03-01

There are no uniform treatments, standards, and specifications for conservative and surgical management of mandibular fractures in children and adolescents. To review the management of mandibular fractures in children and adolescents at our institution. The medical records of 104 children and adolescents (60 male and 44 female) treated for mandibular fractures from 2005 to 2012 at the Ninth People's Hospital, Shanghai, China, were retrospectively reviewed. The participants were classified as having deciduous dentition (age ≤6 years), mixed dentition (age >6 but <12 years), and permanent dentition (age ≥12 but ≤16 years). Conservative treatment and surgical management. Helkimo clinical dysfunction and anamnestic indices. Condylar process fractures accounted for 55.7% of the fractures (112 fractures of 201 total fracture sites), and symphysis fractures, parasymphysis fractures, fractures of the body, and fractures of the angle accounted for 20.9%, 11.9%, 7.0%, and 3.5% of the fractures, respectively. A total of 83 cases with 159 fracture sites with complete follow-up data were included in the treatment analysis. In these 83 patients, 77 fractures were dentigerous bone fractures, 46 were intracapsular fractures, and 36 were extracapsular fractures. Dentigerous bone fractures of the mandible were managed by closed or open reduction in children younger than 12 years and were managed more often by open reduction and fixation in those between ages 12 and 16 years. Closed treatment was performed for 22 condylar process fractures (28.6%), and open reduction was carried out for 55 condylar process fractures (71.4%). In patients with intracapsular fractures, there was no significant relationship between dentation age and treatment method (P = .06). Most patients with extracapsular fractures with permanent dentition underwent surgical fixation (73.3%), whereas most with deciduous dentition received conservative treatment (87.5%). In patients with condylar process fractures, there was no significant difference in Ai and Di based on treatment method (P = .49 and P = .76, respectively). The treatment of mandibular fractures in children and adolescents should be determined by clinical factors including age, location, and type of fracture.

Clinical comparison of a novel extracapsular stabilization procedure and tibial plateau leveling osteotomy for treatment of cranial cruciate ligament deficiency in dogs.

PubMed

Cook, James L; Luther, Jill K; Beetem, Jodi; Karnes, Josh; Cook, Cristi R

2010-04-01

To develop and test a novel extracapsular technique, TightRope CCL technique (TR), and compare its 6-month clinical outcomes to tibial plateau leveling osteotomy (TPLO) in dogs with cranial cruciate ligament (CCL) deficiency. Prospective clinical cohort study. Medium, large, and giant breed dogs (n=47) with CCL deficiency. Before clinical use, TR was evaluated by mechanical testing and the surgical technique was developed and evaluated in canine cadavers. For the clinical study, dogs were assigned to either TR (n=24) or TPLO (n=23) groups and the assigned technique performed after arthroscopic assessment and treatment of joint pathology. Postoperative management was standardized for both groups. Outcome measures were performed immediately postoperatively and up to 6 months after surgery and included complication types and rate, subjective measurement of cranial drawer and tibial thrust, subjective assessment of radiographic progression of osteoarthritis (OA), and function using a validated client questionnaire (6 months only). TR with a fiber tape suture had superior mechanical properties for creep, stiffness, yield load, and load at failure. Duration of anesthesia, total surgical time, and stabilization procedure (TR versus TPLO) were all significantly (P<.001) shorter for TR compared with TPLO. Complications requiring further treatment occurred in 12.5% of TR cases and 17.4% of TPLO cases. No significant differences were noted between groups for cranial tibial thrust, but cranial drawer was significantly (P<.05) lower in TR stifles at all postoperative time points. No significant differences were noted between groups for radiographic OA scores. No statistically or clinically significant differences were noted between TR and TPLO for scores for each of the client questionnaire categories. TR resulted in 6-month outcomes that were not different than TPLO in terms of radiographic progression of OA and client-evaluated level of function. TR was associated with shorter anesthesia and surgery times as well as a lower complication rate. The TR technique is safe and effective and can be considered an appropriate surgical option as part of the overall treatment plan for CCL deficiency in dogs.

Augmented reality fluoroscopy simulation of the guide-wire insertion in DHS surgery: A proof of concept study.

PubMed

van Duren, B H; Sugand, K; Wescott, R; Carrington, R; Hart, A

2018-05-01

Hip fractures contribute to a significant clinical burden globally with over 1.6 million cases per annum and up to 30% mortality rate within the first year. Insertion of a dynamic hip screw (DHS) is a frequently performed procedure to treat extracapsular neck of femur fractures. Poorly performed DHS fixation of extracapsular neck of femur fractures can result in poor mobilisation, chronic pain, and increased cut-out rate requiring revision surgery. A realistic, affordable, and portable fluoroscopic simulation system can improve performance metrics in trainees, including the tip-apex distance (the only clinically validated outcome), and improve outcomes. We developed a digital fluoroscopic imaging simulator using orthogonal cameras to track coloured markers attached to the guide-wire which created a virtual overlay on fluoroscopic images of the hip. To test the accuracy with which the augmented reality system could track a guide-wire, a standard workshop femur was used to calibrate the system with a positional marker fixed to indicate the apex; this allowed for comparison between guide-wire tip-apex distance (TAD) calculated by the system to be compared to that physically measured. Tests were undertaken to determine: (1) how well the apex could be targeted; (2) the accuracy of the calculated TAD. (3) The number of iterations through the algorithm giving the optimal accuracy-time relationship. The calculated TAD was found to have an average root mean square error of 4.2 mm. The accuracy of the algorithm was shown to increase with the number of iterations up to 20 beyond which the error asymptotically converged to an error of 2 mm. This work demonstrates a novel augmented reality simulation of guide-wire insertion in DHS surgery. To our knowledge this has not been previously achieved. In contrast to virtual reality, augmented reality is able to simulate fluoroscopy while allowing the trainee to interact with real instrumentation and performing the procedure on workshop bone models. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

Prostate Postbrachytherapy Seed Distribution: Comparison of High-Resolution, Contrast-Enhanced, T1- and T2-Weighted Endorectal Magnetic Resonance Imaging Versus Computed Tomography: Initial Experience

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

Bloch, B. Nicolas; Department of Radiology, General Hospital Vienna, Medical University Vienna, Vienna; Lenkinski, Robert E.

2007-09-01

Purpose: To compare contrast-enhanced, T1-weighted, three-dimensional magnetic resonance imaging (CEMR) and T2-weighted magnetic resonance imaging (T2MR) with computed tomography (CT) for prostate brachytherapy seed location for dosimetric calculations. Methods and Materials: Postbrachytherapy prostate MRI was performed on a 1.5 Tesla unit with combined surface and endorectal coils in 13 patients. Both CEMR and T2MR used a section thickness of 3 mm. Spiral CT used a section thickness of 5 mm with a pitch factor of 1.5. All images were obtained in the transverse plane. Two readers using CT and MR imaging assessed brachytherapy seed distribution independently. The dependency of datamore » read by both readers for a specific subject was assessed with a linear mixed effects model. Results: The mean percentage ({+-} standard deviation) values of the readers for seed detection and location are presented. Of 1205 implanted seeds, CEMR, T2MR, and CT detected 91.5% {+-} 4.8%, 78.5% {+-} 8.5%, and 96.1% {+-} 2.3%, respectively, with 11.8% {+-} 4.5%, 8.5% {+-} 3.5%, 1.9% {+-} 1.0% extracapsular, respectively. Assignment to periprostatic structures was not possible with CT. Periprostatic seed assignments for CEMR and T2MR, respectively, were as follows: neurovascular bundle, 3.5% {+-} 1.6% and 2.1% {+-} 0.9%; seminal vesicles, 0.9% {+-} 1.8% and 0.3% {+-} 0.7%; periurethral, 7.1% {+-} 3.3% and 5.8% {+-} 2.9%; penile bulb, 0.6% {+-} 0.8% and 0.3% {+-} 0.6%; Denonvillier's Fascia/rectal wall, 0.5% {+-} 0.6% and 0%; and urinary bladder, 0.1% {+-} 0.3% and 0%. Data dependency analysis showed statistical significance for the type of imaging but not for reader identification. Conclusion: Both enumeration and localization of implanted seeds are readily accomplished with CEMR. Calculations with MRI dosimetry do not require CT data. Dose determinations to specific extracapsular sites can be obtained with MRI but not with CT.« less

Identification and optimal postsurgical follow-up of patients with very low-risk papillary thyroid microcarcinomas.

PubMed

Durante, Cosimo; Attard, Marco; Torlontano, Massimo; Ronga, Giuseppe; Monzani, Fabio; Costante, Giuseppe; Ferdeghini, Marco; Tumino, Salvatore; Meringolo, Domenico; Bruno, Rocco; De Toma, Giorgio; Crocetti, Umberto; Montesano, Teresa; Dardano, Angela; Lamartina, Livia; Maniglia, Adele; Giacomelli, Laura; Filetti, Sebastiano

2010-11-01

Most papillary thyroid microcarcinomas (PTMCs; ≤ 1 cm diameter) are indolent low-risk tumors, but some cases behave more aggressively. Controversies have thus arisen over the optimum postoperative surveillance of PTMC patients. We tested the hypothesis that clinical criteria could be used to identify PTMC patients with very low mortality/recurrence risks and attempted to define the best strategy for their management and long-term surveillance. We retrospectively analyzed data from 312 consecutively diagnosed PTMC patients with T1N0M0 stage disease, no family history of thyroid cancer, no history of head-neck irradiation, unifocal PTMC, no extracapsular involvement, and classic papillary histotypes. Additional inclusion criteria were complete follow-up data from surgery to at least 5 yr after diagnosis. All 312 had undergone (near) total thyroidectomy [with radioactive iodine (RAI) remnant ablation in 137 (44%) - RAI group] and were followed up yearly with cervical ultrasonography and serum thyroglobulin, TSH, and thyroglobulin antibody assays. During follow-up (5-23 yr, median 6.7 yr), there were no deaths due to thyroid cancer or reoperations. The first (6-12 months after surgery) and last postoperative cervical sonograms were negative in all cases. Final serum thyroglobulin levels were undetectable (<1 ng/ml) in all RAI patients and almost all (93%) of non-RAI patients. Accurate risk stratification can allow safe follow-up of most PTMC patients with a less intensive, more cost-effective protocol. Cervical ultrasonography is the mainstay of this protocol, and negative findings at the first postoperative examination are highly predictive of positive outcomes.

Predictable and predictive emotions: explaining cheap signals and trust re-extension

PubMed Central

Schniter, Eric; Sheremeta, Roman M.

2014-01-01

Despite normative predictions from economics and biology, unrelated strangers will often develop the trust necessary to reap gains from one-shot economic exchange opportunities. This appears to be especially true when declared intentions and emotions can be cheaply communicated. Perhaps even more puzzling to economists and biologists is the observation that anonymous and unrelated individuals, known to have breached trust, often make effective use of cheap signals, such as promises and apologies, to encourage trust re-extension. We used a pair of trust games with one-way communication and an emotion survey to investigate the role of emotions in regulating the propensity to message, apologize, re-extend trust, and demonstrate trustworthiness. This design allowed us to observe the endogenous emergence and natural distribution of trust-relevant behaviors, remedial strategies used by promise-breakers, their effects on behavior, and subsequent outcomes. We found that emotions triggered by interaction outcomes are predictable and also predict subsequent apology and trust re-extension. The role of emotions in behavioral regulation helps explain why messages are produced, when they can be trusted, and when trust will be re-extended. PMID:25477797

Predictable and predictive emotions: explaining cheap signals and trust re-extension.

PubMed

Schniter, Eric; Sheremeta, Roman M

2014-01-01

Despite normative predictions from economics and biology, unrelated strangers will often develop the trust necessary to reap gains from one-shot economic exchange opportunities. This appears to be especially true when declared intentions and emotions can be cheaply communicated. Perhaps even more puzzling to economists and biologists is the observation that anonymous and unrelated individuals, known to have breached trust, often make effective use of cheap signals, such as promises and apologies, to encourage trust re-extension. We used a pair of trust games with one-way communication and an emotion survey to investigate the role of emotions in regulating the propensity to message, apologize, re-extend trust, and demonstrate trustworthiness. This design allowed us to observe the endogenous emergence and natural distribution of trust-relevant behaviors, remedial strategies used by promise-breakers, their effects on behavior, and subsequent outcomes. We found that emotions triggered by interaction outcomes are predictable and also predict subsequent apology and trust re-extension. The role of emotions in behavioral regulation helps explain why messages are produced, when they can be trusted, and when trust will be re-extended.

A simple extension to the CMASA method for the prediction of catalytic residues in the presence of single point mutations.

PubMed

Flores, David I; Sotelo-Mundo, Rogerio R; Brizuela, Carlos A

2014-01-01

The automatic identification of catalytic residues still remains an important challenge in structural bioinformatics. Sequence-based methods are good alternatives when the query shares a high percentage of identity with a well-annotated enzyme. However, when the homology is not apparent, which occurs with many structures from the structural genome initiative, structural information should be exploited. A local structural comparison is preferred to a global structural comparison when predicting functional residues. CMASA is a recently proposed method for predicting catalytic residues based on a local structure comparison. The method achieves high accuracy and a high value for the Matthews correlation coefficient. However, point substitutions or a lack of relevant data strongly affect the performance of the method. In the present study, we propose a simple extension to the CMASA method to overcome this difficulty. Extensive computational experiments are shown as proof of concept instances, as well as for a few real cases. The results show that the extension performs well when the catalytic site contains mutated residues or when some residues are missing. The proposed modification could correctly predict the catalytic residues of a mutant thymidylate synthase, 1EVF. It also successfully predicted the catalytic residues for 3HRC despite the lack of information for a relevant side chain atom in the PDB file.

Magnetic resonance imaging of breast implants.

PubMed

Shah, Mala; Tanna, Neil; Margolies, Laurie

2014-12-01

Silicone breast implants have significantly evolved since their introduction half a century ago, yet implant rupture remains a common and expected complication, especially in patients with earlier-generation implants. Magnetic resonance imaging is the primary modality for assessing the integrity of silicone implants and has excellent sensitivity and specificity, and the Food and Drug Administration currently recommends periodic magnetic resonance imaging screening for silent silicone breast implant rupture. Familiarity with the types of silicone implants and potential complications is essential for the radiologist. Signs of intracapsular rupture include the noose, droplet, subcapsular line, and linguine signs. Signs of extracapsular rupture include herniation of silicone with a capsular defect and extruded silicone material. Specific sequences including water and silicone suppression are essential for distinguishing rupture from other pathologies and artifacts. Magnetic resonance imaging provides valuable information about the integrity of silicone implants and associated complications.

Scanning electron microscopy analysis of a sputnik-like intraocular lens 28 years after implantation.

PubMed

Ferrer, Consuelo; Abu-Mustafa, Sabat K; Alió, Jorge L

2009-09-01

To report a pupil-supported, iris-clip intraocular lens (IOL) that was explanted more than 28 years after implantation. A pupil-supported, iris-clip, Sputnik-like IOL was implanted in the left eye of a 33-year-old man to correct aphakia after extracapsular cataract extraction due to trauma. Twenty-eight years after implantation, the patient was referred to our center with loss of vision. Clinical examination showed dislocation of the IOL, which was subsequently explanted. Scanning electron microscopic examination showed a transparent, polymethylmethacrylate (PMMA), pupil-supported, iris-clip IOL with melanosomes and cell deposits (foreign-body reaction) on its surface. This case demonstrates the inertness of PMMA material and reports that a foreign body reaction can be induced following IOL dislocation 28 years after implantation. Copyright 2009, SLACK Incorporated.

Clinicians’ Perceptions of Implementation Extensiveness of 100% Tobacco Free Practices: A Longitudinal Study of New York State1

PubMed Central

de Tormes Eby, Lillian Turner; Laschober, Tanja C.

2013-01-01

In 2008, New York State required substance use disorder treatment organizations to be 100% tobacco-free. This longitudinal study examined clinicians’ perceptions of the implementation extensiveness of the tobacco-free practices approximately 10–12 months (Time 1) and 20–24 months (Time 2) post regulation and investigated whether clinicians’ commitment to change and use of provided resources at Time 1 predicts perceptions of implementation extensiveness at Time 2. Clinicians (N = 287) noted a mean implementation of 5.60 patient practices (0–10 scale), 2.33 visitor practices (0–8 scale), and 6.66 employee practices (0–12 scale) at Time 1. At Time 2, clinicians perceived a mean implementation of 5.95 patient practices (no increase from Time 1), 2.89 visitor practices (increase from Time 1), and 7.12 employee practices (no increase from Time 1). Commitment to change and use of resources positively predicted perceived implementation extensiveness of visitor and employee practices. The use of resources positively predicted implementation for patient practices. PMID:23430285

Clinicians' perceptions of implementation extensiveness of 100% tobacco free practices: a longitudinal study of New York state.

PubMed

Eby, Lillian T de Tormes; Laschober, Tanja C

2014-01-01

In 2008, the state of New York required substance use disorder treatment organizations to be 100% tobacco-free. This longitudinal study examined clinicians' perceptions of the implementation extensiveness of the tobacco-free practices approximately 10-12 months (Time 1) and 20-24 months (Time 2) post regulation and investigated whether clinicians' commitment to change and use of provided resources at Time 1 predicts perceptions of implementation extensiveness at Time 2. Clinicians (N = 287) noted a mean implementation of 5.60 patient practices (0-10 scale), 2.33 visitor practices (0-8 scale), and 6.66 employee practices (0-12 scale) at Time 1. At Time 2, clinicians perceived a mean implementation of 5.95 patient practices (no increase from Time 1), 2.89 visitor practices (increase from Time 1), and 7.12 employee practices (no increase from Time 1). Commitment to change and use of resources positively predicted perceived implementation extensiveness of visitor and employee practices. The use of resources positively predicted implementation for patient practices.

Imaging Characteristics of Prostate Cancer Patients Who Discontinued Active Surveillance on 3-T Multiparametric Prostate MRI.

PubMed

Habibian, David J; Liu, Corinne C; Dao, Alex; Kosinski, Kaitlin E; Katz, Aaron E

2017-03-01

Early-stage prostate cancer may be followed with active surveillance to avoid overtreatment. Our institution's active surveillance regimen uses annual MRI in place of serial biopsies, and biopsies are performed only when clinically necessary. The objective of our study was to report the multiparametric MRI characteristics of prostate cancer patients who discontinued active surveillance at our institution after repeat imaging revealed possible evidence of tumor upgrading. The Department of Urology at Winthrop University Hospital prospectively maintains a database of prostate cancer patients who are monitored with active surveillance. At the time of this study, there were 200 prostate cancer patients being monitored with active surveillance. Of those patients, 114 patients had an initial multiparametric MRI study that was performed before active surveillance started and at least one follow-up multiparametric MRI study that was performed after active surveillance began. The MRI findings were evaluated and correlated with pathology results, if available. Fourteen patients discontinued active surveillance because changes on follow-up MRI suggested progression of cancer. Follow-up MRI showed an enlarged or more prominent lesion compared with the appearance on a previous MRI in three (21.4%) patients, a new lesion or lesions suspicious for cancer in two (14.3%) patients, and findings suspicious for or confirming extracapsular extension in nine (64.3%) patients. Seven of the 14 (50.0%) patients had a biopsy after follow-up multiparametric MRI, and biopsy results led to tumor upgrading in six of the 14 (42.9%) patients. The duration of active surveillance ranged from 4 to 110 months. All patients received definitive treatment. The small number of patients with follow-up multiparametric MRI findings showing worsening disease supports the role of MRI in patients with early-stage prostate cancer. Multiparametric MRI is useful in monitoring patients on active surveillance and may identify patients with clinically significant cancer amenable to definitive treatment.

Reirradiation of Head and Neck Cancers With Intensity Modulated Radiation Therapy: Outcomes and Analyses

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

Takiar, Vinita; Garden, Adam S.; Ma, Dominic

Purpose: To review our 15-year institutional experience using intensity modulated radiation therapy (IMRT) to reirradiate patients with head and neck squamous cell carcinomas (HNSCC) and identify predictors of outcomes and toxicity. Methods and Materials: We retrospectively reviewed the records of 227 patients who received head and neck reirradiation using IMRT from 1999 to 2014. Patients treated with noncurative intent were excluded. Radiation-related acute and late toxicities were recorded. Prognostic variables included performance status, disease site, disease-free interval, chemotherapy, and RT dose and volume. Correlative analyses were performed separately for surgery and nonsurgery patients. Results: Two hundred six patients (91%) were retreatedmore » with curative intent, and 173 had HNSCC histology; 104 (50%) underwent salvage resection, and 135 (66%) received chemotherapy. Median follow-up after reirradiation was 24.7 months. Clinical outcomes were worse for HNSCC patients, with 5-year locoregional control, progression-free survival, and overall survival rates of 53%, 22%, and 32%, respectively, compared with 74%, 59%, and 79%, respectively, for non-HNSCC patients. On multivariate analysis, concurrent chemotherapy and retreatment site were associated with tumor control, whereas performance status was associated with survival. Favorable prognostic factors specific to surgery patients were neck retreatment and lack of extracapsular extension, whereas for nonsurgery patients, these were a nasopharynx subsite and complete response to induction chemotherapy. Actuarial rates of grade ≥3 toxicity were 32% at 2 years and 48% at 5 years, with dysphagia or odynophagia being most common. Increased grade ≥3 toxicity was associated with retreatment volume >50 cm{sup 3} and concurrent chemotherapy. Conclusions: Reirradiation with IMRT either definitively or after salvage surgery can produce promising local control and survival in selected patients with head and neck cancers. Treatment-related toxicity remains significant. Prognostic factors are emerging to guide multidisciplinary treatment approaches and clinical trial design.« less

Size of cervical lymph node and metastasis in squamous cell carcinoma of the oral tongue and floor of mouth.

PubMed

Jarungroongruangchai, Weerawut; Charoenpitakchai, Mongkol; Silpeeyodom, Tawatchai; Pruksapong, Chatchai; Burusapat, Chairat

2014-02-01

Squamous cell carcinoma (SCC) of the oral tongue and floor of mouth are the most common head and neck cancers. Regional metastasis of SCC is most likely found at the cervical lymph node. Size and characteristics of pathologically suspicious lymph nodes are related to the aggressiveness of the primary tumor: The objective of this study is to analyze the conrrelation between sizes of cervical node and metastasis in SCC of oral tongue and floor of mouth. Retrospective review was conducted firom the patient's charts between January 2008 and December 2012. Clinical, histopathology and surgical records were reviewed. Cervical lymph nodes ofSCC of oral tongue and floor of mouth were reviewed and divided into four groups depending on their size (1-5 mm, 6-9 mm, 10-30 mm and more than 30 am,). A p-value <0.05 was considered statistically significant. 196 patients with SCC of the oral cavity were recorded. Sixteen patients ofSCC of the oral tongue and 15patients of SCC of the floor of mouth underwent neck dissection (641 cervical nodes). Most ofthe patients were diagnosed with stage 3 (41.94%). Extracapsular extension was found in 72.15% of SCC of oral tongue and 73.33 % of SCC ofthe floor of mouth. Size of cervical lymph nodes less than 10 mm was found to be metastasis at 9.27% and 10.82% of SCC of oral tongue and floor of mouth, respectively. Cervical node metastasis can be found in SCC of the oral tongue and floor ofmouth with clinlically negative node andsize of cervical node less than 10 mm. Here in, size of cervical node less than 10 mm was still important due to the chance for metastasis especially high grade tumors, advanced stage cancer and lymphovascular invasion.

Postoperative Adjuvant Lapatinib and Concurrent Chemoradiotherapy Followed by Maintenance Lapatinib Monotherapy in High-Risk Patients With Resected Squamous Cell Carcinoma of the Head and Neck: A Phase III, Randomized, Double-Blind, Placebo-Controlled Study.

PubMed

Harrington, Kevin; Temam, Stephane; Mehanna, Hisham; D'Cruz, Anil; Jain, Minish; D'Onofrio, Ida; Manikhas, Georgy; Horvath, Zsuzsanna; Sun, Yan; Dietzsch, Stefan; Dubinsky, Pavol; Holeckova, Petra; El-Hariry, Iman; Franklin, Natalie; Biswas-Baldwin, Nigel; Legenne, Philippe; Wissel, Paul; Netherway, Thelma; Farrell, John; Ellis, Catherine; Wang-Silvanto, Jing; Amonkar, Mayur; Ahmed, Nazma; Santillana, Sergio; Bourhis, Jean

2015-12-10

This multicenter phase III study evaluated the efficacy and safety of lapatinib, an epidermal growth factor receptor/ErbB2 inhibitor, administered concomitantly with chemoradiotherapy and as maintenance monotherapy in patients with high-risk surgically treated squamous cell carcinoma of the head and neck (SCCHN). Patients with resected stage II to IVA SCCHN, with a surgical margin ≤ 5 mm and/or extracapsular extension, were randomly assigned to chemoradiotherapy (66 Gy total radiation dose and cisplatin 100 mg/m(2) per day administered on days 1, 22, and 43) plus placebo or lapatinib (1,500 mg per day) before and during chemoradiotherapy, followed by 12 months of maintenance monotherapy. Six hundred eighty-eight patients were enrolled (lapatinib, n = 346; placebo, n = 342). With a median follow-up time of 35.3 months, the study ended early because of the apparent plateauing of disease-free survival (DFS) events. Median DFS assessed by an independent review committee was 53.6 months and not reached for lapatinib and placebo, respectively (hazard ratio, 1.10; 95% CI, 0.85 to 1.43). Investigator-assessed results confirmed the independent review committee assessment. No significant differences in DFS by human papillomavirus status or overall survival were observed between treatment arms. Similar numbers of patients in both treatment arms experienced adverse events (AEs), with more patients in the lapatinib arm than the placebo arm experiencing serious AEs (48% v 40%, respectively). The most commonly observed treatment-related AEs were diarrhea and rash, both predominantly in the lapatinib arm. Addition of lapatinib to chemoradiotherapy and its use as long-term maintenance therapy does not offer any efficacy benefits and had additional toxicity compared with placebo in patients with surgically treated high-risk SCCHN. © 2015 by American Society of Clinical Oncology.

Cost-Effectiveness Analysis of Chemoradiation Therapy Versus Transoral Robotic Surgery for Human Papillomavirus–Associated, Clinical N2 Oropharyngeal Cancer

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

Sher, David J., E-mail: david.sher@utsouthwestern.edu; Fidler, Mary Jo; Tishler, Roy B.

Purpose: To perform a cost-effectiveness analysis of primary chemoradiation therapy (CRT) versus transoral robotic surgery (TORS) for clinical N2, human papillomavirus (HPV)-positive oropharyngeal carcinoma. Methods and Materials: We developed a Markov model to describe the health states after treatment with CRT or TORS, followed by adjuvant radiation therapy or CRT in the presence of high-risk pathology (positive margins or extracapsular extension). Outcomes, toxicities, and costs were extracted from the literature. One-way sensitivity analyses (SA) were performed over a wide range of parameters, as were 2-way SA between the key variables. Probabilistic SA and value of information studies were performed over keymore » parameters. Results: The expected quality-adjusted life years (QALYs)/total costs for CRT and TORS were 7.31/$50,100 and 7.29/$62,200, respectively, so that CRT dominated TORS. In SA, primary CRT was almost always cost-effective up to a societal willingness-to-pay of $200,000/QALY, unless the locoregional recurrence risk after TORS was 30% to 50% lower, at which point it became cost effective at a willingness-to-pay of $50-100,000/QALY. Probabilistic SA confirmed the importance of locoregional recurrence risk, and the value of information in precisely knowing this parameter was more than $7M per year. If the long-term utility after TORS was 0.03 lower than CRT, CRT was cost-effective over nearly any assumption. Conclusions: Under nearly all assumptions, primary CRT was the cost-effective therapy for HPV-associated, clinical N2 OPC. However, in the hypothetical event of a large relative improvement in LRR with surgery and equivalent long-term utilities, primary TORS would become the higher-value treatment, arguing for prospective, comparative study of the 2 paradigms.« less

Normal Central Zone of the Prostate and Central Zone Involvement by Prostate Cancer: Clinical and MR Imaging Implications

PubMed Central

Akin, Oguz; Franiel, Tobias; Goldman, Debra A.; Udo, Kazuma; Touijer, Karim A.; Reuter, Victor E.; Hricak, Hedvig

2012-01-01

Purpose: To describe the anatomic features of the central zone of the prostate on T2-weighted and diffusion-weighted (DW) magnetic resonance (MR) images and evaluate the diagnostic performance of MR imaging in detection of central zone involvement by prostate cancer. Materials and Methods: The institutional review board waived informed consent and approved this retrospective, HIPAA-compliant study of 211 patients who underwent T2-weighted and DW MR imaging of the prostate before radical prostatectomy. Whole-mount step-section pathologic findings were the reference standard. Two radiologists independently recorded the visibility, MR signal intensity, size, and symmetry of the central zone and scored the likelihood of central zone involvement by cancer on T2-weighted MR images and on T2-weighted MR images plus apparent diffusion coefficient (ADC) maps generated from the DW MR images. Descriptive summary statistics were calculated for central zone imaging features. Sensitivity, specificity, and area under the curve were used to evaluate reader performance in detecting central zone involvement. Results: For readers 1 and 2, the central zone was visible, at least partially, in 177 (84%) and 170 (81%) of 211 patients, respectively. The most common imaging appearance of the central zone was symmetric, homogeneous low signal intensity. Cancers involving the central zone had higher prostate-specific antigen values, Gleason scores, and rates of extracapsular extension and seminal vesicle invasion compared with cancers not involving the central zone (P < .05). Area under the curve, sensitivity, and specificity in detecting central zone involvement were 0.70, 0.30, and 0.96 for reader 1 and 0.65, 0.35, and 0.93 for reader 2, and these values did not differ significantly between T2-weighted imaging and T2-weighted imaging plus ADC maps. Conclusion: The central zone was visualized in most patients. Cancers involving the central zone were associated with more aggressive disease than those without central zone involvement. © RSNA, 2012 PMID:22357889

Association between preoperative erectile dysfunction and prostate cancer features--an analysis from the Duke Prostate Center Database.

PubMed

Kimura, Masaki; Bañez, Lionel L; Gerber, Leah; Qi, Jim; Tsivian, Matvey; Freedland, Stephen J; Satoh, Takefumi; Polascik, Thomas J; Baba, Shiro; Moul, Judd W

2012-04-01

Erectile dysfunction (ED) is related to several co-morbidities including obesity, metabolic syndrome, cigarette smoking, and low testosterone, all of which have been reported to be associated with adverse prostate cancer features. To examine whether preoperative ED has a relationship with adverse prostate cancer features in patients who underwent radical prostatectomy (RP). We analyzed data from our institution on 676 patients who underwent RP between 2001 and 2010. Crude and adjusted logistic regression models were used to investigate the association between preoperative ED and several pathological parameters. The log-rank test and multivariate proportional hazards model were conducted to determine the association of preoperative ED with biochemical recurrence (BCR). The expanded prostate cancer index composite (EPIC) instrument was used to evaluate preoperative erectile function (EF). Preoperative normal EF was defined as EPIC-SF ≥ 60 points while ED was defined as preoperative EPIC-SF lower than 60 points. Preoperatively, a total of 343 (50.7%) men had normal EF and 333 (49.3%) men had ED. After adjusting for covariates, preoperative ED was identified a risk factor for positive extracapsular extension (OR 1.57; P = 0.029) and high percentage of tumor involvement (OR 1.56; P = 0.047). In a Kaplan-Meier curve, a trend was identified that patients with ED had higher incidence of BCR than men with normal EF (P = 0.091). Moreover, using a multivariate Cox model, higher preoperative EF was negatively associated with BCR (HR 0.99; P = 0.014). These results suggest that the likelihood for adverse pathological outcomes as well as BCR following prostatectomy is higher among men with preoperative ED, though these results require validation in larger datasets. The present study indicates that preoperative ED might be a surrogate for adverse prostate cancer outcomes following RP. © 2011 International Society for Sexual Medicine.

Cervical lymph node metastasis in adenoid cystic carcinoma of oral cavity and oropharynx: A collective international review☆

PubMed Central

Suárez, Carlos; Barnes, Leon; Silver, Carl E.; Rodrigo, Juan P.; Shah, Jatin P.; Triantafyllou, Asterios; Rinaldo, Alessandra; Cardesa, Antonio; Pitman, Karen T.; Kowalski, Luiz P.; Robbins, K. Thomas; Hellquist, Henrik; Medina, Jesus E.; de Bree, Remco; Takes, Robert P.; Coca-Pelaz, Andrés; Bradley, Patrick J.; Gnepp, Douglas R.; Teymoortash, Afshin; Strojan, Primož; Mendenhall, William M.; Eloy, Jean Anderson; Bishop, Justin A.; Devaney, Kenneth O.; Thompson, Lester D.R.; Hamoir, Marc; Slootweg, Pieter J.; Poorten, Vincent Vander; Williams, Michelle D.; Wenig, Bruce M.; Skálová, Alena; Ferlito, Alfio

2016-01-01

The purpose of this study was to establish general guidelines in the management of the N0 neck of oral cavity and oropharyngeal adenoid cystic carcinoma (AdCC) in order to improve the survival of these patients and/or reduce the risk of neck recurrences. The incidence of cervical node metastasis at diagnosis of head and neck AdCC is variable, and ranges between 3% and 16%. Metastasis to the cervical lymph nodes of intraoral and oropharyngeal AdCC varies from 2% to 43%, with the lower rates pertaining to palatal AdCC and the higher rates to base of the tongue. Neck node recurrence may happen after treatment in 0–14% of AdCC, is highly dependent on the extent of the treatment and is very rare in patients who have been treated with therapeutic or elective neck dissections, or elective neck irradiation. Lymph node involvement with or without extracapsular extension in AdCC has been shown in most reports to be independently associated with decreased overall and cause-specific survival, probably because lymph node involvement is a risk factor for subsequent distant metastasis. The overall rate of occult neck metastasis in patients with head and neck AdCC ranges from 15% to 44%, but occult neck metastasis from oral cavity and/or oropharynx seems to occur more frequently than from other locations such as the sinonasal tract and major salivary glands. Nevertheless, the benefit of elective neck dissection (END) in AdCC is not comparable to that of squamous cell carcinoma, because the main cause of failure is not related to neck or local recurrence, but rather, to distant failure. Therefore, END should be considered in patients with a cN0 neck with AdCC in some high risk oral and oropharyngeal locations when postoperative RT is not planned, or the rare AdCC-high grade transformation. PMID:27017314

The effects of ECE on the benefits of PMRT for breast cancer patients with positive axillary nodes.

PubMed

Geng, Wenwen; Zhang, Bin; Li, Danhua; Liang, Xinrui; Cao, Xunchen

2013-07-01

The purpose of the present study was to retrospectively evaluate the effects of extracapsular extension (ECE) on the benefits of post-mastectomy radiation therapy (PMRT) for groups of patients with varying numbers of positive axillary nodes (1-3, 4-9 and ≥10 positive axillary nodes). A total of 1220 axillary node-positive patients who had received mastectomy were involved in this study. Patients were grouped as 'Radio + /ECE + ', 'Radio-/ECE + ', 'Radio + /ECE-' or 'Radio-/ECE-' according to status of ECE and whether receiving PMRT or not, and were evaluated in terms of local region relapse (LRR) rate. The 5-year and 10-year Kaplan-Meier disease-free survival and overall survival (OS) rates were analyzed. ECE-positive differed from ECE-negative groups with statistical significance for all comparisons in favor of the ECE-negative group: 5-year locoregional failure-free survival (LRFFS) (82.69% vs 91.83%, P < 0.001), 10-year LRFFS (75.39% vs 90.02%, P < 0.001); 5-year OS (52.12% vs 74.46%, P < 0.001), 10-year OS (35.17% vs 67.63%, P < 0.001). There were no significant effects of ECE on the benefits of PMRT for patients with 1-3 (P = 0.5720), ≥10(P = 0.0614) positive axillary nodes. However, for the group of patients with 4-9 positive axillary nodes, ECE status had a significant effect on the benefits of PMRT with respect to 5-year and 10-year LRFFS (P < 0.05). In our study, regardless of the ECE status, PMRT didn't significantly improve the LRFFS for patients with 1-3 or ≥10 positive axillary nodes. However, for patients with 4-9 positive axillary nodes, ECE could be an important criterion to consider when deciding whether to receive PMRT.

Predicting a future lifetime through Box-Cox transformation.

PubMed

Yang, Z

1999-09-01

In predicting a future lifetime based on a sample of past lifetimes, the Box-Cox transformation method provides a simple and unified procedure that is shown in this article to meet or often outperform the corresponding frequentist solution in terms of coverage probability and average length of prediction intervals. Kullback-Leibler information and second-order asymptotic expansion are used to justify the Box-Cox procedure. Extensive Monte Carlo simulations are also performed to evaluate the small sample behavior of the procedure. Certain popular lifetime distributions, such as Weibull, inverse Gaussian and Birnbaum-Saunders are served as illustrative examples. One important advantage of the Box-Cox procedure lies in its easy extension to linear model predictions where the exact frequentist solutions are often not available.

[Original method of extracapsule fragmentation of the lens nucleus during phacoemulsification].

PubMed

Avetisov, S E; Iusef, Iusef Naim; Mamikonian, V R; Vvedenskiĭ, A S; Iusef, Said Naim; Mutonen, N V

2002-01-01

Clinical estimation of different modifications of phacoemulsification revealed the formation of the second tunnel in the nucleus for its division into quadrants in "four-quadrant phaco" increases the required duration of ultrasonography (US) and irrigation, which causes greater endothelial losses associated with the use of nuclear breakdown by means of a chopper tunnel. When the authors used their own methods of "extracapsular half-nuclei" fragmentation, endothelial losses are rather greater than those with the similar method "stop & "chop", which is associated with closer disposition of the US tip to the posterior corneal surface. At the same time nuclear breakdown by means a chapper in the capsular sac by the "stop & chop" method causes dilation of Zinn's ligaments, fraught by their rupture, particularly if latent derangement or defects of the zonular apparatus, and increases the risk of damage to the posterior capsule by the chopper.

Traumatic lenticular abscess: clinical description and outcome.

PubMed

Rajaraman, Revathi; Lalitha, Prajna; Raghavan, Anita; Palanisamy, Manikandan; Prajna, Namperumalsamy Venkatesh

2007-07-01

To analyze cases with posttraumatic lenticular abscess and study the etiology, clinical presentation, management, and outcome. Retrospective case series. Seventeen eyes of 17 patients with traumatic lenticular abscesses were managed with extracapsular cataract extraction after aspirating the abscess. The mean age of the patients was 40.3 years, and males constituted 82%. The mean time to presentation after injury was 14.35 days (range, one to 60 days), and the patients had a mean follow-up of 125.94 days (range, 21 to 300 days). Culture of the lenticular abscess revealed bacterial growth in eight cases (47%) and fungi in four cases (23.5%). In five (29.4%) cases, culture was negative. Staphylococcus epidermidis grew in seven cases (41%). Thirteen eyes (77%) had best-corrected visual acuity better than 20/120. Surgical removal of the abscess, with systemic and local antimicrobial treatment is effective in cases of posttraumatic intralenticular abscess.

Preliminary study of a new intraocular method in the diagnosis and treatment of Propionibacterium acnes endophthalmitis following cataract extraction.

PubMed

Owens, S L; Lam, S; Tessler, H H; Deutsch, T A

1993-04-01

Late endophthalmitis, due to Propionibacterium acnes, developed in three patients following uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens (PC-IOL) insertion. Cultures from the capsular bag yielded P. acnes in all three. With topical anesthesia and through an anterior chamber paracentesis, culture specimens were taken from and clindamycin irrigated into the capsular bag. Filtered 100% oxygen was introduced into the anterior chamber in two; the third also received an injection of gentamicin and dexamethasone into the capsular bag. After treatment, two patients received oral antibiotics; one received hyperbaric oxygen therapy. Visual acuity was improved and inflammation reduced in all three. However, after treatment, ocular toxic effects due to clindamycin were suspected in one. This approach offers several clear advantages, including topical anesthesia, outpatient management, elimination of the need for vitrectomy, and retention of the intraocular lens (IOL).

Classification of parotidectomies: a proposal of the European Salivary Gland Society.

PubMed

Quer, M; Guntinas-Lichius, O; Marchal, F; Vander Poorten, V; Chevalier, D; León, X; Eisele, D; Dulguerov, P

2016-10-01

The objective of this study is to provide a comprehensive classification system for parotidectomy operations. Data sources include Medline publications, author's experience, and consensus round table at the Third European Salivary Gland Society (ESGS) Meeting. The Medline database was searched with the term "parotidectomy" and "definition". The various definitions of parotidectomy procedures and parotid gland subdivisions extracted. Previous classification systems re-examined and a new classification proposed by a consensus. The ESGS proposes to subdivide the parotid parenchyma in five levels: I (lateral superior), II (lateral inferior), III (deep inferior), IV (deep superior), V (accessory). A new classification is proposed where the type of resection is divided into formal parotidectomy with facial nerve dissection and extracapsular dissection. Parotidectomies are further classified according to the levels removed, as well as the extra-parotid structures ablated. A new classification of parotidectomy procedures is proposed.

Pyomyositis of tensor fascia lata: a case report

PubMed Central

Ozkan, Korhan; Unay, Koray; Ugutmen, Ender; Eren, Abdullah; Eceviz, Engin; Saygý, Baransel

2008-01-01

Introduction Pyomyositis is a disease in which an abscess is formed deep within large striated muscles. Case presentation We report the case of a 10-year-old boy who presented with fever and a painful hip and was subsequently diagnosed with pyomyositis of the tensor fascia lata. In children with clinical and laboratory findings of inflammation in the vicinity of the hip joint, the differential diagnosis includes transient synovitis, an early stage of Legg-Calvé-Perthes disease, infectious arthritis of the hip, rheumatologic diseases and extracapsular infection such as osteomyelitis. Conclusion To the best of the authors' knowledge, this is the first report of pyomyositis of the tensor fascia lata. Although pyomyositis is a rare disease and the differential diagnosis includes a variety of other commonly observed diseases, pyomyositis should be considered in cases where children present with fever, leukocytosis and localized pain. PMID:18652647

Multi-procedure management in an eyeglasses-related open globe injury

PubMed Central

Skopiński, Piotr; Langwińska-Wośko, Ewa; Korwin, Magdalena; Kołodziejczyk, Wojciech; Ambroziak, Anna Maria

2014-01-01

We present a case of successful multi-procedure management of a patient with an open globe injury. A 47-year-old man sustained an injury to his left eye caused by glass fragments of his own spectacles shattered while he was protecting an unknown woman from physical assault at a bus stop. Over a span of 65 months the patient underwent multiple procedures including primary wound repair, penetrating keratoplasty combined with extracapsular cataract extraction, neodymium: YAG laser capsulotomy, and laser-assisted subepithelial keratectomy (LASEK), and had a successfully treated episode of corneal graft rejection. This sequence of treatment substantially improved his left eye vision from hand movements at the time of admission to 0.9–0.5 × 90 at the last follow-up nearly 10 years after the trauma. Proper initial surgical management of an open globe injury can create the possibility for virtually complete vision restoration. PMID:24729818

Sushruta-samhitA - A critical Review Part-1 : Historical glimpse

PubMed Central

Sharma, Hari S.; Sharma, Hiroe I.; Sharma, Hemadri A.

2012-01-01

In the history of Ayurveda, Sushruta stands before Caraka. He practically applied Vaidika culture for treatment. His treatise translated into nine foreign languages apart from various Indian languages like Hindi, Bengali, Malayalam, etc., Sushruta is the most celebrated physician and surgeon in India. Though he practiced during the 5th century BC, many of his contributions to medicine and surgery preceded similar discoveries in the western world. Sushruta devotes a complete volume of his experiences to ophthalmologic diseases. In the Uttara Tantram, Sushruta enumerates a sophisticated classification of eye diseases complete with signs, symptoms, prognosis, and medical/surgical interventions. In particular, Sushruta describes what may have been the first extracapsular cataract surgery using a sharply pointed instrument with a handle fashioned into a trough. His ability to manage many common eye conditions of the time with limited diagnostic aids is a testament to his virtuosity. PMID:23559784

Intraocular pressure variation following retrobulbar anaesthesia among the different sex, age and ethnic groups in Malaysia.

PubMed

Lee, F N; Kong, V Y; Lee, G P; Ho, K H; Choon, S C; Hoh, H B

1999-12-01

A total of 114 patients (48 Chinese, 34 Malay and 32 Indian) undergoing extracapsular cataract extraction (ECCE) with intraocular lens implantation, were enrolled. All were given 3 ml of local anaesthetic (combination of equal amounts of lignocaine 2% and bupivacaine 0.5%) using retrobulbar technique. Intraocular pressure (IOP) was measured at different time intervals; before, immediately after and 5 minutes after injection with Honan balloon compression. Mean IOP increased by 5.0 mmHg immediately after injection (p < 0.001) and reduced to baseline level after 5 minutes of external compression. Although there were no statistical difference in terms of IOP variation between sex and age groups, Chinese patients demonstrated the highest IOP rise following retrobulbar anaesthesia. This is the first study to demonstrate the influence of race in the IOP response with Chinese subjects having the highest IOP rise.

An Innovative Network to Improve Sea Ice Prediction in a Changing Arctic

DTIC Science & Technology

2015-09-30

fall (July – Oct), the CFSv2 forecasts are too extensive (positive bias), while in the rest of the year they are not extensive enough (negative bias...the year (January to September), but a negative bias in the early fall (October to December), during the ice growing season. This illustrate the...Overland, and S. Yang, Polar-Low latitude linkages and their role in weather and climate prediction, 2015: Bull. Amer. Meteor . Soc. [in press]. HONORS

An application of quantile random forests for predictive mapping of forest attributes

Treesearch

E.A. Freeman; G.G. Moisen

2015-01-01

Increasingly, random forest models are used in predictive mapping of forest attributes. Traditional random forests output the mean prediction from the random trees. Quantile regression forests (QRF) is an extension of random forests developed by Nicolai Meinshausen that provides non-parametric estimates of the median predicted value as well as prediction quantiles. It...

Comparison of observed rheological properties of hard wheat flour dough with predictions of the Giesekus-Leonov, White-Metzner and Phan-Thien Tanner models

NASA Technical Reports Server (NTRS)

Dhanasekharan, M.; Huang, H.; Kokini, J. L.; Janes, H. W. (Principal Investigator)

1999-01-01

The measured rheological behavior of hard wheat flour dough was predicted using three nonlinear differential viscoelastic models. The Phan-Thien Tanner model gave good zero shear viscosity prediction, but overpredicted the shear viscosity at higher shear rates and the transient and extensional properties. The Giesekus-Leonov model gave similar predictions to the Phan-Thien Tanner model, but the extensional viscosity prediction showed extension thickening. Using high values of the mobility factor, extension thinning behavior was observed but the predictions were not satisfactory. The White-Metzner model gave good predictions of the steady shear viscosity and the first normal stress coefficient but it was unable to predict the uniaxial extensional viscosity as it exhibited asymptotic behavior in the tested extensional rates. It also predicted the transient shear properties with moderate accuracy in the transient phase, but very well at higher times, compared to the Phan-Thien Tanner model and the Giesekus-Leonov model. None of the models predicted all observed data consistently well. Overall the White-Metzner model appeared to make the best predictions of all the observed data.

No extension of quantum theory can have improved predictive power.

PubMed

Colbeck, Roger; Renner, Renato

2011-08-02

According to quantum theory, measurements generate random outcomes, in stark contrast with classical mechanics. This raises the question of whether there could exist an extension of the theory that removes this indeterminism, as suspected by Einstein, Podolsky and Rosen. Although this has been shown to be impossible, existing results do not imply that the current theory is maximally informative. Here we ask the more general question of whether any improved predictions can be achieved by any extension of quantum theory. Under the assumption that measurements can be chosen freely, we answer this question in the negative: no extension of quantum theory can give more information about the outcomes of future measurements than quantum theory itself. Our result has significance for the foundations of quantum mechanics, as well as applications to tasks that exploit the inherent randomness in quantum theory, such as quantum cryptography.

No extension of quantum theory can have improved predictive power

PubMed Central

Colbeck, Roger; Renner, Renato

2011-01-01

According to quantum theory, measurements generate random outcomes, in stark contrast with classical mechanics. This raises the question of whether there could exist an extension of the theory that removes this indeterminism, as suspected by Einstein, Podolsky and Rosen. Although this has been shown to be impossible, existing results do not imply that the current theory is maximally informative. Here we ask the more general question of whether any improved predictions can be achieved by any extension of quantum theory. Under the assumption that measurements can be chosen freely, we answer this question in the negative: no extension of quantum theory can give more information about the outcomes of future measurements than quantum theory itself. Our result has significance for the foundations of quantum mechanics, as well as applications to tasks that exploit the inherent randomness in quantum theory, such as quantum cryptography. PMID:21811240

Histological assessment of cervical lymph node identifies patients with head and neck squamous cell carcinoma (HNSCC): who would benefit from chemoradiation after surgery?

PubMed

Wan, Xiao Chloe; Egloff, Ann Marie; Johnson, Jonas

2012-12-01

Postoperative chemoradiation (CRT) has been shown to be more effective than postoperative radiotherapy (RT) alone in high risk head and neck squamous cell carcinoma (HNSCC) patients. Multimodality therapy is associated with more treatment related-toxicity. In this study, we assessed cervical lymph node histological characteristics to detect prognostic and predictive value differences to help guide therapeutic decision making. Retrospective analysis of Cancer Registry data. HNSCC surgical patients who had tumor resection and neck dissection at our institution from 1980 to 2008 were identified (n=1510). Multivariable Cox proportional hazards regression models were developed to identify significant predictors of three outcomes: overall survival (OS), disease-specific survival (DSS), and neck disease recurrence (NDR). Hazard ratios were estimated for the number of cervical nodal metastases and presence of extracapsular spread (ECS) by adjuvant treatment after controlling for significant covariates. Increasing number of positive nodes was significantly associated with poorer outcomes in OS, DSS, and NDR models (p<0.0001, p<0.0001, p=0.0002, respectively). OS and DSS associated with adjuvant treatment (none, RT, or CRT) were modified by number of positive nodes, ECS status, and cancer site. The presence of ECS was associated with reduced OS and DSS (p=0.077, p=0.001 respectively), but not significantly associated with NDR (p=0.179). Nodal positive patients benefited from adjuvant therapy regardless of ECS status. CRT consistently conferred a survival advantage over RT across all nodal categories, although the difference was not statistically significant. We observed a consistent survival advantage with CRT over RT for patients with positive cervical nodal metastasis, although the difference was not statistically significant. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Tumor infiltrating lymphocytes (TIL) and prognosis in oral cavity squamous carcinoma: a preliminary study.

PubMed

Wolf, Gregory T; Chepeha, Douglas B; Bellile, Emily; Nguyen, Ariane; Thomas, Daffyd; McHugh, Jonathan

2015-01-01

Tumor infiltrating lymphocytes (TILs) in the microenvironment reflect may tumor biology and predict outcome. We previously demonstrated that infiltrates of CD4, CD8, and FoxP3 positive lymphocytes were associated with HPV-status and survival in oropharyngeal cancers. To determine if TILs were of prognostic importance in oral cancer, TIL levels were evaluated retrospectively in 52 oral cancer patients treated with surgery and correlations with outcome determined. Complete TIL and clinical data were available for 39 patients. Levels of CD4, CD8, FoxP3 (Treg), CD68 and NK cells were assessed by immunohistochemistry in tumor cores on a tissue microarray. Associations with clinical variables, tobacco and alcohol use and histologic features were assessed using Spearman correlation coefficient and the non-parametric Kruskal-Wallis testing. Time-to-event outcomes were determined using univariate and multivariate Cox models. Median follow up was 60 months. The ratio of CD4/CD8 (p=.01) and CD8 infiltrates (p=.05) were associated with tumor recurrence but not overall survival. Lower CD4 infiltrates were associated with alcohol use (p=.005) and poor tumor differentiation (p=.02). Interestingly, higher levels of CD68+ macrophages were found associated with positive nodes (p=.06) and poorer overall survival (p=.07). Overall and DSS survival were significantly shorter for patients with positive nodes, extracapsular spread, or perineural invasion. Infiltrating immune cell levels in oral cavity cancer appear influenced by health behaviors and tumor characteristics. In contrast to oropharynx cancer, infiltrates of CD68 positive tumor associated macrophages may contribute to metastatic behavior and outcome in advanced oral cavity carcinoma. Copyright © 2014 Elsevier Ltd. All rights reserved.

Tumor Infiltrating Lymphocytes (TIL) and Prognosis in Oral Cavity Squamous Carcinoma: A Preliminary Study

PubMed Central

Wolf, Gregory T.; Chepeha, Douglas B.; Bellile, Emily; Nguyen, Ariane; Thomas, Daffyd; McHugh, Jonathan

2014-01-01

Objectives Tumor infiltrating lymphocytes (TILs) in the microenvironment reflect may tumor biology and predict outcome. We previously demonstrated that infiltrates of CD4, CD8, and FoxP3 positive lymphocytes were associated with HPV-status and survival in oropharyngeal cancers. To determine if TILs were of prognostic importance in oral cancer, TIL levels were evaluated retrospectively in 52 oral cancer patients treated with surgery and correlations with outcome determined. Methods Complete TIL and clinical data were available for 39 patients. Levels of CD4, CD8, FoxP3 (Treg), CD68 and NK cells were assessed by immunohistochemistry in tumor cores on a tissue microarray. Associations with clinical variables, tobacco and alcohol use and histologic features were assessed using Spearman correlation coefficient and the non-parametric Kruskal-Wallis testing. Timeto-event outcomes were determined using univariate and multivariate Cox models. Median follow up was 60 months. Results The ratio of CD4/CD8 (p=.01) and CD8 infiltrates (p=.05) were associated with tumor recurrence but not overall survival. Lower CD4 infiltrates were associated with alcohol use (p=.005) and poor tumor differentiation (p=.02). Interestingly, there higher levels of CD68+ macrophages were found associated with positive nodes (p=.06) and poorer overall survival (p=.07). Overall and DSS survival were significantly shorter for patients with positive nodes, extracapsular spread , or perineural invasion. Conclusions Infiltrating immune cell levels in oral cavity cancer appear influenced by health behaviors and tumor characteristics. In contrast to oropharynx cancer, infiltrates of CD68 positive tumor associated macrophages may contribute to metastatic behavior and outcome in advanced oral cavity carcinoma. PMID:25283344

RNAstructure: software for RNA secondary structure prediction and analysis.

PubMed

Reuter, Jessica S; Mathews, David H

2010-03-15

To understand an RNA sequence's mechanism of action, the structure must be known. Furthermore, target RNA structure is an important consideration in the design of small interfering RNAs and antisense DNA oligonucleotides. RNA secondary structure prediction, using thermodynamics, can be used to develop hypotheses about the structure of an RNA sequence. RNAstructure is a software package for RNA secondary structure prediction and analysis. It uses thermodynamics and utilizes the most recent set of nearest neighbor parameters from the Turner group. It includes methods for secondary structure prediction (using several algorithms), prediction of base pair probabilities, bimolecular structure prediction, and prediction of a structure common to two sequences. This contribution describes new extensions to the package, including a library of C++ classes for incorporation into other programs, a user-friendly graphical user interface written in JAVA, and new Unix-style text interfaces. The original graphical user interface for Microsoft Windows is still maintained. The extensions to RNAstructure serve to make RNA secondary structure prediction user-friendly. The package is available for download from the Mathews lab homepage at http://rna.urmc.rochester.edu/RNAstructure.html.

Proposed Lymph Node Staging System Using the International Consensus Guidelines for Lymph Node Levels Is Predictive for Nasopharyngeal Carcinoma Patients From Endemic Areas Treated With Intensity Modulated Radiation Therapy

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

Li, Wen-Fei; Sun, Ying; Mao, Yan-Ping

2013-06-01

Purpose: To propose a lymph node (N) staging system for nasopharyngeal carcinoma (NPC) based on the International Consensus Guidelines for lymph node (LN) levels and MRI-determined nodal variables. Methods and Materials: The MRI scans and medical records of 749 NPC patients receiving intensity modulated radiation therapy with or without chemotherapy were retrospectively reviewed. The prognostic significance of nodal level, laterality, maximal axial diameter, extracapsular spread, necrosis, and Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) size criteria were analyzed. Results: Nodal level and laterality were the only independent prognostic factors for distant failure and disease failure in multivariatemore » analysis. Compared with unilateral levels Ib, II, III, and/or Va involvement (hazard ratio [HR] 1), retropharyngeal lymph node involvement alone had a similar prognostic value (HR 0.71; 95% confidence interval [CI] 0.43-1.17; P=.17), whereas bilateral levels Ib, II, III, and/or Va involvement (HR 1.65; 95% CI 1.06-2.58; P=.03) and levels IV, Vb, and/or supraclavicular fossa involvement (HR 3.47; 95% CI 1.92-6.29; P<.01) both significantly increased the HR for distant failure. Thus we propose that the N category criteria could be revised as follows: N0, no regional LN metastasis; N1, retropharyngeal lymph node involvement, and/or unilateral levels Ib, II, III, and/or Va involvement; N2, bilateral levels Ib, II, III, and/or Va involvement; N3, levels IV, Vb, and/or supraclavicular fossa involvement. Compared with the 7th edition of the UICC/AJCC criteria, the proposed N staging system provides a more satisfactory distinction between the HRs for regional failure, distant failure, and disease failure in each N category. Conclusions: The proposed N staging system defined by the International Consensus Guidelines and laterality is predictive and practical. However, because of no measurements of the maximal nodal diameter on MRI slices, the prognostic significance of LN size needs further evaluation.« less

Predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia.

PubMed

Guber, Ivo; Rémont, Laurent; Bergin, Ciara

2015-01-01

To evaluate the predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia. This is a retrospective review of all ISBCS performed at Kantonsspital Winterthur, Switzerland, between April 2000 and September 2013. The case notes of 250 patients were reviewed. Patients having full refraction reported (110 patients/220 eyes) were included. 210 (95 %) eyes had a straight forward phacoemulsification with posterior chamber intraocular lens implantation, seven eyes had a planned extracapsular cataract extraction (ECCE); three eyes had an intracapsular cataract extraction. Both eyes of 110 patients (64 women, 46 men) with a mean age of 79.0 years, standard deviation (SD) ±11.4 (range 26 to 97 years) were included. Median preoperative best corrected visual acuity (BCVA) was 0.5 LogMAR in the first eye, the interquartile range (IQR) was [0.4, 1.2]; 0.7 LogMAR in the second eye with IQR [0.4, 1.8]. At one month, the median BCVA was 0.2 LogMAR, IQR [0.1, 0.3] in the first eye, median BCVA was 0.1 LogMAR and IQR [0.0, 0.5] in the second eye. There were 3 eyes (3 %) that lost 3 lines or more in BCVA at one month (control vs. pre-operatively). In all three cases, poor visual acuity had been recorded pre-operatively (>1 LogMAR). Achieved refraction was within ±1.0 D of the target in 83 % of eyes. There were only 5 % (n = 6) of cases where if delayed sequential bilateral extraction had been performed could potentially intraocular lens (IOL) choice have been adjusted, in four of these cases, target refraction was within ±1.0 D in the second eye. ISBCS performed under general anaesthesia achieves target refraction in 83 % of eyes after consideration of complications, ocular co-morbidities and systemic restrictions. In the majority of cases where IOL power calculation could be considered, the achieved refraction of the second surgical eye was within ±1.0 D of intended refraction. This undermines the utility of IOL power adjustments in the second surgical eye.

Modified linear predictive coding approach for moving target tracking by Doppler radar

NASA Astrophysics Data System (ADS)

Ding, Yipeng; Lin, Xiaoyi; Sun, Ke-Hui; Xu, Xue-Mei; Liu, Xi-Yao

2016-07-01

Doppler radar is a cost-effective tool for moving target tracking, which can support a large range of civilian and military applications. A modified linear predictive coding (LPC) approach is proposed to increase the target localization accuracy of the Doppler radar. Based on the time-frequency analysis of the received echo, the proposed approach first real-time estimates the noise statistical parameters and constructs an adaptive filter to intelligently suppress the noise interference. Then, a linear predictive model is applied to extend the available data, which can help improve the resolution of the target localization result. Compared with the traditional LPC method, which empirically decides the extension data length, the proposed approach develops an error array to evaluate the prediction accuracy and thus, adjust the optimum extension data length intelligently. Finally, the prediction error array is superimposed with the predictor output to correct the prediction error. A series of experiments are conducted to illustrate the validity and performance of the proposed techniques.

A Pilot Study of Individual Muscle Force Prediction during Elbow Flexion and Extension in the Neurorehabilitation Field

PubMed Central

Hou, Jiateng; Sun, Yingfei; Sun, Lixin; Pan, Bingyu; Huang, Zhipei; Wu, Jiankang; Zhang, Zhiqiang

2016-01-01

This paper proposes a neuromusculoskeletal (NMS) model to predict individual muscle force during elbow flexion and extension. Four male subjects were asked to do voluntary elbow flexion and extension. An inertial sensor and surface electromyography (sEMG) sensors were attached to subject's forearm. Joint angle calculated by fusion of acceleration and angular rate using an extended Kalman filter (EKF) and muscle activations obtained from the sEMG signals were taken as the inputs of the proposed NMS model to determine individual muscle force. The result shows that our NMS model can predict individual muscle force accurately, with the ability to reflect subject-specific joint dynamics and neural control solutions. Our method incorporates sEMG and motion data, making it possible to get a deeper understanding of neurological, physiological, and anatomical characteristics of human dynamic movement. We demonstrate the potential of the proposed NMS model for evaluating the function of upper limb movements in the field of neurorehabilitation. PMID:27916853

A Vertically Flow-Following, Icosahedral Grid Model for Medium-Range and Seasonal Prediction. Part 1: Model Description

NASA Technical Reports Server (NTRS)

Bleck, Rainer; Bao, Jian-Wen; Benjamin, Stanley G.; Brown, John M.; Fiorino, Michael; Henderson, Thomas B.; Lee, Jin-Luen; MacDonald, Alexander E.; Madden, Paul; Middlecoff, Jacques;

Status and plans for the ANOPP/HSR prediction system

NASA Technical Reports Server (NTRS)

Nolan, Sandra K.

1992-01-01

ANOPP is a comprehensive prediction system which was developed and validated by NASA. Because ANOPP is a system prediction program, it allows aerospace industry researchers to create trade-off studies with a variety of aircraft noise problems. The extensive validation of ANOPP allows the program results to be used as a benchmark for testing other prediction codes.

Extensively Drug-Resistant Tuberculosis in Women, KwaZulu-Natal, South Africa

PubMed Central

Zelnick, Jennifer; Werner, Lise; Master, Iqbal; Loveday, Marian; Horsburgh, C. Robert; Padayatchi, Nesri

2011-01-01

To determine whether women in KwaZulu-Natal, South Africa, with drug-resistant tuberculosis (TB) were more likely than men to have extensively drug-resistant TB, we reviewed 4,514 adults admitted during 2003–2008 for drug-resistant TB. Female sex independently predicted extensively drug-resistant TB, even after we controlled for HIV infection. This association needs further study. PMID:22000378

In silico prediction of post-translational modifications.

PubMed

Liu, Chunmei; Li, Hui

2011-01-01

Methods for predicting protein post-translational modifications have been developed extensively. In this chapter, we review major post-translational modification prediction strategies, with a particular focus on statistical and machine learning approaches. We present the workflow of the methods and summarize the advantages and disadvantages of the methods.

simulation of the DNA force-extension curve

NASA Astrophysics Data System (ADS)

Shinaberry, Gregory; Mikhaylov, Ivan; Balaeff, Alexander

A molecular dynamics simulation study of the force-extension curve of double-stranded DNA is presented. Extended simulations of the DNA at multiple points along the force-extension curve are conducted with DNA end-to-end length constrained at each point. The calculated force-extension curve qualitatively reproduces the experimental one. The DNA conformational ensemble at each extension shows that the famous plateau of the force-extension curve results from B-DNA melting, whereas the formation of the earlier-predicted novel DNA conformation called 'zip-DNA' takes place at extensions past the plateau. An extensive analysis of the DNA conformational ensemble in terms of base configuration, backbone configuration, solvent interaction energy, etc., is conducted in order to elucidate the physical origin of DNA elasticity and the main interactions responsible for the shape of the force-extension curve.

Geo-environmental model for the prediction of potential transmission risk of Dirofilaria in an area with dry climate and extensive irrigated crops. The case of Spain.

PubMed

Simón, Luis; Afonin, Alexandr; López-Díez, Lucía Isabel; González-Miguel, Javier; Morchón, Rodrigo; Carretón, Elena; Montoya-Alonso, José Alberto; Kartashev, Vladimir; Simón, Fernando

2014-03-01

Zoonotic filarioses caused by Dirofilaria immitis and Dirofilaria repens are transmitted by culicid mosquitoes. Therefore Dirofilaria transmission depends on climatic factors like temperature and humidity. In spite of the dry climate of most of the Spanish territory, there are extensive irrigated crops areas providing moist habitats favourable for mosquito breeding. A GIS model to predict the risk of Dirofilaria transmission in Spain, based on temperatures and rainfall data as well as in the distribution of irrigated crops areas, is constructed. The model predicts that potential risk of Dirofilaria transmission exists in all the Spanish territory. Highest transmission risk exists in several areas of Andalucía, Extremadura, Castilla-La Mancha, Murcia, Valencia, Aragón and Cataluña, where moderate/high temperatures coincide with extensive irrigated crops. High risk in Balearic Islands and in some points of Canary Islands, is also predicted. The lowest risk is predicted in Northern cold and scarcely or non-irrigated dry Southeastern areas. The existence of irrigations locally increases transmission risk in low rainfall areas of the Spanish territory. The model can contribute to implement rational preventive therapy guidelines in accordance with the transmission characteristics of each local area. Moreover, the use of humidity-related factors could be of interest in future predictions to be performed in countries with similar environmental characteristics. Copyright © 2014 Elsevier B.V. All rights reserved.

"The Wonder Years" of XML.

ERIC Educational Resources Information Center

Gazan, Rich

2000-01-01

Surveys the current state of Extensible Markup Language (XML), a metalanguage for creating structured documents that describe their own content, and its implications for information professionals. Predicts that XML will become the common language underlying Web, word processing, and database formats. Also discusses Extensible Stylesheet Language…

PREDICTING SEDIMENT METAL TOXICITY USING A SEDIMENT BIOTIC LIGAND MODEL: METHODOLOGY AND INITIAL APPLICATION

EPA Science Inventory

An extension of the simultaneously extracted metals/acid-volatile sulfide (SEM/AVS) procedure is presented that predicts the acute and chronic sediment metals effects concentrations. A biotic ligand model (BLM) and a pore water–sediment partitioning model are used to predict the ...

New Prediction Model for Probe Specificity in an Allele-Specific Extension Reaction for Haplotype-Specific Extraction (HSE) of Y Chromosome Mixtures

PubMed Central

Rothe, Jessica; Watkins, Norman E.; Nagy, Marion

2012-01-01

Allele-specific extension reactions (ASERs) use 3′ terminus-specific primers for the selective extension of completely annealed matches by polymerase. The ability of the polymerase to extend non-specific 3′ terminal mismatches leads to a failure of the reaction, a process that is only partly understood and predictable, and often requires time-consuming assay design. In our studies we investigated haplotype-specific extraction (HSE) for the separation of male DNA mixtures. HSE is an ASER and provides the ability to distinguish between diploid chromosomes from one or more individuals. Here, we show that the success of HSE and allele-specific extension depend strongly on the concentration difference between complete match and 3′ terminal mismatch. Using the oligonucleotide-modeling platform Visual Omp, we demonstrated the dependency of the discrimination power of the polymerase on match- and mismatch-target hybridization between different probe lengths. Therefore, the probe specificity in HSE could be predicted by performing a relative comparison of different probe designs with their simulated differences between the duplex concentration of target-probe match and mismatches. We tested this new model for probe design in more than 300 HSE reactions with 137 different probes and obtained an accordance of 88%. PMID:23049901

Effects of combined wrist flexion/extension and forearm rotation and two levels of relative force on discomfort.

PubMed

Khan, Abid Ali; O'Sullivan, Leonard; Gallwey, Timothy J

2009-10-01

This study investigated perceived discomfort in an isometric wrist flexion task. Independent variables were wrist flexion/extension (55%, 35% flexion, neutral, 35% and 55% extension ranges of motion (ROM)), forearm rotation (60%, 30% prone, neutral, 30% and 60% supine ROM) and two levels of flexion force (10% and 20% maximum voluntary contraction (MVC)). Discomfort was significantly affected by flexion force, forearm rotation and a two-way interaction of force with forearm rotation (each p < 0.05). High force for 60%ROM forearm pronation and supination resulted in increasingly higher discomfort for these combinations. Flexion forces were set relative to the MVC in each wrist posture and this appears to be important in explaining a lack of significant effect (p = 0.34) for flexion/extension on discomfort. Regression equations predicting discomfort were developed and used to generate iso-discomfort contours, which indicate regions where the risk of injury should be low and others where it is likely to be high. Regression equations predicting discomfort and iso-discomfort contours are presented, which indicate combinations of upper limb postures for which discomfort is predicted to be low, and others where it is likely to be high. These are helpful in the study of limits for risk factors associated with upper limb musculoskeletal injury in industry.

New prediction model for probe specificity in an allele-specific extension reaction for haplotype-specific extraction (HSE) of Y chromosome mixtures.

PubMed

Rothe, Jessica; Watkins, Norman E; Nagy, Marion

2012-01-01

Allele-specific extension reactions (ASERs) use 3' terminus-specific primers for the selective extension of completely annealed matches by polymerase. The ability of the polymerase to extend non-specific 3' terminal mismatches leads to a failure of the reaction, a process that is only partly understood and predictable, and often requires time-consuming assay design. In our studies we investigated haplotype-specific extraction (HSE) for the separation of male DNA mixtures. HSE is an ASER and provides the ability to distinguish between diploid chromosomes from one or more individuals. Here, we show that the success of HSE and allele-specific extension depend strongly on the concentration difference between complete match and 3' terminal mismatch. Using the oligonucleotide-modeling platform Visual Omp, we demonstrated the dependency of the discrimination power of the polymerase on match- and mismatch-target hybridization between different probe lengths. Therefore, the probe specificity in HSE could be predicted by performing a relative comparison of different probe designs with their simulated differences between the duplex concentration of target-probe match and mismatches. We tested this new model for probe design in more than 300 HSE reactions with 137 different probes and obtained an accordance of 88%.

Revolutionizing Toxicity Testing For Predicting Developmental Outcomes (DNT4)

EPA Science Inventory

Characterizing risk from environmental chemical exposure currently requires extensive animal testing; however, alternative approaches are being researched to increase throughput of chemicals screened, decrease reliance on animal testing, and improve accuracy in predicting adverse...

Design of a composite wing extension for a general aviation aircraft

NASA Technical Reports Server (NTRS)

Adney, P. S.; Horn, W. J.

1984-01-01

A composite wing extension was designed for a typical general aviation aircraft to improve lift curve slope, dihedral effect, and lift to drag ratio. Advanced composite materials were used in the design to evaluate their use as primary structural components in general aviation aircraft. Extensive wind tunnel tests were used to evaluate six extension shapes. The extension shape chosen as the best choice was 28 inches long with a total area of 17 square feet. Subsequent flight tests showed the wing extension's predicted aerodynamic improvements to be correct. The structural design of the wing extension consisted of a hybrid laminate carbon core with outer layers of Kevlar - layed up over a foam interior which acted as an internal support. The laminate skin of the wing extension was designed from strength requirements, and the foam core was included to prevent buckling. A joint lap was recommended to attach the wing extension to the main wing structure.

How Extension Can Help Communities Conduct Impact Analyses.

ERIC Educational Resources Information Center

Wisconsin Univ., Madison. Dept. of Agricultural Journalism.

Intended to provide guidance to Extension specialists and agents faced with requests for impact analyses from communities experiencing economic development, this report also summarizes issues that need to be considered. The first section, on private sector impacts, addresses questions on predicting changes in production, employment, and housing…

A Closer Look at Some of Mercury's North Polar Deposits: Three Craters that Could Have Extensive Surface Ice but Don't?

NASA Astrophysics Data System (ADS)

Chabot, N. L.; Neumann, G. A.; Ernst, C. M.; Mazarico, E. M.; Shread, E. E.

2018-05-01

We investigate three of Mercury's north polar craters that are predicted from their thermal conditions to be conducive to the presence of extensive water ice at the surface, but that may lack such ice.

An analytical and experimental study of crack extension in center-notched composites

NASA Technical Reports Server (NTRS)

Beuth, Jack L., Jr.; Herakovich, Carl T.

1987-01-01

The normal stress ratio theory for crack extension in anisotropic materials is studied analytically and experimentally. The theory is applied within a microscopic-level analysis of a single center notch of arbitrary orientation in a unidirectional composite material. The bulk of the analytical work of this study applies an elasticity solution for an infinite plate with a center line to obtain critical stress and crack growth direction predictions. An elasticity solution for an infinite plate with a center elliptical flaw is also used to obtain qualitative predictions of the location of crack initiation on the border of a rounded notch tip. The analytical portion of the study includes the formulation of a new crack growth theory that includes local shear stress. Normal stress ratio theory predictions are obtained for notched unidirectional tensile coupons and unidirectional Iosipescu shear specimens. These predictions are subsequently compared to experimental results.

Amino-acid sequence and predicted three-dimensional structure of pea seed (Pisum sativum) ferritin.

PubMed Central

Lobreaux, S; Yewdall, S J; Briat, J F; Harrison, P M

1992-01-01

The iron storage protein, ferritin, is widely distributed in the living kingdom. Here the complete cDNA and derived amino-acid sequence of pea seed ferritin are described, together with its predicted secondary structure, namely a four-helix-bundle fold similar to those of mammalian ferritins, with a fifth short helix at the C-terminus. An N-terminal extension of 71 residues contains a transit peptide (first 47 residues) responsible for plastid targetting as in other plant ferritins, and this is cleaved before assembly. The second part of the extension (24 residues) belongs to the mature subunit; it is cleaved during germination. The amino-acid sequence of pea seed ferritin is aligned with those of other ferritins (49% amino-acid identity with H-chains and 40% with L-chains of human liver ferritin in the aligned region). A three-dimensional model has been constructed by fitting the aligned sequence to the coordinates of human H-chains, with appropriate modifications. A folded conformation with an 11-residue helix is predicted for the N-terminal extension. As in mammalian ferritins, 24 subunits assemble into a hollow shell. In pea seed ferritin, its N-terminal extension is exposed on the outside surface of the shell. Within each pea subunit is a ferroxidase centre resembling those of human ferritin H-chains except for a replacement of Glu-62 by His. The channel at the 4-fold-symmetry axes defined by E-helices, is predicted to be hydrophilic in plant ferritins, whereas it is hydrophobic in mammalian ferritins. Images Fig. 3. Fig. 5. Fig. 6. PMID:1472006

Point-Mass Aircraft Trajectory Prediction Using a Hierarchical, Highly-Adaptable Software Design

NASA Technical Reports Server (NTRS)

Karr, David A.; Vivona, Robert A.; Woods, Sharon E.; Wing, David J.

2017-01-01

A highly adaptable and extensible method for predicting four-dimensional trajectories of civil aircraft has been developed. This method, Behavior-Based Trajectory Prediction, is based on taxonomic concepts developed for the description and comparison of trajectory prediction software. A hierarchical approach to the "behavioral" layer of a point-mass model of aircraft flight, a clear separation between the "behavioral" and "mathematical" layers of the model, and an abstraction of the methods of integrating differential equations in the "mathematical" layer have been demonstrated to support aircraft models of different types (in particular, turbojet vs. turboprop aircraft) using performance models at different levels of detail and in different formats, and promise to be easily extensible to other aircraft types and sources of data. The resulting trajectories predict location, altitude, lateral and vertical speeds, and fuel consumption along the flight path of the subject aircraft accurately and quickly, accounting for local conditions of wind and outside air temperature. The Behavior-Based Trajectory Prediction concept was implemented in NASA's Traffic Aware Planner (TAP) flight-optimizing cockpit software application.

The Relationship of Static Tibial Tubercle-Trochlear Groove Measurement and Dynamic Patellar Tracking.

PubMed

Carlson, Victor R; Sheehan, Frances T; Shen, Aricia; Yao, Lawrence; Jackson, Jennifer N; Boden, Barry P

2017-07-01

The tibial tubercle to trochlear groove (TT-TG) distance is used for screening patients with a variety of patellofemoral joint disorders to determine who may benefit from patellar medialization using a tibial tubercle osteotomy. Clinically, the TT-TG distance is predominately based on static imaging with the knee in full extension; however, the predictive ability of this measure for dynamic patellar tracking patterns is unknown. To determine whether the static TT-TG distance can predict dynamic lateral displacement of the patella. Cohort study (Diagnosis); Level of evidence, 2. The static TT-TG distance was measured at full extension for 70 skeletally mature subjects with (n = 32) and without (n = 38) patellofemoral pain. The dynamic patellar tracking patterns were assessed from approximately 45° to 0° of knee flexion by use of dynamic cine-phase contrast magnetic resonance imaging. For each subject, the value of dynamic lateral tracking corresponding to the exact knee angle measured in the static images for that subject was identified. Linear regression analysis determined the predictive ability of static TT-TG distance for dynamic patellar lateral displacement for each cohort. The static TT-TG distance measured with the knee in full extension cannot accurately predict dynamic lateral displacement of the patella. There was weak predictive ability among subjects with patellofemoral pain ( r 2 = 0.18, P = .02) and no predictive capability among controls. Among subjects with patellofemoral pain and static TT-TG distances 15 mm or more, 8 of 13 subjects (62%) demonstrated neutral or medial patellar tracking patterns. The static TT-TG distance cannot accurately predict dynamic lateral displacement of the patella. A large percentage of patients with patellofemoral pain and pathologically large TT-TG distances may have neutral to medial maltracking patterns.

Very extensive nonmaternal care predicts mother-infant attachment disorganization: Convergent evidence from two samples.

PubMed

Hazen, Nancy L; Allen, Sydnye D; Christopher, Caroline Heaton; Umemura, Tomotaka; Jacobvitz, Deborah B

2015-08-01

We examined whether a maximum threshold of time spent in nonmaternal care exists, beyond which infants have an increased risk of forming a disorganized infant-mother attachment. The hours per week infants spent in nonmaternal care at 7-8 months were examined as a continuous measure and as a dichotomous threshold (over 40, 50 and 60 hr/week) to predict infant disorganization at 12-15 months. Two different samples (Austin and NICHD) were used to replicate findings and control for critical covariates: mothers' unresolved status and frightening behavior (assessed in the Austin sample, N = 125), quality of nonmaternal caregiving (assessed in the NICHD sample, N = 1,135), and family income and infant temperament (assessed in both samples). Only very extensive hours of nonmaternal care (over 60 hr/week) and mothers' frightening behavior independently predicted attachment disorganization. A polynomial logistic regression performed on the larger NICHD sample indicated that the risk of disorganized attachment exponentially increased after exceeding 60 hr/week. In addition, very extensive hours of nonmaternal care only predicted attachment disorganization after age 6 months (not prior). Findings suggest that during a sensitive period of attachment formation, infants who spend more than 60 hr/week in nonmaternal care may be at an increased risk of forming a disorganized attachment.

Comparative evaluation of GPR versus APRI and FIB-4 in predicting different levels of liver fibrosis of chronic hepatitis B.

PubMed

Liu, D-P; Lu, W; Zhang, Z-Q; Wang, Y-B; Ding, R-R; Zhou, X-L; Huang, D; Li, X-F

2018-05-01

It is of great significance to develop and evaluate noninvasive indexes predicting the level of liver fibrosis. The aim of this study was to comparatively evaluate gamma-glutamyl transpeptidase-to-platelet ratio (GPR) versus aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on 4 factors (FIB-4) in predicting different levels of liver fibrosis of chronic hepatitis B (CHB) within the framework of HBeAg-positive and HBeAg-negative patients. A total of 1157 HBeAg-positive and 859 HBeAg-negative CHB patients were enrolled, among whom the pathological stage ≥S2, ≥S3, ≥S4 were defined as significant fibrosis, extensive fibrosis and cirrhosis, respectively. Receiver operating characteristic (ROC) curves were used to evaluate the performance of GPR, APRI and FIB-4 in predicting different levels of liver fibrosis. In HBeAg-positive patients, the area under ROC curves (AUROCs) of GPR in predicting extensive fibrosis and cirrhosis were both significantly larger than those of APRI (P = .0001 and P < .0001). In HBeAg-negative patients, the AUROCs of GPR in predicting significant fibrosis and cirrhosis were significantly larger than those of FIB-4 (P = .0006 and P = .0041). The AUROC of GPR in predicting extensive fibrosis was significantly larger than that of APRI and FIB-4 (P = .0320 and P = .0018). Using a cut-off of GPR > 0.500 as standard, the sensitivities and specificities of GPR in predicting significant fibrosis in HBeAg-positive patients were 59.6% and 81.2%, and for cirrhosis 80.9% and 63.8%, respectively; and those of HBeAg-negative patients were 60.3% and 78.3%, 84.5% and 66.1%, respectively. Regardless of HBeAg-positive or HBeAg-negative status, GPR had the best performance in predicting different levels of liver fibrosis. © 2017 John Wiley & Sons Ltd.

Modeling the ductile fracture and the plastic anisotropy of DC01 steel at room temperature and low strain rates

NASA Astrophysics Data System (ADS)

Tuninetti, V.; Yuan, S.; Gilles, G.; Guzmán, C. F.; Habraken, A. M.; Duchêne, L.

2016-08-01

This paper presents different extensions of the classical GTN damage model implemented in a finite element code. The goal of this study is to assess these extensions for the numerical prediction of failure of a DC01 steel sheet during a single point incremental forming process, after a proper identification of the material parameters. It is shown that the prediction of failure appears too early compared to experimental results. Though, the use of the Thomason criterion permitted to delay the onset of coalescence and consequently the final failure.

Optimizing the network topology of block copolymer liquid crystal elastomers for enhanced extensibility and toughness

NASA Astrophysics Data System (ADS)

Nowak, Christian; Escobedo, Fernando A.

2017-08-01

Molecular simulations are used to study the effect of synthesis conditions on the tensile response of liquid-crystalline elastomers formed by block copolymer chains. Remarkably, it is found that despite the significant presence of trapped entanglements, these networks can exhibit the sawtooth tensile response previously predicted for ideal unentangled networks. It is also found that the monomer concentration during crosslinking can be tuned to limit the extent of entanglements and inhomogeneities while also maximizing network extensibility. It is predicted that networks synthesized at a "critical" concentration will have the greatest toughness.

Comparison of the effects of intraocular irrigating solutions on the corneal endothelium in intraocular lens implantation.

PubMed Central

Matsuda, M; Kinoshita, S; Ohashi, Y; Shimomura, Y; Ohguro, N; Okamoto, H; Omoto, T; Hosotani, H; Yoshida, H

1991-01-01

We conducted a randomised prospective controlled study to determine the effects of a glucose glutathione bicarbonate solution (BSS Plus) and a citrate acetate bicarbonate solution (S-MA2) on the corneal endothelium in patients undergoing extracapsular cataract extraction with posterior chamber lens implantation. One eye of each patient was randomly assigned to receive BSS Plus, and the other eye to receive S-MA2. BSS Plus caused significantly less corneal swelling on the first postoperative day than did S-MA2. There was no difference between the two solutions in their effect on corneal thickness one week and one month postoperatively. Computer assisted morphometric analysis of wide-field specular microscopic photographs demonstrated minimal changes in endothelial morphological characteristics in the eyes irrigated with BSS Plus. By comparison S-MA2, caused a significant loss of endothelial cells and a marked reduction in the figure coefficient. These results indicated that BSS Plus has a clinical advantage over S-MA2 with respect to the corneal endothelium. PMID:1873266

Definitive diagnosis of breast implant rupture using magnetic resonance imaging.

PubMed

Ahn, C Y; Shaw, W W; Narayanan, K; Gorczyca, D P; Sinha, S; Debruhl, N D; Bassett, L W

1993-09-01

Breast implant rupture is an important complication of augmented and reconstructed breasts. Although several techniques such as mammography, xeromammography, ultrasound, thermography, and computed tomographic (CT) scanning have been proven to be useful to detect implant rupture, they have several disadvantages and lack specificity. In the current study, we have established magnetic resonance imaging (MRI) as a definitive, reliable, and reproducible technique to diagnose both intracapsular and extracapsular ruptures. The study was conducted in 100 symptomatic patients. Our imaging parameters were able to identify ruptures in implants with silicone shells. All the ruptures showed the presence of wavy lines, free-floating silicone shell within the gel ("free-floating loose-thread sign" or "linguine sign"). We had a 3.75 percent incidence of false-positive and false-negative results. The sensitivity for detection of silicone implant rupture was 76 percent, with a specificity of 97 percent. In addition, we also were able to identify the artifacts that may interfere with the definitive diagnosis of implant rupture.

Serial corneal endothelial cell loss with lathe-cut and injection-molded posterior chamber intraocular lenses.

PubMed

Kraff, M C; Sanders, D R; Lieberman, H L

1983-01-01

We compared endothelial cell loss of patients implanted with lathe-cut posterior chamber lenses and those implanted with injection-molded lenses over a three-year postoperative period. Results were based on more than 2,500 measurements of corneal endothelial density. Although the technique of cataract extraction (anterior chamber phacoemulsification, posterior chamber phacoemulsification, or planned extracapsular extraction) significantly affected cell loss (P less than .01), the type of implant (lathe-cut or injection-molded) did not. Significant continuing endothelial cell loss did not occur during the first three postoperative years with injection-molded lenses. There was, however, a statistically significant 7% to 15% additional cell loss after surgery over the first two to three postoperative years with lathe-cut implants. There have been no cases of corneal endothelial decompensation developing after implantation of injection-molded or lathe-cut lenses. Because a standard field clinical specular microscope was used in this study, cell counting errors cannot be ruled out as a cause of these findings.

A rare presentation of haematuria: hip prosthesis in the bladder.

PubMed

Phan, Yih Chyn; Eli, Nnaemeka; Pillai, Praveen; O'Dair, Jonathan

2018-03-22

An 80-year-old woman presented to our department with visible haematuria and stage II acute kidney injury (AKI). She had stage IIB cervical cancer, for which she received chemotherapy and external beam radiotherapy in 2003. Four years later, she had a left dynamic hip screw for an extracapsular neck of femur fracture following a fall. In 2010, she underwent a right total hip replacement owing to osteoarthritis, and it was subsequently revised in 2012 owing to a right acetabular component failure. In this admission, her AKI improved with intravenous fluid administration and her haematuria settled following catheterisation with a three-way catheter and bladder irrigation with saline. She underwent a flexible cystoscopy which revealed that a part of her right hip prosthesis was in the bladder, having eroded through the right bony pelvis. However, she declined any surgical interventions. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prognostic value of lymphovascular invasion of the primary tumor in hypopharyngeal carcinoma after total laryngopharyngectomy.

PubMed

Saito, Yuki; Omura, Go; Yasuhara, Kazuo; Rikitake, Ryoko; Akashi, Ken; Fukuoka, Osamu; Yoshida, Masafumi; Ando, Mizuo; Asakage, Takahiro; Yamasoba, Tatsuya

2017-08-01

We aimed to determinate the prognostic value of lymphovascular invasion in the specimens resected during total laryngopharyngectomy for hypopharyngeal carcinoma. Patients who underwent total laryngopharyngectomy at our institution between 2004 and 2014 were included in this study and retrospectively analyzed. We then discriminated for vascular invasion and lymphatic invasion of the primary tumor in all cases. We reviewed 135 records (120 men and 15 women; age range, 36-84 years). Tumors with lymphatic invasion tended to be associated with more metastatic lymph nodes and extracapsular spread (ECS) of metastatic lymph nodes. Tumors with vascular invasion tended to be associated with nonpyriform sinus locations. In a multivariate analysis, nonpyriform sinus locations, >3 metastatic lymph nodes, and vascular invasion remained significant prognostic factors for overall survival (OS); in recursive partitioning analysis, ECS and vascular invasion remained important categorical variables for OS. Vascular invasion is a strong prognostic biomarker for advanced hypopharyngeal carcinoma. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1535-1543, 2017. © 2017 Wiley Periodicals, Inc.

[Interpretation of ultrasound findings in otorhinolaryngology. Salivary glands, paraganglioma, angioma, esophagus, hypopharynx, extra cranial vessels and temporomandibular joint].

PubMed

Bozzato, A

2015-06-01

The second part of this continuing medical education article focuses on sonographic assessment of the salivary glands, cervical paraganglioma, angioma, esophagus, extra cranial blood vessels and the temporomandibular joint. The currently available minimally invasive therapeutic options (e. g. sialendoscopy, lithotripsy, therapeutic duct lavage and extracapsular dissection) for salivary gland disease presuppose a precise imaging modality. Modern ultrasound is able to meet this challenge, making additional imaging a rare necessity. Regions of the neck with a difficult topography (esophagus and hypopharynx) can often be successfully portrayed sonographically. Furthermore, ultrasound enables functional evaluation of swallowing in the cervical parts of the esophagus in dysphagia patients. In addition to the branchial cleft anomalies and lymph nodes discussed in part 1, paraganglioma, angiomatosis and neurogenic tumors are important differential diagnoses of solid lesions of the neck. Finally, venous and arterial alterations of the extracranial vessels of the neck relevant to clinical routine are depicted, as are pathological conditions of the temporomandibular joint relevant to the otorhinolaryngologist.

The First Cataract Surgeons in Anglo-America

PubMed Central

Leffler, Christopher T.; Schwartz, Stephen G.; Grzybowski, Andrzej; Braich, Puneet S.

2014-01-01

We tried to identify the earliest cataract surgeons in the English-speaking areas of America. In 1751, couching was performed on the Caribbean island of Montserrat by John Morphy. William Stork of England, who couched cataracts, practiced in Jamaica in 1760 and then in cities from Annapolis to Boston between 1761 and 1764. Frederick William Jericho of Germany, upon completion of his training at Utrecht, published his 1767 treatise on his preferred surgical technique of extracapsular cataract extraction. Jericho had practiced in the Leeward Islands by 1776 and then in cities from Charleston to Boston between 1783 and 1785. The French surgeon Lewis Leprilete was the first to advertise cataract extraction in the United States in 1782 and probably passed on the skill to his protégé, Nathaniel Miller of Massachusetts. Leprilete was also the first to publicize Benjamin Franklin's invention of bifocals.. These pioneers exposed American doctors and the public to cataract surgery. Shortly after their arrival, evidence emerges of other surgeons performing these procedures in America. PMID:25444521

Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers

PubMed Central

Vickers, Andrew J; Cronin, Angel M; Elkin, Elena B; Gonen, Mithat

2008-01-01

Background Decision curve analysis is a novel method for evaluating diagnostic tests, prediction models and molecular markers. It combines the mathematical simplicity of accuracy measures, such as sensitivity and specificity, with the clinical applicability of decision analytic approaches. Most critically, decision curve analysis can be applied directly to a data set, and does not require the sort of external data on costs, benefits and preferences typically required by traditional decision analytic techniques. Methods In this paper we present several extensions to decision curve analysis including correction for overfit, confidence intervals, application to censored data (including competing risk) and calculation of decision curves directly from predicted probabilities. All of these extensions are based on straightforward methods that have previously been described in the literature for application to analogous statistical techniques. Results Simulation studies showed that repeated 10-fold crossvalidation provided the best method for correcting a decision curve for overfit. The method for applying decision curves to censored data had little bias and coverage was excellent; for competing risk, decision curves were appropriately affected by the incidence of the competing risk and the association between the competing risk and the predictor of interest. Calculation of decision curves directly from predicted probabilities led to a smoothing of the decision curve. Conclusion Decision curve analysis can be easily extended to many of the applications common to performance measures for prediction models. Software to implement decision curve analysis is provided. PMID:19036144

Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers.

PubMed

Vickers, Andrew J; Cronin, Angel M; Elkin, Elena B; Gonen, Mithat

2008-11-26

Decision curve analysis is a novel method for evaluating diagnostic tests, prediction models and molecular markers. It combines the mathematical simplicity of accuracy measures, such as sensitivity and specificity, with the clinical applicability of decision analytic approaches. Most critically, decision curve analysis can be applied directly to a data set, and does not require the sort of external data on costs, benefits and preferences typically required by traditional decision analytic techniques. In this paper we present several extensions to decision curve analysis including correction for overfit, confidence intervals, application to censored data (including competing risk) and calculation of decision curves directly from predicted probabilities. All of these extensions are based on straightforward methods that have previously been described in the literature for application to analogous statistical techniques. Simulation studies showed that repeated 10-fold crossvalidation provided the best method for correcting a decision curve for overfit. The method for applying decision curves to censored data had little bias and coverage was excellent; for competing risk, decision curves were appropriately affected by the incidence of the competing risk and the association between the competing risk and the predictor of interest. Calculation of decision curves directly from predicted probabilities led to a smoothing of the decision curve. Decision curve analysis can be easily extended to many of the applications common to performance measures for prediction models. Software to implement decision curve analysis is provided.

An intelligent system with EMG-based joint angle estimation for telemanipulation.

PubMed

Suryanarayanan, S; Reddy, N P; Gupta, V

1996-01-01

Bio-control of telemanipulators is being researched as an alternate control strategy. This study investigates the use of surface EMG from the biceps to predict joint angle during flexion of the arm that can be used to control an anthropomorphic telemanipulator. An intelligent system based on neural networks and fuzzy logic has been developed to use the processed surface EMG signal and predict the joint angle. The system has been tested on various angles of flexion-extension of the arm and at several speeds of flexion-extension. Preliminary results show the RMS error between the predicted angle and the actual angle to be less than 3% during training and less than 15% during testing. The technique of direct bio-control using EMG has the potential as an interface for telemanipulation applications.

Life extending control: An interdisciplinary engineering thrust

NASA Technical Reports Server (NTRS)

Lorenzo, Carl F.; Merrill, Walter C.

1991-01-01

The concept of Life Extending Control (LEC) is introduced. Possible extensions to the cyclic damage prediction approach are presented based on the identification of a model from elementary forms. Several candidate elementary forms are presented. These extensions will result in a continuous or differential form of the damage prediction model. Two possible approaches to the LEC based on the existing cyclic damage prediction method, the measured variables LEC and the estimated variables LEC, are defined. Here, damage estimates or measurements would be used directly in the LEC. A simple hydraulic actuator driven position control system example is used to illustrate the main ideas behind LEC. Results from a simple hydraulic actuator example demonstrate that overall system performance (dynamic plus life) can be maximized by accounting for component damage in the control design.

The Efficacy of Violence Prediction: A Meta-Analytic Comparison of Nine Risk Assessment Tools

ERIC Educational Resources Information Center

Yang, Min; Wong, Stephen C. P.; Coid, Jeremy

2010-01-01

Actuarial risk assessment tools are used extensively to predict future violence, but previous studies comparing their predictive accuracies have produced inconsistent findings as a result of various methodological issues. We conducted meta-analyses of the effect sizes of 9 commonly used risk assessment tools and their subscales to compare their…

Predicting the Use of Instructional Technology among Community College Instructors: An Extension of the Technology Acceptance Model (TAM)

ERIC Educational Resources Information Center

Miller, Emma Rebecca

2017-01-01

The purpose of this study was to determine what variables predict the use of instructional technology among community college instructors. Legislators, community college administrators, and students expect innovative lessons from instructors that use technology. This study addresses the problem of not knowing what predicts instructional technology…

Physics based modeling of a series parallel battery pack for asymmetry analysis, predictive control and life extension

NASA Astrophysics Data System (ADS)

Ganesan, Nandhini; Basu, Suman; Hariharan, Krishnan S.; Kolake, Subramanya Mayya; Song, Taewon; Yeo, Taejung; Sohn, Dong Kee; Doo, Seokgwang

2016-08-01

Lithium-Ion batteries used for electric vehicle applications are subject to large currents and various operation conditions, making battery pack design and life extension a challenging problem. With increase in complexity, modeling and simulation can lead to insights that ensure optimal performance and life extension. In this manuscript, an electrochemical-thermal (ECT) coupled model for a 6 series × 5 parallel pack is developed for Li ion cells with NCA/C electrodes and validated against experimental data. Contribution of the cathode to overall degradation at various operating conditions is assessed. Pack asymmetry is analyzed from a design and an operational perspective. Design based asymmetry leads to a new approach of obtaining the individual cell responses of the pack from an average ECT output. Operational asymmetry is demonstrated in terms of effects of thermal gradients on cycle life, and an efficient model predictive control technique is developed. Concept of reconfigurable battery pack is studied using detailed simulations that can be used for effective monitoring and extension of battery pack life.

Timing and Prediction of Climate Change and Hydrological Impacts: Periodicity in Natural Variations

EPA Science Inventory

Hydrological impacts from climate change are of principal interest to water resource policy-makers and practicing engineers, and predictive climatic models have been extensively investigated to quantify the impacts. In palaeoclmatic investigations, climate proxy evidence has une...

Adaptive DIT-Based Fringe Tracking and Prediction at IOTA

NASA Technical Reports Server (NTRS)

Wilson, Edward; Pedretti, Ettore; Bregman, Jesse; Mah, Robert W.; Traub, Wesley A.

2004-01-01

An automatic fringe tracking system has been developed and implemented at the Infrared Optical Telescope Array (IOTA). In testing during May 2002, the system successfully minimized the optical path differences (OPDs) for all three baselines at IOTA. Based on sliding window discrete Fourier transform (DFT) calculations that were optimized for computational efficiency and robustness to atmospheric disturbances, the algorithm has also been tested extensively on off-line data. Implemented in ANSI C on the 266 MHZ PowerPC processor running the VxWorks real-time operating system, the algorithm runs in approximately 2.0 milliseconds per scan (including all three interferograms), using the science camera and piezo scanners to measure and correct the OPDs. Preliminary analysis on an extension of this algorithm indicates a potential for predictive tracking, although at present, real-time implementation of this extension would require significantly more computational capacity.

An Experimental Investigation into Failure and Localization Phenomena in the Extension to Shear Fracture Transition in Rock

NASA Astrophysics Data System (ADS)

Choens, R. C., II; Chester, F. M.; Bauer, S. J.; Flint, G. M.

2014-12-01

Fluid-pressure assisted fracturing can produce mesh and other large, interconnected and complex networks consisting of both extension and shear fractures in various metamorphic, magmatic and tectonic systems. Presently, rock failure criteria for tensile and low-mean compressive stress conditions is poorly defined, although there is accumulating evidence that the transition from extension to shear fracture with increasing mean stress is continuous. We report on the results of experiments designed to document failure criteria, fracture mode, and localization phenomena for several rock types (sandstone, limestone, chalk and marble). Experiments were conducted in triaxial extension using a necked (dogbone) geometry to achieve mixed tension and compression stress states with local component-strain measurements in the failure region. The failure envelope for all rock types is similar, but are poorly described using Griffith or modified Griffith (Coulomb or other) failure criteria. Notably, the mode of fracture changes systematically from pure extension to shear with increase in compressive mean stress and display a continuous change in fracture orientation with respect to principal stress axes. Differential stress and inelastic strain show a systematic increase with increasing mean stress, whereas the axial stress decreases before increasing with increasing mean stress. The stress and strain data are used to analyze elastic and plastic strains leading to failure and compare the experimental results to predictions for localization using constitutive models incorporating on bifurcation theory. Although models are able to describe the stability behavior and onset of localization qualitatively, the models are unable to predict fracture type or orientation. Constitutive models using single or multiple yield surfaces are unable to predict the experimental results, reflecting the difficulty in capturing the changing micromechanisms from extension to shear failure. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Deopartment of Energy's National Security Administration under contract DE-AC04-94AL85000. SAND2014-16578A

A community resource benchmarking predictions of peptide binding to MHC-I molecules.

PubMed

Peters, Bjoern; Bui, Huynh-Hoa; Frankild, Sune; Nielson, Morten; Lundegaard, Claus; Kostem, Emrah; Basch, Derek; Lamberth, Kasper; Harndahl, Mikkel; Fleri, Ward; Wilson, Stephen S; Sidney, John; Lund, Ole; Buus, Soren; Sette, Alessandro

2006-06-09

Recognition of peptides bound to major histocompatibility complex (MHC) class I molecules by T lymphocytes is an essential part of immune surveillance. Each MHC allele has a characteristic peptide binding preference, which can be captured in prediction algorithms, allowing for the rapid scan of entire pathogen proteomes for peptide likely to bind MHC. Here we make public a large set of 48,828 quantitative peptide-binding affinity measurements relating to 48 different mouse, human, macaque, and chimpanzee MHC class I alleles. We use this data to establish a set of benchmark predictions with one neural network method and two matrix-based prediction methods extensively utilized in our groups. In general, the neural network outperforms the matrix-based predictions mainly due to its ability to generalize even on a small amount of data. We also retrieved predictions from tools publicly available on the internet. While differences in the data used to generate these predictions hamper direct comparisons, we do conclude that tools based on combinatorial peptide libraries perform remarkably well. The transparent prediction evaluation on this dataset provides tool developers with a benchmark for comparison of newly developed prediction methods. In addition, to generate and evaluate our own prediction methods, we have established an easily extensible web-based prediction framework that allows automated side-by-side comparisons of prediction methods implemented by experts. This is an advance over the current practice of tool developers having to generate reference predictions themselves, which can lead to underestimating the performance of prediction methods they are not as familiar with as their own. The overall goal of this effort is to provide a transparent prediction evaluation allowing bioinformaticians to identify promising features of prediction methods and providing guidance to immunologists regarding the reliability of prediction tools.

Extension of a Kinetic-Theory Approach for Computing Chemical-Reaction Rates to Reactions with Charged Particles

NASA Technical Reports Server (NTRS)

Liechty, Derek S.; Lewis, Mark J.

2010-01-01

Recently introduced molecular-level chemistry models that predict equilibrium and nonequilibrium reaction rates using only kinetic theory and fundamental molecular properties (i.e., no macroscopic reaction rate information) are extended to include reactions involving charged particles and electronic energy levels. The proposed extensions include ionization reactions, exothermic associative ionization reactions, endothermic and exothermic charge exchange reactions, and other exchange reactions involving ionized species. The extensions are shown to agree favorably with the measured Arrhenius rates for near-equilibrium conditions.

[Comparison of various noninvasive serum markers of liver fibrosis in chronic viral liver disease].

PubMed

Kim, Sun Min; Sohn, Joo Hyun; Kim, Tae Yeob; Roh, Young Wook; Eun, Chang Soo; Jeon, Yong Cheol; Han, Dong Soo; Oh, Young Ha

2009-12-01

The aim of this study was to determine the clinical performances of noninvasive serum markers for the prediction of liver fibrosis in chronic viral liver diseases. We analyzed a total of 225 patients with chronic viral liver diseases (180 with hepatitis B virus, 43 with hepatitis C virus, and 2 with hepatitis B+C virus) who underwent a liver biopsy procedure at the Hanyang University Guri Hospital between March 2002 and February 2007. Serum was also obtained at the time of liver biopsy. Liver fibrosis was staged according to the scoring system proposed by the Korean Study Group for the Pathology of Digestive Diseases. Various noninvasive serum markers were evaluated, including the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), age-platelet (AP) index, AST/platelet ratio index (APRI), cirrhosis discriminant score (CDS), platelet count, hyaluronic acid (HA), and type IV collagen. There were 17, 40, 61, 74, and 33 patients at stages F0, F1, F2, F3, and F4, respectively. The overall diagnostic accuracies of each marker, as determined by the area under receiver operating characteristics curves, were APRI=0.822, CDS=0.776, platelet count=0.773, AP index=0.756, HA=0.749, type IV collagen=0.718, and AAR=0.642 for predicting significant fibrosis (> or =F2); and CDS=0.835, platelet count=0.795, AP index=0.794, HA=0.766, AAR=0.711, type IV collagen=0.697, and APRI=0.691 for predicting extensive fibrosis (> or =F3). All noninvasive serum markers evaluated in this study were useful for predicting significant or extensive liver fibrosis in chronic viral liver diseases. In particular, APRI was most useful for the prediction of significant fibrosis, and CDS was most useful for the prediction of extensive fibrosis.

Novel Computational Approaches to Drug Discovery

NASA Astrophysics Data System (ADS)

Skolnick, Jeffrey; Brylinski, Michal

2010-01-01

New approaches to protein functional inference based on protein structure and evolution are described. First, FINDSITE, a threading based approach to protein function prediction, is summarized. Then, the results of large scale benchmarking of ligand binding site prediction, ligand screening, including applications to HIV protease, and GO molecular functional inference are presented. A key advantage of FINDSITE is its ability to use low resolution, predicted structures as well as high resolution experimental structures. Then, an extension of FINDSITE to ligand screening in GPCRs using predicted GPCR structures, FINDSITE/QDOCKX, is presented. This is a particularly difficult case as there are few experimentally solved GPCR structures. Thus, we first train on a subset of known binding ligands for a set of GPCRs; this is then followed by benchmarking against a large ligand library. For the virtual ligand screening of a number of Dopamine receptors, encouraging results are seen, with significant enrichment in identified ligands over those found in the training set. Thus, FINDSITE and its extensions represent a powerful approach to the successful prediction of a variety of molecular functions.

[Intra-articular reinforcement of a partially torn anterior cruciate ligament (ACL) using newly developed UHMWPE biomaterial in combination with Hexalon ACL/PCL screws: ex-vivo mechanical testing of an animal knee model].

PubMed

Fedorová, P; Srnec, R; Pěnčík, J; Dvořák, M; Krbec, M; Nečas, A

2015-01-01

PURPOSE OF THE STUDY Recent trends in the experimental surgical management of a partial anterior cruciate ligament (ACL) rupture in animals show repair of an ACL lesion using novel biomaterials both for biomechanical reinforcement of a partially unstable knee and as suitable scaffolds for bone marrow stem cell therapy in a partial ACL tear. The study deals with mechanical testing of the newly developed ultra-high-molecular-weight polyethylene (UHMWPE) biomaterial anchored to bone with Hexalon biodegradable ACL/PCL screws, as a new possibility of intra-articular reinforcement of a partial ACL tear. MATERIAL AND METHODS Two groups of ex vivo pig knee models were prepared and tested as follows: the model of an ACL tear stabilised with UHMWPE biomaterial using a Hexalon ACL/PCL screw (group 1; n = 10) and the model of an ACL tear stabilised with the traditional, and in veterinary medicine used, extracapsular technique involving a monofilament nylon fibre, a clamp and a Securos bone anchor (group 2; n = 11). The models were loaded at a standing angle of 100° and the maximum load (N) and shift (mm) values were recorded. RESULTS In group 1 the average maximal peak force was 167.6 ± 21.7 N and the shift was on average 19.0 ± 4.0 mm. In all 10 specimens, the maximum load made the UHMWPE implant break close to its fixation to the femur but the construct/fixation never failed at the site where the material was anchored to the bone. In group 2, the average maximal peak force was 207.3 ± 49.2 N and the shift was on average 24.1 ± 9.5 mm. The Securos stabilisation failed by pullout of the anchor from the femoral bone in nine out of 11 cases; the monofilament fibre ruptured in two cases. CONCLUSIONS It can be concluded that a UHMWPE substitute used in ex-vivo pig knee models has mechanical properties comparable with clinically used extracapsular Securos stabilisation and, because of its potential to carry stem cells and bioactive substances, it can meet the requirements for an implant appropriate to the unique technique of protecting a partial ACL tear. In addition, it has no critical point of ACL substitute failure at the site of its anchoring to the bone (compared to the previously used PET/PCL substitute). Key words: knee stabilisation, stifle surgery, ultra-high-molecular-weight polyethylene, UHMWPE, nylon monofilament thread, biodegradable screw, bone anchor.

Analysis and comparison of nonlinear tree height prediction strategies for Douglas-fir forest.

Treesearch

H. Temesgen; V.J. Monleon; D.W. Hann

2008-01-01

Using an extensive Douglas-fir data set from southwest Oregon, we examined the (I) performance and suitability of selected prediction strategies, (2) contribution of relative position and stand-density measures in improving tree height (h) prediction values, and (3) effect of different subsampling designs to fill in missing h values in a new stand using a regional...

The Motivational Determinants of Task Performance in a Non-Industrial Milieu: A Modification and Extension of Vroom's Model.

ERIC Educational Resources Information Center

Mendel, Raymond M.; Dickinson, Terry L.

Vroom's cognitive model, which proposes to both explain and predict an individual's level of work productivity by drawing on the construct motivation, is discussed and three hypotheses generated: (1) that Vroom's model does predict performance in a non-industrial setting; (2) that it predicts self-perceived performance better than measures…

Tidal extension and sea-level rise: recommendations for a research agenda

USGS Publications Warehouse

Ensign, Scott H.; Noe, Gregory

2018-01-01

Sea-level rise is pushing freshwater tides upstream into formerly non-tidal rivers. This tidal extension may increase the area of tidal freshwater ecosystems and offset loss of ecosystem functions due to salinization downstream. Without considering how gains in ecosystem functions could offset losses, landscape-scale assessments of ecosystem functions may be biased toward worst-case scenarios of loss. To stimulate research on this concept, we address three fundamental questions about tidal extension: Where will tidal extension be most evident, and can we measure it? What ecosystem functions are influenced by tidal extension, and how can we measure them? How do watershed processes, climate change, and tidal extension interact to affect ecosystem functions? Our preliminary answers lead to recommendations that will advance tidal extension research, enable better predictions of the impacts of sea-level rise, and help balance the landscape-scale benefits of ecosystem function with costs of response.

Using Predictability for Lexical Segmentation

ERIC Educational Resources Information Center

Çöltekin, Çagri

2017-01-01

This study investigates a strategy based on predictability of consecutive sub-lexical units in learning to segment a continuous speech stream into lexical units using computational modeling and simulations. Lexical segmentation is one of the early challenges during language acquisition, and it has been studied extensively through psycholinguistic…

Adjuvant radiation for salivary gland malignancies is associated with improved survival: A National Cancer Database analysis.

PubMed

Bakst, Richard L; Su, William; Ozbek, Umut; Knoll, Miriam A; Miles, Brett A; Gupta, Vishal; Rhome, Ryan

2017-01-01

There are no randomized data to support the use of postoperative radiation for salivary gland malignancies. This study uses the National Cancer Database (NCDB) to describe the epidemiology of salivary gland cancer patients and to investigate whether treatment with adjuvant radiation improves overall survival. A total of 8243 patients diagnosed with a major salivary gland cancer were identified from the NCDB. All patients received primary surgical resection of their malignancy. Patients were risk-stratified by adverse features, and overall survival rates were determined. Patients were considered high risk if they had extracapsular extension and/or positive margin after resection. Patients were considered intermediate risk if they did not meet the criteria for high risk but had pT3-T4 disease, pN+ disease, lymphovascular space invasion, adenoid cystic histology, or grade 2-3 disease. Patients who did not meet criteria for high or intermediate risk were considered low risk. Overall patient demographics, disease characteristics, treatment factors, and outcomes were summarized with descriptive statistics and analyzed with STATA. Median follow-up in this cohort was 42.4 months, with the median age of 58 years. Patients in the high-risk group had greater survival (hazard ratio [HR], 0.76; P = .002; 95% confidence interval [CI], 0.64-0.91) if they received adjuvant radiation therapy. In contrast, patients in the intermediate- (HR, 1.01; P = .904; 95% CI, 0.85-1.20) and low-risk groups (HR, 0.85; P  = .427; 95% CI, 0.57-1.26) did not experience a survival benefit with adjuvant radiation therapy. This large analysis compared survival outcomes between observation and adjuvant radiation alone in risk-stratified patients after resection of major salivary glands using a national database. The use of adjuvant radiation for high-risk major salivary gland cancers appears to offer a survival benefit. Although an overall survival benefit was not seen in low- and intermediate-risk salivary gland cancers, this study could not address impact on local control because of the limitations of the NCDB.

High-Dose Adjuvant Radiotherapy After Radical Prostatectomy With or Without Androgen Deprivation Therapy

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

Ost, Piet, E-mail: piet.ost@ugent.be; Cozzarini, Cesare; De Meerleer, Gert

2012-07-01

Purpose: To retrospectively evaluate the outcome and toxicity in patients receiving high-dose (>69 Gy) adjuvant radiotherapy (HD-ART) and the impact of androgen deprivation therapy (ADT). Methods and Materials: Between 1999 and 2008, 225 node-negative patients were referred for HD-ART with or without ADT to two large academic institutions. Indications for HD-ART were extracapsular extension, seminal vesicle invasion (SVI), and/or positive surgical margins at radical prostatectomy (RP). A dose of at least 69.1 Gy was prescribed to the prostate bed and seminal vesicle bed. The ADT consisted of a luteinizing hormone-releasing hormone analog. The duration and indication of ADT was leftmore » at the discretion of the treating physician. The effect of HD-ART and ADT on biochemical (bRFS) and clinical (cRFS) relapse-free survival was examined through univariate and multivariate analysis, with correction for known patient- and treatment-related variables. Interaction terms were introduced to evaluate effect modification. Results: After a median follow-up time of 5 years, the 7-year bRFS and cRFS were 84% and 88%, respectively. On multivariate analysis, the addition of ADT was independently associated with an improved bRFS (hazard ratio [HR] 0.4, p = 0.02) and cRFS (HR 0.2, p = 0.008). Higher Gleason scores and SVI were associated with decreased bRFS and cRFS. A lymphadenectomy at the time of RP independently improved cRFS (HR 0.09, p = 0.009). The 7-year probability of late Grade 2-3 toxicity was 29% and 5% for genitourinary (GU) and gastrointestinal (GI) symptoms, respectively. The absolute incidence of Grade 3 toxicity was <1% and 10% for GI and GU symptoms, respectively. The study is limited by its retrospective design and the lack of a standardized use of ADT. Conclusions: This retrospective study shows significantly improved bRFS and cRFS rates with the addition of ADT to HD-ART, with low Grade 3 gastrointestinal toxicity and 10% Grade 3 genitourinary toxicity.« less

Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer

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

White, Julia, E-mail: Julia.White@osumc.edu; Winter, Kathryn; Kuske, Robert R.

Purpose: To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT). Methods and Materials: Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days formore » low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival. Results: The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR with RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively. Conclusion: This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up.« less

Imaging of prostate cancer: a platform for 3D co-registration of in-vivo MRI ex-vivo MRI and pathology

NASA Astrophysics Data System (ADS)

Orczyk, Clément; Mikheev, Artem; Rosenkrantz, Andrew; Melamed, Jonathan; Taneja, Samir S.; Rusinek, Henry

2012-02-01

Objectives: Multi-parametric MRI is emerging as a promising method for prostate cancer diagnosis. prognosis and treatment planning. However, the localization of in-vivo detected lesions and pathologic sites of cancer remains a significant challenge. To overcome this limitation we have developed and tested a system for co-registration of in-vivo MRI, ex-vivo MRI and histology. Materials and Methods: Three men diagnosed with localized prostate cancer (ages 54-72, PSA levels 5.1-7.7 ng/ml) were prospectively enrolled in this study. All patients underwent 3T multi-parametric MRI that included T2W, DCEMRI, and DWI prior to robotic-assisted prostatectomy. Ex-vivo multi-parametric MRI was performed on fresh prostate specimen. Excised prostates were then sliced at regular intervals and photographed both before and after fixation. Slices were perpendicular to the main axis of the posterior capsule, i.e., along the direction of the rectal wall. Guided by the location of the urethra, 2D digital images were assembled into 3D models. Cancer foci, extra-capsular extensions and zonal margins were delineated by the pathologist and included in 3D histology data. A locally-developed software was applied to register in-vivo, ex-vivo and histology using an over-determined set of anatomical landmarks placed in anterior fibro-muscular stroma, central. transition and peripheral zones. The mean root square distance across corresponding control points was used to assess co-registration error. Results: Two specimens were pT3a and one pT2b (negative margin) at pathology. The software successfully fused invivo MRI. ex-vivo MRI fresh specimen and histology using appropriate (rigid and affine) transformation models with mean square error of 1.59 mm. Coregistration accuracy was confirmed by multi-modality viewing using operator-guided variable transparency. Conclusion: The method enables successful co-registration of pre-operative MRI, ex-vivo MRI and pathology and it provides initial evidence of feasibility of MRI-guided surgical planning.

Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer.

PubMed

White, Julia; Winter, Kathryn; Kuske, Robert R; Bolton, John S; Arthur, Douglas W; Scroggins, Troy; Rabinovitch, Rachel A; Kelly, Tracy; Toonkel, Leonard M; Vicini, Frank A; McCormick, Beryl

2016-08-01

To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT). Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days for low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival. The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR with RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively. This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.

Extending the Simultaneous-Sequential Paradigm to Measure Perceptual Capacity for Features and Words

ERIC Educational Resources Information Center

Scharff, Alec; Palmer, John; Moore, Cathleen M.

2011-01-01

In perception, divided attention refers to conditions in which multiple stimuli are relevant to an observer. To measure the effect of divided attention in terms of perceptual capacity, we introduce an extension of the simultaneous-sequential paradigm. The extension makes predictions for fixed-capacity models as well as for unlimited-capacity…

Tiltrotor Aeroacoustic Code (TRAC) Prediction Assessment and Initial Comparisons with Tram Test Data

NASA Technical Reports Server (NTRS)

Burley, Casey L.; Brooks, Thomas F.; Charles, Bruce D.; McCluer, Megan

1999-01-01

A prediction sensitivity assessment to inputs and blade modeling is presented for the TiltRotor Aeroacoustic Code (TRAC). For this study, the non-CFD prediction system option in TRAC is used. Here, the comprehensive rotorcraft code, CAMRAD.Mod1, coupled with the high-resolution sectional loads code HIRES, predicts unsteady blade loads to be used in the noise prediction code WOPWOP. The sensitivity of the predicted blade motions, blade airloads, wake geometry, and acoustics is examined with respect to rotor rpm, blade twist and chord, and to blade dynamic modeling. To accomplish this assessment, an interim input-deck for the TRAM test model and an input-deck for a reference test model are utilized in both rigid and elastic modes. Both of these test models are regarded as near scale models of the V-22 proprotor (tiltrotor). With basic TRAC sensitivities established, initial TRAC predictions are compared to results of an extensive test of an isolated model proprotor. The test was that of the TiltRotor Aeroacoustic Model (TRAM) conducted in the Duits-Nederlandse Windtunnel (DNW). Predictions are compared to measured noise for the proprotor operating over an extensive range of conditions. The variation of predictions demonstrates the great care that must be taken in defining the blade motion. However, even with this variability, the predictions using the different blade modeling successfully capture (bracket) the levels and trends of the noise for conditions ranging from descent to ascent.

Tiltrotor Aeroacoustic Code (TRAC) Prediction Assessment and Initial Comparisons With TRAM Test Data

NASA Technical Reports Server (NTRS)

Burley, Casey L.; Brooks, Thomas F.; Charles, Bruce D.; McCluer, Megan

1999-01-01

A prediction sensitivity assessment to inputs and blade modeling is presented for the TiltRotor Aeroacoustic Code (TRAC). For this study, the non-CFD prediction system option in TRAC is used. Here, the comprehensive rotorcraft code, CAMRAD.Mod 1, coupled with the high-resolution sectional loads code HIRES, predicts unsteady blade loads to be used in the noise prediction code WOPWOP. The sensitivity of the predicted blade motions, blade airloads, wake geometry, and acoustics is examined with respect to rotor rpm, blade twist and chord, and to blade dynamic modeling. To accomplish this assessment. an interim input-deck for the TRAM test model and an input-deck for a reference test model are utilized in both rigid and elastic modes. Both of these test models are regarded as near scale models of the V-22 proprotor (tiltrotor). With basic TRAC sensitivities established, initial TRAC predictions are compared to results of an extensive test of an isolated model proprotor. The test was that of the TiltRotor Aeroacoustic Model (TRAM) conducted in the Duits-Nederlandse Windtunnel (DNW). Predictions are compared to measured noise for the proprotor operating over an extensive range of conditions. The variation of predictions demonstrates the great care that must be taken in defining the blade motion. However, even with this variability, the predictions using the different blade modeling successfully capture (bracket) the levels and trends of the noise for conditions ranging from descent to ascent.

EXPLOITATION OF FLOODPLAIN RESOURCES BY ADULT LARGESCALE SUCKER OF THE WILLAMETTE RIVER, OREGON

EPA Science Inventory

We tested two predictions of the flood-pulse concept on a large, temperate alluvial river that historically flooded an extensive fringing floodplain. We predicted adult largescale sucker, Catostomus macrocheilus, would: (1) migrate onto the floodplain during high water; and (2) e...

Isolation predicts compositional change after discrete disturbances in a global meta-study

USDA-ARS?s Scientific Manuscript database

Globally, anthropogenic disturbances are occurring at unprecedented rates and over extensive spatial and temporal scales. Human activities also affect natural disturbances, prompting shifts in their timing and intensities. Thus, there is an urgent need to understand and predict the response of ecosy...

Analysis of Satellite Communications Antenna Patterns

NASA Technical Reports Server (NTRS)

Rahmat-Samii, Y.

1985-01-01

Computer program accurately and efficiently predicts far-field patterns of offset, or symmetric, parabolic reflector antennas. Antenna designer uses program to study effects of varying geometrical and electrical (RF) parameters of parabolic reflector and its feed system. Accurate predictions of far-field patterns help designer predict overall performance of antenna. These reflectors used extensively in modern communications satellites and in multiple-beam and low side-lobe antenna systems.

Predicting the 10-year risk of hip and major osteoporotic fracture in rheumatoid arthritis and in the general population: an independent validation and update of UK FRAX without bone mineral density

PubMed Central

Klop, Corinne; de Vries, Frank; Bijlsma, Johannes W J; Leufkens, Hubert G M; Welsing, Paco M J

2016-01-01

Objectives FRAX incorporates rheumatoid arthritis (RA) as a dichotomous predictor for predicting the 10-year risk of hip and major osteoporotic fracture (MOF). However, fracture risk may deviate with disease severity, duration or treatment. Aims were to validate, and if needed to update, UK FRAX for patients with RA and to compare predictive performance with the general population (GP). Methods Cohort study within UK Clinical Practice Research Datalink (CPRD) (RA: n=11 582, GP: n=38 755), also linked to hospital admissions for hip fracture (CPRD-Hospital Episode Statistics, HES) (RA: n=7221, GP: n=24 227). Predictive performance of UK FRAX without bone mineral density was assessed by discrimination and calibration. Updating methods included recalibration and extension. Differences in predictive performance were assessed by the C-statistic and Net Reclassification Improvement (NRI) using the UK National Osteoporosis Guideline Group intervention thresholds. Results UK FRAX significantly overestimated fracture risk in patients with RA, both for MOF (mean predicted vs observed 10-year risk: 13.3% vs 8.4%) and hip fracture (CPRD: 5.5% vs 3.1%, CPRD-HES: 5.5% vs 4.1%). Calibration was good for hip fracture in the GP (CPRD-HES: 2.7% vs 2.4%). Discrimination was good for hip fracture (RA: 0.78, GP: 0.83) and moderate for MOF (RA: 0.69, GP: 0.71). Extension of the recalibrated UK FRAX using CPRD-HES with duration of RA disease, glucocorticoids (>7.5 mg/day) and secondary osteoporosis did not improve the NRI (0.01, 95% CI −0.04 to 0.05) or C-statistic (0.78). Conclusions UK FRAX overestimated fracture risk in RA, but performed well for hip fracture in the GP after linkage to hospitalisations. Extension of the recalibrated UK FRAX did not improve predictive performance. PMID:26984006

Patient-related factors influence stiffness of the soft tissue complex during intraoperative gap balancing in cruciate-retaining total knee arthroplasty.

PubMed

Heesterbeek, P J C; Haffner, N; Wymenga, A B; Stifter, J; Ritschl, P

2017-09-01

How much force is needed to pre-tension the ligaments during total knee arthroplasty? The goal of this study was to determine this force for extension and flexion, and for both compartments, and to identify predicting patient-related factors. Eighty patients [55 females, mean age 71 (SD 9.7)] were recruited and had a navigated cruciate-retaining total knee arthroplasty. Distraction of the medial and lateral compartments of the extension and flexion gap (90°) with an instrumented bi-compartmental double-spring tensioner took place after finishing the bone cuts. Applied forces and resulting gap distances were recorded by the navigation system, resulting in a force-elongation curve. Lines were fitted with the intersection defined as the stiffness transition point. The slopes (N/mm) represented the stiffness of the ligamentous complex. Linear multiple regression analysis was performed to identify predicting factors. The amount of force at the stiffness transition point was on average 52.3 (CI 95 50.7-53.9), 54.5 (CI 95 52.7-56.3), 48.3 (CI 95 46.2-50.2), and 59.3 (CI 95 57.0-61.6) N for the medial and lateral extension and flexion gap, respectively, and varied considerably between patients. The force at the stiffness transition point was significantly different between extension and flexion and both compartments (P < 0.05). Stiffness of the ligaments statistically significantly helped to predict the amount of force at the stiffness transition point, as well as body mass index, gender, and varus-valgus alignment. The amount of force at the stiffness transition point varies between 48 and 59 N, depending on flexion/extension and compartment. Patient-related factors influence the stiffness transition point and can help predict the stiffness transition point. When forces higher than 60 N are used for gap distraction, the ligamentous sleeve of the knee might be over-tensioned. Prognostic study, Level I-high-quality prospective cohort study with >80 % follow-up, and all patients enrolled at same time point in disease.

Increased prediction accuracy in wheat breeding trials using a marker x environment interaction genomic selection model

USDA-ARS?s Scientific Manuscript database

Genomic selection (GS) models use genome-wide genetic information to predict genetic values of candidates for selection. Originally these models were developed without considering genotype ' environment interaction (GE). Several authors have proposed extensions of the cannonical GS model that accomm...

Using the Gamma-Poisson Model to Predict Library Circulations.

ERIC Educational Resources Information Center

Burrell, Quentin L.

1990-01-01

Argues that the gamma mixture of Poisson processes, for all its perceived defects, can be used to make predictions regarding future library book circulations of a quality adequate for general management requirements. The use of the model is extensively illustrated with data from two academic libraries. (Nine references) (CLB)

Optimal and Adaptive Online Learning

ERIC Educational Resources Information Center

Luo, Haipeng

2016-01-01

Online learning is one of the most important and well-established machine learning models. Generally speaking, the goal of online learning is to make a sequence of accurate predictions "on the fly," given some information of the correct answers to previous prediction tasks. Online learning has been extensively studied in recent years,…

Validation, acceptance, and extension of a predictive model of reproductive toxicity using ToxCast data

EPA Science Inventory

The EPA ToxCast research program uses a high-throughput screening (HTS) approach for predicting the toxicity of large numbers of chemicals. Phase-I tested 309 well-characterized chemicals (mostly pesticides) in over 500 assays of different molecular targets, cellular responses an...

Predicting fire scars in Ozark timber species following prescribed burning

Treesearch

Aaron P. Stevenson; Richard P. Guyette; Rose-Marie Muzika

2009-01-01

A potential consequence of using prescribed fire is heat-related injury to timber trees. Scars formed following fire injuries are often associated with extensive decay in hardwoods. The ability to predict scarring caused by prescribed fire is important when multiple management goals are incorporated on a single forest site.

Control of Boundary Layers for Aero-optical Applications

DTIC Science & Technology

2015-06-23

range of subsonic and supersonic Mach numbers was developed and shown to correctly predict experimentally-observed reductions. Heating the wall allows...40 3.3 Extension to supersonic speeds...boundary layers at supersonic speeds. Comparing the model prediction to the experimental results, it was speculated that while the pressure effects can

DIANA-microT web server: elucidating microRNA functions through target prediction.

PubMed

Maragkakis, M; Reczko, M; Simossis, V A; Alexiou, P; Papadopoulos, G L; Dalamagas, T; Giannopoulos, G; Goumas, G; Koukis, E; Kourtis, K; Vergoulis, T; Koziris, N; Sellis, T; Tsanakas, P; Hatzigeorgiou, A G

2009-07-01

Computational microRNA (miRNA) target prediction is one of the key means for deciphering the role of miRNAs in development and disease. Here, we present the DIANA-microT web server as the user interface to the DIANA-microT 3.0 miRNA target prediction algorithm. The web server provides extensive information for predicted miRNA:target gene interactions with a user-friendly interface, providing extensive connectivity to online biological resources. Target gene and miRNA functions may be elucidated through automated bibliographic searches and functional information is accessible through Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. The web server offers links to nomenclature, sequence and protein databases, and users are facilitated by being able to search for targeted genes using different nomenclatures or functional features, such as the genes possible involvement in biological pathways. The target prediction algorithm supports parameters calculated individually for each miRNA:target gene interaction and provides a signal-to-noise ratio and a precision score that helps in the evaluation of the significance of the predicted results. Using a set of miRNA targets recently identified through the pSILAC method, the performance of several computational target prediction programs was assessed. DIANA-microT 3.0 achieved there with 66% the highest ratio of correctly predicted targets over all predicted targets. The DIANA-microT web server is freely available at www.microrna.gr/microT.

Hard sphere perturbation theory for fluids with soft-repulsive-core potentials

NASA Astrophysics Data System (ADS)

Ben-Amotz, Dor; Stell, George

2004-03-01

The thermodynamic properties of fluids with very soft repulsive-core potentials, resembling those of some liquid metals, are predicted with unprecedented accuracy using a new first-order thermodynamic perturbation theory. This theory is an extension of Mansoori-Canfield/Rasaiah-Stell (MCRS) perturbation theory, obtained by including a configuration integral correction recently identified by Mon, who evaluated it by computer simulation. In this work we derive an analytic expression for Mon's correction in terms of the radial distribution function of the soft-core fluid, g0(r), approximated using Lado's self-consistent extension of Weeks-Chandler-Andersen (WCA) theory. Comparisons with WCA and MCRS predictions show that our new extended-MCRS theory outperforms other first-order theories when applied to fluids with very soft inverse-power potentials (n⩽6), and predicts free energies that are within 0.3kT of simulation results up to the fluid freezing point.

Predicting the practice effects on the blood oxygenation level-dependent (BOLD) function of fMRI in a symbolic manipulation task

NASA Astrophysics Data System (ADS)

Qin, Yulin; Sohn, Myeong-Ho; Anderson, John R.; Stenger, V. Andrew; Fissell, Kate; Goode, Adam; Carter, Cameron S.

2003-04-01

Based on adaptive control of thought-rational (ACT-R), a cognitive architecture for cognitive modeling, researchers have developed an information-processing model to predict the blood oxygenation level-dependent (BOLD) response of functional MRI in symbol manipulation tasks. As an extension of this research, the current event-related functional MRI study investigates the effect of relatively extensive practice on the activation patterns of related brain regions. The task involved performing transformations on equations in an artificial algebra system. This paper shows that the base-level activation learning in the ACT-R theory can predict the change of the BOLD response in practice in a left prefrontal region reflecting retrieval of information. In contrast, practice has relatively little effect on the form of BOLD response in the parietal region reflecting imagined transformations to the equation or the motor region reflecting manual programming.

Improving the prediction of African savanna vegetation variables using time series of MODIS products

NASA Astrophysics Data System (ADS)

Tsalyuk, Miriam; Kelly, Maggi; Getz, Wayne M.

2017-09-01

African savanna vegetation is subject to extensive degradation as a result of rapid climate and land use change. To better understand these changes detailed assessment of vegetation structure is needed across an extensive spatial scale and at a fine temporal resolution. Applying remote sensing techniques to savanna vegetation is challenging due to sparse cover, high background soil signal, and difficulty to differentiate between spectral signals of bare soil and dry vegetation. In this paper, we attempt to resolve these challenges by analyzing time series of four MODIS Vegetation Products (VPs): Normalized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI), Leaf Area Index (LAI), and Fraction of Photosynthetically Active Radiation (FPAR) for Etosha National Park, a semiarid savanna in north-central Namibia. We create models to predict the density, cover, and biomass of the main savanna vegetation forms: grass, shrubs, and trees. To calibrate remote sensing data we developed an extensive and relatively rapid field methodology and measured herbaceous and woody vegetation during both the dry and wet seasons. We compared the efficacy of the four MODIS-derived VPs in predicting vegetation field measured variables. We then compared the optimal time span of VP time series to predict ground-measured vegetation. We found that Multiyear Partial Least Square Regression (PLSR) models were superior to single year or single date models. Our results show that NDVI-based PLSR models yield robust prediction of tree density (R2 = 0.79, relative Root Mean Square Error, rRMSE = 1.9%) and tree cover (R2 = 0.78, rRMSE = 0.3%). EVI provided the best model for shrub density (R2 = 0.82) and shrub cover (R2 = 0.83), but was only marginally superior over models based on other VPs. FPAR was the best predictor of vegetation biomass of trees (R2 = 0.76), shrubs (R2 = 0.83), and grass (R2 = 0.91). Finally, we addressed an enduring challenge in the remote sensing of semiarid vegetation by examining the transferability of predictive models through space and time. Our results show that models created in the wetter part of Etosha could accurately predict trees' and shrubs' variables in the drier part of the reserve and vice versa. Moreover, our results demonstrate that models created for vegetation variables in the dry season of 2011 could be successfully applied to predict vegetation in the wet season of 2012. We conclude that extensive field data combined with multiyear time series of MODIS vegetation products can produce robust predictive models for multiple vegetation forms in the African savanna. These methods advance the monitoring of savanna vegetation dynamics and contribute to improved management and conservation of these valuable ecosystems.

Does encapsulation protect embryos from the effects of ocean acidification? The example of Crepidula fornicata.

PubMed

Noisette, Fanny; Comtet, Thierry; Legrand, Erwann; Bordeyne, François; Davoult, Dominique; Martin, Sophie

2014-01-01

Early life history stages of marine organisms are generally thought to be more sensitive to environmental stress than adults. Although most marine invertebrates are broadcast spawners, some species are brooders and/or protect their embryos in egg or capsules. Brooding and encapsulation strategies are typically assumed to confer greater safety and protection to embryos, although little is known about the physico-chemical conditions within egg capsules. In the context of ocean acidification, the protective role of encapsulation remains to be investigated. To address this issue, we conducted experiments on the gastropod Crepidula fornicata. This species broods its embryos within capsules located under the female and veliger larvae are released directly into the water column. C. fornicata adults were reared at the current level of CO2 partial pressure (pCO2) (390 μatm) and at elevated levels (750 and 1400 μatm) before and after fertilization and until larval release, such that larval development occurred entirely at a given pCO2. The pCO2 effects on shell morphology, the frequency of abnormalities and mineralization level were investigated on released larvae. Shell length decreased by 6% and shell surface area by 11% at elevated pCO2 (1400 μatm). The percentage of abnormalities was 1.5- to 4-fold higher at 750 μatm and 1400 μatm pCO2, respectively, than at 390 μatm. The intensity of birefringence, used as a proxy for the mineralization level of the larval shell, also decreased with increasing pCO2. These negative results are likely explained by increased intracapsular acidosis due to elevated pCO2 in extracapsular seawater. The encapsulation of C. fornicata embryos did not protect them against the deleterious effects of a predicted pCO2 increase. Nevertheless, C. fornicata larvae seemed less affected than other mollusk species. Further studies are needed to identify the critical points of the life cycle in this species in light of future ocean acidification.

Correlation of the Hubble Space Telescope (HST) Space Telescope Imaging Spectrometer (STIS) On-Orbit Data with Pre-launch Predictions and Ground Contamination Controls

NASA Technical Reports Server (NTRS)

Hansen, Patricia A.

2003-01-01

The Hubble Space Telescope (HST) Space Telescope Imaging Spectrograph (STIS) was deployed on-orbit in February 1997. The contamination program for STIS was stringently controlled as the five-year end-of-life deposition was set at 158, per optical element. Contamination was controlled through materials selection, extensive vacuum outgassing certifications, cleaning techniques, and environmental controls. In addition to ground contamination controls, on-orbit contamination controls were implemented for both the HST servicing mission activities and early post-servicing mission checkout. The extensive contamination control program will be discussed and the STIS on-orbit data will be correlated with the prelaunch analytical predictions.

Extension of a suspended soap film: a homogeneous dilatation followed by new film extraction.

PubMed

Seiwert, Jacopo; Monloubou, Martin; Dollet, Benjamin; Cantat, Isabelle

2013-08-30

Liquid foams are widely used in industry for their high effective viscosity, whose local origin is still unclear. This Letter presents new results on the extension of a suspended soap film, in a configuration mimicking the elementary deformation occurring during foam shearing. We evidence a surprising two-step evolution: the film first extends homogeneously, then its extension stops, and a new thicker film is extracted from the meniscus. The second step is independent of the nature of the surfactant solution, whereas the initial extension is only observed for surfactant solutions with negligible dilatational moduli. We predict this complex behavior using a model based on Frankel's theory and on interface rigidification induced by confinement.

Predicting 3D structure and stability of RNA pseudoknots in monovalent and divalent ion solutions.

PubMed

Shi, Ya-Zhou; Jin, Lei; Feng, Chen-Jie; Tan, Ya-Lan; Tan, Zhi-Jie

2018-06-01

RNA pseudoknots are a kind of minimal RNA tertiary structural motifs, and their three-dimensional (3D) structures and stability play essential roles in a variety of biological functions. Therefore, to predict 3D structures and stability of RNA pseudoknots is essential for understanding their functions. In the work, we employed our previously developed coarse-grained model with implicit salt to make extensive predictions and comprehensive analyses on the 3D structures and stability for RNA pseudoknots in monovalent/divalent ion solutions. The comparisons with available experimental data show that our model can successfully predict the 3D structures of RNA pseudoknots from their sequences, and can also make reliable predictions for the stability of RNA pseudoknots with different lengths and sequences over a wide range of monovalent/divalent ion concentrations. Furthermore, we made comprehensive analyses on the unfolding pathway for various RNA pseudoknots in ion solutions. Our analyses for extensive pseudokonts and the wide range of monovalent/divalent ion concentrations verify that the unfolding pathway of RNA pseudoknots is mainly dependent on the relative stability of unfolded intermediate states, and show that the unfolding pathway of RNA pseudoknots can be significantly modulated by their sequences and solution ion conditions.

Progressive Dictionary Learning with Hierarchical Predictive Structure for Scalable Video Coding.

PubMed

Dai, Wenrui; Shen, Yangmei; Xiong, Hongkai; Jiang, Xiaoqian; Zou, Junni; Taubman, David

2017-04-12

Dictionary learning has emerged as a promising alternative to the conventional hybrid coding framework. However, the rigid structure of sequential training and prediction degrades its performance in scalable video coding. This paper proposes a progressive dictionary learning framework with hierarchical predictive structure for scalable video coding, especially in low bitrate region. For pyramidal layers, sparse representation based on spatio-temporal dictionary is adopted to improve the coding efficiency of enhancement layers (ELs) with a guarantee of reconstruction performance. The overcomplete dictionary is trained to adaptively capture local structures along motion trajectories as well as exploit the correlations between neighboring layers of resolutions. Furthermore, progressive dictionary learning is developed to enable the scalability in temporal domain and restrict the error propagation in a close-loop predictor. Under the hierarchical predictive structure, online learning is leveraged to guarantee the training and prediction performance with an improved convergence rate. To accommodate with the stateof- the-art scalable extension of H.264/AVC and latest HEVC, standardized codec cores are utilized to encode the base and enhancement layers. Experimental results show that the proposed method outperforms the latest SHVC and HEVC simulcast over extensive test sequences with various resolutions.

Anatomical and neuromuscular variables strongly predict maximum knee extension torque in healthy men.

PubMed

Trezise, J; Collier, N; Blazevich, A J

2016-06-01

This study examined the relative influence of anatomical and neuromuscular variables on maximal isometric and concentric knee extensor torque and provided a comparative dataset for healthy young males. Quadriceps cross-sectional area (CSA) and fascicle length (l f) and angle (θ f) from the four quadriceps components; agonist (EMG:M) and antagonist muscle activity, and percent voluntary activation (%VA); patellar tendon moment arm distance (MA) and maximal voluntary isometric and concentric (60° s(-1)) torques, were measured in 56 men. Linear regression models predicting maximum torque were ranked using Akaike's Information Criterion (AICc), and Pearson's correlation coefficients assessed relationships between variables. The best-fit models explained up to 72 % of the variance in maximal voluntary knee extension torque. The combination of 'CSA + θ f + EMG:M + %VA' best predicted maximum isometric torque (R (2) = 72 %, AICc weight = 0.38) and 'CSA + θ f + MA' (R (2) = 65 %, AICc weight = 0.21) best predicted maximum concentric torque. Proximal quadriceps CSA was included in all models rather than the traditionally used mid-muscle CSA. Fascicle angle appeared consistently in all models despite its weak correlation with maximum torque in isolation, emphasising the importance of examining interactions among variables. While muscle activity was important for torque prediction in both contraction modes, MA only strongly influenced maximal concentric torque. These models identify the main sources of inter-individual differences strongly influencing maximal knee extension torque production in healthy men. The comparative dataset allows the identification of potential variables to target (i.e. weaknesses) in individuals.

A Maximum Muscle Strength Prediction Formula Using Theoretical Grade 3 Muscle Strength Value in Daniels et al.'s Manual Muscle Test, in Consideration of Age: An Investigation of Hip and Knee Joint Flexion and Extension.

PubMed

Usa, Hideyuki; Matsumura, Masashi; Ichikawa, Kazuna; Takei, Hitoshi

2017-01-01

This study attempted to develop a formula for predicting maximum muscle strength value for young, middle-aged, and elderly adults using theoretical Grade 3 muscle strength value (moment fair: M f )-the static muscular moment to support a limb segment against gravity-from the manual muscle test by Daniels et al. A total of 130 healthy Japanese individuals divided by age group performed isometric muscle contractions at maximum effort for various movements of hip joint flexion and extension and knee joint flexion and extension, and the accompanying resisting force was measured and maximum muscle strength value (moment max, M m ) was calculated. Body weight and limb segment length (thigh and lower leg length) were measured, and M f was calculated using anthropometric measures and theoretical calculation. There was a linear correlation between M f and M m in each of the four movement types in all groups, excepting knee flexion in elderly. However, the formula for predicting maximum muscle strength was not sufficiently compatible in middle-aged and elderly adults, suggesting that the formula obtained in this study is applicable in young adults only.

The predictive value of magnetic resonance imaging of retinoblastoma for the likelihood of high-risk pathologic features.

PubMed

Hiasat, Jamila G; Saleh, Alaa; Al-Hussaini, Maysa; Al Nawaiseh, Ibrahim; Mehyar, Mustafa; Qandeel, Monther; Mohammad, Mona; Deebajah, Rasha; Sultan, Iyad; Jaradat, Imad; Mansour, Asem; Yousef, Yacoub A

2018-06-01

To evaluate the predictive value of magnetic resonance imaging in retinoblastoma for the likelihood of high-risk pathologic features. A retrospective study of 64 eyes enucleated from 60 retinoblastoma patients. Contrast-enhanced magnetic resonance imaging was performed before enucleation. Main outcome measures included demographics, laterality, accuracy, sensitivity, and specificity of magnetic resonance imaging in detecting high-risk pathologic features. Optic nerve invasion and choroidal invasion were seen microscopically in 34 (53%) and 28 (44%) eyes, respectively, while they were detected in magnetic resonance imaging in 22 (34%) and 15 (23%) eyes, respectively. The accuracy of magnetic resonance imaging in detecting prelaminar invasion was 77% (sensitivity 89%, specificity 98%), 56% for laminar invasion (sensitivity 27%, specificity 94%), 84% for postlaminar invasion (sensitivity 42%, specificity 98%), and 100% for optic cut edge invasion (sensitivity100%, specificity 100%). The accuracy of magnetic resonance imaging in detecting focal choroidal invasion was 48% (sensitivity 33%, specificity 97%), and 84% for massive choroidal invasion (sensitivity 53%, specificity 98%), and the accuracy in detecting extrascleral extension was 96% (sensitivity 67%, specificity 98%). Magnetic resonance imaging should not be the only method to stratify patients at high risk from those who are not, eventhough it can predict with high accuracy extensive postlaminar optic nerve invasion, massive choroidal invasion, and extrascleral tumor extension.

A Maximum Muscle Strength Prediction Formula Using Theoretical Grade 3 Muscle Strength Value in Daniels et al.'s Manual Muscle Test, in Consideration of Age: An Investigation of Hip and Knee Joint Flexion and Extension

PubMed Central

Matsumura, Masashi; Ichikawa, Kazuna; Takei, Hitoshi

2017-01-01

This study attempted to develop a formula for predicting maximum muscle strength value for young, middle-aged, and elderly adults using theoretical Grade 3 muscle strength value (moment fair: Mf)—the static muscular moment to support a limb segment against gravity—from the manual muscle test by Daniels et al. A total of 130 healthy Japanese individuals divided by age group performed isometric muscle contractions at maximum effort for various movements of hip joint flexion and extension and knee joint flexion and extension, and the accompanying resisting force was measured and maximum muscle strength value (moment max, Mm) was calculated. Body weight and limb segment length (thigh and lower leg length) were measured, and Mf was calculated using anthropometric measures and theoretical calculation. There was a linear correlation between Mf and Mm in each of the four movement types in all groups, excepting knee flexion in elderly. However, the formula for predicting maximum muscle strength was not sufficiently compatible in middle-aged and elderly adults, suggesting that the formula obtained in this study is applicable in young adults only. PMID:28133549

Evaluating the Complementary Roles of an SJT and Academic Assessment for Entry into Clinical Practice

ERIC Educational Resources Information Center

Cousans, Fran; Patterson, Fiona; Edwards, Helena; Walker, Kim; McLachlan, John C.; Good, David

2017-01-01

Although there is extensive evidence confirming the predictive validity of situational judgement tests (SJTs) in medical education, there remains a shortage of evidence for their predictive validity for performance of postgraduate trainees in their first role in clinical practice. Moreover, to date few researchers have empirically examined the…

Towards Accurate Ab Initio Predictions of the Spectrum of Methane

NASA Technical Reports Server (NTRS)

Schwenke, David W.; Kwak, Dochan (Technical Monitor)

2001-01-01

We have carried out extensive ab initio calculations of the electronic structure of methane, and these results are used to compute vibrational energy levels. We include basis set extrapolations, core-valence correlation, relativistic effects, and Born- Oppenheimer breakdown terms in our calculations. Our ab initio predictions of the lowest lying levels are superb.

Predicting fire severity using surface fuels and moisture

Treesearch

Pamela G. Sikkink; Robert E. Keane

2012-01-01

Fire severity classifications have been used extensively in fire management over the last 30 years to describe specific environmental or ecological impacts of fire on fuels, vegetation, wildlife, and soils in recently burned areas. New fire severity classifications need to be more objective, predictive, and ultimately more useful to fire management and planning. Our...

Non-extensive Statistics to the Cosmological Lithium Problem

NASA Astrophysics Data System (ADS)

Hou, S. Q.; He, J. J.; Parikh, A.; Kahl, D.; Bertulani, C. A.; Kajino, T.; Mathews, G. J.; Zhao, G.

2017-01-01

Big Bang nucleosynthesis (BBN) theory predicts the abundances of the light elements D, 3He, 4He, and 7Li produced in the early universe. The primordial abundances of D and 4He inferred from observational data are in good agreement with predictions, however, BBN theory overestimates the primordial 7Li abundance by about a factor of three. This is the so-called “cosmological lithium problem.” Solutions to this problem using conventional astrophysics and nuclear physics have not been successful over the past few decades, probably indicating the presence of new physics during the era of BBN. We have investigated the impact on BBN predictions of adopting a generalized distribution to describe the velocities of nucleons in the framework of Tsallis non-extensive statistics. This generalized velocity distribution is characterized by a parameter q, and reduces to the usually assumed Maxwell-Boltzmann distribution for q = 1. We find excellent agreement between predicted and observed primordial abundances of D, 4He, and 7Li for 1.069 ≤ q ≤ 1.082, suggesting a possible new solution to the cosmological lithium problem.

Undergraduate Navigator Training Attrition Study

DTIC Science & Technology

1975-11-01

stabilization. The Masculinity- Feminity Scale (SVIB), significant at the .05 level, contributed 1.73% to the predicted variance. High scores (those...8217 a iiiftihlilfft-tMJ ^^mm^mmmwm^mmmmm mmmmm Do you have extensive experience in athletic competition? If so, what sport (s) and what kind of...machinery? For example, farm equipment, construction equipment. Do you have extensive experience in athletic competition? If so, what sport (s) and what

Declining Coral Skeletal Extension for Forereef Colonies of Siderastrea siderea on the Mesoamerican Barrier Reef System, Southern Belize

PubMed Central

Castillo, Karl D.; Ries, Justin B.; Weiss, Jack M.

2011-01-01

Background Natural and anthropogenic stressors are predicted to have increasingly negative impacts on coral reefs. Understanding how these environmental stressors have impacted coral skeletal growth should improve our ability to predict how they may affect coral reefs in the future. We investigated century-scale variations in skeletal extension for the slow-growing massive scleractinian coral Siderastrea siderea inhabiting the forereef, backreef, and nearshore reefs of the Mesoamerican Barrier Reef System (MBRS) in the western Caribbean Sea. Methodology/Principal Findings Thirteen S. siderea cores were extracted, slabbed, and X-rayed. Annual skeletal extension was estimated from adjacent low- and high-density growth bands. Since the early 1900s, forereef S. siderea colonies have shifted from exhibiting the fastest to the slowest average annual skeletal extension, while values for backreef and nearshore colonies have remained relatively constant. The rates of change in annual skeletal extension were −0.020±0.005, 0.011±0.006, and −0.008±0.006 mm yr−1 per year [mean±SE] for forereef, backreef, and nearshore colonies respectively. These values for forereef and nearshore S. siderea were significantly lower by 0.031±0.008 and by 0.019±0.009 mm yr−1 per year, respectively, than for backreef colonies. However, only forereef S. siderea exhibited a statistically significant decline in annual skeletal extension over the last century. Conclusions/Significance Our results suggest that forereef S. siderea colonies are more susceptible to environmental stress than backreef and nearshore counterparts, which may have historically been exposed to higher natural baseline stressors. Alternatively, sediment plumes, nutrients, and pollution originating from watersheds of Guatemala and Honduras may disproportionately impact the forereef environment of the MBRS. We are presently reconstructing the history of environmental stressors that have impacted the MBRS to constrain the cause(s) of the observed reductions in coral skeletal growth. This should improve our ability to predict and potentially mitigate the effects of future environmental stressors on coral reef ecosystems. PMID:21359203

Nomograms to predict the pathological stage of clinically localized prostate cancer in Korean men: comparison with western predictive tools using decision curve analysis.

PubMed

Jeong, Chang Wook; Jeong, Seong Jin; Hong, Sung Kyu; Lee, Seung Bae; Ku, Ja Hyeon; Byun, Seok-Soo; Jeong, Hyeon; Kwak, Cheol; Kim, Hyeon Hoe; Lee, Eunsik; Lee, Sang Eun

2012-09-01

To develop and evaluate nomograms to predict the pathological stage of clinically localized prostate cancer after radical prostatectomy in Korean men. We reviewed the medical records of 2041 patients who had clinical stages T1c-T3a prostate cancer and were treated solely with radical prostatectomy at two hospitals. Logistic regressions were carried out to predict organ-confined disease, extraprostatic extension, seminal vesicle invasion, and lymph node metastasis using preoperative variables and resulting nomograms. Internal validations were assessed using the area under the receiver operating characteristic curve and calibration plot, and then external validations were carried out on 129 patients from another hospital. Head-to-head comparisons with 2007 Partin tables and Cancer of the Prostate Risk Assessment score were carried out using the area under the curve and decision curve analysis. The significant predictors for organ-confined disease and extraprostatic extension were clinical stage, prostate-specific antigen, Gleason score and a percent positive core of biopsy. Significant predictors for seminal vesicle invasion were prostate-specific antigen, Gleason score and percent positive core, and those for lymph node metastasis were prostate-specific antigen and percent positive core. The area under the curve of established nomograms for organ-confined disease, extraprostatic extension, seminal vesicle invasion and lymph node metastasis were 0.809, 0.804, 0.889 and 0.838, respectively. The nomograms were well calibrated and externally validated. These nomograms showed significantly higher accuracies and net benefits than two Western tools in Korean men. This is the first study to have developed and fully validated nomograms to predict the pathological stage of prostate cancer in an Asian population. These nomograms might be more accurate and useful for Korean men than other predictive models developed using Western populations. © 2012 The Japanese Urological Association.

Correlation of electron and proton irradiation-induced damage in InP solar cells

NASA Technical Reports Server (NTRS)

Walters, Robert J.; Summers, Geoffrey P.; Messenger, Scott R.; Burke, Edward A.

1995-01-01

When determining the best solar cell technology for a particular space flight mission, accurate prediction of solar cell performance in a space radiation environment is essential. The current methodology used to make such predictions requires extensive experimental data measured under both electron and proton irradiation. Due to the rising cost of accelerators and irradiation facilities, such extensive data sets are expensive to obtain. Moreover, with the rapid development of novel cell designs, the necessary data are often not available. Therefore, a method for predicting cell degradation based on limited data is needed. Such a method has been developed at the Naval Research Laboratory based on damage correlation using 'displacement damage dose' which is the product of the non-ionizing energy loss (NIEL) and the particle fluence. Displacement damage dose is a direct analog of the ionization dose used to correlate the effects of ionizing radiations. In this method, the performance of a solar cell in a complex radiation environment can be predicted from data on a single proton energy and two electron energies, or one proton energy, one electron energy, and Co(exp 60) gammas. This method has been used to accurately predict the extensive data set measured by Anspaugh on GaAs/Ge solar cells under a wide range of electron and proton energies. In this paper, the method is applied to InP solar cells using data measured under 1 MeV electron and 3 MeV proton irradiations, and the calculations are shown to agree well with the measured data. In addition to providing accurate damage predictions, this method also provides a basis for quantitative comparisons of the performance of different cell technologies. The performance of the present InP cells is compared to that published for GaAs/Ge cells. The results show InP to be inherently more resistant to displacement energy deposition than GaAs/Ge.

Modified Weekly Cisplatin-Based Chemotherapy Is Acceptable in Postoperative Concurrent Chemoradiotherapy for Locally Advanced Head and Neck Cancer

PubMed Central

Lu, Hsueh-Ju; Yang, Chao-Chun; Wang, Ling-Wei; Chu, Pen-Yuan; Tai, Shyh-Kuan; Chen, Ming-Huang; Yang, Muh-Hwa; Chang, Peter Mu-Hsin

2015-01-01

Background. Triweekly cisplatin-based postoperative concurrent chemoradiotherapy (CCRT) has high intolerance and toxicities in locally advanced head and neck cancer (LAHNC). We evaluated the effect of a modified weekly cisplatin-based chemotherapy in postoperative CCRT. Methods. A total of 117 patients with LAHNC were enrolled between December 2007 and December 2012. Survival, compliance/adverse events, and independent prognostic factors were analyzed. Results. Median follow-up time was 30.0 (3.1–73.0) months. Most patients completed the entire course of postoperative CCRT (radiotherapy ≥ 60 Gy, 94.9%; ≥6 times weekly chemotherapy, 75.2%). Only 17.1% patients required hospital admission. The most common adverse effect was grade 3/4 mucositis (28.2%). No patient died due to protocol-related adverse effects. Multivariate analysis revealed the following independent prognostic factors: oropharyngeal cancer, extracapsular spread, and total radiation dose. Two-year progression-free survival and overall survival rates were 70.9% and 79.5%, respectively. Conclusion. Modified weekly cisplatin-based chemotherapy is an acceptable regimen in postoperative CCRT for LAHNC. PMID:25793192

Pressure sores and hip fractures.

PubMed

Haleem, S; Heinert, G; Parker, M J

2008-02-01

Development of pressure sores during hospital admission causes morbidity and distress to the patient, increases strain on nursing resources, delaying discharge and possibly increasing mortality. A hip fracture in elderly patients is a known high-risk factor for development of pressure sores. We aimed to determine the current incidence of pressure sores and identify those factors which were associated with an increased risk of pressure sores. We retrospectively analysed prospectively collected data of 4654 consecutive patients admitted to a single unit. One hundred and seventy-eight (3.8%) of our patients developed pressure sores. Patient factors that increased the risk of pressure sores were increased age, diabetes mellitus, a lower mental test score, a lower mobility score, a higher ASA score, lower admission haemoglobin and an intra-operative drop in blood pressure. The risk was higher in patients with an extracapsular neck of femur fracture and patients with an increased time interval between admission to hospital and surgery. Our studies indicate that while co-morbidities constitute a substantial risk in an elderly population, the increase in incidence of pressure sores can be reduced by minimising delays to surgery.

Carcinoma ex pleomorphic adenoma, with particular emphasis on early lesions.

PubMed

Di Palma, Silvana

2013-07-01

Carcinoma ex pleomorphic adenoma (CXPA) is a broad category of carcinomas of the salivary glands which includes at least 2 clinically relevant categories; one is referred here as early CXPA (ECXPA), the other as widely invasive CXPA. The former includes several histological patterns ranging from non-invasive/in situ/intraductal/intratubular, early invasive/extratubular/intracapsular and extracapsular (up to 6 mm). The latter includes any CXPA with invasion of >6 mm. The clinical behaviour of ECXPA is not aggressive and tends to overlap that of a pleomorphic adenoma (PA) which makes the histological report of carcinoma contradictory. These early malignant changes in PA are known since the 1970s but it has been the use of immunohistochemical and molecular genetic analysis for HER-2 and TP53 gene in the last decade that has clarified the genuine malignant nature of the cells. HER-2 and TP53 gene and protein are involved in the early stages of malignant transformation of PA. Moreover the immunohistochemical over-expression HER-2, p53 protein and Mib-1 proliferation marker may be useful markers to identify malignant areas in PA.

A numerical investigation of the effects of the spanwise length on the 3-D wake of a circular cylinder

NASA Astrophysics Data System (ADS)

Labbé, D. F. L.; Wilson, P. A.

2007-11-01

The numerical prediction of vortex-induced vibrations has been the focus of numerous investigations to date using tools such as computational fluid dynamics. In particular, the flow around a circular cylinder has raised much attention as it is present in critical engineering problems such as marine cables or risers. Limitations due to the computational cost imposed by the solution of a large number of equations have resulted in the study of mostly 2-D flows with only a few exceptions. The discrepancies found between experimental data and 2-D numerical simulations suggested that 3-D instabilities occurred in the wake of the cylinder that affect substantially the characteristics of the flow. The few 3-D numerical solutions available in the literature confirmed such a hypothesis. In the present investigation the effect of the spanwise extension of the solution domain on the 3-D wake of a circular cylinder is investigated for various Reynolds numbers between 40 and 1000. By assessing the minimum spanwise extension required to predict accurately the flow around a circular cylinder, the infinitely long cylinder is reduced to a finite length cylinder, thus making numerical solution an effective way of investigating flows around circular cylinders. Results are presented for three different spanwise extensions, namely πD/2, πD and 2πD. The analysis of the force coefficients obtained for the various Reynolds numbers together with a visualization of the three-dimensionalities in the wake of the cylinder allowed for a comparison between the effects of the three spanwise extensions. Furthermore, by showing the different modes of vortex shedding present in the wake and by analysing the streamwise components of the vorticity, it was possible to estimate the spanwise wavelengths at the various Reynolds numbers and to demonstrate that a finite spanwise extension is sufficient to accurately predict the flow past an infinitely long circular cylinder.

Evaluation of long term health-related quality of life in extensive burns: a 12-year experience in a burn center.

PubMed

Xie, Bing; Xiao, Shi-chu; Zhu, Shi-hui; Xia, Zhao-fan

2012-05-01

We sought to evaluate the long term health-related quality of life (HRQOL) in patients survived severely extensive burn and identify their clinical predicting factors correlated with HRQOL. A cross-sectional study was conducted in 20 patients survived more than 2 years with extensive burn involving ≥70% total body surface area (TBSA) between 1997 and 2009 in a burn center in Shanghai. Short Form-36 Medical Outcomes Survey (SF-36), Brief Version of Burn Specific Health Scale (BSHS-B) and Michigan Hand Outcome Questionnaire (MHQ) were used for the present evaluation. SF-36 scores were compared with a healthy Chinese population, and linear correlation analysis was performed to screen the clinical relating factors predicting physical and mental component summary (PCS and MCS) scores from SF-36. HRQOL scores from SF-36 were significantly lower in the domains of physical functioning, role limitations due to physical problems, pain, social functioning and role limitations due to emotional problems compared with population norms. Multiple linear regression analysis demonstrated that only return to work (RTW) predicted improved PCS. While age at injury, facial burns, skin grafting and length of hospital stay were correlated with MCS. Work, body image and heat sensitivity obtained the lowest BSHS-B scores in all 9 domains. Improvements of HRQOL could still be seen in BSHS-B scores in domains of simple abilities, hand function, work and affect even after a quite long interval between burns and testing. Hand function of extensive burn patients obtained relatively poor MHQ scores, especially in those without RTW. Patients with extensive burns have a poorer quality of life compared with that of general population. Relatively poor physical and psychological problems still exist even after a long period. Meanwhile, a trend of gradual improvements was noted. This information will aid clinicians in decision-making of comprehensive systematic regimens for long term rehabilitation and psychosocial treatment. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Flow void of cerebrospinal fluid in idiopathic normal pressure hydrocephalus of the elderly: can it predict outcome after shunting?

PubMed

Krauss, J K; Regel, J P; Vach, W; Jüngling, F D; Droste, D W; Wakhloo, A K

1997-01-01

We investigate the predictive value of cerebrospinal fluid (CSF) flow void on outcome after shunting in a prospective series of patients with idiopathic normal pressure hydrocephalus (NPH). The degree and extension of CSF flow void were examined on T2-weighted magnetic resonance imaging scans of 37 elderly patients with idiopathic NPH who underwent subsequent shunting. The degree of flow void was assessed in comparison with the signal of large cerebral arteries. The extension was evaluated via the calculation of sum scores for the occurrence of flow void in different locations of the ventricular system. Those parameters were not considered in the decision to perform shunting. CSF flow void in the aqueduct and the adjacent third and fourth ventricles of the 37 patients with idiopathic NPH was compared with that of 37 age-matched control patients. CSF flow void scores in patients with idiopathic NPH were investigated for correlations between postoperative outcome scores and ventricular width indices. No difference was found between the occurrence of aqueductal CSF flow void in patients with idiopathic NPH and the control group. A significant difference, however, was noted for the extension of the CSF flow void, which was greater in the NPH group. Postoperative improvement was found in 33 of 37 patients with idiopathic NPH at a mean follow-up of 15.6 months. Only small, statistically not significant correlations were found between CSF flow void and postoperative outcome. Flow void sum scores, however, correlated significantly with ventricular width indices. The degree and extension of CSF flow void on T2-weighted magnetic resonance imaging scans have little predictive value for outcome after shunting in patients with idiopathic NPH. The greater extension of the CSF flow void in patients with NPH is most likely related to increased ventricular width. It is not useful to consider CSF flow void findings on conventional magnetic resonance imaging scans in making the decision to offer shunting in patients with idiopathic NPH.

Impact of SST Anomaly Events over the Kuroshio-Oyashio Extension on the "Summer Prediction Barrier"

NASA Astrophysics Data System (ADS)

Wu, Yujie; Duan, Wansuo

2018-04-01

The "summer prediction barrier" (SPB) of SST anomalies (SSTA) over the Kuroshio-Oyashio Extension (KOE) refers to the phenomenon that prediction errors of KOE-SSTA tend to increase rapidly during boreal summer, resulting in large prediction uncertainties. The fast error growth associated with the SPB occurs in the mature-to-decaying transition phase, which is usually during the August-September-October (ASO) season, of the KOE-SSTA events to be predicted. Thus, the role of KOE-SSTA evolutionary characteristics in the transition phase in inducing the SPB is explored by performing perfect model predictability experiments in a coupled model, indicating that the SSTA events with larger mature-to-decaying transition rates (Category-1) favor a greater possibility of yielding a more significant SPB than those events with smaller transition rates (Category-2). The KOE-SSTA events in Category-1 tend to have more significant anomalous Ekman pumping in their transition phase, resulting in larger prediction errors of vertical oceanic temperature advection associated with the SSTA events. Consequently, Category-1 events possess faster error growth and larger prediction errors. In addition, the anomalous Ekman upwelling (downwelling) in the ASO season also causes SSTA cooling (warming), accelerating the transition rates of warm (cold) KOE-SSTA events. Therefore, the SSTA transition rate and error growth rate are both related with the anomalous Ekman pumping of the SSTA events to be predicted in their transition phase. This may explain why the SSTA events transferring more rapidly from the mature to decaying phase tend to have a greater possibility of yielding a more significant SPB.

Extension of a Suspended Soap Film: A Homogeneous Dilatation Followed by New Film Extraction

NASA Astrophysics Data System (ADS)

Seiwert, Jacopo; Monloubou, Martin; Dollet, Benjamin; Cantat, Isabelle

2013-08-01

Liquid foams are widely used in industry for their high effective viscosity, whose local origin is still unclear. This Letter presents new results on the extension of a suspended soap film, in a configuration mimicking the elementary deformation occurring during foam shearing. We evidence a surprising two-step evolution: the film first extends homogeneously, then its extension stops, and a new thicker film is extracted from the meniscus. The second step is independent of the nature of the surfactant solution, whereas the initial extension is only observed for surfactant solutions with negligible dilatational moduli. We predict this complex behavior using a model based on Frankel’s theory and on interface rigidification induced by confinement.

Comparative Bacterial Proteomics: Analysis of the Core Genome Concept

PubMed Central

Callister, Stephen J.; McCue, Lee Ann; Turse, Joshua E.; Monroe, Matthew E.; Auberry, Kenneth J.; Smith, Richard D.; Adkins, Joshua N.; Lipton, Mary S.

2008-01-01

While comparative bacterial genomic studies commonly predict a set of genes indicative of common ancestry, experimental validation of the existence of this core genome requires extensive measurement and is typically not undertaken. Enabled by an extensive proteome database developed over six years, we have experimentally verified the expression of proteins predicted from genomic ortholog comparisons among 17 environmental and pathogenic bacteria. More exclusive relationships were observed among the expressed protein content of phenotypically related bacteria, which is indicative of the specific lifestyles associated with these organisms. Although genomic studies can establish relative orthologous relationships among a set of bacteria and propose a set of ancestral genes, our proteomics study establishes expressed lifestyle differences among conserved genes and proposes a set of expressed ancestral traits. PMID:18253490

Mathematical modeling of a nickel-cadmium battery

NASA Technical Reports Server (NTRS)

Fan, Deyuan; White, Ralph E.

1991-01-01

Extensions are presented for a mathematical model of an Ni-CD cell (Fan and White, 1991). These extensions consist of intercalation thermodynamics for the nickel electrode and oxygen generation and reduction reactions during charge and overcharge. The simulated results indicate that intercalation may be important in the nickel electrode and that including the oxygen reactions provides a means of predicting the efficiency of the cell on charge and discharge.

Reduction of Risk for Low Back Injury in Theater of Operations

DTIC Science & Technology

2015-06-01

Assessed for eligibility (n = 698) 14 Figure 4. Predicted (from regression) isometric lumbar extension strength ( torque ) mean values (adjusted by...resistance exercise to the lumbar extensors in the ranges required for strength development, torque production from the gluteals and hamstrings must be...the small lumbar muscles play only a minor role in trunk extension torque production.17 Thus, they are considered to be the weak link in trunk

Advocating the Broad Use of the Decision Tree Method in Education

ERIC Educational Resources Information Center

Gomes, Cristiano Mauro Assis; Almeida, Leandro S.

2017-01-01

Predictive studies have been widely undertaken in the field of education to provide strategic information about the extensive set of processes related to teaching and learning, as well as about what variables predict certain educational outcomes, such as academic achievement or dropout. As in any other area, there is a set of standard techniques…

Predicting Institutional Aggression in Offenders with Intellectual Disabilities Using the Violence Risk Appraisal Guide

ERIC Educational Resources Information Center

Pouls, Claudia; Jeandarme, Inge

2018-01-01

Background: One of the most extensively tested risk assessment instruments in offenders with an intellectual disability (OIDs) is the Violence Risk Appraisal Guide (VRAG). The purpose of this prospective study was to test the ability of this instrument to predict institutional aggression in OIDs. Method: VRAG scores were collected for 52 OIDs, and…

Problems of Prediction of Delinquency and Related Conditions Over a Seven Year Period.

ERIC Educational Resources Information Center

Thurston, John R.; And Others

The writers of this paper draw on their own research efforts and an extensive review of the literature related to prediction of delinquency (and the related factors of personal and social adjustment, health problems, welfare status, and academic underachievement) to point out a number of deficiencies and difficulties encountered in research…

Towards accurate ab initio predictions of the vibrational spectrum of methane

NASA Technical Reports Server (NTRS)

Schwenke, David W.

2002-01-01

We have carried out extensive ab initio calculations of the electronic structure of methane, and these results are used to compute vibrational energy levels. We include basis set extrapolations, core-valence correlation, relativistic effects, and Born-Oppenheimer breakdown terms in our calculations. Our ab initio predictions of the lowest lying levels are superb.

Predicted soil management and climate change effects on SOC in South Carolina

USDA-ARS?s Scientific Manuscript database

Extensive use of inversion tillage has contributed to the loss of soil organic carbon (SOC) and degraded soil health in the southeast U.S.A. Our objective was to predict changes in SOC in a Norfolk loamy sand in Florence, SC under several crop rotations (corn (Zea mays L.)-cotton (Gossypium ssp.), C...

Predicting the 10-year risk of hip and major osteoporotic fracture in rheumatoid arthritis and in the general population: an independent validation and update of UK FRAX without bone mineral density.

PubMed

Klop, Corinne; de Vries, Frank; Bijlsma, Johannes W J; Leufkens, Hubert G M; Welsing, Paco M J

2016-12-01

FRAX incorporates rheumatoid arthritis (RA) as a dichotomous predictor for predicting the 10-year risk of hip and major osteoporotic fracture (MOF). However, fracture risk may deviate with disease severity, duration or treatment. Aims were to validate, and if needed to update, UK FRAX for patients with RA and to compare predictive performance with the general population (GP). Cohort study within UK Clinical Practice Research Datalink (CPRD) (RA: n=11 582, GP: n=38 755), also linked to hospital admissions for hip fracture (CPRD-Hospital Episode Statistics, HES) (RA: n=7221, GP: n=24 227). Predictive performance of UK FRAX without bone mineral density was assessed by discrimination and calibration. Updating methods included recalibration and extension. Differences in predictive performance were assessed by the C-statistic and Net Reclassification Improvement (NRI) using the UK National Osteoporosis Guideline Group intervention thresholds. UK FRAX significantly overestimated fracture risk in patients with RA, both for MOF (mean predicted vs observed 10-year risk: 13.3% vs 8.4%) and hip fracture (CPRD: 5.5% vs 3.1%, CPRD-HES: 5.5% vs 4.1%). Calibration was good for hip fracture in the GP (CPRD-HES: 2.7% vs 2.4%). Discrimination was good for hip fracture (RA: 0.78, GP: 0.83) and moderate for MOF (RA: 0.69, GP: 0.71). Extension of the recalibrated UK FRAX using CPRD-HES with duration of RA disease, glucocorticoids (>7.5 mg/day) and secondary osteoporosis did not improve the NRI (0.01, 95% CI -0.04 to 0.05) or C-statistic (0.78). UK FRAX overestimated fracture risk in RA, but performed well for hip fracture in the GP after linkage to hospitalisations. Extension of the recalibrated UK FRAX did not improve predictive performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Molecular properties of the N-terminal extension of the fission yeast kinesin-5, Cut7.

PubMed

Edamatsu, M

2016-02-11

Kinesin-5 plays an essential role in spindle formation and function, and serves as a potential target for anti-cancer drugs. The aim of this study was to elucidate the molecular properties of the N-terminal extension of the Schizosaccharomyces pombe kinesin-5, Cut7. This extension is rich in charged amino acids and predicted to be intrinsically disordered. In S. pombe cells, a Cut7 construct lacking half the N-terminal extension failed to localize along the spindle microtubules and formed a monopolar spindle. However, a construct lacking the entire N-terminal extension exhibited normal localization and formed a typical bipolar spindle. In addition, in vitro analyses revealed that the truncated Cut7 constructs demonstrated similar motile velocities and directionalities as the wild-type motor protein, but the microtubule landing rates were significantly reduced. These findings suggest that the N-terminal extension is not required for normal Cut7 intracellular localization or function, but alters the microtubule-binding properties of this protein in vitro.

Nanosecond Enhancements of the Atmospheric Electron Density by Extensive Air Showers

NASA Astrophysics Data System (ADS)

Rutjes, C.; Camporeale, E.; Ebert, U.; Buitink, S.; Scholten, O.; Trinh, G. T. N.; Witteveen, J.

2015-12-01

As is well known a sufficient density of free electrons and strong electric fields are the basic requirements to start any electrical discharge. In the context of thunderstorm discharges it has become clear that in addition droplets and or ice particles are required to enhance the electric field to values above breakdown. In our recent study [1] we have shown that these three ingredients have to interplay to allow for lightning inception, triggered by an extensive air shower event. The extensive air showers are a very stochastic natural phenomenon, creating highly coherent sub-nanosecond enhancements of the atmospheric electron density. Predicting these electron density enhancements accurately one has to take the uncertainty of the input variables into account. For this study we use the initial energy, inclination and altitude of first interaction, which will influence the evolution of the shower significantly. To this end, we use the stochastic collocation method, [2] to post-process our detailed Monte Carlo extensive air shower simulations, done with the CORSIKA [3] software package, which provides an efficient and elegant way to determine the distribution of the atmospheric electron density enhancements. [1] Dubinova, A., Rutjes, C., Ebert, E., Buitink, S., Scholten, O., and Trinh, G. T. N. "Prediction of Lightning Inception by Large Ice Particles and Extensive Air Showers." PRL 115 015002 (2015)[2] G.J.A. Loeven, J.A.S. Witteveen, H. Bijl, Probabilistic collocation: an efficient nonintrusive approach for arbitrarily distributed parametric uncertainties, 45th AIAA Aerospace Sciences Meeting, Reno, Nevada, 2007, AIAA-2007-317[3] Heck, Dieter, et al. CORSIKA: A Monte Carlo code to simulate extensive air showers. No. FZKA-6019. 1998.

Revalidation of the Score for Neonatal Acute Physiology in the Vermont Oxford Network.

PubMed

Zupancic, John A F; Richardson, Douglas K; Horbar, Jeffrey D; Carpenter, Joseph H; Lee, Shoo K; Escobar, Gabriel J

2007-01-01

Our specific objectives were (1) to document the performance of the revised Score for Neonatal Acute Physiology and the revised Score for Neonatal Acute Physiology Perinatal Extension in predicting death in the Vermont Oxford Network, compared with published normative values; (2) to determine whether this performance could be improved through recalibration of the weights for individual score items; (3) to determine the impact of including congenital anomalies in the predictive model; and (4) to compare performance against that of the Vermont Oxford Network risk adjustment, separately and in combination. Fifty-eight Vermont Oxford Network centers collected data prospectively for the revised Score for Neonatal Acute Physiology in the first 12 hours after admission of infants in 2002. Data were collected for 10,469 infants, and analyses were undertaken for 9897 who met inclusion criteria. The median revised Score for Neonatal Acute Physiology was 5, and the mean birth weight was 1951 g. Recalibration of the revised Score for Neonatal Acute Physiology and revised Score for Neonatal Acute Physiology Perinatal Extension resulted in minimal changes in their discriminatory abilities. The Vermont Oxford Network risk adjustment performed similarly, compared with the revised Score for Neonatal Acute Physiology Perinatal Extension. Current score performance was similar to that observed previously, which suggests that the revised Score for Neonatal Acute Physiology and revised Score for Neonatal Acute Physiology Perinatal Extension have not decalibrated over the 7 years since the first cohort was assembled, despite advances in neonatal care during that period. Addition of congenital anomalies to the revised Score for Neonatal Acute Physiology Perinatal Extension improved discrimination significantly, particularly for infants with birth weights of >1500 g. The Vermont Oxford Network risk adjustment performed similarly, compared with the revised Score for Neonatal Acute Physiology Perinatal Extension.

Estimating apparent maximum muscle stress of trunk extensor muscles in older adults using subject-specific musculoskeletal models.

PubMed

Burkhart, Katelyn A; Bruno, Alexander G; Bouxsein, Mary L; Bean, Jonathan F; Anderson, Dennis E

2018-01-01

Maximum muscle stress (MMS) is a critical parameter in musculoskeletal modeling, defining the maximum force that a muscle of given size can produce. However, a wide range of MMS values have been reported in literature, and few studies have estimated MMS in trunk muscles. Due to widespread use of musculoskeletal models in studies of the spine and trunk, there is a need to determine reasonable magnitude and range of trunk MMS. We measured trunk extension strength in 49 participants over 65 years of age, surveyed participants about low back pain, and acquired quantitative computed tomography (QCT) scans of their lumbar spines. Trunk muscle morphology was assessed from QCT scans and used to create a subject-specific musculoskeletal model for each participant. Model-predicted extension strength was computed using a trunk muscle MMS of 100 N/cm 2 . The MMS of each subject-specific model was then adjusted until the measured strength matched the model-predicted strength (±20 N). We found that measured trunk extension strength was significantly higher in men. With the initial constant MMS value, the musculoskeletal model generally over-predicted trunk extension strength. By adjusting MMS on a subject-specific basis, we found apparent MMS values ranging from 40 to 130 N/cm 2 , with an average of 75.5 N/cm 2 for both men and women. Subjects with low back pain had lower apparent MMS than subjects with no back pain. This work incorporates a unique approach to estimate subject-specific trunk MMS values via musculoskeletal modeling and provides a useful insight into MMS variation. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:498-505, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Mohs micrographic surgery for basal cell carcinomas: appropriateness of 'Rotterdam' criteria and predictive factors for three or more stages.

PubMed

Flohil, S C; van Dorst, A M J M; Nijsten, T; Martino Neumann, H A; Munte, K

2013-10-01

In the Netherlands basal cell carcinomas (BCC) are eligible for Mohs microscopic surgery (MMS) if certain criteria are fulfilled. To study the MMS indication criteria practised at the department of dermatology of the Erasmus University Medical Center, Rotterdam and to identify predictive factors for extensive subclinical tumour spread among BCCs eligible for MMS. Pre-operative patient and tumour characteristics were derived retrospectively between January 2nd 2006 and December 28th 2009 from 1174 patient records, accounting for 1464 BCCs. Multivariate logistic regression models were used to calculate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) for one vs. two or more stages and for narrow (≤ 2 stages) vs. extensive subclinical spread (≥ 3 stages). H-zone location [adjusted OR 1.51 (95% CI 1.16-1.96)], recurrent tumour [adjusted OR 1.50 (95% CI 1.11-2.02)], aggressive subtype [adjusted OR 1.25 (95% CI 1.01-1.56)] and tumour size ≥ 11 mm [adjusted OR 1.53 (95% CI 1.20-1.96)] were significantly associated with two or more stages. Predictive factors for extensive subclinical spread were recurrent tumour [adjusted OR 2.26 (95% CI 1.61-3.17)], tumour size ≥ 21 mm [adjusted OR 1.69 (95% CI 1.13-2.51)] and location in the H-zone [adjusted OR 1.68 (95% CI 1.15-2.46)]. 'Rotterdam' indication criteria used for MMS are appropriate. Predictors for extensive subclinical spread are important for patients' and surgeons' expectations prior to the operation about time span, defect size, reconstruction and possible associated morbidity. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

The Structured Assessment of Violence Risk in Adults with Intellectual Disability: A Systematic Review.

PubMed

Hounsome, J; Whittington, R; Brown, A; Greenhill, B; McGuire, J

2018-01-01

While structured professional judgement approaches to assessing and managing the risk of violence have been extensively examined in mental health/forensic settings, the application of the findings to people with an intellectual disability is less extensively researched and reviewed. This review aimed to assess whether risk assessment tools have adequate predictive validity for violence in adults with an intellectual disability. Standard systematic review methodology was used to identify and synthesize appropriate studies. A total of 14 studies were identified as meeting the inclusion criteria. These studies assessed the predictive validity of 18 different risk assessment tools, mainly in forensic settings. All studies concluded that the tools assessed were successful in predicting violence. Studies were generally of a high quality. There is good quality evidence that risk assessment tools are valid for people with intellectual disability who offend but further research is required to validate tools for use with people with intellectual disability who offend. © 2016 John Wiley & Sons Ltd.

Near elimination of genital warts in Australia predicted with extension of human papillomavirus vaccination to males.

PubMed

Korostil, Igor A; Ali, Hammad; Guy, Rebecca J; Donovan, Basil; Law, Matthew G; Regan, David G

2013-11-01

The National Human Papillomavirus (HPV) Vaccination Program for females delivering the quadrivalent vaccine Gardasil has been included in the National Immunisation Program in Australia since 2007. Sentinel surveillance data show that genital wart incidence has been steadily declining since then. The objective of this study was to estimate the additional impact on genital warts as a result of male vaccination, which was approved by the Australian government in 2012 and commenced in 2013. We use a mathematical model of HPV transmission in the Australian heterosexual population to predict the impact of male vaccination on the incidence of genital warts. Our model produced results that are consistent with the actual observed decline in genital warts and predicted a much lower incidence, approaching elimination, in coming decades with the introduction of male vaccination. Results from our model indicate that the planned extension of the National HPV Vaccination Program to males will lead to the near elimination of genital warts in both the female and male heterosexual populations in Australia.

Toward a Predictive Understanding of Earth’s Microbiomes to Address 21st Century Challenges

PubMed Central

Blaser, Martin J.; Cardon, Zoe G.; Cho, Mildred K.; Dangl, Jeffrey L.; Green, Jessica L.; Knight, Rob; Maxon, Mary E.; Northen, Trent R.; Pollard, Katherine S.

2016-01-01

ABSTRACT Microorganisms have shaped our planet and its inhabitants for over 3.5 billion years. Humankind has had a profound influence on the biosphere, manifested as global climate and land use changes, and extensive urbanization in response to a growing population. The challenges we face to supply food, energy, and clean water while maintaining and improving the health of our population and ecosystems are significant. Given the extensive influence of microorganisms across our biosphere, we propose that a coordinated, cross-disciplinary effort is required to understand, predict, and harness microbiome function. From the parallelization of gene function testing to precision manipulation of genes, communities, and model ecosystems and development of novel analytical and simulation approaches, we outline strategies to move microbiome research into an era of causality. These efforts will improve prediction of ecosystem response and enable the development of new, responsible, microbiome-based solutions to significant challenges of our time. PMID:27178263

Toward a Predictive Understanding of Earth's Microbiomes to Address 21st Century Challenges.

PubMed

Blaser, Martin J; Cardon, Zoe G; Cho, Mildred K; Dangl, Jeffrey L; Donohue, Timothy J; Green, Jessica L; Knight, Rob; Maxon, Mary E; Northen, Trent R; Pollard, Katherine S; Brodie, Eoin L

2016-05-13

Microorganisms have shaped our planet and its inhabitants for over 3.5 billion years. Humankind has had a profound influence on the biosphere, manifested as global climate and land use changes, and extensive urbanization in response to a growing population. The challenges we face to supply food, energy, and clean water while maintaining and improving the health of our population and ecosystems are significant. Given the extensive influence of microorganisms across our biosphere, we propose that a coordinated, cross-disciplinary effort is required to understand, predict, and harness microbiome function. From the parallelization of gene function testing to precision manipulation of genes, communities, and model ecosystems and development of novel analytical and simulation approaches, we outline strategies to move microbiome research into an era of causality. These efforts will improve prediction of ecosystem response and enable the development of new, responsible, microbiome-based solutions to significant challenges of our time. Copyright © 2016 Blaser et al.

Prediction of Launch Vehicle Ignition Overpressure and Liftoff Acoustics

NASA Technical Reports Server (NTRS)

Casiano, Matthew

2009-01-01

The LAIOP (Launch Vehicle Ignition Overpressure and Liftoff Acoustic Environments) program predicts the external pressure environment generated during liftoff for a large variety of rocket types. These environments include ignition overpressure, produced by the rapid acceleration of exhaust gases during rocket-engine start transient, and launch acoustics, produced by turbulence in the rocket plume. The ignition overpressure predictions are time-based, and the launch acoustic predictions are frequency-based. Additionally, the software can predict ignition overpressure mitigation, using water-spray injection into the rocket exhaust stream, for a limited number of configurations. The framework developed for these predictions is extensive, though some options require additional relevant data and development time. Once these options are enabled, the already extensively capable code will be further enhanced. The rockets, or launch vehicles, can either be elliptically or cylindrically shaped, and up to eight strap-on structures (boosters or tanks) are allowed. Up to four engines are allowed for the core launch vehicle, which can be of two different types. Also, two different sizes of strap-on structures can be used, and two different types of booster engines are allowed. Both tabular and graphical presentations of the predicted environments at the selected locations can be reviewed by the user. The output includes summaries of rocket-engine operation, ignition overpressure time histories, and one-third octave sound pressure spectra of the predicted launch acoustics. Also, documentation is available to the user to help him or her understand the various aspects of the graphical user interface and the required input parameters.

Extension of geometrical-optics approximation to on-axis Gaussian beam scattering. II. By a spheroidal particle with end-on incidence.

PubMed

Xu, Feng; Ren, Kuan Fang; Cai, Xiaoshu; Shen, Jianqi

2006-07-10

On the basis of our previous work on the extension of the geometrical-optics approximation to Gaussian beam scattering by a spherical particle, we present a further extension of the method to the scattering of a transparent or absorbing spheroidal particle with the same symmetric axis as the incident beam. As was done for the spherical particle, the phase shifts of the emerging rays due to focal lines, optical path, and total reflection are carefully considered. The angular position of the geometric rainbow of primary order is theoretically predicted. Compared with our results, the Möbius prediction of the rainbow angle has a discrepancy of less than 0.5 degrees for a spheroidal droplet of aspect radio kappa within 0.95 and 1.05 and less than 2 degrees for kappa within 0.89 and 1.11. The flux ratio index F, which qualitatively indicates the effect of a surface wave, is also studied and found to be dependent on the size, refractive index, and surface curvature of the particle.

Extensions to the visual predictive check to facilitate model performance evaluation.

PubMed

Post, Teun M; Freijer, Jan I; Ploeger, Bart A; Danhof, Meindert

2008-04-01

The Visual Predictive Check (VPC) is a valuable and supportive instrument for evaluating model performance. However in its most commonly applied form, the method largely depends on a subjective comparison of the distribution of the simulated data with the observed data, without explicitly quantifying and relating the information in both. In recent adaptations to the VPC this drawback is taken into consideration by presenting the observed and predicted data as percentiles. In addition, in some of these adaptations the uncertainty in the predictions is represented visually. However, it is not assessed whether the expected random distribution of the observations around the predicted median trend is realised in relation to the number of observations. Moreover the influence of and the information residing in missing data at each time point is not taken into consideration. Therefore, in this investigation the VPC is extended with two methods to support a less subjective and thereby more adequate evaluation of model performance: (i) the Quantified Visual Predictive Check (QVPC) and (ii) the Bootstrap Visual Predictive Check (BVPC). The QVPC presents the distribution of the observations as a percentage, thus regardless the density of the data, above and below the predicted median at each time point, while also visualising the percentage of unavailable data. The BVPC weighs the predicted median against the 5th, 50th and 95th percentiles resulting from a bootstrap of the observed data median at each time point, while accounting for the number and the theoretical position of unavailable data. The proposed extensions to the VPC are illustrated by a pharmacokinetic simulation example and applied to a pharmacodynamic disease progression example.

Predicting maximal strength of quadriceps from submaximal performance in individuals with knee joint osteoarthritis.

PubMed

McNair, Peter J; Colvin, Matt; Reid, Duncan

2011-02-01

To compare the accuracy of 12 maximal strength (1-repetition maximum [1-RM]) equations for predicting quadriceps strength in people with osteoarthritis (OA) of the knee joint. Eighteen subjects with OA of the knee joint attended a rehabilitation gymnasium on 3 occasions: 1) a familiarization session, 2) a session where the 1-RM of the quadriceps was established using a weights machine for an open-chain knee extension exercise and a leg press exercise, and 3) a session where the subjects performed with a load at which they could lift for approximately 10 repetitions only. The data were used in 12 prediction equations to calculate 1-RM strength and compared to the actual 1-RM data. Data were examined using Bland and Altman graphs and statistics, intraclass correlation coefficients (ICCs), and typical error values between the actual 1-RM and the respective 1-RM prediction equation data. Difference scores (predicted 1-RM--actual 1-RM) across the injured and control legs were also compared. For the knee extension exercise, the Brown, Brzycki, Epley, Lander, Mayhew et al, Poliquin, and Wathen prediction equations demonstrated the greatest levels of predictive accuracy. All of the ICCs were high (range 0.96–0.99), and typical errors were between 3% and 4%. For the knee press exercise, the Adams, Berger, Kemmler et al, and O'Conner et al equations demonstrated the greatest levels of predictive accuracy. All of the ICCs were high (range 0.95-0.98), and the typical errors ranged from 5.9-6.3%. This study provided evidence supporting the use of prediction equations to assess maximal strength in individuals with a knee joint with OA.

Core Engine Noise Program. Volume III. Prediction Methods -- Supplement I. - Extension of Prediction Methods

DTIC Science & Technology

1976-03-01

frequency noise transmission through turbine blade rows and addition of engine and component data to the prediction method for core noise. " Phase VI...lower turbine blade row attenuation for this low bypass engine . When the blade row attenuation is accounted for by means of a turbine work extrac...component and engine data. Currently, an in-depth program to investigate turbine blade row attenuation is underway (NAS3-19435 and DOT-FA75WA-3688). The

Analytical and experimental vibration studies of a 1/8-scale shuttle orbiter

NASA Technical Reports Server (NTRS)

Pinson, L. D.

1975-01-01

Natural frequencies and mode shapes for four symmetric vibration modes and four antisymmetric modes are compared with predictions based on NASTRAN finite-element analyses. Initial predictions gave poor agreement with test data; an extensive investigation revealed that the major factors influencing agreement were out-of-plane imperfections in fuselage panels and a soft fin-fuselage connection. Computations with a more refined analysis indicated satisfactory frequency predictions for all modes studied, within 11 percent of experimental values.

Importance of Foliar Nitrogen Concentration to Predict Forest Productivity in the Mid-Atlantic Region

Treesearch

Yude Pan; John Hom; Jennifer Jenkins; Richard Birdsey

2004-01-01

To assess what difference it might make to include spatially defined estimates of foliar nitrogen in the regional application of a forest ecosystem model (PnET-II), we composed model predictions of wood production from extensive ground-based forest inventory analysis data across the Mid-Atlantic region. Spatial variation in foliar N concentration was assigned based on...

Serotonin Transporter-Linked Polymorphic Region (5-HTTLPR) Genotype and Stressful Life Events Interact to Predict Preschool-Onset Depression: A Replication and Developmental Extension

ERIC Educational Resources Information Center

Bogdan, Ryan; Agrawal, Arpana; Gaffrey, Michael S.; Tillman, Rebecca; Luby, Joan L.

2014-01-01

Background: Scientific enthusiasm about gene × environment interactions, spurred by the 5-HTTLPR (serotonin transporter-linked polymorphic region) × SLEs (stressful life events) interaction predicting depression, have recently been tempered by sober realizations of small effects and meta-analyses reaching opposing conclusions. These mixed findings…

Predicting Eating Disorder Group Membership: An Examination and Extension of the Sociocultural Model

ERIC Educational Resources Information Center

Engler, Patricia A.; Crowther, Janis H.; Dalton, Ginnie; Sanftner, Jennifer L.

2006-01-01

The purpose of this research was to examine and extend portions of the sociocultural model of bulimia nervosa (Stice, E. (1994). Review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. "Clinical Psychology Review," 14, 633-661; Stice, E., & Agras, W. S. (1998). Predicting onset and…

Code Validation Studies of High-Enthalpy Flows

DTIC Science & Technology

2006-12-01

stage of future hypersonic vehicles. The development and design of such vehicles is aided by the use of experimentation and numerical simulation... numerical predictions and experimental measurements. 3. Summary of Previous Work We have studied extensively hypersonic double-cone flows with and in...the experimental measurements and the numerical predictions. When we accounted for that effect in numerical simulations, and also augmented the

Quantitative predictions of bioconversion of aspen by dilute acid and SPORL pretreatments using a unified combined hydrolysis factor (CHF)

Treesearch

W. Zhu; Carl J. Houtman; J.Y. Zhu; Roland Gleisner; K.F. Chen

2012-01-01

A combined hydrolysis factor (CHF) was developed to predict xylan hydrolysis during pretreatments of native aspen (Populus tremuloides) wood chips. A natural extension of previously developed kinetic models allowed us to account for the effect of catalysts by dilute acid and two sulfite pretreatments at different pH values....

Nuclear power plant life extension using subsize surveillance specimens. Performance report (4/15/92 - 4/14/98)

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

Kumar, Arvind S.

2001-03-05

A new methodology to predict the Upper Shelf Energy (USE) of standard Charpy specimens (Full size) based on subsize specimens has been developed. The prediction methodology uses Finite Element Modeling (FEM) to model the fracture behavior. The inputs to FEM are the tensile properties of material and subsize Charpy specimen test data.

NON-EXTENSIVE STATISTICS TO THE COSMOLOGICAL LITHIUM PROBLEM

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

Hou, S. Q.; He, J. J.; Parikh, A.

Big Bang nucleosynthesis (BBN) theory predicts the abundances of the light elements D, {sup 3}He, {sup 4}He, and {sup 7}Li produced in the early universe. The primordial abundances of D and {sup 4}He inferred from observational data are in good agreement with predictions, however, BBN theory overestimates the primordial {sup 7}Li abundance by about a factor of three. This is the so-called “cosmological lithium problem.” Solutions to this problem using conventional astrophysics and nuclear physics have not been successful over the past few decades, probably indicating the presence of new physics during the era of BBN. We have investigated themore » impact on BBN predictions of adopting a generalized distribution to describe the velocities of nucleons in the framework of Tsallis non-extensive statistics. This generalized velocity distribution is characterized by a parameter q , and reduces to the usually assumed Maxwell–Boltzmann distribution for q  = 1. We find excellent agreement between predicted and observed primordial abundances of D, {sup 4}He, and {sup 7}Li for 1.069 ≤  q  ≤ 1.082, suggesting a possible new solution to the cosmological lithium problem.« less

Predicting Seagrass Occurrence in a Changing Climate Using Random Forests

NASA Astrophysics Data System (ADS)

Aydin, O.; Butler, K. A.

2017-12-01

Seagrasses are marine plants that can quickly sequester vast amounts of carbon (up to 100 times more and 12 times faster than tropical forests). In this work, we present an integrated GIS and machine learning approach to build a data-driven model of seagrass presence-absence. We outline a random forest approach that avoids the prevalence bias in many ecological presence-absence models. One of our goals is to predict global seagrass occurrence from a spatially limited training sample. In addition, we conduct a sensitivity study which investigates the vulnerability of seagrass to changing climate conditions. We integrate multiple data sources including fine-scale seagrass data from MarineCadastre.gov and the recently available globally extensive publicly available Ecological Marine Units (EMU) dataset. These data are used to train a model for seagrass occurrence along the U.S. coast. In situ oceans data are interpolated using Empirical Bayesian Kriging (EBK) to produce globally extensive prediction variables. A neural network is used to estimate probable future values of prediction variables such as ocean temperature to assess the impact of a warming climate on seagrass occurrence. The proposed workflow can be generalized to many presence-absence models.

Engineers have more sons, nurses have more daughters: an evolutionary psychological extension of Baron-Cohen's extreme male brain theory of autism.

PubMed

Kanazawa, Satoshi; Vandermassen, Griet

2005-04-21

In his extreme male brain theory of autism, Baron-Cohen postulates that having a typically male brain was adaptive for ancestral men and having a typically female brain was adaptive for ancestral women. He also suggests that brain types are substantially heritable. These postulates, combined with the insight from the Trivers-Willard hypothesis regarding parental ability to vary offspring sex ratio, lead to the prediction that people who have strong male brains should have more sons than daughters, and people who have strong female brains should have more daughters than sons. The analysis of the 1994 US General Social Survey data provides support for this prediction. Our results suggest potentially fruitful extensions of both Baron-Cohen's theory and the Trivers-Willard hypothesis.

Effect of damage on elastically tailored composite laminates

NASA Technical Reports Server (NTRS)

Armanios, Erian; Badir, Ashraf; Berdichevsky, Victor

1991-01-01

A variationally consistent theory is derived in order to predict the response of anisotropic thin-walled closed sections subjected to axial load, torsion and bending. The theory is valid for arbitrary cross-sections made of laminated composite materials with variable thickness and stiffness. Closed form expressions for the stiffness coefficients are provided as integrals in terms of lay-ups parameters and cross-sectional geometry. A comparison of stiffness coefficients and response with finite element predictions and a closed form solution is performed. The theory is applied to the investigation of the effect of damage on the extension-twist coupling in a thin-walled closed section beam. The damage is simulated as a progressive ply-by-ply failure. Results show that damage can have a significant effect on the extension-twist coupling.

Life extending control for rocket engines

NASA Technical Reports Server (NTRS)

Lorenzo, C. F.; Saus, J. R.; Ray, A.; Carpino, M.; Wu, M.-K.

1992-01-01

The concept of life extending control is defined. A brief discussion of current fatigue life prediction methods is given and the need for an alternative life prediction model based on a continuous functional relationship is established. Two approaches to life extending control are considered: (1) the implicit approach which uses cyclic fatigue life prediction as a basis for control design; and (2) the continuous life prediction approach which requires a continuous damage law. Progress on an initial formulation of a continuous (in time) fatigue model is presented. Finally, nonlinear programming is used to develop initial results for life extension for a simplified rocket engine (model).

Relationships Between Knee Extension Moments During Weighted and Unweighted Gait and Strength Measures That Predict Knee Moments After ACL Reconstruction.

PubMed

Hartigan, Erin; Aucoin, Jennifer; Carlson, Rita; Klieber-Kusak, Melanie; Murray, Thomas; Shaw, Bernadette; Lawrence, Michael

Weighted gait increases internal knee extension moment impulses (KEMI) in the anterior cruciate ligament-reconstructed (ACLR) limb; however, limb differences persist. (1) KEMI during normal gait will influence KEMI during weighted gait and (2) peak knee extension (PKE) torque and time to reach PKE torque will predict KEMI during gait tasks. Descriptive laboratory study. Twenty-four women and 14 men completed 3 gait tasks (unweighted, vest, sled) and strength testing after discharge from rehabilitation and clearance to return to sports. KEMI were calculated during the first 25% of stance. PKE torque and time to reach PKE torque were obtained using a dynamometer. Data on the ACLR limb and symmetry indices (SIs) were analyzed for each sex. Women presented with asymmetrical PKE torques and KEMI across tasks. There were three correlations noted for KEMI: between the walk and vest, walk and sled, and vest and sled tasks. Slower time to PKE torque predicted limb asymmetries across tasks and KEMI in the ACLR limb during the sled task. Men presented with asymmetrical PKE torques and KEMI during the sled task. There was a correlation noted for KEMI between walk and vest tasks only. During the sled task, ACLR limb time to PKE torque predicted KEMI in the ACLR limb and PKE torque SI predicted KEMI SI. Women use asymmetrical KEMI profiles during all gait tasks, and those with worse KEMI during walking have worse KEMI during weighted gait. Men have asymmetrical KEMI when sled towing, and these KEMIs do not correlate with KEMI during walking or vest tasks. PKE torque deficits persist when attempting to return to sports. Only men use gains in PKE torque to improve KEMI profiles. Although quicker PKE torque generation will increase KEMI in women, normalization of KEMI profiles will not occur by increasing rate of force development only. Gait retraining is recommended to correct asymmetrical KEMI profiles used across gait tasks in women.

Testing and extension of a sea lamprey feeding model

USGS Publications Warehouse

Cochran, Philip A.; Swink, William D.; Kinziger, Andrew P.

1999-01-01

A previous model of feeding by sea lamprey Petromyzon marinus predicted energy intake and growth by lampreys as a function of lamprey size, host size, and duration of feeding attachments, but it was applicable only to lampreys feeding at 10°C and it was tested against only a single small data set of limited scope. We extended the model to other temperatures and tested it against an extensive data set (more than 700 feeding bouts) accumulated during experiments with captive sea lampreys. Model predictions of instantaneous growth were highly correlated with observed growth, and a partitioning of mean squared error between model predictions and observed results showed that 88.5% of the variance was due to random variation rather than to systematic errors. However, deviations between observed and predicted values varied substantially, especially for short feeding bouts. Predicted and observed growth trajectories of individual lampreys during multiple feeding bouts during the summer tended to correspond closely, but predicted growth was generally much higher than observed growth late in the year. This suggests the possibility that large overwintering lampreys reduce their feeding rates while attached to hosts. Seasonal or size-related shifts in the fate of consumed energy may provide an alternative explanation. The lamprey feeding model offers great flexibility in assessing growth of captive lampreys within various experimental protocols (e.g., different host species or thermal regimes) because it controls for individual differences in feeding history.

Spectroscopic Study of Neon Z-Pinch Plasma for Sodium-Neon Photopumping Experiments

DTIC Science & Technology

1992-01-06

enhancement of the 11-A radiation from the n=4 level of neon when the sodium pump was present. For the 25-GV pump power, theoretical calculations predict...when the neon plasma is photopumped. Extensive theoretical analysis has been devoted to establishing the appropriate conditions for these plasmas. 5 ,44...producing thermonuclear neutrons. 63-65 Extensive theoretical modeling of the stability of these plasmas has guided this work.66 An imploding-liner Z

The Relationship Between Maximum Isometric Strength and Ball Velocity in the Tennis Serve.

PubMed

Baiget, Ernest; Corbi, Francisco; Fuentes, Juan Pedro; Fernández-Fernández, Jaime

2016-12-01

The aims of this study were to analyze the relationship between maximum isometric strength levels in different upper and lower limb joints and serve velocity in competitive tennis players as well as to develop a prediction model based on this information. Twelve male competitive tennis players (mean ± SD; age: 17.2 ± 1.0 years; body height: 180.1 ± 6.2 cm; body mass: 71.9 ± 5.6 kg) were tested using maximum isometric strength levels (i.e., wrist, elbow and shoulder flexion and extension; leg and back extension; shoulder external and internal rotation). Serve velocity was measured using a radar gun. Results showed a strong positive relationship between serve velocity and shoulder internal rotation (r = 0.67; p < 0.05). Low to moderate correlations were also found between serve velocity and wrist, elbow and shoulder flexion - extension, leg and back extension and shoulder external rotation (r = 0.36 - 0.53; p = 0.377 - 0.054). Bivariate and multivariate models for predicting serve velocity were developed, with shoulder flexion and internal rotation explaining 55% of the variance in serve velocity (r = 0.74; p < 0.001). The maximum isometric strength level in shoulder internal rotation was strongly related to serve velocity, and a large part of the variability in serve velocity was explained by the maximum isometric strength levels in shoulder internal rotation and shoulder flexion.

Flexible polyelectrolyte chain in a strong electrolyte solution: Insight into equilibrium properties and force-extension behavior from mesoscale simulation

NASA Astrophysics Data System (ADS)

Malekzadeh Moghani, Mahdy; Khomami, Bamin

2016-01-01

Macromolecules with ionizable groups are ubiquitous in biological and synthetic systems. Due to the complex interaction between chain and electrostatic decorrelation lengths, both equilibrium properties and micro-mechanical response of dilute solutions of polyelectrolytes (PEs) are more complex than their neutral counterparts. In this work, the bead-rod micromechanical description of a chain is used to perform hi-fidelity Brownian dynamics simulation of dilute PE solutions to ascertain the self-similar equilibrium behavior of PE chains with various linear charge densities, scaling of the Kuhn step length (lE) with salt concentration cs and the force-extension behavior of the PE chain. In accord with earlier theoretical predictions, our results indicate that for a chain with n Kuhn segments, lE ˜ cs-0.5 as linear charge density approaches 1/n. Moreover, the constant force ensemble simulation results accurately predict the initial non-linear force-extension region of PE chain recently measured via single chain experiments. Finally, inspired by Cohen's extraction of Warner's force law from the inverse Langevin force law, a novel numerical scheme is developed to extract a new elastic force law for real chains from our discrete set of force-extension data similar to Padè expansion, which accurately depicts the initial non-linear region where the total Kuhn length is less than the thermal screening length.

Flexible polyelectrolyte chain in a strong electrolyte solution: Insight into equilibrium properties and force-extension behavior from mesoscale simulation.

PubMed

Malekzadeh Moghani, Mahdy; Khomami, Bamin

2016-01-14

Macromolecules with ionizable groups are ubiquitous in biological and synthetic systems. Due to the complex interaction between chain and electrostatic decorrelation lengths, both equilibrium properties and micro-mechanical response of dilute solutions of polyelectrolytes (PEs) are more complex than their neutral counterparts. In this work, the bead-rod micromechanical description of a chain is used to perform hi-fidelity Brownian dynamics simulation of dilute PE solutions to ascertain the self-similar equilibrium behavior of PE chains with various linear charge densities, scaling of the Kuhn step length (lE) with salt concentration cs and the force-extension behavior of the PE chain. In accord with earlier theoretical predictions, our results indicate that for a chain with n Kuhn segments, lE ∼ cs (-0.5) as linear charge density approaches 1/n. Moreover, the constant force ensemble simulation results accurately predict the initial non-linear force-extension region of PE chain recently measured via single chain experiments. Finally, inspired by Cohen's extraction of Warner's force law from the inverse Langevin force law, a novel numerical scheme is developed to extract a new elastic force law for real chains from our discrete set of force-extension data similar to Padè expansion, which accurately depicts the initial non-linear region where the total Kuhn length is less than the thermal screening length.

Predicting post-fire hillslope erosion in forest lands of the western United States

Treesearch

Mary Ellen Miller; Lee H. MacDonald; Peter R. Robichaud; William J. Elliot

2011-01-01

Many forests and their associated water resources are at increasing risk from large and severe wildfires due to high fuel accumulations and climate change. Extensive fuel treatments are being proposed, but it is not clear where such treatments should be focussed. The goals of this project were to: (1) predict potential post-fire erosion rates for forests and shrublands...

Aircraft interior noise prediction using a structural-acoustic analogy in NASTRAN modal synthesis

NASA Technical Reports Server (NTRS)

Grosveld, Ferdinand W.; Sullivan, Brenda M.; Marulo, Francesco

1988-01-01

The noise induced inside a cylindrical fuselage model by shaker excitation is investigated theoretically and experimentally. The NASTRAN modal-synthesis program is used in the theoretical analysis, and the predictions are compared with experimental measurements in extensive graphs. Good general agreement is obtained, but the need for further refinements to account for acoustic-cavity damping and structural-acoustic interaction is indicated.

Extension of a Theory of Predictive Behavior to Immediate Recall by Preschool Children.

ERIC Educational Resources Information Center

Bogartz, Richard S.

This paper is concerned with memory functions in sequentially structured behavior. Twenty-five 4- and 5-year-old preschool children participated in a prediction experiment in which a stack of cards (each card alternately having a patch of red or green tape on it) was displayed to the child. The child was presented with a card and asked to predict…

Motion analysis study on sensitivity of finite element model of the cervical spine to geometry.

PubMed

Zafarparandeh, Iman; Erbulut, Deniz U; Ozer, Ali F

2016-07-01

Numerous finite element models of the cervical spine have been proposed, with exact geometry or with symmetric approximation in the geometry. However, few researches have investigated the sensitivity of predicted motion responses to the geometry of the cervical spine. The goal of this study was to evaluate the effect of symmetric assumption on the predicted motion by finite element model of the cervical spine. We developed two finite element models of the cervical spine C2-C7. One model was based on the exact geometry of the cervical spine (asymmetric model), whereas the other was symmetric (symmetric model) about the mid-sagittal plane. The predicted range of motion of both models-main and coupled motions-was compared with published experimental data for all motion planes under a full range of loads. The maximum differences between the asymmetric model and symmetric model predictions for the principal motion were 31%, 78%, and 126% for flexion-extension, right-left lateral bending, and right-left axial rotation, respectively. For flexion-extension and lateral bending, the minimum difference was 0%, whereas it was 2% for axial rotation. The maximum coupled motions predicted by the symmetric model were 1.5° axial rotation and 3.6° lateral bending, under applied lateral bending and axial rotation, respectively. Those coupled motions predicted by the asymmetric model were 1.6° axial rotation and 4° lateral bending, under applied lateral bending and axial rotation, respectively. In general, the predicted motion response of the cervical spine by the symmetric model was in the acceptable range and nonlinearity of the moment-rotation curve for the cervical spine was properly predicted. © IMechE 2016.

On the comparison of stochastic model predictive control strategies applied to a hydrogen-based microgrid

NASA Astrophysics Data System (ADS)

Velarde, P.; Valverde, L.; Maestre, J. M.; Ocampo-Martinez, C.; Bordons, C.

2017-03-01

In this paper, a performance comparison among three well-known stochastic model predictive control approaches, namely, multi-scenario, tree-based, and chance-constrained model predictive control is presented. To this end, three predictive controllers have been designed and implemented in a real renewable-hydrogen-based microgrid. The experimental set-up includes a PEM electrolyzer, lead-acid batteries, and a PEM fuel cell as main equipment. The real experimental results show significant differences from the plant components, mainly in terms of use of energy, for each implemented technique. Effectiveness, performance, advantages, and disadvantages of these techniques are extensively discussed and analyzed to give some valid criteria when selecting an appropriate stochastic predictive controller.

Real-time, adaptive machine learning for non-stationary, near chaotic gasoline engine combustion time series.

PubMed

Vaughan, Adam; Bohac, Stanislav V

2015-10-01

Fuel efficient Homogeneous Charge Compression Ignition (HCCI) engine combustion timing predictions must contend with non-linear chemistry, non-linear physics, period doubling bifurcation(s), turbulent mixing, model parameters that can drift day-to-day, and air-fuel mixture state information that cannot typically be resolved on a cycle-to-cycle basis, especially during transients. In previous work, an abstract cycle-to-cycle mapping function coupled with ϵ-Support Vector Regression was shown to predict experimentally observed cycle-to-cycle combustion timing over a wide range of engine conditions, despite some of the aforementioned difficulties. The main limitation of the previous approach was that a partially acasual randomly sampled training dataset was used to train proof of concept offline predictions. The objective of this paper is to address this limitation by proposing a new online adaptive Extreme Learning Machine (ELM) extension named Weighted Ring-ELM. This extension enables fully causal combustion timing predictions at randomly chosen engine set points, and is shown to achieve results that are as good as or better than the previous offline method. The broader objective of this approach is to enable a new class of real-time model predictive control strategies for high variability HCCI and, ultimately, to bring HCCI's low engine-out NOx and reduced CO2 emissions to production engines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Analysis and Validation of a Predictive Model for Growth and Death of Aeromonas hydrophila under Modified Atmospheres at Refrigeration Temperatures

PubMed Central

Pin, Carmen; Velasco de Diego, Raquel; George, Susan; García de Fernando, Gonzalo D.; Baranyi, József

2004-01-01

Specific growth and death rates of Aeromonas hydrophila were measured in laboratory media under various combinations of temperature, pH, and percent CO2 and O2 in the atmosphere. Predictive models were developed from the data and validated by means of observations obtained from (i) seafood experiments set up for this purpose and (ii) the ComBase database (http://www.combase.cc; http://wyndmoor.arserrc.gov/combase/).Two main reasons were identified for the differences between the predicted and observed growth in food: they were the variability of the growth rates in food and the bias of the model predictions when applied to food environments. A statistical method is presented to quantitatively analyze these differences. The method was also used to extend the interpolation region of the model. In this extension, the concept of generalized Z values (C. Pin, G. García de Fernando, J. A. Ordóñez, and J. Baranyi, Food Microbiol. 18:539-545, 2001) played an important role. The extension depended partly on the density of the model-generating observations and partly on the accuracy of extrapolated predictions close to the boundary of the interpolation region. The boundary of the growth region of the organism was also estimated by means of experimental results for growth and death rates. PMID:15240265

Impact of Postmastectomy Radiation on Locoregional Recurrence in Breast Cancer Patients With 1-3 Positive Lymph Nodes Treated With Modern Systemic Therapy

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

Tendulkar, Rahul D., E-mail: tendulr@ccf.org; Rehman, Sana; Shukla, Monica E.

2012-08-01

Purpose: Postmastectomy radiation therapy (PMRT) remains controversial for patients with 1-3 positive lymph nodes (LN+). Methods and Materials: We conducted a retrospective review of all 369 breast cancer patients with 1-3 LN+ who underwent mastectomy without neoadjuvant systemic therapy between 2000 and 2007 at Cleveland Clinic. Results: We identified 271 patients with 1-3 LN+ who did not receive PMRT and 98 who did receive PMRT. The median follow-up time was 5.2 years, and the median number of LN dissected was 11. Of those not treated with PMRT, 79% received adjuvant chemotherapy (of whom 70% received a taxane), 79% received hormonalmore » therapy, and 5% had no systemic therapy. Of the Her2/neu amplified tumors, 42% received trastuzumab. The 5-year rate of locoregional recurrence (LRR) was 8.9% without PMRT vs 0% with PMRT (P=.004). For patients who did not receive PMRT, univariate analysis showed 6 risk factors significantly (P<.05) correlated with LRR: estrogen receptor/progesterone receptor negative (hazard ratio [HR] 2.6), lymphovascular invasion (HR 2.4), 2-3 LN+ (HR 2.6), nodal ratio >25% (HR 2.7), extracapsular extension (ECE) (HR 3.7), and Bloom-Richardson grade III (HR 3.1). The 5-year LRR rate was 3.4% (95% confidence interval [CI], 0.1%-6.8%] for patients with 0-1 risk factor vs 14.6% [95% CI, 8.4%-20.9%] for patients with {>=}2 risk factors (P=.0006), respectively. On multivariate analysis, ECE (HR 4.3, P=.0006) and grade III (HR 3.6, P=.004) remained significant risk factors for LRR. The 5-year LRR was 4.1% in patients with neither grade III nor ECE, 8.1% with either grade III or ECE, and 50.4% in patients with both grade III and ECE (P<.0001); the corresponding 5-year distant metastasis-free survival rates were 91.8%, 85.4%, and 59.1% (P=.0004), respectively. Conclusions: PMRT offers excellent control for patients with 1-3 LN+, with no locoregional failures to date. Patients with 1-3 LN+ who have grade III disease and/or ECE should be strongly considered for PMRT.« less

Long term results of postoperative Intensity-Modulated Radiation Therapy (IMRT) in the treatment of Squamous Cell Carcinoma (SCC) located in the oropharynx or oral cavity.

PubMed

Hoffmann, M; Saleh-Ebrahimi, L; Zwicker, F; Haering, P; Schwahofer, A; Debus, J; Huber, P E; Roeder, F

2015-12-04

To report our long-term results with postoperative intensity-modulated radiation therapy (IMRT) in patients suffering from squamous-cell carcinoma (SCC) of the oral cavity or oropharynx. Seventy five patients were retrospectively analyzed. Median age was 58 years and 84 % were male. 76 % of the primaries were located in the oropharynx. Surgery resulted in negative margins (R0) in 64 % of the patients while 36 % suffered from positive margins (R1). Postoperative stages were as follows: stage 1:4 %, stage 2:9 %, stage 3:17 %, stage 4a:69 % with positive nodes in 84 %. Perineural invasion (Pn+) and extracapsular extension (ECE) were present in 7 % and 29 %, respectively. All patients received IMRT using the step-and-shoot approach with a simultaneously integrated boost (SIB) in 84 %. Concurrent systemic therapy was applied to 53 patients, mainly cisplatin weekly. Median follow-up was 55 months (5-150). 13 patients showed locoregional failures (4 isolated local, 4 isolated neck, 5 combined) transferring into 5-year-LRC rates of 85 %. Number of positive lymph nodes (n > 2) and presence of ECE were significantly associated with decreased LRC in univariate analysis, but only the number of nodes remained significant in multivariate analysis. Overall treatment failures occurred in 20 patients (9 locoregional only, 7 distant only, 4 combined), transferring into 3-and 5-year-FFTF rates of 77 % and 75 %, respectively. The 3-and 5-year-OS rates were 80 % and 72 %, respectively. High clinical stage, high N stage, number of positive nodes (n > 2), ECE and Pn1 were significantly associated with worse FFTF and OS in univariate analysis, but only number of nodes remained significant for FFTF in multivariate analysis. Maximum acute toxicity was grade 3 in 64 % and grade 4 in 1 %, mainly hematological or mucositis/dysphagia. Maximum late toxicity was grade 3 in 23 % of the patients, mainly long-term tube feeding dependency. Postoperative IMRT achieved excellent LRC and good OS with acceptable acute and low late toxicity rates. The number of positive nodes (n > 2) was a strong prognostic factor for all endpoints in univariate and the only significant factor for LRC and FFTF in multivariate analysis. Patients with feeding tubes due to postoperative complications had an increased risk for long-term feeding tube dependency.

Effect of a Perturbation on the Chemical Equilibrium: Comparison with Le Châtelier's Principle

NASA Astrophysics Data System (ADS)

Martínez Torres, Emilio

2007-03-01

This article develops a general thermodynamic treatment to predict the direction of shift in a chemical equilibrium when it is subjected to a stress. This treatment gives an inequality that relates the change in the perturbed variable and the change that the equilibrium shift produces in the conjugated variable. To illustrate the generality of this approach, it has been applied to predict the direction of shift caused by changes of pressure, volume, and amount of substance. In this last case, the well-known unexpected shift in the ammonia synthesis equilibrium upon addition of nitrogen is easily explained. From the above referred inequality and the stability criteria of thermodynamics some conclusions have been obtained about the direction of shift in terms of extensive and extensive variables. This article is suitable for physical chemistry courses.

Advancements in Hydrology and Erosion Process Understanding and Post-Fire Hydrologic and Erosion Model Development for Semi-Arid Landscapes

NASA Astrophysics Data System (ADS)

Williams, C. Jason; Pierson, Frederick B.; Al-Hamdan, Osama Z.; Robichaud, Peter R.; Nearing, Mark A.; Hernandez, Mariano; Weltz, Mark A.; Spaeth, Kenneth E.; Goodrich, David C.

2017-04-01

Fire activity continues to increase in semi-arid regions around the globe. Private and governmental land management entities are challenged with predicting and mitigating post-fire hydrologic and erosion responses on these landscapes. For more than a decade, a team of scientists with the US Department of Agriculture has collaborated on extensive post-fire hydrologic field research and the application of field research to development of post-fire hydrology and erosion predictive technologies. Experiments funded through this research investigated the impacts of fire on vegetation and soils and the effects of these fire-induced changes on infiltration, runoff generation, erodibility, and soil erosion processes. The distribution of study sites spans diverse topography across grassland, shrubland, and woodland landscapes throughout the western United States. Knowledge gleaned from the extensive field experiments was applied to develop and enhance physically-based models for hillslope- to watershed-scale runoff and erosion prediction. Our field research and subsequent data syntheses have identified key knowledge gaps and challenges regarding post-fire hydrology and erosion modeling. Our presentation details some consistent trends across a diverse domain and varying landscape conditions based on our extensive field campaigns. We demonstrate how field data have advanced our understanding of post-fire hydrology and erosion for semi-arid landscapes and highlight remaining key knowledge gaps. Lastly, we briefly show how our well-replicated experimental methodologies have contributed to advancements in hydrologic and erosion model development for the post-fire environment.

Additional extensions to the NASCAP computer code, volume 1

NASA Technical Reports Server (NTRS)

Mandell, M. J.; Katz, I.; Stannard, P. R.

1981-01-01

Extensions and revisions to a computer code that comprehensively analyzes problems of spacecraft charging (NASCAP) are documented. Using a fully three dimensional approach, it can accurately predict spacecraft potentials under a variety of conditions. Among the extensions are a multiple electron/ion gun test tank capability, and the ability to model anisotropic and time dependent space environments. Also documented are a greatly extended MATCHG program and the preliminary version of NASCAP/LEO. The interactive MATCHG code was developed into an extremely powerful tool for the study of material-environment interactions. The NASCAP/LEO, a three dimensional code to study current collection under conditions of high voltages and short Debye lengths, was distributed for preliminary testing.

Non-Gaussian Distribution of DNA Barcode Extension In Nanochannels Using High-throughput Imaging

NASA Astrophysics Data System (ADS)

Sheats, Julian; Reinhart, Wesley; Reifenberger, Jeff; Gupta, Damini; Muralidhar, Abhiram; Cao, Han; Dorfman, Kevin

2015-03-01

We present experimental data for the extension of internal segments of highly confined DNA using a high-­throughput experimental setup. Barcode­-labeled E. coli genomic DNA molecules were imaged at a high areal density in square nanochannels with sizes ranging from 40 nm to 51 nm in width. Over 25,000 molecules were used to obtain more than 1,000,000 measurements for genomic distances between 2,500 bp and 100,000 bp. The distribution of extensions has positive excess kurtosis and is skew­ left due to weak backfolding in the channel. As a result, the two Odijk theories for the chain extension and variance bracket the experimental data. We compared to predictions of a harmonic approximation for the confinement free energy and show that it produces a substantial error in the variance. These results suggest an inherent error associated with any statistical analysis of barcoded DNA that relies on harmonic models for chain extension. Present address: Department of Chemical and Biological Engineering, Princeton University.

PSI/TM-Coffee: a web server for fast and accurate multiple sequence alignments of regular and transmembrane proteins using homology extension on reduced databases.

PubMed

Floden, Evan W; Tommaso, Paolo D; Chatzou, Maria; Magis, Cedrik; Notredame, Cedric; Chang, Jia-Ming

2016-07-08

The PSI/TM-Coffee web server performs multiple sequence alignment (MSA) of proteins by combining homology extension with a consistency based alignment approach. Homology extension is performed with Position Specific Iterative (PSI) BLAST searches against a choice of redundant and non-redundant databases. The main novelty of this server is to allow databases of reduced complexity to rapidly perform homology extension. This server also gives the possibility to use transmembrane proteins (TMPs) reference databases to allow even faster homology extension on this important category of proteins. Aside from an MSA, the server also outputs topological prediction of TMPs using the HMMTOP algorithm. Previous benchmarking of the method has shown this approach outperforms the most accurate alignment methods such as MSAProbs, Kalign, PROMALS, MAFFT, ProbCons and PRALINE™. The web server is available at http://tcoffee.crg.cat/tmcoffee. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

Predicted Turbine Heat Transfer for a Range of Test Conditions

NASA Technical Reports Server (NTRS)

Boyle, R. J.; Lucci, B. L.

1996-01-01

Comparisons are shown between predictions and experimental data for blade and endwall heat transfer. The comparisons of computational domain parisons are given for both vane and rotor geometries over an extensive range of Reynolds and Mach numbers. Comparisons are made with experimental data from a variety of sources. A number of turbulence models are available for predicting blade surface heat transfer, as well as aerodynamic performance. The results of an investigation to determine the turbulence model which gives the best agreement with experimental data over a wide range of test conditions are presented.

On the State of Stress and Failure Prediction Near Planetary Surface Loads

NASA Astrophysics Data System (ADS)

Schultz, R. A.

1996-03-01

The state of stress surrounding planetary surface loads has been used extensively to predict failure of surface rocks and to invert this information for effective elastic thickness. As demonstrated previously, however, several factors can be important including an explicit comparison between model stresses and rock strength as well as the magnitude of calculated stress. As re-emphasized below, failure to take stress magnitudes into account can lead to erroneous predictions of near-surface faulting. This abstract results from discussions on graben formation at Fall 1995 AGU.

A high temperature fatigue life prediction computer code based on the total strain version of StrainRange Partitioning (SRP)

NASA Technical Reports Server (NTRS)

Mcgaw, Michael A.; Saltsman, James F.

1993-01-01

A recently developed high-temperature fatigue life prediction computer code is presented and an example of its usage given. The code discussed is based on the Total Strain version of Strainrange Partitioning (TS-SRP). Included in this code are procedures for characterizing the creep-fatigue durability behavior of an alloy according to TS-SRP guidelines and predicting cyclic life for complex cycle types for both isothermal and thermomechanical conditions. A reasonably extensive materials properties database is included with the code.

Limb observations of the 12.32 micron solar emission line during the 1991 July total eclipse

NASA Technical Reports Server (NTRS)

Deming, Drake; Jennings, Donald E.; Mccabe, George; Noyes, Robert; Wiedemann, Gunter; Espenak, Fred

1992-01-01

The limb profile of the Mg I 12.32-micron emission line is determined by occultation in the July 11, 1991 total solar eclipse over Mauna Kea. It is shown that the emission peaks are very close to the 12-micron continuum limb, as predicted by recent theory for this line as a non-LTE photospheric emission. The increase in optical depth for this extreme limb-viewing situation indicates that most of the observed emission arises from above the chromospheric temperature minimum, and it is found that this emission is extended to heights well in excess of the model predictions. The line emission can be observed as high as 2000 km above the 12-micron continuum limb, whereas theory predicts it to remain observable no higher than about 500 km above the continuum limb. The substantial limb extension observed in this line is quantitatively consistent with limb extensions seen in the far-IR continuum, and it is concluded that it is indicative of departures from gravitational hydrostatic equilibrium, or spatial inhomogeneities, in the upper solar atmosphere.

Effects of phase vector and history extension on prediction power of adaptive-network based fuzzy inference system (ANFIS) model for a real scale anaerobic wastewater treatment plant operating under unsteady state.

PubMed

Perendeci, Altinay; Arslan, Sever; Tanyolaç, Abdurrahman; Celebi, Serdar S

2009-10-01

A conceptual neural fuzzy model based on adaptive-network based fuzzy inference system, ANFIS, was proposed using available input on-line and off-line operational variables for a sugar factory anaerobic wastewater treatment plant operating under unsteady state to estimate the effluent chemical oxygen demand, COD. The predictive power of the developed model was improved as a new approach by adding the phase vector and the recent values of COD up to 5-10 days, longer than overall retention time of wastewater in the system. History of last 10 days for COD effluent with two-valued phase vector in the input variable matrix including all parameters had more predictive power. History of 7 days with two-valued phase vector in the matrix comprised of only on-line variables yielded fairly well estimations. The developed ANFIS model with phase vector and history extension has been able to adequately represent the behavior of the treatment system.

Misalignment Effect Function Measurement for Oblique Rotation Axes: Counterintuitive Predictions and Theoretical Extensions

NASA Technical Reports Server (NTRS)

Ellis, Stephen R.; Adelstein, Bernard D.; Yeom, Kiwon

2013-01-01

The Misalignment Effect Function (MEF) describes the decrement in manual performance associated with a rotation between operators' visual display frame of reference and that of their manual control. It now has been empirically determined for rotation axes oblique to canonical body axes and is compared with the MEF previously measured for rotations about canonical axes. A targeting rule, called the Secant Rule, based on these earlier measurements is derived from a hypothetical process and shown to describe some of the data from three previous experiments. It explains the motion trajectories determined for rotations less than 65deg in purely kinematic terms without the need to appeal to a mental rotation process. Further analysis of this rule in three dimensions applied to oblique rotation axes leads to a somewhat surprising expectation that the difficulty posed by rotational misalignment should get harder as the required movement is shorter. This prediction is confirmed. Geometry underlying this rule also suggests analytic extensions for predicting more generally the difficulty of making movements in arbitrary directions subject to arbitrary misalignments.

Characterizing and modeling the free recovery and constrained recovery behavior of a polyurethane shape memory polymer

NASA Astrophysics Data System (ADS)

Volk, Brent L.; Lagoudas, Dimitris C.; Maitland, Duncan J.

2011-09-01

In this work, tensile tests and one-dimensional constitutive modeling were performed on a high recovery force polyurethane shape memory polymer that is being considered for biomedical applications. The tensile tests investigated the free recovery (zero load) response as well as the constrained displacement recovery (stress recovery) response at extension values up to 25%, and two consecutive cycles were performed during each test. The material was observed to recover 100% of the applied deformation when heated at zero load in the second thermomechanical cycle, and a stress recovery of 1.5-4.2 MPa was observed for the constrained displacement recovery experiments. After the experiments were performed, the Chen and Lagoudas model was used to simulate and predict the experimental results. The material properties used in the constitutive model—namely the coefficients of thermal expansion, shear moduli, and frozen volume fraction—were calibrated from a single 10% extension free recovery experiment. The model was then used to predict the material response for the remaining free recovery and constrained displacement recovery experiments. The model predictions match well with the experimental data.

Calculations of reliability predictions for the Apollo spacecraft

NASA Technical Reports Server (NTRS)

Amstadter, B. L.

1966-01-01

A new method of reliability prediction for complex systems is defined. Calculation of both upper and lower bounds are involved, and a procedure for combining the two to yield an approximately true prediction value is presented. Both mission success and crew safety predictions can be calculated, and success probabilities can be obtained for individual mission phases or subsystems. Primary consideration is given to evaluating cases involving zero or one failure per subsystem, and the results of these evaluations are then used for analyzing multiple failure cases. Extensive development is provided for the overall mission success and crew safety equations for both the upper and lower bounds.

Construction of prediction intervals for Palmer Drought Severity Index using bootstrap

NASA Astrophysics Data System (ADS)

Beyaztas, Ufuk; Bickici Arikan, Bugrayhan; Beyaztas, Beste Hamiye; Kahya, Ercan

2018-04-01

In this study, we propose an approach based on the residual-based bootstrap method to obtain valid prediction intervals using monthly, short-term (three-months) and mid-term (six-months) drought observations. The effects of North Atlantic and Arctic Oscillation indexes on the constructed prediction intervals are also examined. Performance of the proposed approach is evaluated for the Palmer Drought Severity Index (PDSI) obtained from Konya closed basin located in Central Anatolia, Turkey. The finite sample properties of the proposed method are further illustrated by an extensive simulation study. Our results revealed that the proposed approach is capable of producing valid prediction intervals for future PDSI values.

Prediction for a Four-Neutron Resonance

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

Shirokov, A. M.; Papadimitriou, G.; Mazur, A. I.

Here, we utilize various ab initio approaches to search for a low-lying resonance in the four-neutron (4n) system using the JISP16 realistic NN interaction. Our most accurate prediction is obtained using a J-matrix extension of the no-core shell model and suggests a 4n resonant state at an energy near E r = 0.8 MeV with a width of approximately Γ = 1.4 MeV.

Prediction for a Four-Neutron Resonance

DOE PAGES

Shirokov, A. M.; Papadimitriou, G.; Mazur, A. I.; ...

2016-10-28

Here, we utilize various ab initio approaches to search for a low-lying resonance in the four-neutron (4n) system using the JISP16 realistic NN interaction. Our most accurate prediction is obtained using a J-matrix extension of the no-core shell model and suggests a 4n resonant state at an energy near E r = 0.8 MeV with a width of approximately Γ = 1.4 MeV.

Edge on Impact Simulations and Experiments

DTIC Science & Technology

2013-09-01

silicon carbide ( SiC ) and aluminum oxynitride (AlON) ceramics are predicted using the Kayenta macroscopic constitutive model. Aspects regarding...damage propagation. 2.1. Silicon Carbide SiC is an opaque ceramic explored by the armor community. It is perhaps the most extensively characterized...the Weibull modulus for SiC . 4.1. Silicon Carbide Figures 3 and 4 compare experimental images with model predictions of EOI of SiC targets at respective

Celebrating the Power of Literacy. The Twenty-Sixth Yearbook: A Peer Reviewed Publication of The College Reading Association [Papers from the College Reading Association Conference, 2004

ERIC Educational Resources Information Center

Dugan, Jo Ann R., Ed.; Linder, Patricia E., Ed.; Sampson, Mary Beth, Ed.; Brancato, Barrie A., Ed.

2004-01-01

This Yearbook begins with Robert J. Rickelman's presidential speech, "Predicting the Whether: Lessons Learned from the Past," which focused on looking at the "History of the College Reading Association" in order to predict some possible (the "whether") courses for the future of the organization. The author relied extensively on the "History of the…

Central Pamir crustal thickening to thinning switch: timing of an orogen wide event?

NASA Astrophysics Data System (ADS)

Rutte, D.; Fox, M.; Stuebner, K.; Ratschbacher, L.

2017-12-01

Asian deep crust exposed in gneiss domes of the Pamir permits the investigation of shortening and extension over 30-50 km of Asian crustal section during the India-Asia collision. In the Central Pamir a stack of fold nappes and thrust sheets records >100 km of N-S shortening at >35-22 Ma. N-S extensional structures crosscut this stack and exhumed the Central Pamir domes at 22-15 Ma. In the South Pamir a similar switch to N-S extension is observed, likely with a coeval onset compared to the Central Pamir, but most extension occurred later at 16-2 Ma. N-S extension in the Karakorum and south Tibet may have onset roughly coeval at 25-20 Ma, too. What forced this switch to N-S extension? While the Central Pamir domes extend >400 km along strike of the orogen, little variation in the amount and timing of the exhumation during N-S extension is observed. In contrast, extension in the South Pamir varies along strike. We scrutinize the exhumation history of the Central Pamir domes. We explore the vast P-T-t-d dataset established in recent publications using one-dimensional thermal models that account for the advection of heat driven by exhumation and thus enable interpretation in an internally consistent framework. Rock trajectories are tracked through the evolving thermal field; T-t paths are used to predict thermochronometric data. Comparison of our predictions with the P-T-t-d data provides best fit exhumation rate histories. Our models suggest that the exhumation rate was initially very high, exceeding 6 km/Myr at 22 Ma, and then exponentially decreased to 0.5 km/Myr by 15 Ma. This requires decreasing extension rates from 22­-15 Ma in the Central Pamir. In contrast, extension rates from age-distance relations in the South Pamir Shakdara dome appear constant during extension from 16-2 Ma. Based on comparisons of the geometry, timing and rates of gneiss dome exhumation in the Central and South Pamir we explore how respective boundary conditions shaped the different dome systems. If further work confirms the coeval switch from thickening to thinning in the Pamir, Karakorum and South Tibet it would suggest that this important phase during orogenic plateau formation is governed by catastrophic, deep-seated processes (e.g., delamination, slab rollback or break-off events), rather than by steady-state processes in the crust.

Systematic review with meta-analysis: proximal disease extension in limited ulcerative colitis.

PubMed

Roda, G; Narula, N; Pinotti, R; Skamnelos, A; Katsanos, K H; Ungaro, R; Burisch, J; Torres, J; Colombel, J-F

2017-06-01

Disease extent in ulcerative colitis is one of the major factors determining prognosis over the long-term. Disease extent is dynamic and a proportion of patients presenting with limited disease progress to more extensive forms of disease over time. To perform a systematic review and meta-analysis of epidemiological studies reporting on extension of ulcerative colitis to determine frequency of disease extension in patients with limited ulcerative colitis at diagnosis. We performed a systematic literature search to identify studies on disease extension of ulcerative colitis (UC) and predictors of disease progression. Overall, 41 studies were eligible for systematic review but only 30 for meta-analysis. The overall pooled frequency of UC extension was 22.8% with colonic extension being 17.8% at 5 years and 31% at 10 years. Extension was 17.8% (95% CI 11.2-27.3) from E1 to E3, 27.5% (95% CI 7.6-45.6) from E2 to E3 and 20.8% (95% CI 11.4-26.8) from E1 to E2. Rate of extension was significantly higher in patients younger than 18 years (29.2% (CI 6.4-71.3) compared to older patients (20.2% (CI 13.0-30.1) (P<.0001). Risk of extension was significantly higher in patients from North America (37.8%) than from Europe (19.6%) (P<.0001). In this meta-analysis, approximately one quarter of patients with limited UC extend over time with most extension occurring during the first 10 years. Rate of extension depends on age at diagnosis and geographic origin. Predicting those at high risk of disease extension from diagnosis could lead to personalised therapeutic strategies. © 2017 John Wiley & Sons Ltd.

An enhanced beam model for constrained layer damping and a parameter study of damping contribution

NASA Astrophysics Data System (ADS)

Xie, Zhengchao; Shepard, W. Steve, Jr.

2009-01-01

An enhanced analytical model is presented based on an extension of previous models for constrained layer damping (CLD) in beam-like structures. Most existing CLD models are based on the assumption that shear deformation in the core layer is the only source of damping in the structure. However, previous research has shown that other types of deformation in the core layer, such as deformations from longitudinal extension and transverse compression, can also be important. In the enhanced analytical model developed here, shear, extension, and compression deformations are all included. This model can be used to predict the natural frequencies and modal loss factors. The numerical study shows that compared to other models, this enhanced model is accurate in predicting the dynamic characteristics. As a result, the model can be accepted as a general computation model. With all three types of damping included and the formulation used here, it is possible to study the impact of the structure's geometry and boundary conditions on the relative contribution of each type of damping. To that end, the relative contributions in the frequency domain for a few sample cases are presented.

Failure Analysis of Discrete Damaged Tailored Extension-Shear-Coupled Stiffened Composite Panels

NASA Technical Reports Server (NTRS)

Baker, Donald J.

2005-01-01

The results of an analytical and experimental investigation of the failure of composite is tiffener panels with extension-shear coupling are presented. This tailored concept, when used in the cover skins of a tiltrotor aircraft wing has the potential for increasing the aeroelastic stability margins and improving the aircraft productivity. The extension-shear coupling is achieved by using unbalanced 45 plies in the skin. The failure analysis of two tailored panel configurations that have the center stringer and adjacent skin severed is presented. Finite element analysis of the damaged panels was conducted using STAGS (STructural Analysis of General Shells) general purpose finite element program that includes a progressive failure capability for laminated composite structures that is based on point-stress analysis, traditional failure criteria, and ply discounting for material degradation. The progressive failure predicted the path of the failure and maximum load capability. There is less than 12 percent difference between the predicted failure load and experimental failure load. There is a good match of the panel stiffness and strength between the progressive failure analysis and the experimental results. The results indicate that the tailored concept would be feasible to use in the wing skin of a tiltrotor aircraft.

A musculoskeletal model for the lumbar spine.

PubMed

Christophy, Miguel; Faruk Senan, Nur Adila; Lotz, Jeffrey C; O'Reilly, Oliver M

2012-01-01

A new musculoskeletal model for the lumbar spine is described in this paper. This model features a rigid pelvis and sacrum, the five lumbar vertebrae, and a rigid torso consisting of a lumped thoracic spine and ribcage. The motion of the individual lumbar vertebrae was defined as a fraction of the net lumbar movement about the three rotational degrees of freedom: flexion-extension lateral bending, and axial rotation. Additionally, the eight main muscle groups of the lumbar spine were incorporated using 238 muscle fascicles with prescriptions for the parameters in the Hill-type muscle models obtained with the help of an extensive literature survey. The features of the model include the abilities to predict joint reactions, muscle forces, and muscle activation patterns. To illustrate the capabilities of the model and validate its physiological similarity, the model's predictions for the moment arms of the muscles are shown for a range of flexion-extension motions of the lower back. The model uses the OpenSim platform and is freely available on https://www.simtk.org/home/lumbarspine to other spinal researchers interested in analyzing the kinematics of the spine. The model can also be integrated with existing OpenSim models to build more comprehensive models of the human body.

Evaluation of antioxidants and argpyrimidine in normal and cataractous lenses in north Indian population

PubMed Central

Mynampati, Bharani K; Ghosh, Sujata; Muthukumarappa, Thungapathra; Ram, Jagat

2017-01-01

AIM To assess the level of glutathione, thioltransferase, and argpyrimidine in nuclear and cortical cataractous lenses as well as in the clear lenses in the north Indian population. METHODS Human cataractous lenses were collected from the patients who underwent extracapsular cataract extraction surgery; clear lenses were collected from the freshly donated eye bank eyes. Antioxidant molecules such as glutathione and thioltransferase enzyme activity were measured; simultaneously in these lenses a blue fluorophore argpyrimidine, an advanced glycation end (AGE) product level was assessed using high performance liquid chromatography (HPLC). RESULTS The protein concentration was found to be present at higher levels in the control lenses compared to cataract lenses. A significant decrease in the glutathione level was observed in the nuclear cataractous lenses compared to cortical cataractous (P=0.004) and clear lenses (P≤0.005), but no significant change in the level of antioxidant enzyme thioltransferase was observed. Further, argpyrimidine a blue fluorophore (AGE) was found to be significantly higher in the nuclear cataract (P=0.013) compared to cortical cataract lenses. CONCLUSION Antioxidants such as glutathione significantly decrease in age-related nuclear and cortical cataract and an AGE, argpyrimidine are present at significantly higher levels in nuclear cataract. PMID:28730112

Factors determining biochemical recurrence in low-risk prostate cancer patients who underwent radical prostatectomy

PubMed Central

Ün, Sıtkı; Türk, Hakan; Koca, Osman; Divrik, Rauf Taner; Zorlu, Ferruh

2015-01-01

Objective: This study was conducted to research the factors determining biochemical recurrence (BCR) in low-risk localized prostate cancer patients who underwent radical prostatectomy (RP). Materials and methods: We retrospectively analyzed the data of 504 patients who had undergone RP between 2003 and 2013 at our clinic. One hundred and fifty-two patients who underwent RP for low-risk prostate cancer were included in the study. Results: The mean follow-up period for patients was 58.7 (21–229) months. The mean age of the patients was 63.7±7.2 years (49–79). The mean prostate specific antigen (PSA) value was 5.25±4.22 ng/mL (3.58–9.45). The BCR rate after the operation was 25% (38/152). In the univariate analysis, recurrence determining factors were shown to include extracapsular involvement (ECI) (p=0.004), capsular invasion (CI) (p=0.001), age (p=0.014), and tumor size (p=0.006). However, only CI was found to be significant in multivariate analysis (p=0.001). Conclusion: Capsular invasion is an independent risk factor in low-risk prostate cancer patients who underwent RP for BCR. PMID:26328203

Utility of up-front transoral robotic surgery in tailoring adjuvant therapy.

PubMed

Gildener-Leapman, Neil; Kim, Jeehong; Abberbock, Shira; Choby, Garret W; Mandal, Rajarsi; Duvvuri, Umamaheswar; Ferris, Robert L; Kim, Seungwon

2016-08-01

The purpose of this study was to describe how the up-front transoral robotic surgery (TORS) approach could be used to individually tailor adjuvant therapy based on surgical pathology. Between January 2009 and December 2013, 76 patients received TORS for oropharyngeal squamous cell carcinoma (OPSCC). Clinical predictors of adjuvant therapy were analyzed and comparisons were made between recommended treatment guidelines for up-front surgery versus definitive nonsurgical approaches. Advanced N classification, human papillomavirus (HPV)-positive tumor, extracapsular spread (ECS; 26 of 76), perineural invasion (PNI; 14 of 76), and positive margins (7 of 76) were significant predictors of adjuvant chemoradiotherapy (CRT) (p < .05). Up-front TORS deintensified adjuvant therapy; 76% of stage I/II and 46% of stage III/IV patients avoided CRT. Conversely, pathologic staging resulted in 33% of patients who would have received radiotherapy (RT) alone based on clinical staging, to be intensified to receive adjuvant CRT. The TORS approach deintensifies adjuvant therapy and provides valuable pathologic information to intensify treatment in select patients. TORS may be less effective in deintensification of adjuvant therapy in patients with clinically advanced N classification disease. © 2016 Wiley Periodicals, Inc. Head Neck 38:1201-1207, 2016. © 2016 Wiley Periodicals, Inc.

Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE3 Gene Fusion: A Rare Case Report with Review of the Literature.

PubMed

Ahluwalia, Puneet; Nair, Balagopal; Kumar, Ginil

2013-01-01

Introduction. The recently recognized renal cell carcinomas associated with Xp11.2 translocations are rare tumors predominantly reported in children. Chromosome Xp11.2 translocation results in gene fusion related to transcription factor E3 (TFE3) that plays an important role in proliferation and survival. Case Report. Herein, we present two cases of a TFE3 translocation-associated RCC in young female adults, one detected incidentally and the other one presenting with gross hematuria. Tumor is characterized by immunohistochemistry and a literature review with optimal treatment regimen is presented. Discussion. Xp11.2 translocation RCCs in adult patients are associated with advanced stages, large tumors, and extracapsular disease and usually have an aggressive clinical course. Conclusion. In TFE3 RCC, the genetic background may not only contribute to tumorigenesis, but also determine the response to chemotherapy and targeted therapy. Therefore it is necessary to diagnose this tumor entity accurately. Because of the small number of TFE3 gene fusion-related renal tumors described in the literature, the exact biologic behavior and impact of current treatment modalities remain to be uncertain.

Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE3 Gene Fusion: A Rare Case Report with Review of the Literature

PubMed Central

Ahluwalia, Puneet; Nair, Balagopal; Kumar, Ginil

2013-01-01

Introduction. The recently recognized renal cell carcinomas associated with Xp11.2 translocations are rare tumors predominantly reported in children. Chromosome Xp11.2 translocation results in gene fusion related to transcription factor E3 (TFE3) that plays an important role in proliferation and survival. Case Report. Herein, we present two cases of a TFE3 translocation-associated RCC in young female adults, one detected incidentally and the other one presenting with gross hematuria. Tumor is characterized by immunohistochemistry and a literature review with optimal treatment regimen is presented. Discussion. Xp11.2 translocation RCCs in adult patients are associated with advanced stages, large tumors, and extracapsular disease and usually have an aggressive clinical course. Conclusion. In TFE3 RCC, the genetic background may not only contribute to tumorigenesis, but also determine the response to chemotherapy and targeted therapy. Therefore it is necessary to diagnose this tumor entity accurately. Because of the small number of TFE3 gene fusion-related renal tumors described in the literature, the exact biologic behavior and impact of current treatment modalities remain to be uncertain. PMID:24455396

A randomised comparison of AMBI, TGN and PFN for treatment of unstable trochanteric fractures.

PubMed

Papasimos, S; Koutsojannis, C M; Panagopoulos, A; Megas, P; Lambiris, E

2005-09-01

In this study, we initiated a prospective, randomised, clinical trial comparing the AMBI, TGN and PFN operations used for treatment of unstable fractures, for differences in intra-operative use, consolidation, complications and functional outcome. We have compared the pre-, intra- and post-operating variables of AMBI, TGN and PFN operations that were used for treatment of unstable trochanteric fractures, of 120 patients all above 60 years old diagnosed with extracapsular hip fractures classified as AO Type 31-A2 or Type 31-A3. According to our results the three methods are comparable in the treatment of unstable trochanteric fractures of patients above 60 years old. The AMBI remains the gold standard for the fractures of trochanteric region. TGN has an easier and faster procedure, facilitates early weight bearing and had minor late complications. An improper use of the PFN system was the reason for the most complications and the longer operation time of the device. PFN is also an accepted minimally invasive implant for unstable proximal femoral fractures but future modification of the implant to avoid Z-effect phenomenon, careful surgical technique and selection of the patients should reduce its high complication rate.

Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India.

PubMed

Jeevarajan, Sakthiushadevi; Duraipandian, Amudhan; Kottayasamy Seenivasagam, Rajkumar; Shanmugam, Subbiah; Ramamurthy, Rajaraman

2017-01-01

Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5%) developed recurrence (systemic = 1, regional = 4, and local = 3). The estimated 5-year disease-free survival (DFS) was 65.4% and the overall survival (OS) was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS) significantly affected both DFS and OS. The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence.

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

PubMed Central

Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

2012-01-01

The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture. PMID:22872830

[Economic assessment of the routine use of Oncotype DX® assay for early breast cancer in Franche-Comte region].

PubMed

Nerich, Virginie; Curtit, Elsa; Bazan, Fernando; Montcuquet, Philippe; Villanueva, Cristian; Chaigneau, Loïc; Cals, Laurent; Méneveau, Nathalie; Dobi, Erion; Altmotlak, Hamadi; Algros, Marie-Paule; Choulot, Marie-Jeanne; Nallet, Gilles; Limat, Samuel; Mansion, Sylvie; Pivot, Xavier

2014-01-01

Oncotype DX® has been validated as quantifying the likelihood of distant recurrence at 10 years and overall chemotherapy benefit in patients with estrogen-receptor-positive and HER-2-negative early breast cancer. In 2012, this genomic signature was routinely available for patients in Franche-Comté, France. Patients eligible for Oncotype DX(®) testing had a ER-positive, HER-2-négative early breast cancer with a nodal involvement limited to 0 or 1 positive-node without extracapsular spread; an adjuvant chemotherapy was indicated based on usual prognostic factors. The aim was to assess the economic impact of Oncotype DX(®) testing in a French region. A cost-minimisation analysis from the French Public Healthcare System perspective was performed. The availability of Oncotype DX(®) in Franche-Comté, France, and its use in clinical routine allowed a decrease of 73 % of adjuvant chemotherapy without increase of the cost of the patients' management and with a potential reduction of the cost for the French Public Healthcare System. This strategy was successful and may allow the reimbursement of this test in France for patients with early breast cancer.

Reliable prediction intervals with regression neural networks.

PubMed

Papadopoulos, Harris; Haralambous, Haris

2011-10-01

This paper proposes an extension to conventional regression neural networks (NNs) for replacing the point predictions they produce with prediction intervals that satisfy a required level of confidence. Our approach follows a novel machine learning framework, called Conformal Prediction (CP), for assigning reliable confidence measures to predictions without assuming anything more than that the data are independent and identically distributed (i.i.d.). We evaluate the proposed method on four benchmark datasets and on the problem of predicting Total Electron Content (TEC), which is an important parameter in trans-ionospheric links; for the latter we use a dataset of more than 60000 TEC measurements collected over a period of 11 years. Our experimental results show that the prediction intervals produced by our method are both well calibrated and tight enough to be useful in practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

Space vehicle acoustics prediction improvement for payloads. [space shuttle

NASA Technical Reports Server (NTRS)

Dandridge, R. E.

1979-01-01

The modal analysis method was extensively modified for the prediction of space vehicle noise reduction in the shuttle payload enclosure, and this program was adapted to the IBM 360 computer. The predicted noise reduction levels for two test cases were compared with experimental results to determine the validity of the analytical model for predicting space vehicle payload noise environments in the 10 Hz one-third octave band regime. The prediction approach for the two test cases generally gave reasonable magnitudes and trends when compared with the measured noise reduction spectra. The discrepancies in the predictions could be corrected primarily by improved modeling of the vehicle structural walls and of the enclosed acoustic space to obtain a more accurate assessment of normal modes. Techniques for improving and expandng the noise prediction for a payload environment are also suggested.

Community detection in complex networks using link prediction

NASA Astrophysics Data System (ADS)

Cheng, Hui-Min; Ning, Yi-Zi; Yin, Zhao; Yan, Chao; Liu, Xin; Zhang, Zhong-Yuan

2018-01-01

Community detection and link prediction are both of great significance in network analysis, which provide very valuable insights into topological structures of the network from different perspectives. In this paper, we propose a novel community detection algorithm with inclusion of link prediction, motivated by the question whether link prediction can be devoted to improving the accuracy of community partition. For link prediction, we propose two novel indices to compute the similarity between each pair of nodes, one of which aims to add missing links, and the other tries to remove spurious edges. Extensive experiments are conducted on benchmark data sets, and the results of our proposed algorithm are compared with two classes of baselines. In conclusion, our proposed algorithm is competitive, revealing that link prediction does improve the precision of community detection.

Earthquake prediction with electromagnetic phenomena

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

Hayakawa, Masashi, E-mail: hayakawa@hi-seismo-em.jp; Advanced Wireless & Communications Research Center, UEC, Chofu Tokyo; Earthquake Analysis Laboratory, Information Systems Inc., 4-8-15, Minami-aoyama, Minato-ku, Tokyo, 107-0062

Short-term earthquake (EQ) prediction is defined as prospective prediction with the time scale of about one week, which is considered to be one of the most important and urgent topics for the human beings. If this short-term prediction is realized, casualty will be drastically reduced. Unlike the conventional seismic measurement, we proposed the use of electromagnetic phenomena as precursors to EQs in the prediction, and an extensive amount of progress has been achieved in the field of seismo-electromagnetics during the last two decades. This paper deals with the review on this short-term EQ prediction, including the impossibility myth of EQsmore » prediction by seismometers, the reason why we are interested in electromagnetics, the history of seismo-electromagnetics, the ionospheric perturbation as the most promising candidate of EQ prediction, then the future of EQ predictology from two standpoints of a practical science and a pure science, and finally a brief summary.« less

Dissociating motivational direction and affective valence: specific emotions alter central motor processes.

PubMed

Coombes, Stephen A; Cauraugh, James H; Janelle, Christopher M

2007-11-01

We aimed to clarify the relation between affective valence and motivational direction by specifying how central and peripheral components of extension movements are altered according to specific unpleasant affective states. As predicted, premotor reaction time was quicker for extension movements initiated during exposure to attack than for extension movements initiated during exposure to all other valence categories (mutilation, erotic couples, opposite-sex nudes, neutral humans, household objects, blank). Exposure to erotic couples and mutilations yielded greater peak force than exposure to images of attack, neutral humans, and household objects. Finally, motor reaction time and peak electromyographic amplitude were not altered by valence. These findings indicate that unpleasant states do not unilaterally prime withdrawal movements, and that the quick execution of extension movements during exposure to threatening images is due to rapid premotor, rather than motor, reaction time. Collectively, our findings support the call for dissociating motivational direction and affective valence.

A review of machine learning methods to predict the solubility of overexpressed recombinant proteins in Escherichia coli.

PubMed

Habibi, Narjeskhatoon; Mohd Hashim, Siti Z; Norouzi, Alireza; Samian, Mohammed Razip

2014-05-08

Over the last 20 years in biotechnology, the production of recombinant proteins has been a crucial bioprocess in both biopharmaceutical and research arena in terms of human health, scientific impact and economic volume. Although logical strategies of genetic engineering have been established, protein overexpression is still an art. In particular, heterologous expression is often hindered by low level of production and frequent fail due to opaque reasons. The problem is accentuated because there is no generic solution available to enhance heterologous overexpression. For a given protein, the extent of its solubility can indicate the quality of its function. Over 30% of synthesized proteins are not soluble. In certain experimental circumstances, including temperature, expression host, etc., protein solubility is a feature eventually defined by its sequence. Until now, numerous methods based on machine learning are proposed to predict the solubility of protein merely from its amino acid sequence. In spite of the 20 years of research on the matter, no comprehensive review is available on the published methods. This paper presents an extensive review of the existing models to predict protein solubility in Escherichia coli recombinant protein overexpression system. The models are investigated and compared regarding the datasets used, features, feature selection methods, machine learning techniques and accuracy of prediction. A discussion on the models is provided at the end. This study aims to investigate extensively the machine learning based methods to predict recombinant protein solubility, so as to offer a general as well as a detailed understanding for researches in the field. Some of the models present acceptable prediction performances and convenient user interfaces. These models can be considered as valuable tools to predict recombinant protein overexpression results before performing real laboratory experiments, thus saving labour, time and cost.

The transition from diffuse to focused extension: Modeled evolution of the West Antarctic Rift system

NASA Astrophysics Data System (ADS)

Huerta, Audrey D.; Harry, Dennis L.

2007-03-01

Two distinct stages of extension are recognized in the West Antarctic Rift system (WARS). During the first stage, beginning in the Late Cretaceous, extension was broadly distributed throughout much of West Antarctica. A second stage of extension in the late Paleogene was focused primarily in the Victoria Land Basin, near the boundary with the East Antarctic craton. The transition to focused extension was roughly coeval with volcanic activity and strike-slip faulting in the adjacent Transantarctic Mountains. This spatial and temporal correspondence suggests that the transition in extensional style could be the result of a change in plate motions or impingement of a plume. Here we use finite element models to study the processes and conditions responsible for the two-stage evolution of rifting in the WARS. Model results indicate that the transition from a prolonged period of broadly distributed extension to a later period of focused rifting did not require a change in the regional stress regime (changes in plate motion), or deep mantle thermal state (impingement of a plume). Instead, we attribute the transition from diffuse to focused extension to an early stage dominated by the initially weak accreted lithosphere of West Antarctica, and a later stage that concentrated around a secondary weakness located at the boundary between the juvenile West Antarctica lithosphere and Precambrian East Antarctic craton. The modeled transition in extension from the initially weak West Antarctica region to the secondary weakness at the West Antarctic-East Antarctic boundary is precipitated by strengthening of the West Antarctica lithosphere during syn-extensional thinning and cooling. The modeled syn-extensional strengthening of the WARS lithosphere promotes a wide-rift mode of extension between 105 and ˜ 65 Ma. By ˜ 65 Ma most of the extending WARS region becomes stronger than the area immediately adjacent to the East Antarctic craton and extension becomes concentrated near the East Antarctic/West Antarctic boundary, forming the Victoria Land Basin region. Mantle necking in this region leads to syn-extensional weakening that promotes a narrow-rift mode of extension that becomes progressively more focused with time, resulting in formation of the Terror Rift in the western Victoria Land Basin. The geodynamic models demonstrate that the transition from diffuse to focused extension occurs only under a limited set of initial and boundary conditions, and is particularly sensitive to the pre-rift thermal state of the crust and upper mantle. Models that predict diffuse extension in West Antarctica followed by localization of rifting near the boundary between East and West Antarctica require upper mantle temperatures of 730 ± 50 °C and sufficient concentration of heat producing elements in the crust to account for ˜ 50% of the upper mantle temperature. Models with upper mantle temperatures < ca. 680 °C and/or less crustal heat production initially undergo diffuse extension in West Antarctica, and quickly develop a lithospheric neck at the model edge furthest from East Antarctica. Models with upper mantle temperatures > ca. 780 °C do not develop focused rifts, and predict indefinite diffuse extension in West Antarctica.

Predictors of Aggressive Inflammatory Bowel Disease

PubMed Central

Yarur, Andres J.; Strobel, Sebastian G.; Deshpande, Amar R.

2011-01-01

Inflammatory bowel disease comprises a group of conditions characterized by idiopathic inflammation of the gastrointestinal tract. The natural course of disease can range from an indolent course with prolonged periods of remission to aggressive, incapacitating disease. Predicting which patients are more susceptible to developing severe disease is important, especially when choosing therapeutic agents and treatment strategies. This paper reviews current evidence on the main demographic, clinical, endoscopic, histologic, serologic, and genetic markers that predict aggressive inflammatory bowel disease. In ulcerative colitis, we considered disease to be aggressive when patients had a high relapse rate, need for admission and/or surgery, development of colon cancer, or extraintestinal manifestations. We defined aggressive Crohn's disease as having a high relapse rate, development of penetrating disease, need for repeat surgery, or multiple admissions for flares. In Crohn's disease, involvement of the upper gastrointestinal tract and ileum, penetrating disease, early age at diagnosis, smoking, extensive ulceration of the mucosa, high titers of serum antibodies, and mutations of the NOD2 gene are markers of aggressive disease. In ulcerative colitis, patients with more extensive involvement of the colon (pancolitis) have more symptomatology and are at higher risk for needing a colectomy and developing colon cancer. Also, plasmocytic infiltration of the colonic mucosa and crypt atrophy predict treatment failure. As with diagnosis, no single method can predict disease aggressiveness. Multiple serologic and genetic tests are being developed to refine the accuracy of prediction. Endoscopic findings can also predict the future course of disease. At present, clinical manifestations are the most useful way to make therapeutic decisions. PMID:22298958

Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer: an NRG Oncology/Gynecologic Oncology Group ancillary data study.

PubMed

Hamilton, C A; Miller, A; Casablanca, Y; Horowitz, N S; Rungruang, B; Krivak, T C; Richard, S D; Rodriguez, N; Birrer, M J; Backes, F J; Geller, M A; Quinn, M; Goodheart, M J; Mutch, D G; Kavanagh, J J; Maxwell, G L; Bookman, M A

2018-02-01

To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors. Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (>10years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC). The analysis dataset included 3010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p<0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC=0.729, which outperformed any of the individual predictors. The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors. Published by Elsevier Inc.

Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer: an NRG Oncology/Gynecologic Oncology Group ancillary data study

PubMed Central

Hamilton, C. A.; Miller, A.; Casablanca, Y.; Horowitz, N. S.; Rungruang, B.; Krivak, T. C.; Richard, S. D.; Rodriguez, N.; Birrer, M.J.; Backes, F.J.; Geller, M.A.; Quinn, M.; Goodheart, M.J.; Mutch, D.G.; Kavanagh, J.J.; Maxwell, G. L.; Bookman, M. A.

2018-01-01

Objective To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors. Methods Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (>10 years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC). Results The analysis dataset included 3,010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p<0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC=0.729, which outperformed any of the individual predictors. Conclusions The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors. PMID:29195926

The Role of Crustal Strength in Controlling Magmatism and Melt Chemistry During Rifting and Breakup

NASA Astrophysics Data System (ADS)

Armitage, John J.; Petersen, Kenni D.; Pérez-Gussinyé, Marta

2018-02-01

The strength of the crust has a strong impact on the evolution of continental extension and breakup. Strong crust may promote focused narrow rifting, while wide rifting might be due to a weaker crustal architecture. The strength of the crust also influences deeper processes within the asthenosphere. To quantitatively test the implications of crustal strength on the evolution of continental rift zones, we developed a 2-D numerical model of lithosphere extension that can predict the rare Earth element (REE) chemistry of erupted lava. We find that a difference in crustal strength leads to a different rate of depletion in light elements relative to heavy elements. By comparing the model predictions to rock samples from the Basin and Range, USA, we can demonstrate that slow extension of a weak continental crust can explain the observed depletion in melt chemistry. The same comparison for the Main Ethiopian Rift suggests that magmatism within this narrow rift zone can be explained by the localization of strain caused by a strong lower crust. We demonstrate that the slow extension of a strong lower crust above a mantle of potential temperature of 1,350 °C can fit the observed REE trends and the upper mantle seismic velocity for the Main Ethiopian Rift. The thermo-mechanical model implies that melt composition could provide quantitative information on the style of breakup and the initial strength of the continental crust.

The Relationship Between Maximum Isometric Strength and Ball Velocity in the Tennis Serve

PubMed Central

Corbi, Francisco; Fuentes, Juan Pedro; Fernández-Fernández, Jaime

2016-01-01

Abstract The aims of this study were to analyze the relationship between maximum isometric strength levels in different upper and lower limb joints and serve velocity in competitive tennis players as well as to develop a prediction model based on this information. Twelve male competitive tennis players (mean ± SD; age: 17.2 ± 1.0 years; body height: 180.1 ± 6.2 cm; body mass: 71.9 ± 5.6 kg) were tested using maximum isometric strength levels (i.e., wrist, elbow and shoulder flexion and extension; leg and back extension; shoulder external and internal rotation). Serve velocity was measured using a radar gun. Results showed a strong positive relationship between serve velocity and shoulder internal rotation (r = 0.67; p < 0.05). Low to moderate correlations were also found between serve velocity and wrist, elbow and shoulder flexion – extension, leg and back extension and shoulder external rotation (r = 0.36 – 0.53; p = 0.377 – 0.054). Bivariate and multivariate models for predicting serve velocity were developed, with shoulder flexion and internal rotation explaining 55% of the variance in serve velocity (r = 0.74; p < 0.001). The maximum isometric strength level in shoulder internal rotation was strongly related to serve velocity, and a large part of the variability in serve velocity was explained by the maximum isometric strength levels in shoulder internal rotation and shoulder flexion. PMID:28149411

Framework for multi-resolution analyses of advanced traffic management strategies [summary].

DOT National Transportation Integrated Search

2017-01-01

Transportation planning relies extensively on software that can simulate and predict travel behavior in response to alternative transportation networks. However, different software packages view traffic at different scales. Some programs are based on...

SPATIAL PREDICTION OF AIR QUALITY DATA

EPA Science Inventory

Site-specific air quality monitoring data have been used extensively in both scientific and regulatory programs. As such, these data provide essential information to the public, environmental managers, and the atmospheric research community. Currently, air quality management prac...

Orthology detection combining clustering and synteny for very large datasets.

PubMed

Lechner, Marcus; Hernandez-Rosales, Maribel; Doerr, Daniel; Wieseke, Nicolas; Thévenin, Annelyse; Stoye, Jens; Hartmann, Roland K; Prohaska, Sonja J; Stadler, Peter F

2014-01-01

The elucidation of orthology relationships is an important step both in gene function prediction as well as towards understanding patterns of sequence evolution. Orthology assignments are usually derived directly from sequence similarities for large data because more exact approaches exhibit too high computational costs. Here we present PoFF, an extension for the standalone tool Proteinortho, which enhances orthology detection by combining clustering, sequence similarity, and synteny. In the course of this work, FFAdj-MCS, a heuristic that assesses pairwise gene order using adjacencies (a similarity measure related to the breakpoint distance) was adapted to support multiple linear chromosomes and extended to detect duplicated regions. PoFF largely reduces the number of false positives and enables more fine-grained predictions than purely similarity-based approaches. The extension maintains the low memory requirements and the efficient concurrency options of its basis Proteinortho, making the software applicable to very large datasets.

Orthology Detection Combining Clustering and Synteny for Very Large Datasets

PubMed Central

Lechner, Marcus; Hernandez-Rosales, Maribel; Doerr, Daniel; Wieseke, Nicolas; Thévenin, Annelyse; Stoye, Jens; Hartmann, Roland K.; Prohaska, Sonja J.; Stadler, Peter F.

2014-01-01

The elucidation of orthology relationships is an important step both in gene function prediction as well as towards understanding patterns of sequence evolution. Orthology assignments are usually derived directly from sequence similarities for large data because more exact approaches exhibit too high computational costs. Here we present PoFF, an extension for the standalone tool Proteinortho, which enhances orthology detection by combining clustering, sequence similarity, and synteny. In the course of this work, FFAdj-MCS, a heuristic that assesses pairwise gene order using adjacencies (a similarity measure related to the breakpoint distance) was adapted to support multiple linear chromosomes and extended to detect duplicated regions. PoFF largely reduces the number of false positives and enables more fine-grained predictions than purely similarity-based approaches. The extension maintains the low memory requirements and the efficient concurrency options of its basis Proteinortho, making the software applicable to very large datasets. PMID:25137074

A role for midline and intralaminar thalamus in the associative blocking of Pavlovian fear conditioning.

PubMed

Sengupta, Auntora; McNally, Gavan P

2014-01-01

Fear learning occurs in response to positive prediction error, when the expected outcome of a conditioning trial exceeds that predicted by the conditioned stimuli present. This role for error in Pavlovian association formation is best exemplified by the phenomenon of associative blocking, whereby prior fear conditioning of conditioned stimulus (CS) A is able to prevent learning to CSB when they are conditioned in compound. The midline and intralaminar thalamic nuclei (MIT) are well-placed to contribute to fear prediction error because they receive extensive projections from the midbrain periaqueductal gray-which has a key role in fear prediction error-and project extensively to prefrontal cortex and amygdala. Here we used an associative blocking design to study the role of MIT in fear learning. In Stage I rats were trained to fear CSA via pairings with shock. In Stage II rats received compound fear conditioning of CSAB paired with shock. On test, rats that received Stage I training expressed less fear to CSB relative to control rats that did not receive this training. Microinjection of bupivacaine into MIT prior to Stage II training had no effect on the expression of fear during Stage II and had no effect on fear learning in controls, but prevented associative blocking and so enabled fear learning to CSB. These results show an important role for MIT in predictive fear learning and are discussed with reference to previous findings implicating the midline and posterior intralaminar thalamus in fear learning and fear responding.

A multibody knee model with discrete cartilage prediction of tibio-femoral contact mechanics.

PubMed

Guess, Trent M; Liu, Hongzeng; Bhashyam, Sampath; Thiagarajan, Ganesh

2013-01-01

Combining musculoskeletal simulations with anatomical joint models capable of predicting cartilage contact mechanics would provide a valuable tool for studying the relationships between muscle force and cartilage loading. As a step towards producing multibody musculoskeletal models that include representation of cartilage tissue mechanics, this research developed a subject-specific multibody knee model that represented the tibia plateau cartilage as discrete rigid bodies that interacted with the femur through deformable contacts. Parameters for the compliant contact law were derived using three methods: (1) simplified Hertzian contact theory, (2) simplified elastic foundation contact theory and (3) parameter optimisation from a finite element (FE) solution. The contact parameters and contact friction were evaluated during a simulated walk in a virtual dynamic knee simulator, and the resulting kinematics were compared with measured in vitro kinematics. The effects on predicted contact pressures and cartilage-bone interface shear forces during the simulated walk were also evaluated. The compliant contact stiffness parameters had a statistically significant effect on predicted contact pressures as well as all tibio-femoral motions except flexion-extension. The contact friction was not statistically significant to contact pressures, but was statistically significant to medial-lateral translation and all rotations except flexion-extension. The magnitude of kinematic differences between model formulations was relatively small, but contact pressure predictions were sensitive to model formulation. The developed multibody knee model was computationally efficient and had a computation time 283 times faster than a FE simulation using the same geometries and boundary conditions.

Cataract and its surgery in Fiji.

PubMed

Brian, Garry; Ramke, Jacqueline; Szetu, John; Qoqonokana, Mundi Qalo

2011-07-01

To characterize cataract and its surgery among adults aged ≥40 years in Fiji. Population-based cross-sectional survey using multistage cluster random sampling. 1381 (= 73.0% participation); eight provinces on Viti Levu. Interview-based questionnaire; visual acuity measured; autorefraction; dilated ocular examination. Prevalence; predictors; surgical outcomes. Being Indian (P = 0.001), elderly (P < 0.001), and previous/current smoker (P = 0.036) were predictive of at least one unoperated vision-impairing or operated cataract. Gender (P = 0.062) and diabetes (P = 0.384) were not. Unoperated cataract (predominantly nucleosclerosis) was the second most frequent (25.0%) cause of low vision (<6/18, ≥6/60) and commonest (71.1%) of blindness (<6/60). Ethnicity-gender-age-domicile adjusted and extrapolating to the Fiji population aged ≥40 years, prevalence of cataract-induced low vision and blindness were each 1.7% (95% confidence interval [CI] 1.0-2.4%). At least one eye of 4.6% and both of 1.8% participants had surgery (86.4% extracapsular). Gender (P = 0.213), age (P = 0.472) and rural/urban domicile (P = 0.895) were not predictors of surgery among those who required it in at least one eye. After intraocular lens surgery: 50.7% had pupillary posterior capsular opacification; mean spherical equivalent was -1.37 ± 1.95D (range, -6.38 to +2.25D); mean cylindrical error was 2.31 ± 1.75D (range, 0.0 to 8.75D); ≥N8 for 39.5%; ≥6/18 for 56.6%; <6/60 for 19.7%, with 2.6% no light perception. Ethnicity-gender-age-domicile adjusted and extrapolating to the Fiji population aged ≥40 years, Cataract Surgical Coverage (Person) was 47.5% (95%CI 29.2-65.8%) at <6/18, and 65.2% (95%CI 37.8-92.6%) at <6/60. Fiji cataract services and outcomes compare favourably with those of neighbouring Papua New Guinea and Timor Leste. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Short-Term Outcomes Following Hip Fractures in Patients at Least 100 Years Old.

PubMed

Manoli, Arthur; Driesman, Adam; Marwin, Rebecca A; Konda, Sanjit; Leucht, Philipp; Egol, Kenneth A

2017-07-05

The number of hip fractures is rising as life expectancy increases. As such, the number of centenarians sustaining these fractures is also increasing. The purpose of this study was to determine whether patients who are ≥100 years old and sustain a hip fracture fare worse in the hospital than those who are younger. Using a large database, the New York Statewide Planning and Research Cooperative System (SPARCS), we identified patients who were ≥65 years old and had been treated for a hip fracture over a 12-year period. Data on demographics, comorbidities, and treatment were collected. Three cohorts were established: patients who were 65 to 80 years old, 81 to 99 years old, and ≥100 years old (centenarians). Outcome measures included hospital length of stay, estimated total costs, and in-hospital mortality rates. A total of 168,087 patients with a hip fracture were identified, and 1,150 (0.7%) of them had sustained the fracture when they were ≥100 years old. Centenarians incurred costs and had lengths of stay that were similar to those of younger patients. Despite the similarities, centenarians were found to have a significantly higher in-hospital mortality rate than the younger populations (7.4% compared with 4.4% for those 81 to 99 years old and 2.6% for those 65 to 80 years old; p < 0.01). Male sex and an increasing number of medical comorbidities were found to predict in-hospital mortality for centenarians sustaining extracapsular hip fractures. No significant predictors of in-hospital mortality were identified for centenarians who sustained femoral neck fractures. An increased time to surgery did not influence the odds of in-hospital mortality. Centenarians had increased in-hospital mortality, but the remaining short-term outcomes were comparable with those for the younger cohorts with similar fracture patterns. For this extremely elderly population, time to surgery does not appear to affect short-term mortality rates, suggesting a potential benefit to preoperative optimization. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

An Investigation of Individual Variability in Brain Activity During Episodic Encoding and Retrieval

DTIC Science & Technology

2008-12-01

variability in mnemonic strategy use is, at least in part, related to the extensive variability observed in brain activity patterns. While a number of...1 AN INVESTIGATION OF INDIVIDUAL VARIABILITY IN BRAIN ACTIVITY DURING EPISODIC ENCODING AND RETRIEVAL C.L. Donovan*, and M.B. Miller Department of...strategy measures for predicting differences in brain activity patterns during a learning and memory task and to compare their predictive value to other

Health Education a Conceptual Approach. Growing and Developing, Interacting, Decision Making. Concept 2: Growing and Developing Follows a Predictable Sequence, Yet is Unique for Each Individual. Teacher-Student Resources.

ERIC Educational Resources Information Center

Creswell, William H., Jr.; And Others

The following resource guide is one in a series which presents extensive bibliographic material oriented around a specific concept, in this guide, the predictability and uniqueness of growing and developing. A section is devoted to selected materials related to the concept; grade levels for which each resource might be useful are indicated beside…

Annotation of Alternatively Spliced Proteins and Transcripts with Protein-Folding Algorithms and Isoform-Level Functional Networks.

PubMed

Li, Hongdong; Zhang, Yang; Guan, Yuanfang; Menon, Rajasree; Omenn, Gilbert S

2017-01-01

Tens of thousands of splice isoforms of proteins have been catalogued as predicted sequences from transcripts in humans and other species. Relatively few have been characterized biochemically or structurally. With the extensive development of protein bioinformatics, the characterization and modeling of isoform features, isoform functions, and isoform-level networks have advanced notably. Here we present applications of the I-TASSER family of algorithms for folding and functional predictions and the IsoFunc, MIsoMine, and Hisonet data resources for isoform-level analyses of network and pathway-based functional predictions and protein-protein interactions. Hopefully, predictions and insights from protein bioinformatics will stimulate many experimental validation studies.

Prediction Analysis for Measles Epidemics

NASA Astrophysics Data System (ADS)

Sumi, Ayako; Ohtomo, Norio; Tanaka, Yukio; Sawamura, Sadashi; Olsen, Lars Folke; Kobayashi, Nobumichi

2003-12-01

A newly devised procedure of prediction analysis, which is a linearized version of the nonlinear least squares method combined with the maximum entropy spectral analysis method, was proposed. This method was applied to time series data of measles case notification in several communities in the UK, USA and Denmark. The dominant spectral lines observed in each power spectral density (PSD) can be safely assigned as fundamental periods. The optimum least squares fitting (LSF) curve calculated using these fundamental periods can essentially reproduce the underlying variation of the measles data. An extension of the LSF curve can be used to predict measles case notification quantitatively. Some discussions including a predictability of chaotic time series are presented.

Analysis of the Mean Absolute Error (MAE) and the Root Mean Square Error (RMSE) in Assessing Rounding Model

NASA Astrophysics Data System (ADS)

Wang, Weijie; Lu, Yanmin

2018-03-01

Most existing Collaborative Filtering (CF) algorithms predict a rating as the preference of an active user toward a given item, which is always a decimal fraction. Meanwhile, the actual ratings in most data sets are integers. In this paper, we discuss and demonstrate why rounding can bring different influences to these two metrics; prove that rounding is necessary in post-processing of the predicted ratings, eliminate of model prediction bias, improving the accuracy of the prediction. In addition, we also propose two new rounding approaches based on the predicted rating probability distribution, which can be used to round the predicted rating to an optimal integer rating, and get better prediction accuracy compared to the Basic Rounding approach. Extensive experiments on different data sets validate the correctness of our analysis and the effectiveness of our proposed rounding approaches.

A generalized procedure for the prediction of multicomponent adsorption equilibria

DOE PAGES

Ladshaw, Austin; Yiacoumi, Sotira; Tsouris, Costas

2015-04-07

Prediction of multicomponent adsorption equilibria has been investigated for several decades. While there are theories available to predict the adsorption behavior of ideal mixtures, there are few purely predictive theories to account for nonidealities in real systems. Most models available for dealing with nonidealities contain interaction parameters that must be obtained through correlation with binary-mixture data. However, as the number of components in a system grows, the number of parameters needed to be obtained increases exponentially. Here, a generalized procedure is proposed, as an extension of the predictive real adsorbed solution theory, for determining the parameters of any activity model,more » for any number of components, without correlation. This procedure is then combined with the adsorbed solution theory to predict the adsorption behavior of mixtures. As this method can be applied to any isotherm model and any activity model, it is referred to as the generalized predictive adsorbed solution theory.« less

Do functional tests predict low back pain?

PubMed

Takala, E P; Viikari-Juntura, E

2000-08-15

A cohort of 307 nonsymptomatic workers and another cohort of 123 workers with previous episodes of low back pain were followed up for 2 years. The outcomes were measured by symptoms, medical consultations, and sick leaves due to low back disorders. To study the predictive value of a set of tests measuring the physical performance of the back in a working population. The hypothesis was that subjects with poor functional capacity are liable to back disorders. Reduced functional performance has been associated with back pain. There are few data to show whether reduced functional capacity is a cause or a consequence of pain. Mobility of the trunk in forward and side bending, maximal isokinetic trunk extension, flexion and lifting strength, and static endurance of back extension were measured. Standing balance and foot reaction time were recorded with a force plate. Clinical tests for the provocation of back or leg pain were performed. Gender, workload, age, and anthropometrics were managed as potential confounders in the analysis. Marked overlapping was seen in the measures of the subjects with different outcomes. Among the nonsymptomatic subjects, low performance in tests of mobility and standing balance was associated with future back disorders. Among workers with previous episodes of back pain, low isokinetic extension strength, poor standing balance, and positive clinical signs predicted future pain. Some associations were found between the functional tests and future low back pain. The wide variation in the results questions the value of the tests in health examinations (e.g., in screening or surveillance of low back disorders).

Estimation of distal arm joint angles from EMG and shoulder orientation for transhumeral prostheses.

PubMed

Akhtar, Aadeel; Aghasadeghi, Navid; Hargrove, Levi; Bretl, Timothy

2017-08-01

In this paper, we quantify the extent to which shoulder orientation, upper-arm electromyography (EMG), and forearm EMG are predictors of distal arm joint angles during reaching in eight subjects without disability as well as three subjects with a unilateral transhumeral amputation and targeted reinnervation. Prior studies have shown that shoulder orientation and upper-arm EMG, taken separately, are predictors of both elbow flexion/extension and forearm pronation/supination. We show that, for eight subjects without disability, shoulder orientation and upper-arm EMG together are a significantly better predictor of both elbow flexion/extension during unilateral (R 2 =0.72) and mirrored bilateral (R 2 =0.72) reaches and of forearm pronation/supination during unilateral (R 2 =0.77) and mirrored bilateral (R 2 =0.70) reaches. We also show that adding forearm EMG further improves the prediction of forearm pronation/supination during unilateral (R 2 =0.82) and mirrored bilateral (R 2 =0.75) reaches. In principle, these results provide the basis for choosing inputs for control of transhumeral prostheses, both by subjects with targeted motor reinnervation (when forearm EMG is available) and by subjects without target motor reinnervation (when forearm EMG is not available). In particular, we confirm that shoulder orientation and upper-arm EMG together best predict elbow flexion/extension (R 2 =0.72) for three subjects with unilateral transhumeral amputations and targeted motor reinnervation. However, shoulder orientation alone best predicts forearm pronation/supination (R 2 =0.88) for these subjects, a contradictory result that merits further study. Copyright © 2017 Elsevier Ltd. All rights reserved.

An improved reversible data hiding algorithm based on modification of prediction errors

NASA Astrophysics Data System (ADS)

Jafar, Iyad F.; Hiary, Sawsan A.; Darabkh, Khalid A.

2014-04-01

Reversible data hiding algorithms are concerned with the ability of hiding data and recovering the original digital image upon extraction. This issue is of interest in medical and military imaging applications. One particular class of such algorithms relies on the idea of histogram shifting of prediction errors. In this paper, we propose an improvement over one popular algorithm in this class. The improvement is achieved by employing a different predictor, the use of more bins in the prediction error histogram in addition to multilevel embedding. The proposed extension shows significant improvement over the original algorithm and its variations.

Game theory and reciprocity in some extensive form experimental games.

PubMed

McCabe, K A; Rassenti, S J; Smith, V L

1996-11-12

We examine decision making in two-person extensive form game trees using nine treatments that vary matching protocol, payoffs, and payoff information. Our objective is to establish replicable principles of cooperative versus noncooperative behavior that involve the use of signaling, reciprocity, and backward induction strategies, depending on the availability of dominated direct punishing strategies and the probability of repeated interaction with the same partner. Contrary to the predictions of game theory, we find substantial support for cooperation under complete information even in various single-play treatments.

Characterization and prediction of rate-dependent flexibility in lumbar spine biomechanics at room and body temperature.

PubMed

Stolworthy, Dean K; Zirbel, Shannon A; Howell, Larry L; Samuels, Marina; Bowden, Anton E

2014-05-01

The soft tissues of the spine exhibit sensitivity to strain-rate and temperature, yet current knowledge of spine biomechanics is derived from cadaveric testing conducted at room temperature at very slow, quasi-static rates. The primary objective of this study was to characterize the change in segmental flexibility of cadaveric lumbar spine segments with respect to multiple loading rates within the range of physiologic motion by using specimens at body or room temperature. The secondary objective was to develop a predictive model of spine flexibility across the voluntary range of loading rates. This in vitro study examines rate- and temperature-dependent viscoelasticity of the human lumbar cadaveric spine. Repeated flexibility tests were performed on 21 lumbar function spinal units (FSUs) in flexion-extension with the use of 11 distinct voluntary loading rates at body or room temperature. Furthermore, six lumbar FSUs were loaded in axial rotation, flexion-extension, and lateral bending at both body and room temperature via a stepwise, quasi-static loading protocol. All FSUs were also loaded using a control loading test with a continuous-speed loading-rate of 1-deg/sec. The viscoelastic torque-rotation response for each spinal segment was recorded. A predictive model was developed to accurately estimate spine segment flexibility at any voluntary loading rate based on measured flexibility at a single loading rate. Stepwise loading exhibited the greatest segmental range of motion (ROM) in all loading directions. As loading rate increased, segmental ROM decreased, whereas segmental stiffness and hysteresis both increased; however, the neutral zone remained constant. Continuous-speed tests showed that segmental stiffness and hysteresis are dependent variables to ROM at voluntary loading rates in flexion-extension. To predict the torque-rotation response at different loading rates, the model requires knowledge of the segmental flexibility at a single rate and specified temperature, and a scaling parameter. A Bland-Altman analysis showed high coefficients of determination for the predictive model. The present work demonstrates significant changes in spine segment flexibility as a result of loading rate and testing temperature. Loading rate effects can be accounted for using the predictive model, which accurately estimated ROM, neutral zone, stiffness, and hysteresis within the range of voluntary motion. Copyright © 2014 Elsevier Inc. All rights reserved.

A novel model for estimating organic chemical bioconcentration in agricultural plants

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

Hung, H.; Mackay, D.; Di Guardo, A.

1995-12-31

There is increasing recognition that much human and wildlife exposure to organic contaminants can be traced through the food chain to bioconcentration in vegetation. For risk assessment, there is a need for an accurate model to predict organic chemical concentrations in plants. Existing models range from relatively simple correlations of concentrations using octanol-water or octanol-air partition coefficients, to complex models involving extensive physiological data. To satisfy the need for a relatively accurate model of intermediate complexity, a novel approach has been devised to predict organic chemical concentrations in agricultural plants as a function of soil and air concentrations, without themore » need for extensive plant physiological data. The plant is treated as three compartments, namely, leaves, roots and stems (including fruit and seeds). Data readily available from the literature, including chemical properties, volume, density and composition of each compartment; metabolic and growth rate of plant; and readily obtainable environmental conditions at the site are required as input. Results calculated from the model are compared with observed and experimentally-determined concentrations. It is suggested that the model, which includes a physiological database for agricultural plants, gives acceptably accurate predictions of chemical partitioning between plants, air and soil.« less

Characterizing and modeling the free recovery and constrained recovery behavior of a polyurethane shape memory polymer

PubMed Central

Volk, Brent L; Lagoudas, Dimitris C; Maitland, Duncan J

2011-01-01

In this work, tensile tests and one-dimensional constitutive modeling are performed on a high recovery force polyurethane shape memory polymer that is being considered for biomedical applications. The tensile tests investigate the free recovery (zero load) response as well as the constrained displacement recovery (stress recovery) response at extension values up to 25%, and two consecutive cycles are performed during each test. The material is observed to recover 100% of the applied deformation when heated at zero load in the second thermomechanical cycle, and a stress recovery of 1.5 MPa to 4.2 MPa is observed for the constrained displacement recovery experiments. After performing the experiments, the Chen and Lagoudas model is used to simulate and predict the experimental results. The material properties used in the constitutive model – namely the coefficients of thermal expansion, shear moduli, and frozen volume fraction – are calibrated from a single 10% extension free recovery experiment. The model is then used to predict the material response for the remaining free recovery and constrained displacement recovery experiments. The model predictions match well with the experimental data. PMID:22003272

Ocean acidification affects coral growth by reducing skeletal density.

PubMed

Mollica, Nathaniel R; Guo, Weifu; Cohen, Anne L; Huang, Kuo-Fang; Foster, Gavin L; Donald, Hannah K; Solow, Andrew R

2018-02-20

Ocean acidification (OA) is considered an important threat to coral reef ecosystems, because it reduces the availability of carbonate ions that reef-building corals need to produce their skeletons. However, while theory predicts that coral calcification rates decline as carbonate ion concentrations decrease, this prediction is not consistently borne out in laboratory manipulation experiments or in studies of corals inhabiting naturally low-pH reefs today. The skeletal growth of corals consists of two distinct processes: extension (upward growth) and densification (lateral thickening). Here, we show that skeletal density is directly sensitive to changes in seawater carbonate ion concentration and thus, to OA, whereas extension is not. We present a numerical model of Porites skeletal growth that links skeletal density with the external seawater environment via its influence on the chemistry of coral calcifying fluid. We validate the model using existing coral skeletal datasets from six Porites species collected across five reef sites and use this framework to project the impact of 21st century OA on Porites skeletal density across the global tropics. Our model predicts that OA alone will drive up to 20.3 ± 5.4% decline in the skeletal density of reef-building Porites corals.

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

Narr, W.; Currie, J.B.

The occurrence of natural fracture systems in subsurface rock can be predicted if careful evaluation is made of the ecologic processes that affect sedimentary strata during their cycle of burial, diagenesis, uplift, and erosional unloading. Variations in the state of stress within rock arise, for example, from changes in temperature, pore pressure, weight of overburden, or tectonic loading. Hence geologic processes acting on a sedimentary unit should be analyzed for their several contributions to the state of stress, and this information used to compute a stress history. From this stress history, predictions may be made as to when in themore » burial cycle to expect fracture (joint) formation, what type of fractures (extension or shear) may occur, and which geologic factors are most favorable to development of fractures. A stress history is computed for strata of the naturally fractured Altamont oil field in Utah's Uinta basin. Calculations suggest that fractures formed in extension, that the well-cemented rocks are those most likely to be fractured, that fractures began to develop only after stata were uplifted and denuded of overburden. Geologic evidence on fracture genesis and development is in accord with the stress history prediction. Stress history can be useful in evaluating a sedimentary basin for naturally fractured reservoir exploration plays.« less

Blind Predictions of DNA and RNA Tweezers Experiments with Force and Torque

PubMed Central

Chou, Fang-Chieh; Lipfert, Jan; Das, Rhiju

2014-01-01

Single-molecule tweezers measurements of double-stranded nucleic acids (dsDNA and dsRNA) provide unprecedented opportunities to dissect how these fundamental molecules respond to forces and torques analogous to those applied by topoisomerases, viral capsids, and other biological partners. However, tweezers data are still most commonly interpreted post facto in the framework of simple analytical models. Testing falsifiable predictions of state-of-the-art nucleic acid models would be more illuminating but has not been performed. Here we describe a blind challenge in which numerical predictions of nucleic acid mechanical properties were compared to experimental data obtained recently for dsRNA under applied force and torque. The predictions were enabled by the HelixMC package, first presented in this paper. HelixMC advances crystallography-derived base-pair level models (BPLMs) to simulate kilobase-length dsDNAs and dsRNAs under external forces and torques, including their global linking numbers. These calculations recovered the experimental bending persistence length of dsRNA within the error of the simulations and accurately predicted that dsRNA's “spring-like” conformation would give a two-fold decrease of stretch modulus relative to dsDNA. Further blind predictions of helix torsional properties, however, exposed inaccuracies in current BPLM theory, including three-fold discrepancies in torsional persistence length at the high force limit and the incorrect sign of dsRNA link-extension (twist-stretch) coupling. Beyond these experiments, HelixMC predicted that ‘nucleosome-excluding’ poly(A)/poly(T) is at least two-fold stiffer than random-sequence dsDNA in bending, stretching, and torsional behaviors; Z-DNA to be at least three-fold stiffer than random-sequence dsDNA, with a near-zero link-extension coupling; and non-negligible effects from base pair step correlations. We propose that experimentally testing these predictions should be powerful next steps for understanding the flexibility of dsDNA and dsRNA in sequence contexts and under mechanical stresses relevant to their biology. PMID:25102226

Predictor - Predictive Reaction Design via Informatics, Computation and Theories of Reactivity

DTIC Science & Technology

2017-10-10

into more complex and valuable molecules, but are limited by: 1. The extensive time it takes to design and optimize a synthesis 2. Multi-step...system. As it is fully compatible to the industry standard SQL, designing a server- based system at a later time will be trivial. Producing a JAVA front...Report: PREDICTOR - Predictive REaction Design via Informatics, Computation and Theories of Reactivity The goal of this program was to create a cyber

Skin prick testing with extensively heated milk or egg products helps predict the outcome of an oral food challenge: a retrospective analysis.

PubMed

Faraj, Zein; Kim, Harold L

2012-07-11

Cow's milk and hen's egg are the most frequently encountered food allergens in the pediatric population. Skin prick testing (SPT) with commercial extracts followed by an oral food challenge (OFC) are routinely performed in the diagnostic investigation of these children. Recent evidence suggests that milk-allergic and/or egg-allergic individuals can often tolerate extensively heated (EH) forms of these foods. This study evaluated the predictive value of a negative SPT with EH milk or egg in determining whether a child would tolerate an OFC to the EH food product. Charts from a single allergy clinic were reviewed for any patient with a negative SPT to EH milk or egg, prepared in the form of a muffin. Data collected included age, sex, symptoms of food allergy, co-morbidities and the success of the OFC to the muffin. Fifty-eight patients had negative SPTs to the EH milk or egg in a muffin and underwent OFC to the appropriate EH food in the outpatient clinic. Fifty-five of these patients tolerated the OFC. The negative predictive value for the SPT with the EH food product was 94.8%. SPT with EH milk or egg products was predictive of a successful OFC to the same food. Larger prospective studies are required to substantiate these findings.

Predicting fatigue service life extension of RC bridges with externally bonded CFRP repairs : [project brief].

DOT National Transportation Integrated Search

2015-12-01

Externally bonded carbon fiber reinforced polymer composites (CFRPs) are increasingly used to : repair concrete bridges. CFRP design techniques are a proven approach for enhancing the strength : of existing structures. This project investigated the d...

Estimation and prediction of statewide Vehicle Miles Traveled (VMT) by highway category and vehicle classification.

DOT National Transportation Integrated Search

2016-02-01

Vehicle Miles Traveled (VMT) is a critical performance measure that is used extensively in highway transportation management for financial analysis, resource allocation, impact assessments, and reporting to oversight agencies. As highway revenue from...

Shear in high strength concrete bridge girders : technical report.

DOT National Transportation Integrated Search

2013-04-01

Prestressed Concrete (PC) I-girders are used extensively as the primary superstructure components in Texas highway bridges. : A simple semi-empirical equation was developed at the University of Houston (UH) to predict the shear strength of PC I-girde...

A network extension of species occupancy models in a patchy environment applied to the Yosemite toad (Anaxyrus canorus)

USGS Publications Warehouse

Berlow, Eric L.; Knapp, Roland A.; Ostoja, Steven M.; Williams, Richard J.; McKenny, Heather; Matchett, John R.; Guo, Qinghau; Fellers, Gary M.; Kleeman, Patrick; Brooks, Matthew L.; Joppa, Lucas

2013-01-01

A central challenge of conservation biology is using limited data to predict rare species occurrence and identify conservation areas that play a disproportionate role in regional persistence. Where species occupy discrete patches in a landscape, such predictions require data about environmental quality of individual patches and the connectivity among high quality patches. We present a novel extension to species occupancy modeling that blends traditionalpredictions of individual patch environmental quality with network analysis to estimate connectivity characteristics using limited survey data. We demonstrate this approach using environmental and geospatial attributes to predict observed occupancy patterns of the Yosemite toad (Anaxyrus (= Bufo) canorus) across >2,500 meadows in Yosemite National Park (USA). A. canorus, a Federal Proposed Species, breeds in shallow water associated with meadows. Our generalized linear model (GLM) accurately predicted ~84% of true presence-absence data on a subset of data withheld for testing. The predicted environmental quality of each meadow was iteratively ‘boosted’ by the quality of neighbors within dispersal distance. We used this park-wide meadow connectivity network to estimate the relative influence of an individual Meadow’s ‘environmental quality’ versus its ‘network quality’ to predict: a) clusters of high quality breeding meadows potentially linked by dispersal, b) breeding meadows with high environmental quality that are isolated from other such meadows, c) breeding meadows with lower environmental quality where long-term persistence may critically depend on the network neighborhood, and d) breeding meadows with the biggest impact on park-wide breeding patterns. Combined with targeted data on dispersal, genetics, disease, and other potential stressors, these results can guide designation of core conservation areas for A. canorus in Yosemite National Park.

Preclinical models used for immunogenicity prediction of therapeutic proteins.

PubMed

Brinks, Vera; Weinbuch, Daniel; Baker, Matthew; Dean, Yann; Stas, Philippe; Kostense, Stefan; Rup, Bonita; Jiskoot, Wim

2013-07-01

All therapeutic proteins are potentially immunogenic. Antibodies formed against these drugs can decrease efficacy, leading to drastically increased therapeutic costs and in rare cases to serious and sometimes life threatening side-effects. Many efforts are therefore undertaken to develop therapeutic proteins with minimal immunogenicity. For this, immunogenicity prediction of candidate drugs during early drug development is essential. Several in silico, in vitro and in vivo models are used to predict immunogenicity of drug leads, to modify potentially immunogenic properties and to continue development of drug candidates with expected low immunogenicity. Despite the extensive use of these predictive models, their actual predictive value varies. Important reasons for this uncertainty are the limited/insufficient knowledge on the immune mechanisms underlying immunogenicity of therapeutic proteins, the fact that different predictive models explore different components of the immune system and the lack of an integrated clinical validation. In this review, we discuss the predictive models in use, summarize aspects of immunogenicity that these models predict and explore the merits and the limitations of each of the models.

Complete Placenta Previa: Ultrasound Biometry and Surgical Outcomes

PubMed Central

Wortman, Alison C.; Schaefer, Stephanie L.; McIntire, Donald D.; Sheffield, Jeanne S.; Twickler, Diane M.

2018-01-01

Objective  To evaluate the relationship between surgical outcomes and ultrasound measurement of placental extension beyond the cervical os in women with placenta previa. Study Design  This is a retrospective cohort study of singleton pregnancies with placenta previa undergoing third-trimester ultrasound and delivering at our institution from 2002 through 2011. For study purposes, an investigator measured placental extension, defined as the placental distance from the internal os across the placenta continuing out to the lowest placental edge. If morbidly adherent placentation was suspected, women were excluded. Receiver operating characteristic (ROC) curves were developed for pertinent surgical outcomes, and multivariate analysis was performed to determine the placental extension with the best predictive discriminatory zone. Results  In total, 157 women had placenta previa, ultrasound, and delivery data: 86 (55%) had a placental extension of <40 mm, and 71 (45%) had a placental extension of ≥40 mm. Women with placental extension of ≥40 mm had increased surgical time, blood loss > 2,000 mL, blood transfusion, and rate of peripartum hysterectomy. After multivariate analysis, only peripartum hysterectomy and surgical time > 90 minutes remained significant, p ≤ 0.05 and p ≤ 0.01, respectively. Conclusion  In women with placenta previa, the placental extension ultrasound measurement of ≥40 mm is a predictor of adverse surgical outcomes. PMID:29686936

Complete Placenta Previa: Ultrasound Biometry and Surgical Outcomes.

PubMed

Wortman, Alison C; Schaefer, Stephanie L; McIntire, Donald D; Sheffield, Jeanne S; Twickler, Diane M

2018-04-01

Objective  To evaluate the relationship between surgical outcomes and ultrasound measurement of placental extension beyond the cervical os in women with placenta previa. Study Design  This is a retrospective cohort study of singleton pregnancies with placenta previa undergoing third-trimester ultrasound and delivering at our institution from 2002 through 2011. For study purposes, an investigator measured placental extension, defined as the placental distance from the internal os across the placenta continuing out to the lowest placental edge. If morbidly adherent placentation was suspected, women were excluded. Receiver operating characteristic (ROC) curves were developed for pertinent surgical outcomes, and multivariate analysis was performed to determine the placental extension with the best predictive discriminatory zone. Results  In total, 157 women had placenta previa, ultrasound, and delivery data: 86 (55%) had a placental extension of <40 mm, and 71 (45%) had a placental extension of ≥40 mm. Women with placental extension of ≥40 mm had increased surgical time, blood loss > 2,000 mL, blood transfusion, and rate of peripartum hysterectomy. After multivariate analysis, only peripartum hysterectomy and surgical time > 90 minutes remained significant, p ≤ 0.05 and p ≤ 0.01, respectively. Conclusion  In women with placenta previa, the placental extension ultrasound measurement of ≥40 mm is a predictor of adverse surgical outcomes.

Skillful prediction of northern climate provided by the ocean

NASA Astrophysics Data System (ADS)

Årthun, Marius; Eldevik, Tor; Viste, Ellen; Drange, Helge; Furevik, Tore; Johnson, Helen L.; Keenlyside, Noel S.

2017-06-01

It is commonly understood that a potential for skillful climate prediction resides in the ocean. It nevertheless remains unresolved to what extent variable ocean heat is imprinted on the atmosphere to realize its predictive potential over land. Here we assess from observations whether anomalous heat in the Gulf Stream's northern extension provides predictability of northwestern European and Arctic climate. We show that variations in ocean temperature in the high latitude North Atlantic and Nordic Seas are reflected in the climate of northwestern Europe and in winter Arctic sea ice extent. Statistical regression models show that a significant part of northern climate variability thus can be skillfully predicted up to a decade in advance based on the state of the ocean. Particularly, we predict that Norwegian air temperature will decrease over the coming years, although staying above the long-term (1981-2010) average. Winter Arctic sea ice extent will remain low but with a general increase towards 2020.

Analysis of view synthesis prediction architectures in modern coding standards

NASA Astrophysics Data System (ADS)

Tian, Dong; Zou, Feng; Lee, Chris; Vetro, Anthony; Sun, Huifang

2013-09-01

Depth-based 3D formats are currently being developed as extensions to both AVC and HEVC standards. The availability of depth information facilitates the generation of intermediate views for advanced 3D applications and displays, and also enables more efficient coding of the multiview input data through view synthesis prediction techniques. This paper outlines several approaches that have been explored to realize view synthesis prediction in modern video coding standards such as AVC and HEVC. The benefits and drawbacks of various architectures are analyzed in terms of performance, complexity, and other design considerations. It is hence concluded that block-based VSP prediction for multiview video signals provides attractive coding gains with comparable complexity as traditional motion/disparity compensation.

Streamflow record extension using power transformations and application to sediment transport

NASA Astrophysics Data System (ADS)

Moog, Douglas B.; Whiting, Peter J.; Thomas, Robert B.

1999-01-01

To obtain a representative set of flow rates for a stream, it is often desirable to fill in missing data or extend measurements to a longer time period by correlation to a nearby gage with a longer record. Linear least squares regression of the logarithms of the flows is a traditional and still common technique. However, its purpose is to generate optimal estimates of each day's discharge, rather than the population of discharges, for which it tends to underestimate variance. Maintenance-of-variance-extension (MOVE) equations [Hirsch, 1982] were developed to correct this bias. This study replaces the logarithmic transformation by the more general Box-Cox scaled power transformation, generating a more linear, constant-variance relationship for the MOVE extension. Combining the Box-Cox transformation with the MOVE extension is shown to improve accuracy in estimating order statistics of flow rate, particularly for the nonextreme discharges which generally govern cumulative transport over time. This advantage is illustrated by prediction of cumulative fractions of total bed load transport.

Extension of nanoconfined DNA: Quantitative comparison between experiment and theory

NASA Astrophysics Data System (ADS)

Iarko, V.; Werner, E.; Nyberg, L. K.; Müller, V.; Fritzsche, J.; Ambjörnsson, T.; Beech, J. P.; Tegenfeldt, J. O.; Mehlig, K.; Westerlund, F.; Mehlig, B.

2015-12-01

The extension of DNA confined to nanochannels has been studied intensively and in detail. However, quantitative comparisons between experiments and model calculations are difficult because most theoretical predictions involve undetermined prefactors, and because the model parameters (contour length, Kuhn length, effective width) are difficult to compute reliably, leading to substantial uncertainties. Here we use a recent asymptotically exact theory for the DNA extension in the "extended de Gennes regime" that allows us to compare experimental results with theory. For this purpose, we performed experiments measuring the mean DNA extension and its standard deviation while varying the channel geometry, dye intercalation ratio, and ionic strength of the buffer. The experimental results agree very well with theory at high ionic strengths, indicating that the model parameters are reliable. At low ionic strengths, the agreement is less good. We discuss possible reasons. In principle, our approach allows us to measure the Kuhn length and the effective width of a single DNA molecule and more generally of semiflexible polymers in solution.

On the importance of incorporating sampling weights in occupancy model estimation

EPA Science Inventory

Occupancy models are used extensively to assess wildlife-habitat associations and to predict species distributions across large geographic regions. Occupancy models were developed as a tool to properly account for imperfect detection of a species. Current guidelines on survey des...

Real-time Java for flight applications: an update

NASA Technical Reports Server (NTRS)

Dvorak, D.

2003-01-01

The RTSJ is a specification for supporting real-time execution in the Java programming language. The specification has been shaped by several guiding principles, particularly: predictable execution as the first priority in all tradeoffs, no syntactic extensions to Java, and backward compatibility.

UTILIZATION OF TREATABILITY AND PILOT TESTS TO PREDICT CAH BIOREMEDIATION

EPA Science Inventory

Multiple tools have been suggested to help in the design of enhanced anaerobic bioremediation systems for CAHs:
- Extensive high quality microcosm testing followed by small-scale, thoroughly observed field pilot tests (i.e., RABITT Protocol, Morse 1998)
- More limited ...

Revolution In Toxicity Testing And Risk Prediction For Chemicals In The Environment (ASA)

EPA Science Inventory

Addressing safety aspects of drugs and environmental chemicals relies extensively on animal testing; however, the quantity of chemicals needing assessment and challenges of species extrapolation require alternative approaches to traditional animal studies. Newer in vitro and in s...

FILTRATION MODEL FOR COAL FLY ASH WITH GLASS FABRICS

EPA Science Inventory

The report describes a new mathematical model for predicting woven glass filter performance with coal fly ash aerosols from utility boilers. Its data base included: an extensive bench- and pilot-scale laboratory investigation of several dust/fabric combinations; field data from t...

Shallow Water Acoustics Studies

DTIC Science & Technology

2015-09-30

and 2) a demonstration that the predictive probability of detection ( PPD ) formalism of Dyer and Abbot works well, using QPE field data. The...applications, and 3) showing that the PPD formalism for detection could be a useful extension of the usual sonar equation ROC curves. TRANSITIONS

Balancing sub- and supra-salt strain in salt-influenced rifts: Implications for extension estimates

NASA Astrophysics Data System (ADS)

Coleman, Alexander J.; Jackson, Christopher A.-L.; Duffy, Oliver B.

2017-09-01

The structural style of salt-influenced rifts may differ from those formed in predominantly brittle crust. Salt can decouple sub- and supra-salt strain, causing sub-salt faults to be geometrically decoupled from, but kinematically coupled to and responsible for, supra-salt forced folding. Salt-influenced rifts thus contain more folds than their brittle counterparts, an observation often ignored in extension estimates. Fundamental to determining whether sub- and supra-salt structures are kinematically coherent, and the relative contributions of thin- (i.e. gravity-driven) and thick-skinned (i.e. whole-plate stretching) deformation to accommodating rift-related strain, is our ability to measure extension at both structural levels. We here use published physical models of salt-influenced extension to show that line-length estimates yield more accurate values of sub- and supra-salt extension compared to fault-heave, before applying these methods to seismic data from the Halten Terrace, offshore Norway. We show that, given the abundance of ductile deformation in salt-influenced rifts, significant amounts of extension may be ignored, leading to the erroneous interpretations of thin-skinned, gravity-gliding. If a system is kinematically coherent, supra-salt structures can help predict the occurrence and kinematics of sub-salt faults that may be poorly imaged and otherwise poorly constrained.

Hydrocode predictions of collisional outcomes: Effects of target size

NASA Technical Reports Server (NTRS)

Ryan, Eileen V.; Asphaug, Erik; Melosh, H. J.

1991-01-01

Traditionally, laboratory impact experiments, designed to simulate asteroid collisions, attempted to establish a predictive capability for collisional outcomes given a particular set of initial conditions. Unfortunately, laboratory experiments are restricted to using targets considerably smaller than the modelled objects. It is therefore necessary to develop some methodology for extrapolating the extensive experimental results to the size regime of interest. Results are reported obtained through the use of two dimensional hydrocode based on 2-D SALE and modified to include strength effects and the fragmentation equations. The hydrocode was tested by comparing its predictions for post-impact fragment size distributions to those observed in laboratory impact experiments.

Laser-Based Trespassing Prediction in Restrictive Environments: A Linear Approach

PubMed Central

Cheein, Fernando Auat; Scaglia, Gustavo

2012-01-01

Stationary range laser sensors for intruder monitoring, restricted space violation detections and workspace determination are extensively used in risky environments. In this work we present a linear based approach for predicting the presence of moving agents before they trespass a laser-based restricted space. Our approach is based on the Taylor's series expansion of the detected objects' movements. The latter makes our proposal suitable for embedded applications. In the experimental results (carried out in different scenarios) presented herein, our proposal shows 100% of effectiveness in predicting trespassing situations. Several implementation results and statistics analysis showing the performance of our proposal are included in this work.

A time-domain method for prediction of noise radiated from supersonic rotating sources in a moving medium

NASA Astrophysics Data System (ADS)

Huang, Zhongjie; Siozos-Rousoulis, Leonidas; De Troyer, Tim; Ghorbaniasl, Ghader

2018-02-01

This paper presents a time-domain method for noise prediction of supersonic rotating sources in a moving medium. The proposed approach can be interpreted as an extensive time-domain solution for the convected permeable Ffowcs Williams and Hawkings equation, which is capable of avoiding the Doppler singularity. The solution requires special treatment for construction of the emission surface. The derived formula can explicitly and efficiently account for subsonic uniform constant flow effects on radiated noise. Implementation of the methodology is realized through the Isom thickness noise case and high-speed impulsive noise prediction from helicopter rotors.

ConKit: a python interface to contact predictions.

PubMed

Simkovic, Felix; Thomas, Jens M H; Rigden, Daniel J

2017-07-15

Recent advances in protein residue contact prediction algorithms have led to the emergence of many new methods and a variety of file formats. We present ConKit , an open source, modular and extensible Python interface which allows facile conversion between formats and provides an interface to analyses of sequence alignments and sets of contact predictions. ConKit is available via the Python Package Index. The documentation can be found at http://www.conkit.org . ConKit is licensed under the BSD 3-Clause. hlfsimko@liverpool.ac.uk or drigden@liverpool.ac.uk. Supplementary data are available at Bioinformatics online. © The Author(s) 2017. Published by Oxford University Press.

Predicting multi-wall structural response to hypervelocity impact using the hull code

NASA Technical Reports Server (NTRS)

Schonberg, William P.

1993-01-01

Previously, multi-wall structures have been analyzed extensively, primarily through experiment, as a means of increasing the meteoroid/space debris impact protection of spacecraft. As structural configurations become more varied, the number of tests required to characterize their response increases dramatically. As an alternative to experimental testing, numerical modeling of high-speed impact phenomena is often being used to predict the response of a variety of structural systems under different impact loading conditions. The results of comparing experimental tests to Hull Hydrodynamic Computer Code predictions are reported. Also, the results of a numerical parametric study of multi-wall structural response to hypervelocity cylindrical projectile impact are presented.

Heat transfer prediction in a square porous medium using artificial neural network

NASA Astrophysics Data System (ADS)

Ahamad, N. Ameer; Athani, Abdulgaphur; Badruddin, Irfan Anjum

2018-05-01

Heat transfer in porous media has been investigated extensively because of its applications in various important fields. Neural network approach is applied to analyze steady two dimensional free convection flows through a porous medium fixed in a square cavity. The backpropagation neural network is trained and used to predict the heat transfer. The results are compared with available information in the literature. It is found that the heat transfer increases with increase in Rayleigh number. It is further found that the local Nusselt number decreases along the height of cavity. The neural network is found to predict the heat transfer behavior accurately for given parameters.

Models for the indices of thermal comfort

PubMed Central

Adrian, Streinu-Cercel; Sergiu, Costoiu; Maria, Mârza; Anca, Streinu-Cercel; Monica, Mârza

2008-01-01

The current paper propose the analysis and extension formulation required for establishing decision in the management of the medical national system from the point of view of quality and efficiency such as: conceiving models for the indices of thermal comfort, defining the predicted mean vote (on the thermal sensation scale) „PMV”, defining the metabolism „M”, heat transfer between the human body and the environment, defining the predicted percent of dissatisfied people „PPD”, defining all indices of thermal comfort. PMID:20108461

Measurement techniques and instruments suitable for life-prediction testing of photovoltaic arrays

NASA Technical Reports Server (NTRS)

Noel, G. T.; Sliemers, F. A.; Deringer, G. C.; Wood, V. E.; Wilkes, K. E.; Gaines, G. B.; Carmichael, D. C.

1978-01-01

Array failure modes, relevant materials property changes, and primary degradation mechanisms are discussed as a prerequisite to identifying suitable measurement techniques and instruments. Candidate techniques and instruments are identified on the basis of extensive reviews of published and unpublished information. These methods are organized in six measurement categories - chemical, electrical, optical, thermal, mechanical, and other physicals. Using specified evaluation criteria, the most promising techniques and instruments for use in life prediction tests of arrays were selected.

Recommendation Techniques for Drug-Target Interaction Prediction and Drug Repositioning.

PubMed

Alaimo, Salvatore; Giugno, Rosalba; Pulvirenti, Alfredo

2016-01-01

The usage of computational methods in drug discovery is a common practice. More recently, by exploiting the wealth of biological knowledge bases, a novel approach called drug repositioning has raised. Several computational methods are available, and these try to make a high-level integration of all the knowledge in order to discover unknown mechanisms. In this chapter, we review drug-target interaction prediction methods based on a recommendation system. We also give some extensions which go beyond the bipartite network case.

firestar--advances in the prediction of functionally important residues.

PubMed

Lopez, Gonzalo; Maietta, Paolo; Rodriguez, Jose Manuel; Valencia, Alfonso; Tress, Michael L

2011-07-01

firestar is a server for predicting catalytic and ligand-binding residues in protein sequences. Here, we present the important developments since the first release of firestar. Previous versions of the server required human interpretation of the results; the server is now fully automatized. firestar has been implemented as a web service and can now be run in high-throughput mode. Prediction coverage has been greatly improved with the extension of the FireDB database and the addition of alignments generated by HHsearch. Ligands in FireDB are now classified for biological relevance. Many of the changes have been motivated by the critical assessment of techniques for protein structure prediction (CASP) ligand-binding prediction experiment, which provided us with a framework to test the performance of firestar. URL: http://firedb.bioinfo.cnio.es/Php/FireStar.php.

A Practical Engineering Approach to Predicting Fatigue Crack Growth in Riveted Lap Joints

NASA Technical Reports Server (NTRS)

Harris, Charles E.; Piascik, Robert S.; Newman, James C., Jr.

1999-01-01

An extensive experimental database has been assembled from very detailed teardown examinations of fatigue cracks found in rivet holes of fuselage structural components. Based on this experimental database, a comprehensive analysis methodology was developed to predict the onset of widespread fatigue damage in lap joints of fuselage structure. Several computer codes were developed with specialized capabilities to conduct the various analyses that make up the comprehensive methodology. Over the past several years, the authors have interrogated various aspects of the analysis methods to determine the degree of computational rigor required to produce numerical predictions with acceptable engineering accuracy. This study led to the formulation of a practical engineering approach to predicting fatigue crack growth in riveted lap joints. This paper describes the practical engineering approach and compares predictions with the results from several experimental studies.

A Practical Engineering Approach to Predicting Fatigue Crack Growth in Riveted Lap Joints

NASA Technical Reports Server (NTRS)

Harris, C. E.; Piascik, R. S.; Newman, J. C., Jr.

2000-01-01

An extensive experimental database has been assembled from very detailed teardown examinations of fatigue cracks found in rivet holes of fuselage structural components. Based on this experimental database, a comprehensive analysis methodology was developed to predict the onset of widespread fatigue damage in lap joints of fuselage structure. Several computer codes were developed with specialized capabilities to conduct the various analyses that make up the comprehensive methodology. Over the past several years, the authors have interrogated various aspects of the analysis methods to determine the degree of computational rigor required to produce numerical predictions with acceptable engineering accuracy. This study led to the formulation of a practical engineering approach to predicting fatigue crack growth in riveted lap joints. This paper describes the practical engineering approach and compares predictions with the results from several experimental studies.

Predicting the process of extinction in experimental microcosms and accounting for interspecific interactions in single-species time series

PubMed Central

Ferguson, Jake M; Ponciano, José M

2014-01-01

Predicting population extinction risk is a fundamental application of ecological theory to the practice of conservation biology. Here, we compared the prediction performance of a wide array of stochastic, population dynamics models against direct observations of the extinction process from an extensive experimental data set. By varying a series of biological and statistical assumptions in the proposed models, we were able to identify the assumptions that affected predictions about population extinction. We also show how certain autocorrelation structures can emerge due to interspecific interactions, and that accounting for the stochastic effect of these interactions can improve predictions of the extinction process. We conclude that it is possible to account for the stochastic effects of community interactions on extinction when using single-species time series. PMID:24304946

firestar—advances in the prediction of functionally important residues

PubMed Central

Lopez, Gonzalo; Maietta, Paolo; Rodriguez, Jose Manuel; Valencia, Alfonso; Tress, Michael L.

2011-01-01

firestar is a server for predicting catalytic and ligand-binding residues in protein sequences. Here, we present the important developments since the first release of firestar. Previous versions of the server required human interpretation of the results; the server is now fully automatized. firestar has been implemented as a web service and can now be run in high-throughput mode. Prediction coverage has been greatly improved with the extension of the FireDB database and the addition of alignments generated by HHsearch. Ligands in FireDB are now classified for biological relevance. Many of the changes have been motivated by the critical assessment of techniques for protein structure prediction (CASP) ligand-binding prediction experiment, which provided us with a framework to test the performance of firestar. URL: http://firedb.bioinfo.cnio.es/Php/FireStar.php. PMID:21672959

Can Energy Cost During Low-Intensity Resistance Exercise be Predicted by the OMNI-RES Scale?

PubMed Central

Vianna, Jefferson M.; Reis, Victor M.; Saavedra, Francisco; Damasceno, Vinicius; Silva, Sérgio G.; Goss, Fredric

2011-01-01

The aim of the present study was to assess the precision of the OMNI-RES scale to predict energy cost (EC) at low intensity in four resistance exercises (RE). 17 male recreational body builders (age = 26.6 ± 4.9 years; height = 177.7 ± 0.1 cm; body weight = 79.0 ± 11.1 kg and percent body fat = 10.5 ± 4.6%) served as subjects. Initially tests to determine 1RM for four resistance exercises (bench press, half squat, lat pull down and triceps extension) were administered. Subjects also performed resistance exercise at 12, 16, 20, and 24% of 1RM at a rate of 40 bpm until volitional exhaustion. Oxygen uptake (VO2) and rate of perceived exertion (RPE) using the OMNI-RES were obtained during and after all RE. EC was calculated using VO2 and the caloric values of VO2 for non-protein RER. Regression analyses were performed for every RE, using EC as the dependent and RPE as the predictor variable. The triceps extension, lat pull down and bench press, RPE correlated strongly with EC (R > 0.97) and predicted EC with a error of less than 0.2 kcal.min−1. In conclusion, RPE using the OMNI-RES scale can be considered as an accurate indicator of EC in the bench press, lat pull down and triceps extension performed by recreational bodybuilders, provided lower intensities are used (up to 24% of 1-RM) and provided each set of exercise is performed for the maximal sustainable duration. It would be interesting in future studies to consider having the subjects exercise at low intensities for longer durations than those in the present study. PMID:23486188

Optimizing treatment for children and adolescents with papillary thyroid carcinoma in post-Chernobyl exposed region: The roles of lymph node dissections in the central and lateral neck compartments.

PubMed

Fridman, Mikhail; Krasko, Olga; Lam, Alfred King-Yin

2018-06-01

There is lack of data to predict lymph node metastases in pediatric thyroid cancer. The aims are to study (1) the factors affecting the lymph node metastases in children and adolescence with papillary thyroid carcinoma in region exposed to radiation and (2) to evaluate the predictive significance of these factors for lateral compartment lymphadenectomy. Five hundred and nine patients with papillary thyroid carcinoma underwent total thyroidectomy and lymph nodes resection (central and lateral compartments of the neck) surgery during the period of 1991-2010 in Belarus were recruited. The factors related to lymph node metastases were studied in these patients. In the patients with papillary thyroid carcinoma, increase number of cancer-positive lymph nodes in the central neck compartment were associated with a risk to develop lateral nodal disease as well as bilateral nodal disease. Futhermore, positive lateral compartment nodal metastases are associated with age and gender of the patients, tumour size, minimal extra-thyroidal extension, solid architectonic, extensive desmoplasia in carcinoma, presence of psammoma bodies, extensive involvement of the thyroid and metastatic ratio index revealed after examination of the central cervical chain lymph nodes. The presence of nodal disease, degree of lymph node involvement and the distribution of lymph node metastases significantly increase the recurrence rates of patients with papillary thyroid carcinoma. To conclude, the lymph nodes metastases in young patients with papillary thyroid carcinoma in post-Chernobyl exposed region are common and the pattern could be predicted by many clinical and pathological factors. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Optimization of composite tiltrotor wings with extensions and winglets

NASA Astrophysics Data System (ADS)

Kambampati, Sandilya

Tiltrotors suffer from an aeroelastic instability during forward flight called whirl flutter. Whirl flutter is caused by the whirling motion of the rotor, characterized by highly coupled wing-rotor-pylon modes of vibration. Whirl flutter is a major obstacle for tiltrotors in achieving high-speed flight. The conventional approach to assure adequate whirl flutter stability margins for tiltrotors is to design the wings with high torsional stiffness, typically using 23% thickness-to-chord ratio wings. However, the large aerodynamic drag associated with these high thickness-to-chord ratio wings decreases aerodynamic efficiency and increases fuel consumption. Wingtip devices such as wing extensions and winglets have the potential to increase the whirl flutter characteristics and the aerodynamic efficiency of a tiltrotor. However, wing-tip devices can add more weight to the aircraft. In this study, multi-objective parametric and optimization methodologies for tiltrotor aircraft with wing extensions and winglets are investigated. The objectives are to maximize aircraft aerodynamic efficiency while minimizing weight penalty due to extensions and winglets, subject to whirl flutter constraints. An aeroelastic model that predicts the whirl flutter speed and a wing structural model that computes strength and weight of a composite wing are developed. An existing aerodynamic model (that predicts the aerodynamic efficiency) is merged with the developed structural and aeroelastic models for the purpose of conducting parametric and optimization studies. The variables of interest are the wing thickness and structural properties, and extension and winglet planform variables. The Bell XV-15 tiltrotor aircraft the chosen as the parent aircraft for this study. Parametric studies reveal that a wing extension of span 25% of the inboard wing increases the whirl flutter speed by 10% and also increases the aircraft aerodynamic efficiency by 8%. Structurally tapering the wing of a tiltrotor equipped with an extension and a winglet can increase the whirl flutter speed by 15% while reducing the wing weight by 7.5%. The baseline design for the optimization is the optimized wing with no extension or winglet. The optimization studies reveal that the optimum design for a cruise speed of 250 knots has an increased aerodynamic efficiency of 7% over the baseline design for only a weight penalty of 3% - thus a better transport range of 5.5% more than the baseline. The optimal design for a cruise speed of 300 knots has an increased aerodynamic efficiency of 5%, a weight penalty of 2.5%, and a better transport range of 3.5% more than the baseline.

Aerothermal modeling program. Phase 2, element B: Flow interaction experiment

NASA Technical Reports Server (NTRS)

Nikjooy, M.; Mongia, H. C.; Murthy, S. N. B.; Sullivan, J. P.

1987-01-01

NASA has instituted an extensive effort to improve the design process and data base for the hot section components of gas turbine engines. The purpose of element B is to establish a benchmark quality data set that consists of measurements of the interaction of circular jets with swirling flow. Such flows are typical of those that occur in the primary zone of modern annular combustion liners. Extensive computations of the swirling flows are to be compared with the measurements for the purpose of assessing the accuracy of current physical models used to predict such flows.

Health, Enterprise, and Labor Complementarity in the Household*

PubMed Central

Adhvaryu, Achyuta; Nyshadham, Anant

2017-01-01

We study the role of household enterprise as a coping mechanism after health shocks. Using variation in the cost of traveling to formal sector health facilities to predict recovery from acute illness in Tanzania, we show that individuals with prolonged illness switch from farm labor to enterprise activity. This response occurs along both the extensive (entry) and intensive (capital stock and labor supply) margins. Family members who are not ill exhibit exactly the same pattern of responses. Deriving a simple extension to the canonical agricultural household model, we show that our results suggest complementarities in household labor. PMID:28943705

Combined Endoscopic/Sonographic-Based Risk Matrix Model for Predicting One-Year Risk of Surgery: A Prospective Observational Study of a Tertiary Center Severe/Refractory Crohn's Disease Cohort.

PubMed

Rispo, Antonio; Imperatore, Nicola; Testa, Anna; Bucci, Luigi; Luglio, Gaetano; De Palma, Giovanni Domenico; Rea, Matilde; Nardone, Olga Maria; Caporaso, Nicola; Castiglione, Fabiana

2018-03-08

In the management of Crohn's Disease (CD) patients, having a simple score combining clinical, endoscopic and imaging features to predict the risk of surgery could help to tailor treatment more effectively. AIMS: to prospectively evaluate the one-year risk factors for surgery in refractory/severe CD and to generate a risk matrix for predicting the probability of surgery at one year. CD patients needing a disease re-assessment at our tertiary IBD centre underwent clinical, laboratory, endoscopy and bowel sonography (BS) examinations within one week. The optimal cut-off values in predicting surgery were identified using ROC curves for Simple Endoscopic Score for CD (SES-CD), bowel wall thickness (BWT) at BS, and small bowel CD extension at BS. Binary logistic regression and Cox's regression were then carried out. Finally, the probabilities of surgery were calculated for selected baseline levels of covariates and results were arranged in a prediction matrix. Of 100 CD patients, 30 underwent surgery within one year. SES-CD©9 (OR 15.3; p<0.001), BWT©7 mm (OR 15.8; p<0.001), small bowel CD extension at BS©33 cm (OR 8.23; p<0.001) and stricturing/penetrating behavior (OR 4.3; p<0.001) were the only independent factors predictive of surgery at one-year based on binary logistic and Cox's regressions. Our matrix model combined these risk factors and the probability of surgery ranged from 0.48% to 87.5% (sixteen combinations). Our risk matrix combining clinical, endoscopic and ultrasonographic findings can accurately predict the one-year risk of surgery in patients with severe/refractory CD requiring a disease re-evaluation. This tool could be of value in clinical practice, serving as the basis for a tailored management of CD patients.

UTILIZATION OF TREATABILITY AND PILOT TESTS TO PREDICT CAH BIOREMEDIATION (Battelle)

EPA Science Inventory

Multiple tools have been suggested to help in the design of enhanced anaerobic bioremediation systems for CAHs:
Extensive high quality microcosm testing followed by small-scale, thoroughly observed, induced flow field pilot tests (i.e. RABITT Protocol, Morse 1998)
More...

Predicting Toxic and Therapeutic Mechanisms of the ToxCast Chemical Library by Phenotypic Screening (SOT)

EPA Science Inventory

Addressing safety aspects of drugs and environmental chemicals relies extensively on animal testing. However the quantity of chemicals needing assessment and challenges of species extrapolation require development of alternative approaches. Using 8 primary human cell systems (Bio...

Predicting fatigue service life extension of RC bridges with externally bonded CFRP repairs.

DOT National Transportation Integrated Search

2015-12-01

This paper presents the results of an experimental study on the fatigue performance of RC beams : strengthened with different externally bonded CFRP systems. Seven specimens were fabricated; three had : no CFRP; the remaining four had one of two CFRP...

Development of a modal emissions model using data from the Cooperative Industry/Government Exhaust Emission test program

DOT National Transportation Integrated Search

2003-06-22

The Environmental Protection Agencys (EPAs) recommended model, MOBILE5a, has been : used extensively to predict emission factors based on average speeds for each fleet type. : Because average speeds are not appropriate in modeling intersections...

Nano-textured high sensitivity ion sensitive field effect transistors

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

Hajmirzaheydarali, M.; Sadeghipari, M.; Akbari, M.

2016-02-07

Nano-textured gate engineered ion sensitive field effect transistors (ISFETs), suitable for high sensitivity pH sensors, have been realized. Utilizing a mask-less deep reactive ion etching results in ultra-fine poly-Si features on the gate of ISFET devices where spacing of the order of 10 nm and less is achieved. Incorporation of these nano-sized features on the gate is responsible for high sensitivities up to 400 mV/pH in contrast to conventional planar structures. The fabrication process for this transistor is inexpensive, and it is fully compatible with standard complementary metal oxide semiconductor fabrication procedure. A theoretical modeling has also been presented to predict themore » extension of the diffuse layer into the electrolyte solution for highly featured structures and to correlate this extension with the high sensitivity of the device. The observed ultra-fine features by means of scanning electron microscopy and transmission electron microscopy tools corroborate the theoretical prediction.« less

Solubility of organic compounds in octanol: Improved predictions based on the geometrical fragment approach.

PubMed

Mathieu, Didier

2017-09-01

Two new models are introduced to predict the solubility of chemicals in octanol (S oct ), taking advantage of the extensive character of log(S oct ) through a decomposition of molecules into so-called geometrical fragments (GF). They are extensively validated and their compliance with regulatory requirements is demonstrated. The first model requires just a molecular formula as input. Despite an extreme simplicity, it performs as well as an advanced random forest model involving 86 descriptors, with a root mean square error (RMSE) of 0.64 log units for an external test set of 100 molecules. For the second one, which requires the melting point T m as input, introducing GF descriptors reduces the RMSE from about 0.7 to <0.5 log units, a performance that could previously be obtained only through the use of Abraham descriptors. A script is provided for easy application of the models, taking into account the limits of their applicability domains. Copyright © 2017 Elsevier Ltd. All rights reserved.

Income reliably predicts daily sadness, but not happiness: A replication and extension of Kushlev, Dunn, & Lucas (2015)

PubMed Central

Hudson, Nathan W.; Lucas, Richard E.; Donnellan, M. Brent; Kushlev, Kostadin

2017-01-01

Kushlev, Dunn, and Lucas (2015) found that income predicts less daily sadness—but not greater happiness—among Americans. The present study used longitudinal data from an approximately representative German sample to replicate and extend these findings. Our results largely replicated Kushlev and colleagues’: income predicted less daily sadness (albeit with a smaller effect size), but was unrelated to happiness. Moreover, the association between income and sadness could not be explained by demographics, stress, or daily time-use. Extending Kushlev and colleagues’ findings, new analyses indicated that only between-persons variance in income (but not within-persons variance) predicted daily sadness—perhaps because there was relatively little within-persons variance in income. Finally, income predicted less daily sadness and worry, but not less anger or frustration—potentially suggesting that income predicts less “internalizing” but not less “externalizing” negative emotions. Together, our study and Kushlev and colleagues’ provide evidence that income robustly predicts select daily negative emotions—but not positive ones. PMID:29250303

The excess choice effect: The role of outcome valence and counterfactual thinking.

PubMed

Hafner, Rebecca J; White, Mathew P; Handley, Simon J

2016-02-01

Contrary to economic theory, psychological research has demonstrated increased choice can undermine satisfaction. When and why this 'excess choice effect' (ECE) occurs remains unclear. Building on theories of counterfactual thinking we argue the ECE is more likely to occur when people experience counterfactual thought or emotion and that a key trigger is a negative versus positive task outcome. Participants either selected a drink (Experiment 1) or chocolate (Experiment 2) from a limited (6) versus extensive (24) selection (Experiment 1) or were given no choice versus extensive (24) choice (Experiment 2). In both experiments, however, the choice was illusory: Half the participants tasted a 'good' flavour, half a 'bad' flavour. As predicted, extensive choice was only detrimental to satisfaction when participants tasted the 'bad' drink or chocolate, and this was mediated by the experience of counterfactual thought (Experiment 1) or emotion (Experiment 2). When outcomes were positive, participants were similarly satisfied with limited versus extensive and no choice versus extensive choice. Implications for our theoretical understanding of the ECE and for the construction of choice architectures aimed at promoting individual satisfaction and well-being are discussed. © 2015 The British Psychological Society.

Extensions of the standard model

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

Ramond, P.

1983-01-01

In these lectures we focus on several issues that arise in theoretical extensions of the standard model. First we describe the kinds of fermions that can be added to the standard model without affecting known phenomenology. We focus in particular on three types: the vector-like completion of the existing fermions as would be predicted by a Kaluza-Klein type theory, which we find cannot be realistically achieved without some chiral symmetry; fermions which are vector-like by themselves, such as do appear in supersymmetric extensions, and finally anomaly-free chiral sets of fermions. We note that a chiral symmetry, such as the Peccei-Quinnmore » symmetry can be used to produce a vector-like theory which, at scales less than M/sub W/, appears to be chiral. Next, we turn to the analysis of the second hierarchy problem which arises in Grand Unified extensions of the standard model, and plays a crucial role in proton decay of supersymmetric extensions. We review the known mechanisms for avoiding this problem and present a new one which seems to lead to the (family) triplication of the gauge group. Finally, this being a summer school, we present a list of homework problems. 44 references.« less

Extended 60 μm Emission from Nearby Mira Variables

NASA Astrophysics Data System (ADS)

Bauer, W. H.; Stencel, R. E.

1993-01-01

Circumstellar dust envelopes around some optically visible late-type stars are so extensive that they are detectable as extended at an arc-minute scale by the IRAS survey observations (Stencel, Pesce and Bauer 1988, Astron. J 95, 141; Hawkins 1990, Astron. Ap. 229, L8). The width of the IRAS scan profiles at 10% of peak intensity is an indicator of source extension. Wyatt and Cahn (1983, Ap. J. 275, 225) presented a sample of 124 Mira variables in the solar neighborhood. Of this sample, 11 Miras which show silicate emission are bright enough at 60 microns for a significant determination of the width of a scan at 10% of peak flux. Individual scans and maps were examined in order to determine whether any observed extension was associated with the central star. Five stars showed significant extension apparently due to mass loss from the central star: R Leo, o Cet, U Ori, R Cas and R Hor. IRAS LRS spectra, point source fluxes and observed extensions of these sources are compared to the predictions of model dust shells which assume steady mass loss. This work was supported in part by NASA grant NAG 5-1213 to Wellesley College.

Predicting links based on knowledge dissemination in complex network

NASA Astrophysics Data System (ADS)

Zhou, Wen; Jia, Yifan

2017-04-01

Link prediction is the task of mining the missing links in networks or predicting the next vertex pair to be connected by a link. A lot of link prediction methods were inspired by evolutionary processes of networks. In this paper, a new mechanism for the formation of complex networks called knowledge dissemination (KD) is proposed with the assumption of knowledge disseminating through the paths of a network. Accordingly, a new link prediction method-knowledge dissemination based link prediction (KDLP)-is proposed to test KD. KDLP characterizes vertex similarity based on knowledge quantity (KQ) which measures the importance of a vertex through H-index. Extensive numerical simulations on six real-world networks demonstrate that KDLP is a strong link prediction method which performs at a higher prediction accuracy than four well-known similarity measures including common neighbors, local path index, average commute time and matrix forest index. Furthermore, based on the common conclusion that an excellent link prediction method reveals a good evolving mechanism, the experiment results suggest that KD is a considerable network evolving mechanism for the formation of complex networks.

Extension of Ko Straight-Beam Displacement Theory to Deformed Shape Predictions of Slender Curved Structures

NASA Technical Reports Server (NTRS)

Ko, William L.; Fleischer, Van Tran

2011-01-01

The Ko displacement theory originally developed for shape predictions of straight beams is extended to shape predictions of curved beams. The surface strains needed for shape predictions were analytically generated from finite-element nodal stress outputs. With the aid of finite-element displacement outputs, mathematical functional forms for curvature-effect correction terms are established and incorporated into straight-beam deflection equations for shape predictions of both cantilever and two-point supported curved beams. The newly established deflection equations for cantilever curved beams could provide quite accurate shape predictions for different cantilever curved beams, including the quarter-circle cantilever beam. Furthermore, the newly formulated deflection equations for two-point supported curved beams could provide accurate shape predictions for a range of two-point supported curved beams, including the full-circular ring. Accuracy of the newly developed curved-beam deflection equations is validated through shape prediction analysis of curved beams embedded in the windward shallow spherical shell of a generic crew exploration vehicle. A single-point collocation method for optimization of shape predictions is discussed in detail

Personalized dynamic prediction of death according to tumour progression and high-dimensional genetic factors: Meta-analysis with a joint model.

PubMed

Emura, Takeshi; Nakatochi, Masahiro; Matsui, Shigeyuki; Michimae, Hirofumi; Rondeau, Virginie

2017-01-01

Developing a personalized risk prediction model of death is fundamental for improving patient care and touches on the realm of personalized medicine. The increasing availability of genomic information and large-scale meta-analytic data sets for clinicians has motivated the extension of traditional survival prediction based on the Cox proportional hazards model. The aim of our paper is to develop a personalized risk prediction formula for death according to genetic factors and dynamic tumour progression status based on meta-analytic data. To this end, we extend the existing joint frailty-copula model to a model allowing for high-dimensional genetic factors. In addition, we propose a dynamic prediction formula to predict death given tumour progression events possibly occurring after treatment or surgery. For clinical use, we implement the computation software of the prediction formula in the joint.Cox R package. We also develop a tool to validate the performance of the prediction formula by assessing the prediction error. We illustrate the method with the meta-analysis of individual patient data on ovarian cancer patients.

Laser-assisted corneal welding in cataract surgery: retrospective study.

PubMed

Menabuoni, Luca; Pini, Roberto; Rossi, Francesca; Lenzetti, Ivo; Yoo, Sonia H; Parel, Jean-Marie

2007-09-01

To evaluate the efficacy of laser welding to close corneal wounds in cataract surgery. Department of Ophthalmology, Hospital of Misericordia e Dolce, Prato, Italy. This retrospective nonrandomized interventional case series included 20 eyes of 20 patients. All eyes had cataract with visual acuity worse than 20/200. Ten patients had phacoemulsification surgery, and 10 had extracapsular cataract extraction (ECCE). Surgeries were followed by laser-assisted closure of the corneal wounds by diode laser welding of the stroma using a technique established in animal models. Preoperative and postoperative (1, 3, 7, 30, and 90 days) astigmatism, level of inflammation, Seidel testing, and endothelial cell counts were obtained. There were minor differences in preoperative and postoperative astigmatism except in 1 eye in the ECCE group. The Seidel test showed no wound leakage during the follow-up examinations, and endothelial cell loss was similar to that published for standard surgical cataract procedures. No collateral effects of the laser welding were detected, nor was postoperative inflammation. Astigmatism was slightly affected by the use of laser welding for corneal wound closure after phacoemulsification and ECCE. The laser-assisted corneal sealing procedure was rapid and safe and could serve as an alternative to corneal suturing, with significant potential applications for the closure of longer incisions, such as those used in penetrating keratoplasty.

The KineSpring® Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis

PubMed Central

Clifford, Anton G; Gabriel, Stefan M; O’Connell, Mary; Lowe, David; Miller, Larry E; Block, Jon E

2013-01-01

Symptomatic medial compartment knee osteoarthritis (OA) is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring® Knee Implant System (Moximed, Inc, Hayward, CA, USA) is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA. PMID:23717052

Axillary silicone lymphadenopathy presenting with a lump and altered sensation in the breast: a case report

PubMed Central

2009-01-01

Introduction Silicone lymphadenopathy is a rare but recognised complication of procedures involving the use of silicone. It has a poorly understood mechanism but is thought to occur following the transportation of silicone particles from silicone-containing prostheses to lymph nodes by macrophages. Case presentation We report of a case involving a 35-year-old woman who presented to the breast clinic with a breast lump and altered sensation below her left nipple 5 years after bilateral cosmetic breast augmentations. A small lump was detected inferior to the nipple but clinical examination and initial ultrasound investigation showed both implants to be intact. However, mammography and magnetic resonance imaging of both breasts revealed both intracapsular and extracapsular rupture of the left breast prosthesis. The patient went on to develop a flu-like illness and tender lumps in the left axilla and right mastoid regions. An excision biopsy of the left axillary lesion and replacement of the ruptured implant was performed. Subsequent histological analysis showed that the axillary lump was a lymph node containing large amounts of silicone. Conclusion The exclusion of malignancy remains the priority when dealing with lumps in the breast or axilla. Silicone lymphadenopathy should however be considered as a differential diagnosis in patients in whom silicone prostheses are present. PMID:19830102

[The history of prostate cancer from the beginning to DaVinci].

PubMed

Hatzinger, M; Hubmann, R; Moll, F; Sohn, M

2012-07-01

For hardly any other organ can the development of medicine and technical advances in the last 150 years be so clearly illustrated as for the prostate. The history of radical prostatectomy was initially characterised by the problems in approaching this relatively difficulty accessible organ. In 1867, Theodor Billroth in Vienna performed the first partial prostatectomy via a perineal access. In 1904, Hugh Hampton Young and William Stewart Halsted at the Johns Hopkins Hospital in Baltimore / USA carried out the first successful extracapsular perineal prostatectomy and opened up a new era. In Germany, Prof. Friedrich Voelcker in Halle in 1924 developed the so-called ischiorectal prostatectomy. But it was left to Terence Millin to publish in 1945 the first series of retropubic prostatectomies. In 1952, the sacroperineal approach according to Thiermann and the sacral prostatectomy according to were introduced. Finally, in 1991 another new era in prostate surgery started with the first laparoscopic prostatectomy. This development peaked in 2011 with the presentation of the laparoscopic DaVinci prostatectomy by Binder. Originally a stepchild of urological surgery that was to be avoided whenever possible due to the fear of serious complications, the prostate has progressed in the course of time to an obscure object of lust. The stepchild has become the favorite child.

Not my "type": larval dispersal dimorphisms and bet-hedging in opisthobranch life histories.

PubMed

Krug, Patrick J

2009-06-01

When conditions fluctuate unpredictably, selection may favor bet-hedging strategies that vary offspring characteristics to avoid reproductive wipe-outs in bad seasons. For many marine gastropods, the dispersal potential of offspring reflects both maternal effects (egg size, egg mass properties) and larval traits (development rate, habitat choice). I present data for eight sea slugs in the genus Elysia (Opisthobranchia: Sacoglossa), highlighting potentially adaptive variation in traits like offspring size, timing of metamorphosis, hatching behavior, and settlement response. Elysia zuleicae produced both planktotrophic and lecithotrophic larvae, a true case of poecilogony. Both intracapsular and post-hatching metamorphosis occurred among clutches of "Boselia" marcusi, E. cornigera, and E. crispata, a dispersal dimorphism often misinterpreted as poecilogony. Egg masses of E. tuca hatched for up to 16 days but larvae settled only on the adult host alga Halimeda, whereas most larvae of E. papillosa spontaneously metamorphosed 5-7 days after hatching. Investment in extra-capsular yolk may allow mothers to increase larval size relative to egg size and vary offspring size within and among clutches. Flexible strategies of larval dispersal and offspring provisioning in Elysia spp. may represent adaptations to the patchy habitat of these specialized herbivores, highlighting the evolutionary importance of variation in a range of life-history traits.

Eye healthcare services in eastern Europe: Part 1. Cataract surgery.

PubMed

Kocur, I; Resnikoff, S; Foster, A

2002-08-01

To describe cataract surgical services in 1998 in 12 eastern European countries and to identify their needs to reduce cataract blindness. All inpatient eye departments in the 12 countries received a standardised questionnaire; the data obtained were further processed at the coordinating centre in Prague. All 458 eye departments in the region were involved. The response rate was 100%, except for Bulgaria (93%) and Romania (93%). The total number of cataract surgeries per one million inhabitants in 1998 was calculated: Belarus (800), Federation of Bosnia and Herzegovina (1275), Bulgaria (1730), the Czech Republic (4210), Estonia (2530), Hungary (3530), Latvia (1860), Lithuania (1550), Trans-Dniester Moldova (1300), Poland (1475), Romania (1260), and Slovakia (2430). Cataracts were mostly operated on by the extracapsular technique. Intracapsular extractions were frequently performed in Federation of Bosnia and Herzegovina (47%), Belarus (46%), Bulgaria (18%), and Romania (14.3%). Phacoemulsification was uncommonly used in 1998, except for the Czech Republic (86%), Estonia (50%), Slovakia (38%), and Hungary (16%). An IOL was implanted in more than 90% of patients in the Czech Republic, Estonia, Hungary, Latvia, Lithuania, and Slovakia. Conditions for cataract surgery in the eastern European region differ. The main barriers to cataract surgery were state budget limitations, insufficient supply of consumables, underutilisation of operating theatres, and poor detection of patients requiring surgery.

Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India

PubMed Central

Duraipandian, Amudhan; Shanmugam, Subbiah; Ramamurthy, Rajaraman

2017-01-01

Background Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Materials and Methods Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. Results The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5%) developed recurrence (systemic = 1, regional = 4, and local = 3). The estimated 5-year disease-free survival (DFS) was 65.4% and the overall survival (OS) was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS) significantly affected both DFS and OS. Conclusion The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence. PMID:29387486

Tularemia: potential role of cytopathology in differential diagnosis of cervical lymphadenitis: multicenter experience in 53 cases and literature review.

PubMed

Tuncer, Ersin; Onal, Binnur; Simsek, Gulcin; Elagoz, Sahande; Sahpaz, Ahmet; Kilic, Selcuk; Altuntas, Emine Elif; Ulu Kilic, Aysegul

2014-03-01

Tularemia is a zoonosis caused by Francisella tularensis. Tularemia outbreaks occurred in Central Anatolia during 2009 and 2011. We evaluated the clinical characteristics and cytomorphologies of fine needle aspirations (FNAs) from cervical lymph nodes in serologically confirmed tularemia cases. To our knowledge, this is the first large series concerning FNA morphology of Tularemia. FNA smears of 53 patients of the 290, diagnosed by microagglutination tests and PCR, were evaluated at three Pathology centers. FNAs were performed by cytopathologists or ear-nose-throat surgeons. Of all patients, 17 had also lymph node resections. FNAs showed the presence of suppuration and abscess. Rare epithelioid histiocytes and granulomas, seldom phagocytosed bacilli-like microorganisms were observed. On histopathology; granulomas, necrosis, and suppurative inflammation extending extracapsular areas were seen. Tularemia is endemic in certain areas of the Northern Hemisphere. The benefit from cytopathology is limited and cytological suspicion should be confirmed by serology. However FNA cytology is helpful in differential diagnosis of tularemia and other diseases presented with suppurative, granulomatous cervical lymphadenitis. It is also useful in providing the material for PCR and culture in early phase when the serology is negative and the treatment is more effective. © 2013 APMIS. Published by John Wiley & Sons Ltd.

Extension of the Transdiagnostic Model to Focus on Intolerance of Uncertainty: A Review of the Literature and Implications for Treatment.

PubMed

Einstein, Danielle A

2014-09-01

This study reviews research on the construct of intolerance of uncertainty (IU). A recent factor analysis ( Journal of Anxiety Disorders , 25 , 2012, p. 533) has been used to extend the transdiagnostic model articulated by Mansell (2005, p. 141) to focus on the role of IU as a facet of the model that is important to address in treatment. Research suggests that individual differences in IU may compromise resilience and that individuals high in IU are susceptible to increased negative affect. The model extension provides a guide for the treatment of clients presenting with uncertainty in the context of either a single disorder or several comorbid disorders. By applying the extension, the clinician is assisted to explore two facets of IU, "Need for Predictability" and "Uncertainty Arousal."