Science.gov

Sample records for primary system loca

  1. Interfacing systems LOCA (loss-of-coolant accidents): Pressurized water reactors

    SciTech Connect

    Bozoki, G.; Kohut, P.; Fitzpatrick, R.

    1989-02-01

    This report summarizes a study performed by Brookhaven National Laboratory for the Office of Nuclear Regulatory Research, Reactor and Plant Safety Issues Branch, Division of Reactor and Plant Systems, US Nuclear Regulatory Commission. This study was requested by the NRC in order to provide a technical basis for the resolution of Generic Issue 105 ''Interfacing LOCA at LWRs.'' This report deals with pressurized water reactors (PWRs). A parallel report was also accomplished for boiling water reactors. This study focuses on three representative PWRs and extrapolates the plant-specific findings for their generic applicability. In addition, a generic analysis was performed to investigate the cost-benefit aspects of imposing a testing program that would require some minimum level of leak testing of the pressure isolation valves on plants that presently have no such requirements. 28 refs., 31 figs., 64 tabs.

  2. Revised Emergency Cooling System LOCA (loss-of-coolant accidents) limits for PKL-reactor Mark 16B-31 charges

    SciTech Connect

    Church, J.P.; Steimke, J.L.

    1986-10-02

    Recent experiments have shown that the assembly damage models used to compute generic Emergency Cooling System (ECS) limits for loss-of-coolant accidents (LOCA) in Mark 16B-31 charges may be nonconservative. The bases of these damage models were experiments that underestimated the heat input into a heated flow channel. This document provides interim ECS limits for Mark 16, Mark 31A, and Mark 31B assemblies. 2 refs., 1 tab.

  3. Geochemical and Hydrologic Controls of Copper-Rich Surface Waters in the Yerba Loca-Mapocho System

    NASA Astrophysics Data System (ADS)

    Pasten, P.; Montecinos, M.; Coquery, M.; Pizarro, G. E.; Abarca, M. I.; Arce, G. J.

    2015-12-01

    Andean watersheds in Northern and Central Chile are naturally enriched with metals, many of them associated to sulfide mineralizations related to copper mining districts. The natural and anthropogenic influx of toxic metals into drinking water sources pose a sustainability challenge for cities that need to provide safe water with the smallest footprint. This work presents our study of the transformations of copper in the Yerba Loca-Mapocho system. Our sampling campaign started from the headwaters at La Paloma Glacier and continues to the inlet of the San Enrique drinking water treatment plant, a system feeding municipalities in the Eastern area of Santiago, Chile. Depending on the season, total copper concentrations go as high as 22 mg/L for the upper sections, which become diluted to <5 mg/L downstream. pH ranged from 3 to 5.6 while suspended solids ranged from <10 to 100 mg/L. We used Geochemist Workbench to assess copper speciation and to evaluate the thermodynamic controls for the formation and dissolution of solid phases. A sediment trap was used to concentrate suspended particulate matter, which was analyzed with ICP-MS, TXRF (total reflection X ray fluorescence) and XRD (X-ray diffraction). Major elements detected in the precipitates were Al (200 g/kg), S (60 g/kg), and Cu (6 g/kg). Likely solid phases include hydrous amorphous phases of aluminum hydroxides and sulfates, and copper hydroxides/carbonates. Efforts are undergoing to find the optimal mixing ratios between the acidic stream and more alkaline streams to maximize attenuation of dissolved copper. The results of this research could be used for enhancing in-stream natural attenuation of copper and reducing treatment needs at the drinking water facility. Acknowledgements to Fondecyt 1130936 and Conicyt Fondap 15110020

  4. Design optimisation of a nanofluid injection system for LOCA events in a nuclear power plant

    NASA Astrophysics Data System (ADS)

    Călimănescu, I.; Stan, L. C.; Velcea, D. D.

    2016-08-01

    The safety issues inside a Nuclear Power Plant (NPP) are encompassing their capacity to ensure the heat sink, meaning the capacity of the systems to release the heat from the rector to the environment. The nanofluids having good heat transfer properties, are recommended to be used in such applications. The paper is solving the following scenario: considering the Safety Injection tank and the Nanofluid injection Tank, and considering the Nanofluid injection Tank filled with a 10% alumina-water nanofluid, how can we select the best design of the connecting point between the pipes of the SIT and the Nanofluid Tank and the pressures inside of any of these tanks in order to have the biggest density of nanoparticles leaving the tanks toward the cold leg. In conclusion the biggest influence over the rate of disposal of the nanofluid inside ECCS is that of the pressure inside the SIT followed in order by the injection pipe diameter and the pressure inside the nanofluid tank. The optimum balance of these three design parameters may be reached following the procedure shown in this paper.

  5. Preliminary LOCA analysis of the westinghouse small modular reactor using the WCOBRA/TRAC-TF2 thermal-hydraulics code

    SciTech Connect

    Liao, J.; Kucukboyaci, V. N.; Nguyen, L.; Frepoli, C.

    2012-07-01

    The Westinghouse Small Modular Reactor (SMR) is an 800 MWt (> 225 MWe) integral pressurized water reactor (iPWR) with all primary components, including the steam generator and the pressurizer located inside the reactor vessel. The reactor core is based on a partial-height 17x17 fuel assembly design used in the AP1000{sup R} reactor core. The Westinghouse SMR utilizes passive safety systems and proven components from the AP1000 plant design with a compact containment that houses the integral reactor vessel and the passive safety systems. A preliminary loss of coolant accident (LOCA) analysis of the Westinghouse SMR has been performed using the WCOBRA/TRAC-TF2 code, simulating a transient caused by a double ended guillotine (DEG) break in the direct vessel injection (DVI) line. WCOBRA/TRAC-TF2 is a new generation Westinghouse LOCA thermal-hydraulics code evolving from the US NRC licensed WCOBRA/TRAC code. It is designed to simulate PWR LOCA events from the smallest break size to the largest break size (DEG cold leg). A significant number of fluid dynamics models and heat transfer models were developed or improved in WCOBRA/TRAC-TF2. A large number of separate effects and integral effects tests were performed for a rigorous code assessment and validation. WCOBRA/TRAC-TF2 was introduced into the Westinghouse SMR design phase to assist a quick and robust passive cooling system design and to identify thermal-hydraulic phenomena for the development of the SMR Phenomena Identification Ranking Table (PIRT). The LOCA analysis of the Westinghouse SMR demonstrates that the DEG DVI break LOCA is mitigated by the injection and venting from the Westinghouse SMR passive safety systems without core heat up, achieving long term core cooling. (authors)

  6. APT Blanket System Loss-of-Coolant Accident (LOCA) Based on Initial Conceptual Design - Case 2: with Beam Shutdown Only

    SciTech Connect

    Hamm, L.L.

    1998-10-07

    This report is one of a series of reports that document normal operation and accident simulations for the Accelerator Production of Tritium (APT) blanket heat removal system. These simulations were performed for the Preliminary Safety Analysis Report. This report documents the results of simulations of a Loss-of-Flow Accident (LOFA) where power is lost to all of the pumps that circulate water in the blanket region, the accelerator beam is shut off and neither the residual heat removal nor cavity flood systems operate.

  7. Results of small break LOCA experiments in the LOFT reactor system with comparison to code calculations. [PWR

    SciTech Connect

    Adams, J.P.; Linebarger, J.H.; Leach, L.P.

    1980-01-01

    The results are presented of three small break loss-of-coolant experiments performed in the LOFT Pressurized Water Reactor (PWR) system. Experiment L3-0, performed without reactor power, represented a loss of coolant from the power operated relief valve on the top of the pressurizer. Experiments L3-1 and L3-2 were initiated with the reactor at full power (maximum linear heat generation rate approximately 52 kW/m) and represented 4-in and 1-in diameter breaks, respectively, in the reactor inlet piping of a commercial PWR. Comparisons of data to analytical model calculations with a number of different models indicate that most major phenomena were correctly calculated, but that improvements in modeling small break behavior are necessary.

  8. Analysis of LOCA Scenarios in the NIST Research Reactor Before and After Fuel Conversion

    SciTech Connect

    Baek, J. S.; Cheng, L. Y.; Diamond, D.

    2015-08-30

    An analysis has been done of hypothetical loss-of-coolant-accidents (LOCAs) in the research reactor (NBSR) at the National Institute of Standards and Technology (NIST). The purpose of the analysis is to determine if the peak clad temperature remains below the Safety Limit, which is the blister temperature for the fuel. The configuration of the NBSR considered in the analysis is that projected for the future when changes will be made so that shutdown pumps do not operate when a LOCA signal is detected. The analysis was done for the present core with high-enriched uranium (HEU) fuel and with the proposed low-enriched uranium (LEU) fuel that would be used when the NBSR is converted from one to the other. The analysis consists of two parts. The first examines how the water would drain from the primary system following a break and the possibility for the loss of coolant from within the fuel element flow channels. This work is performed using the TRACE system thermal-hydraulic code. The second looks at the fuel clad temperature as a function of time given that the water may have drained from many of the flow channels and the water in the vessel is in a quasi-equilibrium state. The temperature behavior is investigated using the three-dimensional heat conduction code HEATING7.3. The results in all scenarios considered for both HEU and LEU fuel show that the peak clad temperature remains below the blister temperature.

  9. The behavior of ANGRA 2 nuclear power plant core for a small break LOCA simulated with RELAP5 code

    SciTech Connect

    Sabundjian, Gaiane; Andrade, Delvonei A.; Belchior, Antonio Jr.; Silva Rocha, Marcelo da; Conti, Thadeu N.; Torres, Walmir M.; Macedo, Luiz A.; Umbehaun, Pedro E.; Mesquita, Roberto N.; Masotti, Paulo H. F.; Souza Lima, Ana Cecilia de

    2013-05-06

    This work discusses the behavior of Angra 2 nuclear power plant core, for a postulate Loss of Coolant Accident (LOCA) in the primary circuit for Small Break Loss Of Coolant Accident (SBLOCA). A pipe break of the hot leg Emergency Core Cooling System (ECCS) was simulated with RELAP 5 code. The considered rupture area is 380 cm{sup 2}, which represents 100% of the ECCS pipe flow area. Results showed that the cooling is enough to guarantee the integrity of the reactor core.

  10. PWR representative behavior during a LOCA

    SciTech Connect

    Allison, C.M.

    1981-01-01

    To date, there has been substantial analytical and experimental effort to define the margins between design basis loss-of-coolant accident (LOCA) behavior and regulatory limits on maximum fuel rod cladding temperature and deformation. As a result, there is extensive documentation on the modeling of fuel rod behavior in test reactors and design basis LOCA's. However, modeling of that behavior using representative, non-conservative, operating histories is not nearly as well documented in the public literature. Therefore, the objective of this paper is (a) to present calculations of LOCA induced behavior for Pressurized Water Reactor (PWR) core representative fuel rods, and (b) to discuss the variability in those calculations given the variability in fuel rod condition at the initiation of the LOCA. This analysis was limited to the study of changes in fuel rod behavior due to different power operating histories. The other two important parameters which affect that behavior, initial fuel rod design and LOCA coolant conditions were held invarient for all of the representative rods analyzed.

  11. Spatializing Sexuality in Jaime Hernandez's "Locas"

    ERIC Educational Resources Information Center

    Jones, Jessica E.

    2009-01-01

    Focusing on Jaime Hernandez's "Locas: The Maggie and Hopey Stories," part of the "Love and Rockets" comic series, I argue that the graphic landscape of this understudied comic offers an illustration of the theories of space in relation to race, gender, and sexuality that have been critical to understandings of Chicana…

  12. Overview of the M5{sup R} Alloy behavior under RIA and LOCA Conditions

    SciTech Connect

    Mardon, J.P.; Dunn, B.

    2007-07-01

    Experience from irradiation in PWRs has confirmed the M5{sup R} possesses all the properties required for upgraded operation including new fuel management approaches and high duty reactor operation. In this paper accident behavior is demonstrated through a comparison of M5{sup R} and Zircaloy-4 cladding behavior under RIA (Reactivity Insertion Accident) and LOCA (Loss Of Coolant Accident) conditions. AREVA NP supports a significant experimental program of analytical and full -scale tests along with comprehensive analyses on both M5{sup R} and SRA low-tin Zircaloy-4. A key presumption in the conduct of such tests is that, for all Zirconium alloys, the primary effects of high burn-up on cladding thermal-mechanical properties arise from the accumulation of hydrogen within the cladding during operation. This hypothesis is supported through a summarisation of the results of the main RIA and LOCA tests performed on virgin, pre-hydrided, and irradiated M5{sup R} and SRA low-tin Zircaloy-4 cladding. The first part of the paper presents the results of recent Room Temperature (RT) and High Temperature High Pressure (HTHP) integral RIA tests, mainly from the NSRR and CABRI programs, and separate effects mechanical properties tests on high burn-up M5{sup R} and Zircaloy- 4 irradiated claddings. In the second part of this paper, studies of cladding performance under LOCA conditions are presented.. The discussion includes high temperature oxidation kinetics, quench behaviour and post quenched mechanical behaviour of virgin, pre-hydrided and irradiated M5{sup R} and Zircaloy-4 cladding tubes after oxidation at LOCA temperatures and various quenching scenarios. The hydrogen concentrations studied are alloy dependent. Included are mechanical tests and in-depth metallurgical investigations developed to understand the failure mechanisms with the differing alloys and hydrogen concentrations. The result is a confirmation that the effect of hydrogen uptake dominates on the RIA and LOCA

  13. Aging and loss-of-coolant accident (LOCA) testing of electrical connections

    SciTech Connect

    Nelson, C.F.

    1998-01-01

    This report presents the results of an experimental program to determine the aging and loss-of-coolant accident (LOCA) behavior of electrical connections in order to obtain an initial scoping of their performance. Ten types of connections commonly used in nuclear power plants were tested. These included 3 types of conduit seals, 2 types of cable-to-device connectors, 3 types of cable-to-cable connectors, and 2 types of in-line splices. The connections were aged for 6 months under simultaneous thermal (99 C) and radiation (46 Gy/hr) conditions. A simulated LOCA consisting of sequential high dose-rate irradiation (3 kGy/hr) and high-temperature steam exposures followed the aging. Connection functionality was monitored using insulation resistance measurements during the aging and LOCA exposures. Because only 5 of the 10 connection types passed a post-LOCA, submerged dielectric withstand test, further detailed investigation of electrical connections and the effects of cable jacket integrity on the cable-connection system is warranted.

  14. APT Blanket System Loss-of-Coolant Accident (LOCA) Based on Initial Conceptual Design - Case 4: External Pressurizer Surge Line Break Near Inlet Header

    SciTech Connect

    Hamm, L.L.

    1998-10-07

    This report is one of a series of reports documenting accident scenario simulations for the Accelerator Production of Tritium (APT) blanket heat removal systems. The simulations were performed in support of the Preliminary Safety Analysis Report (PSAR) for the APT.

  15. APT Blanket System Loss-of-Coolant Accident (LOCA) Analysis Based on Initial Conceptual Design - Case 3: External HR Break at Pump Outlet without Pump Trip

    SciTech Connect

    Hamm, L.L.

    1998-10-07

    This report is one of a series of reports that document normal operation and accident simulations for the Accelerator Production of Tritium (APT) blanket heat removal (HR) system. These simulations were performed for the Preliminary Safety Analysis Report.

  16. APT Blanket System Loss-of-Coolant Accident (LOCA) Based on Initial Conceptual Design - Case 1: External HR Break Near Inlet Header

    SciTech Connect

    Hamm, L.L.

    1998-10-07

    The APT blanket system has about 57 MW of thermal energy deposited within the blanket region under normal operating conditions from the release of neutrons and the interaction of the High energy particles with the blanket materials. This corresponds to about 48 percent of total thermal energy deposited in the APT target/blanket system. The deposited thermal energy under normal operation conditions is an important input parameter used in the thermal-hydraulic design and accident analysis.

  17. Viking orbiter system primary mission

    NASA Technical Reports Server (NTRS)

    Goudy, J. R.

    1977-01-01

    An overview of Viking Orbiter (VO) system and subsystem performances during the primary mission (the time period from VO-1 launch on August 20, 1975, through November 15, 1976) is presented. Brief descriptions, key design requirements, pertinent historical information, unique applications or situations, and predicted versus actual performances are included for all VO-1 and VO-2 subsystems, both individually and as an integrated system.

  18. A simplified time-dependent recovery model as applied to RCP seal LOCAs

    SciTech Connect

    Kohut, P.; Bozoki, G.; Fitzpatrick, R. )

    1991-01-01

    In Westinghouse-designed reactors, the reactor coolant pump (RCP) seals constantly require a modest amount of cooling. This cooling function depends on the service water (SW) system. Upon the loss of the cooling function due to the unavailability of the SW, component cooling water system or electrical power (station blackout), the RCP seals may degrade, resulting in a loss-of-coolant accident (LOCA). Recent studies indicate that the frequency of the loss of SW initiating events is higher than previously thought. This change significantly increases the core damage frequency contribution from RCP seal failure. The most critical/dominant element in the loss of SW events was found to be the SW-induced RCP seal failure. For these potential accident scenarios, there are large uncertainties regarding the actual frequency of RCP seal LOCA, the resulting leakage rate, and time-dependent behavior. The roles of various recovery options based on the time evolution of the seal LOCA have been identified and taken into account in recent NUREG-1150 probabilistic risk assessment PRA analyses. In this paper, a consistent time-dependent recovery model is described that takes into account the effects of various recovery actions based on explicit considerations given to a spectrum of time- and flow-rate dependencies. The model represents a simplified approach but is especially useful when extensive seal leak rate and core uncovery information is unavailable.

  19. TRANSPORT CHARACTERISTICS OF SELECTED PWR LOCA GENERATED DEBRIS.

    SciTech Connect

    A. K. MAJI; B. MARSHALL; ET AL

    2000-10-01

    In the unlikely event of a Loss of Coolant Accident (LOCA) in a pressurized water reactor (PWR), break jet impingement would dislodge thermal insulation from nearby piping, as well as other materials within the containment, such as paint chips, concrete dust, and fire barrier materials. Steam/water flows induced by the break and by the containment sprays would transport debris to the containment floor. Subsequently, debris would likely transport to and accumulate on the suction sump screens of the emergency core cooling system (ECCS) pumps, thereby potentially degrading ECCS performance and possibly even failing the ECCS. In 1998, the U. S. Nuclear Regulatory Commission (NRC) initiated a generic study (Generic Safety Issue-191) to evaluate the potential for the accumulation of LOCA related debris on the PWR sump screen and the consequent loss of ECCS pump net positive suction head (NPSH). Los Alamos National Laboratory (LANL), supporting the resolution of GSI-191, was tasked with developing a method for estimating debris transport in PWR containments to estimate the quantity of debris that would accumulate on the sump screen for use in plant specific evaluations. The analytical method proposed by LANL, to predict debris transport within the water that would accumulate on the containment floor, is to use computational fluid dynamics (CFD) combined with experimental debris transport data to predict debris transport and accumulation on the screen. CFD simulations of actual plant containment designs would provide flow data for a postulated accident in that plant, e.g., three-dimensional patterns of flow velocities and flow turbulence. Small-scale experiments would determine parameters defining the debris transport characteristics for each type of debris. The containment floor transport methodology will merge debris transport characteristics with CFD results to provide a reasonable and conservative estimate of debris transport within the containment floor pool and

  20. Review and evaluation of the RELAP5YA computer code and the Vermont Yankee LOCA (Loss-of-Coolant Accident) licensing analysis model for use in small and large break BWR (Boiling Water Reactor) LOCAS

    SciTech Connect

    Jones, J.L.

    1987-01-01

    A review has been completed of the RELAP5YA computer code to determine its acceptability for performing licensing analyses. The review was limited to Boiling Water Reactor (BWR) reactor applications. In addition, a Loss-Of-Coolant Accident (LOCA) licensing analysis method, using the RELAP5YA computer code, has been reviewed. This method is applicable to the Vermont Yankee Nuclear Power Station to perform full break spectra LOCA and fuel cycle independent analyses. The review of the RELAP5YA code consisted of an evaluation of all Yankee Atomic Electric Company (YAEC) incorporated modifications to the RELAP5/MOD1 Cycle 18 computer code from which the licensing version of the code originated. Qualifying separate and integral effects assessment calculations were reviewed to evaluate the validity and proper implementation of the various added models. The LOCA licensing method was assessed by reviewing two RELAP5YA system input models and evaluating several small and large break qualifying transient calculations. A review of the RELAP5YA code modifications and their assessments, as well as the submitted LOCA licensing method, is given and the results of the review are provided.

  1. Vermont Yankee simulator qualification: large-break LOCA

    SciTech Connect

    Loomis, J.N.; Fernandez, R.T.

    1987-01-01

    Yankee Atomic Electric Company (YAEC) has developed simulator benchmark capabilities for the Seabrook, Maine Yankee, and Vermont Yankee Nuclear Power Station (VYNPS) simulators. The goal is to establish that each simulator has a satisfactory real-time response for different scenarios that will enhance operator training. Vermont Yankee purchased a full-scope plane simulator for the VYNPS, a four-unit boiling water reactor with a Mark-I containment. The following seven benchmark cases were selected by YAEC and VYNPC to supplement the Simulator Acceptance Test Program: (1) control rod swap; (2) partial reactor scram; (3) recirculation pump trip; (4) main steam isolation valve (MSIV) closure without scram, (5) main steamline break, (6) small-break loss-of-coolant accident (LOCA), and (7) large-break LOCA. Five simulator benchmark sessions have been completed. Each session identified simulator capabilities and limitations that needed correction. This paper discusses results from the latest large-break LOCA case.

  2. Primary Atomic Clock Reference System

    NASA Technical Reports Server (NTRS)

    2001-01-01

    An artist's concept of the Primary Atomic Clock Reference System (PARCS) plarned to fly on the International Space Station (ISS). PARCS will make even more accurate atomic time available to everyone, from physicists testing Einstein's Theory of Relativity, to hikers using the Global Positioning System to find their way. In ground-based atomic clocks, lasers are used to cool and nearly stop atoms of cesium whose vibrations are used as the time base. The microgravity of space will allow the atoms to be suspended in the clock rather than circulated in an atomic fountain, as required on Earth. PARCS is being developed by the Jet Propulsion Laboratory with principal investigators at the National Institutes of Standards and Technology and the University of Colorado, Boulder. See also No. 0103191

  3. Primary Atomic Clock Reference System

    NASA Technical Reports Server (NTRS)

    2001-01-01

    An artist's concept of the Primary Atomic Clock Reference System (PARCS) plarned to fly on the International Space Station (ISS). PARCS will make even more accurate atomic time available to everyone, from physicists testing Einstein's Theory of Relativity, to hikers using the Global Positioning System to find their way. In ground-based atomic clocks, lasers are used to cool and nearly stop atoms of cesium whose vibrations are used as the time base. The microgravity of space will allow the atoms to be suspended in the clock rather than circulated in an atomic fountain, as required on Earth. PARCS is being developed by the Jet Propulsion Laboratory with principal investigators at the National Institutes of Standards and Technology and the University of Colorado, Boulder. See also No. 0100120.

  4. LOCA with consequential or delayed LOOP accidents: Unique issues, plant vulnerability, and CDF contributions

    SciTech Connect

    Martinez-Guridi, G.; Samanta, P.; Chu, L.; Yang, J.

    1998-08-01

    A loss-of-coolant accident (LOCA) can cause a loss-of-offsite power (LOOP) wherein the LOOP is usually delayed by few seconds or longer. Such an accident is called LOCA with consequential LOOP, or LOCA with delayed LOOP (here, abbreviated as LOCA/LOOP). This paper analyzes the unique conditions that are associated with a LOCA/LOOP, presents a model, and quantifies its contribution to core damage frequency (CDF). The results show that the CDF contribution can be a dominant contributor to risk for certain plant designs, although boiling water reactors (BWRs) are less vulnerable than pressurized water reactors (PWRs).

  5. SPACE code simulation of cold leg small break LOCA in the ATLAS integral test

    SciTech Connect

    Kim, B. J.; Kim, H. T.; Kim, J.; Kim, K. D.

    2012-07-01

    SPACE code is a system analysis code for pressurized water reactors. This code uses a two-fluid and three-field model. For a few years, intensive validations have been performed to secure the prediction accuracy of models and correlations for two-phase flow and heat transfer. Recently, the code version 1.0 was released. This study is to see how well SPACE code predicts thermal hydraulic phenomena of an integral effect test. The target experiment is a cold leg small break LOCA in the ATLAS facility, which has the same two-loop features as APR1400. Predicted parameters were compared with experimental observations. (authors)

  6. MELCOR code analysis of a severe accident LOCA at Peach Bottom Plant

    SciTech Connect

    Carbajo, J.J. )

    1993-01-01

    A design-basis loss-of-coolant accident (LOCA) concurrent with complete loss of the emergency core cooling systems (ECCSs) has been analyzed for the Peach Bottom atomic station unit 2 using the MELCOR code, version 1.8.1. The purpose of this analysis is to calculate best-estimate times for the important events of this accident sequence and best-estimate source terms. Calculated pressures and temperatures at the beginning of the transient have been compared to results from the Peach Bottom final safety analysis report (FSAR). MELCOR-calculated source terms have been compared to source terms reported in the NUREG-1465 draft.

  7. Modelling of LOCA Tests with the BISON Fuel Performance Code

    SciTech Connect

    Williamson, Richard L; Pastore, Giovanni; Novascone, Stephen Rhead; Spencer, Benjamin Whiting; Hales, Jason Dean

    2016-05-01

    BISON is a modern finite-element based, multidimensional nuclear fuel performance code that is under development at Idaho National Laboratory (USA). Recent advances of BISON include the extension of the code to the analysis of LWR fuel rod behaviour during loss-of-coolant accidents (LOCAs). In this work, BISON models for the phenomena relevant to LWR cladding behaviour during LOCAs are described, followed by presentation of code results for the simulation of LOCA tests. Analysed experiments include separate effects tests of cladding ballooning and burst, as well as the Halden IFA-650.2 fuel rod test. Two-dimensional modelling of the experiments is performed, and calculations are compared to available experimental data. Comparisons include cladding burst pressure and temperature in separate effects tests, as well as the evolution of fuel rod inner pressure during ballooning and time to cladding burst. Furthermore, BISON three-dimensional simulations of separate effects tests are performed, which demonstrate the capability to reproduce the effect of azimuthal temperature variations in the cladding. The work has been carried out in the frame of the collaboration between Idaho National Laboratory and Halden Reactor Project, and the IAEA Coordinated Research Project FUMAC.

  8. A Demonstration of Advanced Safety Analysis Tools and Methods Applied to Large Break LOCA and Fuel Analysis for PWRs

    SciTech Connect

    Szilard, Ronaldo Henriques; Smith, Curtis Lee; Martineau, Richard Charles

    2016-03-01

    The U.S. Nuclear Regulatory Commission (NRC) is currently proposing a rulemaking designated as 10 CFR 50.46c to revise the loss-of-coolant accident (LOCA)/emergency core cooling system acceptance criteria to include the effects of higher burnup on fuel/cladding performance. We propose a demonstration problem of a representative four-loop PWR plant to study the impact of this new rule in the US nuclear fleet. Within the scope of evaluation for the 10 CFR 50.46c rule, aspects of safety, operations, and economics are considered in the industry application demonstration presented in this paper. An advanced safety analysis approach is used, by integrating the probabilistic element with deterministic methods for LOCA analysis, a novel approach to solving these types of multi-physics, multi-scale problems.

  9. French investigations of high burnup effect on LOCA thermomechanical behavior: Part 1. Experimental programmes in support of LOCA design methodologies

    SciTech Connect

    Waeckel, N.; Cauvin, R.; Lebuffe, C.

    1997-01-01

    Within the framework of Burn-Up extension request, EDF, FRAMATOME, CEA and IPSN have carried out experimental programmes in order to provide the design of fuel rods under LOCA conditions with relevant data. The design methods used in France for LOCA are based on standard Appendix K methodology updated to take into account some penalties related to the actual conditions of the Nuclear Power Plant. Best-Estimate assessments are used as well. Experimental programmes concern plastic deformation and burst behavior of advanced claddings (EDGAR) and thermal shock quenching behavior of highly irradiated claddings (TAGCIR). The former reveals the important role played by the {alpha}/{beta} transformation kinetics related to advanced alloys (Niobium alloys) and the latter the significative impact of hydrogen charged during in-reactor corrosion on oxidation kinetics and failure behavior in terms of cooling rates.

  10. TREAT source-term experiment STEP-1 simulating a PWR LOCA

    SciTech Connect

    Simms, R.; Baker, L. Jr.; Blomquist, C.A.; Ritzman, R.L.

    1986-01-01

    In a hypothetical pressurized water reactor (PWR) large-break loss-of-coolant accident (LOCA) in which the emergency core cooling system fails, fission product decay heating causes water boil-off and reduced heat removal. Zircaloy cladding is oxidized by the steam. The noble gases and volatile fission products such as cesium and iodine that constitute a principal part of the source term will be released from the damaged fuel at or shortly after the time of cladding failure. TREAT test STEP-1 simulated the LOCA environment when the volatile fission products would be released using four fuel elements from the Belgonucleaire BR3 reactor. The principal objective was to collect a portion of the releases carried by the flow stream in a region as close as possible to the test zone. In this paper, the test is described and the results of an analysis of the thermal and steam/hydrogen environment are compared with the test measurements in order to provide a characterization for analysis of fission product releases and aerosol formation. The results of extensive sample examinations are reported separately.

  11. Preoperational test report, primary ventilation system

    SciTech Connect

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Primary Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space filtered venting of tanks AY101, AY102, AZ101, AZ102. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  12. TRAC-PF1/MOD1 US/Japanese PWR conservative LOCA prediction

    SciTech Connect

    Gruen, G E; Fisher, J E

    1987-11-01

    This report documents the results of a 200%, double-ended, cold-leg-break, loss-of-coolant-accident (LOCA) calculation using the TRAC-PF1/MOD1 computer code. The reactor system represented a typical United States/Japanese pressurized water reactor with a 15 x 15 fuel bundle arrangement 12-ft long, four loops, and cold-leg Emergency Core Cooling (ECC) Systems. Conservation boundary and initial conditions were used. Reactor power was 102% of the 3250 MWt rated power, decay heat was set to 120% of American Nuclear Society Standard 5.1, highest core lifetime values for power peaking and fuel stored energy were used, and the LOCA occurred simultaneously with a loss of offsite power. Best estimate assumptions were used for the break flow model, fuel rod heat transfer and metal-water reaction correlations, and steady-state fuel temperature profiles. A flow blockage model, having the capability to account for the effects of cladding ballooning or rupturing, was not used. Except for these best estimate assumptions, the boundary and initial conditions were consistent with those used in licensing calculations. Maximum fuel rod temperatures were 1380 K (2020/sup 0/F) and 1040 K (1410/sup 0/F) on the hottest evaluation model rod and hottest best estimate rod, respectively. The high reported values or fuel cladding temperature were a direct consequence of the conservative boundary and initial conditions used for the calculation, primarily the 2% overpower condition, the core decay heat assumption, and the degraded ECCS. The calculation demonstrated successful core reflooding before 1478 K (2200/sup 0/F) cladding temperature was exceeded on any fuel rod. 7 refs., 47 figs., 5 tabs.

  13. Primary systemic amyloidosis presenting as constrictive pericarditis.

    PubMed

    Singh, Vikas; Fishman, Joel E; Alfonso, Carlos E

    2011-01-01

    The most frequent presentation of cardiac amyloidosis is with endomyocardial deposition, and resultant restrictive cardiomyopathy. We present a case of primary systemic amyloidosis causing constrictive pericarditis (CP) and congestive heart failure without clinical evidence of endomyocardial deposition. A comprehensive evaluation by noninvasive and invasive studies facilitated the differentiation of CP from restrictive cardiomyopathy and the patient was effectively treated with pericardectomy. To our knowledge, this is the first documented case of primary systemic amyloidosis causing selective CP with successful antemortem diagnosis and treatment in a young man.

  14. Project Design Concept Primary Ventilation System

    SciTech Connect

    MCGREW, D.L.

    2000-10-02

    Tank Farm Restoration and Safe Operation (TFRSO), Project W-3 14 was established to provide upgrades that would improve the reliability and extend the system life of portions of the waste transfer, electrical, ventilation, instrumentation and control systems for the Hanford Site Tank Farms. An assessment of the tank farm system was conducted and the results are documented in system assessment reports. Based on the deficiencies identified in the tank farm system assessment reports, and additional requirements analysis performed in support of the River Protection Project (RPP), an approved scope for the TFRSO effort was developed and documented in the Upgrade Scope Summary Report (USSR), WHC-SD-W314-RPT-003, Rev. 4. The USSR establishes the need for the upgrades and identifies the specific equipment to be addressed by this project. This Project Design Concept (PDC) is in support of the Phase 2 upgrades and provides an overall description of the operations concept for the W-314 Primary Ventilation Systems. Actual specifications, test requirements, and procedures are not included in this PDC. The PDC is a ''living'' document, which will be updated throughout the design development process to provide a progressively more detailed description of the W-314 Primary Ventilation Systems design. The Phase 2 upgrades to the Primary Ventilation Systems shall ensure that the applicable current requirements are met for: Regulatory Compliance; Safety; Mission Requirements; Reliability; and Operational Requirements.

  15. Challenging mimickers of primary systemic vasculitis.

    PubMed

    Miloslavsky, Eli M; Stone, John H; Unizony, Sebastian H

    2015-01-01

    The need to distinguish true primary systemic vasculitis from its multiple potential mimickers is one of the most challenging diagnostic conundrums in clinical medicine. This article reviews 9 challenging vasculitis mimickers: fibromuscular dysplasia, calciphylaxis, segmental arterial mediolysis, antiphospholipid syndrome, hypereosinophilic syndrome, lymphomatoid granulomatosis, malignant atrophic papulosis, livedoid vasculopathy, and immunoglobulin G4-related disease.

  16. [Transforming health systems based on primary care].

    PubMed

    Durán-Arenas, Luis; Salinas-Escudero, Guillermo; Granados-García, Víctor; Martínez-Valverde, Silvia

    2012-01-01

    Access to health services is a social basic determinant of health in Mexico unlike what happens in developed countries. The demand for health services is focused on primary care, but the design meets only the supply of hospital care services. So it generates a dissonance between the needs and the effective design of health services. In addition, the term affiliation refers to population contributing or in the recruitment process, that has been counted as members of these social security institutions (SS) and Popular Insurance (SP). In the case of Instituto Mexicano del Seguro Social (IMSS) three of four contributors are in contact with health services; while in the SP, this indicator does not exist. Moreover, the access gap between health services is found in the health care packages so that members of the SS and SP do not have same type of coverage. The question is: which model of health care system want the Mexicans? Primary care represents the first choice for increasing the health systems performance, as well as to fulfill their function of social protection: universal access and coverage based on needs, regardless whether it is a public or private health insurance. A central aspect for development of this component is the definition of the first contact with the health system through the creation of a primary health care team, led by a general practitioner as the responsible of a multidisciplinary health team. The process addresses the concepts of primary care nursing, consumption of inputs (mainly medical drugs), maintenance and general services. Adopting a comprehensive strategy that will benefit all Mexicans equally and without discrimination, this primary care system could be financed with a total operating cost of approximately $ 22,809 million by year.

  17. Realization of a primary spectrophotometric system

    NASA Astrophysics Data System (ADS)

    Škerović, V.; Vukadin, P.; Zarubica, V.; Zeković, Lj

    2008-08-01

    The first step in establishing measurement uniformity in spectrophotometry is the realization of a versatile, fully evaluated and documented measurement system, which may, after metrological validation, be upheld as the primary spectrophotometric standard. In this paper, the development and realization of the spectrophotometer—primary standard in the Laboratory for Photometry of Bureau of Measures and Precious Metals—are presented. The construction of the system, as well as its metrological characterization, is shown. Evaluation of systematic errors due to various influential quantities and physical effects, such as light beam geometry effects, inter-reflections, nonlinearities and others, is presented. The results of measurements of spectral transmittance made with neutral optical filters and the evaluation of total measurement uncertainty are presented. Validation of the results was preformed according to National Institute for Standards and Technologies (NIST) certified standards of spectral transmittance.

  18. Systemic primary carnitine deficiency with hypoglycemic encephalopathy

    PubMed Central

    Jun, Jae Sung; Lee, Eun Joo; Park, Hyung Doo

    2016-01-01

    Acute hypoglycemia in children is not an uncommon disease that can be encountered in the Emergency Department. Most cases of childhood hypoglycemia are caused by ketotic hypoglycemia due to missed meals. Often, hypoketotic hypoglycemia can also occur, which suggests hyperinsulinemia or a defect in fatty acid oxidation. Carnitine is essential for long chain fatty acids transfer into mitochondria for oxidation. We present a case of systemic primary carnitine deficiency who presented with seizures due to hypoketotic hypoglycemia. PMID:28164076

  19. Outlier Benchmark Systems With Gaia Primaries

    NASA Astrophysics Data System (ADS)

    Marocco, Federico; Pinfield, David J.; Montes, David; Zapatero Osorio, Maria Rosa; Smart, Richard L.; Cook, Neil J.; Caballero, José A.; Jones, Hugh, R. A.; Lucas, Phil W.

    2016-07-01

    Benchmark systems are critical to assisting sub-stellar physics. While the known population of benchmarks hasincreased significantly in recent years, large portions of the age-metallicity parameter space remain unexplored.Gaia will expand enormously the pool of well characterized primary stars, and our simulations show that we couldpotentially have access to more than 6000 benchmark systems out to 300 pc, allowing us to whittle down thesenbsp;systems into a large sample with outlier properties that will reveal the nature of ultra-cool dwarfs in rare parameternbsp;space. In this contribution we present the preliminary results from our effort to identify and characterize ultra-coolnbsp;companions to Gaia-imaged stars with unusual values of metallicity. Since these systems are intrinsically rare, wenbsp;expand the volume probed by targeting faint, low-proper motion systems.nbsp;/p>

  20. Radiological dose in Muria peninsula from SB-LOCA event

    NASA Astrophysics Data System (ADS)

    Sunarko; Suud, Zaki

    2017-01-01

    Dose assessment for accident condition is performed for Muria Peninsula region using source-term from Three-Mile Island unit 2 SB-LOCA accident. Xe-133, Kr-88, 1-131 and Cs-137 isotopes are considered in the calculation. The effluent is assumed to be released from a 50 m stack. Lagrangian particle dispersion method (LPDM) employing non-Gaussian dispersion coefficient in 3-dimensional mass-consistent wind-field is employed to obtain periodic surface-level concentration which is then time-integrated to obtain spatial distribution of ground-level dose. In 1-hour simulation, segmented plumes with 60 seconds duration with a total of 18.000 particles involved. Simulations using 6-hour worst-case meteorological data from Muria peninsula results in a peak external dose of around 1.668 mSv for low scenario and 6.892 mSv for high scenario in dry condition. In wet condition with 5 mm/hour and 10 mm/hour rain for the whole duration of the simulation provides only minor effect to dose. The peak external dose is below the regulatory limit of 50 mSv for effective skin dose from external gamma exposure.

  1. REPOSITORY SURFACE FACILITIES PRIMARY SYSTEM CRANE DATA

    SciTech Connect

    K. Schwartztrauber

    2005-03-14

    The purpose of this calculation is to compile crane design data for the mechanical primary structures, systems, and components (SSCs) required for the repository Waste Handling Building (WHB) and Carrier Preparation Building (CPB). The work presented in this document has been prepared in accordance with Office of Civilian Radioactive Waste Management approved program document AP-3.12Q, Calculations. This calculation has been developed to supplement information previously prepared using the development plan for ''WHB/WTB Space Program Analysis for Site Recommendation'' (Reference 5), which concentrates on the primary, primary support, facility support, and miscellaneous building support areas located in the WHB and Waste Treatment Building (WTB). The development plan was completed in accordance with AP-2.13Q, ''Technical Product Development Planning''. The work in this calculation is a continuance of the work described in the previous development plan; therefore, in accordance with AP-2.21Q, ''Quality Determinations and Planning for Scientific, Engineering, and Regulatory Compliance Activities'', a new Technical Work Plan is not required.

  2. ACHILLES: Heat Transfer in PWR Core During LOCA Reflood Phase

    SciTech Connect

    2013-11-01

    1. NAME AND TITLE OF DATA LIBRARY ACHILLES -Heat Transfer in PWR Core During LOCA Reflood Phase. 2. NAME AND TITLE OF DATA RETRIEVAL PROGRAMS N/A 3. CONTRIBUTOR AEA Technology, Winfrith Technology Centre, Dorchester DT2 8DH United Kingdom through the OECD Nuclear Energy Agency Data Bank, Issy-les-Moulineaux, France. 4. DESCRIPTION OF TEST FACILITY The most important features of the Achilles rig were the shroud vessel, which contained the test section, and the downcomer. These may be thought of as representing the core barrel and the annular downcomer in the reactor pressure vessel. The test section comprises a cluster of 69 rods in a square array within a circular shroud vessel. The rod diameter and pitch (9.5 mm and 12.6 mm) were typical of PWR dimensions. The internal diameter of the shroud vessel was 128 mm. Each rod was electrically heated over a length of 3.66 m, which is typical of the nuclear heated length in a PWR fuel rod, and each contained 6 internal thermocouples. These were arranged in one of 8 groupings which concentrated the thermocouples in different axial zones. The spacer grids were at prototypic PWR locations. Each grid had two thermocouples attached to its trailing edge at radial locations. The axial power profile along the rods was an 11 step approximation to a "chopped cosine". The shroud vessel had 5 heating zones whose power could be independently controlled. 5. DESCRIPTION OF TESTS The Achilles experiments investigated the heat transfer in the core of a Pressurized Water Reactor during the re-flood phase of a postulated large break loss of coolant accident. The results provided data to validate codes and to improve modeling. Different types of experiments were carried out which included single phase cooling, re-flood under low flow conditions, level swell and re-flood under high flow conditions. Three series of experiments were performed. The first and the third used the same test section but the second used another test section, similar in

  3. Primary helium heater for propellant pressurization systems

    NASA Technical Reports Server (NTRS)

    Reichmuth, D. M.; Nguyen, T. V.; Pieper, J. L.

    1991-01-01

    The primary helium heater is a unique design that provides direct heating of pressurant gas for large pressure fed propulsion systems. It has been conceptually designed to supply a heated (800-1000 R) pressurization gas to both a liquid oxygen and an RP-1 propellant tank. This pressurization gas is generated within the heater by mixing super critical helium (40-300 R and 3000-1600 psi) with an appropriate amount of combustion products from a 4:1 throttling stoichiometric LO2/LH2 combustor. This simple, low cost and reliable mixer utilizes the large quantity of helium to provide stoichiometric combustor cooling, extend the throttling limits and enhance the combustion stability margin. Preliminary combustion, thermal, and CFD analyses confirm that this low-pressure-drop direct helium heater can provide the constant-temperature pressurant suitable for tank pressurization of both fuel and oxidizer tanks of large pressure fed vehicles.

  4. Cobalt-60 simulation of LOCA (loss of coolant accident) radiation effects

    SciTech Connect

    Buckalew, W.H.

    1989-07-01

    The consequences of simulating nuclear reactor loss of coolant accident (LOCA) radiation effects with Cobalt-60 gamma ray irradiators have been investigated. Based on radiation induced damage in polymer base materials, it was demonstrated that electron/photon induced radiation damage could be related on the basis of average absorbed radiation dose. This result was used to estimate the relative effectiveness of the mixed beta/gamma LOCA and Cobalt-60 radiation environments to damage both bare and jacketed polymer base electrical insulation materials. From the results obtained, it is concluded that present simulation techniques are a conservative method for simulating LOCA radiation effects and that the practices have probably substantially overstressed both bare and jacketed materials during qualification testing. 9 refs., 8 figs., 5 tabs.

  5. Primary reflector for solar energy collection systems

    NASA Technical Reports Server (NTRS)

    Miller, C. G. (Inventor); Stephens, J. B.

    1978-01-01

    A fixed, linear, ground-based primary reflector is disclosed which has an extended curved sawtooth-contoured surface covered with a metalized polymeric reflecting material. The device reflects solar energy to a movably supported collector that is kept at the concentrated line focus of the reflector primary. The primary reflector may be constructed by a process utilizing well-known freeway paving machinery.

  6. Considerations for Probabilistic Analyses to Assess Potential Changes to Large-Break LOCA Definition for ECCS Requirements

    SciTech Connect

    Wilkowski, G.; Rudland, D.; Wolterman, R.; Krishnaswamy, P.; Scott, P.; Rahman, S.; Fairbanks, C.

    2002-07-01

    The U.S.NRC has undertaken a study to explore changes to the body of Part 50 of the U.S. Federal Code of Regulations, to incorporate risk-informed attributes. One of the regulations selected for this study is 10 CFR 50.46, {sup A}cceptance Criteria for Emergency Core Cooling Systems for Light-Water Nuclear Power Reactors{sup .} These changes will potentially enhance safety and reduce unnecessary burden on utilities. Specific attention is being paid to redefining the maximum pipe break size for LB-LOCA by determining the spectrum of pipe diameter (or equivalent opening area) versus failure probabilities. In this regard, it is necessary to ensure that all contributors to probabilistic failures are accounted for when redefining ECCS requirements. This paper describes initial efforts being conducted for the U.S.NRC on redefining the LB-LOCA requirements. Consideration of the major contributors to probabilistic failure, and deterministic aspects for modeling them, are being addressed. At this time three major contributors to probabilistic failures are being considered. These include: (1) Analyses of the failure probability from cracking mechanisms that could involve rupture or large opening areas from either through-wall or surface flaws, whether the pipe system was approved for leak-before-break (LBB) or not. (2) Future degradation mechanisms, such as recent occurrence of PWSCC in PWR piping need to be included. This degradation mechanism was not recognized as being an issue when LBB was approved for many plants or when the initial risk-informed inspection plans were developed. (3) Other indirect causes of loss of pressure-boundary integrity than from cracks in the pipe system also should be included. The failure probability from probabilistic fracture mechanics will not account for these other indirect causes that could result in a large opening in the pressure boundary: i.e., failure of bolts on a steam generator manway, flanges, and valves; outside force damage from

  7. Transport Characteristics of Selected Pressurized Water Reactor LOCA-Generated Debris

    SciTech Connect

    Maji, Arup K.; Rao, Daseri V.; Letellier, Bruce; Bartlein, Luke; Marshall, Brooke

    2002-08-15

    In the unlikely event of a loss-of-coolant accident (LOCA) in a pressurized water reactor, break jet impingement would dislodge thermal insulation from nearby piping, as well as other materials within the containment, such as paint chips, concrete dust, and fire barrier materials. Steam/water flows induced by the break and by the containment sprays would transport debris to the containment floor. Subsequently, debris would likely transport to and accumulate on the suction sump screens of the emergency core cooling system (ECCS) pumps, thereby potentially degrading ECCS performance and possibly even failing the ECCS.A systematic study was conducted on various types of fibrous and metallic foil debris to determine their transport in water. Test results reported include incipient movement, bulk movement, accumulation on a screen, the ability of debris to jump over 5-cm (2-in.) and 15-cm (6-in.) curbs, and the effects of accelerating flow and turbulence. These data are currently being used in conjunction with computational fluid dynamics modeling to determine the potential for each debris type to reach the suction screen.

  8. Large-break LOCA, in-reactor fuel bundle Materials Test MT-6A

    SciTech Connect

    Wilson, C.L.; Hesson, G.M.; Pilger, J.P.; King, L.L.; Panisko, F.E.

    1993-09-01

    This is a report on one of a series of experiments to simulates a loss-of-coolant accident (LOCA) using full-length fuel rods for pressurized water reactors (PWR). The experiments were conducted by Pacific Northwest Laboratory (PNL) under the LOCA simulation Program sponsored by the US Nuclear Regulatory Commission (NRC). The major objective of this program was causing the maximum possible expansion of the cladding on the fuel rods from a short-term adiabatic temperature transient to 1200 K (1700 F) leading to the rupture of the cladding; and second, by reflooding the fuel rods to determine the rate at which the fuel bundle is cooled.

  9. Primary central nervous system posttransplant lymphoproliferative disorders.

    PubMed

    Castellano-Sanchez, Amilcar A; Li, Shiyong; Qian, Jiang; Lagoo, Anand; Weir, Edward; Brat, Daniel J

    2004-02-01

    Posttransplant lymphoproliferative disorders (PTLDs) represent a spectrum ranging from Epstein-Barr virus (EBV)-driven polyclonal lymphoid proliferations to EBV+ or EBV- malignant lymphomas. Central nervous system (CNS) PTLDs have not been characterized fully. We reviewed the clinical, radiologic, and pathologic features of 12 primary CNS PTLDs to define them more precisely. Patients included 10 males and 2 females (median age, 43.4 years) who were recipients of kidney (n = 5), liver (n = 2), heart (n = 2), peripheral blood stem cells (n = 2), or bone marrow (n = 1). All received immunosuppressive therapy. CNS symptoms developed 3 to 131 months (mean, 31 months) after transplantation. By neuroimaging, most showed multiple (3 to 9) intra-axial, contrast-enhancing lesions. Histologic sections showed marked expansion of perivascular spaces by large, cytologically malignant lymphoid cells that were CD45+, CD20+, EBV+ and showed light chain restriction or immunoglobulin gene rearrangement. In distinction to PTLDs in other organ systems, CNS PTLDs were uniformly high-grade lymphomas that fulfilled the World Health Organization criteria for monomorphic PTLDs. Extremely short survival periods were noted for each CNS PTLD that followed peripheral blood stem cell transplantation. Survival of others with CNS PTLD varied; some lived more than 2 years.

  10. Pediatric primary care as a component of systems of care.

    PubMed

    Brown, Jonathan D

    2010-02-01

    Systems of care should be defined in a manner that includes primary care. The current definition of systems of care shares several attributes with the definition of primary care: both are defined as community-based services that are accessible, accountable, comprehensive, coordinated, culturally competent, and family focused. However, systems of care is defined as serving only children and youth with serious emotional disturbance and their families and does not fully embrace the concept of primary prevention. Although similarities in the definitions of primary care and systems of care may provide a theoretical foundation for including primary care within the systems of care framework, a definition of systems of care that incorporates the idea of prevention and takes into account the broad population served in primary care would provide communities with a definition that can be used to further the work of integrating primary care into systems of care.

  11. Development of Educational Management System in Small Primary School

    ERIC Educational Resources Information Center

    Alsammarry, Yupayao; Sirisuthi, Chaiyuth; Duangcharthom, Surat

    2016-01-01

    The purposes of the research were: (1) to study the factors of Educational Management System in Small Primary School; (2) to investigate current situations problems and guidelines of developing educational management in small primary school; (3) to develop Educational Management System in Small Primary School; and (4) to examine the results of…

  12. Downscaling humidity with Localized Constructed Analogs (LOCA) over the conterminous United States

    NASA Astrophysics Data System (ADS)

    Pierce, D. W.; Cayan, D. R.

    2016-07-01

    Humidity is important to climate impacts in hydrology, agriculture, ecology, energy demand, and human health and comfort. Nonetheless humidity is not available in some widely-used archives of statistically downscaled climate projections for the western U.S. In this work the Localized Constructed Analogs (LOCA) statistical downscaling method is used to downscale specific humidity to a 1°/16° grid over the conterminous U.S. and the results compared to observations. LOCA reproduces observed monthly climatological values with a mean error of ~0.5 % and RMS error of ~2 %. Extreme (1-day in 1- and 20-years) maximum values (relevant to human health and energy demand) are within ~5 % of observed, while extreme minimum values (relevant to agriculture and wildfire) are within ~15 %. The asymmetry between extreme maximum and minimum errors is largely due to residual errors in the bias correction of extreme minimum values. The temporal standard deviations of downscaled daily specific humidity values have a mean error of ~1 % and RMS error of ~3 %. LOCA increases spatial coherence in the final downscaled field by ~13 %, but the downscaled coherence depends on the spatial coherence in the data being downscaled, which is not addressed by bias correction. Temporal correlations between daily, monthly, and annual time series of the original and downscaled data typically yield values >0.98. LOCA captures the observed correlations between temperature and specific humidity even when the two are downscaled independently.

  13. Teachers' Performance Motivation System in Thai Primary Schools

    ERIC Educational Resources Information Center

    Pasathang, Sarojn; Tesaputa, Kowat; Sataphonwong, Pattananusron

    2016-01-01

    This research aims to: 1) study the present conditions and desirable condition of the motivation systems as well as how to find methods for motivating the performance of teachers in primary schools, 2) develop a motivation system for the performance of teachers in primary schools, 3) study the effects of using the motivation system for compliance…

  14. Pediatric Primary Care as a Component of Systems of Care

    ERIC Educational Resources Information Center

    Brown, Jonathan D.

    2010-01-01

    Systems of care should be defined in a manner that includes primary care. The current definition of systems of care shares several attributes with the definition of primary care: both are defined as community-based services that are accessible, accountable, comprehensive, coordinated, culturally competent, and family focused. However, systems of…

  15. [Primary central nervous system lymphoma: report of one case].

    PubMed

    Zhao, Peng; Su, Rong-Gang

    2002-04-01

    One case of primary central nervous system lymphoma was reported. The patient received comprehensive therapy, mainly the surgical treatment, with the survival time 12 months, and local recurrence was considered as the major cause of death. The pathology, imagine examination, diagnosis and treatment of primary central nervous system lymphoma were discussed.

  16. Primary healthcare system and practice characteristics in Singapore.

    PubMed

    Khoo, Hwee Sing; Lim, Yee Wei; Vrijhoef, Hubertus Jm

    2014-01-01

    It is crucial to adapt and improve the (primary) health care systems of countries to prepare for future patient profiles and their related needs. The main aim of this study was to acquire a comprehensive overview of the perceptions of primary care experts in Singapore about the state of primary care in Singapore, and to compare this with the state of primary care in other countries. Notwithstanding ranked 2(nd) in terms of efficiency of health care, Singapore is facing significant health care challenges. Emails were sent to 85 experts, where they were asked to rate Singapore's primary care system based on nine internationally adopted health system characteristics and six practice characteristics (response rate = 29%). The primary care system in Singapore received an average of 10.9 out of 30 possible points. Lowest ratings were given to: earnings of primary care physicians compared to specialists, requirement for 24 hr accessibility of primary care services, standard of family medicine in academic departments, reflection of community served by practices in patient lists, and the access to specialists without needing to be referred by primary care physicians. Singapore was categorized as a 'low' primary care country according to the experts.

  17. Generic Safety Issue (GSI) 171 -- Engineered Safety Feature (ESF) failure from a loop subsequent to LOCA: Assessment of plant vulnerability and CDF contributions

    SciTech Connect

    Martinez-Guridi, G.; Samanta, P.; Chu, L.; Yang, J.

    1998-03-01

    Generic Safety Issue 171 (GSI-171), Engineered Safety Feature (ESF) from a Loss Of Offsite Power (LOOP) subsequent to a Loss Of Coolant Accident (LOCA), deals with an accident sequence in which a LOCA is followed by a LOOP. This issue was later broadened to include a LOOP followed by a LOCA. Plants are designed to handle a simultaneous LOCA and LOOP. In this paper, the authors address the unique issues that are involved i LOCA with delayed LOOP (LOCA/LOOP) and LOOP with delayed LOCA (LOOP/LOCA) accident sequences. LOCA/LOOP accidents are analyzed further by developing event-tree/fault-tree models to quantify their contributions to core-damage frequency (CDF) in a pressurized water reactor and a boiling water reactor (PWR and a BWR). Engineering evaluation and judgments are used during quantification to estimate the unique conditions that arise in a LOCA/LOOP accident. The results show that the CDF contribution of such an accident can be a dominant contributor to plant risk, although BWRs are less vulnerable than PWRs.

  18. Characteristics of primary electric propulsion systems. [conferences

    NASA Technical Reports Server (NTRS)

    Byers, D. C.

    1979-01-01

    The use of advanced electric propulsion systems is expected to provide cost and performance benefits for future energetic space missions. A methodology to predict the characteristics of advanced electric propulsion systems was developed and programmed for computer calculations to allow evaluation of a broad set of technology and mission assumptions. The impact on overall thrust system characteristics was assessed for variations of propellant type, total accelerating voltage, thruster area, specific impulse, and power system approach. The data may be used both to provide direction to technology emphasis and allow for preliminary estimates of electric propulsion system properties for a wide variety of applications.

  19. Effect of LOCA simulation procedures on ethylene propylene rubber's mechanical and electrical properties

    SciTech Connect

    Bustard, L.D.

    1983-10-01

    Electrical and mechanical properties of several commercial ethylene-propylene rubber (EPR) materials, typically used as electrical cable insulation, have been monitored during three simulations of nuclear power plant aging and accident stresses. For one set of cables and separate tensile specimens we did a sequential test. We first performed accelerated thermal aging, then irradiated the samples to the combined aging and LOCA total dose. Finally we applied a steam exposure. For a second and third set of cables and separate tensile specimens we used simultaneous applications of elevated temperature and radiation stresses to preaccident age our specimens. We followed these aging exposures by simultaneous radiation and steam exposures to simulate a LOCA environment. Our measurement parameters during these tests included: dc insulation resistance, ac leakage current, ultimate tensile strength, ultimate tensile elongation, percentage dimensional changes, and percentage moisture absorption. We present test results for nine EPR materials. The implications of our research results for future cable qualification testing efforts is discussed.

  20. Assessment of CONTAIN and MELCOR for performing LOCA and LOVA analyses in ITER

    SciTech Connect

    Merrill, B.J.; Hagrman, D.L.; Gaeta, M.J.; Petti, D.A.

    1994-09-01

    This report describes the results of an assessment of the CONTAIN and MELCOR computer codes for ITER LOCA and LOVA applications. As part of the assessment, the results of running a test problem that describes an ITER LOCA are presented. It is concluded that the MELCOR code should be the preferred code for ITER severe accident thermal hydraulic analyses. This code will require the least modification to be appropriate for calculating thermal hydraulic behavior in ITER relevant conditions that include vacuum, cryogenics, ITER temperatures, and the presence of a liquid metal test module. The assessment of the aerosol transport models in these codes concludes that several modifications would have to be made to CONTAIN and/or MELCOR to make them applicable to the aerosol transport part of severe accident analysis in ITER.

  1. Effect of LOCA simulation procedures on cross-linked polyolefin cable's performance

    SciTech Connect

    Bustard, L.D.

    1984-04-01

    Electrical and mechanical properties of three commercial cross-linked polyolefin (XLPO) materials, typically used as electrical cable insulation, have been monitored during these simulations of nuclear power plant aging and accident stresses. For one XLPO cable accelerated thermal aging is performed, then the samples are irradiated to the combined aging and LOCA total dose. Finally, a steam exposure is applied. For a second and third set of XLPO cables simultaneous applications of elevated temperature and radiation stresses are used to preaccident age specimens. These aging exposures are followed by simultaneous and steam exposures to simulate a LOCA environment. The measurement parameters during these tests included: dc insulation resistance, ac leakage current, ultimate tensile strength, ultimate tensile elongation, percentage dimensional changes, and percentage moisture absorption. Test results for three XLPO materials are presented.

  2. Effect of aging on EPR cable electrical performance during LOCA simulations. [Ethylene propylene rubber

    SciTech Connect

    Bustard, L.D.

    1984-01-01

    When exposed to a LOCA environment, some ethylene propylene rubber (EPR) cable materials experience substantial moisture absorption and dimensional changes. These phenomena may contribute to mechanical damage of the cable insulation resulting in electrical degradation. Recent experiments illustrate that the extent of moisture absorption and dimensional changes during an accident simulation are dependent on the EPR product, the accelerated age, and the aging technique employed to achieve that age. Results for several commercial EPR materials are summarized.

  3. School Management Information Systems in Primary Schools

    ERIC Educational Resources Information Center

    Demir, Kamile

    2006-01-01

    Developments in information technologies have been impacting upon educational organizations. Principals have been using management information systems to improve the efficiency of administrative services. The aim of this research is to explore principals' perceptions about management information systems and how school management information…

  4. Long-term aging and loss-of-coolant accident (LOCA) testing of electrical cables

    SciTech Connect

    Nelson, C.F.; Gauthier, G.; Carlin, F.

    1996-10-01

    Experiments were performed to assess the aging degradation and loss-of-coolant accident (LOCA) behavior of electrical cables subjected to long-term aging exposures. Four different cable types were tested in both the U.S. and France: (1) U.S. 2 conductor with ethylene propylene rubber (EPR) insulation and a Hypalon jacket. (2) U.S. 3 conductor with cross-linked polyethylene (XLPE) insulation and a Hypalon jacket. (3) French 3 conductor with EPR insulation and a Hypalon jacket. (4) French coaxial with polyethylene (PE) insulation and a PE jacket. The data represent up to 5 years of simultaneous aging where the cables were exposed to identical aging radiation doses at either 40{degrees}C or 70{degrees}C; however, the dose rate used for the aging irradiation was varied over a wide range (2-100 Gy/hr). Aging was followed by exposure to simulated French LOCA conditions. Several mechanical, electrical, and physical-chemical condition monitoring techniques were used to investigate the degradation behavior of the cables. All the cables, except for the French PE cable, performed acceptably during the aging and LOCA simulations. In general, cable degradation at a given dose was highest for the lowest dose rate, and the amount of degradation decreased as the dose rate was increased.

  5. Experimental investigation on the causes for pellet fragmentation under LOCA conditions

    NASA Astrophysics Data System (ADS)

    Bianco, A.; Vitanza, C.; Seidl, M.; Wensauer, A.; Faber, W.; Macián-Juan, R.

    2015-10-01

    This paper addresses a separate effect experiment performed with irradiated fuel to study fuel fragmentation and fission gas release during a loss of coolant accident (LOCA). The paper presents a qualitative and quantitative investigation of the effects of the removal of the geometrical constraint provided by the cladding and the removal of the constraint given by the rod internal pressure in determining the extent of fuel fragmentation and fission gas release during a LOCA for fuel segments with a burnup of approximately 52 MWd/kgU. A review of previous LOCA tests was the starting point for the identification of these constraints and for the selection of the fuel rod burnup, the experiment's procedure and the boundary conditions. An out-of-pile test was considered representative for the scope, and the experiment was performed at the Halden Reactor Project hot cell in Kjeller (Norway) with heat provided by an electric oven. Three fuel rod segments were studied: 1) a fuel segment that experienced only ballooning without burst, 2) a fuel segment that experienced ballooning and burst and 3) a fuel segment that experienced neither ballooning nor burst. The neutron radiography and fuel fragment sifting showed that both cladding constraint and internal pressure play a role in the formation of fuel cracks and fragmentation, and the study of the fission gas release during the transient showed that removing the cladding constraint or the internal pressure increased the amount of fission gas release.

  6. Experimental investigation of sedimentation of LOCA - generated fibrous debris and sludge in BWR suppression pools

    SciTech Connect

    Souto, F.J.; Rao, D.V.

    1995-12-01

    Several tests were conducted in a 1:2.4 scale model of a Mark I suppression pool to investigate the behavior of fibrous insulation and sludge debris under LOCA conditions. NUKON{trademark} shreds, manually cut and tore up in a leaf shredder, and iron oxide particles were used to simulate fibrous and sludge debris, respectively. The suppression pool model included four downcomers fitted with pistons to simulate the steam-water oscillations during chugging expected during a LOCA. The study was conducted to provide debris settling velocity data for the models used in the BLOCKAGE computer code, developed to estimate the ECCS pump head loss due to clogging of the strainers with LOCA generated debris. The tests showed that the debris, both fibrous and particulate, remains fully mixed during chugging; they also showed that, during chugging, the fibrous debris underwent fragmentation into smaller sizes, including individual fibers. Measured concentrations showed that fibrous debris settled slower than the sludge, and that the settling behavior of each material is independent of the presence of the other material. Finally, these tests showed that the assumption of considering uniform debris concentration during strainer calculations is reasonable. The tests did not consider the effects of the operation of the ECCS on the transport of debris in the suppression pool.

  7. Primary care training and the evolving healthcare system.

    PubMed

    Peccoralo, Lauren A; Callahan, Kathryn; Stark, Rachel; DeCherrie, Linda V

    2012-01-01

    With growing numbers of patient-centered medical homes and accountable care organizations, and the potential implementation of the Patient Protection and Affordable Care Act, the provision of primary care in the United States is expanding and changing. Therefore, there is an urgent need to create more primary-care physicians and to train physicians to practice in this environment. In this article, we review the impact that the changing US healthcare system has on trainees, strategies to recruit and retain medical students and residents into primary-care internal medicine, and the preparation of trainees to work in the changing healthcare system. Recruitment methods for medical students include early preclinical exposure to patients in the primary-care setting, enhanced longitudinal patient experiences in clinical clerkships, and primary-care tracks. Recruitment methods for residents include enhanced ambulatory-care training and primary-care programs. Financial-incentive programs such as loan forgiveness may encourage trainees to enter primary care. Retaining residents in primary-care careers may be encouraged via focused postgraduate fellowships or continuing medical education to prepare primary-care physicians as both teachers and practitioners in the changing environment. Finally, to prepare primary-care trainees to effectively and efficiently practice within the changing system, educators should consider shifting ambulatory training to community-based practices, encouraging resident participation in team-based care, providing interprofessional educational experiences, and involving trainees in quality-improvement initiatives. Medical educators in primary care must think innovatively and collaboratively to effectively recruit and train the future generation of primary-care physicians.

  8. Application of Total Quality Management System in Thai Primary Schools

    ERIC Educational Resources Information Center

    Prueangphitchayathon, Setthiya; Tesaputa, Kowat; Somprach, Kanokorn

    2015-01-01

    The present study seeks to develop a total quality management (TQM) system that can be applied to primary schools. The approach focuses on customer orientation, total involvement of all constituencies and continuous improvement. TQM principles were studied and synthesized according to case studies of the best practices in 3 primary schools (small,…

  9. Primary Health Care in Canada: Systems in Motion

    PubMed Central

    Hutchison, Brian; Levesque, Jean-Frederic; Strumpf, Erin; Coyle, Natalie

    2011-01-01

    Context: During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged. Methods: This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Findings: Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Conclusions: Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert. PMID:21676023

  10. Primary amoebic meningoencephalitis in a patient with systemic lupus erythematosus.

    PubMed

    Shrestha, Nabin K; Khanal, Basudha; Sharma, Sanjib K; Dhakal, Subodh S; Kanungo, Reba

    2003-01-01

    This report describes a case of primary amoebic meningoencephalitis in a patient with systemic lupus erythematosus. No specific exposure was identified. Treatment with intravenous amphotericin B was associated with marked clinical improvement, but subsequent fatal relapse while still on therapy.

  11. French investigations of high burnup effect on LOCA thermomecanical behavior. Part two. Oxidation and quenching experiments under simulated LOCA conditions with high burnup clad material

    SciTech Connect

    GrandJean, C.; Cauvin, R.; Lebuffe, C.

    1997-01-01

    In the frame of the high burnup fuel studies to support a possible extension of the current discharge burnup limit, experimental programs have been undertaken, jointly by EDF and IPSN in order to study the thermal-shock behavior of high burnup fuel claddings under typical LOCA conditions. The TAGUS program used unirradiated cladding samples, bare or bearing a pre-corrosion state simulating the end-of-life state of high burnup fuel claddings: the TAGCIR program used actually irradiated cladding samples taken from high burnup rods irradiated over 5 cycles in a commercial EDF PWR and having reached a rod burnup close to 60 GWd/tU. The thermal-shock failure tests consisted in oxidizing the cladding samples under steam flow, on both inner and outer faces or on the outer face alone, and subjecting them to a final water quench. The heating was provided by an inductive furnace the power of which being regulated through monitoring of the sample surface temperature with use of a single-wave optical pyrometer. Analysis of the irradiated tests (TAGCIR series) evidenced an increased oxidation rate as compared to similar tests on unirradiated samples. Results of the quenching tests series on unirradiated and irradiated samples are plotted under the usual presentation of failure maps relative to the oxidation parameters ECR (equivalent cladding reacted) or e{sub {beta}} (thickness of the remaining beta phase layer) as a function of the oxidation temperature. Comparison of the failure limits for irradiated specimens to those for unirradiated specimens indicates a lower brittleness under two side oxidation and possibly the opposite under one-side oxidation. The tentative analysis of the oxidation and quenching tests results on irradiated samples reveals the important role played by the hydrogen charged during in-reactor corrosion on the oxidation kinetics and the failure bearing capability of the cladding under LOCA transient conditions.

  12. Viking 75 project: Viking lander system primary mission performance report

    NASA Technical Reports Server (NTRS)

    Cooley, C. G.

    1977-01-01

    Viking Lander hardware performance during launch, interplanetary cruise, Mars orbit insertion, preseparation, separation through landing, and the primary landed mission, with primary emphasis on Lander engineering and science hardware operations, the as-flown mission are described with respect to Lander system performance and anomalies during the various mission phases. The extended mission and predicted Lander performance is discussed along with a summary of Viking goals, mission plans, and description of the Lander, and its subsystem definitions.

  13. Numerical simulation of PWR response to a small break LOCA (loss-of-coolant accident) with reactor coolant pumps operating

    SciTech Connect

    Adams, J.P.; Dobbe, C.A.; Bayless, P.D.

    1986-01-01

    Calculations have been made of the response of pressurized water reactors (PWRs) during a small-break, loss-of-coolant accident with the reactor coolant pumps (RCPs) operating. This study was conducted, as part of a comprehensive project, to assess the relationship between measurable RCP parameters, such as motor power or current, and fluid density, both local (at the RCP inlet) and global (average reactor coolant system). Additionally, the efficacy of using these RCP parameters, together with fluid temperature, to identify an off-nominal transient as either a LOCA, a heatup transient, or a cooldown transient and to follow recovery from the transient was assessed. The RELAP4 and RELAP5 computer codes were used with three independent sets of RCP, two-phase degradation multipliers. These multipliers were based on data obtained in two-phase flow conditions for the Semiscale, LOFT, and Creare/Combustion Engineering (CE)/Electric Power Research Institute (EPRI) pumps, respectively. Two reference PWRs were used in this study: Zion, a four-loop, 1100-MWe, Westinghouse plant operated by Commonwealth Edison Co. in Zion, Illinois and Bellefonte, a two-by-four loop, 1213 MWe, Babcock and Wilcox designed plant being built by the Tennessee Valley Authority in Scottsboro, Alabama. The results from this study showed that RCP operation resulted in an approximately homogeneous reactor coolant system and that this result was independent of reference plant, computer code, or two-phase RCP head degradation multiplier used in the calculation.

  14. R&D Plan for RISMC Industry Application #1: ECCS/LOCA Cladding Acceptance Criteria

    SciTech Connect

    Szilard, Ronaldo Henriques; Zhang, Hongbin; Epiney, Aaron Simon; Tu, Lei

    2016-04-01

    The Nuclear Regulatory Commission (NRC) is finalizing a rulemaking change that would revise the requirements in 10 CFR 50.46. In the proposed new rulemaking, designated as 10 CFR 50.46c, the NRC proposes a fuel performance-based equivalent cladding reacted (ECR) criterion as a function of cladding hydrogen content before the accident (pre-transient) in order to include the effects of higher burnup on cladding performance as well as to address other technical issues. A loss of operational margin may result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee costs as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. The Idaho National Laboratory (INL) has initiated a project, as part of the DOE Light Water Reactor Sustainability Program (LWRS), to develop analytical capabilities to support the industry in the transition to the new rule. This project is called the Industry Application 1 (IA1) within the Risk-Informed Safety Margin Characterization (RISMC) Pathway of LWRS. The general idea behind the initiative is the development of an Integrated Evaluation Model (IEM). The motivation is to develop a multiphysics framework to analyze how uncertainties are propagated across the stream of physical disciplines and data involved, as well as how risks are evaluated in a LOCA safety analysis as regulated under 10 CFR 50.46c. This IEM is called LOTUS which stands for LOCA Toolkit for US, and it represents the LWRS Program’s response to the proposed new rule making. The focus of this report is to complete an R&D plan to describe the demonstration of the LOCA/ECCS RISMC Industry Application # 1 using the advanced RISMC Toolkit and methodologies. This report includes the description and development plan for a RISMC LOCA tool that fully couples advanced MOOSE tools already in development in order to characterize and optimize

  15. Importance of thermal nonequilibrium considerations for the simulation of nuclear reactor LOCA transients. [PWR

    SciTech Connect

    Fischer, S.R.; Nelson, R.A.; Sullivan, L.H.

    1980-01-01

    The purpose of this paper is to show the importance of considering thermal nonequilibrium effects in computer simulations of the refill and reflood portions of pressurized water reactor (PWR) loss-of-coolnat accident (LOCA) transients. Although RELAP4 assumes thermodynamic equilibrium between phases, models that account for the nonequilibrium phenomena associated with the mixing of subcooled emergency cooling water with steam and the superheating of vapor in the presence of liquid droplets have recently been incorporated into the code. Code calculated results, both with and without these new models, have been compared with experimental test data to assess the importance of including thermal nonequilibrium phenomena in computer code simulations.

  16. Best-estimate LOCA radiation signature for equipment qualification. [PWR; BWR

    SciTech Connect

    Lurie, N.A.; Bonzon, L.L.

    1980-01-01

    The radiation aspect of reactor equipment qualification depends on a knowledge of the appropriate source term. An attempt has been made to define a realistic radiation source corresponding to the loss-of-coolant accident. This best-estimate source is based on available fission product release data from damaged fuel during an unterminated LOCA as described in the Reactor Safety Study (WASH-1400). Energy release rates as a function of time have been calculated for both betas and gamma rays. The results are significantly different from the sources specified in Regulatory Guide 1.89. Spectra corresponding to the best-estimate source have also been computed at selected cooling times.

  17. 78 FR 28896 - Design Limits and Loading Combinations for Metal Primary Reactor Containment System Components

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... COMMISSION Design Limits and Loading Combinations for Metal Primary Reactor Containment System Components... Combinations for Metal Primary Reactor Containment System Components,'' in which there are no substantive... loading combinations for metal primary reactor containment system components. ADDRESSES: Please refer...

  18. The 747 primary flight control systems reliability and maintenance study

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The major operational characteristics of the 747 Primary Flight Control Systems (PFCS) are described. Results of reliability analysis for separate control functions are presented. The analysis makes use of a NASA computer program which calculates reliability of redundant systems. Costs for maintaining the 747 PFCS in airline service are assessed. The reliabilities and cost will provide a baseline for use in trade studies of future flight control system design.

  19. Primary electric power generation systems for advanced-technology engines

    NASA Technical Reports Server (NTRS)

    Cronin, M. J.

    1983-01-01

    The advantages of the all electric airplane are discussed. In the all electric airplane the generator is the sole source of electric power; it powers the primary and secondary flight controls, the environmentals, and the landing gear. Five candidates for all electric power systems are discussed and compared. Cost benefits of the all electric airplane are discussed.

  20. Aging, Loss-of-Coolant Accident (LOCA), and high potential testing of damaged cables

    SciTech Connect

    Vigil, R.A.; Jacobus, M.J.

    1994-04-01

    Experiments were conducted to assess the effects of high potential testing of cables and to assess the survivability of aged and damaged cables under Loss-of-Coolant Accident (LOCA) conditions. High potential testing at 240 Vdc/mil on undamaged cables suggested that no damage was incurred on the selected virgin cables. During aging and LOCA testing, Okonite ethylene propylene rubber (EPR) cables with a bonded jacket experienced unexpected failures. The failures appear to be primarily related to the level of thermal aging and the presence of a bonded jacket that ages more rapidly than the insulation. For Brand Rex crosslinked polyolefin (XLPO) cables, the results suggest that 7 mils of insulation remaining should give the cables a high probability of surviving accident exposure following aging. The voltage necessary to detect when 7 mils of insulation remain on unaged Brand Rex cables is approximately 35 kVdc. This voltage level would almost certainly be unacceptable to a utility for use as a damage assessment tool. However, additional tests indicated that a 35 kvdc voltage application would not damage virgin Brand Rex cables when tested in water. Although two damaged Rockbestos silicone rubber cables also failed during the accident test, no correlation between failures and level of damage was apparent.

  1. Potential for boron dilution during small-break LOCAs in PWRs

    SciTech Connect

    Nourbakhsh, H.P.; Cheng, Z.

    1995-11-01

    This paper documents the results of a scoping study of boron dilution and mixing phenomena during small break loss of coolant accidents (LOCAs) in pressurized water reactors (PWRs). Boron free condensate can accumulate in the cold leg loop seals when the reactor is operating in a reflux/boiler condenser mode. A problem may occur when the subsequent change in flow conditions such as loop seal clearing or re-establishment of natural circulation flow drive the diluted water in the loop seals into the reactor core without sufficient mixing with the highly borated water in the reactor downcomer and lower plenum. The resulting low boron concentration coolant entering the core may cause a power excursion leading to fuel failure. The mixing processes associated with a slow moving stream of diluted water through the loop seal to the core were examined in this report. A bounding evaluation of the range of boron concentration entering the core during a small break LOCA in a typical Westinghouse-designed, four-loop plant is also presented in this report.

  2. An Exploratory Study on How Primary Pupils Approach Systems

    ERIC Educational Resources Information Center

    Koski, Marja-Ilona; de Vries, Marc

    2013-01-01

    This paper presents a study of systems thinking among 27 primary pupils (8-10 years old) and their teacher. The study included a pre-test for the teacher and the pupils, lesson planning, the actual lesson and a post-test for the pupils. The research focused on finding an answer to three questions: (1) do pupils see a system as a structure…

  3. [Primary central nervous system lymphoma: pathogenesis and histomorphology].

    PubMed

    Méhes, Gábor

    2017-03-08

    Lymphoproliferative diseases of the central nervous system are rare, diagnostics and treatment are accordingly challenging. Since the introduction of the 2008 WHO lymphoma classification, primary CNS DLBCL - also covering the associated primary ocular (vitreoretinal) lymphoma - is a separate entity. The special localization is related with a series of newly recognized genetic, genomic and immunologic features directing to the strong interaction between transformed lymphoma cells, neural tissue components and the local immune response. Histological differentiation is frequently disabled by the limited sampling opportunities and requires the application of all available hematopathologic technologies including immunohistochemistry, cytology, liquor serology, flow cytometry, fluorescence in situ hybridization and polymerase chain reaction with sequencing.

  4. Targetable genetic features of primary testicular and primary central nervous system lymphomas

    PubMed Central

    Chapuy, Bjoern; Roemer, Margaretha G. M.; Stewart, Chip; Tan, Yuxiang; Abo, Ryan P.; Zhang, Liye; Dunford, Andrew J.; Meredith, David M.; Thorner, Aaron R.; Jordanova, Ekaterina S.; Liu, Gang; Feuerhake, Friedrich; Ducar, Matthew D.; Illerhaus, Gerald; Gusenleitner, Daniel; Linden, Erica A.; Sun, Heather H.; Homer, Heather; Aono, Miyuki; Pinkus, Geraldine S.; Ligon, Azra H.; Ligon, Keith L.; Ferry, Judith A.; Freeman, Gordon J.; van Hummelen, Paul; Golub, Todd R.; Getz, Gad; Rodig, Scott J.; de Jong, Daphne; Monti, Stefano

    2016-01-01

    Primary central nervous system lymphomas (PCNSLs) and primary testicular lymphomas (PTLs) are extranodal large B-cell lymphomas (LBCLs) with inferior responses to current empiric treatment regimens. To identify targetable genetic features of PCNSL and PTL, we characterized their recurrent somatic mutations, chromosomal rearrangements, copy number alterations (CNAs), and associated driver genes, and compared these comprehensive genetic signatures to those of diffuse LBCL and primary mediastinal large B-cell lymphoma (PMBL). These studies identify unique combinations of genetic alterations in discrete LBCL subtypes and subtype-selective bases for targeted therapy. PCNSLs and PTLs frequently exhibit genomic instability, and near-uniform, often biallelic, CDKN2A loss with rare TP53 mutations. PCNSLs and PTLs also use multiple genetic mechanisms to target key genes and pathways and exhibit near-uniform oncogenic Toll-like receptor signaling as a result of MYD88 mutation and/or NFKBIZ amplification, frequent concurrent B-cell receptor pathway activation, and deregulation of BCL6. Of great interest, PCNSLs and PTLs also have frequent 9p24.1/PD-L1/PD-L2 CNAs and additional translocations of these loci, structural bases of immune evasion that are shared with PMBL. PMID:26702065

  5. A primary mirror metrology system for the GMT

    NASA Astrophysics Data System (ADS)

    Rakich, A.

    2016-07-01

    The Giant Magellan Telescope (GMT)1 is a 25 m "doubly segmented" telescope composed of seven 8.4 m "unit Gregorian telescopes", on a common mount. Each primary and secondary mirror segment will ideally lie on the geometrical surface of the corresponding rotationally symmetrical full aperture optical element. Therefore, each primary and conjugated secondary mirror segment will feed a common instrument interface, their focal planes co-aligned and cophased. First light with a subset of four unit telescopes is currently scheduled for 2022. The project is currently considering an important aspect of the assembly, integration and verification (AIV) phase of the project. This paper will discuss a dedicated system to directly characterize the on-sky performance of the M1 segments, independently of the M2 subsystem. A Primary Mirror Metrology System (PMS) is proposed. The main purpose of this system will be to he4lp determine the rotation axis of an instrument rotator (the Gregorian Instrument Rotator or GIR in this case) and then to characterize the deflections and deformations of the M1 segments with respect to this axis as a function of gravity and temperature. The metrology system will incorporate a small (180 mm diameter largest element) prime focus corrector (PFC) that simultaneously feeds a <60" square acquisition and guiding camera field, and a Shack Hartmann wavefront sensor. The PMS is seen as a significant factor in risk reduction during AIV; it allows an on-sky characterization of the primary mirror segments and cells, without the complications of other optical elements. The PMS enables a very useful alignment strategy that constrains each primary mirror segments' optical axes to follow the GIR axis to within a few arc seconds. An additional attractive feature of the incorporation of the PMS into the AIV plan, is that it allows first on-sky telescope operations to occur with a system of considerably less optical and control complexity than the final doubly

  6. Behavior modification in primary care: the pressure system model.

    PubMed

    Katz, D L

    2001-01-01

    The leading causes of death in the United States are predominantly attributable to modifiable behaviors. Patients with behavioral risk factors for premature death and disability, including dietary practices; sexual practices; level of physical activity; motor vehi cle use patterns; and tobacco, alcohol, and illicit sub stance use, are seen far more consistently by primary care providers than by mental health specialists. Yet models of behavior modification are reported, debated, and revised almost exclusively in the psychology literature. While the Stages of Change Model, or Transtheo retical Model, has won application in a broadening array of clinical settings, its application in the primary care setting is apparently quite limited despite evidence of its utility [Prochaska J, Velicer W. Am J Health Promot 1997;12:38-48]. The lack of a rigorous behavioral model developed for application in the primary care setting is an impediment to the accomplishment of public health goals specified in the Healthy People objectives and in the reports of the U.S. Preventive Services Task Force. The Pressure System Model reported here synthesizes elements of established behavior modification theories for specific application under the constraints of the primary care setting. Use of the model in both clinical and research settings, with outcome evaluation, is encouraged as part of an effort to advance public health.

  7. Preoperational test report, primary ventilation condenser cooling system

    SciTech Connect

    Clifton, F.T.

    1997-10-29

    This represents the preoperational test report for the Primary Ventilation Condenser Cooling System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system uses a closed chilled water piping loop to provide offgas effluent cooling for tanks AY101, AY102, AZ1O1, AZ102; the offgas is cooled from a nominal 100 F to 40 F. Resulting condensation removes tritiated vapor from the exhaust stack stream. The piping system includes a package outdoor air-cooled water chiller with parallel redundant circulating pumps; the condenser coil is located inside a shielded ventilation equipment cell. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  8. RELAP5 MODEL OF THE DIVERTOR PRIMARY HEAT TRANSFER SYSTEM

    SciTech Connect

    Popov, Emilian L; Yoder Jr, Graydon L; Kim, Seokho H

    2010-08-01

    This report describes the RELAP5 model that has been developed for the divertor primary heat transfer system (PHTS). The model is intended to be used to examine the transient performance of the divertor PHTS and evaluate control schemes necessary to maintain parameters within acceptable limits during transients. Some preliminary results are presented to show the maturity of the model and examine general divertor PHTS transient behavior. The model can be used as a starting point for developing transient modeling capability, including control system modeling, safety evaluations, etc., and is not intended to represent the final divertor PHTS design. Preliminary calculations using the models indicate that during normal pulsed operation, present pressurizer controls may not be sufficient to keep system pressures within their desired range. Additional divertor PHTS and control system design efforts may be required to ensure system pressure fluctuation during normal operation remains within specified limits.

  9. The BWR lower head response during a large-break LOCA with core damage

    SciTech Connect

    Alammar, M.A.

    1996-12-31

    Some of the important issues in severe accident management guidelines development deal with estimating the time to lower head vessel failure after core damage and the time window available for water injection that would prevent vessel failure. These issues are obviously scenario dependent, but bounding estimates are needed. The scenario chosen for this purpose was a design-basis accident (DBA) loss-of-coolant accident (LOCA) because it was one of the contributors to the Oyster Creek containment failure frequency. Oyster Creek is a 1930-MW(thermal) boiling water reactor (BWR)-2. The lower head response models have improved since the Three Mile Island unit 2 (TMI-2) vessel investigation project (VIP) results became known, specifically the addition of rapid- and slow-cooling models. These mechanisms were found to have taken place in the TMI-2 lower head during debris cooldown and were important contributors in preventing vessel failure.

  10. Effect of bundle size on cladding deformation in LOCA simulation tests. [PWR; BWR

    SciTech Connect

    Chapman, R.H.; Crowley, J.L.; Longest, A.W.

    1982-01-01

    Two LOCA simulation tests were conducted to investigate the effects of temperature uniformity and radial restraint boundary conditions on Zircaloy cladding deformation. In one of the tests (B-5), boundary conditions typical of a large array were imposed on an inner 4 x 4 square array by two concentric rings of interacting guard fuel pin simulators. In the other test (B-3), the boundary conditions were imposed on a 4 x 4 square array by a non-interacting heated shroud. Test parameters conducive to large deformation were selected in order to favor rod-to-rod interactions. The tests showed that rod-to-rod interactions play an important role in the deformation process.

  11. Modeling of Zr alloy burst cladding internal oxidation and secondary hydriding under LOCA conditions

    NASA Astrophysics Data System (ADS)

    Veshchunov, M. S.; Shestak, V. E.

    2015-06-01

    The recently developed mechanistic model for Zr alloy cladding hydriding has been implemented in the single-rod SVECHA/QUENCH (S/Q) code. The mass transfer in a fuel rod after ballooning and burst opening have been modeled in the modified code that allowed calculating hydrogen and oxygen pickup by the cladding inner-metal surface. The code predicts with a good accuracy the typical distributions of oxygen and hydrogen in the Zr alloy cladding that were observed in the JAERI (Japan Atomic Energy Research Institute) and ANL (Argonne National Laboratory) single-rod tests and KIT (Karlsruhe Institute of Technology) bundle tests under postulated loss-of-coolant accident (LOCA) conditions.

  12. LOCA simulation in NRU program: data report for the fourth materials experiment (MT-4)

    SciTech Connect

    Wilson, C.L.; Mohr, C.L.; Hesson, G.M.; Wildung, N.J.; Russcher, G.E.; Webb, B.J.; Freshley, M.D.

    1983-07-01

    A series of in-reactor experiments were conducted using full-length 32-rod pressurized water reactor (PWR) fuel bundles as part of the Loss-of-Coolant Accident (LOCA) Simulation Program by Pacific Northwest Laboratory (PNL). This experiment (MT-4) was funded by the US Nuclear Regulatory Commission (NRC) to evaluate ballooning and rupture during adiabatic heatup in the temperature range of 1033 to 1200K (1400 to 1700/sup 0/F). The 12 rest rods in the center of the 32-rod bundle were initially pressurized to 4.62 MPa (670 psia) to insure rupture in the correct temperature range. All 12 test rods ruptured with an average strain of 43.7% at the maximum flow blockage elevation of 2.68 m (105.4 in.). Experimental data for the MT-4 transient experiment and post-test measurements and photographs of the fuel are presented in this report.

  13. Ethylene propylene cable degradation during LOCA research tests: tensile properties at the completion of accelerated aging

    SciTech Connect

    Bustard, L.D.

    1982-05-01

    Six ethylene-propylene rubber (EPR) insulation materials were aged at elevated temperature and radiation stress exposures common in cable LOCA qualification tests. Material samples were subjected to various simultaneous and sequential aging simulations in preparation for accident environmental exposures. Tensile properties subsequent to the aging exposure sequences are reported. The tensile properties of some, but not all, specimens were sensitive to the order of radiation and elevated temperature stress exposure. Other specimens showed more severe degradation when simultaneously exposed to radiation and elevated temperature as opposed to the sequential exposure to the same stresses. Results illustrate the difficulty in defining a single test procedure for nuclear safety-related qualification of EPR elastomers. A common worst-case sequential aging sequence could not be identified.

  14. Apollo experience report guidance and control systems: Primary guidance, navigation, and control system development

    NASA Technical Reports Server (NTRS)

    Holley, M. D.; Swingle, W. L.; Bachman, S. L.; Leblanc, C. J.; Howard, H. T.; Biggs, H. M.

    1976-01-01

    The primary guidance, navigation, and control systems for both the lunar module and the command module are described. Development of the Apollo primary guidance systems is traced from adaptation of the Polaris Mark II system through evolution from Block I to Block II configurations; the discussion includes design concepts used, test and qualification programs performed, and major problems encountered. The major subsystems (inertial, computer, and optical) are covered. Separate sections on the inertial components (gyroscopes and accelerometers) are presented because these components represent a major contribution to the success of the primary guidance, navigation, and control system.

  15. Use of Fuzzy Logic Systems for Assessment of Primary Faults

    NASA Astrophysics Data System (ADS)

    Petrović, Ivica; Jozsa, Lajos; Baus, Zoran

    2015-09-01

    In electric power systems, grid elements are often subjected to very complex and demanding disturbances or dangerous operating conditions. Determining initial fault or cause of those states is a difficult task. When fault occurs, often it is an imperative to disconnect affected grid element from the grid. This paper contains an overview of possibilities for using fuzzy logic in an assessment of primary faults in the transmission grid. The tool for this task is SCADA system, which is based on information of currents, voltages, events of protection devices and status of circuit breakers in the grid. The function model described with the membership function and fuzzy logic systems will be presented in the paper. For input data, diagnostics system uses information of protection devices tripping, states of circuit breakers and measurements of currents and voltages before and after faults.

  16. Development of a primary angular shock calibration system

    NASA Astrophysics Data System (ADS)

    Peng, Jun

    2008-06-01

    Primary angular shock calibration system is developed by Changcheng Institute of Metrology & Measurement (CIMM). It uses brushless servo motor driving the air bearing system to generate rotational angle, angular velocity and angular acceleration. Both grating and heterodyne laser interferometer with diffraction grating is used to measure the angular movement, which are traceable to the International System of Units (SI). It can be used to calibrate angular transducers, i.e. angular accelerometer, angular velocity transducer, and rotational angle transducer to obtain sensitivity by angular shock or other kinds of excitation. Heterodyne laser interferometer with diffraction grating is successfully used in the measurement of angular acceleration. The method of using grating and scanning heads measure angular acceleration is developed. One characteristic of this system is that it could generate different kind of excitation signals, which include half sine, trapezoidal, sinusoidal, etc. and it can work as a high performance rate table to generate constant angular velocity. The preliminary test shows the uncertainty in calibrating angular accelerometer should be better than 2%. This paper introduces the mechanic system, control system and measurement system of the angular shock calibration system.

  17. EVALUATION OF THE TEMPORARY TENT COVER TRUSS SYSTEM AP PRIMARY VENT SYSTEM

    SciTech Connect

    HAQ MA

    2009-12-31

    The purpose of this calculation is to evaluate a temporary ten cover truss system. This system will be used to provide weather protection to the workers during replacement of the filter for the Primary Ventilation System in AP Tank Farm. The truss system has been fabricated utilizing tubes and couplers, which are normally used for scaffoldings.

  18. Development of an allergy management support system in primary care

    PubMed Central

    Flokstra - de Blok, Bertine MJ; van der Molen, Thys; Christoffers, Wianda A; Kocks, Janwillem WH; Oei, Richard L; Oude Elberink, Joanne NG; Roerdink, Emmy M; Schuttelaar, Marie Louise; van der Velde, Jantina L; Brakel, Thecla M; Dubois, Anthony EJ

    2017-01-01

    Background Management of allergic patients in the population is becoming more difficult because of increases in both complexity and prevalence. Although general practitioners (GPs) are expected to play an important role in the care of allergic patients, they often feel ill-equipped for this task. Therefore, the aim of this study was to develop an allergy management support system (AMSS) for primary care. Methods Through literature review, interviewing and testing in secondary and primary care patients, an allergy history questionnaire was constructed by allergists, dermatologists, GPs and researchers based on primary care and specialists’ allergy guidelines and their clinical knowledge. Patterns of AMSS questionnaire responses and specific immunoglobulin E (sIgE)-test outcomes were used to identify diagnostic categories and develop corresponding management recommendations. Validity of the AMSS was investigated by comparing specialist (gold standard) and AMSS diagnostic categories. Results The two-page patient-completed AMSS questionnaire consists of 12 (mainly) multiple choice questions on symptoms, triggers, severity and medication. Based on the AMSS questionnaires and sIgE-test outcome of 118 patients, approximately 150 diagnostic categories of allergic rhinitis, asthma, atopic dermatitis, anaphylaxis, food allergy, hymenoptera allergy and other allergies were identified, and the corresponding management recommendations were formulated. The agreement between the allergy specialists’ assessments and the AMSS was 69.2% (CI 67.2–71.2). Conclusion Using a systematic approach, it was possible to develop an AMSS that allows for the formulation of diagnostic and management recommendations for GPs managing allergic patients. The AMSS thus holds promise for the improvement of the quality of primary care for this increasing group of patients. PMID:28352197

  19. Primary propulsion/large space system interaction study

    NASA Technical Reports Server (NTRS)

    Coyner, J. V.; Dergance, R. H.; Robertson, R. I.; Wiggins, J. V.

    1981-01-01

    An interaction study was conducted between propulsion systems and large space structures to determine the effect of low thrust primary propulsion system characteristics on the mass, area, and orbit transfer characteristics of large space systems (LSS). The LSS which were considered would be deployed from the space shuttle orbiter bay in low Earth orbit, then transferred to geosynchronous equatorial orbit by their own propulsion systems. The types of structures studied were the expandable box truss, hoop and column, and wrap radial rib each with various surface mesh densities. The impact of the acceleration forces on system sizing was determined and the effects of single point, multipoint, and transient thrust applications were examined. Orbit transfer strategies were analyzed to determine the required velocity increment, burn time, trip time, and payload capability over a range of final acceleration levels. Variables considered were number of perigee burns, delivered specific impulse, and constant thrust and constant acceleration modes of propulsion. Propulsion stages were sized for four propellant combinations; oxygen/hydrogen, oxygen/methane, oxygen/kerosene, and nitrogen tetroxide/monomethylhydrazine, for pump fed and pressure fed engine systems. Two types of tankage configurations were evaluated, minimum length to maximize available payload volume and maximum performance to maximize available payload mass.

  20. An evaluation of four telemedicine systems for primary care.

    PubMed Central

    Dunn, E V; Conrath, D W; Bloor, W G; Tranquada, B

    1977-01-01

    In an evaluation of the efficacy of four two-way telecommunication systems for use in primary care, more than 1,000 patients seeking care at a community health center received an additional remote examination by use of either color television, black and white television, still-frame black and white television, or hands-free telephone. The diagnosis, clinical tests and X rays requested, and proposed patient management were compared to the actual care received by the patients at the health center. There were no significant differences between any of the modes in relation to diagnostic accuracy, time for the diagnostic interview, tests requested, or referral rates. Furthermore, patient attitudes did not vary significantly. Thus the relatively inexpensive telephone proved to be as efficient and effective a means for delivery of remote physician care as did any of the visual communication systems. PMID:873812

  1. Fission Product Migration in Primary System and Containment

    SciTech Connect

    2015-04-01

    Version 00 ART MOD2 aims at a comprehensive analysis for the FP behaviour in primary system and in containment during severe accidents and therefore the code considers the removal of radio-nuclides of up to 60 materials including chemical compounds by natural deposition and by the engineered safety features (ESF) such as spray systems. As for the natural deposition of radio-nuclides, the code can consider the phenomena such as gravitational settling, thermophoresis, diffusiophoresis, Brownian diffusion, diffusion under laminar or turbulent flows, resuspension, condensation, chemisorption and revaporization. The code also models the aerosol growth by agglomeration of aerosols and condensation/evaporation of volatile material at the aerosol surface. Recently, the models for iodine chemistry in containment sump water was incorporated into ART MOD2 ART MOD2 was modified in January 2015 to correct coding errors and improve the vibration of the calculation result of water (H2O) vapor.

  2. Implementation of non-condensable gases condensation suppression model into the WCOBRA/TRAC-TF2 LOCA safety evaluation code

    SciTech Connect

    Liao, J.; Cao, L.; Ohkawa, K.; Frepoli, C.

    2012-07-01

    The non-condensable gases condensation suppression model is important for a realistic LOCA safety analysis code. A condensation suppression model for direct contact condensation was previously developed by Westinghouse using first principles. The model is believed to be an accurate description of the direct contact condensation process in the presence of non-condensable gases. The Westinghouse condensation suppression model is further revised by applying a more physical model. The revised condensation suppression model is thus implemented into the WCOBRA/TRAC-TF2 LOCA safety evaluation code for both 3-D module (COBRA-TF) and 1-D module (TRAC-PF1). Parametric study using the revised Westinghouse condensation suppression model is conducted. Additionally, the performance of non-condensable gases condensation suppression model is examined in the ACHILLES (ISP-25) separate effects test and LOFT L2-5 (ISP-13) integral effects test. (authors)

  3. Optimized Battery-Type Reactor Primary System Design Utilizing Lead

    SciTech Connect

    Yu, Yong H.; Son, Hyoung M.; Lee, Il S.; Suh, Kune Y.

    2006-07-01

    A number of small and medium size reactors are being developed worldwide as well as large electricity generation reactors for co-generation, district heating or desalination. The Seoul National University has started to develop 23 MWth BORIS (Battery Optimized Reactor Integral System) as a multi-purpose reactor. BORIS is an integral-type optimized fast reactor with an ultra long life core. BORIS is being designed to meet the Generation IV nuclear energy system goals of sustainability, safety, reliability and economics. Major features of BORIS include 20 consecutive years of operation without refueling; elimination of an intermediate heat transport loop and main coolant pump; open core without individual subassemblies; inherent negative reactivity feedback; and inherent load following capability. Its one mission is to provide incremental electricity generation to match the needs of developing nations and especially remote communities without major electrical grid connections. BORIS consists of a reactor module, heat exchanger, coolant module, guard vessel, reactor vessel auxiliary cooling system (RVACS), secondary system, containment and the seismic isolation. BORIS is designed to generate 10 MWe with the resulting thermal efficiency of 45 %. BORIS uses lead as the primary system coolant because of the inherent safety of the material. BORIS is coupled with a supercritical carbon dioxide Brayton cycle as the secondary system to gain a high cycle efficiency in the range of 45 %. The reference core consists of 757 fuel rods without assembly with an active core height of 0.8 m. The BORIS core consists of single enrichment zone composed of a Pu-MA (minor actinides)-U-N fuel and a ferritic-martensitic stainless steel clad. This study is intended to set up appropriate reactor vessel geometry by performing thermal hydraulic analysis on RVACS using computational fluid dynamics codes; to examine the liquid metal coolant behavior along the subchannels; to find out whether the

  4. Parametric study of the potential for BWR ECCS strainer blockage due to LOCA generated debris. Final report

    SciTech Connect

    Zigler, G.; Brideau, J.; Rao, D.V.; Shaffer, C.; Souto, F.; Thomas, W.

    1995-10-01

    This report documents a plant-specific study for a BWR/4 with a Mark I containment that evaluated the potential for LOCA generated debris and the probability of losing long term recirculation capability due ECCS pump suction strainer blockage. The major elements of this study were: (1) acquisition of detailed piping layouts and installed insulation details for a reference BWR; (2) analysis of plant specific piping weld failure probabilities to estimate the LOCA frequency; (3) development of an insulation and other debris generation and drywell transport models for the reference BWR; (4) modeling of debris transport in the suppression pool; (5) development of strainer blockage head loss models for estimating loss of NPSH margin; (6) estimation of core damage frequency attributable to loss of ECCS recirculation capability following a LOCA. Elements 2 through 5 were combined into a computer code, BLOCKAGE 2.3. A point estimate of overall DEGB pipe break frequency (per Rx-year) of 1.59E-04 was calculated for the reference plant, with a corresponding overall ECCS loss of NPSH frequency (per Rx-year) of 1.58E-04. The calculated point estimate of core damage frequency (per Rx-year) due to blockage related accident sequences for the reference BWR ranged from 4.2E-06 to 2.5E-05. The results of this study show that unacceptable strainer blockage and loss of NPSH margin can occur within the first few minutes after ECCS pumps achieve maximum flows when the ECCS strainers are exposed to LOCA generated fibrous debris in the presence of particulates (sludge, paint chips, concrete dust). Generic or unconditional extrapolation of these reference plant calculated results should not be undertaken.

  5. Assessment of Environmental Qualification Practices and Condition Monitoring Techniques for Low-Voltage Electric Cables: LOCA Test Results

    SciTech Connect

    Lofaro, R.; Grove, E.; Villaran, M.; Soo, P.; Hsu, F.

    2001-02-01

    This report documents the results of a research program addressing issues related to the qualification process for low-voltage instrumentation and control (I&C) electric cables used in commercial nuclear power plants. Three commonly used types of I&C cable were tested: Cross-Linked Polyethylene (XLPE) insulation with a Neoprene® jacket, Ethylene Propylene Rubber (EPR) insulation with an unbonded Hypalon® jacket, and EPR with a bonded Hypalon® jacket. Each cable type received accelerated aging to simulate 20, 40, and 60 years of qualified life. In addition, naturally aged cables of the same types were obtained from decommissioned nuclear power plants and tested. The cables were subjected to simulated loss-of-coolant-accident (LOCA) conditions, which included the sequential application of LOCA radiation followed by exposure to steam at high temperature and pressure, as well as to chemical spray. Periodic condition monitoring (CM) was performed using nine different techniques to obtain data on the condition of the cable, as well as to evaluate the effectiveness of those CM techniques for in situ monitoring of cables. Volume 1 of this report presents the results of the LOCA tests, and Volume 2 discusses the results of the condition monitoring tests.

  6. Notes on the Implementation of Non-Parametric Statistics within the Westinghouse Realistic Large Break LOCA Evaluation Model (ASTRUM)

    SciTech Connect

    Frepoli, Cesare; Oriani, Luca

    2006-07-01

    In recent years, non-parametric or order statistics methods have been widely used to assess the impact of the uncertainties within Best-Estimate LOCA evaluation models. The bounding of the uncertainties is achieved with a direct Monte Carlo sampling of the uncertainty attributes, with the minimum trial number selected to 'stabilize' the estimation of the critical output values (peak cladding temperature (PCT), local maximum oxidation (LMO), and core-wide oxidation (CWO A non-parametric order statistics uncertainty analysis was recently implemented within the Westinghouse Realistic Large Break LOCA evaluation model, also referred to as 'Automated Statistical Treatment of Uncertainty Method' (ASTRUM). The implementation or interpretation of order statistics in safety analysis is not fully consistent within the industry. This has led to an extensive public debate among regulators and researchers which can be found in the open literature. The USNRC-approved Westinghouse method follows a rigorous implementation of the order statistics theory, which leads to the execution of 124 simulations within a Large Break LOCA analysis. This is a solid approach which guarantees that a bounding value (at 95% probability) of the 95{sup th} percentile for each of the three 10 CFR 50.46 ECCS design acceptance criteria (PCT, LMO and CWO) is obtained. The objective of this paper is to provide additional insights on the ASTRUM statistical approach, with a more in-depth analysis of pros and cons of the order statistics and of the Westinghouse approach in the implementation of this statistical methodology. (authors)

  7. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false In-service failure of primary braking system. 214... Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In the event of a total in-service failure of its primary braking system, an on-track roadway...

  8. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false In-service failure of primary braking system. 214... Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In the event of a total in-service failure of its primary braking system, an on-track roadway...

  9. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false In-service failure of primary braking system. 214... Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In the event of a total in-service failure of its primary braking system, an on-track roadway...

  10. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false In-service failure of primary braking system. 214... Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In the event of a total in-service failure of its primary braking system, an on-track roadway...

  11. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false In-service failure of primary braking system. 214... Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In the event of a total in-service failure of its primary braking system, an on-track roadway...

  12. Neuropsychological profile of patients with primary systemic hypertension.

    PubMed

    Ostrosky-Solis, F; Mendoza, V U; Ardila, A

    2001-01-01

    Arterial hypertension represents a risk factor for cerebrovascular disease. It has been hypothesized that chronic hypertension may eventually result in small subcortical infarcts associated with some cognitive impairments. One hundred fourteen patients with primary systemic hypertension (PSH) and 114 matched subjects were selected. PSH patients were further divided in four groups depending upon the hypertension severity. In addition to the medical and laboratory exams, a neuropsychological evaluation was administered. The NEUROPSI neuropsychological test battery was used. An association between level of hypertension and cognitive impairment was observed. Most significant differences were observed in the following domains: Reading, executive functioning, constructional, and memory-recall. No differences were observed in orientation, memory-recognition, and language. Some neuropsychological functions appeared impaired even in the PSH group with the least risk factors. Cognitive evaluation may be important in cases of PSH not only to determine early subtle cognitive changes, but also for follow-up purposes, and to assess the efficacy of different therapeutic procedures.

  13. Primary large-cell lymphoma of the central nervous system

    SciTech Connect

    Amendola, B.E.; McClatchey, K.D.; Amendola, M.A.; Gebarski, S.S.

    1986-06-01

    Primary non-Hodgkin's lymphoma of the central nervous system (CNS) is a rare disease. Seven patients were seen and treated at the University of Michigan Medical Center between January 1969 and December 1983. All patients had histologically proven diagnoses of large cell lymphoma with clinical and radiologic evidence of involvement limited to the CNS. Five of seven patients received postoperative radiation therapy, two of whom have had apparent local control at 1- and 2-year follow-up. The two patients without postoperative radiation died of local recurrence 2 and 3 months following subtotal resection. These poor results suggest that adjuvant therapy may be required for improved control of this type of extranodal lymphoma.

  14. Shuttle primary reaction control system engine exhaust plume contamination effects

    NASA Technical Reports Server (NTRS)

    Koontz, Steve; Ehlers, Horst; Pedley, Mike; Cross, John; Hakes, Charles

    1993-01-01

    Space Shuttle proximity operations constitute an important part of the SSF induced external environment. The impingement of primary reaction control system (PRCS) engine plumes on SSF functional surfaces during docking or berthing and separation leads to concerns about molecular contamination and high speed particle impact. The Shuttle Plume Impingement flight Experiment (SPIE) was designed to provide a direct measure of both the molecular contamination and particle impact rates produced by Shuttle PRCS engines in the LEO environment. The measured permanent deposition produced by PRCS engine firings was less than that assumed in current SSF programatic assessments. Only two to three possible high velocity particle impact pits were observed on the RMS end effector hardware.

  15. Chemotherapy in newly diagnosed primary central nervous system lymphoma

    PubMed Central

    Hashemi-Sadraei, Nooshin; Peereboom, David M.

    2010-01-01

    Primary central nervous system lymphoma (PCNSL) accounts for only 3% of brain tumors. It can involve the brain parenchyma, leptomeninges, eyes and the spinal cord. Unlike systemic lymphoma, durable remissions remain uncommon. Although phase III trials in this rare disease are difficult to perform, many phase II trials have attempted to define standards of care. Treatment modalities for patients with newly diagnosed PCNSL include radiation and/or chemotherapy. While the role of radiation therapy for initial management of PCNSL is controversial, clinical trials will attempt to improve the therapeutic index of this modality. Routes of chemotherapy administration include intravenous, intraocular, intraventricular or intra-arterial. Multiple trials have outlined different methotrexate-based chemotherapy regimens and have used local techniques to improve drug delivery. A major challenge in the management of patients with PCNSL remains the delivery of aggressive treatment with preservation of neurocognitive function. Because PCNSL is rare, it is important to perform multicenter clinical trials and to incorporate detailed measurements of long-term toxicities. In this review we focus on different chemotherapeutic approaches for immunocompetent patients with newly diagnosed PCNSL and discuss the role of local drug delivery in addition to systemic therapy. We also address the neurocognitive toxicity of treatment. PMID:21789140

  16. New roles for astrocytes: the nightlife of an 'astrocyte'. La vida loca!

    PubMed

    Horner, Philip J; Palmer, Theo D

    2003-11-01

    Like a newly popular nightspot, the biology of adult stem cells has emerged from obscurity to become one of the most lively new disciplines of the decade. The neurosciences have not escaped this trendy pastime and, from amid the noise and excitement, the astrocyte emerges as a beguiling companion to the adult neural stem cell. A once receding partner to neurons and oligodendrocytes, the astrocyte even takes on an alter ego of the stem cell itself (S. Goldman, this issue of TINS). Putting ego aside, the 'astrocyte' is also (and perhaps more importantly) an integral component of neural progenitor hotspots, where the craziness or 'la vida loca' of the nightlife might not be so wild when compared with our traditional understanding of the astrocyte. Here, astrocytes contribute to the instructive confluence of location, atmosphere and cellular neighbors that define the daily 'vida local' or everyday local life of an adult stem cell. This review discusses astrocytes as influential components in the local stem cell niche.

  17. The Australian experiment: how primary health care organizations supported the evolution of a primary health care system.

    PubMed

    Nicholson, Caroline; Jackson, Claire L; Marley, John E; Wells, Robert

    2012-03-01

    Primary health care in Australia has undergone 2 decades of change. Starting with a vision for a national health strategy with general practice at its core, Australia established local meso-level primary health care organizations--Divisions of General Practice--moving from focus on individual practitioners to a professional collective local voice. The article identifies how these meso-level organizations have helped the Australian primary health care system evolve by supporting the roll-out of initiatives including national practice accreditation, a focus on quality improvement, expansion of multidisciplinary teams into general practice, regional integration, information technology adoption, and improved access to care. Nevertheless, there are still challenges to ensuring equitable access and the supply and distribution of a primary care workforce, addressing the increasing rates of chronic disease and obesity, and overcoming the fragmentation of funding and accountability in the Australian system.

  18. Primary Central Nervous System Anaplastic Large T-cell Lymphoma

    PubMed Central

    Splavski, Bruno; Muzevic, Dario; Ladenhauser-Palijan, Tatjana; Jr, Brano Splavski

    2016-01-01

    Introduction: Primary central nervous system lymphoma (PCNSL) of T-cell origin is an exceptionally rare, highly malignant intracranial neoplasm. Although such a tumor typically presents with a focal mass lesion. Case report: Past medical history of a 26-year-old male patient with a PCNS lymphoma of T-cell origin was not suggestive of intracranial pathology or any disorder of other organs and organic systems. To achieve a gross total tumor resection, surgery was performed via osteoplastic craniotomy using the left frontal transcortical transventricular approach. Histological and immunohistochemical analyses of the tissue removed described tumor as anaplastic large cell lymphoma of T-cells (T-ALCL). Postoperative and neurological recovery was complete, while control imaging of the brain showed no signs of residual tumor at a six-month follow-up. The patient, who did not appear immunocompromized, was referred to a hematologist and an oncologist where corticosteroids, the particular chemotherapeutic protocol and irradiation therapy were applied. Conclusion: Since PCNS lymphoma is a potentially curable brain tumor, we believe that proper selection of the management options, including early radical tumor resection for solitary PCNS lymphoma, may be proposed as a major treatment of such a tumor in selected patients, resulting in a satisfactory outcome. PMID:27703297

  19. Pathway analysis of primary central nervous system lymphoma.

    PubMed

    Tun, Han W; Personett, David; Baskerville, Karen A; Menke, David M; Jaeckle, Kurt A; Kreinest, Pamela; Edenfield, Brandy; Zubair, Abba C; O'Neill, Brian P; Lai, Weil R; Park, Peter J; McKinney, Michael

    2008-03-15

    Primary central nervous system (CNS) lymphoma (PCNSL) is a diffuse large B-cell lymphoma (DLBCL) confined to the CNS. A genome-wide gene expression comparison between PCNSL and non-CNS DLBCL was performed, the latter consisting of both nodal and extranodal DLBCL (nDLBCL and enDLBCL), to identify a "CNS signature." Pathway analysis with the program SigPathway revealed that PCNSL is characterized notably by significant differential expression of multiple extracellular matrix (ECM) and adhesion-related pathways. The most significantly up-regulated gene is the ECM-related osteopontin (SPP1). Expression at the protein level of ECM-related SPP1 and CHI3L1 in PCNSL cells was demonstrated by immunohistochemistry. The alterations in gene expression can be interpreted within several biologic contexts with implications for PCNSL, including CNS tropism (ECM and adhesion-related pathways, SPP1, DDR1), B-cell migration (CXCL13, SPP1), activated B-cell subtype (MUM1), lymphoproliferation (SPP1, TCL1A, CHI3L1), aggressive clinical behavior (SPP1, CHI3L1, MUM1), and aggressive metastatic cancer phenotype (SPP1, CHI3L1). The gene expression signature discovered in our study may represent a true "CNS signature" because we contrasted PCNSL with wide-spectrum non-CNS DLBCL on a genomic scale and performed an in-depth bioinformatic analysis.

  20. Reversible Ammonia Sorption for the Primary Life Support System (PLSS)

    NASA Technical Reports Server (NTRS)

    Wojtowicz, Marek A.; Cosgrove, Joseph E.; Serio, Michael A.; Jennings, Mallory A.

    2012-01-01

    Results are presented on the development of regenerable trace-contaminant (TC) sorbent for use in Extravehicular Activities (EVAs), and more specifically in the Primary Life Support System (PLSS). Since ammonia is the most important TC to be captured, data presented in this paper are limited to ammonia sorption, with results relevant to other TCs to be reported at a later time. The currently available TC-control technology involves the use of a packed bed of acid-impregnated granular charcoal. The sorbent is non-regenerable, and its use is associated with appreciable pressure drop, i.e. power consumption. The objective of this work is to demonstrate the feasibility of using vacuum-regenerable sorbents for PLSS application. In this study, several carbon sorbent monoliths were fabricated and tested. Multiple adsorption/vacuum-regeneration cycles were demonstrated at room temperature, as well as carbon surface conditioning that enhances ammonia sorption without impairing sorbent regeneration. Depending on sorbent monolith geometry, the reduction in pressure drop with respect to granular sorbent was found to be between 50% and two orders of magnitude. Resistive heating of the carbon sorbent monolith was demonstrated by applying voltage to the opposite ends of the monolith.

  1. Development of Effective Academic Affairs Administration System in Thai Primary Schools

    ERIC Educational Resources Information Center

    Thongnoi, Niratchakorn; Srisa-ard, Boonchom; Sri-ampai, Anan

    2013-01-01

    This research aimed to: 1) study current situations and problems of academic affairs administration system in Primary Schools. 2) develop an effective academic affairs administration system, and 3) evaluate the implementation of the developed system in the primary school, Thailand. Research and Development (R&D) was employed which consisted of…

  2. A concept of JAERI passive safety light water reactor system (JPSR)

    SciTech Connect

    Murao, Y.; Araya, F.; Iwamura, T.

    1995-09-01

    The Japan Atomic Energy Research Institute (JAERI) proposed a passive safety reactor system concept, JPSR, which was developed for reducing manpower in operation and maintenance and influence of human errors on reactor safety. In the concept the system was extremely simplified. The inherent matching nature of core generation and heat removal rate within a small volume change of the primary coolant is introduced by eliminating chemical shim and adopting in-vessel control rod drive mechanism units, a low power density core and once-through steam generators. In order to simplify the system, a large pressurizer, canned pumps, passive engineered-safety-features-system (residual heat removal system and coolant injection system) are adopted and the total system can be significantly simplified. The residual heat removal system is completely passively actuated in non-LOCAs and is also used for depressurization of the primary coolant system to actuate accumulators in small break LOCAs and reactor shutdown cooling system in normal operation. All of systems for nuclear steam supply system are built in the containment except for the air coolers as a the final heat sink of the passive residual heat removal system. Accordingly the reliability of the safety system and the normal operation system is improved, since most of residual heat removal system is always working and a heat sink for normal operation system is {open_quotes}safety class{close_quotes}. In the passive coolant injection system, depressurization of the primary cooling system by residual heat removal system initiates injection from accumulators designed for the MS-600 in medium pressure and initiates injection from the gravity driven coolant injection pool at low pressure. Analysis with RETRAN-02/MOD3 code demonstrated the capability of passive load-following, self-power-controllability, cooling and depressurization.

  3. Comparison of computer codes (CE-THERM, FRAP-T5, GT3-FLECHT, and TRUMP-FLECHT) with data from the NRU-LOCA thermal hydraulic tests

    SciTech Connect

    Mohr, C.L.; Rausch, W.N.; Hesson, G.M.

    1981-07-01

    The LOCA Simulation Program in the NRU reactor is the first set of experiments to provide data on the behavior of full-length, nuclear-heated PWR fuel bundles during the heatup, reflood, and quench phases of a loss-of-coolant accident (LOCA). This paper compares the temperature time histories of 4 experimental test cases with 4 computer codes: CE-THERM, FRAP-T5, GT3-FLECHT, and TRUMP-FLECHT. The preliminary comparisons between prediction and experiment show that the state-of-the art fuel codes have large uncertainties and are not necessarily conservative in predicting peak temperatures, turn around times, and bundle quench times.

  4. Mixed-oxide fuel decay heat analysis for BWR LOCA safety evaluation

    SciTech Connect

    Chiang, R. T.

    2013-07-01

    The mixed-oxide (MOX) fuel decay heat behavior is analyzed for Boiling Water Reactor (BWR) Loss of Coolant Accident (LOCA) safety evaluation. The physical reasoning on why the decay heat power fractions of MOX fuel fission product (FP) are significantly lower than the corresponding decay heat power fractions of uranium-oxide (UOX) fuel FP is illustrated. This is primarily due to the following physical phenomena. -The recoverable energies per fission of plutonium (Pu)-239 and Pu-241 are significantly higher than those of uranium (U)-235 and U-238. Consequently, the fission rate required to produce the same amount of power in MOX fuel is significantly lower than that in UOX fuel, which leads to lower subsequent FP generation rate and associated decay heat power in MOX fuel than those in UOX fuel. - The effective FP decay energy per fission of Pu-239 is significantly lower than the corresponding effective FP decay energy per fission of U-235, e.g., Pu-239's 10.63 Mega-electron-Volt (MeV) vs. U-235's 12.81 MeV at the cooling time 0.2 second. This also leads to lower decay heat power in MOX fuel than that in UOX fuel. The FP decay heat is shown to account for more than 90% of the total decay heat immediately after shutdown. The FP decay heat results based on the American National Standard Institute (ANSI)/American Nuclear Society (ANS)-5.1-1979 standard method are shown very close to the corresponding FP decay heat results based on the ANSI/ANS-5.1-2005 standard method. The FP decay heat results based on the ANSI/ANS-5.1-1979 simplified method are shown very close to but mostly slightly lower than the corresponding FP decay heat results based on the ANSI/ANS-5.1-1971 method. The FP decay heat results based on the ANSI/ANS-5.1-1979 simplified method or the ANSI/ANS-5.1-1971 method are shown significantly larger than the corresponding FP decay heat results based on the ANSI/ANS-5.1-1979 standard method or the ANSI/ANS-5.1-2005 standard method. (authors)

  5. Primary Nocturnal Enuresis: A Structural and Strategic Family Systems Approach.

    ERIC Educational Resources Information Center

    Fletcher, Teresa B.

    2000-01-01

    Exploration of the literature regarding primary nocturnal enuresis suggests there are various causes including genetic, biological, physiological, and psychological explanations. Treatments typically consist of medication and behavioral intervention. However, it was believed that this enuretic case was caused by psychological trauma. A series of…

  6. PKL tests on energy transfer mechanisms during small-break LOCAs

    SciTech Connect

    Mandl, R.M.; Weiss, P.A.

    1982-03-01

    The Primarkreislaufe (PKL) test facility, originally designed to examine the refill and reflood phases of a loss-of-coolant accident, was modified and used for a series of transient and steady-state small-break tests. Results from these tests are presented with the intention of showing the influence of such parameters as power, reduce water inventories on the primary or secondary sides, and noncondensible gas on the ability of the system to remove decay heat. It is shown that in the case of a small break, the transport of decay heat from the system is ensured when a two-phase coolant mixture covers the core and energy can be removed from the secondary sides of the steam generators.

  7. A Computerized System for In-Service Formative Evaluation in Primary Care Residencies

    PubMed Central

    Beaujon, H. Jan

    1980-01-01

    A computerized system for in-service formative evaluation in primary care residencies is described. Used by three primary care residency programs at the Medical University of South Carolina, the system includes among its applications: ongoing evaluations of and by residents (rotations, monitoring, chart audits), annual in-service examinations, annual faculty and resident evaluations, and alumni surveys.

  8. Cathode for use in high energy primary thionyl chloride cell systems and high energy primary thionyl chloride cell systems including the cathode

    NASA Astrophysics Data System (ADS)

    Walker, C. W., Jr.; Wade, W. L., Jr.; Binder, M.; Gilman, S.

    1985-08-01

    A cathode is provided for use in high energy primary lithium-thionyl chloride cell systems or calcium-thionyl chloride cell systems. The cathode comprises an expanded metallic current collector screen into which has been pasted a mixture of a low surface area conductive carbon black and a high surface area conductive carbon black previously mixed with a binder.

  9. Optimization design for the supporting system of 5m collimator primary mirror

    NASA Astrophysics Data System (ADS)

    Guan, Shaohua; Ma, Tianmeng; Zhang, Ming

    2016-10-01

    Primary mirror is an important component of collimator. The surface figure error of primary mirror is a critical factor affecting the imaging quality of collimator. Besides, the support system of primary mirror of collimator must be steady, while collimator need be moved safely as an elementary optical measuring tool. The support system of the primary mirror is composed of axial support and lateral support. Due to the axis of the primary mirror is horizontal when collimator working, the lateral support of the primary mirror has a far greater impact on the figure error of the primary mirror. In this paper, static structure analysis with finite element method is carried out for a 5m collimator primary mirror with V-block support under gravity load. With the analysis, the relationship between the structure parameters in primary mirror V-block support and the deformation of the primary mirror is built. With this relationship, the optimization parameters are found out to reduce the gravity deformation of the primary mirror.

  10. The W. M. Keck Telescope segmented primary mirror active control system

    SciTech Connect

    Jared, R.C.; Arthur, A.A.; Andreae, S.; Biocca, A.; Cohen, R.W.; Fuertes, J.M.; Franck, J.; Gabor, G.; Llacer, J.; Mast, T.; Meng, J.; Merrick, T.; Minor, R.; Nelson, J.; Orayani, M.; Salz, P.; Schaefer, B.; Witebsky, C.

    1989-07-01

    The ten meter diameter primary mirror of the W. M. Keck Telescope is a mosaic of thirty-six hexagonal mirrors. An active control system stabilizes the primary mirror. The active control system uses 168 measurements of the relative positions of adjacent mirror segments and 3 measurements of the primary mirror position in the telescope structure to control the 108 degrees of freedom needed to stabilize the figure and position of the primary mirror. The components of the active control system are relative position sensors, electronics, computers, actuators that position the mirrors, and software. The software algorithms control the primary mirror, perform star image stacking, emulate the segments, store and fit calibration data, and locate hardware defects. We give an overview of the active control system, its functional requirements and test measurements. 12 refs.

  11. Description of the primary flight display and flight guidance system logic in the NASA B-737 transport systems research vehicle

    NASA Technical Reports Server (NTRS)

    Knox, Charles E.

    1990-01-01

    A primary flight display format was integrated with the flight guidance and control system logic in support of various flight tests conducted with the NASA Transport Systems Research Vehicle B-737-100 airplane. The functional operation of the flight guidance mode control panel and the corresponding primary flight display formats are presented.

  12. Pressure suppression system

    DOEpatents

    Gluntz, Douglas M.

    1994-01-01

    A pressure suppression system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and an enclosed gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel. The GDCS pool includes a plenum for receiving through an inlet the non-condensable gas carried with steam from the drywell following a loss-of-coolant accident (LOCA). A condenser is disposed in the GDCS plenum for condensing the steam channeled therein and to trap the non-condensable gas therein. A method of operation includes draining the GDCS pool following the LOCA and channeling steam released into the drywell following the LOCA into the GDCS plenum for cooling along with the non-condensable gas carried therewith for trapping the gas therein.

  13. Pressure suppression containment system

    DOEpatents

    Gluntz, D.M.; Townsend, H.E.

    1994-03-15

    A pressure suppression containment system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and a gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel. The wetwell pool includes a plenum for receiving the non-condensable gas carried with steam from the drywell following a loss-of-coolant-accident (LOCA). The wetwell plenum is vented to a plenum above the GDCS pool following the LOCA for suppressing pressure rise within the containment vessel. A method of operation includes channeling steam released into the drywell following the LOCA into the wetwell pool for cooling along with the non-condensable gas carried therewith. The GDCS pool is then drained by gravity, and the wetwell plenum is vented into the GDCS plenum for channeling the non-condensable gas thereto. 6 figures.

  14. Pressure suppression containment system

    DOEpatents

    Gluntz, Douglas M.; Townsend, Harold E.

    1994-03-15

    A pressure suppression containment system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and a gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel. The wetwell pool includes a plenum for receiving the non-condensable gas carried with steam from the drywell following a loss-of coolant-accident (LOCA). The wetwell plenum is vented to a plenum above the GDCS pool following the LOCA for suppressing pressure rise within the containment vessel. A method of operation includes channeling steam released into the drywell following the LOCA into the wetwell pool for cooling along with the non-condensable gas carried therewith. The GDCS pool is then drained by gravity, and the wetwell plenum is vented into the GDCS plenum for channeling the non-condensable gas thereto.

  15. Pressure suppression system

    DOEpatents

    Gluntz, D.M.

    1994-10-04

    A pressure suppression system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and an enclosed gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel. The GDCS pool includes a plenum for receiving through an inlet the non-condensable gas carried with steam from the drywell following a loss-of-coolant accident (LOCA). A condenser is disposed in the GDCS plenum for condensing the steam channeled therein and to trap the non-condensable gas therein. A method of operation includes draining the GDCS pool following the LOCA and channeling steam released into the drywell following the LOCA into the GDCS plenum for cooling along with the non-condensable gas carried therewith for trapping the gas therein. 3 figs.

  16. Control System Modeling for the Thirty Meter Telescope Primary Mirror

    NASA Technical Reports Server (NTRS)

    MacMynowski, Douglas G.; Thompson, Peter M.; Shelton, J. Chris; Roberts, Lewis C., Jr.; Colavita, M. Mark; Sirota, Mark J.

    2011-01-01

    The Thirty Meter Telescope primary mirror is composed of 492 segments that are controlled to high precision in the presence of wind and vibration disturbances, despite the interaction with structural dynamics. The higher bandwidth and larger number of segments compared with the Keck telescopes requires greater attention to modeling to ensure success. We focus here on the development and validation of a suite of quasi-static and dynamic modeling tools required to support the design process, including robustness verification, performance estimation, and requirements flowdown. Models are used to predict the dynamic response due to wind and vibration disturbances, estimate achievable bandwidth in the presence of control-structure-interaction (CSI) and uncertainty in the interaction matrix, and simulate and analyze control algorithms and strategies, e.g. for control of focus-mode, and sensor calibration. Representative results illustrate TMT performance scaling with parameters, but the emphasis is on the modeling framework itself.

  17. Primary lymphoma of the central nervous system: a case report.

    PubMed

    Mackenzie, R A; Braye, S G

    1979-01-01

    A 46-year-old female presented with a 1-week history of mental change, confusion and headaches. Investigations revealed evidence of sterile meningitis. CAT scanning of the brain demonstrated marked contrast enhancement around the ependyma, and later examinations showed extension of the process deep into the white matter, Cerebral biopsies were non-diagnostic and, despite ventricular drainage and treatment with antibiotics and high dose steriods, the patent died. At postmortem there was extensive tumour tissue distributed in a butterfly shape around the ventricles, and microscopy revealed typical apperances of primary CNS lymphoma. On the basis of the experience of this case and a review of recent literature, it is suggested that the CAT scan appearances of this tumour are quite typical, and that cranial irradiation may be justified in the absence of specific histological diagnosis.

  18. Contribution of polymers to classical primary insulation of distribution system

    SciTech Connect

    Shwehdi, M.H.; Al-Rawi, A.

    1996-12-31

    Insulation composites used on present distribution lines frequently consist of several types of materials such as wood, porcelain, polymers and fiberglass reinforced plastics (FRP) connected in series. A study included the laboratory determination of the critical flashover voltage (CFO) of 17 single component and 90 combinations of two components were conducted. The acquired data were used to develop methods of predicting CFO levels of various multiple series electrical insulations. This paper illustrates the results and analyses of the classical primary insulation (porcelain), and of the modern-day insulation of polymers. It also presents the result of whether polymers may add or supplement insulation strength to the two dielectric combination using statistical methods. The paper also presents advantages and guidelines for the use of polymers to either replace or complement porcelain. This may help optimize the choice of dielectrics on distribution lines.

  19. An ion thruster module for primary propulsion systems.

    NASA Technical Reports Server (NTRS)

    King, H. J.; Poeschel, R. L.

    1972-01-01

    The development of a 30 cm thruster module having the operational characteristics, weight, and structural integrity consistent with flight hardware is described. Elements of the program discussed in this paper are selection of an ion optical system design, development of the discharge chamber and its control, and the results of extensive performance mapping tests. The thruster system operates at 2750 sec specific impulse at 69% over-all efficiency and can be throttled from 2.0 A to 0.16 A beam current with a control system requiring a single electrical input. The 1 kV ion beam is formed by a high perveance, two grid ion optical system.

  20. [Differences and similarities of primary care in the German and Spanish health care systems].

    PubMed

    Salvador Comino, María Rosa; Krane, Sibylla; Schelling, Jörg; Regife García, Víctor

    2016-02-01

    An efficient primary care is of particular importance for any countries' health care system. Many differences exist on how distinctive countries try to obtain the goal of an efficient, cost-effective primary care for its population. In this article we conducted a selective literature review, which includes both scientific and socio-political publications. The findings are complemented with the experience of a Spanish physician from Seville in her last year of training in family medicine, who completed a four months long rotation in the German health care system. We highlighted different features by comparing both countries, including their health care expenditure, the relation between primary and secondary care, the organization in the academic field and the training of future primary care physicians. It is clear that primary care in both countries plays a central role, have to deal with shortcomings, and in some points one system can learn from the other.

  1. Primary-secondary pumping conversion: Retrofit of an existing campus chilled water distribution system

    SciTech Connect

    Sczomak, D.P.; Nguyen, P.N.

    1996-08-01

    The chilled water distribution system within an existing 8,300 ton (29,200 kW) capacity regional chilled water plant at Michigan State University (MSU) is being converted from a primary pumping arrangement to a primary-secondary arrangement. The plant presently provides chilled water for air conditioning to twelve remote buildings. In the future, MSU plans to increase the plant`s capacity to 10,800 tons (38,000 kW) in order to serve seven more buildings. The addition of buildings to the distribution system has caused the existing primary pumps to be incapable of producing enough pressure to offset system losses at design flow rates. The existing system has become unable to concurrently provide adequate flow, design supply water temperature and efficient chiller operation due to the distribution system deficiencies. The primary-secondary pumping conversion will include modifications to the distribution piping, the addition of five variable speed secondary pumps, additions and modifications to the control systems, the trimming of impellers on six of the existing primary pumps and replacement of two primary pumps. The campus central control system will be utilized to provide automatic chiller staging, interface with the packaged secondary pump control systems, and control of the building interconnections. The total construction cost is approximately $1,400,000 and is scheduled for completion prior to the 1996 cooling season. Provisions have been made for two additional secondary pumps to accommodate the connection of additional buildings to the distribution system in the future.

  2. Intention and Usage of Computer Based Information Systems in Primary Health Centers

    ERIC Educational Resources Information Center

    Hosizah; Kuntoro; Basuki N., Hari

    2016-01-01

    The computer-based information system (CBIS) is adopted by almost all of in health care setting, including the primary health center in East Java Province Indonesia. Some of softwares available were SIMPUS, SIMPUSTRONIK, SIKDA Generik, e-puskesmas. Unfortunately they were most of the primary health center did not successfully implemented. This…

  3. Current Management of Primary Central Nervous System Lymphoma

    SciTech Connect

    Schultz, Christopher J.; Bovi, Joseph

    2010-03-01

    Primary central nervous cell lymphoma (PCNSL) is an uncommon neoplasm of the brain, leptomeninges, and rarely the spinal cord. Initially thought to be characteristically associated with congenital, iatrogenic, or acquired immunosuppression, PCNSL is now recognized with increasing frequency in immunocompetent individuals. The role of surgery is limited to establishing diagnosis, as PCNSL is often multifocal with a propensity to involve the subarachnoid space. A whole-brain radiation volume has empirically been used to adequately address the multifocal tumor frequently encountered at the time of PCNSL diagnosis. Despite high rates of response after whole-brain radiotherapy (WBRT), rapid recurrence is common and long-term survival is the exception. Chemotherapy alone or in combination with WBRT has more recently become the treatment of choice. Most effective regimens contain high-dose methotrexate and or other agents that are capable of penetrating the blood-brain barrier. High response rates and improved survival with the use of chemotherapy has led to treatment strategies that defer or eliminate WBRT in hopes of lessening the risk of neurotoxicity attributed to WBRT. Unfortunately, elimination of WBRT is also associated with a higher rate of relapse. Combined chemotherapy and WBRT regimens are now being explored that use lower total doses of radiation and altered fractionation schedules with the aim of maintaining high rates of tumor control while minimizing neurotoxicity. Pretreatment, multifactor prognostic indices have recently been described that may allow selection of treatment regimens that strike an appropriate balance of risk and benefit for the individual PCNSL patient.

  4. Progress in systemic chemotherapy of primary breast cancer: an overview.

    PubMed

    Hortobagyi, G N

    2001-01-01

    Substantial progress has been made in the multidisciplinary management of primary breast cancer during the last 30 years. Adjuvant chemotherapy has been shown to significantly reduce the annual risk of cancer recurrence and mortality, and these effects persist even 15 years after diagnosis. Combination chemotherapy is superior to single-agent therapy and anthracycline-containing regimens. Those that combine an anthracycline with 5-fluorouracil and cyclophosphamide are more effective than regimens without an anthracycline. Six cycles of a single regimen appear to provide optimal benefit. Dose reductions below the standard range are associated with inferior results. Dose increases that require growth factor or hematopoietic stem cell support are under investigation; at this time, the existing results provide no compelling reason to use this strategy outside a clinical trial. Regimens using fixed crossover designs with two non-cross-resistant regimens are being evaluated. The addition of a taxane to anthracycline-containing regimens is currently under intense scrutiny, and preliminary analysis of the first three clinical trials has shown encouraging, albeit not compelling, results. For patients with estrogen receptor-positive breast cancer, the sequential administration of chemotherapy and 5 years of tamoxifen therapy provides additive benefits. No compelling evidence exists to combine ovarian ablation with chemotherapy. Most side effects and toxic effects are self-limited, although premature menopause requires monitoring and preventive interventions to preserve bone mineral density. The small risk of acute leukemia is of concern, and additional research to develop safer regimens is clearly indicated. The overall effect of optimal local/regional treatment combined with an anthracycline-containing adjuvant chemotherapy and a taxane (and, for patients with estrogen receptor-positive tumors, 5 years of tamoxifen therapy) is a greater than 50% reduction in annual risks of

  5. The development process for the space shuttle primary avionics software system

    NASA Technical Reports Server (NTRS)

    Keller, T. W.

    1987-01-01

    Primary avionics software system; software development approach; user support and problem diagnosis; software releases and configuration; quality/productivity programs; and software development/production facilities are addressed. Also examined are the external evaluations of the IBM process.

  6. Venous thromboembolism in systemic autoimmune diseases: A narrative review with emphasis on primary systemic vasculitides.

    PubMed

    Tamaki, Hiromichi; Khasnis, Atul

    2015-08-01

    Venous thromboembolism (VTE) is a prevalent multifactorial health condition associated with significant morbidity and mortality. Population-based epidemiological studies have revealed an association between systemic autoimmune diseases and deep venous thrombosis (DVT)/VTE. The etiopathogenesis of increased risk of VTE in systemic autoimmune diseases is not entirely clear but multiple contributors have been explored, especially in the context of systemic inflammation and disordered thrombogenesis. Epidemiologic data on increased risk of VTE in patients with primary systemic vasculitides (PSV) have accumulated in recent years and some of these studies suggest the increased risk while patients have active diseases. This could lead us to hypothesize that venous vascular inflammation has a role to play in this phenomenon, but this is unproven. The role of immunosuppressive agents in modulating the risk of VTE in patients with PSV is not yet clear except for Behçet's disease, where most of the studies are retrospective. Sensitizing physicians to this complication has implications for prevention and optimal management of patients with these complex diseases. This review will focus on the epidemiology and available evidence regarding pathogenesis, and will attempt to summarize the best available data regarding evaluation and treatment of these patients.

  7. Space Shuttle Program Primary Avionics Software System (PASS) Success Legacy - Quality and Reliability Date

    NASA Technical Reports Server (NTRS)

    Orr, James K.; Peltier, Daryl

    2010-01-01

    Thsi slide presentation reviews the avionics software system on board the space shuttle, with particular emphasis on the quality and reliability. The Primary Avionics Software System (PASS) provides automatic and fly-by-wire control of critical shuttle systems which executes in redundant computers. Charts given show the number of space shuttle flights vs time, PASS's development history, and other charts that point to the reliability of the system's development. The reliability of the system is also compared to predicted reliability.

  8. Evaluation of primary stability of innovated orthodontic miniscrew system (STS): An ex-vivo study

    PubMed Central

    Seifi, Massoud

    2016-01-01

    Background Stability is determined as one of the requirements in use of Temporary Anchorage Devices (TAD) in orthodontics. Miniscrew has been a widely used Bone Anchor. Compared with mini-implant that necessitates osseointegration; mechanical retention is a determining factor for primary stability of miniscrew. Studies investigated various ways to increase primary stability. The aim of this study is to introduce a new configuration of miniscrew system which is believed to obtain more primary stability. Material and Methods Freshly ovine mandibles were cut in blocks. Twenty-seven miniscrews (diameter 1.6 × 8 mm; G2, Dual Top Anchor System, Jeil Medical, Seoul, Korea) were inserted in the blocks and divided in 2 experimental groups: single miniscrew and the innovated design “Seifi Twin Screw (STS)”. Primary stability was evaluated by Periotest “M”® device. Results Independent t-test showed a significant difference between 2 experimental groups in periotest evaluation (p< 0.05). STS demonstrated higher primary stability due to its mechanical configuration and design. Conclusions The STS provides higher primary stability and was found to be effective in increased success rate of miniscrew systems from the standpoint of primary stability. Key words:Anchorage procedures, anchorage techniques, orthodontic anchorage procedures, miniscrews, temporary anchorage device. PMID:27398174

  9. Reliability model of fault-tolerant data processing system with primary and backup nodes

    NASA Astrophysics Data System (ADS)

    Rahman, P. A.; Bobkova, E. Yu

    2016-04-01

    This paper deals with the fault-tolerant data processing systems, which are widely used in modern world of information technologies and have acceptable overhead expenses in hardware implementation. A simplified reliability model for duplex systems and the offered by authors advanced model for data processing systems with primary and backup nodes based on a three-state model of recoverable elements, which takes into consideration different failure rates of passive and active nodes and finite time of node activation, are also given. A calculation formula for the availability factor of the dual-node data processing system with primary and backup nodes and calculation examples are also provided.

  10. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment... Benchmark § 141.544 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone or chlorine dioxide for primary disinfection your system...

  11. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment... Benchmark § 141.544 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone or chlorine dioxide for primary disinfection your system...

  12. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment... Benchmark § 141.544 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone or chlorine dioxide for primary disinfection your system...

  13. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment... Benchmark § 141.544 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone or chlorine dioxide for primary disinfection your system...

  14. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment... Benchmark § 141.544 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone or chlorine dioxide for primary disinfection your system...

  15. Implementation of coulometric titration system at constant current for developing of certified materials as primary standards

    NASA Astrophysics Data System (ADS)

    Suarez, H.; Cristancho, R.; Peralta, F.; Torres, H.

    2017-01-01

    Coulometry is a primary method for measuring high purity substances. This is used to certify the primary reference materials required in a chemical analysis process. This paper describes the coulometric titration system developed by the National Metrology Institute (NMI) of Colombia for the certification of hydrochloric acid 0.1mol/kg reference materials. In addition, it also shows preliminary studies for future development of potassium chloride (KCl) and ethylenediaminetetraacetic acid disodium salt (EDTA-Na2) certification.

  16. Role for primary cilia as flow detectors in the cardiovascular system.

    PubMed

    Van der Heiden, Kim; Egorova, Anastasia D; Poelmann, Robert E; Wentzel, Jolanda J; Hierck, Beerend P

    2011-01-01

    The cardiovascular system is exposed to biochemical and biomechanical signals. Various sensors for these signals have been described and they contribute to cardiovascular development, maintenance of vessel integrity during adult life, and to pathogenesis. In the past 10years, primary cilia, membrane-covered, rod-like cellular protrusions, were discovered on multiple cell types of the cardiovascular system. Primary cilia are sensory organelles involved in several key (developmental) signaling pathways and in chemo- and mechanosensing on a myriad of cell types. In the embryonic and adult cardiovascular system, they have been demonstrated to function as shear stress sensors on endothelial cells and could act as strain sensors on smooth muscle cells and cardiomyocytes and as chemosensors on fibroblasts. This review will cover their occurrence and elaborate on established and possible functions of primary cilia in the cardiovascular system.

  17. Determination of the bias in LOFT fuel peak cladding temperature data from the blowdown phase of large-break LOCA experiments

    SciTech Connect

    Berta, V.T.; Hanson, R.G.; Johnsen, G.W.; Schultz, R.R.

    1993-05-01

    Data from the Loss-of-Fluid Test (LOFT) Program help quantify the margin of safety inherent in pressurized water reactors during postulated loss-of-coolant accidents (LOCAs). As early as 1979, questions arose concerning the accuracy of LOFT fuel rod cladding temperature data during several large-break LOCA experiments. This report analyzes how well externally-mounted fuel rod cladding thermocouples in LOFT accurately reflected actual cladding surface temperature during large-break LOCA experiments. In particular, the validity of the apparent core-wide fuel rod cladding quench exhibited during blowdown in LOFT Experiments L2-2 and L2-3 is studied. Also addressed is the question of whether the externally-mounted thermocouples might have influenced cladding temperature. The analysis makes use of data and information from several sources, including later, similar LOFT Experiments in which fuel centerline temperature measurements were made, experiments in other facilities, and results from a detailed FRAP-T6 model of the LOFT fuel rod. The analysis shows that there can be a significant difference (referred to as bias) between the surface-mounted thermocouple reading and the actual cladding temperature, and that the magnitude of this bias depends on the rate of heat transfer between the fuel rod cladding and coolant. The results of the analysis demonstrate clearly that a core-wide cladding quench did occur in Experiments L2-2 and L2-3. Further, it is shown that, in terms of peak cladding temperature recording during LOFT large-break LOCA experiments, the mean bias is 11.4 {plus_minus} 16.2K (20.5 {plus_minus} 29.2{degrees} F). The best-estimate value of peak cladding temperature for LOFT LP-02-6 is 1,104.8 K. The best-estimate peak cladding temperature for LOFT LP-LB-1 is 1284.0 K.

  18. Gender Differences in the Primary Representational System according to Neurolinguistic Programming.

    ERIC Educational Resources Information Center

    Cassiere, M. F.; And Others

    Neurolinguistic Programming (NLP) is a currently popular therapeutic modality in which individuals organize information through three basic sensory systems, one of which is the Primary Representational System (PRS). This study was designed to investigate gender differences in PRS according to the predicate preference method. It was expected that…

  19. Relationships between Digestive, Circulatory, and Urinary Systems in Portuguese Primary Textbooks

    ERIC Educational Resources Information Center

    Carvalho, Graça S.; Clèment, Pierre

    2007-01-01

    In this study, 63 Portuguese primary schoolbooks (1920-2005) were analyzed. The analysis focused on text information (reference to blood absorption and association of the digestive system to other human systems) and on information from images (presence or absence of image "confusion" (when the sequence of the digestive tract is not…

  20. Integration of Oral Health into Primary Health Care System: Views of Primary Health Care Workers in Lagos State, Nigeria

    PubMed Central

    Ogunbodede, Eyitope; Adeniyi, Abiola

    2014-01-01

    The limited access to oral health care in developing countries can be greatly improved by integrating oral health into the Primary Health Care (PHC) system. This study was designed to assess the views of PHC workers on integrating oral health care into the PHC system. A self-administered questionnaire survey was conducted in two selected local government areas of Lagos State. The instrument contained three sections assessing sociodemographic features, knowledge of common oral diseases and views on integration of oral health into PHC respectively. The mean knowledge score was 7.75 (SD=±1.81), while 60.4% of the respondents had average knowledge scores. Educational status (P=0.018) and designation (P=0.033) were significantly related to the mean knowledge scores. There was no significant difference in the oral health knowledge of the various cadres (P=0.393). Majority (85.4%) of the respondents were willing to include oral health education in their job schedule and 82% believed they needed more training on oral health. The knowledge of the respondents on the causes of the common oral diseases was deficient. Oral health education should be included in the future curriculum of these personnel. PMID:28299117

  1. LOFA (loss of flow accident) and LOCA (loss of coolant accident) in the TIBER-II engineering test reactor: Appendix A-4

    SciTech Connect

    Sviatoslavsky, I.N.; Attaya, H.M.; Corradini, M.L.; Lomperski, S.

    1987-01-01

    This paper describes the preliminary analysis of LOFA (loss of flow accident) and LOCA (loss of coolant accident) in the TIBER-II engineering test reactor breeding shield. TIBER-II is a compact reactor with a major radius of 3 m and thus requires a thin, high efficiency shield on the inboard side. The use of tungsten in the inboard shield implies a rather high rate of afterheat upon plasma shutdown, which must be dissipated in a controlled manner to avoid the possibility of radioactivity release or threatening the investment. Because the shield is cooled with an aqueous solution, LOFA does not pose a problem as long as natural convection can be established. LOCA, however, has more serious consequences, particularly on the inboard side. Circulation of air by natural convection is proposed as a means for dissipating the inboard shield decay heat. The safety and environmental implications of such a scheme are evaluated. It is shown that the inboard shield temperature never exceeds 510/sup 0/C following LOCA posing no hazard to reactor personnel and not threatening the investment. 7 refs., 6 figs.

  2. Comparison of the Mismatch Repair System between Primary and Metastatic Colorectal Cancers Using Immunohistochemistry

    PubMed Central

    Jung, Jiyoon; Kang, Youngjin; Lee, Yoo Jin; Kim, Eojin; Ahn, Bokyung; Lee, Eunjung; Kim, Joo Young; Lee, Jeong Hyeon; Lee, Youngseok; Kim, Chul Hwan; Chae, Yang-Seok

    2017-01-01

    Background Colorectal cancer (CRC) is one of the most common malignancies worldwide. Approximately 10%–15% of the CRC cases have defective DNA mismatch repair (MMR) genes. Although the high level of microsatellite instability status is a predictor of favorable outcome in primary CRC, little is known about its frequency and importance in secondary CRC. Immunohistochemical staining (IHC) for MMR proteins (e.g., MLH1, MSH2, MSH6, and PMS2) has emerged as a useful technique to complement polymerase chain reaction (PCR) analyses. Methods In this study, comparison between the MMR system of primary CRCs and paired liver and lung metastatic lesions was done using IHC and the correlation with clinical outcomes was also examined. Results Based on IHC, 7/61 primary tumors (11.4%) showed deficient MMR systems, while 13/61 secondary tumors (21.3%) showed deficiencies. In total, 44 cases showed proficient expression in both the primary and metastatic lesions. Three cases showed deficiencies in both the primary and paired metastatic lesions. In 10 cases, proficient expression was found only in the primary lesions, and not in the corresponding metastatic lesions. In four cases, proficient expression was detected in the secondary tumor, but not in the primary tumor. Conclusions Although each IHC result and the likely defective genes were not exactly matched between the primary and the metastatic tumors, identical results for primary and metastatic lesions were obtained in 77% of the cases (47/61). These data are in agreement with the previous microsatellite detection studies that used PCR and IHC. PMID:28192899

  3. Thermodynamics of greenhouse systems for the northern latitudes: analysis, evaluation and prospects for primary energy saving.

    PubMed

    Bronchart, Filip; De Paepe, Michel; Dewulf, Jo; Schrevens, Eddie; Demeyer, Peter

    2013-04-15

    In Flanders and the Netherlands greenhouse production systems produce economically important quantities of vegetables, fruit and ornamentals. Indoor environmental control has resulted in high primary energy use. Until now, the research on saving primary energy in greenhouse systems has been mainly based on analysis of energy balances. However, according to the thermodynamic theory, an analysis based on the concept of exergy (free energy) and energy can result in new insights and primary energy savings. Therefore in this paper, we analyse the exergy and energy of various processes, inputs and outputs of a general greenhouse system. Also a total system analysis is then performed by linking the exergy analysis with a dynamic greenhouse climate growth simulation model. The exergy analysis indicates that some processes ("Sources") lie at the origin of several other processes, both destroying the exergy of primary energy inputs. The exergy destruction of these Sources is caused primarily by heat and vapour loss. Their impact can be compensated by exergy input from heating, solar radiation, or both. If the exergy destruction of these Sources is reduced, the necessary compensation can also be reduced. This can be accomplished through insulating the greenhouse and making the building more airtight. Other necessary Sources, namely transpiration and loss of CO2, have a low exergy destruction compared to the other Sources. They are therefore the best candidate for "pump" technologies ("vapour heat pump" and "CO2 pump") designed to have a low primary energy use. The combination of these proposed technologies results in an exergy efficient greenhouse with the highest primary energy savings. It can be concluded that exergy analyses add additional information compared to only energy analyses and it supports the development of primary energy efficient greenhouse systems.

  4. CATHARE2 calculation of SPE-3 test small break loca on PMK facility

    SciTech Connect

    Laugier, E.; Radet, J.

    1995-09-01

    Bind and post test calculations with CATHARE2 have been performed concerning the SPE-4 exercise organized under the auspices of IAEA on the hungarian PMK-2 facility, a one loop scaled model of VVER 440/213 Nuclear Power Plant. The SPE-4 test is a cold leg SBLOCA associated to a {open_quotes}bleed and feed{close_quotes} procedure applied in the secondary circuit. The present paper is devoted to the analysis of the post test calculation. For the first part of the transient (until the end of the SIT activations), the primary and secondary pressures are rather well predicted, leading to a good agreement with the experimental trips, as scram, flow coast down, SIT beginning and end of activation. Nevertheless, some discrepancy with the experiment may be due to an over prediction of the thermal exchanges from the primary to the secondary circuits. For the second part of the transient, the predicted primary circuit repressurization is shifted after the SITs are off, while in the experiment this event immediately follows the end of SIT activation. The delay in the calculation leads to underpredict primary and secondary pressures, thus anticipating the timing of events, such as LPIS and emergency feedwater activation.

  5. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment... § 141.535 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone, or chlorine dioxide for primary disinfection, you must...

  6. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment... § 141.535 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone, or chlorine dioxide for primary disinfection, you must...

  7. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment... § 141.535 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone, or chlorine dioxide for primary disinfection, you must...

  8. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment... § 141.535 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone, or chlorine dioxide for primary disinfection, you must...

  9. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment... § 141.535 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone, or chlorine dioxide for primary disinfection, you must...

  10. Degradation and Failure Characteristics of NPP Containment Protective Coating Systems

    SciTech Connect

    Sindelar, R.L.

    2001-04-10

    Nuclear power plants (NPPs) must ensure that the emergency core cooling system (ECCS) or safety-related containment spray system (CSS) remains capable of performing its design safety function throughout the life of the plant. This requires ensuring that long-term core cooling can be maintained following a postulated loss-of-coolant accident (LOCA). Adequate safety operation can be impaired if the protective coatings which have been applied to the concrete and steel structures within the primary containment fail, producing transportable debris which could then accumulate on BWR ECCS suction strainers or PWR ECCS sump debris screens located within the containment. This document will present the data collected during the investigation of coating specimens from plants.

  11. Apotopes and innate immune system: novel players in the primary biliary cirrhosis scenario.

    PubMed

    Lleo, Ana; Invernizzi, Pietro

    2013-08-01

    Our understanding of primary biliary cirrhosis has been rapidly growing over the past decade and the disease is now regarded as a model for other female-predominant, organ-specific autoimmune conditions. Primary biliary cirrhosis ensues from a multi-lineage loss of tolerance to the E2 component of the pyruvate dehydrogenase complex. One of the major unanswered questions in the pathogenesis of primary biliary cirrhosis is the specificity of small intrahepatic bile ducts attack while PDC-E2 is present in mitochondria of all nucleated cells. Recent findings suggest that the uniqueness of the primary target tissue, biliary epithelium, may be of considerable importance for understanding primary biliary cirrhosis and that the biliary epithelial cell is more than an innocent victim. Rather, it attracts an immune attack by virtue of the unique apoptotic mechanisms and by the way it handles PDC-E2. Moreover, recent evidence suggests that apoptotic bodies of biliary epithelial cell are able to activate the innate immune system in the presence of anti-mitochondrial antibodies. This review article is intended to provide a critical overview of the role of apoptosis in biliary epithelial cells, the activation of the innate immune system, and its biological and clinical significance in primary biliary cirrhosis.

  12. Central nervous system compromise in primary Sjögren's syndrome.

    PubMed

    Anaya, Juan-Manuel; Villa, Luis A; Restrepo, Lucas; Molina, Jose F; Mantilla, Rubén D; Vargas, Sergio

    2002-08-01

    Central nervous system (CNS) involvement in primary Sjögren's syndrome (SS) is poorly understood, and its frequency as well as its manifestations are subjects of controversy. The current study was undertaken to determine the prevalence and the clinical and immunogenetic characteristics of CNS compromise in a well defined group of patients with primary SS. In this retrospective study, patients fulfilled the European classification criteria. Among 120 patients with primary SS, 3 (2.5%) had CNS compromise (multiple sclerosis-like illness, complicated migraine, and optic neuritis with epilepsy). The CNS involvement coincided with the onset of sicca symptoms in 1 case. All 3 patients carried the human leukocyte antigen (HLA) DQB1*0303 allele and tested positive for anti-Ro antibodies, but not for anti-cardiolipin antibodies. Although rare, CNS compromise in primary SS can be the presenting manifestation of the disease in a few cases, and may be severe and varied.

  13. Comparison of Carbon and Hi-Z Primary Collimators for the LHC Phase II Collimation System

    SciTech Connect

    Keller, Lewis; Markiewicz, Thomas; Smith, Jeffrey; Assmann, Ralph; Bracco, Chiara; Weiler, Thomas; /Karlsruhe, Inst. Technol.

    2011-10-31

    A current issue with the LHC collimation system is single-diffractive, off-energy protons from the primary collimators that pass completely through the secondary collimation system and are absorbed immediately downbeam in the cold magnets of the dispersion suppressor section. Simulations suggest that the high impact rate could result in quenching of these magnets. We have studied replacing the 60 cm primary graphite collimators, which remove halo mainly by inelastic strong interactions, with 5.25 mm tungsten, which remove halo mainly by multiple coulomb scattering and thereby reduce the rate of single-diffractive interactions that cause losses in the dispersion suppressor.

  14. Primary Systemic Amyloidosis and High Levels of Angiotensin-Converting Enzyme: Two Case Reports

    PubMed Central

    Praena-Segovia, J.; Sanchez-Gastaldo, A.; Bernabeu-Wittel, M.; Ocete-Pérez, R.; Ávila-Polo, R.; Martino, M. L.

    2013-01-01

    Infiltrative heart diseases are caused by a heterogeneous group of disorders; amyloidosis and sarcoidosis are two frequent causes of myocardial infiltration, which differ in clinical and biological outcome and treatment issues. The presence of high levels of angiotensin-converting enzyme (ACE) in a patient with infiltrative heart disease may increase suspicion of sarcoidosis. Nevertheless, no mention about increased ACE levels in extracerebral primary systemic amyloidosis is available. We present two cases of primary systemic amyloidosis, which are cardiac involvement and elevated ACE levels. PMID:24826302

  15. A systems-based partnership learning model for strengthening primary healthcare

    PubMed Central

    2013-01-01

    Background Strengthening primary healthcare systems is vital to improving health outcomes and reducing inequity. However, there are few tools and models available in published literature showing how primary care system strengthening can be achieved on a large scale. Challenges to strengthening primary healthcare (PHC) systems include the dispersion, diversity and relative independence of primary care providers; the scope and complexity of PHC; limited infrastructure available to support population health approaches; and the generally poor and fragmented state of PHC information systems. Drawing on concepts of comprehensive PHC, integrated quality improvement (IQI) methods, system-based research networks, and system-based participatory action research, we describe a learning model for strengthening PHC that addresses these challenges. We describe the evolution of this model within the Australian Aboriginal and Torres Strait Islander primary healthcare context, successes and challenges in its application, and key issues for further research. Discussion IQI approaches combined with system-based participatory action research and system-based research networks offer potential to support program implementation and ongoing learning across a wide scope of primary healthcare practice and on a large scale. The Partnership Learning Model (PLM) can be seen as an integrated model for large-scale knowledge translation across the scope of priority aspects of PHC. With appropriate engagement of relevant stakeholders, the model may be applicable to a wide range of settings. In IQI, and in the PLM specifically, there is a clear role for research in contributing to refining and evaluating existing tools and processes, and in developing and trialling innovations. Achieving an appropriate balance between funding IQI activity as part of routine service delivery and funding IQI related research will be vital to developing and sustaining this type of PLM. Summary This paper draws together

  16. Primary Care Behavioral Health Provider Training: Systematic Development and Implementation in a Large Medical System.

    PubMed

    Dobmeyer, Anne C; Hunter, Christopher L; Corso, Meghan L; Nielsen, Matthew K; Corso, Kent A; Polizzi, Nicholas C; Earles, Jay E

    2016-09-01

    The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense's experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed.

  17. Vapor/Mist Used to Lubricate Gears After Loss of Primary Lubrication System

    NASA Technical Reports Server (NTRS)

    Handschuh, Robert F.; Morales, Wilfredo

    2001-01-01

    Loss of lubrication in rotorcraft drive systems is a demanding requirement placed on drive system manufacturers. The drive system must operate for at least 30 minutes once the primary lubrication system has failed. This test is a military requirement that must be passed prior to certification of the aircraft. As new aircraft engines, operating at higher speeds, are fielded, the requirements for the drive system become increasingly more difficult. Also, the drive system must be lightweight, which minimizes the opportunity to use the gear bodies to absorb the tremendous amount of heating that takes place. In many cases, the amount of heat generated because of the high speed and load requires an emergency lubrication system that negatively impacts the aircraft's weight, complexity, and cost. A single mesh spur gear test rig is being used at the NASA Glenn Research Center to investigate possible emergency lubrication system improvements that will minimize the impact of having these systems onboard rotorcraft. A technique currently being investigated uses a vapor/mist system to lubricate the contacting surfaces after the primary lubrication system has been shut down. A number of tests were conducted in which the vapor/mist used the same lubricant as the primary system, but at a greatly reduced flow rate. Each test was initiated with the primary lubrication system operational and at steady-state conditions for a given speed and load. Then the primary lubrication system was shut down, and the vapor/mist lubrication system was initiated. An example of the tests conducted is shown in the figures. These preliminary tests have uncovered a mechanism that provides a lubricious, carbonaceous solid on the surface that actually reduces the surface temperature of the meshing gear teeth during operation. Surface analysis of the carbonaceous solid revealed it was graphitic. This mechanism is the synthetic lubricant "coking" on the active profile of the gears, which reduces the

  18. Primary healthcare in transition – a qualitative study of how managers perceived a system change

    PubMed Central

    2013-01-01

    Background Primary healthcare in Sweden has undergone widespread reforms in recent years, including freedom of choice regarding provider, freedom of establishment and increased privatisation. The key aims of the reforms were to strengthen the role of the patient and improve performance in terms of access and responsiveness. The aim of this study was to explore how managers at publicly owned primary healthcare centres perceived the transition of the primary healthcare system and the impact it has had on their work. Methods In this qualitative study, 24 managers of publicly owned primary healthcare centres in the metropolitan region of Gothenburg were recruited. Semi-structured interviews were conducted and data were analysed using content analysis inspired by Silverman. Results The analysis revealed two core themes: The transition is perceived as a rapid change, enforced mainly through financial incentives and Prioritisation conflicts arise between patient groups with different needs, demands and levels of empowerment. The transition has produced powerful and rapid effects that were considered to be both positive and negative. While the new financial incentives were seen as a driving force and a tool for change, they also became a stress factor due to uncertainty, competition with other primary healthcare centres and negative feelings associated with staff cutbacks. The shift in power towards the patient improved access and service but also led to more patients with unreasonable demands. Managers found it difficult to prioritise correctly between patient groups with different needs, demands and levels of empowerment and they were concerned about potentially negative effects on less empowered patients, e.g. multi-morbid patients. Managers also experienced shortcomings in their change management skills. Conclusions This qualitative study shows the complexity of the system change and describes the different effects and perceptions of the transition from a manager

  19. A new classification system for primary lymphatic dysplasias based on phenotype.

    PubMed

    Connell, F; Brice, G; Jeffery, S; Keeley, V; Mortimer, P; Mansour, S

    2010-05-01

    Traditional classification systems for lymphoedema are of limited use for the diagnosis of specific forms of primary lymphoedema. The understanding of primary lymphoedema has been impeded by confusing terminology and a tendency to simply divide patients into three categories based on the age of onset: lymphoedema congenita manifests at or shortly after birth, lymphoedema praecox is apparent before the age of 35 years and lymphoedema tarda manifests thereafter. The clinical presentation in the spectrum of primary lymphoedema disorders is very variable; the phenotypes of primary lymphoedema conditions vary in the age of onset, site of the oedema, inheritance patterns, associated features and genetic causes. Different inheritance patterns are recognised and there are numerous associated anomalies. Some subgroups, such as Milroy disease and Lymphoedema distichiasis, are well characterised, but others are not. A new clinical classification for primary lymphoedema has been developed as a diagnostic algorithm. Its use is demonstrated on 333 probands referred to our lymphoedema clinic. Grouping patients by accurate phenotyping facilitates molecular investigations, understanding of inheritance patterns, and the natural history of different types of primary lymphoedema. Descriptions of the diagnostic categories, some of which have not been previously clearly defined as distinct clinical entities, are illustrated by clinical cases.

  20. Release and systemic accumulation of heavy metals from preformed crowns used in restoration of primary teeth.

    PubMed

    Kodaira, Hiroe; Ohno, Kohachiro; Fukase, Naoko; Kuroda, Midori; Adachi, Shiki; Kikuchi, Motohiro; Asada, Yoshinobu

    2013-01-01

    Preformed crowns for restoration of primary teeth are used in various treatments and are essential for restoring the crowns of primary molars. However, there are concerns that mechanical, chemical, and thermal stimulation may cause release of components of such crowns. We examined systemic accumulation of heavy metals associated with preformed crowns (3M Stainless Steel Primary Molar Crowns) used in primary tooth restoration. The participants were 37 children who had visited the Pediatric Dental Clinic of Tsurumi University Dental Hospital. They were divided into two groups: 22 participants without a history of being fitted with a preformed crown for primary tooth restoration (controls), and 15 participants with preformed crowns for primary tooth restoration. Analysis of hair samples showed a significant difference in the level of the trace element Cr - an important component of the preformed crowns - between children with and without preformed crowns, but no significant differences in Fe or Ni levels. Levels of the trace elements Ni, Cr, and Fe were within allowable ranges, indicating that these minerals were not likely to be harmful.

  1. Assessing Primary Representational System (PRS) Preference for Neurolinguistic Programming (NLP) Using Three Methods.

    ERIC Educational Resources Information Center

    Dorn, Fred J.

    1983-01-01

    Considered three methods of identifying Primary Representational System (PRS)--an interview, a word list, and a self-report--in a study of 120 college students. Results suggested the three methods offer little to counselors either collectively or individually. Results did not validate the PRS construct, suggesting the need for further research.…

  2. Assessment of Primary Representational Systems with Neurolinguistic Programming: Examination of Preliminary Literature.

    ERIC Educational Resources Information Center

    Dorn, Fred J.; And Others

    1983-01-01

    Reviews the inconsistent findings of studies on neurolinguistic programing and recommends some areas that should be examined to verify various claims. Discusses methods of assessing client's primary representational systems, including predicate usage and eye movements, and suggests that more reliable methods of assessing PRS must be found. (JAC)

  3. Development of Quality Assurance System in Culture and Nation Character Education in Primary Education in Indonesia

    ERIC Educational Resources Information Center

    Susilana, Rudi; Asra

    2013-01-01

    The purpose of national education is to develop skills and build dignified national character and civilization in educating nation life (Act No. 20, 2003). The paper describes a system of quality assurance in culture and character education in primary education. This study employs the six sigma model which consists of the formula DMAIC (Define,…

  4. Job Realities of Primary School Principals in Greece: Similarities and Variations in a Highly Centralized System

    ERIC Educational Resources Information Center

    Dimopoulos, Kostas; Dalkavouki, Katerina; Koulaidis, Vasilis

    2015-01-01

    This study aims at investigating primary school principals' work on a daily basis in order to understand the ways in which the centralized educational system affects their practices. Four typical cases of principals were selected and asked to keep daily records for a period of four months. Data from logs were complemented with data collected…

  5. Investigating Nigerian Primary School Teachers' Preparedness to Adopt Personal Response System in ESL Classroom

    ERIC Educational Resources Information Center

    Agbatogun, Alaba Olaoluwakotansibe

    2012-01-01

    This study investigated the extent to which computer literacy dimensions (computer general knowledge, documents and documentations, communication and surfing as well as data inquiry), computer use and academic qualification as independent variables predicted primary school teachers' attitude towards the integration of Personal Response System in…

  6. Office Systems and Their Influence on Mammography Use in Rural and Urban Primary Care

    ERIC Educational Resources Information Center

    Engelman, Kimberly K.; Ellerbeck, Edward F.; Perpich, Denise; Nazir, Niaman; McCarter, Kevin; Ahluwalia, Jasjit S.

    2004-01-01

    Breast cancer screening rates are lower in rural communities. Although studies have addressed barriers to mammography for rural residents, physician practice barriers have received less attention. Purpose: Controlled clinical trials have shown that the use of office reminder systems in primary care practices is related to increased clinical care…

  7. Using a Learning Management System to Personalise Learning for Primary School Students

    ERIC Educational Resources Information Center

    Edmunds, Bronwyn; Hartnett, Maggie

    2014-01-01

    This paper reports on one aspect of a descriptive multiple-case study which set out to explore the role of a learning management system (LMS) in personalising learning for students from the perspective of three teachers in one primary school in New Zealand. The intention was to provide insight into the role the LMS could play in classrooms when…

  8. Space shuttle/food system study. Volume 2, Appendix F: Flight food and primary packaging

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The analysis and selection of food items and primary packaging, the development of menus, the nutritional analysis of diet, and the analyses of alternate food mixes and contingency foods is reported in terms of the overall food system design for space shuttle flight. Stowage weights and cubic volumes associated with each alternate mix were also evaluated.

  9. Investigating Power System Primary and Secondary Reserve Interaction under High Wind Power Penetration

    SciTech Connect

    Zhang, Yingchen; Tan, Jin; Krad, Ibrahim; Yang, Rui; Gevorgian, Vahan; Ela, Erik

    2016-12-01

    Power system frequency needs to be maintained close to its nominal value at all times to successfully balance load and generation and maintain system reliability. Adequate primary frequency response and secondary frequency response are the primary forces to correct an energy imbalance at the second-to-minute level. As wind energy becomes a larger portion of the world's energy portfolio, there is an increased need for wind to provide frequency response. This paper addresses one of the major concerns about using wind for frequency regulation: the unknown factor of the interaction between primary and secondary reserves. The lack of a commercially available tool to model this has limited the energy industry's understanding of when the depletion of primary reserves will impact the performance of secondary response or vice versa. This paper investigates the issue by developing a multi-area frequency response integration tool with combined primary and secondary capabilities. The simulation is conducted in close coordination with economical energy scheduling scenarios to ensure credible simulation results.

  10. Post-transplantation primary central nervous system lymphoma in a patient with systemic lupus erythematosus and prolonged use of immunosuppressant.

    PubMed

    Tse, Teresa P K; Chan, Allan N L; Chan, Tony K T; Po, Y C

    2014-12-01

    Post-transplantation primary central nervous system lymphoma is an uncommon and fatal post-transplant lymphoproliferative disorder. Such lymphomas have been described in only a few case series in the literature. The incidence of this condition is rising with improved survival after organ transplantation. A case of post-transplantation primary central nervous system lymphoma in a young Chinese woman with systemic lupus erythematosus is described here. She presented with right-sided weakness and memory loss after tooth extraction 2 weeks before admission. Contrast computed tomography of the brain demonstrated a contrast rim-enhancing lesion over the left frontal lobe. With a history of recent dental procedure, long-term immunosuppressive therapy and computed tomography findings, cerebral abscess was highly suspected. Emergency operation was performed. Histopathology showed post-transplantation primary central nervous system lymphoma, with cells positive for B-cell marker CD20. Immunosuppressant was stopped and she was treated with radiotherapy and rituximab (anti-CD20 monoclonal antibody). She remained disease-free at 16 months. Post-transplantation primary central nervous system lymphoma is rare with variable presentation and radiological features. We believe rituximab may have a role in the treatment of such lymphomas.

  11. Concomitant diagnosis of primary Sjögren's syndrome and systemic AL amyloidosis.

    PubMed

    Delèvaux, I; André, M; Amoura, Z; Kémény, J L; Piette, J C; Aumaître, O

    2001-07-01

    A 48 year old woman was referred to hospital for buccal discomfort. Physical examination showed a macroglossia and features of xerostomia. She was diagnosed as having primary Sjögren's syndrome according to the criteria proposed by the European Community study group in 1993. Furthermore, a lower lip salivary gland biopsy showed amyloid deposits that were also seen in the stomach and in the bone marrow. Echocardiography was consistent with cardiac amyloidosis. Serum immunofixation identified a monoclonal IgGlambda. As far as is known, this is the first report of systemic primary amyloidosis associated with Sjögren's syndrome. The relation between these two disorders is discussed.

  12. Primary lymphomas of the central nervous system: patterns of failure and factors that influence survival

    SciTech Connect

    Loeffler, J.S.; Ervin, T.J.; Mauch, P.; Skarin, A.; Weinstein, H.J.; Canellos, G.; Cassady, J.R.

    1985-04-01

    Primary lymphomas of the CNS are rare tumors accounting for less than 2% of all extranodal non-Hodgkin's lymphomas. The treatment for this disease has been disappointing. Radiation therapy and surgery have produced consistently poor control of this disease, with a median survival of 15 months. A review of ten cases of primary lymphoma of the CNS treated at the Joint Center for Radiation Therapy or Dana-Farber Cancer Institute (Boston) from 1968 to 1981 is presented. All patients had biopsy- proven CNS lymphomas without systemic disease at presentation. In this series, control of CNS lymphoma was seen only in patients receiving craniospinal radiation or CNS-penetrating chemotherapy.

  13. Micro-tensile bond strength of adhesive systems applied on occlusal primary enamel.

    PubMed

    Ramires-Romito, Ana Cláudia; Reis, Alessandra; Loguercio, Alessandro Dourado; de Góes, Mario Fernando; Grande, Rosa Helena Miranda

    2004-01-01

    The aim of this study was to evaluate the micro-tensile bond strength of adhesive systems (OptiBond Solo, Kerr; Prime & Bond NT, Dentsply) on occlusal surface of primary molars. The adhesives were tested under manufacturers' specifications and after contamination of the bonding site with saliva. Hourglass cylindrical-shaped samples were obtained and subjected to a tensile force. No significant difference was observed among the groups. OptiBond Solo and Prime & Bond NT showed similar values of bond strengths when applied on occlusal enamel of primary molar under either saliva contamination or not.

  14. Health system factors affecting communication with pediatricians: gendered work culture in primary care.

    PubMed

    Lynch, Sean

    2011-01-01

    This qualitative study examined the roles that practice setting, education level, and gender may play in social workers' communication satisfaction with pediatricians. Taking an ethnographic approach, the researcher interviewed social workers and pediatricians who worked together to provide mental health services in primary care. The results suggested that gender at the health system level may be an issue and that gendered work culture in primary care was a factor in communication. In particular, reimbursement, an aspect of the gendered work culture, was a substantial communication barrier, and the implications for Medicaid billing are discussed.

  15. Patient-centered primary health care: synergy potential for health systems strengthening.

    PubMed

    Stender, S C; Christensen, A

    2013-10-01

    The ultimate goal of government health systems is to provide highly effective equitable services that save lives and reduce morbidity and mortality. The pressure to conform to duplicative global and donor initiatives compounds existing challenges to health systems strengthening such as shortages of human resources for health, weak supply chains, inadequate laboratory services and parallel data management systems. This article illustrates how primary health care, as the point of entry into the health care system for the majority of individuals in sub-Saharan Africa, should be strengthened to ensure that individuals and their communities receive essential, holistic care.

  16. Development of a handheld computer documentation system to enhance an integrated primary care clerkship.

    PubMed

    Pipas, Catherine F; Carney, Patricia A; Eliassen, M Scottie; Mengshol, Sarah C; Fall, Leslie H; Olson, Ardis L; Schifferdecker, Karen E; Russell, Margaret T; Peltier, Deborah A; Nierenberg, David W

    2002-07-01

    Documentation systems are used by medical schools and residency programs to record the clinical experiences of their learners. The authors developed a system for their school's (Dartmouth's) multidisciplinary primary care clerkship (family medicine, internal medicine, pediatrics) that documents students' clinical and educational experiences and provides feedback designed to enhance clinical training utilizing a timely data-reporting system. The five critical components of the system are (1) a valid, reliable and feasible data-collection instrument; (2) orientation of and ongoing support for student and faculty users; (3) generation and distribution of timely feedback reports to students, preceptors, and clerkship directors; (4) adequate financial and technical support; and (5) a database design that allows for overall evaluation of educational outcomes. The system, whose development began in 1997, generated and distributed approximately 150 peer-comparison reports of clinical teaching experiences to students, preceptors, and course directors during 2001, in formats that are easy to interpret and use to individualize learning. The authors present report formats and annual cost estimate comparisons of paper- and computer-based system development and maintenance, which range from $35,935 to $53,780 for the paper-based system and from $46,820 to $109,308 for the computer-based system. They mention ongoing challenges in components of the system. They conclude that a comprehensive documentation and feedback system provides an essential infrastructure for the evaluation and enhancement of community-based teaching and learning in primary care ambulatory clerkships, whether separate or integrated.

  17. A PCA3 gene-based transcriptional amplification system targeting primary prostate cancer.

    PubMed

    Neveu, Bertrand; Jain, Pallavi; Têtu, Bernard; Wu, Lily; Fradet, Yves; Pouliot, Frédéric

    2016-01-12

    Targeting specifically primary prostate cancer (PCa) cells for immune therapy, gene therapy or molecular imaging is of high importance. The PCA3 long non-coding RNA is a unique PCa biomarker and oncogene that has been widely studied. This gene has been mainly exploited as an accurate diagnostic urine biomarker for PCa detection. In this study, the PCA3 promoter was introduced into a new transcriptional amplification system named the 3-Step Transcriptional Amplification System (PCA3-3STA) and cloned into type 5 adenovirus. PCA3-3STA activity was highly specific for PCa cells, ranging between 98.7- and 108.0-fold higher than that for benign primary prostate epithelial or non-PCa cells, respectively. In human PCa xenografts, PCA3-3STA displayed robust bioluminescent signals at levels that are sufficient to translate to positron emission tomography (PET)-based reporter imaging. Remarkably, when freshly isolated benign or cancerous prostate biopsies were infected with PCA3-3STA, the optical signal produced from primary PCa biopsies was significantly higher than from benign prostate biopsies (4.4-fold, p < 0.0001). PCA3-3STA therefore represents a PCa-specific expression system with the potential to target, with high accuracy, primary or metastatic PCa epithelial cells for imaging, vaccines, or gene therapy.

  18. Perceived role of primary care physicians in Nova Scotia's reformed health care system. Qualitative study.

    PubMed Central

    Sangster, L. M.; McGuire, D. P.

    1999-01-01

    OBJECTIVE: To determine primary care physicians' perceptions of their role in a reformed health system. DESIGN: Qualitative study using in-depth interviews. SETTING: Province of Nova Scotia. PARTICIPANTS: Purposefully selected sample of 14 practising primary care physicians. MAIN OUTCOME FINDINGS: Participants identified seven aspects of their role: primarily, diagnosis and treatment of patient's medical problems; then coordination, counseling, education, advocacy, disease prevention, and gatekeeping. The range of activities and degree of responsibility assumed by participants, however, varied. Factors affecting role perception fell into three categories: philosophical view of health and medicine, willingness to collaborate, and practical realities. Participants differed in their understanding of primary health care and their overall vision of the health system. Remuneration policies and concerns about sharing accountability were factors preventing an integrated, collaborative approach to care. Personal, patient, and structural realities also limited physicians' roles. CONCLUSIONS: This sample of primary care physicians had diverse perceptions of their role. Results of this study could provide information for identifying issues that need to be addressed to facilitate changes taking place in the health care system. PMID:10889862

  19. [The primary research and development of software oversampling mapping system for electrocardiogram].

    PubMed

    Zhou, Yu; Ren, Jie

    2011-04-01

    We put forward a new concept of software oversampling mapping system for electrocardiogram (ECG) to assist the research of the ECG inverse problem to improve the generality of mapping system and the quality of mapping signals. We then developed a conceptual system based on the traditional ECG detecting circuit, Labview and DAQ card produced by National Instruments, and at the same time combined the newly-developed oversampling method into the system. The results indicated that the system could map ECG signals accurately and the quality of the signals was good. The improvement of hardware and enhancement of software made the system suitable for mapping in different situations. So the primary development of the software for oversampling mapping system was successful and further research and development can make the system a powerful tool for researching ECG inverse problem.

  20. Payment systems and incentives in primary care: implications of recent reforms in Estonia and Romania.

    PubMed

    Dan, Sorin; Savi, Riin

    2015-01-01

    Since the early 1990s, major reform in healthcare has been adopted in former communist countries in Central and Eastern Europe. More than 20 years after, reform in healthcare still draws much interest from policy makers and academics alike. One of the dynamic components of reform has been the reform of payment systems in primary care. This article looks at recent developments in payment systems and financial incentives in Estonia and Romania. We conclude that finding the appropriate mix in paying and incentivizing primary care providers in a transitional context is no easy solution for healthcare policy makers who need to carefully weigh in the advantages and inherent problems of various payment arrangements. In a transitional, rapidly changing healthcare system and society, and a context of financial stringency, the theoretical effects of payment mechanisms may be more difficult to predict and manage than it is expected.

  1. Randomized Clinical Trial of Composite Restorations in Primary Teeth: Effect of Adhesive System after Three Years

    PubMed Central

    Donmez, Secil Bektaş; Uysal, Serdar; Ozdemir, Pinar; Tekcicek, Meryem; Zimmerli, Brigitte; Lussi, Adrian

    2016-01-01

    The purpose of this study was to assess the clinical performance of composite restorations placed with different adhesive systems in primary teeth. In 32 patients, 128 composite restorations were placed using a split-mouth design as follows (4 groups/patient): three-step etch-and-rinse (Group 1), two-step etch-and-rinse (Group 2), two-step self-etch (Group 3), and one-step self-etch (Group 4). The restorations were clinically evaluated at baseline and at 6, 18, and 36 months according to the FDI criteria. There was no significant difference between the adhesive systems in retention of the restorations (p > 0.05). Over time, there was a statistically significant decrease in marginal adaptation in all groups, whereas surface and marginal staining significantly increased in Groups 3 and 4 (p < 0.05). The etch-and-rinse adhesive systems resulted in better marginal adaptation than the self-etch adhesive systems (p < 0.05). It was concluded that preetching of the primary enamel might help improve the clinical performance of the self-etch adhesive systems in primary teeth. PMID:27833917

  2. Primary production and sinking export during fall in the Hudson Bay system, Canada

    NASA Astrophysics Data System (ADS)

    Lapoussière, Amandine; Michel, Christine; Gosselin, Michel; Poulin, Michel; Martin, Johannie; Tremblay, Jean-Éric

    2013-01-01

    Primary production and organic material sinking export were investigated in the Hudson Bay system (i.e., Hudson Bay, Hudson Strait and Foxe Basin) under ice-free conditions during early fall 2005, using the 14C-uptake method and short-term free-drifting particle interceptor traps deployed below the euphotic zone at 50 m. Principal component analysis revealed spatial patterns of primary production and chlorophyll a (chl a) biomass in the euphotic zone that were shaped by hydrographic conditions and nutrient concentrations linked to freshwater/seawater influence. Primary production rates varied widely, from 70 to 435 mg C m-2 d-1, while the range of particulate organic carbon (POC) sinking fluxes was narrow, from 50 to 77 mg C m-2 d-1. Consequently, high ratios of POC sinking export to primary production (i.e., export ratios; range of 0.38-0.69) were observed at stations where primary production was low and dominated by small cells, and where heterotrophic protist dominated in biomass. These results show that at short temporal scales neither protist community structure nor biomass or production rates could be used to predict the magnitude of POC sinking export from the euphotic zone.

  3. Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study

    PubMed Central

    Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim

    2015-01-01

    Objectives To examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland. Design Longitudinal study with three points of measurement. Setting Primary care practices in Switzerland. Participants In total, 45 of 91 primary care practices completed European Practice Assessment three times. Outcomes The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time. Results Significant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). Conclusions The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. PMID:25900466

  4. Investigating Power System Primary and Secondary Reserve Interaction under High Wind Penetration Using Frequency Response Model

    SciTech Connect

    Tan, Jin; Zhang, Yingchen; Krad, Ibrahim; Gevorgian, Vahan; Ela, Erik

    2015-10-12

    Power system frequency needs to be maintained close to its nominal value at all times to avoid machine damage, under-frequency load-shedding and even blackouts. Adequate primary frequency response and secondary frequency response are the primary forces to correct an energy imbalance at the second to minute level. As wind energy becomes a larger portion of the world's energy portfolio, there are greater oppotunities for wind to provide frequency response services. This paper addresses one area of frequency control that has been missing in previous work - the reliabilty impacts and interactions between primary and secondary frequency control. The lack of a commercially available tools to simulate the interaction of these two responses has limited the energy industry's understanding of when the depletion of primary control reserve will impact the performance of secondary conrol response or vice versa. To investigate this issue, in this paper we develop a multi-area frequency response integration model with combined primary and secondary frequency control capabilities.

  5. Advising potential recipients on the use of organs from donors with primary central nervous system tumors.

    PubMed

    Warrens, Anthony N; Birch, Rhiannon; Collett, David; Daraktchiev, Maren; Dark, John H; Galea, George; Gronow, Katie; Neuberger, James; Hilton, David; Whittle, Ian R; Watson, Christopher J E

    2012-02-27

    Deciding to use an organ from a donor with a primary central nervous system (CNS) tumor necessitates offsetting the risk of tumor transmission with the chances of survival if the patient waits for another offer of a transplant. Published data vary in the quoted risk of tumor transmission. We used data obtained by reviewing 246 UK recipients of organs taken from donors with CNS tumors and found no evidence of a difference in overall patient mortality for recipients of a kidney, liver, or cardiothoracic organ, compared with recipients of organs from donors without a CNS tumor. Recent publication of the UK experience of transplanting organs from CNS tumor donors found no transmission in 448 recipients of organs from 177 donors with a primary CNS tumor (Watson et al., Am J Transplant 2010; 10: 1437). This 0% transmission rate is associated with an upper 95% confidence interval limit of 1.5%. Using a series of assumptions of risk, we compared the risks of dying as a result of the transmission of a primary brain tumor with the risks of dying if not transplanted. On this basis, the use of kidneys from a donor with a primary CNS tumor provides a further 8 years of life over someone who waited for a donor who did not have a primary CNS tumor, in addition to the life years gained by the transplant itself. The benefits for the recipients of livers and cardiothoracic organs were less, but there was no disadvantage in the impact on life expectancy.

  6. Evaluation of combustible gas concentration in a multi-compartment containment after a LOCA

    SciTech Connect

    Goodwin, E.F.

    1995-12-31

    The General Electric Company`s Simplified Boiling Water Reactor (SBWR) is an advanced reactor and containment design relying on passive safety features. The containment is a pressure suppression type containment with heat removed from the containment by a Passive Containment Cooling System. This paper reports on an analysis using the GOTHIC code to investigate the distribution of non-condensable gases within the containment system. The goal of the analysis was to determine areas in the containment that may collect combustible mixtures following an accident. The SBWR`s Flammability Control System, using Passive Autocatalytic Recombiners, is not modeled in this analysis. The analysis is useful for demonstrating basic design requirements of the Flammability Control System.

  7. Increased Light-Use Efficiency Sustains Net Primary Productivity of Shaded Coffee Plants In Agroforestry System.

    PubMed

    Charbonnier, Fabien; Roupsard, Olivier; le Maire, Guerric; Guillemot, Joannès; Casanoves, Fernando; Lacointe, André; Vaast, Philippe; Allinne, Clémentine; Audebert, Louise; Cambou, Aurélie; Clément-Vidal, Anne; Defrenet, Elsa; Duursma, Remko A; Jarri, Laura; Jourdan, Christophe; Khac, Emmanuelle; Leandro, Patricia; Medlyn, Belinda E; Saint-André, Laurent; Thaler, Philippe; Van den Meersche, Karel; Barquero Aguilar, Alejandra; Lehner, Peter; Dreyer, Erwin

    2017-04-06

    In agroforestry systems, shade trees strongly affect the physiology of the undergrown crop. However, a major paradigm is that the reduction in absorbed photosynthetically active radiation is, to a certain extent, compensated by an increase in light-use efficiency, thereby reducing the difference in net primary productivity between shaded and non-shaded plants. Due to the large spatial heterogeneity in agroforestry systems and the lack of appropriate tools, the combined effects of such variables have seldom been analysed, even though they may help understand physiological processes underlying yield dynamics. In this study, we monitored net primary productivity, during two years, on scales ranging from individual coffee plants to the entire plot. Absorbed radiation was mapped with a 3D-model (MAESPA). Light-use efficiency and net assimilation rate were derived for each coffee plant individually. We found that although irradiance was reduced by 60% below crowns of shade trees, coffee light-use efficiency increased by 50%, leaving net primary productivity fairly stable across all shade levels. Variability of aboveground net primary productivity of coffee plants was caused primarily by the age of the plants and by intraspecific competition among them (drivers usually overlooked in the agroforestry literature) rather than by the presence of shade trees.

  8. Effects of Hospital Systems on Medical Home Transformation in Primary Care Residency Training Practices.

    PubMed

    Knierim, Kyle; Hall, Tristen; Fernald, Douglas; Staff, Thomas J; Buscaj, Emilie; Allen, Jessica Cornett; Onysko, Mary; Dickinson, W Perry

    2016-11-23

    Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology.

  9. Photovoltaic Systems for Government Agencies

    DTIC Science & Technology

    1994-02-01

    i -- • • ;__ S• .... S,<, - Loca ted in the Adirondacks this photovoltaic system powers a facility offering visitors a clean, odorless, and...current depends on type of metal, composition of the soil, salinity of water, and surface area of metal to be protected. Historically, cathodic

  10. Primary health care and public health: foundations of universal health systems.

    PubMed

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.

  11. Primary angiitis of the central nervous system mimicking tumor-like lesion--case report.

    PubMed

    Tanei, Takafumi; Nakahara, Norimoto; Takebayashi, Shigenori; Ito, Masafumi; Hashizume, Yoshio; Wakabayashi, Toshihiko

    2011-01-01

    A 60-year-old man presented with a rare case of primary angiitis of the central nervous system mimicking a tumor-like lesion and manifesting as slight disorientation, left hemiparesis, and motor aphasia. Computed tomography showed multiple low density lesions in the left frontal lobe, brain stem, and right parietal lobe. Magnetic resonance images revealed a slightly enhanced mass lesion in the right parietal lobe with surrounding brain edema. Serum, cerebrospinal fluid, and other image examinations did not show any abnormal findings, so surgical removal of the right parietal mass was performed. Histological examination revealed that the mass consisted of hemorrhagic infarction without cellular atypia. Proliferations of endothelial cells in small and medium arteries, and infiltration of macrophages in the perivascular space were detected in the infarction tissues. The histological diagnosis was primary angiitis of the central nervous system.

  12. INTEGRATED DRILLING SYSTEM USING MUD ACTUATED DOWN HOLE HAMMER AS PRIMARY ENGINE

    SciTech Connect

    John V. Fernandez; David S. Pixton

    2005-12-01

    A history and project summary of the development of an integrated drilling system using a mud-actuated down-hole hammer as its primary engine are given. The summary includes laboratory test results, including atmospheric tests of component parts and simulated borehole tests of the hammer system. Several remaining technical hurdles are enumerated. A brief explanation of commercialization potential is included. The primary conclusion for this work is that a mud actuated hammer can yield substantial improvements to drilling rate in overbalanced, hard rock formations. A secondary conclusion is that the down-hole mud actuated hammer can serve to provide other useful down-hole functions including generation of high pressure mud jets, generation of seismic and sonic signals, and generation of diagnostic information based on hammer velocity profiles.

  13. Primary reaction control system/remote manipulator system interaction with loaded arm. Space shuttle engineering and operations support

    NASA Technical Reports Server (NTRS)

    Taylor, E. C.; Davis, J. D.

    1978-01-01

    A study of the interaction between the orbiter primary reaction control system (PRCS) and the remote manipulator system (RMS) with a loaded arm is documented. This analysis was performed with the Payload Deployment and Retrieval Systems Simulation (PDRSS) program with the passive arm bending option. The passive-arm model simulates the arm as massless elastic links with locked joints. The study was divided into two parts. The first part was the evaluation of the response of the arm to step inputs (i.e. constant jet torques) about each of the orbiter body axes. The second part of the study was the evaluation of the response of the arm to minimum impulse primary RCS jet firings with both single pulse and pulse train inputs.

  14. [Correction of spectral interferences by ICP-AES primary expert system].

    PubMed

    Ying, H; Yang, P; Wang, X; Huang, B

    1998-12-01

    A subpackage for spectral interference correction has been set up in ICP-AES primary expert system. Some numerical recipes have been applied in this subpackage, such as curve smoothing, derivative spectrum, FFT technique, spectral resolving etc. A comprehensive method for spectral interference correction is presented. All these numeric recipes have been tested with simulated data and also utilized in several typical examples of real spectra. Results are satisfactory.

  15. Analysis of N-16 concentration in primary cooling system of AP1000 power reactor

    SciTech Connect

    Rohanda, Anis; Waris, Abdul

    2015-04-16

    Nitrogen-16 (N-16) is one of the radiation safety parameter on the primary reactor system. The activation product, N-16, is the predominant contributor to the activity in the reactor coolant system during reactor operation. N-16 is activation product derived from activation of O-16 with fast neutron based on {sup 16}O(n,p){sup 16}N reaction. Thus study is needed and it performs to determine N-16 concentration in reactor coolant (primary coolant) in supporting radiation safety. One of the way is using analytical methode based on activation and redecay princip to obtain N-16 concentration. The analysis was performed on the configuration basis and operational of Westinghouse AP1000 power reactor in several monitoring points at coolant reactor system. The results of the calculation of N-16 concentration at the core outlet, reactor vessel outlet, pressurizer line, inlet and outlet of steam generators, primary pumps, reactor vessels inlet and core inlet are: 281, 257, 255, 250, 145, 142, 129 and 112 µCi/gram respectively. The results of analysis compared with AP1000 design control document as standard values. The verification showed very high accuracy comparation between analytical results and standard values.

  16. Analysis of N-16 concentration in primary cooling system of AP1000 power reactor

    NASA Astrophysics Data System (ADS)

    Rohanda, Anis; Waris, Abdul

    2015-04-01

    Nitrogen-16 (N-16) is one of the radiation safety parameter on the primary reactor system. The activation product, N-16, is the predominant contributor to the activity in the reactor coolant system during reactor operation. N-16 is activation product derived from activation of O-16 with fast neutron based on 16O(n,p)16N reaction. Thus study is needed and it performs to determine N-16 concentration in reactor coolant (primary coolant) in supporting radiation safety. One of the way is using analytical methode based on activation and redecay princip to obtain N-16 concentration. The analysis was performed on the configuration basis and operational of Westinghouse AP1000 power reactor in several monitoring points at coolant reactor system. The results of the calculation of N-16 concentration at the core outlet, reactor vessel outlet, pressurizer line, inlet and outlet of steam generators, primary pumps, reactor vessels inlet and core inlet are: 281, 257, 255, 250, 145, 142, 129 and 112 µCi/gram respectively. The results of analysis compared with AP1000 design control document as standard values. The verification showed very high accuracy comparation between analytical results and standard values.

  17. Deployment and Validation of a Smart System for Screening of Language Disorders in Primary Care

    PubMed Central

    Martín-Ruiz, María Luisa; Duboy, Miguel Ángel Valero; de la Cruz, Iván Pau

    2013-01-01

    Neuro-evolutive development from birth until the age of six years is a decisive factor in a child's quality of life. Early detection of development disorders in early childhood can facilitate necessary diagnosis and/or treatment. Primary-care pediatricians play a key role in its detection as they can undertake the preventive and therapeutic actions requested to promote a child's optimal development. However, the lack of time and little specific knowledge at primary-care avoid to applying continuous early-detection anomalies procedures. This research paper focuses on the deployment and evaluation of a smart system that enhances the screening of language disorders in primary care. Pediatricians get support to proceed with early referral of language disorders. The proposed model provides them with a decision-support tool for referral actions to trigger essential diagnostic and/or therapeutic actions for a comprehensive individual development. The research was conducted by starting from a sample of 60 cases of children with language disorders. Validation was carried out through two complementary steps: first, by including a team of seven experts from the fields of neonatology, pediatrics, neurology and language therapy, and, second, through the evaluation of 21 more previously diagnosed cases. The results obtained show that therapist positively accepted the system proposal in 18 cases (86%) and suggested system redesign for single referral to a speech therapist in three remaining cases. PMID:23752564

  18. Activities and Attributes of Nurse Practitioner Leaders: Lessons from a Primary Care System Change.

    PubMed

    O'Rourke, Tammy; Higuchi, Kathryn Smith

    2016-01-01

    Nurse practitioners (NPs) are being encouraged to practice to the full extent of their skills, and they have a critical role to play in leading health system reform. The evidence in support of NP-led initiatives is growing; however, in spite of the positive outcomes associated with these initiatives, considerable opposition to and debate about the potential for NPs to lead health system change and interprofessional teams continues. To date, we know very little about NP leadership activities, particularly those activities that contribute to primary care system change, and there are very few examples of this type of leadership. The qualitative descriptive study here was part of a larger case study that examined stakeholder participation in a system change led by NPs. The change involved the introduction of a new NP-led model of team-based primary care delivery in Ontario, Canada. Data from participant interviews and public documents were analyzed to describe the activities and attributes (perseverance, risk-taking and effective communication) of two NP leaders who were the drivers of this change. Knowledge of these activities and attributes has the potential to inform NP leadership roles in health system policy planning and implementation. However, to be able to provide effective leadership in system change, NPs need access to educational content about public policy and opportunities to develop and practice the skills required to work with multiple stakeholders, including those who oppose change.

  19. Cooperative Research and Development of Primary Surface Recuperator for Advanced Microturbine Systems

    SciTech Connect

    Escola, George

    2007-01-17

    Recuperators have been identified as key components of advanced gas turbines systems that achieve a measure of improvement in operating efficiency and lead the field in achieving very low emissions. Every gas turbine manufacturer that is studying, developing, or commercializing advanced recuperated gas turbine cycles requests that recuperators operate at higher temperature without a reduction in design life and must cost less. The Solar Cooperative Research and Development of Primary Surface Recuperator for Advanced Microturbine Systems Program is directed towards meeting the future requirements of advanced gas turbine systems by the following: (1) The development of advanced alloys that will allow recuperator inlet exhaust gas temperatures to increase without significant cost increase. (2) Further characterization of the creep and oxidation (dry and humid air) properties of nickel alloy foils (less than 0.13 mm thick) to allow the economical use of these materials. (3) Increasing the use of advanced robotic systems and advanced in-process statistical measurement systems.

  20. Primary breast lymphoma sequentially relapsed in the peripheral and central nervous system.

    PubMed

    Tang, Tzung-Chih; Chang, Hung; Chuang, Wen-Yu

    2012-09-01

    Primary breast lymphoma (PBL) is an uncommon extranodal type of lymphoma, exhibiting more aggressive behavior and poorer prognosis. Patients with PBL have a higher incidence to relapse in central nervous system (CNS), which is always leading to a dismal outcome even treating with high intensity chemotherapy plus radiotherapy. Lymphoma involving the peripheral nervous system (PNS), either primarily or secondarily, is also rare. But no PBL with PNS relapse has been reported before. Herein, we reported a case of PBL who presented with subsequent relapse in two discrete sites of the PNS followed by the CNS.

  1. Primary propulsion of electrothermal, ion and chemical systems for space-based radar orbit transfer

    NASA Technical Reports Server (NTRS)

    Wang, S. Y.; Staiger, P. J.

    1985-01-01

    An orbit transfer mission concept has been studied for a Space-Based Radar (SBR) where 40 kW required for radar operation is assumed available for orbit transfer propulsion. Arcjet, pulsed electrothermal (PET), ion, and storable chemical systems are considered for the primary propulsion. Transferring two SBR per shuttle flight to 1112 km/60 deg using electrical propulsion systems offers an increased payload at the expense of increased trip time, up to 2000 kg each, which may be critical for survivability. Trade offs between payload mass, transfer time, launch site, inclination, and height of parking orbits are presented.

  2. Primary propulsion of electrothermal, ion, and chemical systems for space-based radar orbit transfer

    NASA Technical Reports Server (NTRS)

    Wang, S.-Y.; Staiger, P. J.

    1985-01-01

    An orbit transfer mission concept has been studied for a Space-Based Radar (SBR) where 40 kW required for radar operation is assumed available for orbit transfer propulsion. Arcjet, pulsed electrothermal (PET), ion, and storable chemical systems are considered for the primary propulsion. Transferring two SBR per shuttle flight to 1112 km/60 deg using eiectrical propulsion systems offers an increased payload at the expense of increased trip time, up to 2000 kg each, which may be critical for survivability. Trade offs between payload mass, transfer time, launch site, inclination, and height of parking orbits are presented.

  3. Environmental standards for primary and secondary containment systems and transfer stations

    SciTech Connect

    Maguire, D.M.

    1995-04-01

    Environmental Standards for Primary and Secondary Containment Systems and Transfer Stations will supersede all previous requirements for design of dikes, storage tanks, and transfer stations in order to maintain consistency throughout the Y-12 Plant. This document is organized into six distinct sections, each with a specific purpose. Section I outlines the objectives of the document along with its applications and limitations; this section should be of interest to all readers for essential background information. Section II lists all definitions and is consistent with definitions outlined by environmental regulations. Section III discusses primary containment standards. Section IV outlines secondary containment standards; this section contains the actual standards for the diking of storage tanks and storage containers. Section V discusses transfer station standards. Section VI of this document outlines how exemptions may be granted for specific cases.

  4. Gut mucosal nutritional support--enteral nutrition as primary therapy after multiple system trauma.

    PubMed Central

    Kudsk, K A

    1994-01-01

    Over the past 10 years, several clinical and experimental studies report the potential benefit of enteral nutrition as primary therapy after multiple system trauma. In this study, 98 patients sustaining blunt and penetrating trauma were randomised to receive either enteral or parenteral feeding for 15 days. There were significantly fewer infectious complications in patients randomised to receive enteral feeding with particular benefit shown in the most severely injured patients. Serum protein concentrations correlated with the clinical outcome with an increase in constitutive protein and decrease in acute phase protein concentrations occurring in the enteral group through a decrease in septic complications and possible direct hepatic 'reprioritisation'. Enteral feeding serves as a primary therapy affecting the outcome of critically ill patients. PMID:8125392

  5. Colon Targeted Drug Delivery Systems: A Review on Primary and Novel Approaches

    PubMed Central

    Philip, Anil K.; Philip, Betty

    2010-01-01

    The colon is a site where both local and systemic delivery of drugs can take place. Local delivery allows topical treatment of inflammatory bowel disease. However, treatment can be made effective if the drugs can be targeted directly into the colon, thereby reducing the systemic side effects. This review, mainly compares the primary approaches for CDDS (Colon Specific Drug Delivery) namely prodrugs, pH and time dependent systems, and microbially triggered systems, which achieved limited success and had limitations as compared with newer CDDS namely pressure controlled colonic delivery capsules, CODESTM, and osmotic controlled drug delivery which are unique in terms of achieving in vivo site specificity, and feasibility of manufacturing process. PMID:22125706

  6. Design and testing of the U.S. Space Station Freedom primary propulsion system

    NASA Technical Reports Server (NTRS)

    Morano, Joseph S.; Delventhal, Rex A.; Chilcot, Kimberly J.

    1992-01-01

    The primary propulsion system (PPS) for the Space Station Freedom is discussed in terms of salient design characteristics and key testing procedures. The rocket engine modules contain reboost and attitude control thrusters, and their designs are illustrated showing the mounting structures, thruster solenoid valves, and thrust chambers. The propellant tank assembly for storing gaseous N pressurant and hydrazine propellant is described as are the system avionics, thruster solenoid valves, and latching isolation valves. PPS testing conducted on the development systems includes the use of a propulsion-module development unit, a development test article, and system qualification testing. Specific test articles include functional heaters, mass/thermal simulated components, flight-quality structures, and software control operations.

  7. Design and testing of the U.S. Space Station Freedom primary propulsion system

    NASA Astrophysics Data System (ADS)

    Morano, Joseph S.; Delventhal, Rex A.; Chilcot, Kimberly J.

    1992-07-01

    The primary propulsion system (PPS) for the Space Station Freedom is discussed in terms of salient design characteristics and key testing procedures. The rocket engine modules contain reboost and attitude control thrusters, and their designs are illustrated showing the mounting structures, thruster solenoid valves, and thrust chambers. The propellant tank assembly for storing gaseous N pressurant and hydrazine propellant is described as are the system avionics, thruster solenoid valves, and latching isolation valves. PPS testing conducted on the development systems includes the use of a propulsion-module development unit, a development test article, and system qualification testing. Specific test articles include functional heaters, mass/thermal simulated components, flight-quality structures, and software control operations.

  8. Optimization of system parameters for modulator design in x-ray scatter correction using primary modulation

    NASA Astrophysics Data System (ADS)

    Gao, Hewei; Zhu, Lei; Fahrig, Rebecca

    2010-04-01

    The impact of the system parameters of the modulator on X-ray scatter correction using primary modulation is studied and an optimization of the modulator design is presented. Recently, a promising scatter correction method for X-ray computed tomography (CT) that uses a checkerboard pattern of attenuating blockers (primary modulator) placed between the X-ray source and the object has been developed and experimentally verified. The blocker size, d, and the blocker transmission factor, α, are critical to the performance of the primary modulation method. In this work, an error caused by aliasing of primary whose magnitude depends on the choices of d and α, and the scanned object, is set as the object function to be minimized, with constraints including the X-ray focal spot, the physical size of the detector element, and the noise level. The optimization is carried out in two steps. In the first step, d is chosen as small as possible but should meet a lower-bound condition. In the second step, α should be selected to balance the error level in the scatter estimation and the noise level in the reconstructed image. The lower bound of d on our tabletop CT system is 0.83 mm. Numerical simulations suggest 0.6 < α < 0.8 is appropriate. Using a Catphan 600 phantom, a copper modulator (d = 0.89 mm, α = 0.70) expectedly outperforms an aluminum modulator (d = 2.83 mm, α = 0.90). With the aluminum modulator, our method reduces the average error of CT number in selected contrast rods from 371.4 to 25.4 Hounsfield units (HU) and enhances the contrast to noise ratio (CNR) from 10.9 to 17.2; when the copper modulator is used, the error is further reduced to 21.9 HU and the CNR is further increased to 19.2.

  9. Belgian experience in applying the {open_quotes}leak-before-break{close_quotes} concept to the primary loop piping

    SciTech Connect

    Gerard, R.; Malekian, C.; Meessen, O.

    1997-04-01

    The Leak Before Break (LBB) concept allows to eliminate from the design basis the double-ended guillotine break of the primary loop piping, provided it can be demonstrated by a fracture mechanics analysis that a through-wall flaw, of a size giving rise to a leakage still well detectable by the plant leak detection systems, remains stable even under accident conditions (including the Safe Shutdown Earthquake (SSE)). This concept was successfully applied to the primary loop piping of several Belgian Pressurized Water Reactor (PWR) units, operated by the Utility Electrabel. One of the main benefits is to permit justification of supports in the primary loop and justification of the integrity of the reactor pressure vessel and internals in case of a Loss Of Coolant Accident (LOCA) in stretch-out conditions. For two of the Belgian PWR units, the LBB approach also made it possible to reduce the number of large hydraulic snubbers installed on the primary coolant pumps. Last but not least, the LBB concept also facilitates the steam generator replacement operations, by eliminating the need for some pipe whip restraints located close to the steam generator. In addition to the U.S. regulatory requirements, the Belgian safety authorities impose additional requirements which are described in details in a separate paper. An novel aspect of the studies performed in Belgium is the way in which residual loads in the primary loop are taken into account. Such loads may result from displacements imposed to close the primary loop in a steam generator replacement operation, especially when it is performed using the {open_quote}two cuts{close_quotes} technique. The influence of such residual loads on the LBB margins is discussed in details and typical results are presented.

  10. EVALUATION OF BEST AVAILABLE CONTROL TECHNOLOGY FOR TOXICS (TBACT) DOUBLE SHELL TANK FARMS PRIMARY VENTILATION SYSTEM SUPPORTING WASTE TRANSFER OPERATIONS

    SciTech Connect

    KELLY SE; HAASS CC; KOVACH JL; TURNER DA

    2010-06-03

    This report is an evaluation of Best Available Control Technology for Toxics (tBACT) for installation and operation of the Hanford double shell (DST) tank primary ventilation systems. The DST primary ventilation systems are being modified to support Hanford's waste retrieval, mixing, and delivery of single shell tank (SST) and DST waste throught the DST storage system to the Waste Treatment and Immobilization Plant (WTP).

  11. EVALUATION OF BEST AVAILABLE CONTROL TECHNOLOGY FOR TOXICS -TBACT- DOUBLE SHELL TANK FARMS PRIMARY VENTILATION SYSTEMS SUPPORTING WASTE TRANSFER OPERATIONS

    SciTech Connect

    HAAS CC; KOVACH JL; KELLY SE; TURNER DA

    2010-06-24

    This report is an evaluation of Best Available Control Technology for Toxics (tBACT) for installation and operation of the Hanford double shell (DST) tank primary ventilation systems. The DST primary ventilation systems are being modified to support Hanford's waste retrieval, mixing, and delivery of single shell tank (SST) and DST waste through the DST storage system to the Waste Treatment and Immobilizaiton Plant (WTP).

  12. EHR systems in the Spanish Public Health National System: the lack of interoperability between primary and specialty care.

    PubMed

    de la Torre-Díez, Isabel; González, Sandra; López-Coronado, Miguel

    2013-02-01

    One of the problems of the Spanish Public Health National System is the lack of interoperability in the implemented Electronic Health Records (EHRs) systems in primary and specialty care. There is a deficiency in the electronic health systems that store the data of primary care patients, so one of the basic problems that prevent that every hospital and health center working on the same method is that deficiency. In this paper we research on this problem and to give expression to a series of solutions to it. Bibliographic material in this work has been obtained mainly from MEDLINE source. Additionally, due to the lack of information and privacy about the different EHRs systems, we have resorted to making direct contact with the organizations that have implemented those systems and technological providers. Two solutions have been propounded given several aspects for a feasibility study. The first solution is based upon in the execution of backups in different EHRs databases, which implies a huge economical and infrastructure development. The second of these solutions so that due to the creation of protocols by means of Cloud Computing Technologies. It is crucial the need to reach a homogeneity concerning to the storage of patients clinical data. On the results achieved we can emphasize that maybe the main problems are not the economical handicaps or the large technological development needed, but, as for Health each Region manages its own competences, each one governs with independent policies and decisions.

  13. Primary lymphoma of the central nervous system and HTLV-I infection.

    PubMed

    Calderón, Enrique J; Japón, Miguel A; Chinchón, Isidoro; Soriano, Vicente; Capote, Francisco J

    2002-01-01

    Only a few cases of AIDS-related primary lymphomas of the central nervous system (CNS) show a T-cell phenotype. We have recently studied two intravenous drug users with HIV infection who had primary CNS T-cell lymphomas. In both cases, the enzyme immunoassay (EIA) for HTLV gave a positive result. In the first case, study by western-blot (WB) and specific PCR confirmed the human T-cell lymphotropic virus type I (HTLV-I) infection and serological study by EIA for HTLV of his mother was negative. In the second case, analysis of ante-mortem serum samples by two different WBs showed an indeterminate pattern suggestive of HTLV-I infection, but adequate samples for PCR were not available. We speculate about the possibility that the horizontal transmission of HTLV-I infection could have facilitated the devepolment of a primary CNS T-cell lymphoma in these HIV patients, although they cannot be strictly considered as ATLL cases.

  14. Heat transfer characteristics of current primary packaging systems for pharmaceutical freeze-drying.

    PubMed

    Hibler, Susanne; Gieseler, Henning

    2012-11-01

    In the field of freeze-drying, the primary packaging material plays an essential role. Here, the packaging system not only contains and protects the drug product during storage and shipping, but it is also directly involved in the freeze-drying process itself. The heat transfer characteristics of the actual container system influence product temperature and therefore product homogeneity and quality as well as process performance. Consequently, knowledge of the container heat transfer characteristics is of vital importance for process optimization. It is the objective of this review article to provide a summary of research focused on heat transfer characteristics of different container systems for pharmaceutical freeze-drying. Besides the common tubing and molded glass vials and metal trays, more recent packaging solutions like polymer vials, LYOGUARD® trays, syringes, and blister packs are discussed. Recent developments in vial manufacturing are also taken into account.

  15. The Simplest Chronoscope V: A Theory of Dual Primary and Secondary Reaction Time Systems.

    PubMed

    Montare, Alberto

    2016-12-01

    Extending work by Montare, visual simple reaction time, choice reaction time, discriminative reaction time, and overall reaction time scores obtained from college students by the simplest chronoscope (a falling meterstick) method were significantly faster as well as significantly less variable than scores of the same individuals from electromechanical reaction timers (machine method). Results supported the existence of dual reaction time systems: an ancient primary reaction time system theoretically activating the V5 parietal area of the dorsal visual stream that evolved to process significantly faster sensory-motor reactions to sudden stimulations arising from environmental objects in motion, and a secondary reaction time system theoretically activating the V4 temporal area of the ventral visual stream that subsequently evolved to process significantly slower sensory-perceptual-motor reactions to sudden stimulations arising from motionless colored objects.

  16. System facilitators and barriers to discussing older driver safety in primary care settings

    PubMed Central

    Betz, Marian E.; Jones, Jacqueline; Carr, David B.

    2015-01-01

    Background Primary care physicians play a leading role in counseling older drivers, but discussions often do not occur until safety concerns arise. Prior work suggests that routine questioning about driving might facilitate these difficult conversations. Objective To explore system-level factors affecting driving discussions in primary care settings, in order to inform the design and implementation of a program supporting routine conversations. Methods This qualitative descriptive study used iterative interviews with providers (physicians, nurses, medical assistants, social workers, and administrative staff) working at two clinics (one geriatric, one general internal medicine) at a tertiary-care teaching hospital. General inductive techniques in transcript analysis were used to identify stakeholder-perceived system-level barriers and facilitators to routine conversations with older drivers. Results From fifteen interviews, four themes emerged: (1) complexity of defined provider roles within primary care setting (which can both support team work and hamper efficiency); (2) inadequate resources to support providers (including clinical prompts, local guides, and access to social workers and driving specialists); (3) gaps in education of providers and patients about discussing driving; and (4) suggested models to enhance provider conversations with older drivers (including following successful examples and using defined pathways integrated into the electronic medical record). A fifth theme was that participants characterized their experiences in terms of current and ideal states. Conclusions Physicians have been tasked with assessing older driver safety and guiding older patients through the process of “driving retirement.” Attention to system-level factors such as provider roles, resources, and training can support them in this process. PMID:25617342

  17. Not lost in translation: generalization of the primary systems hypothesis to Japanese-specific language processes.

    PubMed

    Ueno, Taiji; Saito, Satoru; Saito, Akie; Tanida, Yuki; Patterson, Karalyn; Lambon Ralph, Matthew A

    2014-02-01

    The emergentist-connectionist approach assumes that language processing reflects interaction between primary neural systems (Primary Systems Hypothesis). This idea offers an overarching framework that generalizes to various kinds of (English) language and nonverbal cognitive activities. The current study advances this approach with respect to language in two new and important ways. The first is the provision of a neuroanatomically constrained implementation of the theory. The second is a test of its ability to generalize to a language other than English (in this case Japanese) and, in particular, to a feature of that language (pitch accent) for which there is no English equivalent. A corpus analysis revealed the presence and distribution of typical and atypical accent forms in Japanese vocabulary, forming a quasiregular domain. Consequently, according to the Primary Systems Hypothesis, there should be a greater semantic impact on the processing of words with an atypical pitch accent. In turn, when word meaning is intrinsically less rich (e.g., abstract words), speakers should be prone to regularization errors of pitch accent. We explored these semantic-phonological interactions, first, in a neuroanatomically constrained, parallel-distributed processing model of spoken language processing. This model captured the accent typicality effect observed in nonword repetition in Japanese adults and children and exhibited the predicted semantic impact on repetition of words with atypical accent patterns. Second, also as predicted, in word repetition and immediate serial recall of spoken words, human participants exhibited reduced pitch-accent accuracy and/or slower RT for low imageability words with atypical accent patterns, and they generated accent errors reflecting the more typical accent patterns found in Japanese.

  18. Work stress of primary care physicians in the US, UK and German health care systems.

    PubMed

    Siegrist, Johannes; Shackelton, Rebecca; Link, Carol; Marceau, Lisa; von dem Knesebeck, Olaf; McKinlay, John

    2010-07-01

    Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort-reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005 to 2007. Results demonstrate country-specific differences in work stress with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions.

  19. A Case of Primary Central Nervous System Lymphoma Located at Brain Stem in a Child

    PubMed Central

    Kim, Jinho

    2016-01-01

    Primary central nervous system lymphoma (PCNSL) is an extranodal Non-Hodgkin's lymphoma that is confined to the brain, eyes, and/or leptomeninges without evidence of a systemic primary tumor. Although the tumor can affect all age groups, it is rare in childhood; thus, its incidence and prognosis in children have not been well defined and the best treatment strategy remains unclear. A nine-year old presented at our department with complaints of diplopia, dizziness, dysarthria, and right side hemiparesis. Magnetic resonance image suggested a diffuse brain stem glioma with infiltration into the right cerebellar peduncle. The patient was surgically treated by craniotomy and frameless stereotactic-guided biopsy, and unexpectedly, the histopathology of the mass was consistent with diffuse large B cell lymphoma, and immunohistochemical staining revealed positivity for CD20 and CD79a. Accordingly, we performed a staging work-up for systemic lymphoma, but no evidence of lymphoma elsewhere in the body was obtained. In addition, she had a negative serologic finding for human immunodeficient virus, which confirmed the histopathological diagnosis of PCNSL. She was treated by radiosurgery at 12 Gy and subsequent adjuvant combination chemotherapy based on high dose methotrexate. Unfortunately, 10 months after the tissue-based diagnosis, she succumbed due to an acute hydrocephalic crisis. PMID:27867930

  20. Envisioning a Learning Health Care System: The Electronic Primary Care Research Network, A Case Study

    PubMed Central

    Delaney, Brendan C.; Peterson, Kevin A.; Speedie, Stuart; Taweel, Adel; Arvanitis, Theodoros N.; Hobbs, F. D. Richard

    2012-01-01

    PURPOSE The learning health care system refers to the cycle of turning health care data into knowledge, translating that knowledge into practice, and creating new data by means of advanced information technology. The electronic Primary Care Research Network (ePCRN) was a project, funded by the US National Institutes of Health, with the aim to facilitate clinical research using primary care electronic health records (EHRs). METHODS We identified the requirements necessary to deliver clinical studies via a distributed electronic network linked to EHRs. After we explored a variety of informatics solutions, we constructed a functional prototype of the software. We then explored the barriers to adoption of the prototype software within US practice-based research networks. RESULTS We developed a system to assist in the identification of eligible cohorts from EHR data. To preserve privacy, counts and flagging were performed remotely, and no data were transferred out of the EHR. A lack of batch export facilities from EHR systems and ambiguities in the coding of clinical data, such as blood pressure, have so far prevented a full-scale deployment. We created an international consortium and a model for sharing further ePCRN development across a variety of ongoing projects in the United States and Europe. CONCLUSIONS A means of accessing health care data for research is not sufficient in itself to deliver a learning health care system. EHR systems need to use sophisticated tools to capture and preserve rich clinical context in coded data, and business models need to be developed that incentivize all stakeholders from clinicians to vendors to participate in the system. PMID:22230831

  1. Measuring access to primary medical care: some examples of the use of geographical information systems.

    PubMed

    Parker, E B; Campbell, J L

    1998-06-01

    This paper explores the potential for geographical information system technology in defining some variables influencing the use of primary care medical services. Eighteen general practices in Scotland contributed to a study examining the accessibility of their services and their patients' use of the local Accident and Emergency Department. Geo-referencing of information was carried out through analysis of postcode data relating to practices and patients. This information was analyzed using ARC/INFO GIS software in conjunction with the ORACLE relational database and 1991 census information. The results demonstrate that GIS technology has an important role in defining and analyzing the use of health services by the population.

  2. Thermal Analysis of the Divertor Primary Heat Transfer System Piping During the Gas Baking Process

    SciTech Connect

    Yoder Jr, Graydon L; Harvey, Karen; Ferrada, Juan J

    2011-02-01

    A preliminary analysis has been performed examining the temperature distribution in the Divertor Primary Heat Transfer System (PHTS) piping and the divertor itself during the gas baking process. During gas baking, it is required that the divertor reach a temperature of 350 C. Thermal losses in the piping and from the divertor itself require that the gas supply temperature be maintained above that temperature in order to ensure that all of the divertor components reach the required temperature. The analysis described in this report was conducted in order to estimate the required supply temperature from the gas heater.

  3. NOA-03 trial of high-dose methotrexate in primary central nervous system lymphoma: final report.

    PubMed

    Herrlinger, Ulrich; Küker, Wilhelm; Uhl, Martin; Blaicher, Hans-Peter; Karnath, Hans-Otto; Kanz, Lothar; Bamberg, Michael; Weller, Michael

    2005-06-01

    The NOA-03 trial explored high-dose methotrexate alone in 37 patients with primary central nervous system lymphoma. The overall median survival was 25 months. After 4 years, the rate of leukoencephalopathy in patients surviving more than 12 months was 58% with and 10% without whole-brain radiotherapy given at relapse (p = 0.11). Attention deficits were found in all six tested patients, and memory deficits in four patients. Two patients had normal, three had moderately restricted, and one had markedly restricted quality of life. Thus, high-dose methotrexate with deferred radiotherapy had only moderate efficacy and was associated with significant neurotoxicity in long-term surviving patients.

  4. Embedding effective depression care: using theory for primary care organisational and systems change

    PubMed Central

    2010-01-01

    agreement is reached about how care is organised; and reflexive monitoring, which proposes that depression work requires agreement about how depression work will be monitored at the patient and practice level. We describe how these constructs can be used to guide the design and implementation of effective depression care in a way that can take account of contextual differences. Conclusions Ideas about what is required for an effective model and system of depression care in primary care need to be accompanied by theoretically informed frameworks that consider how these can be implemented. The conceptual framework we have presented can be used to guide organisational and system change to develop common language around each construct between policy makers, service users, professionals, and researchers. This shared understanding across groups is fundamental to the effective implementation of change in primary care for depression. PMID:20687962

  5. Evaluation of computerized health management information system for primary health care in rural India

    PubMed Central

    2010-01-01

    Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

  6. Development of a computerised decisions support system for renal risk drugs targeting primary healthcare

    PubMed Central

    Helldén, Anders; Al-Aieshy, Fadiea; Bastholm-Rahmner, Pia; Bergman, Ulf; Gustafsson, Lars L; Höök, Hans; Sjöviker, Susanne; Söderström, Anders; Odar-Cederlöf, Ingegerd

    2015-01-01

    Objectives To assess general practitioners (GPs) experience from the implementation and use of a renal computerised decision support system (CDSS) for drug dosing, developed for primary healthcare, integrated into the patient’s electronic health record (EHR), and building on estimation of the patient's creatinine clearance (ClCG). Design Qualitative research design by a questionnaire and a focus group discussion. Setting and participants Eight GPs at two primary healthcare centres (PHCs). Interventions The GP at PHC 1, and the project group, developed and tested the technical solution of the CDSS. Proof-of-concept was tested by seven GPs at PHC 2. They also participated in a group discussion and answered a questionnaire. A web window in the EHR gave drug and dosage in relation to ClCG. Each advice was according to three principles: If? Why? Because. Outcome measures (1) The GPs’ experience of ‘easiness to use’ and ‘perceived usefulness’ at PHC 2, based on loggings of use, answers from a questionnaire using a 5-point Likert scale, and answers from a focus group discussion. (2) The number of patients aged 65 years and older with an estimation of ClCG before and after the implementation of the CDSS. Results The GPs found the CDSS fast, simple and easy to use. They appreciated the automatic presentation of the CICG status on opening the medication list, and the ability to actively look up specific drug recommendations in two steps. The CDSS scored high on the Likert scale. All GPs wanted to continue the use of the CDSS and to recommend it to others. The number of patients with an estimated ClCG increased 1.6-fold. Conclusions Acceptance of the simple graphical interface of this push and pull renal CDSS was high among the primary care physicians evaluating this proof of concept. The graphical model should be useful for further development of renal decision support systems. PMID:26150141

  7. Recent Clinical Characteristics of Labors Using Three Japanese Systems of Midwife-Led Primary Delivery Care

    PubMed Central

    Suzuki, Shunji

    2016-01-01

    Objective. The objective of this study was to describe the recent clinical characteristics of labor using 3 systems of Japanese midwife-led primary delivery care, as follows: (1) those intending to give birth at home managed by midwives who do not belong to our hospital, (2) those planning to give birth in our hospital managed by the same midwives, and (3) those planning to give birth managed by midwives who belong to our hospital. Methods. A retrospective cohort study was performed. Results. There were no significant differences in the obstetric or neonatal outcomes among the 3 groups. The rate of transfers during labor with the system involving midwives belonging to our hospital was higher than those with the other 2 systems. In addition, the timing of transfers in the system with the midwives belonging to our hospital was earlier than with the other 2 systems. Among the 3 groups, there were no significant differences in the rate of the main 2 indications for transfers: fetal heart rate abnormality and failure to progress. Conclusion. There were no significant differences in perinatal outcomes among the 3 systems; however, there were some differences in the status of transfers to obstetric shared care. PMID:27034827

  8. Isolated primary central nervous system lymphoma arising from the optic chiasm.

    PubMed

    Vassal, F; Pommier, B; Boutet, C; Forest, F; Campolmi, N; Nuti, C

    2014-12-01

    A 58-year-old previously healthy woman rapidly developed progressive bilateral visual loss. Magnetic resonance imaging revealed a bulging appearance of the optic chiasm, with homogeneous enhancement after gadolinium administration, which suggested an optic glioma or inflammatory disease. In the absence of (para)clinical clues for a specific diagnosis despite extensive investigation, a biopsy of one optic nerve was performed, resulting in a diagnosis of non-Hodgkin B-cell lymphoma. There was no evidence of any other ocular or systemic involvement, therefore the conclusion was that this immunocompetent patient had a primary central nervous system lymphoma isolated in the anterior visual pathway. Treatment included two cycles of polychemotherapy (rituximab, methotrexate, carmustine, etoposide, methylprednisolone), followed by autologous peripheral blood stem cell transplantation and rituximab plus cytarabine consolidation therapy. Subsequently, the patient exhibited significant improvement in vision, and was still disease-free at the 1-year follow-up examination. The aim of the present paper was to provide well-documented clinical, radiological, and intraoperative features of isolated primary malignant lymphoma arising from the anterior visual pathway. A better recognition of this rare pathological entity is necessary for clinicians who may encounter similar presentations, as prompt management is crucial for both a visual and vital prognosis.

  9. Modeling and Simulation of the ITER First Wall/Blanket Primary Heat Transfer System

    SciTech Connect

    Ying, Alice; Popov, Emilian L

    2011-01-01

    ITER inductive power operation is modeled and simulated using a thermal-hydraulics system code (RELAP5) integrated with a 3-D CFD (SC-Tetra) code. The Primary Heat Transfer System (PHTS) functions are predicted together with the main parameters operational ranges. The control algorithm strategy and derivation are summarized as well. The First Wall and Blanket modules are the primary components of PHTS, used to remove the major part of the thermal heat from the plasma. The modules represent a set of flow channels in solid metal structure that serve to absorb the radiation heat and nuclear heating from the fusion reactions and to provide shield for the vacuum vessel. The blanket modules are water cooled. The cooling is forced convective with constant blanket inlet temperature and mass flow rate. Three independent water loops supply coolant to the three blanket sectors. The main equipment of each loop consists of a pump, a steam pressurizer and a heat exchanger. A major feature of ITER is the pulsed operation. The plasma does not burn continuously, but on intervals with large periods of no power between them. This specific feature causes design challenges to accommodate the thermal expansion of the coolant during the pulse period and requires active temperature control to maintain a constant blanket inlet temperature.

  10. Distributed Hierarchical Control of Multi-Area Power Systems with Improved Primary Frequency Regulation

    SciTech Connect

    Lian, Jianming; Marinovici, Laurentiu D.; Kalsi, Karanjit; Du, Pengwei; Elizondo, Marcelo A.

    2012-12-12

    The conventional distributed hierarchical control architecture for multi-area power systems is revisited. In this paper, a new distributed hierarchical control architecture is proposed. In the proposed architecture, pilot generators are selected in each area to be equipped with decentralized robust control as a supplementary to the conventional droop speed control. With the improved primary frequency control, the system frequency can be restored to the nominal value without the help of secondary frequency control, which reduces the burden of the automatic generation control for frequency restoration. Moreover, the low frequency inter-area electromechanical oscillations can also be effectively damped. The effectiveness of the proposed distributed hierarchical control architecture is validated through detailed simulations.

  11. [Health situation assessment by primary care workers based on geographic information systems].

    PubMed

    Ritter, Fernando; Rosa, Roger dos Santos; Flores, Rui

    2013-12-01

    Primary healthcare has made little use of information systems to assess the population's health situation due to the difficulty in understanding the reports. Generic definitions of actions are common, based on empirical observations. The current study aimed to evaluate whether the introduction of georeferenced indicators can serve to better identify individuals' health situation, which would help planning actions by health teams. Healthcare workers from eight teams answered a questionnaire at three different moments: the first, before reading the information system's reports; the second after reading; and the third after using georeferencing. The results showed a significant difference in the classification of the health situation using georeferencing when compared to the previous moments (p < 0.05). Georeferencing facilitated analysis of the health situation, fostering better monitoring of work processes. Finally, use of the data points to rationalization of actions and possible upgrading of healthcare. The study suggests the use of georeferencing in the work agenda to become an effective tool for orienting actions.

  12. Genome-wide analysis uncovers novel recurrent alterations in primary central nervous system lymphomas

    PubMed Central

    Braggio, Esteban; Van Wier, Scott; Ojha, Juhi; McPhail, Ellen; Asmann, Yan W.; Egan, Jan; da Silva, Jackline Ayres; Schiff, David; Lopes, M Beatriz; Decker, Paul A; Valdez, Riccardo; Tibes, Raoul; Eckloff, Bruce; Witzig, Thomas E.; Stewart, A Keith; Fonseca, Rafael; O’Neill, Brian Patrick

    2015-01-01

    Purpose Primary central nervous system lymphoma (PCNSL) is an aggressive non-Hodgkin lymphoma confined to the CNS. Whether there is a PCNSL-specific genomic signature and, if so, how it differs from systemic diffuse large B-cell lymphoma (DLBCL) is uncertain. Experimental design We performed a comprehensive genomic study of tumor samples from 19 immunocompetent PCNSL patients. Testing comprised array-comparative genomic hybridization and whole exome sequencing. Results Biallelic inactivation of TOX and PRKCD were recurrently found in PCNSL but not in systemic DLBCL, suggesting a specific role in PCNSL pathogenesis. Additionally, we found a high prevalence of MYD88 mutations (79%) and CDKN2A biallelic loss (60%). Several genes recurrently affected in PCNSL were common with systemic DLBCL, including loss of TNFAIP3, PRDM1, GNA13, TMEM30A, TBL1XR1, B2M, CD58, activating mutations of CD79B, CARD11 and translocations IgH-BCL6. Overall, BCR/TLR/NF-κB pathways were altered in >90% of PNCSL, highlighting its value for targeted therapeutic approaches. Furthermore, integrated analysis showed enrichment of pathways associated with immune response, proliferation, apoptosis, and lymphocyte differentiation. Conclusions In summary, genome-wide analysis uncovered novel recurrent alterations, including TOX and PRKCD, helping to differentiate PCNSL from systemic DLBCL and related lymphomas. PMID:25991819

  13. The activation pattern of macrophages in giant cell (temporal) arteritis and primary angiitis of the central nervous system.

    PubMed

    Mihm, Bernhard; Bergmann, Markus; Brück, Wolfgang; Probst-Cousin, Stefan

    2014-06-01

    To determine if the pattern of macrophage activation reflects differences in the pathogenesis and clinical presentation of giant cell arteritis and primary angiitis of the central nervous system, specimens of 10 patients with giant cell arteritis and five with primary angiitis of the central nervous system were immunohistochemically studied and the expression of the macrophage activation markers 27E10, MRP14, MRP8 and 25F9 was determined in the vasculitic infiltrates. Thus, a partly different expression pattern of macrophage activation markers in giant cell arteritis and primary angiitis of the central nervous system was observed. The group comparison revealed that giant cell arteritis cases had significantly higher numbers of acute activated MRP14-positive macrophages, whereas primary angiitis of the central nervous system is characterized by a tendency toward more MRP8-positive intermediate/late activated macrophages. Furthermore, in giant cell arteritis comparably fewer CD8-positive lymphocytes were observed. These observations suggest, that despite their histopathological similarities, giant cell arteritis and primary angiitis of the central nervous system appear to represent either distinct entities within the spectrum of granulomatous vasculitides or different stages of similar disease processes. Their discrete clinical presentation is reflected by different activation patterns of macrophages, which may characterize giant cell arteritis as a more acute process and primary angiitis of the central nervous system as a more advanced inflammatory process.

  14. Exploring Online Learning at Primary Schools: Students' Perspectives on Cyber Home Learning System through Video Conferencing (CHLS-VC)

    ERIC Educational Resources Information Center

    Lee, June; Yoon, Seo Young; Lee, Chung Hyun

    2013-01-01

    The purposes of the study are to investigate CHLS (Cyber Home Learning System) in online video conferencing environment in primary school level and to explore the students' responses on CHLS-VC (Cyber Home Learning System through Video Conferencing) in order to explore the possibility of using CHLS-VC as a supportive online learning system. The…

  15. Clinicopathological and immunohistochemical features of primary central nervous system germ cell tumors: a 24-years experience.

    PubMed

    Gao, Yuping; Jiang, Jiyao; Liu, Qiang

    2014-01-01

    Primary central nervous system (CNS) germ cell tumors (GCTs) are a rare heterogeneous group of lesions, which the clinicopathological features have a marked degree of heterogeneity comparing with that of gonadal GCTs. Accurately diagnosing CNS GCTs might be extremely difficult and requires immunohistochemical verification. This study was to investigate the biological feature of CNS GCTs and diagnostic value of immunohistochemical markers OCT3/4, C-kit, PLAP, and CD30 in CNS GCTs. A retrospective study was performed on 34 patients with CNS germ cell tumors between 1990 and 2014. 34 CNS GCTs account for 9.2% of all primary CNS neoplasms. The sellar region (35.3%) and pineal gland (17.6%) were the most common sites of intracranial GCTs. Hydrocephalus (82.4%) and diplopia (46.9%) were the two most common clinical presentations. The most common histological subtypes were germinoma (67.6%). PLAP, c-kit, OCT3/4 were highly expressed in gernimomas. CD30 and CK AE1/3 stainings were positive in embryonal carcinoma. Yolk sac tumor component showed positive staining for AFP and CK AE1/3. β-HCG staining was positive in choriocarcinoma and STGC. Patients with mature teratomas and germinomas had a better prognosis (a 5-year survival rate) than those with embryonal carcinoma and choriocarcinoma (a 5-year survival rates were 0). Our finding suggest that the incidences of primary CNS GCTs are higher in South China than in the West, but mixed GCTs are uncommon in our study. The judicious use of a panel of selected markers is helpful in diagnosing and predicting the prognosis for CNS GCTs.

  16. Bronchial Artery and Systemic Artery Embolization in the Management of Primary Lung Cancer Patients with Hemoptysis

    SciTech Connect

    Park, Hong Suk Kim, Young Il; Kim, Hyae Young; Zo, Jae-Ill; Lee, Joo Hyuk; Lee, Jin Soo

    2007-07-15

    Purpose. To assess the safety and effectiveness of arterial embolization in lung cancer patients with hemoptysis. Methods. Nineteen primary lung cancer patients with hemoptysis underwent bronchial artery and systemic artery embolization from April 2002 to March 2005. There were 17 men and 2 women, with a mean age of 59 years. Histologic analysis revealed squamous cell carcinoma in 10 patients and poorly differentiated adenocarcinoma in 9 patients. The amount of hemoptysis was bleeding of 25-50 ml within 24 hr in 8 patients, recurrent blood-tinged sputum in 6, and bleeding of 100 ml or more per 24 hr in 5. Embolization was done with a superselective technique using a microcatheter and polyvinyl alcohol particles to occlude the affected vessels. Results. Arterial embolization was technically successful in all patients and clinically successful in 15 patients (79%). The average number of arteries embolized was 1.2. Bronchial arteriography revealed staining (all patients), dilatation of the artery or hypervascularity (10 patients), and bronchopulmonary shunt (6 patients). The recurrence rate was 33% (5/15) and 11 patients were alive with a mean follow-up time of 148 days (30-349 days). Conclusion. Arterial embolotherapy for hemoptysis in patients with primary lung cancer is an effective, safe therapeutic modality despite the fact the vascular changes are subtle on angiography.

  17. Patient-centered medical home: an emerging primary care model and the military health system.

    PubMed

    Marshall, Robert C; Doperak, Martin; Milner, Michelle; Motsinger, Charles; Newton, Terry; Padden, Maureen; Pastoor, Sara; Hughes, Cortney L; LeFurgy, Jennifer; Mun, Seong K

    2011-11-01

    The patient-centered medical home (PCMH) is a primary care model that aims to provide quality care that is coordinated, comprehensive, and cost-effective. PCMH is hinged upon building a strong patient-provider relationship and using a team-based approach to care to increase continuity and access. It is anticipated that PCMH can curb the growth of health care costs through better preventative medicine and lower utilization of services. The Navy, Air Force, and Army are implementing versions of PCMH, which includes the use of technologies for improved documentation, better disease management, improved communication between the care teams and patients, and increased access to care. This article examines PCMH in the Military Health System by providing examples of the transition from each of the branches. The authors argue that the military must overcome unique challenges to implement and sustain PCMH that civilian providers may not face because of the deployment of patients and staff, the military's mission of readiness, and the use of both on-base and off-base care by beneficiaries. Our objective is to lay out these considerations and to provide ways that they have been or can be addressed within the transition from traditional primary care to PCMH.

  18. Performance of newly implemented Environmental Management Systems in primary schools in South Africa.

    PubMed

    Hens, Luc; Wiedemann, Torsten; Raath, Schalk; Stone, Riana; Renders, Paul; Craenhals, Eric

    2010-01-01

    Quantitative results from Environmental Management Systems (EMS) at primary schools have rarely been examined in literature. This paper presents the monitoring results of environmental care in 39 primary schools in Northern South Africa. During 2 years, after the EMS was implemented in the curriculum and in the school's management, the progress of environmental performances of the participating schools has been measured, by means of detailed questionnaires, related to four environmental aspects: water, waste, energy and greening. At the beginning of the project, 50% of the schools performed well on water-related environmental actions. Two years later it was 76%. For waste-related activities the improvement was even stronger: from 50% to 100%. The environmental performances of the schools improved also for greening-related actions, from 50% at the start of the project to 64% two years later. Only energy-related activities did not improve significantly with only 24% of all schools performing well at the end of the survey period. In general, the introduction of an EMS succeeded in an improvement of the overall environmental performances of the schools, but cost-intensive activities were less successful than others.

  19. Primary activity measurements with a 4πβ-4πγ coincidence counting system.

    PubMed

    Nedjadi, Youcef; Bailat, Claude J; Bochud, François O

    2012-01-01

    The radioactive concentrations of (166m)Ho, (134)Cs and (133)Ba solutions have been standardised using a 4πβ-4πγ coincidence counting system we have recently set up. The detection in the beta channel is performed using various geometries of a UPS-89 plastic scintillator optically coupled to a selected low-noise 1in. diameter photomultiplier tube. The light-tight thin capsule that encloses this beta detector is housed within the well of a 5in.×5in. NaI(Tl) monocrystal detector. The beta detection efficiency can be varied either by optical filtering or electronic discrimination when the electrons loose all their energy in the plastic scintillator. This 4πβ-4πγ coincidence system improves on our 4πβ(PC)-γ system in that its sample preparation is less labour intensive, it yields larger beta- and gamma-counting efficiencies thus enabling the standardisation of low activity sources with good statistics in reasonable time, and it makes standardising short-lived radionuclides easier. The resulting radioactive concentrations of (166m)Ho, (134)Cs and (133)Ba are found to agree with those measured with other primary measurement methods thus validating our 4πβ-4πγ coincidence counting system.

  20. Effect of the Keck telescope`s segmented primary on the performance on the Keck adaptive optics system

    SciTech Connect

    Gavel, D.

    1997-06-01

    The 349 degree of freedom Keck adaptive optics system will be mapped on to the 36 segment Keck primary mirror. Each telescope segment is independently controlled in piston and tilt by an active control system and each segment also has its own set of aberrations. This presents a unique set of problems for the Keck adaptive optics system, not encountered with continuous primaries. To a certain extent the low order segment aberrations, beginning with focus, can be corrected statically by the adaptive optic system. However, the discontinuous surface at the segment edges present special problems in sensing and correcting wavefront with laser guide stars or natural guide stars.

  1. District nurses' experiences with the free-choice system in Swedish primary care.

    PubMed

    Hollman, Djana; Lennartsson, Sandra; Rosengren, Kristina

    2014-01-01

    This article aims to describe the experiences of district nurses regarding their work situation after the free-choice system in primary care in Sweden was implemented. The study comprised a total of 17 semi-structured narratives with district nurses. The narratives were analysed using manifest qualitative content analysis. One category,'being an underused resource', and three subcategories, 'being financially aware','being flexible' and 'being appealing', were identified. A focus on economic benefit can limit the cooperation and exchange of experiences within and between different care units, which could have a negative impact on the quality of care due to competition between different care providers. Underused resources and restrictions in terms of improvement skills have an impact on job satisfaction and the working environment, and affect the quality of care as a result.

  2. Primary central nervous system lymphoma: implication of high-dose chemotherapy followed by auto-SCT.

    PubMed

    Reddy, N; Savani, B N

    2012-10-01

    Primary central nervous system lymphoma is a rare and distinct subtype of non-Hodgkin's lymphoma that is sensitive to radiation and chemotherapy. Decisions regarding the initial therapeutic approach are influenced by age and risk of therapy-related neurotoxicity. Despite several albeit small phase II studies, and the acknowledged need for larger prospective trials, there is supporting evidence to consider auto-SCT following induction chemotherapy in patients with good performance status. The international extranodal lymphoma study group is conducting a randomized phase II study comparing consolidative radiation therapy to high-dose therapy. Novel therapeutic options including early aggressive approach with upfront auto-SCT and strategies to prevent relapse following transplantation is an area of focus.

  3. Salvage Therapy for Refractory Aids-Related Primary Central Nervous System Lymphoma

    PubMed Central

    Ferro, Hugo; Parino, Eduardo

    2012-01-01

    A 27-year-old male patient presented with speech disorders and multiple brain masses on MRI evaluation. He tested positive for HIV. A sterotactic biopsy diagnosed primary central nervous system lymphoma (diffuse large B-cell lymphoma). After two cycles of high-dose metotrexate (HD-MTX-)-based chemotherapy, the tumor progressed. He underwent whole brain radiotherapy achieving complete response. Six cycles of consolidating immunochemotherapy with rituximab-temozolomide were administered after radiation. Forty-three months after remission, he has not recurred and his neurological status is optimal. Younger HIV patients with refractory PCNSL and preserved immune function can face salvage therapy successfully achieving long term remissions with no remarkable neurotoxicity. PMID:23029628

  4. Salvage therapy for refractory AIDS-related primary central nervous system lymphoma.

    PubMed

    Ferro, Hugo; Parino, Eduardo

    2012-01-01

    A 27-year-old male patient presented with speech disorders and multiple brain masses on MRI evaluation. He tested positive for HIV. A sterotactic biopsy diagnosed primary central nervous system lymphoma (diffuse large B-cell lymphoma). After two cycles of high-dose metotrexate (HD-MTX-)-based chemotherapy, the tumor progressed. He underwent whole brain radiotherapy achieving complete response. Six cycles of consolidating immunochemotherapy with rituximab-temozolomide were administered after radiation. Forty-three months after remission, he has not recurred and his neurological status is optimal. Younger HIV patients with refractory PCNSL and preserved immune function can face salvage therapy successfully achieving long term remissions with no remarkable neurotoxicity.

  5. A case of primary central nervous system lymphoma presenting diffuse infiltrative leukoencephalopathy.

    PubMed

    Yamamoto, Tatsuya; Kojima, Kazuho; Koibuchi, Katsura; Ito, Shoichi; Higuchi, Yoshinori; Iwadate, Yasuo; Oide, Takashi; Kuwabara, Satoshi

    2012-01-01

    A 58-year-old immunocompetent man gradually developed loss of appetite, cognitive decline, gait disturbances, and personality changes over 4 months. Brain magnetic resonance imaging (MRI) revealed bilateral diffuse leukoencephalopathy without mass formation on admission. His condition progressively deteriorated, and we treated him with intravenous high-dose steroids. His symptoms improved rapidly, but exacerbated when therapy was withdrawn. A brain biopsy was performed, and the diagnosis of primary central nervous system lymphoma (PCNSL) was confirmed. He was successfully treated with high-dose methotrexate therapy. Although it is difficult to diagnose PCNSL without mass formation in the early stages, steroid responsiveness is important and brain biopsy is essential for the correct diagnosis of PCNSL.

  6. Post-traumatic basal ganglia haemorrhage in a child with primary central nervous system lymphoma.

    PubMed

    Jankowski, Pawel P; Levy, Michael L; Crawford, John Ross

    2013-07-31

    Primary central nervous system lymphoma (PCNSL) is a rare tumour of childhood with 15-20 cases reported yearly in North America. We present a case of a 13-year-old boy diagnosed with PCNSL who presented more than one-and-a-half years post-treatment with high dose cytosine arabinoside and methotrexate with a right-sided basal ganglia haemorrhage on MRI following a concussion while playing organised football against medical advice. There was no evidence of an underlying vascular malformation or recurrent disease by MRI, cerebrospinal fluid analysis or positron emission tomography computed tomography (PET-CT). However, 6 months post-injury he presented with asymptomatic disease recurrence of the frontal lobe. Our case reports an unusual MRI pattern of post-traumatic injury in a child previously treated for PCNSL that would support a recommendation for the avoidance of contact sports in this population.

  7. The Systemic Changes to Improve Efficiency in Polish Primary Health Care

    PubMed Central

    Holecki, Tomasz; Romaniuk, Piotr; Woźniak-Holecka, Joanna

    2016-01-01

    Primary health care is an important part of any health care system. In highly developed countries it secures the population's most elementary health needs, with particular emphasis on preventive care and early intervention. Polish PHC model is currently undergoing a thorough transformation, associated with the need to adapt to standards designated based on the WHO's criteria, and with reference to the experience of other European countries. The paper describes the process of changes being carried out, in the context of previous experiences of reform relating to the sphere of organization, processes and efficiency. A review and systematization has been made, with regard to the undertaken activities in the field of deregulation and change of legal provisions, which are aimed at achieving the improvement of the efficiency of treatment and resource allocation. A set of recommendations based on expert's discourse have also been provided, with respect to future directions of Polish PHC transformation. PMID:27468269

  8. Astrocytes As the Main Players in Primary Degenerative Disorders of the Human Central Nervous System

    PubMed Central

    Capani, Francisco; Quarracino, Cecilia; Caccuri, Roberto; Sica, Roberto E. P.

    2016-01-01

    Along the last years it has been demonstrated that non-neural cells play a major role in the pathogenesis of the primary degenerative disorders (PDDs) of the human central nervous system. Among them, astrocytes coordinate and participate in many different and complex metabolic processes, in close interaction with neurons. Moreover, increasing experimental evidence hints an early astrocytic dysfunction in these diseases. In this mini review we summarize the astrocytic behavior in PDDs, with special consideration to the experimental observations where astrocytic pathology precedes the development of neuronal dysfunction. We also suggest a different approach that could be consider in human investigations in Alzheimer’s and Parkinson’s disease. We believe that the study of PDDs with human brain samples may hold the key of a paradigmatic physiopathological process in which astrocytes might be the main players. PMID:26973519

  9. Astrocytes As the Main Players in Primary Degenerative Disorders of the Human Central Nervous System.

    PubMed

    Capani, Francisco; Quarracino, Cecilia; Caccuri, Roberto; Sica, Roberto E P

    2016-01-01

    Along the last years it has been demonstrated that non-neural cells play a major role in the pathogenesis of the primary degenerative disorders (PDDs) of the human central nervous system. Among them, astrocytes coordinate and participate in many different and complex metabolic processes, in close interaction with neurons. Moreover, increasing experimental evidence hints an early astrocytic dysfunction in these diseases. In this mini review we summarize the astrocytic behavior in PDDs, with special consideration to the experimental observations where astrocytic pathology precedes the development of neuronal dysfunction. We also suggest a different approach that could be consider in human investigations in Alzheimer's and Parkinson's disease. We believe that the study of PDDs with human brain samples may hold the key of a paradigmatic physiopathological process in which astrocytes might be the main players.

  10. A Systems Model for Ursodeoxycholic Acid Metabolism in Healthy and Patients With Primary Biliary Cirrhosis

    PubMed Central

    Dobbins, RL; O'Connor‐Semmes, RL; Young, MA

    2016-01-01

    A systems model was developed to describe the metabolism and disposition of ursodeoxycholic acid (UDCA) and its conjugates in healthy subjects based on pharmacokinetic (PK) data from published studies in order to study the distribution of oral UDCA and potential interactions influencing therapeutic effects upon interruption of its enterohepatic recirculation. The base model was empirically adapted to patients with primary biliary cirrhosis (PBC) based on current understanding of disease pathophysiology and clinical measurements. Simulations were performed for patients with PBC under two competing hypotheses: one for inhibition of ileal absorption of both UDCA and conjugates and the other only of conjugates. The simulations predicted distinctly different bile acid distribution patterns in plasma and bile. The UDCA model adapted to patients with PBC provides a platform to investigate a complex therapeutic drug interaction among UDCA, UDCA conjugates, and inhibition of ileal bile acid transport in this rare disease population. PMID:27537780

  11. Dynamic Scheduling Real-Time Task Using Primary-Backup Overloading Strategy for Multiprocessor Systems

    NASA Astrophysics Data System (ADS)

    Sun, Wei; Yu, Chen; Défago, Xavier; Inoguchi, Yasushi

    The scheduling of real-time tasks with fault-tolerant requirements has been an important problem in multiprocessor systems. The primary-backup (PB) approach is often used as a fault-tolerant technique to guarantee the deadlines of tasks despite the presence of faults. In this paper we propose a dynamic PB-based task scheduling approach, wherein an allocation parameter is used to search the available time slots for a newly arriving task, and the previously scheduled tasks can be re-scheduled when there is no available time slot for the newly arriving task. In order to improve the schedulability we also propose an overloading strategy for PB-overloading and Backup-backup (BB) overloading. Our proposed task scheduling algorithm is compared with some existing scheduling algorithms in the literature through simulation studies. The results have shown that the task rejection ratio of our real-time task scheduling algorithm is almost 50% lower than the compared algorithms.

  12. Systems for the management of respiratory disease in primary care - an international series: Canada.

    PubMed

    Kaplan, Alan

    2008-06-01

    Canada has a universal health care system funded by the government. All people are supposed to have unrestricted access to all essential health care in a timely fashion. Canada has ten provinces and three territories. Health care is funded by each province/territory, with federal payments providing some of the funding. The bulk of the provision of respiratory care in Canada is provided by primary care practitioners. Across the country we have a family physician shortage; thus, in many areas of the country there is insufficient access since patients do not actually have a family physician. This has less effect on acute medical services, which can be available in ER or walk-in settings, but certainly does affect the provision of services for chronic illnesses. While thus far the health care system is 'free', there are some significant limitations; the commonest is waiting times for specialist care and investigations. Other significant deficiencies include the lack of coverage for medications for both acute and chronic conditions and of medical devices. Primary care reforms by local governments have attempted to fix these issues by changing care models. Fee-for-service medicine by physicians is slowly being changed in places to capitation models and other systems such as rewards for managing chronic conditions optimally. Ontario has instituted 'reward systems' for diabetes and smoking cessation. British Columbia has rewards for multiple chronic diseases. In many areas, care in the provinces is regionalised to allow local arrangements to help decide on where and how care is organised. Respiratory diseases (excluding lung cancer) rank fourth in Canada in the total proportion of direct health care costs (behind neuropsychiatric, injury and cardiovascular diseases). A number of studies have shown that respiratory conditions such as asthma and COPD are underdiagnosed and/or undermanaged. Other conditions need treatment by specialists or physicians with a special interest

  13. Treatment of central nervous system involvement associated with primary Sjögren's syndrome.

    PubMed

    Ozgocmen, Salih; Gur, Ali

    2008-01-01

    Sjögren's syndrome (SS) is a chronic autoimmune disease that mainly affects the exocrine glands and usually presents with sicca symptoms of the main mucosal surfaces. The prevalence and the type of central nervous system (CNS) tissue damage caused by SS are debatable. The wide spectrum of CNS manifestations, different classification criteria used and unclear inclusion or exclusion criteria pose some difficulty reviewing these studies. Careful examination of the SS patients and to be aware of neurological findings which may be associated with suspicious CNS involvement is highly important. Central nervous system may also hypothetically have a role in the pathophysiology of SS. The wide spectrum of CNS involvement includes focal (sensorial and motor deficits, brain stem, cerebellar lesions, seizure, migraine etc.) or non-focal (encephalomyelitis, aseptic meningitis, neuropsychiatric dysfunctions), spinal cord (myelopathy, transverse myelitis, motor neuron disease etc.) findings or multiple sclerosis-like illness and optic neuritis. Evolving imaging techniques such as single photon emission computed tomography (SPECT), magnetic resonance spectroscopy or magnetization transfer imaging are promising for better understanding the nature of CNS involvement in SS. Treatments usually comprise symptomatic approach in milder cases however, pulse cyclophosphamide and steroids or other immunosuppressants (chlorambucil or azathioprine) are required in cases with progressive symptoms leading to neurological impairment. Anti-TNF agents (infliximab and etanercept) and B cell targeted therapies (rituximab and epratuzumab) are used in primary SS however their efficacy on CNS manifestation is still unclear. Randomized, multicenter studies are warranted to confirm the efficacy of treatment regimes which were reported to be effective in anecdotal reports or in small uncontrolled series. This article reviews the clinical approach to current therapy of CNS involvement in patients with

  14. Geodynamic stability of the primary in the binary asteroid system 65803 Didymos

    NASA Astrophysics Data System (ADS)

    Barnouin, Olivier S.; Maurel, Clara; Richardson, Derek C.; Ballouz, Ronald-Louis; Schwartz, Stephen; Michel, Patrick

    2015-11-01

    The moon of the near-Earth binary asteroid 65803 Didymos is the target of the Asteroid Impact and Deflection Assessment (AIDA) mission. This mission is a joint concept between NASA and ESA to investigate the effectiveness of a kinetic impactor in deflecting an asteroid. The mission is composed of two components: the NASA-led Double Asteroid Redirect Test (DART) that will impact the Didymos moon, and the ESA-led Asteroid Impact Monitoring (AIM) mission that will characterize the Didymos system. In order to provide AIDA constraints on the physical character of the both objects in this binary system, we undertook preliminary numerical investigations to evaluate the stability of the shape of the primary using its rapid 2.26 h rotation. We modeled the primary as a rubble pile. Each model consisted of thousands of uniform rigid spheres collapsed together under their own gravity to form a spherical pile that was then carved to match the current radar-derived shape model of the primary, as well as other comparable shapes (e.g. asteroid 1999 KW4, spheres) that were scaled to match best estimates of the size of Didymos. Each model was given a starting rotation period of 6 h with the spin axis aligned to the pole. At each timestep the spin rate was increased by a small amount so that after about 1 million timesteps the spin would match the observed rotation of 2.26 h. We tested a range of bulk densities spanning the current observational uncertainty (mean 2.4 g/cc) using "gravel"-like material parameters that provide significant resistance to sliding and rolling. We find that at the upper range of the density uncertainty it is possible for Didymos to hold its shape and not lose mass at its nominal rotation period, without the need for cohesive forces. At lower densities or with smoother particles, significant shape change occurs and mass loss is possible. We conclude that based on the radar shape available at the time of this writing, Didymos is marginally stable as a rubble

  15. [A case of primary intracerebral malignant lymphoma in systemic lupus erythematosus].

    PubMed

    Tomabechi, M; Daita, G; Ohgami, S; Yonemasu, Y; Maekawa, I

    1992-04-01

    The patient, a 44-year-old female, was admitted to our department because of right hemiparesis and left oculomotor nerve palsy on February 7, 1986. Neither lymphadenopathy nor hepatosplenomegaly was present. She had been treated with prednisolone for systemic lupus erythematosus (SLE) for one and a half year before admission. The CT scan revealed a homogeneously enhanced mass lesion from the midbrain through the thalamus on the right side. The whole body gallium scintigram showed no abnormal uptake except in the brain. Stereotaxic biopsy was performed. Histopathological diagnosis was malignant lymphoma, diffuse, large cell type (International Working Formulation). The enhanced mass lesion disappeared after radiation therapy. Subsequently, she received chemotherapy. She remained well until May 1988 when she died because of the systemic lymphadenopathy. The association of malignant lymphoma and SLE has appeared occasionally in the literature. Primary intracerebral malignant lymphoma associated with SLE is much rarer but it should be considered in the differential diagnosis of symptoms of the central nervous system in a patient with SLE. Therefore, biopsy of a cerebral mass lesion is mandatory if appropriate therapy such as radiation and chemotherapy is to be administered.

  16. Radiotherapy in the treatment of primary central nervous system lymphoma (PCNSL).

    PubMed

    Nelson, D F

    1999-07-01

    The use of radiotherapy alone to treat primary central nervous system lymphoma (PCNSL) does not produce the high local control and survival rates that it does in limited extranodal non-Hodgkin's lymphoma outside the central nervous system (CNS). Even with doses of whole brain radiation therapy (WBRT) to 40+20 Gy boost, the Radiation Therapy Oncology Group (RTOG) reported a local control rate of 39%. Seventy-nine percent of recurrences were in the 60 Gy region. The median survival was 11.6 months. This response to local radiotherapy is quite different from the response of non-CNS Diffuse Large Cell Lymphoma where doses of 30-40 and >40 Gy have a 75-90% local control rate. Neither systemic lymphoma nor PCNSL have a classic radiotherapy dose response. For PCNSL there appears to be a threshold dose that ranges in the literature between 30 and > 50 Gy with a median of 40 Gy. Therefore, when radiotherapy is combined with chemotherapy that crosses the BBB, WBRT and/or boost doses may be able to be decreased, especially in patients achieving a complete response. Promising data from the Centre Leon Berard suggest that this is possible. When such chemotherapy was combined with intrathecal chemotherapy and 20 Gy WBRT, they obtained a 56% actuarial 5 year survival rate. Confirmation of single institution reports of favorable results such as these are needed. Cooperative group and intergroup trials are needed to define optimal therapy.

  17. Changes in functional connectivity of pain modulatory systems in women with primary dysmenorrhea.

    PubMed

    Wei, Shyh-Yuh; Chao, Hsiang-Tai; Tu, Cheng-Hao; Li, Wei-Chi; Low, Intan; Chuang, Chih-Ying; Chen, Li-Fen; Hsieh, Jen-Chuen

    2016-01-01

    Menstrual pain is the most prevalent gynecological complaint, and is usually without organic cause (termed primary dysmenorrhea, PDM). The high comorbidity in the later life of PDM with many functional pain disorders (associated with central dysfunction of pain inhibition, eg, fibromyalgia) suggests possible maladaptive functionality of pain modulatory systems already occurred in young PDM women, making them vulnerable to functional pain disorders. Periaqueductal gray (PAG) matter functions as a critical hub in the neuraxis of pain modulatory systems; therefore, we investigated the functional connectivity of PAG in PDM. Forty-six PDM subjects and 49 controls received resting-state functional magnetic resonance imaging during menstruation and periovulatory phases. The PAG of PDM subjects exhibited adaptive/reactive hyperconnectivity with the sensorimotor cortex during painful menstruation, whereas it exhibited maladaptive hypoconnectivity with the dorsolateral prefrontal cortex and default mode network (involving the ventromedial prefrontal cortex, posterior cingulate cortex, or posterior parietal cortex) during menstruation or periovulatory phase. We propose that the maladaptive descending pain modulatory systems in PDM may underpin the central susceptibility to subsequent development of various functional disorders later in life. This hypothesis is corroborated by the growing body of evidence that hypoconnectivity between PAG and default mode network is a coterminal to many functional pain disorders.

  18. Modeling and Analysis of Alternative Concept of ITER Vacuum Vessel Primary Heat Transfer System

    SciTech Connect

    Carbajo, Juan J; Yoder Jr, Graydon L; Dell'Orco, Giovanni; Curd, Warren; Kim, Seokho H

    2010-01-01

    A RELAP5-3D model of the ITER (Latin for the way ) vacuum vessel (VV) primary heat transfer system has been developed to evaluate a proposed design change that relocates the heat exchangers (HXs) from the exterior of the tokamak building to the interior. This alternative design protects the HXs from external hazards such as wind, tornado, and aircraft crash. The proposed design integrates the VV HXs into a VV pressure suppression system (VVPSS) tank that contains water to condense vapour in case of a leak into the plasma chamber. The proposal is to also use this water as the ultimate sink when removing decay heat from the VV system. The RELAP5-3D model has been run under normal operating and abnormal (decay heat) conditions. Results indicate that this alternative design is feasible, with no effects on the VVPSS tank under normal operation and with tank temperature and pressure increasing under decay heat conditions resulting in a requirement to remove steam generated if the VVPSS tank low pressure must be maintained.

  19. Patients’ perceptions of the triage system in a primary healthcare facility, Cape Town, South Africa

    PubMed Central

    Adeniji, Adeloye Amoo

    2016-01-01

    Background In public healthcare facilities, where the patient numbers and the available resources are often disproportionate, triage is used to prioritise when patients are seen. Patients may not understand the triage process and have strong views on how to improve their experience. Aim This study explored the views of patients who had undergone triage in the emergency centre of a primary care facility. Setting Gugulethu Community Health Centre, Cape Town. Methods A purposive sample consisted of five women (one coded green, three orange, one yellow) and four men (one coded green and three yellow). A semi-structured qualitative interview was conducted in either Xhosa or English and the transcripts analysed using the framework method. Results All of the respondents complained of a lack of information and poor understanding of the triage process. Those coded green experienced the process as biased and unfair and reported that the triage nurse was rude and unprofessional. By contrast, those coded yellow or orange found the triage nurse to be helpful and professional. Most patients turned to support staff (e.g. security staff or cleaners) for assistance in dealing with the triage system. Most patients waited longer than the guidelines recommend and the green-coded patients complained about this issue. Conclusion Patients did not have a good experience of the triage system. Managers of the triage system need to design better strategies to improve patient acceptance and share information. The important role of support staff needs to be recognised and strengthened. PMID:27380788

  20. A new control method depending on primary phase angle of transcutaneous energy transmission system for artificial heart.

    PubMed

    Miura, H; Saito, I; Sato, F; Shiraishi, Y; Yambe, T; Matsuki, H

    2013-01-01

    A new control method for stabilizing output voltage of the transcutaneous energy transmission system for artificial heart is proposed. This method is primary side, is outside of the body, which is not depending on a signal transmission system from the implanted device. The impedance observed from primary side changes from inductive to capacitive and the output voltage decreases drastically when the output current is large and the coupling factor is higher than that of the optimal condition. In this case, the driving frequency should be changed to higher so that the phase angle of the primary impedance is zero degree. The preliminary examination showed that this control method can enhance the output voltage limit to twice and the feasibility of the primary side control.

  1. Probability of pipe fracture in the primary coolant loop of a PWR plant. Volume 5. Probabilistic fracture mechanics analysis. Load Combination Program Project I final report

    SciTech Connect

    Harris, D.O.; Lim, E.Y.; Dedhia, D.D.

    1981-06-01

    The primary purpose of the Load Combination Program covered in this report is to estimate the probability of a seismic induced LOCA in the primary piping of a commercial pressurized water reactor (PWR). Best estimates, rather than upper bound results are desired. This was accomplished by use of a fracture mechanics model that employs a random distribution of initial cracks in the piping welds. Estimates of the probability of cracks of various sizes initially existing in the welds are combined with fracture mechanics calculations of how these cracks would grow during service. This then leads to direct estimates of the probability of failure as a function of time and location within the piping system. The influence of varying the stress history to which the piping is subjected is easily determined. Seismic events enter into the analysis through the stresses they impose on the pipes. Hence, the influence of various seismic events on the piping failure probability can be determined, thereby providing the desired information.

  2. Passive containment cooling system

    DOEpatents

    Billig, Paul F.; Cooke, Franklin E.; Fitch, James R.

    1994-01-01

    A passive containment cooling system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and a gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel and is vented to the drywell. An isolation pool is disposed above the GDCS pool and includes an isolation condenser therein. The condenser has an inlet line disposed in flow communication with the drywell for receiving the non-condensable gas along with any steam released therein following a loss-of-coolant accident (LOCA). The condenser also has an outlet line disposed in flow communication with the drywell for returning to the drywell both liquid condensate produced upon cooling of the steam and the non-condensable gas for reducing pressure within the containment vessel following the LOCA.

  3. Passive containment cooling system

    DOEpatents

    Billig, P.F.; Cooke, F.E.; Fitch, J.R.

    1994-01-25

    A passive containment cooling system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and a gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel and is vented to the drywell. An isolation pool is disposed above the GDCS pool and includes an isolation condenser therein. The condenser has an inlet line disposed in flow communication with the drywell for receiving the non-condensable gas along with any steam released therein following a loss-of-coolant accident (LOCA). The condenser also has an outlet line disposed in flow communication with the drywell for returning to the drywell both liquid condensate produced upon cooling of the steam and the non-condensable gas for reducing pressure within the containment vessel following the LOCA. 1 figure.

  4. Enhanced Control of PWR Primary Coolant Water Chemistry Using Selective Separation Systems for Recovery and Recycle of Enriched Boric Acid

    SciTech Connect

    Ken Czerwinski; Charels Yeamans; Don Olander; Kenneth Raymond; Norman Schroeder; Thomas Robison; Bryan Carlson; Barbara Smit; Pat Robinson

    2006-02-28

    The objective of this project is to develop systems that will allow for increased nuclear energy production through the use of enriched fuels. The developed systems will allow for the efficient and selective recover of selected isotopes that are additives to power water reactors' primary coolant chemistry for suppression of corrosion attack on reactor materials.

  5. Creating an optical spectroscopy system for use in a primary care clinical setting (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Eshein, Adam; Nguyen, The-Quyen; Radosevich, Andrew J.; Gould, Bradley; Wu, Wenli; Konda, Vani; Yang, Leslie W.; Koons, Ann; Feder, Seth; Valuckaite, Vesta; Roy, Hemant K.; Backman, Vadim

    2016-03-01

    While there are a plethora of in-vivo spectroscopic techniques that have demonstrated the ability to detect a number of diseases in research trials, very few techniques have successfully become a fully realized clinical technology. This is primarily due to the stringent demands on a clinical device for widespread implementation. Some of these demands include: simple operation requiring minimal or no training, safe for in-vivo patient use, no disruption to normal clinic workflow, tracking of system performance, warning for measurement abnormality, and meeting all FDA guidelines for medical use. Previously, our group developed a fiber optic probe-based optical sensing technique known as low-coherence enhanced backscattering spectroscopy (LEBS) to quantify tissue ultrastructure in-vivo. Now we have developed this technique for the application of prescreening patients for colonoscopy in a primary care (PC) clinical setting. To meet the stringent requirements for a viable medical device used in a PC clinical setting, we developed several novel components including an automated calibration tool, optical contact sensor for signal acquisition, and a contamination sensor to identify measurements which have been affected by debris. The end result is a state-of-the-art medical device that can be realistically used by a PC physician to assess a person's risk for harboring colorectal precancerous lesions. The pilot study of this system shows great promise with excellent stability and accuracy in identifying high-risk patients. While this system has been designed and optimized for our specific application, the system and design concepts are universal to most in-vivo fiber optic based spectroscopic techniques.

  6. RELAP5 Model of the First Wall/Blanket Primary Heat Transfer System

    SciTech Connect

    Popov, Emilian L; Yoder Jr, Graydon L; Kim, Seokho H

    2010-06-01

    ITER inductive power operation is modeled and simulated using a system level computer code to evaluate the behavior of the Primary Heat Transfer System (PHTS) and predict parameter operational ranges. The control algorithm strategy and derivation are summarized in this report as well. A major feature of ITER is pulsed operation. The plasma does not burn continuously, but the power is pulsed with large periods of zero power between pulses. This feature requires active temperature control to maintain a constant blanket inlet temperature and requires accommodation of coolant thermal expansion during the pulse. In view of the transient nature of the power (plasma) operation state a transient system thermal-hydraulics code was selected: RELAP5. The code has a well-documented history for nuclear reactor transient analyses, it has been benchmarked against numerous experiments, and a large user database of commonly accepted modeling practices exists. The process of heat deposition and transfer in the blanket modules is multi-dimensional and cannot be accurately captured by a one-dimensional code such as RELAP5. To resolve this, a separate CFD calculation of blanket thermal power evolution was performed using the 3-D SC/Tetra thermofluid code. A 1D-3D co-simulation more realistically models FW/blanket internal time-dependent thermal inertia while eliminating uncertainties in the time constant assumed in a 1-D system code. Blanket water outlet temperature and heat release histories for any given ITER pulse operation scenario are calculated. These results provide the basis for developing time dependent power forcing functions which are used as input in the RELAP5 calculations.

  7. Primary Central Nervous System Lymphoma: A Critical Review of the Role of Surgery for Resection

    PubMed Central

    Yun, Jonathan; Iwamoto, Fabio M.; Sonabend, Adam M.

    2016-01-01

    Background Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that carry a poor prognosis, with most patients suffering recurrence. Progress has been made in the treatment of this pathology, notably with the widespread use of systemic high dose methotrexate. However, unlike most other malignant CNS neoplasms, surgery for cytoreduction is not routinely performed for this disease, mainly as a result of negative experiences decades ago. Since these studies were published, the availability of intraoperative monitoring, MR imaging and neuro-navigation as well as surgical adjuncts such as fluorescence- guided resection have greatly improved the safety of intracranial procedures. More recent data is suggestive of a potential survival benefit for resection of single PCNSL lesions when patients are subsequently treated with modern regimen high-dose methotrexate, yet this evidence is limited, and should be interpreted conservatively. Methods and findings A systematic review of the literature was performed to identify trials evaluating surgical options for the treatment of PCNSL. Conclusion In this review, we provide a critical overview of the evidence favoring and discouraging resection for PCNSL. This literature suffers from several biases and limitations that must be considered in the context of the extrapolation of this literature into clinical decision-making. PMID:28239600

  8. Primary central nervous system anaplastic large-cell lymphoma mimicking lymphomatosis cerebri.

    PubMed

    Sugino, Toshiya; Mikami, Takeshi; Akiyama, Yukinori; Wanibuchi, Masahiko; Hasegawa, Tadashi; Mikuni, Nobuhiro

    2013-01-01

    Primary central nervous system lymphoma (PCNSL) is usually diffuse large B-cell lymphoma. Anaplastic large-cell lymphoma (ALCL) rarely occurs in the central nervous system. PCNSL always presents as single or multiple nodular contrast-enhancing mass lesions within T2-hyperintense areas on magnetic resonance imaging (MRI). Infrequently, diffuse infiltrating change with little contrast enhancement called lymphomatosis cerebri can be seen in PCNSL. In this report, we describe a 75-year-old immunocompetent man who had progressive dementia. On MRI, diffuse white matter lesions with little contrast enhancement were observed to gradually progress, which was clinically consistent with his worsening condition. A biopsy specimen revealed non-destructive, diffusely infiltrating, anaplastic large CD30-positive lymphoma, indicating a diagnosis of ALCL. After the biopsy, he was treated by whole brain irradiation (total 46 Gy) and focal boost irradiation (total 14 Gy). However, his performance status worsened and there was no symptom improvement. The patient died 8 months after symptom onset. The clinical course, diagnostic workup, pathologic correlates, and treatment outcomes are described herein.

  9. A Conceptual Framework for Evaluation of Public Health and Primary Care System Performance in Iran

    PubMed Central

    Jahanmehr, Nader; Rashidian, Arash; Khosravi, Ardeshir; Farzadfar, Farshad; Shariati, Mohammad; Majdzadeh, Reza; Sari, Ali Akbari; Mesdaghinia, Alireza

    2015-01-01

    Introduction: The main objective of this study was to design a conceptual framework, according to the policies and priorities of the ministry of health to evaluate provincial public health and primary care performance and to assess their share in the overall health impacts of the community. Methods: We used several tools and techniques, including system thinking, literature review to identify relevant attributes of health system performance framework and interview with the key stakeholders. The PubMed, Scopus, web of science, Google Scholar and two specialized databases of Persian language literature (IranMedex and SID) were searched using main terms and keywords. Following decision-making and collective agreement among the different stakeholders, 51 core indicators were chosen from among 602 obtained indicators in a four stage process, for monitoring and evaluation of Health Deputies. Results: We proposed a conceptual framework by identifying the performance area for Health Deputies between other determinants of health, as well as introducing a chain of results, for performance, consisting of Input, Process, Output and Outcome indicators. We also proposed 5 dimensions for measuring the performance of Health Deputies, consisting of efficiency, effectiveness, equity, access and improvement of health status. Conclusion: The proposed Conceptual Framework illustrates clearly the Health Deputies success in achieving best results and consequences of health in the country. Having the relative commitment of the ministry of health and Health Deputies at the University of Medical Sciences is essential for full implementation of this framework and providing the annual performance report. PMID:25946937

  10. Partial decoupling of primary productivity from upwelling in the California Current system

    NASA Astrophysics Data System (ADS)

    Renault, Lionel; Deutsch, Curtis; McWilliams, James C.; Frenzel, Hartmut; Liang, Jun-Hong; Colas, François

    2016-07-01

    Coastal winds and upwelling of deep nutrient-rich water along subtropical eastern boundaries yield some of the ocean's most productive ecosystems. Simple indices of coastal wind strength have been extensively used to estimate the timing and magnitude of biological productivity on seasonal and interannual timescales and underlie the prediction that anthropogenic climate warming will increase the productivity by making coastal winds stronger. The effect of wind patterns on regional net primary productivity is not captured by such indices and is poorly understood. Here we present evidence, using a realistic model of the California Current system and satellite measurements, that the observed slackening of the winds near the coast has little effect on near-shore phytoplankton productivity despite a large reduction in upwelling velocity. On the regional scale the wind drop-off leads to substantially higher production even when the total upwelling rate remains the same. This partial decoupling of productivity from upwelling results from the impact of wind patterns on alongshore currents and the eddies they generate. Our results imply that productivity in eastern boundary upwelling systems will be better predicted from indices of the coastal wind that account for its offshore structure.

  11. Assessment of Field Experience Related to Pressurized Water Reactor Primary System Leaks

    SciTech Connect

    Shah, Vikram Naginbhai; Ware, Arthur Gates; Atwood, Corwin Lee; Sattison, Martin Blaine; Hartley, Robert Scott; Hsu, C.

    1999-08-01

    This paper presents our assessment of field experience related to pressurized water reactor (PWR) primary system leaks in terms of their number of rates, how aging affects frequency of leak events, the safety significance of such leaks, industry efforts to reduce leaks, and effectiveness of current leak detection systems. We have reviewed the licensee event reports to identify the events that took place during 1985 to the third quarter of 1996, and reviewed related technical literature and visited PWR plants to analyze these events. Our assessment shows that USNRC licensees have taken effective actions to reduce the number of leak events. One main reason for this decreasing trend was the elimination or reportable leakages from valve stem packing after 1991. Our review of leak events related to vibratory fatigue reveals a statistically significant decreasing trend with age (years of operation), but not in calendar time. Our assessment of worldwide data on leakage caused by thermal fatigue cracking is that the fatigue of aging piping is a safety significant issue. Our review of leak events has identified several susceptible sites in piping having high safety significance; but the inspection of some of these sites is not required by the ASME Code. These sites may be included in the risk-informed inspection programs.

  12. Assessment of Field Experience Related to Pressurized Water Reactor Primary System Leaks

    SciTech Connect

    A. G. Ware; C. Hsu; C. L. Atwood; M. B. Sattison; R. S. Hartley; V. N. Shah

    1999-02-01

    This paper presents our assessment of field experience related to pressurized water reactor (PWR) primary system leaks in terms of their number and rates, how aging affects frequency of leak events, the safety significance of such leaks, industry efforts to reduce leaks, and effectiveness of current leak detection systems. We have reviewed the licensee event reports to identify the events that took place during 1985 to the third quarter of 1996, and reviewed related technical literature and visited PWR plants to analyze these events. Our assessment shows that USNRC licensees have taken effective actions to reduce the number of leak events. One main reason for this decreasing trend was the elimination or reportable leakages from valve stem packing after 1991. Our review of leak events related to vibratory fatigue reveals a statistically significant decreasing trend with age (years of operation), but not in calendar time. Our assessment of worldwide data on leakage caused by thermal fatigue cracking is that the fatigue of aging piping is a safety significant issue. Our review of leak events has identified several susceptible sites in piping having high safety significance; but the inspection of some of these sites is not required by the ASME Code. These sites may be included in the risk-informed inspection programs.

  13. Primary Progressive Aphasia

    MedlinePlus

    Primary progressive aphasia Overview By Mayo Clinic Staff Primary progressive aphasia (uh-FAY-zhuh) is a rare nervous system (neurological) syndrome ... your ability to communicate. People with primary progressive aphasia can have trouble expressing their thoughts and understanding ...

  14. Feasibility of using a knowledge-based system concept for in-flight primary flight display research

    NASA Technical Reports Server (NTRS)

    Ricks, Wendell R.

    1991-01-01

    A study was conducted to determine the feasibility of using knowledge-based systems architectures for inflight research of primary flight display information management issues. The feasibility relied on the ability to integrate knowledge-based systems with existing onboard aircraft systems. And, given the hardware and software platforms available, the feasibility also depended on the ability to use interpreted LISP software with the real time operation of the primary flight display. In addition to evaluating these feasibility issues, the study determined whether the software engineering advantages of knowledge-based systems found for this application in the earlier workstation study extended to the inflight research environment. To study these issues, two integrated knowledge-based systems were designed to control the primary flight display according to pre-existing specifications of an ongoing primary flight display information management research effort. These two systems were implemented to assess the feasibility and software engineering issues listed. Flight test results were successful in showing the feasibility of using knowledge-based systems inflight with actual aircraft data.

  15. Metabolic Profiling of Systemic Lupus Erythematosus and Comparison with Primary Sjögren's Syndrome and Systemic Sclerosis.

    PubMed

    Bengtsson, Anders A; Trygg, Johan; Wuttge, Dirk M; Sturfelt, Gunnar; Theander, Elke; Donten, Magdalena; Moritz, Thomas; Sennbro, Carl-Johan; Torell, Frida; Lood, Christian; Surowiec, Izabella; Rännar, Stefan; Lundstedt, Torbjörn

    2016-01-01

    Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease which can affect most organ systems including skin, joints and the kidney. Clinically, SLE is a heterogeneous disease and shares features of several other rheumatic diseases, in particular primary Sjögrens syndrome (pSS) and systemic sclerosis (SSc), why it is difficult to diagnose The pathogenesis of SLE is not completely understood, partly due to the heterogeneity of the disease. This study demonstrates that metabolomics can be used as a tool for improved diagnosis of SLE compared to other similar autoimmune diseases. We observed differences in metabolic profiles with a classification specificity above 67% in the comparison of SLE with pSS, SSc and a matched group of healthy individuals. Selected metabolites were also significantly different between studied diseases. Biochemical pathway analysis was conducted to gain understanding of underlying pathways involved in the SLE pathogenesis. We found an increased oxidative activity in SLE, supported by increased xanthine oxidase activity and an increased turnover in the urea cycle. The most discriminatory metabolite observed was tryptophan, with decreased levels in SLE patients compared to control groups. Changes of tryptophan levels were related to changes in the activity of the aromatic amino acid decarboxylase (AADC) and/or to activation of the kynurenine pathway.

  16. Metabolic Profiling of Systemic Lupus Erythematosus and Comparison with Primary Sjögren’s Syndrome and Systemic Sclerosis

    PubMed Central

    Bengtsson, Anders A.; Trygg, Johan; Wuttge, Dirk M.; Sturfelt, Gunnar; Theander, Elke; Donten, Magdalena; Moritz, Thomas; Sennbro, Carl-Johan; Torell, Frida; Lood, Christian; Surowiec, Izabella; Rännar, Stefan; Lundstedt, Torbjörn

    2016-01-01

    Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease which can affect most organ systems including skin, joints and the kidney. Clinically, SLE is a heterogeneous disease and shares features of several other rheumatic diseases, in particular primary Sjögrens syndrome (pSS) and systemic sclerosis (SSc), why it is difficult to diagnose The pathogenesis of SLE is not completely understood, partly due to the heterogeneity of the disease. This study demonstrates that metabolomics can be used as a tool for improved diagnosis of SLE compared to other similar autoimmune diseases. We observed differences in metabolic profiles with a classification specificity above 67% in the comparison of SLE with pSS, SSc and a matched group of healthy individuals. Selected metabolites were also significantly different between studied diseases. Biochemical pathway analysis was conducted to gain understanding of underlying pathways involved in the SLE pathogenesis. We found an increased oxidative activity in SLE, supported by increased xanthine oxidase activity and an increased turnover in the urea cycle. The most discriminatory metabolite observed was tryptophan, with decreased levels in SLE patients compared to control groups. Changes of tryptophan levels were related to changes in the activity of the aromatic amino acid decarboxylase (AADC) and/or to activation of the kynurenine pathway. PMID:27441838

  17. Sleep misperception, EEG characteristics and autonomic nervous system activity in primary insomnia: a retrospective study on polysomnographic data.

    PubMed

    Maes, J; Verbraecken, J; Willemen, M; De Volder, I; van Gastel, A; Michiels, N; Verbeek, I; Vandekerckhove, M; Wuyts, J; Haex, B; Willemen, T; Exadaktylos, V; Bulckaert, A; Cluydts, R

    2014-03-01

    Misperception of Sleep Onset Latency, often found in Primary Insomnia, has been cited to be influenced by hyperarousal, reflected in EEG- and ECG-related indices. The aim of this retrospective study was to examine the association between Central Nervous System (i.e. EEG) and Autonomic Nervous System activity in the Sleep Onset Period and the first NREM sleep cycle in Primary Insomnia (n=17) and healthy controls (n=11). Furthermore, the study examined the influence of elevated EEG and Autonomic Nervous System activity on Stage2 sleep-protective mechanisms (K-complexes and sleep spindles). Confirming previous findings, the Primary Insomnia-group overestimated Sleep Onset Latency and this overestimation was correlated with elevated EEG activity. A higher amount of beta EEG activity during the Sleep Onset Period was correlated with the appearance of K-complexes immediately followed by a sleep spindle in the Primary Insomnia-group. This can be interpreted as an extra attempt to protect sleep continuity or as a failure of the sleep-protective role of the K-complex by fast EEG frequencies following within one second. The strong association found between K-alpha (K-complex within one second followed by 8-12 Hz EEG activity) in Stage2 sleep and a lower parasympathetic Autonomic Nervous System dominance (less high frequency HR) in Slow-wave sleep, further assumes a state of hyperarousal continuing through sleep in Primary Insomnia.

  18. Model Systems for Examining Effects of Leukemia-Associated Oncogenes in Primary Human CD34+ Cells via Retroviral Transduction

    PubMed Central

    Wunderlich, Mark; Mulloy, James C.

    2010-01-01

    Summary The use of primary human cells to model cancer initiation and progression is now within the grasp of investigators. It has been nearly a decade since the first defined genetic elements were introduced into primary human epithelial and fibroblast cells to model oncogenesis. This approach has now been extended to the hematopoietic system, with the first described experimental transformation of primary human hematopoietic cells. Human cell model systems will lead to a better understanding of the species and cell type specific signals necessary for oncogenic initiation and progression, and will allow investigators to interrogate the cancer stem cell hypothesis using a well-defined hierarchical system that has been studied for decades. The molecular and biochemical link between self-renewal and differentiation can now be experimentally approached using primary human cells. In addition, the models that result from these experiments are likely to generate highly relevant systems for use in identification and validation of potential therapeutic targets as well as testing of small molecule therapeutics. We describe here the methodologies and reagents that are used to examine the effects of leukemia fusion protein expression on primary human hematopoietic cells, both in vitro and in vivo. PMID:19277588

  19. Establishing a Viable Workforce Pipeline of Primary Care Nurse Practitioners: Benefits of a Health System and Academic Partnership.

    PubMed

    Madler, Billie; Helland, Mary

    Maldistribution and shortages of primary care providers, changing reimbursement structures, movement from inpatient to community-based models of care, an aging population, and health care reform lead to increased numbers of patients seeking care. All of these phenomena have a part in creating a health care landscape that requires industry leaders enlist innovative strategies to meet the health care needs of their communities. Delivery of high-quality, efficient care by qualified providers is essential for the success of any health care system. Partnerships between health systems and academic centers of learning to develop a pipeline of providers is one inventive approach that can address primary care workforce needs. The purpose of this article was to share an example of an academic/health care system partnership to address primary care workforce needs in a rural Midwestern region.

  20. HD 35502: a hierarchical triple system with a magnetic B5IVpe primary

    NASA Astrophysics Data System (ADS)

    Sikora, J.; Wade, G. A.; Bohlender, D. A.; Shultz, M.; Adelman, S. J.; Alecian, E.; Hanes, D.; Monin, D.; Neiner, C.; MiMeS Collaboration; BinaMIcS Collaboration

    2016-08-01

    We present our analysis of HD 35502 based on high- and medium-resolution spectropolarimetric observations. Our results indicate that the magnetic B5IVsnp star is the primary component of a spectroscopic triple system and that it has an effective temperature of 18.4 ± 0.6 kK, a mass of 5.7 ± 0.6 M⊙, and a polar radius of 3.0^{+1.1}_{-0.5} R_{odot }. The two secondary components are found to be essentially identical A-type stars for which we derive effective temperatures (8.9 ± 0.3 kK), masses (2.1 ± 0.2 M⊙), and radii (2.1 ± 0.4 R⊙). We infer a hierarchical orbital configuration for the system in which the secondary components form a tight binary with an orbital period of 5.668 66(6) d that orbits the primary component with a period of over 40 yr. Least-Squares Deconvolution profiles reveal Zeeman signatures in Stokes V indicative of a longitudinal magnetic field produced by the B star ranging from approximately -4 to 0 kG with a median uncertainty of 0.4 kG. These measurements, along with the line variability produced by strong emission in Hα, are used to derive a rotational period of 0.853 807(3) d. We find that the measured v sin i = 75 ± 5 km s-1 of the B star then implies an inclination angle of the star's rotation axis to the line of sight of 24^{+6}_{-10}{}^circ. Assuming the Oblique Rotator Model, we derive the magnetic field strength of the B star's dipolar component (14^{+9}_{-3} kG) and its obliquity (63± 13deg). Furthermore, we demonstrate that the calculated Alfvén radius (41^{+17}_{-6}R_ast) and Kepler radius (2.1^{+0.4}_{-0.7}R_ast) place HD 35502's central B star well within the regime of centrifugal magnetosphere-hosting stars.

  1. Meckel-Gruber syndrome and the role of primary cilia in kidney, skeleton, and central nervous system development

    PubMed Central

    Barker, Amy R; Thomas, Rhys; Dawe, Helen R

    2014-01-01

    The ciliopathies are a group of related inherited diseases characterized by malformations in organ development. The diseases affect multiple organ systems, with kidney, skeleton, and brain malformations frequently observed. Research over the last decade has revealed that these diseases are due to defects in primary cilia, essential sensory organelles found on most cells in the human body. Here we discuss the genetic and cell biological basis of one of the most severe ciliopathies, Meckel-Gruber syndrome, and explain how primary cilia contribute to the development of the affected organ systems. PMID:24322779

  2. Central nervous system recurrence of systemic lymphoma in the era of stem cell transplantation--an International Primary Central Nervous System Lymphoma Study Group project.

    PubMed

    Bromberg, Jacoline E; Doorduijn, Jeanette K; Illerhaus, Gerald; Jahnke, Kristoph; Korfel, Agniezka; Fischer, Lars; Fritsch, Kristina; Kuittinen, Outti; Issa, Samar; van Montfort, Cees; van den Bent, Martin J

    2013-05-01

    Autologous stem cell transplantation has greatly improved the prognosis of systemic recurrent non-Hodgkin's lymphoma. However, no prospective data are available concerning the feasibility and efficacy of this strategy for systemic lymphoma relapsing in the central nervous system. We, therefore, we performed an international multicenter retrospective study of patients with a central nervous system recurrence of systemic lymphoma to assess the outcome of these patients in the era of stem cell transplantation. We collected clinical and treatment data on patients with a first central nervous system recurrence of systemic lymphoma treated between 2000 and 2010 in one of five centers in four countries. Patient- and treatment-related factors were analyzed and compared descriptively. Primary outcome measures were overall survival and percentage of patients transplanted. We identified 92 patients, with a median age of 59 years and a median Eastern Cooperative Oncology Group/World Health Organization performance status of 2, of whom 76% had diffuse large B-cell histology. The majority (79%) of these patients were treated with systemic chemotherapy with or without intravenous rituximab. Twenty-seven patients (29%) were transplanted; age and insufficient response to induction chemotherapy were the main reasons for not being transplanted in the remaining 65 patients. The median overall survival was 7 months (95% confidence interval 2.6-11.4), being 8 months (95% confidence interval 3.8-5.2) for patients ≤ 65 years old. The 1-year survival rate was 34.8%; of the 27 transplanted patients 62% survived more than 1 year. The Memorial Sloan Kettering Prognostic Index for primary central nervous system lymphoma was prognostic for both undergoing transplantation and survival. In conclusion, despite the availability of autologous stem cell transplantation for patients with central nervous system progression or relapse of systemic lymphoma, prognosis is still poor. Long-term survival

  3. Intermittency Coding in the Primary Olfactory System: A Neural Substrate for Olfactory Scene Analysis

    PubMed Central

    Park, Il Memming; Bobkov, Yuriy V.; Ache, Barry W.

    2014-01-01

    The spatial and temporal characteristics of the visual and acoustic sensory input are indispensable attributes for animals to perform scene analysis. In contrast, research in olfaction has focused almost exclusively on how the nervous system analyzes the quality and quantity of the sensory signal and largely ignored the spatiotemporal dimension especially in longer time scales. Yet, detailed analyses of the turbulent, intermittent structure of water- and air-borne odor plumes strongly suggest that spatio-temporal information in longer time scales can provide major cues for olfactory scene analysis for animals. We show that a bursting subset of primary olfactory receptor neurons (bORNs) in lobster has the unexpected capacity to encode the temporal properties of intermittent odor signals. Each bORN is tuned to a specific range of stimulus intervals, and collectively bORNs can instantaneously encode a wide spectrum of intermittencies. Our theory argues for the existence of a novel peripheral mechanism for encoding the temporal pattern of odor that potentially serves as a neural substrate for olfactory scene analysis. PMID:24431452

  4. Primary central nervous system ALK-positive anaplastic large cell lymphoma in an adult

    PubMed Central

    Dong, Xiaoqin; Li, Jun; Huo, Na; Wang, Yan; Wu, Zhao; Lin, Xiaohong; Zhao, Hong

    2016-01-01

    Abstract Rationale: Anaplastic large cell lymphoma (ALCL) is an aggressive non-Hodgkin lymphoma. It mostly invades lymph nodes with extranodal involvement observed in the soft tissue, bone, and skin. Patient concerns: We report a 34-year-old Chinese male patient who presented with headache, diplopia, and vomit. Cerebrospinal fluid (CSF) analysis via lumbar puncture showed elevated CSF pressure, elevated CSF protein concentrations, decreased CSF glucose and chloride concentration significantly, and pleocytosis of 68 to 350 × 106/L, in which lymphocytes and monocytes were predominant. These changes could be suggestive of tuberculous (TB) meningitis. Enhanced magnetic resonance imaging of spinal cord delineated multiple enhancing nodules in spinal cord, cauda equina, and cristae membrane, and multiple abnormal enhancing lesions in bilateral lumbar intervertebral foramen. Diagnoses: Spinal dura mater biopsy and paraffin pathology examination revealed anaplastic lymphoma kinase positive ALCL. Interventions: High-dose methotrexate, cytosine arabinoside craniospinal, and radiotherapy. Outcomes: Last follow-up on September 22, 2015 showed no evidence of tumor recurrence and the lower extremity muscle strength recovered to 4/5. Lessons: ALCL of primary central nervous system is an exceedingly rare tumor, which is usually misdiagnosed as meningitis (especially TB meningitis) according to clinical manifestation and laboratory examination. Thus closely monitoring patient's conditions and timely adjusting therapeutic regimen during treatment are necessary. PMID:27930548

  5. [Retrospective study of 48 cases of primary central nervous system lymphoma].

    PubMed

    Alessandro, Lucas; Pastor Rueda, José M; Villalonga, Juan F; Bruno, Verónica A; Carpani, Federico; Blaquier, Juan B; Tognarelli, Sofía; Varela, Francisco J; Muggeri, Alejandro

    2017-01-01

    Primary central nervous system lymphoma (PCNSL) is an infrequent form of non-Hodgkin lymphoma restricted to the CNS. More than 90% are type B and mainly affect patients aged 50-70 years. Immunodeficiency is the most important risk factor. The aim of our study was to evaluate the immune status, clinical presentation and findings in complementary studies of PCNSL patients. A retrospective analysis of 48 cases treated in our center between January 1992 and May 2015 was performed. Median age at diagnosis was 61 years (range 25-84); with male predominance (2.1:1). Forty one cases (85%) were immunocompetent patients. Brain MRI findings showed parenchymal involvement in 45 cases (94%), 43% with frontal lobe and 35% basal ganglia, 4% had meningeal involvement and 2% had ophthalmic involvement at diagnosis. Fifty-five percent had restricted signal on diffusion weighted imaging and contrast enhancement was found in 89%. Pyramidal syndrome was the main initial clinical manifestation (56%). There were abnormal findings in 62% of CSF samples, but in only 11.1% positive cytology results were detected. The most frequent type was diffuse large B-cell lymphoma (83%), being B-cell type the most common form between them (96%). In our series PCNSL was more frequent in immunocompetent elderly male subjects. At initial evaluation, clinical manifestations and MRI findings were variable. The initial suspicion of this entity would allow an early diagnosis, avoiding empirical treatments that may confuse or delay diagnosis.

  6. Review of Failure Probability Calculations for HFIR Primary Coolant System Piping

    SciTech Connect

    Simonen, Fredric A.

    2001-10-31

    During July 2001, Pacific Northwest National Laboratory was requested by the U.S. Department of Energy, Office of Nuclear Facilities Management, Office of Nuclear Energy, Science and Technology, Germantown, Maryland, to review calculations of piping failure probabilities for the High Flux Test Reactor (HFIR) located at and operated by the Oak Ridge National Laboratory (ORNL). The objective of the failure probability calculations was to estimate the probabilities of large leaks (>1500 gpm) that are of sufficient size to disable the primary coolant system of HFIR to the extent that there is a potential for core damage. PNNL reviewed the computational methods and the inputs to the calculations along with an evaluation of potential failure mechanisms not explicitly addressed by the ORNL calculations. The review concluded that the calculated failure probabilities even with consideration of uncertainties in the calculations and of other potential failure mechanisms provide a high level of confidence that failure frequencies are less than the stated goal of 10-6 piping failures per year.

  7. Trends in primary central nervous system lymphoma incidence and survival in the U.S.

    PubMed

    Shiels, Meredith S; Pfeiffer, Ruth M; Besson, Caroline; Clarke, Christina A; Morton, Lindsay M; Nogueira, Leticia; Pawlish, Karen; Yanik, Elizabeth L; Suneja, Gita; Engels, Eric A

    2016-08-01

    It is suspected that primary central nervous system lymphoma (PCNSL) rates are increasing among immunocompetent people. We estimated PCNSL trends in incidence and survival among immunocompetent persons by excluding cases among human immunodeficiency virus (HIV)-infected persons and transplant recipients. PCNSL data were derived from 10 Surveillance, Epidemiology and End Results (SEER) cancer registries (1992-2011). HIV-infected cases had reported HIV infection or death due to HIV. Transplant recipient cases were estimated from the Transplant Cancer Match Study. We estimated PCNSL trends overall and among immunocompetent individuals, and survival by HIV status. A total of 4158 PCNSLs were diagnosed (36% HIV-infected; 0·9% transplant recipients). HIV prevalence in PCNSL cases declined from 64·1% (1992-1996) to 12·7% (2007-2011), while the prevalence of transplant recipients remained low. General population PCNSL rates were strongly influenced by immunosuppressed cases, particularly in 20-39 year-old men. Among immunocompetent people, PCNSL rates in men and women aged 65+ years increased significantly (1·7% and 1·6%/year), but remained stable in other age groups. Five-year survival was poor, particularly among HIV-infected cases (9·0%). Among HIV-uninfected cases, 5-year survival increased from 19·1% (1992-1994) to 30·1% (2004-2006). In summary, PCNSL rates have increased among immunocompetent elderly adults, but not in younger individuals. Survival remains poor for both HIV-infected and HIV-uninfected PCNSL patients.

  8. Task-relevant modulation of primary somatosensory cortex suggests a prefrontal-cortical sensory gating system.

    PubMed

    Schaefer, Michael; Heinze, Hans-Jochen; Rotte, Michael

    2005-08-01

    Increasing evidence suggests that somatosensory information is modulated cortically for task-specific sensory inflow: Several studies report short-term adaptation of representational maps in primary somatosensory cortex (SI) due to attention or induced by task-related motor activity such as handwriting. Recently, it has been hypothesized that the frontal or prefrontal cortex may modulate SI. In order to test this hypothesis, we studied the functional organization of SI while subjects performed the Tower of Hanoi task. This task is known to be related to activation of frontal or prefrontal areas. The functional organization of SI while performing the Tower of Hanoi task was compared to the organization of SI during performing the same movements but without the Tower of Hanoi task and with rest. Topography of SI was assessed using neuromagnetic source imaging based on tactile stimulation of the first (D1) and fifth digits (D5). Performing the Tower of Hanoi task was accompanied by plastic changes in SI as indicated by significant shifts in the cortical representations of D1 and D5: They moved further apart during the Tower of Hanoi task compared to the control task containing the same movements but without the cognitive characteristic. Thus, we conclude that SI maps undergo dynamic modulation depending on motor tasks with different cognitive demands. The results suggest that this short-term plasticity may be regulated by a prefrontal-cortical sensory gating system.

  9. Imbalances of T cell subpopulations in primary immunodeficiencies and systemic lupus erythematosus.

    PubMed

    Pandolfi, F; Quinti, I; Sirianni, M C; Fiorilli, M; Zolla, S; Aiuti, F

    1981-01-01

    In the present report we describe a recently proposed technique for the enumeration of T lymphocyte subpopulations. The study was performed on peripheral blood lymphocytes (PBL) of 21 patients with primary immunodeficiencies and 10 with systemic lupus erythematosus (SLE). With this methodology, sheep rosettes are evaluated before and after preincubation with theophylline. Previous reports have shown that cells rosetting after the preincubation (T-res) contain most of the percentages of the helper activity, whereas sensitive cells (T-sens) exert suppression. T-res and T-sens cells were compared to several clinical and immunological parameters, including the detection of lymphocytes with Fc IgM and IgG receptors. We demonstrated a significant positive correlation between T-res and and EAox IgM cells and between T-sens and EAox IgG cells. In addition, patients with Ig defects demonstrated heterogeneity regarding alterations in the proportions of T-res and T-sens cells. On the contrary, in 8 patients with SLE, there was a markedly reduced proportion of T-sens cells. Variations in the balance of subpopulations were observed after treatment with thymic hormones and levamisole. We may conclude that theophylline rosettes represent an easy technique that can be profitably used in the evaluation of T cell subpopulations in immunological diseases.

  10. Intraoperative rapid diagnosis of primary central nervous system lymphomas: advantages and pitfalls.

    PubMed

    Sugita, Yasuo; Terasaki, Mizuhiko; Nakashima, Shinji; Ohshima, Koichi; Morioka, Motohiro; Abe, Hideyuki

    2014-10-01

    To study the advantages and pitfalls of intraoperative rapid diagnosis (IRD) of primary central nervous system lymphomas (PCNSL), pathology reports and frozen sections in our institution were reviewed. We examined 27 cases of PCNSL, one case of anaplastic glioma, and one case of metastatic brain tumor that were diagnosed on neuroimaging. Fifteen cases of intraoperative cytological preparations were also reviewed in a correlative manner. Among the 27 cases initially diagnosed as PCNSL, 18 were also diagnosed as PCNSL by IRD. However, IRD identified four of the 27 cases as gliosis, two as demyelination, one as atypical epithelial cells, one as malignant glioma and anaplastic astrocytoma. In addition, the case identified as metastatic brain tumor on neuroimaging was corrected to a diagnosis of PCNSL based on IRD. The final accuracy of IRD in the present study was 89.6% (26/29). After postoperative definitive diagnosis, two cases of anaplastic astrocytoma and one case of PCNSL by IRD were corrected to PCNSL, anaplastic oligodendroglioma and demyelination, respectively. PCNSL were sometimes histologically indistinguishable from malignant gliomas or demyelinating diseases in the present study, particularly in frozen sections. Notably, all cases for which both intraoperative cytology and frozen section were performed concomitantly were correctly diagnosed in the present study. In particular, lymphoglandular bodies were highly characteristic cytological findings of PCNSL. Both intraoperative cytology and frozen sections should therefore be performed concomitantly when PCNSL are suspected.

  11. Treating asthma by the guidelines: developing a medication management information system for use in primary care.

    PubMed

    Twiggs, Joan E; Fifield, J; Jackson, E; Cushman, R; Apter, A

    2004-01-01

    The aim of this study was to develop, implement, and assess an automated asthma medication management information system (MMIS) that provides patient-specific evaluative guidance based on 1997 NAEPP clinical consensus guidelines. MMIS was developed and implemented in primary care settings within a pediatric asthma disease management program. MMIS infrastructure featured a centralized database with Internet access. MMIS collects detailed patient asthma medication data, evaluates pharmacotherapy relative to practitioner-reported disease severity, symptom control and model of guideline-recommended severity-appropriate medications and produces a patient-specific "curbside consult" feedback report. A system algorithm translates actual detailed medication data into actual severity-specific medication-class combinations. A table-driven computer program compares actual medication-class combinations to a guideline-based medication-class combinations model. Methodology determines whether the patient was prescribed a "severity-appropriate" amount or an amount "more" or "less" medication than indicated for patient's reported severity. Feedback messages comment on comparison. Missing data, unrecognized amounts of controller medication or unrecognized medication combinations create error cases. Post hoc review analyzed error cases to determine prevalence of non-guideline medicating practices among these practitioners. Proportion of valid and error cases across two clinical visits before and after post hoc clinical review were measured, as well as proportion of severity-appropriate, out-of-severity and non-guideline medications. MMIS produced a valid feedback report for 83% of patient visits. Missing data accounted for 60% of error cases. Practitioners used severity-appropriate medications for 60% of cases. When non-severity-appropriate medications were used they tended to be "too much" rather than "too little" (22%, 5%), suggesting appropriate use of guideline-recommended "step

  12. MGMT promoter methylation and correlation with protein expression in primary central nervous system lymphoma.

    PubMed

    Toffolatti, L; Scquizzato, E; Cavallin, S; Canal, F; Scarpa, M; Stefani, P M; Gherlinzoni, F; Dei Tos, A P

    2014-11-01

    The O (6)-methylguanine-DNA-methyltransferase (MGMT) gene encodes for a DNA repairing enzyme of which silencing by promoter methylation is involved in brain tumorigenesis. MGMT promoter methylation represents a favorable prognostic factor and has been associated with a better response to alkylating agents in glioma and systemic lymphoma. Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal malignant lymphoma. The current standard of care, based on high-dose methotrexate chemotherapy, has improved prognosis but outcome remains poor for a majority of patients. Therapeutic progress in this field is conditioned by limited biological and molecular knowledge about the disease. Temozolomide has recently emerged as an alternative option for PCNSL treatment. We aimed to analyze the MGMT gene methylation status in a series of 24 PCNSLs, to investigate the relationship between methylation status of the gene and immunohistochemical expression of MGMT protein and to evaluate the possible prognostic significance of these biomarkers. Our results confirm that methylation of the MGMT gene and loss of MGMT protein are frequent events in these lymphomas (54 % of our cases) and suggest that they are gender and age related. MGMT methylation showed high correlation with loss of protein expression (concordance correlation coefficient = -0.49; Fisher exact test: p < 0.01), different from what has been observed in other brain tumors. In the subgroup of ten patients who received high dose chemotherapy, the presence of methylated MGMT promoter (n = 4), seems to be associated with a prolonged overall survival (>60 months in three of four patients). The prognostic significance of these molecular markers in PCNSL needs to be further studied in groups of patients treated in a homogeneous way.

  13. Cell communication in a coculture system consisting of outgrowth endothelial cells and primary osteoblasts.

    PubMed

    Herzog, David Paul Eric; Dohle, Eva; Bischoff, Iris; Kirkpatrick, Charles James

    2014-01-01

    Bone tissue is a highly vascularized and dynamic system with a complex construction. In order to develop a construct for implant purposes in bone tissue engineering, a proper understanding of the complex dependencies between different cells and cell types would provide further insight into the highly regulated processes during bone repair, namely, angiogenesis and osteogenesis, and might result in sufficiently equipped constructs to be beneficial to patients and thereby accomplish their task. This study is based on an in vitro coculture model consisting of outgrowth endothelial cells and primary osteoblasts and is currently being used in different studies of bone repair processes with special regard to angiogenesis and osteogenesis. Coculture systems of OECs and pOBs positively influence the angiogenic potential of endothelial cells by inducing the formation of angiogenic structures in long-term cultures. Although many studies have focused on cell communication, there are still numerous aspects which remain poorly understood. Therefore, the aim of this study is to investigate certain growth factors and cell communication molecules that are important during bone repair processes. Selected growth factors like VEGF, angiopoietins, BMPs, and IGFs were investigated during angiogenesis and osteogenesis and their expression in the cultures was observed and compared after one and four weeks of cultivation. In addition, to gain a better understanding on the origin of different growth factors, both direct and indirect coculture strategies were employed. Another important focus of this study was to investigate the role of "gap junctions," small protein pores which connect adjacent cells. With these bridges cells are able to exchange signal molecules, growth factors, and other important mediators. It could be shown that connexins, the gap junction proteins, were located around cell nuclei, where they await their transport to the cell membrane. In addition, areas in which two

  14. Measuring primary care services performance: issues and opportunities from a home care pilot experience in the Tuscan health system.

    PubMed

    Cinquini, Lino; Vainieri, Milena

    2008-08-01

    In recent years in Italy, as in other European countries, profound changes have been introduced in health care both at central and regional levels. Most of them were oriented towards a shift from 'hospital-centred' health care to health care based more on primary care services. This transition pursues two objectives: giving more effective responses to citizens' needs and reducing public health expenditure. Changes that involve organizational structure must also be carried out with the introduction of measurement tools that can help in planning and can control the changes. The paper provides the results obtained through the experience of modelling a measurement system for primary care carried out in 2004 and 2005 by some territorial managers and controllers in the Tuscan Health system, and the main issues in measuring primary care services emerging from this pilot experience focused on integrated home care services.

  15. Design and Testing of the Primary and Secondary Oxygen Regulators for the Flexible Portable Life Support System (FlexPLSS)

    NASA Technical Reports Server (NTRS)

    Campbell, Colin; Hepworth, Mark

    2010-01-01

    The next generation space suit requires additional capabilities for controlling and adjusting internal pressure compared to that of historical designs. Although the general configuration of the oxygen systems for the next generation space suit is similar or derived from the Apollo and Shuttle Extravehicular Mobility Unit (EMU) with Primary closed loop life support operation and Secondary sourced open loop life support operations, nearly everything else has evolved with new available technologies. For the case of the primary and secondary regulators, the design has gone away from purely mechanical systems actuated with pull-cords or "bicycle cables" to electro-mechanical hybrids that provide the best of both worlds with respect to power draw, reliability, and versatility. This paper discusses the development and testing of a Secondary Oxygen Regulator bench-top prototype along with comparisons of operation with the various prototypes for the Primary Oxygen Regulator.

  16. Role of primary substrate composition and concentration on attenuation of trace organic chemicals in managed aquifer recharge systems.

    PubMed

    Alidina, Mazahirali; Li, Dong; Ouf, Mohamed; Drewes, Jörg E

    2014-11-01

    This study was undertaken to investigate the role of primary substrate composition and concentration on the attenuation of biodegradable emerging trace organic chemicals (TOrCs) in simulated managed aquifer recharge (MAR) systems. Four sets of soil columns were established in the laboratory, each receiving synthetic feed solutions comprising different ratios and concentrations of peptone-yeast and humic acid as the primary substrate to investigate the effect on removal of six TOrCs (atenolol, caffeine, diclofenac, gemfibrozil, primidone, and trimethoprim). Based on abiotic control experiments, adsorption was not identified as a significant attenuation mechanism for primidone, gemfibrozil and diclofenac. Caffeine, atenolol and trimethoprim displayed initial adsorptive losses, however, adsorption coefficients derived from batch tests confirmed that adsorption was limited and in the long-term experiment, biodegradation was the dominant attenuation process. Within a travel time of 16 h, caffeine - an easily degradable compound exhibited removal exceeding 75% regardless of composition or concentration of the primary substrate. Primidone - a poorly degradable compound, showed no removal in any column regardless of the nature of the primary substrate. The composition and concentration of the primary substrate, however, had an effect on attenuation of moderately degradable TOrCs, such as atenolol, gemfibrozil and diclofenac, with the primary substrate composition seeming to have a larger impact on TOrC attenuation than its concentration. When the primary substrate consisted mainly of refractory substrate (humic acid), higher removal of the moderately degradable TOrCs was observed. The microbial communities in the columns receiving more refractory carbon, were noted to be more diverse and hence likely able to express a wider range of enzymes, which were more suitable for TOrC transformation. The effect of the primary substrate on microbial community composition, diversity

  17. Quantifying Human Appropriated Net Primary Productivity (HANPP) in a Ghanaian Cocoa System

    NASA Astrophysics Data System (ADS)

    Morel, A.; Adu-Bredu, S.; Adu Sasu, M.; Ashley Asare, R.; Boyd, E.; Hirons, M. A.; Malhi, Y.; Mason, J.; Norris, K.; Robinson, E. J. Z.; McDermott, C. L.

    2015-12-01

    Ghana is the second largest producer of cocoa (Theobroma cacoa), exporting approximately 18 percent of global volumes. These cocoa farms are predominantly small-scale, ranging in size from 2-4 hectares (ha). Traditionally, the model of cocoa expansion in Ghana relied on clearing new areas of forest and establishing a farm under remnant forest trees. This is increasingly less practical due to few unprotected forest areas remaining and management practices favoring close to full sun cocoa to maximize short-term yields. This study is part of a larger project, ECOLMITS, which is an interdisciplinary, ESPA-funded[1] initiative exploring the ecological limits of ecosystem system services (ESS) for alleviating poverty in small-scale agroforestry systems. The ecological study plots are situated within and around the Kakum National Forest, a well-protected, moist-evergreen forest of the Lower Guinea Forest region. Net primary productivity (NPP) is a measure of the rate at which carbon dioxide (CO2) is incorporated into plant tissues (e.g. canopy, stem and root). For this study, NPP was monitored in situ using methods developed by the Global Environmental Monitoring Network (GEM, http://gem.tropicalforests.ox.ac.uk/). By comparing NPP measured in intact forest and farms, the human appropriated NPP (HANPP) of this system can be estimated. The forest measures provide the "potential" NPP of the region, and then the reduction in NPP for farm plots is calculated for both land-cover change (HANPPLUC) and cocoa harvesting (HANPPHARV). The results presented are of the first year of NPP measurements across the cocoa landscape, including measurements from intact forest, logged forest and cocoa farms across a shade gradient and located at varying distances from the forest edge (e.g. 100 m, 500 m, 1 km and 5 km). These measures will have implications for carbon sequestration potential over the region and long-term sustainability of the Ghanaian cocoa sector. [1] Ecosystem Services for

  18. Design of an interferometric system for piston measurements in segmented primary mirrors

    NASA Astrophysics Data System (ADS)

    Arasa, Josep; Laguarta, Ferran; Pizarro, Carlos; Tomas, Nuria; Pinto, Agusti

    2000-10-01

    Recently, telescopes with segmented primary mirrors are becoming increasingly popular due to their ability of achieving large apertures without the inconveniences caused by the fabrication and handling of monolithic surfaces with 8m (or over) in diameter. The difference in position of each pair of adjacent segments along the local normal of their interface (called piston hereafter), however, needs to be precisely measured in order to provide a diffraction- limited image. If a system yielding the nanometric accuracy required in piston measurements worked in daylight hours, the resultant saving in observation time would be an important advance on a majority of the state-of-the-art piston measurement systems. An interferometric piston measurement instrument accomplishing such objectives has been designed starting from the usual Michelson configuration at the CD6 (Terrassa, Spain), and its final test has been carried out in the test workbench of the Instituto de Astrofisica de Canarias (IAC, Canary Islands, Spain). Its optical layout relies on projecting the reference arm of the interferometer onto one of the segments of the pair considered, along the direction of the local normal to the surface while the measurement arm is projected onto the interface which divides the pair of segments considered. The field of view and its illumination are calculated to be equivalent in both segments. The lateral shift of the fringes in both interferograms determines the piston error present. A combination of monochromatic and white light is used, in order to remove the (lambda) /2 phase ambiguities present in piston measurements without losing the required resolution in the measurement. In this paper, the optical design of this interferometric piston measurement instrument will be presented. The particular configuration used in the interferometer, the implementation of an imaging system allowing to see both the interface of the segments and the interference fringes, the effect of the

  19. Aesthetic Education of Primary School Pupils as an Integral Part of the National System of Continuous Art Education in Japan

    ERIC Educational Resources Information Center

    Kuchai, Tetiana

    2014-01-01

    The article examines aesthetic education of primary school pupils as an integral part of the national system of continuous art education in Japan. One of the most important traditional means of aesthetic education in Japan, according to L. Tsaryova is considered nature. Analysis of the scientific literature by domestic and foreign scientists…

  20. Profiling Bioactivity of the ToxCast Chemical Library Using BioMAP Primary Human Cell Systems

    EPA Science Inventory

    The complexity of human biology has made prediction of health effects as a consequence of exposure to environmental chemicals especially challenging. Complex cell systems, such as the Biologically Multiplexed Activity Profiling (BioMAP) primary, human, cell-based disease models, ...

  1. Effect of 5E Instructional Model in Student Success in Primary School 6th Year Circulatory System Topic

    ERIC Educational Resources Information Center

    Cardak, Osman; Dikmenli, Musa; Saritas, Ozge

    2008-01-01

    The aim of this study is to research the effect of the 5E instructional model on primary (sixth grade) student success during the circulatory system unit. This study was conducted with 38 students in two different classes by the same researcher in 2006-2007. One of the classes was assigned as the control group and the other as the experimental…

  2. Development of Portable Rapid Diagnostic Microbiology Systems for Support of Primary Health Care Delivery.

    DTIC Science & Technology

    1981-11-01

    should receive primary attention. In the collective opinion of the delegates to the Alma -Ata Con- ference in 1978, sponsored by the World Health...diagnostic challenge of tropical diseases as seen by an epidemiologist. Amer J Trop Med Hyg 28:171, 1979. 3. WHO (Ed): Alma -Ata 1978. Primary Health Care...World Health Organization, Geneva. p2. 4. Waddy BB: African epidemic cerebro -spinal, meningitis. J Trop Med Hyg 60:179, 19. 5. Sanborn WR: A portable

  3. Risk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques.

    PubMed

    Zannad, Faiez; De Backer, Guy; Graham, Ian; Lorenz, Matthias; Mancia, Giuseppe; Morrow, David A; Reiner, Zeljko; Koenig, Wolfgang; Dallongeville, Jean; Macfadyen, Robert J; Ruilope, Luis M; Wilhelmsen, Lars

    2012-04-01

    The aim of this paper is to review and discuss current methods of risk stratification for cardiovascular disease (CVD) prevention, emerging biomarkers, and imaging techniques, and their relative merits and limitations. This report is based on discussions that took place among experts in the area during a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy in September 2009. Classical risk factors such as blood pressure and low-density lipoprotein cholesterol levels remain the cornerstone of risk estimation in primary prevention but their use as a guide to management is limited by several factors: (i) thresholds for drug treatment vary with the available evidence for cost-effectiveness and benefit-to-risk ratios; (ii) assessment may be imprecise; (iii) residual risk may remain, even with effective control of dyslipidemia and hypertension. Novel measures include C-reactive protein, lipoprotein-associated phospholipase A(2) , genetic markers, and markers of subclinical organ damage, for which there are varying levels of evidence. High-resolution ultrasound and magnetic resonance imaging to assess carotid atherosclerotic lesions have potential but require further validation, standardization, and proof of clinical usefulness in the general population. In conclusion, classical risk scoring systems are available and inexpensive but have a number of limitations. Novel risk markers and imaging techniques may have a place in drug development and clinical trial design. However, their additional value above and beyond classical risk factors has yet to be determined for risk-guided therapy in CVD prevention.

  4. Antiglutamate Receptor Antibodies and Cognitive Impairment in Primary Antiphospholipid Syndrome and Systemic Lupus Erythematosus

    PubMed Central

    Gerosa, Maria; Poletti, Barbara; Pregnolato, Francesca; Castellino, Gabriella; Lafronza, Annalisa; Silani, Vincenzo; Riboldi, Piersandro; Meroni, Pier Luigi; Merrill, Joan T.

    2016-01-01

    Systemic lupus erythematosus (SLE) and antiphospholipid syndrome have an increased risk to develop cognitive impairment. A possible role for antiphospholipid antibodies (aPL) and antiglutamate receptor (anti-NMDA) antibodies in the pathogenesis of neurological manifestations of these two conditions, have been suggested. In particular, the role of anti-NMDA antibodies in the pathogenesis of neuropsychiatric SLE is supported by several experimental studies in animal models and by the finding of a correlation between anti-NMDA positivity in cerebrospinal fluid and neurological manifestations of SLE. However, data from the literature are controversial, as several studies have reported a correlation of these antibodies with mild cognitive impairment in SLE, but more recent studies have not confirmed this finding. The synergism between anti-NMDA and other concomitant autoantibodies, such as aPL, can be hypothesized to play a role in inducing the tissue damage and eventually the functional abnormalities. In line with this hypothesis, we have found a high incidence of at least one impaired cognitive domain in a small cohort of patients with primary APS (PAPS) and SLE. Interestingly, aPL were associated with low scoring for language ability and attention while anti-NMDA titers and mini-mental state examination scoring were inversely correlated. However, when patients were stratified according to the presence/absence of aPL, the correlation was confirmed in aPL positive patients only. Should those findings be confirmed, the etiology of the prevalent defects found in PAPS patients as well as the synergism between aPL and anti-NMDA antibodies would need to be explored. PMID:26870034

  5. Distinct antibody profile: a clue to primary antiphospholipid syndrome evolving into systemic lupus erythematosus?

    PubMed

    Freire, Paula Vieira; Watanabe, Elisa; dos Santos, Nelita Rocha; Bueno, Cleonice; Bonfá, Eloísa; de Carvalho, Jozélio Freire

    2014-03-01

    We have performed a retrospective study to determine if patients with antiphospholipid syndrome that developed systemic lupus erythematosus (APS/SLE) had distinct clinical and/or serological features. All 80 primary APS (PAPS) patients followed up at our APS unit were included in the study and divided into two groups: 14 APS/SLE and 66 PAPS. Prior or at onset of lupus manifestations, six patients were uniformly negative for lupus and Sjögren autoantibodies, and the other eight patients had persistent positive. In the first year after diagnosis of SLE, three patients remained with negative antibodies, the other seven patients maintained the same antibodies, and four patients developed other antibodies. APS/SLE group had a significant lower mean age at PAPS diagnosis (26.0 ± 8.0 vs. 34.2 ± 11.9 years, p = 0.03) and a longer disease duration (14.0 ± 7.0 vs. 6.0 ± 5.0 years, p < 0.0001). The mean time for PAPS to develop SLE was 5.2 ± 4.3 years. The typical clinical and laboratorial findings of APS did not discriminate both groups of patients. At lupus onset, antinuclear antibodies were more frequently observed in those who evolved to SLE (100 vs. 51.5%, p = 0.0005). Anti-double-stranded DNA (dsDNA), anti-ribosomal P, anti-Ro/SS-A, anti-La/SS-B, and anti-U1RNP antibodies were exclusively found in the APS/SLE patients, whereas anti-Smith (Sm) antibodies were not detected in both groups. The detection of a distinct subgroup of lupus-associated autoantibody in PAPS patients seems to be a hint to overt SLE disease, particularly in those patients with young age at diagnosis.

  6. Primary central nervous system lymphoma report of 32 cases and review of the literature.

    PubMed

    Dubuisson, Annie; Kaschten, Bruno; Lénelle, Jacques; Martin, Didier; Robe, Pierre; Fassotte, Marie-France; Rutten, Isabelle; Deprez, Manuel; Stevenaert, Achille

    2004-12-01

    We retrospectively analyzed 32 cases of primary central nervous system lymphoma (PCNSL). Five cases were diagnosed in the period 1987-1994, for 27 cases in the period 1995-2002. There were 17 men and 15 women whose median age was 69 years. Three patients were immunodeficient. The commonest symptoms were focal deficit (16 patients) and cognitive/behaviour disturbances (14 patients). Radiologically, a total of 47 contrast-enhancing lesions were observed in 32 patients; 18 patients had deep-seated lesions. All but two patients underwent histological diagnosis following craniotomy (11 patients) and/or stereotaxic biopsy (22 patients); diagnosis was obtained on CSF cytology in one patient with a third ventricle tumour. In the last patient, the diagnosis was based on the finding of marked tumour shrinkage under corticotherapy, despite two negative histological examinations. Treatment included surgical resection (10 patients), chemotherapy (25 patients) and/or radiotherapy (12 patients). According to the therapeutic recommendations of the GELA (Groupe d'Etude des Lymphomes de l'Adulte), 19 patients received at least two courses of high-dose methotrexate; intrathecal chemotherapy was used in 20 patients with methotrexate and/or cytosine arabinoside. Radiation therapy consisted of whole brain irradiation followed by a boost on tumour site. Nine patients received a combined treatment of chemotherapy and radiotherapy. Twelve patients showed rapid progression to death. At the time of last contact, 28/32 patients (88%) had died, all from PCNSL disease or from complications due to its treatment. The median survival time was 13.9 months. We conclude that PCNSL is an increasingly frequent tumour. The diagnosis is obtained by stereotactic biopsy in the majority of cases. The prognosis appears dismal despite an intensive multidisciplinary therapeutic approach.

  7. Neurocognitive Features Distinguishing Primary Central Nervous System Lymphoma from Other Possible Causes of Rapidly Progressive Dementia

    PubMed Central

    Deutsch, Mariel B.; Mendez, Mario F.

    2015-01-01

    Objective Define the neurocognitive features of primary central nervous system lymphoma (PCNSL) presenting with dementia, and compare with other causes of rapidly progressive dementia (RPD). Background PCNSL can present as an RPD. Differentiating PCNSL from other RPDs is critical because lymphomatous dementia may be reversible, and untreated PCNSL is fatal. Methods We performed a meta-analysis of case reports of dementia from PCNSL (between 1950 and 2013); 20 patients (14 with lymphomatosis cerebri) met our criteria. We compared these patients to a case series of patients with RPD from Creutzfeldt-Jakob disease and other non-PCNSL etiologies (Sala et al, 2012. Alzheimer Dis Assoc Disord. 26:267–271). Results Median age was 66 (range 41–81); 70% were men. Time from symptom onset to evaluation was < 6 months in 65%. No patients had seizures; 5% had headaches; 45% had non-aphasic speech difficulty. There was significantly more memory impairment in patients with PCNSL than other RPDs and significantly less myoclonus and parkinsonism. Behavioral changes and cerebellar signs were not significantly different. Significantly more patients with PCNSL than other RPDs had white matter changes; significantly fewer had atrophy. Elevated CSF protein and pleocytosis were more frequent in PCNSL; patients with other RPDs tended to have normal CSF ± 14-3-3 protein. Conclusions Unlike patients with RPD from other causes, those with PCNSL commonly present with impaired memory, apathy, and abnormal speech and gait, without headache, seizure, or myoclonus. White-matter changes and CSF abnormalities predominate. Improved clinical awareness of PCNSL can prompt earlier diagnosis and treatment. PMID:25812125

  8. Analysis of genetic mutations in Chinese patients with systemic primary carnitine deficiency.

    PubMed

    Han, Lianshu; Wang, Fei; Wang, Yu; Ye, Jun; Qiu, Wenjuan; Zhang, Huiwen; Gao, Xiaolan; Gong, Zhuwen; Gu, Xuefan

    2014-10-01

    Systemic primary carnitine deficiency (CDSP) is caused by mutations in SLC22A5 gene, which encodes organic cation transporter 2(OCTN2). CDSP leads to skeletal or cardiac myopathy and hepatic encephalopathy. The present study aimed to identify SLC22A5 gene mutations and analyze the potential relationship between genotype and clinical symptoms in 20 Chinese patients with CDSP. The complete coding region of the SLC22A5 gene including intron-exon boundaries were amplified and sequenced in all patients. Eighteen different mutations were found; of which, nine were novel. The mutations clustering in exons 1 and 4 accounted for 66.7% of all mutant alleles (26/39). The c.760C>T (p. R254X) was the most frequent mutation (25.6%, 10/39), suggesting it as an ethnic founder mutation. The relationship between genotype and phenotype was investigated in patients carrying the R254X mutation. Homozygous patients with R254X were late-onset cases who presented with dilated cardiomyopathy and muscle weakness after 1 year of age. Compound heterozygous patients carrying R254X, combined with other missense mutations occurred in very specific positions, dramatically altered OCTN2 protein function. Based on the analysis of case studies, a clear relationship between free carnitine (C0) level in plasma and OCTN2 genotype was not found in the present work, however, the low plasma C0 level could not indicate disease severity or genotype. Further functional studies with a large sample size are required to understand the relationship between R254X mutation and CDSP.

  9. Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

    PubMed Central

    2011-01-01

    Background There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden. Methods This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®). Results The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix. Conclusions Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain. PMID:21645335

  10. Primary localized cutaneous amyloidosis with lichen and poikiloderma-like lesions and an excellent response to systemic acitretin*

    PubMed Central

    MA, Han; Su, Xiangyang; Zhu, Guoxing; Yin, Songchao; Lu, Chun; Lai, Wei

    2016-01-01

    Primary localized cutaneous amyloidosis is a skin-limited amyloidosis that does not involve internal organs. It is clinically subclassified into 3 general categories and some rare variants. However, there is considerable overlap within the classification. Though there are a variety of therapeutic measures, the treatment is often unsatisfactory, particularly when the disease is severe and extensive. We describe a rare case of primary localized cutaneous amyloidosis with lichen and poikiloderma-like lesions that showed an excellent response to systemic acitretin. PMID:27828646

  11. Primary peripheral T-cell lymphoma, not otherwise specified, of the central nervous system in a child.

    PubMed

    Momota, Hiroyuki; Kato, Seiichi; Fujii, Masazumi; Tsujiuchi, Takashi; Takahashi, Yoshiyuki; Kojima, Seiji; Wakabayashi, Toshihiko

    2015-10-01

    Primary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), is a rare disease that infrequently involves the central nervous system (CNS), and it is even rarer in pediatric patients. Here, we report of a 13-year-old male with primary CNS PTCL-NOS who exhibited a malignant clinical course with recurrence after radiochemotherapy followed by bone marrow transplantation; he died 43 months after diagnosis. Pathology revealed the proliferation of cytotoxic T-cells and clonal T-cell receptor gene rearrangements. Although the optimal therapy for PTCL remains controversial, intensive radiochemotherapy may be required for some patients.

  12. Development and Assessment of CFD Models Including a Supplemental Program Code for Analyzing Buoyancy-Driven Flows Through BWR Fuel Assemblies in SFP Complete LOCA Scenarios

    NASA Astrophysics Data System (ADS)

    Artnak, Edward Joseph, III

    This work seeks to illustrate the potential benefits afforded by implementing aspects of fluid dynamics, especially the latest computational fluid dynamics (CFD) modeling approach, through numerical experimentation and the traditional discipline of physical experimentation to improve the calibration of the severe reactor accident analysis code, MELCOR, in one of several spent fuel pool (SFP) complete loss-ofcoolant accident (LOCA) scenarios. While the scope of experimental work performed by Sandia National Laboratories (SNL) extends well beyond that which is reasonably addressed by our allotted resources and computational time in accordance with initial project allocations to complete the report, these simulated case trials produced a significant array of supplementary high-fidelity solutions and hydraulic flow-field data in support of SNL research objectives. Results contained herein show FLUENT CFD model representations of a 9x9 BWR fuel assembly in conditions corresponding to a complete loss-of-coolant accident scenario. In addition to the CFD model developments, a MATLAB based controlvolume model was constructed to independently assess the 9x9 BWR fuel assembly under similar accident scenarios. The data produced from this work show that FLUENT CFD models are capable of resolving complex flow fields within a BWR fuel assembly in the realm of buoyancy-induced mass flow rates and that characteristic hydraulic parameters from such CFD simulations (or physical experiments) are reasonably employed in corresponding constitutive correlations for developing simplified numerical models of comparable solution accuracy.

  13. Could astrocytes be the primary target of an offending agent causing the primary degenerative diseases of the human central nervous system? A hypothesis.

    PubMed

    Sica, Roberto E

    2015-05-01

    Most of the named primary degenerative diseases of the human central nervous system have been attributed to a direct, primary damage of some particular population of neurons. Within the spectrum of these illnesses there are disorders like amyotrophic lateral sclerosis, fronto-temporal dementia, Alzheimer's dementia, Parkinson's disease, Huntington's dementia and cerebellar ataxias affecting exclusively the human species. In the last years it has been shown that non-neural cells, mainly astrocytes, have a crucial role in the starting and development of these diseases. We suggest that the causative agent of these illnesses gets home first within the astrocytes, rather than the neurons, making them sick by modifying the structure of some proteins; from these cells the abnormal process would start a trip to other astrocytes having the same genetic, metabolic, structural and functional profiles that the originally affected astrocytes have, going through the gap junctions which connect that particular population devoted to a particular set of neurons. This appears to be a likely hypothesis because the astrocytes related to a defined population of neurons have their own, private properties and characteristics needed to support one particular set of neurons performing a defined function, making them a different and unique population, a fact which would limit the spreading of the disease to those astrocytes, sparing other astrocyte populations which do not share those characteristics. If this were the mechanism underlying these illnesses, the neurons, which their health depends on those astrocytes, would be deprived of their patronage and would start all the changes that characterizes a programmed cell death, and the clinical manifestations of a defined pathology would consequently appear.

  14. Innovative approaches to establish and characterize primary cultures: an ex vivo 3D system and the zebrafish model

    PubMed Central

    Liverani, Chiara; La Manna, Federico; Groenewoud, Arwin; Mercatali, Laura; Van Der Pluijm, Gabri; Pieri, Federica; Cavaliere, Davide; De Vita, Alessandro; Spadazzi, Chiara; Miserocchi, Giacomo; Bongiovanni, Alberto; Recine, Federica; Riva, Nada; Amadori, Dino; Tasciotti, Ennio; Snaar-Jagalska, Ewa

    2017-01-01

    ABSTRACT Patient-derived specimens are an invaluable resource to investigate tumor biology. However, in vivo studies on primary cultures are often limited by the small amount of material available, while conventional in vitro systems might alter the features and behavior that characterize cancer cells. We present our data obtained on primary dedifferentiated liposarcoma cells cultured in a 3D scaffold-based system and injected into a zebrafish model. Primary cells were characterized in vitro for their morphological features, sensitivity to drugs and biomarker expression, and in vivo for their engraftment and invasiveness abilities. The 3D culture showed a higher enrichment in cancer cells than the standard monolayer culture and a better preservation of liposarcoma-associated markers. We also successfully grafted primary cells into zebrafish, showing their local migratory and invasive abilities. Our work provides proof of concept of the ability of 3D cultures to maintain the original phenotype of ex vivo cells, and highlights the potential of the zebrafish model to provide a versatile in vivo system for studies with limited biological material. Such models could be used in translational research studies for biomolecular analyses, drug screenings and tumor aggressiveness assays. PMID:27895047

  15. Factors Associated With Adoption of the Electronic Health Record System Among Primary Care Physicians

    PubMed Central

    Cheung, Clement SK; Tong, Ellen LH; Cheung, Ngai Tseung; Chan, Wai Man; Wang, Harry HX; Kwan, Mandy WM; Fan, Carmen KM; Liu, Kirin QL

    2013-01-01

    Background A territory-wide Internet-based electronic patient record allows better patient care in different sectors. The engagement of private physicians is one of the major facilitators for implementation, but there is limited information about the current adoption level of electronic medical record (eMR) among private primary care physicians. Objective This survey measured the adoption level, enabling factors, and hindering factors of eMR, among private physicians in Hong Kong. It also evaluated the key functions and the popularity of electronic systems and vendors used by these private practitioners. Methods A central registry consisting of 4324 private practitioners was set up. Invitations for self-administered surveys and the completed questionnaires were sent and returned via fax, email, postal mail, and on-site clinic visits. Current users and non-users of eMR system were compared according to their demographic and practice characteristics. Student’s t tests and chi-square tests were used for continuous and categorical variables, respectively. Results A total of 524 completed surveys (response rate 524/4405 11.90%) were collected. The proportion of using eMR in private clinics was 79.6% (417/524). When compared with non-users, the eMR users were younger (users: 48.4 years SD 10.6 years vs non-users: 61.7 years SD 10.2 years, P<.001); more were female physicians (users: 80/417, 19.2% vs non-users: 14/107, 13.1%, P=.013); possessed less clinical experience (with more than20 years of practice: users: 261/417, 62.6% vs non-user: 93/107, 86.9%, P<.001); fewer worked under a Health Maintenance Organization (users: 347/417, 83.2% vs non-users: 97/107, 90.7%, P<.001) and more worked with practice partners (users: 126/417, 30.2% vs non-users: 4/107, 3.7%, P<.001). Efficiency (379/417, 90.9%) and reduction of medical errors (229/417, 54.9%) were the major enabling factors, while patient-unfriendliness (58/107, 54.2%) and limited consultation time (54/107, 50

  16. Reforming healthcare systems on a locally integrated basis: is there a potential for increasing collaborations in primary healthcare?

    PubMed Central

    2013-01-01

    . This is with the exception of private medical clinics, where collaborations decreased both outside and within LHNs. Conclusion Health system reforms aimed at creating geographically based networks influenced primary healthcare practices’ both among themselves (horizontal collaborations) and with hospitals (vertical collaborations). There is evidence of increased collaborations within defined geographic areas, particularly among new type of primary healthcare. PMID:23835105

  17. Research on the reflection coating at three wavelengths for primary reflector of the optical antenna in the laser communication systems

    NASA Astrophysics Data System (ADS)

    Liu, Huasong; Liu, Muxiao; Wang, Zhanshan; Ji, Yiqin; Lu, Jiangtao

    2011-02-01

    Primary reflector of the optical antenna is a key component in the space laser communication systems, and multi-wavelengths laser need to be worked in the common aperture. Reflection coating is designed for the primary reflector of a laser communication system, which can work at three wavelengths (633nm, 808nm, 1550nm), the designed target reflectance are R633nm>=50%, R808nm>=99% and R1550nm>=99% at angle of incidence from 0 to 20 deg. We selected Ta2O5 and SiO2 as the high refractive index and low refractive index coating materials, analyzed the impact on the reflection coating of the systemic errors and random errors, and determined the manufacture error of the coater system which can't greater than 1%. The Ion beam sputtering deposition technique was used to manufacture reflection coating for three-wavelengths and a LAMBDA900 spectrophotometer was used to analysis the reflectance at three wavelengths which achieved the design requirements. Finally we give the origin of manufacture error source for this high reflection coating. The reflection coating component was successfully used in the primary reflector of the optical antenna of the laser communication systems.

  18. Research on the reflection coating at three wavelengths for primary reflector of the optical antenna in the laser communication systems

    NASA Astrophysics Data System (ADS)

    Liu, Huasong; Liu, Muxiao; Wang, Zhanshan; Ji, Yiqin; Lu, Jiangtao

    2010-10-01

    Primary reflector of the optical antenna is a key component in the space laser communication systems, and multi-wavelengths laser need to be worked in the common aperture. Reflection coating is designed for the primary reflector of a laser communication system, which can work at three wavelengths (633nm, 808nm, 1550nm), the designed target reflectance are R633nm>=50%, R808nm>=99% and R1550nm>=99% at angle of incidence from 0 to 20 deg. We selected Ta2O5 and SiO2 as the high refractive index and low refractive index coating materials, analyzed the impact on the reflection coating of the systemic errors and random errors, and determined the manufacture error of the coater system which can't greater than 1%. The Ion beam sputtering deposition technique was used to manufacture reflection coating for three-wavelengths and a LAMBDA900 spectrophotometer was used to analysis the reflectance at three wavelengths which achieved the design requirements. Finally we give the origin of manufacture error source for this high reflection coating. The reflection coating component was successfully used in the primary reflector of the optical antenna of the laser communication systems.

  19. Increase in the systemic exposure of primary metabolites of Midazolam in rat arising from CYP inhibition or hepatic dysfunction.

    PubMed

    Hasegawa, Tsubasa; Nakanishi, Satomi; Minami, Keiko; Higashino, Haruki; Kataoka, Makoto; Shitara, Yoshihisa; Yamashita, Shinji

    2017-02-01

    The main purpose of this study is to demonstrate the possibility of increase in the systemic exposure of drug metabolites by CYP-inhibition or acute hepatitis. Midazolam (MDZ) was used as a model substrate of CYP3A and 1-aminobenzotriazole (ABT) was used as a CYP-inhibitor. After oral pretreatment with ABT, MDZ was intravenously injected to rats and the plasma profiles of MDZ and its primary metabolites, 1'-hydroxy MDZ and 4-hydroxy MDZ, were observed. In the ABT-pretreatment rats, plasma AUCs of both metabolites were much larger than those in control rats, demonstrating a higher systemic exposure of metabolites under CYP-inhibited condition. Furthermore, kinetic analysis revealed that the amount of both metabolites entered into the systemic circulation increased significantly (about 5-times). Increases in the systemic exposure of the primary metabolites of MDZ were also observed in the acute hepatitis rats induced by CCl4-pretreatment. As underlying mechanisms, it was speculated that ABT inhibited the subsequent metabolism of primary metabolites of MDZ in the hepatocytes and enhanced their release to the systemic circulation. In vitro study with rat liver microsomes supported this speculation. In conclusion, this study showed the complexity of PK profiles of drug metabolites, which might lead to new aspects on their safety issue.

  20. [Primary hyperoxaluria].

    PubMed

    Cochat, Pierre; Fargue, Sonia; Bacchetta, Justine; Bertholet-Thomas, Aurélia; Sabot, Jean-François; Harambat, Jérôme

    2011-07-01

    Primary hyperoxalurias are rare recessive inherited inborn errors of glyoxylate metabolism. They are responsible for progressive renal involvement, which further lead to systemic oxalate deposition, which can even occur in infants. Primary hyperoxaluria type 1 is the most common form in Europe and is due to alanine-glyoxylate aminostransferase deficiency, a hepatic peroxisomal pyridoxin-dependent enzyme. Therefore primary hyperoxaluria type 1 is responsible for hyperoxaluria leading to aggressive stone formation and nephrocalcinosis. As glomerular filtration rate decreases, systemic oxalate storage occurs throughout all the body, and mainly in the skeleton. The diagnosis is first based on urine oxalate measurement, then on genotyping, which may also allow prenatal diagnosis to be proposed. Conservative measures - including hydration, crystallization inhibitors and pyridoxine - are safe and may allow long lasting renal survival, provided it is given as soon as the diagnosis has been even suspected. No dialysis procedure can remove enough oxalate to compensate oxalate overproduction from the sick liver, therefore a combined liver and kidney transplantation should be planned before advanced renal disease has occurred, in order to limit/avoid systemic oxalate deposition. In the future, primary hyperoxaluria type 1 may benefit from hepatocyte transplantation, chaperone molecules, etc.

  1. Design and evaluation of a primary/secondary pumping system for a heat pump assisted solar thermal loop

    NASA Astrophysics Data System (ADS)

    Krockenberger, Kyle G.

    A heat pump assisted solar thermal system was designed, commissioned, tested and analyzed over a period of two years. The unique system uses solar energy whenever it is available, but switches to heat pump mode at night or whenever there is a lack of solar energy. The solar thermal energy is added by a variety of flat plat solar collectors and an evacuated tube heat pipe solar collector. The working medium in the entire system is a 50% mixture of propylene glycol and water for freeze protection. During the design and evaluation the primary / secondary pumping system was the focus of the evaluation. Testing within this research focused on the operation modes, pump stability, and system efficiency. It was found that the system was in full operation, the pumps were stable and that the efficiency factor of the system was 1.95.

  2. An Update of the Mayo Clinic Cohort of Patients With Adult Primary Central Nervous System Vasculitis

    PubMed Central

    Salvarani, Carlo; Brown, Robert D.; Christianson, Teresa; Miller, Dylan V.; Giannini, Caterina; Huston, John; Hunder, Gene G.

    2015-01-01

    Abstract Primary central nervous system vasculitis (PCNSV) is an uncommon condition in which lesions are limited to vessels of the brain and spinal cord. Because the clinical manifestations are not specific, the diagnosis is often difficult, and permanent disability and death are frequent outcomes. This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnetic resonance imaging (MRI), along with less mortality and disability at last follow-up. The patients diagnosed by angiograms more frequently had at presentation hemiparesis or a persistent neurologic deficit or stroke, more frequent infarcts on MRI and an increased mortality. These differences were mainly related to the different size of the vessels involved in the 2 groups. Although most patients responded to therapy with glucocorticoids alone or in conjunction with cyclophosphamide and tended to improve during the follow-up period, an overall increased mortality rate was observed. Relapses occurred in one-quarter of the patients and were less frequent in patients treated with prednisone and cyclophosphamide compared with those treated with prednisone alone. The mortality rate and degree of disability at last follow-up were greater in those with increasing age, cerebral infarctions on MRI, angiographic large vessel involvement, and diagnosis made by angiography alone, but were lower in those with gadolinium-enhanced lesions on MRI and in those with

  3. A baseline survey of the Primary Healthcare system in south eastern Nigeria.

    PubMed

    Chukwuani, Chinyere Mercellina; Olugboji, Akindeji; Akuto, Edward Erdorga; Odebunmi, Akim; Ezeilo, Ezenta; Ugbene, Emmanuel

    2006-07-01

    A baseline survey to audit the PHC operations and determine community perception and expectations of PHC service delivery was conducted in 72 communities in Enugu state, southeastern Nigeria. The study was intended to facilitate the development of intermediate performance indicators for monitoring the progress of an ongoing health sector reform and to gather baseline data for planning and policy formulation. The tools used for the operations audit assessed indicators for evaluating: (a) Stewardship, (b) Service Provision and (c) Administrative and financial management; while the community survey was assessed by, (a) utilization of health services, (b) perception of service delivery and (c) health care financing. One hundred and sixteen respondents from each of the facilities in the sample frame were interviewed using a structured self-assessment questionnaire and a qualitative assessment was undertaken in 53 of the facilities using an audit guide. Focus group discussions (FGD) were conducted with the policy makers and planners in each of the 17 LGAs in the state. A total of 832 respondents were interviewed in the communities (using a structured questionnaire) and 42 community FGDs were conducted. The results indicate a lack of operational efficiency in the majority of the facilities audited. It was also observed that majority of the facilities do not provide all services required of it, are poorly maintained, do not have enough skilled health workers and operate without a budget. There appears to be no formal financial management system in place and no policy on financial resource generation. The community survey identified two major problems; low utilization of PHCs and poor service provision. The key indicator identified by the community for evaluating performance of the PHCs remains "access to essential drugs". The major prospect was the willingness of an appreciable number of respondents to invest in health financing through insurance schemes and payment of

  4. The role of the Family Health Program in the organization of primary care in municipal health systems.

    PubMed

    Medina, Maria Guadalupe; Hartz, Zulmira Maria de Araújo

    2009-05-01

    The contribution of primary care to population health and health systems organization has been well documented, but some authors have highlighted that in Third World countries it has gained more ground in discourse than in facts and practices, with different possible configurations. The objectives of the current study were to evaluate and correlate organizational and local contextual characteristics to the degree of implementation of primary care in two municipalities (counties) in the State of Bahia State, Brazil, that had adopted the Family Health Program (FHP) as the system's central thrust. The research was based on two case studies with interwoven levels of analysis, using as the point of departure the underlying goal-image of primary care in the definition of criteria and standards for degree of implementation. The total scores for Municipalities A and B were 66 and 81, respectively (maximum total score = 100), while differences were observed between the urban and rural teams. The political and institutional contexts helped explain differences in the degree of implementation of primary care, but regardless of the municipal context, the study showed the emergence of organizational innovations closely related to the FHP.

  5. Review of accidental safety studies for the European HCPB test blanket system

    NASA Astrophysics Data System (ADS)

    Boccaccini, L. V.; Ciattaglia, S.; Meyder, R.; Jin, X.

    2007-07-01

    This paper presents a review of safety studies for accidental sequences in the European solid breeder test blanket module (TBM) system. These studies are the starting point for the Preliminary Safety Analysis Report of ITER, under preparation to get the construction permit first and then later the operation licence. In general the reduced inventory of activation products and tritium associated with the TBM system makes the impact of this test system almost negligible on the overall safety risk of ITER. Nevertheless, the possibility of jeopardizing the ITER safety concept has been analysed in connection to the consequences of specific accident sequences, e.g. the pressurization of the vacuum vessel due to the He coolant blow-down, the hydrogen production from the Be-steam reaction, the possible interconnection between the port cell and the vacuum vessel causing air ingress and the necessity to assure heat removal in the short and long periods. In the frame of this assessment, three LOCA sequences have been selected as representative of accidents judged to cover all scenarios envisaged in Cat II to IV events involving the TBM, namely, in-vessel LOCA, ex-vessel LOCA and in-box LOCA.

  6. The primary cilia, a 'Rab-id' transit system for hedgehog signaling.

    PubMed

    Oro, Anthony E

    2007-12-01

    Intense focus has been centered around how the primary cilia transduces the hedgehog (Hh) signal from smoothened (Smo) to the Gli transcription factors. New data indicate that ligand and signaling lipids help regulate small GTPase-dependent accumulation and activity of signaling components.

  7. Structures and Systems and Bodies and Things: Historical Research on Primary Schooling and Its Professional Relevance

    ERIC Educational Resources Information Center

    Cunningham, Peter

    2012-01-01

    Recalling its origins as a research journal addressing educationists this article seeks to understand historical research published in "History of Education" as aimed at a professional audience. Primary schooling provides a significant focus as the study of education history was fostered especially in the training of elementary…

  8. State Liability for Abuse in Primary Schools: Systemic Failure and "O'Keeffe" v. "Hickey"

    ERIC Educational Resources Information Center

    O'Mahony, Conor

    2009-01-01

    Due to the historical arrangement between Church and State, the Irish State has always discharged its duty to provide for free primary education exclusively through the provision of funding to privately owned and managed schools. Consequently, in "O'Keeffe" v. "Hickey," where a woman sued the State in respect of sex abuse she…

  9. Uneven Distribution of Novice Teachers in the Chilean Primary School System

    ERIC Educational Resources Information Center

    Meckes, Lorena; Bascope, Martin

    2012-01-01

    This study examines the allocation of novice primary teachers in Chilean schools, looking at their characteristics and at the attributes of the schools at which they are hired after having completed their initial teacher training. The study reveals that in Chile, more qualified novice teachers are more prone to get jobs in socio-economically…

  10. Student Transition from Primary to Lower Secondary School in Cambodia: Narrative Insights into Complex Systems

    ERIC Educational Resources Information Center

    Edwards, D. Brent, Jr.; Zimmermann, Thomas; Sitha, Chhinh; Williams, James H.; Kitamura, Yuto

    2014-01-01

    This article has three purposes. First, it presents findings from a study of student retention and dropout in Cambodia, as pupils transition from primary to lower secondary school. Second, it aims to understand from an in-depth, emic perspective the dynamics of this process and the challenges that individual families and their students face around…

  11. Final report spent nuclear fuel retrieval system primary cleaning development testing

    SciTech Connect

    Ketner, G.L.; Meeuwsen, P.V.

    1997-09-01

    Developmental testing of the primary cleaning station for spent nuclear fuel (SNF) and canisters is reported. A primary clean machine will be used to remove the gross sludge from canisters and fuel while maintaining water quality in the downstream process area. To facilitate SNF separation from canisters and minimize the impact to water quality, all canisters will be subjected to mechanical agitation and flushing with the Primary Clean Station. The Primary Clean Station consists of an outer containment box with an internally mounted, perforated wash basket. A single canister containing up to 14 fuel assemblies will be loaded into the wash basket, the confinement box lid closed, and the wash basket rotated for a fixed cycle time. During this cycle, basin water will be flushed through the wash basket and containment box to remove and entrain the sludge and carry it out of the box. Primary cleaning tests were performed to provide information concerning the removal of sludge from the fuel assemblies while in the basin canisters. The testing was also used to determine if additional fuel cleaning is required outside of the fuel canisters. Hydraulic performance and water demand requirements of the cleaning station were also evaluated. Thirty tests are reported in this document. Tests demonstrated that sludge can be dislodged and suspended sufficiently to remove it from the canister. Examination of fuel elements after cleaning suggested that more than 95% of the exposed fuel surfaces were cleaned so that no visual evidence of remained. As a result of testing, recommendations are made for the cleaning cycle. 3 refs., 16 figs., 4 tabs.

  12. Linking Primary Care Information Systems and Public Health Vertical Programs in the Philippines: An Open-source Experience

    PubMed Central

    Tolentino, Herman; Marcelo, Alvin; Marcelo, Portia; Maramba, Inocencio

    2005-01-01

    Community-based primary care information systems are one of the building blocks for national health information systems. In the Philippines, after the devolution of health care to local governments, we observed “health information system islands” connected to national vertical programs being implemented in devolved health units. These structures lead to a huge amount of “information work” in the transformation of health information at the community level. This paper describes work done to develop and implement the open-source Community Based Health Information Tracking System (CHITS) Project, which was implemented to address this information management problem and its outcomes. Several lessons learned from the field as well as software development strategies are highlighted in building community level information systems that link to national level health information systems. PMID:16779052

  13. [Traditional and Complementary Medicine in Brazil: inclusion in the Brazilian Unified National Health System and integration with primary care].

    PubMed

    Sousa, Islandia Maria Carvalho de; Tesser, Charles Dalcanale

    2017-01-23

    This study aimed to analyze the inclusion of Traditional and Complementary Medicine in Brazilian Unified National Health System (SUS) and its integration with primary healthcare (PHC). A qualitative study drew on institutional data, indexed articles, and case studies in selected Brazilian cities: Campinas (São Paulo State), Florianópolis (Santa Catarina State), Recife (Pernambuco State), Rio de Janeiro, and São Paulo. The analysis adopted the perspective of inclusion of Traditional and Complementary Medicine in the healthcare network and its integration with primary healthcare, based on the following dimensions: presence of Traditional and Complementary Medicine on the municipal agenda; position in the services; mode of access to Traditional and Complementary Medicine; Traditional and Complementary Medicine practitioners; types of practices; demand profile; and potential for expansion in the SUS. The authors identified and characterized four types of inclusion and integration of Traditional and Complementary Medicine, whether in association or not: Type 1 - in primary healthcare via professionals from the family health teams - Integrated; Type 2 - in primary healthcare via professionals with full-time employment - Juxtaposed; Type 3 - in primary healthcare via matrix-organized teams - Matrix Organization; Type 4 - in specialized services - Without Integration. The combination of types 1 and 3 was considered a potential guideline for the expansion of Traditional and Complementary Medicine in the SUS and can orient the growth and integration of Traditional and Complementary Medicine with primary healthcare. The growing presence of Traditional and Complementary Medicine in the SUS requires conceiving its strategic expansion, while existing experiences should not be wasted.

  14. Development of a Mobile System Decision-support for Medical Diagnosis of Asthma in Primary Healthcare--InteliMED.

    PubMed

    Menezes, Júlio; Gusmão, Cristine

    2015-01-01

    The structure of public and primary healthcare in Brazil is organized in a way to provide decentralized services. In theory, this scenario could enable the usage of mobile devices integrated with information systems of several purposes. In addition, there is a need of decision-support tools that are based on collected evidences, once the professional of primary healthcare, which essentially has general knowledge (non-specialist). Therefore there is a need of information that support the decision-making process on more specific contexts. This paper presents the proposal, experience of development and application of the InteliMED, a decision-support system to asthma diagnosis of children and adolescents through decision-trees and mobile devices (smartphones and tablets).

  15. ESHAP chemotherapy is efficient in refractory/relapsed primary central nervous system lymphoma: report of four cases

    PubMed Central

    Ungur, Rodica; Tempescul, Adrian; Berthou, Christian; Bagacean, Cristina; Radeanu, Doinel; Muresan, Adriana; Zdrenghea, Mihnea

    2015-01-01

    Primary central nervous system non-Hodgkin’s lymphoma is a rare presentation, almost always of diffuse large B-cell type. Although there is no consensus regarding therapy for this condition, induction regimens are based on high-dose methotrexate and consolidation whole-brain radiotherapy, or, more preferred recently, blood–brain barrier penetrating drugs such as etoposide, cytarabine, and alkylating agents like temozolomide, ifosfamide, and lomustine. We present here four cases of relapsed/refractory primary central nervous system lymphoma treated with ESHAP (etoposide, solumedrol, high-dose cytarabine, and platinum) chemotherapy to complete remission, with the eligible patients proceeding to autologous transplantation. We want to draw attention to this interesting, relatively well tolerated, underused therapeutic option, in a setting where treatment options are scarce and evidence-based recommendations are lacking. PMID:26491351

  16. Primary lymphoma of the brain

    MedlinePlus

    Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain ... The cause of primary brain lymphoma is not known. People with a weakened immune system are at high risk for primary lymphoma of the brain. ...

  17. Development of primary central nervous system lymphoma in a systemic lupus erythematosus patient after treatment with mycophenolate mofetil and review of the literature.

    PubMed

    Balci, M A; Pamuk, G E; Unlu, E; Usta, U; Pamuk, O N

    2017-01-01

    Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin lymphoma and four cases of PCNSL have previously been described in association with mycophenolate mofetil. We report the fifth case of PCNSL in a patient with lupus nephropathy while on mycophenolate mofetil treatment.

  18. Gene Mutation Profiles in Primary Diffuse Large B Cell Lymphoma of Central Nervous System: Next Generation Sequencing Analyses.

    PubMed

    Todorovic Balint, Milena; Jelicic, Jelena; Mihaljevic, Biljana; Kostic, Jelena; Stanic, Bojana; Balint, Bela; Pejanovic, Nadja; Lucic, Bojana; Tosic, Natasa; Marjanovic, Irena; Stojiljkovic, Maja; Karan-Djurasevic, Teodora; Perisic, Ognjen; Rakocevic, Goran; Popovic, Milos; Raicevic, Sava; Bila, Jelena; Antic, Darko; Andjelic, Bosko; Pavlovic, Sonja

    2016-05-06

    The existence of a potential primary central nervous system lymphoma-specific genomic signature that differs from the systemic form of diffuse large B cell lymphoma (DLBCL) has been suggested, but is still controversial. We investigated 19 patients with primary DLBCL of central nervous system (DLBCL CNS) using the TruSeq Amplicon Cancer Panel (TSACP) for 48 cancer-related genes. Next generation sequencing (NGS) analyses have revealed that over 80% of potentially protein-changing mutations were located in eight genes (CTNNB1, PIK3CA, PTEN, ATM, KRAS, PTPN11, TP53 and JAK3), pointing to the potential role of these genes in lymphomagenesis. TP53 was the only gene harboring mutations in all 19 patients. In addition, the presence of mutated TP53 and ATM genes correlated with a higher total number of mutations in other analyzed genes. Furthermore, the presence of mutated ATM correlated with poorer event-free survival (EFS) (p = 0.036). The presence of the mutated SMO gene correlated with earlier disease relapse (p = 0.023), inferior event-free survival (p = 0.011) and overall survival (OS) (p = 0.017), while mutations in the PTEN gene were associated with inferior OS (p = 0.048). Our findings suggest that the TP53 and ATM genes could be involved in the molecular pathophysiology of primary DLBCL CNS, whereas mutations in the PTEN and SMO genes could affect survival regardless of the initial treatment approach.

  19. Gene Mutation Profiles in Primary Diffuse Large B Cell Lymphoma of Central Nervous System: Next Generation Sequencing Analyses

    PubMed Central

    Todorovic Balint, Milena; Jelicic, Jelena; Mihaljevic, Biljana; Kostic, Jelena; Stanic, Bojana; Balint, Bela; Pejanovic, Nadja; Lucic, Bojana; Tosic, Natasa; Marjanovic, Irena; Stojiljkovic, Maja; Karan-Djurasevic, Teodora; Perisic, Ognjen; Rakocevic, Goran; Popovic, Milos; Raicevic, Sava; Bila, Jelena; Antic, Darko; Andjelic, Bosko; Pavlovic, Sonja

    2016-01-01

    The existence of a potential primary central nervous system lymphoma-specific genomic signature that differs from the systemic form of diffuse large B cell lymphoma (DLBCL) has been suggested, but is still controversial. We investigated 19 patients with primary DLBCL of central nervous system (DLBCL CNS) using the TruSeq Amplicon Cancer Panel (TSACP) for 48 cancer-related genes. Next generation sequencing (NGS) analyses have revealed that over 80% of potentially protein-changing mutations were located in eight genes (CTNNB1, PIK3CA, PTEN, ATM, KRAS, PTPN11, TP53 and JAK3), pointing to the potential role of these genes in lymphomagenesis. TP53 was the only gene harboring mutations in all 19 patients. In addition, the presence of mutated TP53 and ATM genes correlated with a higher total number of mutations in other analyzed genes. Furthermore, the presence of mutated ATM correlated with poorer event-free survival (EFS) (p = 0.036). The presence of the mutated SMO gene correlated with earlier disease relapse (p = 0.023), inferior event-free survival (p = 0.011) and overall survival (OS) (p = 0.017), while mutations in the PTEN gene were associated with inferior OS (p = 0.048). Our findings suggest that the TP53 and ATM genes could be involved in the molecular pathophysiology of primary DLBCL CNS, whereas mutations in the PTEN and SMO genes could affect survival regardless of the initial treatment approach. PMID:27164089

  20. A station blackout simulation for the Advanced Neutron Source Reactor using the integrated primary and secondary system model

    SciTech Connect

    Schneider, E.A.

    1994-06-01

    The Advanced Neutron Source Reactor (ANSR) is a research reactor to be built at Oak Ridge National Laboratory. This paper deals with thermal-hydraulic analysis of ANSR`s cooling systems during nominal and transient conditions, with the major effort focusing upon the construction and testing of computer models of the reactor`s primary, secondary and reflector vessel cooling systems. The code RELAP5 was used to simulate transients, such as loss of coolant accidents and loss of off-site power, as well as to model the behavior of the reactor in steady state. Three stages are involved in constructing and using a RELAP5 model: (1) construction and encoding of the desired model, (2) testing and adjustment of the model until a satisfactory steady state is achieved, and (3) running actual transients using the steady-state results obtained earlier as initial conditions. By use of the ANSR design specifications, a model of the reactor`s primary and secondary cooling systems has been constructed to run a transient simulating a loss of off-site power. This incident assumes a pump coastdown in both the primary and secondary loops. The results determine whether the reactor can survive the transition from forced convection to natural circulation.

  1. Do the origins of primary teeth affect the bond strength of a self-etching adhesive system to dentin?

    PubMed

    Bengtson, Camilla Regina Galvão; Bengtson, Antonio Lucindo; Bengtson, Nadya Galvão; Turbino, Miriam Lacalle

    2010-01-01

    The aim of this in vitro study was to evaluate the tensile bond strength of a self-etching adhesive system to three different dentinal substrates. Primary molar teeth that had been recently exfoliated (RE), with unknown time of exfoliation (UT), and extracted due to prolonged retention (PR) were used for this investigation. Ten primary molar teeth of each group were cut in the middle following the mesio-distal direction, creating a total of twenty specimens per group. The specimens were included in acrylic resin and had a flat dentin surface exposed. The self-etching adhesive system was applied to this surface and a 3-millimeter high cone with diameter of 2 mm in the adhesion area was constructed using composite resin. The specimens were stored in distilled water at 37ºC for 24 hours. Fifteen specimens of each substrate were used for the tensile bond test (n = 15) and 5 had the interface analyzed by scanning electron microscopy (SEM). The data was examined by one-way ANOVA and presented no significant differences between groups (p = 0.5787). The mean values obtained for RE, UT and PR were 18.39 ± 9.70, 19.41 ± 7.80, and 23.30 ± 9.37 MPa, respectively. Any dentinal substrates of primary teeth studied are safe for tensile bond strength tests with adhesive systems.

  2. Design and Stability of Load-Side Primary Frequency Control in Power Systems

    SciTech Connect

    Zhao, CH; Topcu, U; Li, N; Low, S

    2014-05-01

    We present a systematic method to design ubiquitous continuous fast-acting distributed load control for primary frequency regulation in power networks, by formulating an optimal load control (OLC) problem where the objective is to minimize the aggregate cost of tracking an operating point subject to power balance over the network. We prove that the swing dynamics and the branch power flows, coupled with frequency-based load control, serve as a distributed primal-dual algorithm to solve OLC. We establish the global asymptotic stability of a multimachine network under such type of load-side primary frequency control. These results imply that the local frequency deviations on each bus convey exactly the right information about the global power imbalance for the loads to make individual decisions that turn out to be globally optimal. Simulations confirm that the proposed algorithm can rebalance power and resynchronize bus frequencies after a disturbance with significantly improved transient performance.

  3. Common Infections in Patients Prescribed Systemic Glucocorticoids in Primary Care: A Population-Based Cohort Study

    PubMed Central

    Fardet, Laurence; Petersen, Irene; Nazareth, Irwin

    2016-01-01

    Background Little is known about the relative risk of common bacterial, viral, fungal, and parasitic infections in the general population of individuals exposed to systemic glucocorticoids, or about the impact of glucocorticoid exposure duration and predisposing factors on this risk. Methods and Findings The hazard ratios of various common infections were assessed in 275,072 adults prescribed glucocorticoids orally for ≥15 d (women: 57.8%, median age: 63 [interquartile range 48–73] y) in comparison to those not prescribed glucocorticoids. For each infection, incidence rate ratios were calculated for five durations of exposure (ranging from 15–30 d to >12 mo), and risk factors were assessed. Data were extracted from The Health Improvement Network (THIN) primary care database. When compared to those with the same underlying disease but not exposed to glucocorticoids, the adjusted hazard ratios for infections with significantly higher risk in the glucocorticoid-exposed population ranged from 2.01 (95% CI 1.83–2.19; p < 0.001) for cutaneous cellulitis to 5.84 (95% CI 5.61–6.08; p < 0.001) for lower respiratory tract infection (LRTI). There was no difference in the risk of scabies, dermatophytosis and varicella. The relative increase in risk was stable over the durations of exposure, except for LRTI and local candidiasis, for which it was much higher during the first weeks of exposure. The risks of infection increased with age and were higher in those with diabetes, in those prescribed higher glucocorticoid doses, and in those with lower plasma albumin level. Most associations were also dependent on the underlying disease. A sensitivity analysis conducted on all individuals except those with asthma or chronic obstructive pulmonary disease produced similar results. Another sensitivity analysis assessing the impact of potential unmeasured confounders such as disease severity or concomitant prescription of chemotherapy suggested that it was unlikely that

  4. Standardisation of positron-emitters in gas with the NPL primary gas counting system.

    PubMed

    Marouli, M; Dean, J C J; Sephton, J P; Spyrou, N M

    2010-01-01

    A primary standard for positron-emitters in gas has been developed. The method involves internal gas proportional counting and the use of the PENELOPE Monte Carlo code to determine corrections for counting losses. The development work was carried out using (11)C, although the method can be applied to other positron emitters. The results were compared with measurements of (11)C (in solution) carried out using a secondary standard re-entrant ionisation chamber previously calibrated with reference to absolute counting techniques.

  5. [Interdisciplinary neuro-oncology: part 2: systemic therapy of primary brain tumors].

    PubMed

    Tabatabai, G; Hattingen, E; Schlegel, J; Stummer, W; Schlegel, U

    2014-08-01

    By combining the expertise of clinical neuroscience, the aim of neuro-oncology is to optimize diagnostic planning and therapy of primary brain tumors in an interdisciplinary setting together with radio-oncology and medical oncology. High-end imaging frequently allows brain tumors to be diagnosed preoperatively with respect to tumor entity and even tumor malignancy grade. Moreover, neuroimaging is indispensable for guidance of biopsy resection and monitoring of therapy. Surgical resection of intracranial lesions with preservation of neurological function has become dramatically more extensive. Tools to achieve this goal are, for example neuronavigation, functional magnetic resonance imaging (fMRI), tractography, intraoperative cortical stimulation and precise intraoperative definition of tumor margins by virtue of various techniques. In addition to classical histopathological diagnosis and tumor classification, modern neuropathology is supplemented by molecular characterization of brain tumors in order to provide clinicians with prognostic and predictive (of therapy) markers, such as codeletion of chromosomes 1p and 19q in anaplastic gliomas and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation in glioblastomas. Although this is not yet individualized tumor therapy, the increasingly more detailed analysis of the molecular pathogenesis of an individual glioma will eventually lead to specific pharmacological blockade of disturbed intracellular pathways in individual patients. This article gives an overview of the state of the art of interdisciplinary neuro-oncology whereby part 1 deals with the diagnostics and surgical therapy of primary brain tumors and part 2 describes the medical therapy of primary brain tumors.

  6. [Clinical perspectives of the study of RANK/RANKL/OPG system components in primary and metastatic bone tumor].

    PubMed

    Kushlinskiĭ, N E; Timofeev, Iu S; Gershteĭn, E S; Solov'ev, Iu N

    2014-01-01

    Disbalance of bone homeostasis, associated with malfunctioning of RANK/RANKL/OPG system underlies the oncological processes such as the destruction of bone, metastasis development, tumor progression. Pathological activity of system was described in such conditions, as breast cancer, prostate cancer, multiple myeloma, squamous cell carcinoma, Hodgkin's disease, and also metastasis in bones from lung cancer and other malignant diseases. In the literature, there is evidence of involvement of RANK/RANKL/OPG system in the pathogenesis of bone tumors (osteosarcoma, giant cell tumor of bone, chondroblastoma). Experimental data show that RANKL inhibitors can play a role in reducing tumor-induced lesions of bone in multiple myeloma, breast cancer, prostate cancer and lung cancer. Also this review presents data from clinical studies of the drug efficacy targeted on RANK/RANKL/OPG system and results of authors' study of the levels of this system's components and proinflammatory cytokines in blood serum of primary bone sarcoma patients.

  7. Using Principles of Complex Adaptive Systems to Implement Secondary Prevention of Coronary Heart Disease in Primary Care

    PubMed Central

    Kottke, Thomas E; Huebsch, Jacquelyn A; McGinnis, Paul; Nichols, Jolleen M; Parker, Emily D; Tillema, Juliana O; Maciosek, Michael V

    2016-01-01

    Context: Primary care practice. Objective: To test whether the principles of complex adaptive systems are applicable to implementation of team-based primary care. Design: We used complex adaptive system principles to implement team-based care in a private, five-clinic primary care practice. We compared randomly selected samples of patients with coronary heart disease (CHD) and diabetes before system implementation (March 1, 2009, to February 28, 2010) and after system implementation (December 1, 2011, to March 31, 2013). Main Outcome Measures: Rates of patients meeting the composite goals for CHD (blood pressure < 140/90 mmHg, low-density lipoprotein cholesterol level < 100 mg/dL, tobacco-free, and using aspirin unless contraindicated) and diabetes (CHD goal plus hemoglobin A1c concentration < 8%) before and after the intervention. We also measured provider and patient satisfaction with preventive services. Results: The proportion of patients with CHD who met the composite goal increased from 40.3% to 59.9% (p < 0.0001) because documented aspirin use increased (65.2%–97.5%, p < 0.0001) and attainment of the cholesterol goal increased (77.0%–83.9%, p = 0.0041). The proportion of diabetic patients meeting the composite goal rose from 24.5% to 45.4% (p < 0.0001) because aspirin use increased (58.6%–97.6%, p < 0.0001). Increased percentages of patients meeting the CHD and diabetes composite goals were not significantly different (p = 0.2319). Provider satisfaction with preventive services delivery increased significantly (p = 0.0017). Patient satisfaction improved but not significantly. Conclusion: Principles of complex adaptive systems can be used to implement team-based care systems for patients with CHD and possibly diabetic patients. PMID:26784851

  8. Performance of the Primary Mirror Center-of-Curvature Optical Metrology System during Cryogenic Testing of the JWST Pathfinder Telescope

    NASA Technical Reports Server (NTRS)

    Hadaway, James B.; Wells, Conrad; Olczak, Gene; Waldman, Mark; Whitman, Tony; Cosentino, Joseph; Connolly, Mark; Chaney, David; Telfer, Randal

    2016-01-01

    The JWST primary mirror consists of 18 1.5 m hexagonal segments, each with 6-DoF and RoC adjustment. The telescope will be tested at its cryogenic operating temperature at Johnson Space Center. The testing will include center-of-curvature measurements of the PM, using the Center-of-Curvature Optical Assembly (COCOA) and the Absolute Distance Meter Assembly (ADMA). The performance of these metrology systems, including hardware, software, procedures, was assessed during two cryogenic tests at JSC, using the JWST Pathfinder telescope. This paper describes the test setup, the testing performed, and the resulting metrology system performance.

  9. Space Shuttle Program Primary Avionics Software System (PASS) Success Legacy - Major Accomplishments and Lessons Learned Detail Historical Timeline Analysis

    NASA Technical Reports Server (NTRS)

    Orr, James K.

    2010-01-01

    This presentation focuses on the Space Shuttle Primary Avionics Software System (PASS) and the people who developed and maintained this system. One theme is to provide quantitative data on software quality and reliability over a 30 year period. Consistent data relates to code break discrepancies. Requirements were supplied from external sources. Requirement inspections and measurements not implemented until later, beginning in 1985. Second theme is to focus on the people and organization of PASS. Many individuals have supported the PASS project over the entire period while transitioning from company to company and contract to contract. Major events and transitions have impacted morale (both positively and negatively) across the life of the project.

  10. Primary central nervous system B cell lymphoma with features intermediate between diffuse large B cell lymphoma and Burkitt lymphoma

    PubMed Central

    Jiang, Liuyan; Li, Zhimin; Finn, Laura E; Personnet, David A; Edenfield, Brandy; Foran, James M; Jaeckle, Kurt A; Reimer, Ronald; Menke, David M; Ketterling, Rhett P; Tun, Han W

    2012-01-01

    B cell lymphoma with features intermediate between diffuse large B cell lymphoma and Burkitt lymphoma (DLBCL/BL) is a new lymphoma entity which is recognized in the current World Health Organization (WHO) classification (2008). We report a case of a primary central nervous system lymphoma (PCNSL) with findings consistent with DLBCL/BL. It is characterized by a very aggressive clinical course, and a widespread multifocal involvement of the CNS. Our case shows that a DLBCL/BL can manifest in the CNS alone without any systemic involvement. PMID:22295149

  11. Development of Participative Management System in Learning Environment Management for Small Sized Primary Schools

    ERIC Educational Resources Information Center

    Hernthaisong, Prasertsak; Sirisuthi, Chaiyuth; Wisetrinthong, Kanjana

    2017-01-01

    The research aimed to: 1) study the factors of a participative management system in learning environment management, 2) study the current situation, desirable outcomes, and further needs for developing a participative management system in learning management, 3) develop a working participative management system, and 4) assess the system's…

  12. The design of an active support control system for a thin 1.2m primary mirror

    NASA Astrophysics Data System (ADS)

    Liu, Rong; Li, Xiaojin; Liu, Haitao; Wang, Hongqiao

    2014-09-01

    Active support system is a low-frequency wavefront error correction system, which is often used to correct the mirror deformation resulting from gravity, temperature, wind load, manufacture, installation and other factors. In addition, the active support technology can improve the efficiency of grinding and polishing by adjusting the surface shape in the process of manufacturing large mirrors. This article describes the design of an active support control system for a thin 1.2m primary mirror. The support system consists of 37 axial pneumatic actuators. And in order to change the shape of thin primary mirror we need to precisely control the 37 pneumatic actuators. These 37 pneumatic actuators are divided into six regions. Each region is designed with a control circuit board to realize force closed-loop control for the pneumatic actuators, and all control panels are connected to the PC by CAN bus. The control panels have to support: receive commands from the host PC; control the actuators; periodically return result of control. The whole control system is composed by hardware and control algorithm and communication program.

  13. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27648258

  14. The Effect of Cinnamon on Menstrual Bleeding and Systemic Symptoms With Primary Dysmenorrhea

    PubMed Central

    Jaafarpour, Molouk; Hatefi, Masoud; Najafi, Fatemeh; Khajavikhan, Javaher; Khani, Ali

    2015-01-01

    Background: Primary dysmenorrhea with interferes in daily activities can have adverse effects on quality of life of women. Objectives: Regarding the use of herbal medicine, the aim of this study was to assess the effect of cinnamon on primary dysmenorrhea in a sample of Iranian female college students from Ilam University of Medical Sciences (west of Iran) during 2013-2014. Patients and Methods: In a randomized double-blind trial, 76 female student received placebo (n = 38, capsules containing starch, three times a day (TDS)) or cinnamon (n = 38, capsules containing 420 mg cinnamon, TDS) in 24 hours. Visual analogue scale (VAS) was used to determine the severity of pain and nausea. Vomiting and menstrual bleeding were assessed by counting the number of saturated pads. The parameters were recorded in the group during the first 72 hours of the cycle. Results: The mean amount of menstrual bleeding in the cinnamon group was significantly lower than the placebo group (P < 0.05 and P < 0.001, respectively). The mean pain severity score in the cinnamon group was less than the placebo group at various intervals (4.1 ± 0.5 vs. 6.1 ± 0.4 at 24 hours, 3.2 ± 0.6 vs. 6.1 ± 0.4 at 48 hours, and 1.8 ± 0.4 vs. 4.0 ± 0.3 at 72 hours, respectively) (P < 0.001). The mean severity of nausea and the frequencies of vomiting significantly decreased in the cinnamon group compared with the placebo group at various intervals (P < 0.001, P < 0.05). Conclusions: Regarding the significant effect of cinnamon on reduction of pain, menstrual bleeding, nausea and vomiting with primary dysmenorrhea without side effects, it can be regarded as a safe and effective treatment for dysmenorrhea in young women. PMID:26023350

  15. Development of a Primary Standard for Calibration of [18F]FDG Activity Measurement Systems

    NASA Astrophysics Data System (ADS)

    Capogni, M.; DeFelice, P.; Fazio, A.; Simonelli, F.; D'Ursi, V.; Pecorale, A.; Giliberti, C.; Abbas, K.

    2006-05-01

    The 18F national primary standard was developed by the INMRI-ENEA using the 4πβ Liquid Scintillation Spectrometry Method with 3H-Standard Efficiency Tracing. Measurements were performed at JRCIspra under a scientific collaboration between the Institute for Health and Consumer Production, the Amersham Health and the National Institute for Occupational Safety and Prevention (ISPESL). The goal of the work was to calibrate, with minimum uncertainty, the INMRI-ENEA transfer standard portable well-type ionisation chamber as well as other JRC-Ispra and Amersham Health reference Ionising Chambers used for FDG activity measurement.

  16. Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria

    PubMed Central

    Garg, Lalit; Eze, Godson

    2016-01-01

    Background Nigeria contributes only 2% to the world’s population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. Objective The purpose of this study was to document costs associated with a mobile technology–supported, community-based health insurance scheme. Methods This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. Results All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (P<.001). This indicates that average out-of-pocket cost of services at private health care facilities is significantly

  17. EULAR Sjogren's syndrome disease activity index: development of a consensus systemic disease activity index for primary Sjogren's syndrome

    PubMed Central

    Seror, Raphaèle; Ravaud, Philippe; Bowman, Simon; Baron, Gabriel; Tzioufas, Athanasios; Theander, Elke; Gottenberg, Jacques-Eric; Bootsma, Hendrika; Mariette, Xavier; Vitali, Claudio

    2010-01-01

    Objective To develop a disease activity index for patients with primary Sjögren’s syndrome (SS): the European League Against Rheumatism (EULAR) Sjögren’s Syndrome Disease Activity Index (ESSDAI). Methods Thirty-nine SS experts participated in an international collaboration, promoted by EULAR, to develop the ESSDAI. Experts identified 12 organ-specific “domains” contributing to disease activity. For each domain, features of disease activity were classified in 3 or 4 levels according to their severity. Data abstracted from 96 patients with systemic complications of primary SS were used to generate 702 realistic vignettes for which all possible systemic complications were represented. Using the 0–10 physician global assessment (PhGA) scale, each expert scored the disease activity of 5 patient profiles and 20 realistic vignettes. Multiple regression modelling, with PhGA used as the dependent variable, was used to estimate the weight of each domain. Results All 12 domains were significantly associated with disease activity in the multivariate model, domain weights ranged from 1 to 6. The ESSDAI scores varied from 2 to 47 and were significantly correlated with PhGA for both real patient profiles and realistic vignettes (r=0.61 and r=0.58, respectively, p<0.0001). Compared to 57 (59.4%) of the real patient profiles, 468 (66.7%) of the realistic vignettes were considered likely or very likely to be true. Conclusion The ESSDAI is a clinical index designed to measure disease activity in patients with primary SS. Once validated, such a standardized evaluation of primary SS should facilitate clinical research and should be helpful as an outcome measure in clinical trials. PMID:19561361

  18. Carcinoma of the extrahepatic biliary system--results of primary and adjuvant radiotherapy

    SciTech Connect

    Fields, J.N.; Emami, B.

    1987-03-01

    From 1975-1983, 20 patients with primary carcinomas of the gallbladder (GB) or extrahepatic bile ducts (EHBD) were irradiated with curative intent at the Washington University Medical Center and affiliated hospitals. Of the 17 patients with EHBD cancer, one received adjuvant irradiation after gross resection with positive microscopic margins. All others received primary irradiation for unresectable tumors, or for gross residual tumor after incomplete resection. The 8 patients receiving Ir192 implant in addition to external radiation showed improved survival compared to the 9 receiving external only: median 15 months (range 1.5-34 + months) versus 7 months (range 2.5-21 months). Failures were predominantly local-regional, with only one patient showing metastatic spread without known local-regional tumor. Adjuvant radiation therapy was given after cholecystectomy to 3 patients with GB cancers showing tumor extension beyond the serosa or to regional lymphatics. Of these, two survived at 22+ and 27+ months; the third died of local recurrence at 5 1/2 months. Although numbers are small, these results appear to support the use of adjuvant radiotherapy in patients with microscopic residual GB cancer. Aggressive local and regional radiotherapy can add to the quality and length of survival in both patient groups, that is, those with resectable lesions with high likelihood of microscopic residual, and also those with unresectable or gross residual disease after surgery.

  19. Carcinoma of the extrahepatic biliary system--results of primary and adjuvant radiotherapy.

    PubMed

    Fields, J N; Emami, B

    1987-03-01

    From 1975-1983, 20 patients with primary carcinomas of the gallbladder (GB) or extrahepatic bile ducts (EHBD) were irradiated with curative intent at the Washington University Medical Center and affiliated hospitals. Of the 17 patients with EHBD cancer, one received adjuvant irradiation after gross resection with positive microscopic margins. All others received primary irradiation for unresectable tumors, or for gross residual tumor after incomplete resection. The 8 patients receiving Ir192 implant in addition to external radiation showed improved (p = 0.06) survival compared to the 9 receiving external only: median 15 months (range 1.5-34 + months) versus 7 months (range 2.5-21 months). Failures were predominantly local-regional, with only one patient showing metastatic spread without known local-regional tumor. Adjuvant radiation therapy was given after cholecystectomy to 3 patients with GB cancers showing tumor extension beyond the serosa or to regional lymphatics. Of these, two survived at 22+ and 27+ months; the third died of local recurrence at 5 1/2 months. Although numbers are small, these results appear to support the use of adjuvant radiotherapy in patients with microscopic residual GB cancer. Aggressive local and regional radiotherapy can add to the quality and length of survival in both patient groups, that is, those with resectable lesions with high likelihood of microscopic residual, and also those with unresectable or gross residual disease after surgery.

  20. Designing for Risk Assessment Systems for Patient Triage in Primary Health Care: A Literature Review

    PubMed Central

    Carvalho, Paulo Victor Rodrigues

    2016-01-01

    Background This literature review covers original journal papers published between 2011 and 2015. These papers review the current status of research on the application of human factors and ergonomics in risk assessment systems’ design to cope with the complexity, singularity, and danger in patient triage in primary health care. Objective This paper presents a systematic literature review that aims to identify, analyze, and interpret the application of available evidence from human factors and ergonomics to the design of tools, devices, and work processes to support risk assessment in the context of health care. Methods Electronic search was performed on 7 bibliographic databases of health sciences, engineering, and computer sciences disciplines. The quality and suitability of primary studies were evaluated, and selected papers were classified according to 4 classes of outcomes. Results A total of 1845 papers were retrieved by the initial search, culminating in 16 selected for data extraction after the application of inclusion and exclusion criteria and quality and suitability evaluation. Conclusions Results point out that the study of the implications of the lack of understanding about real work performance in designing for risk assessment in health care is very specific, little explored, and mostly focused on the development of tools. PMID:27528543

  1. A genetic history questionnaire-based system in primary prenatal care to screen for selected fetal disorders.

    PubMed

    Bradley, Linda A; Kloza, Edward M; Haddow, Paula K; Beauregard, Laurent J; Johnson, Judith L; Haddow, James E

    2007-01-01

    DNA (and other) diagnostic tests are now available for a number of serious, but uncommon, fetal disorders. We designed and evaluated a screening system for this purpose in primary care, coupled with targeted information for practitioners and patients. We developed a 15-question family history form for completion by office staff or patients, addressing conditions for which definitive diagnosis was available, linked to secondary questionnaires to follow up on "yes" answers. Guidelines for assessing risk, follow-up recommendations, and information resources were also linked. Following pilot testing, this screening system was introduced throughout Maine. We enrolled 212 providers (85-90% of the state's pregnancies). In a subsequent survey, 85% of the practices were screening all new patients and 3% some; 12% did not use the system. Time for form completion averaged 7 min. Overall, provider satisfaction was 4.4 on a five-point scale. Patients responded favorably; a minority was anxious or overwhelmed. Total referral calls to Maine's genetic/perinatal centers did not increase, but calls about family history of genetic disorders or maternal conditions increased significantly. This screening system for guiding appropriate use of DNA (and other) testing in pregnancy can be used successfully in primary care.

  2. HOW THE LEED VENTILATION CREDIT IMPACTS ENERGY CONSUMPTION OF GSHP SYSTEMS A CASE STUDY FOR PRIMARY SCHOOLS

    SciTech Connect

    Liu, Xiaobing

    2011-01-01

    This paper presents a study on the impacts of increased outdoor air (OA) ventilation on the performance of ground-source heat pump (GSHP) systems that heat and cool typical primary schools. Four locations Phoenix, Miami, Seattle, and Chicago are selected in this study to represent different climate zones in the United States. eQUEST, an integrated building and HVAC system energy analysis program, is used to simulate a typical primary school and the GSHP system at the four locations with minimum and 30% more than minimum OA ventilation. The simulation results show that, without an energy recovery ventilator, the 30% more OA ventilation results in an 8.0 13.3% increase in total GSHP system energy consumption at the four locations. The peak heating and cooling loads increase by 20.2 30% and 14.9 18.4%, respectively, at the four locations. The load imbalance of the ground heat exchanger is increased in hot climates but reduced in mild and cold climates.

  3. A classification system based on a new wrapper feature selection algorithm for the diagnosis of primary and secondary polycythemia.

    PubMed

    Korfiatis, Vasileios Ch; Asvestas, Pantelis A; Delibasis, Konstantinos K; Matsopoulos, George K

    2013-12-01

    Primary and Secondary Polycythemia are diseases of the bone marrow that affect the blood's composition and prohibit patients from becoming blood donors. Since these diseases may become fatal, their early diagnosis is important. In this paper, a classification system for the diagnosis of Primary and Secondary Polycythemia is proposed. The proposed system classifies input data into three classes; Healthy, Primary Polycythemic (PP) and Secondary Polycythemic (SP) and is implemented using two separate binary classification levels. The first level performs the Healthy/non-Healthy classification and the second level the PP/SP classification. To this end, a novel wrapper feature selection algorithm, called the LM-FM algorithm, is presented in order to maximize the classifier's performance. The algorithm is comprised of two stages that are applied sequentially: the Local Maximization (LM) stage and the Floating Maximization (FM) stage. The LM stage finds the best possible subset of a fixed predefined size, which is then used as an input for the next stage. The FM stage uses a floating size technique to search for an even better solution by varying the initially provided subset size. Then, the Support Vector Machine (SVM) classifier is used for the discrimination of the data at each classification level. The proposed classification system is compared with various well-established feature selection techniques such as the Sequential Floating Forward Selection (SFFS) and the Maximum Output Information (MOI) wrapper schemes, and with standalone classification techniques such as the Multilayer Perceptron (MLP) and SVM classifier. The proposed LM-FM feature selection algorithm combined with the SVM classifier increases the overall performance of the classification system, scoring up to 98.9% overall accuracy at the first classification level and up to 96.6% at the second classification level. Moreover, it provides excellent robustness regardless of the size of the input feature

  4. National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care.

    PubMed

    Gvozdanović, Darko; Koncar, Miroslav; Kojundzić, Vinko; Jezidzić, Hrvoje

    2007-01-01

    In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1) to provide efficient healthcare-related data management in support of decision-making processes; (2) to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS) on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories) into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution.

  5. A contemporary look at the sedimentary system of the coastal sabkha of Abu Dhabi (UAE): Primary deposition vs. early diagenesis

    NASA Astrophysics Data System (ADS)

    Paul, Andreas; Wang, Jiayi; Court, Wesley; Lokier, Stephen

    2016-04-01

    More than half a century ago, the Abu Dhabi coastline was subject to intensive research efforts by institutions from all over the world. This activity was mostly related to the onset of oil exploration in the region and the hypothesis that the modern Abu Dhabi Sabkha provides a direct analogue to the ancient deposits of the hydrocarbon-bearing Arab Formation. While research initially concentrated on a characterisation of the bulk depositional system, focus has recently shifted to answer more specific questions such as the role of microbial mats in the formation of dolomite. Through this shift to a smaller scale, the remainder of the sabkha, including its microbial mats, was neglected and little further activity was undertaken to characterise the coastal sabkha using modern, state-of-the-art, research tools and methods. This paper will not attempt to reinvent the wheel with respect to the work of the early researchers; we will instead present an updated model of the sedimentary system of the coastal sabkha of Abu Dhabi. This model will focus on establishing the relationship and controlling factors between primary deposits of the carbonate ramp system and secondary early diagenetic precipitates. Initial results show that primary deposits of the UAE's carbonate ramp are equivalent to carbonate mudstones, packstones, grainstones, and occasional rudstones with a packstone matrix, that form above a Holocene to Recent hardground. These deposits occur mostly in a subtidal to lower intertidal setting, landward of which they are gradually being covered by a green cyanobacterial layer that binds the primarily unconsolidated sediment. Further landward, in the middle and upper intertidal zones, these cyanobacterial layers grade into more complex microbial mat layers of potentially highly diverse bacterial and algal faunal composition. Microbial mat layers in the upper intertidal and the lower supratidal zones are increasingly interspersed with gypsum crystals and white

  6. Primary healthcare information system--the cornerstone for the next generation healthcare sector in Republic of Croatia.

    PubMed

    Koncar, Miroslav; Gvozdanović, Darko

    2006-01-01

    At no time in the history of medicine has the growth in knowledge and technologies been so profound [Crossing the Quality Chasm: A New Health System for the 21st Century, Institute of Medicine (IOM), 2001. ISBN 0-309-07280-8]. However, healthcare delivery systems today are not able to keep up with the pace. Studies have shown that it takes an average of about 17 years for new knowledge generated by randomized trials to be incorporated into practice [B. Andrew, S. Boren, Managing clinical knowledge for health care improvement, in: Yearbook of Medical Informatics, National Library of Medicine, Bethesda, MD, 2000, pp. 65-70]. It is safe to say that today healthcare systems "have the data, but not information". In order to provide highest quality patient care, Republic of Croatia has started the process of introducing enterprise information systems to support business processes in the healthcare domain. Two major requirements are in focus: to provide efficient healthcare related data management in support of decision-making processes; and to support continuous process of healthcare resources spending optimization. The first initiated project refers to Primary Healthcare Information System (PHCIS) that provides domain of primary care with state-of-the-art enterprise information system that connects General Practitioners, Pediatricians and Gynecologists offices with the Croatian Institute for Health Insurance and Public Health Institute. In the years to come, PHCIS will serve as the main integration platform for connecting all other stakeholders and levels of healthcare (e.g. hospitals, pharmacies, laboratories) into single enterprise healthcare network. This article gives an overview of PHCIS, explains challenges that were faced in designing and implementing the system, and elaborates PHCIS role as the cornerstone for the next generation healthcare provisioning in Republic of Croatia.

  7. Volumetric determination of primary arylamines and nitrites, using an internal indicator system.

    PubMed

    Szekely, E; Bandel, A; Flitman, M

    1972-11-01

    A new nitrite titration method is presented. The titration is performed in the presence of a standard solution of 4,4'-sulphonyl-dianiline and diphenylamine, which is used as an internal indicator. An intense red colour develops during the titration as a result of a simultaneous diazotization and coupling process. A very sharp end-point is given by a colour change to yellow. The titration is performed at a temperature of about 45 degrees in the presence of large amounts of nitrate. The method is specific and precise. It is suitable for the direct volumetric determination of various easily diazotized primary arylamines, sulphonamides and other amino-compounds which can be determined by nitrite titration. It is suitable also for the indirect determination of nitrites. The method is applicable on the semimicro and macro scales.

  8. Constraining geochemistry and biological primary productivity in hydrothermal systems via in situ mass spectrometric geochemical mapping

    NASA Astrophysics Data System (ADS)

    Vidoudez, Charles; Marcon, Yann; Bach, Wolfgang; Lebris, Nadine; Dubilier, Nicole; Girguis, Peter

    2014-05-01

    Hydrothermal vent ecosystems are biological hot spots, supported by chemoautotrophic primary productivity and achieving densities comparable to rainforests. Nevertheless, our understanding of the geochemical factors that govern the distribution of animals and microbes within vents is limited. It is well known that vent endemic organisms are found in specific vent "microenvironments", and that these microenvironments are distributed -coarsely speaking- in predictable patterns within a vent field. However, the relative differences in activity among these faunal patches, and their role in influencing geochemical flux remains largely unknown due to historical limitations in our ability to sample and quantify geochemical constituents with fine spatial resolution. In particular, the distribution of biologically important volatiles around vent fields is poorly constrained, as is the degree to which their distribution influences the destiny and distribution of organisms. To characterize the relationship between the distribution of volatiles, chemosynthetic microbes, and chemosynthetic symbioses, we generated detailed geo-referenced maps of methane, hydrogen sulfide, carbon dioxide and oxygen (four of the key volatiles that are both vent- and seawater derived) using an in situ mass spectrometer (ISMS). We characterized these concentrations in over 130 spots across three vent sites associated with the mid-Atlantic ridge in the Menez Gwen vent field. We quantified gases in sites ranging from hot fluids to mussel beds, and found notable relationships between the distribution and consumption of hydrogen sulfide and methane and the animal and microbial communities. Finally, we also developed a metabolic energy "map", which enables us to constrain both the potential energy that is available to these communities as well as the extent to which it is being used, and places constraints on the extent of primary production that can be supported by the realized use of these volatiles.

  9. The Role of Nature and Nurture for Individual Differences in Primary Emotional Systems: Evidence from a Twin Study

    PubMed Central

    Reuter, Martin; Spinath, Frank M.; Davis, Ken; Panksepp, Jaak

    2016-01-01

    The present study investigated for the first time the relative importance of genetics and environment on individual differences in primary emotionality as measured with the Affective Neuroscience Personality Scales (ANPS) by means of a twin-sibling study design. In N = 795 participants (n = 303 monozygotic twins, n = 172 dizygotic twins and n = 267 non-twin full siblings), moderate to strong influences of genetics on individual differences in these emotional systems are observed. Lowest heritability estimates are presented for the SEEKING system (33%) and highest for the PLAY system (69%). Further, multivariate genetic modeling was applied to the data showing that associations among the six ANPS scales were influences by both, a genetic as well as an environmental overlap between them. In sum, the study underlines the usefulness of the ANPS for biologically oriented personality psychology research. PMID:26999649

  10. Biotechnological reduction of sulfide in an industrial primary wastewater treatment system: A sustainable and successful case study

    SciTech Connect

    Rajamani, S.

    1996-12-31

    The leather industry is an important export-oriented industry in India, with more than 3,000 tanneries located in different clusters. Sodium sulfide, a toxic chemical, is used in large quantities to remove hair and excess flesh from hides and skins. Most of the sodium sulfide used in the process is discharged as waste in the effluent, which causes serious environmental problems. Reduction of sulfide in the effluent is generally achieved by means of chemicals in the pretreatment system, which involves aerobic mixing using large amounts of chemicals and high energy, and generating large volumes of sludge. A simple biotechnological system that uses the residual biosludge from the secondary settling tank was developed, and the commercial-scale application established that more than 90% of the sulfide could be reduced in the primary treatment system. In addition to the reduction of sulfide, foul smells, BOD and COD are reduced to a considerable level. 3 refs., 2 figs., 1 tab.

  11. The Role of Nature and Nurture for Individual Differences in Primary Emotional Systems: Evidence from a Twin Study.

    PubMed

    Montag, Christian; Hahn, Elisabeth; Reuter, Martin; Spinath, Frank M; Davis, Ken; Panksepp, Jaak

    2016-01-01

    The present study investigated for the first time the relative importance of genetics and environment on individual differences in primary emotionality as measured with the Affective Neuroscience Personality Scales (ANPS) by means of a twin-sibling study design. In N = 795 participants (n = 303 monozygotic twins, n = 172 dizygotic twins and n = 267 non-twin full siblings), moderate to strong influences of genetics on individual differences in these emotional systems are observed. Lowest heritability estimates are presented for the SEEKING system (33%) and highest for the PLAY system (69%). Further, multivariate genetic modeling was applied to the data showing that associations among the six ANPS scales were influences by both, a genetic as well as an environmental overlap between them. In sum, the study underlines the usefulness of the ANPS for biologically oriented personality psychology research.

  12. Chondrodermatitis nodularis chronica helicis in a patient with systemic sclerosis associated with primary biliary cirrhosis (Reynolds syndrome): A case report

    PubMed Central

    Giraldo, Walter Alberto Sifuentes; González-García, Carmen; de las Heras Alonso, Elena; de la Puente Bujidos, Carlos

    2014-01-01

    Chondrodermatitis nodularis chronica helicis is a rare non-neoplastic inflammatory and degenerative process of the external ear, characterized by necrobiotic changes in the dermis that extend down to the perichondrium. This condition has been occasionally reported in patients with limited cutaneous systemic sclerosis but not in those with concomitant primary biliary cirrhosis; this association is known as Reynolds syndrome. We report a 70-year-old woman diagnosed with primary biliary cirrhosis at age 47 and with limited cutaneous systemic sclerosis at age 54 who developed a painful ulcerated nodule on the helical rim of the left ear shortly after the last diagnosis. The lesion was excised because of the suspicion of malignancy, but the histopathology was consistent with chondrodermatitis nodularis chronica helicis. Although this condition is infrequent, it is necessary to know, because it may occur in patients with systemic sclerosis and be mistaken for neoplasms, such as basal cell and squamous cell carcinoma, and these patients have an increased risk for the development of skin malignancies. PMID:27708905

  13. SURFACE ARTHROPLASTY FOR TREATING PRIMARY AND/OR SECONDARY SHOULDER OSTEOARTHROSIS BY MEANS OF THE HEMICAP-ARTHROSURFACE® SYSTEM

    PubMed Central

    Visco, Adalberto; Vieira, Luis Alfredo Gómez; Gonçalves, Felipe Borges; Fernandes, Luis Filipe Daneu; dos Santos, Murilo Cunha Rafael; Filho, Nivaldo Souza Cardozo; Cordero, Nicolas Gerardo Gómez

    2015-01-01

    Objective: To present the surgical technique for the He-miCAP-Arthrosurface® system and evaluate our results from this technique for treating primary and/or secondary shoulder osteoarthrosis. Method: Between June 2007 and June 2009, 10 shoulders of 10 patients (nine with primary osteoarthrosis and one with avascular necrosis of the humeral head) underwent surface arthroplasty using the HemiCAP-Arthrosurface® system to correct the problem. The follow-up time ranged from six to 29 months (mean of 17 months). The patients’ ages ranged from 62 to 73 years (mean of 67.5 years). Six patients were female and four patients were male. The patients were followed up weekly for the first month after the surgical procedure and every three months thereafter. The clinic evaluation was done using the criteria of the University of California at Los Angeles (UCLA) and a visual analogue pain scale. Results: All the patients said that they were satisfied with the results from the surgical treatment, with a mean UCLA score of 30 points and a mean analogue pain score of two points. Conclusion: The HemiCAP-Arthrosurface® system for shoulder surgery for a specific group of patients is a technique that preserves the bone stock with good functional and antalgic results. PMID:27047820

  14. HIV Education and Welfare Services in Primary Care: An Empirical Model of Integration in Brazil’s Unified Health System

    PubMed Central

    Rahman, Rahbel; Pinto, Rogério M.; Wall, Melanie M.

    2017-01-01

    Integration of health education and welfare services in primary care systems is a key strategy to solve the multiple determinants of chronic diseases, such as Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS). However, there is a scarcity of conceptual models from which to build integration strategies. We provide a model based on cross-sectional data from 168 Community Health Agents, 62 nurses, and 32 physicians in two municipalities in Brazil’s Unified Health System (UHS). The outcome, service integration, comprised HIV education, community activities (e.g., health walks and workshops), and documentation services (e.g., obtainment of working papers and birth certificates). Predictors included individual factors (provider confidence, knowledge/skills, perseverance, efficacy); job characteristics (interprofessional collaboration, work-autonomy, decision-making autonomy, skill variety); and organizational factors (work conditions and work resources). Structural equation modeling was used to identify factors associated with service integration. Knowledge and skills, skill variety, confidence, and perseverance predicted greater integration of HIV education alongside community activities and documentation services. Job characteristics and organizational factors did not predict integration. Our study offers an explanatory model that can be adapted to examine other variables that may influence integration of different services in global primary healthcare systems. Findings suggest that practitioner trainings to improve integration should focus on cognitive constructs—confidence, perseverance, knowledge, and skills. PMID:28335444

  15. Effect of a computerized online grading system on patient satisfaction in a military primary health care setting.

    PubMed

    Levy, Gad; Goldstein, Liav; Barenboim, Erez; Bar-Dayan, Yaron

    2007-04-01

    Patient satisfaction is gaining recognition as an important determinant of the quality of medical care. We conducted an analysis to evaluate the effect of a computerized online system that comparatively displays grades of patient satisfaction among primary care military infirmaries. Fifteen Israel Air Force primary care infirmaries served as the intervention group, and 130 Israel Defense Force infirmaries were the control group. Baseline patient satisfaction was surveyed in all infirmaries. In the intervention group only, infirmaries were resurveyed at 3-month intervals during a 1-year period. Satisfaction scores were continuously displayed on an intranet site in a comparative graphical manner by using the computerized system, available only to the intervention group. At the endpoint, patient satisfaction improved in both groups. However, the magnitude of improvement in the intervention group was significantly greater, in comparison with the control group. The most pronounced improvement was noted in availability of service (intervention group, 57.9% at baseline vs. 66.0% at endpoint, p < 0.001; control group, 67.5% vs. 69.6%, p < 0.025). We conclude that the use of this computerized system in conjunction with promotional efforts resulted in significant improvements in patient satisfaction.

  16. Mathematical model of the primary CD8 T cell immune response: stability analysis of a nonlinear age-structured system.

    PubMed

    Terry, Emmanuelle; Marvel, Jacqueline; Arpin, Christophe; Gandrillon, Olivier; Crauste, Fabien

    2012-08-01

    The primary CD8 T cell immune response, due to a first encounter with a pathogen, happens in two phases: an expansion phase, with a fast increase of T cell count, followed by a contraction phase. This contraction phase is followed by the generation of memory cells. These latter are specific of the antigen and will allow a faster and stronger response when encountering the antigen for the second time. We propose a nonlinear mathematical model describing the T CD8 immune response to a primary infection, based on three nonlinear ordinary differential equations and one nonlinear age-structured partial differential equation, describing the evolution of CD8 T cell count and pathogen amount. We discuss in particular the roles and relevance of feedback controls that regulate the response. First we reduce our system to a system with a nonlinear differential equation with a distributed delay. We study the existence of two steady states, and we analyze the asymptotic stability of these steady states. Second we study the system with a discrete delay, and analyze global asymptotic stability of steady states. Finally, we show some simulations that we can obtain from the model and confront them to experimental data.

  17. Primary systemic amyloidosis presenting as a colonic stricture: successful treatment with left hemicolectomy followed by autologous hematopoietic stem-cell transplantation: report of a case.

    PubMed

    Rives, S; Pera, M; Rosiñol, L; Vidal, O; Miquel, R; Solé, M; García-Valdecasas, J; Bladé, J

    2002-09-01

    Intestinal tract involvement by primary systemic amyloidosis is frequent but usually asymptomatic. Ischemic colitis caused by amyloid infiltration of wall blood vessels can occasionally be observed. We report a 62-year-old female with primary systemic amyloidosis who presented with intestinal obstruction caused by ischemic stricture of the sigmoid colon, secondary to submucosal amyloid deposition. The patient was successfully treated with surgical resection followed by high-dose chemotherapy and hematopoietic stem-cell transplantation. The clinical manifestations and differential diagnosis of gastrointestinal involvement of primary systemic amyloidosis, as well as its current treatment, are discussed.

  18. Work-up and management of a high-risk patient with primary central nervous system lymphoma

    PubMed Central

    Zeynalova, Pervin A.; Tumyan, Gayane S.; Dolgushin, Mikhail B.; Akhmedov, Mobil I.

    2016-01-01

    Primary central nervous system lymphoma (PCNSL) is a rare disorder that, in 95% of cases, represents diffuse large B-cell lymphoma. As such, making an accurate diagnosis is important. At present, stereotactic-guided biopsy is a recognized method of choice for tissue analysis. However, the diagnostic work-up for high-risk patients is determined by their performance status. Here, we report a case of PCNSL in a high-risk patient, for whom diagnosis was established by cerebrospinal fluid cytology and flow cytometry, which significantly shortened a diagnostic work-up period and allowed for the immediate treatment of the patient. PMID:28154784

  19. Structural Arrangement Trade Study. Volume 1: Reusable Hydrogen Composite Tank System (RHCTS) and Graphite Composite Primary Structures (GCPS). Executive summary

    NASA Technical Reports Server (NTRS)

    1995-01-01

    This volume is the first of a three volume set that discusses the structural arrangement trade study plan that will identify the most suitable configuration for an SSTO winged vehicle capable of delivering 25,000 lbs to a 220 nm circular orbit at 51.6 deg inclination. The Reusable Hydrogen Composite Tank System (RHCTS), and Graphite Composite Primary Structures most suitable for intertank, wing and thrust structures are identified. This executive summary presents the trade study process, the selection process, requirements used, analysis performed and data generated. Conclusions and recommendations are also presented.

  20. Mortality, causes of death and risk factors for death among primary amphetamine users in the Swedish criminal justice system.

    PubMed

    Ericsson, Emmy; Bradvik, Louise; Hakansson, Anders

    2014-02-01

    This study examined mortality and predictors of death in 1,396 primary amphetamine users (85% males) who were interviewed with the Addiction Severity Index in the Swedish criminal justice system during 2000-2006 and followed through 2008. Forty-nine clients deceased (standardized mortality ratio 4.1 [3.0-5.4]), at least 84% of deaths were violent or drug-related (12% suicides), and Cox regression analysis indicated that death was associated with frequent use of sedatives and less frequent use of amphetamine. No female deaths were observed; death and male gender were associated in binary analysis. Implications for diagnostics and treatment are discussed.

  1. Integrative medicine and systemic outcomes research: issues in the emergence of a new model for primary health care.

    PubMed

    Bell, Iris R; Caspi, Opher; Schwartz, Gary E R; Grant, Kathryn L; Gaudet, Tracy W; Rychener, David; Maizes, Victoria; Weil, Andrew

    2002-01-28

    Clinicians and researchers are increasingly using the term integrative medicine to refer to the merging of complementary and alternative medicine (CAM) with conventional biomedicine. However, combination medicine (CAM added to conventional) is not integrative. Integrative medicine represents a higher-order system of systems of care that emphasizes wellness and healing of the entire person (bio-psycho-socio-spiritual dimensions) as primary goals, drawing on both conventional and CAM approaches in the context of a supportive and effective physician-patient relationship. Using the context of integrative medicine, this article outlines the relevance of complex systems theory as an approach to health outcomes research. In this view, health is an emergent property of the person as a complex living system. Within this conceptualization, the whole may exhibit properties that its separate parts do not possess. Thus, unlike biomedical research that typically examines parts of health care and parts of the individual, one at a time, but not the complete system, integrative outcomes research advocates the study of the whole. The whole system includes the patient-provider relationship, multiple conventional and CAM treatments, and the philosophical context of care as the intervention. The systemic outcomes encompass the simultaneous, interactive changes within the whole person.

  2. Integrated system to automatize information collecting for the primary health care at home.

    PubMed

    Oliveira, Edson N; Cainelli, Jean; Pinto, Maria Eugênia B; Cazella, Silvio C; Dahmer, Alessandra

    2013-01-01

    Data collected in a consistent manner is the basis for any decision making. This article presents a system that automates data collection by community-based health workers during their visits to the residences of users of the Brazilian Health Care System (Sistema Único de Saúde - SUS) The automated process will reduce the possibility of mistakes in the transcription of visit information and make information readily available to the Ministry of Health. Furthermore, the analysis of the information provided via this system can be useful in the implementation of health campaigns and in the control of outbreaks of epidemiological diseases.

  3. Integrated guidance, navigation and control verification plan primary flight system. [space shuttle avionics integration

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The verification process and requirements for the ascent guidance interfaces and the ascent integrated guidance, navigation and control system for the space shuttle orbiter are defined as well as portions of supporting systems which directly interface with the system. The ascent phase of verification covers the normal and ATO ascent through the final OMS-2 circularization burn (all of OPS-1), the AOA ascent through the OMS-1 burn, and the RTLS ascent through ET separation (all of MM 601). In addition, OPS translation verification is defined. Verification trees and roadmaps are given.

  4. Primary light-harvesting system: phycobilisomes and associated membranes. Progress report, December 1979-January 1983

    SciTech Connect

    Gantt, E.

    1983-01-01

    The structure of phycobilisomes, which serve as primary light-harvesting complexes for photosynthesis, were investigated in red and blue-green algae (cyanobacteria). Structurally the phycobilisomes have the same fundamental arrangement in the various species, with allophycocyanin being in the core from which peripheral rods composed of phycocyanin or phycocyanin-phycoerythyrin radiate. Such studies were extended to show that energetically functional phycobilisomes could be formed in vitro from separated fractions of allophycocyanin and phycoerythrin-phycocyanin within the same species (Nostoc) and between separate species (Fremyella and Nostoc). A large (95 kD) blue-colored polypeptide is being regarded as an anchor component between phycobilisomes and thylakoids. The polypeptide, isolated from phycobilisomes, had two long wavelength-emitting types of chromophores, one similar to allophycocyanin and another to chlorophyll. Such a large (95 kD) polypeptide occurred in phycobilisomes of red and blue-green algae examined, with the exception of Anacystis where it was somewhat smaller (75 kD). The effect of light quality on phycobilisome structure varied among the blue-green species studied. The relationship of the photosystems and phycobilisomes was investigated in Anacystis wild type cells, and in mutants deficient in phycocyanin. Although the phycocyanin and chlorophyll content per cell changed with light quality the phycobilisome per Reaction Center 2 ratio remained at ca. 0.9 +- 0.3 suggesting that only the size of the antennae varied.

  5. A fully automated primary screening system for the discovery of therapeutic antibodies directly from B cells.

    PubMed

    Tickle, Simon; Howells, Louise; O'Dowd, Victoria; Starkie, Dale; Whale, Kevin; Saunders, Mark; Lee, David; Lightwood, Daniel

    2015-04-01

    For a therapeutic antibody to succeed, it must meet a range of potency, stability, and specificity criteria. Many of these characteristics are conferred by the amino acid sequence of the heavy and light chain variable regions and, for this reason, can be screened for during antibody selection. However, it is important to consider that antibodies satisfying all these criteria may be of low frequency in an immunized animal; for this reason, it is essential to have a mechanism that allows for efficient sampling of the immune repertoire. UCB's core antibody discovery platform combines high-throughput B cell culture screening and the identification and isolation of single, antigen-specific IgG-secreting B cells through a proprietary technique called the "fluorescent foci" method. Using state-of-the-art automation to facilitate primary screening, extremely efficient interrogation of the natural antibody repertoire is made possible; more than 1 billion immune B cells can now be screened to provide a useful starting point from which to identify the rare therapeutic antibody. This article will describe the design, construction, and commissioning of a bespoke automated screening platform and two examples of how it was used to screen for antibodies against two targets.

  6. Primary Central Nervous System (CNS) Lymphoma B Cell Receptors Recognize CNS Proteins.

    PubMed

    Montesinos-Rongen, Manuel; Purschke, Frauke G; Brunn, Anna; May, Caroline; Nordhoff, Eckhard; Marcus, Katrin; Deckert, Martina

    2015-08-01

    Primary lymphoma of the CNS (PCNSL) is a diffuse large B cell lymphoma confined to the CNS. To elucidate its peculiar organ tropism, we generated recombinant Abs (recAbs) identical to the BCR of 23 PCNSLs from immunocompetent patients. Although none of the recAbs showed self-reactivity upon testing with common autoantigens, they recognized 1547 proteins present on a large-scale protein microarray, indicating polyreactivity. Interestingly, proteins (GRINL1A, centaurin-α, BAIAP2) recognized by the recAbs are physiologically expressed by CNS neurons. Furthermore, 87% (20/23) of the recAbs, including all Abs derived from IGHV4-34 using PCNSL, recognized galectin-3, which was upregulated on microglia/macrophages, astrocytes, and cerebral endothelial cells upon CNS invasion by PCNSL. Thus, PCNSL Ig may recognize CNS proteins as self-Ags. Their interaction may contribute to BCR signaling with sustained NF-κB activation and, ultimately, may foster tumor cell proliferation and survival. These data may also explain, at least in part, the affinity of PCNSL cells for the CNS.

  7. Primary care and reform of health systems: a framework for the analysis of Latin American experiences.

    PubMed

    Frenk, J; González-Block, M A

    1992-03-01

    The article first proposes a framework within which to assess the potential of health sector reforms in Latin America for primary health care (PHC). Two dimensions are recognized: the scope of the reforms, content, and the means of participation that are put into play. This framework is then complemented through a critique of the often-sought but little-analyzed PHC reform strategies of decentralization and health sector integration. The analytical framework is next directed to the financing of health services, a chief aspect of any reform aiming toward PHC. Two facets of health service finance are first distinguished: its formal aspect as a means for economic subsistence and growth, and its substantive aspect as a means to promote the rational use of services and thus improvement of health. Once finance is understood in this microeconomic perspective, the focus shifts to the analysis of health care reforms at the macro, health policy level. The article concludes by positing that PHC is in essence a new health care paradigm, oriented by the values of universality, redistribution, integration, plurality, quality, and efficiency.

  8. A microcarrier-based cultivation system for expansion of primary mesenchymal stem cells.

    PubMed

    Frauenschuh, Simone; Reichmann, Elisabeth; Ibold, Yvonne; Goetz, Peter M; Sittinger, Michael; Ringe, Jochen

    2007-01-01

    Microcarrier cultures have been shown to allow extensive cell expansion of tissue engineering relevant cells, such as chondrocytes, while maintaining their phenotype. Our aim was to investigate the in vitro three-dimensional expansion of porcine bone-marrow-derived primary mesenchymal stem cells (MSC) using commercially available Cytodex type 1, type 2, and type 3 microcarriers. In comparison, the Cytodex type 1 microcarriers showed the best results for adherence with over 80% adherent cells after 3 h of incubation, analyzed by the Poisson distribution. Different start cell densities ranging from 1 to 3 x 106 cells per 100 cm2 had only a minor influence on adhesion. The proliferation was examined on Cytodex type 1 microcarriers over a cultivation time of 28 days, which could reveal cell growth and proof of cells recolonizing freshly added microcarriers. Scanning electron microscopy displayed appropriate cell morphology and confirmed cell proliferation. After enzymatic harvest from microcarriers, the osteogenic and chondrogenic differentiation of these cells was induced and shown by relevant histochemistry, such as von Kossa and Alcian blue staining. Totaling the results, we have shown that the three-dimensional expansion of MSC on microcarriers represents a beneficial alternative to the conventional two-dimensional monolayer cultivation method.

  9. Enhancing the Effectiveness of Significant Event Analysis: Exploring Personal Impact and Applying Systems Thinking in Primary Care

    PubMed Central

    McNaughton, Elaine; Bruce, David; Holly, Deirdre; Forrest, Eleanor; Macleod, Marion; Kennedy, Susan; Power, Ailsa; Toppin, Denis; Black, Irene; Pooley, Janet; Taylor, Audrey; Swanson, Vivien; Kelly, Moya; Ferguson, Julie; Stirling, Suzanne; Wakeling, Judy; Inglis, Angela; McKay, John; Sargeant, Joan

    2016-01-01

    Introduction: Significant event analysis (SEA) is well established in many primary care settings but can be poorly implemented. Reasons include the emotional impact on clinicians and limited knowledge of systems thinking in establishing why events happen and formulating improvements. To enhance SEA effectiveness, we developed and tested “guiding tools” based on human factors principles. Methods: Mixed-methods development of guiding tools (Personal Booklet—to help with emotional demands and apply a human factors analysis at the individual level; Desk Pad—to guide a team-based systems analysis; and a written Report Format) by a multiprofessional “expert” group and testing with Scottish primary care practitioners who submitted completed enhanced SEA reports. Evaluation data were collected through questionnaire, telephone interviews, and thematic analysis of SEA reports. Results: Overall, 149/240 care practitioners tested the guiding tools and submitted completed SEA reports (62.1%). Reported understanding of how to undertake SEA improved postintervention (P < .001), while most agreed that the Personal Booklet was practical (88/123, 71.5%) and relevant to dealing with related emotions (93/123, 75.6%). The Desk Pad tool helped focus the SEA on systems issues (85/123, 69.1%), while most found the Report Format clear (94/123, 76.4%) and would recommend it (88/123, 71.5%). Most SEA reports adopted a systems approach to analyses (125/149, 83.9%), care improvement (74/149, 49.7), or planned actions (42/149, 28.2%). Discussion: Applying human factors principles to SEA potentially enables care teams to gain a systems-based understanding of why things go wrong, which may help with related emotional demands and with more effective learning and improvement. PMID:27583996

  10. High-dose methotrexate following intravitreal methotrexate administration in preventing central nervous system involvement of primary intraocular lymphoma.

    PubMed

    Akiyama, Hiroki; Takase, Hiroshi; Kubo, Fumito; Miki, Tohru; Yamamoto, Masahide; Tomita, Makoto; Mochizuki, Manabu; Miura, Osamu; Arai, Ayako

    2016-10-01

    In order to prevent central nervous system (CNS) involvement and improve the prognosis of primary intraocular lymphoma (PIOL), we prospectively evaluated the efficacy of combined therapy using intravitreal methotrexate (MTX) and systemic high-dose MTX on treatment-naïve PIOL. Patients with newly diagnosed PIOL whose lymphoma was limited to the eyes were enrolled. The patients were treated with weekly intravitreal MTX until the ocular lesions were resolved, followed by five cycles of systemic high-dose MTX (3.5 g/m(2) ) every other week. Ten patients were enrolled in this study and completed the treatment. All patients achieved complete response for their ocular lesions with rapid decrease of intravitreal interleukin-10 concentration. Adverse events of intravitreal and systemic high-dose MTX were mild and tolerable. With a median follow-up of 29.5 months, four patients (40%) experienced the CNS disease development and the mean CNS lymphoma-free survival (CLFS) time was 51.1 months. Two-year CLFS, which was the primary end-point of the study, was 58.3% (95% confidence interval, 23.0-82.1%). In contrast, eight patients were treated with intravitreal MTX alone in our institute, and their 2-year CLFS was 37.5% (95% confidence interval, 8.7-67.4%). In conclusion, systemic high-dose MTX following intravitreal MTX is feasible and might be effective in preventing CNS involvement of PIOL. Further arrangements are worth considering in order to improve the effects. This study was registered with UMIN Clinical Trials Registry (UMIN000003921).

  11. Amenorrhea - primary

    MedlinePlus

    ... of periods - primary Images Primary amenorrhea Normal uterine anatomy (cut section) Absence of menstruation (amenorrhea) References Bulun SE. The physiology and pathology of the female reproductive axis. In: ...

  12. Design, analysis, and control of large transport aircraft utilizing engine thrust as a backup system for the primary flight controls

    NASA Technical Reports Server (NTRS)

    Gerren, Donna S.

    1993-01-01

    A review of accidents that involved the loss of hydraulic flight control systems serves as an introduction to this project. In each of the accidents--involving transport aircraft such as the DC-10, the C-5A, the L-1011, and the Boeing 747--the flight crew attempted to control the aircraft by means of thrust control. Although these incidents had tragic endings, in the absence of control power due to primary control system failure, control power generated by selective application of engine thrust has proven to be a viable alternative. NASA Dryden has demonstrated the feasibility of controlling an aircraft during level flight, approach, and landing conditions using an augmented throttles-only control system. This system has been successfully flown in the flight test simulator for the B-720 passenger transport and the F-15 air superiority fighter and in actual flight tests for the F-15 aircraft. The Douglas Aircraft Company is developing a similar system for the MD-11 aircraft. The project's ultimate goal is to provide data for the development of thrust control systems for mega-transports (600+ passengers).

  13. Primary and secondary faulting in the Najd fault system, Kingdom of Saudi Arabia

    USGS Publications Warehouse

    Moore, John McMahon

    1979-01-01

    The Najd fault system is a major transcurrent (strike-slip) fault system of Proterozoic age in the Arabian Shield. The system is a braided complex of parallel and curved en echelon faults. Complex arrays of secondary structures including strike-slip, oblique-slip, thrust, and normal faults, together with folds and dike swarms, are associated with some major faults, particularly near their terminations. The secondary structures indicate that compressional and extensional and dilational conditions existed synchronously in different parts of the fault zone. The outcrop traces of faults and syntectonic dikes have been used to interpret the configuration of principal compressive stresses during formation of parts of the secondary fracture systems. Second-order deformation was a series of separate events in a complex episodic faulting history. Comparison with model studies indicates that master faults extended in length in stages and periodically developed arrays of secondary structures. Propagation of the major faults took place along splay trajectories, which inter-connected to form a subparallel sheeted and braided zone. Interpretation of the aeromagnetic maps indicates that the Najd system is broader at depth than the outcropping fault complex, and that more continuous structures underlie arrays of faults at surface. The fault pattern is mechanically explicable in terms of simple shear between rigid blocks beneath the exposed structures.

  14. Control system for an alternative actuator for the primary surface of the Large Millimeter Telescope (LMT/GTM)

    NASA Astrophysics Data System (ADS)

    Hernández Rebollar, José Luis; Lázaro Hernández, Josefina; Arteaga Magaña, Cesar; Hughes, David H.; Gale, David M.

    2016-07-01

    The Large Millimeter Telescope/Gran Telescopio Milimétrico (LMT/GTM) is a bi-national project between INAOE in México and UMASS in the USA. It is an open air radio telescope designed for astronomical observations in wavelengths ranging from 0.85 mm to 4 mm. Its 50-meter diameter primary reflector is so massive that its shape deviates from the theoretical parabola due to gravitational effect as it moves in elevation, which ultimately affects gain, one of the most important features of the telescope. To correct this elevation-dependent deformation, the primary surface is divided into 180 segments that are automatically positioned by means of four electro mechanical actuators. Unfortunately, the lifetime expectancy of the interim actuators installed in rings 1 to 3 during 2013, are below specs and the cost of substituting them with the new actuators, now under development for rings 4 and 5, may not be affordable. In this paper an alternative actuator control system that re uses most of the current electronics coupled to a completely redesigned mechanism is presented. The results of the performance tests under load show that the system is capable of achieving positioning with RMS error of 4 micron and that the accuracy is dominated by the LVDT characterization error.

  15. Dependency of global primary bioenergy crop potentials in 2050 on food systems, yields, biodiversity conservation and political stability.

    PubMed

    Erb, Karl-Heinz; Haberl, Helmut; Plutzar, Christoph

    2012-08-01

    The future bioenergy crop potential depends on (1) changes in the food system (food demand, agricultural technology), (2) political stability and investment security, (3) biodiversity conservation, (4) avoidance of long carbon payback times from deforestation, and (5) energy crop yields. Using a biophysical biomass-balance model, we analyze how these factors affect global primary bioenergy potentials in 2050. The model calculates biomass supply and demand balances for eleven world regions, eleven food categories, seven food crop types and two livestock categories, integrating agricultural forecasts and scenarios with a consistent global land use and NPP database. The TREND scenario results in a global primary bioenergy potential of 77 EJ/yr, alternative assumptions on food-system changes result in a range of 26-141 EJ/yr. Exclusion of areas for biodiversity conservation and inaccessible land in failed states reduces the bioenergy potential by up to 45%. Optimistic assumptions on future energy crop yields increase the potential by up to 48%, while pessimistic assumptions lower the potential by 26%. We conclude that the design of sustainable bioenergy crop production policies needs to resolve difficult trade-offs such as food vs. energy supply, renewable energy vs. biodiversity conservation or yield growth vs. reduction of environmental problems of intensive agriculture.

  16. Rare case of a primary non-dural central nervous system low grade B-cell lymphoma and literature review

    PubMed Central

    Papanicolau-Sengos, Antonios; Wang-Rodriguez, Jessica; Wang, Huan-You; Lee, Roland R; Wong, Anna; Hansen, Lawrence A; Mahooti, Sepi; Rashidi, Hooman H

    2012-01-01

    We present a case of a 70-year-old HIV negative man with a five-year history of progressive dysnomia and new onset right extremity numbness, dysarthria, and blurry vision. On magnetic resonance imaging (MRI), an infiltrative enhancing tumor was noted. Follow up brain biopsy results revealed a small lymphocytic infiltrate with scattered plasma cells in a predominantly perivascular growth pattern. Flow-cytometric findings revealed a lambda monotypic B-cell population. The morphology and the flow cytometric findings were consistent with involvement by a low grade B-cell lymphoma. Subsequent positron emission tomography (PET) studies along with bone marrow biopsy and serum protein electrophoresis showed no evidence of systemic disease. The above findings are consistent with involvement by a non-dural extranodal marginal zone B-cell lymphoma (MZBCL) primary to the central nervous system (CNS). This is the first reported case of a primary CNS MZBCL with flow cytometric analysis. A review of literature on this rare entity is also included. PMID:22295152

  17. Rare case of a primary non-dural central nervous system low grade B-cell lymphoma and literature review.

    PubMed

    Papanicolau-Sengos, Antonios; Wang-Rodriguez, Jessica; Wang, Huan-You; Lee, Roland R; Wong, Anna; Hansen, Lawrence A; Mahooti, Sepi; Rashidi, Hooman H

    2012-01-01

    We present a case of a 70-year-old HIV negative man with a five-year history of progressive dysnomia and new onset right extremity numbness, dysarthria, and blurry vision. On magnetic resonance imaging (MRI), an infiltrative enhancing tumor was noted. Follow up brain biopsy results revealed a small lymphocytic infiltrate with scattered plasma cells in a predominantly perivascular growth pattern. Flow-cytometric findings revealed a lambda monotypic B-cell population. The morphology and the flow cytometric findings were consistent with involvement by a low grade B-cell lymphoma. Subsequent positron emission tomography (PET) studies along with bone marrow biopsy and serum protein electrophoresis showed no evidence of systemic disease. The above findings are consistent with involvement by a non-dural extranodal marginal zone B-cell lymphoma (MZBCL) primary to the central nervous system (CNS). This is the first reported case of a primary CNS MZBCL with flow cytometric analysis. A review of literature on this rare entity is also included.

  18. Dependency of global primary bioenergy crop potentials in 2050 on food systems, yields, biodiversity conservation and political stability

    PubMed Central

    Erb, Karl-Heinz; Haberl, Helmut; Plutzar, Christoph

    2012-01-01

    The future bioenergy crop potential depends on (1) changes in the food system (food demand, agricultural technology), (2) political stability and investment security, (3) biodiversity conservation, (4) avoidance of long carbon payback times from deforestation, and (5) energy crop yields. Using a biophysical biomass-balance model, we analyze how these factors affect global primary bioenergy potentials in 2050. The model calculates biomass supply and demand balances for eleven world regions, eleven food categories, seven food crop types and two livestock categories, integrating agricultural forecasts and scenarios with a consistent global land use and NPP database. The TREND scenario results in a global primary bioenergy potential of 77 EJ/yr, alternative assumptions on food-system changes result in a range of 26–141 EJ/yr. Exclusion of areas for biodiversity conservation and inaccessible land in failed states reduces the bioenergy potential by up to 45%. Optimistic assumptions on future energy crop yields increase the potential by up to 48%, while pessimistic assumptions lower the potential by 26%. We conclude that the design of sustainable bioenergy crop production policies needs to resolve difficult trade-offs such as food vs. energy supply, renewable energy vs. biodiversity conservation or yield growth vs. reduction of environmental problems of intensive agriculture. PMID:23576836

  19. High Flux Isotope Reactor system RELAP5 input model

    SciTech Connect

    Morris, D.G.; Wendel, M.W.

    1993-01-01

    A thermal-hydraulic computational model of the High Flux Isotope Reactor (HFIR) has been developed using the RELAP5 program. The purpose of the model is to provide a state-of-the art thermal-hydraulic simulation tool for analyzing selected hypothetical accident scenarios for a revised HFIR Safety Analysis Report (SAR). The model includes (1) a detailed representation of the reactor core and other vessel components, (2) three heat exchanger/pump cells, (3) pressurizing pumps and letdown valves, and (4) secondary coolant system (with less detail than the primary system). Data from HFIR operation, component tests, tests in facility mockups and the HFIR, HFIR specific experiments, and other pertinent experiments performed independent of HFIR were used to construct the model and validate it to the extent permitted by the data. The detailed version of the model has been used to simulate loss-of-coolant accidents (LOCAs), while the abbreviated version has been developed for the operational transients that allow use of a less detailed nodalization. Analysis of station blackout with core long-term decay heat removal via natural convection has been performed using the core and vessel portions of the detailed model.

  20. Control and primary processing of data from the portable spectrometric system ISOCH-111

    NASA Astrophysics Data System (ADS)

    Mishev, D. N.; Krumov, A. Kh.; Totev, A.; Petkov, D. I.; Tsenov, B. Kh.

    1985-11-01

    The basic moduli and software configuration are examined for the spectrometric system ISOCH-111. Brief summary is made on definition of the basic problems to be resolved in the field of remote sensing. The main principles of operation are discussed for the optoelectron conversion bloc (OEC). Its simplified macromodels are examined in brief as well as the procedures for the solution of the reverse problems in the automatic control of sensitivity and dark current, calibration and data correction. The general configuration of ISOCH-111 is given, its main program moduli are described. In conclusion, the experience of the authors is summarized in the provision of mathematical and system software for the device. The possibility for system expansion is also discussed.

  1. The primary test of measuremental system for the actual emittance of relativistic electron beams

    SciTech Connect

    Liang Fu; Tai-bin Du; Xin Chen

    1995-12-31

    Recent, a new measuremental system has been established basically in Tsinghua University PRA. This system is able to measure the lower emittance of the electron beams from the RF accelerators for the FEL. It consists of a scanning magnetic field, a slit, a fluorescent screen, and a TV camera, an image processing system, a CAD 386 computer. Using it an actual phase diagram is obtained for 4-10 Mev electron beams, The principle and structure of the facility were reported in the Proceeding of the 15th FEL Conference. This paper describes the performance of the main components and the results of first measurement for the electron gun and 4Mev standing wave LINAC, Some new suggests are related too.

  2. Health worker posting and transfer at primary level in Tamil Nadu: Governance of a complex health system function

    PubMed Central

    Garimella, Surekha; Sheikh, Kabir

    2016-01-01

    Background: Posting and transfer (PT) of health personnel – placing the right health workers in the right place at the right time – is a core function of any large-scale health service. In the context of government health services, this may be seen as a simple process of bureaucratic governance and implementation of the rule of law. However the literature from India and comparable low and middle-income country health systems suggests that in reality PT is a contested domain, driven by varied expressions of private and public interest throughout the chain of implementation. Objective: To investigate policymaking for PT in the government health sector and implementation of policies as experienced by different health system actors and stakeholders at primary health care level. Methodology: We undertook an empirical case study of a PT reform policy at primary health care level in Tamil Nadu State, to understand how different groups of health systems actors experience PT. In-depth qualitative methods were undertaken to study processes of implementation of PT policies enacted through ‘counselling’ of health workers (individualized consultations to determine postings and transfers). Results: PT emerges as a complex phenomenon, shaped partially by the laws of the state and partially as a parallel system of norms and incentives requiring consideration and coordination of the interests of different groups. Micro-practices of governance represent homegrown coping mechanisms of health administrators that reconcile public and private interests and sustain basic health system functions. Beyond a functional perspective of PT, it also reflects justice and fairness as it plays out in the health system. It signifies how well a system treats its employees, and by inference, is an index of the overall health of the system. Conclusions: For a complex governance function such as PT, the roles of private actors and private interests are not easily separable from the public, but

  3. Primary Care Clinicians’ Perspectives on Reducing Low-Value Care in an Integrated Delivery System

    PubMed Central

    Buist, Diana SM; Chang, Eva; Handley, Matt; Pardee, Roy; Gundersen, Gabrielle; Cheadle, Allen; Reid, Robert J

    2016-01-01

    Context: Perceptions about low-value care (eg, medical tests and procedures that may be unnecessary and/or harmful) among clinicians with capitated salaries are unknown. Objective: Explore clinicians’ perceived use of and responsibility for reducing low-value care by focusing on barriers to use, awareness of the Choosing Wisely campaign, and response to reports of peer-comparison resource use and practice patterns. Methods: Electronic, cross-sectional survey, distributed in 2013, to 304 salaried primary care physicians and physician assistants at Group Health Cooperative. Main Outcome Measures: Attitudes, awareness, and barriers of low-value care strategies and initiatives. Results: A total of 189 clinicians responded (62% response rate). More than 90% believe cost is important to various stakeholders and believe it is fair to ask clinicians to be cost-conscious. Most found peer-comparison resource-use reports useful for understanding practice patterns and prompting peer discussions. Two-thirds of clinicians were aware of the Choosing Wisely campaign; among them, 97% considered it a legitimate information source. Although 88% reported being comfortable discussing low-value care with patients, 80% reported they would order tests or procedures when a patient insisted. As key barriers in reducing low-value care, clinicians identified time constraints (45%), overcoming patient preferences/values (44%), community standards (43%), fear of patients’ dissatisfaction (41%), patients’ knowledge about the harms of low-value care (38%), and availability of tools to support shared decision making (37%). Conclusions: Salaried clinicians are aware of rising health care costs and want to be stewards of limited health care resources. Evidence-based initiatives such as the Choosing Wisely campaign may help motivate clinicians to be conscientious stewards of limited health care resources. PMID:26562308

  4. Methotrexate Re-Challenge for Recurrent Primary Central Nervous System Lymphoma

    PubMed Central

    Pentsova, Elena; DeAngelis, Lisa M.; Omuro, Antonio

    2017-01-01

    Background The prognosis of primary CNS lymphoma (PCNSL) recurring after methotrexate is poor (objective response rates [ORR] = 26%–53%; 1-year overall survival [OS] = 35%–57%). Salvage PCNSL chemotherapies have been based on the use of different agents to avoid cross-resistance; however, methotrexate is the most active agent in PCNSL, and methotrexate re-challenge may be an effective strategy for recurrent disease. We report our experience with methotrexate re-challenge in PCNSL. Methods We reviewed 39 patients with histologically confirmed PCNSL who responded to methotrexate at initial diagnosis, experienced disease relapse and received methotrexate re-challenge. Results At the time of re-challenge, median age was 66 and median Karnofsky Performance Score (KPS) was 70. Median time from initial diagnosis was 26m. Twenty-six patients were at first relapse and 13 at second or later relapse. At re-challenge, methotrexate was given in combination with other agents to 33 patients and as a single agent to six. The objective response rate was 85%, with a complete response in 29 (75%) patients, partial response in four (10%) and disease progression in six (15%). At median follow-up of 26m, the median progression-free survival was 16m; 1-year OS was 79% (95%CI 63–89) and median OS was 41m. KPS was a prognostic factor for progression free survival (p=0.04). Conclusion In this population selected by previous methotrexate response, methotrexate re-challenge was a safe and effective strategy, indicating chemosensitivity was retained. Efficacy compared favorably to other salvage treatments suggesting methotrexate re-challenge should be considered in recurrent PCNSL patients who previously responded to methotrexate. PMID:24481997

  5. Neural substrates of the 'low-level' system for speech articulation: Evidence from primary opercular syndrome.

    PubMed

    Silveri, Maria Caterina; Incordino, Francesco; Lo Monaco, Rita; Bizzarro, Alessandra; Masullo, Carlo; Piludu, Francesca; Colosimo, Cesare

    2016-02-07

    We describe a patient with progressive disorder of speech, without language impairment (opercular syndrome). Morphometric analysis confirmed asymmetric volume reduction of the precentral areas (>left). Diffusion imaging showed significant white matter changes in the left frontal lobe, with specific involvement of the left corticobulbar tract and connections between supplementary/pre-supplementary motor areas and the frontal operculum (frontal aslant tract). We suggest that the organization of expressive language includes a 'low level' motor system principally distributed in the left hemisphere that shows specific susceptibility to neurodegeneration, distinct from neural systems subtending praxic, and cognitive aspects of language.

  6. The Primary Care Physician in the Early Diagnosis of Systemic Sclerosis: the Cornerstone of Recognition and Hope

    PubMed Central

    Saketkoo, Lesley Ann; Magnus, Jeanette H.; Doyle, Mittie K.

    2013-01-01

    Systemic sclerosis (SSc) is a disease of unknown etiology that manifests as a heterogeneous group of multi-organ system manifestations and is characterized by vasculopathy and fibrosis of the skin and internal organs, with mortality related to pulmonary, cardiac, renal or gastrointestinal involvement. The prevalence of SSc may be underestimated in the general population. Cases are often undiagnosed or misdiagnosed, particularly cases with mild or no skin manifestations. Due to late referrals to rheumatologic care, many moderate-to-severe cases progress to irreversible end-organ damage that might have been prevented by early diagnosis. Early diagnosis of SSc with initiation of appropriate treatment is essential, with great impact on morbidity and mortality. This review examines presenting features, ensuing complications and treatment providing a focus on SSc as a treatable disease. Primary care providers play a pivotal role in recognizing initial symptoms associated with SSc and securing early diagnosis through early referral to specialists. PMID:24366221

  7. Primary Angiitis of the Central Nervous System: A Report of Three Cases from a Single Colombian Center

    PubMed Central

    Coronel-Restrepo, Nicolás; Bonilla-Abadía, Fabio; Cortes, Omar A.; Izquierdo, Jorge H.; Shinchi, Alberto M.; Bravo, Juan C.; Tobón, Gabriel J.; Cañas, Carlos A.

    2013-01-01

    The primary angiitis of the central nervous system (PACNS) is an entity with a very low incidence and prevalence. It is not clear why the inflammatory process of this entity is limited to the cerebral vasculature without systemic manifestations. Its clinical manifestations are very heterogeneous and make clinical diagnosis difficult. In most cases, a brain biopsy is required. Only the clinical suspicion and the ability to recognize the possible clinical and imagenological patterns of presentation make an accurate diagnosis possible. The vast majority of the treatment recommendations are given by series of case reports. The following paper described the clinical, imagenological, and histopathological characteristics of three Colombian patients with PACNS. The strategic therapeutic used in shown. PMID:23738167

  8. Tracking and data system support for the Mariner Mars 1971 mission. Volume 3: Orbit insertion through end of primary mission

    NASA Technical Reports Server (NTRS)

    Barnum, P. W.; Renzetti, N. A.; Textor, G. P.; Kelly, L. B.

    1973-01-01

    The Tracking and Data System (TDS) Support for the Mariner Mars 1971 Mission final report contains the deep space tracking and data acquisition activities in support of orbital operations. During this period a major NASA objective was accomplished: completion of the 180th revolution and 90th day of data gathering with the spacecraft about the planet Mars. Included are presentations of the TDS flight support pass chronology data for each of the Deep Space Stations used, and performance evaluation for the Deep Space Network Telemetry, Tracking, Command, and Monitor Systems. With the loss of Mariner 8 at launch, Mariner 9 assumed the mission plan of Mariner 8, which included the TV mapping cycles and a 12-hr orbital period. The mission plan was modified as a result of a severe dust storm on the surface of Mars, which delayed the start of the TV mapping cycles. Thus, the end of primary mission date was extended to complete the TV mapping cycles.

  9. An Air-Liquid Interface Culture System for 3D Organoid Culture of Diverse Primary Gastrointestinal Tissues.

    PubMed

    Li, Xingnan; Ootani, Akifumi; Kuo, Calvin

    2016-01-01

    Conventional in vitro analysis of gastrointestinal epithelium usually relies on two-dimensional (2D) culture of epithelial cell lines as monolayer on impermeable surfaces. However, the lack of context of differentiation and tissue architecture in 2D culture can hinder the faithful recapitulation of the phenotypic and morphological characteristics of native epithelium. Here, we describe a robust long-term three-dimensional (3D) culture methodology for gastrointestinal culture, which incorporates both epithelial and mesenchymal/stromal components into a collagen-based air-liquid interface 3D culture system. This system allows vigorously expansion of primary gastrointestinal epithelium for over 60 days as organoids with both proliferation and multilineage differentiation, indicating successful long-term intestinal culture within a microenvironment accurately recapitulating the stem cell niche.

  10. Westinghouse Small Modular Reactor passive safety system response to postulated events

    SciTech Connect

    Smith, M. C.; Wright, R. F.

    2012-07-01

    The Westinghouse Small Modular Reactor (SMR) is an 800 MWt (>225 MWe) integral pressurized water reactor. This paper is part of a series of four describing the design and safety features of the Westinghouse SMR. This paper focuses in particular upon the passive safety features and the safety system response of the Westinghouse SMR. The Westinghouse SMR design incorporates many features to minimize the effects of, and in some cases eliminates the possibility of postulated accidents. The small size of the reactor and the low power density limits the potential consequences of an accident relative to a large plant. The integral design eliminates large loop piping, which significantly reduces the flow area of postulated loss of coolant accidents (LOCAs). The Westinghouse SMR containment is a high-pressure, compact design that normally operates at a partial vacuum. This facilitates heat removal from the containment during LOCA events. The containment is submerged in water which also aides the heat removal and provides an additional radionuclide filter. The Westinghouse SMR safety system design is passive, is based largely on the passive safety systems used in the AP1000{sup R} reactor, and provides mitigation of all design basis accidents without the need for AC electrical power for a period of seven days. Frequent faults, such as reactivity insertion events and loss of power events, are protected by first shutting down the nuclear reaction by inserting control rods, then providing cold, borated water through a passive, buoyancy-driven flow. Decay heat removal is provided using a layered approach that includes the passive removal of heat by the steam drum and independent passive heat removal system that transfers heat from the primary system to the environment. Less frequent faults such as loss of coolant accidents are mitigated by passive injection of a large quantity of water that is readily available inside containment. An automatic depressurization system is used to

  11. Efficacy of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP) Primary Version

    ERIC Educational Resources Information Center

    DiPerna, James Clyde; Lei, Puiwa; Bellinger, Jillian; Cheng, Weiyi

    2015-01-01

    A multisite cluster randomized trial was conducted to examine the effects of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP; Elliott & Gresham, 2007) on students' classroom social behavior. The final sample included 432 students across 38 second grade classrooms. Social skills and problem behaviors were measured…

  12. One vs two primary LOX feedline configuration study for the National Launch System

    NASA Technical Reports Server (NTRS)

    Dill, K.; Davis, D.; Bates, R.; Tarwater, R.

    1992-01-01

    Six single LOX feedline designs were evaluated for use on the National Launch Vehicle. A single feedline design, designated the 'Spider', was chosen and compared to the baseline system. The baseline configuration employs two 20-inch I.D. lines, each supplying LOX to three 650,000 lbf thrust Space Transportation Main Engines. Five single feedline diameters were examined for the spider configuration; 22, 24, 26, 28, and 30-inch I.D. System dry weights and LOX residuals were estimated. These parameters, along with calculated staged mass for the different single line and baseline configurations, were used to calculate the payload mass to orbit. For the cases where LOX is drained to minimum NPSP conditions, none of the single lines performed as well as the dual line system, although the 22-inch diameter single line compared well. However, for the cases where LOX is drained to operating levels (LOX level at the booster and spider manifolds for the dual and single line configurations, respectively), the 22 - 26-inch I.D. single line systems show a greater payload capability.

  13. The Integration of Pedagogical Aspects in Environmental Management Systems in Selected South African Primary Schools

    ERIC Educational Resources Information Center

    Kanyimba, Alex; Richter, Barry; Raath, Schalk

    2015-01-01

    Environmental management systems implemented in schools are regarded by many as a mechanism for the integration of environmental matters in all the operational functions of the school. The links, however, between environmental management and curriculum practice have not been adequately addressed in the literature. This article reports on the…

  14. Technical Information on the Carbonation of the EBR-II Reactor, Summary Report Part 2: Application to EBR-II Primary Sodium System and Related Systems

    SciTech Connect

    Steven R. Sherman; Collin J. Knight

    2006-03-01

    Residual sodium is defined as sodium metal that remains behind in pipes, vessels, and tanks after the bulk sodium metal has been melted and drained from such components. The residual sodium has the same chemical properties as bulk sodium, and differs from bulk sodium only in the thickness of the sodium deposit. Typically, sodium is considered residual when the thickness of the deposit is less than 5-6 cm. This residual sodium must be removed or deactivated when a pipe, vessel, system, or entire reactor is permanently taken out of service, in order to make the component or system safer and/or to comply with decontamination and decomissioning regulations. As an alternative to the established residual sodium deactivation techniques (steam-and-nitrogen, wet vapor nitrogen, etc.), a technique involving the use of moisture and carbon dioxide has been developed. With this technique, sodium metal is converted into sodium bicarbonate by reacting it with humid carbon dioxide. Hydrogen is emitted as a by-product. This technique was first developed in the laboratory by exposing sodium samples to humidifed carbon dioxide under controlled conditions, and then demonstrated on a larger scale by treating residual sodium within the Experimental Breeder Reactor II (EBR-II) secondary cooling system, followed by the primary cooling system, respectively. The EBR-II facility is located at the Idaho National Laboratory (INL) in southeastern Idaho, USA. This report is Part 2 of a two-part report. This second report provides a supplement to the first report and describes the application of the humdidified carbon dioxide technique ("carbonation") to the EBR-II primary tank, primary cover gas systems, and the intermediate heat exchanger. Future treatment plans are also provided.

  15. [Chirality as a primary switch of hierarchical levels in molecular biological systems].

    PubMed

    Tverdislov, V A

    2013-01-01

    A synergetic law, being of common physicochemical and biological sense, is formulated: any evolving system that possesses an excess of free energy and elements with chiral asymmetry, while being within one hierarchical level, is able to change the type of symmetry in the process of self-organization increasing its complexity but preserving the sign of a prevailing chirality (left - L or right - D twist). The same system tends to form spontaneously a sequence of hierarchical levels with alternating chirality signs of de novo formed structures and with an increase of the structures relative scales. In living systems, the hierarchy of conjugated levels of macromolecular structures that begins from the "lowest" asymmetric carbon serves as an anti-entropic factor as well as the structural basis of "selected mechanical degrees of freedom" in molecular machines. During transition of DNA to a higher level of structural and functional organization regular alterations of the chirality sign D-L-D-L and L-D-L-D for DNA and protein structures, respectively, are observed. Sign-alternating chiral hierarchies of DNA and protein structure, in turn, form a complementary conjugated chiral pair that represents an achiral invariant, that "consummates" the molecular-biological block of living systems. The ability of a carbon atom to form choral compounds is an important factor that determined carbon basis of living systems on the Earth as well as their development though a series of chiral bifurcations. The hierarchy of macromolecular structures demarcated by the chirality sign predetermined the possibility of the "block" character of biological evolution.

  16. Development of a 12-Thrust Chamber Kerosene /Oxygen Primary Rocket Sub-System for an Early (1964) Air-Augmented Rocket Ground-Test System

    NASA Technical Reports Server (NTRS)

    Pryor, D.; Hyde, E. H.; Escher, W. J. D.

    1999-01-01

    Airbreathing/Rocket combined-cycle, and specifically rocket-based combined- cycle (RBCC), propulsion systems, typically employ an internal engine flow-path installed primary rocket subsystem. To achieve acceptably short mixing lengths in effecting the "air augmentation" process, a large rocket-exhaust/air interfacial mixing surface is needed. This leads, in some engine design concepts, to a "cluster" of small rocket units, suitably arrayed in the flowpath. To support an early (1964) subscale ground-test of a specific RBCC concept, such a 12-rocket cluster was developed by NASA's Marshall Space Flight Center (MSFC). The small primary rockets used in the cluster assembly were modified versions of an existing small kerosene/oxygen water-cooled rocket engine unit routinely tested at MSFC. Following individual thrust-chamber tests and overall subsystem qualification testing, the cluster assembly was installed at the U. S. Air Force's Arnold Engineering Development Center (AEDC) for RBCC systems testing. (The results of the special air-augmented rocket testing are not covered here.) While this project was eventually successfully completed, a number of hardware integration problems were met, leading to catastrophic thrust chamber failures. The principal "lessons learned" in conducting this early primary rocket subsystem experimental effort are documented here as a basic knowledge-base contribution for the benefit of today's RBCC research and development community.

  17. Off-label indications for antidepressants in primary care: descriptive study of prescriptions from an indication based electronic prescribing system

    PubMed Central

    Motulsky, Aude; Abrahamowicz, Michal; Eguale, Tewodros; Buckeridge, David L; Tamblyn, Robyn

    2017-01-01

    Objective To examine off-label indications for antidepressants in primary care and determine the level of scientific support for off-label prescribing. Design Descriptive study of antidepressant prescriptions written by primary care physicians using an indication based electronic prescribing system. Setting Primary care practices in and around two major urban centres in Quebec, Canada. Participants Patients aged 18 years or older who visited a study physician between 1 January 2003 and 30 September 2015 and were prescribed an antidepressant through the electronic prescribing system. Main outcome measures Prevalence of off-label indications for antidepressant prescriptions by class and by individual drug. Among off-label antidepressant prescriptions, the proportion of prescriptions in each of the following categories was measured: strong evidence supporting use of the prescribed drug for the respective indication; no strong evidence for the prescribed drug but strong evidence supporting use of another drug in the same class for the indication; or no strong evidence supporting use of the prescribed drug and all other drugs in the same class for the indication. Results 106 850 antidepressant prescriptions were written by 174 physicians for 20 920 adults. By class, tricyclic antidepressants had the highest prevalence of off-label indications (81.4%, 95% confidence interval, 77.3% to 85.5%), largely due to a high off-label prescribing rate for amitriptyline (93%, 89.6% to 95.7%). Trazodone use for insomnia was the most common off-label use for antidepressants, accounting for 26.2% (21.9% to 30.4%) of all off-label prescriptions. For only 15.9% (13.0% to 19.3%) of all off-label prescriptions, the prescribed drug had strong scientific evidence for the respective indication. For 39.6% (35.7% to 43.2%) of off-label prescriptions, the prescribed drug did not have strong evidence but another antidepressant in the same class had strong evidence for the respective

  18. Leaf chlorophyll constraint on model simulated gross primary productivity in agricultural systems

    NASA Astrophysics Data System (ADS)

    Houborg, Rasmus; McCabe, Matthew F.; Cescatti, Alessandro; Gitelson, Anatoly A.

    2015-12-01

    Leaf chlorophyll content (Chll) may serve as an observational proxy for the maximum rate of carboxylation (Vmax), which describes leaf photosynthetic capacity and represents the single most important control on modeled leaf photosynthesis within most Terrestrial Biosphere Models (TBMs). The parameterization of Vmax is associated with great uncertainty as it can vary significantly between plants and in response to changes in leaf nitrogen (N) availability, plant phenology and environmental conditions. Houborg et al. (2013) outlined a semi-mechanistic relationship between Vmax25 (Vmax normalized to 25 °C) and Chll based on inter-linkages between Vmax25, Rubisco enzyme kinetics, N and Chll. Here, these relationships are parameterized for a wider range of important agricultural crops and embedded within the leaf photosynthesis-conductance scheme of the Community Land Model (CLM), bypassing the questionable use of temporally invariant and broadly defined plant functional type (PFT) specific Vmax25 values. In this study, the new Chll constrained version of CLM is refined with an updated parameterization scheme for specific application to soybean and maize. The benefit of using in-situ measured and satellite retrieved Chll for constraining model simulations of Gross Primary Productivity (GPP) is evaluated over fields in central Nebraska, U.S.A between 2001 and 2005. Landsat-based Chll time-series records derived from the Regularized Canopy Reflectance model (REGFLEC) are used as forcing to the CLM. Validation of simulated GPP against 15 site-years of flux tower observations demonstrate the utility of Chll as a model constraint, with the coefficient of efficiency increasing from 0.91 to 0.94 and from 0.87 to 0.91 for maize and soybean, respectively. Model performances particularly improve during the late reproductive and senescence stage, where the largest temporal variations in Chll (averaging 35-55 μg cm-2 for maize and 20-35 μg cm-2 for soybean) are observed. While

  19. Test system for evaluating the influence of polymer properties on primary human keratinocytes and fibroblasts in mono- and coculture.

    PubMed

    Trescher, Karoline; Roch, Toralf; Cui, Jing; Kratz, Karl; Lendlein, Andreas; Jung, Friedrich

    2013-06-20

    Interactions of cells with polymer-based biomaterials are influenced by properties of the substrate. Polymers, which are able to induce cell specific effects, gain increasing importance for biotechnology and regenerative therapies. A test system was developed, which allows studying primary human keratinocytes and fibroblasts in mono- and cocultures to analyze and operate the effect of polymer properties. This system offers to identify polymers for keratinocyte cultivation or wound dressings, since adherence, viability and functionality can be analyzed. Especially the coculture system enables the characterization of potential cell specific effects of polymer-based biomaterials. To establish a coculture test system, it is challenging to find a suitable culture medium, to identify initial seeding densities for comparable cell growth and to develop methods to distinguish and characterize both cell types. Poly(n-butyl acrylate) networks (cPnBAs) as model biomaterials were used to demonstrate the applicability of our newly developed coculture screening system for differential cell growth. The apparent Young's modulus of the cPnBAs differentially regulated fibroblasts and keratinocytes. Particularly, cPnBA73 with an apparent Young's modulus of 930±140 kPa measured in phosphate buffered saline (PBS) solution at ambient temperature seemed to have favoring properties for keratinocyte adhesion, while fibroblast adhesion was not affected. For keratinocytes the concentration of some pro-inflammatory cytokines was lower on cPnBA73 and a decreased deposition of collagen, elastin and fibronectin was observed in the coculture.

  20. Gas dilution system using critical flow Venturi nozzles for generating primary trace-moisture standards in multiple gas species

    NASA Astrophysics Data System (ADS)

    Amano, Minami; Abe, Hisashi

    2017-02-01

    Gas dilution systems are commonly used to generate calibration gas mixtures for secondary gas standards. However, if a gas dilution system is used to generate gas mixtures for primary trace-moisture standards in multiple gas species, difficulty arises; flow control with relative stability of better than 0.009% is required although the relative uncertainty of the best gas flow meter to date is around 0.3%. In this study, we developed a novel gas dilution system using critical flow Venturi nozzles to address this problem. The developed dilution system can measure and control the flow rates of gases in the range of approximately 0.05 l min-1 to 7 l min-1 (when converted to those measured at 101 325 Pa and 273.15 K) with relative stability of better than 0.007%. Using the dilution system, we developed a magnetic suspension balance/diffusion-tube humidity generator capable of generating trace moisture in N2 in the range of approximately 10 nmol mol-1 to 5 µmol mol-1 in amount fraction. The accuracy of the generated trace-moisture standard was verified by measurement with cavity ring-down spectroscopy.

  1. Closing the Feedback Loop: An Interactive Voice Response System to Provide Follow-up and Feedback in Primary Care Settings

    PubMed Central

    Willig, James H.; Krawitz, Marc; Panjamapirom, Anantachai; Ray, Midge N.; Nevin, Christa R.; English, Thomas M.; Cohen, Mark P.; Berner, Eta S.

    2013-01-01

    In primary care settings, follow-up regarding the outcome of acute outpatient visits is largely absent. We sought to develop an automated interactive voice response system (IVRS) for patient follow-up with feedback to providers capable of interfacing with multiple pre-existing electronic medical records (EMRs). A system was designed to extract data from EMRs, integrate with the IVRS, call patients for follow-up, and provide a feedback report to providers. Challenges during the development process were analyzed and summarized. The components of the technological solution and details of its implementation are reported. Lessons learned include: (1) Modular utilization of system components is often needed to adapt to specific clinic workflow and patient population needs (2) Understanding the local telephony environment greatly impacts development and is critical to success, and (3) Ample time for development of the IVRS questionnaire (mapping all branching paths) and speech recognition tuning (sensitivity, use of barge-in tuning, use of “known voice”) is needed. With proper attention to design and development, modular follow-up and feedback systems can be integrated into existing EMR systems providing the benefits of IVRS follow-up to patients and providers across diverse practice settings. PMID:23340825

  2. Oleic acid stimulates system A amino acid transport in primary human trophoblast cells mediated by toll-like receptor 4.

    PubMed

    Lager, Susanne; Gaccioli, Francesca; Ramirez, Vanessa I; Jones, Helen N; Jansson, Thomas; Powell, Theresa L

    2013-03-01

    Obese women have an increased risk to deliver large babies. However, the mechanisms underlying fetal overgrowth in these pregnancies are not well understood. Obese pregnant women typically have elevated circulating lipid levels. We tested the hypothesis that fatty acids stimulate placental amino acid transport, mediated via toll-like receptor 4 (TLR4) and mammalian target of rapamycin (mTOR) signaling pathways. Circulating NEFA levels and placental TLR4 expression were assessed in women with varying prepregnancy body mass index (BMI). The effects of oleic acid on system A and system L amino acid transport, and on the activation of the mTOR (4EBP1, S6K1, rpS6), TLR4 (IĸB, JNK, p38 MAPK), and STAT3 signaling pathways were determined in cultured primary human trophoblast cells. Maternal circulating NEFAs (n = 33), but not placental TLR4 mRNA expression (n = 16), correlated positively with BMI (P < 0.05). Oleic acid increased trophoblast JNK and STAT3 phosphorylation (P < 0.05), whereas mTOR activity was unaffected. Furthermore, oleic acid doubled trophoblast system A activity (P < 0.05), without affecting system L activity. siRNA-mediated silencing of TLR4 expression prevented the stimulatory effect of oleic acid on system A activity. Our data suggest that maternal fatty acids can increase placental nutrient transport via TLR4, thereby potentially affecting fetal growth.

  3. [A computerised clinical decision-support system for the management of depression in Primary Care].

    PubMed

    Aragonès, Enric; Comín, Eva; Cavero, Myriam; Pérez, Víctor; Molina, Cristina; Palao, Diego

    2017-01-09

    Despite its clinical relevance and its importance as a public health problem, there are major gaps in the management of depression. Evidence-based clinical guidelines are useful to improve processes and clinical outcomes. In order to make their implementation easier these guidelines have been transformed into computerised clinical decision support systems. In this article, a description is presented on the basics and characteristics of a new computerised clinical guideline for the management of major depression, developed in the public health system in Catalonia. This tool helps the clinician to establish reliable and accurate diagnoses of depression, to choose the best treatment a priori according to the disease and the patient characteristics. It also emphasises the importance of systematic monitoring to assess the clinical course, and to adjust therapeutic interventions to the patient's needs at all times.

  4. A simple system for auditing the quality of primary care screening in school-age children.

    PubMed

    Longo, G; Bembi, B; Benussi, G; Carrara, F

    1988-01-01

    A system for auditing quality of care and increasing effectiveness was applied to a health screening program for school-age children and the results were analyzed during 2 subsequent years. A problem-oriented record to be filled in whenever the screening was positive represented the basic tool for the evaluation. The record was sent to the specialist who was requested to make a diagnostic assessment and a treatment plan. The same record returned back to the first-level staff thus providing feedback information about diagnostic accuracy and effectiveness of the screening. Periodic self-evaluation meetings and a tutorial system for diagnostic procedures were instituted leading to a general improvement in quality indexes.

  5. Solid Waste Processing Center Primary Opening Cells Systems, Equipment and Tools

    SciTech Connect

    Bailey, Sharon A.; Baker, Carl P.; Mullen, O Dennis; Valdez, Patrick LJ

    2006-04-17

    This document addresses the remote systems and design integration aspects of the development of the Solid Waste Processing Center (SWPC), a facility to remotely open, sort, size reduce, and repackage mixed low-level waste (MLLW) and transuranic (TRU)/TRU mixed waste that is either contact-handled (CH) waste in large containers or remote-handled (RH) waste in various-sized packages.

  6. Double shell tank primary ventilation exhaust flow monitor system design description

    SciTech Connect

    Willingham, W.E., Fluor Daniel Hanford

    1997-03-11

    This document describes the flow monitoring systems that will be installed on the ventilation exhaust ducts of the flammable gas watch list double shell tanks (241-AN-103, 241-AN-104, 241-AN-105, 241-AN-107, 241-AW-101 and 241-SY-103), the saltwell receiver tanks (241-AN-101 and 241-SY-102) and the cross-site receiver tank (241-AP-104).

  7. Alternatives generation and analysis for double-shell tank primary ventilation systems emissions control and monitoring

    SciTech Connect

    SEDERBURG, J.P.

    1999-09-30

    This AGA addresses the question: ''What equipment upgrades, operational changes, and/or other actions are required relative to the DST tanks farms' ventilation systems to support retrieval, staging (including feed sampling), and delivery of tank waste to the Phase I private contractor?'' Issues and options for the various components within the ventilation subsystem affect each other. Recommended design requirements are presented and the preferred alternatives are detailed.

  8. Study on the primary structural members and thermal protection system for HOPE

    NASA Astrophysics Data System (ADS)

    Kobayashi, Tomoyuki; Matsushita, T.; Yamamoto, M.; Ohnishi, T.; Atsumi, M.

    The research objective is to develop high performance main structural materials and Thermal Protection System (TPS) for the H-II Orbiting Plane (HOPE). Preliminary evaluation tests and fundamental tests of heat-resistant fiber-reinforced plastics for the HOPE body structure have been evaluated. For TPS, heat shield concept tests and preliminary evaluation tests have been conducted of high performance TPS based on Ti-alloy, Ni-alloy and advanced carbon/carbon.

  9. Primary and secondary electrical space power based on advanced PEM systems

    NASA Technical Reports Server (NTRS)

    Vanderborgh, N. E.; Hedstrom, J. C.; Stroh, K. R.; Huff, J. R.

    1993-01-01

    For new space ventures, power continues to be a pacing function for mission planning and experiment endurance. Although electrochemical power is a well demonstrated space power technology, current hardware limitations impact future mission viability. In order to document and augment electrochemical technology, a series of experiments for the National Aeronautics and Space Administration Lewis Research Center (NASA LeRC) are underway at the Los Alamos National Laboratory that define operational parameters on contemporary proton exchange membrane (PEM) hardware operating with hydrogen and oxygen reactants. Because of the high efficiency possible for water electrolysis, this hardware is also thought part of a secondary battery design built around stored reactants - the so-called regenerative fuel cell. An overview of stack testing at Los Alamos and of analyses related to regenerative fuel cell systems are provided in this paper. Finally, this paper describes work looking at innovative concepts that remove complexity from stack hardware with the specific intent of higher system reliability. This new concept offers the potential for unprecedented electrochemical power system energy densities.

  10. The Waveform Correlation Event Detection System project, Phase II: Testing with the IDC primary network

    SciTech Connect

    Young, C.J.; Beiriger, J.I.; Moore, S.G.

    1998-04-01

    Further improvements to the Waveform Correlation Event Detection System (WCEDS) developed by Sandia Laboratory have made it possible to test the system on the accepted Comprehensive Test Ban Treaty (CTBT) seismic monitoring network. For our test interval we selected a 24-hour period from December 1996, and chose to use the Reviewed Event Bulletin (REB) produced by the Prototype International Data Center (PIDC) as ground truth for evaluating the results. The network is heterogeneous, consisting of array and three-component sites, and as a result requires more flexible waveform processing algorithms than were available in the first version of the system. For simplicity and superior performance, we opted to use the spatial coherency algorithm of Wagner and Owens (1996) for both types of sites. Preliminary tests indicated that the existing version of WCEDS, which ignored directional information, could not achieve satisfactory detection or location performance for many of the smaller events in the REB, particularly those in the south Pacific where the network coverage is unusually sparse. To achieve an acceptable level of performance, we made modifications to include directional consistency checks for the correlations, making the regions of high correlation much less ambiguous. These checks require the production of continuous azimuth and slowness streams for each station, which is accomplished by means of FK processing for the arrays and power polarization processing for the three-component sites. In addition, we added the capability to use multiple frequency-banded data streams for each site to increase sensitivity to phases whose frequency content changes as a function of distance.

  11. Spatial complexity of character-based writing systems and arithmetic in primary school: a longitudinal study.

    PubMed

    Rodic, Maja; Tikhomirova, Tatiana; Kolienko, Tatiana; Malykh, Sergey; Bogdanova, Olga; Zueva, Dina Y; Gynku, Elena I; Wan, Sirui; Zhou, Xinlin; Kovas, Yulia

    2015-01-01

    Previous research has consistently found an association between spatial and mathematical abilities. We hypothesized that this link may partially explain the consistently observed advantage in mathematics demonstrated by East Asian children. Spatial complexity of the character-based writing systems may reflect or lead to a cognitive advantage relevant to mathematics. Seven hundered and twenty one 6-9-year old children from the UK and Russia were assessed on a battery of cognitive skills and arithmetic. The Russian children were recruited from specialist linguistic schools and divided into four different language groups, based on the second language they were learning (i.e., English, Spanish, Chinese, and Japanese). The UK children attended regular schools and were not learning any second language. The testing took place twice across the school year, once at the beginning, before the start of the second language acquisition, and once at the end of the year. The study had two aims: (1) to test whether spatial ability predicts mathematical ability in 7-9 year-old children across the samples; (2) to test whether acquisition and usage of a character-based writing system leads to an advantage in performance in arithmetic and related cognitive tasks. The longitudinal link from spatial ability to mathematics was found only in the Russian sample. The effect of second language acquisition on mathematics or other cognitive skills was negligible, although some effect of Chinese language on mathematical reasoning was suggested. Overall, the findings suggest that although spatial ability is related to mathematics at this age, one academic year of exposure to spatially complex writing systems is not enough to provide a mathematical advantage. Other educational and socio-cultural factors might play a greater role in explaining individual and cross-cultural differences in arithmetic at this age.

  12. INTEGRATED SYSTEM TO CONTROL PRIMARY PM 2.5 FROM ELECTRIC POWER PLANTS

    SciTech Connect

    Unknown

    2002-03-01

    This is the 6th Quarterly Report under this contract. During this period, the Advanced ElectroCore module precharger and its support frame were installed at Alabama Power Company's E.C. Gaston Steam Plant in Wilsonville, Alabama. This represents the vast portion of the installation work. Ductwork and instrumentation needs to installed before the Advanced ElectroCore module can be tested and demonstrated. Also, the Advanced ElectroCore test plan draft has been prepared, and a design arrangement of a new multipollutant control system with the ElectroCore has been developed.

  13. Loca, Eco Tentokorkvtes (Terrapin Race).

    ERIC Educational Resources Information Center

    Factor, Susannah

    Developed as part of the Seminole Bilingual Education Project, this story and coloring book presents the story of "The Terrapin Race" in both Seminole and English. Right-hand pages offer full-page illustrations for students to color; left-hand pages contain a brief narrative in the two languages in large type. The book uses the sounds…

  14. [Analysis of the MGTI (Mycobacteria Growth Indicator Tube) system in the primary isolation of mycobacteria].

    PubMed

    Togneri, A M; Cimalando, L

    2000-01-01

    The advantages of Mycobacteria Growth Indicator Tube (MGIT) system were analyzed and compared to Löwenstein-Jensen (LJ) and Stonebrink (S) solid media when searching for a fast method to diagnose tuberculosis and mycobacterioses, which should be easy to perform in laboratories and of non-invasive reading. All nonsterile specimens were pretreated with Petroff method. A total of 191 specimens were processed (among which 152 were pulmonary and 39 extrapulmonary). Twenty-nine tested positive by one of the methods employed. The rate of recovery of smear positive specimens (ED+) was of 92% with LJ/S, and 85% with MGIT. The mean time to detect a positive result was 18.7 days with MGIT, and 20.6 days with LJ/S. The rate of recovery of smear negative specimens (ED-) was 88.2% with LJ, 70.6% with S, and 23.5% with MGIT. The mean time to detect a positive result were 38.5; 26.5 and 29 days, respectively. During this experiment, MGIT did not seem to have any advantage over the traditional methods, particularly when working with samples containing a low number of bacilli (p < 0.05). It is obviously necessary to make a comparative study with a large amount of cases which might support this observation and to analyze the influence of the reagents employed in the pre-treatment of the specimens on the MGIT system's efficacy to detect mycobacteria.

  15. Dynamic Tunnel Usability Study: Format Recommendations for Synthetic Vision System Primary Flight Displays

    NASA Technical Reports Server (NTRS)

    Arthur, Jarvis J., III; Prinzel, Lawrence J., III; Kramer, Lynda J.; Bailey, Randall E.

    2006-01-01

    A usability study evaluating dynamic tunnel concepts has been completed under the Aviation Safety and Security Program, Synthetic Vision Systems Project. The usability study was conducted in the Visual Imaging Simulator for Transport Aircraft Systems (VISTAS) III simulator in the form of questionnaires and pilot-in-the-loop simulation sessions. Twelve commercial pilots participated in the study to determine their preferences via paired comparisons and subjective rankings regarding the color, line thickness and sensitivity of the dynamic tunnel. The results of the study showed that color was not significant in pilot preference paired comparisons or in pilot rankings. Line thickness was significant for both pilot preference paired comparisons and in pilot rankings. The preferred line/halo thickness combination was a line width of 3 pixels and a halo of 4 pixels. Finally, pilots were asked their preference for the current dynamic tunnel compared to a less sensitive dynamic tunnel. The current dynamic tunnel constantly gives feedback to the pilot with regard to path error while the less sensitive tunnel only changes as the path error approaches the edges of the tunnel. The tunnel sensitivity comparison results were not statistically significant.

  16. Performance of the primary mirror center-of-curvature optical metrology system during cryogenic testing of the JWST Pathfinder telescope

    NASA Astrophysics Data System (ADS)

    Hadaway, James B.; Wells, Conrad; Olczak, Gene; Waldman, Mark; Whitman, Tony; Cosentino, Joseph; Connolly, Mark; Chaney, David; Telfer, Randal

    2016-07-01

    The James Webb Space Telescope (JWST) primary mirror (PM) is 6.6 m in diameter and consists of 18 hexagonal segments, each 1.5 m point-to-point. Each segment has a six degree-of-freedom hexapod actuation system and a radius of-curvature (RoC) actuation system. The full telescope will be tested at its cryogenic operating temperature at Johnson Space Center. This testing will include center-of-curvature measurements of the PM, using the Center-of-Curvature Optical Assembly (COCOA) and the Absolute Distance Meter Assembly (ADMA). The COCOA includes an interferometer, a reflective null, an interferometer-null calibration system, coarse and fine alignment systems, and two displacement measuring interferometer systems. A multiple-wavelength interferometer (MWIF) is used for alignment and phasing of the PM segments. The ADMA is used to measure, and set, the spacing between the PM and the focus of the COCOA null (i.e. the PM center-of-curvature) for determination of the ROC. The performance of these metrology systems was assessed during two cryogenic tests at JSC. This testing was performed using the JWST Pathfinder telescope, consisting mostly of engineering development and spare hardware. The Pathfinder PM consists of two spare segments. These tests provided the opportunity to assess how well the center-of-curvature optical metrology hardware, along with the software and procedures, performed using real JWST telescope hardware. This paper will describe the test setup, the testing performed, and the resulting metrology system performance. The knowledge gained and the lessons learned during this testing will be of great benefit to the accurate and efficient cryogenic testing of the JWST flight telescope.

  17. Performance of the Primary Mirror Center-of-curvature Optical Metrology System During Cryogenic Testing of the JWST Pathfinder Telescope

    NASA Technical Reports Server (NTRS)

    Hadaway, James B.; Wells, Conrad; Olczak, Gene; Waldman, Mark; Whitman, Tony; Cosentino, Joseph; Connolly, Mark; Chaney, David; Telfer, Randal

    2016-01-01

    The James Webb Space Telescope (JWST) primary mirror (PM) is 6.6 m in diameter and consists of 18 hexagonal segments, each 1.5 m point-to-point. Each segment has a six degree-of-freedom hexapod actuation system and a radius-of-curvature (RoC) actuation system. The full telescope will be tested at its cryogenic operating temperature at Johnson Space Center. This testing will include center-of-curvature measurements of the PM, using the Center-of-Curvature Optical Assembly (COCOA) and the Absolute Distance Meter Assembly (ADMA). The COCOA includes an interferometer, a reflective null, an interferometer-null calibration system, coarse & fine alignment systems, and two displacement measuring interferometer systems. A multiple-wavelength interferometer (MWIF) is used for alignment & phasing of the PM segments. The ADMA is used to measure, and set, the spacing between the PM and the focus of the COCOA null (i.e. the PM center-of-curvature) for determination of the ROC. The performance of these metrology systems was assessed during two cryogenic tests at JSC. This testing was performed using the JWST Pathfinder telescope, consisting mostly of engineering development & spare hardware. The Pathfinder PM consists of two spare segments. These tests provided the opportunity to assess how well the center-of-curvature optical metrology hardware, along with the software & procedures, performed using real JWST telescope hardware. This paper will describe the test setup, the testing performed, and the resulting metrology system performance. The knowledge gained and the lessons learned during this testing will be of great benefit to the accurate & efficient cryogenic testing of the JWST flight telescope.

  18. Frontal lobe dementia syndrome as a first manifestation of primary angiitis of the central nervous system (PACNS).

    PubMed

    Bönstrup, Marlene; Ott, Katja; Glatzel, Markus; Magnus, Tim

    2016-02-01

    This case presents a clinical course of a frontal lobe dysexecutive syndrome with dementia caused by a primary angiitis of the central nervous system (PACNS) of exclusively very small vessels. An isolated frontal lobe dementia syndrome as a primary manifestation of PACNS highlights the diverse clinical manifestations of the disease. The patient presented with a progressive cognitive decline with loss of memory, disinhibited behavior, inappropriate affect and frontal release signs. The diagnostic workup essentially revealed a lymphocytic pleocytosis in the cerebrospinal fluid and a generalized cortical atrophy without any vascular abnormalities. To grasp a diagnosis for this enigmatic clinical picture of a frontal lobe syndrome with signs of inflammation we targeted a tissue-based diagnosis. A brain biopsy gave the decisive hint towards a microvasculitis. Although the histopathologic picture showed peculiarities, a destruction of the vascular bed of very small vessels by lymphocytic infiltration was evident. Our case illustrates an uncommon clinical picture of a PACNS and points to shortcomings of the current histopathologic criteria if only very small vessels are involved.

  19. Activated neu oncogene sequences in primary tumors of the peripheral nervous system induced in rats by transplacental exposure to ethylnitrosourea

    SciTech Connect

    Perantoni, A.O.; Rice, J.M.; Reed, C.D.; Watatani, M.; Wenk, M.L.

    1987-09-01

    Neurogenic tumors were selectively induced in high incidence in F344 rats by a single transplacental exposure to the direct-acting alkylating agent N-ethyl-N-nitrosourea (EtNU). The authors prepared DNA for transfection of NIH 3T3 cells from primary glial tumors of the brain and form schwannomas of the cranial and spinal nerves that developed in the transplacentally exposed offspring between 20 and 40 weeks after birth. DNA preparations from 6 of 13 schwannomas, but not from normal liver, kidney, or intestine of tumor-bearing rats, transformed NIH 3T3 cells. NIH 3T3 clones transformed by schwannoma DNA contained rat repetitive DNA sequences, and all isolates contained rat neu oncogene sequences. A point mutation in the transmembrane region of the putative protein product of neu was identified in all six transformants and in the primary tumors from which they were derived as well as in 5 of 6 schwannomas tested that did not transform NIH 3T3 cells. Of 59 gliomas, only one yielded transforming DNA, and an activated N-ras oncogen was identified. The normal cellular neu sequence for the transmembrane region, but not the mutated sequence, was identified in DNA from all 11 gliomas surveyed by oligonucleotide hybridization. Activation of the neu oncogene, originally identified in cultured cell lines derived from EtNU-induced neurogenic tumors appears specifically associated with tumors of the peripheral nervous system in the F344 inbred strain.

  20. The Five Planets in the Kepler-296 Binary System All Orbit the Primary: An Application of Importance Sampling

    NASA Astrophysics Data System (ADS)

    Barclay, Thomas; Quintana, Elisa; Adams, Fred; Ciardi, David; Huber, Daniel; Foreman-Mackey, Daniel; Montet, Benjamin Tyler; Caldwell, Douglas

    2015-08-01

    Kepler-296 is a binary star system with two M-dwarf components separated by 0.2 arcsec. Five transiting planets have been confirmed to be associated with the Kepler-296 system; given the evidence to date, however, the planets could in principle orbit either star. This ambiguity has made it difficult to constrain both the orbital and physical properties of the planets. Using both statistical and analytical arguments, this paper shows that all five planets are highly likely to orbit the primary star in this system. We performed a Markov-Chain Monte Carlo simulation using a five transiting planet model, leaving the stellar density and dilution with uniform priors. Using importance sampling, we compared the model probabilities under the priors of the planets orbiting either the brighter or the fainter component of the binary. A model where the planets orbit the brighter component, Kepler-296A, is strongly preferred by the data. Combined with our assertion that all five planets orbit the same star, the two outer planets in the system, Kepler-296 Ae and Kepler-296 Af, have radii of 1.53 ± 0.26 and 1.80 ± 0.31 R⊕, respectively, and receive incident stellar fluxes of 1.40 ± 0.23 and 0.62 ± 0.10 times the incident flux the Earth receives from the Sun. This level of irradiation places both planets within or close to the circumstellar habitable zone of their parent star.

  1. The Five Planets in the Kepler-296 Binary System All Orbit the Primary: A Statistical and Analytical Analysis

    NASA Astrophysics Data System (ADS)

    Barclay, Thomas; Quintana, Elisa V.; Adams, Fred C.; Ciardi, David R.; Huber, Daniel; Foreman-Mackey, Daniel; Montet, Benjamin T.; Caldwell, Douglas

    2015-08-01

    Kepler-296 is a binary star system with two M-dwarf components separated by 0.″2. Five transiting planets have been confirmed to be associated with the Kepler-296 system; given the evidence to date, however, the planets could in principle orbit either star. This ambiguity has made it difficult to constrain both the orbital and physical properties of the planets. Using both statistical and analytical arguments, this paper shows that all five planets are highly likely to orbit the primary star in this system. We performed a Markov-Chain Monte Carlo simulation using a five transiting planet model, leaving the stellar density and dilution with uniform priors. Using importance sampling, we compared the model probabilities under the priors of the planets orbiting either the brighter or the fainter component of the binary. A model where the planets orbit the brighter component, Kepler-296A, is strongly preferred by the data. Combined with our assertion that all five planets orbit the same star, the two outer planets in the system, Kepler-296 Ae and Kepler-296 Af, have radii of 1.53 ± 0.26 and 1.80 ± 0.31 {R}\\oplus , respectively, and receive incident stellar fluxes of 1.40 ± 0.23 and 0.62 ± 0.10 times the incident flux the Earth receives from the Sun. This level of irradiation places both planets within or close to the circumstellar habitable zone of their parent star.

  2. Characterization of primary human hepatocyte spheroids as a model system for drug-induced liver injury, liver function and disease

    PubMed Central

    Bell, Catherine C.; Hendriks, Delilah F. G.; Moro, Sabrina M. L.; Ellis, Ewa; Walsh, Joanne; Renblom, Anna; Fredriksson Puigvert, Lisa; Dankers, Anita C. A.; Jacobs, Frank; Snoeys, Jan; Sison-Young, Rowena L.; Jenkins, Rosalind E.; Nordling, Åsa; Mkrtchian, Souren; Park, B. Kevin; Kitteringham, Neil R.; Goldring, Christopher E. P.; Lauschke, Volker M.; Ingelman-Sundberg, Magnus

    2016-01-01

    Liver biology and function, drug-induced liver injury (DILI) and liver diseases are difficult to study using current in vitro models such as primary human hepatocyte (PHH) monolayer cultures, as their rapid de-differentiation restricts their usefulness substantially. Thus, we have developed and extensively characterized an easily scalable 3D PHH spheroid system in chemically-defined, serum-free conditions. Using whole proteome analyses, we found that PHH spheroids cultured this way were similar to the liver in vivo and even retained their inter-individual variability. Furthermore, PHH spheroids remained phenotypically stable and retained morphology, viability, and hepatocyte-specific functions for culture periods of at least 5 weeks. We show that under chronic exposure, the sensitivity of the hepatocytes drastically increased and toxicity of a set of hepatotoxins was detected at clinically relevant concentrations. An interesting example was the chronic toxicity of fialuridine for which hepatotoxicity was mimicked after repeated-dosing in the PHH spheroid model, not possible to detect using previous in vitro systems. Additionally, we provide proof-of-principle that PHH spheroids can reflect liver pathologies such as cholestasis, steatosis and viral hepatitis. Combined, our results demonstrate that the PHH spheroid system presented here constitutes a versatile and promising in vitro system to study liver function, liver diseases, drug targets and long-term DILI. PMID:27143246

  3. Validation of a whole slide imaging system for primary diagnosis in surgical pathology: A community hospital experience

    PubMed Central

    Buck, Thomas P.; Dilorio, Rebecca; Havrilla, Lauren; O’Neill, Dennis G.

    2014-01-01

    Guidelines for validating whole slide imaging (WSI) for primary diagnosis in surgical pathology have been recommended by an expert panel commissioned by the College of American Pathologists. The implementation of such a system using these validation guidelines has not been reported from the community hospital setting. The objective was to implement a WSI system, validate each pathologist using the system and run the system in parallel with routine glass slide interpretation. Six pathologists re-reviewed approximately 300 previously diagnosed specimens each, divided equally between glass slides and digital images (scanned at ×20). Baseline intraobserver discordance rates (glass to glass) were calculated and compared to discordance rates between the original glass slide interpretation and the reviewed digital slide interpretation. A minimum of 3 months was used as the washout period. After validation, a subset of daily cases was diagnosed in parallel using traditional microscopy (TM) and WSI over an 8-month period. The TM and WSI discordance rates ranged from 3.3% to 13.3% and 2.1% to 10.1%, respectively. There was no statistically significant difference among the pathologists. The parallel study yielded similar rates of discordances. In our laboratory, after appropriate implementation and training, there was no difference between the WSI and TM methods. PMID:25535591

  4. Validation of a whole slide imaging system for primary diagnosis in surgical pathology: A community hospital experience.

    PubMed

    Buck, Thomas P; Dilorio, Rebecca; Havrilla, Lauren; O'Neill, Dennis G

    2014-01-01

    Guidelines for validating whole slide imaging (WSI) for primary diagnosis in surgical pathology have been recommended by an expert panel commissioned by the College of American Pathologists. The implementation of such a system using these validation guidelines has not been reported from the community hospital setting. The objective was to implement a WSI system, validate each pathologist using the system and run the system in parallel with routine glass slide interpretation. Six pathologists re-reviewed approximately 300 previously diagnosed specimens each, divided equally between glass slides and digital images (scanned at ×20). Baseline intraobserver discordance rates (glass to glass) were calculated and compared to discordance rates between the original glass slide interpretation and the reviewed digital slide interpretation. A minimum of 3 months was used as the washout period. After validation, a subset of daily cases was diagnosed in parallel using traditional microscopy (TM) and WSI over an 8-month period. The TM and WSI discordance rates ranged from 3.3% to 13.3% and 2.1% to 10.1%, respectively. There was no statistically significant difference among the pathologists. The parallel study yielded similar rates of discordances. In our laboratory, after appropriate implementation and training, there was no difference between the WSI and TM methods.

  5. Instrumentation Needs for Integral Primary System Reactors (IPSRs) - Task 1 Final Report

    SciTech Connect

    Gary D. Storrick; Bojan Petrovic; Luca Oriani; Lawrence E. Conway; Diego Conti

    2005-09-30

    This report presents the results of the Westinghouse work performed under Task 1 of this Financial Assistance Award and satisfies a Level 2 Milestone for the project. While most of the signals required for control of IPSRs are typical of other PWRs, the integral configuration poses some new challenges in the design or deployment of the sensors/instrumentation and, in some cases, requires completely new approaches. In response to this consideration, the overall objective of Task 1 was to establish the instrumentation needs for integral reactors, provide a review of the existing solutions where available, and, identify research and development needs to be addressed to enable successful deployment of IPSRs. The starting point for this study was to review and synthesize general characteristics of integral reactors, and then to focus on a specific design. Due to the maturity of its design and availability of design information to Westinghouse, IRIS (International Reactor Innovative and Secure) was selected for this purpose. The report is organized as follows. Section 1 is an overview. Section 2 provides background information on several representative IPSRs, including IRIS. A review of the IRIS safety features and its protection and control systems is used as a mechanism to ensure that all critical safety-related instrumentation needs are addressed in this study. Additionally, IRIS systems are compared against those of current advanced PWRs. The scope of this study is then limited to those systems where differences exist, since, otherwise, the current technology already provides an acceptable solution. Section 3 provides a detailed discussion on instrumentation needs for the representative IPSR (IRIS) with detailed qualitative and quantitative requirements summarized in the exhaustive table included as Appendix A. Section 3 also provides an evaluation of the current technology and the instrumentation used for measurement of required parameters in current PWRs. Section 4

  6. The intrinsic features of Environmental Management Systems that facilitate adoption and encourage innovation in primary industries.

    PubMed

    Carruthers, Genevieve; Vanclay, Frank

    2012-11-15

    This paper examines the theoretical underpinnings of the adoption of innovations, and applies this knowledge to the uptake of Environmental Management Systems (EMS) amongst Australian farmers. We examine the specific features of the EMS process that might encourage or inhibit EMS adoption. We also consider elements of the EMS process to assess their utility in promoting adoption of various other innovations. We evaluate the EMS process in the light of two characteristics previously found to influence adoption of improved natural resource management practices - 'relative advantage' and 'trialability'. Drawing on literature, and our research and experience with farmers, we conclude that there are inherent features of EMS that promote the adoption of new practices, and that the elements of the EMS process actually create an on-going process of culture change as it is implemented. We believe that the EMS process offers significant advantages to farmers seeking to improve production whilst simultaneously meeting societal expectations for enhanced natural resource management.

  7. Usefulness of a Regional Health Care Information System in primary care: a case study.

    PubMed

    Maass, Marianne C; Asikainen, Paula; Mäenpää, Tiina; Wanne, Olli; Suominen, Tarja

    2008-08-01

    The goal of this paper is to describe some benefits and possible cost consequences of computer based access to specialised health care information. A before-after activity analysis regarding 20 diabetic patients' clinical appointments was performed in a Health Centre in Satakunta region in Finland. Cost data, an interview, time-and-motion studies, and flow charts based on modelling were applied. Access to up-to-date diagnostic information reduced redundant clinical re-appointments, repeated tests, and mail orders for missing data. Timely access to diagnostic information brought about several benefits regarding workflow, patient care, and disease management. These benefits resulted in theoretical net cost savings. The study results indicated that Regional Information Systems may be useful tools to support performance and improve efficiency. However, further studies are required in order to verify how the monetary savings would impact the performance of Health Care Units.

  8. A Smartphone Client-Server Teleradiology System for Primary Diagnosis of Acute Stroke

    PubMed Central

    2011-01-01

    Background Recent advances in the treatment of acute ischemic stroke have made rapid acquisition, visualization, and interpretation of images a key factor for positive patient outcomes. We have developed a new teleradiology system based on a client-server architecture that enables rapid access to interactive advanced 2-D and 3-D visualization on a current generation smartphone device (Apple iPhone or iPod Touch, or an Android phone) without requiring patient image data to be stored on the device. Instead, a server loads and renders the patient images, then transmits a rendered frame to the remote device. Objective Our objective was to determine if a new smartphone client-server teleradiology system is capable of providing accuracies and interpretation times sufficient for diagnosis of acute stroke. Methods This was a retrospective study. We obtained 120 recent consecutive noncontrast computed tomography (NCCT) brain scans and 70 computed tomography angiogram (CTA) head scans from the Calgary Stroke Program database. Scans were read by two neuroradiologists, one on a medical diagnostic workstation and an iPod or iPhone (hereafter referred to as an iOS device) and the other only on an iOS device. NCCT brain scans were evaluated for early signs of infarction, which includes early parenchymal ischemic changes and dense vessel sign, and to exclude acute intraparenchymal hemorrhage and stroke mimics. CTA brain scans were evaluated for any intracranial vessel occlusion. The interpretations made on an iOS device were compared with those made at a workstation. The total interpretation times were recorded for both platforms. Interrater agreement was assessed. True positives, true negatives, false positives, and false negatives were obtained, and sensitivity, specificity, and accuracy of detecting the abnormalities on the iOS device were computed. Results The sensitivity, specificity, and accuracy of detecting intraparenchymal hemorrhage were 100% using the iOS device with a

  9. The systemic vascular resistance response: a cardiovascular response modulating blood viscosity with implications for primary hypertension and certain anemias.

    PubMed

    Sloop, Gregory D; Weidman, Joseph J; St Cyr, John A

    2015-12-01

    Without an active regulatory feedback loop, increased blood viscosity could lead to a vicious cycle of ischemia, increased erythropoiesis, further increases of blood viscosity, decreased tissue perfusion with worsened ischemia, further increases in red cell mass, etc. We suggest that an increase in blood viscosity is detected by mechanoreceptors in the left ventricle which upregulate expression of cardiac natriuretic peptides and soluble erythropoietin receptor. This response normalizes systemic vascular resistance and blood viscosity at the cost of producing 'anemia of chronic disease or inflammation' or 'hemolytic anemia' both of which are better described as states of compensated hyperviscosity. Besides its role in disease, this response is also active in the physiologic adaptation to chronic exercise. Malfunction of this response may cause primary hypertension.

  10. Successful Treatment of Advanced Primary Cutaneous Apocrine Carcinoma on the Scrotum with Systemic Chemotherapy and Radiotherapy Followed by Denosumab

    PubMed Central

    Furudate, Sadanori; Fujimura, Taku; Tsukada, Akira; Sato, Yota; Hidaka, Takanori; Tanita, Kayo; Kambayashi, Yumi; Haga, Takahiro; Hashimoto, Akira; Aiba, Setsuya

    2017-01-01

    Primary cutaneous apocrine carcinoma (PCAC) is a rare and highly aggressive cutaneous adnexal type of tumor that has a high metastasis rate and a poor prognosis. Although there are several case reports describing the successful treatment of PCAC with chemoradiotherapy or molecular targeting therapy, no standard therapy for the treatment of advanced PCAC has been established yet. Since receptor activator of nuclear factor kappa-B ligand (RANKL) is expressed in cancers of apocrine origin, leading to immunosuppression at the tumor site, we hypothesized that targeting RANKL with denosumab might be useful for the treatment of PCAC. In this report, we describe a case with advanced PCAC on the scrotum successfully treated with systemic chemotherapy using carboplatin and paclitaxel, and radiotherapy followed by denosumab. PMID:28203164

  11. The team approach to home-based primary care: restructuring care to meet individual, program, and system needs.

    PubMed

    Reckrey, Jennifer M; Soriano, Theresa A; Hernandez, Cameron R; DeCherrie, Linda V; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2015-02-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address individual, program, and system needs, a portion of a large, physician-led academic home-based primary care practice was restructured into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. The Team Approach is an innovative way to improve interdisciplinary, team-based care through practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound.

  12. The Team Approach to Home-Based Primary Care: Restructuring Care to Meet Patient, Program, and System Needs

    PubMed Central

    Reckrey, Jennifer M.; Soriano, Theresa A.; Hernandez, Cameron R.; DeCherrie, Linda V.; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2016-01-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address patient, program, and system needs, we restructured a portion of our large, physician-led academic home-based primary care practice into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. Our Team Approach is an innovative way to improve interdisciplinary, team-based care though practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound. PMID:25645568

  13. A Systematic Review of Peripheral and Central Nervous System Involvement of Rheumatoid Arthritis, Systemic Lupus Erythematosus, Primary Sjögren's Syndrome, and Associated Immunological Profiles

    PubMed Central

    Bougea, Anastasia; Anagnostou, Evangelos; Konstantinos, Giatas; George, Paraskevas; Triantafyllou, Nikolaos; Kararizou, Evangelia

    2015-01-01

    Both central (CNS) and peripheral nervous system (PNS) complications are frequent and varied in connective tissue diseases. A systematic review was conducted between 1989 and 2014 in the databases Medline, Scopus, and Cochrane Library using the search terms, peripheral and central nervous complications and immunological profiles, to identify studies in specific connective tissue disorders such as rheumatoid arthritis, systemic lupus erythematosus, and primary Sjögren's syndrome. A total of 675 references were identified, of which 118 were selected for detailed analysis and 22 were included in the final review with a total of 2338 participants. Our search focused only on studies upon connective tissue disorders such as rheumatoid arthritis, systemic lupus erythematosus, and primary Sjögren's syndrome associated with seroimmunological data. The reported prevalence of CNS involvement ranges from 9 to 92% across the reported studies. However, the association between CNS and PNS manifestations and seroimmunological profiles remains controversial. Τo date, no laboratory test has been shown as pathognomonic neither for CNS nor for PNS involvement. PMID:26688829

  14. Primary results from the Pan-STARRS-1 Outer Solar System Key Project

    NASA Astrophysics Data System (ADS)

    Holman, Matthew J.; Chen, Ying-Tung; Lackner, Michael; Payne, Matthew John; Lin, Hsing-Wen; Cristopher Fraser, Wesley; Lacerda, Pedro; Pan-STARRS 1 Science Consortium

    2016-10-01

    We have completed a search for slow moving bodies in the data obtained by the Pan-STARRS-1 (PS1) Science Consortium from 2010 to 2014. The data set covers the full sky north of -30 degrees declination, in the PS1 g, r, i, z, y, and w (g+r+i) filters. Our novel distance-based search is effective at detecting and linking very slow moving objects with sparsely sampled observations, even if observations are widely separated in RA, Dec and time, which is relevant to the future LSST solar system searches. In particular, our search is sensitive to objects at heliocentric distances of 25-2000 AU with magnitudes brighter than approximately r=22.5, without limits on the inclination of the object. We recover hundreds of known TNOs and Centaurs and discover hundreds of new objects, measuring phase and color information for many of them. Other highlights include the discovery of a second retrograde TNO, a number of Neptune Trojans, and large numbers of distant resonant TNOs.

  15. A coded structured light system based on primary color stripe projection and monochrome imaging.

    PubMed

    Barone, Sandro; Paoli, Alessandro; Razionale, Armando Viviano

    2013-10-14

    Coded Structured Light techniques represent one of the most attractive research areas within the field of optical metrology. The coding procedures are typically based on projecting either a single pattern or a temporal sequence of patterns to provide 3D surface data. In this context, multi-slit or stripe colored patterns may be used with the aim of reducing the number of projected images. However, color imaging sensors require the use of calibration procedures to address crosstalk effects between different channels and to reduce the chromatic aberrations. In this paper, a Coded Structured Light system has been developed by integrating a color stripe projector and a monochrome camera. A discrete coding method, which combines spatial and temporal information, is generated by sequentially projecting and acquiring a small set of fringe patterns. The method allows the concurrent measurement of geometrical and chromatic data by exploiting the benefits of using a monochrome camera. The proposed methodology has been validated by measuring nominal primitive geometries and free-form shapes. The experimental results have been compared with those obtained by using a time-multiplexing gray code strategy.

  16. Hypothalamic dysfunction in a patient with primary lymphoma of the central nervous system.

    PubMed

    Antic, Darko; Smiljanic, Mihajlo; Bila, Jelena; Jankovic, Snezana; Todorovic, Milena; Andjelic, Bosko; Mihaljevic, Biljana

    2012-04-01

    A 60-year-old woman with no previous history of chronic disease or malignancy presented with intense back and left leg pain and sleep disturbances. The patient had been treated unsuccessfully for the past 6 months with analgetics. Magnetic resonance imaging showed a soft tissue tumor in the L5-S1 region that involved the spinal canal, and a pathohistological analysis of the tumor specimen confirmed the presence of non-Hodgkin, diffuse large B cell lymphoma. After the diagnosis was confirmed, malaise, nausea, and vomiting developed. Multislice computed tomography of the endocranium showed focal infiltration of the hypothalamus and lateral ventricle; dissemination of a systemic lymphoma was excluded. Therapy was initiated as per the De Angelis protocol. After intravenous and intrathecal administration of metotrexate, the patient developed signs of central diabetes insipidus, which responded to therapy with an antidiuretic hormone analog. Despite the obvious infiltration of the hypothalamus, we cannot exclude an idiosyncratic effect of methotrexate on the central diabetes insipidus.

  17. Applying a complex adaptive system's understanding of health to primary care.

    PubMed

    Bircher, Johannes; Hahn, Eckhart G

    2016-01-01

    This paper explores the diagnostic and therapeutic potential of a new concept of health. Investigations into the nature of health have led to a new definition that explains health as a complex adaptive system (CAS) and is based on five components (a-e). Humans like all biological creatures must satisfactorily respond to (a) the demands of life. For this purpose they need (b) a biologically given potential (BGP) and (c) a personally acquired potential (PAP). These properties of individuals are embedded within (d) social and (e) environmental determinants of health. Between these five components of health there are 10 complex interactions that justify viewing health as a CAS. In each patient, the current state of health as a CAS evolved from the past, will move forward to a new future, and has to be analyzed and treated as an autonomous whole. A diagnostic procedure is suggested as follows: together with the patient, the five components and 10 complex interactions are assessed. This may help patients to better understand their situations and to recognize possible next steps that may be useful in order to evolve toward better health by themselves. In this process mutual trust in the patient-physician interaction is critical. The described approach offers new possibilities for helping patients improve their health prospects.

  18. Applying a complex adaptive system's understanding of health to primary care

    PubMed Central

    Bircher, Johannes; Hahn, Eckhart G.

    2016-01-01

    This paper explores the diagnostic and therapeutic potential of a new concept of health. Investigations into the nature of health have led to a new definition that explains health as a complex adaptive system (CAS) and is based on five components (a-e). Humans like all biological creatures must satisfactorily respond to (a) the demands of life. For this purpose they need (b) a biologically given potential (BGP) and (c) a personally acquired potential (PAP). These properties of individuals are embedded within (d) social and (e) environmental determinants of health. Between these five components of health there are 10 complex interactions that justify viewing health as a CAS. In each patient, the current state of health as a CAS evolved from the past, will move forward to a new future, and has to be analyzed and treated as an autonomous whole. A diagnostic procedure is suggested as follows: together with the patient, the five components and 10 complex interactions are assessed. This may help patients to better understand their situations and to recognize possible next steps that may be useful in order to evolve toward better health by themselves. In this process mutual trust in the patient-physician interaction is critical. The described approach offers new possibilities for helping patients improve their health prospects. PMID:27746902

  19. Activated neu oncogene sequences in primary tumors of the peripheral nervous system induced in rats by transplacental exposure to ethylnitrosourea.

    PubMed Central

    Perantoni, A O; Rice, J M; Reed, C D; Watatani, M; Wenk, M L

    1987-01-01

    Neurogenic tumors were selectively induced in high incidence in F344 rats by a single transplacental exposure to the direct-acting alkylating agent N-ethyl-N-nitrosourea (EtNU). We prepared DNA for transfection of NIH 3T3 cells from primary glial tumors of the brain and from schwannomas of the cranial and spinal nerves that developed in the transplacentally exposed offspring between 20 and 40 weeks after birth. DNA preparations from 6 of 13 schwannomas, but not from normal liver, kidney, or intestine of tumor-bearing rats, transformed NIH 3T3 cells. NIH 3T3 clones transformed by schwannoma DNA contained rat repetitive DNA sequences, and all isolates contained rat neu oncogene sequences. One schwannoma yielded a transformant with rat-specific sequences for both neu and N-ras. A point mutation in the transmembrane region of the putative protein product of neu was identified in all six transformants and in the primary tumors from which they were derived as well as in 5 of 6 schwannomas tested that did not transform NIH 3T3 cells. Of 59 gliomas, only one yielded transforming DNA, and an activated N-ras oncogene was identified. The normal cellular neu sequence for the transmembrane region, but not the mutated sequence, was identified in DNA from all 11 gliomas surveyed by oligonucleotide hybridization. Activation of the neu oncogene, originally identified [Schechter, A.L., Stern, D.F., Vaidyanathan, L., Decker, S.J., Drebin, J.A., Greene, M.I. & Weinberg, R.A. (1984) Nature (London) 312, 513-516] in cultured cell lines derived from EtNU-induced neurogenic tumors that by biochemical but not histologic criteria were thought to originate in the central nervous system in BD-IX rats, appears specifically associated with tumors of the peripheral nervous system in the F344 inbred strain. Images PMID:3476947

  20. Increased cerebellar activation after repetitive transcranial magnetic stimulation over the primary motor cortex in patients with multiple system atrophy

    PubMed Central

    Li, Linling; Wu, Tianxia; Hou, Bo; Wu, Shuang; Feng, Feng; Cui, Liying

    2016-01-01

    Background Previous review reported that the high-frequency repetitive transcranial magnetic stimulation (rTMS) over the primary motor area (M1) of Parkinson’s disease (PD) patients could alleviate their symptoms. This study aimed to investigate the effect of rTMS over the left M1 of patients with multiple system atrophy (MSA). Methods Fifteen MSA patients were randomly assigned to receive a 10-session real (EP: group of experimental patients; n=7) or sham (CP: group of control patients; n=8) rTMS stimulation over two weeks. The overall experimental procedure consisted of two functional magnetic resonance imaging (fMRI) sessions, before and after a 10-session rTMS treatment. A complex self-paced sequential tapping task was performed during fMRI scanning. In addition, 18 age and gender matched healthy controls (HC) were enrolled. Subjects from the HC group did not receive any rTMS treatment and they underwent fMRI examination only once. The primary end point was the motor score change of the Unified Multiple System Atrophy Rating Scale (UMSARS-II) measured before and after the 5th and 10th session. Task-related activation was also compared among groups. Results After active rTMS treatment, only patients of EP group significant improvement in UMSARS-II score. Compared to HC, MSA patients showed significant activation over similar brain areas except for the cerebellum. Increased activation was obtained in the bilateral cerebellum after rTMS treatment in the EP group. On the contrary, no increased activation was identified in the CP group. Conclusions Our results highlight rTMS over M1 induced motor improvement in MSA patients that may be associated with increased activation in the cerebellum. PMID:27127756

  1. A Monte Carlo Model of Immune System T-Cell Receptor Cross-Reactivity During Primary Response

    NASA Astrophysics Data System (ADS)

    Burns, J.; Ruskin, H. J.

    2003-04-01

    We present a unique Monte Carlo based cellular automata model that allows us to study aspects of the immune system by combining two distinct formalisms - (i) Physical Space and (ii) Shape Space. The motivation for combining these two formalisms comes from the observation that both local change and global condition inform the immune response to a given stimulus. One common feature of the stimuli under investigation is that they effect an alteration in the immune repertoire density and distribution. The shape-space formalism supports classification of the immune repertoire density and distribution, as well as classification of T-cell receptor/antigen presentation cell affinity. The objective of this paper is to examine the sensitivity of the primary immune response (during clonal expansion) to cross-reactivity of T-cell receptors (ρ). The T-cell receptors and antigen presentation cells are located at specific points within a two-dimensional shape-space, and affinity is measured by the Euclidean distance between T-cell receptor and antigen presentation cell. In order to drive our shape-space, we utilize an enhanced physical-space model to represent one lymph node. Our enhancements include - (i) realistic dynamics within the lymph node compartment accounting for cells entering and leaving via the bloodstream, (ii) Monte Carlo time steps based on the fastest aging entity, thus providing a clinically-realistic time signature, and (iii) realistic cell density levels within the lymph node compartment. As a result of these enhancements our model closely exhibits known clinical patterns during immune system primary response.

  2. Mucopolysaccharidosis type IVA: evidence of primary and secondary central nervous system involvement.

    PubMed

    Borlot, Felippe; Arantes, Paula Ricci; Quaio, Caio Robledo; Franco, José Francisco da Silva; Lourenço, Charles Marques; Gomy, Israel; Bertola, Debora Romeo; Kim, Chong Ae

    2014-05-01

    Mucopolysaccharidosis type IVA is a rare lysosomal storage disease caused by a deficiency of N-acetylgalactosamine 6-sulfatase. Studies usually focus on skeletal abnormalities and their consequences. This study explores the neurological manifestations in a cohort of mucopolysaccharidosis type IVA patients, with a detailed focus on brain and spinal magnetic resonance imaging (MRI) findings. We performed a cross-sectional study involving nine patients with a biochemical confirmation of mucopolysaccharidosis type IVA. The protocol consists of a comprehensive clinical examination and brain and spinal cord MRI analysis for all subjects. The mean age was 16.4 years (±5.7) and the mean onset of symptoms was 11.5 months (±6.3). Overall, cognition was spared in all but one patient and motor weakness was a constant finding in all patients. Deep sensation impairment was found in six patients. The brain MRIs showed non-specific white matter changes in two patients. Other abnormalities such as clival hypoplasia, basilar invagination, and arachnoid cists appeared in seven of the nine patients. Eight patients presented spinal cord compression, and in three of them, two spinal levels were compromised. Odontoid hypoplasia and degenerative features in the neuroaxis were present in all patients. Our experience with mucopolysaccharidosis type IVA patients supports the evidence of central nervous system involvement. We emphasize the importance of regular clinical assessments with complete MRI studies, as an attempt to detect the early signs of spinal cord compression. This evaluation may be especially important before surgical interventions, as occult lesions may become symptomatic and promote postoperative unfavorable outcomes.

  3. In-vivo quantification of primary microRNA processing by Drosha with a luciferase based system

    SciTech Connect

    Allegra, Danilo; Mertens, Daniel

    2011-03-25

    Research highlights: {yields} Posttranscriptional regulation of miRNA processing is difficult to quantify. {yields} Our in-vivo processing assay can quantify Drosha cleavage in live cells. {yields} It is based on luciferase reporters fused with pri-miRNAs. {yields} The assay validates the processing defect caused by a mutation in pri-16-1. {yields} It is a sensitive method to quantify pri-miRNA cleavage by Drosha in live cells. -- Abstract: The RNAse III Drosha is responsible for the first step of microRNA maturation, the cleavage of primary miRNA to produce the precursor miRNA. Processing by Drosha is finely regulated and influences the amount of mature microRNA in a cell. We describe in the present work a method to quantify Drosha processing activity in-vivo, which is applicable to any microRNA. With respect to other methods for measuring Drosha activity, our system is faster and scalable, can be used with any cellular system and does not require cell sorting or use of radioactive isotopes. This system is useful to study regulation of Drosha activity in physiological and pathological conditions.

  4. First description of an in vitro culture system for Eimeria ovinoidalis macromeront formation in primary host endothelial cells.

    PubMed

    Carrau, Tessa; Silva, Liliana Machado Ribeiro; Pérez, David; Ruiz de Ybáñez, Rocio; Taubert, Anja; Hermosilla, Carlos

    2016-10-01

    The apicomplexan parasite Eimeria ovinoidalis is distributed worldwide and causes clinical ovine coccidiosis. As one of the most pathogenic species in sheep, the principal clinical sign is profuse diarrhoea in young animals, which leads to important economic losses in the ovine industry. We here aimed to establish an in vitro culture system for the development of E. ovinoidalis macromeronts, as no suitable systems are currently available for any ovine Eimeria species. Faecal samples containing more than 90% of E. ovinoidalis oocysts were collected from naturally infected lambs and ewes in Murcia Region (Spain). E. ovinoidalis oocysts were collected, left to sporulate in potassium dichromate and stored at 4°C until further studies were conducted. Moreover, a suitable excystation protocol was effectively established, resulting in the release of viable sporozoites, which were allowed to infect primary bovine umbilical vein endothelial cells (BUVEC) and permanent bovine colonic epithelial cells (BCEC). In vitro first merogony was successfully accomplished exclusively in BUVEC leading to macromeront formation (up to 100μm) and the release of fully developed and viable merozoites I stages. Given that we were able to establish a suitable in vitro system for the first merogony of such pathogenic Eimeria species in sheep, advances might be further made not only on studies regarding the control of ovine coccidiosis, such as drug screenings, but also on the better understanding of molecular parasite-host cell interactions as already demonstrated for other ruminant Eimeria species.

  5. Neurological Involvement in Primary Sjögren Syndrome: A Focus on Central Nervous System

    PubMed Central

    Morreale, Manuela; Marchione, Pasquale; Giacomini, Patrizia; Pontecorvo, Simona; Marianetti, Massimo; Vento, Claudio; Tinelli, Emanuele; Francia, Ada

    2014-01-01

    Objectives Sjögren syndrome is an autoimmune disease involving mainly salivary and lacrimal glands. Beyond widely described PNS involvement, high variable prevalence of CNS manifestations ranging from 2.5 and 60% of all pSS patients has been reported, without specific syndrome definition. The aim of this cohort study was to evaluate the prevalence of CNS signs and symptoms in pSS patients and to identify possible biomarkers of CNS damage. Methods 120 patients with pSS diagnosis according to the 2002 American-European Consensus Group criteria were enrolled after exclusion of secondary causes. All patients underwent to a wide neurological, neuropsychological, psychiatric, neuroradiological and ultrasonographic evaluation. Results Central and peripheral nervous system involvement was observed in 81 patients with a prevalence of 67.5%. The prevalence of CNS involvement was significantly higher than PNS disease (p 0.001). 68 patients (84%) shown non-focal CNS symptoms and 64 (79%) focal CNS deficits with headache as the most common feature (46.9%), followed by cognitive (44.4%) and mood disorders (38.3%). Particularly, we observed a high prevalence of migraine without aura, subcortical frontal executive functions and verbal memory impairment and apathy/alexythimia. MR spectroscopy revealed a reduction of NAA levels or NAA/Cr ratio decrease in subcortical frontal and basal ganglia white matter, while ultrasonography showed an impairment of microvasculature response. At multivariate analysis, headache, cognitive disorders and psychiatric symptoms was significantly associated to serological markers (anti-SSA), MRS and ultrasonographic features. Conclusions The higher prevalence of MWO-mimic headache, cognitive dys-esecutive syndrome and mood disorders observed in this series confirmed previous evidences of a higher diffused CNS compromission rather than focal involvement such as SM-like clinical course or NMO-like syndrome. The association with immunological biomarkers

  6. INTEGRATED SYSTEM TO CONTROL PRIMARY PM 2.5 FROM ELECTRIC POWER PLANTS

    SciTech Connect

    Ralph Altman

    2002-06-30

    The performance tests at E.C. Gaston showed how the Advanced ElectroCore field prototype performance changed as a function of the gas flow, inlet loading and the voltage applied to the central electrode in the separator. With the optimum voltage applied to the electrode, the unit achieved a maximum efficiency of 96.38 percent and a minimum outlet loading of 0.0021 grains/dscf while operating with a specific separating area (SSA) of 100 square feet per thousand acfm. The minimum outlet loading translates to about 0.00575 lb{sub m}/million Btu or less than one fifth of the current NSPS standard of 0.03 lb{sub m}/million Btu. The highest efficiency for the upstream ESP was about 99.75 percent. Together these two systems are capable of removing 99.991 percent of the particulate matter coming from the uncontrolled boiler. This efficiency is higher than the target efficiency of 99.99 percent and the outlet loading of 0.00575 lb{sub m}/million Btu is almost half of the target emission rate of 0.01 lb{sub m}/million stated in the program objectives. In terms of efficiency and outlet concentration, the tests showed that the Advanced ElectroCore can meet or exceed the program goals. The mercury capture tests were conducted using the Ontario Hydro method. When injection activated carbon at the rate of 7 pounds per million cubic feet of gas, the measured removal efficiency was about 90 percent. At the time of this writing, LSR was unable to obtain the full report on the mercury testing. If it does become available, it will be included as an appendix to this report. The results show that the ElectroCore has been successfully scaled up by a factor of 12 from the 500 acfm unit tested at Alabama Power Company's Plant Miller in the summer of 1997. The addition of the central electrode has improved the separation efficiency when inlet loadings get very low.

  7. Renin angiotensin aldosterone system altered in resistant hypertension in Sub-Saharan African diabetes patients without evidence of primary hyperaldosteronism

    PubMed Central

    Edinga-Melenge, Bertille Elodie; Ama Moor, Vicky J; Nansseu, Jobert Richie N; Nguetse Djoumessi, Romance; Mengnjo, Michel K; Katte, Jean-Claude; Noubiap, Jean Jacques N

    2017-01-01

    Background The renin-angiotensin-aldosterone system may be altered in patients with resistant hypertension. This study aimed to evaluate the relation between renin-angiotensin-aldosterone system activity and resistant hypertension in Cameroonian diabetes patients with resistant hypertension. Methods We carried out a case-control study including 19 diabetes patients with resistant hypertension and 19 diabetes patients with controlled hypertension matched to cases according to age, sex and duration of hypertension since diagnosis. After collection of data, fasting blood was collected for measurement of sodium, potassium, chloride, active renin and plasma aldosterone of which the aldosterone-renin ratio was derived to assess the activity of renin-angiotensin-aldosterone system. Then, each participant received 2000 ml infusion of saline solution after which plasma aldosterone was re-assayed. Results Potassium levels were lower among cases compared to controls (mean: (4.10 ± 0.63 mmol/l vs. 4.47 ± 0.58 mmol/l), though nonsignificant (p = 0.065). Active renin, plasma aldosterone both before and after the dynamic test and aldosterone-renin ratio were comparable between cases and controls (all p values > 0.05). Plasma aldosterone significantly decreased after the dynamic test in both groups (p < 0.001), but no participant exhibited a post-test value>280 pmol/l. We found a significant negative correlation between potassium ion and plasma aldosterone (ρ = −0.324; p = 0.047), the other correlations being weak and unsignificant. Conclusion Although this study failed to show an association between RH and primary hyperaldosteronism in our context, there was a hyperactivity of renin-angiotensin-aldosterone system. Moreover, this study confirms the importance of potassium dosage when screening the renin-angiotensin-aldosterone system. PMID:28321294

  8. Is litter decomposition 'primed' by primary producer-release of labile carbon in terrestrial and aquatic experimental systems?

    NASA Astrophysics Data System (ADS)

    Soares, A. Margarida P. M.; Kritzberg, Emma S.; Rousk, Johannes

    2015-04-01

    It is possible that recalcitrant organic matter (ROM) can be 'activated' by inputs of labile organic matter (LOM) through the priming effect (PE). Investigating the PE is of major importance to fully understand the microbial use of ROM and its role on carbon (C) and nutrient cycling in both aquatic and terrestrial ecosystems. In aquatic ecosystems it is thought that the PE is triggered by periphytic algae release of LOM. Analogously, in terrestrial systems it is hypothesized that the LOM released in plant rhizospheres, or from the green crusts on the surface of agricultural soils, stimulate the activity and growth of ROM decomposers. Most previous studies on PE have utilised pulse additions of single substrates at high concentrations. However, to achieve an assessment of the true importance of the PE, it is important to simulate a realistic delivery of LOM. We investigated, in a series of 2-week laboratory experiments, how primary producer (PP)-release of LOM influence litter degradation in terrestrial and aquatic experimental systems. We used soil (terrestrial) and pond water (aquatic) microbial communities to which litter was added under light and dark conditions. In addition, glucose was added at PP delivery rates in dark treatments to test if the putative PE in light systems could be reproduced. We observed an initial peak of bacterial growth rate followed by an overall decrease over time with no treatment differences. In light treatments, periphytic algae growth and increased fungal production was stimulated when bacterial growth declined. In contrast, both fungal growth and algal production were negligible in dark treatments. This reveals a direct positive influence of photosynthesis on fungal growth. To investigate if PP LOM supplements, and the associated fungal growth, translate into a modulated litter decomposition, we are using stable isotopes to track the use of litter and algal-derived carbon by determining the δ13C in produced CO2. Fungi and bacteria

  9. Primary Hyperparathyroidism

    MedlinePlus

    ... What is PRIMARY HYPERPARATH YROIDIS M? The body’s parathyroid glands—four pea-sized glands in the neck—produce parathyroid hormone (PTH). Primary hyperparathyroidism (PHPT) is a condition ...

  10. Primary thrombocythemia

    MedlinePlus

    ... as myeloproliferative disorders. Others include: Chronic myelogenous leukemia Polycythemia vera Primary myelofibrosis This disorder is most common ... PA: Elsevier Saunders; 2013:chap 68. Tefferi A. Polycythemia vera, essential thrombocytoemia, and primary myelofibrosis. In: Goldman ...

  11. Primary Aldosteronism

    MedlinePlus

    ... Endocrinology Find an Endocrinologist Value of an Endocrinologist Learn About Clinical Trials Keep Your Body in Balance › Primary Aldosteronism Fact Sheet Primary Aldosteronism March 2012 Download PDFs English Espanol Editors Paul Stewart, MD, FRCP William Young, ...

  12. CHOD/BVAM Chemotherapy and Whole-Brain Radiotherapy for Newly Diagnosed Primary Central Nervous System Lymphoma

    SciTech Connect

    Laack, Nadia N.; O'Neill, Brian Patrick; Ballman, Karla V.; O'Fallon, Judith Rich; Carrero, Xiomara W.; Kurtin, Paul J.; Scheithauer, Bernd W.; Brown, Paul D.; Habermann, Thomas M.; Colgan, Joseph P.; Gilbert, Mark R.; Hawkins, Roland B.; Morton, Roscoe F.; Windschitl, Harry E.; Fitch, Tom R.; Pajon, Eduardo R.

    2011-10-01

    Purpose: To assess the efficacy and toxicity of chemotherapy consisting of cyclophosphamide, doxorubicin (Adriamycin), vincristine, and dexamethasone (CHOD) plus bis-chloronitrosourea (BCNU), cytosine arabinoside, and methotrexate (BVAM) followed by whole-brain irradiation (WBRT) for patients with primary central nervous system lymphoma (PCNSL). Methods and Materials: Patients 70 years old and younger with newly diagnosed, biopsy-proven PCNSL received one cycle of CHOD followed by two cycles of BVAM. Patients then received WBRT, 30.6 Gy, if a complete response was evoked, or 50.4 Gy if the response was less than complete; both doses were given in 1.8-Gy daily fractions. The primary efficacy endpoint was 1-year survival. Results: Thirty-six patients (19 men, 17 women) enrolled between 1995 and 2000. Median age was 60.5 years (range, 34 to 69 years). Thirty (83%) patients had baseline Eastern Cooperative Oncology Group performance scores of 0 to 1. All 36 patients were eligible for survival and response evaluations. Median time to progression was 12.3 months, and median survival was 18.5 months. The percentages of patients alive at 1, 2, and 3 years were 64%, 36%, and 33%, respectively. The best response was complete response in 10 patients and immediate progression in 7 patients. Ten (28%) patients had at least one grade 3 or higher neurologic toxicity. Conclusions: This regimen did improve the survival of PCNSL patients but also caused substantial toxicity. The improvement in survival is less than that reported with high-dose methotrexate-based therapies.

  13. Cisplatin-based chemotherapy followed by focal, reduced-dose irradiation for pediatric primary central nervous system germinomas.

    PubMed

    Douglas, James G; Rockhill, Jason K; Olson, James M; Ellenbogen, Richard G; Geyer, J Russell

    2006-01-01

    The objective of this study was to evaluate retrospectively one institution's experience treating pediatric central nervous system (CNS) pure germinomas with platinum-based chemotherapy followed by focal, reduced-dose irradiation. Eight patients were identified with localized, pure CNS germinomas from 1993 to 2004 at the authors' institution. The median age at diagnosis was 13 years (range 7-19). The median follow-up was 40 months (range 8-141). The tumor location was suprasellar in four, the pineal region in three, and the third ventricle in one. Irradiation was started a median of 20 weeks (range 17-22) from diagnosis and consisted of conformal fields to the primary site as determined by the initial diagnostic MR plus a 1.5- to 2-cm margin. Six of the eight patients received a dose of 3,060 cGy; two patients received 3,600 cGy. The 5-year actuarial event free survival was 71% (56-86%, 95% CI). Two patients suffered marginal (at field edge) failures and both were salvaged using reinduction platinum-based chemotherapy followed by cranial spinal irradiation and a boost to the primary tumor. The 5-year actuarial overall survival was 100%. There were no spinal failures. These data suggest that a reduction in both volume and dose (30.6-36 Gy) retains the excellent survival rates for patients with localized, pure germinomas of the CNS. A higher rate of ventricular relapse rate is observed, although salvage of those patients is feasible.

  14. Primary vitamin D receptor target genes as biomarkers for the vitamin D3 status in the hematopoietic system.

    PubMed

    Wilfinger, Julia; Seuter, Sabine; Tuomainen, Tomi-Pekka; Virtanen, Jyrki K; Voutilainen, Sari; Nurmi, Tarja; de Mello, Vanessa D F; Uusitupa, Matti; Carlberg, Carsten

    2014-08-01

    Vitamin D(3) belongs to the few nutritional compounds that has, via the binding of its metabolite 1α,25-dihydroxyvitamin D(3) (1,25(OH)(2)D(3)) to the transcription factor vitamin D receptor (VDR), a direct effect on gene regulation. The relation of thousands of genomic VDR-binding sites to a few hundred primary 1,25(OH)(2)D(3) target genes is still largely unresolved. We studied chromatin domains containing genes for the adhesion molecules CD97 and LRRC8A, the glucose transporter SLC37A2 and the coactivator NRIP1. These domains vary significantly in size (7.3 to 956 kb) but contain each one major VDR-binding site. In monocytic cells these four sites are associated with open chromatin and occupied by VDR, while in macrophage-like cells only the sites of LRRC8A, SLC37A2 and NRIP1 are accessible and receptor bound. The VDR site of CD97 does, in contrast to the three other loci, not carry any DR3-type binding sequence. CD97, LRRC8A, SLC37A2 and NRIP1 are early responding 1,25(OH)(2)D(3) target genes in monocytic cells, while in macrophage-like cells they respond less and, in part, delayed. In primary human peripheral blood mononuclear cells from 71 prediabetic subjects of a vitamin D(3) intervention study (VitDmet) CD97, LRRC8A, SLC37A2 and NRIP1 can be used as transcriptomic biomarkers for classifying human individuals for their possible benefit from vitamin D(3) supplementation. In particular, NRIP1 exceeds the potential of the previously identified marker CD14 by more than 40% and seems to be a well-suited molecular marker for the vitamin D(3) status in the hematopoietic system.

  15. Impact of biodiversity-climate futures on primary production and metabolism in a model benthic estuarine system

    PubMed Central

    2011-01-01

    Background Understanding the effects of anthropogenically-driven changes in global temperature, atmospheric carbon dioxide and biodiversity on the functionality of marine ecosystems is crucial for predicting and managing the associated impacts. Coastal ecosystems are important sources of carbon (primary production) to shelf waters and play a vital role in global nutrient cycling. These systems are especially vulnerable to the effects of human activities and will be the first areas impacted by rising sea levels. Within these coastal ecosystems, microalgal assemblages (microphytobenthos: MPB) are vital for autochthonous carbon fixation. The level of in situ production by MPB mediates the net carbon cycling of transitional ecosystems between net heterotrophic or autotrophic metabolism. In this study, we examine the interactive effects of elevated atmospheric CO2 concentrations (370, 600, and 1000 ppmv), temperature (6°C, 12°C, and 18°C) and invertebrate biodiversity on MPB biomass in experimental systems. We assembled communities of three common grazing invertebrates (Hydrobia ulvae, Corophium volutator and Hediste diversicolor) in monoculture and in all possible multispecies combinations. This experimental design specifically addresses interactions between the selected climate change variables and any ecological consequences caused by changes in species composition or richness. Results The effects of elevated CO2 concentration, temperature and invertebrate diversity were not additive, rather they interacted to determine MPB biomass, and overall this effect was negative. Diversity effects were underpinned by strong species composition effects, illustrating the importance of individual species identity. Conclusions Overall, our findings suggest that in natural systems, the complex interactions between changing environmental conditions and any associated changes in invertebrate assemblage structure are likely to reduce MPB biomass. Furthermore, these effects would be

  16. Interleukin-1β inhibits insulin signaling and prevents insulin-stimulated system A amino acid transport in primary human trophoblasts.

    PubMed

    Aye, Irving L M H; Jansson, Thomas; Powell, Theresa L

    2013-12-05

    Interleukin-1β (IL-1β) promotes insulin resistance in tissues such as liver and skeletal muscle; however the influence of IL-1β on placental insulin signaling is unknown. We recently reported increased IL-1β protein expression in placentas of obese mothers, which could contribute to insulin resistance. In this study, we tested the hypothesis that IL-1β inhibits insulin signaling and prevents insulin-stimulated amino acid transport in cultured primary human trophoblast (PHT) cells. Cultured trophoblasts isolated from term placentas were treated with physiological concentrations of IL-1β (10pg/ml) for 24h. IL-1β increased the phosphorylation of insulin receptor substrate-1 (IRS-1) at Ser307 (inhibitory) and decreased total IRS-1 protein abundance but did not affect insulin receptor β expression. Furthermore, IL-1β inhibited insulin-stimulated phosphorylation of IRS-1 (Tyr612, activation site) and Akt (Thr308) and prevented insulin-stimulated increase in PI3K/p85 and Grb2 protein expression. IL-1β alone stimulated cRaf (Ser338), MEK (Ser221) and Erk1/2 (Thr202/Tyr204) phosphorylation. The inflammatory pathways nuclear factor kappa B and c-Jun N-terminal kinase, which are involved in insulin resistance, were also activated by IL-1β treatment. Moreover, IL-1β inhibited insulin-stimulated System A, but not System L amino acid uptake, indicating functional impairment of insulin signaling. In conclusion, IL-1β inhibited the insulin signaling pathway by inhibiting IRS-1 signaling and prevented insulin-stimulated System A transport, thereby promoting insulin resistance in cultured PHT cells. These findings indicate that conditions which lead to increased systemic maternal or placental IL-1β levels may attenuate the effects of maternal insulin on placental function and consequently fetal growth.

  17. The BDNF Val66Met polymorphism is associated with the functional connectivity dynamics of pain modulatory systems in primary dysmenorrhea

    PubMed Central

    Wei, Shyh-Yuh; Chao, Hsiang-Tai; Tu, Cheng-Hao; Lin, Ming-Wei; Li, Wei-Chi; Low, Intan; Shen, Horng-Der; Chen, Li-Fen; Hsieh, Jen-Chuen

    2016-01-01

    Primary dysmenorrhea (PDM), menstrual pain without an organic cause, is a prevailing problem in women of reproductive age. We previously reported alterations of structure and functional connectivity (FC) in the periaqueductal gray (PAG) of PDM subjects. Given that the brain derived neurotrophic factor (BDNF) acts as a pain modulator within the PAG and the BDNF Val66Met polymorphism contributes towards susceptibility to PDM, the present study of imaging genetics set out to investigate the influence of, firstly, the BDNF Val66Met single nucleotide polymorphism and, secondly, the genotype-pain interplays on the descending pain modulatory systems in the context of PAG-seeded FC patterning. Fifty-six subjects with PDM and 60 controls participated in the current study of resting-state functional magnetic resonance imaging (fMRI) during the menstruation and peri-ovulatory phases; in parallel, blood samples were taken for genotyping. Our findings indicate that the BDNF Val66Met polymorphism is associated with the diverse functional expressions of the descending pain modulatory systems. Furthermore, PAG FC patterns in pain-free controls are altered in women with PDM in a genotype-specific manner. Such resilient brain dynamics may underpin the individual differences and shed light on the vulnerability for chronic pain disorders of PDM subjects. PMID:27010666

  18. Health Information System in Primary Health Care: The Challenges and Barriers from Local Providers’ Perspective of an Area in Iran

    PubMed Central

    Yazdi-Feyzabadi, Vahid; Emami, Mozhgan; Mehrolhassani, Mohammad Hossein

    2015-01-01

    Background: Health information system (HIS) has been utilized for collecting, processing, storing, and transferring the required information for planning and decision-making at different levels of health sector to provide quality services. In this study, in order to provide high-quality HIS, primary health care (PHC) providers’ perspective on current challenges and barriers were investigated. Methods: This study was carried out with a qualitative approach using semi-structured audiotaped focus group discussions (FGDs). One FGD was conducted with 13 Behvarz and health technicians as front-line workers and the other with 16 personnel including physicians, statisticians, and health professionals working in health centers of the PHC network in KUMS. The discussions were transcribed and then analyzed using the framework analysis method. Results: The identified organizational challenges were categorized into two groups: HIS structure and the current model of PHC in urban areas. Furthermore, the structural challenges were classified into HIS management structure (information systems resources, including human, supplies, and organizational rules) and information process. Conclusions: The HIS works effectively and efficiently when there are a consistency and integrity between the human, supplies, and process aspects. Hence, multifaceted interventions including strengthening the organizational culture to use the information in decisions, eliminating infrastructural obstacles, appointing qualified staff and more investment for service delivery at urban areas are the most fundamental requirements of high-quality HIS in PHC. PMID:26236444

  19. A randomized controlled trial comparing primary tumour resection plus systemic therapy with systemic therapy alone in metastatic breast cancer (PRIM-BC): Japan Clinical Oncology Group Study JCOG1017.

    PubMed

    Shien, Tadahiko; Nakamura, Kenichi; Shibata, Taro; Kinoshita, Takayuki; Aogi, Kenjiro; Fujisawa, Tomomi; Masuda, Norikazu; Inoue, Kenichi; Fukuda, Haruhiko; Iwata, Hiroji

    2012-10-01

    This trial is being conducted to confirm the superiority, in terms of overall survival, of primary tumour resection plus systemic therapy to systemic therapy alone in patients with Stage IV breast cancer who are not refractory to primary systemic therapy. The inclusion criteria for the study are as follows: untreated patients with histologically confirmed invasive breast cancer with one or more measurable metastatic lesions diagnosed by radiological examination. All patients receive primary systemic therapy according to the estrogen receptor and human epidermal growth factor receptor type-2 status of the primary breast cancer after the first registration. After 3 months, the patients without disease progression are randomized to the primary tumour resection plus systemic therapy arm or the systemic therapy alone arm. The primary endpoint is the overall survival, and the secondary endpoints are proportion of patients without tumour progression at the metastatic sites, yearly local recurrence-free survival, proportion of local ulcer/local bleeding, yearly primary tumour resection-free survival, adverse events of chemotherapy, operative morbidity and serious adverse events. The patient recruitment was commenced in May 2011. Enrolment of 410 patients for randomization is planned over a 5 year recruitment period. We hereby report the details of the study.

  20. International Expert Consensus on Primary Systemic Therapy in the Management of Early Breast Cancer: Highlights of the Fifth Symposium on Primary Systemic Therapy in the Management of Operable Breast Cancer, Cremona, Italy (2013)

    PubMed Central

    Amoroso, Vito; Generali, Daniele; Buchholz, Thomas; Cristofanilli, Massimo; Pedersini, Rebecca; Curigliano, Giuseppe; Daidone, Maria Grazia; Di Cosimo, Serena; Dowsett, Mitchell; Fox, Stephen; Harris, Adrian L.; Makris, Andreas; Vassalli, Lucia; Ravelli, Andrea; Cappelletti, Maria Rosa; Hatzis, Christos; Hudis, Clifford A.; Pedrazzoli, Paolo; Sapino, Anna; Semiglazov, Vladimir; Von Minckwitz, Gunter; Simoncini, Edda L.; Jacobs, Michael A.; Barry, Peter; Kühn, Thorsten; Darby, Sarah; Hermelink, Kerstin; Symmans, Fraser; Gennari, Alessandra; Schiavon, Gaia; Dogliotti, Luigi; Berruti, Alfredo

    2015-01-01

    Expert consensus-based recommendations regarding key issues in the use of primary (or neoadjuvant) systemic treatment (PST) in patients with early breast cancer are a valuable resource for practising oncologists. PST remains a valuable therapeutic approach for the assessment of biological antitumor activity and clinical efficacy of new treatments in clinical trials. Neoadjuvant trials provide endpoints, such as pathological complete response (pCR) to treatment, that potentially translate into meaningful improvements in overall survival and disease-free survival. Neoadjuvant trials need fewer patients and are less expensive than adjuvant trial, and the endpoint of pCR is achieved in months, rather than years. For these reasons, the neoadjuvant setting is ideal for testing emerging targeted therapies in early breast cancer. Although pCR is an early clinical endpoint, its role as a surrogate for long-term outcomes is the key issue. New and better predictors of treatment efficacy are needed to improve treatment and outcomes. After PST, accurate management of post-treatment residual disease is mandatory. The surgery of the sentinel lymph-node could be an acceptable option to spare the axillary dissection in case of clinical negativity (N0) of the axilla at the diagnosis and/or after PST. No data exists yet to support the modulation of the extent of locoregional radiation therapy on the basis of the response attained after PST although trials are underway. PMID:26063896