Science.gov

Sample records for primary system loca

  1. System code requirements for SBWR LOCA predictions

    SciTech Connect

    Rohatgi, U.S.; Slovik, G.; Kroeger, P.

    1994-12-31

    The simplified boiling water reactor (SBWR) is the latest design in the family of boiling water reactors (BWRs) from General Electric. The concept is based on many innovative, passive, safety systems that rely on naturally occurring phenomena, such as natural circulation, gravity flows, and condensation. Reliability has been improved by eliminating active systems such as pumps and valves. The reactor pressure vessel (RPV) is connected to heat exchangers submerged in individual water tanks, which are open to atmosphere. These heat exchanger, or isolation condensers (ICs), provide a heat sink to reduce the RPV pressure when isolated. The RPV is also connected to three elevated tanks of water called the gravity-driven cooling system (GDCS). During a loss-of-coolant accident (LOCA), the RPV is depressurized by the automatic depressurization system (ADS), allowing the gravity-driven flow from the GDCS tanks. The containment pressure is controlled by a passive containment cooling system (PCCS) and suppression pool. Similarly, there are new plant protection systems in the SBWR, such as fine-motion control rod drive, passive standby liquid control system, and the automatic feedwater runback system. These safety and plant protection systems respond to phenomena that are different from previous BWR designs. System codes must be upgraded to include models for the phenomena expected during transients for the SBWR.

  2. Code System for Supercritical Water Cooled Reactor LOCA Analysis.

    1999-10-13

    Version 00 The new SCRELA code was developed to analyze the LOCA of the supercritical water cooled reactor. Since the currently available LWR codes for LOCA analysis could not analyze the significant differences in reactor characteristics between the supercritical-water cooled reactor and the current LWR, the first objective of this code development was to analyze the uniqueness of this reactor. The behavior of the supercritical water in the blowdown phase and the reflood phase ismore » modeled.« less

  3. Comparison of TRAC and RELAP5 reactor system calculations for a DEGB LOCA in K-14.1

    SciTech Connect

    Griggs, D.P.; Liebmann, M.L.

    1990-09-01

    A comparison of TRAC and RELAP5 predictions of steady-state and DEGB LOCA results (FI phase) for K-14.1 has been made. Both codes had been previously benchmarked against 1985 L Reactor AC Flow data and were under configuration control. The purpose of the code-to-code comparison is to provide insight on the transient uncertainty in TRAC plenum and tank bottom plenum pressures. The comparisons focus on LOCA results between 0.5 and 2.0 s, which is the primary period of interest for Flow Instability (FI) limits.

  4. Comparison of TRAC and RELAP5 reactor system calculations for a DEGB LOCA in K-14. 1

    SciTech Connect

    Griggs, D.P. ); Liebmann, M.L. )

    1990-09-01

    A comparison of TRAC and RELAP5 predictions of steady-state and DEGB LOCA results (FI phase) for K-14.1 has been made. Both codes had been previously benchmarked against 1985 L Reactor AC Flow data and were under configuration control. The purpose of the code-to-code comparison is to provide insight on the transient uncertainty in TRAC plenum and tank bottom plenum pressures. The comparisons focus on LOCA results between 0.5 and 2.0 s, which is the primary period of interest for Flow Instability (FI) limits.

  5. Continuation and bifurcation analysis of large-scale dynamical systems with LOCA.

    SciTech Connect

    Salinger, Andrew Gerhard; Phipps, Eric Todd; Pawlowski, Roger Patrick

    2010-06-01

    Dynamical systems theory provides a powerful framework for understanding the behavior of complex evolving systems. However applying these ideas to large-scale dynamical systems such as discretizations of multi-dimensional PDEs is challenging. Such systems can easily give rise to problems with billions of dynamical variables, requiring specialized numerical algorithms implemented on high performance computing architectures with thousands of processors. This talk will describe LOCA, the Library of Continuation Algorithms, a suite of scalable continuation and bifurcation tools optimized for these types of systems that is part of the Trilinos software collection. In particular, we will describe continuation and bifurcation analysis techniques designed for large-scale dynamical systems that are based on specialized parallel linear algebra methods for solving augmented linear systems. We will also discuss several other Trilinos tools providing nonlinear solvers (NOX), eigensolvers (Anasazi), iterative linear solvers (AztecOO and Belos), preconditioners (Ifpack, ML, Amesos) and parallel linear algebra data structures (Epetra and Tpetra) that LOCA can leverage for efficient and scalable analysis of large-scale dynamical systems.

  6. 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.

  7. Code System for Best-Estimate Analysis of LOCA in BWR.

    2001-07-23

    Version 00 TRAC-BD1 performs best estimate analyses of loss-of-coolant accidents (LOCA) and other transients in boiling water reactors (BWRs). The program provides LOCA analysis capability for BWRs and for many BWR-related thermal-hydraulic experimental facilities. The program features a three-dimensional treatment of the BWR pressure vessel, a detailed model of a BWR fuel bundle including multi-rod, multi-bundle, radiation heat transfer, and leakage path modeling capability; flow-regime-dependent constitutive equation treatment; reflood tracking capability both for falling filmsmore » and bottom flood quench fronts; and consistent treatment of the entire accident sequence. Dump/restart capabilities are also provided.« less

  8. TRACG prediction of gravity-driven cooling system response in the SBWR/GIST facility LOCA tests

    SciTech Connect

    Alamgir, M.; Andersen, J.G.M.; Yang, A.I.; Shiralkar, B.S. )

    1990-01-01

    General Electric (BE) Nuclear Energy has initiated work on technology programs in support of the advanced light water reactor (ALWR) plants under contract to the U.S. Department of Energy (DOE). Work has been performed under the advanced boiling water reactor (ABWT) design verification program and the simplified boiling water reactor (SBWR) program. The objective of the SBWR program is to develop the key features of a simplified reactor design. The gravity-driven cooling system (GDCS) is an important feature of the SBWR design. The main objectives of the GDCS test program at GE were to demonstrate the technical feasibility of the GDCS concept by performing a section-scaled integrated systems test of the SBWR design and to provide a data base to qualify the TRACG computer code for use in SBWR accident analysis. This paper describes the qualification of TRACG for GDCS applications. The calculational capability and analytical models of TRACG are tested by performing assessment analysis for five loss-of-coolant-accident (LOCA) tests in the GDCS Integrated Systems Test (GIST) facility. The results of the qualification comparisons are presented and TRACG application ranges are discussed.

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. Fuel behavior during a LOCA: LOFT experiments

    SciTech Connect

    Russell, M.L.

    1980-11-01

    The LOFT experiments have provided the following fuel behavior information which appears to be valuable for improving the safety of PWR operation and resolving PWR licensing issues: (1) A generic unassisted core cooling event occurs during large-break LOCAs that dominates the cooling of the core before ECC reflood commences and potentially eliminates the possibility of flow channel blockage from prepressurized fuel rod swelling. (2) The large-break LOCA decompression forces do not disturb the normal control rod gravity drop and may not structually damage the fuel assemblies. (3) Large-break LOCA core cooling may also be enhanced by spacer grid and core counter flow delay of liquid escape from the core boundaries and liquid fallback from the upper plenum into the core region. (4) Lower fuel rod prepressurization may be possible in PWR fuel rods which would reduce flow channel blockage complications during LOCA's. (5) Uniform fuel rod cladding temperature indications during the large break LOCA's do not confirm expectations for the fuel rod cladding temperature variations that would inhibit development of flow channel blockages by ballooning of prepressurized fuel rods.

  15. Gemini primary mirror support system

    NASA Astrophysics Data System (ADS)

    Stepp, Larry M.; Huang, Eugene W.; Cho, Myung K.

    1994-06-01

    The primary mirror selected for the Gemini 8-m Telescopes is a thin meniscus made of Corning ULE(superscript TM) glass. The conceptual design of the Gemini support system has evolved in response to the properties of the meniscus mirror and the functional requirements of the Gemini Telescopes. This paper describes the design requirements, the design features, and predicted performance of this system.

  16. 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.

  17. 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 sexuality. Set in a barrio…

  18. 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

  19. 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.

  20. Calculation of fuel pin failure timing under LOCA conditions

    SciTech Connect

    Jones, K.R.; Wade, N.L.; Siefken, L.J.; Straka, M.; Katsma, K.R.

    1991-10-01

    The objective of this research was to develop and demonstrate a methodology for calculation of the time interval between receipt of the containment isolation signals and the first fuel pin failure for loss-of-coolant accidents (LOCAs). Demonstration calculations were performed for a Babcock and Wilcox (B W) design (Oconee) and a Westinghouse (W) 4-loop design (Seabrook). Sensitivity studies were performed to assess the impacts of fuel pin burnup, axial peaking factor, break size, emergency core cooling system (ECCS) availability, and main coolant pump trip on these items. The analysis was performed using a four-code approach, comprised of FRAPCON-2, SCDAP/RELAP5/MOD3, TRAC-PF1/MOD1, and FRAP-T6. In addition to the calculation of timing results, this analysis provided a comparison of the capabilities of SCDAP/RELAP5/MOD3 with TRAC-PF1/MOD1 for large-break LOCA analysis. This paper discusses the methodology employed and the code development efforts required to implement the methodology. The shortest time intervals calculated between initiation of containment isolation and fuel pin failure were 11.4 s and 19.1 for the B W and W plants, respectively. The FRAP-T6 fuel pin failure times calculated using thermal-hydraulic data generated by SCDAP/RELAP5/MOD3 were more conservative than those calculated using data generated by TRAC-PF1/MOD1. 18 refs., 7 figs., 4 tabs.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Effect of spray parameter on containment depressurization during LOCA in KAPP 3 and 4, 700 MWE IPHWR

    SciTech Connect

    Sharma, S. K.; Bhartia, D. K.; Mohan, N.; Malhotra, P. K.; Ghadge, S. G.

    2012-07-01

    KAPP 3 and 4 is an Indian Pressurized Heavy Water Reactor (IPHWR) of 700 MWe capacities. It is a pressure tube type reactor with heavy water as moderator and coolant and natural Uranium Dioxide as fuel. It consists of 392 horizontal fuel channel assemblies and surrounded by three separate water systems i.e. primary coolant, moderator and calandria vault water system. Containment of Indian PHWR is an ultimate barrier, which is designed to envelope whole reactor systems, to prevent the spread of active air-borne fission products in accident condition. Containment Spray System has been provided for energy as well as activity removal from the Containment system. This paper discusses about the studies done to assess the effect of spray parameters such as spray flow rate, droplets diameter and height of fall on containment peak pressure and temperature, long term containment depressurization and energy removal from the containment during Loss of Coolant Accident (LOCA). The spray flow rate and droplets diameter play an important role in removing residual energy from containment atmosphere, which influences depressurization of containment. It is obvious that faster depressurization of containment during postulated LOCA helps in limiting radiological consequences. From radiological considerations, droplets diameter is required to be kept to the lowest practically possible value and flow rate of spray should be high. Spray water droplets fall height governs the exposure time of droplets, which is the direct indication of energy removal rate. However, it is observed from the sensitivity studies that for a height of spray droplet fall more than 16.5 m, for the range of spray water flow rate and droplets sizes considered in the analyses, there is no significant change in heat removal. (authors)

  7. Preoperational test report, primary ventilation condensate system

    SciTech Connect

    Clifton, F.T.

    1997-01-29

    Preoperational test report for Primary Ventilation Condensate System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides a collection point for condensate generated by the W-030 primary vent offgas cooling system serving tanks AYIOI, AY102, AZIOI, AZI02. The system is located inside a shielded ventilation equipment cell and consists of a condensate seal pot, sampling features, a drain line to existing Catch Tank 241-AZ-151, and a cell sump jet pump. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  8. The VST active primary mirror support system

    NASA Astrophysics Data System (ADS)

    Schipani, Pietro; Capaccioli, Massimo; D'Orsi, Sergio; Ferragina, Luigi; Marty, Laurent; Molfese, Cesare; Perrotta, Francesco; De Paris, Giacinto; Fierro, Davide; Tomelleri, Raffaele; Rossettini, Pierfrancesco; Perina, Francesco; Recchia, Stefano; Magrin, Demetrio

    2010-07-01

    The 2.6-m primary mirror of the VST telescope is equipped with an active optics system in order to correct low-order aberrations, constantly monitoring the optical quality of the image and controlling the relative position and the shape of the optical elements. Periodically an image analyser calculates the deviation of the image from the best quality. VST is equipped with both a Shack-Hartmann in the probe system and a curvature sensor embedded in the OmegaCAM instrument. The telescope control software decomposes the deviation into single optical contributions and calculates the force correction that each active element has to perform to achieve the optimal quality. The set of correction forces, one for each axial actuator, is computed by the telescope central computer and transmitted to the local control unit of the primary mirror system for execution. The most important element of the VST active optics is the primary mirror, with its active support system located within the primary mirror cell structure. The primary mirror support system is composed by an axial and a lateral independent systems and includes an earthquake safety system. The system is described and the results of the qualification test campaign are discussed.

  9. 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

  10. 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)

  11. 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.

  12. 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.

  13. Systemic karyomegaly with primary pulmonary presentation.

    PubMed

    Tagliente, Damian J; Voss, Jesse S; Peters, Steve G; Aubry, Marie Christine; Cornell, Lynn D; Maleszewski, Joseph J

    2014-01-01

    Systemic karyomegaly is a distinct disorder characterized by progressive renal failure and enlarged, bizarre renal tubular epithelial cells. We report the first case of systemic karyomegaly with primary pulmonary presentation and present the first detailed characterization of the karyomegalic cells in lung tissue. A 33-year-old woman was evaluated for chronic and progressive restrictive lung disease, ultimately necessitating single-lung transplantation. Her post-transplant course was marked by graft dysfunction, respiratory decline and renal failure culminating in her death 97 days post-transplant. At autopsy, karyomegalic cells were identified in her kidneys, prompting a careful examination of her native lung and other tissue. Karyomegalic cells were identified in the alveolar epithelium and airway walls. Viral studies were negative. DNA ploidy studies revealed an abnormal ploidy status of the karyomegalic cells. The identification and characterization of systemic karyomegaly with symptomatic lung involvement expands the differential diagnosis for relatively young patients presenting with interstitial lung disease.

  14. Transient deformation properties of Zircaloy for LOCA simulation. Final report

    SciTech Connect

    Hann, C. R.; Mohr, C. L.; Busness, K. M.; Olson, N. J.; Reich, F. R.; Stewart, K. B.

    1980-05-01

    This experimental data report is Volume 4 of a series of 5 volumes describing the oxidation and deformation rate behavior of Zircaloy cladding under simulated LOCA conditions. It contains listings of strain versus stress, time, and temperature evaluated from the numerical constitutive relationships and the original data used to develop them. This volume also contains listings of the ramp load, pressure, and temperature test data from both current and previous phases of the series, as well as material describing applications of the data.

  15. Zircoloy Cladding Oxidation Simulation for LWR under LOCA Conditions

    2003-04-25

    PRECIP-2 simulates zircaloy cladding oxidation under LOCA conditions of LWR’s. The code calculates oxygen concentration distribution across the cladding wall by solving the diffusion equation with moving boundary conditions, taking into account the structure change of the beta— phase, i.e. alpha precipitation during the cooling period. The code also predicts total oxygen uptake, thicknesses of alpha, beta and oxide layers.

  16. Hydrogen motion in Zircaloy-4 cladding during a LOCA transient

    NASA Astrophysics Data System (ADS)

    Elodie, T.; Jean, D.; Séverine, G.; M-Christine, B.; Michel, C.; Berger, P.; Martine, B.; Antoine, A.

    2016-04-01

    Hydrogen and oxygen are key elements influencing the embrittlement of zirconium-based nuclear fuel cladding during the quench phase following a Loss Of Coolant Accident (LOCA). The understanding of the mechanisms influencing the motion of these two chemical elements in the metal is required to fully describe the material embrittlement. High temperature steam oxidation tests were performed on pre-hydrided Zircaloy-4 samples with hydrogen contents ranging between 11 and 400 wppm prior to LOCA transient. Thanks to the use of both Electron Probe Micro-Analysis (EPMA) and Elastic Recoil Detection Analysis (μ-ERDA), the chemical elements partitioning has been systematically quantified inside the prior-β phase. Image analysis and metallographic examinations were combined to provide an average oxygen profile as well as hydrogen profile within the cladding thickness after LOCA transient. The measured hydrogen profile is far from homogeneous. Experimental distributions are compared to those predicted numerically using calculations derived from a finite difference thermo-diffusion code (DIFFOX) developed at IRSN.

  17. 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.

  18. Advances in Primary Central Nervous System Lymphoma.

    PubMed

    Patrick, Lauren B; Mohile, Nimish A

    2015-12-01

    Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma that is limited to the CNS. Although novel imaging techniques aid in discriminating lymphoma from other brain tumors, definitive diagnosis requires brain biopsy, vitreoretinal biopsy, or cerebrospinal fluid analysis. Survival rates in clinical studies have improved over the past 20 years due to the addition of high-dose methotrexate-based chemotherapy regimens to whole-brain radiotherapy. Long-term survival, however, is complicated by clinically devastating delayed neurotoxicity. Newer regimens are attempting to reduce or eliminate radiotherapy from first-line treatment with chemotherapy dose intensification. Significant advances have also been made in the fields of pathobiology and treatment, with more targeted treatments on the horizon. The rarity of the disease makes conducting of prospective clinical trials challenging, requiring collaborative efforts between institutions. This review highlights recent advances in the biology, detection, and treatment of PCNSL in immunocompetent patients.

  19. Advances in Primary Central Nervous System Lymphoma.

    PubMed

    Patrick, Lauren B; Mohile, Nimish A

    2015-12-01

    Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma that is limited to the CNS. Although novel imaging techniques aid in discriminating lymphoma from other brain tumors, definitive diagnosis requires brain biopsy, vitreoretinal biopsy, or cerebrospinal fluid analysis. Survival rates in clinical studies have improved over the past 20 years due to the addition of high-dose methotrexate-based chemotherapy regimens to whole-brain radiotherapy. Long-term survival, however, is complicated by clinically devastating delayed neurotoxicity. Newer regimens are attempting to reduce or eliminate radiotherapy from first-line treatment with chemotherapy dose intensification. Significant advances have also been made in the fields of pathobiology and treatment, with more targeted treatments on the horizon. The rarity of the disease makes conducting of prospective clinical trials challenging, requiring collaborative efforts between institutions. This review highlights recent advances in the biology, detection, and treatment of PCNSL in immunocompetent patients. PMID:26475775

  20. 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.

  1. Neurologic complications of primary systemic amyloidosis.

    PubMed

    Kelly, John J

    2006-01-01

    Amyloid is a botanical term that denotes a waxy, amorphous, eosinophilic material and is used to describe similar pathological findings in humans. The deposits in primary systemic amyloidosis are derived from monoclonal serum proteins in plasma cell dyscrasia, which are degraded locally in tissues and deposited in insoluble sheets that damage organs. The cause of organ damage in amyloidosis is unclear but most likely due to the direct toxic effects of amyloid. Symptoms of the disorder include neuropathy, myopathy, and cardiac or renal insufficiency; there is often multiple-organ involvement. Congestive heart failure and nephrotic syndrome are predominant causes of death. Differential difficulties exist in diagnosing the disorder, and familial amyloid polyneuropathy directly mimics the disease. Diagnostic tools include electromyography, laboratory testing for abnormalities in serum and urine, and histological investigation of appropriate tissue. The median survival of patients is 2 years. However, melphalan and prednisone treatment for at least 1 year has resulted in increased survival rates. There have also been reports of benefit from high-dose chemotherapy followed by peripheral blood stem cell transplantation. Without early therapy, however, the disease has a dismal prognosis, and peripheral neuropathy usually persists or worsens despite therapy and improvement in other organs.

  2. Modeling control systems for primary mirror supports

    NASA Astrophysics Data System (ADS)

    Fisher, Martin; Haque, Jaque; Wilkes, John D.; Amos, Clive S.; Steel, Darrin J.

    1995-06-01

    The RGO is involved in a number of mirror support programs, ranging from new controllers for its existing Isaac Newton Group (ING) telescopes to new primary mirror supports for the UK Infra-red Telescope (UKIRT) and design proposals for the active support of the Gemini 8 m meniscus mirrors. This work has led to the identification or development of critical components such as load cells and control valves which have high precision and stability. Even so it is still necessary to develop servo controllers capable of minimizing the effects of non- linearity and maintaining stability, particularly in regard to the highly non-linear behavior of pneumatic supports. In order to predict the performance of mirror supports and compare differing control strategies, components and systems are modelled using Matlab(superscript R) and Simulink(superscript R). These models are presented, together with parameters derived experimentally, and results from recent laboratory tests are discussed. Specific applications are described and current status of the work at the time of submission is presented.

  3. 47 CFR 11.14 - Primary Entry Point (PEP) System.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Primary Entry Point (PEP) System. 11.14 Section 11.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) General § 11.14 Primary Entry Point (PEP) System. The PEP system is a nationwide network of...

  4. 47 CFR 11.14 - Primary Entry Point (PEP) System.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Primary Entry Point (PEP) System. 11.14 Section 11.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) General § 11.14 Primary Entry Point (PEP) System. The PEP system is a nationwide network of...

  5. Best-Estimate Analysis PWR LOCA.

    2005-11-11

    Version: 00 TRAC‑PF1 performs best estimate analyses of loss of coolant accidents and other transients in pressurized light water reactors. The program can also be used to model a wide range of thermal hydraulic experiments in reduced scale facilities. Models employed include reflood, multi‑dimensional two‑phase flow, nonequilibrium thermodynamics, generalized heat transfer, and reactor kinetics. Automatic steady‑state and dump/restart capabilities are provided. The changes reported in TRACNEWS issues through Number 7 are incorporated in this release.more » TRAC-PF1 was developed on a CDC computer at Los Alamos National Laboratory. The PC version of TRAC‑PF1 was converted at CNEN in 1989 and has not been updated since that time. The NRC no longer supports the TRAC codes. They currently develop and maintain the TRACE code system, which is the TRAC/RELAP Advanced Computational Engine. TRACE is a modernized thermal-hydraulics code designed to consolidate the capabilities of NRC's 3 legacy safety codes - TRAC-P, TRAC-B and RELAP. This is NRC's flagship thermal-hydraulics analysis tool. See the website for more information http://www.nrccodes.com/.« less

  6. 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…

  7. 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…

  8. 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.

  9. Contribution of Primary Care to Health Systems and Health

    PubMed Central

    Starfield, Barbara; Shi, Leiyu; Macinko, James

    2005-01-01

    Evidence of the health-promoting influence of primary care has been accumulating ever since researchers have been able to distinguish primary care from other aspects of the health services delivery system. This evidence shows that primary care helps prevent illness and death, regardless of whether the care is characterized by supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care. The evidence also shows that primary care (in contrast to specialty care) is associated with a more equitable distribution of health in populations, a finding that holds in both cross-national and within-national studies. The means by which primary care improves health have been identified, thus suggesting ways to improve overall health and reduce differences in health across major population subgroups. PMID:16202000

  10. 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. PMID:25120380

  11. Radiative transfer during the reflooding step of a LOCA

    NASA Astrophysics Data System (ADS)

    Gérardin, J.; Seiler, N.; Ruyer, P.; Boulet, P.

    2013-10-01

    Within the evaluation of the heat transfer downstream a quench front during the reflood phase of a Loss of Coolant Accident (LOCA) in a nuclear power plant, a numerical study has been conducted on radiative transfer through a vapor-droplet medium. The non-grey behavior of the medium is obvious since it can be optically thin or thick depending on the wavelength. A six wide bands model has been tested, providing a satisfactory accuracy for the description of the radiative properties. Once the radiative properties of the medium computed, they have been introduced in a model solving the radiative heat transfer based on the Improved Differential Approximation. The fluxes and the flux divergence have been computed on a geometry characteristic of the reactor core showing that radiative transfer plays a relevant role, quite as important as convective heat transfer.

  12. Resin bonding to primary teeth using three adhesive systems.

    PubMed

    Mazzeo, N; Ott, N W; Hondrum, S O

    1995-01-01

    In vitro bond strengths of three resin adhesive systems were tested using 111 primary teeth. Ninety-six flat dentin surface specimens were divided into six groups consisting of 16 primed or 16 unprimed samples for each adhesive system. The remaining 15 tooth samples were divided into three groups of five to determine each adhesive system's bond strength to primary etched enamel. Resin buttons were polymerized to all specimens with visible light, thermocycled for 2000 cycles between 5 and 55 degrees C, and shear bond strength was measured with a Instron Testing Machine (Instron Engineering Corp, Canton, MA). ANOVA and multiple comparison tests showed that Optibond Multiuse Bonding Agent had a statistically greater mean shear bond strength to primary dentin (20.5 +/- 3.5 MPa) than Prisma Universal Bond 3 Multi-purpose Bonding System (9.1 +/- 4.4 MPa), Scotchbond Multi-purpose Dental Adhesive System (7.3 +/- 3.7 MPa), and primary etched enamel (9.8 +/- 4.4 MPa) at P < 0.05. This study demonstrated that resin adhesive systems may achieve bond strengths to primary dentin comparable to those of primary enamel, and that these bonds may be as strong as bonds to permanent enamel and dentin. These adhesive systems may allow more confident esthetic restoration of primary anterior teeth.

  13. 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…

  14. 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,…

  15. Evaluation of prompt nucleation of bubbles in annular fuel elements during the initial depressurization transient of a DEGB LOCA

    SciTech Connect

    Smith, A.C.

    1997-06-01

    In the first moments following the pipe break, of a DEGB LOCA, the depressurization wave is postulated to propagate rapidly through the system, in the manner of an acoustic or water hammer wave. this is immediately followed by a (reflected) repressurization wave, as the flow of coolant through the break is established. The pressure history is then dictated by the flow from the break and the ability of the pressurizer, pumps and accumulators to supply coolant. The initial sudden drop in pressure may result in the system pressure falling below the saturation pressure of the coolant. This could, in turn, result in bubble formation. Such immediate vapor formation (prompt nucleation of bubbles), in the period before the repressurization wave restores the system pressure to a level above the saturation pressure might initiate flow instability. Such an interruption in flow would allow the fuel tube clad temperature to increase rapidly. Depending on the duration of the flow interruption, the reactor might not be able to survive the initial moments of DEGB LOCA. It has generally been that this phenomenon would not actually occur in an operating reactor. The purpose of this investigation is to evaluate the possibility of occurrence of bubble formation as a result of initial depressurization. 7 refs., 6 figs.

  16. THE CONTRIBUTIONS OF PHYSICIAN ASSISTANTS IN PRIMARY CARE SYSTEMS

    PubMed Central

    Hooker, Roderick S.; Everett, Christine M.

    2013-01-01

    Shortages of primary care doctors are occurring globally; one means of meeting this demand has been the use of physician assistants (PAs). Introduced in the United States in the late 1960s to address doctor shortages, the PA movement has grown to over 75,000 providers in 2011 and spread to Australia, Canada, Great Britain, The Netherlands, Germany, Ghana, and South Africa. A purposeful literature review was undertaken to assess the contribution of PAs to primary care systems. Contemporary studies suggest that PAs can contribute to the successful attainment of primary care functions, particularly the provision of comprehensive care, accessibility, and accountability. Employing PAs seems a reasonable strategy for providing primary care for diverse populations. PMID:21851446

  17. 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.

  18. 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

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

    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 maymore » 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

  20. 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

  1. 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.

  2. 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.

  3. 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…

  4. 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.

  5. Measurement of convectional heat transfer coefficients in a primary containment vessel with outer pool

    SciTech Connect

    Fukui, Toru; Kataoka, Yoshiyuki; Hatamiya, Shigeo

    1990-01-01

    New concepts with passive safety systems that use no active compounds, such as pumps, have been recently developed for next-generation nuclear power plants. In these concepts, several ideas and their combination of passive components were adopted for emergency core cooling and residual heat removal systems. For the residual heat removal system, utilization of natural circulation heat transfer in water pools was proposed as a passive containment cooling system (PCCS), which removes decay heat from the primary containment vessel (PCV) during loss-of-coolant accidents (LOCAs). This system consists of a suppression pool (S/P) and an outer pool (O/P), which are set adjacently inside and outside of the steel PCV wall. The core decay heat during LOCA is released through a break as steam and is led into the S/P. The injected steam condenses there, resulting a pool temperature rise. The adsorbed heat in the S/P is transferred to the O/P by convection in both pools and thermal conduction through the steel PCV wall. The heat transferred to the O/P is finally released to the atmosphere by vaporization of the O/P water. Estimation of the convectional heat transfer coefficients in both pools is necessary to predict the heat removal capability in this system precisely. The heat transfer coefficients measured in this study are useful for the design of the next-generation nuclear reactor as the fundamental thermal-hydraulic data in the primary containment vessel with the outer pool.

  6. Active support system for 1-m SONG primary mirror

    NASA Astrophysics Data System (ADS)

    Niu, Dongsheng; Wang, Guomin; Gu, Bozhong

    2012-05-01

    Chinese-node telescope of Stellar Observations Network Group (SONG) has a primary mirror 1m in diameter with flat back, which will be supported actively. The performance evaluation of the telescope's active optics system is conducted. Finite element analysis (FEA) is employed to analyze the optical surface figures of the primary mirror, and two optimizations are carried out by using ANSYS: (1) the locations and forces of axial supports are optimized with the telescope pointing to zenith; (2) the lateral support forces are calculated with the telescope pointing to horizon. Axial support force sensitivities are calculated in a case that a single axial support has a force error of 0.5N. The correction ability of the active support system is analyzed when an arbitrary axial support is failure. Several low order Zernike modes are modeled with MATLAB procedure, and active optics corrections are applied to these modes. Thermal deformation of the mirror is also corrected using active support system.

  7. EST Telescope: primary mirror, support, and cooling system

    NASA Astrophysics Data System (ADS)

    Volkmer, R.; Manni, F.; Giannuzzi, M.; Scotto, A.; Cavaller, L.; Scheiffelen, T.; Bettonvil, F.; Berrilli, F.

    2010-07-01

    The solar telescope EST is currently in the conceptual design phase. It is planned to be build on the Canary Islands until end of the decade. It is specialized on polarimetric observations and will provide high spatial and spectral observations of the different solar atmospheric layers. The diameter of the primary mirror blank is 4.2m. Different types of mirror shapes were investigated with respect to thermal and mechanical characteristics. To remove the absorbed heat an air cooling system from the back side will be applied. Additional an air flushing system will remove remaining warm air from the front side. A major problem of a large open telescope will be the wind load. Results of the investigations will be shown. To achieve optimal optical performance an active support system is planned. The primary mirror cell needs to be stiff enough to support the primary mirror without deformation at strong wind in case of the open telescope option, but sufficient room for the active support system and cooling system below the backside of the mirror is also required. Preliminary designs and analysis results will be presented.

  8. Optimization of the ATST primary mirror support system

    NASA Astrophysics Data System (ADS)

    Cho, Myung K.; Price, Ronald S.; Moon, Il K.

    2006-06-01

    The Advanced Technology Solar Telescope (ATST) primary mirror is a 4.24-m diameter, 75-mm thick, off-axis parabola solid meniscus mirror made out of a glass or glass ceramic material. Its baseline support system consists of 120 axial supports mounted at the mirror back surface and 24 lateral supports along the outer edge with an active optics capability. This primary mirror support system was optimized for the telescope at a near horizon position to achieve the best gravity and thermal effects. To fulfill the optical and mechanical performance requirements, extensive finite element analyses using I-DEAS and optical analyses with PCFRINGE have been conducted for the support optimization. Analyses include static deformation (gravity and thermal), frequency calculations, and support system sensitivity evaluations. An influence matrix was established to compensate potential errors using an active optics system. Performances of the primary mirror support system were evaluated from mechanical deformation calculations and the optical analyses before and after active optics corrections. The performance of the mirror cell structure was also discussed.

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

    PubMed

    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; Shipp, Margaret A

    2016-02-18

    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

  10. Growth of primary embryo cells in a microculture system

    PubMed Central

    Villa, Max; Pope, Sara; Conover, Joanne; Fan, Tai-Hsi

    2011-01-01

    We present optimal perfusion conditions for the growth of primary mouse embryonic fibroblasts (mEFs) and mouse embryonic stem cells (mESCs) using a microfluidic perfusion culture system. In an effort to balance nutrient renewal while ensuring the presence of cell secreted factors, we found that the optimal perfusion rate for culturing primary embryonic fibroblasts (mEFs) in our experimental setting is 10 nL/min with an average flow velocity 0.55 μm/sec in the microchannel. Primary mEFs may have a greater dependence on cell secreted factors when compared to their immortalized counterpart 3T3 fibroblasts cultured under similar conditions. Both the seeding density and the perfusion rate are critical for the proliferation of primary cells. A week long cultivation of mEFs and mESCs using the microculture system exhibited similar morphology and viability to those grown in a petri dish. Both mEFs and mESCs were analyzed using fluorescence immunoassays to determine their proliferative status and protein expression. Our results demonstrate that a perfusion-based microculture environment is capable of supporting the highly proliferative status of pluripotent embryonic stem cells. PMID:20012208

  11. Primary mirror support system for the SUBARU Telescope

    NASA Astrophysics Data System (ADS)

    Iye, Masanori; Kodaira, Keiichi

    1994-06-01

    The Japan National Large Telescope `SUBARU' will be completed on the summit of Mauna Kea by the end of the century. One of the major characteristics new to the SUBARU telescope is the active support system for its large monolithic primary mirror, which has 261 points of computer-controlled actuators to maintain a precise mirror figure. This paper describes the control principle, design concepts, results of engineering experiments and numerical simulations of the active support system to ensure the high imaging performance of this system.

  12. Large break LOCA calculations for the AP600 design

    SciTech Connect

    Fisher, J.E.

    1992-08-01

    This paper presents the application of RELAP5 to the calculation of a Large Break (200% doubled-ended rupture) Loss-of-Colant-Accident (LBLOCA) at the reactor vessel inlet for the proposed Westinghouse AP600 design. A parametric calculation was also performed to determine effects of loss of a complete Emergency Core Cooling system (ECCS) train. These calculations were performed over the core blowdown, refill, and reflood phases of the LBLOCA and did not address long term cooling. RELAP5 was shown to be adequate for system response calculation over the period of interest. The passive safety systems were predicted to effectively mitigate the consequences of LBLOCAs; the calculations showed less severe thermal responses than for a current generation Pressurized Water Reactor (PWR) plant. The two primary differences between the AP600 design and a current generation plant that affect LBLOCA response are the lower core thermal power, which results in lower temperatures during the blowdown phase, and the long duration accumulator injection, which provides ample core inventory makeup for final quenching.

  13. Bipod flexure for 1-m primary mirror system.

    PubMed

    Kihm, Hagyong; Yang, Ho-Soon; Lee, Yun-Woo

    2014-12-01

    We present an analytical formulation of the bipod flexure for mounting the 1-m primary mirror in a space telescope. Compliance and stiffness matrices of the bipod flexure are derived to estimate theoretical performance and to make initial design guidelines. We use finite element analysis to optimize the bipod design satisfying the application requirements. Experimental verification is achieved by vibration test with a dummy mirror system. PMID:25554320

  14. LSST primary, secondary, and tertiary mirror support systems

    NASA Astrophysics Data System (ADS)

    Cuerden, Brian; Sebag, Jacques; Mathews, Scott; Cho, Myung; Lee, Joon; West, Steven

    2004-09-01

    The current LSST Baseline Configuration has a field of view of 3.5 degrees and an optical etendue of 302 meters square degrees square. The etendue calculation includes the effect of gradual vignetting by the camera as the field angle increases. A current optical point design includes an 8.4 m spun cast light-weighted borosilicate primary mirror, a 3.2 m secondary mirror and a 5.0 m tertiary mirror. The goal of this study is to determine if these mirrors can be actively supported and retain figure control over elevation angles without closed-loop control based on wave-front measurement. Support systems for the tertiary and primary mirrors are adapted from proven systems utilized on 6.5 and 8.4 m class primaries developed by the University of Arizona"s Mirror Laboratory. The number and locations of axial and lateral supports is determined for each mirror and the gravitational and support induced surface distortions are calculated and are shown to be within budgeted limits. The support components and their performance are described and it is demonstrated that predicted mirror distortion attributable to the support system is consistent with the known performance of the support components.

  15. LBT primary mirrors: the final design of the supporting system

    NASA Astrophysics Data System (ADS)

    Parodi, Giancarlo; Cerra, G. C.; Hill, John M.; Davison, Warren B.; Salinari, Piero

    1997-03-01

    The main final results in terms of stresses and optical performances are reported for the large binocular telescope (LBT) primary mirrors. The two borosilicate LBT primary mirrors f/1.14 have 8.4 diameter and are produced at the Steward Observatory Mirror Lab (SOML). They are honeycomb shaped in order to achieve light weight, short thermal constant and high stiffness. The back plate is flat and the upper is paraboloid shaped. Each elementary cell has, in the lower plate, one circular hole permitting the ventilation of cell itself. The material used is the borosilicate Ohara E6. Different supporting systems have been analyzed from the mirror casting to the operative conditions, i.e.: supporting system during the cooling of the casting phase; supporting system for the handling after the casting phase and before the optical surface grinding and polishing; supporting system for the handling after the optical surface polishing and for maintenance; passive support system in non-operative condition; supporting system in operative condition. The stress checks carried out show that the values of the maximum principal tensile stresses are below 0.7 MPa for long times and/or stresses affecting large volumes, and are below 1.05 MPa for short times and small volumes. Optical performances in operative condition respect the specification.

  16. 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.

  17. 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.

  18. 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.

  19. Links between systems in Accident & Emergency and primary care.

    PubMed

    Harrop, Nick

    2005-01-01

    The hospital emergency department and other elements of rapid access primary care constitute an emergency care network. Integration aims to maximise the network's strengths and overcome its weaknesses. Taking the patient as a starting point, it is possible to envisage an objective data model that can operate at multiple levels within the network to describe its process efficiency and clinical effectiveness. Other means of integration are also identified. These contain significant subjective elements. In particular, the decision support system of NHSDirect has operated successfully to legitimise national and local intervention based on skill-mix, whereas its technical operation has been susceptible to human deviation from prescribed routine. As we scrutinise a system, we discover that it contains people who are doing things. Logical elements in the system turn out to be givers or recipients of deliberate and thoughtful care. Information systems in Accident & Emergency (A&E) and primary care can help accountable planners to measure and control aspects of the network's operation. Clinicians also need their systems to enable, rather than constrain, effective interactions.

  20. 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.

  1. 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.

  2. Design and analysis of support system of LAMOST primary mirror

    NASA Astrophysics Data System (ADS)

    Gong, Xuefei; Cui, Xiangqun; Chen, Haiyuan; Ye, Xizhang; Zhang, Ru

    2003-02-01

    LAMOST (The Large Sky Area Multi-object Fiber Spectroscopic Telescope) is a reflecting Schmidt telescope. There are two large segmented mirrors in LAMOST: One is the Schmidt plate MA, and the other is the spherical primary mirror MB. The dimension of MB is about 6.7m×6m and it is face down in 25°. MB is composed of 37 hexagonal sub-mirrors. During the observation, one should maintain the correct mirror figure for each sub-mirror and co-focus for all 37 sub-mirrors to obtain the good image, even it is an unconventional designed telescope without tracking movement on the primary mirror. This paper presents the design and the finite element analysis for the whole primary mirror support system, which includes the optimization of the mirror support points distribution, the design and the testing of the prototype of MB sub-cell, the structure analysis and the design of the mirror support truss.

  3. Provider's Constraints and Difficulties in Primary Health Care System

    PubMed Central

    Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Anu

    2014-01-01

    Background: The contractualization of human resource in recent years has resulted into various human resource management issues. Objective: To explore the administrative and management issues of contractual model of human resource under primary health care system in Delhi. Materials and Methods: Comparative study was conducted on randomly selected sample of 333, comprised of Medical Officers, ANMs, Pharmacist and Laboratory Assistants and Technicians, both regular and contractual cadre. The data was collected using the semi-structured interview schedule and thematic content analysis was done. Results: The five major themes emerged in the analysis; these are (i) physical infrastructure, (ii) organization's working environment, (iii) privileges of staff, (iv) discontentment, (v) human resource development. Comparative analysis of themes between regular and contractual staff revealed significant differences in factors which are embedded into the organization's culture. Element of discontentment is high amongst contractual staff particularly for discrimination in job, undermining of authority, patient care relationship and privileges provided to regular staff. This reflects the area of dissatisfaction which varies between regular and contractual staff in the organization. Conclusion: If primary health care system fails to address genuine constraints of human resources of both regular and contractual cadre and perception of discrimination persists, it is bound to result into poor motivation for good performance in the system of health care. So, adopting good practices in human resource management keeping regular and contractual employees grievances at forefront are urgently needed to ensure the availability of adequately trained and motivated personnel's in health facilities. PMID:25161964

  4. The primary mirror support system of the ESO-VLT.

    NASA Astrophysics Data System (ADS)

    Schneermann, M.; Cui, X.-Q.

    1988-10-01

    The 8 meter unit telescopes of the ESO very large telescope (VLT) will have primary mirrors of the solid thin meniscus type. Presently various different options concerning material and thickness are still under consideration for the production of the mirror blanks. This paper describes the performance analysis of a glass ceramic mirror with a thickness of 200 mm. This mirror is supported by a functionally separated axial and radial support system. The results of the analytical assessment of the mirror performance under those loading conditions are discussed.

  5. 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.

  6. Strengthening weak primary care systems: steps towards stronger primary care in selected Western and Eastern European countries.

    PubMed

    Groenewegen, Peter P; Dourgnon, Paul; Greß, Stefan; Jurgutis, Arnoldas; Willems, Sara

    2013-11-01

    European health care systems are facing diverse challenges. In health policy, strong primary care is seen as key to deal with these challenges. European countries differ in how strong their primary care systems are. Two groups of traditionally weak primary care systems are distinguished. First a number of social health insurance systems in Western Europe. In these systems we identified policies to strengthen primary care by small steps, characterized by weak incentives and a voluntary basis for primary care providers and patients. Secondly, transitional countries in Central and Eastern Europe (CCEE) that transformed their state-run, polyclinic based systems to general practice based systems to a varying extent. In this policy review article we describe the policies to strengthen primary care. For Western Europe, Germany, Belgium and France are described. The CCEE transformed their systems in a completely different context and urgency of problems. For this group, we describe the situation in Estonia and Lithuania, as former states of the Soviet Union that are now members of the EU, and Belarus which is not. We discuss the usefulness of voluntary approaches in the context of acceptability of such policies and in the context of (absence of) European policies.

  7. 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.

  8. 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.

  9. Fission Product Migration in Primary System and Containment

    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, diffusionmore » 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.« less

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Primary central nervous system lymphoma a report of nine cases.

    PubMed

    Lakshmaiah, K C; Lokanath, D; Ramesh, C; Babu, K G; Rao, C R; Swamy, K

    1996-06-01

    Primary Central Nervous System Lymphoma (PCNSL) is a rare neoplasm of B cell origin and constitute less than 1% of Non-Hodgkin's lymphoma (NHL). Histology is mainly of high grade and intermediate type. Although NHL is known to be highly sensitive to both irradiation and cytotoxic drugs, being a curable malignancy, the therapeutic results remain disappointing. Clinical observations on nine cases of PCNSL seen in one of the major cancer centres in India is presented in this paper. Radiotherapy combined with Chemotherapy although yielded encouraging initial response in these patients, the long term response was unsatisfactory with median survival for these patients being only 19 months. This warrants an alternative therapeutic approach to improve the dismal prognosis of PCNSL. PMID:8979473

  16. 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...

  17. 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...

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. Clinical epidemiology for childhood primary central nervous system tumors.

    PubMed

    Bauchet, Luc; Rigau, Valérie; Mathieu-Daudé, Hélène; Fabbro-Peray, Pascale; Palenzuela, Gilles; Figarella-Branger, Dominique; Moritz, Jorge; Puget, Stéphanie; Bauchet, Fabienne; Pallusseau, Lorelei; Duffau, Hugues; Coubes, Philippe; Trétarre, Brigitte; Labrousse, François; Dhellemmes, Patrick

    2009-03-01

    This work was conducted by the French Brain Tumor Data Bank (FBTDB) and aims to prospectively record all primary central nervous system tumors (PCNST), in France, for which histological diagnosis is available. Results concerning children are presented. This study analyzes the childhood cases (0-19 years) of newly diagnosed and histologically confirmed PCNST (during the years 2004-2006) which have been recorded by the FBTDB. All French neuropathology and neurosurgery departments participated in this program. Neurosurgeons and neuropathologists completed a data file containing socio-demographic, clinical, radiologic and anatomopathologic information. The Tumor Registry from Herault was authorized to compile the data files with personal identifiers. About 1,017 cases (533 boys and 484 girls) of newly diagnosed childhood PCNST have been recorded (gliomas: 52%, all other neuroepithelial tumors: 31%, craniopharyngioma: 5%, germ cell tumors, meningioma and neurinoma: approximately 3% each, all histological subtypes have been detailed). Tumor resections were performed in 83.3%, and biopsies in 16.7%. The distributions by histology, cryopreservation of the samples, age, sex, tumor site and surgery have been detailed. To our knowledge, this work is the first databank in Europe dedicated to PCNST that includes the collection of clinical, radiological and histological data (including cryopreservation of the specimen). The long term goals of the FBTDB are to create a national registry and a network to perform epidemiological studies, to implement clinical and basic research protocols, and to evaluate and harmonize the healthcare of children and adult patients affected by PCNST. PMID:19020806

  4. 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. PMID:11912866

  5. Radiation Therapy for Primary Carcinoma of the Extrahepatic Biliary System

    PubMed Central

    Flickinger, John C.; Epstein, Alan H.; Iwatsuki, Shunzaburo; Carr, Brian I.; Starzl, Thomas E.

    2010-01-01

    From 1976 to 1988, 63 patients received radiation therapy for primary cancers of the extrahepatic biliary system (eight gallbladder and 55 extrahepatic biliary duct). Twelve patients underwent orthotopic liver transplantation. Chemotherapy was administered to 13 patients. Three patients underwent intraluminal brachytherapy alone (range, 28 to 55 Gy). Sixty patients received megavoltage external-beam radiation therapy (range, 5.4 to 61.6 Gy; median, 45 Gy), of whom nine received additional intraluminal brachytherapy (range, 14 to 45 Gy; median, 30 Gy). The median survival of all patients was 7 months. Sixty patients died, all within 39 months of radiation therapy. One patient is alive 11 months after irradiation without surgical resection, and two are alive 50 months after liver transplantation and irradiation. Symptomatic duodenal ulcers developed after radiation therapy in seven patients but were not significantly related to any clinical variable tested. Extrahepatic biliary duct cancers, the absence of metastases, increasing calendar year of treatment, and liver transplantation with postoperative radiation therapy were factors significantly associated with improved survival. PMID:2070327

  6. 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.

  7. Mutational analysis of primary central nervous system lymphoma

    PubMed Central

    Bruno, Aurélie; Boisselier, Blandine; Labreche, Karim; Marie, Yannick; Polivka, Marc; Jouvet, Anne; Adam, Clovis; Figarella-Branger, Dominique; Miquel, Catherine; Eimer, Sandrine; Houillier, Caroline; Soussain, Carole; Mokhtari, Karima; Daveau, Romain; Hoang-Xuan, Khê

    2014-01-01

    Little is known about the genomic basis of primary central nervous system lymphoma (PCNSL) tumorigenesis. To investigate the mutational profile of PCNSL, we analyzed nine paired tumor and germline DNA samples from PCNSL patients by high throughput exome sequencing. Eight genes of interest have been further investigated by focused resequencing in 28 additional PCNSL tumors to better estimate their incidence. Our study identified recurrent somatic mutations in 37 genes, some involved in key signaling pathways such as NFKB, B cell differentiation and cell cycle control. Focused resequencing in the larger cohort revealed high mutation rates for genes already described as mutated in PCNSL such as MYD88 (38%), CD79B (30%), PIM1 (22%) and TBL1XR1 (19%) and for genes not previously reported to be involved in PCNSL tumorigenesis such as ETV6 (16%), IRF4 (14%), IRF2BP2 (11%) and EBF1 (11%). Of note, only 3 somatically acquired SNVs were annotated in the COSMIC database. Our results demonstrate a high genetic heterogeneity of PCNSL and mutational pattern similarities with extracerebral diffuse large B cell lymphomas, particularly of the activated B-cell (ABC) subtype, suggesting shared underlying biological mechanisms. The present study provides new insights into the mutational profile of PCNSL and potential targets for therapeutic strategies. PMID:24970810

  8. 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.

  9. Probabilistic based design rules for intersystem LOCAS in ABWR piping

    SciTech Connect

    Ware, A.G.; Wesley, D.A.

    1993-05-01

    A methodology has been developed for probability-based standards for low-pressure piping systems that are attached to the reactor coolant loops of advanced light water reactors (ALWRs) which could experience reactor coolant loop temperatures and pressures because of multiple isolation valve failures. This accident condition is called an intersystem loss-of-coolant accident (ISLOCA). The methodology was applied to various sizes of carbon and stainless steel piping designed to advanced boiling water reactor (ABWR) temperatures and pressures.

  10. 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…

  11. 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…

  12. 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.

  13. Health system challenges to integration of mental health delivery in primary care in Kenya- perspectives of primary care health workers

    PubMed Central

    2013-01-01

    Background Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Methods Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). Results These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to

  14. 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... Regulatory Commission (NRC) is issuing Revision 2 to Regulatory Guide (RG) 1.57, ``Design Limits and Loading Combinations for Metal Primary Reactor Containment System Components,'' in which there are no...

  15. Design and analysis of large spaceborne light-weighted primary mirror and its support system

    NASA Astrophysics Data System (ADS)

    Yan, Yong; Jin, Guang; Yang, Hong-bo

    2007-12-01

    With the development of the resolution of spaceborne remote sensor, the diameter of the primary mirror of spaceborne telescope becomes larger and larger. The distortion of primary mirror which is influenced by the mirror material, structure, self-weight, support system and temperature environment affects optical image quality finally. In this paper, an on-axis TMA high-resolution Cassegrain optical payload with a primary mirror whose diameter is φ 650mm was designed and the effects of the influence factors of the distortion acts on the on-axis TMA optical system primary mirror had been analyzed by means of Finite Element Analysis. During work, the technology of the primary mirror design had been summarized and general consideration of the primary mirror design technology also had been described at the same time. Considering the telescope manufacture and work station, a reasonable and optimal structure of the primary mirror sub-assembly is taken finally. In the end, the distortion of the primary mirror during its fabrication station and work station had been analyzed by integrated Finite Element Analysis Method. The results implicated the synthesis profile error (P-V value) for the primary mirror is less than λ/10 and all the indexes of the primary mirror satisfy the requirements of the optical system.

  16. 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.

  17. 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.

  18. 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.

  19. Oxidation of SiC cladding under Loss of Coolant Accident (LOCA) conditions in LWRs

    SciTech Connect

    Lee, Y.; Yue, C.; Arnold, R. P.; McKrell, T. J.; Kazimi, M. S.

    2012-07-01

    An experimental assessment of Silicon Carbide (SiC) cladding oxidation rate in steam under conditions representative of Loss of Coolant Accidents (LOCA) in light water reactors (LWRs) was conducted. SiC oxidation tests were performed with monolithic alpha phase tubular samples in a vertical quartz tube at a steam temperature of 1140 deg. C and steam velocity range of 1 to 10 m/sec, at atmospheric pressure. Linear weight loss of SiC samples due to boundary layer controlled reaction of silica scale (SiO{sub 2} volatilization) was experimentally observed. The weight loss rate increased with increasing steam flow rate. Over the range of test conditions, SiC oxidation rates were shown to be about 3 orders of magnitude lower than the oxidation rates of zircaloy 4. A SiC volatilization correlation for developing laminar flow in a vertical channel is formulated. (authors)

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. [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. PMID:26363955

  6. [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.

  7. 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.

  8. 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…

  9. 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.

  10. Reproductive health in India's primary health care system.

    PubMed

    Rao, M

    1997-01-01

    India's family planning program having reached a dead end, the government of India appointed an expert group to develop a new population policy for the country. While the group's report, submitted in May 1994, proclaimed a new orientation described as pro-poor, pro-nature, and pro-women, the recommendations of the report were criticized as not being serious about gender equity. The government of India, describing a new reproductive health care approach, envisions a paradigm shift in the family planning program strategy. Reproductive health is defined as a state in which people can reproduce and regulate their fertility, women are able to go through pregnancy and childbirth safely, the outcome of pregnancy is successful with regard to maternal and infant survival and well-being, and couples are able to have sexual relations free of the fear of pregnancy and of contracting disease. To further the discussion on the newly initiated reproductive health care approach, the faculty of the Center of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi, organized a workshop for November 4-5, 1996, on the place of reproductive health in India's primary health care. The workshop brought together public health persons, clinicians, and health and women's rights activists. The author outlines the content of papers presented at the workshop.

  11. Reproductive health in India's primary health care system.

    PubMed

    Rao, M

    1997-01-01

    India's family planning program having reached a dead end, the government of India appointed an expert group to develop a new population policy for the country. While the group's report, submitted in May 1994, proclaimed a new orientation described as pro-poor, pro-nature, and pro-women, the recommendations of the report were criticized as not being serious about gender equity. The government of India, describing a new reproductive health care approach, envisions a paradigm shift in the family planning program strategy. Reproductive health is defined as a state in which people can reproduce and regulate their fertility, women are able to go through pregnancy and childbirth safely, the outcome of pregnancy is successful with regard to maternal and infant survival and well-being, and couples are able to have sexual relations free of the fear of pregnancy and of contracting disease. To further the discussion on the newly initiated reproductive health care approach, the faculty of the Center of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi, organized a workshop for November 4-5, 1996, on the place of reproductive health in India's primary health care. The workshop brought together public health persons, clinicians, and health and women's rights activists. The author outlines the content of papers presented at the workshop. PMID:9230606

  12. Systemic Lupus Erythematosus: Primary Care Approach to Diagnosis and Management.

    PubMed

    Lam, Nguyet-Cam Vu; Ghetu, Maria V; Bieniek, Marzena L

    2016-08-15

    Systemic lupus erythematosus is an autoimmune disease that affects many systems, including the skin, musculoskeletal, renal, neuropsychiatric, hematologic, cardiovascular, pulmonary, and reproductive systems. Family physicians should be familiar with the manifestations of lupus to aid in early diagnosis, monitoring patients with mild disease, recognizing warning signs that require referral to a rheumatologist, and helping to monitor disease activity and treatment in patients with moderate to severe disease. The American College of Rheumatology has 11 classification criteria for lupus. If a patient meets at least four criteria, lupus can be diagnosed with 95% specificity and 85% sensitivity. All patients with lupus should receive education, counseling, and support. Hydroxychloroquine is the cornerstone of treatment because it reduces disease flares and other constitutional symptoms. Low-dose glucocorticoids can be used to treat most manifestations of lupus. The use of immunosuppressive and cytotoxic agents depends on the body systems affected. Patients with mild disease that does not involve major organ systems can be monitored by their family physician. Patients with increased disease activity, complications, or adverse effects from treatment should be referred to a rheumatologist. To optimize treatment, it is important that a rheumatologist coordinate closely with the patient's family physician to improve chronic care as well as preventive health services. PMID:27548593

  13. 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.

  14. Primary central nervous system lymphoma: is absence of intratumoral hemorrhage a characteristic finding on MRI?

    PubMed Central

    Sakata, Akihiko; Okada, Tomohisa; Yamamoto, Akira; Kanagaki, Mitsunori; Fushimi, Yasutaka; Dodo, Toshiki; Arakawa, Yoshiki; Takahashi, Jun C; Miyamoto, Susumu; Togashi, Kaori

    2015-01-01

    Background. Previous studies have shown that intratumoral hemorrhage is a common finding in glioblastoma multi-forme, but is rarely observed in primary central nervous system lymphoma. Our aim was to reevaluate whether intratumoral hemorrhage observed on T2-weighted imaging (T2WI) as gross intratumoral hemorrhage and on susceptibility-weighted imaging as intratumoral susceptibility signal can differentiate primary central nervous system lymphoma from glioblastoma multiforme. Patients and methods. A retrospective cohort of brain tumors from August 2008 to March 2013 was searched, and 58 patients (19 with primary central nervous system lymphoma, 39 with glioblastoma multiforme) satisfied the inclusion criteria. Absence of gross intratumoral hemorrhage was examined on T2WI, and an intratumoral susceptibility signal was graded using a 3-point scale on susceptibility-weighted imaging. Results were compared between primary central nervous system lymphoma and glioblastoma multiforme, and values of P < 0.05 were considered significant. Results. Gross intratumoral hemorrhage on T2WI was absent in 15 patients (79%) with primary central nervous system lymphoma and 23 patients (59%) with glioblastoma multiforme. Absence of gross intratumoral hemorrhage could not differentiate between the two disorders (P = 0.20). However, intratumoral susceptibility signal grade 1 or 2 was diagnostic of primary central nervous system lymphoma with 78.9% sensitivity and 66.7% specificity (P < 0.001), irrespective of gross intratumoral hemorrhage. Conclusions. Low intratumoral susceptibility signal grades can differentiate primary central nervous system lymphoma from glioblastoma multiforme. However, specificity in this study was relatively low, and primary central nervous system lymphoma cannot be excluded based solely on the presence of an intratumoral susceptibility signal. PMID:26029023

  15. Primary Systemic Al Amyloidosis Presenting as Temporal Arteritis

    PubMed Central

    Emmungil, Hakan; Kalfa, Melike; Başarık, Burcu; Kahraman, Hasip; Tanhan, Ferhat; Yaman, Banu; Öztürk, Atiye; Erdemir, Zehra; Kandiloğlu, Gülşen; İnal, Vedat; Kabasakal, Yasemin

    2014-01-01

    Temporal arteritis is most common vasculitis in elderly and imitated by miscellaneous disorders. Temporal artery biopsy is the gold standard test in the diagnosis of giant cell arteritis (GCA). Hereby, we describe a case of a 67-year-old man who presented initially with temporal arteritis; however, a lip biopsy then revealed AL amyloidosis. In this respect, temporal artery biopsy should be performed for definitive diagnosis of GCA particularly patients with systemic symptoms and treatment resistant. PMID:24551471

  16. Modulation of Tumor Tolerance in Primary Central Nervous System Malignancies

    PubMed Central

    Johnson, Theodore S.; Munn, David H.; Maria, Bernard L.

    2012-01-01

    Central nervous system tumors take advantage of the unique immunology of the CNS and develop exquisitely complex stromal networks that promote growth despite the presence of antigen-presenting cells and tumor-infiltrating lymphocytes. It is precisely this immunological paradox that is essential to the survival of the tumor. We review the evidence for functional CNS immune privilege and the impact it has on tumor tolerance. In this paper, we place an emphasis on the role of tumor-infiltrating myeloid cells in maintaining stromal and vascular quiescence, and we underscore the importance of indoleamine 2,3-dioxygenase activity as a myeloid-driven tumor tolerance mechanism. Much remains to be discovered regarding the tolerogenic mechanisms by which CNS tumors avoid immune clearance. Thus, it is an open question whether tumor tolerance in the brain is fundamentally different from that of peripheral sites of tumorigenesis or whether it simply stands as a particularly strong example of such tolerance. PMID:22312408

  17. 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

  18. 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.

  19. 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.

  20. 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)

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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.

  7. Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

    PubMed Central

    2013-01-01

    Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices

  8. 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.

  9. The Place of Creativity in Pakistani Primary Education System: An Investigation into the Factors Enhancing and Inhibiting Primary School Children's Creativity

    ERIC Educational Resources Information Center

    Shaheen, Robina

    2011-01-01

    The study presented in this book provides a baseline analysis of the extent to which the primary education system in Pakistan is capable of enhancing or inhibiting children's creativity. It involved 1008 primary schools who participated in a survey, 154 children who took the Torrance Tests of Creative Thinking, and classroom observation in 16…

  10. Central nervous system involvement in primary Sjogren`s syndrome manifesting as multiple sclerosis.

    PubMed

    Liu, Jing-Yao; Zhao, Teng; Zhou, Chun-Kui

    2014-04-01

    Central nervous system symptoms in patients with primary Sjogren`s syndrome are rare. They can present as extraglandular manifestations and require a differential diagnosis from multiple sclerosis. Due to a variety of presentations, Sjogren`s syndrome with neurologic involvement may be difficult to diagnose. Here, we report a case of a 75-year-old woman who was first diagnosed with multiple sclerosis in 2010, but who was subsequently diagnosed with primary Sjogren`s syndrome 2 years later after showing signs of atypical neurologic manifestations. Therefore, primary Sjogren`s syndrome should be suspected in patients who present with atypical clinical and radiologic neurologic manifestations.

  11. Primary Mirror Figure Maintenance of the Hobby-Eberly Telescope using the Segment Alignment Maintenance System

    NASA Technical Reports Server (NTRS)

    Rakoczy, John; Hall, Drew; Howard, Ricky; Ly, William; Weir, John; Montgomery, Edward; Brantley, Lott W. (Technical Monitor)

    2002-01-01

    The Segment Alignment Maintenance System (SAMs) was installed on McDonald Observatory's Hobby-Eberly Telescope (HET) in August 2001. The SAMs became fully operational in October 2001. The SAMs uses a system of 480 inductive edge sensors to correct misalignments of the HET's 91 primary mirror segments when the segments are perturbed from their aligned reference positions. A special observer estimated and corrects for the global radius of curvature (GroC) mode, a mode unobservable by the edge sensors. The SAMs edge sensor system and (GroC) estimator are able to maintain HET's primary figure for much longer durations than previously had been observed. Telescope image quality has improved, and the amount of overhead time required from primary mirror alignment has been reduced. This paper gives a functional description of the SAMs control system and presents performance verification data. This paper also describes how the SAMs has improved the operational efficiency of the HET.

  12. Preparation of gaseous CRMs from the primary system for (222)Rn activity measurement.

    PubMed

    Kim, B J; Kim, B C; Lee, K B; Lee, J M; Park, T S

    2016-03-01

    For disseminating the gaseous radon standard traceable to the KRISS primary system based on the defined solid angle counting method, two kinds of radon CRM (a glass ampule type and a stainless steel cylinder type) were developed. The activity of the CRM was certified by subtracting a residual activity from the measured activity by the primary system. After certification, the ampule CRM was used to calibrate a radon-monitoring instrument and the cylinder CRM to calibrate an HPGe system. We also improved the measurement procedure of the radon primary system. In a typical radon energy spectrum, the radon peak overlaps with the polonium peak. For more reliable and accurate measurement of radon activity, a fitting method was adopted for the evaluation of radon area in the alpha energy spectrum. The result of radon activity evaluated by using the fitting method is in good agreement with that by the previous integration method. PMID:26778761

  13. 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.

  14. Case report of a patient with primary central nervous system lymphoma treated with radioimmunotherapy.

    PubMed

    Shah, Jatin J; Meredith, Ruby; Shen, Sui; Nabors, Burt; Lobuglio, Albert; Yester, Michael; Forero, Andres

    2006-11-01

    Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma arising within and confined to the central nervous system and, unlike other primary brain tumors, is very responsive to treatment. Aggressive management can lead to prolonged remissions or cures. However, the prognosis at relapse is generally poor with limited therapeutic options; clearly, new strategies are needed for these patients. Radioimmunotherapy has a growing role in the management of systemic non-Hodgkin lymphoma but has not been evaluated in PCNSL. We report here the first patient with PCNSL treated with radioimmunotherapy.

  15. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In the... machine may be operated for the remainder of its tour of duty with the use of a secondary braking system or by coupling to another machine, if such operations may be done safely. (b) If the total...

  16. Active optics primary mirror support system for the 26m VST telescope

    NASA Astrophysics Data System (ADS)

    Schipani, Pietro; D'Orsi, Sergio; Ferragina, Luigi; Fierro, Davide; Marty, Laurent; Molfese, Cesare; Perrotta, Francesco

    2010-03-01

    The Very Large Telescope Survey Telescope (VST) is equipped with an active optics system in order to correct low-order aberrations. The 2.6 m primary mirror is supported both axially and laterally and is surrounded by several safety devices for earthquake protection. We describe the mirror support system and discuss the results of the qualification test campaign.

  17. 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…

  18. 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…

  19. 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.

  20. 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.

  1. 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. PMID:23474336

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. A primary culture system of mouse thick ascending limb cells with preserved function and uromodulin processing.

    PubMed

    Glaudemans, Bob; Terryn, Sara; Gölz, Nadine; Brunati, Martina; Cattaneo, Angela; Bachi, Angela; Al-Qusairi, Lama; Ziegler, Urs; Staub, Olivier; Rampoldi, Luca; Devuyst, Olivier

    2014-02-01

    The epithelial cells lining the thick ascending limb (TAL) of the loop of Henle perform essential transport processes and secrete uromodulin, the most abundant protein in normal urine. The lack of differentiated cell culture systems has hampered studies of TAL functions. Here, we report a method to generate differentiated primary cultures of TAL cells, developed from microdissected tubules obtained in mouse kidneys. The TAL tubules cultured on permeable filters formed polarized confluent monolayers in ∼12 days. The TAL cells remain differentiated and express functional markers such as uromodulin, NKCC2, and ROMK at the apical membrane. Electrophysiological measurements on primary TAL monolayers showed a lumen-positive transepithelial potential (+9.4 ± 0.8 mV/cm(2)) and transepithelial resistance similar to that recorded in vivo. The transepithelial potential is abolished by apical bumetanide and in primary cultures obtained from ROMK knockout mice. The processing, maturation and apical secretion of uromodulin by primary TAL cells is identical to that observed in vivo. The primary TAL cells respond appropriately to hypoxia, hypertonicity, and stimulation by desmopressin, and they can be transfected. The establishment of this primary culture system will allow the investigation of TAL cells obtained from genetically modified mouse models, providing a critical tool for understanding the role of that segment in health and disease. PMID:23887378

  8. 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. PMID:17041358

  9. 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.

  10. Primary Systemic Amyloidosis with Unusual Dermatological Manifestations: A Rare Case Report

    PubMed Central

    Vyas, Kapil; Morgaonkar, Manjaree; Gupta, Savera; Jain, Suresh Kumar

    2016-01-01

    Amyloidosis is a group of heterogeneous diseases characterized by pathological deposition of proteinaceous substance extracellularly in various tissues. The clinical presentation depends on the site of amyloid deposition, with predominant involvement of mesenchymal elements and cutaneous findings in 30–40% of patients in case of primary systemic amyloidosis. We present a case of idiopathic primary systemic amyloidosis presenting with an unusual finding of nodulo-ulcerative lesion over tongue along with multiple skin-colored nodules, mimicking squamous cell carcinoma of tongue with secondary cutaneous metastasis, as well as lacking the classical presentation of purpura, macroglossia, waxy papules, and plaques. PMID:27057028

  11. [Effect of implementation of essential medicine system in the primary health care institution in China].

    PubMed

    Huang, Donghong; Ren, Xiaohua; Hu, Jingxuan; Shi, Jingcheng; Xia, Da; Sun, Zhenqiu

    2015-02-01

    Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question. PMID:25769336

  12. Gaps In Primary Care And Health System Performance In Six Latin American And Caribbean Countries.

    PubMed

    Macinko, James; Guanais, Frederico C; Mullachery, Pricila; Jimenez, Geronimo

    2016-08-01

    The rapid demographic and epidemiological transitions occurring in Latin America and the Caribbean have led to high levels of noncommunicable diseases in the region. In addition to reduced risk factors for chronic conditions, a strong health system for managing chronic conditions is vital. This study assessed the extent to which populations in six Latin American and Caribbean countries receive high-quality primary care, and it examined the relationship between experiences with care and perceptions of health system performance. We applied a validated survey on access, use, and satisfaction with health care services to nationally representative samples of the populations of Brazil, Colombia, El Salvador, Jamaica, Mexico, and Panama. Respondents reported considerable gaps in the ways in which primary care is organized, financed, and delivered. Nearly half reported using the emergency department for a condition they considered treatable in a primary care setting. Reports of more primary care problems were associated with worse perceptions of health system performance and quality and less receipt of preventive care. Urgent attention to primary care performance is required as the region's population continues to age at an unprecedented rate. PMID:27503978

  13. Gaps In Primary Care And Health System Performance In Six Latin American And Caribbean Countries.

    PubMed

    Macinko, James; Guanais, Frederico C; Mullachery, Pricila; Jimenez, Geronimo

    2016-08-01

    The rapid demographic and epidemiological transitions occurring in Latin America and the Caribbean have led to high levels of noncommunicable diseases in the region. In addition to reduced risk factors for chronic conditions, a strong health system for managing chronic conditions is vital. This study assessed the extent to which populations in six Latin American and Caribbean countries receive high-quality primary care, and it examined the relationship between experiences with care and perceptions of health system performance. We applied a validated survey on access, use, and satisfaction with health care services to nationally representative samples of the populations of Brazil, Colombia, El Salvador, Jamaica, Mexico, and Panama. Respondents reported considerable gaps in the ways in which primary care is organized, financed, and delivered. Nearly half reported using the emergency department for a condition they considered treatable in a primary care setting. Reports of more primary care problems were associated with worse perceptions of health system performance and quality and less receipt of preventive care. Urgent attention to primary care performance is required as the region's population continues to age at an unprecedented rate.

  14. 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

  15. 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. PMID:27484777

  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. 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.

  19. Fission product plateout and liftoff in the MHTGR primary system: A review

    SciTech Connect

    Wichner, R.P. )

    1991-04-01

    A review is presented of the technical basis for predicting radioactivity release resulting from depressurization of an MHTGR primary system. Consideration is restricted to so called dry events with no involvement of the steam system. The various types of deposition mechanisms effective for iodine, cesium, strontium, and silver are discussed in terms of their chemical characteristics and the nature of the materials in the primary system. Emphasis is given to iodine behavior, including means for estimating the quantity available for release, the types of plateout locations in the primary system, and the effect of dust on distribution and release. The behavior of fission products cesium, strontium, and silver in such accidents is presented qualitatively. A major part of the review deals with expected dust levels, types, and transport. Available information on the level and nature of dust in the HTGR primary system is reviewed. A summary is presented of dust deposition and liftoff mechanisms. It was concluded that recent approaches to dust liftoff modeling, based on turbulent burst concepts for removal from surfaces, probably offer advantages over the current shear ratio approach. This study concludes that iodine releases from dry depressurization events are likely to be extremely low, on the order of millicuries, due to a predictably low degree of chemical desorption, a low degree of dust liftoff, and a low involvement of iodine with dust. It was also concluded that deposition mechanisms controlling the distribution of fission product material in the primary system, and hence also controlling the degree of liftoff, depend strongly on the chemical nature of the individual elements. Therefore contrary to the current practice, both plateout and liftoff models should reflect those unique chemical and physical properties. 56 refs., 16 figs., 23 tabs.

  20. 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,…

  1. 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…

  2. 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…

  3. 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…

  4. 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)

  5. 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.…

  6. 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.

  7. A new primary care rostering and capitation system in Norway: Lessons for Canada?

    PubMed Central

    Ostbye, T; Hunskaar, S

    1997-01-01

    Providing every patient with a personal primary care physician or, from the physician's perspective, establishing a stable roster or list of patients is currently being actively debated in Canada. Norway's system of primary care medicine, similar to Canada's, faces many of the same problems. In 1992 a trial rostering system with blended funding (capitation, fee-for-service and user fees) was established in 4 Norwegian municipalities. After 3 years of close monitoring, the results of system evaluations have attracted strong interest. This article reports on the benefits and problems encountered with the new rostering system in Norway. If Canada is moving in the same direction, some of the lessons learned may be helpful. PMID:9220943

  8. Monitoring network design for phytoremediation systems using primary and secondary data sources.

    PubMed

    Gopalakrishnan, Gayathri; Minsker, Barbara S; Valocchi, Albert J

    2011-06-01

    Phytoremediation, or contaminant removal using plants, has been deployed at many sites to remediate contaminated soil and groundwater. Research has shown that trees are low-cost, rapid, and relatively simple-to-use monitoring systems as well as inexpensive alternatives to traditional pump-and-treat systems. However, tree monitoring is also an indirect measure of subsurface contamination and inherently more uncertain than conventional techniques such as wells or soil borings that measure contaminant concentrations directly. This study explores the implications for monitoring network design at real-world sites where scarce primary data such as monitoring wells or soil borings are supplemented by extensive secondary data such as trees. In this study, we combined secondary and primary data into a composite data set using models to transform secondary data to primary, as primary data were too sparse to attempt cokriging. Optimal monitoring networks using both trees and conventional techniques were determined using genetic algorithms, and trade-off curves between cost and uncertainty are presented for a phytoremediation system at Argonne National Laboratory. Optimal solutions found at this site indicate that increasing the number of secondary data sampled resulted in a significant decrease in global uncertainty with a minimal increase in cost. The choice of the data transformation model had an impact on the optimal designs and uncertainty estimated at the site. Using a data transformation model with a higher error resulted in monitoring network designs where primary data were favored over colocated secondary data. The spatial configuration of the monitoring network design was similar with regard to the areas sampled, irrespective of the data transformation model used. Overall, this study shows that using a composite data set, with primary and secondary data, results in effective monitoring designs, even at sites where the only data transformation model available is one

  9. Getting on with your computer is associated with job satisfaction in primary care: entrants to primary care should be assessed for their competency with electronic patient record systems.

    PubMed

    de Lusignan, Simon; Pearce, Christopher; Munro, Neil

    2013-01-01

    Job satisfaction in primary care is associated with getting on with your computer. Many primary care professionals spend longer interacting with their computer than anything else in their day. However, the computer often makes demands rather than be an aid or supporter that has learned its user's preferences. The use of electronic patient record (EPR) systems is underrepresented in the assessment of entrants to primary care, and in definitions of the core competencies of a family physician/general practitioner. We call for this to be put right: for the use of the EPR to support direct patient care and clinical governance to be given greater prominence in training and assessment. In parallel, policy makers should ensure that the EPR system use is orientated to ensuring patients receive evidence-based care, and EPR system suppliers should explore how their systems might better support their clinician users, in particular learning their preferences.

  10. 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. PMID:22085327

  11. Primary mirror back surface shape research of GEO laser communication system

    NASA Astrophysics Data System (ADS)

    Liu, Weida; Zhang, Li-zhong; Meng, Li-xin

    2015-11-01

    The research of laser communication system primary mirror deformation caused by back surface shape variation was done in this paper. The usual mirror back surface shapes were sphere, double arch, flat and biconcave shape and so on. Based on the four shape mirror, with the center hole rim support pattern, the four shape mirror temperature distribution equation was inferred by thermal elastic theory, deformation are compared in 1-5℃ radius direction temperature difference, in the case of minor weight gap and equal maximum thickness. As a result, the deformation of sphere back surface shape mirror is minimal. So sphere back surface shape is fit for the primary mirror.

  12. 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. PMID:25488034

  13. Structural and Contextual Dimensions of Iranian Primary Health Care System at Local Level

    PubMed Central

    Zanganeh Baygi, Mehdi; Seyedin, Hesam; Salehi, Masoud; Jafari Sirizi, Mehdi

    2014-01-01

    Background: In recent years, family physician plan was established as the main strategy of health system in Iran, while organizational structure of the primary health care system has remained the same as thirty years ago. Objectives: This study was performed to illustrate structural and contextual dimensions of organizational structure and relationship between them in Iranian primary health care system at local level. Materials and Methods: A cross-sectional quantitative study was conducted from January to June 2013, during which 121 questionnaires were distributed among senior and junior managers of city health centers at Medical Sciences universities in Iran. Validity of the questionnaire was confirmed by experts (CVI = 0.089 and CVR more than 0.85) and Cronbach α was utilized for reliability (α = 0.904). We used multistage sampling method in this study and analysis of the data was performed by SPSS software using different tests. Results: Local level of primary health care system in Iran had mechanical structure, but in contextual dimensions the results showed different types. There was a significant relationship between structural and contextual dimensions (r = 0.642, P value < 0.001). Goals and culture dimensions had strongest effects on structural dimensions. Conclusions: Because of the changes in goals and strategies of Iranian health system in recent years, it is urgently recommended to reform the current structure to increase efficiency and effectiveness of the system. PMID:25763257

  14. Simple system of aberration correction for very large spherical primary mirrors

    NASA Astrophysics Data System (ADS)

    Beach, David A.

    2000-10-01

    Several large telescopes are now being proposed that would benefit from the cost reduction due to the use of spherical primary mirror. However, structural cost constraints require compact formats that tend to impose very high speeds, e.g. f/1.5, which renders difficult the correction of the resulting very large spherical aberration. A technique is described here in which a spherical concentric Cassegrain-like primary-secondary combination is followed by a simple catadioptric focal modifier. The spherical primary is 9m diameter, f/1.5, and the final focus is f/5 with a sub-arcsecond resolution over a 5 arcminute angular field for a passband of 480-850nm. Primary- secondary separation is only 11m and central obscuration is only 11% of pupil area. The two relatively small corrector components provide the functions of concentric meniscus and zonal corrector plate and are made from the same single glass- BK7 is the example given, but silica or any other preferred glass is possible. The relatively small zonal corrector is the only aspheric surface in the entire system. A related system is described elsewhere in which a 30 arcminute angular field can be achieved with a similar resolution, but with more complex glass requirements. However, supply of such exotic glasses may be difficult in large diameters, and the system presented here may find a place in some specialized applications.

  15. Hessian facilitated analysis of optimally controlled quantum dynamics of systems with coupled primary and secondary states.

    PubMed

    Shu, Chuan-Cun; Edwalds, Melanie; Shabani, Alireza; Ho, Tak-San; Rabitz, Herschel

    2015-07-28

    The efficacy of optimal control of quantum dynamics depends on the topology and associated local structure of the underlying control landscape defined as the objective as a function of the control field. A commonly studied control objective involves maximization of the transition probability for steering the quantum system from one state to another state. This paper invokes landscape Hessian analysis performed at an optimal solution to gain insight into the controlled dynamics, where the Hessian is the second-order functional derivative of the control objective with respect to the control field. Specifically, we consider a quantum system composed of coupled primary and secondary subspaces of energy levels with the initial and target states lying in the primary subspace. The primary and secondary subspaces may arise in various scenarios, for example, respectively, as sub-manifolds of ground and excited electronic states of a poly-atomic molecule, with each possessing a set of rotational-vibrational levels. The control field may engage the system through electric dipole transitions that occur either (I) only in the primary subspace, (II) between the two subspaces, or (III) only in the secondary subspace. Important insights about the resultant dynamics in each case are revealed in the structural patterns of the corresponding Hessian. The Fourier spectrum of the Hessian is shown to often be complementary to mechanistic insights provided by the optimal control field and population dynamics.

  16. 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. PMID:24301716

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. Health policy and the policymaking system: A case study of primary care in Ireland.

    PubMed

    Kelly, Niall; Garvey, John; Palcic, Dónal

    2016-08-01

    In 2001 the Irish government published a reforming policy intended to modernise and expand the delivery of primary care in Ireland. Fifteen years later, the Irish health system remains beset by problems indicative of a fragmented and underdeveloped primary care system. This case study examines the formation and implementation of the 2001 primary care policy and identifies key risk categories within the policymaking process itself that inhibited the timely achievement of policy objectives. Our methodology includes a directed content analysis of the policy formation and implementation documents and the influencing academic literature, as well as semi-structured interviews with key personnel involved in the process. We identify three broad risk categories - power, resources and capability - within the policymaking process that strongly influenced policy formation and implementation. We additionally show that the disjoint between policy formation and policy implementation was a contested issue among those involved in the policy process and provided space for these risks to critically undermine Ireland's primary care policy. PMID:27342835

  2. 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.

  3. Combined heat and power systems for commercial buildings: investigating cost, emissions, and primary energy reduction based on system components

    NASA Astrophysics Data System (ADS)

    Smith, Amanda D.

    Combined heat and power (CHP) systems produce electricity and useful heat from fuel. When power is produced near a building which consumes power, transmission losses are averted, and heat which is a byproduct of power production may be useful to the building. That thermal energy can be used for hot water or space heating, among other applications. This dissertation focuses on CHP systems using natural gas, a common fuel, and systems serving commercial buildings in the United States. First, the necessary price difference between purchased electricity and purchased fuel is analyzed in terms of the efficiencies of system components by comparing CHP with a conventional separate heat and power (SHP) configuration, where power is purchased from the electrical grid and heat is provided by a gas boiler. Similarly, the relationship between CDE due to electricity purchases and due to fuel purchases is analyzed as well as the relationship between primary energy conversion factors for electricity and fuel. The primary energy conversion factor indicates the quantity of source energy necessary to produce the energy purchased at the site. Next, greenhouse gas emissions are investigated for a variety of commercial buildings using CHP or SHP. The relationship between the magnitude of the reduction in emissions and the parameters of the CHP system is explored. The cost savings and reduction in primary energy consumption are evaluated for the same buildings. Finally, a CHP system is analyzed with the addition of a thermal energy storage (TES) component, which can store excess thermal energy and deliver it later if necessary. The potential for CHP with TES to reduce cost, emissions, and primary energy consumption is investigated for a variety of buildings. A case study is developed for one building for which TES does provide additional benefits over a CHP system alone, and the requirements for a water tank TES device are examined.

  4. Collaborative practice in health systems change: the Nova Scotia experience with the Strengthening Primary Care Initiative.

    PubMed

    Martin-Misener, Ruth; McNab, John; Sketris, Ingrid S; Edwards, Lynn

    2004-05-01

    Recently attention has been focussed on the significance of primary care to the Canadian healthcare system. Nova Scotia. Like other provinces, is seeking ways to improve the healthcare that it provides within a financially constrained publicly funded system. The Strengthening Primary Care Initiative in Nova Scotia (SPCI) was a primary care demonstration project to evaluate specific goals related to primary care. Although the provincial government conceived the SPCI, the approach to its planning and implementation was participatory and consultative. Funded through the federal Health Transition Fund (HTF) (Health Canada 2002) and the government of Nova Scotia, the SPCI involved changes in four communities over a three-year period (2000-2002). These changes included the introduction of a primary healthcare nurse practitioner in collaborative practice with one or more family physicians; remuneration of the family physician(s) with methods other than a solely fee-for-service (FFS) arrangement; and the introduction and utilization of a computerized patient medical record. The SPCI was committed to a consultative process with stakeholders, and this gave rise to several challenges. Initially there was disagreement on the requirement for nurse practitioners at each of the demonstration sites. The Minister of Health confirmed that a nurse practitioner was a required component at each demonstration site. Differences in perspectives on the role of allied health professionals in the SPCI were encountered, and the significance of the role pharmacists have in primary care was not fully appreciated until after the SPCI had started. At the time the SPCI began there was no legislation for nurse practitioners in Nova Scotia; therefore, an approval mechanism for nurse practitioner practice was authorized through the provincial regulatory bodies for nursing and medicine. Malpractice and liability issues, particularly on the part of providers who had never worked with nurse

  5. 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.

  6. 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.

  7. [Legislation on primary care in Brazilian Unified National Health System: document analysis].

    PubMed

    Domingos, Carolina Milena; Nunes, Elisabete de Fátima Polo de Almeida; Carvalho, Brígida Gimenez; Mendonça, Fernanda de Freitas

    2016-03-01

    A reflection on Brazil's legislation for primary care helps understand the way health policy is implemented in the country. This study focuses on the legal provisions aimed at strengthening primary care, drawing on an analysis of documents from the Ministry of Health's priority actions, programs, and strategies. A total of 224 provisions were identified, in two groups of documents, so-called instituting provisions and complementary provisions. The former include the principles and guidelines of the Brazilian Unified National Health System (SUS) and also involve the expansion of actions. Financing was a quantitatively central theme, especially in the complementary provisions. The analysis led to reflection on the extent to which these strategies can induce linkage between health system managers and civil society in building a political project resulting in improvements and meeting the population's health needs.

  8. Role of microRNAs in primary central nervous system lymphomas.

    PubMed

    Yu, Xin; Li, Zheng; Shen, Jianxiong; Chan, Matthew T V; Wu, William Ka Kei

    2016-04-01

    Primary central nervous system lymphomas (PCNSL) are extranodal non-Hodgkin lymphomas arising exclusively inside the CNS, and account for about 3% of primary intracranial tumours. This tumour lacks systemic manifestations and prognosis of patients with PCNSL remains poor despite recent advancement of chemoradiotherapy. MicroRNAs are small non-coding RNAs that post-transcriptionally downregulate gene expression by binding to target mRNAs, inducing their degradation or translational repression. MicroRNAs play significant roles in almost all malignancy-related biological processes, including cell proliferation, differentiation, apoptosis and metabolism. Many deregulated miRNAs has been identified in PCNSL but their biological significance remains to be fully elucidated. In this review, we summarize current evidence regarding the pathogenic role of PCNSL-associated microRNAs and their potential applications for diagnosis and prognostication of this deadly disease. PMID:26990358

  9. Primary central nervous system peripheral T-cell lymphoma in a child.

    PubMed

    Gualco, Gabriela; Wludarski, Sheila; Hayashi-Silva, Luciana; Medeiros Filho, Plinio; Veras, Geni; Bacchi, Carlos Eduardo

    2010-01-01

    A 10-year-old Caucasian boy was admitted to the hospital with a 3-month history of headache, vomiting, ataxia, and right amaurosis. A magnetic resonance imaging (MRI) showed a solid, expansive, parasagittal mass in the right parietal hemisphere that extended sagitally to include the optical chiasm. The lesion was considered unresectable. Histology and immunophenotyping of biopsy tissue revealed characteristics of peripheral T-cell lymphoma. No other anatomical region, including bone marrow, was compromised. Primary T-cell lymphomas of the central nervous system are rare, especially in childhood. Here, we describe the rapidly deteriorating and fatal clinical course of a boy with a primary T-cell lymphoma in the central nervous system.

  10. [Legislation on primary care in Brazilian Unified National Health System: document analysis].

    PubMed

    Domingos, Carolina Milena; Nunes, Elisabete de Fátima Polo de Almeida; Carvalho, Brígida Gimenez; Mendonça, Fernanda de Freitas

    2016-03-01

    A reflection on Brazil's legislation for primary care helps understand the way health policy is implemented in the country. This study focuses on the legal provisions aimed at strengthening primary care, drawing on an analysis of documents from the Ministry of Health's priority actions, programs, and strategies. A total of 224 provisions were identified, in two groups of documents, so-called instituting provisions and complementary provisions. The former include the principles and guidelines of the Brazilian Unified National Health System (SUS) and also involve the expansion of actions. Financing was a quantitatively central theme, especially in the complementary provisions. The analysis led to reflection on the extent to which these strategies can induce linkage between health system managers and civil society in building a political project resulting in improvements and meeting the population's health needs. PMID:27027459

  11. 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.

  12. Mixing phenomena of interest to boron dilution during small break LOCAs in PWRs. Revision 7/95

    SciTech Connect

    Nourbakhsh, H.P.; Cheng, Z.

    1995-07-01

    This paper presents the results of a study of mixing phenomena related to boron dilution 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 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 are examined in this paper. Bounding calculations for boron concentration of coolant entering the core during a small break LOCA in a typical Westinghouse-designed four-loop plant are also presented.

  13. Deployment and validation of a smart system for screening of language disorders in primary care.

    PubMed

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

    2013-06-10

    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.

  14. 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.

  15. 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

  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. Breast cancer brain metastases responding to lapatinib plus capecitabine as second-line primary systemic therapy.

    PubMed

    Bergen, Elisabeth S; Berghoff, Anna S; Rudas, Margaretha; Preusser, Matthias; Bartsch, Rupert

    2015-06-01

    Brain metastases (BM) are diagnosed in up to 40% of HER2-positive breast cancer patients. Standard treatment includes local approaches such as whole-brain radiotherapy (WBRT), radiosurgery, and neurosurgery. The landscape trial established primary systemic therapy as an effective and safe alternative to WBRT in selected patients with Her2-positive BM. We aim to further focus on the role of systemic therapy in oligosymptomatic patients by presenting this case report. We report on a 50-year-old patient diagnosed with multiple BM 5 years after early breast cancer diagnosis. As the patient was asymptomatic and had a favorable diagnosis-specific GPA score, she received primary systemic treatment with T-DM1. She achieved partial remission within the brain for eight treatment cycles and then progressed despite stable extracranial disease. As the patient remained asymptomatic and refused WBRT, we decided upon trastuzumab, lapatinib plus capecitabine as second-line therapy. Another partial remission of BM was observed; to date, she has received 11 treatment cycles without any sign of disease progression. In this case, WBRT was delayed by at least 14 months, again indicating the activity of systemic treatment in BM. Apparently, in selected patients, BM can be controlled with multiple lines of systemic therapy similar to extracranial disease. Further investigation of systemic treatment approaches is therefore warranted.

  18. 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.

  19. 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.

  20. 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.

  1. Design Of A Support System For The Primary Mirror Of A Cryogenic Space Telescope

    NASA Astrophysics Data System (ADS)

    DiTolla, Robert; Richard, Ralph M.; Vukobratovich, Daniel

    1986-07-01

    The finite element method was used for the structural design of the Space Infrared Telescope Facility (SIRTF) primary mirror and its support system in a cryogenic environment similar to space-shuttle cargo-bay launch conditions. Shuttle loads were specified by power spectral density functions (PSDF) obtained from previous shuttle launches. The primary goal in the development of a design to withstand this random loading was to ensure the structural integrity of the support system, which comprised an aluminum baseplate and three titanium flexures. This design was an extension of a support system previously developed for cryogenic static effects only. The displacements and stresses of the support system are greatly affected by the damping characteristics of the flexures, which are very difficult to quantify. A parametric study illustrates the behavior of the system over the range of the estimated damping values. Recommendations and techniques for modeling this type of structure are presented. The methods and approaches used in the analysis and the effect of model refinement upon solution accuracy are discussed.

  2. The Large Binocular Telescope primary mirror support control system description and current performance results

    NASA Astrophysics Data System (ADS)

    Ashby, David S.; Kern, Jonathan; Hill, John M.; Davison, Warren B.; Cuerden, Brian; Brynnel, Joar G.; Biddick, Chris; Duffek, Kenneth

    2008-07-01

    The Large Binocular Telescope (LBT) is built around two lightweight borosilicate honeycomb mirrors which, at 8.4 meters in diameter, are the largest operational examples of this technology. Since the mirrors are relatively stiff, the LBT mirror support system relies on passive position control and active force control. Passive position control is performed by six extendable hardpoints organized as a truncated hexapod, which may be positioned as required by the active optics control loop. The hardpoints rely on their axial stiffness to maintain the mirror position against residual external disturbances. The active force control system minimizes the force exerted by the hardpoints on the glass. Additionally, the axial component of the nominally uniform active support forces can be perturbed to distort the mirror as required by the active optics control loop. Because of the relatively large CTE of borosilicate glass, the differential temperature of the mirror is critical. Thus, the force control system must support a 16 metric ton mirror using less than 100 Watts of electrical power. The authors present a description of the primary mirror support system as implemented at the LBT. Initial stability problems made the mirrors nearly unusable in freezing temperatures. The authors explain the reason for this instability and describe the solutions implemented. Data demonstrating the current performance of the primary mirror support system are also presented.

  3. Design of the primary mirror segment support system for the E-ELT

    NASA Astrophysics Data System (ADS)

    Cavaller, Lluis; Marrero, Juan; Castro, Javier; Morante, Esteban; Ronquillo, Mariano; Hernández, Elvio

    2008-07-01

    The European Extremely Large Telescope (E-ELT) is a 42-m class optical telescope with a segmented primary mirror composed of 984 segments which is currently being studied by ESO (European Southern Observatory). The segment support system combines a series of mechanical whiffletrees for the axial support, a central diaphragm for lateral support and a torsional constrainer. These elements are fixed to a common moving frame which is actively moved by means of three actuators in piston and tip-tilt in order to keep the whole primary mirror in phase. The moving frame is fixed to the segments subcells, which properly attach the segments to the cell structure, by means of special flexures, allowing large axial alignment capability combined with high lateral stiffness. This paper describes the development of the support system for the primary mirror segments of the E-ELT, which has been specified for a high stiffness and eigenfrequencies, 60Hz for axial modes and 40Hz for lateral ones.

  4. Lab on a chip-based hepatic sinusoidal system simulator for optimal primary hepatocyte culture.

    PubMed

    Choi, Yoon Young; Kim, Jaehyung; Lee, Sang-Hoon; Kim, Dong-Sik

    2016-08-01

    Primary hepatocyte cultures have been used in studies on liver disease, physiology, and pharmacology. While they are an important tool for in vitro liver studies, maintaining liver-specific characteristics of hepatocytes in vitro is difficult, as these cells rapidly lose their unique characteristics and functions. Portal flow is an important condition to preserve primary hepatocyte functions and liver regeneration in vivo. We have developed a microfluidic chip that does not require bulky peripheral devices or an external power source to investigate the relationship between hepatocyte functional maintenance and flow rates. In our culture system, two types of microfluidic devices were used as scaffolds: a monolayer- and a concave chamber-based device. Under flow conditions, our chips improved albumin and urea secretion rates after 13 days compared to that of the static chips. Reverse transcription polymerase chain reaction demonstrated that hepatocyte-specific gene expression was significantly higher at 13 days under flow conditions than when using static chips. For both two-dimensional and three-dimensional culture on the chips, flow resulted in the best performance of the hepatocyte culture in vitro. We demonstrated that flow improves the viability and efficiency of long-term culture of primary hepatocytes and plays a key role in hepatocyte function. These results suggest that this flow system has the potential for long-term hepatocyte cultures as well as a technique for three-dimensional culture. PMID:27334878

  5. A microfluidic system to study cytoadhesion of Plasmodium falciparum infected erythrocytes to primary brain microvascularendothelial cells.

    PubMed

    Herricks, Thurston; Seydel, Karl B; Turner, George; Molyneux, Malcolm; Heyderman, Robert; Taylor, Terrie; Rathod, Pradipsinh K

    2011-09-01

    The cellular events leading to severe and complicated malaria in some Plasmodium falciparum infections are poorly understood. Additional tools are required to better understand the pathogenesis of this disease. In this technical report, we describe a microfluidic culture system and image processing algorithms that were developed to observe cytoadhesion interactions of P. falciparum parasitized erythrocytes rolling on primary brain microvascularendothelial cells. We isolated and cultured human primary microvascular brain endothelial cells in a closed loop microfluidic culture system where a peristaltic pump and media reservoirs were integrated onto a microscope stage insert. We developed image processing methods to enhance contrast of rolling parasitized erythrocytes on endothelial cells and to estimate the local wall shear stress. The velocity of parasitized erythrocytes rolling on primary brain microvascularendothelial cells was then measured under physiologically relevant wall shear stresses. Finally, we deployed this method successfully at a field site in Blantyre, Malawi. The method is a promising new tool for the investigation of the pathogenesis of severe malaria.

  6. C-shaped mandibular primary first molar diagnosed with cone beam computed tomography: A novel case report and literature review of primary molars' root canal systems.

    PubMed

    Ozcan, Gozde; Sekerci, Ahmet Ercan; Kocoglu, Fatma

    2016-01-01

    Knowledge of the different anatomical variations in root canal system of dedicious dentition will improve the practice of the pediatric dentists. The teeth with C-shaped root canal configurations are definitely a problem in endodontic treatment. Dentists who are specialists of endodontics must have adequate knowledge about various root canal morphologies of primary tooth that have a tendency for rapid progression of dental caries to achieve a technically satisfactory outcome. This report presents an extraordinary case of unusual tooth morphology involving the mandibular first primary molar with a C-shaped configuration which has not yet been reported. PMID:27681406

  7. 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

  8. 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.

  9. Frequent involvement of central nervous system in primary Sjögren syndrome.

    PubMed

    Moreira, Isabel; Teixeira, Filipa; Martins Silva, Ana; Vasconcelos, Carlos; Farinha, Fátima; Santos, Ernestina

    2015-02-01

    Primary Sjögren syndrome (pSS) is a systemic autoimmune disease characterized by lymphocytic infiltration of the salivary and tear glands, and autoantibody secretion, in the absence of other systemic autoimmune disorder. Among autoimmune diseases, it is a relatively common disease, but the burden of central nervous system (CNS) involvement is controversial. This retrospective study evaluates the prevalence, clinical patterns and outcomes of CNS involvement in a cohort of patients with primary Sjögren syndrome. We evaluated 93 patients with pSS diagnosed according to American-European Consensus Group criteria. Fourteen patients (15.1 %) had CNS involvement. All were women with an average age of onset of the disease of 42.1 ± 14.7 years (average ± SD) and an average age of onset of neurological involvement of 47.29 ± 16 years. Three had parkinsonian syndrome, two epilepsy, two motor and sensory deficits, two headache with brain magnetic resonance abnormalities, two neuromyelitis optica, two chronic progressive myelitis and one aseptic meningitis. Neurological involvement preceded Sjögren syndrome diagnosis in nine of the patients (64 %), and neurological outcome was good in 11 patients (78.6 %). Central nervous involvement was not as rare as expected, and the frequency was similar to the frequency of peripheral nervous system involvement. In half of the patients, this was the first symptom of the disease, emphasizing the importance of considering this diagnosis, especially in young female with neurological symptoms without other evident cause.

  10. A framework to support team-based models of primary care within the Australian health care system.

    PubMed

    Naccarella, Lucio; Greenstock, Louise N; Brooks, Peter M

    2013-09-01

    Health systems with strong primary care orientations are known to be associated with improved equity, better access for patients to appropriate services at lower costs, and improved population health. Team-based models of primary care have emerged in response to health system challenges due to complex patient profiles, patient expectations and health system demands. Successful team-based models of primary care require a combination of interprofessional education and learning; organisational and management policies and systems; and practice support systems. To ensure evidence is put into practice, we propose a framework comprising five domains (theory, implementation, infrastructure, sustainability and evaluation) to assist policymakers, educators, researchers, managers and health professionals in supporting team-based models of primary care within the Australian health care system.

  11. A framework to support team-based models of primary care within the Australian health care system.

    PubMed

    Naccarella, Lucio; Greenstock, Louise N; Brooks, Peter M

    2013-09-01

    Health systems with strong primary care orientations are known to be associated with improved equity, better access for patients to appropriate services at lower costs, and improved population health. Team-based models of primary care have emerged in response to health system challenges due to complex patient profiles, patient expectations and health system demands. Successful team-based models of primary care require a combination of interprofessional education and learning; organisational and management policies and systems; and practice support systems. To ensure evidence is put into practice, we propose a framework comprising five domains (theory, implementation, infrastructure, sustainability and evaluation) to assist policymakers, educators, researchers, managers and health professionals in supporting team-based models of primary care within the Australian health care system. PMID:25370088

  12. 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).

  13. 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).

  14. 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. PMID:23321962

  15. Factors influencing the role of primary care providers as gatekeepers in the Malaysian public healthcare system.

    PubMed

    Ang, K T; Ho, B K; Mimi, O; Salmah, N; Salmiah, M S; Noridah, M S

    2014-01-01

    Primary care providers play an important gatekeeping role in ensuring appropriate referrals to secondary care facilities. This cross-sectional study aimed to determine the level, pattern and rate of referrals from health clinics to hospitals in the public sector, and whether the placement of resident family medicine specialist (FMS) had made a significant difference. The study was carried out between March and April in 2012, involving 28 public primary care clinics. It showed that the average referral rate was 1.56% for clinics with resident FMS and 1.94% for those without resident FMS, but it was not statistically significant. Majority of referred cases were considered appropriate (96.1%). Results of the multivariate analysis showed that no prior consultation with senior healthcare provider and illnesses that were not severe and complex were independently associated with inappropriate referrals. Severity, complexity or uncertain diagnosis of patients' illness or injury significantly contributed to unavoidable referrals. Adequate facilities or having more experienced doctors could have avoided 14.5% of the referrals. The low referral rate and very high level of appropriate referrals could indicate that primary care providers in the public sector played an effective role as gatekeepers in the Malaysian public healthcare system.

  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. Characterization of a primary brown adipocyte culture system derived from human fetal interscapular fat

    PubMed Central

    Seiler, Sarah E; Xu, Dan; Ho, Jia-Pei; Lo, Kinyui Alice; Buehrer, Benjamin M; Ludlow, Y John W; Kovalik, Jean-Paul; Sun, Lei

    2015-01-01

    Brown fat has gained widespread attention as a potential therapeutic target to treat obesity and associated metabolic disorders. Indeed, the anti-obesity potential of multiple targets to stimulate both brown adipocyte differentiation and recruitment have been verified in rodent models. However, their therapeutic potential in humans is unknown due to the lack of a human primary brown adipocyte cell culture system. Likewise, the lack of a well-characterized human model has limited the discovery of novel targets for the activation of human brown fat. To address this current need, we aimed to identify and describe the first primary brown adipocyte cell culture system from human fetal interscapular brown adipose tissue. Pre-adipocytes isolated from non-viable human fetal interscapular tissue were expanded and cryopreserved. Cells were then thawed and plated alongside adult human subcutaneous and omental pre-adipocytes for subsequent differentiation and phenotypic characterization. Interscapular pre-adipocytes in cell culture differentiated into mature adipocytes that were morphologically indistinguishable from the adult white depots. Throughout differentiation, cultured human fetal interscapular adipocytes demonstrated increased expression of classical brown fat markers compared to subcutaneous and omental cells. Further, functional analysis revealed an elevation in fatty acid oxidation as well as maximal and uncoupled oxygen consumption in interscapular brown adipocytes compared to white control cells. These data collectively identify the brown phenotype of these cells. Thus, our primary cell culture system derived from non-viable human fetal interscapular brown adipose tissue provides a valuable tool for the study of human brown adipocyte biology and for the development of anti-obesity therapeutics. PMID:26451287

  18. 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.

  19. 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.

  20. A comparison of primary care systems in the USA, Denmark, Finland and Sweden: lessons for Scandinavia?

    PubMed

    Weiner, J

    1988-02-01

    In the United States large corporately owned health care delivery institutions, some of which are known as health maintenance organizations (HMOs), are assuming an increased prominence in the provision of primary care (PC). These private organizations are similar in many ways to the public-sector providers that have functioned for decades within the Scandinavian systems. This article explores the similarities and differences between these two PC approaches. This is accomplished by contrasting the governance, organization, financing and staffing of the PC systems of three Nordic countries (Denmark, Finland, and Sweden) to that of the US. Also provided is a critical analysis of the extent to which each model attains the ideal attributes of PC including; 1) accessibility, 2) comprehensiveness, 3) coordination and continuity, and 4) sensitivity to the patient's social milieu. For each facet of PC assessed, the American models offer approaches that are worthy of consideration by Scandinavian clinicians and planners. These include innovations in the areas of coordination between primary and secondary care, preventive care for adults and incentives for financial efficiency. Also, although successful in attaining many attributes of PC, this article discusses some perceived weaknesses of the Scandinavian systems. PMID:3353591

  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. PMID:10671022

  2. A Wireless, Handheld Decision Support System To Promote Smoking Cessation in Primary Care

    PubMed Central

    Michel, George; Marcy, Theodore; Shiffman, Richard N.

    2005-01-01

    Tobacco use remains a relatively unaddressed cause of disease and death in the daily care of patients by physicians. To overcome the barriers that physicians face in addressing tobacco use and its treatment in the primary care setting, we have developed a clinical decision support system that is readily accessible through the use of familiar wireless handheld devices and supportive of treatment through the implementation of the Tobacco Use and Dependence Treatment Guideline recommendations. We adopted the Information Management Services model to ensure that the application would effectively implement the guideline. The techniques used here are readily adaptable to implementing a broad range of clinical guidelines. PMID:16779096

  3. Primary central nervous system T-cell lymphoma in a common dolphin (Delphinus delphis).

    PubMed

    Arbelo, M; Espinosa de los Monteros, A; Herráez, P; Suárez-Bonnet, A; Andrada, M; Rivero, M; Grau-Bassas, E R; Fernández, A

    2014-01-01

    This report describes the pathological findings in an adult female short-beaked common dolphin (Delphinus delphis) stranded alive in the Canary Islands. Necropsy examination revealed the presence of a nodular neoplastic growth in the central nervous system (CNS) at the level of the thalamus. Microscopical examination revealed the mass to be a lymphoma and immunohistochemical labelling demonstrated a T-cell origin. No significant lesions were observed in other organs, including lymphoid organs. This is the first report of a primary T-cell lymphoma in the CNS in cetaceans. PMID:24650893

  4. Salvage therapy for primary central nervous system lymphoma with (90)Y-Ibritumomab and Temozolomide.

    PubMed

    Pitini, Vincenzo; Baldari, Sergio; Altavilla, Giuseppe; Arrigo, Carmela; Naro, Claudia; Perniciaro, Francesca

    2007-07-01

    Aggressive initial treatment of Primary Central Nervous System Lymphoma (PCNSL) has achieved prolonged survival and occasional cures. However, some patients do not respond to initial therapy and others relapse after an initial remission. The optimal salvage regimen is not known and many different strategies have been proposed. In this report we describe the efficacy of a combination of (90)Y-Ibritumomab Tiuxetan (Zevalin) and Temozolamide as a maintenance therapy for recurrent PCNS Lymphoma in two patients that are both alive and in complete remission after 9 and 10 months respectively. This combination merits further study and provides a reasonable therapeutic alternative for older patients with progressive PCNSL.

  5. [Primary Central Nervous System Post-Transplant Lymphoproliferative Disorder in a Patient with Acute Lymphocytic Leukemia].

    PubMed

    Azuma, Yoshiko; Nakaya, Aya; Fujita, Shinya; Hotta, Masaaki; Fujita, Yukie; Yoshimura, Hideaki; Nakanishi, Takahisa; Satake, Atsushi; Ito, Tomoki; Ishii, Kazuyoshi; Nomura, Shosaku

    2015-08-01

    A 27-year-old woman with acute lymphocytic leukemia, who underwent allogeneic hematopoietic stem cell transplantation, complained of nausea and blurred vision 288 days after the transplantation. Intracranial tumors were identified on brain MRI. She received whole brain radiation after open biopsy, but she died. The tumors had characteristics of diffuse large B cell lymphoma, and she was finally diagnosed with primary central nervous system post-transplant lymphoproliferative disorder. This disease is rare and has a poor outcome. Therefore, accumulation of cases and establishment of treatments for this condition are urgently needed.

  6. 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.

  7. 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

    Flight test results have been obtained which demonstrate the feasibility and desirability of using knowledge-based systems architectures for flight test investigations of primary flight display information management-related issues. LISP-based software was used for real-time operation of the primary flight display. The two integrated knowledge-based systems designed to control the primary flight displays were implemented aboard a NASA-Langley B-737. The programmer is noted to be capable of more easily developing initial systems via the present method than with more conventional techniques.

  8. [Primary care pediatrics in the public health system of the twenty-first century. SESPAS report 2012].

    PubMed

    Domínguez Aurrecoechea, Begoña; Valdivia Jiménez, Carlos

    2012-03-01

    Today in our country, the primary care pediatrician is the first contact between children and adolescents with the health system, being also a highly resolving specialist that addresses over 90% of the health needs of this population, monitors growth and development and participates in all activities of prevention, health promotion and health education within primary care teams with nurses and family doctors. Witnessing rapid and profound demographic, social, cultural, scientific and technological changes as well as the demands and expectations of health care for citizens, which should enhance the value and response capacity of primary care. These changes also affect infant morbidity and health care priorities in child and adolescent, posing new challenges for primary care practice and reinforce the role of the pediatrician in primary care. Primary care is not only the gateway to the health system. Primary care teams have to take responsibility for the care of people assigned to coordinate the necessary resources and advising citizens on their health problems and his itinerary care by the health system. It identifies the need to foster teamwork within the health department involved nursing staff to take care activities in this age group. It aims to foster a model based on cooperation and complementarity. A recent systematic review recommended maintaining the figure of the pediatrician in primary care teams and strengthen their specific role as first point of contact with the child's health care system, found significant benefits for children. PMID:22196036

  9. Experimental investigation on circumferential and axial temperature gradient over fuel channel under LOCA

    NASA Astrophysics Data System (ADS)

    Yadav, Ashwini Kumar; kumar, Ravi; Gupta, Akhilesh; Chatterjee, Barun; Mukhopadhyay, Deb; Lele, H. G.

    2014-06-01

    In a nuclear reactor temperature rises drastically in fuel channels under loss of coolant accident due to failure of primary heat transportation system. Present investigation has been carried out to capture circumferential and axial temperature gradients during fully and partially voiding conditions in a fuel channel using 19 pin fuel element simulator. A series of experiments were carried out by supplying power to outer, middle and center rods of 19 pin fuel simulator in ratio of 1.4:1.1:1. The temperature at upper periphery of pressure tube (PT) was slightly higher than at bottom due to increase in local equivalent thermal conductivity from top to bottom of PT. To simulate fully voided conditions PT was pressurized at 2.0 MPa pressure with 17.5 kW power injection. Ballooning initiated from center and then propagates towards the ends and hence axial temperature difference has been observed along the length of PT. For asymmetric heating, upper eight rods of fuel simulator were activated and temperature difference up-to 250 °C has been observed from top to bottom periphery of PT. Such situation creates steep circumferential temperature gradient over PT and could lead to breaching of PT under high pressure.

  10. 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

  11. PROMIS in Primary Care: Demonstration of a Computerized Problem-Oriented Medical Information System in Primary Care

    PubMed Central

    Powell, H.; Davis, E.; Wolf, L.

    1981-01-01

    This paper describes the implementation of a computerized PROMIS (Problem Oriented Medical Information System) at the Champlain Islands Health Center, a Rural Health Initiative Project, in Grand Isle County, Vermont. The goal of the contract with the National Center for Health Services Research was to develop a well defined, computerized and coordinated system of care that would provide a mid-level provider staff with guidance, as they practice health care in a rural, isolated county. The conceptualization of this technology as a method to meet the needs of rural health care, a brief description of POMR (Problem Oriented Medical Records) and the technological aspects of the system will all be addressed in this paper.

  12. 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

  13. Frequency response properties of primary afferent neurons in the posterior lateral line system of larval zebrafish

    PubMed Central

    Levi, Rafael; Akanyeti, Otar; Ballo, Aleksander

    2014-01-01

    The ability of fishes to detect water flow with the neuromasts of their lateral line system depends on the physiology of afferent neurons as well as the hydrodynamic environment. Using larval zebrafish (Danio rerio), we measured the basic response properties of primary afferent neurons to mechanical deflections of individual superficial neuromasts. We used two types of stimulation protocols. First, we used sine wave stimulation to characterize the response properties of the afferent neurons. The average frequency-response curve was flat across stimulation frequencies between 0 and 100 Hz, matching the filtering properties of a displacement detector. Spike rate increased asymptotically with frequency, and phase locking was maximal between 10 and 60 Hz. Second, we used pulse train stimulation to analyze the maximum spike rate capabilities. We found that afferent neurons could generate up to 80 spikes/s and could follow a pulse train stimulation rate of up to 40 pulses/s in a reliable and precise manner. Both sine wave and pulse stimulation protocols indicate that an afferent neuron can maintain their evoked activity for longer durations at low stimulation frequencies than at high frequencies. We found one type of afferent neuron based on spontaneous activity patterns and discovered a correlation between the level of spontaneous and evoked activity. Overall, our results establish the baseline response properties of lateral line primary afferent neurons in larval zebrafish, which is a crucial step in understanding how vertebrate mechanoreceptive systems sense and subsequently process information from the environment. PMID:25355959

  14. 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. PMID:25245922

  15. 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.

  16. [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.

  17. Highly practical copper(I)/TEMPO catalyst system for chemoselective aerobic oxidation of primary alcohols.

    PubMed

    Hoover, Jessica M; Stahl, Shannon S

    2011-10-26

    Aerobic oxidation reactions have been the focus of considerable attention, but their use in mainstream organic chemistry has been constrained by limitations in their synthetic scope and by practical factors, such as the use of pure O(2) as the oxidant or complex catalyst synthesis. Here, we report a new (bpy)Cu(I)/TEMPO catalyst system that enables efficient and selective aerobic oxidation of a broad range of primary alcohols, including allylic, benzylic, and aliphatic derivatives, to the corresponding aldehydes using readily available reagents, at room temperature with ambient air as the oxidant. The catalyst system is compatible with a wide range of functional groups and the high selectivity for 1° alcohols enables selective oxidation of diols that lack protecting groups. PMID:21861488

  18. RELAP5 Model of the Vacuum Vessel Primary Heat Transfer System

    SciTech Connect

    Carbajo, Juan J; Yoder Jr, Graydon L; Kim, Seokho H

    2010-07-01

    This report describes the RELAP5 models that have been developed for the Vacuum Vessel (VV) Primary Heat Transfer System (PHTS). The models are intended to be used to examine the transient performance of the VV 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 models and to examine general VV PHTS transient behavior. The models can be used as a starting point to develop transient modeling capability in several directions including control system modeling, safety evaluations, etc, and are not intended to represent the final VV PHTS design. Preliminary calculations using the models indicate that during normal pulsed operation, heat exchanger control may not be necessary, and that temperatures within the vacuum vessel during decay heat operation remain low.

  19. Development of an inducible gene expression system for primary murine keratinocytes

    PubMed Central

    Nagarajan, Priyadharsini

    2008-01-01

    Background The tetracycline (Tet) responsive system is a valuable tool that is routinely used in a wide variety of mammalian cells for regulatable expression of gene products. However, technical difficulties such as harsh selection conditions and extensive screening processes to identify suitably responsive clones limit the generation of stable cell lines. Hence, application of this system in mammalian cells with relatively slow growth rates and / or the capacity to undergo terminal differentiation such as primary mouse keratinocytes is particularly challenging. Objective To our knowledge, no Tet-responsive stable cell lines have been generated from mouse keratinocytes, presumably due to their sensitivity to selection conditions. Our goal was to utilize a modified and robust Tet-expression system to generate a stable primary mouse keratinocyte cell line. These cells could be then utilized for conditional expression of potentially toxic proteins in an inducible fashion. Methods We utilized a eukaryotic promoter instead of a viral promoter to express a modified reverse tetracycline transactivator in mouse keratinocytes and optimized the selection process for generating stable cell lines. Results Here, we report the generation of a stable mouse keratinocyte cell line for Tet-regulated gene expression with minimal leakiness and high degree of Tet responsivity. This mouse keratinocyte cell line was further engineered for generation of a double stable cell line, which expresses the transcription factor AP-2α in an inducible manner. Importantly, the selected cells retain their inherent keratinocyte morphology, respond to differentiation signals and exhibit a persistent and highly tunable Tet inducibility upon continuous culturing. Conclusion We have generated a tetracycline inducible gene expression model system in mouse epidermal keratinocytes. Such inducible cell lines will serve as valuable in vitro models for future gain-of-function and loss-of-function studies. PMID

  20. [Management problems of improving the quality and efficiency of primary health care system of Georgia].

    PubMed

    Dzhakeli, I V; Edzhibadze, O I; Gerzmava, O Kh

    2009-01-01

    Improving the quality and efficiency of primary health care system is a key challenge. In this regard, problems that have accumulated in the system over the past decade - a weak material base of outpatient-polyclinic institutions, especially in rural areas; a surplus of medical personnel; lack of control by local, regional and central authorities--still remain as serious obstacle. The issue of financing the provided health services, is also particularly important, given the fact that a significant portion of the cost of medical services is covered by the patient directly. And as a consequence, the low level of applications for outpatient-polyclinic assistance due to declining affordability of medical services. In connection with the foregoing, the authors of the paper raise the question of implementing strict, multi-component system of quality control of medical care for patients. In particular, they propose: to base modern organization works on improving the quality of primary health care system on the principles of general management theory; Modern management of service quality should be clearly oriented towards the needs of the population in health care, its structure and dynamics; accessibility, incentives, determined by economic and technological competition characteristic to the market; Modern quality management, regardless of ownership and scale of outpatient-polyclinic establishment should optimally combine the actions, methods and tools that provide, on the one hand--the organization of diagnostic and therapeutic-prophylactic processes meeting the needs of the people, and on the other--the introduction of new methods and means to ensure the modern level of medical care; Schematic diagram of quality control mechanism organically interacts with the market research and includes a block of policy development in terms of quality.

  1. 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

  2. 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.

  3. Improvements to the Apache Point 3.5-m primary-mirror support system

    NASA Astrophysics Data System (ADS)

    Brown, Yorke J.; Davis, Jon E.

    1998-05-01

    The primary mirror of the Apache Point 3.5 meter telescope rests on an array of small pneumatic actuators distributed over the back plate of the mirror and within its honey comb cells. A control system constantly adjusts the pressure in the actuators so as to synthesize a perfectly rigid mounting, thus maintaining both the figure of the mirror and its orientation with respect to the mirror cell. In its original configuration, the APO 3.5 meter system exhibited a number of anomalous behaviors that detracted from the optical performance of the telescope. Analysis of the design indicated three basic problems: first that the pneumatic servovalves suffered from mechanical nonlinearities and an adverse dependence of their transfer function on operating pressure; second, that the air supply system could not exhaust air from the actuators rapidly enough near the horizon and zenith; and third, that the control system did not adequately account for the inertia of the mirror under dynamic conditions. Consequently, we have designed and installed a new control system which addresses these deficiencies. The new system employs high-bandwidth, flapper-type proportional valves that eliminate the mechanical problems and permit implementation of a high- performance controller. The new controller utilizes the existing hard points for mirror position sensing, but implements a pressure-feedback inner loop and a more sophisticated dynamic model. The air supply system now incorporates a sub-atmospheric return and operates closed- loop to minimize contamination problems. The new system exhibits substantial improvements over its previous performance, with positioning errors in the sub-micron range. The design has been selected for use on the Sloan Digital Sky Survey telescope.

  4. 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.

  5. Living In A Country With A Strong Primary Care System Is Beneficial To People With Chronic Conditions.

    PubMed

    Hansen, Johan; Groenewegen, Peter P; Boerma, Wienke G W; Kringos, Dionne S

    2015-09-01

    In light of the growing pressure that multiple chronic diseases place on health care systems, we investigated whether strong primary care was associated with improved health outcomes for the chronically ill. We did this by combining country- and individual-level data for the twenty-seven countries of the European Union, focusing on people's self-rated health status and whether or not they had severe limitations or untreated conditions. We found that people with chronic conditions were more likely to be in good or very good health in countries that had a stronger primary care structure and better coordination of care. People with more than two chronic conditions benefited most: Their self-rated health was higher if they lived in countries with a stronger primary care structure, better continuity of care, and a more comprehensive package of primary care services. In general, while having access to a strong primary care system mattered for people with chronic conditions, the degree to which it mattered differed across specific subgroups (for example, people with primary care-sensitive conditions) and primary care dimensions. Primary care reforms, therefore, should be person centered, addressing the needs of subgroups of patients while also finding a balance between structure and service delivery.

  6. Using the gene pulser MXcell electroporation system to transfect primary cells with high efficiency.

    PubMed

    McCoy, Adam M; Collins, Michelle L; Ugozzoli, Luis A

    2010-01-01

    It is becoming increasingly apparent that electroporation is the most effective way to introduce plasmid DNA or siRNA into primary cells. The Gene Pulser MXcell electroporation system and Gene Pulser electroporation buffer (Bio-Rad) were specifically developed to easily transfect nucleic acids into mammalian cells and difficult-to-transfect cells, such as primary and stem cells. We will demonstrate how to perform a simple experiment to quickly identify the best electroporation conditions. We will demonstrate how to run several samples through a range of electroporation conditions so that an experiment can be conducted at the same time as optimization is performed. We will also show how optimal conditions identified using 96-well electroporation plates can be used with standard electroporation cuvettes, facilitating the switch from electroporation plates to electroporation cuvettes while maintaining the same electroporation efficiency. In the video, we will also discuss some of the key factors that can lead to the success or failure of electroporation experiments. PMID:20057352

  7. On the nonlinear primary resonances of a piezoelectric laminated micro system under electrostatic control voltage

    NASA Astrophysics Data System (ADS)

    Raeisifard, Hamed; Zamanian, Mehdi; Nikkhah Bahrami, Mansour; Yousefi-Koma, Aghil; Raeisi Fard, Hafez

    2014-10-01

    In this article, a comprehensive nonlinear analysis for a piezoelectric laminated micro system around its static deflection is presented. This static deflection is created by an electrostatic DC control voltage through an electrode plate. The micro system beam is assumed as an elastic Euler-Bernoulli beam with clamped-free end conditions. The dynamic equations of this model have been derived by using the Hamilton method and considering the nonlinear inertia, curvature, piezoelectric and electrostatic terms. The static and dynamic solutions have been achieved by using the Galerkin method and the multiple-scales perturbation approach, respectively. The results are compared with numerical and other existing experimental results. By studying the primary resonance excitation, the effects of different parameters such as geometry, material and excitations voltage on the system's softening and hardening behaviors are evaluated. In a piezoelectrically actuated micro system it was showed that because of existence of curvature and inertia nonlinear terms a small change in excitation amplitude can lead to the formation and expansion of nonlinear response. In this paper, it is demonstrated that by applying an electrostatic DC control voltage, these nonlinearities can be controlled and altered to a linear domain. This model can be used to design a nano or micro-scale smart device.

  8. Applying Quality Improvement into Systems-based Learning to Improve Diabetes Outcomes in Primary Care.

    PubMed

    Moreo, Kathleen; Sapir, Tamar; Greene, Laurence

    2015-01-01

    In the U.S., where the prevalence of type 2 diabetes has reached epidemic proportions, many patients with this disease are treated by primary care physicians in community-based systems, including accountable care organisations (ACOs). To address gaps in the quality of diabetes care, national quality measures have been established, including patient-centered measures adopted by the Centers for Medicare and Medicaid Services for its Shared Savings Program for ACOs. From a patient-centered perspective, high-quality diabetes care depends on effective communication between clinicians and patients, along with patient education and counseling about medications and lifestyle. We designed and implemented a quality improvement (QI) program for 30 primary care physicians treating patients with type 2 diabetes in three structurally similar but geographically diverse ACOs. Retrospective chart audits were conducted before (n = 300) and after (n = 300) each physician participated in accredited continuing medical education (CME) courses that focused on QI strategies. Randomly selected charts were audited to measurably assess essential interventions for improved outcomes in type 2 diabetes including the physicians' documentation of patient counseling and assessment of side effects, and patients' medication adherence status and changes in hemoglobin A1C (A1C) and body mass index (BMI). Paced educational interventions included a private performance improvement Internet live course conducted for each physician, small-group Internet live courses involving peer discussion, and a set of enduring materials, which were also multi-accredited for all clinicians in the physician's practice. Continual improvement cycles were guided by analysis of the baseline chart audits, quantitative survey data, and qualitative feedback offered by participants. To extend the benefit of the education, the enduring materials were offered to the interprofessional team of clinicians throughout the U.S. who did

  9. 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.

  10. 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

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

    PubMed

    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

  12. 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

  13. 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. PMID:26973519

  14. Combined primary-secondary system approach to the design of an equipment isolation system with High-Damping Rubber Bearings

    NASA Astrophysics Data System (ADS)

    Reggio, Anna; De Angelis, Maurizio

    2014-04-01

    Isolating acceleration-sensitive equipment from the motion of the supporting structure represents an effective protection from earthquake damage. In this paper, a passive equipment isolation system composed of High-Damping Rubber Bearings (HDRB) is designed by adopting a coupled approach in which the supporting structure and the isolated equipment are considered as parts of a combined primary-secondary system and analyzed together. This allows for taking into account their dynamic interaction when significant and non-negligible according to the mass ratio and to the frequency ratio. The design methodology is developed by resorting to a reduced-order 2-DOF model of the combined system, a linear visco-elastic constitutive model of the isolation system and to a modal damping constraint depending upon the damping properties of the HDRB and their rubber compound. A 1:5 scale experimental model, consisting of a two-storey steel frame and a heavy block-type mass isolated from the second floor, is subsequently used to exemplify the design methodology and to perform shaking table tests. The dynamic properties of the experimental model are identified and the seismic performance of the equipment isolation system is discussed under a wide selection of seismic inputs, both artificial and natural.

  15. 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

  16. 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.

  17. Mechanism for the primary transformation of acetaminophen in a soil/water system.

    PubMed

    Liang, Chuanzhou; Lan, Zhonghui; Zhang, Xu; Liu, Yingbao

    2016-07-01

    The transformation of acetaminophen (APAP) in a soil/water system was systematically investigated by a combination of kinetic studies and a quantitative analysis of the reaction intermediates. Biotransformation was the predominant pathway for the elimination of APAP, whereas hydrolysis or other chemical transformation, and adsorption processes made almost no contribution to the transformation under a dark incubation. Bacillus aryabhattai strain 1-Sj-5-2-5-M, Klebsiella pneumoniae strain S001, and Bacillus subtilis strain HJ5 were the main bacteria identified in the biotransformation of APAP. The soil-to-water ratio and soil preincubation were able to alter the transformation kinetic pattern. Light irradiation promoted the overall transformation kinetics through enhanced biotransformation and extra photosensitized chemical reactions. The transformation pathways were strongly dependent on the initial concentration of APAP. The main primary transformation products were APAP oligomers and p-aminophenol, with the initial addition of 26.5 and 530 μM APAP, respectively. APAP oligomers accounted for more than 95% of transformed APAP, indicating that almost no bound residues were generated through the transformation of APAP in the soil/water system. The potential environmental risks of APAP could increase following the transformation of APAP in the soil/water system because of the higher toxicity of the transformation intermediates. PMID:27107139

  18. Assessment of Primary Production of Horticultural Safety Management Systems of Mushroom Farms in South Africa.

    PubMed

    Dzingirayi, Garikayi; Korsten, Lise

    2016-07-01

    Growing global consumer concern over food safety in the fresh produce industry requires producers to implement necessary quality assurance systems. Varying effectiveness has been noted in how countries and food companies interpret and implement food safety standards. A diagnostic instrument (DI) for global fresh produce industries was developed to measure the compliancy of companies with implemented food safety standards. The DI is made up of indicators and descriptive grids for context factors and control and assurance activities to measure food safety output. The instrument can be used in primary production to assess food safety performance. This study applied the DI to measure food safety standard compliancy of mushroom farming in South Africa. Ten farms representing almost half of the industry farms and more than 80% of production were independently assessed for their horticultural safety management system (HSMS) compliance via in-depth interviews with each farm's quality assurance personnel. The data were processed using Microsoft Office Excel 2010 and are represented in frequency tables. The diagnosis revealed that the mushroom farming industry had an average food safety output. The farms were implementing an average-toadvanced HSMS and operating in a medium-risk context. Insufficient performance areas in HSMSs included inadequate hazard analysis and analysis of control points, low specificity of pesticide assessment, and inadequate control of suppliers and incoming materials. Recommendations to the industry and current shortcomings are suggested for realization of an improved industry-wide food safety assurance system.

  19. Advancement of the segment support system for the Thirty Meter Telescope primary mirror

    NASA Astrophysics Data System (ADS)

    Williams, Eric C.; Baffes, Curtis; Mast, Terry; Nelson, Jerry; Platt, Benjamin; Ponchione, R. J.; Ponslet, Eric; Setoodeh, Shahriar; Sirota, Mark; Stephens, Vince; Stepp, Larry; Tubb, Alan

    2008-07-01

    This paper presents refinements to the design of the TMT primary mirror segment passive-support system that are effective in reducing gravity print-through and thermal distortion effects. First, a novel analytical method is presented for tuning the axial and lateral support systems in a manner that results in improved optical performance when subject to varying gravity fields. The method utilizes counterweights attached to the whiffletrees to cancel astigmatic and comatic errors normally resulting when the lateral support system resists transverse loads induced by gravity. Secondly, several central diaphragm designs are presented and analyzed to assess lateral-gravity and thermal distortion performance: 1) a simple flat diaphragm, 2) a stress-relieving diaphragm having a slotted outer rim and a circumferential convolution near the outside diameter, and 3) a flat diaphragm having a slotted outer rim. The latter design is chosen based on results from analytical studies which show it to have better overall optical performance in the presence of gravity and thermal environments.

  20. Revitalising primary healthcare requires an equitable global economic system - now more than ever.

    PubMed

    Sanders, David; Baum, Fran E; Benos, Alexis; Legge, David

    2011-08-01

    The promised revitalisation of primary healthcare (PHC) is happening at a time when the contradictions and unfairness of the global economic system have become clear, suggesting that the current system is unsustainable. In the past two decades, one of the most significant impediments to the implementation of comprehensive PHC has been neoliberal economic policies and their imposition globally. This article questions what will be required for PHC to flourish. PHC incorporates five key principles: equitable provision of services, comprehensive care, intersectoral action, community involvement and appropriate technology. This article considers intersectoral action and comprehensiveness and their potential to be implemented in the current global environment. It highlights the constraints to intersectoral action through a case study of nutrition in the context of globalisation of the food chain. It also explores the challenges to implementing a comprehensive approach to health that are posed by neoliberal health sector reforms and donor practices. The paper concludes that even well-designed health systems based on PHC have little influence over the broader economic forces that shape their operation and their ability to improve health. Reforming these economic forces will require greater regulation of the national and global economic environment to emphasise people's health rather than private profit, and action to address climate change. Revitalisation of PHC and progress towards health equity are unlikely without strong regulation of the market. The further development and strengthening of social movements for health will be key to successful advocacy action.

  1. 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.

  2. Users’ satisfaction with the primary health care information system in Croatia: a cross-sectional study

    PubMed Central

    Andrijašević, Lidija; Angebrandt, Petra; Kern, Josipa

    2012-01-01

    Aim To evaluate the primary health care information system from the general practitioner's (GP) point of view. Methods Sixty-seven Croatian GPs were distributed a questionnaire about characteristics of the GP’s office, overall impression of the application, handling of daily routine information, more sophisticated information needs, and data security, and rated their satisfaction with each component from 1 to 5. We also compared two most frequently used applications – application with distantly installed software (DIS) and that with locally installed software (LIS, personal computer-based application). Results GPs were most satisfied with the daily procedures and the reminder component of the health information system (rating 4.1). The overall impression ranked second (3.5) and flexibility of applications followed closely (3.4). The most questionable aspect of applications was data security (3.0). LIS system received better overall rate than DIS (4.2 vs 3.2). Conclusion Applications received better ratings for daily routine use than for overall impression and ability to get specific information according the GPs’ needs. Poor ratings on the capability of the application, complaints about unreliable links, and doubts about data security point to a need for more user-friendly interfaces, more information on the capability of the application, and a valid certificate of assessment for every application. PMID:22351580

  3. 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

  4. Assessment of Primary Production of Horticultural Safety Management Systems of Mushroom Farms in South Africa.

    PubMed

    Dzingirayi, Garikayi; Korsten, Lise

    2016-07-01

    Growing global consumer concern over food safety in the fresh produce industry requires producers to implement necessary quality assurance systems. Varying effectiveness has been noted in how countries and food companies interpret and implement food safety standards. A diagnostic instrument (DI) for global fresh produce industries was developed to measure the compliancy of companies with implemented food safety standards. The DI is made up of indicators and descriptive grids for context factors and control and assurance activities to measure food safety output. The instrument can be used in primary production to assess food safety performance. This study applied the DI to measure food safety standard compliancy of mushroom farming in South Africa. Ten farms representing almost half of the industry farms and more than 80% of production were independently assessed for their horticultural safety management system (HSMS) compliance via in-depth interviews with each farm's quality assurance personnel. The data were processed using Microsoft Office Excel 2010 and are represented in frequency tables. The diagnosis revealed that the mushroom farming industry had an average food safety output. The farms were implementing an average-toadvanced HSMS and operating in a medium-risk context. Insufficient performance areas in HSMSs included inadequate hazard analysis and analysis of control points, low specificity of pesticide assessment, and inadequate control of suppliers and incoming materials. Recommendations to the industry and current shortcomings are suggested for realization of an improved industry-wide food safety assurance system. PMID:27357039

  5. 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.

  6. 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.

  7. 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.

  8. Gaining in New Orleans. With help from a federal grant, wounded city builds a model primary-care system.

    PubMed

    Zigmond, Jessica

    2010-01-18

    In the wake of Hurricane Katrina, a thriving primary-care network of neighborhood clinics in New Orleans seemed unimaginable. But today, thanks to a federal grant, the flood-damaged city has built a model system. "From the devastation emerged an opportunity to restructure and reorganize primary care for low-income and vulnerable populations in New Orleans," says Melinda Abrams, left, of the Commonwealth Fund.

  9. An updated T-series thermocouple measurement system for high-accuracy temperature measurements of the MMT primary mirror

    NASA Astrophysics Data System (ADS)

    Clark, D.; Gibson, J. D.

    2012-09-01

    Starting in 2009, MMTO began design and installation of a new set of electronics to measure a set of radiallydistributed type T thermocouples installed after the primary mirror polishing was completed. These thermocouples are arranged in both single measurement points and as thermopiles for differential temperature sensing. Since the goal of the primary mirror temperature control system is to minimize mirror seeing and mirror figure errors induced by temperature variation across the primary mirror, it depends on excellent accuracy from the temperature sensing system. The new electronics encompass on-board cold-junction compensation, real-time ITS-90 curve fitting, and Ethernet connectivity to the data servers running in the MMTO software infrastructure. We describe the hardware design, system wiring, and software used in this system.

  10. Analysis of cell identity, morphology, apoptosis and mitotic activity in a primary neural cell culture system in Drosophila

    PubMed Central

    2012-01-01

    In Drosophila, most neurogenetic research is carried out in vivo. Mammalian research demonstrates that primary cell culture techniques provide a powerful model to address cell autonomous and non-autonomous processes outside their endogenous environment. We developed a cell culture system in Drosophila using wildtype and genetically manipulated primary neural tissue for long-term observations. We assessed the molecular identity of distinct neural cell types by immunolabeling and genetically expressed fluorescent cell markers. We monitored mitotic activity of cell cultures derived from wildtype and tumorous larval brains. Our system provides a powerful approach to unveil developmental processes in the nervous system and to complement studies in vivo. PMID:22554060

  11. Primary paranasal sinus lymphoma: natural history and improved outcome with central nervous system chemoprophylaxis.

    PubMed

    Laskin, Janessa J; Savage, Kerry J; Voss, Nicholas; Gascoyne, Randy D; Connors, Joseph M

    2005-12-01

    Non-Hodgkin's lymphoma of the paranasal sinus is an uncommon presentation of extranodal lymphoma. Its natural history, treatment and prognosis have been infrequently characterized in the medical literature; however, a tendency to involve the central nervous system (CNS) has been noted. In British Columbia (population 4 million), a central database for lymphomas has allowed us to accurately track cases of paranasal sinus lymphoma diagnosed since 1980. A retrospective review was performed on the 44 patients who presented with primary paranasal sinus lymphoma (stage I or II) between 1980 and 1999. Histologic features were identified and immunophenotypic classification performed. Complete diagnostic and follow-up data including stage, treatment, response rates, sites of relapse and survival data were available for all patients. There were 26 men and 18 women. The types of lymphoma found were: diffuse large B cell (including immunoblastic), n = 37 (84%); T/NK nasal type, n = 3 (8%); peripheral T cell, not otherwise classified, n = 2 (4%); and others, n = 2 (4%). The median age at presentation was 66 years (range 27-97 years). The median follow-up for living patients was 114 months. For all 44 patients, the 5- and 10-year overall survivals were 48% and 41% and the disease-specific survivals 62% and 62%, respectively. Beginning in May 1985, intrathecal chemotherapy was added to our standard treatment plan of multi-agent chemotherapy and local irradiation. Before 1985, 2 of 5 patients developed leptomeningeal metastasis. Following the institution of intrathecal chemotherapy, only 8% (3 of 39) of patients have developed CNS disease. Introduction of intrathecal chemoprophylaxis was also associated with an improvement in overall survival from 20% to 51% and disease-specific survival from 40% to 65%. Primary paranasal sinus lymphoma is an uncommon presentation of lymphoma that carries the potential risk of spreading to the leptomeninges. Treatment with combined modality

  12. Pembrolizumab: first experience with recurrent primary central nervous system (CNS) tumors.

    PubMed

    Blumenthal, Deborah T; Yalon, Michal; Vainer, Gilad W; Lossos, Alexander; Yust, Shlomit; Tzach, Lior; Cagnano, Emanuela; Limon, Dror; Bokstein, Felix

    2016-09-01

    Patients with progressive primary brain tumors (PBT) are attracted to promising new treatments, even prior to convincing data. Anti-PD1 immunotherapies have been in the spotlight since publication of groundbreaking results for metastatic melanoma with pembrolizumab (PBL). Our objective was to report on the response and toxicity of PBL in patients with advanced PBT. We retrospectively reviewed the charts of 22 patients (17 adults and 5 children) with recurrent central nervous system tumors treated with PBL. We analyzed prior antineoplastic therapies, steroid usage, and outcomes. Patients received a median of two neoplastic therapies prior to PBL, and a median of three infusions of PBL in adults and four in children. Twelve patients (9 adults and 3 children) started PBL on steroids (median dose in adults 4 mg; range 2-8, and in children 1.5 mg, range 0.5-4) and five patients received steroids later during PBL treatment. Twelve patients (10 adults and 2 children) received concomitant bevacizumab with PBL. Side effects were minimal. All patients showed progressive tumor growth during therapy. Median OS from the start of PBL was 2.6 months in adults and 3.2 months in children. Two GB patients underwent tumor resection following treatment with PBL. Tumor-lymphocytic response in these cases was unremarkable, and PD-L1 immuno-staining was negative. In this series of 22 patients with recurrent primary brain tumors, PBL showed no clinical or histologic efficacy. We do not recommend further use of PBL for recurrent PBT unless convincing prospective clinical trial data are published.

  13. 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.

  14. 2005 PRETEXT: a revised staging system for primary malignant liver tumours of childhood developed by the SIOPEL group

    PubMed Central

    Aronson, Daniel; Clapuyt, Philippe; Czauderna, Piotr; de Ville de Goyet, Jean; Gauthier, Frédéric; MacKinlay, Gordon; Maibach, Rudolf; McHugh, Kieran; Olsen, Øystein E.; Otte, Jean-Bernard; Pariente, Danièle; Plaschkes, Jack; Childs, Margaret; Perilongo, Giorgio

    2006-01-01

    Over the last 15 years, various oncology groups throughout the world have used the PRETEXT system for staging malignant primary liver tumours of childhood. This paper, written by members of the radiology and surgery committees of the International Childhood Liver Tumor Strategy Group (SIOPEL), presents various clarifications and revisions to the original PRETEXT system. PMID:17186233

  15. 2005 PRETEXT: a revised staging system for primary malignant liver tumours of childhood developed by the SIOPEL group.

    PubMed

    Roebuck, Derek J; Aronson, Daniel; Clapuyt, Philippe; Czauderna, Piotr; de Ville de Goyet, Jean; Gauthier, Frédéric; Mackinlay, Gordon; Maibach, Rudolf; McHugh, Kieran; Olsen, Oystein E; Otte, Jean-Bernard; Pariente, Danièle; Plaschkes, Jack; Childs, Margaret; Perilongo, Giorgio

    2007-02-01

    Over the last 15 years, various oncology groups throughout the world have used the PRETEXT system for staging malignant primary liver tumours of childhood. This paper, written by members of the radiology and surgery committees of the International Childhood Liver Tumor Strategy Group (SIOPEL), presents various clarifications and revisions to the original PRETEXT system. PMID:17186233

  16. Red Light-Green Light: A Classwide Management System for Students with Behavior Disorders in Primary Grades.

    ERIC Educational Resources Information Center

    Barbetta, Patricia M.

    1990-01-01

    Red Light-Green Light is a levels system providing immediate behavior modification feedback and varying privilege levels throughout the school day for primary students with behavior disorders. This article presents guidelines for implementation, covering development of classroom rules, classroom expectations, and system maintenance. Tips for…

  17. 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.

  18. Performance Enhancement of Multi-Cyclic Detector for Cognitive Radios with an OFDM Primary System

    NASA Astrophysics Data System (ADS)

    Kim, Minseok; Po, Kimtho; Takada, Jun-Ichi

    Spectrum sensing, a key technical challenge in cognitive radios (CR) technology, is a technique that enables the spectrum of licensed systems to be accessed without causing undue interference. It is well known that cyclostationarity detectors have great advantages over energy detectors in terms of the robustness to noise uncertainty that significantly degrades the performance as well as the capability to distinguish the signal of interest from the other interferences and noise. The generalized likelihood ratio test (GLRT) is a recognized sensing technique that utilizes the inherent cyclostationarity of the signal and has been intensively studied. However, no comprehensive evaluation on its performance enhancement has been published to date. Moreover high computational complexity is still a significant problem for its realization. This paper proposes a maximum ratio combining multi-cyclic detector which uses multiple cyclic frequencies for performance enhancement with reduced computational complexity. An orthogonal frequency-division multiplexing (OFDM) signal based on the ISDB-T (integrated services digital broadcasting terrestrial), a Japanese digital television broadcasting standard, was used in the evaluation assuming this as a primary system in WRAN (wireless regional area network) applications like IEEE 802.22.

  19. 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.

  20. Primary Care Physicians’ Use of an Electronic Medical Record System: A Cognitive Task Analysis

    PubMed Central

    Hadas-Dayagi, Michal; Ziv, Amitai; Reis, Shmuel

    2009-01-01

    OBJECTIVE To describe physicians’ patterns of using an Electronic Medical Record (EMR) system; to reveal the underlying cognitive elements involved in EMR use, possible resulting errors, and influences on patient–doctor communication; to gain insight into the role of expertise in incorporating EMRs into clinical practice in general and communicative behavior in particular. DESIGN Cognitive task analysis using semi-structured interviews and field observations. PARTICIPANTS Twenty-five primary care physicians from the northern district of the largest health maintenance organization (HMO) in Israel. RESULTS The comprehensiveness, organization, and readability of data in the EMR system reduced physicians’ need to recall information from memory and the difficulty of reading handwriting. Physicians perceived EMR use as reducing the cognitive load associated with clinical tasks. Automaticity of EMR use contributed to efficiency, but sometimes resulted in errors, such as the selection of incorrect medication or the input of data into the wrong patient’s chart. EMR use interfered with patient–doctor communication. The main strategy for overcoming this problem involved separating EMR use from time spent communicating with patients. Computer mastery and enhanced physicians’ communication skills also helped. CONCLUSIONS There is a fine balance between the benefits and risks of EMR use. Automaticity, especially in combination with interruptions, emerged as the main cognitive factor contributing to errors. EMR use had a negative influence on communication, a problem that can be partially addressed by improving the spatial organization of physicians’ offices and by enhancing physicians’ computer and communication skills. PMID:19130148

  1. 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.

  2. 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.

  3. Optimization design for the supporting system of 2m telescope primary mirror

    NASA Astrophysics Data System (ADS)

    Zhao, Fu; Wang, Ping; Gong, Yanjue; Zhang, Li; Lin, Jianlong

    2008-12-01

    This paper describes the optimization solution improving the total quality of the primary mirror supporting type. With the methods of Finite element analysis(FEA), Orthogonal experiment and BP Neural Network, the relationship between the structure parameters in primary mirror supporting type and the deformation of the primary mirror is built. With this relationship and Genetic Algorithm(GA) optimization design, a group of reasonable technology parameters is found that can improve the static stiffness of the primary mirror supporting type so as to reduce the gravity deformation of the primary mirror. The modal analysis and random vibration analysis are also discussed in detail, and the results indicate that the dynamic stiffness of the primary mirror supporting type is also improved.

  4. 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

  5. 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.

  6. 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.

  7. Applying quality assurance to the primary health care service delivery system in Tahoua, Niger.

    PubMed

    Winter, L

    1994-01-01

    The Quality Assurance Project is helping the government of Niger institutionalize quality assurance (QA) within the primary health care delivery system in the Tahoua region. Quality Improvement Teams (QIT) have been organized in the medical center of each of Tahoua's 7 districts. They use QA methods to solve service delivery problems. In Konni District, a key service delivery problem was poor case management of malaria. Health workers administered an incorrect dosage of chloroquine and aspirin to 66% of malaria cases. They did not use patient weight properly to calculate the dosage. The District Medical Officer ran an in-service training for the staff and hung up a treatment algorithm next to the triage table. The QIT developed a system to make sure that staff took vital signs on all patients in the triage room. The system improved work flow, provided privacy, and reduced congestion. Staff now have more time for clients and are more likely to use correct dosage. The QIT found high drop out rates in the ambulatory nutritional rehabilitation service (CRENA). It used a flow chart to define the CRENA process for managing malnourished children. A QA checklist helped the QIT obtain critical information about services through direct observations of service delivery and interviews with staff and clients. Other identified weaknesses were inconsistency of drawing the growth curve in the child's health booklet and lack of explanation about the child's progress to the mother. The QIT first aimed to improve the organization of patient flow. It integrated curative care into the CRENA service. The patient now moves from reception to health education, weighing station, counseling and appointment for return visits, curative care, and supplement distribution. The integrated curative service and reorganized patient flow clarify the role of the providers.

  8. Post-quench ductility evaluation of Zircaloy-4 and select iron alloys under design basis and extended LOCA conditions

    NASA Astrophysics Data System (ADS)

    Yan, Y.; Keiser, J. R.; Terrani, K. A.; Bell, G. L.; Snead, L. L.

    2014-05-01

    Oxidation experiments were conducted at 1200 °C in flowing steam with tubing specimens of Zircaloy-4, 317, 347 stainless steels, and the commercial FeCrAl alloy APMT. The purpose was to determine the oxidation behavior and post-quench ductility under postulated and extended LOCA conditions. The parabolic rate constant for Zircaloy-4 tubing samples at 1200 °C was determined to be k = 2.173 × 107 g2/cm4/s, in excellent agreement with the Cathcart-Pawel correlation. The APMT alloy experienced the slowest oxidation rate among all materials examined in this work. The ductility of post-quenched samples was evaluated by ring compression tests at 135 °C. For Zircaloy-4, the ductile to brittle transition occurs at an equivalent cladding reacted (ECR) of 19.3%. SS-347 was still ductile after being oxidized for 2400 s (CP-ECR ≈ 50%), but the maximum load was reduced significantly owing to the metal layer thickness reduction. No ductility decrease was observed for the post-quenched APMT samples oxidized up to 4 h.

  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. Multispectral imaging of a space shuttle primary reaction control system firing

    NASA Astrophysics Data System (ADS)

    Rall, David L. A.; Kofsky, Irving L.; Viereck, Rodney A.; Pike, Charles P.

    1996-11-01

    A series of three-second firings of Space Shuttle Orbiter's 870-lbf Primary Reaction Control System thruster motors were photographed from the crew cabin with an intensified video camera. The spectral imager sequentially recorded 4 ms exposures at 30 Hz in six 20 to 30 nm FWHM channels centered from 400 to 800 nm, chosen specifically to study bi- propellant (monomethyl hydrazine fuel/nitrogen dioxide oxidizer) thruster exhaust chemistry. The species producing the visible radiance were earlier identified as CN, CH, C2, NO2, and HNO; the electronic bands originating from the same excited states of CN (B-X) and CH (A-X) extend into the near UV. Images of the vacuum core viewing within a few degrees of perpendicular to the first several meters from the exit plane were analyzed to relate the spatial distribution of exhaust product species and afterburning chemistry to a flowfield-kinetics model. Profiles of radiance transverse to the exhaust symmetry-axis show substantial limb brightening in all six channels, indicating that the distribution of the radiating species corresponds to a `zone'-type model of liquid-fuel film-cooled engine performance. Profiles of band radiance along the axis indicate the production and quenching of excited species as the exhaust gas adiabatically expands and cools.

  11. mTORC1 signaling in primary central nervous system lymphoma

    PubMed Central

    Nitta, Naoki; Nakasu, Satoshi; Shima, Ayako; Nozaki, Kazuhiko

    2016-01-01

    Background: Mammalian target of rapamycin (mTOR) complex 1 (mTORC1) acts as a downstream effector of phosphatidyl-inositol-3 kinase, which is frequently hyperactivated in glioblastoma multiforme and links to cell signaling in cellular proliferation, differentiation, metabolism, and survival. Although many studies have suggested the importance of mTORC1 in tumorigenesis, its role remains unclear in brain tumors other than glioblastoma. Methods: In the present study, we evaluated the activation of mTORC1 in 24 cases of primary central nervous system lymphoma (PCNSL). Results: Immunohistochemical analysis showed overexpression of Rheb, which is immediately upstream of mTORC1, in 20 cases of PCNSL. Immunohistochemical analysis also showed overexpression of phospho-4E-BP1 (Thr37/46) and phospho-S6 (Ser235/236), which are increased after mTORC1 activation as mTORC1 downstream effectors in 17 and 21 cases, respectively. Conclusion: Our data suggest that abnormal activation of the mTORC1 signaling pathway may cause tumor growth in patients with PCNSL. PMID:27512609

  12. 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

  13. Diagnostic delay and prognosis in primary central nervous system lymphoma compared with glioblastoma multiforme.

    PubMed

    Cerqua, R; Balestrini, S; Perozzi, C; Cameriere, V; Renzi, S; Lagalla, G; Mancini, G; Montanari, M; Leoni, P; Scerrati, M; Iacoangeli, M; Silvestrini, M; Luzzi, S; Provinciali, L

    2016-01-01

    Glioblastoma multiforme (GBM) and primary central nervous system lymphoma (PCNSL) are malignant cerebral neoplasms associated with poor prognosis. Early diagnosis and subsequent planning of adequate treatment strategy are relevant to improve survival and reduce neurological deficit. Two groups of patients affected by GBM and PCNSL were compared to identify: (1) factors influencing the time necessary to obtain a correct diagnosis; (2) the influence of the interval time from clinical onset to diagnosis on the prognosis. Fifty-six patients (28 PCNSL and 28 GBM, 23 females and 33 males) referred to the same hospital setting were retrospectively evaluated. The mean age at diagnosis was 61 years. The two groups were comparable in terms of age, sex, clinical symptoms at onset and performance status. There was no relevant difference in time span from clinical onset to first neuroimaging examination, while time span from first neuroimaging to final morphological diagnosis was much longer in PCNSL patients (p = 0.008). Multivariate Cox regression analysis, including both PCNSL and GBM cases, showed a significant association of the overall survival with: time to diagnosis (HR 0.06), age at onset (HR 1.04). Our results show a significant diagnostic delay in PCNSL cases. Age at onset of disease and time to diagnosis emerge as clinical factors affecting overall survival in both groups. Stereotactic-guided biopsy should be chosen as routine method to early diagnose PCNSL. The clinical relevance of early diagnosis in GBM and PCNSL needs to be emphasized to maximize the overall survival in both neoplasms.

  14. Pathologic Correlates of Primary Central Nervous System Lymphoma Defined in an Orthotopic Xenograft Model

    PubMed Central

    Kadoch, Cigall; Dinca, Eduard B.; Voicu, Ramona; Chen, Lingjing; Nguyen, Diana; Parikh, Seema; Karrim, Juliana; Shuman, Marc A.; Lowell, Clifford A.; Treseler, Patrick A.; James, C. David; Rubenstein, James L.

    2014-01-01

    Purpose The prospect for advances in the treatment of patients with primary central nervous system lymphoma (PCNSL) is likely dependent on the systematic evaluation of its pathobiology. Animal models of PCNSL are needed to facilitate the analysis of its molecular pathogenesis and for the efficient evaluation of novel therapeutics. Experimental Design We characterized the molecular pathology of CNS lymphoma tumors generated by the intracerebral implantation of Raji B lymphoma cells in athymic mice. Lymphoma cells were modified for bioluminescence imaging to facilitate monitoring of tumor growth and response to therapy. In parallel, we identified molecular features of lymphoma xenograft histopathology that are evident in human PCNSL specimens. Results Intracerebral Raji tumors were determined to faithfully reflect the molecular pathogenesis of PCNSL, including the predominant immunophenotypic state of differentiation of lymphoma cells and their reactive microenvironment. We show the expression of interleukin-4 by Raji and other B lymphoma cell lines in vitro and by Raji tumors in vivo and provide evidence for a role of this cytokine in the M2 polarization of lymphoma macrophages both in the murine model and in diagnostic specimens of human PCNSL. Conclusion Intracerebral implantation of Raji cells results in a reproducible and invasive xenograft model, which recapitulates the histopathology and molecular features of PCNSL, and is suitable for preclinical testing of novel agents. We also show for the first time the feasibility and accuracy of tumor bioluminescence in the monitoring of a highly infiltrative brain tumor. PMID:19276270

  15. 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. PMID:15886021

  16. Intermittency coding in the primary olfactory system: a neural substrate for olfactory scene analysis.

    PubMed

    Park, Il Memming; Bobkov, Yuriy V; Ache, Barry W; Príncipe, José C

    2014-01-15

    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.

  17. 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.

  18. 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

  19. [Case of primary central nervous system lymphoma after open head injury].

    PubMed

    Honma, Mari; Ota, Mamoru; Sato, Naoki; Ogawa, Kazuei; Sugino, Takashi; Yamamoto, Teiji

    2012-01-01

    A 65-year-old man had suffered contusion of the left frontal lobe of the brain with a skull base fracture, pneumocephalus, and cerebrospinal fluid (CSF) leakage. He was treated with ceftriaxone 4 g/day for 14 days, but after 1 month he developed multiple cranial nerve palsies (bilateral III-X). CSF contained increased levels of protein (96 mg/dl) and mononuclear cells (72 cells/mm³), and low glucose levels (40 mg/dl, blood sugar 120 mg/dl), but no malignant cells were detected. Magnetic resonance imaging (MRI) disclosed swelling in multiple cranial nerves with Gd enhancement. Anti-biotic and antifungal therapy remitted the facial, glossopharyngeal, and vagus nerve palsies and reduced the Gd-enhancement lesion, as detected by MRI. However, the eyes were bilaterally dilated and medially fixed, and hearing impairments persisted. After 3 months, follow-up MRIs revealed the presence of Gd-enhanced small masses at the ventral pontine base, medulla, and cervicomedullary junctions despite a lack of change in neurological symptoms. Those lesions subsided favorably upon treatment with intravenous and oral corticosteroids. After 1 year and 9 months, Gd-enhanced small cystic masses appeared on the medulla and cerebellum. An open biopsy of the cerebellar tonsillar lesions revealed diffuse large B cell lymphoma. Although the development of primary central nervous system lymphoma after open head injury and infection has not been reported to date, central nervous system lymphomas may mimic diverse neurological diseases. Brain biopsy remains the only definitive diagnosis, and thus should be pursued if blood and CSF markers appear normal. PMID:22688112

  20. 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.

  1. Primary and secondary central nervous system vasculitis: clinical manifestations, laboratory findings, neuroimaging, and treatment analysis.

    PubMed

    Vera-Lastra, Olga; Sepúlveda-Delgado, Jesús; Cruz-Domínguez, María del Pilar; Medina, Gabriela; Casarrubias-Ramírez, Moisés; Molina-Carrión, Luis E; Pineda-Galindo, Luis F; Olvera-Acevedo, Arturo; Hernández-Gonzalez, Claudia; Jara, Luis J

    2015-04-01

    The objectives of this study are to compare the initial clinical, laboratory, and imaging features in primary central nervous system vasculitis (PCNSV) vs secondary central nervous system vasculitis (SCNSV) and follow up after treatment with intravenous cyclophosphamide (IV-CYC) plus glucocorticosteroids (GCS): methylprednisolone (MP). Neurological, laboratory, and neuroimaging findings were analyzed in PCNSV and SCNSV patients. Cerebral biopsy (CB) was performed in nine patients. Both groups received at onset MP plus IV-CYC for 6 months, followed by bimonthly IV-CYC plus prednisone (PND) for 12 months. All patients were followed during 36 months. Thirty patients were included (12 PCNSV and 18 SCNSV). Focal and non-focal neurological manifestations were similar in both groups, headache being the most frequent manifestation in both groups. Fatigue, myalgias, arthralgias, neuropathy, low leukocytes and platelets, elevated erythrocyte sedimentation rate, positive antinuclear antibodies (ANA), anti-double-stranded DNA (dsDNA), antineutrophil cytoplasmic antibodies (ANCA), low complement, and rheumatoid factor were more frequent in SCNSV (p < 0.05). In cerebrospinal fluid, pleocytosis and proteins were higher in PCNSV (p < 0.05). Periventricular and subcortical hyperintense lesions were observed in cranial magnetic resonance imaging in both vasculitides. Cerebral angiography and angioresonance showed narrowing of vasculature in all patients in both groups. CB showed gliosis and lymphocytic infiltration within and around the walls in four patients and granulomatous infiltration in the other patients. After treatment, the Kaplan-Meier survival curve showed a higher relapse-free survival in PCNSV (p < 0.05). Neurological manifestations and neuroimaging findings were similar in both groups of vasculitides, but general symptoms, joint, musculoskeletal, and peripheral neuropathy were preponderant in SCNSV. After treatment with IV-CYC and GCS, patients with PCNSV

  2. Reducing diagnostic errors in primary care. A systematic meta-review of computerized diagnostic decision support systems by the LINNEAUS collaboration on patient safety in primary care

    PubMed Central

    Nurek, Martine; Kostopoulou, Olga; Delaney, Brendan C; Esmail, Aneez

    2015-01-01

    ABSTRACT Background: Computerized diagnostic decision support systems (CDDSS) have the potential to support the cognitive task of diagnosis, which is one of the areas where general practitioners have greatest difficulty and which accounts for a significant proportion of adverse events recorded in the primary care setting. Objective: To determine the extent to which CDDSS may meet the requirements of supporting the cognitive task of diagnosis, and the currently perceived barriers that prevent the integration of CDDSS with electronic health record (EHR) systems. Methods: We conducted a meta-review of existing systematic reviews published in English, searching MEDLINE, Embase, PsycINFO and Web of Knowledge for articles on the features and effectiveness of CDDSS for medical diagnosis published since 2004. Eligibility criteria included systematic reviews where individual clinicians were primary end users. Outcomes we were interested in were the effectiveness and identification of specific features of CDDSS on diagnostic performance. Results: We identified 1970 studies and excluded 1938 because they did not fit our inclusion criteria. A total of 45 articles were identified and 12 were found suitable for meta-review. Extraction of high-level requirements identified that a more standardized computable approach is needed to knowledge representation, one that can be readily updated as new knowledge is gained. In addition, a deep integration with the EHR is needed in order to trigger at appropriate points in cognitive workflow. Conclusion: Developing a CDDSS that is able to utilize dynamic vocabulary tools to quickly capture and code relevant diagnostic findings, and coupling these with individualized diagnostic suggestions based on the best-available evidence has the potential to improve diagnostic accuracy, but requires evaluation. PMID:26339829

  3. 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

  4. 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

  5. A primary neuron culture system for the study of herpes simplex virus latency and reactivation.

    PubMed

    Kobayashi, Mariko; Kim, Ju-Youn; Camarena, Vladimir; Roehm, Pamela C; Chao, Moses V; Wilson, Angus C; Mohr, Ian

    2012-04-02

    Herpes simplex virus type-1 (HSV-1) establishes a life-long latent infection in peripheral neurons. This latent reservoir is the source of recurrent reactivation events that ensure transmission and contribute to clinical disease. Current antivirals do not impact the latent reservoir and there are no vaccines. While the molecular details of lytic replication are well-characterized, mechanisms controlling latency in neurons remain elusive. Our present understanding of latency is derived from in vivo studies using small animal models, which have been indispensable for defining viral gene requirements and the role of immune responses. However, it is impossible to distinguish specific effects on the virus-neuron relationship from more general consequences of infection mediated by immune or non-neuronal support cells in live animals. In addition, animal experimentation is costly, time-consuming, and limited in terms of available options for manipulating host processes. To overcome these limitations, a neuron-only system is desperately needed that reproduces the in vivo characteristics of latency and reactivation but offers the benefits of tissue culture in terms of homogeneity and accessibility. Here we present an in vitro model utilizing cultured primary sympathetic neurons from rat superior cervical ganglia (SCG) (Figure 1) to study HSV-1 latency and reactivation that fits most if not all of the desired criteria. After eliminating non-neuronal cells, near-homogeneous TrkA(+) neuron cultures are infected with HSV-1 in the presence of acyclovir (ACV) to suppress lytic replication. Following ACV removal, non-productive HSV-1 infections that faithfully exhibit accepted hallmarks of latency are efficiently established. Notably, lytic mRNAs, proteins, and infectious virus become undetectable, even in the absence of selection, but latency-associated transcript (LAT) expression persists in neuronal nuclei. Viral genomes are maintained at an average copy number of 25 per neuron

  6. A computer program for assessment of emergency operation procedures under non-loca transient conditions in BWRs

    SciTech Connect

    Ohga, Y.

    1983-06-01

    A program analyzing long-term transients after abnormal incidents, excluding loss-of-coolant accidents, has been developed to assess emergency operation procedures for cold shutdown of reactors. The main program features are: The thermal hydraulics in both the reactor pressure vessel (RPV) and the primary containment vessel (PCV) are treated. Analytical models of the cooling system are included for not only the emergency core cooling system but other cooling systems that are effective for RPV and PCV cooling. The on/off switching of cooling systems by plant interlocks, component failures, and operator actions is simulated. The applicability of this program has been evaluated by simulation of long-term thermal-hydraulic behavior of the boiling water reactor transients initiated by loss of feedwater. From the evaluation results, it has been confirmed that the main program models can assess emergency operation procedures.

  7. 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

  8. 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

  9. At a Crossroad between Memory and Thinking: The Case of Primary History Education in the Greek Cypriot Educational System

    ERIC Educational Resources Information Center

    Perikleous, Lukas

    2010-01-01

    At the moment primary history education in the Greek Cypriot educational system is mainly about providing substantive knowledge and promoting Greek national identity and other social goals. Debates about history education are mostly about the kind of the past that should conveyed to the students and the social aims which should be promoted through…

  10. Validating "Value Added" in the Primary Grades: One District's Attempts to Increase Fairness and Inclusivity in Its Teacher Evaluation System

    ERIC Educational Resources Information Center

    Amrein-Beardsley, Audrey; Polasky, Sarah; Holloway-Libell, Jessica

    2016-01-01

    One urban district in the state of Arizona sought to use an alternative achievement test (i.e., the Northwest Evaluation Association's (NWEA) Measures of Academic Progress for Primary Grades (MAP)) to include more value-added ineligible teachers in the districts' growth and merit pay system. The goal was to allow for its K-2 teachers to be more…

  11. 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, ...

  12. An Analysis of Two Beginning Reading Programs: Scott Foresman's "Reading Unlimited" and Pittsburgh LRDC's "New Primary Grades Reading Systems."

    ERIC Educational Resources Information Center

    Popp, Helen Mitchell

    The two reading programs discussed in this paper, "Reading Unlimited" (RU) published by Scott Foresman and "New Primary Grades Reading Systems" (RS) by the University of Pittsburgh Learning Research and Development Center, provide maximal contrasts in materials and teaching strategies. The instructional strategies in RU are analytic and inductive,…

  13. 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…

  14. A dichotomy in primary marine organic aerosol-cloud-climate system

    NASA Astrophysics Data System (ADS)

    Ceburnis, D.; Ovadnevaite, J.; Martucci, G.; Bialek, J.; Monahan, C.; Rinaldi, M.; Facchini, C.; Berresheim, H.; Worsnop, D. R.; O'Dowd, C.

    2011-12-01

    D. Ceburnis1, J. Ovadnevaite1, G. Martucci1, J. Bialek1, C. Monahan1, M. Rinaldi2, M. C. Facchini2, H. Berresheim1, D. R. Worsnop3,4 and C. D. O'Dowd1 1School of Physics & Centre for Climate and Air Pollution Studies, National University of Ireland Galway, University Road, Galway, Ireland 2Institute of Atmospheric Sciences and Climate, National Research Council, Bologna, 20129, Italy. 3 Aerodyne Research, Inc., 45 Manning Road, Billerica, MA 01821-3976, USA 4 Physics Department, University of Helsinki, P.O. Box 64, 00014, Helsinki, Finland Organic matter has been observed to significantly contribute to particulate matter in every environment including pristine remote oceans. A significant if not dominant contribution of insoluble organic matter to marine aerosol has been proved to be of biogenic origin1,2. High time resolution measurements of marine organic matter have demonstrated a dynamic system with regular organic matter plume events occurring during summer3 as well as frequent open ocean particle formation events4. High-time resolution measurements of primary marine organic sea-spray physico-chemical properties reveal an apparent dichotomous behavior in terms of water uptake: specifically sea-spray aerosol enriched in organic matter possesses a low hygroscopic Growth Factor (GF~1.25) while simultaneously having a cloud condensation nucleus/condensation nuclei (CCN/CN) activation efficiency of between 83% at 0.25% supersaturation and 100% at 0.75%5. Simultaneous retrieval of Cloud Droplet Number Concentration (CDNC) during primary organic aerosol plumes reveal CDNC concentrations of 350 cm-3 in newly formed marine stratocumulus cloud for boundary layer organic mass concentrations of 3-4 ug m-36. It is suggested that marine hydrogels are responsible for this dichotomous behavior which has profound impacts to aerosol-cloud-climate system along with a better understood process analysis of aerosol formation by sea-spray7. A hydrophobic character of organic matter

  15. 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

  16. Environmental monitoring of urban streams using a primary fish gill cell culture system (FIGCS).

    PubMed

    Schnell, Sabine; Bawa-Allah, Kafilat; Otitoloju, Adebayo; Hogstrand, Christer; Miller, Thomas H; Barron, Leon P; Bury, Nic R

    2015-10-01

    The primary fish gill cell culture system (FIGCS) is an in vitro technique which has the potential to replace animals in whole effluent toxicity tests. In the current study FIGCS were transported into the field and exposed to filtered (0.2μm) river water for 24h from 4 sites, on 2 different sampling dates. Sites 1 and 2 are situated in an urban catchment (River Wandle, London, UK) with site 1 downstream of a sewage treatment work; site 3 is located in a suburban park (River Cray, Kent, UK), and site 4 is more rural (River Darent, Kent, UK). The change in transepithelial electrical resistance (TER), the expression of the metal responsive genes metallothionein A (mta) and B (mtb), cytochrome P450 1A1 (cyp1a1) and 3A27 (cyp3a27), involved in phase 1 metabolism, were assessed following exposure to sample water for 24h. TER was comparable between FIGCS exposed to 0.2μm filtered river water and those exposed to synthetic moderately soft water for 24h. During the first sampling time, there was an increase in mta, cyp1a1 and cyp3a27 gene expression in epithelium exposed to water from sites 1 and 2, and during the second sampling period an increase in cyp3a27 gene expression at sites 1 and 4. Urban river water is a complex mixture of contaminants (e.g., metals, pesticides, pharmaceuticals and polyaromatic hydrocarbons) and the increase in the expression of genes encoding mta, cyp1a1 and cyp3a27 in FIGCS is indicative of the presence of biologically active pollutants.

  17. Efficacy of Procarbazine, Lomustine, and Vincristine Chemotherapy for Recurrent Primary Central Nervous System Lymphomas

    PubMed Central

    Kim, Young-Joo; Choe, Jai-ho; Park, Jae-Hyun

    2015-01-01

    Background Optimal treatment for recurrent primary central nervous system lymphomas (PCNSLs) has not been defined yet and there is no general consensus about the salvage chemotherapy after high-dose methotrexate (HD-MTX)-based chemotherapy. The purpose of the present study was to evaluate the efficacy and safety of procarbazine, lomustine, and vincristine (PCV) chemotherapy for recurrent PCNSLs. Methods We reviewed eight immunocompetent patients (five males/three females, mean age: 56 years) who received salvage PCV chemotherapy (procarbazine 60 mg/m2, days 8 through 21: CCNU 110 mg/m2, day 1: vincristine 2 mg, days 8 and 28) for recurrent PCNSL and two patients switched to PCV chemotherapy due to severe adverse effects of HD-MTX chemotherapy. Radiologic responses, survival, and adverse effects were analyzed. Results Of the eight recurrent PCNSLs, three patients (37.5%) showed radiologic complete response, one patient (12.5%) showed partial response, and four patients (50%) showed progressive disease after PCV chemotherapy. Median progression free survival (PFS) from the first administration of PCV to relapse or last follow-up was 7 months (range 5-32 months) and median overall survival was 8 months (range 2-41 months). The two patients who switched to PCV chemotherapy showed PFS of 9 and 5 months from the beginning of PCV to relapse. The common side effects were thrombocytopenia, neutropenia, and peripheral neuropathy. There were 4 grade III or IV myelo-suppression, but no fatal complications, including severe hemorrhage or infection, were observed. Conclusion Salvage PCV chemotherapy has a moderate anti-lymphoma activity for recurrent PCNSLs after the HD-MTX-based chemotherapy with tolerable toxicity. PMID:26605261

  18. 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

  19. Systemic chemotherapy with vincristine, cyclophosphamide, doxorubicin and prednisolone following radiotherapy for primary central nervous system lymphoma: a phase II study.

    PubMed

    Shibamoto, Y; Sasai, K; Oya, N; Hiraoka, M

    1999-04-01

    We treated 23 patients with primary central nervous system lymphoma with a protocol of conventional radiation up to 55 +/- 5 Gy followed by 4 to 6 cycles of intravenous doxorubicin (30 mg/m2), vincristine (1 mg/m2) and cyclophosphamide (350 mg/m2), and oral prednisolone (8-30 mg/m2) (VEPA chemotherapy) repeated at 2-week intervals. The median age of the 23 patients was 59 years, and the median World Health Organization performance status score was 2. Seventeen patients received 4 or more courses of the chemotherapy, but 6 received only 1 or 2 courses for various reasons. The median survival time for all 23 patients was 25.5 months and their 5-year survival rate was 23%. These values were 34 months and 32%, respectively, for the 17 patients who received 4-6 courses of chemotherapy. After treatment, decline in performance status unaccompanied with tumor recurrence was observed in 44% of the patients; the incidence was apparently higher in older than in younger patients. The survival results obtained with this combined radiochemotherapy regimen appear to be better than those reported in most previous studies of patients treated with radiation alone. Post-irradiation VEPA chemotherapy appears to be worthy of further evaluation.

  20. Effects of adaptation on neural coding by primary sensory interneurons in the cricket cercal system.

    PubMed

    Clague, H; Theunissen, F; Miller, J P

    1997-01-01

    Methods of stochastic systems analysis were applied to examine the effect of adaptation on frequency encoding by two functionally identical primary interneurons of the cricket cercal system. Stimulus reconstructions were obtained from a linear filtering transformation of spike trains elicited in response to bursts of broadband white noise air current stimuli (5-400 Hz). Each linear reconstruction was compared with the actual stimulus in the frequency domain to obtain a measure of waveform coding accuracy as a function of frequency. The term adaptation in this paper refers to the decrease in firing rate of a cell after the onset or increase in power of a white noise stimulus. The increase in firing rate after stimulus offset or decrease in stimulus power is assumed to be a complementary aspect of the same phenomenon. As the spike rate decreased during the course of adaptation, the total amount of information carried about the velocity waveform of the stimulus also decreased. The quality of coding of frequencies between 70 and 400 Hz decreased dramatically. The quality of coding of frequencies between 5 and 70 Hz decreased only slightly or even increased in some cases. The disproportionate loss of information about the higher frequencies could be attributed in part to the more rapid loss of spikes correlated with high-frequency stimulus components than of spikes correlated with low-frequency components. An increase in the responsiveness of a cell to frequencies > 70 Hz was correlated with a decrease in the ability of that cell to encode frequencies in the 5-70 Hz range. This nonlinear property could explain the improvement seen in some cases in the coding accuracy of frequencies between 5 and 70 Hz during the course of adaptation. Waveform coding properties also were characterized for fully adapted neurons at several stimulus intensities. The changes in coding observed through the course of adaptation were similar in nature to those found across stimulus powers

  1. Primary blast injury: pathophysiology and implications for treatment. Part III: Injury to the central nervous system and the limbs.

    PubMed

    Guy, R J; Glover, M A; Cripps, N P

    2000-01-01

    There are some structures in which changes consistent with primary blast may be found despite secondary and tertiary blast being the most frequent sources of injury. The Central Nervous System for example, especially the brain, is well protected yet there are historical and experimental accounts of damage which cannot be attributed to secondary or tertiary blast or even air embolism resulting from pulmonary disruption. Similarly, analysis and experimental simulation of specific skeletal injuries has shown that primary blast alone can fracture bones and that it is likely to be responsible for limb avulsions in victims exposed to stress waves of sufficiently high intensity. PMID:10892035

  2. 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

  3. The energetic contributions of aquatic primary producers to terrestrial food webs in a mid-size river system.

    PubMed

    Kautza, Adam; Mazeika, S; Sullivan, P

    2016-03-01

    Rivers are increasingly recognized as providing nutritional subsidies (i.e., energy and nutrients) to adjacent terrestrial food webs via depredation of aquatic organisms (e.g., emergent aquatic insects, crayfish, fish) by terrestrial consumers. However, because these prey organisms assimilate energy from both aquatic (e.g., benthic algae, phytoplankton, aquatic macrophytes) and terrestrial (e.g., riparian leaf detritus) primary producers, river subsidies to terrestrial consumers represent a combination of aquatically and terrestrially derived energy. To date, the explicit contribution of energy derived from aquatic primary producers to terrestrial consumers has not been fully explored yet might be expected to be quantitatively important to terrestrial food webs. At 12 reaches along a 185-km segment of the sixth-order Scioto River system (Ohio, USA), we quantified the relative contribution of energy derived from aquatic primary producers to a suite of terrestrial riparian consumers that integrate the adjacent landscape across multiple spatial scales through their foraging activities (tetragnathid spiders, rove beetles, adult coenagrionid damselflies, riparian swallows, and raccoons). We used naturally abundant stable isotopes (13C and 15N) of periphyton, phytoplankton, macrophytes, and terrestrial vegetation to evaluate the energetic contribution of aquatic primary producers to terrestrial food webs. Shoreline tetragnathid spiders were most reliant on aquatic primary producers (50%), followed by wider-ranging raccoons (48%), damselflies (44%), and riparian swallows (41%). Of the primary producers, phytoplankton (19%) provisioned the greatest nutritional contribution to terrestrial consumers (considered collectively), followed by periphyton (14%) and macrophytes (11%). Our findings provide empirical evidence that aquatic primary producers of large streams and rivers can be a critical nutritional resource for terrestrial food webs. We also show that aquatically

  4. The energetic contributions of aquatic primary producers to terrestrial food webs in a mid-size river system.

    PubMed

    Kautza, Adam; Mazeika, S; Sullivan, P

    2016-03-01

    Rivers are increasingly recognized as providing nutritional subsidies (i.e., energy and nutrients) to adjacent terrestrial food webs via depredation of aquatic organisms (e.g., emergent aquatic insects, crayfish, fish) by terrestrial consumers. However, because these prey organisms assimilate energy from both aquatic (e.g., benthic algae, phytoplankton, aquatic macrophytes) and terrestrial (e.g., riparian leaf detritus) primary producers, river subsidies to terrestrial consumers represent a combination of aquatically and terrestrially derived energy. To date, the explicit contribution of energy derived from aquatic primary producers to terrestrial consumers has not been fully explored yet might be expected to be quantitatively important to terrestrial food webs. At 12 reaches along a 185-km segment of the sixth-order Scioto River system (Ohio, USA), we quantified the relative contribution of energy derived from aquatic primary producers to a suite of terrestrial riparian consumers that integrate the adjacent landscape across multiple spatial scales through their foraging activities (tetragnathid spiders, rove beetles, adult coenagrionid damselflies, riparian swallows, and raccoons). We used naturally abundant stable isotopes (13C and 15N) of periphyton, phytoplankton, macrophytes, and terrestrial vegetation to evaluate the energetic contribution of aquatic primary producers to terrestrial food webs. Shoreline tetragnathid spiders were most reliant on aquatic primary producers (50%), followed by wider-ranging raccoons (48%), damselflies (44%), and riparian swallows (41%). Of the primary producers, phytoplankton (19%) provisioned the greatest nutritional contribution to terrestrial consumers (considered collectively), followed by periphyton (14%) and macrophytes (11%). Our findings provide empirical evidence that aquatic primary producers of large streams and rivers can be a critical nutritional resource for terrestrial food webs. We also show that aquatically

  5. Design and simulation of the active support system for a 1.2m meniscus primary mirror

    NASA Astrophysics Data System (ADS)

    Liu, Haitao; Fan, Bin; Zeng, Zhige; Li, Xiaojin; Wang, Hongqiao; Liu, Rong

    2015-07-01

    Thin meniscus primary mirrors with active support have been used successfully in many large telescopes, and also draw attention of many optical fabricators. Because the active support system can correct the low order figure errors, such as astigmatism, coma, trefoil 3rd astigmatism, the optical fabricators can just focus on to remove high order figure errors. This will shorten the fabrication time. In this paper, we present an active support system for a 1.2m meniscus parabolic primary mirror. It contains 37 axial push-pull force supports, 3 axial fixed points, and 4 lateral restraints. Some basic performance of the active support system is analyzed and the figure error correction capability is also studied based on Zernike modes.

  6. Primary afferent fibers establish dye-coupled connections in the frog central nervous system.

    PubMed

    Bácskai, Timea; Matesz, Clara

    Neurobiotin and Lucifer yellow, indicators of gap junctional coupling, were applied to primary afferent fibers of the frog. Following application of tracers to cervical or lumbar dorsal root fibers, a large number of labeled granule cells were detected in the corpus cerebelli, the brainstem, and the spinal cord. The vestibular nerve was found to be in dye-coupled connection with the granule cells of the auricular lobe of the cerebellum. After application of the tracers to the trigeminal nerve, elicited dye-coupled neurons located mainly in the termination area of the descending limb of the mesencephalic trigeminal nucleus. In control experiments with biotinylated dextrane amine, only primary afferent fibers were labeled. Our results suggest that gap junctional coupling exists between primary afferent fibers and their postsynaptic targets in the frog.

  7. Open communication: Recommendations for enhancing communication among primary care and mental health providers, services, and systems.

    PubMed

    Wong, Shale L; Talmi, Ayelet

    2015-06-01

    Comments on the article "Please break the silence: Parents' views on communication between pediatric primary care and mental health providers" by Greene et al. (see record 2015-14521-001). The article highlights the need to improve communication between primary care and mental health care providers to better serve children and families. The report reaffirms that parents understand the value and necessity of collaborative care, as evidenced by the identification of gaps in consistency of bidirectional communication between providers in traditional and separate practice settings and the desire for improved care coordination.

  8. 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

  9. N-deacetyl ketoconazole-induced hepatotoxicity in a primary culture system of rat hepatocytes.

    PubMed

    Rodriguez, R J; Acosta, D

    1997-02-28

    Ketoconazole (KT) is an azole antifungal agent that has been associated with hepatotoxicity. The mechanism of its hepatotoxicity has not yet been resolved. It has been suggested that a reactive metabolite may be the cause of toxicity because the hepatic injury does not appear to be mediated through an immunoallergic mechanism. Several metabolites of KT have been reported in the literature of which the deacetylated metabolite, N-deacetyl ketoconazole (DAK), is the major metabolite which undergoes further metabolism by the flavin-containing monooxygenases (FMO) to form a potentially toxic dialdehyde. The objective of this study was to evaluate DAK's cytotoxicity and the role of FMO in a primary culture system of rat hepatocytes. Cytotoxicity was evaluated by measuring the leakage of the cytosolic enzyme, lactate dehydrogenase (LDH), into the medium and by assessing mitochondrial reduction of 3-(4,5-dimethythiazol-2yl)-2,5-diphenyl tetrazolium bromide (MTT). The cultures were exposed to various concentrations of DAK (20-160 microM) for 0.5-4 h. There was a significant increase (P < 0.05) in LDH leakage and an immediate decrease in MTT reduction (P < 0.05) as early as 0.5 h. The MTT reduction assay appeared to be more sensitive than the LDH assay in that lower concentrations were needed to observe a 50% reduction of MTT (107, 90, 75, 58 microM DAK at 0.5, 1.0, 2.0 and 4.0 h, respectively). The concentrations to observe 50% LDH leakage from the hepatocytes were 155, 133, 100, 70 microM DAK at 0.5, 1.0, 2.0 and 4.0 h, respectively. Moreover, co-treatment with methimazole, a competitive substrate for FMO, produced a significant decrease (P < 0.05) in % LDH leakage as early as 0.5 h, when compared to cells treated solely with DAK. Also, the toxicity was significantly (P < 0.05) enhanced as early as 0.5 h by n-octylamine, a known positive effector for FMO. These results demonstrate that DAK is a more potent cytotoxicant than its parent compound, KT, as reported previously

  10. 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.

  11. Associations of Primary and Secondary Organic Aerosols With Airway and Systemic Inflammation in an Elderly Panel Cohort

    PubMed Central

    Delfino, Ralph J.; Staimer, Norbert; Tjoa, Thomas; Arhami, Mohammad; Polidori, Andrea; Gillen, Daniel L.; George, Steven C.; Shafer, Martin M.; Schauer, James J.; Sioutas, Constantinos

    2013-01-01

    Background Exposure-response information about particulate air-pollution constituents is needed to protect sensitive populations. Particulate matter <2.5 mm (PM2.5) components may induce oxidative stress through reactive-oxygen-species generation, including primary organics from combustion sources and secondary organics from photochemically oxidized volatile organic compounds. We evaluated differences in airway versus systemic inflammatory responses to primary versus secondary organic particle components, particle size fractions, and the potential of particles to induce cellular production of reactive oxygen species. Methods A total of 60 elderly subjects contributed up to 12 weekly measurements of fractional exhaled nitric oxide (NO; airway inflammation biomarker), and plasma interleukin-6 (IL-6; systemic inflammation biomarker). PM2.5 mass fractions were PM0.25 (<0.25 µm) and PM0.25–2.5 (0.25–2.5 µm). Primary organic markers included PM2.5 primary organic carbon, and PM0.25 polycyclic aromatic hydrocarbons and hopanes. Secondary organic markers included PM2.5 secondary organic carbon, and PM0.25 water soluble organic carbon and n-alkanoic acids. Gaseous pollutants included carbon monoxide (CO) and nitrogen oxides (NOx; combustion emissions markers), and ozone (O3; photochemistry marker). To assess PM oxidative potential, we exposed rat alveolar macrophages in vitro to aqueous extracts of PM0.25 filters and measured reactive-oxygen-species production. Biomarker associations with exposures were evaluated with mixed-effects models. Results Secondary organic markers, PM0.25–2.5, and O3 were positively associated with exhaled NO. Primary organic markers, PM0.25, CO, and NOx were positively associated with IL-6. Reactive oxygen species were associated with both outcomes. Conclusions Particle effects on airway versus systemic inflammation differ by composition, but overall particle potential to induce generation of cellular reactive oxygen species is related to

  12. 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 teachers.1 In that…

  13. A Dynamic Primary Care Curriculum Based on the Problem-Oriented System

    ERIC Educational Resources Information Center

    Bouchard, Richard E.; Tufo, Henry M.

    1977-01-01

    The audit of medical care in primary care practices has proven to be a valuable tool for teaching the essentials of efficient health care delivery to medical students at the University of Vermont. Practice standards and methods are continually revised based on the audit of the providers of care and the curriculum is updated based on student…

  14. 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…

  15. Primary systemic amyloidosis as a real diagnostic challenge – case study

    PubMed Central

    Jerzykowska, Sonia; Gil, Lidia A.; Balcerzak, Andrzej; Pupek-Musialik, Danuta; Komarnicki, Mieczysław A.

    2014-01-01

    Primary amyloidosis (AL) is a rare variety of plasma cell dyscrasia, the diagnosis of which is often difficult to establish. Pathogenesis of amyloidosis involves extracellular deposition of insoluble protein fibrils in tissues, leading to insufficiency of affected organs. According to various sources, mean survival rate of patients with primary amyloidosis ranges from 12 to 24 months, making primary amyloidosis a disease with a very poor prognosis. Survival rate is significantly lowered in case of cardiac manifestation of amyloidosis (about 6 months survival in untreated patients). In recent years a considerable progress in AL treatment has been observed. Nowadays we are able not only to delay progression of amyloidosis, but also to improve the function of the affected organs. Unfortunately as first signs and symptoms of AL are usually nonspecific, the diagnosis of AL is often delayed, resulting in late introduction of optimal therapy. There are many diagnostic tests which can be used in diagnostic process of amyloidosis, i.e. electrophoresis, serum and urine immunofixation or affected organs and bone marrow biopsy. On establishing the diagnosis in a patient with suspected amyloidosis it should be remembered that particular diagnostic methods vary considerably in sensitivity. The aim of this paper is to present a case report of a 27-year-old patient with primary amyloidosis focusing on diagnostic aspect of this condition. On the basis of this case, the authors would like to emphasize the value of precise diagnostic process, with immunological techniques playing undoubtedly a crucial role. PMID:26155101

  16. 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 suffered when in…

  17. 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…

  18. Construing Systems of Management among Primary Headteachers: Moving Forward from Work Activity Studies.

    ERIC Educational Resources Information Center

    Jones, Norah; Connolly, Michael

    2001-01-01

    A study used a Personal Construct Theory/Repertory Grid approach to examine the work of 12 Welsh primary headteachers. Analysis of thematic work-activity grids suggests principals have a more coherent view of their work (as centered on children and education) than Henry Mintzberg's observational studies portrayed. (Contains 36 references.) (MLH)

  19. 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.

  20. Computer visualisation of patient safety in primary care: a systems approach adapted from management science and engineering.

    PubMed

    Singh, Ranjit; Singh, Ashok; Fox, Chester; Seldan Taylor, John; Rosenthal, Thomas; Singh, Gurdev

    2005-01-01

    Patient safety and medical errors in ambulatory primary care are receiving increasing attention from policy makers, accreditation bodies and researchers, as well as by practising family physicians and their patients. While a great deal of progress has been made in understanding errors in hospital settings, it is important to recognise that ambulatory settings pose a very large and different set of challenges and that the types of hazards that exist and the strategies required to reduce them are very different. What is needed is a logical theoretical model for understanding the causes of errors in primary care, the role of healthcare systems in contributing to errors, the propagation of errors through complex systems and, importantly, for understanding ambulatory primary care in the context of the larger healthcare system. The authors have developed such a model using a formal 'systems engineering' approach borrowed from the management sciences and engineering. This approach has not previously been formally described in the medical literature.This paper outlines the formal systems approach, presents our visual model of the system, and describes some experiences with and potential applications of the model for monitoring and improving safety. Applications include providing a framework to help focus research efforts, creation of new (visual) error reporting and taxonomy systems, furnishing a common and unambiguous vision for the healthcare team, and facilitating retrospective and prospective analyses of errors and adverse events. It is aimed at system redesign for safety improvement through a computer-based patient-centred safety enhancement and monitoring instrument (SEMI-P). This model can be integrated with electronic medical records (EMRs).

  1. A first look at LOCAs in the SBWR using RELAP5/MOD3

    SciTech Connect

    Ghan, L.S.; Shaw, R.A.; Kullberg, C.M.

    1992-01-01

    The General Electric Company (GE) is designing an advanced light-water reactor, the Simplified Boiling Water Reactor (SBWR), that utilizes passive safety concepts. The SBWR reactor coolant system will operate on natural circulation with decay heat removal and emergency core coolant injection being provided by passive, gravity-driven systems. The Idaho National Engineering Laboratory has developed an input model of the SBWR for the RELAP5/MOD3 thermal-hydraulic safety analysis code. Preliminary calculations have been performed to simulate three loss-of-coolant accidents: (1) a main steam line break, (2) spurious opening of one automatic depressurization valve, and (3) the rupture of the bottom drain line. Results from these three calculations were, in general, intuitively reasonable. The analyses revealed that the input model, which was created with preliminary design data, needs to be updated to reflect the current SBWR design. Nodalization of certain regions will also need to be improved. The results of the main steam line break calculation were compared to a similar TRACG calculation presented in GE's Standard Safety Analysis Report. Comparisons of the preliminary RELAP5/MOD3 results to TRACG results indicated good qualitative agreement.

  2. A first look at LOCAs in the SBWR using RELAP5/MOD3

    SciTech Connect

    Ghan, L.S.; Shaw, R.A.; Kullberg, C.M.

    1992-12-31

    The General Electric Company (GE) is designing an advanced light-water reactor, the Simplified Boiling Water Reactor (SBWR), that utilizes passive safety concepts. The SBWR reactor coolant system will operate on natural circulation with decay heat removal and emergency core coolant injection being provided by passive, gravity-driven systems. The Idaho National Engineering Laboratory has developed an input model of the SBWR for the RELAP5/MOD3 thermal-hydraulic safety analysis code. Preliminary calculations have been performed to simulate three loss-of-coolant accidents: (1) a main steam line break, (2) spurious opening of one automatic depressurization valve, and (3) the rupture of the bottom drain line. Results from these three calculations were, in general, intuitively reasonable. The analyses revealed that the input model, which was created with preliminary design data, needs to be updated to reflect the current SBWR design. Nodalization of certain regions will also need to be improved. The results of the main steam line break calculation were compared to a similar TRACG calculation presented in GE`s Standard Safety Analysis Report. Comparisons of the preliminary RELAP5/MOD3 results to TRACG results indicated good qualitative agreement.

  3. 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

  4. Medication incidents in primary care medicine: protocol of a study by the Swiss Federal Sentinel Reporting System

    PubMed Central

    Gnädinger, Markus; Ceschi, Alessandro; Conen, Dieter; Herzig, Lilli; Puhan, Milo; Staehelin, Alfred; Zoller, Marco

    2015-01-01

    Background/rationale Patient safety is a major concern in healthcare systems worldwide. Although most safety research has been conducted in the inpatient setting, evidence indicates that medical errors and adverse events are a threat to patients in the primary care setting as well. Since information about the frequency and outcomes of safety incidents in primary care is required, the goals of this study are to describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents. Methods and analysis Study design and setting: We will conduct a prospective surveillance study to identify cases of medication incidents among primary care patients in Switzerland over the course of the year 2015. Participants: Patients undergoing drug treatment by 167 general practitioners or paediatricians reporting to the Swiss Federal Sentinel Reporting System. Inclusion criteria: Any erroneous event, as defined by the physician, related to the medication process and interfering with normal treatment course. Exclusion criteria: Lack of treatment effect, adverse drug reactions or drug–drug or drug–disease interactions without detectable treatment error. Primary outcome: Medication incidents. Risk factors: Age, gender, polymedication, morbidity, care dependency, hospitalisation. Statistical Analysis: Descriptive statistics to assess type, frequency, seasonal and regional distribution of medication incidents and logistic regression to assess their association with potential risk factors. Estimated sample size: 500 medication incidents. Limitations: We will take into account under-reporting and selective reporting among others as potential sources of bias or imprecision when interpreting the results. Ethics and dissemination No formal request was necessary because of fully anonymised data. The results will be published in a peer-reviewed journal. Trial registration number

  5. Strengthening of oral health systems: oral health through primary health care.

    PubMed

    Petersen, Poul Erik

    2014-01-01

    Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work with the newly established WHO Collaborating Centre, Kuwait University, to strengthen the development of appropriate models for primary oral health care.

  6. 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

  7. 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

    2016-01-01

    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

  8. 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

  9. FUV Spectroscopy of the sdOB Primary of the Eclipsing Binary System AA Dor

    NASA Astrophysics Data System (ADS)

    Fleig, J.; Rauch, T.; Werner, K.; Kruk, J. W.

    AADor is an eclipsing, close, post common-envelope binary (PCEB). We present a detailed spectral analysis of its sdOB primary based on observations obtained with the Far Ultraviolet Spectroscopic Explorer (FUSE). Due to a strong contamination by interstellar absorption, we had to model both, the stellar spectrum as well as the interstellar line absorption in order to reproduce the FUV observation well and to determine the photospheric parameters precisely.

  10. 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. ...

  11. Development of Non-LOCA Safety Analysis Methodology with RETRAN-3D and VIPRE-01/K

    SciTech Connect

    Kim, Yo-Han; Cheong, Ae-Ju; Yang, Chang-Keun

    2004-10-15

    Korea Electric Power Research Institute has launched a project to develop an in-house non-loss-of-coolant-accident analysis methodology to overcome the hardships caused by the narrow analytical scopes of existing methodologies. Prior to the development, some safety analysis codes were reviewed, and RETRAN-3D and VIPRE-01 were chosen as the base codes. The codes have been modified to improve the analytical capabilities required to analyze the nuclear power plants in Korea. The methodologies of the vendors and the Electric Power Research Institute have been reviewed, and some documents of foreign utilities have been used to compensate for the insufficiencies. For the next step, a draft methodology for pressurized water reactors has been developed and modified to apply to Westinghouse-type plants in Korea. To verify the feasibility of the methodology, some events of Yonggwang Units 1 and 2 have been analyzed from the standpoints of reactor coolant system pressure and the departure from nucleate boiling ratio. The results of the analyses show trends similar to those of the Final Safety Analysis Report.

  12. [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. PMID:25552059

  13. 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

  14. System Factors Affect the Recognition and Management of Post-Traumatic Stress Disorder by Primary Care Clinicians

    PubMed Central

    Meredith, Lisa S; Eisenman, David P; Green, Bonnie L; Basurto-Dávila, Ricardo; Cassells, Andrea; Tobin, Jonathan

    2009-01-01

    Background Post-traumatic stress disorder (PTSD) is common with an estimated prevalence of 8% in the general population and up to 17% in primary care patients. Yet, little is known about what determines primary care clinician’s (PCC) provision of PTSD care. Objective To describe PCC’s reported recognition and management of PTSD and identify how system factors affect the likelihood of performing clinical actions with regard to patients with PTSD or “PTSD treatment proclivity.” Design Linked cross-sectional surveys of medical directors and PCCs. Participants Forty-six medical directors and 154 PCCs in community health centers (CHCs) within a practice-based research network in New York and New Jersey. Measurements Two system factors (degree of integration between primary care and mental health services, and existence of linkages with other community, social, and legal services) as reported by medical directors, and PCC reports of self-confidence, perceived barriers, and PTSD treatment proclivity. Results Surveys from 47 (of 58) medical directors (81% response rate) and 154 PCCs (86% response rate). PCCs from CHCs with better mental health integration reported greater confidence, fewer barriers, and higher PTSD treatment proclivity (all p<.05). PCCs in CHCs with better community linkages reported greater confidence, fewer barriers, higher PTSD treatment proclivity, and lower proclivity to refer patients to mental health specialists or to use a “watch and wait” approach (all p<.05). Conclusion System factors play an important role in PCC PTSD management. Interventions are needed that restructure primary care practices by making mental health services more integrated and community linkages stronger. PMID:19433999

  15. 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.

  16. 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.

  17. 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:27175280

  18. 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.

  19. 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

  20. 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.

  1. 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

  2. Mineralized human primary osteoblast matrices as a model system to analyse interactions of prostate cancer cells with the bone microenvironment.

    PubMed

    Reichert, Johannes C; Quent, Verena M C; Burke, Leslie J; Stansfield, Scott H; Clements, Judith A; Hutmacher, Dietmar W

    2010-11-01

    Prostate cancer metastasis is reliant on the reciprocal interactions between cancer cells and the bone niche/micro-environment. The production of suitable matrices to study metastasis, carcinogenesis and in particular prostate cancer/bone micro-environment interaction has been limited to specific protein matrices or matrix secreted by immortalised cell lines that may have undergone transformation processes altering signaling pathways and modifying gene or receptor expression. We hypothesize that matrices produced by primary human osteoblasts are a suitable means to develop an in vitro model system for bone metastasis research mimicking in vivo conditions. We have used a decellularized matrix secreted from primary human osteoblasts as a model for prostate cancer function in the bone micro-environment. We show that this collagen I rich matrix is of fibrillar appearance, highly mineralized, and contains proteins, such as osteocalcin, osteonectin and osteopontin, and growth factors characteristic of bone extracellular matrix (ECM). LNCaP and PC3 cells grown on this matrix, adhere strongly, proliferate, and express markers consistent with a loss of epithelial phenotype. Moreover, growth of these cells on the matrix is accompanied by the induction of genes associated with attachment, migration, increased invasive potential, Ca(2+) signaling and osteolysis. In summary, we show that growth of prostate cancer cells on matrices produced by primary human osteoblasts mimics key features of prostate cancer bone metastases and thus is a suitable model system to study the tumor/bone micro-environment interaction in this disease.

  3. Sensitivity Analyses in Small Break LOCA with HPI-Failure: Effect of Break-Size in Secondary-Side Depressurization

    NASA Astrophysics Data System (ADS)

    Kinoshita, Ikuo; Torige, Toshihide; Yamada, Minoru

    2014-06-01

    In the case of total failure of the high pressure injection (HPI) system following small break loss of coolant accident (SBLOCA) in pressurized water reactor (PWR), the break size is so small that the primary system does not depressurize to the accumulator (ACC) injection pressure before the core is uncovered extensively. Therefore, steam generator (SG) secondary-side depressurization is necessary as an accident management in order to grant accumulator system actuation and core reflood. A thermal-hydraulic analysis using RELAP5/MOD3 was made on SBLOCA with HPI-failure for Oi Units 3/4 operated by Kansai Electoric Power Co., which are conventional 4 loop PWR plants. The effectiveness of SG secondary-side depressurization procedure was investigated for the real plant design and operational characteristics. The sensitivity analyses using RELAP5/MOD3.2 showed that the accident management was effective for a wide range of break sizes, various orientations and positions. The critical break can be 3 inch cold-leg bottom break.

  4. Whole slide images for primary diagnostics of urinary system pathology: a feasibility study

    PubMed Central

    Al-Janabi, Shaimaa; Huisman, André; Jonges, Geertruida N.; ten Kate, Fiebo J.W.; Goldschmeding, Roel; van Diest, Paul J.

    2014-01-01

    Introduction: During the last decade, whole slide images (WSI) have been used in many areas of pathology such as teaching, research, digital archiving, teleconsultation and quality assurance testing. However, WSI have as yet not much been used for upfront diagnostics because of the lack of validation studies. Objectives: The aim of this study was to test the feasibility of WSI for primary diagnosis of urinary tract pathology. Materials and Methods: 100 consecutive urinary tract biopsies and resections which had been diagnosed conventionally between the years 2008-2009 were scanned at 20× magnification, and rediagnosed by two pathologists on WSI, having the original clinical information available, but blinded to the original diagnoses. Original and WSI diagnoses were compared and classified as concordant, slightly discordant (without clinical consequences) and discordant. Results: Original and WSI based rediagnosis were concordant in 87% of the cases. Original and WSI diagnosis were slightly discordant in 8% of cases. Major discrepancies with clinical or prognostic implications were founded in only 5 cases. However, for 6 out of the 13 discrepancies, WSI based diagnoses were considered to be better than the original diagnoses. Conclusion: Primary diagnostics of urinary tract specimens can be reliably done on WSI. Further improvements of image resolution may help to increase diagnostic accuracy and WSI acceptance in routine pathology. PMID:25610886

  5. 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

  6. 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

  7. Physician user satisfaction with an electronic medical records system in primary healthcare centres in Al Ain: a qualitative study

    PubMed Central

    Al Alawi, Shamma; Al Dhaheri, Aysha; Al Baloushi, Durra; Al Dhaheri, Mouza; Prinsloo, Engela A M

    2014-01-01

    Objectives To explore physician satisfaction with an electronic medical records (EMR) system, to identify and explore the main limitations of the system and finally to submit recommendations to address these limitations. Design A descriptive qualitative study that entailed three focus group interviews was performed among physicians using open-ended questions. The interviews were audiotaped, documented and transcribed verbatim. The themes were explored and analysed in different categories. Setting The study was conducted in primary healthcare centres (PHC) in Al Ain, United Arab Emirates (UAE). Participants A total of 23 physicians, all using the same EMR system, attended one of three focus groups held in PHC in Al Ain Medical District. Each focus group consisted of 7–9 physicians working in PHC as family medicine specialists, residents or general practitioners. Primary outcome measure Physician satisfaction with the EMR system. Results Key themes emerged and were categorised as physician-dependent, patient-related and system-related factors. In general, physicians were satisfied with the EMR system in spite of initial difficulties with implementation. Most participants identified that the long time required to do the documentation affected their practice and patient communication. Many physicians expressed satisfaction with the orders and results of laboratory and radiology functions and they emphasised that this was the strongest point in the EMR. They were also satisfied with the electronic prescription function, stating that it reduced errors and saved time. Conclusions Physicians are satisfied with the EMR and have a positive perception regarding the application of the system. Several themes emerged during this study that need to be considered to enhance the EMR system. Further studies need to be conducted among other healthcare practitioners and patients to explore their attitude and perception about the EMR. PMID:25377010

  8. 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.

  9. 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.

  10. 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. PMID:18005567

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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. PMID:16213189

  17. Non-categorical problem lists in a primary-care information system.

    PubMed Central

    Wilton, R.

    1991-01-01

    An ambulatory-care patient-tracking system has been implemented that records non-categorical problem descriptions in the outpatient problem list. The system does not restrict physicians to the use of predefined diagnostic categories. Instead, the system stores patient problems in a database as free-text records. Subsequent diagnostic categorization and coding is accomplished through prompted free-text input and appropriate reference databases. This system design allows an outpatient problem-list summary to reflect non-categorical health-status information in addition to coded medical diagnoses. PMID:1807721

  18. Sex Determination in the Fly Megaselia Scalaris, a Model System for Primary Steps of Sex Chromosome Evolution

    PubMed Central

    Traut, W.

    1994-01-01

    The fly Megaselia scalaris Loew possesses three homomorphic chromosome pairs; 2 is the sex chromosome pair in two wild-type laboratory stocks of different geographic origin (designated ``original'' sex chromosome pair in this paper). The primary male-determining function moves at a very low rate to other chromosomes, thereby creating new Y chromosomes. Random amplified polymorphic DNA markers obtained by polymerase chain reaction with single decamer primers and a few available phenotypic markers were used in testcrosses to localize the sex-determining loci and to define the new sex chromosomes. Four cases are presented in which the primary male-determining function had been transferred from the original Y chromosome to a new locus either on one of the autosomes or on the original X chromosome, presumably by transposition. In these cases, the sex-determining function had moved to a different locus without an obvious cotransfer of other Y chromosome markers. Thus, with Megaselia we are afforded an experimental system to study the otherwise hypothetical primary stages of sex chromosome evolution. An initial molecular differentiation is apparent even in the new sex chromosomes. Molecular differences between the original X and Y chromosomes illustrate a slightly more advanced stage of sex chromosome evolution. PMID:8005417

  19. Towards a Healthy District: Organizing and Managing District Health Systems Based on Primary Health Care.

    ERIC Educational Resources Information Center

    Tarimo, E.

    This book is concerned with orienting health care workers in district health systems in developing countries to ways and means of overcoming problems, and describes briefly how district health systems can be improved. The book is organized around nine issues in nine chapters, each of which is an integral part of a district planning cycle. The…

  20. 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. PMID:26999649

  1. A portable system for identifying urinary tract infection in primary care using a PC-based chromatic technique.

    PubMed

    Deakin, A G; Jones, G R; Spencer, J W; Bongard, E J; Gal, M; Sufian, A T; Butler, C C

    2014-05-01

    An approach is described for monitoring urine samples using a portable system based on chromatic techniques and for predicting urinary tract infection (UTI) from the results. The system uses a webcam-computer combination with the screen of a computer visual display unit as a tuneable illumination source. It is shown that the system can operate in a robust manner under ambient lighting conditions and with potential for use as a point of care test in primary care. The present approach combines information on urine liquid concentration and turbidity. Its performance in an exploratory study is compared with microbiological culture of 200 urine samples, of which 79 had bacterial growth >10(5) colony forming unit/millilitre (cfu ml(-1)) indicative of UTI. It is shown that both sensitivity and negative predictive value of 0.92 could be achieved. PMID:24682226

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. Epstein-Barr and human immunodeficiency viruses in acquired immunodeficiency syndrome-related primary central nervous system lymphoma.

    PubMed Central

    Morgello, S.

    1992-01-01

    The prevalence of Epstein-Barr virus (EBV) and human immunodeficiency virus (HIV) in acquired immunodeficiency syndrome (AIDS)-related primary central nervous system (CNS) lymphoma was examined. Deoxyribonucleic acid (DNA) extracted from 12 formalin-fixed, paraffin-embedded tumors was used as substrate for the polymerase chain reaction (PCR). Targets for amplification were the EBNA-1 region of EBV, the gag region of HIV, and a single copy cellular sequence as a control. The cases studied were autopsy and surgical specimens collected between the years 1985 and 1989. By the working formulation for non-Hodgkin's lymphomas, five had large cell, four had mixed large and small cleaved cell, two had small cleaved cell, and one had an unclassified histology. Epstein-Barr virus was detected in 6 of 12 tumors studied. Human immunodeficiency virus was not detected in any of the tumors. The presence of EBV was not correlated with any particular histologic tumor type. It is concluded that EBV, not HIV, can be detected in a large percentage (50%) of AIDS-related primary central nervous system (CNS) lymphomas. This viral association may be significant in light of the demonstrated ability of EBV to induce lymphoid tumors in experimental mammalian systems. Images Figure 1 Figure 2 PMID:1323221

  7. 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.

  8. 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.

  9. Presence of Systemic Inflammatory Response Syndrome Predicts a Poor Clinical Outcome in Dogs with a Primary Hepatitis.

    PubMed

    Kilpatrick, Scott; Dreistadt, Margaret; Frowde, Polly; Powell, Roger; Milne, Elspeth; Smith, Sionagh; Morrison, Linda; Gow, Adam G; Handel, Ian; Mellanby, Richard J

    2016-01-01

    Primary hepatopathies are a common cause of morbidity and mortality in dogs. The underlying aetiology of most cases of canine hepatitis is unknown. Consequently, treatments are typically palliative and it is difficult to provide accurate prognostic information to owners. In human hepatology there is accumulating data which indicates that the presence of systemic inflammatory response syndrome (SIRS) is a common and debilitating event in patients with liver diseases. For example, the presence of SIRS has been linked to the development of complications such as hepatic encephalopathy (HE) and is associated with a poor clinical outcome in humans with liver diseases. In contrast, the relationship between SIRS and clinical outcome in dogs with a primary hepatitis is unknown. Seventy dogs with histologically confirmed primary hepatitis were enrolled into the study. Additional clinical and clinicopathological information including respiratory rate, heart rate, temperature, white blood cell count, sodium, potassium, sex, presence of ascites, HE score, alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin and red blood cell concentration were available in all cases. The median survival of dogs with a SIRS score of 0 or 1 (SIRS low) was 231 days compared to a median survival of 7 days for dogs with a SIRS score of 2, 3 or 4 (SIRS high) (p<0.001). A Cox proportional hazard model, which included all other co-variables, revealed that a SIRS high score was an independent predictor of a poor clinical outcome. The effect of modulating inflammation on treatment outcomes in dogs with a primary hepatitis is deserving of further study. PMID:26808672

  10. Presence of Systemic Inflammatory Response Syndrome Predicts a Poor Clinical Outcome in Dogs with a Primary Hepatitis.

    PubMed

    Kilpatrick, Scott; Dreistadt, Margaret; Frowde, Polly; Powell, Roger; Milne, Elspeth; Smith, Sionagh; Morrison, Linda; Gow, Adam G; Handel, Ian; Mellanby, Richard J

    2016-01-01

    Primary hepatopathies are a common cause of morbidity and mortality in dogs. The underlying aetiology of most cases of canine hepatitis is unknown. Consequently, treatments are typically palliative and it is difficult to provide accurate prognostic information to owners. In human hepatology there is accumulating data which indicates that the presence of systemic inflammatory response syndrome (SIRS) is a common and debilitating event in patients with liver diseases. For example, the presence of SIRS has been linked to the development of complications such as hepatic encephalopathy (HE) and is associated with a poor clinical outcome in humans with liver diseases. In contrast, the relationship between SIRS and clinical outcome in dogs with a primary hepatitis is unknown. Seventy dogs with histologically confirmed primary hepatitis were enrolled into the study. Additional clinical and clinicopathological information including respiratory rate, heart rate, temperature, white blood cell count, sodium, potassium, sex, presence of ascites, HE score, alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin and red blood cell concentration were available in all cases. The median survival of dogs with a SIRS score of 0 or 1 (SIRS low) was 231 days compared to a median survival of 7 days for dogs with a SIRS score of 2, 3 or 4 (SIRS high) (p<0.001). A Cox proportional hazard model, which included all other co-variables, revealed that a SIRS high score was an independent predictor of a poor clinical outcome. The effect of modulating inflammation on treatment outcomes in dogs with a primary hepatitis is deserving of further study.

  11. 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. PMID:11802746

  12. Integrating Oral Health and Primary Care: Federal Initiatives to Drive Systems Change.

    PubMed

    Joskow, Capt Renée W

    2016-10-01

    This article describes federal programs, initiatives, and partnerships that have the demonstrated potential to initiate and institutionalize interprofessional practice that includes oral health providers as integral to the provider team. A discussion of landmark documents and reports, the role of legislation and statutory authority, and the influence of federal program priorities towards a national movement to increase access to care to bridge the chasms between the medical health care system, dental delivery system, and oral health is presented.

  13. Integrating Oral Health and Primary Care: Federal Initiatives to Drive Systems Change.

    PubMed

    Joskow, Capt Renée W

    2016-10-01

    This article describes federal programs, initiatives, and partnerships that have the demonstrated potential to initiate and institutionalize interprofessional practice that includes oral health providers as integral to the provider team. A discussion of landmark documents and reports, the role of legislation and statutory authority, and the influence of federal program priorities towards a national movement to increase access to care to bridge the chasms between the medical health care system, dental delivery system, and oral health is presented. PMID:27671964

  14. 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.

  15. An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells.

    PubMed

    Silva, Ariosto; Jacobson, Timothy; Meads, Mark; Distler, Allison; Shain, Kenneth

    2015-01-01

    In this work we describe a novel approach that combines ex vivo drug sensitivity assays and digital image analysis to estimate chemosensitivity and heterogeneity of patient-derived multiple myeloma (MM) cells. This approach consists in seeding primary MM cells freshly extracted from bone marrow aspirates into microfluidic chambers implemented in multi-well plates, each consisting of a reconstruction of the bone marrow microenvironment, including extracellular matrix (collagen or basement membrane matrix) and stroma (patient-derived mesenchymal stem cells) or human-derived endothelial cells (HUVECs). The chambers are drugged with different agents and concentrations, and are imaged sequentially for 96 hr through bright field microscopy, in a motorized microscope equipped with a digital camera. Digital image analysis software detects live and dead cells from presence or absence of membrane motion, and generates curves of change in viability as a function of drug concentration and exposure time. We use a computational model to determine the parameters of chemosensitivity of the tumor population to each drug, as well as the number of sub-populations present as a measure of tumor heterogeneity. These patient-tailored models can then be used to simulate therapeutic regimens and estimate clinical response. PMID:26274375

  16. 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.

  17. 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. PMID:26116512

  18. 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

  19. NLTE spectral analysis of the sdOB primary of the eclipsing binary system LB 3459 (AA Dor)

    NASA Astrophysics Data System (ADS)

    Rauch, T.

    2000-04-01

    We present a spectral analysis of the sdOB primary star of the binary system LB 3459 based on high-resolution high-S/N optical and UV spectra. The metal abundances are determined by means of state-of-the-art NLTE model atmospheres. We determined Teffw42 and log gw{5.2} within very small error limits. The He (1/125 solar), C (1/265), N (1/33), O (1/12), and Si (1/5) abundances appear strongly depleted while that of Fe and Ni are roughly solar and Mg is strongly enriched by a factor of 6. The spectroscopic distance to LB 3459 is d = 396 pc. The mass of the primary component of LB 3459 is 0.330 M_sun derived from comparisons with theoretical models for sdO stars in the log T_eff - \\log g plane. The mass of the secondary is then 0.066 M_sun derived from the mass function. There remains some disagreement between the radius derived from log g and the above mass, and that derived from analysis of the radial-velocity curve and the eclipse curves. LB 3459 is a close binary system which had experienced a common envelope (CE) phase during its evolution. It fits in the ``low mass case B'' scenario of Iben & Livio (1993) and the secondary is a brown dwarf. The spectroscopically determined rotational velocity of the primary is v_rot = 34 ± 10 km* sec-1. Thus even bound rotation (v_rot = 45.7 km* sec-1) cannot be ruled out. Based on observations collected at the European Southern Observatory, La Silla, Chile (proposals 55.D-0319, 56.C-0165) and on data retrieved from the International Ultraviolet Explorer (IUE) Final Archive.

  20. A feasibility study of a Salix viminalis gravel hydroponic system to renovate primary settled wastewater.

    PubMed

    Mant, Catherine; Peterkin, John; May, Eric; Butler, John

    2003-10-01

    A Salix viminalis/gravel system based on hydroponics was developed for wastewater renovation in order to avoid the problems of soil damage and pollution associated with long-term application of wastewater to soil. For such a system to work the mineral elements applied must match closely the requirements of the tree species. To examine this the growth and nutrient uptake of S. viminalis in wastewater was compared with that in Long Ashton nutrient solution (1/4 strength). S. viminalis grew more slowly in wastewater than in Long Ashton solution, but exhibited no obvious deficiency or toxicity symptoms. Since industrial wastewaters often contain metals, the extent to which copper might inhibit wastewater treatment in this system was also examined. S. viminalis was grown in wastewater amended with 10 and 100 ppm copper. Trees were unaffected by wastewater with 10 ppm copper when compared to trees grown in wastewater alone. Wastewater containing with 100 ppm copper was too toxic for the trees to thrive and wastewater treatment was reduced. Treatment efficiencies for unamended wastewater were 57.7% for nitrogen, 90.6% for phosphorus and 24.9% for potassium. These efficiencies are much greater than those quoted for a Salix/soil system, and thus Salix/gravel systems may have potential for wastewater treatment in environmentally sensitive areas or situations.

  1. 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.

  2. Practical Implementation of a Large Primary Care Pediatric Practice Patient Care Information System

    PubMed Central

    Mize, Susan G.; Kramer, Robert I.

    1987-01-01

    THIS PAPER PRESENTS THE USE OF A PATIENT CARE INFORMATION PORTION OF A COMPUTERIZED OFFICE PRACTICE MANAGEMENT SYSTEM. THE KEY TO IMPLEMENTING THIS SYSTEM IN A COST EFFECTIVE MANNER WAS THE ABILITY TO AUTOMATICALLY ABSTRACT MEDICAL INFORMATION FROM THE ACCOUNTING PROGRAMS WITHOUT HAVING TO REKEY THE DESIGNATED PATIENT MEDICAL INFORMATION ITEMS. THE PATIENT MANAGEMENT FUNCTIONS SPECIFICALLY INCLUDE: (1) A MINIMAL PATIENT MEDICAL INFORMATION SET WHICH IS PRINTED ON THE PATIENT “CARE SLIP” OR “SUPERBILL”; (2) CLINICAL NOTES WHICH ALLOW NURSES AND PHYSICIANS TO DOCUMENT PATIENT PHONE CALLS; (3) A THERAPEUTIC GUIDE WHICH GIVES ACCESS TO NURSES TO READ ON THE TERMINAL SCREEN STANDARD RECOMMENDATIONS BY THEIR PHYSICIANS FOR THE MORE COMMON PROBLEMS AND QUESTIONS ENCOUNTERED WHILE HANDLING PATIENT PHONE CALLS; AND (4) A NURSE TELEPHONE MESSAGE SYSTEM.

  3. 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.

  4. 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

  5. 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).

  6. 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.

  7. 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

  8. Advancing the application of systems thinking in health: South African examples of a leadership of sensemaking for primary health care

    PubMed Central

    2014-01-01

    Background New forms of leadership are required to bring about the fundamental health system changes demanded by primary health care (PHC). Using theory about complex adaptive systems and policy implementation, this paper considers how actors’ sensemaking and the exercise of discretionary power currently combine to challenge PHC re-orientation in the South African health system; and provides examples of leadership practices that promote sensemaking and power use in support of PHC. Methods The paper draws on observational, interview, and reflective data collected as part of the District Innovation and Action Learning for Health Systems Development (DIALHS) project being implemented in Cape Town, South Africa. Undertaken collaboratively between health managers and researchers, the project is implemented through cycles of action-learning, including systematic reflection and synthesis. It includes a particular focus on how local health managers can better support front line facility managers in strengthening PHC. Results The results illuminate how the collective understandings of staff working at the primary level - of their working environment and changes within it – act as a barrier to centrally-led initiatives to strengthen PHC. Staff often fail to take ownership of such initiatives and experience them as disempowering. Local area managers, located between the centre and the service frontline, have a vital role to play in providing a leadership of sensemaking to mediate these challenges. Founded on personal values, such leadership entails, for example, efforts to nurture PHC-aligned values and mind-sets among staff; build relationships and support the development of shared meanings about change; instil a culture of collective inquiry and mutual accountability; and role-model management practices, including using language to signal meaning. Conclusions PHC will only become a lived reality within the South African health system when frontline staff are able to

  9. LOCA hydroloads calculations with multidimensional nonlinear fluid/structure interaction. Volume 1: STEALTH 1D single-phase fluid studies. Final report. [PWR

    SciTech Connect

    Santee, G.E. Jr.; Mortensen, G.A.; Caraher, D.L.

    1980-04-01

    This report, which is the first in a series of reports for RP-1065, describes the first step in the stepwise approach for developing the methodology to assess the hydroloads on a large PWR during the subcooled portions of a hypothetical LOCA. The first step in the methodology considers enhancements and special modifications to the 1D STEALTH computer code in order that acoustic phenomena in piping and vessel networks may be simulated. The resulting code is termed 1D STEALTH-HYDRO. The 1D STEALTH-HYDRO enhancements consist of three control volume models to simulate area changes, orifices, and tees in piping networks. The theory of the control volume models is described.

  10. LOCA hydroloads calculations with multidimensional nonlinear fluid/structure interaction. Volume 3. Fluid/structure interaction studies using 3-D STEALTH/WHAMSE. Final report. [PWR

    SciTech Connect

    Santee, G.E. Jr.; Chang, F.H.; Mortensen, G.A.; Brockett, G.F.; Gross, M.B.; Belytschko, T.B.

    1982-11-01

    This report, the third in a series of reports for RP-1065, describes the final step in the stepwise approach for developing the three-dimensional, nonlinear, fluid-structure interaction methodology to assess the hydroloads on a large PWR during the subcooled portions of a hypothetical LOCA. The final step in the methodology implements enhancements and special modifications to the STEALTH 3D computer program and the WHAMSE 3D computer program. After describing the enhancements, the individual and the coupled computer programs are assessed by comparing calculational results with either analytical solutions or with experimental data. The coupled 3D STEALTH/WHAMSE computer program is then applied to the simulation of HDR Test V31.1 to further assess the program and to investigate the role that fluid-structure interaction plays in the hydrodynamic loading of reactor internals during subcooled blowdown.

  11. 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

  12. The primary care physician in the early diagnosis of systemic sclerosis: the cornerstone of recognition and hope.

    PubMed

    Saketkoo, Lesley Ann; Magnus, Jeanette H; Doyle, Mittie K

    2014-01-01

    Systemic sclerosis (SSc) is a disease of unknown causative factor that manifests as a heterogenous group of multiorgan 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. Because of 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.

  13. Mass-forming primary angiitis of central nervous system with Rosai-Dorfmann disease-like massive histiocytosis with emperipolesis.

    PubMed

    Kim, Seong-Ik; Kim, Soo Hee; Cho, Hwa Jin; Kim, Hannah; Chung, Chun-Kee; Choi, Seung Hong; Park, Sung-Hye

    2015-08-01

    Primary angiitis of the central nervous system (PACNS) is a vasculitis restricted to the CNS without systemic involvement. We report a case of PACNS that was radiologically tumor-mimicking, and pathologically similar to the Rosai-Dorfmann disease. A 20-year-old woman presented with a focal facial motor seizure. Magnetic resonance image revealed heterogeneously enhanced well-demarcated solitary cerebral mass in the posterior frontal lobe. Histopathologically, the lesion showed lymphoplasmacytic vasculitis with massive parenchymal infiltration of large histiocytes with emperipolesis. Diffuse ischemic change, necrosis, hemorrhage of the brain parenchyma with neuronophagia, and extensive reactive gliosis by gemistocytic astrocytes were accompanying microscopic features. The patient was doing well for 3 years after complete resection of the lesion, except for occasional occurrence of alcohol- or sleep deprivation-associated seizure. We describe this unique case to provide evidence that mass formation can be developed in PACNS by accompanying parenchymal lymphohistiocytic infiltration, necrosis, and marked reactive gliosis.

  14. 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

  15. 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.

  16. 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…

  17. 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…

  18. Identifying patients with asthma in primary care electronic medical record systems

    PubMed Central

    Xi, Nancy; Wallace, Rebecca; Agarwal, Gina; Chan, David; Gershon, Andrea; Gupta, Samir

    2015-01-01

    Objective To develop and test a variety of electronic medical record (EMR) search algorithms to allow clinicians to accurately identify their patients with asthma in order to enable improved care. Design A retrospective chart analysis identified 5 relevant unique EMR information fields (electronic disease registry, cumulative patient profile, billing diagnostic code, medications, and chart notes); asthma-related search terms were designated for each field. The accuracy of each term was tested for its ability to identify the asthma patients among all patients whose charts were reviewed. Increasingly sophisticated search algorithms were then designed and evaluated by serially combining individual searches with Boolean operators. Setting Two large academic primary care clinics in Hamilton, Ont. Participants Charts for 600 randomly selected patients aged 16 years and older identified in an initial EMR search as likely having asthma (n = 150), chronic obstructive pulmonary disease (n = 150), other respiratory conditions (n = 150), or nonrespiratory conditions (n = 150) were reviewed until 100 patients per category were identified (or until all available names were exhausted). A total of 398 charts were reviewed in full and included. Main outcome measures Sensitivity and specificity of each search for asthma diagnosis (against the reference standard of a physician chart review–based diagnosis). Results Two physicians reviewed the charts identified in the initial EMR search using a standardized data collection form and ascribed the following diagnoses in 398 patients: 112 (28.1%) had asthma, 81 (20.4%) had chronic obstructive pulmonary disease, 104 (26.1%) had other respiratory conditions, and 101 (25.4%) had nonrespiratory conditions. Concordance between reviewers in chart abstraction diagnosis was high (κ = 0.89, 95% CI 0.80 to 0.97). Overall, the algorithm searching for patients who had asthma in their cumulative patient profiles or for whom an asthma billing code

  19. Leaf chlorophyll constraint on model simulated gross primary productivity in agricultural systems

    NASA Astrophysics Data System (ADS)

    Houborg, Rasmus; F. McCabe, Matthew; Cescatti, Alessandro; A. Gitelson, Anatoly

    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

  20. 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.

  1. 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.

  2. Development and assessment of U.S. Nuclear Regulatory Commission thermal-hydraulic system computer codes

    SciTech Connect

    Shotkin, L.M.

    1996-11-01

    A review is provided of the reasons why the US Nuclear Regulatory Commission needs thermal-hydraulic system computer codes, the assumptions and approximations contained within these codes, and the reasons why test data are required to assess the accuracy of the codes. Specific examples of codes and test programs are given. The use of computer codes assessed against data from scaled test facilities to predict the full-scale plant response is discussed. A method to help focus resources and the need for quantifying code uncertainties are discussed. This paper concentrates on the loss-of-coolant accident (LOCA) because most of the analytical and experimental research has been concentrated in LOCAs.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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. PMID:25859235

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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. PMID:22776757

  16. 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

  17. Localization of Physical Activity in Primary School Children Using Accelerometry and Global Positioning System

    PubMed Central

    Bürgi, Rahel; Tomatis, Laura; Murer, Kurt; de Bruin, Eling D.

    2015-01-01

    Background Ecological approaches have highlighted the importance of the built environment as a factor affecting physical activity. However, knowledge on children’s activity patterns is still incomplete. Particularly, data on the spatial context of physical activity is limited, which limits the potential to design location-based interventions effectively. Using global positioning system (GPS) and accelerometry, this study aimed to identify locations where children engage in moderate-vigorous physical activity (MVPA). Methods Participants included 119 children (11–14 years, 57% girls) from public schools in Winterthur, Switzerland. During a regular school week between February and April 2013, children wore an accelerometer and GPS sensor for seven consecutive days. Time-matched accelerometer and GPS data was mapped with a geographic information system and each data point was assigned to one of seven defined activity settings. Both the absolute amount of MVPA and proportion of time in MVPA were calculated for every setting. Multilevel analyses accounting for the hierarchical structure of the data were conducted to investigate any gender differences. Results Children achieved most MVPA on streets (34.5%) and on school grounds (33.4%). The proportion children spent in MVPA was highest in recreational facilities (19.4%), at other schools (19.2%) and on streets (18.6%). Boys accumulated significantly more MVPA overall and on other school grounds (p < 0.05) and showed a significantly higher proportion of time in MVPA at own school and outside of Winterthur (p < 0.05). Conclusions The results indicate the importance of streets and school grounds as activity-promoting environments. The high use of streets may be an indicator for active transportation, which appears to contribute to an active lifestyle in both genders. In contrast, the school setting is more likely to encourage physical activity in boys. Recreational facilities seem to be conducive for MVPA among both

  18. Rotavirus-like particles primary recovery from insect cells in aqueous two-phase systems.

    PubMed

    Benavides, Jorge; Mena, Jimmy A; Cisneros-Ruiz, Mayra; Ramírez, Octavio T; Palomares, Laura A; Rito-Palomares, Marco

    2006-09-14

    Virus-like particles have a wide range of applications, including vaccination, gene therapy, and even as nanomaterials. Their successful utilization depends on the availability of selective and scalable methods of product recovery and purification that integrate effectively with upstream operations. In this work, a strategy based on aqueous two phase system (ATPS) was developed for the recovery of double-layered rotavirus-like particles (dlRLP) produced by the insect cell-baculovirus expression system. Polyethylene glycol (PEG) molecular mass, PEG and salt concentrations, and volume ratio (Vr, volume of top phase/volume of bottom phase) were evaluated in order to determine the conditions where dlRLP and contaminants concentrated to opposite phases. Two-stage ATPS consisting of PEG 400-phosphate with a Vr of 13.0 and a tie-line length (TLL) of 35% (w/w) at pH 7.0 provided the best conditions for processing highly concentrated crude extract from disrupted cells (dlRLP concentration of 5 microg/mL). In such conditions intracellular dlRLP accumulated in the top phase (recovery of 90%), whereas cell debris remained in the interface. Furthermore, dlRLP from culture supernatants accumulated preferentially in the interface (recovery of 82%) using ATPS with a Vr of 1.0, pH of 7.0, PEG 3350 (10.1%, w/w) and phosphate (10.9%, w/w). The purity of dlRLP from culture supernatant increased up to 55 times after ATPS. The use of ATPS resulted in a recovery process that produced dlRLP with a purity between 6 and 11% and an overall product yield of 85% (w/w), considering purification from intracellular and extracellular dlRLP. Overall, the strategy proposed in this study is simpler than traditional methods for recovering dlRLP, and represents a scalable and economically viable alternative for production processes of vaccines against rotavirus infection with significant scope for generic commercial application.

  19. Varying uses of the ABCD2 scoring system in primary and secondary care: a qualitative study

    PubMed Central

    Edwards, Duncan; Cohn, Simon R; Mavaddat, Nahal; Virdee, Satnam K; Lasserson, Daniel; Milner, Siobhan; Giles, Matthew; McManus, Richard; Mant, Jonathan

    2012-01-01

    Objectives To explore the usage of the ABCD2 risk stratification score by general practitioners (GPs) and hospital staff during the referral of patients with suspected transient ischaemic attack (TIA) or minor stroke. Design Qualitative study using semistructured interviews. Setting Nine general practices and two hospital sites in England (Birmingham and Cambridge). Participants Nine GPs and nine hospital staff (two consultants, four nurses, two ultrasonographers and one administrator). Results In both sites, clinicians used a referral proforma based around the ABCD2 scoring system for a range of purposes including self-education, to assist emphasising urgency to the patient, as a referral pathway facilitator and as a diagnostic tool. Negative views of its role included potential medicolegal threats, that it was a barrier to appropriate care, and led to misdiagnoses. Despite having differing uses by different clinicians, the ABCD2 proforma was the central means of interprofessional communication in TIA referrals across both sites. Conclusions Understanding how prediction rules are used in practice is key to determining their impact on processes of care and clinical outcomes. In practice, GPs and their colleagues use the ABCD2 score in subtly different ways and it functions as a ‘boundary object’ by both accommodating these multiple purposes, yet still successfully aiding communication between them. PMID:23194953

  20. 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.

  1. A Coded Structured Light System Based on Primary Color Stripe Projection and Monochrome Imaging

    PubMed Central

    Barone, Sandro; Paoli, Alessandro; Razionale, Armando Viviano

    2013-01-01

    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. PMID:24129018

  2. Primary single event effect studies on Xilinx 28-nm System-on-Chip (SoC)

    NASA Astrophysics Data System (ADS)

    Zhang, Yao; Liu, Shuhuan; Du, Xuecheng; Yuan, Yuan; He, Chaohui; Ren, Xiaotang; Du, Xiaozhi; Li, Yonghong

    2016-09-01

    Single Event Effect (SEE) on Xilinx 28-nm System-on-Chip (SoC) was investigated by both simulation and experiments in this study. In the simulation process, typical structure of NAND gate and flip-flop in SoC were designed using Cadence tool. Various kinds of radiation were simulated as pulsed current source in consideration of multilayer wiring and energy loss before reaching the sensitive area. The circuit modules were simulated as SEE occurred and malfunctioned when pulsed current source existed. The changes of the circuit modules output were observed when pulsed current signals were placed at different sensitive nodes or the circuit operated under different conditions. The sensitive nodes in typical modules and the possible reasons of test program malfunction were primarily studied. In the experimental process, SoC chip was irradiated with α particles, protons and laser respectively. The irradiation test results showed that Single Event Upset (SEU) occurred in typical modules of SoC, in accordance with the simulation results.

  3. Descriptive epidemiology and risk factors of primary central nervous system tumors: Current knowledge.

    PubMed

    Pouchieu, C; Baldi, I; Gruber, A; Berteaud, E; Carles, C; Loiseau, H

    2016-01-01

    Although comparisons are difficult due to differences in methodologies, the annual incidence rates of central nervous system (CNS) tumors range from 8.5 to 21.4/100,000 population according to cancer registries, with a predominance of neuroepithelial tumors in men and meningiomas in women. An increase in the incidence of CNS tumors has been observed during the past decades in several countries. It has been suggested that this trend could be due to aging of the population, and improvements in diagnostic imaging and healthcare access, but these factors do not explain differences in incidence by gender and histological subtypes. Several etiological hypotheses related to intrinsic (sociodemographic, anthropometric, hormonal, immunological, genetic) and exogenous (ionizing radiation, electromagnetic fields, diet, infections, pesticides, drugs) risk factors have led to analytical epidemiological studies to establish relationships with CNS tumors. The only established environmental risk factor for CNS tumors is ionizing radiation exposure. However, for other risk factors, studies have been inconsistent and inconclusive due to systematic differences in study design and difficulties in accurately measuring exposures. Thus, the etiology of CNS tumors is complex and may involve several genetic and/or environmental factors that may act differently according to histological subtype. PMID:26708326

  4. 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

  5. Prototype of a primary calibration system for measurement of radon activity concentration.

    PubMed

    Mostafa, M Y A; Vasyanovich, M; Zhukovsky, M

    2016-01-01

    To calibrate measurement devices for monitoring the activity concentration of (222)Rn in air, a prototype of a calibration facility is tested using a solid (226)Ra source and a high-purity germanium (HPGe) detector. An emanation box was mounted on the detector for online gamma measurements. Inside this box, a 32.8 kBq ±3% (226)Ra standard source was placed. An AlphaGUARD control radon monitor was connected to the emanation box with a pumping air system in an open flow mode as a reference monitor. The emanation coefficient of the source was controlled online by comparing the gamma activity of (214)Bi (Eγ=609.3 keV), progeny of (226)Ra, to that of the calibration source. A standard (137)Cs source, installed within the emanation box, was used as a reference for gamma spectroscopy using the HPGe detector, with a total systematic error of 4% and a random error less than 2%. The ratio between gamma measurements and AlphaGUARD was 0.94±0.4; which is within the 9% uncertainties of AlphaGUARD calibration. PMID:26490512

  6. The influence of different vibration exciter systems on high frequency primary calibration of single-ended accelerometers: II

    NASA Astrophysics Data System (ADS)

    Bruns, Th; Link, A.; Täubner, A.

    2012-02-01

    During the monitoring of the long term stability of two accelerometers intended for use in the CIPM key comparison CCAUV.V-K2, significant deviations of the magnitude results of the single-ended transducer were discovered. These deviations depend on whether the calibration was performed on an armature made of beryllium or of ceramic. After first investigations which led to an interpretation as a relative motion effect published in Täubner et al (2010 Metrologia 47 58-64), now, more detailed measurements combined with modelling and system identification have led to a better understanding of what is happening. The measurements, model considerations and corresponding results are presented and discussed in order to further the understanding of this important issue of primary accelerometer calibration. This contribution can be considered a sequel to the former publication (Täubner et al 2010 Metrologia 47 58-64) on the topic.

  7. 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

  8. [Knowledge, attitudes, and practices of Brazilian women treated in the primary health care system concerning sexually transmitted diseases].

    PubMed

    Fernandes, A M; de Gaspari Antonio, D; Bahamondes, L G; Cupertino, C V

    2000-01-01

    An increase has been observed in the prevalence of HIV infection among Brazilian women in recent years. This study focused on women's knowledge, attitudes, and practices towards prevention of sexually transmitted diseases (STDs) in the primary health care system in Campinas, São Paulo. Of the 249 women interviewed, 10% reported condom use, while consistent use was reported by 7.6%. Although most women reported receiving information from television (87.6%), the quality of such information was insufficient to sensitize women as to their risk of exposure to STD. Most of the women reported physician confidence as an important factor. We conclude that women do not opt for condoms to prevent STD/AIDS, but as a contraceptive method. An instructive dialogue on STD/AIDS should be adopted during physician consultation, and the kind and quality of information should be updated to foster compliance with safer sex practices by the population.

  9. 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.

  10. 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. PMID:25645568

  11. T-Cell/Histiocyte-Rich Large B-Cell Lymphoma Presenting as a Primary Central Nervous System Lymphoma.

    PubMed

    Advani, Pooja; Starr, Jason; Swaika, Abhisek; Jiang, Liuyan; Qiu, Yushi; Li, Zhimin; Tun, Han W

    2015-12-29

    Primary central nervous system (PCNSL) lymphoma is an aggressive extranodal non-Hodgkin lymphoma, and most cases are classified as diffuse large B-cell lymphoma (DLBCL) by histology. T-cell/histiocyte-rich large B-cell lymphoma (TCRLBCL) represents a distinct subtype of diffuse large B-cell lymphoma and is characterized by the presence of scattered large neoplastic B-cells in a background of abundant T-cells and histiocytes. This is in contrast to the dense perivascular cuffing of neoplastic B-cells in classic DLBCL. T-cell/histiocyte-rich large B-cell lymphoma should be considered in PCNSL cases in which neoplastic B-cells are sparse and scattered. Immunohistochemistry will help identify the B-cells and surrounding infiltrate rich in Tlymphocytes and histiocytes. Future studies exploring the biology of TCRLBCL and the crosstalk between the neoplastic cells and the surrounding inflammatory infiltrate may provide exciting prospects for future therapies for TCRLBCL. PMID:26788280

  12. TNF-α stimulates System A amino acid transport in primary human trophoblast cells mediated by p38 MAPK signaling.

    PubMed

    Aye, Irving L M H; Jansson, Thomas; Powell, Theresa L

    2015-10-01

    Maternal obesity and gestational diabetes mellitus (GDM) increase the risk of delivering infants that are large for gestational age with greater adiposity, who are prone to the development of metabolic disease in childhood and beyond. These maternal conditions are also associated with increased levels of the proinflammatory cytokine TNF-α in maternal tissues and the placenta. Recent evidence suggests that changes in placental amino acid transport contribute to altered fetal growth. TNF-α was previously shown to stimulate System A amino acid transport in primary human trophoblasts (PHTs), however the molecular mechanisms remain unknown. In this study, we tested the hypothesis that TNF-α regulates amino acid uptake in cultured PHTs by a mitogen-activated protein kinase (MAPK)-dependent mechanism. Treatment of PHTs with TNF-α significantly increased System A amino acid transport, as well as Erk and p38 MAPK signaling. Pharmacological antagonism of p38, but not Erk MAPK activity, inhibited TNF-α stimulated System A activity. Silencing of p38 MAPK using siRNA transfections prevented TNF-α stimulated System A transport in PHTs. TNF-α significantly increased the protein expression of System A transporters SNAT1 and SNAT2, but did not affect their mRNA expression. The effects of TNF-α on SNAT1 and SNAT2 protein expression were reversed by p38 MAPK siRNA silencing. In conclusion, TNF-α regulates System A activity through increased SNAT1 and SNAT2 transporter protein expression in PHTs. These findings suggest that p38 MAPK may represent a critical mechanistic link between elevated proinflammatory cytokines and increased placental amino acid transport in obese and GDM pregnancies associated with fetal overgrowth.

  13. TNF-α stimulates System A amino acid transport in primary human trophoblast cells mediated by p38 MAPK signaling.

    PubMed

    Aye, Irving L M H; Jansson, Thomas; Powell, Theresa L

    2015-10-01

    Maternal obesity and gestational diabetes mellitus (GDM) increase the risk of delivering infants that are large for gestational age with greater adiposity, who are prone to the development of metabolic disease in childhood and beyond. These maternal conditions are also associated with increased levels of the proinflammatory cytokine TNF-α in maternal tissues and the placenta. Recent evidence suggests that changes in placental amino acid transport contribute to altered fetal growth. TNF-α was previously shown to stimulate System A amino acid transport in primary human trophoblasts (PHTs), however the molecular mechanisms remain unknown. In this study, we tested the hypothesis that TNF-α regulates amino acid uptake in cultured PHTs by a mitogen-activated protein kinase (MAPK)-dependent mechanism. Treatment of PHTs with TNF-α significantly increased System A amino acid transport, as well as Erk and p38 MAPK signaling. Pharmacological antagonism of p38, but not Erk MAPK activity, inhibited TNF-α stimulated System A activity. Silencing of p38 MAPK using siRNA transfections prevented TNF-α stimulated System A transport in PHTs. TNF-α significantly increased the protein expression of System A transporters SNAT1 and SNAT2, but did not affect their mRNA expression. The effects of TNF-α on SNAT1 and SNAT2 protein expression were reversed by p38 MAPK siRNA silencing. In conclusion, TNF-α regulates System A activity through increased SNAT1 and SNAT2 transporter protein expression in PHTs. These findings suggest that p38 MAPK may represent a critical mechanistic link between elevated proinflammatory cytokines and increased placental amino acid transport in obese and GDM pregnancies associated with fetal overgrowth. PMID:26508738

  14. 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

  15. 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.

  16. Therapeutic management of refractory or relapsed primary central nervous system lymphomas.

    PubMed

    Reni, M; Ferreri, A J

    2001-01-01

    Despite the high rate of complete remission achieved with first-line therapy, 10-15% of immunocompetent PCNSL patients are treatment refractory while 35-60% relapse and die of lymphoma within a few months. In many cases, salvage therapy produces a second complete remission with consequent symptomatic and survival improvement. Due to the heterogeneity of both first and second line therapies employed, the optimal schedule for salvage therapy can not be identified. Nevertheless, some therapeutic guidelines could be suggested. Radiotherapy is an effective option for both previously irradiated and radiotherapy naïve patients. Some authors have been able to minimize the incidence of actinic toxicity by using chemotherapy alone at failure. In patients that have relapsed after receiving high-dose methotrexate (HD-MTX), the same drug again has been successfully employed while HD-cytarabine has been the most widely used cytostatic. Ocular recurrence can be treated with cytarabine or focal radiotherapy. Meningeal relapse can be treated with spinal cord irradiation, intrathecal and/or systemic chemotherapy. Salvage therapy, beyond improving survival, constitutes the selection ground for testing active agents. The addition of other cytostatics to HD-MTX has been empirically based and without a clear survival benefit, but with a higher toxicity. Intriguing preliminary results from small pilot studies are now available with topotecan, rituximab, temozolomide, PCV regimen and HD-chemotherapy supported by autologous or allogeneic peripheral blood stem cells transplantation. Considering its positive effect on survival and the potential improvement in neurological symptoms and quality of life, salvage therapy seems to be a valuable treatment in PCNSL patients. Finally, the inclusion of relapsing or progressive PCNSL patients into second-line prospective clinical trials for testing therapeutic agents should be strongly encouraged. PMID:11757691

  17. Probability of pipe fracture in the primary coolant loop of a PWR plant. Volume 9. PRAISE computer code user's manual. Load Combination Program Project I final report

    SciTech Connect

    Lim, E.Y.

    1981-06-01

    The PRAISE (Piping Reliability Analysis Including Seismic Events) computer code estimates the influence of earthquakes on the probability of failure at a weld joint in the primary coolant system of a pressurized water reactor. Failure, either a through-wall defect (leak) or a complete pipe severance (a large-LOCA), is assumed to be caused by fatigue crack growth of an as-fabricated interior surface circumferential defect. These defects are assumed to be two-dimensional and semi-elliptical in shape. The distribution of initial crack sizes is a function of crack depth and aspect ratio. PRAISE treats the inter-arrival times of operating transients either as a constant or exponentially distributed according to observed or postulated rates. Leak rate and leak detection models are also included. The criterion for complete pipe severance is exceedance of a net section critical stress. Earthquakes of various intensity and arbitrary occurrence times can be modeled. PRAISE presently assumes that exactly one initial defect exists in the weld and that the earthquake of interest is the first earthquake experienced at the reactor. PRAISE has a very modular structure and can be tailored to a variety of crack growth and piping reliability problems. Although PRAISE was developed on a CDC-7600 computer, it was, however, coded in standard FORTRAN IV and is readily transportable to other machines.

  18. Electrophysiological characteristics of primary afferent fibers after systemic administration of anti-GD2 ganglioside antibody.

    PubMed

    Xiao, W H; Yu, A L; Sorkin, L S

    1997-01-01

    An animal model showing mechanical allodynia following systemic bolus injection of a human/mouse chimeric monoclonal antibody to the GD2 ganglioside (ch14.18) has been established (e.g. pain behavior generated by a light tactile stimulus). This is of clinical relevance since ch14.18 is a promising experimental treatment for pediatric neuroblastoma. The present study examined the hypothesis that allodynic effects of the anti-GD2 antibody are mediated by actions on cutaneous nerve fibers. After determining the basal magnitude of the mechanical stimulus required to produce withdrawal, ch14.18, a murine form of the anti-GD2 antibody of IgG2a isotype (14G2a), a control murine anti-melanoma antibody of IgG2a isotype (9.2.27) or saline was injected through a previously implanted jugular cannula. The experimenter was blinded to the syringe contents. Withdrawal threshold was tested at 15 min intervals for 1 h. After administration of either ch14.18 or 14G2a mechanical allodynia typically started within the first 15 min and persisted throughout the hour of behavioral testing. In the control antibody group, a modest change in tactile withdrawal threshold was observed at the 60 min time point only. Rats were then anesthetized with pentobarbital and prepared for single fiber recordings from the sural nerve. Fibers were classified based on conduction velocity, as A beta (> 25 m/s), A delta (2-25 m/s) or C (< 2 m/s). Background activity (BA) was observed in a significant number of A delta (12/61) and C (32/42) fibers in both anti-GD2 treated groups compared to the anti-melanoma antibody (1/17 A delta and 2/10 C fibers) and saline (0/26 A delta and 0/19 C fibers) treated groups. Mean mechanical threshold for A delta fibers in all three antibody treated groups was significantly reduced compared to the saline control; this was not observed for C-fibers in any group. Intravenous bolus injection (15 mg/kg) and infusion of lidocaine (plasma level 0.3-2.2 micrograms/ml) both reduced

  19. 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.

  20. Treatment of newly diagnosed B-cell origin primary CNS lymphoma with systemic R-IDARAM chemotherapy and intrathecal immunochemotherapy

    PubMed Central

    Qian, Liren; Zhou, Chunhui; Shen, Jianliang; Cen, Jian; Yin, Wenjie

    2016-01-01

    Background Primary central nervous system lymphoma (PCNSL) is a rare subtype of non-Hodgkin's lymphoma (NHL). The aim was to evaluate response rate, progression free survival (PFS), overall survival (OS), and toxicity in PCNSL after systemic R-IDARAM and intrathecal immunochemotherapy with deferred radiotherapy. Results The response rate was 94% with 17 (89%) complete responses and 1 (5%) partial responses. Follow-up time is from 5 to 63 months (median, 39 months). Median survival has not been reached. 3-year overall survival and progression-free survival rates were 84.2% (CI 72.6% to 99.8%) and 63.2% (CI 41.4% to 73.8%). Systemic toxicity was mainly hematologic. Neurocognitive and neuromotor deterioration as a result of treatment occurred in only one patient (5%). Patients and Methods From September 2010 to June 2015, 19 consecutive patients with PCNSL (median age, 54 years) were enrolled into a pilot phase II study evaluating immunochemotherapy without radiotherapy. The patients were accrued to a chemotherapy regimen that incorporated rituximab, idarubicin, dexamethasone, cytarabine (Ara-c) and methotrexate (MTX) combined with intrathecal rituximab, MTX, dexamethasone and Ara-c. Conclusions The results indicate that R-IDARAM regimen with intrathecal immunochemotherapy is generally well tolerated and produces a high complete response rate and survival rate. PMID:27029056

  1. Staging Primary CNS Lymphoma

    MedlinePlus

    ... large vein near the heart. Having a weakened immune system may increase the risk of developing primary CNS ... immunodeficiency syndrome (AIDS) or other disorders of the immune system or who have had a kidney transplant . For ...

  2. 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

  3. CHOD/BVAM CHEMOTHERAPY AND WHOLE-BRAIN RADIOTHERAPY FOR NEWLY DIAGNOSED PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA

    PubMed Central

    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.

    2014-01-01

    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. PMID:20800387

  4. Systemic lupus erythematosus and primary fibromyalgia can be distinguished by testing for cell-bound complement activation products

    PubMed Central

    Wallace, Daniel J; Silverman, Stuart L; Conklin, John; Barken, Derren; Dervieux, Thierry

    2016-01-01

    Objective We sought to establish the performance of cell-bound complement activation products (CB-CAPs) as a diagnostic tool to distinguish primary fibromyalgia (FM) from systemic lupus erythematosus (SLE). Methods A total of 75 SLE and 75 primary FM adult subjects who fulfilled appropriate classification criteria were enrolled prospectively. CB-CAPs (erythrocyte-C4d (EC4d) and B-lymphocyte-C4d (BC4d)) were determined by flow cytometry. Antinuclear antibodies (ANAs) were determined using indirect immunofluorescence while other autoantibodies were determined by solid-phase assays. The CB-CAPs in a multi-analyte assay with algorithm (MAAA) relied on two consecutive tiers of analysis that was reported as an overall positive or negative assessment. Test performance was assessed using sensitivity, specificity, positive and negative likelihood ratio (LR). Results ANAs yielded 80% positives for SLE and 33% positives for FM. High CB-CAP expression (EC4d >14 units or BC4d >60 units) was 43% sensitive and 96% specific for SLE. The CB-CAPs in MAAA assessment was evaluable in 138 of the 150 subjects enrolled (92%) and yielded 60% sensitivity (CI 95% 48% to 72%) for SLE with no FM patient testing positive (100% specificity). A positive test result was associated with a strong positive LR for SLE (>24, CI 95%; 6 to 102), while a negative test result was associated with a moderate negative LR (0.40; CI 95% 0.30 to 0.54). Conclusion Our data indicate that CB-CAPs in MAAA can distinguish FM from SLE. PMID:26870391

  5. 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.

  6. Development of digital rectangular phantoms for quality controls of medical primary monitors in RIS-PACS systems

    NASA Astrophysics Data System (ADS)

    Mattacchioni, A.; Cristianini, M.; Lo Bosco, A.

    2013-03-01

    The purpose of this paper is to project digital rectangular phantoms, Di.Recta Multipurpose Phantoms (Di.Recta MP) for quality controls of primary high resolution medical monitors. The first approach for the monitors quality evaluation is represented by AAPM tests using multipurpose TG-18- CQ phantoms. The TG18-QC patterns are available in two sizes: 1024x1024 and 2048x2048 and the use of these phantoms requires a correct monitor setup. The study demonstrates that this type of phantoms is suitable for CRT monitors with adequate settings procedures. In the second step LCD monitors are analysed. Different types of primary monitors are included in a range between 2 and 5 Mp. The difference between the resolution of monitors and phantoms does not allow a complete analysis of the entire system, just moving phantoms in different positions. Of course, the analysis of images in the peripheral regions of medical monitors can not be neglected, especially because of the possible legal implications. A simpler analysis of these areas can be done through the use of rectangular phantoms in place of square ones. Furthermore, because of different technology, also different analysis patches are necessary for these types of monitors. Therefore, there are proposed digital rectangular phantoms, Di.Recta MP, compatible with the spatial resolution of most of commercial monitors. These phantoms are designed to simulate typical radiological conditions to determine the presence of significant defects using appropriate patches such as luminance, contrast, noise patterns. Finally a preliminary study of dedicate Di.Recta MP are proposed for LED monitors.

  7. Pomalidomide and Dexamethasone in Treating Patients With Relapsed or Refractory Primary Central Nervous System Lymphoma or Newly Diagnosed or Relapsed or Refractory Intraocular Lymphoma

    ClinicalTrials.gov

    2016-09-12

    B-Cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Burkitt Lymphoma; Central Nervous System Lymphoma; Intraocular Lymphoma; Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System; Recurrent Adult Diffuse Large Cell Lymphoma; Retinal Lymphoma

  8. 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

    2013-12-01

    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.

  9. 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

  10. 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

  11. Association of transcobalamin c. 776C>G with overall survival in patients with primary central nervous system lymphoma

    PubMed Central

    Linnebank, M; Moskau, S; Kowoll, A; Semmler, A; Bangard, C; Vogt-Schaden, M; Egerer, G; Schackert, G; Reichmann, H; Schmidt-Wolf, I G H; Pels, H; Schlegel, U

    2012-01-01

    Background: Chemotherapy for primary central nervous system lymphoma (PCNSL) is based on methotrexate (MTX), which interferes with both nucleic acid synthesis and methionine metabolism. We have reported previously that genetic variants with influence on methionine metabolism are associated with MTX side effects, that is, the occurrence of white matter lesions as a sign of MTX neurotoxicity. Here, we investigated whether such variants are associated with MTX efficacy in terms of overall survival in MTX-treated PCNSL patients. Methods: We analysed seven genetic variants influencing methionine metabolism in 68 PCNSL patients treated with systemic and facultative intraventricular MTX-based polychemotherapy (Bonn protocol). Results: Median age at diagnosis was 59 years (range: 28–77), 32 patients were female. Younger age (Wald=8.9; P=0.003) and the wild-type C (CC) allele of the genotype transcobalamin c (Tc2). 776C>G (Wald=6.7; P=0.010) were associated with longer overall survival in a multivariate COX regression analysis. Conclusion: This observation suggests that the missense variant Tc2. 776C>G influences both neurotoxicity and efficacy of MTX in the Bonn PCNSL protocol. PMID:23099805

  12. Evaluating Area-Based Socioeconomic Status Indicators for Monitoring Disparities within Health Care Systems: Results from a Primary Care Network

    PubMed Central

    Berkowitz, Seth A; Traore, Carine Y; Singer, Daniel E; Atlas, Steven J

    2015-01-01

    Objective To determine which area-based socioeconomic status (SES) indicator is best suited to monitor health care disparities from a delivery system perspective. Data Sources/Study Setting 142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011. Study Design Cross-sectional, comparing associations between area-based SES indicators and patient outcomes. Data Collection Address data were geocoded to construct area-based SES indicators at block group (BG), census tract (CT), and ZIP code (ZIP) levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (RIIs) were calculated to quantify disparities detected by area-based SES indicators and compared to RIIs from self-reported educational attainment. Principal Findings ZIP indicators had less missing data than BG or CT indicators (p < .0001). Area-based SES indicators were strongly associated with self-report educational attainment (p < .0001). ZIP, BG, and CT indicators all detected expected SES gradients in health outcomes similarly. Single-item, cut point defined indicators performed as well as multidimensional indices and quantile indicators. Conclusions Area-based SES indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP-level median household income or percent poverty, using cut points. PMID:25219917

  13. Primary central nervous system lymphoma treated with high-dose methotrexate and rituximab: A single-institution experience

    PubMed Central

    LY, K. INA; CREW, LAURA L.; GRAHAM, CARRIE A.; MRUGALA, MACIEJ M.

    2016-01-01

    Rituximab (RTX) improves the outcome in patients with systemic diffuse large B-cell lymphoma (DLBCL), but its benefit in primary central nervous system lymphoma (PCNSL) is unclear. In the present study, a single-institution retrospective analysis was performed for 12 patients with newly diagnosed PCNSL treated with combined high-dose methotrexate (HD-MTX) and RTX. MTX was administered biweekly at 8 g/m2/dose until a complete response (CR) was achieved or for a maximum of eight doses. RTX was provided for a total of eight weekly doses at 375 mg/m2/dose. Following a median of 11 cycles of MTX, the radiographic overall response rate was 91% and the CR rate was 58%. A CR was achieved after a median 6 cycles of MTX. The median progression-free survival time was 22 months and the median overall survival time has not yet been attained. These results compare favorably to single-agent HD-MTX and suggest a role for immunochemotherapy in the treatment of PCNSL. PMID:27123138

  14. 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

  15. 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

    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; Bottini, Alberto

    2015-05-01

    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

  16. 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

  17. 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.

  18. Modeling host interactions with hepatitis B virus using primary and induced pluripotent stem cell-derived hepatocellular systems.

    PubMed

    Shlomai, Amir; Schwartz, Robert E; Ramanan, Vyas; Bhatta, Ankit; de Jong, Ype P; Bhatia, Sangeeta N; Rice, Charles M

    2014-08-19

    Hepatitis B virus (HBV) chronically infects 400 million people worldwide and is a leading driver of end-stage liver disease and liver cancer. Research into the biology and treatment of HBV requires an in vitro cell-culture system that supports the infection of human hepatocytes, and accurately recapitulates virus-host interactions. Here, we report that micropatterned cocultures of primary human hepatocytes with stromal cells (MPCCs) reliably support productive HBV infection, and infection can be enhanced by blocking elements of the hepatocyte innate immune response associated with the induction of IFN-stimulated genes. MPCCs maintain prolonged, productive infection and represent a facile platform for studying virus-host interactions and for developing antiviral interventions. Hepatocytes obtained from different human donors vary dramatically in their permissiveness to HBV infection, suggesting that factors--such as divergence in genetic susceptibility to infection--may influence infection in vitro. To establish a complementary, renewable system on an isogenic background in which candidate genetics can be interrogated, we show that inducible pluripotent stem cells differentiated into hepatocyte-like cells (iHeps) support HBV infection that can also be enhanced by blocking interferon-stimulated gene induction. Notably, the emergence of the capacity to support HBV transcriptional activity and initial permissiveness for infection are marked by distinct stages of iHep differentiation, suggesting that infection of iHeps can be used both to study HBV, and conversely to assess the degree of iHep differentiation. Our work demonstrates the utility of these infectious systems for studying HBV biology and the virus' interactions with host hepatocyte genetics and physiology. PMID:25092305

  19. Modern techniques of magnetic resonance in the evaluation of primary central nervous system lymphoma: contributions to the diagnosis and differential diagnosis

    PubMed Central

    da Rocha, Antonio José; Sobreira Guedes, Bruno Vasconcelos; da Silveira da Rocha, Talita Maira Bueno; Maia Junior, Antonio Carlos Martins; Chiattone, Carlos Sérgio

    2015-01-01

    In addition to findings from conventional magnetic resonance imaging, modern magnetic resonance imaging techniques have provided important information about tumor metabolism, in vivo metabolite formation, water molecule diffusion, microvascular density, and blood-brain barrier permeability, all of which have improved the in vivo diagnostic accuracy of this method in the evaluation of primary central nervous system lymphoma. These nonconventional magnetic resonance techniques are useful in the clinical practice because they enhance conventional magnetic resonance imaging by reinforcing the possibility of a diagnosis and by allowing the early detection of disease recurrence. This report is a review of the most relevant contributions of nonconventional magnetic resonance techniques to the imaging diagnosis of primary central nervous system lymphoma, the differential diagnosis of this disease, and the prognosis of patients. This paper aims to describe a wide range of presentations of primary central nervous system lymphoma, their appearance in imaging, and the differential diagnoses of this disease. PMID:26969774

  20. Pediatricians’ and health visitors’ views towards detection and management of maternal depression in the context of a weak primary health care system: a qualitative study

    PubMed Central

    2014-01-01

    Background The present study’s aim has been to investigate, identify and interpret the views of pediatric primary healthcare providers on the recognition and management of maternal depression in the context of a weak primary healthcare system. Methods Twenty six pediatricians and health visitors were selected by using purposive sampling. Face to face in-depth interviews of approximately 45 minutes duration were conducted. The data were analyzed by using the framework analysis approach which includes five main steps: familiarization, identifying a thematic framework, indexing, charting, mapping and interpretation. Results Fear of stigmatization came across as a key barrier for detection and management of maternal depression. Pediatric primary health care providers linked their hesitation to start a conversation about depression with stigma. They highlighted that mothers were not receptive to discussing depression and accepting a referral. It was also revealed that the fragmented primary health care system and the lack of collaboration between health and mental health services have resulted in an unfavorable situation towards maternal mental health. Conclusions Even though pediatricians and health visitors are aware about maternal depression and the importance of maternal mental health, however they fail to implement detection and management practices successfully. The inefficiently decentralized psychiatric services but also stigmatization and misconceptions about maternal depression have impeded the integration of maternal mental health into primary care and prevent pediatric primary health care providers from implementing detection and management practices. PMID:24725738